Sample records for management good practice

  1. The ethical dimensions of wildlife disease management in an evolutionary context.

    PubMed

    Crozier, Gkd; Schulte-Hostedde, Albrecht I

    2014-08-01

    Best practices in wildlife disease management require robust evolutionary ecological research (EER). This means not only basing management decisions on evolutionarily sound reasoning, but also conducting management in a way that actively contributes to the on-going development of that research. Because good management requires good science, and good science is 'good' science (i.e., effective science is often science conducted ethically), good management therefore also requires practices that accord with sound ethical reasoning. To that end, we propose a two-part framework to assist decision makers to identify ethical pitfalls of wildlife disease management. The first part consists of six values - freedom, fairness, well-being, replacement, reduction, and refinement; these values, developed for the ethical evaluation of EER practices, are also well suited for evaluating the ethics of wildlife disease management. The second part consists of a decision tree to help identify the ethically salient dimensions of wildlife disease management and to guide managers toward ethically responsible practices in complex situations. While ethical reasoning cannot be used to deduce from first principles what practices should be undertaken in every given set of circumstances, it can establish parameters that bound what sorts of practices will be acceptable or unacceptable in certain types of scenarios.

  2. Perceptions of good medical practice in the NHS: a survey of senior health professionals.

    PubMed

    Hutchinson, A; Williams, M; Meadows, K; Barbour, R S; Jones, R

    1999-12-01

    To categorize senior health professionals' experience with poor medical practice in hospitals and in general practice, to describe perceptions which senior NHS staff have of good medical practice, and to describe how problems of poor medical practice are currently managed. A postal questionnaire survey. The questionnaire sought perceptions of good medical practice, asked participants to characterise deviations from good practice, and to describe experience with managing poor performance at the time of the introduction of the General Medical Council (GMC) performance procedures. A range of NHS settings in the UK: hospital trusts, health authorities/boards, local medical committees, community health councils. Senior health professionals involved in the management of medical professional performance. Perceptions of what constitutes good medical practice. Most respondents considered that persistent problems related to clinical practice (diagnosis, management, and outcome and prescribing) would require local management and, possibly, referral to the GMC performance procedures. Informal mechanisms, including informal discussion, education, training, and work shifting, were the most usual means of handling a doctor whose performance was poor. Many took a less serious view of deficiencies in performance on manner and attitude and communication, although consultation skills rather than technical skills comprised the greatest number of complaints about doctors. Senior NHS professionals seem reluctant to consider persistently poor consultation skills in the same critical light as they do persistently poor technical practice. These attitudes may need to change with the implementation of clinical governance and updated guidance from the GMC on what constitutes good medical practice.

  3. 9 CFR 147.26 - Procedures for establishing isolation and maintaining sanitation and good management practices...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... rodent population and other pests under control; (6) Tailor vaccination programs to needs of farm and... and maintaining sanitation and good management practices for the control of Salmonella and Mycoplasma... management practices for the control of Salmonella and Mycoplasma infections. (a) The following procedures...

  4. 9 CFR 147.26 - Procedures for establishing isolation and maintaining sanitation and good management practices...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... rodent population and other pests under control; (6) Tailor vaccination programs to needs of farm and... and maintaining sanitation and good management practices for the control of Salmonella and Mycoplasma... management practices for the control of Salmonella and Mycoplasma infections. (a) The following procedures...

  5. 9 CFR 147.26 - Procedures for establishing isolation and maintaining sanitation and good management practices...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... rodent population and other pests under control; (6) Tailor vaccination programs to needs of farm and... and maintaining sanitation and good management practices for the control of Salmonella and Mycoplasma... management practices for the control of Salmonella and Mycoplasma infections. (a) The following procedures...

  6. 9 CFR 147.26 - Procedures for establishing isolation and maintaining sanitation and good management practices...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... and maintaining sanitation and good management practices for the control of Salmonella and Mycoplasma... management practices for the control of Salmonella and Mycoplasma infections. (a) The following procedures...) Allow no visitors except under controlled conditions to minimize the introduction of Salmonella and...

  7. You and your manager: reducing workplace stress by creating and maintaining a good relationship.

    PubMed

    Hills, Laura Sachs

    2007-01-01

    The relationship a medical practice employee has with his or her practice manager is probably the most important relationship the employee will have at work. No matter what position an employee has in the medical practice, it's to his or her advantage to get along well with the practice manager. This article offers concrete suggestions to medical practice employees to help them establish and cultivate a positive working relationship with their practice managers. It examines different working styles of practice managers and suggests strategies for medical practice employees who want or need different amounts and styles of supervision. It describes five personal characteristics a practice manager expects in employees and two basic rules of thumb for using the practice manager's time efficiently. This article also emphasizes the importance of good communication with the practice manager and offers 12 practical and specific tips for building the employee-practice manager relationship. Finally, this article offers advice to medical practice employees about what to do when they disagree with their practice managers.

  8. The ethical dimensions of wildlife disease management in an evolutionary context

    PubMed Central

    Crozier, GKD; Schulte-Hostedde, Albrecht I

    2014-01-01

    Best practices in wildlife disease management require robust evolutionary ecological research (EER). This means not only basing management decisions on evolutionarily sound reasoning, but also conducting management in a way that actively contributes to the on-going development of that research. Because good management requires good science, and good science is ‘good’ science (i.e., effective science is often science conducted ethically), good management therefore also requires practices that accord with sound ethical reasoning. To that end, we propose a two-part framework to assist decision makers to identify ethical pitfalls of wildlife disease management. The first part consists of six values – freedom, fairness, well-being, replacement, reduction, and refinement; these values, developed for the ethical evaluation of EER practices, are also well suited for evaluating the ethics of wildlife disease management. The second part consists of a decision tree to help identify the ethically salient dimensions of wildlife disease management and to guide managers toward ethically responsible practices in complex situations. While ethical reasoning cannot be used to deduce from first principles what practices should be undertaken in every given set of circumstances, it can establish parameters that bound what sorts of practices will be acceptable or unacceptable in certain types of scenarios. PMID:25469160

  9. The constraints of good governance practice in national solid waste management policy (NSWMP) implementation: A case study of Malaysia

    NASA Astrophysics Data System (ADS)

    Wee, Seow Ta; Abas, Muhamad Azahar; Chen, Goh Kai; Mohamed, Sulzakimin

    2017-10-01

    Nowadays, international donors have emphasised on the adoption of good governance practices in solid waste management which include policy implementation. In Malaysia, the National Solid Waste Management Policy (NSWMP) was introduced as the main guideline for its solid waste management and the Malaysian government has adopted good governance practice in the NSMWP implementation. However, the good governance practices implemented by the Malaysian government encountered several challenges. This study was conducted to explore the good governance constraints experienced by stakeholders in the NSWMP implementation. An exploratory research approach is applied in this study through in-depth interviews with several government agencies and concessionaires that involved in the NSWMP implementation in Malaysia. A total of six respondents took part in this study. The findings revealed three main good governance constraints in the NSWMP implementation, namely inadequate fund, poor staff's competency, and ambiguity of policy implementation system. Moreover, this study also disclosed that the main constraint influenced the other constraints. Hence, it is crucial to identify the main constraint in order to minimise its impact on the other constraints.

  10. Managers' duty to maintain good workplace communications skills.

    PubMed

    Timmins, Fiona

    2011-06-01

    Communication is a fundamental element of care at every level of nursing practice. It is important, therefore, for nurse managers to create environments that promote and encourage good communication, and help nurses to develop their communication skills formally and informally. This article discusses the effects of communication on the quality of care. It examines nurses' professional duty to maintain good communication skills and how managers can help them do this. It also discusses nurse managers' communication skills in the context of leadership style, conflict resolution and self-awareness. Finally, it considers the notion of shared governance as good practice.

  11. 23 CFR 971.212 - Federal lands safety management system (SMS).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    .... (b) The SMS may be based on the guidance in “Safety Management Systems: Good Practices for Development and Implementation.”3 3 “Safety Management Systems: Good Practices for Development and... various levels of complexity depending on the nature of the facility and/or network involved. (e) The SMS...

  12. 23 CFR 971.212 - Federal lands safety management system (SMS).

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    .... (b) The SMS may be based on the guidance in “Safety Management Systems: Good Practices for Development and Implementation.”3 3 “Safety Management Systems: Good Practices for Development and... various levels of complexity depending on the nature of the facility and/or network involved. (e) The SMS...

  13. 23 CFR 971.212 - Federal lands safety management system (SMS).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    .... (b) The SMS may be based on the guidance in “Safety Management Systems: Good Practices for Development and Implementation.”3 3 “Safety Management Systems: Good Practices for Development and... various levels of complexity depending on the nature of the facility and/or network involved. (e) The SMS...

  14. 23 CFR 971.212 - Federal lands safety management system (SMS).

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    .... (b) The SMS may be based on the guidance in “Safety Management Systems: Good Practices for Development and Implementation.”3 3 “Safety Management Systems: Good Practices for Development and... various levels of complexity depending on the nature of the facility and/or network involved. (e) The SMS...

  15. 23 CFR 971.212 - Federal lands safety management system (SMS).

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    .... (b) The SMS may be based on the guidance in “Safety Management Systems: Good Practices for Development and Implementation.”3 3 “Safety Management Systems: Good Practices for Development and... various levels of complexity depending on the nature of the facility and/or network involved. (e) The SMS...

  16. Teleworking: Guidelines for Good Practice. IES Report 329.

    ERIC Educational Resources Information Center

    Huws, Ursula; And Others

    Because teleworking presents major new challenges to human resource managers, trade unions, and others involved in the development of good employment practices, this book provides practical guidelines for good practice in regard to teleworkers that recognize that teleworking is not a single category, but covers at least five distinct groups with…

  17. Good governance in national solid waste management policy (NSWMP) implementation: A case study of Malaysia

    NASA Astrophysics Data System (ADS)

    Wee, Seow Ta; Abas, Muhamad Azahar; Mohamed, Sulzakimin; Chen, Goh Kai; Zainal, Rozlin

    2017-10-01

    The National Solid Waste Management Policy (NSWMP) was introduced in 2007 under the Act 672. The execution of NSWMP involves stakeholders from various government agencies and a collaboration with the private sectors. Despite the initiatives taken by the stakeholders, the objectives of NSWMP failed to materialise. One of the major constraints is weak governance among stakeholders with regards to the NSWMP implementation. This paper will explore the good governance practices implemented by the stakeholders. Identifying the current good governance practices implemented by the stakeholders is crucial as it will serve as a guideline to improve good governance practice in the future. An exploratory research approach is applied in this study through in-depth interviews with several government agencies and concessionaires involved in the NSWMP implementation. A total of six respondents took part in this study. The findings of this study show that there are several good governance practices implemented in policy promotion, participation of stakeholders, and capacity enhancement programme for the staff. This study also proposed some points on good governance practices in the context of policy promotion and staff development. A paradigm shift by the stakeholders is imperative so as to enhance the good governance practice in NSWMP implementation towards an efficient solid waste management in Malaysia.

  18. Emergency management training program: Guide to good practice

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

    Not Available

    1991-07-01

    The Emergency Management Training Program Guide to Good Practice is a project of the Training Resources and Data Exchange (TRADE) Emergency Management Issues Special Interest Group (EMI SIG). EMI SIG members expressed interest in a resource to assist in development of a comprehensive emergency management training program. This publication provides guidelines, methods, and materials for EMI SIG members to use, assisting in complete and effective emergency management programs. The purposes of the Emergency Management Training Program Guide to Good Practice are: Provide guidance in the development and management of Emergency Management (EM) training programs; Assist EM trainers to incorporate componentsmore » of the DOE Emergency Management System philosophy of planning, preparedness, readiness assurance, and response into EM training programs; Help EM training managers meet EM training requirements and conditions established by current regulations and policies; Supplement other TRADE EMI SIG documents and complement individual facility training documents. This program is designed for emergency management personnel who are responsible for providing or overseeing EM training but who do not necessarily possess expertise in developing training. It provides good practices from the manager`s point of view on how to produce, administer, and document facility EM training programs in the spirit of the DOE EM system philosophy. Basic guidance is also included for personnel who design, develop, deliver, and/or evaluate EM training programs or parts. This guidance includes key points of EM training programs and identifies other documents that contain useful and/or more detailed training information.« less

  19. A DRDC Management Accountability Framework

    DTIC Science & Technology

    2009-09-01

    51 A.2 Cultural Theory: Risk, Blame and Good Governance ................................................. 53 A.3...the MAF. These elements guide good management, enclosing the elements required to make good decisions. 18 In essence, the elements focus on the...of these areas.20 As a guide to good management practices, the elements focus on organizational capacity and capability within a department 21

  20. Emergency management training program: Guide to good practice

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

    Not Available

    1991-07-01

    The Emergency Management Training Program Guide to Good Practice is a project of the Training Resources and Data Exchange (TRADE) Emergency Management Issues Special Interest Group (EMI SIG). EMI SIG members expressed interest in a resource to assist in development of a comprehensive emergency management training program. This publication provides guidelines, methods, and materials for EMI SIG members to use, assisting in complete and effective emergency management programs. The purposes of the Emergency Management Training Program Guide to Good Practice are: Provide guidance in the development and management of Emergency Management (EM) training programs; Assist EM trainers to incorporate componentsmore » of the DOE Emergency Management System philosophy of planning, preparedness, readiness assurance, and response into EM training programs; Help EM training managers meet EM training requirements and conditions established by current regulations and policies; Supplement other TRADE EMI SIG documents and complement individual facility training documents. This program is designed for emergency management personnel who are responsible for providing or overseeing EM training but who do not necessarily possess expertise in developing training. It provides good practices from the manager's point of view on how to produce, administer, and document facility EM training programs in the spirit of the DOE EM system philosophy. Basic guidance is also included for personnel who design, develop, deliver, and/or evaluate EM training programs or parts. This guidance includes key points of EM training programs and identifies other documents that contain useful and/or more detailed training information.« less

  1. Robust data enables managers to promote good practice.

    PubMed

    Bassett, Sally; Westmore, Kathryn

    2012-11-01

    This is the third in a series of articles examining the components of good corporate governance. The effective and efficient use of information and sources of information is crucial for good governance. This article explores the ways in which boards and management can obtain and use information to monitor performance and promote good practice, and how boards can be assured about the quality of information on which they rely. The final article in this series will look at the role of accountability in corporate governance.

  2. Good Laboratory Practice. Part 3. Implementing Good Laboratory Practice in the Analytical Lab

    ERIC Educational Resources Information Center

    Wedlich, Richard C.; Pires, Amanda; Fazzino, Lisa; Fransen, Joseph M.

    2013-01-01

    Laboratories submitting experimental results to the Food and Drug Administration (FDA) or the Environmental Protection Agency (EPA) in support of Good Laboratory Practice (GLP) nonclinical laboratory studies must conduct such work in compliance with the GLP regulations. To consistently meet these requirements, lab managers employ a "divide…

  3. The Principal's Role in Helping Teachers Manage Their Classrooms.

    ERIC Educational Resources Information Center

    Klitgaard, Guy C.

    1987-01-01

    The principal should lead in instructional improvement and have a good understanding of the principles and practices of classroom management and a good classroom management system. Discusses instructional supervision and assessing teacher performance. (MD)

  4. Diarrhea management in children under five in sub-Saharan Africa: does the source of care matter? A Countdown analysis.

    PubMed

    Carvajal-Vélez, Liliana; Amouzou, Agbessi; Perin, Jamie; Maïga, Abdoulaye; Tarekegn, Hayalnesh; Akinyemi, Akanni; Shiferaw, Solomon; Young, Mark; Bryce, Jennifer; Newby, Holly

    2016-08-19

    Diarrhea remains a high burden disease, responsible for nine percent of deaths in children under five globally. We analyzed diarrhea management practices in young children and their association with the source of care. We used Demographic and Health Survey data from 12 countries in sub-Saharan Africa with high burdens of childhood diarrhea. We classified the quality of diarrhea management practices as good, fair, or poor based on mothers' reports for children with diarrhea, using WHO/UNICEF recommendations for appropriate treatment. We described the prevalence of diarrhea management by type and assessed the association between good management and source of care, adjusting for potential confounders. Prevalence of good diarrhea management is low in 11 of the 12 analyzed surveys, varying from 17 % in Cote d'Ivoire to 38 % in Niger. The exception is Sierra Leone, where prevalence of good practice is 67 %. Prevalence of good management was low even among children taken to health facilities [median 52 %, range: 34-64 %]. Diarrhea careseeking from health facilities or community providers was associated with higher odds of good management than care from traditional/informal sources or no care. Careseeking from facilities did not result systematically in a higher likelihood of good diarrhea management than care from community providers. The odds of good diarrhea management were similar for community versus facility providers in six countries, higher in community than facility providers in two countries, and higher in facility than in community providers in four countries. Many children's lives can be saved with correct management of childhood diarrhea. Too many children are not receiving adequate care for diarrhea in high-burden sub-Saharan African countries, even among those seen in health facilities. Redoubling efforts to increase careseeking and improve quality of care for childhood diarrhea in both health facilities and at community level is an urgent priority.

  5. Factors affecting vaccine handling and storage practices among immunization service providers in Ibadan, Oyo State, Nigeria.

    PubMed

    Dairo, David M; Osizimete, Oyarebu E

    2016-06-01

    Improper handling has been identified as one of the major reasons for the decline in vaccine potency at the time of administration. Loss of potency becomes evident when immunised individuals contract the diseases the vaccines were meant to prevent. Assessing the factors associated with vaccine handling and storage practices. This was a cross-sectional study. Three-stage sampling was used to recruit 380 vaccine handlers from 273 health facilities from 11 Local Government areas in Ibadan. Data was analysed using SPSS version 16. Seventy-three percent were aware of vaccine handling and storage guidelines with 68.4% having ever read such guidelines. Only 15.3% read a guideline less than 1 month prior to the study. About 65.0% had received training on vaccine management. Incorrect handling practices reported included storing injections with vaccines (13.7%) and maintaining vaccine temperature using ice blocks (7.6%). About 43.0% had good knowledge of vaccine management, while 66.1% had good vaccine management practices. Respondents who had good knowledge of vaccine handling and storage [OR=10.0, 95%CI (5.28 - 18.94), p < 0.001] and had received formal training on vaccine management [OR=5.3, 95%CI (2.50 - 11.14), p< 0.001] were more likely to have good vaccine handling and storage practices. Regular training is recommended to enhance vaccine handling and storage practices.

  6. 76 FR 2123 - Agency Information Collection Activities; Announcement of Office of Management and Budget...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-12

    ...; Current Good Manufacturing Practice Quality System Regulation AGENCY: Food and Drug Administration, HHS... information entitled ``Current Good Manufacturing Practice Quality System Regulation'' has been approved by...

  7. 76 FR 49509 - Records Schedules; Availability and Request for Comments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-10

    ... Agency (N1-258-09-3, 1 item, 1 temporary item). Good Farming Practice Documentation, including producer... reconsideration of adverse good farming practice determinations. 3. Department of Agriculture, Risk Management... materials, legislation files, negotiation files, review files, unfair trade practices files, and...

  8. 76 FR 55067 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-06

    ... Pharmaceutical Current Good Manufacturing Practice AGENCY: Food and Drug Administration, HHS. ACTION: Notice... Good Manufacturing Practice--(OMB Control Number 0910-0563)--Extension The guidance is intended to... products, on how to resolve disputes of scientific and technical issues relating to current good...

  9. Management Documentation: Indicators & Good Practice at Cultural Heritage Places

    NASA Astrophysics Data System (ADS)

    Eppich, R.; Garcia Grinda, J. L.

    2015-08-01

    Documentation for cultural heritage places usually refers to describing the physical attributes, surrounding context, condition or environment; most of the time with images, graphics, maps or digital 3D models in their various forms with supporting textural information. Just as important as this type of information is the documentation of managerial attributes. How do managers of cultural heritage places collect information related to financial or economic well-being? How are data collected over time measured, and what are significant indicators for improvement? What quality of indicator is good enough? Good management of cultural heritage places is essential for conservation longevity, preservation of values and enjoyment by the public. But how is management documented? The paper will describe the research methodology, selection and description of attributes or indicators related to good management practice. It will describe the criteria for indicator selection and why they are important, how and when they are collected, by whom, and the difficulties in obtaining this information. As importantly it will describe how this type of documentation directly contributes to improving conservation practice. Good practice summaries will be presented that highlight this type of documentation including Pamplona and Ávila, Spain and Valletta, Malta. Conclusions are drawn with preliminary recommendations for improvement of this important aspect of documentation. Documentation of this nature is not typical and presents a unique challenge to collect, measure and communicate easily. However, it is an essential category that is often ignored yet absolutely essential in order to conserve cultural heritage places.

  10. Guided by Theory, Informed by Practice: Training and Support for the Good Behavior Game, a Classroom-Based Behavior Management Strategy

    ERIC Educational Resources Information Center

    Poduska, Jeanne M.; Kurki, Anja

    2014-01-01

    Moving evidence-based practices for classroom behavior management into real-world settings is a high priority for education and public health. This article describes the development and use of a model of training and support for the Good Behavior Game (GBG), one of the few preventive interventions shown to have positive outcomes for elementary…

  11. The "general recognition and acceptance" standard of objectivity for good faith in prescribing: legal and medical implications.

    PubMed

    Brushwood, David B

    2007-01-01

    The United States Court of Appeals for the 4th Circuit has ruled that a jury considering charges of drug trafficking against a pain management physician should be instructed that the defendant's good faith is a defense to the charges. The court rejected a subjective standard of good faith, and instead ruled that the good faith of the defendant must be evaluated from an objective perspective. This objective standard requires that the jury determine whether the defendant was practicing in accordance with the standard generally recognized and accepted in the United States. General recognition and acceptance are determined on a case-by-case basis, within the context of a defendant's practice. Simply because a physician's practice is out of the norm for many physicians does not mean it can't be generally recognized and accepted within the standard of medical practice. Expert witness testimony of pain management physicians will assist juries in the application of this standard for good faith in prescribing.

  12. Influence of farm management upon arbuscular mycorrhizal fungi

    USDA-ARS?s Scientific Manuscript database

    Good farming practices are conducted for a variety of reasons. Farmers now include management practices such as over wintering cover crops, reduced tillage, and crop rotation with the goals of reducing soil erosion, managing nutrient availability, building soil organic matter, controlling weeds, an...

  13. What is Good University Financial Management?

    ERIC Educational Resources Information Center

    Taylor, Mark P.

    2013-01-01

    In the current and foreseeable harsh UK higher education environment, aspiring to best-practice financial management will be key to ensuring the prosperity--and indeed the survival--of any university. In this article I argue that good university financial management should provide stability to the institution, allow for investment as well as…

  14. [Qualitative evaluation of employer requirements associated with occupational health and safety as good practice in small-scale enterprises].

    PubMed

    Kuroki, Naomi; Miyashita, Nana; Hino, Yoshiyuki; Kayashima, Kotaro; Fujino, Yoshihisa; Takada, Mikio; Nagata, Tomohisa; Yamataki, Hajime; Sakuragi, Sonoko; Kan, Hirohiko; Morita, Tetsuya; Ito, Akiyoshi; Mori, Koji

    2009-09-01

    The purpose of this study was to identify what motivates employers to promote good occupational health and safety practices in small-scale enterprises. Previous studies have shown that small-scale enterprises generally pay insufficient attention to issues of occupational health and safety. These findings were mainly derived from questionnaire based surveys. Nevertheless, some small-scale enterprises in which employers exercise good leadership do take a progressive approach to occupational health and safety. Although good practices can be identified in small-scale enterprises, it remains unclear what motivates employers in small-scale enterprises to actively implement occupational health and safety practices. We speculated that identifying employer motivations in promoting occupational health would help to spread good practices among small-scale enterprises. Using a qualitative approach based on the KJ methods, we interviewed ten employers who actively promote occupational health and safety in the workplace. The employers were asked to discuss their views of occupational health and safety in their own words. A semi-structured interview format was used, and transcripts were made of the interviews. Each transcript was independently coded by two or more researchers. These transcripts and codes were integrated and then the research group members discussed the heading titles and structural relationships between them according to the KJ method. Qualitative analysis revealed that all the employers expressed a strong interest in a "good company" and "good management". They emphasized four elements of "good management", namely "securing human resources", "trust of business partners", "social responsibility" and "employer's health condition itself", and considered that addressing occupational health and safety was essential to the achievement of these four elements. Consistent with previous findings, the results showed that implementation of occupational health and safety activities depended on "cost", "human resources", "time to perform", and "advisory organization". These results suggest that employer awareness of the relationship between good management and occupational health is essential to the implementation of occupational health and safety practices in small-scale enterprises.

  15. Good practices in health care "management experimentation models": insights from an international public-private partnership on transplantation and advanced specialized therapies.

    PubMed

    Longo, Maria Cristina

    2015-01-01

    The research analyzes good practices in health care "management experimentation models," which fall within the broader range of the integrative public-private partnerships (PPPs). Introduced by the Italian National Healthcare System in 1991, the "management experimentation models" are based on a public governance system mixed with a private management approach, a patient-centric orientation, a shared financial risk, and payment mechanisms correlated with clinical outcomes, quality, and cost-savings. This model makes public hospitals more competitive and efficient without affecting the principles of universal coverage, solidarity, and equity of access, but requires higher financial responsibility for managers and more flexibility in operations. In Italy the experience of such experimental models is limited but successful. The study adopts the case study methodology and refers to the international collaboration started in 1997 between two Italian hospitals and the University of Pittsburgh Medical Center (UPMC - Pennsylvania, USA) in the field of organ transplants and biomedical advanced therapies. The research allows identifying what constitutes good management practices and factors associated with higher clinical performance. Thus, it allows to understand whether and how the management experimentation model can be implemented on a broader basis, both nationwide and internationally. However, the implementation of integrative PPPs requires strategic, cultural, and managerial changes in the way in which a hospital operates; these transformations are not always sustainable. The recognition of ISMETT's good management practices is useful for competitive benchmarking among hospitals specialized in organ transplants and for its insights on the strategies concerning the governance reorganization in the hospital setting. Findings can be used in the future for analyzing the cross-country differences in productivity among well-managed public hospitals.

  16. Simulation of changes on the psychosocial risk in the nursing personnel after implementing the policy of good practices on the risk treatment.

    PubMed

    Bolívar Murcia, María Paula; Cruz González, Joan Paola; Rodríguez Bello, Luz Angélica

    2018-02-01

    Evaluate the change over time of psychosocial risk management for the nursing personnel of an intermediate complexity clinic of Bogota (Colombia). Descriptive and correlational research performed under the approach of risk management (identification, analysis, assessment and treatment). The psychosocial risk of the nursing personnel was studied through 10-year system dynamics models (with and without the implementation of the policy of good practices on the risk treatment) in two scenarios: when the nursing personnel works shifts of 6 hours (morning or afternoon) and when they work over 12 hours (double shift or night shift). When implementing a policy of good practices on the risk treatment, the double shift scenario shows an improvement among 25% to 88% in the variables of: health, labor motivation, burnout, service level and productivity; as well as in the variables of the organization associated to number of patients, nursing personnel and profit. Likewise, the single shift scenario with good practices improves in all the above-mentioned variables and generates stability on the variables of absenteeism and resignations. The best scenario is the single shift scenario with the application of good practices of risk treatment in comparison with the double shift scenario with good practices, which allows concluding that the good practices have a positive effect on the variables of nursing personnel and on those associated to the organization. Copyright© by the Universidad de Antioquia.

  17. [Identifying indicators of good practice in clinical and healthcare management].

    PubMed

    Bermúdez Tamayo, C; Olry de Labry Lima, A; García Mochón, L

    To identify good practices in order to develop and implement indicators of health outcomes for clinical and healthcare management, as well as the characteristics for an indicator to be considered adequate. A scoping review was performed, with the following phases: 1) Search and identification of bibliography. 2) Selection of relevant documents. Including those studies that discussed issues related to good practices for the use of health indicators in the management field. Those published in a language other than English or Spanish or before 2006 were excluded. 3) Analysis and extraction of information. 4) Consultation with stakeholders, using a qualitative methodology through Concept Mapping, with the participation of 40 experts (decision-makers, scientific societies, and health professionals). The data collection process included an inductive and structured procedure, with prioritisation of ideas grouped into clusters, according to feasibility and importance criteria (0-10 scale). Good practices identified 2 levels: 1) macro-management: Define a framework for the evaluation of indicators and establish a benchmark of indicators. 2) meso-management: Establish indicators according to evidence and expert consensus, taking into account priority areas and topics, testing before final use, and communicate results adequately. The characteristics of a suitable indicator are: 1) Approach of an important issue, 2) Scientific validity, 3) Possibility of measurement with reliable data, 4) Meaning of useful and applicable measurement, and 5) Wide scope. The best practices for the use of indicators in clinical and healthcare management can make it easier to monitor performance and accountability, as well as to support the decision-making addressed at the development of initiatives for quality improvement. Copyright © 2018 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Management practices in substance abuse treatment programs.

    PubMed

    McConnell, K John; Hoffman, Kim A; Quanbeck, Andrew; McCarty, Dennis

    2009-07-01

    Efforts to understand how to improve the delivery of substance abuse treatment have led to a recent call for studies on the "business of addiction treatment." This study adapts an innovative survey tool to collect baseline management practice data from 147 addiction treatment programs enrolled in the Network for the Improvement of Addiction Treatment 200 project. Measures of "good" management practice were strongly associated with days to treatment admission. Management practice scores were weakly associated with revenues per employee but were not correlated with operating margins. Better management practices were more prevalent among programs with a higher number of competitors in their catchment area.

  19. The contribution of arbusclar mycorrhizal fungi to the success or failure of agricultural practices

    USDA-ARS?s Scientific Manuscript database

    Good farming practices are conducted for a variety of reasons. Farmers now include management practices such as over wintering cover crops, reduced tillage, and crop rotation with the goals of reducing soil erosion, managing nutrient availability, building soil organic matter, controlling weeds, an...

  20. 76 FR 718 - General Administrative Regulations; Good-Performance Refunds

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-06

    ... demonstrate good farming practices, providing, in effect, a premium discount to individual producers... Refund program will specifically encourage sound management practices as well as encouraging insured... regardless of the size of their farming operation. The amount of work required of the insurance companies...

  1. 49 CFR 385.323 - May FMCSA extend the period under § 385.319(c) for a new entrant to take corrective action to...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) for a new entrant to take corrective action to remedy its safety management practices? 385.323 Section....319(c) for a new entrant to take corrective action to remedy its safety management practices? (a... determines the new entrant is making a good faith effort to remedy its safety management practices. (b) FMCSA...

  2. The good CPD guide: A practical guide to managed continuing professional development in medicine Janet Grant The good CPD guide: A practical guide to managed continuing professional development in medicine Radcliffe Publishing 190pp £29.99 9781846195709 1846195705 [Formula: see text].

    PubMed

    2012-02-10

    DURING HARD times, when education budgets decrease, the purpose of continuing professional development (CPD) programmes must be made clear to practitioners and services. Clarity is crucial in ensuring that CPD programmes receive adequate funding, and that enough time and professional effort are devoted to them.

  3. 77 FR 23732 - Agency Information Collection Activities; Announcement of Office of Management and Budget...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-20

    ...; Current Good Manufacturing Practices and Related Regulations for Blood and Blood Components; and Requirements for Donor Testing, Donor Notification, and ``Lookback'' AGENCY: Food and Drug Administration, HHS... information entitled ``Current Good Manufacturing Practices and Related Regulations for Blood and Blood...

  4. Natural regeneration - small ownerships from concept to practice

    Treesearch

    Arthur G., Jr. Dodge

    1977-01-01

    Established concepts of successful natural regeneration are not necessarily practiced on small ownerships of ten to 500 acres. Unevenage management will be the primary management system on small ownerships and natural regeneration is the most practical method of providing for continuous forest production. We can obtain satisfactory natural regeneration by good planning...

  5. Variable implementation of good practice recommendations for the assessment and management of UK children with neurodisability.

    PubMed

    Gray, L; Gibbs, J; Jolleff, N; Williams, J; McConachie, H; Parr, J R

    2015-11-01

    The aims of this study were to determine whether UK child development teams (CDTs) have implemented good practice recommendations for the co-ordinated assessment and support of children with neurodisability and to explore some of the factors associated with variations in good practice implementation. Surveys were sent to every UK CDT in 2009/2010. Responses about CDT provision and ways of working were compared with good practice recommendations from national policy documents and professional organizations. The extent to which CDTs in England and Wales met 11 selected good practice recommendations was scored; teams in Scotland and Northern Ireland were given a score out of 9 to reflect the optional use of the common assessment framework and early support materials in these countries. Responses were received from 225/240 (94%) UK CDTs. Thirty-seven per cent of CDTs in England and Wales had implemented nine or more of the 11 recommendations. Fifty-nine per cent of teams in Scotland and 78% of teams in Northern Ireland met between six and nine recommendations of good working practice. Higher levels of implementation of recommendations were found when the CDT had a Child Development Centre base and for teams who had received increased funding in the 5 years preceding the survey. There was considerable variability in the degree to which CDTs implemented good practice recommendations for the diagnosis and management of children with neurodisability. Evidence about child and parent satisfaction, and the effectiveness of CDT practices and provision, is required, so policymakers, healthcare commissioners and clinicians can provide the most appropriate services to children with neurodisability and their families. © 2015 John Wiley & Sons Ltd.

  6. General business theory applied to the physician's practice.

    PubMed

    Shaw, D V

    2002-01-01

    In the pursuit of clinical excellence in today's competitive medical market place, practice managers--clinical or non-clinical--can loose sight of standard management and business principles that are key to success. Also, at times individuals are hesitant to identify a physician practice as a 'business,' preferring to see it as a social good. Still, it is a business--perhaps dealing with a product that is a social good, but still, a business. And, as such, benefits can be derived from a review of business management theory. This article provides a brief review of such theory and also illustrates how to apply this theory to the physician's practice. Key factors in building a successful business will be discussed and applied to the clinical practice, such as resource maximization, rate of return and product mix synergy. Some tools to assist the reader in analyzing their practice will also be provided, such as the RVU Analysis and the Ratio of Service Analysis.

  7. 76 FR 28045 - Agency Information Collection Activities; Announcement of Office of Management and Budget...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-13

    ...] Agency Information Collection Activities; Announcement of Office of Management and Budget Approval; Current Good Manufacturing Practice in Manufacturing, Packaging, Labeling, or Holding Operations for... Practice in Manufacturing, Packaging, Labeling, or Holding Operations for Dietary Supplements'' has been...

  8. Caught between the global economy and local bureaucracy: the barriers to good waste management practice in South Africa.

    PubMed

    Godfrey, Linda; Scott, Dianne; Trois, Cristina

    2013-03-01

    Empirical research shows that good waste management practice in South Africa is not always under the volitional control of those tasked with its implementation. While intention to act may exist, external factors, within the distal and proximal context, create barriers to waste behaviour. In addition, these barriers differ for respondents in municipalities, private industry and private waste companies. The main barriers to implementing good waste management practice experienced by respondents in municipalities included insufficient funding for waste management and resultant lack of resources; insufficient waste knowledge; political interference in decision-making; a slow decision-making process; lack of perceived authority to act by waste staff; and a low priority afforded to waste. Barriers experienced by respondents in private industry included insufficient funding for waste and the resultant lack of resources; insufficient waste knowledge; and government bureaucracy. Whereas, barriers experienced in private waste companies included increasing costs; government bureaucracy; global markets; and availability of waste for recycling. The results suggest that respondents in public and private waste organizations are subject to different structural forces that shape, enable and constrain waste behaviour.

  9. Knowledge, Attitude, and Practice on Menstrual Hygiene Management among School Adolescents.

    PubMed

    Yadav, Ram Naresh; Joshi, Shrijana; Poudel, Rajesh; Pandeya, Pawan

    2018-01-01

    Menstrual hygiene management remains a taboo in many communities in Nepal. Cultural beliefs about menstruation such as food taboos and untouchability have negative impact on dignity, health and education of adolescent girls. The objective of the study was to assess the current knowledge, attitude and practice of school adolescents on menstrual hygiene management in Doti District in Far-Western Nepal. This cross-sectional study was carried out from October to December 2016 at seven village development committees in Doti district, Nepal. This study was done among 276 students from grade seven and eight of 11 schools. Self-administered structured questionnaire was used to obtain information from school students. Descriptive analysis was done to analyse the knowledge, attitude and practice of school adolescents on menstrual hygiene management. 67.4% respondents had fair knowledge and 26.4% respondents had good knowledge on menstrual hygiene management. However, out of 141 female adolescent respondents, only 56 (40%) were engaged in good menstrual hygiene practices. Around half of the respondents had positive attitude towards menstrual hygiene management related issues. Although knowledge on menstrual hygiene management among school adolescents is fair, still attitude and practice need to improve. Findings indicate the need of behavior change communication campaigns along with frequent reinforcement of school health education programs.

  10. 76 FR 71276 - Common Crop Insurance Regulations; Pecan Revenue Crop Insurance Provisions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... CFR part 400, subpart J for the informal administrative review process of good farming practices as... farming operation. For instance, all producers are required to submit an application and acreage report to... and discourages good management practices. Language in sections 3(d)(3) and 6(b) provides consequences...

  11. Reducing the Environmental Impact of Clinical Laboratories.

    PubMed

    Lopez, Joseph B; Jackson, David; Gammie, Alistair; Badrick, Tony

    2017-02-01

    Healthcare is a significant contributor to environmental impact but this has received little attention. The typical laboratory uses far more energy and water per unit area than the typical office building. There is a need to sensitise laboratories to the importance of adopting good environmental practices. Since this comes at an initial cost, it is vital to obtain senior management support. Convincing management of the various tangible and intangible benefits that can accrue in the long run should help achieve this support. Many good environmental practices do not have a cost but will require a change in the culture and mind-set of the organisation. Continuing education and training are important keys to successful implementation of good practices. There is a need to undertake a rigorous cost-benefit analysis of every change that is introduced in going green. The adoption of good practices can eventually lead to ISO certification if this is desired. This paper provides suggestions that will allow a laboratory to start going green. It will allow the industry to enhance its corporate citizenship whilst improving its competitive advantage for long-term.

  12. Managing Productive Schools: Toward an Ecology.

    ERIC Educational Resources Information Center

    Snyder, Karolyn J.; Anderson, Robert H.

    Intended for use by graduate students in educational administration and supervision as well as by practicing school administrators, this book is a guide to the most effective practices surrounding the school principalship. Ideas in the book reflect current views of good management, including systems approaches, participative and collaborative…

  13. Small business, cash budgets and general practice.

    PubMed

    Jackson, A R

    1991-01-01

    In practice management, general practice falls into the category of small business with all its attendant generic problems. Disciplined planning and good financial management are not often seen in small business. These are required if general practitioners are to continue (or return to) the provision of high quality medical services. An effective budget process, especially cash-flow budgeting, is the key to successful planning and financial management. Budgeting will bring Control, Co-ordination, and Credibility to your practice. It will enable you to set goals and to achieve them.

  14. WHO Expert Committee on Specifications for Pharmaceutical Preparations. Fiftieth report.

    PubMed

    2016-01-01

    The Expert Committee on Specifications for Pharmaceutical Preparations works towards clear, independent and practical standards and guidelines for the quality assurance of medicines. Standards are developed by the Committee through worldwide consultation and an international consensus-building process. The following new guidelines were adopted and recommended for use. Good pharmacopoeial practices; FIP-WHO technical guidelines: points to consider in the provision by health-care professionals of children-specific preparations that are not available as authorized products; Guidance on good manufacturing practices for biological products; Guidance on good manufacturing practices: inspection report, including Appendix 1: Model inspection report; Guidance on good data and record management practices; Good trade and distribution practices for starting materials; Guidelines on the conduct of surveys of the quality of medicines; Collaborative procedure between the World Health Organization (WHO) prequalification team and national regulatory authorities in the assessment and accelerated national registration of WHO-prequalified pharmaceutical products and vaccines; Guidance for organizations performing in vivo bioequivalence studies; and World Health Organization (WHO) general guidance on variations to multisource pharmaceutical products.

  15. Food: Too Good to Waste Implementation Guide and Toolkit

    EPA Pesticide Factsheets

    The Food: Too Good to Waste (FTGTW) Implementation Guide and Toolkit is designed for community organizations, local governments, households and others interested in reducing wasteful household food management practices.

  16. A-Z of management and finance in the NHS: outcomes and use of resources.

    PubMed

    Batstone, G

    In general, clinical outcomes are the product of clinical practice and good outcomes are associated with the judicious application of the best available evidence of what constitutes good practice. From the patient's viewpoint this application needs to be tempered by personal choice, cultural beliefs, and questions of optimal time and location of treatment.

  17. 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.

  18. Quality management for the international transport of laboratory animals.

    PubMed

    Leary, Steven L

    2008-01-01

    Increased collaboration between investigators at different institutions has increased the number of laboratory animals being transported. The current system of laws and regulations governing animal shipments is inconsistent and government agencies often have areas of overlapping regulatory management. Furthermore, the lack of industry-wide shipping standards and good practices contributes to confusion among those responsible for shipment. One answer to these quality control issues would be the establishment of independent, industry-regulated 'good practices' for animal transport, similar to those used in laboratories for experimental design. These good practices could be based on the existing International Air Transport Association Live Animals Regulations, with contributions from representatives of the specialties involved. Additionally, quality control under the current system of patchwork regulations could be improved if each institution, both academic and commercial, would designate a single point of contact to follow each shipment from start to finish.

  19. Good Manufacturing Practices (GMP) / Good Laboratory Practices (GLP) Review and Applicability for Chemical Security Enhancements

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

    Iveson, Steven W.

    Global chemical security has been enhanced through the determined use and integration of both voluntary and legislated standards. Many popular standards contain components that specifically detail requirements for the security of materials, facilities and other vital assets. In this document we examine the roll of quality management standards and how they affect the security culture within the institutions that adopt these standards in order to conduct business within the international market place. Good manufacturing practices and good laboratory practices are two of a number of quality management systems that have been adopted as law in many nations. These standards aremore » designed to protect the quality of drugs, medicines, foods and analytical test results in order to provide the world-wide consumer with safe and affective products for consumption. These standards provide no established security protocols and yet manage to increase the security of chemicals, materials, facilities and the supply chain via the effective and complete control over the manufacturing, the global supply chains and testing processes. We discuss the means through which these systems enhance security and how nations can further improve these systems with additional regulations that deal specifically with security in the realm of these management systems. We conclude with a discussion of new technologies that may cause disruption within the industries covered by these standards and how these issues might be addressed in order to maintain or increase the level of security within the industries and nations that have adopted these standards.« less

  20. 23 CFR 500.108 - SMS.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Management Systems: Good Practices for Development and Implementation.” 3 An effective SMS should include, at... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION TRANSPORTATION INFRASTRUCTURE MANAGEMENT MANAGEMENT AND MONITORING SYSTEMS Management Systems § 500.108 SMS. An SMS is a systematic process with the goal of reducing the...

  1. 23 CFR 500.108 - SMS.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Management Systems: Good Practices for Development and Implementation.” 3 An effective SMS should include, at... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION TRANSPORTATION INFRASTRUCTURE MANAGEMENT MANAGEMENT AND MONITORING SYSTEMS Management Systems § 500.108 SMS. An SMS is a systematic process with the goal of reducing the...

  2. Research Nurse | Center for Cancer Research

    Cancer.gov

    We are looking for research nurses to join our clinical program to help us manage the care of patients participating in clinical trials. Duties include, but are not limited to, ensuring adherence to ethical practice in the conduct of clinical trials, research protocol compliance and good clinical practice, ensuring patient comprehension of informed consent, management of care

  3. Risk Management for Study Abroad Programs: Issues and Resources to Inform Program Development, Administration, and Training

    ERIC Educational Resources Information Center

    Rhodes, Gary

    2014-01-01

    This chapter provides a practical background to the health and safety risks and challenges for U.S. colleges and universities and other program providers. Potential risks, field-based guidelines, good practices, and resources to support the management of risks by study abroad offices will be covered.

  4. Good pharmacovigilance practices: technology enabled.

    PubMed

    Nelson, Robert C; Palsulich, Bruce; Gogolak, Victor

    2002-01-01

    The assessment of spontaneous reports is most effective it is conducted within a defined and rigorous process. The framework for good pharmacovigilance process (GPVP) is proposed as a subset of good postmarketing surveillance process (GPMSP), a functional structure for both a public health and corporate risk management strategy. GPVP has good practices that implement each step within a defined process. These practices are designed to efficiently and effectively detect and alert the drug safety professional to new and potentially important information on drug-associated adverse reactions. These practices are enabled by applied technology designed specifically for the review and assessment of spontaneous reports. Specific practices include rules-based triage, active query prompts for severe organ insults, contextual single case evaluation, statistical proportionality and correlational checks, case-series analyses, and templates for signal work-up and interpretation. These practices and the overall GPVP are supported by state-of-the-art web-based systems with powerful analytical engines, workflow and audit trials to allow validated systems support for valid drug safety signalling efforts. It is also important to understand that a process has a defined set of steps and any one cannot stand independently. Specifically, advanced use of technical alerting methods in isolation can mislead and allow one to misunderstand priorities and relative value. In the end, pharmacovigilance is a clinical art and a component process to the science of pharmacoepidemiology and risk management.

  5. Practice leadership and active support in residential services for people with intellectual disabilities: an exploratory study.

    PubMed

    Beadle-Brown, J; Mansell, J; Ashman, B; Ockenden, J; Iles, R; Whelton, B

    2014-09-01

    We hypothesised that a key factor determining the quality of active support was 'practice leadership' - provided by the first-line manager to focus staff attention and develop staff skills in providing direct support to enable people with intellectual disabilities to have a good quality of life. This exploratory study focused on what levels of practice leadership were found and its role in explaining variation in active support. Relevant aspects of management, including practice leadership, were assessed by questionnaires administered to staff in residential settings alongside observational measures of active support and resident engagement in meaningful activity. Relationships between these variables were explored using regression and post hoc group comparisons. There was wide variation, with average levels of practice leadership being low, though improving over the period studied. Practice leadership had a significant impact on active support, but was fully mediated by the effect of quality of management. When the quality of management was higher better practice leadership did produce a significant difference in active support. However, higher quality of management on its own did not produce better active support. A number of limitations are acknowledged and further research is required. Practice leadership appears to be an important factor in enabling staff to provide active support but as part of generally good management. Given the rather low levels found, attention needs to be given to the training, career development and support of practice leaders and also to how to protect their time from their many other responsibilities. © 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  6. Alternative Fuels Data Center

    Science.gov Websites

    technologies and operational practices which increase fuel efficiency and reduce emissions from goods movement . EPA provides partners with performance benchmarking tools, fleet management best practices, technology is working with partners to test and verify advanced technologies and operational practices that save

  7. Improving work-life balance: what can employers and employees do?

    PubMed

    Herrera, Manuela

    2013-12-14

    Effective time management can play a big part in reducing stress for busy vets, but too often miscommunication between practice employers and employees can make it harder to achieve a good work-life balance. Manuela Herrera reports on a session at the BVA Congress which considered what vets can do to facilitate better time management in practice.

  8. Assessment of knowledge and practice of community pharmacy personnel on diabetes mellitus management in Kathmandu district: a cross sectional descriptive study.

    PubMed

    Shrestha, M; Maharjan, R; Prajapati, A; Ghimire, S; Shrestha, N; Banstola, A

    2015-01-01

    Pharmacists are the most reachable healthcare professionals to many chronically ill patients. It has been found that pharmacists see patients with diabetes up to five times more often than any other healthcare provider. Therefore, to provide quality health care to patients it is important that they have appropriate knowledge and practice on diabetes mellitus management. Thus, this study was conducted to assess the knowledge and practice of diabetes mellitus management among community pharmacy personnel involved in retail community pharmacies of Kathmandu. Three hundred and fifteen community pharmacies, selected by systematic random sampling were surveyed by using pre-validated self-administered questionnaires. The first set of questionnaire evaluated the community pharmacy personnel's diabetes knowledge based on a pre-validated 20-item questionnaire. The second set of questionnaire documented about the practice of community pharmacy personnel on diabetes mellitus management which contained 22 questions. Data was entered in EPI Data and analyzed by using SPSS version 20. This survey demonstrated that 76.5 % respondents had poor knowledge and 86.4 % had negative practice on diabetes mellitus (DM) management. Only 26.2 % respondents had good knowledge as well as good practice. 31.4 % of respondents had poor knowledge as well as poor practice on DM management. Laws and regulations regarding community pharmacy personnel need to be implemented. There should be more advanced and experiment based training. Additionally, the provision for further education curriculum in pharmacy education should be implemented which should intensively include disease and proper management. Guidelines covering diabetes care should be distributed and implemented throughout community pharmacies.

  9. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    MedlinePlus

    ... Combined Councils Patient Education Primary Care Provider Risk Management Veteran Resources Community Health Behavioral Health Environmental Health ... Tools Diabetes Education Lesson Plan Outlines Integrating Case Management Into Your Practice [PDF – 290 KB] Integrating DSMES ...

  10. 40 CFR 160.31 - Testing facility management.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Testing facility management. 160.31... GOOD LABORATORY PRACTICE STANDARDS Organization and Personnel § 160.31 Testing facility management. For each study, testing facility management shall: (a) Designate a study director as described in § 160.33...

  11. [Analysis of the model OPM3® application and results for health area].

    PubMed

    Augusto Dos Santos, Luis; de Fátima Marin, Heimar

    2011-01-01

    This research sought to analyze if a questionnaire model created by an international community of project management is applicable to health organizations. The model OPM3 ® (Organizational Project Management Maturity Model) was created in order that organizations of any area or size can identify the presence or absence of good management practices. The aim of applying this model is to always evaluate the organization and not the interviewee. In this paper, one presents the results of employing this model in an organization that has information technology products and services applied to health area. This study verified that the model is rapidly applicable and that the analyzed organization has an expressive number of good practices.

  12. Assessing the quality of cost management

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

    Fayne, V.; McAllister, A.; Weiner, S.B.

    1995-12-31

    Managing environmental programs can be effective only when good cost and cost-related management practices are developed and implemented. The Department of Energy`s Office of Environmental Management (EM), recognizing this key role of cost management, initiated several cost and cost-related management activities including the Cost Quality Management (CQM) Program. The CQM Program includes an assessment activity, Cost Quality Management Assessments (CQMAs), and a technical assistance effort to improve program/project cost effectiveness. CQMAs provide a tool for establishing a baseline of cost-management practices and for measuring improvement in those practices. The result of the CQMA program is an organization that has anmore » increasing cost-consciousness, improved cost-management skills and abilities, and a commitment to respond to the public`s concerns for both a safe environment and prudent budget outlays. The CQMA program is part of the foundation of quality management practices in DOE. The CQMA process has contributed to better cost and cost-related management practices by providing measurements and feedback; defining the components of a quality cost-management system; and helping sites develop/improve specific cost-management techniques and methods.« less

  13. 21 CFR 58.31 - Testing facility management.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Organization and Personnel § 58.31 Testing facility management. For each nonclinical laboratory study, testing facility management shall: (a) Designate a study...

  14. Aggressive behaviour - prevention and management in the general practice environment.

    PubMed

    Sim, Moira G; Wain, Toni; Khong, Eric

    2011-11-01

    Aggressive behaviour is commonly encountered in the general practice setting and can often be de-escalated using good communication skills. This article provides strategies to reduce and manage early aggression in the general practice environment. Aggressive behaviour usually occurs when a person feels unfairly treated. Having a systematic approach to the problem can improve safety for both staff and patients. This includes patient centred practice, identifying and managing the early signs of aggression to prevent escalation, having a plan to seek assistance if required, setting limits using a calm respectful manner and reinforcing limits using behaviour contracts when required. The physical layout of the practice and restraint of aggressive people are beyond the scope of this article.

  15. Good Teachers, Good Schools: How to Create a Successful School

    ERIC Educational Resources Information Center

    Hudson, David

    2009-01-01

    "Good schools think 'with' people and not 'to' people" argues David Hudson in this thought provoking practical guide for those wanting to bridge the gap between middle and senior management roles, and make a difference in their schools. Accessibly and engagingly written and packed with real-life examples, this book will prove essential…

  16. Standardization of haematology critical results management in adults: an International Council for Standardization in Haematology, ICSH, survey and recommendations.

    PubMed

    Keng, T B; De La Salle, B; Bourner, G; Merino, A; Han, J-Y; Kawai, Y; Peng, M T; McCafferty, R

    2016-10-01

    These recommendations are intended to develop a consensus in the previously published papers as to which parameters and what values should be considered critical. A practical guide on the standardization of critical results management in haematology laboratories would be beneficial as part of good laboratory and clinical practice and for use by laboratory-accrediting agencies. A working group with members from Europe, America, Australasia and Asia was formed by International Council for Standardization in Haematology. A pattern of practice survey of 21 questions was distributed in 2014, and the data were collected electronically by Survey Monkey. The mode, or most commonly occurring value, was selected as the threshold for the upper and lower alert limits for critical results reporting. A total of 666 laboratories submitted data to this study and, of these, 499 submitted complete responses. Full blood count critical results alert thresholds, morphology findings that trigger critical result notification, critical results alert list, notification process and maintenance of critical results management protocol are described. This international survey provided a snapshot of the current practice worldwide and has identified the existence of considerable heterogeneity of critical results management. The recommendations in this study represent a consensus of good laboratory practice. They are intended to encourage the implementation of a standardized critical results management protocol in the laboratory. © 2016 John Wiley & Sons Ltd.

  17. Teacher's Knowledge, Attitudes and Management Practices about Diabetes Care in Riyadh's Schools.

    PubMed

    Abdel Gawwad, Ensaf S

    2008-01-01

    The objective of this study was to assess diabetes-related knowledge, attitudes and management practices among school teachers in order to determine their diabetes training needs and preparedness to provide adequate care for students with diabetes. A cross sectional descriptive study was carried out among 177 school teachers in Boys and Girls primary and intermediate school compounds in Riyadh City. Data was collected using self-administered questionnaires during the period February-March 2007. The results showed that most of the school teachers had fair diabetes knowledge (78%), and unfavorable attitudes toward taking responsibility of diabetes education and care in schools. Recognizing normal, low and high blood sugar levels was the least known. The most frequent sources of information were booklets, brochures, mass media and own experience. A negative significant relationship was found between knowledge and attitude scores. Only 18.6% of teachers had got good total score of diabetes management practices for their diabetic students. The most frequent practices mentioned were trying to have competency in using glucometer, and allowing students to use restroom as needed. Developing an emergency action plan, and observing diabetic students all the school day were the least mentioned practices. Good diabetes managers were more knowledgeable and more expressing unfavorable attitudes. This study highlighted the need of diabetes education training courses especially designed to school teachers to promote adequate care and management of diabetes emergencies in schools.

  18. Correlation Research of Medical Security Management System Network Platform in Medical Practice

    NASA Astrophysics Data System (ADS)

    Jie, Wang; Fan, Zhang; Jian, Hao; Li-nong, Yu; Jun, Fei; Ping, Hao; Ya-wei, Shen; Yue-jin, Chang

    Objective-The related research of medical security management system network in medical practice. Methods-Establishing network platform of medical safety management system, medical security network host station, medical security management system(C/S), medical security management system of departments and sections, comprehensive query, medical security disposal and examination system. Results-In medical safety management, medical security management system can reflect the hospital medical security problem, and can achieve real-time detection and improve the medical security incident detection rate. Conclusion-The application of the research in the hospital management implementation, can find hospital medical security hidden danger and the problems of medical disputes, and can help in resolving medical disputes in time and achieve good work efficiency, which is worth applying in the hospital practice.

  19. Safety and compliance-related hazards in the medical practice: Part one.

    PubMed

    Calway, R C

    2001-01-01

    Safety and risk management hazards are a fact of life for the medical practice, and the costs of these incidents can place the group at significant risk of liability. Good compliance and risk management programs help minimize these incidents, improve staff morale, increase a practice's visibility in the community, and positively affect the practice's financial and operational bottom line performance. Medical practices that implement effective safety and risk management programs can realize savings in staffing costs, operational efficiency, morale, insurance premiums, and improved third-party relationships while at the same time avoiding embarrassing risks, fines, and liability. This article outlines some of the most common safety and risk management-related deficiencies seen in medical practices today. The author explains how to remedy these deficiencies and provides a self-test tool to enable the reader to assess areas within his or her own practice in need of attention.

  20. Guide to good practices for line and training manager activities

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

    NONE

    1998-06-01

    The purpose of this guide is to provide direction for line and training managers in carrying out their responsibilities for training and qualifying personnel and to verify that existing training activities are effective.

  1. European Federation of Neurological Societies/Peripheral Nerve Society guideline on management of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society - first revision.

    PubMed

    Van den Bergh, P Y K; Hadden, R D M; Bouche, P; Cornblath, D R; Hahn, A; Illa, I; Koski, C L; Léger, J-M; Nobile-Orazio, E; Pollard, J; Sommer, C; van Doorn, P A; van Schaik, I N

    2010-03-01

    Consensus guidelines on the definition, investigation, and treatment of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) have been previously published in European Journal of Neurology and Journal of the Peripheral Nervous System. To revise these guidelines. Disease experts, including a representative of patients, considered references retrieved from MEDLINE and Cochrane Systematic Reviews published between August 2004 and July 2009 and prepared statements that were agreed in an iterative fashion. The Task Force agreed on Good Practice Points to define clinical and electrophysiological diagnostic criteria for CIDP with or without concomitant diseases and investigations to be considered. The principal treatment recommendations were: (i) intravenous immunoglobulin (IVIg) (Recommendation Level A) or corticosteroids (Recommendation Level C) should be considered in sensory and motor CIDP; (ii) IVIg should be considered as the initial treatment in pure motor CIDP (Good Practice Point); (iii) if IVIg and corticosteroids are ineffective, plasma exchange (PE) should be considered (Recommendation Level A); (iv) if the response is inadequate or the maintenance doses of the initial treatment are high, combination treatments or adding an immunosuppressant or immunomodulatory drug should be considered (Good Practice Point); (v) symptomatic treatment and multidisciplinary management should be considered (Good Practice Point).

  2. Determining the optimum strategy of techniques from the municipal solid waste management hierarchy to maximize social value. Master`s thesis

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

    Still, C.M.

    1996-12-01

    The primary waste management alternatives are source reduction, recycling, composting, incineration, and landfilling. Often waste management policies are based entirely on technical considerations and ignore that actual disposal practices depend on individuals` attitudes and behaviors. This research formulated a decision analysis model that incorporates social value measures to determine the waste management strategy that maximizes the individuals` willingness to participate. The social values that are important and that were considered in the decision support model to assist with making decisions about solid waste management were convenience, feeling good about reducing waste, feeling good about leaving a good environment for futuremore » generations, and the value of recreation programs that can be provided with profit from a recycling program.« less

  3. Price fixing in general practice.

    PubMed

    Brushin, Bella; Watts, Ian

    2008-07-01

    Dr Bev Young has just finished packing up her office. This is her last day in her Preston practice of 19 years. Bev enjoys the autonomy of being a solo general practitioner, but lately she finds managing the practice increasingly stressful. Teaming up with a fellow GP seemed a good alternative.

  4. The EUA Institutional Evaluation Programme: An Account of Institutional Best Practices

    ERIC Educational Resources Information Center

    Rosa, Maria Joao; Cardoso, Sonia; Dias, Diana; Amaral, Alberto

    2011-01-01

    When evaluating the EUA Institutional Evaluation Programme (IEP), Nilsson "et al." emphasised the interest in creating a data bank on good practices derived from its reports that would contribute to disseminating examples of effective quality management practices and to supporting mutual learning among universities. In IEP, evaluated…

  5. School Indoor Air Quality Best Management Practices Manual.

    ERIC Educational Resources Information Center

    Hall, Richard; Ellis, Richard; Hardin, Tim

    This manual, written in response to requirements of the Washington State legislature, focuses on practices which can be undertaken during the siting, design, construction, or renovation of a school, recommends practices to help ensure good indoor air quality during building occupancy, and suggests protocols and useful reference documents for…

  6. Implementation of Good Clinical Laboratory Practice (GCLP) guidelines within the External Quality Assurance Program Oversight Laboratory (EQAPOL).

