Ethical questions for resource managers.

Treesearch

G.H. Reeves; D.L. Bottom; M.H. Brookes

1992-01-01

The decisions of natural resource managers are not simply scientific issues but involve fundamental questions of ethics. Conflicts in fisheries management, forestry, and other applied sciences arise from social and economic factors that affect natural resource values. Administrative processes, cost-benefit analyses, and various management "myths" have been...

Managing water resources infrastructure in the face of different values

NASA Astrophysics Data System (ADS)

Mostert, Erik

Water resources infrastructure (WRI) plays a key role in water management. It can serve or negatively affect some seven to ten different and sometimes conflicting values. WRI management is therefore not a purely technical issue. Economic analyses can help to some extent, but only for values related to current human use. Multi-criteria analysis can cover all values, but in the end WRI management is not an analytical issue, but a governance issue. Different governance paradigms exist: markets, hierarchies and “third alternatives”, such as common pool resources management and network management. This article presents social learning as the most promising paradigm. Positive experiences with social learning have been described and guidance on putting social learning into practice exists. Nonetheless, there are no magic solutions for managing WRI in the face of