    PubMed

    Todd, Christopher A; Sanchez, Ana M; Garcia, Ambrosia; Denny, Thomas N; Sarzotti-Kelsoe, Marcella

    2014-07-01

    The EQAPOL contract was awarded to Duke University to develop and manage global proficiency testing programs for flow cytometry-, ELISpot-, and Luminex bead-based assays (cytokine analytes), as well as create a genetically diverse panel of HIV-1 viral cultures to be made available to National Institutes of Health (NIH) researchers. As a part of this contract, EQAPOL was required to operate under Good Clinical Laboratory Practices (GCLP) that are traditionally used for laboratories conducting endpoint assays for human clinical trials. EQAPOL adapted these guidelines to the management of proficiency testing programs while simultaneously incorporating aspects of ISO/IEC 17043 which are specifically designed for external proficiency management. Over the first two years of the contract, the EQAPOL Oversight Laboratories received training, developed standard operating procedures and quality management practices, implemented strict quality control procedures for equipment, reagents, and documentation, and received audits from the EQAPOL Central Quality Assurance Unit. GCLP programs, such as EQAPOL, strengthen a laboratory's ability to perform critical assays and provide quality assessments of future potential vaccines. © 2013.

  7. Discovering successful strategies for diabetic self-management: a qualitative comparative study

    PubMed Central

    Baer, Roberta; Nash, Anita; Perez, Noe

    2017-01-01

    Objective This project explored lifestyles of patients in good and poor control to identify naturally occurring practices and strategies that result in successful diabetes management. Research design and methods Semistructured interviews with adult patients with type 2 diabetes explored diet, food preparation, physical activity, medication use and glucose monitoring. Patients (n=56) were classified into good (A1C <7.0%), fair (7.0%8.0%) control groups and matched across groups on diabetes duration (±5 years) and medication modality (none, oral, insulin±oral) to control for non-lifestyle factors. A qualitative comparative analysis identified practices that distinguished glycemic groups. Results Good control patients were more likely to test their glucose two or more times a day and reduce their sodium intake, as well as increase fruits and vegetables and limit portion sizes, some attaining good control without exercise. Fair control patients discussed several dietary strategies including limiting sweets, drinking non-caloric beverages, reducing carbs, ‘cheating’ (eating only a few sweets/limiting carbs in one meal to have more in another meal) and tested their glucose once a day. Poor control patients were more likely to skip antidiabetic medications and not test their glucose. Conclusions Although clinical trials indicate most self-management practices have limited effectiveness over time, increased glucose monitoring is a valuable component in daily management. Research is needed on effectiveness of dietary strategies that emphasize sodium monitoring and allow some degree of cheating. Reoffering diabetes education classes and providing pill boxes as memory aids may help improve poor control. PMID:28761649

  8. Discovering successful strategies for diabetic self-management: a qualitative comparative study.

    PubMed

    Weller, Susan C; Baer, Roberta; Nash, Anita; Perez, Noe

    2017-01-01

    This project explored lifestyles of patients in good and poor control to identify naturally occurring practices and strategies that result in successful diabetes management. Semistructured interviews with adult patients with type 2 diabetes explored diet, food preparation, physical activity, medication use and glucose monitoring. Patients (n=56) were classified into good (A1C <7.0%), fair (7.0%8.0%) control groups and matched across groups on diabetes duration (±5 years) and medication modality (none, oral, insulin±oral) to control for non-lifestyle factors. A qualitative comparative analysis identified practices that distinguished glycemic groups. Good control patients were more likely to test their glucose two or more times a day and reduce their sodium intake, as well as increase fruits and vegetables and limit portion sizes, some attaining good control without exercise. Fair control patients discussed several dietary strategies including limiting sweets, drinking non-caloric beverages, reducing carbs, 'cheating' (eating only a few sweets/limiting carbs in one meal to have more in another meal) and tested their glucose once a day. Poor control patients were more likely to skip antidiabetic medications and not test their glucose. Although clinical trials indicate most self-management practices have limited effectiveness over time, increased glucose monitoring is a valuable component in daily management. Research is needed on effectiveness of dietary strategies that emphasize sodium monitoring and allow some degree of cheating. Reoffering diabetes education classes and providing pill boxes as memory aids may help improve poor control.

  9. Recommended practices for the management of embryology, andrology, and endocrinology laboratories: a committee opinion.

    PubMed

    2014-10-01

    This document provides a general overview for physicians of the qualities and conditions necessary for good management practices within the endocrinology, andrology, and embryology laboratories in the United States. It is intended as an addendum to previously published guidelines that further detail these responsibilities. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  10. The Local Turn: an Introductory Essay Revisiting Leadership, Elite Capture and Good Governance in Indonesian Conservation and Development Programs.

    PubMed

    Warren, Carol; Visser, Leontine

    The local turn in good governance theory and practice responded to critiques of the ineffectiveness of state management and the inequity of privatization alternatives in natural resource management. Confounding expectations of greater effectiveness from decentralised governance, including community-based natural resource management, however, critics argue that expanded opportunities for elite capture have become widely associated with program failures. This overview of theoretical controversies on leadership, patronage and elite capture is part of a themed section in this issue that challenges assumptions across a wide range of current policy literature. It introduces a set of Indonesian case studies that examine practices of local leaders and elites and seek to account in structural terms for appropriations both by ('elite capture') and of ('captured elites') these key figures. These studies explore the structural factors and co-governance practices most likely to promote effective participation of the full spectrum of local interests in pursuit of better local natural resource governance.

  11. 75 FR 59266 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-27

    ...] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment Request; Current Good Manufacturing Practice in Manufacturing, Packaging, Labeling, or Holding Operations... submitted to the Office of Management and Budget (OMB) for review and clearance under the Paperwork...

  12. 75 FR 60463 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-30

    ...] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment...: Current Good Manufacturing Practice in Manufacturing, Packaging, Labeling, or Holding Operations for... Management and Budget (OMB) for review and clearance under the Paperwork Reduction Act of 1995. DATES: Fax...

  13. 21 CFR 5.1100 - Headquarters.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., and Social Sciences. Regulations and Special Government Employees Management Staff. Division of Social... and Management Staff. Good Clinical Practice Staff. Office of Combination Products. Office of Orphan... Branch. Division of Communication Media. Television Design and Development Branch. Division of Freedom of...

  14. 21 CFR 5.1100 - Headquarters.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ..., and Social Sciences. Regulations and Special Government Employees Management Staff. Division of Social... and Management Staff. Good Clinical Practice Staff. Office of Combination Products. Office of Orphan... Branch. Division of Communication Media. Television Design and Development Branch. Division of Freedom of...

  15. 21 CFR 5.1100 - Headquarters.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ..., and Social Sciences. Regulations and Special Government Employees Management Staff. Division of Social... and Management Staff. Good Clinical Practice Staff. Office of Combination Products. Office of Orphan... Branch. Division of Communication Media. Television Design and Development Branch. Division of Freedom of...

  16. European Federation of Neurological Societies/Peripheral Nerve Society guideline on management of multifocal motor neuropathy.

    PubMed

    van Schaik, I N; Bouche, P; Illa, I; Léger, J-M; Van den Bergh, P; Cornblath, D R; Evers, E M A; Hadden, R D M; Hughes, R A C; Koski, C L; Nobile-Orazio, E; Pollard, J; Sommer, C; van Doorn, P A

    2006-08-01

    Several diagnostic criteria for multifocal motor neuropathy have been proposed in recent years and a beneficial effect of intravenous immunoglobulin (IVIg) and various other immunomodulatory drugs has been suggested in several trials and uncontrolled studies. The objectives were to prepare consensus guidelines on the definition, investigation and treatment of multifocal motor neuropathy. Disease experts and a patient representative considered references retrieved from MEDLINE and the Cochrane Library in July 2004 and prepared statements which were agreed in an iterative fashion. The Task Force agreed good practice points to define clinical and electrophysiological diagnostic criteria for multifocal motor neuropathy and investigations to be considered. The principal recommendations and good practice points were: (i) IVIg (2 g/kg given over 2-5 days) should be considered as the first line treatment (level A recommendation) when disability is sufficiently severe to warrant treatment. (ii) Corticosteroids are not recommended (good practice point). (iii) If initial treatment with IVIg is effective, repeated IVIg treatment should be considered (level C recommendation). The frequency of IVIg maintenance therapy should be guided by the individual response (good practice point). Typical treatment regimens are 1 g/kg every 2-4 weeks or 2 g/kg every 4-8 weeks (good practice point). (iv) If IVIg is not or not sufficiently effective then immunosuppressive treatment may be considered. Cyclophosphamide, ciclosporin, azathioprine, interferon beta1a, or rituximab are possible agents (good practice point). (v) Toxicity makes cyclophosphamide a less desirable option (good practice point).

  17. Are Leadership and Management Essential for Good Research? An Interview Study of Genetic Researchers

    PubMed Central

    Antes, Alison L.; Mart, Adelina; DuBois, James M.

    2016-01-01

    Principal investigators are responsible for a myriad of leadership and management activities in their work. The practices they employ to navigate these responsibilities ultimately influence the quality and integrity of research. However, leadership and management roles in research have received scant empirical examination. Semi-structured interviews with 32 National Institutes of Health (NIH)-funded genetic researchers revealed that they considered leadership and management essential for effective research, but their scientific training inadequately prepared them. We also report management practices that the researchers described employing in their labs, as well as their perceptions of a proposed intervention to enhance laboratory leadership. These findings suggest best practices for the research community, future directions for scientific training, and implications for research on leadership and management in science. PMID:27646401

  18. Are Leadership and Management Essential for Good Research? An Interview Study of Genetic Researchers.

    PubMed

    Antes, Alison L; Mart, Adelina; DuBois, James M

    2016-12-01

    Principal investigators are responsible for a myriad of leadership and management activities in their work. The practices they use to navigate these responsibilities ultimately influence the quality and integrity of research. However, leadership and management roles in research have received scant empirical examination. Semi-structured interviews with 32 National Institutes of Health (NIH)-funded genetic researchers revealed that they considered leadership and management essential for effective research, but their scientific training inadequately prepared them. We also report management practices that the researchers described using in their labs, as well as their perceptions of a proposed intervention to enhance laboratory leadership. These findings suggest best practices for the research community, future directions for scientific training, and implications for research on leadership and management in science.

  19. Negotiations 1978.

    ERIC Educational Resources Information Center

    Taylor, Bruce; And Others

    Reflecting the management advocacy position taken by school boards in collective bargaining procedures, this report analyzes New Jersey school labor negotiations laws and practices as of 1978. Terms and issues of special interest are defined and explained. Topics include contract language, good faith bargaining, past practice, negotiations…

  20. Examples of Holistic Good Practices in Promoting and Protecting Mental Health in the Workplace: Current and Future Challenges.

    PubMed

    Sivris, Kelly C; Leka, Stavroula

    2015-12-01

    While attention has been paid to physical risks in the work environment and the promotion of individual employee health, mental health protection and promotion have received much less focus. Psychosocial risk management has not yet been fully incorporated in such efforts. This paper presents good practices in promoting mental health in the workplace in line with World Health Organization (WHO) guidance by identifying barriers, opportunities, and the way forward in this area. Semistructured interviews were conducted with 17 experts who were selected on the basis of their knowledge and expertise in relation to good practice identified tools. Interviewees were asked to evaluate the approaches on the basis of the WHO model for healthy workplaces. The examples of good practice for Workplace Mental Health Promotion (WMHP) are in line with the principles and the five keys of the WHO model. They support the third objective of the WHO comprehensive mental health action plan 2013-2020 for multisectoral implementation of WMHP strategies. Examples of good practice include the engagement of all stakeholders and representatives, science-driven practice, dissemination of good practice, continual improvement, and evaluation. Actions to inform policies/legislation, promote education on psychosocial risks, and provide better evidence were suggested for higher WMHP success. The study identified commonalities in good practice approaches in different countries and stressed the importance of a strong policy and enforcement framework as well as organizational responsibility for WMHP. For progress to be achieved in this area, a holistic and multidisciplinary approach was unanimously suggested as a way to successful implementation.

  1. Examples of Holistic Good Practices in Promoting and Protecting Mental Health in the Workplace: Current and Future Challenges

    PubMed Central

    Sivris, Kelly C.; Leka, Stavroula

    2015-01-01

    Background While attention has been paid to physical risks in the work environment and the promotion of individual employee health, mental health protection and promotion have received much less focus. Psychosocial risk management has not yet been fully incorporated in such efforts. This paper presents good practices in promoting mental health in the workplace in line with World Health Organization (WHO) guidance by identifying barriers, opportunities, and the way forward in this area. Methods Semistructured interviews were conducted with 17 experts who were selected on the basis of their knowledge and expertise in relation to good practice identified tools. Interviewees were asked to evaluate the approaches on the basis of the WHO model for healthy workplaces. Results The examples of good practice for Workplace Mental Health Promotion (WMHP) are in line with the principles and the five keys of the WHO model. They support the third objective of the WHO comprehensive mental health action plan 2013–2020 for multisectoral implementation of WMHP strategies. Examples of good practice include the engagement of all stakeholders and representatives, science-driven practice, dissemination of good practice, continual improvement, and evaluation. Actions to inform policies/legislation, promote education on psychosocial risks, and provide better evidence were suggested for higher WMHP success. Conclusion The study identified commonalities in good practice approaches in different countries and stressed the importance of a strong policy and enforcement framework as well as organizational responsibility for WMHP. For progress to be achieved in this area, a holistic and multidisciplinary approach was unanimously suggested as a way to successful implementation. PMID:26929841

  2. British Thoracic Society Guideline for the initial outpatient management of pulmonary embolism

    PubMed Central

    Howard, Luke S; Barden, Steven; Condliffe, Robin; Connolly, Vincent; Davies, Chris; Donaldson, James; Everett, Bernard; Free, Catherine; Horner, Daniel; Hunter, Laura; Kaler, Jasvinder; Nelson-Piercy, Catherine; O’Dowd, Emma; Patel, Raj; Preston, Wendy; Sheares, Karen; Tait, Campbell

    2018-01-01

    The following is a summary of the recommendations and good practice points for the BTS Guideline for the initial outpatient management of pulmonary embolism. Please refer to the full guideline for full information about each section.

  3. European Federation of Neurological Societies/Peripheral Nerve Society Guideline on management of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society--First Revision.

    PubMed

    2010-03-01

    Consensus guidelines on the definition, investigation, and treatment of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) have been published (J Peripher Nerv Syst 2005; 10: 220-228, Eur J Neurol 2006; 13: 326-332). To revise these guidelines. Disease experts, including a representative of patients, considered references retrieved from MEDLINE and Cochrane Systematic Reviews published between August 2004 and July 2009 and prepared statements that were agreed in an iterative fashion. The Task Force agreed on Good Practice Points to define clinical and electrophysiological diagnostic criteria for CIDP with or without concomitant diseases and investigations to be considered. The principal treatment recommendations were: (i) intravenous immunoglobulin (IVIg) (Recommendation Level A) or corticosteroids (Recommendation Level C) should be considered in sensory and motor CIDP; (ii) IVIg should be considered as the initial treatment in pure motor CIDP (Good Practice Point); (iii) if IVIg and corticosteroids are ineffective, plasma exchange (PE) should be considered (Recommendation Level A); (iv) if the response is inadequate or the maintenance doses of the initial treatment are high, combination treatments or adding an immunosuppressant or immunomodulatory drug should be considered (Good Practice Point); (v) symptomatic treatment and multidisciplinary management should be considered (Good Practice Point).

  4. A quantitative study of the U.S. wood pallet industry based on supply chain management practices

    Treesearch

    Henry Quesada-Pineda; Scarlett Sanchez-Gomez; Philip A. Araman

    2012-01-01

    Pallets play an important role in the movement of goods from place to place. They are not only used in warehouses or distribution centers, but also in all those activities that require an efficient and effective method of transportation. To better understand business practices and external factors that impacts supply chain management (SCM), a survey of 1,500 U.S. wood...

  5. Coaching the Vegetarian Athlete

    ERIC Educational Resources Information Center

    Mandali, Swarna L.

    2011-01-01

    Good nutrition is important for optimal athletic performance. Adolescent athletes often depend on their coaches for nutritional information on weight management, dietary supplements, and dietary practices. Some dietary practices, such as vegetarianism, have the potential to be harmful to the adolescent athlete if not followed with careful…

  6. [The institutional promotion of good practices in the operational management of health and safety: the experience of Italy Crown Aerosols on the monitoring of behavior].

    PubMed

    de Merich, D; Pellicci, M; Serignoli, R

    2010-01-01

    Within the intelligence support and training to small and medium-sized enterprises (SMEs) and promoting a culture of health and safety at work, ISPESL is engaged on two fundamental pillars of activity: Consolidation of the national surveillance system of injuries through the promotion of methods and tools for the reconstruction of the dynamics incidental identification of causal determinants, with the aim of improving the capabilities of risk assessment of systems to prevent corporate. The promotion of good working practices, as Focal Point of the European Health and Safety at Work in Bilbao, the goal is to support prevention activities by providing business application examples of measures for improvement (technical, organizational, procedural) made in the proposing firms and validated by a technical appraisal conducted by ISPESL. Among the methodologies and tools that can be made available to companies in the operational management of health and safety in work activities, the approach to analyze and evaluate the behavior implemented by all persons within the company (managers, employees, workers) is a the most innovative preventive strategies that can be implemented to correct any improper practices behavioral wrongly tolerated in everyday work practice. The experience of Crown Aerosol Italy, the program "STOP TO ACCIDENTS, 2009 Best Practices award in the competition on the theme" Risk Assessment ", aims to demonstrate how the application of a method for monitoring behavior at work, shared in its planning with all those business, has not only reached but would assist the organization has developed at an individual level greater awareness and sense of responsibility also to their colleagues, by promoting good working practices.

  7. Articulating current service development practices: a qualitative analysis of eleven mental health projects

    PubMed Central

    2014-01-01

    Background The utilisation of good design practices in the development of complex health services is essential to improving quality. Healthcare organisations, however, are often seriously out of step with modern design thinking and practice. As a starting point to encourage the uptake of good design practices, it is important to understand the context of their intended use. This study aims to do that by articulating current health service development practices. Methods Eleven service development projects carried out in a large mental health service were investigated through in-depth interviews with six operation managers. The critical decision method in conjunction with diagrammatic elicitation was used to capture descriptions of these projects. Stage-gate design models were then formed to visually articulate, classify and characterise different service development practices. Results Projects were grouped into three categories according to design process patterns: new service introduction and service integration; service improvement; service closure. Three common design stages: problem exploration, idea generation and solution evaluation - were then compared across the design process patterns. Consistent across projects were a top-down, policy-driven approach to exploration, underexploited idea generation and implementation-based evaluation. Conclusions This study provides insight into where and how good design practices can contribute to the improvement of current service development practices. Specifically, the following suggestions for future service development practices are made: genuine user needs analysis for exploration; divergent thinking and innovative culture for idea generation; and fail-safe evaluation prior to implementation. Better training for managers through partnership working with design experts and researchers could be beneficial. PMID:24438471

  8. Articulating current service development practices: a qualitative analysis of eleven mental health projects.

    PubMed

    Jun, Gyuchan Thomas; Morrison, Cecily; Clarkson, P John

    2014-01-17

    The utilisation of good design practices in the development of complex health services is essential to improving quality. Healthcare organisations, however, are often seriously out of step with modern design thinking and practice. As a starting point to encourage the uptake of good design practices, it is important to understand the context of their intended use. This study aims to do that by articulating current health service development practices. Eleven service development projects carried out in a large mental health service were investigated through in-depth interviews with six operation managers. The critical decision method in conjunction with diagrammatic elicitation was used to capture descriptions of these projects. Stage-gate design models were then formed to visually articulate, classify and characterise different service development practices. Projects were grouped into three categories according to design process patterns: new service introduction and service integration; service improvement; service closure. Three common design stages: problem exploration, idea generation and solution evaluation - were then compared across the design process patterns. Consistent across projects were a top-down, policy-driven approach to exploration, underexploited idea generation and implementation-based evaluation. This study provides insight into where and how good design practices can contribute to the improvement of current service development practices. Specifically, the following suggestions for future service development practices are made: genuine user needs analysis for exploration; divergent thinking and innovative culture for idea generation; and fail-safe evaluation prior to implementation. Better training for managers through partnership working with design experts and researchers could be beneficial.

  9. Status quo of management of the human tissue banks in Taiwan.

    PubMed

    Chou, Ching-Pang; Chou, Szu-Cheng; Chen, Ying-Hua; Chen, Yu-Hsuan; Lee, Ming-Shin

    2017-03-01

    As the technologies associated with transplantation and biological tissue engineering continue to advance, human cells and tissues form an integral part to the practice of regenerative medicine. The patient's use of tissues entails the risk of introducing, transmitting and spreading communicable diseases. To prevent such risk and to ensure that the human organs, tissues and cells remain intact and functional after being handled and processed, the transplanted tissues must be subject to good management standards through all stages of collection, screening, processing, storage and distribution as the safety of the users is of the utmost importance. On February 2009, the government of Taiwan promulgated the Regulations for Administration on Human Organ Bank that requires all human tissues banks to adhere to the Good Tissue Practice for Human Organ, Tissue and Cell in terms of establishment and operation in order to cope with the international management trend and the development and management need of the domestic industry. Six years have passed since the law became effective. This article seeks to introduce the current management mechanism and status quo of management of human tissue banks in Taiwan. We also conducted statistical analysis of the data relating to the tissue banks to identify potential risks and the room for improvement. The study concludes that human tissue banks in Taiwan are on the right track with their management practice, leading to a state of steady development and progress.

  10. BTS guideline for the investigation and management of malignant pleural mesothelioma.

    PubMed

    Woolhouse, Ian; Bishop, Lesley; Darlison, Liz; de Fonseka, Duneesha; Edey, Anthony; Edwards, John; Faivre-Finn, Corinne; Fennell, Dean A; Holmes, Steve; Kerr, Keith M; Nakas, Apostolos; Peel, Tim; Rahman, Najib M; Slade, Mark; Steele, Jeremy; Tsim, Selina; Maskell, Nick A

    2018-01-01

    The full guideline for the investigation and management of malignant pleural mesothelioma is published in Thorax . The following is a summary of the recommendations and good practice points. The sections referred to in the summary refer to the full guideline.

  11. School Bus Fleet Safety: Planning and Development.

    ERIC Educational Resources Information Center

    Bieber, Robert M.

    1984-01-01

    To ensure worker safety, fleet safety managers need professional staffs, good access to top management, and sufficient authority to discharge their duties. Safety programs should include careful driver hiring; training, including orientation, testing, and practice; comprehensive accident reporting; and cooperative compliance programs with…

  12. Quality management in European screening laboratories in blood establishments: A view of current approaches and trends.

    PubMed

    Pereira, Paulo; Westgard, James O; Encarnação, Pedro; Seghatchian, Jerard; de Sousa, Gracinda

    2015-04-01

    The screening laboratory has a critical role in the post-transfusion safety. The success of its targets and efficiency depends on the management system used. Even though the European Union directive 2002/98/EC requires a quality management system in blood establishments, its requirements for screening laboratories are generic. Complementary approaches are needed to implement a quality management system focused on screening laboratories. This article briefly discusses the current good manufacturing practices and good laboratory practices, as well as the trends in quality management system standards. ISO 9001 is widely accepted in some European Union blood establishments as the quality management standard, however this is not synonymous of its successful application. The ISO "risk-based thinking" is interrelated with the quality risk-management process of the EuBIS "Standards and criteria for the inspection of blood establishments". ISO 15189 should be the next step on the quality assurance of a screening laboratory, since it is focused on medical laboratory. To standardize the quality management systems in blood establishments' screening laboratories, new national and European claims focused on technical requirements following ISO 15189 is needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Using the reference framework for good measles management in practice--a case study from North Rhine-Westphalia.

    PubMed

    Schröter, Matthias; Schröder-Bäck, Peter; Brand, Helmut

    2009-12-01

    In 2005, WHO Europe reconfirmed the objective of eradicating measles and fixed a strategy plan for the years 2005 up to 2010. While a downward trend of measles infections in Germany between 2001 and 2004 could be observed, as many as 780 cases of measles were reported in 2005 and in 2006 even 2.281 cases. These high figures in 2006 were almost exclusively caused by an outbreak in the German region of North Rhine-Westphalia. This case study describes how a reference framework for good health management of measles prevention was applied for this region. As a result, various recommendations for action could be given, among them the recommendation to implement individual vaccination reminder systems for parents and bonus systems for parents. Based on these results, a comprehensive policy concept has been drawn up and has become the subject of a political agreement process in this region. Thus this case study shows a paradigm how reference frameworks for good health management can be utilised in practice.

  14. Integrated Pest Management of Poplar Species

    Treesearch

    T. H. Filer; J. D. Solomon; D. T. Cooper; M. Hubbes

    1979-01-01

    Proper site selection, good site preparation, correct planting practices, and 1st-year cultivation directly and indirectly affect survival rate of trees. Losses from canker fungi are minimized by cultural practices that increase tree vigor--poor tree vigor means more cankers per acre and greater mortality.

  15. Control Points in School Business Management, Presenting General Observations, Specific Control Points, and a Series of Checkpoints for the Practicing School Business Administrator.

    ERIC Educational Resources Information Center

    Association of School Business Officials, Chicago, IL.

    This revised outline of a 1962 address contains general guidelines considered still useful for practicing school business administrators. Introductory "general observations" and a preamble give advice about good personal qualities, policy and planning practices, and relations with school boards, community, staff, and fellow professional…

  16. Managing the Risk of Occupational Allergy in the Enzyme Detergent Industry

    PubMed Central

    Basketter, David A.; Kruszewski, Francis H.; Mathieu, Sophie; Kirchner, Donald Bruce; Panepinto, Anthony; Fieldsend, Mark; Siegert, Volker; Barnes, Fiona; Bookstaff, Robert; Simonsen, Merete; Concoby, Beth

    2015-01-01

    Enzyme proteins have potential to cause occupational allergy/asthma. Consequently, as users of enzymes in formulated products, detergents manufacturers have implemented a number of control measures to ensure that the hazard does not translate into health effects in the workforce. To that end, trade associations have developed best practice guidelines which emphasize occupational hygiene and medical monitoring as part of an effective risk management strategy. The need for businesses to recognize the utility of this guidance is reinforced by reports where factories which have failed to follow good industrial hygiene practices have given rise to incidences of occupational allergy. In this article, an overview is provided of how the industry guidelines are actually implemented in practice and what experience is to be derived therefrom. Both medical surveillance and air monitoring practices associated with the implementation of industry guidelines at approximately 100 manufacturing facilities are examined. The data show that by using the approaches described for the limitation of exposure, for the provision of good occupational hygiene and for the active monitoring of health, the respiratory allergenic risk associated with enzyme proteins can be successfully managed. This therefore represents an approach that could be recommended to other industries contemplating working with enzymes. PMID:25692928

  17. Managing the Risk of Occupational Allergy in the Enzyme Detergent Industry.

    PubMed

    Basketter, David A; Kruszewski, Francis H; Mathieu, Sophie; Kirchner, Donald Bruce; Panepinto, Anthony; Fieldsend, Mark; Siegert, Volker; Barnes, Fiona; Bookstaff, Robert; Simonsen, Merete; Concoby, Beth

    2015-01-01

    Enzyme proteins have potential to cause occupational allergy/asthma. Consequently, as users of enzymes in formulated products, detergents manufacturers have implemented a number of control measures to ensure that the hazard does not translate into health effects in the workforce. To that end, trade associations have developed best practice guidelines which emphasize occupational hygiene and medical monitoring as part of an effective risk management strategy. The need for businesses to recognize the utility of this guidance is reinforced by reports where factories which have failed to follow good industrial hygiene practices have given rise to incidences of occupational allergy. In this article, an overview is provided of how the industry guidelines are actually implemented in practice and what experience is to be derived therefrom. Both medical surveillance and air monitoring practices associated with the implementation of industry guidelines at approximately 100 manufacturing facilities are examined. The data show that by using the approaches described for the limitation of exposure, for the provision of good occupational hygiene and for the active monitoring of health, the respiratory allergenic risk associated with enzyme proteins can be successfully managed. This therefore represents an approach that could be recommended to other industries contemplating working with enzymes.

  18. Guided by Theory, Informed by Practice: Training and Support for the Good Behavior Game, a Classroom-based Behavior Management Strategy

    PubMed Central

    Poduska, Jeanne M.; Kurki, Anja

    2015-01-01

    Moving evidence-based practices for classroom behavior management into real-world settings is a high priority for education and public health. This paper describes the development and use of a model of training and support for the Good Behavior Game (GBG), one of the few preventive interventions shown to have positive outcomes for elementary school children lasting through to young adulthood, ages 19–21, including reductions in the use of drugs and alcohol, school-based mental health services, and suicide ideation and attempts. We first describe the conceptual framework guiding the development of the model of training and support. Data on implementation of the model, from an ongoing trial of GBG being conducted in partnership with the Houston Independent School District, are then presented. We end with a discussion of the lessons learned and the implications for the next stage of research and practice. PMID:26236144

  19. Management of intrathecal baclofen therapy for severe acquired brain injury: consensus and recommendations for good clinical practice.

    PubMed

    De Tanti, Antonio; Scarponi, Federico; Bertoni, Michele; Gasperini, Giulio; Lanzillo, Bernardo; Molteni, Franco; Posteraro, Federico; Vitale, Dino Francesco; Zanpolini, Mauro

    2017-08-01

    Although widespread in the treatment of generalised spasticity due to severe acquired brain injury, clinical use of intrathecal baclofen administered through an implanted catheter is not yet supported by full scientific evidence. The aim of the study is to provide recommendations for good clinical practice regarding intrathecal baclofen therapy. We used a modified RAND Delphi method to develop consensus-based medical guidelines, involving clinicians who use intrathecal baclofen therapy throughout Italy. The clinicians were asked 38 questions grouped in six areas (patient selection, contraindications for implant, tests prior to implant, method of implant and management of therapy, efficacy evaluation and goal setting, and management of complications). To establish consensus, 75% agreement was required in answers to every question. Consensus was reached on the second round of the Delphi process on 27/38 questions (71%), specifically those regarding identification of objectives, efficacy evaluation, and method of implant and management of therapy, whereas management of complications and contraindications for implant remained critical areas. Despite the limits of our method, a set of recommendations was drawn up for clinical practice in this sector. The study also revealed residual critical areas and indicated future lines of research necessary to reach evidence-based consensus.

  20. United States import safety, environmental health, and food safety regulation in China.

    PubMed

    Nyambok, Edward O; Kastner, Justin J

    2012-01-01

    China boasts a rapidly growing economy and is a leading food exporter. Since China has dominated world export markets in food, electronics, and toys, many safety concerns about Chinese exports have emerged. For example, many countries have had problems with Chinese food products and food-processing ingredients. Factors behind food safety and environmental health problems in China include poor industrial waste management, the use of counterfeit agricultural inputs, inadequate training of farmers on good farm management practices, and weak food safety laws and poor enforcement. In the face of rising import safety problems, the U.S. is now requiring certification of products and foreign importers, pursuing providing incentives to importers who uphold good safety practices, and considering publicizing the names of certified importers.

  1. Understanding growth and development of forage plants

    USDA-ARS?s Scientific Manuscript database

    Understanding the developmental morphology of forage plants is important for making good management decisions. Many such decisions involve timing the initiation or termination of a management practice to a particular stage of development in the life cycle of the forage. The life cycles of forage pl...

  2. BTS guideline for the investigation and management of malignant pleural mesothelioma

    PubMed Central

    Woolhouse, Ian; Bishop, Lesley; Darlison, Liz; de Fonseka, Duneesha; Edey, Anthony; Edwards, John; Faivre-Finn, Corinne; Fennell, Dean A; Holmes, Steve; Kerr, Keith M; Nakas, Apostolos; Peel, Tim; Rahman, Najib M; Slade, Mark; Steele, Jeremy; Tsim, Selina; Maskell, Nick A

    2018-01-01

    The full guideline for the investigation and management of malignant pleural mesothelioma is published in Thorax. The following is a summary of the recommendations and good practice points. The sections referred to in the summary refer to the full guideline. PMID:29531746

  3. Knowing (and understanding) the key numbers for your practice.

    PubMed

    Schumann, Ted

    2013-12-01

    Most dentists see accounting and bookkeeping as a necessary evil instead of a helpful tool. Yet the most financially successful and happy dentists understand the need for good financial management. Here's an overview that will help you better-understand the key numbers in your practice.

  4. Gardening in Cyberspace: A Metaphor to Enhance Online Teaching and Learning.

    ERIC Educational Resources Information Center

    May, Gary L.; Short, Darren

    2003-01-01

    Uses the metaphor of gardening in cyberspace as a guide to the creation of an environment that fosters learning and growth in online courses. Draws analogies between good gardening practices and online teaching practices, instructional design, and course management techniques. Contains 63 references. (SK)

  5. Good practice statements on safe laboratory testing: A mixed methods study by the LINNEAUS collaboration on patient safety in primary care.

    PubMed

    Bowie, Paul; Forrest, Eleanor; Price, Julie; Verstappen, Wim; Cunningham, David; Halley, Lyn; Grant, Suzanne; Kelly, Moya; Mckay, John

    2015-09-01

    The systems-based management of laboratory test ordering and results handling is a known source of error in primary care settings worldwide. The consequences are wide-ranging for patients (e.g. avoidable harm or poor care experience), general practitioners (e.g. delayed clinical decision making and potential medico-legal implications) and the primary care organization (e.g. increased allocation of resources to problem-solve and dealing with complaints). Guidance is required to assist care teams to minimize associated risks and improve patient safety. To identify, develop and build expert consensus on 'good practice' guidance statements to inform the implementation of safe systems for ordering laboratory tests and managing results in European primary care settings. Mixed methods studies were undertaken in the UK and Ireland, and the findings were triangulated to develop 'good practice' statements. Expert consensus was then sought on the findings at the wider European level via a Delphi group meeting during 2013. We based consensus on 10 safety domains and developed 77 related 'good practice' statements (≥ 80% agreement levels) judged to be essential to creating safety and minimizing risks in laboratory test ordering and subsequent results handling systems in international primary care. Guidance was developed for improving patient safety in this important area of primary care practice. We need to consider how this guidance can be made accessible to frontline care teams, utilized by clinical educators and improvement advisers, implemented by decision makers and evaluated to determine acceptability, feasibility and impacts on patient safety.

  6. Natural reproduction of shasta red fir from a single good cone crop.

    Treesearch

    William I. Stein

    1954-01-01

    The initiation and rapid increase in harvesting of Shasta red fir mountain hemlock stands in southwestern Oregon have emphasized the lack of information needed to manage these species intelligently. The most important single management practice for converting old growth to managed forests is the application of cutting methods that will assure prompt regeneration of...

  7. The restoration experience: volunteers' motives, values, and concepts of nature

    Treesearch

    Herbert W. Schroeder

    2000-01-01

    The last several years have brought significant changes in the management of public lands and natural resources in the United States. As a result of debates over management practices, shifts in the goods and services demanded by the public, and evelopment in scientific knowledge, there has emerged a general philosophical shift toward managing natural environmnets as...

  8. Observing practice leadership in intellectual and developmental disability services.

    PubMed

    Beadle-Brown, J; Bigby, C; Bould, E

    2015-12-01

    Improving staff performance is an issue in services for people with intellectual disability. Practice leadership, where the front line leader of a staff team focuses on service user outcomes in everything they do and provides coaching, modeling, supervision and organisation to the team, has been identified as important in improving staff performance. To date this finding is based only on self-report measures. This paper describes and tests an observational measure of practice leadership based on an interview with the front-line manager, a review of paperwork and observations in 58 disability services in Australia. The measure showed good internal consistency and acceptable inter-rater reliability. Practice leadership was associated with staff practice and outcomes for service users. The observed measure of practice leadership appears to be a useful tool for assessing whether leadership within a service promotes enabling and empowering support by staff. It was found to discriminate higher and lower performing services in terms of active support. The measure had good reliability and validity although some further testing is required to give a complete picture of the possible uses and reliability of the measure. The measure is potentially useful in contexts of both research and service development. The confirmation of previous findings from self-report measures that practice leadership is related to the quality of staff practice and outcomes for service users has implications for policy and practice in terms of the training of managers and structures for organisational management. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  9. Proposal and Evaluation of Management Method for College Mechatronics Education Applying the Project Management

    NASA Astrophysics Data System (ADS)

    Ando, Yoshinobu; Eguchi, Yuya; Mizukawa, Makoto

    In this research, we proposed and evaluated a management method of college mechatronics education. We applied the project management to college mechatronics education. We practiced our management method to the seminar “Microcomputer Seminar” for 3rd grade students who belong to Department of Electrical Engineering, Shibaura Institute of Technology. We succeeded in management of Microcomputer Seminar in 2006. We obtained the good evaluation for our management method by means of questionnaire.

  10. Making time to talk.

    PubMed

    2016-09-01

    NHS Employers has updated its people performance management toolkit, which now includes links to new guidance and resources. The toolkit encourages managers to 'make time to talk' about performance with staff, provides practical support, increases managers' knowledge about what good performance management is, and aims to increase their confidence in dealing with associated challenges, such as what to do if a team member is underperforming and how to give constructive feedback.

  11. Knowledge, attitude and practice of physiotherapists towards promotion of physically active lifestyles in patient management.

    PubMed

    Aweto, Happiness A; Oligbo, Cynthia N; Fapojuwo, Oluseun A; Olawale, Olajide A

    2013-01-14

    Physiotherapists as primary health care practitioners are well placed in promoting physically active lifestyles, but their role and practice towards its promotion among patients in Nigeria has not been fully investigated. This study was therefore aimed at determining the knowledge, attitude and practice of Nigerian physiotherapists towards promotion of non-treatment physical activity among patients. Three hundred and eight practicing physiotherapists from various public and private hospitals in 14 states of Nigeria completed an adopted 20-item questionnaire, which collected information on physical activity promotion in physiotherapy practice. Respondents with good knowledge and attitude towards physical activity promotion in patient management were 196(63.6%) and 292(94.8%) respectively. Only 111 (36%) of the respondents counselled more than 10 patients in the past one month on the benefits of adopting a more physically active lifestyle. Chi-square analysis showed a significant association between low practice of physical activity promotion in patient management with inadequate consultation time (ℵ2=3.36, p=0.043), years of working experience of physiotherapists (ℵ2=11.37, p=0.023) and relative physical activity levels of physiotherapists (ℵ2=11.82, p=0.037). The need for Physical activity recommendation guideline was supported by 287 (97%) respondents. Nigerian physiotherapists have good knowledge and attitude towards promotion of physically active lifestyle in their patients but do not counsel many of them, due to insufficient consultation time. Integrating brief counselling into usual treatment sessions is perceived as the most feasible form of physical activity promotion in patient management.

  12. Surveying the Need for Technology Management for Global Health Training Programmes

    ERIC Educational Resources Information Center

    Balakrishnan, Usha R.; Troyer, Lisa; Brands, Edwin

    2007-01-01

    Technology licensing office managers often need to evaluate profitability and commercial potential in their decision making. However, increased consideration of important global public health goals requires forging new collaborative relationships, incorporating creative licensing practices and embracing global public good within the academic and…

  13. Head games. The psychology of medical group financial management and the role of physician leaders.

    PubMed

    Zismer, Daniel K

    2003-01-01

    Good practice leaders must understand the psychology of presenting and managing the financial performance of the medical group. Leaders--especially physicians--must strive to understand this psychology to shepherd the group through the various financial challenges it will face.

  14. [Analysis of good practices for inhabitant participation in the clinical management units of the Andalusian Health Service (Spain)].

    PubMed

    Gómez Martínez, M Eugenia; Pastor Moreno, Guadalupe; Pérez Corral, Olivia; Iriarte de Los Santos, M Teresa; Mena Jiménez, Ángel Luis; Escudero Espinosa, M Cecilia; García Romera, Inmaculada; Blanco García, Martín Germán; Martín Barato, Amelia

    To discover good practices for inhabitant participation in the clinical management units (CMUs) of the Andalusian Health Service (AHS) (Spain) and to explore the reasons perceived by CMU and AHS professionals that may influence the presence and distribution of those good practices among the CMU. Study with mixed methodology carried out in Andalusia (Spain) in two phases (2013-2015). Firstly, an online survey was delivered to the Directors of the CMUs which had set up an inhabitant participation commission. In a second phase, a qualitative study was carried out through semi-structured interviews with professionals from the Andalusian Health Service with previous experience in inhabitant participation. A descriptive analysis of the quantitative information and a semantic content analysis of the qualitative information were carried out. 530 CMUs took part in the survey. The inhabitant participation practices more often implemented in the CMUs are those related to the informing and consultation levels. Twelve professionals were interviewed in the second phase. Other practices with higher inhabitant involvement and delegation are secondary. The barriers which were identified by professionals are related to the beliefs and attitudes of the inhabitants, the professionals, the health system and the environment. The main practices for inhabitant participation in the CMUs are related to the most basic levels of participation. The method and dynamics which facilitate inhabitant empowerment within the health system are not clearly recognised. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Angling into the Future: Ten Commandments for Recreational Fisheries Science, Management, and Stewardship in a Good Anthropocene

    NASA Astrophysics Data System (ADS)

    Elmer, Laura K.; Kelly, Lisa A.; Rivest, Stephanie; Steell, S. Clay; Twardek, William M.; Danylchuk, Andy J.; Arlinghaus, Robert; Bennett, Joseph R.; Cooke, Steven J.

    2017-08-01

    A new geological epoch, the "Anthropocene", has been defined as the period in which humans have had substantial geological and ecological influence on the planet. A positive future for this epoch can be referred to as the "good Anthropocene" and would involve effective management strategies and changes in human behavior that promote the sustainability and restoration of ecosystems. Recreational fisheries hold significant social, cultural, and economic value and can generate many benefits when managed sustainably and thus be an integral part of a "good Anthropocene". Here, we list ten commandments to facilitate persistence and long-term sustainability of recreational fisheries in the "good Anthropocene". This list includes fostering aquatic stewardship, promoting education, using appropriate capture gear, adopting evidence-based management approaches, promoting the concept of resilience, obtaining and using effort data in management, embracing the ecosystem approach, engaging in multilevel collaboration, enhancing accessibility, and embracing optimism. When used singly, or simultaneously, these ten commandments will contribute to the harmonization of sustainable fish populations and angling practices, to create recreational fisheries' "bright spots".

  16. 40 CFR 63.11115 - What are my general duties to minimize emissions?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Dispensing Facilities Emission Limitations and Management Practices § 63.11115 What are my general duties to... consistent with safety and good air pollution control practices for minimizing emissions. Determination of... and maintenance procedures, review of operation and maintenance records, and inspection of the source...

  17. 40 CFR 63.11115 - What are my general duties to minimize emissions?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Dispensing Facilities Emission Limitations and Management Practices § 63.11115 What are my general duties to... consistent with safety and good air pollution control practices for minimizing emissions. Determination of... and maintenance procedures, review of operation and maintenance records, and inspection of the source...

  18. 40 CFR 63.11115 - What are my general duties to minimize emissions?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Dispensing Facilities Emission Limitations and Management Practices § 63.11115 What are my general duties to... consistent with safety and good air pollution control practices for minimizing emissions. Determination of... and maintenance procedures, review of operation and maintenance records, and inspection of the source...

  19. TH-E-19A-01: Quality and Safety in Radiation Therapy

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

    Ford, E; Ezzell, G; Miller, B

    2014-06-15

    Clinical radiotherapy data clearly demonstrate the link between the quality and safety of radiation treatments and the outcome for patients. The medical physicist plays an essential role in this process. To ensure the highest quality treatments, the medical physicist must understand and employ modern quality improvement techniques. This extends well beyond the duties traditionally associated with prescriptive QA measures. This session will review the current best practices for improving quality and safety in radiation therapy. General elements of quality management will be reviewed including: what makes a good quality management structure, the use of prospective risk analysis such as FMEA,more » and the use of incident learning. All of these practices are recommended in society-level documents and are incorporated into the new Practice Accreditation program developed by ASTRO. To be effective, however, these techniques must be practical in a resource-limited environment. This session will therefore focus on practical tools such as the newly-released radiation oncology incident learning system, RO-ILS, supported by AAPM and ASTRO. With these general constructs in mind, a case study will be presented of quality management in an SBRT service. An example FMEA risk assessment will be presented along with incident learning examples including root cause analysis. As the physicist's role as “quality officer” continues to evolve it will be essential to understand and employ the most effective techniques for quality improvement. This session will provide a concrete overview of the fundamentals in quality and safety. Learning Objectives: Recognize the essential elements of a good quality management system in radiotherapy. Understand the value of incident learning and the AAPM/ASTRO ROILS incident learning system. Appreciate failure mode and effects analysis as a risk assessment tool and its use in resource-limited environments. Understand the fundamental principles of good error proofing that extends beyond traditional prescriptive QA measures.« less

  20. Factors influencing the work efficiency of district health managers in low-resource settings: a qualitative study in Ghana.

    PubMed

    Bonenberger, Marc; Aikins, Moses; Akweongo, Patricia; Wyss, Kaspar

    2016-01-14

    There is increasing evidence that good district management practices can improve health system performance and conversely, that poor and inefficient management practices have detrimental effects. The aim of the present study was to identify factors contributing to inefficient management practices of district health managers and ways to improve their overall efficiency. Nineteen semi-structured interviews were conducted with district health managers in three districts of the Eastern Region in Ghana. The 19 interviews conducted comprised 90% of the managerial workforce in these districts in 2013. A thematic analysis was carried out using the WHO's leadership and management strengthening framework to structure the results. Key factors for inefficient district health management practices were identified to be: human resource shortages, inadequate planning and communication skills, financial constraints, and a narrow decision space that constrains the authority of district health managers and their ability to influence decision-making. Strategies that may improve managerial efficiency at both an individual and organizational level included improvements to planning, communication, and time management skills, and ensuring the timely release of district funds. Filling District Health Management Team vacancies, developing leadership and management skills of district health managers, ensuring a better flow of district funds, and delegating more authority to the districts seems to be a promising intervention package, which may result in better and more efficient management practices and stronger health system performance.

  1. Awareness, knowledge and practice of dyslipidaemia management among postgraduate primary care trainees in Malaysia: a cross-sectional study.

    PubMed

    Said, Abdul Hadi; Chia, Yook Chin

    2017-03-01

    Dyslipidaemia is one of the main risk factors for cardiovascular disease, the leading cause of death in Malaysia. This study assessed the awareness, knowledge and practice of lipid management among primary care physicians undergoing postgraduate training in Malaysia. Cross sectional study. Postgraduate primary care trainees in Malaysia. 759 postgraduate primary care trainees were approached through email or hard copy, of whom 466 responded. A self-administered questionnaire was used to assess their awareness, knowledge and practice of dyslipidaemia management. The total cumulative score derived from the knowledge section was categorised into good or poor knowledge based on the median score, where a score of less than the median score was categorised as poor and a score equal to or more than the median score was categorised as good. We further examined the association between knowledge score and sociodemographic data. Associations were considered significant when p<0.05. The response rate achieved was 61.4%. The majority (98.1%) were aware of the national lipid guideline, and 95.6% reported that they used the lipid guideline in their practice. The median knowledge score was 7 out of 10; 70.2% of respondents scored 7 or more which was considered as good knowledge. Despite the majority (95.6%) reporting use of guidelines, there was wide variation in their clinical practice whereby some did not practise based on the guidelines. There was a positive significant association between awareness and the use of the guideline with knowledge score (p<0.001). However there was no significant association between knowledge score and sociodemographic data (p>0.05). The level of awareness and use of the lipid guideline among postgraduate primary care trainees was good. However, there were still gaps in their knowledge and practice which are not in accordance with standard guidelines. 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/.

  2. Modeling effectiveness of management practices for flood mitigation using GIS spatial analysis functions in Upper Cilliwung watershed

    NASA Astrophysics Data System (ADS)

    Darma Tarigan, Suria

    2016-01-01

    Flooding is caused by excessive rainfall flowing downstream as cumulative surface runoff. Flooding event is a result of complex interaction of natural system components such as rainfall events, land use, soil, topography and channel characteristics. Modeling flooding event as a result of interaction of those components is a central theme in watershed management. The model is usually used to test performance of various management practices in flood mitigation. There are various types of management practices for flood mitigation including vegetative and structural management practices. Existing hydrological model such as SWAT and HEC-HMS models have limitation to accommodate discrete management practices such as infiltration well, small farm reservoir, silt pits in its analysis due to the lumped structure of these models. Aim of this research is to use raster spatial analysis functions of Geo-Information System (RGIS-HM) to model flooding event in Ciliwung watershed and to simulate impact of discrete management practices on surface runoff reduction. The model was validated using flooding data event of Ciliwung watershed on 29 January 2004. The hourly hydrograph data and rainfall data were available during period of model validation. The model validation provided good result with Nash-Suthcliff efficiency of 0.8. We also compared the RGIS-HM with Netlogo Hydrological Model (NL-HM). The RGIS-HM has similar capability with NL-HM in simulating discrete management practices in watershed scale.

  3. Benchmarking Australian and New Zealand University Meta-Policy in an Increasingly Regulated Tertiary Environment

    ERIC Educational Resources Information Center

    Freeman, Brigid

    2014-01-01

    The agencies responsible for tertiary education quality assurance in Australia and New Zealand have established regulatory regimes that increasingly intersect with tertiary institution policy management. An examination of university meta-policies identified good practices guiding university policy and policy management. Most Australian and half of…

  4. Chapter 7: Developing collaboration and cooperation

    Treesearch

    G. Bartlett

    2012-01-01

    Good forestry practices require onsite flexibility. A core concept in U.S. Forest Service General Technical Report PSW-GTR-220 "An Ecosystem Management Strategy for Sierran Mixed-Conifer Forests" (North et al. 2009) is that management treatments and thinning intensity should differ depending on local forest conditions and topographic location. In the...

  5. [First line management without IVF of infertility related to endometriosis: Result of medical therapy? Results of ovarian superovulation? Results of intrauterine insemination? CNGOF-HAS Endometriosis Guidelines].

    PubMed

    Boujenah, J; Santulli, P; Mathieu-d'Argent, E; Decanter, C; Chauffour, C; Poncelet, P

    2018-03-01

    Using the structured methodology of French guidelines (HAS-CNGOF), the aim of this chapter was to formulate good practice points (GPP), in relation to optimal non-ART management of endometriosis related to infertility, based on the best available evidence in the literature. This guideline was produced by a group of experts in the field including a thorough systematic search of the literature (from January 1980 to March 2017). Were included only women with endometriosis related to infertility. For each recommendation, a grade (A-D, where A is the highest quality) was assigned based on the strength of the supporting evidence. Management of endometriosis related to infertility should be multidisciplinary and take account into the pain, the global evaluation of infertile couple and the different phenotypes of endometriotic lesions (good practice point). Hormonal treatment for suppression of ovarian function should not prescribe to improve fertility (grade A). After laproscopy for endometriosis related to infertility, the Endometriosis Fertility Index should be used to counsel patients regarding duration of conventional treatments before undergoing ART (grade C). After laparoscopy surgery for infertile women with AFS/ASRM stage I/II endometriosis or superficial peritoneal endometriosis, controlled ovarian stimulation with or without intrauterine insemination could be used to enhance non-ART pregnancy rate (grade C). Gonadotrophins should be the first line therapy for the stimulation (grade B). The number of cycles before referring ART should not exceed up to 6 cycles (good practice point). No recommendation can be performed for non-ART management of deep infiltrating endometriosis or endometrioma, as suitable evidence is lacking. Non-ART management is a possible option for the management of endometriosis related to infertility. Endometriosis Fertilty Index could be a useful tool for subsequent postoperative fertility management. Controlled ovarian stimulation can be proposed. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  6. [The school doctorand suspected child abuse : towards good practice recommendations in the child's interest].

    PubMed

    Noirhomme-Renard, F; Blavier, A; Lachaussée, S; Monville, C; Nihoul, C; Gosset, C

    2016-10-01

    Child maltreatment, including all forms of mal¬treatment, remains a major public health problem in high-income countries. Healthcare professionals only contribute to a small proportion of reports. In French-speaking Belgium, almost 100 % of school-aged children are regularly submitted to periodical school health visits. The school health doctor is well placed to recognize neglected or abused children. Based on international good practice recommendations, this paper proposes means for the detection and management of child abuse in the context of school medicine.

  7. The influence of ethics on leadership.

    PubMed

    Kraemer, A M

    1995-05-01

    Value driven ethical leadership is needed today. The housekeeping field employs a diverse work force, and managers must develop and empower workers to attain organization goals. As managers, we must understand and develop our personal value structures that affect our decision making. This paper reviews Lawrence Kohlberg's study of moral behavior and how those stages are relevant to ethical management practices. It also addresses ways to overcome some obstacles in understanding and dealing with personal values that may threaten moral and ethical practices. Mature ethical principles and good communication are the foundation for and foster strong leadership for the future.

  8. Practical considerations for disaster preparedness and continuity management in research facilities.

    PubMed

    Mortell, Norman; Nicholls, Sam

    2013-10-01

    Many research facility managers, veterinarians and directors are familiar with the principles of Good Laboratory Practice, requirements of the Association for Assessment and Accreditation of Laboratory Animal Care International, tenets of biosecurity and standards of animal welfare and housing but may be less familiar with the ideas of business continuity. But business continuity considerations are as applicable to research facilities as they are to other institutions. The authors discuss how business continuity principles can be applied in the research context and propose that such application, or 'research continuity management,' enables a focused but wide-reaching approach to disaster preparedness.

  9. Can Videos Play a Role in Promoting Good Landscape Management Behaviors?

    ERIC Educational Resources Information Center

    Warner, Laura A.; Lamm, Alexa J.; Rumble, Joy N.

    2018-01-01

    This study tested the effect of four short videos appealing to environmental values on home irrigation users' intent to use good irrigation and fertilization practices. The videos were largely ineffective, and there was only a small effect on one of the behaviors within the fertilizer loss treatment group. Implications point to a need for…

  10. Institutional Regimes and Induced Dependency in Homes for the Aged.

    ERIC Educational Resources Information Center

    Booth, Tim

    1986-01-01

    Reports effects of institutional regimes on levels of dependency among residents of public homes for the elderly in England. Differences in management practices and caring routines did not affect the creation or reduction of dependency among residents. Questions the rationale that informs some current notions of good practice in residential work.…

  11. The new caring: financial asset management and older people.

    PubMed

    Tilse, Cheryl; Wilson, Jill; Setterlund, Deborah; Rosenman, Linda

    2007-10-01

    Increasing longevity and the growing proportion of the aged in the population in most countries have served to focus on the question of how governments and older people can finance living, health, and care options in retirement. Prudent management of income and assets is an increasingly complex and important aspect of aging as assets and expectations of self-financing increase. Although many informal caregivers act as asset managers and/or substitute decision-makers for older people, little attention has been paid to this increasingly important aspect of care. This paper summaries key findings of a broad research program exploring family involvement in the management of older people's assets and the practices that constitute good practice as well as financial mismanagement and abuse. It identifies multi-level and multi-strategy responses needed to address the issues raised by the research and outlines an innovative community demonstration project aimed at improving financial management practices in relation to older people's assets.

  12. A review study of maintenance and management issues in Malaysian commercial building towards sustainable future practice

    NASA Astrophysics Data System (ADS)

    Nawi, Mohd Nasrun Mohd; Baharum, Faizal; Ibrahim, Siti Halipah; Riazi, Salman Riazi Mehdi

    2017-10-01

    Good management of the building will be able to influence the quality of the buildings that remain long, safe and beautiful without any damage and problems. This research paper aims to explore the issue of maintenance and management that appear in managing the commercial building in Malaysian construction and property industry. The data in this research has been gathered through the reviewing process of secondary data such as journals, proceeding, thesis etc. in the area that related to maintenance and management issue in commercial building. As highlighted by previous study, building a good management can ensure that the facilities available in the building are well and meet the standard. Thus, exposure to the problems and needs in the management of the building would be able to improve the quality of building management systems to be more effective and fulfil the client needs and features.

  13. Good practice in social care: the views of people with severe and complex needs and those who support them.

    PubMed

    Gridley, Kate; Brooks, Jenni; Glendinning, Caroline

    2014-11-01

    This paper reports findings drawn from a study of good practice in English social care for adults with disability and older people with severe and complex needs. People with severe and complex needs are a relatively small proportion of adult social care service users, but they are growing in numbers and have resource-intensive needs. The study involved qualitative research with adults with disability and older people with severe and complex needs, family carers and members of specialist organisations (n = 67), focusing on the features of social care services they considered to be good practice. Data were collected between August 2010 and June 2011. The approach to data collection was flexible, to accommodate participants' communication needs and preferences, including face-to-face and telephone interviews, Talking Mats(©) sessions and a focus group. Data were managed using Framework and analysed thematically. Features of good practice were considered at three levels: (i) everyday support; (ii) service organisation; and (iii) commissioning. Findings relating to the first two of these are presented here. Participants emphasised the importance of person-centred ways of working at all levels. Personalisation, as currently implemented in English social care, aims to shift power from professionals to service users through the allocation of personal budgets. This approach focuses very much on the role of the individual in directing his/her own support arrangements. However, participants in this study also stressed the importance of ongoing professional support, for example, from a specialist key worker or case manager to co-ordinate diverse services and ensure good practice at an organisational level. The paper argues that, despite the recent move to shift power from professionals to service users, people with the most complex needs still value support from professionals and appropriate organisational support. Without these, they risk being excluded from the benefits that personalisation, properly supported, could yield. © 2014 John Wiley & Sons Ltd.

  14. Practice-based Research Network Research Good Practices (PRGPs): Summary of Recommendations.

    PubMed

    Dolor, Rowena J; Campbell-Voytal, Kimberly; Daly, Jeanette; Nagykaldi, Zsolt J; O'Beirne, Maeve; Sterling, Pamela; Fagnan, Lyle J; Levy, Barcey; Michaels, LeAnn; Louks, Hannah A; Smith, Paul; Aspy, Cheryl B; Patterson, V Beth; Kano, Miria; Sussman, Andrew L; Williams, Robert; Neale, Anne Victoria

    2015-12-01

    Practice-based research networks (PBRNs) conduct research in community settings, which poses quality control challenges to the integrity of research, such as study implementation and data collection. A foundation for improving research processes within PBRNs is needed to ensure research integrity. Network directors and coordinators from seven U.S.-based PBRNs worked with a professional team facilitator during semiannual in-person meetings and monthly conference calls to produce content for a compendium of recommended research practices specific to the context of PBRNs. Participants were assigned to contribute content congruent with their expertise. Feedback on the draft document was obtained from attendees at the preconference workshop at the annual PBRN meeting in 2013. A revised document was circulated to additional PBRN peers prior to finalization. The PBRN Research Good Practices (PRGPs) document is organized into four chapters: (1) Building PBRN Infrastructure; (2) Study Development and Implementation; (3) Data Management, and (4) Dissemination Policies. Each chapter contains an introduction, detailed procedures for each section, and example resources with information links. The PRGPs is a PBRN-specific resource to facilitate PBRN management and staff training, to promote adherence to study protocols, and to increase validity and generalizability of study findings. © 2015 Wiley Periodicals, Inc.

  15. Methyl Bromide Fumigant Management Plan Phase 2 Templates

    EPA Pesticide Factsheets

    Templates provide a checklist and framework for elements including certified pesticide applicator details, application block, buffer zones, sign posting, tarp plan, soil conditions, air monitoring, and good agricultural practices (GAPs).

  16. Nursing professional practice environments: setting the stage for constructive conflict resolution and work effectiveness.

    PubMed

    Siu, Heidi; Spence Laschinger, Heather K; Finegan, Joan

    2008-05-01

    The aim of this study was to examine the impact of nurses' perceived professional practice environment on their quality of nursing conflict management approaches and ultimately their perceptions of unit effectiveness from the perspective of Deutsch's theory of constructive conflict management. Rising reports of hostility and conflict among Canadian nurses are a concern to nurses' health and the viability of effective patient care delivery. However, research on the situational factors that influence nurses' ability to apply effective conflict resolution skills that lead to positive results in practice is limited. A nonexperimental, predictive design was used in a sample of 678 registered nurses working in community hospitals within a large metropolitan area in Ontario. The results supported a modified version of the hypothesized model [chi2(1) = 16.25, Goodness of Fit = 0.99, Comparative Fit Index = 0.98, Root-Mean-Square Error of Approximation = 0.15] linking professional practice environment and core self-evaluation to nurses' conflict management and, ultimately, unit effectiveness. Professional practice environment, conflict management, and core-self evaluation explained approximately 46.6% of the variance in unit effectiveness. Positive professional practice environments and high core self-evaluations predicted nurses' constructive conflict management and, in turn, greater unit effectiveness.

  17. Development of the private practice management standards for psychology.

    PubMed

    Mathews, Rebecca; Stokes, David; Littlefield, Lyn; Collins, Leah

    2011-01-01

    This paper describes the process of developing a set of private practice management standards to support Australian psychologists and promote high quality services to the public. A review of the literature was conducted to identify management standards relevant to psychology, which were further developed in consultation with a panel of experts in psychology or in the development of standards. Forty-three psychologists in independent private practice took part in either a survey (n=22) to provide feedback on the relevance of, and their compliance with, the identified standards, or a 6-month pilot study (n=21) in which a web-based self-assessment instrument evaluating the final set of standards and performance indicators was implemented in their practice to investigate self-reported change in management procedures. The pilot study demonstrated good outcomes for practitioners when evaluation of compliance to the standards was operationalized in a self-assessment format. Study results are based on a small sample size. Nevertheless, relevance and utility of the standards was found providing an initial version of management standards that have relevance to the practice of psychology in Australia, along with a system for evaluating psychological service provision to ensure best practice in service delivery. © 2010 National Association for Healthcare Quality.

  18. Adaptive management of ecosystem services across different land use regimes.

    PubMed

    Ruhl, J B

    2016-12-01

    Using adaptive management to manage desired flows of ecosystem services may seem on the surface to be a good fit, but many social, economic, environmental, legal, and political factors influence how good a fit. One strongly influential factor is the land use regime within which the profile of ecosystem services is being managed. Shaped largely by legal mandates, market forces, and social and cultural practices, different land use regimes present different opportunities for and constraints on goals for ecosystem services and pose different decision making environments. Even where all other conditions appear amenable to using adaptive management, therefore, it is essential to consider the constraining (or liberating) effects of different land use regimes when deciding whether to adopt adaptive management to achieve those goals and, if so, how to implement it. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Current UK practices in the management of subacromial impingement.

    PubMed

    Bryceland, James K; Drury, Colin; Tait, Gavin R

    2015-07-01

    Controversy presently exists surrounding the management of patients with subacromial impingement. This study aims to highlight current UK practices in the management of these patients. BESS members were invited to complete a questionnaire and responses were received from 157 consultant shoulder surgeons. Physiotherapy is an integral part of management for 93% of surgeons with a minimum period of 12 weeks being most popular prior to consideration of arthroscopic subacromial decompression. Subacromial steroid injection is used by 95% and 86% repeat this if the patient has failed to respond to a previous injection by the general practioner. From initial presentation, 77% felt there should be at least 3 months of conservative management before proceeding to surgery. Good but transient response to subacromial injection was considered the best predictor of good surgical outcome by 77%. The coracoacromial ligament is fully released by 78%, although there was greater variation in how aggressive surgeons were with acromioplasty. Most (59%) do not include the nontender acromioclavicular joint to any extent in routine acromioplasty. Hospital physiotherapy protocols are used by 63% for postoperative rehabilitation. Variation exists in the management regimes offered to patients with subacromial impingement, but most employ a minimum period of 12 weeks of conservative management incorporating physiotherapy and at least 2 subacromial steriod injections.

  20. Current UK practices in the management of subacromial impingement

    PubMed Central

    Drury, Colin; Tait, Gavin R

    2015-01-01

    Background Controversy presently exists surrounding the management of patients with subacromial impingement. This study aims to highlight current UK practices in the management of these patients. Methods BESS members were invited to complete a questionnaire and responses were received from 157 consultant shoulder surgeons. Results Physiotherapy is an integral part of management for 93% of surgeons with a minimum period of 12 weeks being most popular prior to consideration of arthroscopic subacromial decompression. Subacromial steroid injection is used by 95% and 86% repeat this if the patient has failed to respond to a previous injection by the general practioner. From initial presentation, 77% felt there should be at least 3 months of conservative management before proceeding to surgery. Good but transient response to subacromial injection was considered the best predictor of good surgical outcome by 77%. The coracoacromial ligament is fully released by 78%, although there was greater variation in how aggressive surgeons were with acromioplasty. Most (59%) do not include the nontender acromioclavicular joint to any extent in routine acromioplasty. Hospital physiotherapy protocols are used by 63% for postoperative rehabilitation. Conclusions Variation exists in the management regimes offered to patients with subacromial impingement, but most employ a minimum period of 12 weeks of conservative management incorporating physiotherapy and at least 2 subacromial steriod injections. PMID:27582972

  1. Supporting Information Governance through Records and Information Management. Research Bulletin

    ERIC Educational Resources Information Center

    Kaczmarek, Joanne

    2014-01-01

    The expanding scope of IT initiatives in higher education institutions now goes well beyond basic desktop and enterprise applications. IT is often asked to focus on efforts to establish good information-governance practices. The many aspects of information governance are often found in a records and information management (RIM) program, but not…

  2. Thinking on Your Feet: Understanding the Immediate Responses of Staff to Adults Who Challenge Intellectual Disability Services

    ERIC Educational Resources Information Center

    Ravoux, Peggy; Baker, Peter; Brown, Hilary

    2012-01-01

    Background: A gap prevails between the conceptualization of good practice in challenging behaviour management and its implementation in intellectual disability services. This study aimed to investigate staff members' perspectives of managing clients with challenging behaviours in residential services. Materials and Methods: Semi-structured…

  3. Perceived safety management practices in the logistics sector.

    PubMed

    Auyong, Hui-Nee; Zailani, Suhaiza; Surienty, Lilis

    2016-03-09

    Malaysia's progress on logistics has been slowed to keep pace with its growth in trade. The Government has been pressing companies to improve the safety of their activities in order to reduce society's loss due to occupational accidents and illnesses. Occupational safety and health is a crucial part of a workplace because every worker has to take care of his/her own safety and health. The main occupational safety and health (OSH) national policy in Malaysia is the enactment of the Occupational Safety and Health Act (OSHA) 1994. Only those companies which have excellent health and safety care have good quality and productive employees. This study investigated safety management practices in the logistics sector. The present study is concerned with the human factors to safety in the logistics industry. The authors examined the perceived safety management practices of workers in the logistics sector. The purpose was to identify the perception of safety management practices of Malaysian logistics personnel. Survey questionnaires were distributed to assess logistics personnel about management commitment. The quantitative method using the availability sampling method was applied. The data gathered from the survey were analysed using SPSS software. The responses to the survey were rated according to the Likert scale type, with '1' indicating strongly disagree and '5' indicating strongly agree. One hundred and three employees of logistics functions completed the survey. The highest mean scores were found for fire apparatus, prioritisation of safety, and safety policy. The results from this study also emphasise the importance of the management's commitment in enhancing workplace safety. Specifically, companies should maintain good relations between the employer and the employee to help reduce workplace injuries.

  4. Are Chicken Eggs Good or Bad for My Cholesterol?

    MedlinePlus

    ... of Privacy Practices Notice of Nondiscrimination Manage Cookies Advertising Mayo Clinic is a not-for-profit organization and proceeds from Web advertising help support our mission. Mayo Clinic does not ...

  5. Professional roles in physiotherapy practice: Educating for self-management, relational matching, and coaching for everyday life.

    PubMed

    Solvang, Per Koren; Fougner, Marit

    2016-11-01

    The patient's active participation in treatment and rehabilitation represents a cultural change in clinical practice as well as a major change in physiotherapist and patient roles. This article presents findings from a study aimed at gaining a better understanding of how physiotherapists in actual practice understand their interactions with patients during the treatment process. This article reports on the findings from focus-group interviews with physiotherapists working in three different settings. Analyses of the interview data identified three modes of physiotherapy practice. In one, physiotherapists educate their patients to be self-managing in conducting exercise programs based on sound evidence. Educational films available on the Internet are included in these efforts to teach patients. In another, physiotherapists emphasize the importance of a close relationship to the patient. A good personal chemistry is believed to improve the treatment process. And finally, what physiotherapists learn about the living conditions and the biographies of their patients was shown to be very important. Understanding the importance of the life-world and taking this into consideration in the treatment process were factors considered to be central to good practice. The article concludes with a discussion linking these findings to those of other studies identifying those factors contributing to our knowledge of what is involved in biopsychosocial practice in physiotherapy.

  6. Integration of QR codes into an anesthesia information management system for resident case log management.

    PubMed

    Avidan, Alexander; Weissman, Charles; Levin, Phillip D

    2015-04-01

    Quick response (QR) codes containing anesthesia syllabus data were introduced into an anesthesia information management system. The code was generated automatically at the conclusion of each case and available for resident case logging using a smartphone or tablet. The goal of this study was to evaluate the use and usability/user-friendliness of such system. Resident case logging practices were assessed prior to introducing the QR codes. QR code use and satisfactions amongst residents was reassessed at three and six months. Before QR code introduction only 12/23 (52.2%) residents maintained a case log. Most of the remaining residents (9/23, 39.1%) expected to receive a case list from the anesthesia information management system database at the end of their residency. At three months and six months 17/26 (65.4%) and 15/25 (60.0%) residents, respectively, were using the QR codes. Satisfaction was rated as very good or good. QR codes for residents' case logging with smartphones or tablets were successfully introduced in an anesthesia information management system and used by most residents. QR codes can be successfully implemented into medical practice to support data transfer. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. USDA-ARS?s Scientific Manuscript database

    Ecosystems that maximize soil organic matter and good soil structure maintain high soil biological functioning, soil health and plant growth. Natural ecosystems such as prairies are valuable benchmarks for developing sustainable crop and soil management practices. Soil biological properties critical...

  8. 7 CFR 37.5 - Order of furnishing service.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD CONTAINER... are received, insofar as consistent with good management, efficiency, and economy. ...

  9. Potential contributions of figured wood to the practice of sustainable forestry

    Treesearch

    Don C. Bragg

    2006-01-01

    The birdseye grain of sugar maple (Acer saccharum Marsh.) can showcase the potential of figured wood in sustainable forestry. This poorly understood but valuable grain abnormality commands such a premium that its presence alone can influence timber management. Good forestry and logging practices can help assure that quality birdseye maple logs are not relegated to low-...

  10. Discipline for Democracy? Neutrality and Justice in Schools' Management of Conflict and Social Exclusion.

    ERIC Educational Resources Information Center

    Bickmore, Kathy

    Knowledge and values for good citizenship are communicated through explicit subject-area curriculum, such as social studies, health, and language arts, and through the implicit models and practices embedded in a school's system of human rights protections and discipline practices. This paper presents the conceptual framework, and a few very early…

  11. Optimising boiler performance.

    PubMed

    Mayoh, Paul

    2009-01-01

    Soaring fuel costs continue to put the squeeze on already tight health service budgets. Yet it is estimated that combining established good practice with improved technologies could save between 10% and 30% of fuel costs for boilers. Paul Mayoh, UK technical manager at Spirax Sarco, examines some of the practical measures that healthcare organisations can take to gain their share of these potential savings.

  12. Nature and Quality of Antipsychotic Prescribing Practice in UK Psychiatry of Intellectual Disability Services

    ERIC Educational Resources Information Center

    Paton, C.; Flynn, A.; Shingleton-Smith, A.; McIntyre, S.; Bhaumik, S.; Rasmussen, J.; Hardy, S.; Barnes, T.

    2011-01-01

    Background: Antipsychotics are perceived to be over-used in the management of behavioural problems in people with an intellectual disability (ID). Published guidelines have set good practice standards for the use of these drugs for behavioural indications. We sought to identify the range of indications for which antipsychotic drugs are prescribed…

  13. Practical ways to facilitate ergonomics improvements in occupational health practice.

    PubMed

    Kogi, Kazutaka

    2012-12-01

    Recent advances in participatory programs for improving workplace conditions are discussed to examine practical ways to facilitate ergonomics improvements. Participatory training programs are gaining importance, particularly in promoting occupational health and safety in small-scale workplaces. These programs have led to many improvements that can reduce work-related risks in varied situations. Recent experiences in participatory action-oriented training programs in small workplaces and agriculture are reviewed.The emphasis of the review is on training steps, types of improvements achieved, and the use of action tools by trainers and training participants. Immediate improvements in multiple technical areas are targeted, including materials handling,workstation design, physical environment, welfare facilities, and work organization. In facilitating ergonomics improvements in each local situation, it is important to focus on (a) building on local good practices; (b) applying practical, simple improvements that apply the basic principles of ergonomics; and (c) developing action-oriented toolkits for direct use by workers and managers. This facilitation process is effective when locally designed action toolkits are used by trainers, including local good examples, action checklists, and illustrated how-to guides. Intervention studies demonstrate the effectiveness of participatory steps that use these toolkits in promoting good practices and reducing work-related risks. In facilitating ergonomics improvements in small-scale workplaces, it is important to focus on practical, low-cost improvements that build on local good practices. The use of action-oriented toolkits reflecting basic ergonomics principles is helpful.The promotion of the intercountry networking of positive experiences in participatory training is suggested.

  14. Disability management practices in education, hotel/motel, and health care workplaces.

    PubMed

    Williams, Renee M; Westmorland, Muriel G; Shannon, Harry S; Rasheed, Farah; Amick, Benjamin C

    2005-03-01

    The high costs and the impact of work disability have become a growing concern for workplaces. As a result, workplace disability management approaches have been developed to lower disability costs, protect the employability of workers, and promote early return to work. A stratified random sample of 455 employers in education (n = 157), hotel/motel (n = 110), and health care (n = 188) sectors who completed a mailed Organizational Policies and Practices (OPP) questionnaire is reported. The OPP questionnaire asked questions about eight workplace disability management practices. The article examined the multi-dimensionality, internal consistency, and discriminant validity of the OPP and compares disability management practices across the three sectors. The OPP questionnaire showed good internal consistency (Cronbach's alpha = 0.95) and discriminant validity. A one-way analysis of variance (ANOVA) for each of the eight subscales demonstrated that there were statistically significant differences between the sectors in ergonomic practices (F (2,452) = 15.8, P < 0.001), disability case management (F (2,452) = 4.6, P < 0.01), return to work (F (2,452) = 10.3, P < 0.001), and people-oriented culture (F (2,452) = 4.5, P < 0.01). On examining disability management practices in education, hotel/motel, and health care sectors, the OPP seems to be a promising instrument that can be used to assess and monitor how employers are managing disability.

  15. IS/IT the prescription to enable medical group practices attain their goals.

    PubMed

    Wickramasinghe, Nilmini; Silvers, J B

    2003-05-01

    The US spends significantly more money as a percentage of GDP on health care than any other OECD country and more importantly, this amount is anticipated to increase exponentially. In this high cost environment, two important trends have occurred: (1) the movement to managed care, and (2) large investments in Information Systems/Information Technology (IS/IT). Managed care has emerged as an attempt to provide good quality yet cost effective health care treatment. Its implications are not well discussed in the literature while, its impact on different types of medical group practices is even less well understood. The repercussions of the large investments in IS/IT on the health care sector in general and on the medical group practice in particular, although clearly of importance, are also largely ignored by the literature. This study attempts to address this significant void in the literature. By analyzing three different types of group practices; an Independent Practice Association (IPA), a Faculty Practice and a Multi Specialty Group Practice in a managed care environment during their implementation of practice management/billing systems, we are able to draw some conclusions regarding the impacts of these two central trends on health care in general as well as on the medical group practice in particular.

  16. The reality of task shifting in medicines management- a case study from Tanzania.

    PubMed

    Wiedenmayer, Karin A; Kapologwe, Ntuli; Charles, James; Chilunda, Fiona; Mapunjo, Siana

    2015-01-01

    Tanzania suffers a severe shortage of pharmaceutical staff. This negatively affects the provision of pharmaceutical services and access to medicines, particularly in rural areas. Task shifting has been proposed as a way to mitigate the impact of health worker shortfalls.The aim of this study was to understand the context and extent of task shifting in pharmaceutical management in Dodoma Region, Tanzania. We explored 1) the number of trained pharmaceutical staff as compared to clinical cadres managing medicines, 2) the national establishment for staffing levels, 3) job descriptions, 4) supply management training conducted and 5) availability of medicines and adherence to Good Storage Practice. A cross-sectional study was conducted in 270 public health facilities in 2011. A pre-tested questionnaire was administered to the person in charge of the facility to collect data on staff employed and their respective pharmaceutical tasks. Availability of 26 tracer medicines and adherence to Good Storage Practice guidelines was surveyed by direct observation. The national establishments for pharmaceutical staffing levels and job descriptions of facility cadres were analysed. While required staffing levels in 1999 were 50, the region employed a total of only 14 pharmaceutical staff in 2011. Job descriptions revealed that, next to pharmaceutical staff, only nurses were required to provide dispensing services and adherence counselling. In 95.5% of studied health facilities medicines management was done by non-pharmaceutically trained cadres, predominantly medical attendants. The first training on supply management was provided in 2005 with no refresher training thereafter. Mean availability of tracer medicines was 53%, while 56% of health facilities fully met criteria of Good Storage Practice. Task shifting is a reality in the pharmaceutical sector in Tanzania and it occurs mainly as a coping mechanism rather than a formal response to the workforce crisis. In Dodoma Region, pharmacy-related tasks and supply management have informally been shifted to clinical staff without policy guidance, explicit job descriptions, and without the necessary support through training. Implicit task shifting should be recognized and formalized. Job orientation, training and operational procedures may be useful to support non-pharmaceutical health workers to effectively manage medicine supply.

  17. Influence of forest structure and experimental green-tree retention on northern flying squirrel (Glaucomys sabrinus) abundance

    Treesearch

    Gillian L. Holloway; Winston P. Smith; Charles B. Halpern; Robert A. Gitzen; Christine C. Maguire; Stephen D. West

    2012-01-01

    In many regions of the world, forest management has shifted from practices emphasizing timber production to more sustainable harvesting that integrates ecological values, including maintenance of biodiversity, wildlife habitat, and ecological goods and services. To this end, management strategies emphasize retention of stand structures that meet the needs of forest-...

  18. Managing vulnerabilities and achieving compliance for Oracle databases in a modern ERP environment

    NASA Astrophysics Data System (ADS)

    Hölzner, Stefan; Kästle, Jan

    In this paper we summarize good practices on how to achieve compliance for an Oracle database in combination with an ERP system. We use an integrated approach to cover both the management of vulnerabilities (preventive measures) and the use of logging and auditing features (detective controls). This concise overview focusses on the combination Oracle and SAP and it’s dependencies, but also outlines security issues that arise with other ERP systems. Using practical examples, we demonstrate common vulnerabilities and coutermeasures as well as guidelines for the use of auditing features.

  19. Nissan Showcases the Results of an Energy-Wise Corporate Culture

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

    None

    2010-06-11

    The corporate leadership at Nissan cultivates a culture of energy efficiency, encouraging employees to practice good energy management at work and in every part of their lives. Read about Nissan's energy-conscience culture.

  20. Aggressive behaviour by people with dementia in residential care settings: a review.

    PubMed

    Pulsford, D; Duxbury, J

    2006-10-01

    This paper considers the phenomenon of aggressive behaviour perpetrated by people with dementia in residential care settings. Aggressive behaviour is defined in the context of people with dementia, and the problem of ascertaining the incidence of aggression among people with dementia is discussed. The emotional impact of assaults on nurses and other professionals is highlighted, and differing perspectives on the causation of aggressive behaviour are considered. Management strategies derived from the physical/pharmacological; environment management; behaviour modification and person-centred approaches are reviewed. Our conclusion is that while certain strategies appear to reflect good and common sense practice, in particular those deriving from the person-centred approach, there is no clear research evidence for the general effectiveness of any one management approach, and each has drawbacks of a practical or ethical nature. There is also little empirical information about how professional carers actually manage aggressive behaviour in practice.

  1. Career development. Opportunity 2000.

    PubMed

    Adams, J

    Opportunity 2000 is an initiative designed to increase the role of women in the workforce and to promote equal opportunities in the workplace. The NHS Management Executive has set up a women's unit to put Opportunity 2000 into practice and to develop more 'women-friendly' working practices. The unit has produced a good practice handbook. The article discusses the eight goals produced by the NHSME to be achieved by health authorities and trusts by this year.

  2. Attitudes of US neurologists concerning the ethical dimensions of managed care.

    PubMed

    Bernat, J L; Ringel, S P; Vickrey, B G; Keran, C

    1997-07-01

    We surveyed attitudes of US neurologists about the ethical dimensions of managed care by administering a written instrument containing paradigmatic cases portraying conflicts of physicians, patients, and managed care organizations (MCOs). After each case, we assessed neurologists' attitudes by asking them their degree of agreement with a series of statements. We found that neurologists (1) generally were willing to follow clinical practice guidelines if they were created by medical societies; (2) experienced frequent conflicts of interest or conflicts of obligation in the care of their MCO patients; (3) feared legal ramifications of their clinical decisions on MCO patients; (4) were unwilling to employ deception or gaming to achieve what they perceived to be good patient care; (5) believed that their professional prerogatives and autonomy were under attack by MCOs; and (6) felt that the good of their patients should not be sacrificed for the good of society.

  3. "Inclusive Working Life" in Norway--experience from "Models of Good Practice" enterprises.

    PubMed

    Lie, Arve

    2008-08-01

    To determine whether enterprises belonging to the Bank of Models of Good Practice were more successful than average Norwegian enterprises in the reduction of sickness absence, promotion of early return to work, and prevention of early retirement. In 2004 we selected 86 enterprises with a total of approximately 90000 employees from the Inclusive Working Life (IWL) Bank of Models of Good Practice. One representative of workers and one of management from each enterprise received a questionnaire on the aims, organization, and the results of the IWL program by mail. Data on sickness absence, use of early retirement, and disability retirement in the 2000-2004 period were collected from the National Insurance Registry. Data on comparable enterprises were obtained from the National Bureau of Statistics. The response rate was 65%. Although the IWL campaign was directed at reducing sickness absence, preventing early retirement, and promoting employment of the functionally impaired, most attention was paid to reducing sickness absence. Sickness absence rate in Models of Good Practice enterprises (8.2%) was higher than in comparable enterprises that were not part of the Models of Good Practice (6.9%). Implementation of many IWL activities, empowerment and involvement of employees, and good cooperation with the occupational health service were associated with a lower rate of sickness absence. On average, 0.7% new employees per year received disability pension, which is a significantly lower percentage than expected on the basis of the rate of 1.3% per year in comparable enterprises. Frequent use of disability pensioning was associated with high rate of sickness absence and having many employees older than 50 years. On average, 0.4% employees per year received early retirement compensation, which was expected on the basis of national estimates. Frequent use of early retirement was associated with having many employees older than 50 years. Models of Good Practice enterprises had a higher than expected sickness absence rate. This indicates that it is difficult to identify Models of Good Practice enterprises and that they cannot be treated as role model enterprises. Good cooperation with the occupational health service and the empowerment and involvement of the employees is associated with a low sickness absence rate.

  4. Managing change: an overview.

    PubMed

    Lorenzi, N M; Riley, R T

    2000-01-01

    As increasingly powerful informatics systems are designed, developed, and implemented, they inevitably affect larger, more heterogeneous groups of people and more organizational areas. In turn, the major challenges to system success are often more behavioral than technical. Successfully introducing such systems into complex health care organizations requires an effective blend of good technical and good organizational skills. People who have low psychological ownership in a system and who vigorously resist its implementation can bring a "technically best" system to its knees. However, effective leadership can sharply reduce the behavioral resistance to change-including to new technologies-to achieve a more rapid and productive introduction of informatics technology. This paper looks at four major areas-why information system failures occur, the core theories supporting change management, the practical applications of change management, and the change management efforts in informatics.

  5. Development of a waste management protocol based on assessment of knowledge and practice of healthcare personnel in surgical departments.

    PubMed

    Mostafa, Gehan M A; Shazly, Mona M; Sherief, Wafaa I

    2009-01-01

    Good healthcare waste management in a hospital depends on a dedicated waste management team, good administration, careful planning, sound organization, underpinning legislation, adequate financing, and full participation by trained staff. Hence, waste management protocols must be convenient and sensible. To assess the knowledge and practice related to waste management among doctors, nurses, and housekeepers in the surgical departments at Al-Mansoura University Hospital, and to design and validate a waste management protocol for the health team in these settings. This cross-sectional study was carried out in the eight surgical departments at Al-Mansoura University Hospital. All health care personnel and their assistants were included: 38 doctors, 106 nurses, and 56 housekeepers. Two groups of jury were included for experts' opinions validation of the developed protocol, one from academia (30 members) and the other from service providers (30 members). Data were collected using a self-administered knowledge questionnaire for nurses and doctors, and an interview questionnaire for housekeepers. Observation checklists were used for assessment of performance. The researchers developed the first draft of the waste management protocol according to the results of the analysis of the data collected in the assessment phase. Then, the protocol was presented to the jury group for validation, and then was implemented. Only 27.4% of the nurses, 32.1% of the housekeepers, and 36.8% of the doctors had satisfactory knowledge. Concerning practice, 18.9% of the nurses, 7.1% of the housekeepers, and none of the doctors had adequate practice. Nurses' knowledge score had a statistically significant weak positive correlation with the attendance of training courses (r=0.23, p<0.05). Validation of the developed protocol was done, and the percent of agreement ranged between 60.0% and 96.7% for the service group, and 60.0% and 90.0% for the academia group. The majority of the doctors, nurses, and housekeepers have unsatisfactory knowledge and inadequate practice related to health care waste management. The knowledge among nurses is positively affected by attendance of training programs. Based on the findings, a protocol for healthcare waste management was developed and validated. It is recommended to implement the developed waste management protocol for the surgical departments in the designed hospital, with establishment of waste management audits.

  6. Ecological models supporting environmental decision making: a strategy for the future

    USGS Publications Warehouse

    Schmolke, Amelie; Thorbek, Pernille; DeAngelis, Donald L.; Grimm, Volker

    2010-01-01

    Ecological models are important for environmental decision support because they allow the consequences of alternative policies and management scenarios to be explored. However, current modeling practice is unsatisfactory. A literature review shows that the elements of good modeling practice have long been identified but are widely ignored. The reasons for this might include lack of involvement of decision makers, lack of incentives for modelers to follow good practice, and the use of inconsistent terminologies. As a strategy for the future, we propose a standard format for documenting models and their analyses: transparent and comprehensive ecological modeling (TRACE) documentation. This standard format will disclose all parts of the modeling process to scrutiny and make modeling itself more efficient and coherent.

  7. Tests That Work: Designing and Delivering Fair and Practical Measurement Tools in the Workplace.

    ERIC Educational Resources Information Center

    Westgaard, Odin

    This guide shows organization managers how to use tests to assess skills and values in the workplace, as well as how to develop good, fair tests without needing any other resources. Part 1, chapters 1 through 5, presents basic information about tests and their practical applications. Part 2 describes the 15 steps of the testing process. The…

  8. Professional Growth: From First Job to Retirement.

    ERIC Educational Resources Information Center

    Hitt, Dorothy

    1987-01-01

    The author discusses how secretaries can manage their own professional development. Major points are (1) practice and update technical skills, (2) work toward certification, and (3) maintain a professional image, good etiquette, and a positive attitude. (CH)

  9. APOM-project: managing change to the customer in community pharmacy practice.

    PubMed

    Mobach, M P; van der Werf, J; Tromp, T F

    1999-10-01

    In 1994, a Ph.D.-study started regarding pharmacy, organization and management (APOM) in the Netherlands. This article describes the final phase of the study in community pharmacy practice: managerial problems in change to the customer and the difference between supported pharmacy managers and independent ones. It appeared that pharmacy managers experienced problems with the formulation and use of aims, norms, and measurements. Although many organizations operating in the pharmaceutical sector are a good source for new ideas, they lack to have the proper support for these problems. The difference between supported and independent pharmacy managers was minimal in the change to the customer. Pharmacy managers are in need of micro-instrumentalization: aims, norms, and monitor instruments for customer activities applicable at their own pharmacy. Moreover, pharmacy managers will have to learn how to deal with the tension between money and care in order to improve the 'grip' on their organization.

  10. Building physician resilience.

    PubMed

    Jensen, Phyllis Marie; Trollope-Kumar, Karen; Waters, Heather; Everson, Jennifer

    2008-05-01

    To explore the dimensions of family physician resilience. Qualitative study using in-depth interviews with family physician peers. Hamilton, Ont. Purposive sample of 17 family physicians. An iterative process of face-to-face, in-depth interviews that were audiotaped and transcribed. The research team independently reviewed each interview for emergent themes with consensus reached through discussion and comparison. Themes were grouped into conceptual categories. Four main aspects of physician resilience were identified: 1) attitudes and perspectives, which include valuing the physician role, maintaining interest, developing self-awareness, and accepting personal limitations; 2) balance and prioritization, which include setting limits, taking effective approaches to continuing professional development, and honouring the self;3) practice management style, which includes sound business management, having good staff, and using effective practice arrangements; and 4) supportive relations, which include positive personal relationships, effective professional relationships, and good communication. Resilience is a dynamic, evolving process of positive attitudes and effective strategies.

  11. Space Station: Actions Under Way to Manage Cost, but Significant Challenges Remain

    DTIC Science & Technology

    2002-07-01

    GAO United States General Accounting OfficeReport to Congressional CommitteesJuly 2002 SPACE STATION Actions Under Way to Manage Cost , but...because NASA does not have good cost - accounting systems or practices. 1 The estimated cost growth is having a profound effect on the utility of the...SPACE STATION: Actions Under Way to Manage Cost , but Significant Challenges Remain Contract Number Grant Number Program Element Number Author(s

  12. The commensurability of environmental geology and petroleum geology

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

    Argen, R.J.

    1990-05-01

    Environmental geology and petroleum geology are practical applications of pure geology. These two applied sciences differ with respect to their philosophical and ethical mandates. A good petroleum geologist finds hydrocarbons, but the role of a good environmental geologist is not well defined. If the good environmental geologist's role is not simply to protect the environment from the good petroleum geologist then how do the mandates of these geologists differ, yet remain compatible If the mandate of a good environmental geologist were to protect every natural resource from all managed use, then the good environmental geologist and the good petroleum geologistmore » would forever be at war. This mandate provides no framework for agreement because it assumes the inherent worth of each natural resource is discoverable. If the mandate of a good environmental geologist is to discover how to maximize the long-term benefits of the managed use of natural resource, then both the good environmental geologist and the good petroleum geologist would agree that no natural resource has inherent worth. The value of a natural resource is not determined by what it is, but by how it enhances the quality of life for a particular class of sentient creatures. An instrumental theory of value will provide a medium for interim disagreement on how to enhance the quality of life for sentient creatures, and also will provide the means for a long-term agreement that the managed use of natural resources enhances the long-term quality of life for sentient creatures.« less

  13. Treatment outcomes in 4 modes of orthodontic practice.

    PubMed

    Poulton, Donald; Vlaskalic, Vicki; Baumrind, Sheldon

    2005-03-01

    This study is a continuation of a previously published report on the outcome of orthodontic treatment provided in offices representing different modes of practice. The sample consisted of duplicate pretreatment (T1) and posttreatment (T2) dental casts of 348 patients from traditional private orthodontic practices (5 offices, 134 patients), company-owned practices (5 offices, 107 patients), offices associated with practice-management organizations (2 offices, 60 patients), and general dental practices (2 offices, 47 patients). Methods were used to obtain random, representative samples from each office, starting with lists of patients who were treated consecutively with full fixed orthodontic appliances. The dental casts were measured by 2 independent judges who used the unweighted PAR score. Good interjudge agreement was shown on the initial casts, but the agreement was not as strong on the final casts. The measurements showed that treatment outcomes were generally satisfactory, although some significant differences between offices and management modes were shown.

  14. Managing the Action/Reflection Polarity Through Dialogue: A Path to Transformative Learning. NALL Working Paper.

    ERIC Educational Resources Information Center

    Laiken, Marilyn E.

    At the Ontario Institute for Studies in Education of the University of Ontario, a course entitled Developing and Leading High Performing Teams: Theory and Practice is experimenting with a design that surfaces the action/reflection paradox for the purpose of learning how to manage this polarity. Whether the product is defined as services or goods,…

  15. Evaluating the Skills Strategy through a Graduate Certificate in Management: An Experiential Learning Theory Approach

    ERIC Educational Resources Information Center

    Butler, Michael J. R.; Gheorghiu, Lidia

    2010-01-01

    Purpose: The purpose of this paper is to evaluate how a UK business school is addressing the Government's skills strategy through its Graduate Certificate in Management, and to identify good practice and development needs and to clarify how the Graduate Certificate is adapting to the needs of Generation X and Millennial students. The paper also…

  16. Turkish adaptation and psychometric characteristics of the Nursing Authority and Autonomy Scale.

    PubMed

    Basaran Acil, Seher; Dinç, Leyla

    2018-04-14

    To adapt the Nursing Authority and Autonomy Scale (NAAS) into Turkish the Nursing Authority and Autonomy Scale (NAAS) to Turkish and assess its psychometric properties for Turkish nurses and nurse managers. The NAAS is a tool that specifically measures nursing authority and autonomy from the perspectives of nurses and nurse managers. The study sample consisted of 160 nurse managers and 266 staff nurses. Content validity was assessed using expert approval. Construct validity was assessed using confirmatory factor analysis. Internal consistency was assessed using Cronbach's α, and the test-retest reliability was assessed using Pearson's correlation coefficients. The model achieved a good fit. The internal reliability of the NAAS' authority and autonomy in nursing practice and importance of nursing practice subscales were .84. The Cronbach's α of the instrument was .88. The test-retest scores within an interval of 3 weeks were statistically not significant. The Turkish version of the NAAS has good psychometric properties and this scale can be employed to measure nurses' authority and autonomy. Nurse managers and educators should use an appropriate scale such as NAAS in order to assess nurses' clinical authority and autonomy to improve patient outcomes and develop nurses. © 2018 John Wiley & Sons Ltd.

  17. When it can be good to feel bad and bad to feel good: Exploring asymmetries in workplace emotional outcomes

    PubMed Central

    Lindebaum, Dirk; Jordan, Peter J

    2014-01-01

    Within the field of Management and Organizational Studies, we have noted a tendency for researchers to explore symmetrical relationships between so-called positive discrete emotions or emotion-infused concepts and positive outcomes, and negative emotions or emotion-infused concepts and negative outcomes, respectively. In this Special Issue, we seek to problematize this assumption (without aiming to entirely discard it) by creating space for researchers to study what we term asymmetrical relationships. In particular, we explore the topic of when it can be good to feel bad and bad to feel good. The articles presented in this forum demonstrate both theoretically and empirically that appreciating these asymmetrical relationships holds considerable promise for enhanced understanding of a range of management and organizational phenomena, ranging from leadership and followership to emotional labor and dirty work. These unique theoretical and empirical insights have important relevance for organizational practice. PMID:25418996

  18. Promoting Good Psychiatric Management for Patients With Borderline Personality Disorder.

    PubMed

    Links, Paul S; Ross, James; Gunderson, John G

    2015-08-01

    General psychiatric management for patients with borderline personality disorder was devised to be an outpatient intervention that could be readily learned and easily delivered by independent community mental health professionals. To disseminate the approach, Drs. Gunderson and Links developed the Handbook of Good Psychiatric Management for Borderline Personality Disorder (Gunderson & Links, ) that presented the basics of the approach, videos to illustrate the appropriate clinical skills, and case examples to practice adherence to the approach. Unfortunately, the inclusion of "psychiatric" in the treatment's name may discourage psychologists and other mental health professionals from using this therapy. In this article, we review the basic principles and approaches related to general psychiatric management. With a case example, we illustrate how psychologists can use all the general psychiatric management principles for their patients with BPD, except medications and, as a result, provide and deliver this approach effectively. © 2015 Wiley Periodicals, Inc.

  19. The ARIA guidelines in specialist practice: a nationwide survey.

    PubMed

    Van Hoecke, H; Van Cauwenberge, P; Thas, O; Watelet, J B

    2010-03-01

    In 2001, the ARIA guidelines were published to assist healthcare practitioners in managing allergic rhinitis (AR) according to the best evidence. Very limited information, however, is avail-able on the impact of these guidelines on clinical practice. All Belgian Otorhinolaryngologists were invited to complete a questionnaire, covering demographic and professional characteristics, knowledge, use and perception of the ARIA guidelines and 4 clinical case scenarios of AR. Of the 258 (44%) Belgian Otorhinolaryngologists who participated, almost 90% had ever heard about ARIA and 64% had followed a lecture specifically dedicated to the ARIA guidelines. Furthermore, 62% stated to always or mostly follow the ARIA treatment algorithms in the daily management of AR patients. In the clinical case section, adherence to the ARIA guidelines raised with increased self-reported knowledge and use of the ARIA guidelines and among participants that considered the guidelines more userfriendly. Of the respondents, 51% were considered as good com-pliers. Younger age was a significant predictor for good compliance. More efforts are required to improve the translation of scientific knowledge into clinical practice and to further identify which factors may influence guideline compliance.

  20. Does a quality management system improve quality in primary care practices in Switzerland? A longitudinal study

    PubMed Central

    Goetz, Katja; Hess, Sigrid; Jossen, Marianne; Huber, Felix; Rosemann, Thomas; Brodowski, Marc; Künzi, Beat; Szecsenyi, Joachim

    2015-01-01

    Objectives To examine the effectiveness of the quality management programme—European Practice Assessment—in primary care in Switzerland. Design Longitudinal study with three points of measurement. Setting Primary care practices in Switzerland. Participants In total, 45 of 91 primary care practices completed European Practice Assessment three times. Outcomes The interval between each assessment was around 36 months. A variance analyses for repeated measurements were performed for all 129 quality indicators from the domains: ‘infrastructure’, ‘information’, ‘finance’, and ‘quality and safety’ to examine changes over time. Results Significant improvements were found in three of four domains: ‘quality and safety’ (F=22.81, p<0.01), ‘information’ (F=27.901, p<0.01) and ‘finance’ (F=4.073, p<0.02). The 129 quality indicators showed a significant improvement within the three points of measurement (F=33.864, p<0.01). Conclusions The European Practice Assessment for primary care practices thus provides a functioning quality management programme, focusing on the sustainable improvement of structural and organisational aspects to promote high quality of primary care. The implementation of a quality management system which also includes a continuous improvement process would give added value to provide good care. PMID:25900466

  1. Toilet privacy in hospital.

    PubMed

    Logan, Karen

    Good practice in toilet management and continence promotion can help hospital patients to maintain their dignity. This article reports on an audit that highlighted the issues important to patients and nurses in terms of improving privacy and dignity for inpatients using the toilet.

  2. Seeking an oracle: using the Delphi process to develop practice guidelines for the treatment of endometriosis with Chinese herbal medicine.

    PubMed

    Flower, Andrew; Lewith, George T; Little, Paul

    2007-11-01

    For most complementary and alternative medicine interventions, the absence of a high-quality evidence base to define good practice presents a serious problem for clinicians, educators, and researchers. The Delphi process may offer a pragmatic way to establish good practice guidelines until more rigorous forms of assessment can be undertaken. To use a modified Delphi to develop good practice guidelines for a feasibility study exploring the role of Chinese herbal medicine (CHM) in the treatment of endometriosis. To compare the outcomes from Delphi with data derived from a systematic review of the Chinese language database. An expert group was convened for a three-round Delphi that initially produced key statements relating to the CHM diagnosis and treatment of endometriosis (round 1) and then anonymously rated these on a 1-7 Likert scale (rounds 2 and 3). Statements with a median score of 5 and above were regarded as demonstrating positive group consensus. The differential diagnoses within Chinese Medicine and rating of the clinical value of individual herbs were then contrasted with comparable data from a review of Chinese language reports in the Chinese Biomedical Retrieval System (1978-2002), and China Academy of Traditional Chinese Medicine (1985-2002) databases and the Chinese TCM and magazine literature (1984-2004) databases. Consensus (good practice) guidelines for the CHM treatment of endometriosis relating to common diagnostic patterns, herb selection, dosage, and patient management were produced. The Delphi guidelines demonstrated a high degree of congruence with the information from the Chinese language databases. In the absence of rigorous evidence, Delphi offers a way to synthesize expert knowledge relating to diagnosis, patient management, and herbal selection in the treatment of endometriosis. The limitations of the expert group and the inability of Delphi to capture the subtle nuances of individualized clinical decision-making limit the usefulness of this approach.

  3. [Hospital management in Brazil: a review of the literature with a view toenhance administrative practices in hospitals].

    PubMed

    Farias, Diego Carlos; Araujo, Fernando Oliveira de

    2017-06-01

    Hospitals are complex organizations which, in addition to the technical assistance expected in the context of treatment and prevention of health hazards, also require good management practices aimed at improving their efficiency in their core business. However, in administrative terms, recurrent conflicts arise involving technical and managerial areas. Thus, this article sets out to conducta review of the scientific literature pertaining to the themes of hospital management and projects that have been applied in the hospital context. In terms of methodology, the study adopts the webiblioming method of collection and systematic analysis of knowledge in indexed journal databases. The results show a greater interest on the part of researchers in looking for a more vertically and horizontally dialogical administration, better definition of work processes, innovative technological tools to support the management process and finally the possibility of applying project management methodologies in collaboration with hospital management.

  4. Interactive effects among ecosystem services and management practices on crop production: pollination in coffee agroforestry systems.

    PubMed

    Boreux, Virginie; Kushalappa, Cheppudira G; Vaast, Philippe; Ghazoul, Jaboury

    2013-05-21

    Crop productivity is improved by ecosystem services, including pollination, but this should be set in the context of trade-offs among multiple management practices. We investigated the impact of pollination services on coffee production, considering variation in fertilization, irrigation, shade cover, and environmental variables such as rainfall (which stimulates coffee flowering across all plantations), soil pH, and nitrogen availability. After accounting for management interventions, bee abundance improved coffee production (number of berries harvested). Some management interventions, such as irrigation, used once to trigger asynchronous flowering, dramatically increased bee abundance at coffee trees. Others, such as the extent and type of tree cover, revealed interacting effects on pollination and, ultimately, crop production. The effects of management interventions, notably irrigation and addition of lime, had, however, far more substantial positive effects on coffee production than tree cover. These results suggest that pollination services matter, but managing the asynchrony of flowering was a more effective tool for securing good pollination than maintaining high shade tree densities as pollinator habitat. Complex interactions across farm and landscape scales, including both management practices and environmental conditions, shape pollination outcomes. Effective production systems therefore require the integrated consideration of management practices in the context of the surrounding habitat structure. This paper points toward a more strategic use of ecosystem services in agricultural systems, where ecosystem services are shaped by the coupling of management interventions and environmental variables.

  5. Neural correlates of self-deception and impression-management.

    PubMed

    Farrow, Tom F D; Burgess, Jenny; Wilkinson, Iain D; Hunter, Michael D

    2015-01-01

    Self-deception and impression-management comprise two types of deceptive, but generally socially acceptable behaviours, which are common in everyday life as well as being present in a number of psychiatric disorders. We sought to establish and dissociate the 'normal' brain substrates of self-deception and impression-management. Twenty healthy participants underwent fMRI scanning at 3T whilst completing the 'Balanced Inventory of Desirable Responding' test under two conditions: 'fake good', giving the most desirable impression possible and 'fake bad' giving an undesirable impression. Impression-management scores were more malleable to manipulation via 'faking' than self-deception scores. Response times to self-deception questions and 'fake bad' instructions were significantly longer than to impression-management questions and 'fake good' instructions respectively. Self-deception and impression-management manipulation and 'faking bad' were associated with activation of medial prefrontal cortex (mPFC) and left ventrolateral prefrontal cortex (vlPFC). Impression-management manipulation was additionally associated with activation of left dorsolateral prefrontal cortex and left posterior middle temporal gyrus. 'Faking bad' was additionally associated with activation of right vlPFC, left temporo-parietal junction and right cerebellum. There were no supra-threshold activations associated with 'faking good'. Our neuroimaging data suggest that manipulating self-deception and impression-management and more specifically 'faking bad' engages a common network comprising mPFC and left vlPFC. Shorter response times and lack of dissociable neural activations suggests that 'faking good', particularly when it comes to impression-management, may be our most practiced 'default' mode. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Good enough practices in scientific computing.

    PubMed

    Wilson, Greg; Bryan, Jennifer; Cranston, Karen; Kitzes, Justin; Nederbragt, Lex; Teal, Tracy K

    2017-06-01

    Computers are now essential in all branches of science, but most researchers are never taught the equivalent of basic lab skills for research computing. As a result, data can get lost, analyses can take much longer than necessary, and researchers are limited in how effectively they can work with software and data. Computing workflows need to follow the same practices as lab projects and notebooks, with organized data, documented steps, and the project structured for reproducibility, but researchers new to computing often don't know where to start. This paper presents a set of good computing practices that every researcher can adopt, regardless of their current level of computational skill. These practices, which encompass data management, programming, collaborating with colleagues, organizing projects, tracking work, and writing manuscripts, are drawn from a wide variety of published sources from our daily lives and from our work with volunteer organizations that have delivered workshops to over 11,000 people since 2010.

  7. Getting Things Done Key to Utilization of People.

    ERIC Educational Resources Information Center

    Pollok, Ted

    1979-01-01

    Presented are 16 practical rules based upon the experiences of successful managers that can help executives get more things accomplished by their subordinates. The rules include: delegate responsibility, acknowledge good work, schedule work breaks, encourage suggestions, and handle grievances promptly. (JMD)

  8. Critical litter moisture maximizes ammonia generation

    USDA-ARS?s Scientific Manuscript database

    The natural breakdown of litter (bedding material mixed with deposits of feces, feathers, spilled feed and water) generates ammonia in poultry houses. Good management practices can reduce ammonia concentrations in poultry houses. Findings from a recent publication indicate there is a critical litt...

  9. Leading the Student Experience: Academic and Professional Services in Partnership Literature Review and Overview of Results. Leading the Student Experience

    ERIC Educational Resources Information Center

    Parkes, Sarah; Young, Julie Blackwell; Cleaver, Elizabeth; Archibald, Kenny

    2014-01-01

    This research project explored how academic and professional personnel work together in new ways to deliver the best possible student experience. The project analysed why certain models of good working practice seemed to work well. The research investigated: how the change management process was perceived and managed by key stakeholders; the role…

  10. Common pressure vessel development for the nickel hydrogen technology

    NASA Technical Reports Server (NTRS)

    Holleck, G.

    1981-01-01

    The design of a pressure vessel nickel hydrogen cell is described. The cell has the following key features: it eliminates electrolyte bridging; provides for independent electrolyte management for each unit stack; provides for independent oxygen management for each unit stack; has good heat dissipation; has a mechanically sound and practical interconnection; and has the maximum in common with state of the art individual pressure vessel technology.

  11. An audit of management of differentiated thyroid cancer in specialist and non-specialist clinic settings.

    PubMed

    Kumar, H; Daykin, J; Holder, R; Watkinson, J C; Sheppard, M C; Franklyn, J A

    2001-06-01

    Thyroid cancer is the most common endocrine malignancy but is none the less rare. Some aspects of its management remain controversial. Previous audits of patient management in the United Kingdom have revealed deficiencies, especially in communication between specialists. We have audited patient management in a large university-associated teaching hospital, assessing points of good practice identified from published guidelines and reviews, and have compared findings in groups of patients managed jointly by specialists with an interest in thyroid cancer (including surgeon, endocrinologist and oncologist) with a group managed by other clinicians outside that setting. Retrospective case-note review of 205 patients with differentiated (papillary or follicular) cancer including group A (n = 134; managed in a specialist multi-disciplinary clinic setting) and group B (n = 71; managed in other clinic settings). Points of good practice investigated were adequacy of surgery, surgical complications, prescription and adequacy of T4 treatment, adequacy of monitoring by measurement of serum thyroglobulin and action taken and appropriate administration of ablative radioiodine. Deficiencies in management of the cohort as a whole were identified, including inadequate surgery and inadequate TSH suppression in approximately one-fifth of the cases. Monitoring with thyroglobulin measurements and action when serum thyroglobulin was high were also inadequate in some cases and ablative radioiodine was not given, despite being indicated in 11.7% of the cohort. Inadequate surgery and failure to administer radioiodine were less common in those managed in a specialist clinic setting than in those managed in other clinic settings. The findings highlight the need for locally agreed protocols in managing relatively rare endocrine disorders such as thyroid cancer and argue in favour of centralization of expertise and patient management in multi-disciplinary specialist clinic settings.

  12. Are general practice characteristics predictors of good glycaemic control in patients with diabetes? A cross-sectional study.

    PubMed

    Esterman, Adrian J; Fountaine, Tim; McDermott, Robyn

    2016-01-18

    To determine whether certain characteristics of general practices are associated with good glycaemic control in patients with diabetes and with completing an annual cycle of care (ACC). Our cross-sectional analysis used baseline data from the Australian Diabetes Care Project conducted between 2011 and 2014. Practice characteristics were self-reported. Characteristics of the patients that were assessed included glycaemic control (HbA1c level ≤ 53 mmol/mol), age, sex, duration of diabetes, socio-economic disadvantage (SEIFA) score, the complexity of the patient's condition, and whether the patient had completed an ACC for diabetes in the past 18 months. Clustered logistic regression was used to establish predictors of glycaemic control and a completed ACC. Data were available from 147 general practices and 5455 patients with established type 1 or type 2 diabetes in three Australian states. After adjustment for other patient characteristics, only the patient completing an ACC was statistically significant as a predictor of glycaemic control (P = 0.011). In a multivariate model, the practice having a chronic disease-focused practice nurse (P = 0.036) and running educational events for patients with diabetes (P = 0.004) were statistically significant predictors of the patient having complete an ACC. Patient characteristics are moderately good predictors of whether the patient is in glycaemic control, whereas practice characteristics appear to predict only the likelihood of patients completing an ACC. The ACC is an established indicator of good diabetes management. This is the first study to report a positive association between having completed an ACC and the patient being in glycaemic control.

  13. How to get the customer service your practice deserves.

    PubMed

    Cavallo, Nancy

    2009-01-01

    What is good customer service, and how can office managers and others who deal with medical supply distributors get the customer service they deserve? This article covers the basics of good customer service, including examples of companies known for putting the customer first-Nordstrom, Disney, Johnson &Johnson, and VaxServe. Helpful tips on what to look for in a distributor include personalized service, cost considerations, dedication, knowledge, experience, helpfulness, openness, reliability, and compatibility.

  14. Implementation of sustainable evidence-based practice for the assessment and management of pain in residential aged care facilities.

    PubMed

    Savvas, Steven; Toye, Christine; Beattie, Elizabeth; Gibson, Stephen J

    2014-12-01

    Pain is common in residential aged care facilities (RACFs). In 2005, the Australian Pain Society developed 27 recommendations for good practice in the identification, assessment, and management of pain in these settings. This study aimed to address implementation of the standards and evaluate outcomes. Five facilities in Australia participated in a comprehensive evaluation of RACF pain practice and outcomes. Pre-existing pain management practices were compared with the 27 recommendations, before an evidence-based pain management program was introduced that included training and education for staff and revised in-house pain-management procedures. Post-implementation audits evaluated the program's success. Aged care staff teams also were assessed on their reports of self-efficacy in pain management. The results show that before the implementation program, the RACFs demonstrated full compliance on 6 to 12 standards. By the project's completion, RACFs demonstrated full compliance with 10 to 23 standards and major improvements toward compliance in the remaining standards. After implementation, the staff also reported better understanding of the standards (p < .001) or of facility pain management guidelines (p < .001), increased confidence in therapies for pain management (p < .001), and increased confidence in their training to assess pain (p < .001) and recognize pain in residents with dementia who are nonverbal (p = .003). The results show that improved evidence-based practice in RACFs can be achieved with appropriate training and education. Investing resources in the aged care workforce via this implementation program has shown improvements in staff self-efficacy and practice. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  15. Practice management based on risk assessment.

    PubMed

    Sandberg, Hans

    2004-01-01

    The management of a dental practice is most often focused on what clinicians do (production of items), and not so much on what is achieved in terms of oral health. The main reason for this is probably that it is easier to measure production and more difficult to measure health outcome. This paper presents a model based on individual risk assessment that aims to achieve a financially sound economy and good oral health. The close-to-the-clinic management tool, the HIDEP Model (Health Improvement in a DEntal Practice) was pioneered initially in Sweden at the end of 1980s. The experience over a 15-year period with different elements of the model is presented, including: the basis of examination and risk assessment; motivation; task delegation and leadership issues; health-finance evaluations; and quality development within a dental clinic. DentiGroupXL, a software program designed to support the work based on the model, is also described.

  16. The Role of Healthcare Technology Management in Facilitating Medical Device Cybersecurity.

    PubMed

    Busdicker, Mike; Upendra, Priyanka

    2017-09-02

    This article discusses the role of healthcare technology management (HTM) in medical device cybersecurity and outlines concepts that are applicable to HTM professionals at a healthcare delivery organization or at an integrated delivery network, regardless of size. It provides direction for HTM professionals who are unfamiliar with the security aspects of managing healthcare technologies but are familiar with standards from The Joint Commission (TJC). It provides a useful set of recommendations, including relevant references for incorporating good security practices into HTM practice. Recommendations for policies, procedures, and processes referencing TJC standards are easily applicable to HTM departments with limited resources and to those with no resource concerns. The authors outline processes from their organization as well as best practices learned through information sharing at AAMI, National Health Information Sharing and Analysis Center (NH-ISAC), and Medical Device Innovation, Safety, and Security Consortium (MDISS) conferences and workshops.

  17. Practice Management: The Game Changer

    PubMed Central

    Pessis, Paul

    2016-01-01

    The reimbursement landscape is undergoing significant changes. Practice management, which encompasses reimbursement, is becoming increasingly more important in securing business success. Each practitioner within a facility is responsible for fortifying the practice through thoughtful business protocols. Knowing legislation that impacts health care along with understanding the foundational components of reimbursement is key for keeping a practice financially healthy. Change is good, but making the changes is what counts! Legislation such as the Medicare Access and Chip Reauthorization Act defines the new payment models. Correcting current business practices might seem difficult on the surface, but implementing change is rewarding and an obligation of the practitioners within a facility to their patients. Financial stability for a practice occurs when sound business practices are routine. Today's audiologist must not only be proficient at performing his or her scope of practice, but must also accept that performing best business practices is part of the job. In the end, the patients seeking the services of the audiologist benefit most when a practice has the financial stability to be best in its class. PMID:28028326

  18. PORTALS: design of an innovative approach to anticoagulation management through eHealth.

    PubMed

    Talboom-Kamp, E P W A; Verdijk, N A; Talboom, I J S H; Harmans, L M; Numans, M E; Chavannes, N H

    2017-03-16

    For the monitoring of International Normalized Ratio (INR) values, venous thromboembolism (VTE) and atrial fibrillation (AF) patients can visit anticoagulation clinics, laboratories, or physicians for venous puncture. Point-of-care testing (POCT) made it possible for patients to monitor INR themselves (self-monitoring) and even self-adjust their medication dosage (self-dosage). Both skills are accepted as forms of self-management. eHealth applications can improve this self-management, resulting in better clinical outcomes. Our study, called PORTALS, aims at identifying the optimal implementation strategy of training to improve self-management and explore factors that enhance good self-management skills. In addition, the relationship between the implementation strategy of training, clinical outcomes, and individual characteristics will be investigated. Of the 247 recruited participants, 110 chose to continue with regular care. 137 patients have been randomly divided in subgroups and compared using a parallel cohort design: one group will be trained and educated by e-learning, and the other group will receive face-to-face group training. More insight in factors that enhance good self-management will help to improve clinical outcomes and patient satisfaction on anticoagulation therapy. Our study will provide practical insights and knowledge of eHealth in daily practice and of the importance of education on the adoption of self-management. We expect the self-management program including training to help patients to better manage their own INR values and medication use, thereby increasing health status and diminishing thromboembolic events and hospitalisation. The Netherlands National Trial Register, number NTR3947 .

  19. [Clinical practice guidelines and knowledge management in healthcare].

    PubMed

    Ollenschläger, Günter

    2013-10-01

    Clinical practice guidelines are key tools for the translation of scientific evidence into everyday patient care. Therefore guidelines can act as cornerstones of evidence based knowledge management in healthcare, if they are trustworthy, and its recommendations are not biased by authors' conflict of interests. Good medical guidelines should be disseminated by means of virtual (digital/electronic) health libraries - together with implementation tools in context, such as guideline based algorithms, check lists, patient information, a.s.f. The article presents evidence based medical knowledge management using the German experiences as an example. It discusses future steps establishing evidence based health care by means of combining patient data, evidence from medical science and patient care routine, together with feedback systems for healthcare providers.

  20. In search of practice performance data? Call the hospital.

    PubMed

    Bellile, S K

    1997-01-01

    Comparative performance data is increasingly being used by hospitals and managed care plans to evaluate physician practices. Outcomes data can also be a valuable tool for continuous improvement within a practice. Administrators need to understand the different categories and sources of physician practice data. Hospitals are a particularly good, yet often underutilized, data resource. Descriptive, financial and clinical information available from hospital systems can be used to compare one physician's performance to norms for specific case types (e.g. DRG's), focus internal review efforts and support managed care marketing and negotiation. Administrators need to identify key hospital contacts, make specific data requests and knowledgeably (and cautiously) interpret the data received. Finally, the administrator plays a crucial role turning data into information: identifying and presenting key findings and insuring that the information is used to the group's competitive advantage.

  1. Drainpipe network management information system design based on GIS and SCADA technique

    NASA Astrophysics Data System (ADS)

    Gu, Ze-Yu; Zhao, De-An

    2011-02-01

    Achieving urban drainpipe network integration of geographical information system (GIS) and supervisory control and data acquisition (SCADA) technology is described in this paper. The system design's plans are put forward, which have realized GIS and SCADA system supplementary in the technology and strengthened the model visible analysis ability. It is verified by practical cases that the system has more practical values and a good prospect.

  2. Influence of slash burning on regeneration, other plant cover, and fire hazard in the Douglas-fir region (a progress report).

    Treesearch

    William G. Morris

    1958-01-01

    In the Douglas-fir region, is slash burning ultimately good or bad practice? During the early 1940's whenever a group of foresters, met to discuss management or silviculture of that region, they usually debated this question. Until then they had burned slash in most clear cuttings east of the narrow coastal fog belt as accepted practice. Fire...

  3. A critical analysis of the South African Disaster Management Act and Policy Framework.

    PubMed

    van Niekerk, Dewald

    2014-10-01

    The promulgation of the South African Disaster Management Act No. 57 of 2002 and the National Disaster Management Policy Framework of 2005 placed South Africa at the international forefront by integrating disaster risk reduction into all spheres of government through a decentralised approach. Yet, good policy and legislation do not necessarily translate into good practice. This paper provides a critical analysis of the Act and Policy Framework. Using qualitative research methods, it analyses the attitudes and perceptions of senior public officials on all levels of government, the private sector and academia. The study finds that one of the weakest aspects of the Act and Framework is the absence of clear guidance to local municipalities. The placement of the disaster risk management function on all tiers of government remains problematic, funding is inadequate and overall knowledge and capacities for disaster risk reduction are insufficient. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

  4. Reducing risk for mother-to-infant transmission of hepatitis C virus: a systematic review for the U.S. Preventive Services Task Force.

    PubMed

    Cottrell, Erika Barth; Chou, Roger; Wasson, Ngoc; Rahman, Basmah; Guise, Jeanne-Marie

    2013-01-15

    Mother-to-infant transmission is the leading cause of childhood hepatitis C virus (HCV) infection, with up to 4000 new cases each year in the United States. To evaluate effects of mode of delivery, labor management strategies, and breastfeeding practices on risk for mother-to-infant transmission of HCV. MEDLINE (1947 to May 2012), the Cochrane Library Database, clinical trial registries, and reference lists. Randomized trials and observational studies on mode of delivery, labor management strategies, and breastfeeding practices and risk for mother-to-infant transmission of HCV. Investigators abstracted and reviewed study details and quality using predefined criteria. Eighteen observational studies evaluated the association between mode of delivery, labor management strategies, or breastfeeding practices and risk for mother-to-infant HCV transmission. Fourteen studies (2 good-quality, 4 fair-quality, and 8 poor-quality studies) found no clear association between mode of delivery (vaginal versus cesarean delivery) and risk for transmission. Two studies (1 good-quality and 1 poor-quality study) reported an association between prolonged duration of ruptured membranes and increased risk for transmission. Fourteen studies (2 good-quality, 2 fair-quality, and 10 poor-quality studies) found no association between breastfeeding and risk for transmission. Only English-language articles were included. Studies were observational, and most had important methodological shortcomings, including failure to adjust for potential confounders and small sample sizes. No intervention has been clearly demonstrated to reduce the risk for mother-to-infant HCV transmission. Avoidance of breastfeeding does not seem to be indicated for reducing transmission risk. Agency for Healthcare Research and Quality.

  5. Provider- and patient-related determinants of diabetes self-management among recent immigrants: Implications for systemic change.

    PubMed

    Hyman, Ilene; Shakya, Yogendra; Jembere, Nathaniel; Gucciardi, Enza; Vissandjée, Bilkis

    2017-02-01

    To examine provider- and patient-related factors associated with diabetes self-management among recent immigrants. Demographic and experiential data were collected using an international survey instrument and adapted to the Canadian context. The final questionnaire was pretested and translated into 4 languages: Mandarin, Tamil, Bengali, and Urdu. Toronto, Ont. A total of 130 recent immigrants with a self-reported diagnosis of type 2 diabetes mellitus who had resided in Canada for 10 years or less. Diabetes self-management practices (based on a composite of 5 diabetes self-management practices, and participants achieved a score for each adopted practice); and the quality of the provider-patient interaction (measured with a 5-point Likert-type scale that consisted of questions addressing participants' perceptions of discrimination and equitable care). A total of 130 participants in this study were recent immigrants to Canada from 4 countries of origin-Sri Lanka, Bangladesh, Pakistan, and China. Two factors were significant in predicting diabetes self-management among recent immigrants: financial barriers, specifically, not having enough money to manage diabetes expenses ( P  = .0233), and the quality of the provider-patient relationship ( P = .0016). Participants who did not have enough money to manage diabetes were 9% less likely to engage in self-management practices; and participants who rated the quality of their interactions with providers as poor were 16% less likely to engage in self-management practices. Financial barriers can undermine effective diabetes self-management among recent immigrants. Ensuring that patients feel comfortable and respected and that they are treated in culturally sensitive ways is also critical to good diabetes self-management. Copyright© the College of Family Physicians of Canada.

  6. Does a quality management system improve quality in primary care practices in Switzerland? A longitudinal study.

    PubMed

    Goetz, Katja; Hess, Sigrid; Jossen, Marianne; Huber, Felix; Rosemann, Thomas; Brodowski, Marc; Künzi, Beat; Szecsenyi, Joachim

    2015-04-21

    To examine the effectiveness of the quality management programme--European Practice Assessment--in primary care in Switzerland. Longitudinal study with three points of measurement. Primary care practices in Switzerland. In total, 45 of 91 primary care practices completed European Practice Assessment three times. The interval between each assessment was around 36 months. A variance analyses for repeated measurements were performed for all 129 quality indicators from the domains: 'infrastructure', 'information', 'finance', and 'quality and safety' to examine changes over time. Significant improvements were found in three of four domains: 'quality and safety' (F=22.81, p<0.01), 'information' (F=27.901, p<0.01) and 'finance' (F=4.073, p<0.02). The 129 quality indicators showed a significant improvement within the three points of measurement (F=33.864, p<0.01). The European Practice Assessment for primary care practices thus provides a functioning quality management programme, focusing on the sustainable improvement of structural and organisational aspects to promote high quality of primary care. The implementation of a quality management system which also includes a continuous improvement process would give added value to provide good care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. Does management really work?

    PubMed

    Bloom, Nicholas; Sadun, Raffaella; Van Reenen, John

    2012-11-01

    HBR's 90th anniversary is a sensible time to revisit a basic question: Are organizations more likely to succeed if they adopt good management practices? The answer may seem obvious to most HBR readers, but these three economists cast their net much wider than that. In a decadelong study of thousands of organizations in 20 countries, they and their interview teams assessed how well manufacturers, schools, and hospitals adhere to three management basics: targets, incentives, and monitoring. They found that huge numbers of companies follow none of those fundamentals, that adopting the basics yields big improvements in outcomes such as productivity and longevity, and that good nuts-and-bolts management at individual firms shapes national performance. At 14 textile manufacturers in India, for example, an intervention--involving free, high-quality advice from a consultant who was on-site half-time for five months--cut defects by half, reduced inventory by 20%, and raised output by 10%. A control group saw no such gains. The authors' global data set suggests that implementing good management at schools and hospitals yields change more slowly than at manufacturers--but it does come eventually. And the macroeconomic potential--for incomes, productivity, and delivery of critically needed services--is huge. A call for "better management" may sound prosaic, but given the global payoffs, it's actually quite radical.

  8. Promoting and Disseminating Good Practice in the Planning and Management of Educational Facilities: Capital Investment Strategic Planning - A Case Study, Gold Coast Institute of TAFE, Queensland, Australia.

    ERIC Educational Resources Information Center

    Crump, Kelvin

    This paper presents a case study of the process of capital investment strategic planning at the Gold Coast Institute of Technical and Further Education (TAFE), Queensland, Australia. Capital investment strategic planning is a means of contributing to success by providing strategies to ensure that assets are managed efficiently, effectively, and…

  9. Achieving Success in Small Business: A Self-Instruction Program for Small Business Owner-Managers. Success in Small Business: Luck or Pluck?

    ERIC Educational Resources Information Center

    Virginia Polytechnic Inst. and State Univ., Blacksburg. Div. of Vocational-Technical Education.

    This self-instructional module on success in small business is the first in a set of twelve modules designed for small business owner-managers. Competency objectives for this module are (1) ability to evaluate chances of success based upon one's personality and knowledge of good business practices and (2) ability to determine one's commitment to…

  10. Managing managed care: habitus, hysteresis and the end(s) of psychotherapy.

    PubMed

    Kirschner, S R; Lachicotte, W S

    2001-12-01

    In this paper we examine how clinicians at a community mental health center are responding to the beginnings of changes in the health care delivery system, changes that are designated under the rubric of "managed care." We describe how clinicians' attitudes about good mental health care are embodied in what sociologist Pierre Bourdieu calls their habitus, i.e., their professional habits and sense of good practice. Viewed in this light, their moral outrage and sense of threat, as well as their strategic attempts to resist or subvert the dictates of managed care agencies, become a function of what Bourdieu terms the hysteresis effect. The paper is based on ethnographic fieldwork conducted by a team of researchers at the mental health and substance abuse service of a hospital-affiliated, storefront clinic which serves residents of several neighborhoods in a large northeastern city. Data consist primarily of observations of meetings and interviews with staff members. We describe four aspects of the clinicians' professional habitus: a focus on cases as narratives of character and relationship, an imperative of authenticity, a distinctive orientation towards time, and an ethic of ambiguity. We then chronicle practices that have emerged in response to the limits on care imposed by managed care protocols, which are experienced by clinicians as violating the integrity of their work. These are discussed in relation to the concept of hysteresis.

  11. An appraisal of the 2012 American College of Rheumatology Guidelines for the Management of Gout.

    PubMed

    Nuki, George

    2014-03-01

    Appraisal of the 2012 American College of Rheumatology (ACR) Guidelines for the Management of Gout. The ACRs first clinical practice guidelines for the management of gout focus on recommendations for nonpharmacologic and pharmacologic approaches to hyperuricaemia and the treatment and prophylaxis of acute gouty arthritis. The RAND/UCLA appropriateness methodology employed assessed risks and benefits of alternative treatments for efficacy, safety and quality but not for cost-effectiveness. Novel recommendations include the use of either allopurinol or febuxostat for first-line urate-lowering drug therapy (ULT), screening for HLA-B*5801 prior to initiation of allopurinol in Asians at relatively high risk for allopurinol hypersensitivity, and the use of pegloticase for patients with severe, symptomatic, tophaceous gout refractory to, or intolerant of, appropriately dosed ULTs. Appraisal and comparison with other guidelines using Guidelines International Network and Appraisal of Guidelines, Research and Evaluation (AGREE II) criteria showed good scores for scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, editorial independence and, overall quality, but not for applicability. The ACR guidelines provide comprehensive, up-to-date, good-quality, evidence-based, expert consensus recommendations for the management of gout in clinical practice but score poorly for applicability. To improve the management of gout in the community a summary of key recommendations, criteria for audit and standards of care are now required.

  12. Principled Leadership and Business Diplomacy. A Practical, Values-Based Direction for Management Development.

    ERIC Educational Resources Information Center

    London, Manuel

    1999-01-01

    Describes business diplomacy based on the Japanese concept of kyosei (working for the common good). Gives case examples of application of principled diplomacy to ethical dilemmas and suggests ways to establish an organizational culture to support principled business leadership. (SK)

  13. Effects of cropping systems on soil biology

    USDA-ARS?s Scientific Manuscript database

    The need for fertilizer use to enhance soil nutrient pools to achieve good crop yield is essential to modern agriculture. Specific management practices, including cover cropping, that increase the activities of soil microorganisms to fix N and mobilize P and micronutrients may reduce annual inputs ...

  14. 21 CFR 10.115 - Good guidance practices.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ..., journal articles and editorials, media interviews, press materials, warning letters, memoranda of... document “Guidance Document Submission” and submit it to Division of Dockets Management (HFA-305), 5630... review. (iv) After providing an opportunity for public comment on a Level 1 guidance document, FDA will...

  15. 21 CFR 10.115 - Good guidance practices.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ..., journal articles and editorials, media interviews, press materials, warning letters, memoranda of... document “Guidance Document Submission” and submit it to Division of Dockets Management (HFA-305), 5630... review. (iv) After providing an opportunity for public comment on a Level 1 guidance document, FDA will...

  16. 21 CFR 10.115 - Good guidance practices.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ..., journal articles and editorials, media interviews, press materials, warning letters, memoranda of... document “Guidance Document Submission” and submit it to Division of Dockets Management (HFA-305), 5630... review. (iv) After providing an opportunity for public comment on a Level 1 guidance document, FDA will...

  17. 21 CFR 10.115 - Good guidance practices.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., journal articles and editorials, media interviews, press materials, warning letters, memoranda of... document “Guidance Document Submission” and submit it to Division of Dockets Management (HFA-305), 5630... review. (iv) After providing an opportunity for public comment on a Level 1 guidance document, FDA will...

  18. Aggregate stability in soils cultivated with eucalyptus

    USDA-ARS?s Scientific Manuscript database

    Eucalyptus cultivation has increased in many Brazilian regions. In order to recommend good management practices, it is necessary to understand changes in soil properties where eucalyptus is planted. Aggregate stability analyses have proved to be a useful tool to measure soil effects caused by change...

  19. Managing wetlands for disaster risk reduction: A case study of the eastern Free State, South Africa

    PubMed Central

    Collins, Nacelle

    2018-01-01

    This article investigated the knowledge and practice of a nature-based solution to reduce disaster risks of drought, veld fires and floods using wetlands in the eastern Free State, South Africa. A mixed research method approach was used to collect primary data using three data collection tools, namely questionnaires, interviews and field observations. Ninety-five wetlands under communal and private ownership as well as a few in protected areas were sampled, with their users completing questionnaires. The study showed that communal wetlands were more degraded, while wetlands in protected areas and in private commercial farms were in a good ecological state. An extensive literature review reveals that healthy wetlands are effective buffers in reducing disaster risks such as drought, veld fires and floods which are recurrent in the study area. Therefore, through better land-use and management practices, backed by education and awareness, wetlands could be good instruments to mitigate recurrent natural hazards in the agriculturally dominated eastern Free State in South Africa.

  20. Interactive effects among ecosystem services and management practices on crop production: Pollination in coffee agroforestry systems

    PubMed Central

    Boreux, Virginie; Kushalappa, Cheppudira G.; Vaast, Philippe; Ghazoul, Jaboury

    2013-01-01

    Crop productivity is improved by ecosystem services, including pollination, but this should be set in the context of trade-offs among multiple management practices. We investigated the impact of pollination services on coffee production, considering variation in fertilization, irrigation, shade cover, and environmental variables such as rainfall (which stimulates coffee flowering across all plantations), soil pH, and nitrogen availability. After accounting for management interventions, bee abundance improved coffee production (number of berries harvested). Some management interventions, such as irrigation, used once to trigger asynchronous flowering, dramatically increased bee abundance at coffee trees. Others, such as the extent and type of tree cover, revealed interacting effects on pollination and, ultimately, crop production. The effects of management interventions, notably irrigation and addition of lime, had, however, far more substantial positive effects on coffee production than tree cover. These results suggest that pollination services matter, but managing the asynchrony of flowering was a more effective tool for securing good pollination than maintaining high shade tree densities as pollinator habitat. Complex interactions across farm and landscape scales, including both management practices and environmental conditions, shape pollination outcomes. Effective production systems therefore require the integrated consideration of management practices in the context of the surrounding habitat structure. This paper points toward a more strategic use of ecosystem services in agricultural systems, where ecosystem services are shaped by the coupling of management interventions and environmental variables. PMID:23671073

  1. Medical negligence--prevention and management.

    PubMed

    Chao, T C

    1987-04-01

    The rising spate of malpractice cases against doctors appearing in the press and annual reports of medical insurance companies causes concern. Are our doctors more careless or is the public more conscious of litigation? A well publicized malpractice case can ruin the doctor's career and practice. It is well worth a doctor's while to know the pitfalls and learn how to prevent them, and if a mistake happens, how to manage it. Not all mistakes amount to negligence. How will the court view these cases? Some local cases are cited to illustrate the difference between misadventure and negligence. They will serve as guidelines for good medical practice.

  2. The vendor/laboratory manager relationship: some practical negotiation tips.

    PubMed

    Bickford, G R

    1993-01-01

    We negotiate practically every minute of the day with ourselves, as well as with spouses or loved ones, family members, friends, bosses, and coworkers. Skilled negotiators search for the common good, present accurate information, create alternatives, and strive for agreements that are fair to all concerned. Those who use misinformation and manipulation to win their short-term positions fail to build long-term relationships. Developing a positive attitude toward negotiating involves experience, recognizing the negotiating mechanism, evaluating decisions, and correctly determining when to stop negotiating and move on. Negotiations between suppliers and laboratory managers are used in this article to illustrate these processes.

  3. An assessment of workplace programmes designed to control inhalation risks using respiratory protective equipment.

    PubMed

    Bell, Nikki; Vaughan, Nicholas P; Morris, Len; Griffin, Peter

    2012-04-01

    Few studies have assessed respiratory protective equipment (RPE) failures at the organizational level despite evidence to suggest that compliance with good practice may be low. The aim of this study was to develop an understanding of what current RPE programmes look like across industry and how this compares with good practice. Twenty cross-industry site visits were conducted with companies that had RPE programmes in place. Visits involved management interviews to explore current RPE systems and procedures and the decision making underpinning these. Observations of RPE operatives were included followed by short interviews to discuss the behaviours observed. Post-site assessments jointly undertaken by an RPE scientist and psychologist produced ratings for each site on six critical aspects of RPE programmes (knowledge/awareness, selection, use, training/information, supervision, and storage/cleaning/maintenance). Overall ratings for theoretical competence (i.e. management knowledge of RPE) and practical control (i.e. actual RPE practice on the shop floor) were also given. Qualitative analysis was performed on all interview data. The performance of RPE programmes varied across industry. Fewer than half the companies visited were considered to have an acceptable level of theoretical competence and practical control. Four distinct groups emerged from the 20 sites studied, ranging from Learners (low theoretical competence and practical control--four sites), Developers (acceptable theoretical competence and low practical control--five sites), and Fortuitous (low theoretical competence and acceptable practical control--two sites), to Proficient (acceptable theoretical competence and practical control--nine sites). None of the companies visited were achieving optimal control through the use of RPE. Widespread inadequacies were found with programme implementation, particularly training, supervision, and maintenance. Our taxonomy based on the four groups (Learners, Developers, Fortuitous, and Proficient) provided a useful expert-informed tool for explaining the variation in performance of RPE programmes across industry. Although further research and development are required, this taxonomy offers a useful starting point for the development of practical tools that may assist managers in making the much-needed improvements to all facets of programme implementation, particularly training, supervision, and maintenance.

  4. Perspectives for geographically oriented management of fusarium mycotoxins in the cereal supply chain.

    PubMed

    van der Fels-Klerx, H J; Booij, C J H

    2010-06-01

    This article provides an overview of available systems for management of Fusarium mycotoxins in the cereal grain supply chain, with an emphasis on the use of predictive mathematical modeling. From the state of the art, it proposes future developments in modeling and management and their challenges. Mycotoxin contamination in cereal grain-based feed and food products is currently managed and controlled by good agricultural practices, good manufacturing practices, hazard analysis critical control points, and by checking and more recently by notification systems and predictive mathematical models. Most of the predictive models for Fusarium mycotoxins in cereal grains focus on deoxynivalenol in wheat and aim to help growers make decisions about the application of fungicides during cultivation. Future developments in managing Fusarium mycotoxins should include the linkage between predictive mathematical models and geographical information systems, resulting into region-specific predictions for mycotoxin occurrence. The envisioned geographically oriented decision support system may incorporate various underlying models for specific users' demands and regions and various related databases to feed the particular models with (geographically oriented) input data. Depending on the user requirements, the system selects the best fitting model and available input information. Future research areas include organizing data management in the cereal grain supply chain, developing predictive models for other stakeholders (taking into account the period up to harvest), other Fusarium mycotoxins, and cereal grain types, and understanding the underlying effects of the regional component in the models.

  5. Review on diagnosis and management of urolithiasis in pregnancy: an ESUT practical guide for urologists.

    PubMed

    Somani, Bhaskar K; Dellis, Athanasios; Liatsikos, Evangellos; Skolarikos, Andreas

    2017-11-01

    Management of urolithiasis in pregnancy can be challenging for most urologists with diagnostic and treatment dilemma to ensure the best outcome for both mother and fetus. We wanted to review the literature for urolithiasis in pregnancy with a practical management guide for urologists. A non-systematic review of literature was carried out for all English language literature using Medline. To ensure a more comprehensive search, the review of diagnosis and management of pregnant patients with urolithiasis was carried out separately, by two authors independently. Due to diagnostic complexity, investigations (US, CT, MRI) carried out were assessed separately. Our search included diagnostic studies such as US, CT and MRI (73, 20 and 27 articles, respectively) and management studies (55 articles in total). Details on etiology, radiation risk, safety of various diagnostic modalities, medications and treatment options are covered through an evidence-based approach. We provide a practical guide for urologists in what is clearly a stressful situation for patient and physician alike. Urolithiasis in pregnancy needs a careful multidisciplinary management to achieve good outcomes for both mother and baby. Our review shows that a balanced approach for diagnosis and treatment seems to achieve the best outcomes in pregnancy.

  6. Improving waste segregation while reducing costs in a tertiary-care hospital in a lower-middle-income country in Central America.

    PubMed

    Johnson, Kyle M; González, Miriam L; Dueñas, Lourdes; Gamero, Mario; Relyea, George; Luque, Laura E; Caniza, Miguela A

    2013-07-01

    Healthcare waste (HCW) management and segregation are essential to ensure safety, environmental protection and cost control. Poor HCW management increase risks and costs for healthcare institutions. On-going surveillance and training are important to maintain good HCW practices. Our objectives were to evaluate and improve HCW practices at Hospital Bloom, San Salvador, El Salvador. We studied HCW disposal practices by observing waste containers, re-segregating waste placed in biohazardous waste bags, and administering a seven-itemsknowledge survey before and after training in waste management at Hospital Bloom. The training was based on national and international standards. We followed total biohazardous waste production before and after the training. The hospital staff was knowledgeable about waste segregation practices, but had poor compliance with national policies. Re-segregating waste in biohazardous waste bags showed that 61% of this waste was common waste, suggesting that the staff was possibly unaware of the cost of mis-segregating healthcare waste. After staff training in HCW management, the correct responses increased by 44% and biohazardous waste disposal at the hospital reduced by 48%. Better segregation of biohazardous waste and important savings can be obtained by HCW management education of hospital staff. Hospitals can benefit from maximising the use of available resources by sustaining best practices of HCW, especially those in hospitals in lower-middle-income countries.

  7. Report of a Meeting on Contemporary Topics in Zebrafish Husbandry and Care

    PubMed Central

    Osborne, Nikki; Paull, Gregory; Grierson, Adam; Dunford, Karen; Busch-Nentwich, Elisabeth M.; Sneddon, Lynne U.; Wren, Natalie; Higgins, Joe

    2016-01-01

    Abstract A meeting on Contemporary Topics in Zebrafish Husbandry and Care was held in the United Kingdom in 2014, with the aim of providing a discussion forum for researchers, animal technologists, and veterinarians from academia and industry to share good practice and exchange ideas. Presentation topics included protocols for optimal larval rearing, implementing the 3Rs (replacement, reduction, and refinement) in large-scale colony management, and environmental enrichment. The audience also participated in a survey of current practice relating to practical husbandry, cryopreservation, and the provision of enrichment. PMID:27537782

  8. Report of a Meeting on Contemporary Topics in Zebrafish Husbandry and Care.

    PubMed

    Osborne, Nikki; Paull, Gregory; Grierson, Adam; Dunford, Karen; Busch-Nentwich, Elisabeth M; Sneddon, Lynne U; Wren, Natalie; Higgins, Joe; Hawkins, Penny

    2016-12-01

    A meeting on Contemporary Topics in Zebrafish Husbandry and Care was held in the United Kingdom in 2014, with the aim of providing a discussion forum for researchers, animal technologists, and veterinarians from academia and industry to share good practice and exchange ideas. Presentation topics included protocols for optimal larval rearing, implementing the 3Rs (replacement, reduction, and refinement) in large-scale colony management, and environmental enrichment. The audience also participated in a survey of current practice relating to practical husbandry, cryopreservation, and the provision of enrichment.

  9. Impact of waste management training intervention on knowledge, attitude and practices of teaching hospital workers in Pakistan.

    PubMed

    Kumar, Ramesh; Somrongthong, Ratana; Ahmed, Jamil

    2016-01-01

    To evaluate the sustainability and effectiveness of training as an intervention to improve the knowledge, attitude and practices of hospital workers on health care waste management. We conducted this quasi-experimental study in two tertiary care teaching hospitals in Rawalpindi in October 2013. Training, practical demonstrations and reminders on standard waste management were given to 138 hospital workers in one hospital and compared with 137 workers from the control hospital. We collected data 18 months after intervention through a structured questionnaire to assess the impact of the intervention. We used paired t-test to compare the scores on knowledge, attitude and practices at baseline and first follow up and final impact assessment. Chi square test was used to compare group variables between intervention and control groups. After 18 months since intervention the mean scores on knowledge attitude and practices differed statistically significantly since baseline and intervention group had statistically significantly better knowledge positive attitudes and good health care waste management practices (p < 0.001). Health care and sanitary workers in intervention group scored statistically significantly higher (p < 0.001). Trainings of health and sanitary workers on health care waste management guidelines were sustainable among the intervention group after 18 months which shows the positive impact of our intervention. It is recommended that the trainings as intervention be included in the overall policies of the public and private sector hospitals in Pakistan and other similar settings.

  10. Preparing for an EPA Inspection and Avoiding Common Mistakes.

    ERIC Educational Resources Information Center

    Manicone, Santo

    2000-01-01

    Discusses how a higher education facility can prepare for an Environmental Protection Agency inspection with some quick topics designed to smooth the process. Tips include determining if waste is hazardous, labeling waste properly, preventing pollution, improving housekeeping, and having good hazardous materials management practices. (GR)

  11. 22 CFR 1420.1 - Purpose and scope.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of the Foreign Service Labor-Management Relations Statute. They prescribe the procedures and basic principles or criteria under which the Foreign Service Labor Relations Board or the General Counsel of the... practices; (c) Resolve issues relating to the obligation to bargain in good faith; (d) Resolve disputes...

  12. Managing Meetings

    ERIC Educational Resources Information Center

    Hay, Susan

    2010-01-01

    Meetings are a means of giving people a chance to contribute. Meetings are also the nursery where the people's skills of listening, speaking, and building good working relationships are honed. They are where people practice being courteously challenging and confident, and they are where people are fascinated and fascinating. Meetings are where…

  13. Student Complainants--Vexatious or Vulnerable?

    ERIC Educational Resources Information Center

    Millward, Christine V.

    2016-01-01

    In December 2014, the Office of the Independent Adjudicator (OIA) introduced the "Good practice framework for handling complaints and academic appeals" which will inform external judgement on each university's approach to conflict management from the current academic year 2015-2016. The framework aims to improve the complaint process for…

  14. Team research at the biology-mathematics interface: project management perspectives.

    PubMed

    Milton, John G; Radunskaya, Ami E; Lee, Arthur H; de Pillis, Lisette G; Bartlett, Diana F

    2010-01-01

    The success of interdisciplinary research teams depends largely upon skills related to team performance. We evaluated student and team performance for undergraduate biology and mathematics students who participated in summer research projects conducted in off-campus laboratories. The student teams were composed of a student with a mathematics background and an experimentally oriented biology student. The team mentors typically ranked the students' performance very good to excellent over a range of attributes that included creativity and ability to conduct independent research. However, the research teams experienced problems meeting prespecified deadlines due to poor time and project management skills. Because time and project management skills can be readily taught and moreover typically reflect good research practices, simple modifications should be made to undergraduate curricula so that the promise of initiatives, such as MATH-BIO 2010, can be implemented.

  15. Guidelines for maintaining and managing the vaccine cold chain.

    PubMed

    2003-10-24

    In February 2002, the Advisory Committee on Immunization Practices (ACIP) and American Academy of Family Physicians (AAFP) released their revised General Recommendations on Immunization, which included recommendations on the storage and handling of immunobiologics. Because of increased concern over the potential for errors with the vaccine cold chain (i.e., maintaining proper vaccine temperatures during storage and handling to preserve potency), this notice advises vaccine providers of the importance of proper cold chain management practices. This report describes proper storage units and storage temperatures, outlines appropriate temperature-monitoring practices, and recommends steps for evaluating a temperature-monitoring program. The success of efforts against vaccine-preventable diseases is attributable in part to proper storage and handling of vaccines. Exposure of vaccines to temperatures outside the recommended ranges can affect potency adversely, thereby reducing protection from vaccine-preventable diseases. Good practices to maintain proper vaccine storage and handling can ensure that the full benefit of immunization is realized.

  16. Lean practices for quality results: a case illustration.

    PubMed

    Hwang, Pauline; Hwang, David; Hong, Paul

    2014-01-01

    Increasingly, healthcare providers are implementing lean practices to achieve quality results. Implementing lean healthcare practices is unique compared to manufacturing and other service industries. The purpose of this paper is to present a model that identifies and defines the lean implementation key success factors in healthcare organisations. The model is based on an extant literature review and a case illustration that explores actual lean implementation in a major USA hospital located in a Midwestern city (approximately 300,000 people). An exploratory/descriptive study using observation and follow-up interviews was conducted to identify lean practices in the hospital. Lean practice key drivers include growing elderly populations, rising medical expenses, decreasing insurance coverage and decreasing management support. Effectively implementing lean practices to increase bottom-line results and improve organisational integrity requires sharing goals and processes among healthcare managers and professionals. An illustration explains the model and the study provides a sound foundation for empirical work. Practical implications are included. Lean practices minimise waste and unnecessary hospital stays while simultaneously enhancing customer values and deploying resources in supply systems. Leadership requires clear project targets based on sound front-end planning because initial implementation steps involve uncertainty and ambiguity (i.e. fuzzy front-end planning). Since top management support is crucial for implementing lean practices successfully, a heavyweight manager, who communicates well both with top managers and project team members, is an important success factor when implementing lean practices. Increasingly, green orientation and sustainability initiatives are phrases that replaced lean practices. Effective results; e.g. waste reduction, employee satisfaction and customer values are applicable to bigger competitive challenges arising both in specific organisations and inter-organisational networks. Healthcare managers are adopting business practices that improve efficiency and productivity while ensuring their healthcare mission and guaranteeing that customer values are achieved. Shared understanding about complex goals (e.g. reducing waste and enhancing customer value) at the front-end is crucial for implementing successful lean practices. In particular, this study shows that nursing practices, which are both labour intensive and technology enabled, are good candidates for lean practice.

  17. [Application of password manager software in health care].

    PubMed

    Ködmön, József

    2016-12-01

    When using multiple IT systems, handling of passwords in a secure manner means a potential source of problem. The most frequent issues are choosing the appropriate length and complexity, and then remembering the strong passwords. Password manager software provides a good solution for this problem, while greatly increasing the security of sensitive medical data. This article introduces a password manager software and provides basic information of the application. It also discusses how to select a really secure password manager software and suggests a practical application to efficient, safe and comfortable use for health care. Orv. Hetil., 2016, 157(52), 2066-2073.

  18. Evaluation of a rule base for decision making in general practice.

    PubMed Central

    Essex, B; Healy, M

    1994-01-01

    BACKGROUND. Decision making in general practice relies heavily on judgmental expertise. It should be possible to codify this expertise into rules and principles. AIM. A study was undertaken to evaluate the effectiveness, of rules from a rule base designed to improve students' and trainees' management decisions relating to patients seen in general practice. METHOD. The rule base was developed after studying decisions about and management of thousands of patients seen in one general practice over an eight year period. Vignettes were presented to 93 fourth year medical students and 179 general practitioner trainees. They recorded their perception and management of each case before and after being presented with a selection of relevant rules. Participants also commented on their level of agreement with each of the rules provided with the vignettes. A panel of five independent assessors then rated as good, acceptable or poor, the participants' perception and management of each case before and after seeing the rules. RESULTS. Exposure to a few selected rules of thumb improved the problem perception and management decisions of both undergraduates and trainees. The degree of improvement was not related to previous experience or to the stated level of agreement with the proposed rules. The assessors identified difficulties students and trainees experienced in changing their perceptions and management decisions when the rules suggested options they had not considered. CONCLUSION. The rules developed to improve decision making skills in general practice are effective when used with vignettes. The next phase is to transform the rule base into an expert system to train students and doctors to acquire decision making skills. It could also be used to provide decision support when confronted with difficult management decisions in general practice. PMID:8204334

  19. Measuring the Effect of Management on Performance: A Modern Biblical Paradigm

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

    Corcoran, W.R.

    1999-11-14

    The ability to measure the effect of management on performance enables higher management and regulators to prescribe measures to ensure that actual management practices are compatible with results important to stakeholders. The principal stakeholders of higher management are the owners, and the principal stakeholders of the regulators are the public. Extended shutdowns and confirmatory action letters over the past decade or so at Cook, Millstone, Zion, Haddam Neck, Clinton, South Texas, Calvert Cliffs, Pilgrim, and other stations strongly suggest that neither higher management nor regulators have a firm grasp of the measurement of the effect of management on performance. Effortsmore » in the past have focused on attributes of effective management rather than data. For example, the U.S. Nuclear Regulatory Commission uses Appendix B, and the Institute of Nuclear Power Operations uses its ''Excellence in Human Performance'' among other guidance. In both cases, assessment focuses on the observation of what is going on in an organization and comparing it with the criteria. In this paper, the emphasis is on data, not attributes. The data of concern here are results (consequences, events, precursors). The biblical paradigm is that a good tree bears good fruit. It does not take a botanist to tell that the apples are firm and tasty. ''Not everything that counts can be counted, and not everything that can be counted counts'' is a popular defense of attribute-driven assessment. The validity of attribute-driven assessment is not disputed, but this paper explores data-driven assessment that is becoming more practical as information technology advances rapidly. This paper does not address a complete management effect measurement system but only explores one aspect of such a system. The aspect chosen is regulatory violation performance.« less

  20. Team Science Approach to Developing Consensus on Research Good Practices for Practice-Based Research Networks: A Case Study.

    PubMed

    Campbell-Voytal, Kimberly; Daly, Jeanette M; Nagykaldi, Zsolt J; Aspy, Cheryl B; Dolor, Rowena J; Fagnan, Lyle J; Levy, Barcey T; Palac, Hannah L; Michaels, LeAnn; Patterson, V Beth; Kano, Miria; Smith, Paul D; Sussman, Andrew L; Williams, Robert; Sterling, Pamela; O'Beirne, Maeve; Neale, Anne Victoria

    2015-12-01

    Using peer learning strategies, seven experienced PBRNs working in collaborative teams articulated procedures for PBRN Research Good Practices (PRGPs). The PRGPs is a PBRN-specific resource to facilitate PBRN management and staff training, to promote adherence to study protocols, and to increase validity and generalizability of study findings. This paper describes the team science processes which culminated in the PRGPs. Skilled facilitators used team science strategies and methods from the Technology of Participation (ToP®), and the Consensus Workshop Method to support teams to codify diverse research expertise in practice-based research. The participatory nature of "sense-making" moved through identifiable stages. Lessons learned include (1) team input into the scope of the final outcome proved vital to project relevance; (2) PBRNs with diverse domains of research expertise contributed broad knowledge on each topic; and (3) ToP® structured facilitation techniques were critical for establishing trust and clarifying the "sense-making" process. © 2015 Wiley Periodicals, Inc.

  1. Promoting Good Clinical Laboratory Practices and Laboratory Accreditation to Support Clinical Trials in Sub-Saharan Africa

    PubMed Central

    Shott, Joseph P.; Saye, Renion; Diakité, Moussa L.; Sanogo, Sintry; Dembele, Moussa B.; Keita, Sekouba; Nagel, Mary C.; Ellis, Ruth D.; Aebig, Joan A.; Diallo, Dapa A.; Doumbo, Ogobara K.

    2012-01-01

    Laboratory capacity in the developing world frequently lacks quality management systems (QMS) such as good clinical laboratory practices, proper safety precautions, and adequate facilities; impacting the ability to conduct biomedical research where it is needed most. As the regulatory climate changes globally, higher quality laboratory support is needed to protect study volunteers and to accurately assess biological parameters. The University of Bamako and its partners have undertaken a comprehensive QMS plan to improve quality and productivity using the Clinical and Laboratory Standards Institute standards and guidelines. The clinical laboratory passed the College of American Pathologists inspection in April 2010, and received full accreditation in June 2010. Our efforts to implement high-quality standards have been valuable for evaluating safety and immunogenicity of malaria vaccine candidates in Mali. Other disease-specific research groups in resource-limited settings may benefit by incorporating similar training initiatives, QMS methods, and continual improvement practices to ensure best practices. PMID:22492138

  2. Risk assessment and management approaches on mental health units.

    PubMed

    Woods, P

    2013-11-01

    This exploratory and descriptive study took place in one Canadian province. The study aimed to: (1) to identify and describe the nature and extent of current risk assessment and management approaches used in the adult inpatient mental health and forensic units; and (2) to identify good practice and shortfalls in the nature and extent of the approaches currently utilized. Data were collected from 48 participants through nine focus groups. Participants reported that they used a clinical approach to risk assessment. They had also not considered risk assessment and management as a proactive structured process. Education and training was also limited and skills were developed over time through practice. Five keys issues are discussed as important: reliance on clinical judgement alone is not the best choice to make; the need to consider risk as a whole concept; risk management being more reactive than proactive; education and training; and client involvement in risk assessment. © 2012 John Wiley & Sons Ltd.

  3. Governance of professional nursing practice in a hospital setting: a mixed methods study.

    PubMed

    dos Santos, José Luís Guedes; Erdmann, Alacoque Lorenzini

    2015-01-01

    To elaborate an interpretative model for the governance of professional nursing practice in a hospital setting. A mixed methods study with concurrent triangulation strategy, using data from a cross-sectional study with 106 nurses and a Grounded Theory study with 63 participants. The quantitative data were collected through the Brazilian Nursing Work Index - Revised and underwent descriptive statistical analysis. Qualitative data were obtained from interviews and analyzed through initial, selective and focused coding. Based on the results obtained with the Brazilian Nursing Work Index - Revised, it is possible to state that nurses perceived that they had autonomy, control over the environment, good relationships with physicians and organizational support for nursing governance. The governance of the professional nursing practice is based on the management of nursing care and services carried out by the nurses. To perform these tasks, nurses aim to get around the constraints of the organizational support and develop management knowledge and skills. It is important to reorganize the structures and processes of nursing governance, especially the support provided by the organization for the management practices of nurses.

  4. Disability management practices in Ontario workplaces: employees' perceptions.

    PubMed

    Westmorland, Muriel G; Williams, Renee M; Amick, Ben C; Shannon, Harry; Rasheed, Farah

    2005-07-22

    The purpose of this study was to obtain employees' perceptions about disability management (DM) at their workplaces. Data were obtained from focus group interviews and individual telephone interviews with 58 employees who had sustained a work-related injury or disability in Ontario, Canada. Participants also completed a 22-item Organizational Policies and Practices (OPP) Questionnaire that asked questions about workplace DM practices. Respondents emphasized the need for job accommodation, the importance of open and clear communication and the necessity of job retraining. The provision of ergonomic modifications to their worksites and the development of meaningful and specific DM policies and procedures were seen as key to a comprehensive workplace DM program. Education about health and safety also was identified as an important component of creating a supportive workplace environment. The OPP questionnaire showed good internal consistency (Cronbach's alpha=0.95) and discriminant validity. This study demonstrates the importance of workplaces communicating with their employees and respecting their opinions when establishing and carrying out DM policies and practices. The OPP Questionnaire is useful in determining how DM is managed in the workplace.

  5. Diagnostic laboratory for bleeding disorders ensures efficient management of haemorrhagic disorders.

    PubMed

    Riddell, A; Chuansumrit, A; El-Ekiaby, M; Nair, S C

    2016-07-01

    Haemorrhagic disorders like Postpartum haemorrhage and Dengue haemorrhagic fever are life threatening and requires an active and efficient transfusion service that could provide the most appropriate blood product which could be effective in managing them. This would essentially require prompt identification of the coagulopathy so that the best available product can be given to the bleeding patient to correct the identified haemostatic defect which will help control the bleeding. This would only be possible if the transfusion service has a laboratory to correctly detect the haemostatic defect and that too with an accuracy and precision which is ensured by a good laboratory quality assurance practices. These same processes are necessary for the transfusion services to ensure the quality of the blood products manufactured by them and that it contains adequate amounts of haemostasis factors which will be good to be effective in the management of haemorrhagic disorders. These issues are discussed in detail individually in the management of postpartum haemorrhage and Dengue haemorrhagic fever including when these can help in the use of rFVIIa in Dengue haemorrhagic fever. The requirements to ensure good-quality blood products are made available for the management of these disorders and the same have also been described. © 2016 John Wiley & Sons Ltd.

  6. Sales Simulation Games: Student and Instructor Perceptions

    ERIC Educational Resources Information Center

    Beuk, Frederik

    2016-01-01

    This study combines the perspective of students (n = 137) and sales instructors (n = 248). It compares how well selling and sales management simulation games, case discussions, and traditional lectures are perceived to conform to the seven principles for good practice in undergraduate education. The study further compares each method's performance…

  7. Key Skills Portfolio Assessment: Good Practice Guide

    ERIC Educational Resources Information Center

    Rolfe, Martin; Wilson, Lorraine

    2007-01-01

    This guide offers advice and guidance to key skills managers, coordinators and other practitioners who are responsible for ensuring that the standards of portfolio assessment in their center are consistent across the center and with national standards. It describes and offers advice and guidance on the stages of assessment and internal moderation…

  8. Dreaming, Stealing, Dancing, Showing Off.

    ERIC Educational Resources Information Center

    Lavender, Peter; Taylor, Chris

    2002-01-01

    Lessons learned from British projects to delivery literacy, numeracy, and English as a second language through community agencies included the following: (1) innovation and measured risks are required to attract hard-to-reach adults; (2) good practice needs to be shared; and (3) projects worked best when government funds were managed by community…

  9. 77 FR 36603 - Proposed Agency Information Collection Activities; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-19

    ..., Washington, DC 20590 (telephone: (202) 493-6292), or Ms. Kimberly Toone, Office of Information Technology... Paperwork Reduction Act of 1995 (PRA), Public Law 104-13, Section 2, 109 Stat. 163 (1995) (codified as..., information for the improvement of safety at highway-rail crossings. Good management practices necessitate...

  10. Nova Scotia Teachers' ADHD Knowledge, Beliefs, and Classroom Management Practices

    ERIC Educational Resources Information Center

    Blotnicky-Gallant, Pamela; Martin, Cheron; McGonnell, Melissa; Corkum, Penny

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) has a significant impact on children's social, emotional, and academic performance in school, and as such, teachers are in a good position to provide evidence-based interventions to help ensure optimal adjustment of their students. The current study examined teachers' knowledge and beliefs about…

  11. Achieving Quality Learning in Higher Education.

    ERIC Educational Resources Information Center

    Nightingale, Peggy; O'Neil, Mike

    This volume on quality learning in higher education discusses issues of good practice particularly action learning and Total Quality Management (TQM)-type strategies and illustrates them with seven case studies in Australia and the United Kingdom. Chapter 1 discusses issues and problems in defining quality in higher education. Chapter 2 looks at…

  12. Competitive Intelligence for SMEs. From Intellectual Concepts to Actionable CI Rules and Good Practices.

    ERIC Educational Resources Information Center

    Dou, Henri

    2000-01-01

    Presents several aspects of the development of actionable competitive intelligence into SMEs (small and medium enterprises). Describes types of information used in SMEs, economic intelligence in France, suggestions for information management, and various works undertaken through the European Community. (Contains 11 references.) (Author/LRW)

  13. Managing Microcomputer Applications: A Primer and Guide to Good Practice,

    DTIC Science & Technology

    1988-03-01

    15 What are the Attitude Changes...39 Behavioral Characteristics of the Computer-Oriented Worker ....... 42 Implications for...widespread in the Corps. Attitudes Computer usage is often Communications problems with ADP groups in many looked on as an ’extra’ FOA’s have created a

  14. Texas A&M Texarkana Illustrates Best Practices in PLA

    ERIC Educational Resources Information Center

    Delleville, Valerie

    2017-01-01

    Some institutions' prior learning assessment (PLA) programs are far more successful than others. As with any strategic initiative, the best-intentioned policy is only as good as the implementation, operations, and people behind it. Beyond progressing through the change management process, ensuring sustainability is critical to long-term PLA…

  15. Creating a Healthy Camp Community: A Nurse's Role.

    ERIC Educational Resources Information Center

    Lishner, Kris Miller; Bruya, Margaret Auld

    This book provides an organized, systematic overview of the basic aspects of health program management, nursing practice, and human relations issues in camp nursing. A foremost assumption is that health care in most camps needs improvement. Good health is dependent upon interventions involving social, environmental, and lifestyle factors that…

  16. 76 FR 60052 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-28

    ... Request; Current Good Manufacturing Practice Regulations for Finished Pharmaceuticals AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0362...

  17. Threats and countermeasures for network security

    NASA Technical Reports Server (NTRS)

    Denning, Peter J.

    1991-01-01

    In the late 1980's, the traditional threat of anonymous break-ins to networked computers was joined by viruses and worms, multiplicative surrogates that carry out the bidding of their authors. Technologies for authentication and secrecy, supplemented by good management practices, are the principal countermeasures. Four articles on these subjects are presented.

  18. Policy Issues in the Administration of Higher Education in Nigeria

    ERIC Educational Resources Information Center

    Ogbogu, Christiana O.

    2013-01-01

    This paper evaluates policy initiatives in the Nigerian higher educational system with a view to bringing it in line with good practices. Issues of gender, management/governance, teaching, research and funding were discussed. The study revealed that government's funding is insufficient to maintain institutional performance because of the policy…

  19. Applying Industrial Design Best Practices in the Acquisition of Soldier Equipment

    DTIC Science & Technology

    2002-03-01

    their meal when it is included. Presently, the US Army is considering a complete change of uniform if for no other reason, the soldier will feel...to increase soldier acceptance of equipment. The conclusion provides recommendations to program managers on how they can design a good product, what...

  20. Barriers and enablers to good communication and information-sharing practices in care planning for chronic condition management.

    PubMed

    Lawn, Sharon; Delany, Toni; Sweet, Linda; Battersby, Malcolm; Skinner, Timothy

    2015-01-01

    Our aim was to document current communication and information-sharing practices and to identify the barriers and enablers to good practices within the context of care planning for chronic condition management. Further aims were to make recommendations about how changes to policy and practice can improve communication and information sharing in primary health care. A mixed-method approach was applied to seek the perspectives of patients and primary health-care workers across Australia. Data was collected via interviews, focus groups, non-participant observations and a national survey. Data analysis was performed using a mix of thematic, discourse and statistical approaches. Central barriers to effective communication and information sharing included fragmented communication, uncertainty around client and interagency consent, and the unacknowledged existence of overlapping care plans. To be most effective, communication and information sharing should be open, two-way and inclusive of all members of health-care teams. It must also only be undertaken with the appropriate participant consent, otherwise this has the potential to cause patients harm. Improvements in care planning as a communication and information-sharing tool may be achieved through practice initiatives that reflect the rhetoric of collaborative person-centred care, which is already supported through existing policy in Australia. General practitioners and other primary care providers should operationalise care planning, and the expectation of collaborative and effective communication of care that underpins it, within their practice with patients and all members of the care team. To assist in meeting these aims, we make several recommendations.

  1. Biosafety principles and practices for the veterinary diagnostic laboratory.

    PubMed

    Kozlovac, Joseph; Schmitt, Beverly

    2015-01-01

    Good biosafety and biocontainment programs and practices are critical components of the successful operation of any veterinary diagnostic laboratory. In this chapter we provide information and guidance on critical biosafety management program elements, facility requirements, protective equipment, and procedures necessary to ensure that the laboratory worker and the environment are adequately protected in the challenging work environment of the veterinary diagnostic laboratory in general and provide specific guidance for those laboratories employing molecular diagnostic techniques.

  2. [How to promote the respect of good infusion practices by meeting health care professionals?].

    PubMed

    Le Reste, C; Fiedler, A; Dubois, S; Dewailly, A; Le Du, I; Cogulet, V

    2016-05-01

    Health care professionals often forget that there are risks associated with infusion therapy even if it is a common care. In order to assess this practice and to draw potential improvement actions, an audit of local gravity-flow intravenous infusion practices was conducted. The audit, based on a grid including 66 items from the medical prescription to the end of the infusion therapy administration, was conducted in the 6 units which use the most gravity-flow intravenous infusion devices. A multidisciplinary working group was created to decide and organize priority corrective measures in order to improve infusion practices and quality of healthcare. The audit enabled to observe 90hours of nurse's practices (96 infusions) and highlighted heterogeneity in infusion, in some cases inappropriate infusion practices and misuse of infusion devices. We found 4 main issues: labelling infusion therapy, training of health care professionals on good practices, support the purchase of infusion pumps and standardize perfusion line. An interactive educational program for nurses (workshops) was organized to enhance the respect of good practices: infusion identification at any time, respect of hygiene rules, flow rate regulation by counting drops, appropriate use of pumps and flow rate regulators. The audit drew up work priorities. The workshops made easier exchanges between professionals and had a warm welcome that's why it is essential to carry on such training. This collaborative approach between pharmacists, nurses, hygienists and biomedical technicians contribute to drug management improvement and promote optimal patient care. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

  3. Women's work. Maintaining a healthy body weight.

    PubMed

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

    2009-08-01

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

  4. Regulation of solid waste management at Brazilian ports: analysis and proposals for Brazil in light of the European experience.

    PubMed

    Jaccoud, Cristiane; Magrini, Alessandra

    2014-02-15

    With a coastline of 8500 km, Brazil has 34 public ports and various private terminals, which together in 2012 handled 809 million tonnes of goods. The solid wastes produced (from port activities, ships and cargoes) pose a highly relevant problem, both due to the quantity and diversity, requiring a complex and integrated set of practices resulting from legal requirements and proactive initiatives. The main Brazilian law on solid waste management is recent (Law 12,305/2010) and the specific rules on solid waste in ports are badly in need of revision to meet the challenges caused by expansion of the sector and to harmonize them with the best global practices. This paper analyzes the current legal/regulatory framework for solid waste management at Brazilian ports and compares this structure with the practice in Europe. At the end, we suggest initiatives to improve the regulation of solid wastes at Brazilian ports. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Risk factors and monitoring for water quality to determine best management practices for splash parks.

    PubMed

    de Man, H; Leenen, E J T M; van Knapen, F; de Roda Husman, A M

    2014-09-01

    Splash parks have been associated with infectious disease outbreaks as a result of exposure to poor water quality. To be able to protect public health, risk factors were identified that determine poor water quality. Samples were taken at seven splash parks where operators were willing to participate in the study. Higher concentrations of Escherichia coli were measured in water of splash parks filled with rainwater or surface water as compared with sites filled with tap water, independent of routine inspection intervals and employed disinfection. Management practices to prevent fecal contamination and guarantee maintaining good water quality at splash parks should include selection of source water of acceptable quality.

  6. Cost Estimation and Control for Flight Systems

    NASA Technical Reports Server (NTRS)

    Hammond, Walter E.; Vanhook, Michael E. (Technical Monitor)

    2002-01-01

    Good program management practices, cost analysis, cost estimation, and cost control for aerospace flight systems are interrelated and depend upon each other. The best cost control process cannot overcome poor design or poor systems trades that lead to the wrong approach. The project needs robust Technical, Schedule, Cost, Risk, and Cost Risk practices before it can incorporate adequate Cost Control. Cost analysis both precedes and follows cost estimation -- the two are closely coupled with each other and with Risk analysis. Parametric cost estimating relationships and computerized models are most often used. NASA has learned some valuable lessons in controlling cost problems, and recommends use of a summary Project Manager's checklist as shown here.

  7. [Integrated Management Area of Vascular Risk: A new organisational model for global control of risk factors].

    PubMed

    Armario, P; Jericó, C; Vila, L; Freixa, R; Martin-Castillejos, C; Rotllan, M

    Cardiovascular disease (CVD), is a major cause of morbidity and mortality that increases the cost of care. Currently there is a low degree of control of the main cardiovascular risk factors, although we have a good therapeutic arsenal. To achieve the improvement of this reality, a good coordination and multidisciplinary participation are essential. The development of new organizational models such as the Integrated Management Area of Vascular Risk can facilitate the therapeutic harmonization and unification of the health messages offered by different levels of care, based on clinical practice guidelines, in order to provide patient-centred integrated care. Copyright © 2016 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Report of the FELASA Working Group on evaluation of quality systems for animal units.

    PubMed

    Howard, B; van Herck, H; Guillen, J; Bacon, B; Joffe, R; Ritskes-Hoitinga, M

    2004-04-01

    This report compares and considers the merits of existing, internationally available quality management systems suitable for implementation in experimental animal facilities. These are: the Good Laboratory Practice Guidelines, ISO 9000:2000 (International Organization for Standardization) and AAALAC International (Association for Assessment and Accreditation of Laboratory Animal Care International). Good laboratory practice (GLP) is a legal requirement for institutions undertaking non-clinical health and environmental studies for the purpose of registering or licensing for use and which have to be 'GLP-compliant'. GLP guidelines are often only relevant for and obtainable by those institutions. ISO is primarily an external business standard, which provides a management tool to master and optimize a business activity; it aims to implement and enhance 'customer satisfaction'. AAALAC is primarily a peer-reviewed system of accreditation which evaluates the organization and procedures in programmes of animal care and use to ensure the appropriate use of animals, safeguard animal well-being (ensuring state-of-the-art housing, management, procedural techniques, etc.) as well as the management of health and safety of staff. Management needs to determine, on the basis of a facility's specific goals, whether benefits would arise from the introduction of a quality system and, if so, which system is most appropriate. The successful introduction of a quality system confers peer-recognition against an independent standard, thereby providing assurance of standards of animal care and use, improving the quality of animal studies, and contributing to the three Rs-reduction, refinement and replacement.

  9. Communicating Uncertain News in Cancer Consultations.

    PubMed

    Alby, Francesca; Zucchermaglio, Cristina; Fatigante, Marilena

    2017-12-01

    In cancer communication, most of the literature is in the realm of delivering bad news while much less attention has been given to the communication of uncertain news around the diagnosis and the possible outcomes of the illness. Drawing on video-recorded cancer consultations collected in two Italian hospitals, this article analyzes three communication practices used by oncologists to interactionally manage the uncertainty during the visit: alternating between uncertain bad news and certain good news, anticipating scenarios, and guessing test results. Both diagnostic and personal uncertainties are not hidden to the patient, yet they are reduced through these practices. Such communication practices are present in 32 % of the visits in the data set, indicating that the interactional management of uncertainty is a relevant phenomenon in oncological encounters. Further studies are needed to improve both its understanding and its teaching.

  10. Identification, definition and quantification of goods and services provided by marine biodiversity: implications for the ecosystem approach.

    PubMed

    Beaumont, N J; Austen, M C; Atkins, J P; Burdon, D; Degraer, S; Dentinho, T P; Derous, S; Holm, P; Horton, T; van Ierland, E; Marboe, A H; Starkey, D J; Townsend, M; Zarzycki, T

    2007-03-01

    This paper identifies and defines ecosystem goods and services provided by marine biodiversity. Case studies have been used to provide an insight into the practical issues associated with the assessment of marine ecosystem goods and services at specific locations. The aim of this research was to validate the definitions of goods and services, and to identify knowledge gaps and likely difficulties of quantifying the goods and services. A validated theoretical framework for the assessment of goods and services is detailed, and examples of the goods and services at a variety of case study areas are documented. These results will enable future assessments of marine ecosystem goods and services. It is concluded that the utilisation of this goods and services approach has the capacity to play a fundamental role in the Ecosystem Approach, by enabling the pressures and demands of society, the economy and the environment to be integrated into environmental management.

  11. Donor cycle and donor segmentation: new tools for improving blood donor management.

    PubMed

    Veldhuizen, I; Folléa, G; de Kort, W

    2013-07-01

    An adequate donor population is of key importance for the entire blood transfusion chain. For good donor management, a detailed overview of the donor database is therefore imperative. This study offers a new description of the donor cycle related to the donor management process. It also presents the outcomes of a European Project, Donor Management IN Europe (DOMAINE), regarding the segmentation of the donor population into donor types. Blood establishments (BEs) from 18 European countries, the Thalassaemia International Federation and a representative from the South-Eastern Europe Health Network joined forces in DOMAINE. A questionnaire assessed blood donor management practices and the composition of the donor population using the newly proposed DOMAINE donor segmentation. 48 BEs in 34 European countries were invited to participate. The response rate was high (88%). However, only 14 BEs could deliver data on the composition of their donor population. The data showed large variations and major imbalances in the donor population. In 79% of the countries, inactive donors formed the dominant donor type. Only in 21%, regular donors were the largest subgroup, and in 29%, the proportion of first-time donors was higher than the proportion of regular donors. Good donor management depends on a thorough insight into the flow of donors through their donor career. Segmentation of the donor database is an essential tool to understand the influx and efflux of donors. The DOMAINE donor segmentation helps BEs in understanding their donor database and to adapt their donor recruitment and retention practices accordingly. Ways to use this new tool are proposed. © 2013 International Society of Blood Transfusion.

  12. Construction and Application of a Refined Hospital Management Chain.

    PubMed

    Lihua, Yi

    2016-01-01

    Large scale development was quite common in the later period of hospital industrialization in China. Today, Chinese hospital management faces such problems as service inefficiency, high human resources cost, and low rate of capital use. This study analyzes the refined management chain of Wuxi No.2 People's Hospital. This consists of six gears namely, "organizational structure, clinical practice, outpatient service, medical technology, and nursing care and logistics." The gears are based on "flat management system targets, chief of medical staff, centralized outpatient service, intensified medical examinations, vertical nursing management and socialized logistics." The core concepts of refined hospital management are optimizing flow process, reducing waste, improving efficiency, saving costs, and taking good care of patients as most important. Keywords: Hospital, Refined, Management chain

  13. Quality Risk Management: Putting GMP Controls First.

    PubMed

    O'Donnell, Kevin; Greene, Anne; Zwitkovits, Michael; Calnan, Nuala

    2012-01-01

    This paper presents a practical way in which current approaches to quality risk management (QRM) may be improved, such that they better support qualification, validation programs, and change control proposals at manufacturing sites. The paper is focused on the treatment of good manufacturing practice (GMP) controls during QRM exercises. It specifically addresses why it is important to evaluate and classify such controls in terms of how they affect the severity, probability of occurrence, and detection ratings that may be assigned to potential failure modes or negative events. It also presents a QRM process that is designed to directly link the outputs of risk assessments and risk control activities with qualification and validation protocols in the GMP environment. This paper concerns the need for improvement in the use of risk-based principles and tools when working to ensure that the manufacturing processes used to produce medicines, and their related equipment, are appropriate. Manufacturing processes need to be validated (or proven) to demonstrate that they can produce a medicine of the required quality. The items of equipment used in such processes need to be qualified, in order to prove that they are fit for their intended use. Quality risk management (QRM) tools can be used to support such qualification and validation activities, but their use should be science-based and subject to as little subjectivity and uncertainty as possible. When changes are proposed to manufacturing processes, equipment, or related activities, they also need careful evaluation to ensure that any risks present are managed effectively. This paper presents a practical approach to how QRM may be improved so that it better supports qualification, validation programs, and change control proposals in a more scientific way. This improved approach is based on the treatment of what are called good manufacturing process (GMP) controls during those QRM exercises. A GMP control can be considered to be any control that is put in place to assure product quality and regulatory compliance. This improved approach is also based on how the detectability of risks is assessed. This is important because when producing medicines, it is not always good practice to place a high reliance upon detection-type controls in the absence of an adequate level of assurance in the manufacturing process that leads to the finished medicine.

  14. Prospective, observational study comparing automated and visual point-of-care urinalysis in general practice

    PubMed Central

    van Delft, Sanne; Goedhart, Annelijn; Spigt, Mark; van Pinxteren, Bart; de Wit, Niek; Hopstaken, Rogier

    2016-01-01

    Objective Point-of-care testing (POCT) urinalysis might reduce errors in (subjective) reading, registration and communication of test results, and might also improve diagnostic outcome and optimise patient management. Evidence is lacking. In the present study, we have studied the analytical performance of automated urinalysis and visual urinalysis compared with a reference standard in routine general practice. Setting The study was performed in six general practitioner (GP) group practices in the Netherlands. Automated urinalysis was compared with visual urinalysis in these practices. Reference testing was performed in a primary care laboratory (Saltro, Utrecht, The Netherlands). Primary and secondary outcome measures Analytical performance of automated and visual urinalysis compared with the reference laboratory method was the primary outcome measure, analysed by calculating sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and Cohen's κ coefficient for agreement. Secondary outcome measure was the user-friendliness of the POCT analyser. Results Automated urinalysis by experienced and routinely trained practice assistants in general practice performs as good as visual urinalysis for nitrite, leucocytes and erythrocytes. Agreement for nitrite is high for automated and visual urinalysis. κ's are 0.824 and 0.803 (ranked as very good and good, respectively). Agreement with the central laboratory reference standard for automated and visual urinalysis for leucocytes is rather poor (0.256 for POCT and 0.197 for visual, respectively, ranked as fair and poor). κ's for erythrocytes are higher: 0.517 (automated) and 0.416 (visual), both ranked as moderate. The Urisys 1100 analyser was easy to use and considered to be not prone to flaws. Conclusions Automated urinalysis performed as good as traditional visual urinalysis on reading of nitrite, leucocytes and erythrocytes in routine general practice. Implementation of automated urinalysis in general practice is justified as automation is expected to reduce human errors in patient identification and transcribing of results. PMID:27503860

  15. Prospective, observational study comparing automated and visual point-of-care urinalysis in general practice.

    PubMed

    van Delft, Sanne; Goedhart, Annelijn; Spigt, Mark; van Pinxteren, Bart; de Wit, Niek; Hopstaken, Rogier

    2016-08-08

    Point-of-care testing (POCT) urinalysis might reduce errors in (subjective) reading, registration and communication of test results, and might also improve diagnostic outcome and optimise patient management. Evidence is lacking. In the present study, we have studied the analytical performance of automated urinalysis and visual urinalysis compared with a reference standard in routine general practice. The study was performed in six general practitioner (GP) group practices in the Netherlands. Automated urinalysis was compared with visual urinalysis in these practices. Reference testing was performed in a primary care laboratory (Saltro, Utrecht, The Netherlands). Analytical performance of automated and visual urinalysis compared with the reference laboratory method was the primary outcome measure, analysed by calculating sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and Cohen's κ coefficient for agreement. Secondary outcome measure was the user-friendliness of the POCT analyser. Automated urinalysis by experienced and routinely trained practice assistants in general practice performs as good as visual urinalysis for nitrite, leucocytes and erythrocytes. Agreement for nitrite is high for automated and visual urinalysis. κ's are 0.824 and 0.803 (ranked as very good and good, respectively). Agreement with the central laboratory reference standard for automated and visual urinalysis for leucocytes is rather poor (0.256 for POCT and 0.197 for visual, respectively, ranked as fair and poor). κ's for erythrocytes are higher: 0.517 (automated) and 0.416 (visual), both ranked as moderate. The Urisys 1100 analyser was easy to use and considered to be not prone to flaws. Automated urinalysis performed as good as traditional visual urinalysis on reading of nitrite, leucocytes and erythrocytes in routine general practice. Implementation of automated urinalysis in general practice is justified as automation is expected to reduce human errors in patient identification and transcribing of results. 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/

  16. Factors Affecting Attraction, Recruitment, and Retention of NATO Military Medical Professionals (Facteurs d’influence sur l’attraction, le recrutement et la fidelisation des professionnels de sante militaires de l’otan)

    DTIC Science & Technology

    2012-12-01

    problems in this area. Similarly, only 4 Nations were not able in general to provide the required numbers of medical NCOs ( nurses , paramedics, etc.) and...of service and employment status (i.e. license for private practice , teaching, etc.) n 1Other measures 6Human Resources Management 12Financial... practical skills in speciality.” Private practice and private teaching have to conform to some requirements : flexible working hours on duty, “good

  17. [Hygiene in Urological Surgeries - Results of the Health Authority's Visit to all Urological Surgeries in Braunschweig].

    PubMed

    Buhr-Riehm, B; Lenz, T

    2015-07-01

    Following a patient complaint, the Health Department carried out a hygiene inspection of a urological practice in Braunschweig in February 2013. The topic of the complaint was that a patient assumed having acquired a resistant pathogen in the practice. In the subsequent visit, significant hygiene defects were found, particularly with regard to the processing of medical devices. This led to a decision to commit all urological practices in Braunschweig to hygiene inspections as part of a priority project. In retrospect, the hygiene surveys were justified. Deficiencies included inadequate preparation of medical products, procedures in practice inconsistent with hygiene plans, poor knowledge of hygiene procedures among assistant staff and doctors, lack of expertise of assistant staff and lack of hygiene risk awareness by doctors. Positive experiences were: open communication in a good atmosphere with the Practice managers, willingness to change, good cooperation between the Health Authority and the Labor Inspectorate and Physicians' Association. The claimed deficits were corrected by spring 2014 by the practice operators. The consulting expertise of the health authorities was made use of continuously. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Going GLP: Conducting Toxicology Studies in Compliance with Good Laboratory Practices.

    PubMed

    Carroll, Erica Eggers

    2016-01-01

    Good laboratory practice standards are US federal regulations enacted as part of the Federal Insecticide, Fungicide, and Rodenticide Act (40 CFR Part 160), the Toxic Substance Control Act (40 CFR Part 792), and the Good Laboratory Practice for Nonclinical Laboratory Studies (21 CFR Part 58) to support protection of public health in the areas of pesticides, chemicals, and drug investigations in response to allegations of inaccurate data acquisition. Essentially, good laboratory practices (GLPs) are a system of management controls for nonclinical research studies involving animals to ensure the uniformity, consistency, reliability, reproducibility, quality, and integrity of data collected as part of chemical (including pharmaceuticals) tests, from in vitro through acute to chronic toxicity tests. The GLPs were established in the United States in 1978 as a result of the Industrial Bio-Test Laboratory scandal which led to congressional hearings and actions to prevent fraudulent data reporting and collection. Although the establishment of infrastructure for GLPs compliance is labor-intensive and time-consuming, achievement and maintenance of GLP compliance ensures the accuracy of the data collected from each study, which is critical for defending results, advancing science, and protecting human and animal health. This article describes how and why those in the US Army Medical Department responsible for protecting the public health of US Army and other military personnel made the policy decision to have its toxicology laboratory achieve complete compliance with GLP standards, the first such among US Army laboratories. The challenges faced and how they were overcome are detailed.

  19. How shift scheduling practices contribute to fatigue amongst freight rail operating employees: Findings from Canadian accident investigations.

    PubMed

    Rudin-Brown, Christina M; Harris, Sarah; Rosberg, Ari

    2018-02-01

    Canada's freight rail system moves 70% of the country's surface goods and almost half of all exports (RAC, 2016). These include dangerous goods. Anonymous survey of freight rail operating employees conducted by the Teamsters Canada Rail Conference (TCRC, 2014) revealed that many do not report getting enough sleep because of their work schedules, and that fatigue may be affecting their performance at work. Besides general impairments in attention and cognitive functioning, fatigue in railway operating employees slows reaction time to safety alarms and impairs conformance to train operating requirements. Shift scheduling practices can contribute to sleep-related fatigue by restricting sleep opportunities, requiring extended periods of wakefulness and by disrupting daily (circadian) rhythms. The primary goal of accident investigation is to identify causal and contributing factors so that similar occurrences can be prevented. A database search of Transportation Safety Board (TSB) rail investigation reports published in the 21-year period from 1995 to 2015 identified 18 that cited sleep-related fatigue of freight rail operating employees as a causal, contributing, or risk finding. This number represents about 20% of TSB rail investigations from the same period in which a human factors aspect of freight train activities was a primary cause. Exploration of accident themes suggests that management of fatigue and shift scheduling in the freight rail industry is a complex issue that is often not conducive to employee circadian rhythms and sleep requirements. It also suggests that current shift scheduling and fatigue management practices may be insufficient to mitigate the associated safety risk. Railway fatigue management systems that are based on the principles of modern sleep science are needed to improve scheduling practices and mitigate the ongoing safety risk. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  20. Health service support of breast feeding--are we practising what we preach?

    PubMed Central

    Beeken, S.; Waterston, T.

    1992-01-01

    OBJECTIVE--To ascertain the attitudes of health professionals and breast feeding mothers to breast feeding and their views on current practice. DESIGN--Questionnaire to all midwives and health visitors and to breast feeding mothers in Newcastle upon Tyne. SETTING--Maternity units and community in Newcastle upon Tyne. SUBJECTS--127 hospital midwives, 23 community midwives, 63 health visitors, and 50 first time breast feeding mothers. RESULTS--Optimum practice guidelines were not followed. 30 (60%) mothers said they were separated from their babies on the first night after birth. 82 (42%) professionals said that breast fed babies were frequently given water to drink. 28 (56%) babies in the mothers survey had received food or water other than breast milk; 19 of these had been given water. Professionals expressed mainly positive attitudes towards breast feeding in general but less positive attitudes to specific issues such as the beneficial effects on child health and the value of voluntary organisations in breast feeding promotion and management. CONCLUSIONS--Although many health workers are in favour of breast feeding there is conflict among the professions working most closely with breast feeding mothers. Good breast feeding support requires closer attention to monitoring hospital practices and continued training on good lactation management. Images p286-a p287-a PMID:1392861

  1. Practice‐based Research Network Research Good Practices (PRGPs): Summary of Recommendations

    PubMed Central

    Campbell‐Voytal, Kimberly; Daly, Jeanette; Nagykaldi, Zsolt J.; O'Beirne, Maeve; Sterling, Pamela; Fagnan, Lyle J.; Levy, Barcey; Michaels, LeAnn; Louks, Hannah A.; Smith, Paul; Aspy, Cheryl B.; Patterson, V. Beth; Kano, Miria; Sussman, Andrew L.; Williams, Robert; Neale, Anne Victoria

    2015-01-01

    Abstract Introduction Practice‐based research networks (PBRNs) conduct research in community settings, which poses quality control challenges to the integrity of research, such as study implementation and data collection. A foundation for improving research processes within PBRNs is needed to ensure research integrity. Methods Network directors and coordinators from seven U.S.‐based PBRNs worked with a professional team facilitator during semiannual in‐person meetings and monthly conference calls to produce content for a compendium of recommended research practices specific to the context of PBRNs. Participants were assigned to contribute content congruent with their expertise. Feedback on the draft document was obtained from attendees at the preconference workshop at the annual PBRN meeting in 2013. A revised document was circulated to additional PBRN peers prior to finalization. Results The PBRN Research Good Practices (PRGPs) document is organized into four chapters: (1) Building PBRN Infrastructure; (2) Study Development and Implementation; (3) Data Management, and (4) Dissemination Policies. Each chapter contains an introduction, detailed procedures for each section, and example resources with information links. Conclusion The PRGPs is a PBRN‐specific resource to facilitate PBRN management and staff training, to promote adherence to study protocols, and to increase validity and generalizability of study findings. PMID:26296309

  2. [Assessment of medical waste management in a Palestinian hospital].

    PubMed

    Al-Khatib, I A; Khatib, R A

    2006-01-01

    We studied medical waste management in a Palestinian hospital in the West Bank and the role of municipality in this management. In general, "good management practices" were inadequate; there was insufficient separation between hazardous and non-hazardous wastes, an absence of necessary rules and regulations for the collection of wastes from the hospital wards and the on-site transport to a temporary storage location inside and outside the hospital and inadequate waste treatment and disposal of hospital wastes along with municipal garbage. Moreover, training of personnel was lacking and protective equipment and measures for staff were not available. No special landfills for hazardous wastes were found within the municipality.

  3. Factors influencing private health providers' technical quality of care for acute respiratory infections among under-five children in rural West Bengal, India.

    PubMed

    Chakraborty, Sarbani; Frick, Kevin

    2002-11-01

    In many developing countries, private health practitioners provide a significant portion of curative care for diseases which are of public health importance. Currently, health sector reform efforts in these countries are fostering increased participation of private providers in the delivery of health services, including those of public health importance. Guaranteeing good technical quality of care is critical to the process. However, little is known about private providers' technical quality of care (disease management practices) and the factors influencing these services. The purpose of this study was to contribute information on this topic. The study was conducted among private providers in rural West Bengal, India and focused on providers' disease management practices for acute respiratory infections (ARI) among under-five children. World Health Organization (WHO) guidelines for ARI case management were used as the expected standard of care. Observations of patient-provider encounters and interviews with the providers and mothers were the main sources of data. The study found that private health providers in rural West Bengal have inadequate technical quality of care. The problem was related both to low levels of performance (limited potential) and inconsistency in performance (within-provider variation). Limited potential for good technical quality for ARI among the providers was related to lack of knowledge (technical incompetence). One of the important factors influencing within-provider variation was patient load. Since rural private providers operate on a fee-for-service payment system, there are incentives related to seeing many patients. The study concluded that to bring about sustainable improvements in private providers' ARI disease management practices, training programs and interventions that improved compliance were necessary.

  4. Manufacturing of tattoo ink products today and in future: Europe.

    PubMed

    Michel, Ralf

    2015-01-01

    The article describes the European market situation and the legal framework in Europe. It shows the state-of-the-art production under ISO 9001:2008 quality management and describes the future of tattoo ink production based on good manufacturing practice guidelines for tattoo inks. © 2015 S. Karger AG, Basel.

  5. Marketing and the Management of Public Schools: Borrowing from Business.

    ERIC Educational Resources Information Center

    Nebgen, Mary K.

    1983-01-01

    Many techniques that American business has developed for marketing goods and services can be used to build public support for the schools. Practical elements of a marketing plan include: (1) developing a customer philosophy; (2) creating an organizational image; (3) employing and supporting marketing personnel; (4) communications; and (5)…

  6. Learning from Experience--How Development Projects Spread "Good Practice" in Britain.

    ERIC Educational Resources Information Center

    Clynes, Roger

    1992-01-01

    Architects and Buildings Branch (A&B) of Department of Education in London, England, is specifically responsible for design and management of educational facilities. Current development project provides example of emphasis, aims, methods of work, and outcome of a typical project. Fact file on British public schools and list of type of reports…

  7. Public and private forest ownership in the conterminous United States. Chapter 6.

    Treesearch

    Greg C. Liknes; Mark D. Nelson; Brett J. Butler

    2010-01-01

    Forests and the goods and services they provide are influenced by both the biophysical and human environments. To fully understand forest ecosystems, we need to understand the social context in which forests exist because landowners determine land use and management practice. To influence decisions related to the forests, we need to...

  8. The Use of Collaboration Tools when Teaching with Learning Content Management Systems (LCMS)

    ERIC Educational Resources Information Center

    Mncube-Barnes, Fatima Maria

    2010-01-01

    This study was designed to determine whether faculty members utilized collaboration tools within Desire2Learn Inc., in accordance with Chickering and Gamson's (1987) "Seven Principles of Good Practice: A Framework for Evaluating Effective Teaching in Undergraduate Education." The population for this study was faculty members at…

  9. Assessing and managing rangeland and enterprise resilience using the integrated grazingland assessment method

    USDA-ARS?s Scientific Manuscript database

    Resilient shifts into undesirable natural States (as described in State-and-Transition models) opens up opportunities for using agronomic practices to maintain the function of rangeland ecosystems as well as maintaining the provisioning of goods and services from these areas. There is a need for a m...

  10. PERMEABLE PARKING: A GREEN APPROACH TO MANAGING WATER RUNOFF AT THE UNIVERSITY OF ST. FRANCIS

    EPA Science Inventory

    The main goals of the proposed project are to serve the students of the University and local residents (people) through good environmental practices, to further establish a “Gre...

  11. Planning Good Days for Children with ADHD: Tips for Parents.

    ERIC Educational Resources Information Center

    Brozovich, Richard; And Others

    Practical suggestions are offered for parents of children with attention deficit hyperactivity disorder (ADHD) for managing the behavior of their children through the use of positive and negative consequences. Suggestions focus on the child getting up in the morning, getting ready for school, homework, chores, dinner time, free time, bed time,…

  12. 9 CFR 147.26 - Procedures for establishing isolation and maintaining sanitation and good management practices...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Procedures for establishing isolation... infections. 147.26 Section 147.26 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE LIVESTOCK IMPROVEMENT AUXILIARY PROVISIONS ON NATIONAL POULTRY IMPROVEMENT PLAN...

  13. Race, socioeconomic status, health-related quality of life, and self-care of type 2 diabetes mellitus among adults in North Carolina.

    PubMed

    Piper, Crystal N; Chalakalal, Shilpa; Sebastian, Neethu; Warren-Findlow, Jan; Thompson, Michael E

    2015-04-01

    The objective of this study was to examine the associations among race, education, income, and health-related quality of life (HRQoL) in self-care of type 2 diabetes mellitus among adults in North Carolina. A secondary analysis was conducted using data from the 2009 Behavioral Risk Factor Surveillance Survey (BRFSS), a large population-based survey (N = 432,607) conducted in the United States. The data were analyzed to account for the weighted complex multistage sampling design of the Behavioral Risk Factor Surveillance Survey. Parametric testing using univariate/bivariate/multivariate analysis was performed. The majority of participants reported taking a class/course on diabetes mellitus management and having checked their blood glucose levels at least once per day. The majority (61.26%) of the participants did not have good self-management skills, based on the education and blood glucose-monitoring criteria established for this study. Participants with poor HRQoL had significantly increased odds of good diabetes mellitus self-care practices. Individuals with poor HRQoL had significantly increased odds of good diabetes mellitus self-care practices. Although findings on race, education, and income were not statistically significant, they were consistent with previous research. In the future, individuals who are nonwhite, have less than a high school level of education, and have no health insurance should be targeted to improve diabetes mellitus self-care practices through educational and informational materials. Further investigation using more comprehensive measures of diabetes mellitus self-care is warranted.

  14. Effectiveness of participatory planning for community management of fisheries in Bangladesh.

    PubMed

    Sultana, Parvin; Abeyasekera, Savitri

    2008-01-01

    This study provides statistical evidence that support for community-based management of resources was more effective when initiated through a process known as participatory action plan development (PAPD). Thirty-six sites were studied where community management of fisheries was facilitated by NGOs. All involved community participation and establishing local fisheries management institutions. However, communities were able to take up more conservation-related interventions and faced fewer conflicts in the 18 sites where a PAPD was the basis for collective action and institution development. This indicates the value and effectiveness of adopting good practice in participatory planning, such as PAPD, which helps diverse stakeholders find common problems and solutions for natural resource management.

  15. The evaluation of a mental health facilitator in general practice: effects on recognition, management, and outcome of mental illness.

    PubMed

    Bashir, K; Blizard, B; Bosanquet, A; Bosanquet, N; Mann, A; Jenkins, R

    2000-08-01

    Facilitation uses personal contact between the facilitator and the professional to encourage good practice and better service organisation. The model has been applied to physical illness but not to psychiatric disorders. To determine if a non-specialist facilitator can improve the recognition, management, and outcome of psychiatric illness presenting to general practitioners (GPs). Six practices were visited over an 18-month period by a facilitator whose activities included providing guidelines and organising training initiatives. Six other practices acted as controls. Recognition (identification index of family doctors), management (psychotropic prescribing, psychological consultations with the GP, specialist mental health treatment, and the use of medical interventions and investigations), and patient outcome at four months were assessed before and after intervention. The mean identification index of facilitator GPs rose from 0.51 to 0.64 following intervention, while that of the control GPs fell from 0.67 to 0.59 (P = 0.046). The facilitator had no detectable effect on management or patient outcome. The facilitator improved recognition of psychiatric illness by GPs. Generic facilitators can be trained to take on a mental health role; however, the failure to achieve more fundamental changes in treatment and outcome implies that facilitator intervention requires development.

  16. Profile of medical waste management in two healthcare facilities in Lagos, Nigeria: a case study.

    PubMed

    Idowu, Ibijoke; Alo, Babajide; Atherton, William; Al Khaddar, Rafid

    2013-05-01

    Proper management and safe disposal of medical waste (MW) is vital in the reduction of infection or illness through contact with discarded material and in the prevention of environmental contamination in hospital facilities. The management practices for MW in selected healthcare facilities in Lagos, Nigeria were assessed. The cross-sectional study involved the use of questionnaires, in-depth interviews, focused group discussions and participant observation strategies. It also involved the collection, segregation, identification and weighing of waste types from wards and units in the representative facilities in Lagos, Nigeria, for qualitative and quantitative analysis of the MW streams. The findings indicated that the selected Nigerian healthcare facilities were lacking in the adoption of sound MW management (MWM) practices. The average MW ranged from 0.01 kg/bed/day to 3.98 kg/bed/day. Moreover, about 30% of the domestic waste from the healthcare facilities consisted of MW due to inappropriate co-disposal practices. Multiple linear regression was applied to predict the volume of waste generated giving a correlation coefficient (R(2)) value of 0.99 confirming a good fit of the data. This study revealed that the current MWM practices and strategies in Lagos are weak, and suggests an urgent need for review to achieve vital reversals in the current trends.

  17. What qualities are valued in residential direct care workers from the perspective of people with an intellectual disability and managers of accommodation services?

    PubMed

    Dodevska, G A; Vassos, M V

    2013-07-01

    To date, the descriptions of a 'good' direct care worker used to recruit workers for disability services have largely been drawn up by managerial professionals in charge of hiring supports for people with disabilities. However, previous research highlights that these professionals conceptualise a 'good' direct care worker differently from service users with an intellectual disability (ID), with professionals placing an emphasis on describing workers with a range of practical skills and knowledge and service users placing an emphasis on describing workers with interpersonal skills. The aim of this research was to replicate this finding using a methodological approach that rectifies some of the weaknesses of previous research in this field. Semi-structured interviews were conducted to explore the qualities that are valued in residential direct care workers (RDCWs) from the perspective of seven residents with ID and seven managers of accommodation services located in metropolitan Melbourne, Australia. Thematic and chi-squared analysis confirmed the findings of previous research with residents with an ID placing more of an emphasis on the interpersonal behaviours of RDCWs in their descriptions compared to the managers. The interpersonal skills of a potential worker along with their practical skills and knowledge must be considered when recruiting RDCWs. It is also implied that given the different conceptualisation of a 'good' direct care worker across service users and professionals, increased service user participation in the organisation of appropriate supports is warranted. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

  18. [Hospital maintenance: management, risks, and responsibilities].

    PubMed

    Rabino, F

    2002-01-01

    Principal activities of maintenance carried out in hospital, staff required, various type of organization (inside team or global service), management aspects are described. Subjects responsible of maintenance are characterized and the relationships between Service of Maintenance and Service of Prevention and Protection in hospital are specified. Responsibility aspects concerning safety of maintenance workers and main risks which are exposed are defined. The importance of disponibility of a good maintenance handbook and of projects and programs of practice for new hospitals are emphasized.

  19. Spreading the "good news" of total quality management: faith, conversion, and commitment.

    PubMed

    Fleming, S T; Bopp, K D; Anderson, K G

    1993-01-01

    In many ways the spread of total quality management (TQM) across this country can be compared to a religious conversion. Both cases are characterized by a philosophical shift with far-reaching changes in responsibilities and incentives for the people involved. This article bridges the disciplines of theology and health services management by elaborating a metaphor in which TQM is compared to various aspects of the Judeo-Christian faiths, such as the role of laws and standards; the importance of miracles, prophets, and evangelists; and the practical applications of living out the faith.

  20. Healthcare associated infection: good practices, knowledge and the locus of control in heatlhcare professionals.

    PubMed

    Taffurelli, Chiara; Sollami, Alfonso; Camera, Carmen; Federa, Francesca; Grandi, Annise; Marino, Marcella; Marrosu, Tiziano; Sarli, Leopoldo

    2017-07-18

      The incidence of Healthcare Associated Infections (HAI) is an important indicator of the quality of care. The behaviors associated with the prevention of infections are not only supported by rational knowledge or motivation, but are mediated by social, emotional and often stereotyped behaviors. The awarness of the good practices related to HAI, may be a factor. Other studies, identify how the perception of the problem in healthcare professionals is often influenced by a tendency towards an external Locus of Control: the patient, the family, the other wards, other care settings. The aim of this study is to investigate the perception of healthcare professionals. In particular they have been measured their  awarness of the good practices, perceptions of the potential contamination level of some commonly used objects, knowledge about the management of invasive devices, Locus of Control.   A cross-sectional correlational design was utilized.  An ad hoc questionnaire was interviewed by 222 health professionals nurses and physicians in a northern hospital of Italy. The percentage of professionals who have attended training courses over the last 5 years was quite high, both for upgrades on HAI (78.7%) and Vascular Catheters (78.8%), while the percentage of professionals who updated on bladder catheterization (59.46%) was lower. The mean  score of good practice awareness towards HAI (5.06), is high. The perception of the potential level of contamination of some devices had a  mean ranging from 4.62 (for the drip) to 5.26 (for the door handle). The average value of the Locus of Control (43.54) indicates that participants demonstrated a value that is midway between External and Internal. The correlation test analysis revealed no significant relationships among professionals'age, knowledge about HAI, or infection related venus catheter. Also, results revealed that there were statistically significant positive relationships between professionals' Good Practices awareness about HAI , Knowledge, and Locus of Control. The study findings demonstrated that good practice awareness towards HAI among nurse and physician was good but not completely optimal. Findings revealed that knowledge toward HAI prevention and HAI related device prevention were not completely adequate. The educational courses, according to our correlational findings, should definitely take into account the psycho-social aspects of this phenomenon.

  1. Orchestrating care: nursing practice with hospitalised older adults.

    PubMed

    Dahlke, Sherry Ann; Phinney, Alison; Hall, Wendy Ann; Rodney, Patricia; Baumbusch, Jennifer

    2015-12-01

    The increased incidence of health challenges with aging means that nurses are increasingly caring for older adults, often in hospital settings. Research about the complexity of nursing practice with this population remains limited. To seek an explanation of nursing practice with hospitalised older adults. Design. A grounded theory study guided by symbolic interactionism was used to explore nursing practice with hospitalised older adults from a nursing perspective. Glaserian grounded theory methods were used to develop a mid-range theory after analysis of 375 hours of participant observation, 35 interviews with 24 participants and review of selected documents. The theory of orchestrating care was developed to explain how nurses are continuously trying to manage their work environments by understanding the status of the patients, their unit, mobilising the assistance of others and stretching available resources to resolve their problem of providing their older patients with what they perceived as 'good care' while sustaining themselves as 'good' nurses. They described their practice environments as hard and under-resourced. Orchestrating care is comprised of two subprocesses: building synergy and minimising strain. These two processes both facilitated and constrained each other and nurses' abilities to orchestrate care. Although system issues presented serious constraints to nursing practice, the ways in which nurses were making meaning of their work environment both aided them in managing their challenges and constrained their agency. Nurses need to be encouraged to share their important perspective about older adult care. Administrators have a role to play in giving nurses voice in workplace committees and in forums. Further research is needed to better understand how multidisciplinary teams influence care of hospitalized older adults. © 2014 John Wiley & Sons Ltd.

  2. Assessment, Diagnosis, and Treatment of HIV-Associated Neurocognitive Disorder: A Consensus Report of the Mind Exchange Program

    PubMed Central

    Antinori, Andrea; Arendt, Gabriele; Grant, Igor; Letendre, Scott; Chair; Muñoz-Moreno, Jose A.; Eggers, Christian; Brew, Bruce; Brouillette, Marie-Josée; Bernal-Cano, Francisco; Carvalhal, Adriana; Christo, Paulo Pereira; Cinque, Paola; Cysique, Lucette; Ellis, Ronald; Everall, Ian; Gasnault, Jacques; Husstedt, Ingo; Korten, Volkan; Machala, Ladislav; Obermann, Mark; Ouakinin, Silvia; Podzamczer, Daniel; Portegies, Peter; Rackstraw, Simon; Rourke, Sean; Sherr, Lorraine; Streinu-Cercel, Adrian; Winston, Alan; Wojna, Valerie; Yazdanpannah, Yazdan; Arbess, Gordon; Baril, Jean-Guy; Begovac, Josip; Bergin, Colm; Bonfanti, Paolo; Bonora, Stefano; Brinkman, Kees; Canestri, Ana; Cholewińska-Szymańska, Graźyna; Chowers, Michal; Cooney, John; Corti, Marcelo; Doherty, Colin; Elbirt, Daniel; Esser, Stefan; Florence, Eric; Force, Gilles; Gill, John; Goffard, Jean-Christophe; Harrer, Thomas; Li, Patrick; de Kerckhove, Linos Van; Knecht, Gaby; Matsushita, Shuzo; Matulionyte, Raimonda; McConkey, Sam; Mouglignier, Antoine; Oka, Shinichi; Penalva, Augusto; Riesenberg, Klaris; Sambatakou, Helen; Tozzi, Valerio; Vassallo, Matteo; Wetterberg, Peter; Drapato, Alicia Wiercińska

    2013-01-01

    Many practical clinical questions regarding the management of human immunodeficiency virus (HIV)–associated neurocognitive disorder (HAND) remain unanswered. We sought to identify and develop practical answers to key clinical questions in HAND management. Sixty-six specialists from 30 countries provided input into the program, which was overseen by a steering committee. Fourteen questions were rated as being of greatest clinical importance. Answers were drafted by an expert group based on a comprehensive literature review. Sixty-three experts convened to determine consensus and level of evidence for the answers. Consensus was reached on all answers. For instance, good practice suggests that all HIV patients should be screened for HAND early in disease using standardized tools. Follow-up frequency depends on whether HAND is already present or whether clinical data suggest risk for developing HAND. Worsening neurocognitive impairment may trigger consideration of antiretroviral modification when other causes have been excluded. The Mind Exchange program provides practical guidance in the diagnosis, monitoring, and treatment of HAND. PMID:23175555

  3. Diabetes management. Analysis of the American Diabetes Association's clinical practice recommendations.

    PubMed

    Strano-Paul, L; Phanumas, D

    2000-04-01

    Type 2 diabetes generally develops in persons older than age 45 and comprises more than 90% of the estimated 15 million diabetes cases identified in the United States. Due to the burgeoning population of older Americans and the increased prevalence of obesity and sedentariness, type 2 diabetes is nearing epidemic proportions. Tight glycemic control combined with good diet and regular exercise can reduce the incidence of complications associated with unchecked disease. To help physicians and patients achieve such objectives, the American Diabetes Association publishes clinical practice recommendations that propose the most effective methods for screening, diagnosis, and disease management. The position statements presenting the standard of care for treatment of diabetes are reviewed and critiqued from an evidence-based medicine perspective.

  4. Improving the management and referral of patients with transient ischaemic attacks: a change strategy for a health community

    PubMed Central

    Wright, J; Harrison, S; McGeorge, M; Patterson, C; Russell, I; Russell, D; Small, N; Taylor, M; Walsh, M; Warren, E; Young, J

    2006-01-01

    Problem Rapid referral and management of patients with transient ischaemic attacks is a key component in the national strategy for stroke prevention. However, patients with transient ischaemic attacks are poorly identified and undertreated. Design and setting Before and after evaluation of quality improvement programme with controlled comparison in three primary care trusts reflecting diverse populations and organisational structures in an urban district in the North of England. Key measures for improvement The proportion of patients receiving antiplatelet drugs and safe driving advice on referral to a speciality clinic, and the numbers of referrals, adjusted for age, to the specialist clinic before and after the improvement programme. Strategies for change Interviews with patient and professionals to identify gaps and barriers to good practice; development of evidence based guidelines for the management of patients with transient ischaemic attacks; interactive multidisciplinary workshops for each primary care trust with feedback of individual audit results of referral practice; outreach visits to teams who were unable to attend the workshops; referral templates and desktop summaries to provide reminders of the guidelines to clinicians; incorporation of standards into professional contracts. Effects of change A significant improvement occurred in identification and referral of patients with transient ischaemic attacks to specialist clinics, with a 41% increase in referrals from trained practices compared with control practices. There were also significant improvements in the early treatment and safety advice provided to patients before referral. Lessons learnt A strategic approach to effective quality improvement across a diverse health community is feasible and achievable. Careful planning with patient and professional involvement to develop a tailored and multifaceted quality improvement programme to implement evidence based practice can work in very different primary care settings. Key components of the effectiveness of the model include contextual analysis, strong professional support, clear recommendations based on robust evidence, simplicity of adoption, good communication, and use of established networks and opinion leaders. PMID:16456203

  5. Improving the management and referral of patients with transient ischaemic attacks: a change strategy for a health community.

    PubMed

    Wright, J; Harrison, S; McGeorge, M; Patterson, C; Russell, I; Russell, D; Small, N; Taylor, M; Walsh, M; Warren, E; Young, J

    2006-02-01

    Rapid referral and management of patients with transient ischaemic attacks is a key component in the national strategy for stroke prevention. However, patients with transient ischaemic attacks are poorly identified and undertreated. Before and after evaluation of quality improvement programme with controlled comparison in three primary care trusts reflecting diverse populations and organisational structures in an urban district in the North of England. The proportion of patients receiving antiplatelet drugs and safe driving advice on referral to a specialty clinic, and the numbers of referrals, adjusted for age, to the specialist clinic before and after the improvement programme. Interviews with patient and professionals to identify gaps and barriers to good practice; development of evidence based guidelines for the management of patients with transient ischaemic attacks; interactive multidisciplinary workshops for each primary care trust with feedback of individual audit results of referral practice; outreach visits to teams who were unable to attend the workshops; referral templates and desktop summaries to provide reminders of the guidelines to clinicians; incorporation of standards into professional contracts. A significant improvement occurred in identification and referral of patients with transient ischaemic attacks to specialist clinics, with a 41% increase in referrals from trained practices compared with control practices. There were also significant improvements in the early treatment and safety advice provided to patients before referral. A strategic approach to effective quality improvement across a diverse health community is feasible and achievable. Careful planning with patient and professional involvement to develop a tailored and multifaceted quality improvement programme to implement evidence based practice can work in very different primary care settings. Key components of the effectiveness of the model include contextual analysis, strong professional support, clear recommendations based on robust evidence, simplicity of adoption, good communication, and use of established networks and opinion leaders.

  6. Organisational participation and health among smallholder farmers: a longitudinal study in a Latin American context

    PubMed Central

    Orozco, Fadya; Mota, Eduardo; Cole, Donald C

    2014-01-01

    Objective To understand the impact of social organisation affiliation and farmers’ agricultural production practices on farmer health. Organisations facilitate the acquisition and exchange of forms of social capital which can influence the adoption of practices with potential health impacts. In countries such as Ecuador, smallholder agriculture is practised by socially vulnerable populations. Agricultural production often involves the use of extremely hazardous pesticides, while practices that reduce the use of chemicals through integrated pest management (IPM) remain uncommon. Design Longitudinal study (2007–2010). Setting 12 Ecuadorian communities, previously part of a participatory action research study. Participants 208 small-scale farmers. Inclusion criteria were: age between 18 and 65 years, literate and resident in the community for the previous 3 years. Primary outcomes The differential effects of the membership in social organisations (as an effect modifier), on the relationship between the implementation of IPM practices (main independent variable) and farmers’ health, measured by neurocognitive performance scores (better higher value; dependent variable). Results Among organisational participants, the coefficient of association between the implementation of IPM practices for the category good/very good (vs no use) and neurocognitive performance, when farmers were involved in organisations, was negative and moderate (β=−0.17, SE 0.21) though not significant (p>0.1); for the category little/moderate use, the coefficient was positive (β=0.34, SE 0.19) and significant. Among those who did not participate in organisations, both little/moderate use and good/very good use of IPM practices were associated with an increase in neurocognitive performance. Conclusions The effect of agricultural production practices on farmers’ health, transmitted through organisations, can be differentiated. Organisations as structures of social capital seem to be functional in the social reproduction process of the communities studied. Results highlight the need to redirect the analysis of social capital to a more integrated study of social determination of health. PMID:25344481

  7. Safe injections and waste management among healthcare workers at a regional hospital in northern Tanzania.

    PubMed

    Nilsson, Josefine; Pembe, Andrea B; Urasa, Miriam; Darj, Elisabeth

    2013-01-01

    Unsafe injections and substandard waste management are public health issues exposing healthcare workers and the community to the risk of infections. The objective of this study was to assess the knowledge and practice of safe injections and health care waste management among healthcare workers at a regional hospital in northern Tanzania. This cross sectional descriptive study was conducted in a regional hospital in northern Tanzania. Data was collected through a self-administered questionnaire with additional observations of the incinerator, injections, waste practices, and the availability of medical supplies. Data was analysed in SPSS descriptive statistics and chi-square tests were performed. A total of 223 of 305 (73%) healthcare workers from different cadres were included in the study. The majority of healthcare workers had adequate knowledge and practice of safe injections, but inadequate knowledge about waste management. The majority of the staff reported knowledge of HIV as a risk factor, however, had less knowledge about other blood-borne infections. Guidelines and posters on post exposure prophylaxes and waste management -were present at the hospital, however, the incinerator had no fence or temperature gauge. In conclusion, healthcare workers reported good knowledge and practice of injections, and high knowledge of HIV transmission routes. However, the hospital is in need of a well functioning incinerator and healthcare workers require sufficient medical supplies. There was a need for continual training about health care waste management and avoidance of blood-borne pathogens that may be transmitted through unsafe injections or poor health care waste management.

  8. Medical practice in organized settings. Redefining medical autonomy.

    PubMed

    Astrachan, J H; Astrachan, B M

    1989-07-01

    Physicians are perplexed by the ongoing erosion of their individual professional autonomy. While the economic forces underlying such change have received much attention, the evolution of new organizational forms that modify and often diminish medical autonomy is less well understood. The practice of medicine is becoming more organized and more hierarchical. We emphasize the importance of organized medical groups, including the medical staff organization, as structures for appropriate peer monitoring, and for counterbalancing the burgeoning influence of governance and administrative constraints on practice. There is an ongoing tension within organizations between management, governance, and physicians. Over time one or another of these groups achieves some measure of dominance, but good management requires a balance of power. The role of the medical staff, which is poorly represented in some health care institutions and under threat in others, is considered. In general, we find that medical work is becoming more hierarchical, and that physician "leaders" do not substitute for collegial processes.

  9. Color us (or somebody) green

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

    Hill, L.W.

    1993-04-01

    Customers are turning green with environmental awareness in the marketplace. This movement is quickly gaining momentum with increasing demand for natural ingredients, recyclable materials, and low pollution technology. Although foresters have practiced environmental awareness for a long time and have become pretty good at it, the green consumerism needs their attention. Products from the world's forests circulate in world trade. Consumer attitudes about what these products are, where they come from and how they are produced and transported affect our profession. The international Forest Stewardship Council (FSC) was formed in 1992 to set a worldwide standard for good forest managementmore » by promoting widely recognized and respected principles of good forest management. The ten principles are listed.« less

  10. Issues in practice based learning in nursing in the United Kingdom and the Republic of Ireland: Results from a multi professional scoping exercise.

    PubMed

    Mallik, Maggie; McGowan, Brian

    2007-01-01

    The first year (2003-2004) of a three year nationally funded project focused on completing a scoping exercise on the nature of practice education in five selected health care professions: Dietetics, Nursing, Occupational Therapy, Physiotherapy and Radiography (). A survey questionnaire, focus groups and secondary sources were used to collect data. Profession specific contributors completed the analysis of results. Resulting case studies were combined to produce a cross-professional overview of current issues in practice-based learning. The nursing case study identified areas of good practice such as; the mentorship model; the development of new support roles; and joint responsibility between Higher Education Institutes (HEIs) and Health Service areas for practice assessment. However, there were variations in the application of these areas of good practice throughout the United Kingdom (UK). Issues included; an inadequate supply of qualified mentors; formal recognition of the mentor role; and lack of knowledge of the relative impact of the differing mentor preparation programmes. In comparing the five professions, all had statutory requirements regarding the nature of practice learning but each profession differed in how this was managed and organised. The need for formal preparation, recognition and reward for the mentor/practice educator role was recognised with collaborative working across the professions a recommendation in order to achieve national improvement in the quality of practice learning support for health care professions.

  11. From actors to authors: a first account about the involvement of patients in the informed consent governance of a major Italian translational research hospital.

    PubMed

    Casati, Sara; Monti, Paolo; Bonino, Ferruccio

    2010-01-01

    From 2007 to 2009 Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, one of the major public research hospitals in Italy, has invested on a participatory action to promote a good practice of informed consent. The project focused on the improvement and innovation of informed consent considered as a participated act through the involvement of all the actors at stake. The main purpose was to improve the informative practices through the participatory innovation of institutional and organizational elements as conditions of possibility. Therefore the project has pursued the involvement of managers, healthcare professionals, patients and their associations in the institutional governance of informed consent. The involvement of citizens and patients within the whole process meant to put them in charge not just as actors or final evaluators of a good practice, but as co-authors in defining standards, tools and conditions for a good practice. Several actions were taken, including a phase of analysis which involved 20 patients from 8 Associations, a phase of innovation and education where 113 patients and citizens worked together with clinicians from 53 Units in deliberative laboratories, the institution of a multidisciplinary committee inclusive of representatives from 6 associations of patients.The project has produced different outcomes: new institutional guidelines adopted by the hospital; the renewal of consent forms and procedures as part of an explicit shared informative process; an increased implementation of institutional standards of good informative practice; the measure and communication of the outcomes of care and their bench-marking; bottom-up building of paths of validation; the creation of participatory electronic tools; an innovative education on the field for patients and clinicians.

  12. Evaluation of the DCA Vantage analyzer for HbA 1c assay.

    PubMed

    Szymezak, Jean; Leroy, Nathalie; Lavalard, Emmanuelle; Gillery, Philippe

    2008-01-01

    Measurement of HbA 1c is key in monitoring diabetic patients in both laboratories and clinical units, where HbA 1c results are used as part of patient education. We have evaluated the DCA Vantage, a new device for immunological assay of HbA 1c. HbA 1c results obtained were evaluated in terms of precision, linearity, specificity and practicability, and were compared with results obtained by a Variant II HPLC method. The method exhibited intra- and inter-assay coefficients of variation lower than 2.6% and 4.0%, respectively, and good correlation with the comparison HPLC method (r2=0.9776). No interference was noted in the presence of labile HbA 1c or carbamylated hemoglobin. The new device exhibited improved practicability characteristics and allowed better sample identification, better management of quality control routines and greater connectivity possibilities compared to the previous DCA 2000 analyzer. This new analyzer exhibited analytical and practical characteristics very suitable for HbA 1c assay for laboratory or point-of-care use according to good laboratory practice.

  13. [Institutional violence, medical authority, and power relations in maternity hospitals from the perspective of health workers].

    PubMed

    Aguiar, Janaina Marques de; d'Oliveira, Ana Flávia Pires Lucas; Schraiber, Lilia Blima

    2013-11-01

    The current article discusses institutional violence in maternity hospitals from the health workers' perspective, based on data from a study in the city of São Paulo, Brazil. Eighteen health workers from the public and private sectors were interviewed, including obstetricians, nurses, and nurse technicians. A semi-structured interview was used with questions on professional experience and the definition of violence. The analysis revealed that these health workers acknowledged the existence of discriminatory and disrespectful practices against women during prenatal care, childbirth, and the postpartum. Examples of such practices cited by interviewees included the use of pejorative slang as a form of "humor", threats, reprimands, and negligence in the management of pain. Such practices are not generally viewed by health workers as violent, but rather as the exercise of professional authority in what is considered a "difficult" context. The institutional violence is thus trivialized, disguised as purportedly good practice (i.e., "for the patient's own good"), and rendered invisible in the daily routine of care provided by maternity services.

  14. Managing breastfeeding and work: a Foucauldian secondary analysis.

    PubMed

    Payne, Deborah; Nicholls, David A

    2010-08-01

    This paper is a report of a secondary analysis of the experiences of employed breastfeeding mothers. Health promotion policies exhort mothers to feed their infants breastmilk exclusively for the first 6 months and partially until the age of 2 years. More mothers are returning to paid employment less than a year after having a baby. Combining breastfeeding and paid work is an issue for nursing and midwifery as predominantly female professions caring for women and their children. Foucauldian discourse analysis was used for a secondary analysis of interviews performed in 2005 with 20 women who continued to breastfeed on their return to work. The discursive positions and disciplinary practices were identified and analysed. Combining breastfeeding and paid work required negotiating the positions of good mother and good worker. Being a good mother conferred health benefits on infants. Being a good worker required the mothers to constrain their breastfeeding practices. The practices performed by the mothers involved stockpiling breastmilk, maintaining milk supply, preparing the baby ready for absence, making sacrifices and remaining silent and invisible as a breastfeeding worker. Breastfeeding workers have the potential to threaten the focus of the workplace. They discipline themselves to minimize their disruptive potential. Such strategies serve to maintain the marginalization of breastfeeding in the workplace and to keep women's efforts to continue breastfeeding invisible. The work of breastfeeding workers needs to be better recognized and supported.

  15. Tramadol/Paracetamol Fixed-Dose Combination for Chronic Pain Management in Family Practice: A Clinical Review

    PubMed Central

    Morón Merchante, Ignacio; Pergolizzi, Joseph V.; van de Laar, Mart; Mellinghoff, Hans-Ulrich; O'Brien, Joanne; Perrot, Serge; Raffa, Robert B.

    2013-01-01

    The family practitioner plays an important role in the prevention, diagnosis, and early management of chronic pain. He/she is generally the first to be consulted, the one most familiar with the patients and their medical history, and is likely the first to be alerted in case of inadequate pain control or safety and tolerability issues. The family practitioner should therefore be at the center of the multidisciplinary team involved in a patient's pain management. The most frequent indications associated with chronic pain in family practice are of musculoskeletal origin, and the pain is often multimechanistic. Fixed-dose combination analgesics combine compounds with different mechanisms of action; their broader analgesic spectrum and potentially synergistic analgesic efficacy and improved benefit/risk ratio might thus be useful. A pain specialist meeting held in November 2010 agreed that the fixed-dose combination tramadol/paracetamol might be a useful pharmacological option for chronic pain management in family practice. The combination is effective in a variety of pain conditions with generally good tolerability. Particularly in elderly patients, it might be considered as an alternative to conventional analgesics such as NSAIDs, which should be used rarely with caution in this population. PMID:24959571

  16. Business ethics: the materiel/manufacturing perspective.

    PubMed

    Marucheck, A S; Robbins, L B

    1990-08-01

    The discussion of purchasing practices and product integrity, which have ethical implications for materiel/manufacturing management, serves to illustrate how routine decisions can have larger implications for the firm as a whole. Management needs to take a proactive role in confronting ethical issues by (1) demonstrating a corporate commitment to sound ethics in business practices, (2) providing written policies where appropriate to provide a basis for sound ethical conducts, (3) educating various functional areas to understand their responsibility in seeming unrelated ethical problems, (4) delegating authority in ethical issues where such issues are considered in decision making, and (5) fostering interfunctional communication as a means in establishing corporatewide responsibility. The basic philosophical principles of JIT serve as a blueprint for recognizing and managing ethical responsibility. The unexpected by-products of a JIT implementation may be vendor/customer good will and an excellent reputation for the firm.

  17. Good Data Can Be Better Data - How Data Management Maturity Can Help Repositories Improve Operations, Data Quality, And Usability, Helping Researchers

    NASA Astrophysics Data System (ADS)

    Stall, S.

    2015-12-01

    Much earth and space science data and metadata are managed and supported by an infrastructure of repositories, ranging from large agency or instrument facilities, to institutions, to smaller repositories including labs. Scientists face many challenges in this ecosystem both on storing their data and in accessing data from others for new research. Critical for all uses is ensuring the credibility and integrity of the data and conveying that and provenance information now and in the future. Accurate information is essential for future researchers to find (or discover) the data, evaluate the data for use (content, temporal, geolocation, precision) and finally select (or discard) that data as meeting a "fit-for-purpose" criteria. We also need to optimize the effort it takes in describing the data for these determinations, which means making it efficient for the researchers who collect the data. At AGU we are developing a program aimed at helping repositories, and thereby researchers, improve data quality and data usability toward these goals. AGU has partnered with the CMMI Institute to develop their Data Management Maturity (DMM) framework within the Earth and space sciences. The CMMI DMM framework guides best practices in a range of data operations, and the application of the DMM, through an assessment, reveals how repositories and institutions can best optimize efforts to improve operations and functionality throughout the data lifecycle and elevate best practices across a variety of data management operations. Supporting processes like data operations, data governance, and data architecture are included. An assessment involves identifying accomplishment, and weaknesses compared to leading practices for data management. Broad application of the DMM can help improve quality in data and operations, and consistency across the community that will facilitate interoperability, discovery, preservation, and reuse. Good data can be better data. Consistency results in sustainability.

  18. Functionality of cooperation between health, welfare and education sectors serving children and families

    PubMed Central

    Kanste, Outi; Halme, Nina; Perälä, Marja-Leena

    2013-01-01

    Introduction Children and their families use a lot of different services, which poses challenges in terms of cooperation between service providers. The purpose of the study was to evaluate and compare the functioning of this cooperation between services for children and families in Finland's mainland municipalities from the viewpoints of employees and managers. Method The study was carried out using a cross-sectional survey design. Data were gathered using two postal surveys from employees and managers working in health care, social welfare and educational settings. The data consisted of responses from 457 employees and 327 managers. Results Employees working in primary health care and education services assessed cooperation as working better than did those working in social welfare, special health care or mental health and substance abuse services. Well-functioning cooperation at the operational and strategic level was related to good awareness of services and to agreed and well-functioning cooperation practices with few barriers to cooperation. Employees were more critical than managers concerning the occurrence of barriers and about the agreed cooperation practices. Conclusions Successful cooperation in providing services for children and families requires an awareness of services, management structures that support cooperation, agreed practices and efforts to overcome barriers to cooperation. PMID:24363637

  19. Universities and the Public Good: A Review of Knowledge Exchange Policy and Related University Practice in Australia

    ERIC Educational Resources Information Center

    Cuthill, Michael; O'Shea, Éidín; Wilson, Bruce; Viljoen, Pierre

    2014-01-01

    Australian policy relating to knowledge exchange has never been well articulated, notwithstanding that the nexus between knowledge, engagement and higher education in Australia has been on the national agenda for several decades (Grattan Institute, 2013). In universities, this policy deficit is reflected in a lack of project management and…

  20. Family forest stewardship: do owners need a financial incentive?

    Treesearch

    Michael A. Kilgore; Stephanie Snyder; Steven Taff; Joseph Schertz

    2008-01-01

    This study assessed family forest owner interest in formally committing to the types of land use and management practices that characterize good stewardship if compensated for doing so, using Minnesota's Sustainable Forest Incentives Act (SFIA) as a proxy measure of forest stewardship. The SFIA provides an annual payment in return for obtaining and using a forest...

  1. The Self-Managed Heart: Teaching Gender and Doing Emotional Labour in a Higher Education Institution

    ERIC Educational Resources Information Center

    Koster, Shirley

    2011-01-01

    It is considered good pedagogical practice for undergraduate social science students to reflexively use their real-life experiences to illustrate concepts and theories, especially in relation to themes of social inequality and power. When teaching gender and sexuality, this can become problematic because of the emotional topics involved such as…

  2. Mastering the Diversity Challenge: Easy On-the-Job Applications for Measurable Results.

    ERIC Educational Resources Information Center

    Lebo, Fern

    This book provides practical, step-by-step guidelines and gives important reasons why managing diversity is good for overall business. It identifies issues specific to designated groups and provides effective techniques for creating a level playing field, as well as specific on-the-job applications for running meetings, building a team, opening…

  3. For-Profit Colleges and Universities: Their Markets, Regulation, Performance, and Place in Higher Education

    ERIC Educational Resources Information Center

    Hentschke, Guilbert C., Ed.; Lechuga, Vicente M., Ed.; Tierney, William G., Ed.

    2010-01-01

    This book offers a clear-eyed and balanced analysis of for-profit colleges and universities (FPCUs), reviewing their history, business strategies, and management practices; setting them in the context of marketplace conditions, the framework of public policy and government regulations; and viewing them in the light of the public good. Individual…

  4. 77 FR 21795 - Notice of Submission of Proposed Information Collection to OMB Public Housing Agency Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-11

    ... been submitted to the Office of Management and Budget (OMB) for review, as required by the Paperwork... comprehensive guide to PHA policies, programs, operations, and strategies for meeting local housing needs and... proposals. It is expected that Qualified PHAs, as a matter of good business practice, continue to keep their...

  5. EFNS guidelines for the diagnosis and management of Alzheimer's disease.

    PubMed

    Hort, J; O'Brien, J T; Gainotti, G; Pirttila, T; Popescu, B O; Rektorova, I; Sorbi, S; Scheltens, P

    2010-10-01

    In 2008 a task force was set up to develop a revision of the European Federation of the Neurological Societies (EFNS) guideline for the diagnosis and management of Alzheimer's disease (AD) and other disorders associated with dementia, published in early 2007. The aim of this revised international guideline was to present a peer-reviewed evidence-based statement for the guidance of practice for clinical neurologists, geriatricians, psychiatrists, and other specialist physicians responsible for the care of patients with AD. Mild cognitive impairment and non-Alzheimer dementias are not included in this guideline. The task force working group reviewed evidence from original research articles, meta-analysis, and systematic reviews, published before May 2009. The evidence was classified and consensus recommendations graded (A, B, or C) according to the EFNS guidance. Where there was a lack of evidence, but clear consensus, good practice points were provided. The recommendations for clinical diagnosis, blood tests, neuropsychology, neuroimaging, electroencephalography, cerebrospinal fluid (CSF) analysis, genetic testing, disclosure of diagnosis, treatment of AD, behavioural and psychological symptoms in dementia, legal issues, counselling and support for caregivers were all revised as compared with the previous EFNS guideline. A number of new recommendations and good practice points are made, namely in CSF, neuropsychology, neuroimaging and reviewing non-evidence based therapies. The assessment, interpretation, and treatment of symptoms, disability, needs, and caregiver stress during the course of AD require the contribution of many different professionals. These professionals should adhere to these guideline to improve the diagnosis and management of AD. © 2010 The Author(s). European Journal of Neurology © 2010 EFNS.

  6. Insight into the prevalence and distribution of microbial contamination to evaluate water management in the fresh produce processing industry.

    PubMed

    Holvoet, Kevin; Jacxsens, Liesbeth; Sampers, Imca; Uyttendaele, Mieke

    2012-04-01

    This study provided insight into the degree of microbial contamination in the processing chain of prepacked (bagged) lettuce in two Belgian fresh-cut produce processing companies. The pathogens Salmonella and Listeria monocytogenes were not detected. Total psychrotrophic aerobic bacterial counts (TPACs) in water samples, fresh produce, and environmental samples suggested that the TPAC is not a good indicator of overall quality and best manufacturing practices during production and processing. Because of the high TPACs in the harvested lettuce crops, the process water becomes quickly contaminated, and subsequent TPACs do not change much throughout the production process of a batch. The hygiene indicator Escherichia coli was used to assess the water management practices in these two companies in relation to food safety. Practices such as insufficient cleaning and disinfection of washing baths, irregular refilling of the produce wash baths with water of good microbial quality, and the use of high product/water ratios resulted in a rapid increase in E. coli in the processing water, with potential transfer to the end product (fresh-cut lettuce). The washing step in the production of fresh-cut lettuce was identified as a potential pathway for dispersion of microorganisms and introduction of E. coli to the end product via cross-contamination. An intervention step to reduce microbial contamination is needed, particularly when no sanitizers are used as is the case in some European Union countries. Thus, from a food safety point of view proper water management (and its validation) is a critical point in the fresh-cut produce processing industry.

  7. It's so hard to be fair.

    PubMed

    Brockner, Joel

    2006-03-01

    When employees believe they are being treated fairly-when they feel heard, when they understand how and why important decisions are made, and when they believe they are respected-their companies will benefit. Research shows that practicing process fairness reduces legal costs from wrongful-termination suits, lowers employee turnover, helps generate support for new strategic initiatives, and fosters a culture that promotes innovation. What's more, it costs little financially to implement Yet few companies practice it consistently. Joel Brockner examines this paradox, exploring psychological and other reasons that cause managers to resist embracing process fairness. The fact that it's relatively inexpensive to implement, for instance, may be why some numbers-oriented executives undervalue it. Many managers believe that they practice process fairness, but 360-degree feedback tells another story. Some corporate policies actually undermine it--such as when the legal department won't let managers fully explain decisions for fear that disclosure could expose the firm to lawsuits. And, frequently, managers simply follow the all-too-human tendency to avoid uncomfortable situations. But the good news is that organizations can take concrete steps to promote greater process fairness. Many studies have shown that training programs make a big difference, and the author describes the most effective format. In addition, warning your managers that they may experience negative emotions when practicing fair process will help prepare them to cope with those feelings. Finally, role modeling fair process on the executive level will help spread the practice throughout the organization. The fact is, process fairness is the responsibility of all executives, at all levels and in all functions; it cannot be delegated to HR. The sooner managers realize that and work to make it a company norm, the better off the organization will be.

  8. Catchment scale multi-objective flood management

    NASA Astrophysics Data System (ADS)

    Rose, Steve; Worrall, Peter; Rosolova, Zdenka; Hammond, Gene

    2010-05-01

    Rural land management is known to affect both the generation and propagation of flooding at the local scale, but there is still a general lack of good evidence that this impact is still significant at the larger catchment scale given the complexity of physical interactions and climatic variability taking place at this level. The National Trust, in partnership with the Environment Agency, are managing an innovative project on the Holnicote Estate in south west England to demonstrate the benefits of using good rural land management practices to reduce flood risk at the both the catchment and sub-catchment scales. The Holnicote Estate is owned by the National Trust and comprises about 5,000 hectares of land, from the uplands of Exmoor to the sea, incorporating most of the catchments of the river Horner and Aller Water. There are nearly 100 houses across three villages that are at risk from flooding which could potentially benefit from changes in land management practices in the surrounding catchment providing a more sustainable flood attenuation function. In addition to the contribution being made to flood risk management there are a range of other ecosystems services that will be enhanced through these targeted land management changes. Alterations in land management will create new opportunities for wildlife and habitats and help to improve the local surface water quality. Such improvements will not only create additional wildlife resources locally but also serve the landscape response to climate change effects by creating and enhancing wildlife networks within the region. Land management changes will also restore and sustain landscape heritage resources and provide opportunities for amenity, recreation and tourism. The project delivery team is working with the National Trust from source to sea across the entire Holnicote Estate, to identify and subsequently implement suitable land management techniques to manage local flood risk within the catchments. These techniques will include: controlling headwater drainage, increasing evapotranspiration and interception by creating new woodlands in the upper catchment areas, enabling coarse woody debris dams to slow down water flows through steep valleys, improving soil water storage potential by appropriate soil and crop management, retaining water on lowland flood meadows and wet woodland creation within the floodplain. The project, due to run from 2009 until 2013, incorporates hydrometric and water quality monitoring, together with hydrologic and hydraulic modelling in order to attempt to demonstrate the effect of land management changes on flood dynamics and flood risk management. To date, the project team have undertaken the fundamental catchment characterisation work to understand its physical setting and the interaction of the physical processes that influence the hydrological response of the catchment to incident precipitation. The results of this initial work has led to the identification of a suitably robust hydrometric monitoring network within the catchments to meet the needs of providing both quantitative evidence of the impacts of land management change on flood risk, together with generating good quality datasets for the validation and testing of the new hydrologic models. As the project aims to demonstrate ‘best practice' in all areas, the opportunity has been taken to install a network of automatic hydrometric monitoring equipment, together with an associated telemetry system, in order to maximise data coverage, accuracy and reliability. Good quality datasets are a critical requirement for reliable modelling. The modelling will also be expanded to incorporate climate change scenarios. This paper will describe the catchment characterisation work undertaken to date, the proposed land management changes in relation to flood risk management, the initial catchment hydraulic modelling work and the implementation of the new hydrometric monitoring network within the study area.

  9. Using MSD prevention for cultural change in mining: Queensland Government/Anglo Coal Industry partnership.

    PubMed

    Tilbury, Trudy; Sanderson, Liz

    2012-01-01

    Queensland Mining has a strong focus on safety performance, but risk management of health, including Musculoskeletal Disorders (MSDs) continues to have a lower priority. The reliance on individual screening of workers and lower level approaches such as manual handling training is part of the coal mining 'culture'. Initiatives such as the New South Wales and Queensland Mining joint project to develop good practice guidance for mining has allowed for a more consistent message on participatory ergonomics and prevention of MSD. An evidence based practice approach, including the introduction of participatory ergonomics and safe design principles, was proposed to Anglo American Coal operations in Queensland. The project consisted of a skills analysis of current health personnel, design of a facilitated participatory ergonomics training program, site visits to identify good practice and champions, and a graduated mentoring program for health personnel. Early results demonstrate a number of sites are benefiting from site taskforces with a focus on positive performance outcomes.

  10. Integrated Primary Care Readiness and Behaviors Scale: Development and validation in behavioral health professionals.

    PubMed

    Blaney, Cerissa L; Redding, Colleen A; Paiva, Andrea L; Rossi, Joseph S; Prochaska, James O; Blissmer, Bryan; Burditt, Caitlin T; Nash, Justin M; Bayley, Keri Dotson

    2018-03-01

    Although integrated primary care (IPC) is growing, several barriers remain. Better understanding of behavioral health professionals' (BHPs') readiness for and engagement in IPC behaviors could improve IPC research and training. This study developed measures of IPC behaviors and stage of change. The sample included 319 licensed, practicing BHPs with a range of interests and experience with IPC. Sequential measurement development procedures, with split-half cross-validation were conducted. Exploratory principal components analyses (N = 152) and confirmatory factor analyses (N = 167) yielded a 12-item scale with 2 factors: consultation/practice management (CPM) and intervention/knowledge (IK). A higher-order Integrated Primary Care Behavior Scale (IPCBS) model showed good fit to the data, and excellent internal consistencies. The multivariate analysis of variance (MANOVA) on the IPCBS demonstrated significant large-sized differences across stage and behavior groups. The IPCBS demonstrated good psychometric properties and external validation, advancing research, education, and training for IPC practice. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  11. From bad pharma to good pharma: aligning market forces with good and trustworthy practices through accreditation, certification, and rating.

    PubMed

    Miller, Jennifer E

    2013-01-01

    This article explores whether the bioethical performance and trustworthiness of pharmaceutical companies can be improved by harnessing market forces through the use of accreditation, certification, or rating. Other industries have used such systems to define best practices, set standards, and assess and signal the quality of services, processes, and products. These systems have also informed decisions in other industries about where to invest, what to buy, where to work, and when to regulate. Similarly, accreditation, certification, and rating programs can help drug companies address stakeholder concerns in four areas: clinical trial design and management, dissemination of clinical trial results, marketing practices, and the accessibility of medicines. To illuminate processes - such as conflicts of interests and revolving-door policies - that can jeopardize the integrity of accreditation, certification, and ratings systems, the article concludes with a consideration of recent failures of credit-rating agencies and a review of the regulatory capture literature. © 2013 American Society of Law, Medicine & Ethics, Inc.

  12. European Consensus Guidelines on the Management of Respiratory Distress Syndrome - 2016 Update.

    PubMed

    Sweet, David G; Carnielli, Virgilio; Greisen, Gorm; Hallman, Mikko; Ozek, Eren; Plavka, Richard; Saugstad, Ola Didrik; Simeoni, Umberto; Speer, Christian P; Vento, Máximo; Visser, Gerard H A; Halliday, Henry L

    2017-01-01

    Advances in the management of respiratory distress syndrome (RDS) ensure that clinicians must continue to revise current practice. We report the third update of the European Guidelines for the Management of RDS by a European panel of expert neonatologists including input from an expert perinatal obstetrician based on available literature up to the beginning of 2016. Optimizing the outcome for babies with RDS includes consideration of when to use antenatal steroids, and good obstetric practice includes methods of predicting the risk of preterm delivery and also consideration of whether transfer to a perinatal centre is necessary and safe. Methods for optimal delivery room management have become more evidence based, and protocols for lung protection, including initiation of continuous positive airway pressure and titration of oxygen, should be implemented from soon after birth. Surfactant replacement therapy is a crucial part of the management of RDS, and newer protocols for surfactant administration are aimed at avoiding exposure to mechanical ventilation, and there is more evidence of differences among various surfactants in clinical use. Newer methods of maintaining babies on non-invasive respiratory support have been developed and offer potential for greater comfort and less chronic lung disease. As technology for delivering mechanical ventilation improves, the risk of causing lung injury should decrease although minimizing the time spent on mechanical ventilation using caffeine and if necessary postnatal steroids are also important considerations. Protocols for optimizing the general care of infants with RDS are also essential with good temperature control, careful fluid and nutritional management, maintenance of perfusion and judicious use of antibiotics all being important determinants of best outcome. © 2016 S. Karger AG, Basel.

  13. Practice Paper of the Academy of Nutrition and Dietetics: Selecting Nutrient-Dense Foods for Good Health.

    PubMed

    Hingle, Melanie D; Kandiah, Jayanthi; Maggi, Annette

    2016-09-01

    The 2015 Dietary Guidelines for Americans encourage selection of nutrient-dense foods for health promotion and disease prevention and management. The purpose of this Academy of Nutrition and Dietetics practice paper is to provide an update regarding the science and practice of nutrient-dense food identification and selection. Characterization of tools used to identify nutrient density of foods is provided and recommendations for how registered dietitian nutritionists and nutrition and dietetics technicians, registered, might use available profiling tools to help consumers select nutrient-dense foods is discussed. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  14. Preserving community in health care.

    PubMed

    Emanuel, E J; Emanuel, L L

    1997-02-01

    There are two prominent trends in health care today: first, increasing demands for accountabilty, and second, increasing provision of care through managed care organizations. These trends promote the question: What form of account-ability is appropriate to managed care plans? Accountability is the process by which a party justifies its actions and policies. Components of accountability include parties that can be held or hold others accountable, domains and content areas being assessed, and procedures of assessment. Traditionally, the professional model of accountability has operated in medical care. In this model, physicians establish the standards of accountability and hold each other accountable through professional organizations. This form of accountability seems outdated and inapplicable to managed care plans. The alternatives are the economic and the political models of accountability. In the economic model, medicine becomes more like a commodity, and "exit" (consumers changing providers for reasons of cost and quality) is the dominant procedure of accountability. In the political model, medicine becomes more like a community good, and "voice" (citizens communicating their views in public forums or on policy committees, or in elections for representatives) is the dominant procedure of accountability. The economic model's advantages affirm American individualism, make minimal demands on consumers, and use a powerful incentive, money. Its disadvantages undermine health care as a nonmarket good, undermine individual autonomy, undermine good medical practice, impose significant demands on consumers to be informed, sustain differentials of power, and use indirect procedures of accountability. The political model's advantages affirm health care as a matter of justice, permit selecting domains other than price and quality for accountability, reinforce good medical practice, and equalize power between patients and physicians. Its disadvantages include inefficiency in decision making, capture by extremists or experts, intractable value conflicts, fragmentation of community, and oppression of minorities. The political model is the model we should endorse. Its disadvantages can be minimized by proper institutional design. In addition, recent research on managed care plans suggests that the political model may be the best for a competitive marketplace because it can ensure that tough allocation decisions are addressed and improve health through changes in nonmedical aspects of community life.

  15. Building Bridges between healthcare professionals, patients and families: A coproduced and integrated approach to self-management support in stroke.

    PubMed

    Jones, Fiona; Pöstges, Heide; Brimicombe, Lucinda

    2016-10-14

    Programmes providing self-management support for patients and families are gaining attention and have shown promising outcomes with regards to reducing long-term unmet needs post stroke. However, notions of what good self-management support looks like can differ depending on professional opinion, individual preferences, skills and experiences of patients and their families as well as on how care and rehabilitation is organised in a particular healthcare setting. This resonates with the perspective of patient-centred care, according to which the meaning of good care is not universal, but rather jointly shaped between healthcare professionals and patients in everyday interactions. While self-management support is continuously co-produced in care and rehabilitation practices, most self-management programmes are typically provided as an 'add-on' to existing statutory care. This paper aims to deepen the understanding of how self-management support can be made an integral part of everyday care and rehabilitation using Bridges methodology. The authors provide a self-reflective account on 'Bridges' an integrated approach to self-management support, which is used by healthcare professionals within acute and community stroke rehabilitation across the UK, and in some parts of New Zealand and Australia. Bridges is based on self-efficacy principles, but has a central aim of professionals sharing decision-making and expertise with patients and families in every healthcare interaction. Methodologically, the co-production of a Bridges support package with local healthcare professionals and patients is critical. The authors present the values articulated by the support package and how it engages professionals, patients and Bridges training facilitators in a continuous process of adjusting and re-adjusting situated self-management support practices. Our reflections reveal the need to consider development and implementation of self-management support as one and the same on-going process, if we are to facilitate successful engagement and interest from healthcare professionals as well as their patients and families.

  16. IEC 61511 and the capital project process--a protective management system approach.

    PubMed

    Summers, Angela E

    2006-03-17

    This year, the process industry has reached an important milestone in process safety-the acceptance of an internationally recognized standard for safety instrumented systems (SIS). This standard, IEC 61511, documents good engineering practice for the assessment, design, operation, maintenance, and management of SISs. The foundation of the standard is established by several requirements in Part 1, Clauses 5-7, which cover the development of a management system aimed at ensuring that functional safety is achieved. The management system includes a quality assurance process for the entire SIS lifecycle, requiring the development of procedures, identification of resources and acquisition of tools. For maximum benefit, the deliverables and quality control checks required by the standard should be integrated into the capital project process, addressing safety, environmental, plant productivity, and asset protection. Industry has become inundated with a multitude of programs focusing on safety, quality, and cost performance. This paper introduces a protective management system, which builds upon the work process identified in IEC 61511. Typical capital project phases are integrated with the management system to yield one comprehensive program to efficiently manage process risk. Finally, the paper highlights areas where internal practices or guidelines should be developed to improve program performance and cost effectiveness.

  17. Delivery room management of extremely low birth weight infants in Italy: comparison between academic and non-academic birth centres.

    PubMed

    Mardegan, Veronica; Satariano, Irene; Doglioni, Nicoletta; Criscoli, Giulio; Cavallin, Francesco; Gizzi, Camilla; Martano, Claudio; Ciralli, Fabrizio; Torielli, Flaminia; Villani, Paolo Ernesto; Di Fabio, Sandra; Quartulli, Lorenzo; Giannini, Luigi; Trevisanuto, Daniele

    2016-01-01

    International Guidelines provide a standardised approach to newborn resuscitation in the DR and, in their most recent versions, recommendations dedicated to management of ELBWI were progressively increased. It is expected that introduction in clinical practice and dissemination of the most recent evidence should be more consistent in academic than in non-academic hospitals. The aim of the study was to compare adherence to the International Guidelines and consistency of practice in delivery room management of extremely low birth weight infants between academic and non-academic institutions. A questionnaire was sent to the directors of all Italian level III centres between April and August 2012. There was a 92% (n = 98/107) response rate. Apart from polyethylene wrapping to optimise thermal control, perinatal management approach was comparable between academic and non-academic centres. There were minor differences in management of extremely low birth weight infants between Italian academic and non-academic institutions, apart from thermal management. Although there was a good, overall adherence to the International Guidelines for Neonatal Resuscitation, temperature management was not in accordance with official recommendations and every effort has to be done to improve this aspect.

  18. As good as it gets? Managing risks of cardiovascular disease in California's top-performing physician organizations.

    PubMed

    Rodriguez, Hector P; Ivey, Susan L; Raffetto, Brian J; Vaughn, Jennifer; Knox, Margae; Hanley, Hattie Rees; Mangione, Carol M; Shortell, Stephen M

    2014-04-01

    The California Right Care Initiative (RCI) accelerates the adoption of evidence-based guidelines and improved care management practices for conditions for which the gap between science and practice is significant, resulting in preventable disability and death. Medical directors and quality improvement leaders from 11 of the 12 physician organizations that met the 2010 national 90th percentile performance benchmarks for control of hyperlipidemia and glycated hemoglobin in 2011 were interviewed in 2012. Interviews, as well as surveys, assessed performance reporting and feedback to individual physicians; medication management protocols; team-based care management; primary care team huddles; coordination of care between primary care clinicians and specialists; implementation of shared medical appointments; and telephone visits for high-risk patients. All but 1 of 11 organizations implemented electronic health records. Electronic information exchange between primary care physicians and specialists, however, was uncommon. Few organizations routinely used interdisciplinary team approaches, shared medical appointments, or telephonic strategies for managing cardiovascular risks among patients. Implementation barriers included physicians' resistance to change, limited resources and reimbursement for team approaches, and limited organizational capacity for change. Implementation facilitators included routine use of reliable data to guide improvement, leadership facilitation of change, physician buy-in, health information technology use, and financial incentives. To accelerate improvements in managing cardiovascular risks, physician organizations may need to implement strategies involving extensive practice reorganization and work flow redesign.

  19. Is alcohol and community sport a good mix? Alcohol management, consumption and social capital in community sports clubs.

    PubMed

    Rowland, Bosco C; Wolfenden, Luke; Gillham, Karen; Kingsland, Melanie; Richardson, Ben; Wiggers, John

    2015-06-01

    Community sports clubs provide an important contribution to the health and wellbeing of individuals and the community; however, they have also been associated with risky alcohol consumption. This study assessed whether a club's alcohol management strategies were related to risky alcohol consumption by members and levels of social capital, as measured in terms of participation in and perceived safety of the club. A total of 723 sports club members from 33 community football clubs in New South Wales, Australia, completed a computer assisted telephone interview (CATI) and a management representative from each club also completed a CATI. The club representative reported on the club's implementation of 11 alcohol management practices, while club members reported their alcohol consumption and perceived levels of safety at the club and participation in the club. A structural equation model identified having the bar open for more than four hours; having alcohol promotions; and serving intoxicated patrons were associated with increased risky alcohol consumption while at the club; which in turn was associated with lower levels of perceived club safety and member participation. The positive contribution of community sports clubs to the community may be diminished by specific inadequate alcohol management practices. Changing alcohol management practices can reduce alcohol consumption, and possibly increase perceived aspects of social capital, such as safety and participation. © 2014 Public Health Association of Australia.

  20. Examples of actions that improve partnering cooperation among the participants of construction projects

    NASA Astrophysics Data System (ADS)

    Radziszewska-Zielina, E.; Szewczyk, B.

    2017-10-01

    The aim of the article is to present examples of actions that can be undertaken in order to improve partnering cooperation in construction projects. These actions are a practical supplementation to the previously developed fuzzy system of controlling partnering relations in construction projects. The actions relate to 18 parameters of partnering relations that describe cooperation between a general contractor or a company that manages the project and four other participants: the contractors (subcontractors), the designer, the material and equipment suppliers and the real estate developer. The actions have been listed based on a review of subject literature, self-analysis, as well as interviews with participants of construction projects. They can provide examples of good practices that maintain partnering cooperation at a high level. Good cooperation, in turn, translates into a better performance of the project.

  1. Simple solution to the medical instrumentation software problem

    NASA Astrophysics Data System (ADS)

    Leif, Robert C.; Leif, Suzanne B.; Leif, Stephanie H.; Bingue, E.

    1995-04-01

    Medical devices now include a substantial software component, which is both difficult and expensive to produce and maintain. Medical software must be developed according to `Good Manufacturing Practices', GMP. Good Manufacturing Practices as specified by the FDA and ISO requires the definition and compliance to a software processes which ensures quality products by specifying a detailed method of software construction. The software process should be based on accepted standards. US Department of Defense software standards and technology can both facilitate the development and improve the quality of medical systems. We describe the advantages of employing Mil-Std-498, Software Development and Documentation, and the Ada programming language. Ada provides the very broad range of functionalities, from embedded real-time to management information systems required by many medical devices. It also includes advanced facilities for object oriented programming and software engineering.

  2. Health Information Management Leaders and the Practice of Leadership through the Lens of Bowen Theory.

    PubMed

    Sheridan, Patty Thierry; Watzlaf, Valerie; Fox, Leslie Ann

    2016-01-01

    Even though leadership is one of the most examined topics in the organizational literature, its application in the field of health information management (HIM) has not been studied extensively. This descriptive, mixed-methodology study examined HIM leadership through the lens of Bowen theory. The researchers conducted surveys of HIM directors and managers, administrators and colleagues of HIM leaders, and HIM staff using focus groups, observations of meetings, and face-to-face interviews. Results showed that HIM leaders are valued for HIM expertise in electronic health records, privacy, security, and coding; for being the center or heart of the organization; and for commonly valued leadership behaviors and skills including dependability, strategic planning, project management, listening ability, and fairness. Leadership was seen as a reciprocal process, and a team approach was preferred. Good communication, education, and training on HIM topics were also valued. However, HIM leaders believed that they spend more time on management activities than on leadership activities, although they would prefer the reverse. Future research is needed to examine how HIM leadership can be practiced more consistently in the workplace across different HIM functions.

  3. [General background and practical implementation of the health management service institution in Korea].

    PubMed

    Okahara, Shintaro; Lee, Byeong-Woo; Ogasawara, Takayuki; Mori, Koji

    2014-09-01

    The Korean Occupational Safety and Health Act requires an employer with more than 50 employees to assign a health manager or an occupational physician. However, there are many cases where it is difficult for medium-scale enterprises to perform occupational health practices autonomously because their financial base is weaker than that of large-scale enterprises. The Korean Occupational Safety and Health Act was amended in 1990 so that medium-scale enterprises could entrust a health management service institution with their health management tasks. This system is similar to the outsourcing of medical examinations, occupational physicians, or the measurement of the working environment in Japan, but its legal background and actual activities are korea-specific, and it has some different points. In particular, the quality control of health management service institutions by legal and administrative regulations, and the multidisciplinary provision of services contribute to the development of occupational health in medium-scale enterprises. This will be a good reference for occupational health services in small- and medium-scale enterprises in the future in Japan.

  4. Towards an evaluation framework for information quality management (IQM) practices for health information systems--evaluation criteria for effective IQM practices.

    PubMed

    Mohammed, Siti Asma; Yusof, Maryati Mohd

    2013-04-01

    Poor information quality (IQ) must be understood as a business problem rather than systems problem. In health care organization, what is required is an effective quality management that continuously manages and reviews the factors influencing IQ in health information systems (HIS) so as to achieve the desired outcomes. Hence, in order to understand the issues of information quality management (IQM) practices in health care organizations, a more holistic evaluation study should be undertaken to investigate the IQM practices in health care organizations. It is the aim of this paper to identify the significant evaluation criteria that influence the production of good IQ in HIS. Six selected frameworks and best practices both from health informatics and information systems literature have been reviewed to identify the evaluation criteria from the perspective of human, organizational and technological factors. From the review, it was found that human and organization factors are of greater significance in influencing HIS IQ. Our review depicts that there is still shortage in finding a comprehensive IQM evaluation framework. Thus, the criteria from the frameworks reviewed can be used in combination for more comprehensive evaluation criteria. Integrated IQM evaluation criteria for HIS are then proposed in this study. Poor IQ is the result of complex interdependency within sociotechnical factors in health care organization and lack of formal and structured IQM practices. Thus, a feedback mechanism such as evaluation is needed to understand the issues in depth in the future. © 2012 Blackwell Publishing Ltd.

  5. The rationale for simple approaches for sustainability assessment and management in contaminated land practice.

    PubMed

    Bardos, R Paul; Bone, Brian D; Boyle, Richard; Evans, Frank; Harries, Nicola D; Howard, Trevor; Smith, Jonathan W N

    2016-09-01

    The scale of land-contamination problems, and of the responses to them, makes achieving sustainability in contaminated land remediation an important objective. The Sustainable Remediation Forum in the UK (SuRF-UK) was established in 2007 to support more sustainable remediation practice in the UK. The current international interest in 'sustainable remediation' has achieved a fairly rapid consensus on concepts, descriptions and definitions for sustainable remediation, which are now being incorporated into an ISO standard. However the sustainability assessment methods being used remain diverse with a range of (mainly) semi-quantitative and quantitative approaches and tools developed, or in development. Sustainability assessment is site specific and subjective. It depends on the inclusion of a wide range of considerations across different stakeholder perspectives. Taking a tiered approach to sustainability assessment offers important advantages, starting from a qualitative assessment and moving through to semi-quantitative and quantitative assessments on an 'as required' basis only. It is also clear that there are a number of 'easy wins' that could improve performance against sustainability criteria right across the site management process. SuRF-UK has provided a checklist of 'sustainable management practices' that describes some of these. This paper provides the rationale for, and an outline of, and recently published SuRF-UK guidance on preparing for and framing sustainability assessments; carrying out qualitative sustainability assessment; and simple good management practices to improve sustainability across contaminated land management activities. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  6. Consensus statement on the anticipation and prevention of acute postoperative pain: multidisciplinary RADAR approach.

    PubMed

    Vickers, A; Bali, S; Baxter, A; Bruce, G; England, J; Heafield, R; Langford, R; Makin, R; Power, I; Trim, J

    2009-10-01

    There has been considerable investment in efforts to improve postoperative pain management, including the introduction of acute pain teams. There have also been a number of guidelines published on postoperative pain management and there is widespread agreement on how pain should be practically managed. Despite these advances, there is no apparent improvement in the number of patients experiencing moderately severe or extreme pain after surgery. This highlights significant scope for improvement in acute postoperative pain management. In January 2009, a multidisciplinary UK expert panel met to define and agree a practical framework to encourage implementation of the numerous guidelines and fundamentals of pain management at a local level. The panel recognised that to do this, there was a need to organise the information and guidelines into a simplified, accessible and easy-to-implement system based on their practical clinical experience. Given the volume of literature in this area, the Chair recommended that key international guidelines from professional bodies should be distributed and then reviewed during the meeting to form the basis of the framework. Consensus was reached by unanimous agreement of all ten participants. This report provides a framework for the key themes, including consensus recommendations based upon practical experience agreed during the meeting, with the aim of consolidating the key guidelines to provide a fundamental framework which is simple to teach and implement in all areas. Key priorities that emerged were: Responsibility, Anticipation, Discussion, Assessment and Response. This formed the basis of RADAR, a novel framework to help pain specialists educate the wider care team on understanding and prioritising the management of acute pain. Acute postoperative pain can be more effectively managed if it is prioritised and anticipated by a well-informed care team who are educated with regard to appropriate analgesic options and understand what the long-term benefits of pain relief are. The principles of RADAR provide structure to help with training and implementation of good practice, to achieve effective postoperative pain management.

  7. Health promotion in Swedish schools: school managers' views.

    PubMed

    Persson, Louise; Haraldsson, Katarina

    2017-04-01

    Schools are recognized worldwide as settings for health promotion, and leadership has a bearing on schools' ability to be health promoting. School managers have a great influence on what is prioritized in school, which in turn affects students' school performance and health. There is lack of research into school managers' views on health promotion, and what they consider to be central to health promotion. The aim was therefore to examine school managers' views about what health promotion in schools include. An explorative design, qualitative content analysis, was performed. In-depth interviews were conducted with all 13 school managers of a middle-sized municipality in central Sweden. The analysis had both manifest and latent content and three categories: 'Organization and Collaboration', 'Optimize the arena' and 'Strengthen the individual', and 10 subcategories emerged. The theme, 'Opportunities for learning and a good life', describes the latent content of these categories. Taking into account the views of school managers are important because these views help form a more complete picture of how school managers work with health promotion and what is needed to enhance health promotion to improve students' opportunities for learning and a good life. The Ottawa Charter for Health promotion is thereby transformed into practice. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Crop monoculture rather than agriculture reduces the spatial turnover of soil bacterial communities at a regional scale.

    PubMed

    Figuerola, Eva L M; Guerrero, Leandro D; Türkowsky, Dominique; Wall, Luis G; Erijman, Leonardo

    2015-03-01

    The goal of this study was to investigate the spatial turnover of soil bacterial communities in response to environmental changes introduced by the practices of soybean monoculture or crop rotations, relative to grassland soils. Amplicon sequencing of the 16S rRNA gene was used to analyse bacterial diversity in producer fields through three successive cropping cycles within one and a half years, across a regional scale of the Argentinean Pampas. Unlike local diversity, which was not significantly affected by land use type, agricultural management had a strong influence on β-diversity patterns. Distributions of pairwise distances between all soils samples under soybean monoculture had significantly lower β-diversity and narrower breadth compared with distributions of pairwise distances between soils managed with crop rotation. Interestingly, good agricultural practices had similar degree of β-diversity as natural grasslands. The higher phylogenetic relatedness of bacterial communities in soils under monoculture across the region was likely determined by the observed loss of endemic species, and affected mostly to phyla with low regional diversity, such as Acidobacteria, Verrucomicrobia and the candidates phyla SPAM and WS3. These results suggest that the implementation of good agricultural practices, including crop rotation, may be critical for the long-term conservation of soil biodiversity. © 2014 Society for Applied Microbiology and John Wiley & Sons Ltd.

  9. Oral health knowledge and practices of dentists practicing in a teaching hospital in Nigeria.

    PubMed

    Jegede, Akinlolu Tolulope; Oyedele, Titus Ayodeji; Sodipo, Babasola Olufemi; Folayan, Morenike Oluwatoyin

    2016-01-01

    To assess the oral health practices and knowledge of practicing dentists at a tertiary health institution in Nigeria, and the possible association of age and sex with caries prevention practices. A cross-sectional study was conducted. All practicing dentists in the institution were eligible to participate in the study. A questionnaire that assessed oral health practices and knowledge was administered. Respondents were expected to select the most appropriate responses that reflected their knowledge of oral health practices and caries prevention practices. Questions included assessment of knowledge and practice of tooth brushing, flossing, refined carbohydrate intake, and dental service utilization. Participants' responses were scored and dichotomized to poor and good knowledge, and poor and good practices, using the median scores. Bivariate analysis was conducted to identify factors associated with good and poor oral health practices, and good and poor knowledge. Fifty-two eligible study participants were accessible at the time of questionnaire administration. Only 46 respondents returned the filled questionnaire giving a response rate of 88.5%. The age of respondents ranged between 25 and 48 years. The majority of respondents had good oral health practices (65.2%) and good oral health knowledge (85%). However, few respondents had good caries prevention practices: 39.2% brushed at least twice daily, 45.7% took refined carbohydrate less than once daily, 36.9% used dental floss at least once daily, and 60.9% undertook preventive dental care. The correlation between the dentists' oral health knowledge score and oral health practices score was insignificant (0.90; P = 0.55). A large number of dentists practicing in the tertiary hospital had good oral health practices and good oral health knowledge. However, the proportion of dentists with good caries prevention practices was low.

  10. Development and implementation of clinical algorithms in occupational health practice.

    PubMed

    Ghafur, Imran; Lalloo, Drushca; Macdonald, Ewan B; Menon, Manju

    2013-12-01

    Occupational health (OH) practice is framed by legal, ethical, and regulatory requirements. Integrating this information into daily practice can be a difficult task. We devised evidence-based framework standards of good practice that would aid clinical management, and assessed their impact. The clinical algorithm was the method deemed most appropriate to our needs. Using "the first OH consultation" as an example, the development, implementation, and evaluation of an algorithm is described. The first OH consultation algorithm was developed. Evaluation demonstrated an overall improvement in recording of information, specifically consent, recreational drug history, function, and review arrangements. Clinical algorithms can be a method for assimilating and succinctly presenting the various facets of OH practice, for use by all OH clinicians as a practical guide and as a way of improving quality in clinical record-keeping.

  11. What makes up good consultations? A qualitative study of GPs' discourses.

    PubMed

    Van Roy, Kaatje; Vanheule, Stijn; Deveugele, Myriam

    2013-05-16

    In medical literature, several principles that define 'good consultations' have been outlined. These principles tend to be prescriptive in nature, overlooking the complexity of general practitioners (GPs)' perspectives of everyday practice. Focusing on perspectives might be particularly relevant, since they may affect decisions and actions. Therefore, the present study adopts a bottom-up approach, analyzing GPs' narratives about 'good' and 'bad' consultations. We aimed at describing the range of discourses GPs use in relating on their practice. Semi-structured interviews were conducted with 19 Belgian GPs. By means of a qualitative analysis, the authors mapped patterns in the interview narratives and described the range of different discourses. Four discourses were identified: a biomedically-centered discourse, a communication-focused discourse, a problem-solving discourse and a satisfaction-oriented discourse. Each discourse was further specified in terms of predominant themes, problems the GPs prefer to deal with and inherent difficulties. Although most participants used elements from all four discourses, the majority of the GPs relied on an individual set of predominant discourses and focused on a limited number of themes. This study clearly indicates that there is no uniform way in which GPs perceive clinical practice. Each of the participants used a subtle mix of different criteria to define good and bad medical consultations. Some discourse elements appear to be rooted in medical literature, whereas others are of a more personal nature. By focusing on the limitations of each discourse, this study can shed new light on some of the difficulties GPs encounter in their daily practice: being confronted with specific problems might be an effect of adhering to a specific discourse. The typification of different discourses on consultations may function as a framework to help GPs reflect on how they perceive their practice, and help them manage some of the challenges met in daily practice.

  12. Evaluation of all African clinical practice guidelines for hypertension: Quality and opportunities for improvement.

    PubMed

    Okwen, Patrick Mbah; Maweu, Irene; Grimmer, Karen; Margarita Dizon, Janine

    2018-06-14

    Good-quality clinical practice guidelines (CPGs) provide recommendations based on current best-evidence summaries. Hypertension is a prevalent noncommunicable disease in Africa, with disastrous sequelae (stroke, heart, and kidney disease). Its effective management relies on good quality, current, locally relevant evidence. This paper reports on an all African review of the guidance documents currently informing hypertension management. Attempts were made to contact 62 African countries for formal guidance documents used nationally to inform diagnosis and management of hypertension. Their quality was assessed by using Appraisal of Guidelines for Research & Evaluation (AGREE) II, scored by 2 independent reviewers. Differences in domain scores were compared between documents written prior to 2011 and 2011 onward. Findings were compared with earlier African CPG reviews. Guidelines and protocols were provided by 26 countries. Six used country-specific stand-alone hypertension guidelines, and 10 used protocols embedded in Standard Treatment Guidelines for multiple conditions. Six used guidelines developed by the World Health Organization, and 4 indicated ad hoc use of international guidance (US, Portugal, and Brazil). Only 1 guidance document met CPG construction criteria, and none scored well on all AGREE domain scores. The lowest-scoring domain was rigour of development. There was no significant quality difference between pre-2011 and post-2011 guidance documents, and there were variable AGREE II scores for the same CPGs when comparing the African reviews. The quality of hypertension guidance used by African nations could be improved. The need for so many guidance documents is questioned. Adopting a common evidence base from international good-quality CPGs and layering it with local contexts offer 1 way to efficiently improve African hypertension CPG quality and implementation. © 2018 John Wiley & Sons, Ltd.

  13. Integrated care in the management of chronic diseases: an Italian perspective.

    PubMed

    Stefani, Ilario; Scolari, Francesca; Croce, Davide; Mazzone, Antonino

    2016-12-01

    This letter provides a view on the issue of the organizational model of Primary Care Groups (PCGs), which represent a best practice in continuity and appropriateness of care for chronic patients. Our analysis aimed at estimating the impact of PCGs introduction in terms of efficiency and effectiveness. The results of our study showed a better performance of PCGs compared with the other General Practitioners of Local Health Authority Milano 1, supporting the conclusion that good care cannot be delivered without good organization of care. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  14. Recruitment versus retention: why working to keep good employees is worth the effort.

    PubMed

    Van, Allen

    2008-01-01

    The tight demand for medical professionals has many organizations lowering hiring standards in desperate hopes of filling long-vacant positions, but one physician recruiter cautions practice managers against making that mistake. Instead, maintaining high standards and working from the outset with a strategic plan to retain valued employees is the best long-term solution. Breaking down the time and cost investment, and looking at the consequences of both good and bad hires, there's no doubt that waiting longer for the right candidate beats settling for the next warm body that walks through the door.

  15. Business continuity 2014: From traditional to integrated Business Continuity Management.

    PubMed

    Ee, Henry

    As global change continues to generate new challenges and potential threats to businesses, traditional business continuity management (BCM) slowly reveals its limitations and weak points to ensuring 'business resiliency' today. Consequently, BCM professionals also face the challenge of re-evaluating traditional concepts and introducing new strategies and industry best practices. This paper points to why traditional BCM is no longer sufficient in terms of enabling businesses to survive in today's high-risk environment. It also looks into some of the misconceptions about BCM and other stumbling blocks to establishing effective BCM today. Most importantly, however, this paper provides tips based on the Business Continuity Institute's (BCI) Good Practices Guideline (GPG) and the latest international BCM standard ISO 22301 on how to overcome the issues and challenges presented.

  16. Data management strategies for multinational large-scale systems biology projects.

    PubMed

    Wruck, Wasco; Peuker, Martin; Regenbrecht, Christian R A

    2014-01-01

    Good accessibility of publicly funded research data is essential to secure an open scientific system and eventually becomes mandatory [Wellcome Trust will Penalise Scientists Who Don't Embrace Open Access. The Guardian 2012]. By the use of high-throughput methods in many research areas from physics to systems biology, large data collections are increasingly important as raw material for research. Here, we present strategies worked out by international and national institutions targeting open access to publicly funded research data via incentives or obligations to share data. Funding organizations such as the British Wellcome Trust therefore have developed data sharing policies and request commitment to data management and sharing in grant applications. Increased citation rates are a profound argument for sharing publication data. Pre-publication sharing might be rewarded by a data citation credit system via digital object identifiers (DOIs) which have initially been in use for data objects. Besides policies and incentives, good practice in data management is indispensable. However, appropriate systems for data management of large-scale projects for example in systems biology are hard to find. Here, we give an overview of a selection of open-source data management systems proved to be employed successfully in large-scale projects.

  17. Data management strategies for multinational large-scale systems biology projects

    PubMed Central

    Peuker, Martin; Regenbrecht, Christian R.A.

    2014-01-01

    Good accessibility of publicly funded research data is essential to secure an open scientific system and eventually becomes mandatory [Wellcome Trust will Penalise Scientists Who Don’t Embrace Open Access. The Guardian 2012]. By the use of high-throughput methods in many research areas from physics to systems biology, large data collections are increasingly important as raw material for research. Here, we present strategies worked out by international and national institutions targeting open access to publicly funded research data via incentives or obligations to share data. Funding organizations such as the British Wellcome Trust therefore have developed data sharing policies and request commitment to data management and sharing in grant applications. Increased citation rates are a profound argument for sharing publication data. Pre-publication sharing might be rewarded by a data citation credit system via digital object identifiers (DOIs) which have initially been in use for data objects. Besides policies and incentives, good practice in data management is indispensable. However, appropriate systems for data management of large-scale projects for example in systems biology are hard to find. Here, we give an overview of a selection of open-source data management systems proved to be employed successfully in large-scale projects. PMID:23047157

  18. Diagnosis and management practices for gestational diabetes mellitus in Australia: Cross-sectional survey of the multidisciplinary team.

    PubMed

    Meloncelli, Nina; Barnett, Adrian; Pelly, Fiona; de Jersey, Susan

    2018-04-18

    Gestational diabetes mellitus (GDM) is one of the most common pregnancy disorders; however, if well managed, women with GDM experience similar pregnancy outcomes to those without. Currently, there is limited evidence on actual management practices across Australia or how multidisciplinary teams interact to optimise care. To examine the current screening, diagnostic, task and role perceptions and management practices, as reported by members of the GDM multidisciplinary team. A 64-item electronic survey containing multiple choice, Likert scale and open-ended questions was developed for this cross-sectional observational study and advertised through health professional organisations and Queensland Health facilities in May and June, 2017. The 183 survey respondents included 45 diabetes educators, 43 dietitians, 21 endocrinologists/diabetes specialists, 14 obstetricians and 21 midwives. Although almost 90% reported using updated diagnostic guidelines, less than two-thirds used GDM management guidelines. While 68% reported using the same blood glucose targets for GDM management, there was variation to what criteria prompted the commencement of medication to control blood glucose levels. There was a good consensus concerning the health professional responsible for tasks such as medical nutrition therapy, gestational weight gain and self-blood glucose monitoring education and ultrasound use. Other tasks appeared to be the role of almost any member of the GDM multidisciplinary team. The survey results indicate there is a need for consistent evidence on how to best manage GDM and that role identity, access to specialist knowledge and best practice need to be clearly defined within GDM models of care. © 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  19. Incentives to improve farm management: EMS, supply-chains and civil society.

    PubMed

    Gunningham, Neil

    2007-02-01

    This paper focuses on impediments to environmentally sound management practices and how these might be overcome, with an emphasis on the role of environmental management systems, supply chains and civil society. It argues that: Farmers are under increased pressure to cut costs and improve production but with little opportunity to increase prices. Commonly short-term economic interest has damaging environmental implications. Current government policy, in Australia and in many other jurisdictions, relies heavily on voluntary arrangements, education and information, as the main policy instruments through which to persuade farmers to adopt better environmental farm management - e.g. the recent push to encourage the use of voluntary environmental management systems. However, there is good evidence to suggest that these can only make a valuable contribution when combined with a range of other policy instruments, including positive and negative incentives, intervention by third parties and in some cases, an underpinning of regulation. Arguably, what is needed is a strategy that builds on the strengths of voluntary environmental management arrangements while compensating for their weaknesses by combining them with other, complementary policy instruments. If so, we must engage with a range of questions that have not so far figured substantially in the policy debate. Although the principal focus has been on the role of government in bringing about on-farm change in management practices, supply chain pressure (at least in respect of agricultural chemicals and practices which threaten food safety) and civil society action are also potentially powerful mechanisms for bringing about change. Government can and should play a role in harnessing such forces in the interests of improved environmental on-farm practices.

  20. Mind the Gap: How do climate and agricultural management explain the "yield gap" of croplands around the world?

    NASA Astrophysics Data System (ADS)

    Licker, R.; Foley, J. A.; Johnston, M.

    2007-12-01

    At present, cultivated lands extend across approximately fifteen million square kilometers of the Earth's surface, making it one of the most dominant land cover types. The management practices used on these lands have become increasingly intensified, requiring large inputs of fertilizers and water, in addition to mechanization and biotechnology. These intensified practices have had implications for ecosystem goods and services ranging from water quality and availability to carbon sequestration. However, the billions of additional people that are projected to inhabit the planet in the twenty-first century will require further outputs from our global agricultural system. Given our food system's already expansive and intensive state, it is important to consider where the additional yields might come from and what additional management inputs this might require. In this study, we compare yields both within crop types and within regions of similar climate to determine where yield gaps exist. We do so using recently created, five-minute datasets of the area harvested and yield of 175 different crop types for the year 2000. We also explore the links of these yield gaps to global patterns of management. For example, we consider the ways in which management practices such as irrigation and fire are influencing yields around the world - analyses that can help critically evaluate the level of management currently employed and help imagine what management might be necessary to achieve higher yields in the future. These data will be needed in the next generation of Earth System models, in order to better represent the practices of agricultural land use in more realistic ways, thereby improving our understanding of land use / land cover change on the global carbon and water cycles, and the climate system.

  1. A Student View of Technology in the Classroom: Does It Enhance the Seven Principles of Good Practice in Undergraduate Education?

    ERIC Educational Resources Information Center

    McCabe, Deborah Brown; Meuter, Matthew L.

    2011-01-01

    There has been an explosion of classroom technologies, yet there is a lack of research investigating the connection between classroom technology and student learning. This research project explores faculty usage of classroom-based course management software, student usage and opinions of these software tools, and an exploration of whether or not…

  2. Too Safe for Their Own Good? Helping Children Learn about Risk and Lifeskills.

    ERIC Educational Resources Information Center

    Lindon, Jennie

    Because young children have a limited understanding of risks that surround them, many adults try to create a risk-free environment for them. Suggesting that this strategy may leave children without the skills to manage risk and may make it difficult for them to judge situations for themselves, this book provides a practical guide showing adults…

  3. An Approach to the Internationalisation of the Curriculum: Sino-British Joint Efforts for Three Online Courses

    ERIC Educational Resources Information Center

    Yawan, Li; Ying, Li

    2011-01-01

    With a view to facilitating good practice and enhancing further exchanges and collaboration with the Open University UK, the Open University of China initiated a joint programme of training to offer online tutors and academic management staff three courses: Student Support, Tutoring On-line, and Course Design. The programme brought in not only a…

  4. A Junior High School Industrial Technology Curriculum Project: A Final Evaluation of the Industrial Arts Curriculum Project (IACP), 1965-1971.

    ERIC Educational Resources Information Center

    Buffer, James J.; And Others

    The objective of the Industrial Arts Curriculum Project (IACP) was to develop, refine, and institutionalize a new and relevant 2-year junior high industrial arts program. The study focused on "industrial technology," the knowledge of management, production, and personnel practices used by men to produce goods to satisfy their needs…

  5. "I Feel Pain"--Audit of Communication Skills and Understanding of Pain and Health Needs with People with Learning Disabilities

    ERIC Educational Resources Information Center

    Beacroft, Monica; Dodd, Karen

    2011-01-01

    An audit was conducted across Surrey to investigate pain recognition and management with people with learning disabilities. This section of the audit looked at what people with learning disabilities understood and experienced when they had pain compared to good practice from the literature. The results show that people with learning disabilities…

  6. Model Policies in Support of High Performance School Buildings for All Children

    ERIC Educational Resources Information Center

    21st Century School Fund, 2006

    2006-01-01

    Model Policies in Support of High Performance School Buildings for All Children is to begin to create a coherent and comprehensive set of state policies that will provide the governmental infrastructure for effective and creative practice in facility management. There are examples of good policy in many states, but no state has a coherent set of…

  7. Strategic Planning in Higher Education: A Guide for Heads of Institutions, Senior Managers and Members of Governing Bodies.

    ERIC Educational Resources Information Center

    Higher Education Funding Council for England, Bristol.

    This guide provides examples of good practice in strategic planning within higher education, particularly as it applies to Northern Ireland. Examples are drawn from the experiences of 13 case study universities and colleges. Sections of the report include a summary; an introduction and overview of the strategic planning process; and a discussion…

  8. Using physical parameters and geographic information system analyses to predict potential riparian restoration sites for giant cane in southern Illinois

    Treesearch

    Amanda M. Nelson; Timothy J. Stoebner; Jon E. Schoonover; Karl W.J. Williard

    2014-01-01

    Riparian buffers have been widely advocated as a best management practice for improving stream and lake water quality. Giant cane (Arundinaria gigantean) is a good candidate to include in multispecies riparian buffers designs, as it promotes infiltration of surface runoff and deposition of sediment and associated nutrients. To examine the potential...

  9. Sustaining Good Management Practices in Public Schools: Decolonising Principals' Minds for Effective Schools

    ERIC Educational Resources Information Center

    Buka, Andrea Mqondiso; Matiwane-Mcengwa, Nomzi Florida; Molepo, Maisha

    2017-01-01

    While there are perspectives on how to approach decolonisation and transformation of education in schools, the reality is that all rests with individuals and ways that they change their attitudes and mind-set. In the midst of mismatch in the minds of teachers and principals about these two concepts, another confusing term is "democracy"…

  10. Greening academia: Developing sustainable waste management at Higher Education Institutions

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

    Zhang, N.; Williams, I.D., E-mail: idw@soton.ac.uk; Kemp, S.

    Higher Education Institutions (HEIs) are often the size of small municipalities. Worldwide, the higher education (HE) sector has expanded phenomenally; for example, since the 1960s, the United Kingdom (UK) HE system has expanded sixfold to >2.4 million students. As a consequence, the overall production of waste at HEIs throughout the world is very large and presents significant challenges as the associated legislative, economic and environmental pressures can be difficult to control and manage. This paper critically reviews why sustainable waste management has become a key issue for the worldwide HE sector to address and describes some of the benefits, barriers,more » practical and logistical problems. As a practical illustration of some of the issues and problems, the four-phase waste management strategy developed over 15 years by one of the largest universities in Southern England - the University of Southampton (UoS) - is outlined as a case study. The UoS is committed to protecting the environment by developing practices that are safe, sustainable and environmentally friendly and has developed a practical, staged approach to manage waste in an increasingly sustainable fashion. At each stage, the approach taken to the development of infrastructure (I), service provision (S) and behavior change (B) is explained, taking into account the Political, Economic, Social, Technological, Legal and Environmental (PESTLE) factors. Signposts to lessons learned, good practice and useful resources that other institutions - both nationally and internationally - can access are provided. As a result of the strategy developed at the UoS, from 2004 to 2008 waste costs fell by around Pounds 125k and a recycling rate of 72% was achieved. The holistic approach taken - recognizing the PESTLE factors and the importance of a concerted ISB approach - provides a realistic, successful and practical example for other institutions wishing to effectively and sustainably manage their waste.« less

  11. Greening academia: developing sustainable waste management at Higher Education Institutions.

    PubMed

    Zhang, N; Williams, I D; Kemp, S; Smith, N F

    2011-07-01

    Higher Education Institutions (HEIs) are often the size of small municipalities. Worldwide, the higher education (HE) sector has expanded phenomenally; for example, since the 1960s, the United Kingdom (UK) HE system has expanded sixfold to >2.4 million students. As a consequence, the overall production of waste at HEIs throughout the world is very large and presents significant challenges as the associated legislative, economic and environmental pressures can be difficult to control and manage. This paper critically reviews why sustainable waste management has become a key issue for the worldwide HE sector to address and describes some of the benefits, barriers, practical and logistical problems. As a practical illustration of some of the issues and problems, the four-phase waste management strategy developed over 15 years by one of the largest universities in Southern England--the University of Southampton (UoS)--is outlined as a case study. The UoS is committed to protecting the environment by developing practices that are safe, sustainable and environmentally friendly and has developed a practical, staged approach to manage waste in an increasingly sustainable fashion. At each stage, the approach taken to the development of infrastructure (I), service provision (S) and behavior change (B) is explained, taking into account the Political, Economic, Social, Technological, Legal and Environmental (PESTLE) factors. Signposts to lessons learned, good practice and useful resources that other institutions--both nationally and internationally--can access are provided. As a result of the strategy developed at the UoS, from 2004 to 2008 waste costs fell by around £125k and a recycling rate of 72% was achieved. The holistic approach taken--recognizing the PESTLE factors and the importance of a concerted ISB approach--provides a realistic, successful and practical example for other institutions wishing to effectively and sustainably manage their waste. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Emergency nurses' knowledge of pain management principles.

    PubMed

    Tanabe, P; Buschmann, M

    2000-08-01

    The purpose of this study was to determine areas of emergency nurses' knowledge deficit regarding pain management, and to identify barriers to pain management as perceived by emergency nurses. Data were collected anonymously in a mail survey using a 52-item knowledge questionnaire addressing pain management principles and asking emergency nurses (Illinois Emergency Nurses Association members) to rate various barriers as to how often they affect their practice. Questionnaires were mailed to all Illinois ENA members (n = 1000). Three hundred five emergency nurses' questionnaires were returned. A significant deficit existed on 2 domains of knowledge: understanding of the terms "addiction," "tolerance," and "dependence"; and knowledge of various pharmacologic analgesic principles. Nurses with a master's degree or higher, or those who attended a 1-day seminar on pain management, achieved statistically significantly higher scores. The 2 barriers identified by emergency nurses as the most common were the inability to administer medication until a diagnosis is made (53%), and inadequate assessment of pain and pain relief (48%) (the percentage indicates how often the emergency nurses believed the barrier was present in their practice). The data indicate that emergency nurses may not have a good understanding of the management of pain with drugs, or of such issues as risk of addiction.

  13. General practitioners' management of mental disorders: a rewarding practice with considerable obstacles.

    PubMed

    Fleury, Marie-Josée; Imboua, Armelle; Aubé, Denise; Farand, Lambert; Lambert, Yves

    2012-03-16

    Primary care improvement is the cornerstone of current reforms. Mental disorders (MDs) are a leading cause of morbidity worldwide and widespread in industrialised countries. MDs are treated mainly in primary care by general practitioners (GPs), even though the latter ability to detect, diagnose, and treat patients with MDs is often considered unsatisfactory. This article examines GPs' management of MDs in an effort to acquire more information regarding means by which GPs deal with MD cases, impact of such cases on their practices, factors that enable or hinder MD management, and patient-management strategies. This study employs a mixed-method approach with emphasis on qualitative investigation. Based on a previous survey of 398 GPs in Quebec, Canada, 60 GPs representing a variety of practice settings were selected for further study. A 10-minute-long questionnaire comprising 27 items was administered, and 70-minute-long interviews were conducted. Quantitative (SPSS) and qualitative (NVivo) analyses were performed. At least 20% of GP visits were MD-related. GPs were comfortable managing common MDs, but not serious MDs. GPs' based their treatment of MDs on pharmacotherapy, support therapy, and psycho-education. They used clinical intuition with few clinical tools, and closely followed their patients with MDs. Practice features (salary or hourly fees payment; psycho-social teams on-site; strong informal networks), and GPs' individual characteristics (continuing medical education; exposure and interest in MDs; traits like empathy) favoured MD management. Collaboration with psychologists and psychiatrists was considered key to good MD management. Limited access to specialists, system fragmentation, and underdeveloped group practice and shared-care models were impediments. MD management was seen as burdensome because it required more time, flexibility, and emotional investment. Strategies exist to reduce the burden (one-problem-per-visit rule; longer time slots). GPs found MD practice rewarding as patients were seen as grateful and more complying with medical recommendations compared to other patients, generally leading to positive outcomes. To improve MD management, this study highlights the importance of extending multidisciplinary GP practice settings with salary or hourly fee payment; access to psychotherapeutic and psychiatric expertise; and case-discussion training involving local networks of GPs and MD specialists that encourage both knowledge transfer and shared care.

  14. General practitioners' management of mental disorders: A rewarding practice with considerable obstacles

    PubMed Central

    2012-01-01

    Background Primary care improvement is the cornerstone of current reforms. Mental disorders (MDs) are a leading cause of morbidity worldwide and widespread in industrialised countries. MDs are treated mainly in primary care by general practitioners (GPs), even though the latter ability to detect, diagnose, and treat patients with MDs is often considered unsatisfactory. This article examines GPs' management of MDs in an effort to acquire more information regarding means by which GPs deal with MD cases, impact of such cases on their practices, factors that enable or hinder MD management, and patient-management strategies. Methods This study employs a mixed-method approach with emphasis on qualitative investigation. Based on a previous survey of 398 GPs in Quebec, Canada, 60 GPs representing a variety of practice settings were selected for further study. A 10-minute-long questionnaire comprising 27 items was administered, and 70-minute-long interviews were conducted. Quantitative (SPSS) and qualitative (NVivo) analyses were performed. Results At least 20% of GP visits were MD-related. GPs were comfortable managing common MDs, but not serious MDs. GPs' based their treatment of MDs on pharmacotherapy, support therapy, and psycho-education. They used clinical intuition with few clinical tools, and closely followed their patients with MDs. Practice features (salary or hourly fees payment; psycho-social teams on-site; strong informal networks), and GPs' individual characteristics (continuing medical education; exposure and interest in MDs; traits like empathy) favoured MD management. Collaboration with psychologists and psychiatrists was considered key to good MD management. Limited access to specialists, system fragmentation, and underdeveloped group practice and shared-care models were impediments. MD management was seen as burdensome because it required more time, flexibility, and emotional investment. Strategies exist to reduce the burden (one-problem-per-visit rule; longer time slots). GPs found MD practice rewarding as patients were seen as grateful and more complying with medical recommendations compared to other patients, generally leading to positive outcomes. Conclusions To improve MD management, this study highlights the importance of extending multidisciplinary GP practice settings with salary or hourly fee payment; access to psychotherapeutic and psychiatric expertise; and case-discussion training involving local networks of GPs and MD specialists that encourage both knowledge transfer and shared care. PMID:22423592

  15. Challenges for Sustainable Land Management through Climate-Smart Agriculture

    NASA Astrophysics Data System (ADS)

    Dougill, Andrew; Stringer, Lindsay

    2017-04-01

    There are increasing pushes for agricultural land management to be both sustainable and climate-smart (in terms of increasing productivity, building resilience to climate change and enhancing carbon storage). Climate-smart agriculture initiatives include conservation agriculture, based on minimum soil disturbance, permanent soil cover and crop rotation, and agroforestry. Such efforts address key international goals of the United Nations Convention to Combat Desertification (UNCCD) and United Nations Framework Convention on Climate Change (UNFCCC), but as yet have not seen widespread uptake. Based on analyses of different project interventions from across a range of southern African countries, we outline the inter-related challenges that are preventing adoption of climate-smart agriculture initiatives. We then identify routes to building multi-stakeholder partnerships and empowering communities through participatory monitoring with the aim of increasing uptake of such sustainable land management practices. Good practice examples remain largely restricted to local-level project interventions with significant donor (or private-sector) support, aligned to short-term community priorities relating to access to inputs or reduced labour requirements. Scaling-up to district- and national-level initiatives is yet to be widely successful due to problems of: limited policy coherence; a lack of communication between stakeholders at different levels; and limited understanding of long-term benefits associated with changes in agricultural practices. We outline opportunities associated with improved communication of climate information, empowerment of district-level adaptation planning and diversification of agricultural livelihood strategies as key routes to guide farmers towards more sustainable, and climate-smart, land management practices. Recent experiences in Malawi, which has experienced significant floods and an El Niño drought year in the last two years, are used to empirically illustrate the extent of the remaining challenges in moving from 'win-win' conceptualisations to implementing significant changes in land management practices.

  16. Risk management measures for chemicals: the "COSHH essentials" approach.

    PubMed

    Garrod, A N I; Evans, P G; Davy, C W

    2007-12-01

    "COSHH essentials" was developed in Great Britain to help duty holders comply with the Control of Substances Hazardous to Health (COSHH) Regulations. It uses a similar approach to that described in the new European "REACH" Regulation (Registration, Evaluation, Authorisation and Restriction of Chemicals; EC No. 1907/2006 of the European Parliament), insofar as it identifies measures for managing the risk for specified exposure scenarios. It can therefore assist REACH duty holders with the identification and communication of appropriate risk-management measures. The technical basis for COSHH essentials is explained in the original papers published in the Annals of Occupational Hygiene. Its details will, therefore, not be described here; rather, its ability to provide a suitable means for communicating risk-management measures will be explored. COSHH essentials is a simple tool based on an empirical approach to risk assessment and risk management. The output is a "Control Guidance Sheet" that lists the "dos" and "don'ts" for control in a specific task scenario. The guidance in COSHH essentials recognises that exposure in the workplace will depend not just on mechanical controls, but also on a number of other factors, including administrative and behavioural controls, such as systems of work, supervision and training. In 2002, COSHH essentials was made freely available via the internet (http://www.coshh-essentials.org.uk/). This electronic delivery enabled links to be made between product series that share tasks, such as drum filling, and with ancillary guidance, such as setting up health surveillance for work with a respiratory sensitiser. COSHH essentials has proved to be a popular tool for communicating good control practice. It has attracted over 1 million visits to its site since its launch. It offers a common benchmark of good practice for chemical users, manufacturers, suppliers and importers, as well as regulators and health professionals.

  17. Testing soil and water conservation methods in 16 countries; do best practices exist?

    NASA Astrophysics Data System (ADS)

    Jetten, V.; Shrestha, D. P.

    2012-04-01

    In order to find suitable conservation measures to protect the land from further deterioration leading to desertification, sustainable land management technologies were applied in 16 locations in countries having land degradation problems such as erosion (by wind and water), salinization, vegetation degradation and wild fire. The technologies were selected in consultation with all the stakeholders involved which included farmers, land users, local administrators and scientists. The selected technologies varied from vegetative (planting trees) through agronomic (crop rotation, contour ploughing, minimum tillage) to mechanical (terracing, fencing, prescribed burning) measures. They were applied in the 16 hotspot locations in semi-arid and arid regions to test their suitability for conservation purposes. Improvement on soil conditions was monitored during 2-3 years and the effectiveness of the applied technologies were evaluated. Although data from monitoring is available for only 2-3 years the results show improvements of soil conditions and indicate that good land management practices can help in minimizing land degradation. The results also show that the so called "the best practices" which could be applied everywhere with big success do not exist. Each region is characterized by having its own bio-physical and socio-economic factors which determine whether certain land management practices can be applied successfully which is also socially acceptable in the area.

  18. Factors affecting job motivation among health workers: a study from Iran.

    PubMed

    Daneshkohan, Abbas; Zarei, Ehsan; Mansouri, Tahere; Maajani, Khadije; Ghasemi, Mehri Siyahat; Rezaeian, Mohsen

    2014-11-26

    Human resources are the most vital resource of any organizations which determine how other resources are used to accomplish organizational goals. This research aimed to identity factors affecting health workers' motivation in Shahid Beheshti University of Medical Sciences (SBUMS). This is a cross-sectional survey conducted with participation of 212 health workers of Tehran health centers in November and December 2011. The data collection tool was a researcher-developed questionnaire that included 17 motivating factors and 6 demotivating factors and 8 questions to assess the current status of some factors. Validity and reliability of the tool were confirmed. Data were analyzed with descriptive and analytical statistical tests. The main motivating factors for health workers were good management, supervisors and managers' support and good working relationship with colleagues. On the other hand, unfair treatment, poor management and lack of appreciation were the main demotivating factors. Furthermore, 47.2% of health workers believed that existing schemes for supervision were unhelpful in improving their performance. Strengthening management capacities in health services can increase job motivation and improve health workers' performance. The findings suggests that special attention should be paid to some aspects such as management competencies, social support in the workplace, treating employees fairly and performance management practices, especially supervision and performance appraisal.

  19. 21 CFR 110.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 110.5 Section...) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD General Provisions § 110.5 Current good manufacturing practice. (a) The criteria and...

  20. Knowledge, attitudes and practices of traceability among livestock traders in south-western Nigeria: implications for sustainable livestock industry.

    PubMed

    Adesokan, Hezekiah K; Ocheja, Samuel E

    2014-01-01

    Livestock diseases and other animal health events are a threat to achieving sustainable livestock industry. The knowledge of trace-back and the practice of providing feedback on diseases encountered in slaughtered animals from the abattoir to the farm can help limit the spread as well as manage potential future incidents of such diseases. We assessed the knowledge, attitudes and practices of 200 willing livestock traders on traceability in Bodija Municipal Abattoir, south-western Nigeria. The results reveal that the majority of these traders had poor knowledge (79.5 %) and practices (74.0 %) of traceability, though 89.5 % demonstrated good attitudes. While 22.9 % knew that traceability could be an effective means to control diseases, only a lower proportion (9.0 %) knew the health status of the animals being purchased. Though 29.0 % reported the diseases encountered in their animals during slaughter to the farm, only 9.5 % followed up to ensure the farmers take steps at preventing further occurrence of the reported diseases. While age (p = 0.000; 0.014) and education (p = 0.000; 0.000) were both significant for good knowledge and attitudes, frequency of condemned cases (p = 0.000) and length of years in the trade (p = 0.004) were, respectively, significant for good knowledge and attitudes with none associated with practice. These poor levels of knowledge and practices of traceability are a threat to sustainable livestock industry, food security and human health; hence, there is an urgent need to institute national feedback mechanism on slaughtered animals in order to strengthen interventions against diseases at farm levels.

  1. Exploration and practice of the cultivation of optoelectronic innovative talents based on the Students Innovation Training Program

    NASA Astrophysics Data System (ADS)

    Lei, Bing; Liu, Wei; Shi, Jianhua; Yao, Tianfu; Wang, Wei; Hu, Haojun

    2017-08-01

    The Students Innovation Training Program (SITP) has become an effective method to impel the teaching reform and improve undergraduate's innovative practical ability in Chinese colleges and universities, which is quite helpful for students to understand the social requirement, to grasp the basic means of scientific research and to improve their innovative practical ability and team work spirit. In this paper, three problems have been analyzed and discussed based on our organizing and instructing experience of SITP in recent years. Firstly, the SITP is a synthetically training project, and it is quite suitable to cultivate the students' innovative practical ability. Because SITP is similar to the real scientific research activity, and both of them include the steps of project application, solution design, research implementation and project summary etc. By making great efforts to these basic training steps, the undergraduates' innovative practical ability has been improved systemically. Secondly, a new talents cultivation system has been constructed based on SITP by integrating the subject competitions, graduation design and other conventional training activities, which is quite good to improve the training quality and decrease the total training class hours. Thirdly, a series of long-term effective operation and management guidelines have been established to ensure the SITP work normally, including doing a good job of project evaluation, setting up a reward and punishment system and creating a good atmosphere for innovation. In conclusion, great efforts have been made to enhance undergraduates' innovative ability, and the research results will provide useful reference for improving the training effects and reforming talents cultivating mode further.

  2. Patient empowerment, an additional characteristic of the European definitions of general practice/family medicine.

    PubMed

    Mola, Ernesto

    2013-06-01

    Growing evidence supports the inclusion of patient empowerment as a key ingredient of care for patients with chronic conditions. In recent years, several studies based on patient empowerment, have been carried out in different European countries in the context of general practice and primary care to improve management of chronic diseases. These studies have shown good results of the care model, increasing patient and health professionals' satisfaction, adherence to guidelines and to treatment, and improving clinical outcomes. In 2011, the Wonca European Council included as the twelfth characteristic of the European definitions of general practice/family medicine: 'promote patient empowerment'. The aim of this paper is to clarify the meaning of 'patient empowerment' and to explain why family medicine should be considered the most suitable setting to promote it. The inclusion of patient empowerment as one of the essential characteristics of general practice fills a conceptual gap and clearly suggests to the European health care systems a tested model to face chronic diseases: involving and empowering patients in managing their own conditions to improve health and well-being.

  3. Correlates to sleepiness on night shift among male workers engaged in three-shift work in a chemical plant: its association with sleep practice and job stress.

    PubMed

    Kageyama, Takayuki; Kobayashi, Toshio; Abe-Gotoh, Ayano

    2011-01-01

    The purpose of this study was to examine the correlation of sleepiness during night shift (SNS) in male shiftworkers with nonpharmacological self-management (nPSM) practices to facilitate good day sleep, and also with job stress. Sleepiness on the job and possible correlates to SNS among 157 male shiftworkers in a rotating three-shift schedule at a chemical plant were cross-sectionally investigated using a self-administered questionnaire. Multivariate analyses revealed that SNS was positively associated with drinking alcoholic beverages before day sleep, but inversely associated with subjective health status, being of the evening type, abstaining from caffeine before day sleep, having a bath before day sleep, job control, reward from work, feeling suited to the job, and support from colleagues. SNS correlated with certain nPSM practices and also with possible modifiers of job stress. These findings provide clues to developing countermeasures against SNS among shiftworkers. The effects of nPSM practices and job stress management on their day sleep and SNS should be examined in detail.

  4. Healthy Eating Practices: Perceptions, Facilitators, and Barriers Among Youth With Diabetes

    PubMed Central

    Gellar, Lauren A.; Schrader, Kelly; Nansel, Tonja R.

    2008-01-01

    Purpose The purpose of this study was to explore the perceptions of healthy eating by youth with diabetes as well as facilitators of and barriers to healthy eating behavior. Methods One hundred forty youth aged 7 to 16 years with diabetes participated in 18 focus groups. Sample race/ethnicity was 71% white, 18% African American, 6% Hispanic, and 5% other; 69% of the participants were female. Results Healthy eating was defined primarily in terms of eating fruits and vegetables, low fat, low sugar, and eating to keep blood sugar in range. However, there were notable differences in perceptions of healthy eating versus perceptions of eating practices good for diabetes management. Specifically, “free” foods (foods high in fat but low in carbohydrate) were commonly reported as being good for diabetes management. Major barriers to healthy eating included widespread availability of unhealthy foods, preparation time, and social situations. Parental behaviors, including monitoring food choices and positive modeling, were the most commonly reported facilitators of healthy eating. Conclusion Findings suggest that youth with diabetes have a general understanding of healthy eating and face similar barriers and facilitators to healthy eating as nondiabetic children do. However, the diabetes regimen may influence their understanding of healthy eating, sometimes negatively. Diabetes nutrition education sessions should emphasize the connection between healthy eating and both short-and long-term diabetes outcomes, and they should highlight strategies to reduce saturated fat consumption while avoiding excessive carbohydrate consumption. The diabetes educator can play an integral role in promoting healthy dietary practices by facilitating parental involvement, designing action plans for managing social situations, and increasing awareness of healthier alternatives to widely available unhealthy foods. PMID:17684168

  5. Significance of the Hygiene Charter towards different sectors in Hong Kong.

    PubMed

    Lee, A; Cheng, F F K; Yuen, H S K; Ho, M; Ngan, W P; Suen, Y P; Au, S M Y; Li, S N; Tso, C Y; Ng, P P Y; Wong, Y P; Keung, M W; Lo, A S C; Wong, W S; Siu, D C H; Yuen, W K; Mok, K K; Fung, W Y; Wong, K K

    2004-01-01

    The occurrence of SARS in March 2003 has resulted in an increased interest, worldwide in emerging infectious diseases. The SARS experience provided us a lesson on the importance of promoting hygienic practices among individuals and different working sectors. In Hong Kong, a voluntary organization called the UNITE proposed a Hygiene Charter which aimed at taking hygiene to new levels. This action has been supported by individuals and different sectors including the Personal and Family, Management, Buildings, Catering, Education, Finance and Commercial, Industrial, Medical and Health, Public Transportation, Social Welfare, Sports and Culture and Tourism. As promotion and maintenance of environmental health requires input from different sectors, the signing of the Hygiene Charter provides an opportunity for individuals and the public to show their pledge and commitment to good hygiene practices. As a result, with environment improvement and good infectious disease control measures, prevention of epidemics of infectious diseases is deemed to be possible.

  6. Electronic business model for small- and medium-sized manufacturing enterprises (SME): a case study

    NASA Astrophysics Data System (ADS)

    Yuen, Karina; Chung, Walter W.

    2001-10-01

    This paper identifies three essential factors (information infrastructure, executive information system and a new manufacturing paradigm) that are used to support the development of a new business model for competitiveness. They facilitate changes in organization structure in support of business transformation. A SME can source a good manufacturing practice using a model of academic-university collaboration to gain competitive advantage in the e-business world. The collaboration facilitates the change agents to use information systems development as a vehicle to increase the capability of executives in using information and knowledge management to gain higher responsiveness and customer satisfaction. The case company is used to illustrate the application of a web-based executive information system to interface internal communications with external operation. It explains where a good manufacturing practice may be re-applied by other SMEs to acquire skills as a learning organization grows in an extended enterprise setting.

  7. Evaluation by undergraduate medical students of a role-playing training program on the management of acute states of agitation.

    PubMed

    Rolland, B; Fovet, T; Poissy, J; Eichholtzer, C; Lesage, M; Thomas, P; Jourdain, M

    2018-04-01

    Acute states of agitation (ASAs) are frequent in daily medical practice. However, training on real ASAs raises technical and ethical issues, whereas lecture-based teaching hardly addresses some educational objectives, e.g., improving relational skills and team-based coordination. Simulation-based medical education (SBME) is a promising medium to train students on managing ASAs. We have recently implemented a role-playing training module on ASAs. In this scenario, four to five students play the role of the staff, while a trained professional actor plays the agitated patient. A subsequent standardized debriefing is conducted by a senior psychiatrist. A first wave of 219 students participated in a one-session training of this ASA module in June 2015. They completed pre-session and post-session questionnaires aiming to collect "proof-of-concept" data. The pre-session questionnaire investigated: previous experience of ASA among students during their clinical training; previous participation in a role-playing SBME; and perceived knowledge of the good practice rules for managing ASAs. The post-session questionnaire investigated among the students if: they thought having been able to appropriately manage the simulated ASA; they found the SBME medium more fitted for training than real situations; they found that the SBME session faithfully reproduced a real ASA; and the session was found useful for transmitting the skills on correct management of ASA. The average level of stress induced by the training was assessed using a numerical rating scale (0-10). Two hundred and six of the 219 students completed the pre-session questionnaire (63% females; response rate 96.7%). A hundred and thirty four students played the scenario and completed the post-session questionnaire (65.7% females; response rate 100%). 38.3% of the responders reported having previously experienced a situation of ASA in their practice, and 31.1% deemed to know the good practices rules for managing an ASA. In post-session, 29.9% of the participants considered that they appropriately managed the ASA, 79.9% deemed that the role-playing session faithfully reproduced a real ASA, and 97% deemed that this SBME was more fitted and useful than a real clinical situation to improve their medical skills. Bivariate analyses revealed that the post-session responses and level of stress were not influenced by previous experience on ASA, previous participation in a SBME role-playing session, or thinking to know the rules for managing ASAs. SBME role-playing training appears a promising, realistic, and well-accepted method for teaching the management of ASA. Copyright © 2017 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  8. Socio-hydrological implications of water management in the dry zone of Sri Lanka

    NASA Astrophysics Data System (ADS)

    Upeksha Gamage, Isurun; Arachchige Hemachandra Jayasena, Hetti

    2018-06-01

    Water management plays a vital role in the agricultural economy and living conditions of people in Sri Lanka. Though government and non-government organizations have been readily contributing to water management, it is still inefficient, especially in terms of water allocation, consumption and conservation. To identify factors which could be used to implement integrated water resources management (IWRM), a socio-hydrological study was performed in five areas within the dry zone in Sri Lanka. The study covers a comprehensive analysis of how the household income, demography and education level correlating to water usage, purification and disposal methods. The average household income ranges from LKR 2500 to 15 000 per month. The results show that the average daily usage for drinking, cooking, washing, toiletries and bathing are 3, 5, 10, 7, and 85 L per person, respectively. Majority of the families use dug wells and pipe-borne water as the primary source. Correlation coefficients suggest that higher household income or level of education leads to increased water consumption (R = 0.91, 0.94). There is no linear relationship between the level of education with the good practices of water purification and disposal. Though these results indicate preliminary assessments based on the dry zone practices, efficient water management could be enhanced by strong socio-hydrological implications through educating people on conservation, usage, disposal practices and health concerns.

  9. National Practice Patterns for Prenatal Monitoring in Gastroschisis: Gastroschisis Outcomes of Delivery (GOOD) Provider Survey.

    PubMed

    Amin, Ruchi; Domack, Aaron; Bartoletti, Joseph; Peterson, Erika; Rink, Britton; Bruggink, Jennifer; Christensen, Melissa; Johnson, Anthony; Polzin, William; Wagner, Amy J

    2018-05-23

    Gastroschisis is an abdominal wall defect with increasing incidence. Given the lack of surveillance guidelines among maternal-fetal medicine (MFM) specialists, this study describes current practices in gastroschisis management. An online survey was administered to MFM specialists from institutions affiliated with the North American Fetal Therapy Network (NAFTNet). Questions focused on surveillance timing, testing, findings that changed clinical management, and delivery plan. Responses were obtained from 29/29 (100%) NAFTNet centers, comprising 143/371 (39%) providers. The majority had a regimen for antenatal surveillance in patients with stable gastroschisis (94%; 134/141). Antenatal testing began at 32 weeks for 68% (89/131) of MFM specialists. The nonstress test (55%; 72/129), biophysical profile (50%; 63/126), and amniotic fluid index (64%; 84/131) were used weekly. Estimated fetal weight (EFW) was performed monthly by 79% (103/131) of providers. At 28 weeks, abnormal EFW (77%; 97/126) and Doppler ultrasound (78%; 99/127) most frequently altered management. In stable gastroschisis, 43% (60/140) of providers delivered at 37 weeks, and 29% (40/ 140) at 39 weeks. Gastroschisis management differs among NAFTNet centers, although the majority initiate surveillance at 32 weeks. Timing of delivery still requires consensus. Prospective studies are necessary to further optimize practice guidelines and patient care. © 2018 S. Karger AG, Basel.

  10. A qualitative evaluation of occupational therapy-led work rehabilitation for people with inflammatory arthritis: Perspectives of therapists and their line managers.

    PubMed

    Prior, Yeliz; Amanna, Evangeline A; Bodell, Sarah J; Hammond, Alison

    2015-08-01

    Occupational therapy-led work rehabilitation for employed people with inflammatory arthritis and work problems was piloted in five hospitals in the United Kingdom. This qualitative study explored the views of participating occupational therapists and their line managers about the work rehabilitation training received and conducting the intervention, with particular focus on the structured interview used, the Work Experience Survey - Rheumatic Conditions. Face-to-face semi-structured interviews were conducted with occupational therapists ( n  = 9), followed by telephone interviews with their line managers ( n  = 2). Interviews were audio-recorded, transcribed verbatim and thematically analysed by three researchers to maximize validity. The main themes emerging from the occupational therapists' interviews were: varying levels of prior knowledge and experience of work rehabilitation, initial concerns about the feasibility of a lengthy work assessment in practice and increased confidence in delivering work rehabilitation as the study progressed. The line managers' interviews generated themes around the positive impact of the work rehabilitation training the occupational therapists received, and changes in their practice. The Work Experience Survey - Rheumatic Conditions was considered a good choice of work assessment which can be implemented in practice. Once therapists had provided the work intervention several times, their confidence and skills increased.

  11. Practical implementation of good practice in health, environment and safety management in enterprise in the Lodz region.

    PubMed

    Michalak, Jacek

    2002-10-01

    Good practice in health, environment and safety management in enterprise (GP HESME) is the process that aims at continuous improvement in health, environment and safety performance, involving all stakeholders within and outside the enterprise. The GP HESME system is intended to function at different levels: international, national, local community, and enterprise. The most important issues at the first stage of GP HESME implementation in the Lodz region are described. Also, the proposals of future activities in Lodz are presented. Practical implementation of GP HESME requires close co-operation among all stakeholders: local authorities, employers, employees, research institutions, and the state inspectorate. The WHO and the Nofer Institute of Occupational Medicine (NIOM) are initiating implementation, delivering professional consultation, education and training of stakeholders in the NIOM School of Public Health. The implementation of GP HESME in the Lodz region started in 1999 from a WHO meeting on criteria and indicators, followed by close collaboration of NIOM with the city's Department of Public Health. 'Directions of Actions for Health of Lodz Citizens' is now the city's official document that includes GP HESME as an important part of public health policy in Lodz. Several conferences were organized by NIOM together with the Professional Managers' Club, Labor Inspection, and the city's Department of Public Health to assess the most important needs of enterprises. The employers and managerial staff, who predominated among the participants, stated the need for tailored sets of indicators and economic appraisal of GP HESME activities. Special attention is paid to GP HESME in supermarkets and community-owned enterprises, e.g., a local transportation company. A special program for small- and medium-size enterprises will be the next step of GP HESME in the Lodz region. The implementation of GP HESME is possible if the efforts of local authorities; research institutions and state inspectorate are combined with the support of employers' organizations.

  12. 76 FR 47593 - Guidance for Small Business Entities on Current Good Manufacturing Practice for Positron Emission...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-05

    ...] Guidance for Small Business Entities on Current Good Manufacturing Practice for Positron Emission... entitled ``PET Drugs--Current Good Manufacturing Practice (CGMP); Small Entity Compliance Guide.'' FDA has... consistent with FDA's good guidance practices regulation (21 CFR 10.115). The guidance represents the Agency...

  13. 21 CFR 225.1 - Current good manufacturing practice.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Current good manufacturing practice. 225.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS General Provisions § 225.1 Current good manufacturing practice. (a) Section 501(a)(2)(B) of the Federal Food, Drug, and Cosmetic Act...

  14. 21 CFR 210.1 - Status of current good manufacturing practice regulations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Status of current good manufacturing practice... SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL § 210.1 Status of current good manufacturing practice regulations...

  15. 21 CFR 226.1 - Current good manufacturing practice.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Current good manufacturing practice. 226.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES General Provisions § 226.1 Current good manufacturing practice. (a) The criteria in §§ 226.10 through 226.115, inclusive...

  16. 'Animateurs' and animation: what makes a good commissioning manager?

    PubMed

    Checkland, Kath; Snow, Stephanie; McDermott, Imelda; Harrison, Stephen; Coleman, Anna

    2012-01-01

    To examine the managerial behaviours adopted by commissioning managers in English primary care trusts (PCTs), and to explore the impact of these behaviours. Qualitative case studies were undertaken in four PCTs, focusing on staff engaged in the commissioning of hospital services. Both formal and informal observation were undertaken (150 hours), and 41 in-depth interviews conducted with managers and general practitioners (GPs). Managers adopted many managerial behaviours familiar from the literature, including sharing information, and networking inside and outside the organization. Multiple organizational layers and unclear decision-making processes hindered this activity. In addition, some managers with responsibility for facilitating practice-based commissioning (PbC) adopted a managerial mode that we have called being an 'animateur'. This approach involved the active management of disparate groups of people over whom the manager had no authority, and appeared to be a factor in determining success. It was facilitated by managerial autonomy and was more prevalent where managers were seen to have legitimacy. Some organizational practices appeared to inhibit its development. From 2012/13 it is planned that GPs will be taking more responsibility for commissioning in the English NHS. This research suggests that managers of the new commissioning organizations will require a deep and contextualized understanding of the NHS and that it is important that organizational processes do not inhibit managerial behaviour. Legitimacy may be an issue in contexts were managers are automatically transferred from their existing appointments.

  17. Use of antimicrobial resistance information and prescribing guidance for management of urinary tract infections: survey of general practitioners in the West Midlands.

    PubMed

    Ironmonger, Dean; Edeghere, Obaghe; Gossain, Savita; Hawkey, Peter M

    2016-05-24

    There is a marked variation in both antibiotic prescribing practice and urine sampling rates for diagnostic microbiology across general practices in England. To help understand factors driving this variation, we undertook a survey in 2012/13 to determine sampling protocols and antibiotic formularies used by general practitioners (GPs) for managing urinary tract infections (UTIs) in the West Midlands region of England. Cross-sectional survey of all eligible general practices in the West Midlands region of England undertaken in November 2012. GPs were invited to complete an online survey questionnaire to gather information on policies used within the practice for urine sampling for microbiological examination, and the source of antibiotic formularies used to guide treatment of UTIs. The questionnaire also gathered information on how they would manage five hypothetical clinical scenarios encountered in the community. The response rate was 11.3 % (409/3635 GPs), equivalent to a practice response rate of 26 % (248/950). Only 50 % of GPs reported having a practice policy for urine sampling. Although there was good agreement from GPs regarding collecting specimens in scenarios symbolising treatment failure (98 %), UTI in an adult male (98 %) and asymptomatic UTI in pregnancy (97 %), there was variation in GPs requesting a specimen for the scenarios involving a suspected uncomplicated urinary tract infection (UTI) and an asymptomatic catheterised elderly patient; with 40 and 38 % respectively indicating they would collect a specimen for microbiological examination. Standardised evidence based clinical management policies and antibiotic formularies for GPs should be readily available. This will promote the rational use of diagnostic microbiology services, improve antimicrobial stewardship and aid the interpretation of ongoing antimicrobial resistance surveillance.

  18. Biocontainment, biosecurity, and security practices in beef feedyards.

    PubMed

    Brandt, Aric W; Sanderson, Michael W; DeGroot, Brad D; Thomson, Dan U; Hollis, Larry C

    2008-01-15

    To determine the biocontainment, biosecurity, and security practices at beef feedyards in the Central Plains of the United States. Survey. Managers of feedyards in Colorado, Kansas, Nebraska, Oklahoma, and Texas that feed beef cattle for finish before slaughter; feedyards had to have an active concentrated animal feeding operation permit with a 1-time capacity of >or= 1,000 cattle. A voluntary survey of feedyard personnel was conducted. Identified feedyard personnel were interviewed and responses regarding facility design, security, employees, disease preparedness, feedstuffs, hospital or treatment systems, sanitation, cattle sources, handling of sick cattle, and disposal of carcasses were collected in a database questionnaire. The survey was conducted for 106 feedyards with a 1-time capacity that ranged from 1,300 to 125,000 cattle. Feedyards in general did not have high implementation of biocontainment, biosecurity, or security practices. Smaller feedyards were, in general, less likely to use good practices than were larger feedyards. Results of the survey provided standard practices for biocontainment, biosecurity, and security in feedyards located in Central Plains states. Information gained from the survey results can be used by consulting veterinarians and feedyard managers as a basis for discussion and to target training efforts.

  19. Risk factors associated with Salmonella and Listeria monocytogenes contamination of produce fields.

    PubMed

    Strawn, Laura K; Gröhn, Yrjo T; Warchocki, Steven; Worobo, Randy W; Bihn, Elizabeth A; Wiedmann, Martin

    2013-12-01

    Identification of management practices associated with preharvest pathogen contamination of produce fields is crucial to the development of effective Good Agricultural Practices (GAPs). A cross-sectional study was conducted to (i) determine management practices associated with a Salmonella- or Listeria monocytogenes-positive field and (ii) quantify the frequency of these pathogens in irrigation and nonirrigation water sources. Over 5 weeks, 21 produce farms in New York State were visited. Field-level management practices were recorded for 263 fields, and 600 environmental samples (soil, drag swab, and water) were collected and analyzed for Salmonella and L. monocytogenes. Management practices were evaluated for their association with the presence of a pathogen-positive field. Salmonella and L. monocytogenes were detected in 6.1% and 17.5% of fields (n = 263) and 11% and 30% of water samples (n = 74), respectively. The majority of pathogen-positive water samples were from nonirrigation surface water sources. Multivariate analysis showed that manure application within a year increased the odds of a Salmonella-positive field (odds ratio [OR], 16.7), while the presence of a buffer zone had a protective effect (OR, 0.1). Irrigation (within 3 days of sample collection) (OR, 6.0), reported wildlife observation (within 3 days of sample collection) (OR, 6.1), and soil cultivation (within 7 days of sample collection) (OR, 2.9) all increased the likelihood of an L. monocytogenes-positive field. Our findings provide new data that will assist growers with science-based evaluation of their current GAPs and implementation of preventive controls that reduce the risk of preharvest contamination.

  20. Risk Factors Associated with Salmonella and Listeria monocytogenes Contamination of Produce Fields

    PubMed Central

    Gröhn, Yrjo T.; Warchocki, Steven; Worobo, Randy W.; Bihn, Elizabeth A.; Wiedmann, Martin

    2013-01-01

    Identification of management practices associated with preharvest pathogen contamination of produce fields is crucial to the development of effective Good Agricultural Practices (GAPs). A cross-sectional study was conducted to (i) determine management practices associated with a Salmonella- or Listeria monocytogenes-positive field and (ii) quantify the frequency of these pathogens in irrigation and nonirrigation water sources. Over 5 weeks, 21 produce farms in New York State were visited. Field-level management practices were recorded for 263 fields, and 600 environmental samples (soil, drag swab, and water) were collected and analyzed for Salmonella and L. monocytogenes. Management practices were evaluated for their association with the presence of a pathogen-positive field. Salmonella and L. monocytogenes were detected in 6.1% and 17.5% of fields (n = 263) and 11% and 30% of water samples (n = 74), respectively. The majority of pathogen-positive water samples were from nonirrigation surface water sources. Multivariate analysis showed that manure application within a year increased the odds of a Salmonella-positive field (odds ratio [OR], 16.7), while the presence of a buffer zone had a protective effect (OR, 0.1). Irrigation (within 3 days of sample collection) (OR, 6.0), reported wildlife observation (within 3 days of sample collection) (OR, 6.1), and soil cultivation (within 7 days of sample collection) (OR, 2.9) all increased the likelihood of an L. monocytogenes-positive field. Our findings provide new data that will assist growers with science-based evaluation of their current GAPs and implementation of preventive controls that reduce the risk of preharvest contamination. PMID:24077713

  1. Practices in security and confidentiality of HIV/AIDS patients' information: A national survey among staff at HIV outpatient clinics in Vietnam.

    PubMed

    Khac Hai, Nguyen; Lawpoolsri, Saranath; Jittamala, Podjanee; Thi Thu Huong, Phan; Kaewkungwal, Jaranit

    2017-01-01

    Breach of confidentiality or invasion of privacy from the collection and use of medical records, particularly those of patients with HIV/AIDS or other diseases sensitive to stigmatization, should be prevented by all related stakeholders in healthcare settings. The main focus of this study was to assess practices regarding security and confidentiality of HIV-related information among staff at HIV outpatient clinics (HIV-OPCs) in Vietnam. A descriptive cross-sectional study was conducted at all 312 HIV-OPCs across the country using an online survey technique. In general, the staff practices for securing and protecting patient information were at acceptable levels. Most staff had proper measures and practices for maintaining data security; however, the protection of patient confidentiality, particularly for data access, sharing, and transfer still required improvement. Most HIV-OPC staff had good or moderate knowledge and positive perceptions towards security and confidentiality issues. Staff who were not trained in the practice of security measures differed significantly from those who were trained (OR: 3.74; 95%CI: 1.44-9.67); staff needing improved knowledge levels differed significantly from those with good (OR: 5.20; 95%CI: 2.39-11.32) and moderate knowledge levels (OR: 5.10; 95%CI: 2.36-11.00); and staff needing improved perception levels differed significantly from those with good (i.e., with 100% proper practices) and moderate perception levels (OR: 5.67; 95%CI: 2.93-10.95). Staff who were not trained in the protection of data confidentiality differed significantly from those who were trained (OR: 2.18; 95%CI: 1.29-3.65). Training is an important factor to help raise the levels of proper practices regarding confidentiality and security, to improve knowledge and raise awareness about change among staff. The operation and management of HIV treatment and care in Vietnam are currently transitioning from separate healthcare clinics (HIV-OPC) into units integrated into general hospitals/healthcare facilities. The findings of this study highlight topics that could be used for improving management and operation of information system and revising guidelines and regulations on protection measures/strategies for data security and confidentiality of HIV/AIDS patients by Vietnam health authorities or other countries facing similar situations. Secure infrastructure and secure measures for data access and use are very important, worthwhile investments. The provision of continuous training and active enforcement and monitoring of the practices of healthcare personnel might lead to an improved understanding and acknowledegement of the importance of national policies/guidelines regarding HIV-related patient information.

  2. Good Practice Chaplaincy: An Exploratory Study Identifying the Appropriate Skills, Attitudes and Practices for the Selection, Training and Utilisation of Chaplains.

    PubMed

    Carey, Lindsay B; Rumbold, Bruce

    2015-08-01

    This article presents an overview of exploratory research regarding the skills, knowledge, attitudes and practices considered necessary for chaplains to be highly competent in providing holistic care to clients and staff. Utilising a qualitative methodology, two focus groups comprising Salvation Army chaplains and their managers provided data about their expectations of chaplaincy personnel and about the pastoral care interventions undertaken by chaplains. The results indicated that while there were some differences in opinion, nevertheless, in overall terms, there was general agreement between chaplains and their managers about particular personal and professional qualities necessary for chaplains to be considered appropriate and proficient. Evidence was also obtained indicating a need for change with regard to the organisational attitude and culture of The Salvation Army towards chaplaincy. Recommendations are presented concerning (1) the selection criteria for chaplaincy, (2) training and utilisation of chaplains plus (3) issues relating to organizational cultural change necessary to develop a future-ready chaplaincy more suitable for the twenty-first century.

  3. Swiss clinical practice guidelines on field cancerization of the skin.

    PubMed

    Hofbauer, Günther; Anliker, Mark; Boehncke, Wolf-Henning; Brand, Christoph; Braun, Ralph; Gaide, Olivier; Hafner, Jürg; Hunger, Robert; Itin, Peter; Kaeuper, Gina; Lautenschlager, Stephan; Mainetti, Carlo; Streit, Markus

    2014-01-01

    Actinic keratosis (AK) affects millions of people worldwide, and its prevalence continues to increase. AK lesions are caused by chronic ultraviolet radiation exposure, and the presence of two or more AK lesions along with photodamage should raise the consideration of a diagnosis of field cancerization. Effective treatment of individual lesions as well as field cancerization is essential for good long-term outcomes. The Swiss Registry of Actinic Keratosis Treatment (REAKT) Working Group has developed clinical practice guidelines for the treatment of field cancerization in patients who present with AK. These guidelines are intended to serve as a resource for physicians as to the most appropriate treatment and management of AK and field cancerization based on current evidence and the combined practical experience of the authors. Treatment of AK and field cancerization should be driven by consideration of relevant patient, disease, and treatment factors, and appropriate treatment decisions will differ from patient to patient. Prevention measures and screening recommendations are discussed, and special considerations related to management of immunocompromised patients are provided.

  4. A realist evaluation of the management of a well- performing regional hospital in Ghana

    PubMed Central

    2010-01-01

    Background Realist evaluation offers an interesting approach to evaluation of interventions in complex settings, but has been little applied in health care. We report on a realist case study of a well performing hospital in Ghana and show how such a realist evaluation design can help to overcome the limited external validity of a traditional case study. Methods We developed a realist evaluation framework for hypothesis formulation, data collection, data analysis and synthesis of the findings. Focusing on the role of human resource management in hospital performance, we formulated our hypothesis around the high commitment management concept. Mixed methods were used in data collection, including individual and group interviews, observations and document reviews. Results We found that the human resource management approach (the actual intervention) included induction of new staff, training and personal development, good communication and information sharing, and decentralised decision-making. We identified 3 additional practices: ensuring optimal physical working conditions, access to top managers and managers' involvement on the work floor. Teamwork, recognition and trust emerged as key elements of the organisational climate. Interviewees reported high levels of organisational commitment. The analysis unearthed perceived organisational support and reciprocity as underlying mechanisms that link the management practices with commitment. Methodologically, we found that realist evaluation can be fruitfully used to develop detailed case studies that analyse how management interventions work and in which conditions. Analysing the links between intervention, mechanism and outcome increases the explaining power, while identification of essential context elements improves the usefulness of the findings for decision-makers in other settings (external validity). We also identified a number of practical difficulties and priorities for further methodological development. Conclusion This case suggests that a well-balanced HRM bundle can stimulate organisational commitment of health workers. Such practices can be implemented even with narrow decision spaces. Realist evaluation provides an appropriate approach to increase the usefulness of case studies to managers and policymakers. PMID:20100330

  5. A realist evaluation of the management of a well-performing regional hospital in Ghana.

    PubMed

    Marchal, Bruno; Dedzo, McDamien; Kegels, Guy

    2010-01-25

    Realist evaluation offers an interesting approach to evaluation of interventions in complex settings, but has been little applied in health care. We report on a realist case study of a well performing hospital in Ghana and show how such a realist evaluation design can help to overcome the limited external validity of a traditional case study. We developed a realist evaluation framework for hypothesis formulation, data collection, data analysis and synthesis of the findings. Focusing on the role of human resource management in hospital performance, we formulated our hypothesis around the high commitment management concept. Mixed methods were used in data collection, including individual and group interviews, observations and document reviews. We found that the human resource management approach (the actual intervention) included induction of new staff, training and personal development, good communication and information sharing, and decentralised decision-making. We identified 3 additional practices: ensuring optimal physical working conditions, access to top managers and managers' involvement on the work floor. Teamwork, recognition and trust emerged as key elements of the organisational climate. Interviewees reported high levels of organisational commitment. The analysis unearthed perceived organisational support and reciprocity as underlying mechanisms that link the management practices with commitment. Methodologically, we found that realist evaluation can be fruitfully used to develop detailed case studies that analyse how management interventions work and in which conditions. Analysing the links between intervention, mechanism and outcome increases the explaining power, while identification of essential context elements improves the usefulness of the findings for decision-makers in other settings (external validity). We also identified a number of practical difficulties and priorities for further methodological development. This case suggests that a well-balanced HRM bundle can stimulate organisational commitment of health workers. Such practices can be implemented even with narrow decision spaces. Realist evaluation provides an appropriate approach to increase the usefulness of case studies to managers and policymakers.

  6. Best Practice for the Administration of Daratumumab in Multiple Myeloma: Australian Myeloma Nurse Expert Opinion

    PubMed Central

    King, Tracy; Jagger, Jacqueline; Wood, Jodie; Woodrow, Carmel; Snowden, Alicia; Haines, Sally; Crosbie, Christina; Houdyk, Kristen

    2018-01-01

    Patients with multiple myeloma (MM) are typically of an advanced age and may have significant co-existing medical conditions. They have often had multiple lines of therapy and as such experience disease-related effects alongside associated treatment toxicities. Daratumumab is a monoclonal antibody approved for the treatment of MM in the relapsed/refractory setting. Clinical studies found that daratumumab showed good tolerability as a monotherapy and in combination with current standard therapies. However, the administration of daratumumab does require specific management considerations. It is administered as an intravenous infusion and infusion-related reactions (IRRs) may occur. Daratumumab also interferes with routine blood transfusion tests, giving false positives for the indirect antiglobulin test. This article highlights key nursing care considerations and practical management aspects to improve the treatment experience of patients receiving daratumumab infusions. Pretreatment aspects, patient education, pre- and post-medication, daratumumab administration, and the management of IRRs are discussed. An IRR management sheet that could be used by nurses and a patient information sheet are located at the end of this article.

  7. Multilevel integrated flood management aproach

    NASA Astrophysics Data System (ADS)

    Brilly, Mitja; Rusjan, Simon

    2013-04-01

    The optimal solution for complex flood management is integrated approach. Word »integration« used very often when we try to put something together, but should distinguish full multiple integrated approach of integration by parts when we put together and analyse only two variables. In doing so, we lost complexity of the phenomenon. Otherwise if we try to put together all variables we should take so much effort and time and we never finish the job properly. Solution is in multiple integration captures the essential factors, which are different on a case-by-case (Brilly, 2000). Physical planning is one of most important activity in which flood management should be integrated. The physical planning is crucial for vulnerability and its future development and on other hand our structural measures must be incorporate in space and will very often dominated in. The best solution is if space development derived on same time with development of structural measures. There are good examples with such approach (Vienna, Belgrade, Zagreb, and Ljubljana). Problems stared when we try incorporating flood management in already urbanised area or we would like to decrease risk to some lower level. Looking to practice we learn that middle Ages practices were much better than to day. There is also »disaster by design« when hazard increased as consequence of upstream development or in stream construction or remediation. In such situation we have risk on areas well protected in the past. Good preparation is essential for integration otherwise we just lost time what is essential for decision making and development. We should develop clear picture about physical characteristics of phenomena and possible solutions. We should develop not only the flood maps; we should know how fast phenomena could develop, in hour, day or more. Do we need to analyse ground water - surface water relations, we would like to protected area that was later flooded by ground water. Do we need to take care about sediment transport, phenomenon close related to floods - could the river bad bottom increase or decrease for some meters or river completely rearrange morphology - how then inundated area will look like. Hazard of floods should be presented properly, with maps, uncertainty and trends related to natural and anthropogenic impacts. We should look time back, how our river look in past centuries and what are water management plans for future. Which activities are on the river? There are good practice in flood protection, hydropower development and physical planning (Vienna, Sava River).

  8. Revised guidelines for good practice in IVF laboratories (2015).

    PubMed

    De los Santos, Maria José; Apter, Susanna; Coticchio, Giovanni; Debrock, Sophie; Lundin, Kersti; Plancha, Carlos E; Prados, Fernando; Rienzi, Laura; Verheyen, Greta; Woodward, Bryan; Vermeulen, Nathalie

    2016-04-01

    Which recommendations can be provided by the European Society of Human Reproduction and Embryology Special Interest Group (ESHRE SIG) Embryology to support laboratory specialists in the organization and management of IVF laboratories and the optimization of IVF patient care? Structured in 13 sections, the guideline development group formulated recommendations for good practice in the organization and management of IVF laboratories, and for good practice of the specific procedures performed within the IVF laboratory. NA. The guideline was produced by a group of 10 embryologists representing different European countries, settings and levels of expertise. The group evaluated the document of 2008, and based on this assessment, each group member rewrote one or more sections. Two 2-day meetings were organized during which each of the recommendations was discussed and rewritten until consensus within the guideline group was reached. After finalizing the draft, the members of the ESHRE SIG embryology were invited to review the guideline. NA. The guideline provides recommendations on the general organization of an IVF laboratory (staffing and direction, quality management, laboratory safety), and on the specific aspects of the procedures performed in IVF laboratories (Identification of patients and traceability of their reproductive cells, consumables, handling of biological material, oocyte retrieval, sperm preparation, insemination of oocytes, scoring for fertilization, embryo culture and transfer, and cryopreservation). A last section provides recommendations regarding an Emergency plan for IVF laboratories. Evidence on most of the issues described is scarce, and therefore it was decided not to perform a formal search for and assessment of scientific evidence. However, recommendations published in the EUTCD and relevant and recent documents, manuals and consensus papers were taken into account when formulating the recommendations. Despite the limitations, the guideline group is confident that this document will be helpful to directors and managers involved in the management and organization of IVF laboratories, but also to embryologists and laboratory technicians performing daily tasks. The guideline was developed and funded by ESHRE, covering expenses associated with the guideline meetings. The guideline group members did not receive payment. Dr Coticchio reports speaker's fees from IBSA and Cook, outside the submitted work; Dr Lundin reports grants from Vitrolife, personal fees from Merck Serono, non-financial support from Unisense, outside the submitted work; Dr. Rienzi reports personal fees from Merck Serono, personal fees from MSD, grants from GFI, outside the submitted work; the other authors had nothing to disclose. NA. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Give Water a Hand. Leader Guidebook. Youth Action Program. Promoting Good Water Management Practices at Home and in the Community.

    ERIC Educational Resources Information Center

    Wisconsin Univ., Madison. Coll. of Agricultural and Life Sciences.

    Educators of students grades 4-8 can use this guide to lead a community service project using the "Give Water a Hand" youth action program. Youth groups investigate water and water conservation within the home, farm, ranch, school, or community, with the help of local experts. The guide contains six chapters that cover: (1) an…

  10. Postgraduate Research Students' Knowledge and Attitudes towards Good Supervisory Practice at the University of Exeter

    ERIC Educational Resources Information Center

    Abdelhafez, Ahmed M. M.

    2007-01-01

    Background: Research reveals that the relationship between a student and a supervisor is so crucial that students cannot afford to leave it to chance. It must be managed. Phillips and Pugh (2000, p. 193) maintains that if students are to do this well, they must understand what their supervisors expect of them. Once they have this "inside…

  11. Handbook for Volcanic Risk Management: an outcome from MIAVITA project

    NASA Astrophysics Data System (ADS)

    Bignami, Christian; Bosi, Vittorio; Costantini, Licia; Cristiani, Chiara; Lavigne, Franck; Thierry, Pierre

    2013-04-01

    Volcanic eruptions are one of the most impressive, violent and dramatic agents of change on Earth, threatening hundreds of millions of people. The crises management implies a strong cooperation among the main stakeholders (e.g., civil protection authorities, scientific institutions, operational forces). Considering the great amount of different actions required during the whole volcanic cycle (e.g., preparedness, unrest phase, crisis management, resilience), the role and responsibilities of stakeholders should be clarified in advance. In particular, the role of scientists, fundamental in all the phases, should be well discussed with the other stakeholders and well defined, for every country. This will allow a better management and response, and contribute to avoid misunderstanding. The new "Handbook for Volcanic Risk Management" issued by the MIAVITA European project, funded by the European Commission (Mitigate and Assess risk from Volcanic Impact on Terrain and human Activities) gives a contribution to that. Indeed, this handbook aims at synthesizing the acquired knowledge on volcanic risk management, such as prevention, preparedness, mitigation, intervention, crisis management and resilience, in a practical and useful way. It promotes the creation of an ideal bridge between different actors involved in risk management, improving and facilitating interactions among authorities and scientists. This work is based on current scientific research and the shared experience of the different MIAVITA project partners as well as on international good practices previously recommended. The handbook is composed of six sections. The first one briefly explains the global volcanic context and the principles of corresponding risk management. Section 2 contains a description of volcanic phenomena, damage and understanding size and effects that can be expected. Sections 3, 4 and 5 meet preparation and prevention issues and describe actions to be undertaken during the response phase of the volcano in order to improve the preparedness of stakeholders and population and to minimize the effects of future eruptions. The last one, section 6, deals with crisis management and shows some recovery examples. In sections 4, 5 and 6, the readers can find the proposed definition of roles and responsibilities for the main actors, and some insights and good practices to improve the capability of the civil protection system to better include the scientific communities. Suggestions are also given in order to develop a common training in order to have efficient communication with the media, setting up a collaborative approach with the media itself, with the civil protection authorities, and with the public. The handbook It is presently available for free on the following websites: http://miavita.brgm.fr, http://www.ingv.it/en, www.protezionecivile.it.

  12. Forecasting the Emergency Department Patients Flow.

    PubMed

    Afilal, Mohamed; Yalaoui, Farouk; Dugardin, Frédéric; Amodeo, Lionel; Laplanche, David; Blua, Philippe

    2016-07-01

    Emergency department (ED) have become the patient's main point of entrance in modern hospitals causing it frequent overcrowding, thus hospital managers are increasingly paying attention to the ED in order to provide better quality service for patients. One of the key elements for a good management strategy is demand forecasting. In this case, forecasting patients flow, which will help decision makers to optimize human (doctors, nurses…) and material(beds, boxs…) resources allocation. The main interest of this research is forecasting daily attendance at an emergency department. The study was conducted on the Emergency Department of Troyes city hospital center, France, in which we propose a new practical ED patients classification that consolidate the CCMU and GEMSA categories into one category and innovative time-series based models to forecast long and short term daily attendance. The models we developed for this case study shows very good performances (up to 91,24 % for the annual Total flow forecast) and robustness to epidemic periods.

  13. Evaluation of high fidelity patient simulator in assessment of performance of anaesthetists.

    PubMed

    Weller, J M; Bloch, M; Young, S; Maze, M; Oyesola, S; Wyner, J; Dob, D; Haire, K; Durbridge, J; Walker, T; Newble, D

    2003-01-01

    There is increasing emphasis on performance-based assessment of clinical competence. The High Fidelity Patient Simulator (HPS) may be useful for assessment of clinical practice in anaesthesia, but needs formal evaluation of validity, reliability, feasibility and effect on learning. We set out to assess the reliability of a global rating scale for scoring simulator performance in crisis management. Using a global rating scale, three judges independently rated videotapes of anaesthetists in simulated crises in the operating theatre. Five anaesthetists then independently rated subsets of these videotapes. There was good agreement between raters for medical management, behavioural attributes and overall performance. Agreement was high for both the initial judges and the five additional raters. Using a global scale to assess simulator performance, we found good inter-rater reliability for scoring performance in a crisis. We estimate that two judges should provide a reliable assessment. High fidelity simulation should be studied further for assessing clinical performance.

  14. 21 CFR 212.2 - What is current good manufacturing practice for PET drugs?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false What is current good manufacturing practice for... HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR POSITRON EMISSION TOMOGRAPHY DRUGS (Eff. 12-12-2011) General Provisions § 212.2 What is current good manufacturing practice for...

  15. 21 CFR 1271.150 - Current good tissue practice requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Current good tissue practice requirements. 1271... HUMAN CELLS, TISSUES, AND CELLULAR AND TISSUE-BASED PRODUCTS Current Good Tissue Practice § 1271.150 Current good tissue practice requirements. (a) General. This subpart D and subpart C of this part set...

  16. Good vaccination practice: it all starts with a good vaccine storage temperature.

    PubMed

    Vangroenweghe, Frédéric

    2017-01-01

    Recent introduction of strategies to reduce antibiotic use in food animal production implies an increased use of vaccines in order to prevent the economic impact of several important diseases in swine. Good Vaccination Practice (GVP) is an overall approach on the swine farm aiming to obtain maximal efficacy of vaccination through good storage, preparation and finally correct application to the target animals. In order to have a better insight into GVP on swine farms and the vaccine storage conditions, a survey on vaccination practices was performed on a farmers' fair and temperatures in the vaccine storage refrigerators were measured during farm visits over a period of 1 year. The survey revealed that knowledge on GVP, such as vaccine storage and handling, needle management and injection location could be improved. Less than 10% had a thermometer in their vaccine storage refrigerator on the moment of the visit. Temperature measurement revealed that only 71% of the measured refrigerators were in line with the recommended temperature range of +2 °C to +8 °C. Both below +2 °C and above +8 °C temperatures were registered during all seasons of the year. Compliance was lower during summer with an average temperature of 9.2 °C while only 43% of the measured temperatures were within the recommended range. The present study clearly showed the need for continuous education on GVP for swine veterinarians, swine farmers and their farm personnel in general and vaccine storage management in particular. In veterinary medicine, the correct storage of vaccines is crucial since both too low and too high temperatures can provoke damage to specific vaccine types. Adjuvanted killed or subunit vaccines can be damaged (e.g. structure of aluminiumhydroxide in adjuvans) by too low temperatures (below 0 °C), whereas lyophilized live vaccines are susceptible (e.g. loss of vaccine potency) to heat damage by temperatures above +8 °C. In conclusion, knowledge and awareness of GVP and vaccine storage conditions are crucial under practical field conditions in swine herds. Focus on a correct on-farm vaccine storage is part of the responsible veterinarians' guidance in order to obtain the required vaccine efficacy.

  17. Integrating water quality responses to best management practices in Portugal.

    PubMed

    Fonseca, André; Boaventura, Rui A R; Vilar, Vítor J P

    2018-01-01

    Nutrient nonpoint pollution has a significant impact on water resources worldwide. The main challenge of this work was to assess the application of best management practices in agricultural land to comply with water quality legislation for surface waters. The Hydrological Simulation Program-FORTRAN was used to evaluate water quality of Ave River in Portugal. Best management practices (infiltration basin) (BMP) were applied to agricultural land (for 3, 6, 9, 12, and 15% area) with removal efficiencies of 50% for fecal coliforms and 30% for nitrogen, phosphorus, and biochemical oxygen demand. The inflow of water quality constituents was reduced for all scenarios, with fecal coliforms achieving the highest reduction between 5.8 and 28.9% and nutrients and biochemical oxygen demand between 2 and 13%. Biochemical oxygen demand and orthophosphates concentrations achieved a good water quality status according to the European Legislation for scenarios of BMP applied to 3 and 12% agricultural area, respectively. Fecal coliform levels in Ave River basin require further treatment to fall below the established value in the abovementioned legislation. This study shows that agricultural watersheds such as Ave basins demand special attention in regard to nonpoint pollution sources effects on water quality and nutrient loads.

  18. Sponsorship in non-commercial clinical trials: definitions, challenges and the role of Good Clinical Practices guidelines.

    PubMed

    Ravinetto, Raffaella; De Nys, Katelijne; Boelaert, Marleen; Diro, Ermias; Meintjes, Graeme; Adoke, Yeka; Tagbor, Harry; Casteels, Minne

    2015-12-30

    Non-commercial clinical research plays an increasingly essential role for global health. Multiple partners join in international consortia that operate under the limited timeframe of a specific funding period. One organisation (the sponsor) designs and carries out the trial in collaboration with research partners, and is ultimately responsible for the trial's scientific, ethical, regulatory and legal aspects, while another organization, generally in the North (the funder), provides the external funding and sets funding conditions. Even if external funding mechanisms are key for most non-commercial research, the dependence on an external funder's policies may heavily influence the choices of a sponsor. In addition, the competition for accessing the available external funds is great, and non-commercial sponsors may not be in a position to discuss or refuse standard conditions set by a funder. To see whether the current definitions adequately address the intricacies of sponsorship in externally-funded trials, we looked at how a "sponsor" of clinical trials is defined in selected international guidelines, with particular focus on international Good Clinical Practices codes, and in selected European and African regulations/legislations. Our limited analysis suggests that the sponsors definition from the 1995 WHO Good Clinical Practices code has been integrated as such into many legislations, guidelines and regulations, and that it is not adequate to cover today's reality of funding arrangements in global health, where the legal responsibility and the funding source are de facto split. In agreement with other groups, we suggest that the international Good Clinical Practices codes should be updated to reflect the reality of non-commercial clinical research. In particular, they should explicitly include the distinction between commercial and non-commercial sponsors, and provide guidance to non-commercial sponsors for negotiating with external funding agencies and other research counterparts. Non-commercial sponsors of clinical trials should surely invest in the development of adequate legal, administrative and management skills. By acknowledging their role and specificities, and by providing them with adapted guidance, the international Good Clinical Practices codes would provide valuable guidance and support to non-commercial clinical research, whose relevance for global health is increasingly evident.

  19. Nurse Managers' prerequisite for nursing development: a survey on pressure ulcers and contextual factors in hospital organizations.

    PubMed

    Gunningberg, Lena; Brudin, Lars; Idvall, Ewa

    2010-09-01

    To describe and compare pressure ulcer prevalence in two county councils and concurrently explore Nurse Managers' perspective of contextual factors in a hospital organization. Despite good knowledge about risk factors and prevention of pressure ulcers, the prevalence of pressure ulcers remains high. Nurse Managers' have a key role in implementing evidence-based practice. The present study included five hospitals in two Swedish county councils: county council A (non-university setting) and county council B (university setting). A pressure ulcer prevalence study was conducted according to the methodology developed by the European Pressure Ulcer Advisory Panel. The Nurse Managers' answered a (27-item) questionnaire on contextual factors. County council B had significantly less pressure ulcers grade (2-4) (7.7%) than county council A (11.3%). The Nurse Managers' assessed only two out of the 27 general contextual items significantly differently. Some significant differences were observed in ward organization. In county council B, the Nurse Managers' seemed more aware of prevention strategies compared with Nurse Managers' in county council A. The Nurse Managers' should take more responsibility to develop the prerequisite for quality improvement in nursing. Nursing outcomes (e.g. pressure ulcers) should be incorporated into national quality registries for benchmarking and Nurse Managers' competence in evidence-based practice and research methodology increased. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

  20. IT-supported integrated care pathways for diabetes: A compilation and review of good practices.

    PubMed

    Vrijhoef, Hubertus Jm; de Belvis, Antonio Giulio; de la Calle, Matias; de Sabata, Maria Stella; Hauck, Bastian; Montante, Sabrina; Moritz, Annette; Pelizzola, Dario; Saraheimo, Markku; Guldemond, Nick A

    2017-06-01

    Integrated Care Pathways (ICPs) are a method for the mutual decision-making and organization of care for a well-defined group of patients during a well-defined period. The aim of a care pathway is to enhance the quality of care by improving patient outcomes, promoting patient safety, increasing patient satisfaction, and optimizing the use of resources. To describe this concept, different names are used, e.g. care pathways and integrated care pathways. Modern information technologies (IT) can support ICPs by enabling patient empowerment, better management, and the monitoring of care provided by multidisciplinary teams. This study analyses ICPs across Europe, identifying commonalities and success factors to establish good practices for IT-supported ICPs in diabetes care. A mixed-method approach was applied, combining desk research on 24 projects from the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) with follow-up interviews of project participants, and a non-systematic literature review. We applied a Delphi technique to select process and outcome indicators, derived from different literature sources which were compiled and applied for the identification of successful good practices. Desk research identified sixteen projects featuring IT-supported ICPs, mostly derived from the EIP on AHA, as good practices based on our criteria. Follow-up interviews were then conducted with representatives from 9 of the 16 projects to gather information not publicly available and understand how these projects were meeting the identified criteria. In parallel, the non-systematic literature review of 434 PubMed search results revealed a total of eight relevant projects. On the basis of the selected EIP on AHA project data and non-systematic literature review, no commonalities with regard to defined process or outcome indicators could be identified through our approach. Conversely, the research produced a heterogeneous picture in all aspects of the projects' indicators. Data from desk research and follow-up interviews partly lacked information on outcome and performance, which limited the comparison between practices. Applying a comprehensive set of indicators in a multi-method approach to assess the projects included in this research study did not reveal any obvious commonalities which might serve as a blueprint for future IT-supported ICP projects. Instead, an unexpected high degree of heterogeneity was observed, that may reflect diverse local implementation requirements e.g. specificities of the local healthcare system, local regulations, or preexisting structures used for the project setup. Improving the definition of and reporting on project outcomes could help advance research on and implementation of effective integrated care solutions for chronic disease management across Europe.

  1. Health Information Management Leaders and the Practice of Leadership through the Lens of Bowen Theory

    PubMed Central

    Sheridan, Patty Thierry; Watzlaf, Valerie; Fox, Leslie Ann

    2016-01-01

    Even though leadership is one of the most examined topics in the organizational literature, its application in the field of health information management (HIM) has not been studied extensively. This descriptive, mixed-methodology study examined HIM leadership through the lens of Bowen theory. The researchers conducted surveys of HIM directors and managers, administrators and colleagues of HIM leaders, and HIM staff using focus groups, observations of meetings, and face-to-face interviews. Results showed that HIM leaders are valued for HIM expertise in electronic health records, privacy, security, and coding; for being the center or heart of the organization; and for commonly valued leadership behaviors and skills including dependability, strategic planning, project management, listening ability, and fairness. Leadership was seen as a reciprocal process, and a team approach was preferred. Good communication, education, and training on HIM topics were also valued. However, HIM leaders believed that they spend more time on management activities than on leadership activities, although they would prefer the reverse. Future research is needed to examine how HIM leadership can be practiced more consistently in the workplace across different HIM functions. PMID:27134609

  2. Attitudes and beliefs of emergency department staff regarding alcohol-related presentations.

    PubMed

    Indig, Devon; Copeland, Jan; Conigrave, Katherine M; Rotenko, Irene

    2009-01-01

    This study examined emergency department (ED) staff attitudes and beliefs about alcohol-related ED presentations in order to recommend improved detection and brief intervention strategies. The survey was conducted at two inner-Sydney hospital EDs in 2006 to explore ED clinical staff's attitudes, current practice and barriers for managing alcohol-related ED presentations. The sample included N=78 ED staff (54% nurses, 46% doctors), representing a 30% response rate. Management of alcohol-related problems was not routine among ED staff, with only 5% usually formally screening for alcohol problems, only 16% usually conducting brief interventions, and only 27% usually providing a referral to specialist treatment services. Over 85% of ED staff indicated that lack of patient motivation made providing alcohol interventions very difficult. Significant predictors of good self-reported practice among ED staff for patients with alcohol problems included: being a doctor, being confident and having a sense of responsibility towards managing patients with alcohol-related problems. This study reported that many staff lack the confidence or sense of clinical responsibility to fully and appropriately manage ED patients with alcohol-related problems. ED staff appear to require additional training, resources and support to enhance their management of patients with alcohol-related problems.

  3. Healthcare waste management: qualitative and quantitative appraisal of nurses in a tertiary care hospital of India.

    PubMed

    Shivalli, Siddharudha; Sanklapur, Vasudha

    2014-01-01

    The nurse's role in healthcare waste management is crucial. (1) To appraise nurses quantitatively and qualitatively regarding healthcare waste management; (2) to elicit the determinants of knowledge and attitudes of healthcare waste management. A cross-sectional study was undertaken at a tertiary care hospital of Mangalore, India. Self-administered pretested questionnaire and "nonparticipatory observation" were used for quantitative and qualitative appraisals. Percentage knowledge score was calculated based on their total knowledge score. Nurses' knowledge was categorized as excellent (>70%), good (50-70%), and poor (<50%). Chi square test was applied to judge the association of study variables with their attitudes and knowledge. Out of 100 nurses 47 had excellent knowledge (>70% score). Most (86%) expressed the need of refresher training. No study variable displayed significant association (P > 0.05) with knowledge. Apt segregation practices were followed except in casualty. Patients and entourages misinterpreted the colored containers. Nurses' knowledge and healthcare waste management practices were not satisfactory. There is a need of refresher trainings at optimum intervals to ensure sustainability and further improvement. Educating patients and their entourages and display of segregation information board in local language are recommended.

  4. [Concept analysis of a participatory approach to occupational safety and health].

    PubMed

    Yoshikawa, Etsuko

    2013-01-01

    The purpose of this study was to analyze a participatory approach to occupational safety and health, and to examine the possibility of applying the concept to the practice and research of occupational safety and health. According to Rodger's method, descriptive data concerning antecedents, attributes and consequences were qualitatively analyzed. A total of 39 articles were selected for analysis. Attributes with a participatory approach were: "active involvement of both workers and employers", "focusing on action-oriented low-cost and multiple area improvements based on good practices", "the process of emphasis on consensus building", and "utilization of a local network". Antecedents of the participatory approach were classified as: "existing risks at the workplace", "difficulty of occupational safety and health activities", "characteristics of the workplace and workers", and "needs for the workplace". The derived consequences were: "promoting occupational safety and health activities", "emphasis of self-management", "creation of safety and healthy workplace", and "contributing to promotion of quality of life and productivity". A participatory approach in occupational safety and health is defined as, the process of emphasis on consensus building to promote occupational safety and health activities with emphasis on self-management, which focuses on action-oriented low-cost and multiple area improvements based on good practices with active involvement of both workers and employers through utilization of local networks. We recommend that the role of the occupational health professional be clarified and an evaluation framework be established for the participatory approach to promote occupational safety and health activities by involving both workers and employers.

  5. Affirmative Action Plan, October 1991--September 1992

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

    Not Available

    1991-10-01

    This report documents Reynolds Electrical Engineering Co., Inc., analysis of all major job groups with explanations if minorities and females are underutilized in any one or more job group. Goals and timetables have been developed and good faith efforts are directed to correct any deficiencies. In addition, Affirmative Action Plans for the Handicapped, Vietnam Era Veterans, and Disabled Veterans are included which set forth policies, practices, and procedures in accordance with Department of Labor regulations. All personnel decisions are made at the Company level. Decisions regarding the General Manager or Deputy General Manager are made at the corporate level.

  6. Weight Management Belief is the Leading Influential Factor of Weight Monitoring Compliance in Congestive Heart Failure Patients.

    PubMed

    Lu, Min-Xia; Zhang, Yan-Yun; Jiang, Jun-Fang; Ju, Yang; Wu, Qing; Zhao, Xin; Wang, Xiao-Hua

    2016-11-01

    Daily weight monitoring is frequently recommended as a part of heart failure self-management to prevent exacerbations. This study is to identify factors that influence weight monitoring compliance of congestive heart failure patients at baseline and after a 1-year weight management (WM) program. This was a secondary analysis of an investigative study and a randomized controlled study. A general information questionnaire assessed patient demographics and clinical variables such as medicine use and diagnoses, and the weight management scale evaluated their WM abilities. Good and poor compliance based on abnormal weight gain from the European Society of Cardiology (> 2 kg in 3 days) were compared, and hierarchical multiple logistic regression analysis was used to identify factors influencing weight monitoring compliance. A total of 316 patients were enrolled at baseline, and 66 patients were enrolled after the 1-year WM program. Of them, 12.66% and 60.61% had good weight monitoring compliance at baseline and after 1 year of WM, respectively. A high WM-related belief score indicated good weight monitoring compliance at both time points [odds ratio (OR), 1.043, 95% confidence interval (CI), 1.023-1.063, p < 0.001; and OR, 2.054, 95% CI, 1.209-3.487, p < 0.001, respectively). Patients with a high WM-related practice score had good weight monitoring compliance at baseline (OR, 1.046, 95% CI, 1.027-1.065, p < 0.001), and patients who had not monitored abnormal weight had poor weight monitoring compliance after the 1-year WM program (OR, 0.244, 95% CI, 0.006-0.991, p = 0.049). Data from this study suggested that belief related to WM plays an important role in weight monitoring compliance.

  7. Survey of food safety practices on small to medium-sized farms and in farmers markets.

    PubMed

    Harrison, Judy A; Gaskin, Julia W; Harrison, Mark A; Cannon, Jennifer L; Boyer, Renee R; Zehnder, Geoffrey W

    2013-11-01

    As produce consumption has increased, so have foodborne disease outbreaks associated with fresh produce. Little research has addressed food safety practices used on small to medium-sized farms selling locally or in farmers markets. This study evaluated current food safety practices used by farmers on small to medium-sized farms and managers of farmers markets in Georgia, Virginia, and South Carolina based on responses to surveys. Surveys were developed, pretested, and revised before implementation with target audiences and were implemented via mail and the Web to maximize participation, with reminders sent to nonrespondents. Data were collected from 226 farmers and 45 market managers. Frequencies and percentages were calculated for all response variables. Responses from farmers indicated that more than 56% of them use manures. Of those who use manures, 34% use raw or mixtures of raw and composted manure, and over 26% wait fewer than 90 days between application of raw manure and harvest. Over 27% use water sources that have not been tested for safety for irrigation, and 16% use such water sources for washing produce. Over 43% do not sanitize surfaces that touch produce at the farm. Only 33% of farmers always clean transport containers between uses. Responses from market managers indicated that over 42% have no food safety standards in place for the market. Only 2 to 11% ask farmers specific questions about conditions on the farm that could affect product safety. Less than 25% of managers sanitize market surfaces. Only 11% always clean market containers between uses. Over 75% of markets offer no sanitation training to workers or vendors. While farmers and market managers are using many good practices, the results indicate that some practices being used may put consumers at risk of foodborne illness. Consequently, there is a need for training for both farmers and market managers.

  8. Emerging Good Practices for Transforming Value Assessment: Patients' Voices, Patients' Values.

    PubMed

    Perfetto, Eleanor M; Harris, Jason; Mullins, C Daniel; dosReis, Susan

    2018-04-01

    Patient engagement is a transformative strategy for improving value assessment. US value framework developers have increased engagement activities, but more needs to be learned about how to best achieve meaningful patient engagement in value assessment. The objective was to glean good practices in patient engagement emerging from patient community experiences, to be used in value assessment. The National Health Council Value Workgroup conducted a survey and held a focus group with its member advocacy organizations to gather experiences with value framework developers and views on emerging good practices. Ten of 13 organizations completed the survey; reporting 13 interactions with four framework developers. Most rated experiences as "good" to "very good." Emerging good practices included (1) engage early; (2) engage a range of patients; (3) leverage patient-provided information, data resources, and outreach mechanisms; (4) be transparent; and (5) appreciate and accommodate resource constraints. Twelve of 13 organizations participated in the focus group, and this produced 30 emerging good practices in four areas: (1) timing; (2) methodology and data; (3) partnering; and (4) characterizing engagement. Patient engagement was limited in early development of value frameworks but has increased in the past few years. Patient groups report positive experiences that can serve as emerging good practices. These groups also reported experienced challenges in their interactions and recommended good practices to mitigate those challenges. The growing pool of patient engagement experiences can be translated into good practices to advance a patient-centered, value-driven health care ecosystem. Lessons learned from these early experiences can help establish recommend emerging good practices that can eventually result in best practices and standards in the field. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  9. The Research on the Impact of Management Level's Charismatic Leadership Style on Miners' Unsafe Behavior.

    PubMed

    Li, Hongxia; Di, Hongxi; Tian, Shuicheng; Li, Jian

    2015-01-01

    The aim of this study is research the impact of management level's charismatic leadership style on miners' unsafe behavior by using the questionnaires on charismatic leadership style, safety attitude and the miners' unsafe behavior measurement to investigate 200 employees in Shen Dong Company. The research results suggest that management level's charismatic leadership style have very important influence on miners' unsafe behavior and the influence is affected by the safety attitude which is the intermediary function. In the end, this study propose advice on how to improve the coal mine enterprise managers charismatic leadership style in the coal mine enterprise's safety management work, including attach great importance to a variety of incentive methods, set up safety moral models, practice of inductive leadership concept, create a good atmosphere of safety, etc for reference for coal mining enterprises.

  10. [Compatibility of different quality control systems].

    PubMed

    Invernizzi, Enrico

    2002-01-01

    Management of the good laboratory practice (GLP) quality system presupposes its linking to a basic recognized and approved quality system, from which it can draw on management procedures common to all quality systems, such as the ISO 9000 set of norms. A quality system organized in this way can also be integrated with other dedicated quality systems, or parts of them, to obtain principles or management procedures for specific topics. The aim of this organization is to set up a reliable, recognized quality system compatible with the principles of GLP and other quality management systems, which provides users with a simplified set of easily accessible management tools and answers. The organization of this quality system is set out in the quality assurance programme, which is actually the document in which the test facility incorporates the GLP principles into its own quality organization.

  11. The use of health status questionnaires in the management of chronic obstructive pulmonary disease patients in clinical practice.

    PubMed

    van der Molen, Thys; Diamant, Zuzana; Kocks, Jan Willem H; Tsiligianni, Ioanna G

    2014-08-01

    Current guidelines recommend chronic obstructive pulmonary disease (COPD) management based on symptoms or health status assessment and lung function parameters. However, COPD is a complex and heterogeneous disease that needs an individualized approach for proper disease management. A structured consultation including health status assessment tools, such as the Clinical COPD Questionnaire and the COPD Assessment Test should improve the quality of the consultation, providing more information than symptoms alone. Both questionnaires are designed to provide the clinician information enabling a more personalized disease approach and subsequent management. Although both Clinical COPD Questionnaire and COPD Assessment Test have good discriminate properties, their use as prognostic markers of severity and their ability to modify disease management has not yet been fully established. New studies are needed to further determine their value on several disease outcomes.

  12. Factors Affecting Job Motivation among Health Workers: A Study From Iran

    PubMed Central

    Daneshkohan, Abbas; Zarei, Ehsan; Mansouri, Tahere; Maajani, Khadije; Ghasemi, Mehri Siyahat; Rezaeian, Mohsen

    2015-01-01

    Objective: Human resources are the most vital resource of any organizations which determine how other resources are used to accomplish organizational goals. This research aimed to identity factors affecting health workers’ motivation in Shahid Beheshti University of Medical Sciences (SBUMS). Method: This is a cross-sectional survey conducted with participation of 212 health workers of Tehran health centers in November and December 2011. The data collection tool was a researcher-developed questionnaire that included 17 motivating factors and 6 demotivating factors and 8 questions to assess the current status of some factors. Validity and reliability of the tool were confirmed. Data were analyzed with descriptive and analytical statistical tests. Results: The main motivating factors for health workers were good management, supervisors and managers’ support and good working relationship with colleagues. On the other hand, unfair treatment, poor management and lack of appreciation were the main demotivating factors. Furthermore, 47.2% of health workers believed that existing schemes for supervision were unhelpful in improving their performance. Conclusion: Strengthening management capacities in health services can increase job motivation and improve health workers’ performance. The findings suggests that special attention should be paid to some aspects such as management competencies, social support in the workplace, treating employees fairly and performance management practices, especially supervision and performance appraisal. PMID:25948438

  13. The quality assurance-risk management interface.

    PubMed

    Little, N

    1992-08-01

    Involvement with both risk management and quality assurance programs has led many authors to the conclusion that the fundamental differences between these activities are, in fact, very small. "At the point of overlap, it is almost impossible to distinguish the purposes and methods of both functions from one another." "Good risk management includes real improvement in patient care through organized quality assurance activities." The interface between a proactive risk management program and a quality assurance program is dynamic and can serve the legitimate interests of both. There is little to be gained by thinking of them as separate entities and much to be gained by sharing the lessons of both. If one thinks of risk management in terms of "risk" to quality patient care, and that "assuring quality" is the most productive type of risk management, then there is no practical reason to separate one from the other.

  14. [Effective delegation].

    PubMed

    Fang, Li; Hung, Chich-Hsiu

    2008-12-01

    Ninety-seven percent of middle level managers feel they face work overload. The source of this problem may lie in a failure to delegate tasks effectively. If a manager does not effectively delegate, he/she is more likely to report fatigue, stress and depression. Conversely, effectively delegating tasks will improve overall job quality, professional growth in subordinates and cooperation within the team. While it is necessary for managers to delegate tasks effectively, few can be considered to be good natural 'delegators'. Learning and training is necessary for managers to develop the necessary confidence and maturity. This article describes the definitions, purpose and benefits of delegation; factors related to effective delegation; strategies related to successful delegation and skills related to performing cross-cultural delegations. Such issues have seldom been addressed in previous articles. Moreover, nursing implications and suggested applications in nursing practice, education, management and research are mentioned. This article is intended to provide directions to nursing managers and subordinates to promote delegation knowledge and skills.

  15. Assessment of system reliability for a stochastic-flow distribution network with the spoilage property

    NASA Astrophysics Data System (ADS)

    Lin, Yi-Kuei; Huang, Cheng-Fu; Yeh, Cheng-Ta

    2016-04-01

    In supply chain management, satisfying customer demand is the most concerned for the manager. However, the goods may rot or be spoilt during delivery owing to natural disasters, inclement weather, traffic accidents, collisions, and so on, such that the intact goods may not meet market demand. This paper concentrates on a stochastic-flow distribution network (SFDN), in which a node denotes a supplier, a transfer station, or a market, while a route denotes a carrier providing the delivery service for a pair of nodes. The available capacity of the carrier is stochastic because the capacity may be partially reserved by other customers. The addressed problem is to evaluate the system reliability, the probability that the SFDN can satisfy the market demand with the spoilage rate under the budget constraint from multiple suppliers to the customer. An algorithm is developed in terms of minimal paths to evaluate the system reliability along with a numerical example to illustrate the solution procedure. A practical case of fruit distribution is presented accordingly to emphasise the management implication of the system reliability.

  16. [Privatization in healthcare management: an adverse effect of the economic crisis and a symptom of bad governance. SESPAS report 2014].

    PubMed

    Sánchez-Martínez, Fernando I; Abellán-Perpiñán, José María; Oliva-Moreno, Juan

    2014-06-01

    It is often asserted that public management of healthcare facilities is inefficient. On the basis of that unproven claim, it is argued that privatization schemes are needed. In this article we review the available evidence, in Spain and other countries, on the application of private management mechanisms to publicly funded systems similar to the Spanish national health system. The evidence suggests that private management of healthcare services is not necessarily better than public management, nor vice versa. Ownership-whether public or private-of health care centers does not determine their performance which, on the contrary, depends on other factors, such as the workplace culture or the practice of suitable monitoring by the public payer. Promoting competition among centers (irrespective of the specific legal form of the management arrangements), however, could indeed lead to improvements under some circumstances. Therefore, it is advisable to cease the narrow-minded debate on the superiority of one or other model in order to focus on improving healthcare services management per se. Understanding that good governance affects health policies, the management of health care organizations, and clinical practice is, undoubtedly, an essential requirement but may not necessarily lead to policies that stimulate the solvency of the system. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  17. Good practices in Local Government - A first overview of Portuguese reality

    NASA Astrophysics Data System (ADS)

    Carvalhosa, P.; Portela, F.; Machado, J.; Santos, M. F.; Abelha, A.

    2017-03-01

    Good practices in eGov are being increasingly used by Local Governments being that it is considered by them as an advantage. The main goal is providing to the town hall a differentiation point and approximate their services to the citizens. For this, it is necessary to define and apply innovative strategies in order to increase the use of services by the citizens. This paper is framed in a research work and it presents a first overview of the existing good practices in eGov, taking in consideration the Portuguese’s reality. The good practices identified were distinguished with many awards and with a positive response from the target audience. The use of digital marketing strategies aims to increase their membership and coming closer the municipalities of its citizens through the dissemination of the good practices. At this moment the data collected are almost exclusively of good practice in Portugal, however some international practices were also identified. As a result of this study the community has a list of good practices that can be applied in their municipalities.

  18. Accountability in action?: the case of a database purchasing decision.

    PubMed

    Neyland, Daniel; Woolgar, Steve

    2002-06-01

    The increasing prevalence of audit in university settings has raised concerns about the potentially adverse effects of invasive measures of performance upon the conduct of research and generation of knowledge. What sustains the current commitment to audit? It is argued that in order to address this question we need to understand how and to what extent notions of accountability are played out in practice. This is illustrated through the analysis of materials from an ethnographic study of 'good management practice' in the deployment of technologies in university settings. The paper examines the ways in which ideas of accountability - involving considerations such as 'value for money' - inform the practical processes of deciding about the purchase of a new database technology.

  19. Building community and public health nursing capacity: a synthesis report of the National Community Health Nursing Study.

    PubMed

    Underwood, Jane M; Mowat, David L; Meagher-Stewart, Donna M; Deber, Raisa B; Baumann, Andrea O; MacDonald, Mary B; Akhtar-Danesh, Noori; Schoenfeld, Bonnie M; Ciliska, Donna K; Blythe, Jennifer M; Lavoie-Tremblay, Mélanie; Ehrlich, Anne S; Knibbs, Kristin M; Munroe, Valerie J

    2009-01-01

    1) To describe the community health nursing workforce in Canada; 2) To compare, across political jurisdictions and community health sectors, what helps and hinders community nurses to work effectively; 3) To identify organizational attributes that support one community subsector--public health nurses--to practise the full scope of their competencies. Our study included an analysis of the Canadian Institute for Health Information nursing databases (1996-2007), a survey of over 13,000 community health nurses across Canada and 23 focus groups of public health policy-makers and front-line public health nurses. Over 53,000 registered and licensed practical nurses worked in community health in Canada in 2007, about 16% of the nursing workforce. Community nurses were older on average than the rest of their profession. Typical practice settings for community nurses included community health centres, home care and public health units/departments. To practise effectively, community nurses need professional confidence, good team relationships, supportive workplaces and community support. Most community nurses felt confident in their practice and relationships with other nurses and professionals, though less often with physicians. Their feelings about salary and job security were mixed, and most community nurses would like more learning opportunities, policy and practice information and chances to debrief about work. They needed their communities to do more to address social determinants of health and provide good quality resources. Public health nursing needs a combination of factors to succeed: sound government policy, supportive organizational culture and good management practices. Organizational attributes identified as supports for optimal practice include: flexibility in funding, program design and job descriptions; clear organizational vision driven by shared values and community needs; coordinated public health planning across jurisdictions; and strong leadership that openly promotes public health, values their staff's work and invests in education and training. The interchangeable and inconsistent use of titles used by community nurses and their employers makes it difficult to discern differences within this sector such as home care, public health, etc. Our studies also revealed that community nurses: thrive in workplaces where they share the vision and goals of their organization and work collaboratively in an atmosphere that supports creative, autonomous practice; work well together, but need time, flexible funding and management support to develop relationships with the community and their clients, and to build teams with other professionals; could sustain their competencies and confidence in their professional abilities with more access to continuing education, policies, evidence and debriefing sessions.

  20. Assessment of current practices in management of childhood TB among frontline clinicians in Southern Nigeria.

    PubMed

    Chukwu, Joseph N; Ukwaja, Kingsley N; Ekeke, Ngozi; Nwafor, Charles C; Meka, Anthony O; Madichie, Nelson O; Anyim, Moses C; Ogbudebe, Chidubem; Adegbesan, Julie; Ikebudu, Joy; Oshi, Daniel C

    2016-07-01

    Poor competence of clinicians may be a critical factor responsible for the under-diagnosis of childhood TB in high-burden settings. Our objective was to assess the current practices of management of childhood TB among clinicians in Nigeria. A cross-sectional survey was conducted among clinicians recruited through a three-stage sampling technique from 76 health facilities in Southern Nigeria. A semi-structured questionnaire was administered to all participants. Of 106 clinicians who completed the survey, 73 (68.9%) were <40 years and 67 (63.2%) were males. Also, 14 (13.2%) were paediatricians, 22 (20.8%) were paediatric specialist trainees and 70 (66%) were medical officers in primary and secondary care health facilities. About 94% of the respondents perceived diagnosis of childhood TB a challenge in Nigeria. The overall mean (SD) knowledge score was 3.8±0.9 (maximum 5), and 68 (64.2%) had good knowledge of childhood TB. The mean (SD) appropriate practice score was 4.0±1.7 (maximum 10) and, only 8 (7.5%) of them were considered to have adopted appropriate practices regarding childhood TB care. There are gaps in practices adopted by frontline clinicians in the management of childhood TB in Nigeria. Focused training of health workers on childhood TB care is urgently recommended. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Influence of good manufacturing practices on the shelf life of refrigerated fillets of tilapia (Oreochromis niloticus) packed in modified atmosphere and gamma-irradiated

    PubMed Central

    Monteiro, Maria Lúcia Guerra; Mársico, Eliane Teixeira; Mano, Sérgio Borges; Teixeira, Claudia Emília; da Cruz Silva Canto, Anna Carolina Vilhena; de Carvalho Vital, Helio; Conte-Júnior, Carlos Adam

    2013-01-01

    This study evaluated the influence of good manufacturing practices (GMP) on the shelf life of refrigerated fillets of Nile tilapia (Oreochromis niloticus) packed in modified atmosphere packaging (MAP) and irradiated. In a first series of experiments, 120 tilapia fillets kept under controlled sanitary conditions were purchased from a fish market managed by a cooperative. A second lot totaling 200 tilapia fillets was obtained under controlled storage conditions from a pilot plant. The combined effects of MAP (40% CO2 and 60% N2) and irradiation (1.5 kGy) were investigated by monitoring physical and chemical (total volatile bases and pH), bacteriological (aerobic heterotrophic mesophilic and psychrophilic bacteria) and sensory (acceptance test) changes in the samples. The quality of samples decreased with storage time regardless of the treatment, remaining higher in fillets produced in the pilot plant in comparison with the commercially produced fillets. The observed shelf life of nonirradiated commercially produced fillets was only 3 days, compared to 8 days for those produced in the pilot plant, probably due to GMP in the latter. It was concluded that, even with a combination of proven conservation methods for meats, the adoption of good manufacturing practices still remains essential before, during, and after the filleting process in order to ensure the effectiveness of the entire treatment. PMID:24804034

  2. Using Quality Management Systems to Improve Test Development and Standards and to Promote Good Practice: A Case Study of Testing Italian as a Foreign Language

    ERIC Educational Resources Information Center

    Grego Bolli, Giuliana

    2014-01-01

    This article discusses the problem of quality in the production of language tests in the context of Italian language examinations. The concept of quality is closely related to the application of stated standards and related procedures. These standards, developed over the last thirty years, are mainly related to the concepts of the accountability…

  3. Environmental Compliance Audit Handbook (ECAH): U.S. Fish and Wildlife Service (FWS) (Revision)

    DTIC Science & Technology

    1999-09-01

    with FWS, began research on this handbook. The concept was to combine the Code of Federal Regulations with good management practices and risk... The numbers of environmental laws and regulations have continued to grow in the United States, making compliance with these regulations increasingly...violations by the U.S. Environmental Protection Agency (USEPA). Beginning in 1993, the U.S. Army Construction Engineering Research Laboratory, in cooperation

  4. I.S.Mu.L.T. first-time patellar dislocation guidelines

    PubMed Central

    Vetrano, Mario; Oliva, Francesco; Bisicchia, Salvatore; Bossa, Michela; De Carli, Angelo; Di Lorenzo, Luigi; Erroi, Davide; Forte, Alfonso; Foti, Calogero; Frizziero, Antonio; Gasparre, Giuseppe; Via, Alessio Giai; Innocenti, Bernardo; Longo, Umile Giuseppe; Mahmoud, Asmaa; Masiero, Stefano; Mazza, Daniele; Natali, Simone; Notarangelo, Christian; Osti, Leonardo; Padulo, Johnny; Pellicciari, Leonardo; Perroni, Fabrizio; Piccirilli, Eleonora; Ramponi, Carlo; Salvatore, Giuseppe; Panni, Alfredo Schiavone; Suarez, Tania; Tarantino, Umberto; Vittadini, Filippo; Vulpiani, Maria Chiara; Ferretti, Andrea; Maffulli, Nicola

    2017-01-01

    Summary Primary traumatic patellar dislocation is common, particularly in young active individuals. A consensus on its management is still lacking. The present work provides easily accessible guidelines to be considered as recommendations for a good clinical practice developed through a process of systematic review of the literature and expert opinion, to improve the quality of care and rationalize the use of resources. Level of evidence: Ia. PMID:28717605

  5. Should I get a Master of Business Administration? The anesthesiologist with education training: training options and professional opportunities.

    PubMed

    Desai, Arjun M; Trillo, Raul A; Macario, Alex

    2009-04-01

    Many physicians want to know whether they should get a Master of Business Administration (MBA), what type of program is best, and what career paths exist. It is commonly (incorrectly) assumed that a physician successful in clinical practice can easily transfer to managing/leading an organization. To be effective, the MD/MBA must bridge the cultures of the business world and medicine. Often just a single management course is sufficient to give the physician the knowledge they seek. MBA programs come in many forms and require choosing from a range of time commitments. Leaving a good clinical job in favor of the less-defined course of an MD/MBA can be daunting. Although a wide spectrum of opportunities are available, the MD/MBA may have to start over professionally, most likely with a pay cut, and will have to 'work their way up' again. A stigma exists for MD/MBAs because they are often perceived as caring more about business than about patients. Many MD/MBAs eventually choose to stay in full-time medical practice because financial and geographic stability may be more easily attained. The MBA is a good idea for the physicians who enjoy the intellectual challenges of business administration and proactively plan their own career.

  6. Pesticide residues in Portuguese strawberries grown in 2009-2010 using integrated pest management and organic farming.

    PubMed

    Fernandes, Virgínia C; Domingues, Valentina F; Mateus, Nuno; Delerue-Matos, Cristina

    2012-11-01

    Pesticides are among the most widely used chemicals in the world. Because of the widespread use of agricultural chemicals in food production, people are exposed to low levels of pesticide residues through their diets. Scientists do not yet have a total understanding of the health effects of these pesticide residues. This work aims to determine differences in terms of pesticide residue content in Portuguese strawberries grown using different agriculture practices. The Quick, Easy, Cheap, Effective, Rugged, and Safe sample preparation method was conducted and shown to have good performance for multiclass pesticides extraction in strawberries. The screening of 25 pesticides residue was performed by gas chromatography-tandem mass spectrometry. In quantitative validation, acceptable performances were achieved with recoveries of 70-120 and <12 % residual standard deviation for 25 pesticides. Good linearity was obtained for all the target compounds, with highly satisfactory repeatability. The limits of detection were in the range of 0.1-28 μg/kg. The method was applied to analyze strawberry samples from organic and integrated pest management (IPM) practices harvested in 2009-2010. The results showed the presence of fludioxonil, bifenthrin, mepanipyrim, tolylfluanid, cyprodinil, tetraconazole, and malathion when using IPM below the maximum residue levels.

  7. Rationale and methods of the European Study on Cardiovascular Risk Prevention and Management in Daily Practice (EURIKA).

    PubMed

    Rodríguez-Artalejo, Fernando; Guallar, Eliseo; Borghi, Claudio; Dallongeville, Jean; De Backer, Guy; Halcox, Julian P; Hernández-Vecino, Ramón; Jiménez, Francisco Javier; Massó-González, Elvira L; Perk, Joep; Steg, Philippe Gabriel; Banegas, José R

    2010-06-30

    The EURIKA study aims to assess the status of primary prevention of cardiovascular disease (CVD) across Europe. Specifically, it will determine the degree of control of cardiovascular risk factors in current clinical practice in relation to the European guidelines on cardiovascular prevention. It will also assess physicians' knowledge and attitudes about CVD prevention as well as the barriers impeding effective risk factor management in clinical practice. Cross-sectional study conducted simultaneously in 12 countries across Europe. The study has two components: firstly at the physician level, assessing eight hundred and nine primary care and specialist physicians with a daily practice in CVD prevention. A physician specific questionnaire captures information regarding physician demographics, practice settings, cardiovascular prevention beliefs and management. Secondly at the patient level, including 7641 patients aged 50 years or older, free of clinical CVD and with at least one classical risk factor, enrolled by the participating physicians. A patient-specific questionnaire captures information from clinical records and patient interview regarding sociodemographic data, CVD risk factors, and current medications. Finally, each patient provides a fasting blood sample, which is sent to a central laboratory for measuring serum lipids, apolipoproteins, hemoglobin-A1c, and inflammatory biomarkers. Primary prevention of CVD is an extremely important clinical issue, with preventable circulatory diseases remaining the leading cause of major disease burden. The EURIKA study will provide key information to assess effectiveness of and attitudes toward primary prevention of CVD in Europe. A transnational study creates opportunities for benchmarking good clinical practice across countries and improving outcomes. (ClinicalTrials.gov number, NCT00882336).

  8. Good practice in reviewing and publishing studies on herbal medicine, with special emphasis on traditional Chinese medicine and Chinese materia medica.

    PubMed

    Chan, Kelvin; Shaw, Debbie; Simmonds, Monique S J; Leon, Christine J; Xu, Qihe; Lu, Aiping; Sutherland, Ian; Ignatova, Svetlana; Zhu, You-Ping; Verpoorte, Rob; Williamson, Elizabeth M; Duez, Pierre

    2012-04-10

    Studies on traditional Chinese medicine (TCM), like those of other systems of traditional medicine (TM), are very variable in their quality, content and focus, resulting in issues around their acceptability to the global scientific community. In an attempt to address these issues, an European Union funded FP7 consortium, composed of both Chinese and European scientists and named "Good practice in traditional Chinese medicine" (GP-TCM), has devised a series of guidelines and technical notes to facilitate good practice in collecting, assessing and publishing TCM literature as well as highlighting the scope of information that should be in future publications on TMs. This paper summarises these guidelines, together with what has been learned through GP-TCM collaborations, focusing on some common problems and proposing solutions. The recommendations also provide a template for the evaluation of other types of traditional medicine such as Ayurveda, Kampo and Unani. GP-TCM provided a means by which experts in different areas relating to TCM were able to collaborate in forming a literature review good practice panel which operated through e-mail exchanges, teleconferences and focused discussions at annual meetings. The panel involved coordinators and representatives of each GP-TCM work package (WP) with the latter managing the testing and refining of such guidelines within the context of their respective WPs and providing feedback. A Good Practice Handbook for Scientific Publications on TCM was drafted during the three years of the consortium, showing the value of such networks. A "deliverable - central questions - labour division" model had been established to guide the literature evaluation studies of each WP. The model investigated various scoring systems and their ability to provide consistent and reliable semi-quantitative assessments of the literature, notably in respect of the botanical ingredients involved and the scientific quality of the work described. This resulted in the compilation of (i) a robust scoring system and (ii) a set of minimum standards for publishing in the herbal medicines field, based on an analysis of the main problems identified in published TCM literature. Good quality, peer-reviewed literature is crucial in maintaining the integrity and the reputation of the herbal scientific community and promoting good research in TCM. These guidelines provide a clear starting point for this important endeavour. They also provide a platform for adaptation, as appropriate, to other systems of traditional medicine. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  9. Identifying factors associated with experiences of coronary heart disease patients receiving structured chronic care and counselling in European primary care

    PubMed Central

    2012-01-01

    Background Primary care for chronic illness varies across European healthcare systems. In patients suffering from coronary heart disease (CHD), factors associated with patients’ experiences of receiving structured chronic care and counselling at the patient and practice level were investigated. Methods In an observational study comprising 140 general practices from five European countries (Austria, Germany, the Netherlands, Switzerland and the United Kingdom), 30 patients with Coronary Heart Disease (CHD) per practice were chosen at random to partake in this research. Patients were provided with a questionnaire and the Patient Assessment of Chronic Illness Care (PACIC-5A) - instrument. Practice characteristics were assessed through a practice questionnaire and face to face interviews. Data were aggregated to obtain two practice scores representing quality management and CHD care, respectively. A hierarchical multilevel analysis was performed to examine the impact of patient and practice characteristics on PACIC scores. Results The final sample included 1745 CHD-patients from 131 general practices with a mean age of 67.8 (SD 9.9) years. The overall PACIC score was 2.84 (95%CI: 2.79; 2.89) and the 5A score reflecting structured lifestyle counselling was 2.75 (95% CI: 2.69; 2.79). At the patient level, male gender, more frequent practice contact and fewer related or unrelated conditions were associated with higher PACIC scores. At the practice level, performance scores reflecting quality management (p = 0.013) and CHD care (p = 0.009) were associated with improved assessment of the structured chronic care and counselling received. Conclusions Patients’ perceived quality of care varies. However, good practice management and organisation of care were positively reflected in patients’ assessments of receiving structured chronic illness care. This highlights the importance of integrating patient experiences into quality measurements to provide feedback to health care professionals. PMID:22838403

  10. Securing the Adoption of Good Practice in Scotland's Colleges. A Report by HM Inspectors of Education for the Scottish Funding Council

    ERIC Educational Resources Information Center

    Her Majesty's Inspectorate of Education, 2006

    2006-01-01

    The purpose of this report is to describe the main mechanisms currently in use in Scotland's colleges to ensure that the adoption of good practice actually happens. It investigates how colleges identify and promote good practice in their own institutions; how they develop strategies and processes to ensure good practice is shared, adopted and…

  11. Randomised controlled trial of a web-based programme in sustaining best practice alcohol management practices at community sports clubs: a study protocol

    PubMed Central

    McFadyen, Tameka; Kingsland, Melanie; Tindall, Jennifer; Rowland, Bosco; Sherker, Shauna; Gillham, Karen; Heaton, Rachael; Clinton-McHarg, Tara; Lecathelinais, Christophe; Brooke, Daisy; Wiggers, John

    2018-01-01

    Introduction Community-based interventions have been found to effectively increase the implementation of alcohol management practices and reduce excessive alcohol use and alcohol-related harm at sports clubs. However, once implementation support ceases there may be a reduction in such intervention effects. Thus, ongoing contribution to improving the health of the community is diminished; sustaining practice implementation is a key determinant to address this. One possible solution to the strategic and logistical challenges of sustainability involves the use of the web. The primary aim of this study is to assess the effectiveness of a web-based programme in sustaining the implementation of alcohol management practices by community football clubs. The secondary aim is to assess the effectiveness of the programme in preventing excessive alcohol consumption and alcohol-related harm among members of community football clubs. Methods and analysis The study will employ a repeat randomised controlled trial design and be conducted in regional and metropolitan areas within two states of Australia. Community level football clubs who are currently accredited with an existing alcohol management programme (‘Good Sports’) and implementing at least 10 of the 13 core alcohol management practices (eg, not serving alcohol to <18-year-olds) required by the programme will be recruited and randomised to either a web-based sustainability programme or a ‘minimal contact’ programme. The primary outcome measures are the proportion of football clubs implementing ≥10 of the 13 required alcohol management practices and the mean number of those practices being implemented at 3-year follow-up. Secondary outcomes include: the proportion of club members who report risky drinking at their club, the Alcohol Use Disorder Identification Test (AUDIT) score and mean AUDIT score of club members. Outcome data will be collected via observation at the club during a 1-day visit to a home game, conducted by trained research assistants at baseline and follow-up. Ethics and dissemination The study was approved by The University of Newcastle Human Research Ethics Committee (reference: H-2013-0429). Study findings will be disseminated widely through peer-reviewed publications and conference presentations. Trial registration number ACTRN12614000746639; Pre-results. PMID:29362250

  12. Minimizing the Risk of Infection and Bleeding at Trans-Vaginal Ultrasound-Guided Ovum Pick-up: Results of a Prospective Web-Based World-Wide Survey.

    PubMed

    Bhandari, Harish; Agrawal, Rina; Weissman, Ariel; Shoham, Gon; Leong, Milton; Shoham, Zeev

    2015-12-01

    The objective of this study was to identify clinical practices worldwide, which would help in recognizing women at risk of excessive bleeding or of developing pelvic infection following trans-vaginal ovum pick-up (TV-OPU), measures taken to minimize risks and their management. A prospective, web-based questionnaire with distinct questions related to the practice of TV-OPU. A total of 155 units from 55 countries performing 97,200 IVF cycles annually responded to this web-based survey. A majority (65 %) responded that they would routinely carry out full blood count, while 35 % performed coagulation profile. Less than a third agreed screening women for vaginal infections. About a third used both sterile water and antiseptic to minimize ascending infection, and 52 % used antibiotics for prophylaxis. Doppler ultrasound was routinely used by 20 % of clinicians. 73 % of the clinicians preferred conservative management as their first line management for patients diagnosed with intra-abdominal bleeding. The study has identified a wide variation in the practices of minimizing infection and bleeding complications. The dearth of good quality evidence may be responsible for the lack of published guidelines, and therefore a lack of consensus on the optimum practice for minimizing the risk of infection and bleeding during TV-OPU.

  13. Development and construct validity of the Classroom Strategies Scale-Observer Form.

    PubMed

    Reddy, Linda A; Fabiano, Gregory; Dudek, Christopher M; Hsu, Louis

    2013-12-01

    Research on progress monitoring has almost exclusively focused on student behavior and not on teacher practices. This article presents the development and validation of a new teacher observational assessment (Classroom Strategies Scale) of classroom instructional and behavioral management practices. The theoretical underpinnings and empirical basis for the instructional and behavioral management scales are presented. The Classroom Strategies Scale (CSS) evidenced overall good reliability estimates including internal consistency, interrater reliability, test-retest reliability, and freedom from item bias on important teacher demographics (age, educational degree, years of teaching experience). Confirmatory factor analyses (CFAs) of CSS data from 317 classrooms were carried out to assess the level of empirical support for (a) a 4 first-order factor theory concerning teachers' instructional practices, and (b) a 4 first-order factor theory concerning teachers' behavior management practice. Several fit indices indicated acceptable fit of the (a) and (b) CFA models to the data, as well as acceptable fit of less parsimonious alternative CFA models that included 1 or 2 second-order factors. Information-theory-based indices generally suggested that the (a) and (b) CFA models fit better than some more parsimonious alternative CFA models that included constraints on relations of first-order factors. Overall, CFA first-order and higher order factor results support the CSS-Observer Total, Composite, and subscales. Suggestions for future measurement development efforts are outlined. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  14. Evidence, education and practice.

    PubMed

    Kaste, Markku

    2006-01-01

    Stroke causes greater loss of quality-adjusted life years than any other disease and is also one of the most expensive disorders. The burden of stroke will increase in the future due to change in the age structure of populations. We have a vast body of evidence on how to prevent stroke and how to treat stroke patients. Good examples are treatment of hypertension, antithrombotic agents and carotid surgery in stroke prevention, thrombolysis in ischaemic stroke and stroke unit care for all stroke patients. We only have to translate scientific evidence into daily practice. If some pieces are missing, it is our duty to generate them through research. While taking part in randomized clinical trials (RCTs), the discipline, an essential part of RCTs, will improve the daily care of all stroke patients. Besides RCTs there are many other sources of scientific evidence for stroke management, one of which is the European Stroke Initiative (EUSI). The mission of the EUSI is to improve and optimize stroke management in Europe through education and by offering best practice guidelines. Also national and international societies and organizations play an important role in providing education. The human factor is one obstacle to more successful stroke management because to be more effective we must change our own clinical routine. We can make a difference by applying available evidence to our daily practice. Copyright (c) 2006 S. Karger AG, Basel.

  15. Palliative care for cirrhosis: a UK survey of health professionals’ perceptions, current practice and future needs

    PubMed Central

    Low, Joseph; Vickerstaff, Victoria; Davis, Sarah; Bichard, Julia; Greenslade, Lynda; Hopkins, Katherine; Marshall, Aileen; Thorburn, Douglas; Jones, Louise

    2016-01-01

    Objective To determine the knowledge and practice patterns of a UK cohort of relevant healthcare professionals (HCPs) about delivering palliative care in cirrhosis, and to inform priorities for future research. Design An on-line questionnaire survey with closed and open responses. Setting HCPs identified from the mailing list of special interest groups in hepatology and gastroenterology (liver), general practice and specialist palliative care (SPC) across the UK. Results Of the 6181 potential contacts identified, 517 HCPs responded. Most believed a role exists for SPC in caring for people with cirrhosis, but many SPC HCPs felt ill prepared to provide good care to those facing death. Further training was needed in managing liver-related symptoms, symptom control and end of life issues. All HCP groups wished to increase community provision of palliative care support, but many general practitioners felt unable to manage advanced cirrhosis in the community. There were differences in the optimal trigger for SPC referral with liver HCPs less likely to refer at symptom deterioration. Prognostication, symptom management and service configuration were key areas identified for future research. Conclusions All who responded acknowledged the role of SPC in caring for those dying with cirrhosis and need for further training to improve confidence and enable joint working between SPC, general practice and liver teams. Low response rates make it difficult to generalise these findings, which require further validation. PMID:28839829

  16. 21 CFR 184.1452 - Manganese gluconate.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... used in food with no limitation other than current good manufacturing practice. The affirmation of this... following current good manufacturing practice conditions of use: (1) The ingredient is used as a nutrient... levels not to exceed current good manufacturing practice: baked goods as defined in § 170.3(n)(1) of this...

  17. The virtuous pathologist. An ethical basis for laboratory medicine.

    PubMed

    Stempsey, W E

    1989-06-01

    The profession of pathology is a practice in the technical sense used by many philosophers. Such practices have internal goods, which, it is hoped, lead to the attainment of a certain end. The ultimate end of the practice of pathology must be the good of the patient in terms of restoring health. Key internal goods in pathology are technical competence, the proper pathologist-patient relationship, and the proper pathologist-clinician relationship. Virtues are predispositions to act so as to attain the end of the practice and further the internal goods. Technical growth in the practice of pathology must be accompanied by continued attempts to articulate the goals and internal goods of the practice. Only if pathologists are predisposed to act in accordance with proper goals will an ethical practice be assured.

  18. [Good drug distribution practice and its implementation in drug distribution companies].

    PubMed

    Draksiene, Gailute

    2002-01-01

    Good Distribution Practice is based on the Directive of the Board of the European Community 92/25/EEC regarding the wholesale distribution of drugs for human consumption. It is stated in the Directive that the whole drug distribution channel is to be controlled from the point of drug production or import down to the supplies to the end user. In order to reach the goal, the drug distribution company must create the quality assurance system and facilitate its correct functioning. This aim requires development of the rules of the Good Distribution Practice. Those rules set the general requirements of the Good Distribution Practice for distribution companies that they must conduct. The article explains main requirements postulated in the rules of the Good Distribution Practice and implementation of the Good Distribution Practice requirements in drug distribution companies.

  19. Designing quality course management systems that foster intra-professional education.

    PubMed

    Bowers, Helen F

    2006-12-01

    This paper draws on the experiences of the author in designing and implementing quality course management policies and procedures for vocational and higher educational programs, both overseas and in Australia. In particular, the paper focuses on those programs of study that require practicums within the curriculum. Whether these are clinical nursing placements, physiotherapy hands-on practical blocks or teacher training instruction, there are many principles of adult education that can be applied to the design and development of course management systems that foster inter-professional education. It is important that the components of any such system allow for a multi-faceted approach that relates collaborative learning to collaborative practice and supports a team of professionals through the skilled use of group-based learning, interactive assessments and inter-organisational processes and practices. The term 'course management system' is used here to describe all those policies and procedures that form the framework of any higher education department or faculty that has the overall responsibility for developing curriculum, teaching and learning resources that ensure quality educational outcomes for its students. In these days of multi-skilling, the benefits of inter-professional education may be significant. To guarantee that standards are kept high and learning outcomes are achievable, the management of an educational system must cover many areas of professional practice. It needs to be supported by all stakeholders in the organisation so that there is an environment of understanding, good interpersonal communication, supportive inter-group relations and an atmosphere of professionalism that is pervasive. This paper introduces a third definition to the model and suggests that intra-professional education be added to form a tripartite foundation for quality professional learning outcomes.

  20. An assessment of maintainability of elevator system to improve facilities management knowledge-base

    NASA Astrophysics Data System (ADS)

    Siti, N. A.; Asmone, A. S.; Chew, M. Y. L.

    2018-02-01

    Elevator system is a highly specialized machinery that requires technicians that have a wider array of knowledge in maintaining the system to be safe and reliable. While attaining reliable data of elevator malfunction become challenges, this study has filled the gap by gathering the management-maintenance issues and operational defects of elevator system. Forty-three types of operation defects were found and the consequence defects and their possible causes of occurrences were discussed. To respond to the prime challenges of maintaining elevator system provided by the industry players’ perspective, a theoretical framework is established as a recommendation to improve knowledge base of defects in elevator system which comprises good practices, and solutions to rectify each defects found. Hence, this research paper has theoretically improved the knowledge base of maintainability of elevator system and provide meaningful guidelines in practical senses to the industry professionals.

  1. Individualized glycaemic targets and pharmacotherapy in type 2 diabetes.

    PubMed

    Bailey, Clifford J; Aschner, Pablo; Del Prato, Stefano; LaSalle, James; Ji, Linong; Matthaei, Stephan

    2013-09-01

    The Global Partnership for Effective Diabetes Management, established to provide practical guidance to improve patient outcomes in diabetes, has developed and modified recommendations to improve glycaemic control in type 2 diabetes. The Global Partnership advocates an individualized therapeutic approach and, as part of the process to customize therapy, has previously identified specific type 2 diabetes patient subgroups that require special consideration. This article builds on earlier publications, expanding the scope of practical guidance to include newly diagnosed individuals with complications and women with diabetes in pregnancy. Good glycaemic control remains the cornerstone of managing type 2 diabetes, and plays a vital role in preventing or delaying the onset and progression of diabetic complications. Individualizing therapeutic goals and treatments to meet glycaemic targets safely and without delay remains paramount, in addition to a wider programme of care to reduce cardiovascular risk factors and improve patient outcomes.

  2. [Identification of Good-Practice Projects in Promoting Physical Activity - Methods, Pitfalls and Sampled Outcomes].

    PubMed

    Henn, Annette; Karger, Claudia; Wöhlken, Katrin; Meier, Diana; Ungerer-Röhrich, Ulrike; Graf, Christine; Woll, Alexander

    2017-03-01

    The aim of this paper is to identify and show examples of good practice of public health promotion. For this, uniform quality criteria were worked out under consideration of national and international scientific literature.For the identification of examples of good practice, a comparison of different quality criteria was carried out and combined with each other in a first step. In the following step, examples of good practice were identified after a comprehensive search. The choice of the "good-practice" projects is exemplary and lays no claim to completeness.6 main quality criteria (QC) of programs promoting physical activity could be identified in the national and international context. The analysis showed altogether 10 projects which can exemplarily be classified as examples of good practice of the target groups of children and teenagers, adults, older people and people with pre-existing illnesses. These projects, however, show major differences in their (methodological) quality.The analysis reports a lack of "Good-Practice" examples. Deficits lie mainly in documentation and sustainability. Because of incomplete documentation, an assessment as a "Good-Practice" example is only possible to a limited extent; a lot of information, particularly in the evaluation, is missing. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Maintaining the 'good maternal body': expressing milk as a way of negotiating the demands and dilemmas of early infant feeding.

    PubMed

    Johnson, Sally; Leeming, Dawn; Williamson, Iain; Lyttle, Steven

    2013-03-01

    To report a descriptive study of early infant feeding experiences focusing on ACCOUNTS OF WOMEN WHO EXPRESSED MILK EXTENSIVELY IN THE FIRST FEW WEEKS POSTPARTUM. Relatively little is known about the reasons for expressing milk following healthy term births. Evidence indicates it is an increasingly common practice during early infant feeding in Westernized countries. A more comprehensive understanding of this practice will help midwives and nurses assist mothers negotiate early feeding challenges. Qualitative data were collected in two phases in the first few weeks postpartum. Audio-diary and semi-structured interview data from seven British women who extensively expressed milk in the first month postpartum were analysed. These data were drawn from a larger qualitative longitudinal study which took place in 2006-2007. Themes, discursive constructions and discourses are identified through the use of a feminist informed analysis. The practice of expressing was employed as a solution to managing the competing demands and dilemmas of early breastfeeding and ensuring the continued provision of breast milk, thereby deflecting potential accusations of poor mothering. In addition, the practice may afford a degree of freedom to new mothers. The need to maintain the 'good maternal body' can account for the motivation to express milk, although there may be reasons to be cautious about promoting expression as a solution to breastfeeding difficulties. Education for health professionals, which emphasizes the complexities and contradictions of mothering and which challenges prescriptive notions of 'good mothering' could better support new mothers in their feeding 'choices'. © 2012 Blackwell Publishing Ltd.

  4. Interpersonal team leadership skills.

    PubMed

    Nelson, M

    1995-05-01

    To say that a team leader's job is a tough one is certainly not saying enough. It is up to the team leader to manage a group of people to be individuals but yet work as a team. The team leader must keep the peace and yet create a revolution with this group all at the same time. The good leader will require a lot of education, training, and tons of practical application to be a success. The good news, however, is that the team leader's job is a rewarding one, one that they'll always feel good about if they do it right. How many of us get the opportunity to take a group of wonderful, thinking individual minds and pull from them ideas that a whole team can take to success? Yes, the job is indeed tough, but the paybacks are many.

  5. A reliability-based maintenance technicians' workloads optimisation model with stochastic consideration

    NASA Astrophysics Data System (ADS)

    Ighravwe, D. E.; Oke, S. A.; Adebiyi, K. A.

    2016-06-01

    The growing interest in technicians' workloads research is probably associated with the recent surge in competition. This was prompted by unprecedented technological development that triggers changes in customer tastes and preferences for industrial goods. In a quest for business improvement, this worldwide intense competition in industries has stimulated theories and practical frameworks that seek to optimise performance in workplaces. In line with this drive, the present paper proposes an optimisation model which considers technicians' reliability that complements factory information obtained. The information used emerged from technicians' productivity and earned-values using the concept of multi-objective modelling approach. Since technicians are expected to carry out routine and stochastic maintenance work, we consider these workloads as constraints. The influence of training, fatigue and experiential knowledge of technicians on workload management was considered. These workloads were combined with maintenance policy in optimising reliability, productivity and earned-values using the goal programming approach. Practical datasets were utilised in studying the applicability of the proposed model in practice. It was observed that our model was able to generate information that practicing maintenance engineers can apply in making more informed decisions on technicians' management.

  6. Who does workforce planning well? Workforce review team rapid review summary.

    PubMed

    Curson, J A; Dell, M E; Wilson, R A; Bosworth, D L; Baldauf, B

    2010-01-01

    This paper sets out to disseminate new knowledge about workforce planning, a crucial health sector issue. The Health Select Committee criticised NHS England's failure to develop and apply effective workforce planning. The Workforce Review Team (WRT) commissioned the Institute for Employment Research, Warwick University, to undertake a "rapid review" of global literature to identify good practice. A workforce planning overview, its theoretical principles, good practice exemplars are provided before discussing their application to healthcare. The literature review, undertaken September-November 2007, determined the current workforce planning evidence within and outside health service provision and any consensus on successful workforce planning. Much of the literature was descriptive and there was a lack of comparative or evaluative research-based evidence to inform U.K. healthcare workforce planning. Workforce planning practices were similar in other countries. There was no evidence to challenge current WRT approaches to NHS England workforce planning. There are a number of indications about how this might be extended and improved, given additional resources. The evidence-base for workforce planning would be strengthened by robust and authoritative studies. Systematic workforce planning is a key healthcare quality management element. This review highlights useful information that can be turned into knowledge by informed application to the NHS. Best practice in other sectors and other countries appears to warrant exploration.

  7. 21 CFR 129.1 - Current good manufacturing practice.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 129.1 Section... Current good manufacturing practice. The applicable criteria in part 110 of this chapter, as well as the..., methods, practices, and controls used in the processing, bottling, holding, and shipping of bottled...

  8. Integrated soil fertility management in sub-Saharan Africa: unravelling local adaptation

    NASA Astrophysics Data System (ADS)

    Vanlauwe, B.; Descheemaeker, K.; Giller, K. E.; Huising, J.; Merckx, R.; Nziguheba, G.; Wendt, J.; Zingore, S.

    2014-12-01

    Intensification of smallholder agriculture in sub-Saharan Africa is necessary to address rural poverty and natural resource degradation. Integrated Soil Fertility Management (ISFM) is a means to enhance crop productivity while maximizing the agronomic efficiency (AE) of applied inputs, and can thus contribute to sustainable intensification. ISFM consists of a set of best practices, preferably used in combination, including the use of appropriate germplasm, the appropriate use of fertilizer and of organic resources, and good agronomic practices. The large variability in soil fertility conditions within smallholder farms is also recognised within ISFM, including soils with constraints beyond those addressed by fertilizer and organic inputs. The variable biophysical environments that characterize smallholder farming systems have profound effects on crop productivity and AE and targeted application of limited agro-inputs and management practices is necessary to enhance AE. Further, management decisions depend on the farmer's resource endowments and production objectives. In this paper we discuss the "local adaptation" component of ISFM and how this can be conceptualized within an ISFM framework, backstopped by analysis of AE at plot and farm level. At plot level, a set of four constraints to maximum AE is discussed in relation to "local adaptation": soil acidity, secondary nutrient and micro-nutrient (SMN) deficiencies, physical constraints, and drought stress. In each of these cases, examples are presented whereby amendments and/or practices addressing these have a significantly positive impact on fertilizer AE, including mechanistic principles underlying these effects. While the impact of such amendments and/or practices is easily understood for some practices (e.g., the application of SMNs where these are limiting), for others, more complex interactions with fertilizer AE can be identified (e.g., water harvesting under varying rainfall conditions). At farm scale, adjusting fertilizer applications within-farm soil fertility gradients has the potential to increase AE compared with blanket recommendations, in particular where fertility gradients are strong. In the final section, "local adaption" is discussed in relation to scale issues and decision support tools are evaluated as a means to create a better understanding of complexity at farm level and to communicate best scenarios for allocating agro-inputs and management practices within heterogeneous farming environments.

  9. Integrated soil fertility management in sub-Saharan Africa: unravelling local adaptation

    NASA Astrophysics Data System (ADS)

    Vanlauwe, B.; Descheemaeker, K.; Giller, K. E.; Huising, J.; Merckx, R.; Nziguheba, G.; Wendt, J.; Zingore, S.

    2015-06-01

    Intensification of smallholder agriculture in sub-Saharan Africa is necessary to address rural poverty and natural resource degradation. Integrated soil fertility management (ISFM) is a means to enhance crop productivity while maximizing the agronomic efficiency (AE) of applied inputs, and can thus contribute to sustainable intensification. ISFM consists of a set of best practices, preferably used in combination, including the use of appropriate germplasm, the appropriate use of fertilizer and of organic resources, and good agronomic practices. The large variability in soil fertility conditions within smallholder farms is also recognized within ISFM, including soils with constraints beyond those addressed by fertilizer and organic inputs. The variable biophysical environments that characterize smallholder farming systems have profound effects on crop productivity and AE, and targeted application of agro-inputs and management practices is necessary to enhance AE. Further, management decisions depend on the farmer's resource endowments and production objectives. In this paper we discuss the "local adaptation" component of ISFM and how this can be conceptualized within an ISFM framework, backstopped by analysis of AE at plot and farm level. At plot level, a set of four constraints to maximum AE is discussed in relation to "local adaptation": soil acidity, secondary nutrient and micronutrient (SMN) deficiencies, physical constraints, and drought stress. In each of these cases, examples are presented whereby amendments and/or practices addressing these have a significantly positive impact on fertilizer AE, including mechanistic principles underlying these effects. While the impact of such amendments and/or practices is easily understood for some practices (e.g. the application of SMNs where these are limiting), for others, more complex processes influence AE (e.g. water harvesting under varying rainfall conditions). At farm scale, adjusting fertilizer applications to within-farm soil fertility gradients has the potential to increase AE compared with blanket recommendations, in particular where fertility gradients are strong. In the final section, "local adaption" is discussed in relation to scale issues and decision support tools are evaluated as a means to create a better understanding of complexity at farm level and to communicate appropriate scenarios for allocating agro-inputs and management practices within heterogeneous farming environments.

  10. Microvascular management of ring avulsion injuries.

    PubMed

    Urbaniak, J R; Evans, J P; Bright, D S

    1981-01-01

    Microsurgical revascularization has proved to be a useful method in managing the ring avulsion injury where both neurovascular bundles are damaged with only partial skin avulsion. Representative cases are used to illustrate guidelines for a practical classification for helping to decide the optimal method of treatment of acute ring avulsion injuries in light of digital revascularization techniques. Nine ring fingers were successfully revascularized of 24 acute ring avulsion injuries reviewed. Sensibility recovery was good and a functional range of motion obtained. No patient who has had his ring finger revascularized has requested its amputation because of appearance, painful neuromas, stiffness, or cold intolerance. Complete amputations, especially proximal to the superficialis insertion, and complete degloving injuries of the ring finger are usually best managed by surgical amputation of the digit.

  11. Ethical Issues Raised by Private Practice Physiotherapy Are More Diverse than First Meets the Eye: Recommendations from a Literature Review

    PubMed Central

    Drolet, Marie-Josée; Williams-Jones, Bryn

    2015-01-01

    ABSTRACT Purpose: Physiotherapy in private practice differs from physiotherapy practised in a public setting in several ways, the most evident of which is the for-profit nature of private physiotherapy clinics; these differences can generate distinct and challenging ethical issues. The objectives of this article are to identify ethical issues encountered by physiotherapists in private practice settings and to identify potential solutions and recommendations to address these issues. Method: After a literature search of eight databases, 39 studies addressing ethical issues in a private practice context were analyzed. Results: A total of 25 ethical issues emerging from the included studies were classified into three main categories: (1) business and economic issues (e.g., conflicts of interests, inequity in a managed care context, lack of time affecting quality of care); (2) professional issues (e.g., professional autonomy, clinical judgment, treatment effectiveness, professional conduct); and (3) patients' rights and welfare issues (e.g., confidentiality, power asymmetries, paternalism vs. patient autonomy, informed consent). Recommendations as to how physiotherapists could better manage these issues were then identified and categorized. Conclusions: The physiotherapy community should reflect on the challenges raised by private practice so that professionals can be supported—through education, research, and good governance—in providing the best possible care for their patients. PMID:25931663

  12. Beyond evidence-based nursing: tools for practice.

    PubMed

    Jutel, Annemarie

    2008-05-01

    This commentary shares my views of evidence-based nursing as a framework for practice, pointing out its limitations and identifying a wider base of appraisal tools required for making good clinical decisions. As the principles of evidence-based nursing take an increasingly greater hold on nursing education, policy and management, it is important to consider the range of other decision-making tools which are subordinated by this approach. This article summarizes nursing's simultaneous reliance on and critique of evidence-based practice (EBP) in a context of inadequate critical reasoning. It then provides an exemplar of the limitations of evidence-based practice and offers an alternative view of important precepts of decision-making. I identify means by which nurses can develop skills to engage in informed and robust critique of practices and their underpinning rationale. Nurses need to be able to locate and assess useful and reliable information for decision-making. This skill is based on a range of tools which include, but also go beyond EBP including: information literacy, humanities, social sciences, public health, statistics, marketing, ethics and much more. This essay prompts nursing managers to reflect upon whether a flurried enthusiasm to adopt EBP neglects other important decision-making skills which provide an even stronger foundation for robust nursing decisions.

  13. Professional development training through the veterinary curriculum at the University of Minnesota.

    PubMed

    Kustritz, Margaret V Root; Nault, André J

    2010-01-01

    Veterinary education has traditionally focused on clinical skills. Success as a practicing veterinarian, however, also depends on good communication skills, emotional intelligence, and other "soft" skills that can lead to greater employee and employer satisfaction and increased practice revenue. The University of Minnesota has approached this curricular need by convening a task force and creating a series of courses aimed at improving leadership skills, teamwork, and verbal and written communication; managing conflict; and understanding ethics and personal finance. This article describes the evolution and structure of these soft-skill classes and the challenges in securing faculty and student buy-in essential for success.

  14. Individualised patient care: a framework for guidelines.

    PubMed

    Redfern, S

    It is assumed that individualised patient care (IPC) benefits both patients and nurses. This study set out to clarify what IPC means to nurses and how they practise it, as well as how it is experienced by patients. With some exceptions, IPC was not practised widely in the seven wards used as case studies. Even in the wards where it was more common, there were some examples of bad practice. Factors that facilitated IPC were: the personal qualities of the nurses; a shared understanding among the ward team of the goals of nursing care and what constitutes good practice; levels of staffing and skill mix; effective leadership and management of nursing work.

  15. Management of long term sickness absence: a systematic realist review.

    PubMed

    Higgins, Angela; O'Halloran, Peter; Porter, Sam

    2012-09-01

    The increasing impact and costs of long term sickness absence have been well documented. However, the diversity and complexity of interventions and of the contexts in which these take place makes a traditional review problematic. Therefore, we undertook a systematic realist review to identify the dominant programme theories underlying best practice, to assess the evidence for these theories, and to throw light on important enabling or disabling contextual factors. A search of the scholarly literature from 1950 to 2011 identified 5,576 articles, of which 269 formed the basis of the review. We found that the dominant programme theories in relation to effective management related to: early intervention or referral by employers; having proactive organisational procedures; good communication and cooperation between stakeholders; and workplace-based occupational rehabilitation. Significant contextual factors were identified as the level of support for interventions from top management, the size and structure of the organisation, the level of financial and organisational investment in the management of long-term sickness absence, and the quality of relationships between managers and staff. Consequently, those with responsibility for managing absence should bear in mind the contextual factors that are likely to have an impact on interventions, and do what they can to ensure stakeholders have at least a mutual understanding (if not a common purpose) in relation to their perceptions of interventions, goals, culture and practice in the management of long term sickness absence.

  16. 21 CFR 184.1101 - Diacetyl tartaric acid esters of mono- and diglycerides.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... used in food with no limitation other than current good manufacturing practice. The affirmation of this... following current good manufacturing practice conditions of use: (1) The ingredient is used in food as an... levels not to exceed current good manufacturing practice: baked goods and baking mixes as defined in...

  17. 21 CFR 184.1101 - Diacetyl tartaric acid esters of mono- and diglycerides.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... used in food with no limitation other than current good manufacturing practice. The affirmation of this... following current good manufacturing practice conditions of use: (1) The ingredient is used in food as an... levels not to exceed current good manufacturing practice: baked goods and baking mixes as defined in...

  18. Protection of people and environment from radiation risk through good regulatory practice

    NASA Astrophysics Data System (ADS)

    Jais, Azlina Mohammad; Hassan, Najwa

    2017-01-01

    The term "good regulatory practice" has seen growing frequency of usage worldwide, especially since the 2011 Fukushima nuclear incident. However, the term appears quite ambiguous as it may mean differently to different people. This leads us to the first important question: what does "good regulatory practice" actually mean? When used in conjunction with the Fukushima incident, do we imply that there is an absence of "good regulatory practice" in the Japanese' Nuclear and Industry Safety Agency (NISA)? This is quite troubling. It is clear that the term should be defined formally so that our understanding of "good regulatory practice" can be standardized. There is still another important question beyond agreeing on what "good regulatory practice" is: is "good regulatory practice" specific to a region, or is it global? And is it applicable only to nuclear regulators, or to all types of regulators per se? This paper aims to deliberate on the above mentioned questions. Specifically, we hope to discuss the "good regulatory practice" for atomic energy activities in order to protect the people and the environment from radiation risk of such activities. By understanding what "good regulatory practice" truly means, a newcomer country such as Malaysia can quickly learn and adopt these practices so as to assure a competent national nuclear regulatory authority who will be responsible in ensuring the safety, security and safeguards of peaceful atomic energy activities in the country including nuclear liability. In understanding this concept, a holistic approach will be taken by looking into example of advanced and newcomer countries of various nuclear regulatory authorities all around the world. Then the paper will focus on the challenges that the current nuclear regulatory authority in Malaysia which is Atomic Energy Licensing Board has, its challenges to follow the concept of "good regulatory practice" and its ways to overcome it. This study explore the initiatives could be considered by nuclear regulatory authority and the necessary criteria of an "ideal" how nuclear regulatory authority should implement the "good regulatory practice" approach.

  19. Patient-reported outcomes in type 2 diabetes mellitus: patients' and primary care physicians' perspectives in the Spanish health care system.

    PubMed

    Franch-Nadal, Josep; Labrador Barba, Elena; Gómez-García, M Carmen; Buil-Cosiales, Pilar; Millaruelo, José Manuel; Peña, María Luisa Orera

    2015-01-01

    Understanding patients' and physicians' perceptions of type 2 diabetes mellitus (T2DM) management and treatment has important implications for diabetes care, allowing the identification of clinical practice issues that could be improved, leading to patients' better understanding of the illness and, consequently, healthier self-management behaviors. The objective of this study was to identify differences between physicians' and T2DM patients' perceptions related to health status, patient-reported outcomes assessments, and T2DM management and treatment, in routine clinical practice in Spain. This was an observational, cross-sectional study including 1,012 T2DM patients and 974 physicians from 47 and 52 Spanish provinces, respectively. An electronic structured self-administered questionnaire containing 17 questions was designed aiming to address both physicians' and patient's perceptions on overall T2DM health status and patient-reported outcomes. T2DM patients perceived a worse health status (40% reported having a "good" and 38% a "neither good nor bad" health status) compared with physicians' perceptions (77% thought patients had a "good" health status). Most patients answered being "satisfied" or "neither satisfied nor unsatisfied" with the given information, while physicians considered that patients were "satisfied" or "very satisfied" with the information for self-monitoring blood glucose and treatment administration. Fifty-seven percent of patients reported that medical recommendations were "important", while 58% of physicians considered it as "very important". Fifty-three percent of patients perceived that their current T2DM treatment suited their preferences "quite a lot", and this was lower than the proportion of physicians (69%) that believed this for their patients. Additionally, a lower percentage of patients (53%) than physicians (79%) believed that their treatment improved their health-related quality of life "quite a lot". All differences between patients and physicians were statistically significant (P<0.001). Patients and physicians demonstrate different views concerning all questions related to T2DM health status and diabetes management and treatment (information, recommendations, satisfaction, and preferences).

  20. Knowledge and practice of food hygiene and safety among food handlers in fast food restaurants in Benin City, Edo State.

    PubMed

    Isara, A R; Isah, E C

    2009-09-01

    To assess the knowledge and practice of food hygiene and safety among food handlers in fast food restaurants in Benin City, Edo State. A descriptive cross-sectional study was carried out among 350 respondents who were selected by means of a systematic sampling method and interviewed using a semi-structured researcher-administered questionnaire. An observational checklist was thereafter used to inspect their personal hygiene status. The mean age of the food handlers was 26.4 +/- 6.1 years. Two hundred and twenty eight (65.1%) were females while 34.9% were males. A majority (98%) of the respondents had formal education. There was good knowledge and practice of food hygiene and safety among the respondents. Knowledge was significantly influenced by previous training in food hygiene and safety (p = 0.002). Food handlers who had worked for longer years in the fast food restaurants had better practice of food hygiene and safety (p = 0.036). The level of education of respondents did not significantly influenced their practice of food hygiene and safety (p = 0.084). Although, 299 (85.4%) food handlers were generally clean, skin lesions was seen in 4 (7.3%) of them. This study showed good knowledge and practice of food hygiene and safety by food handlers in the fast food restaurants in Benin City, but there is need for improvement through training and retraining of food handlers by the management of the restaurants and the local government authorities.

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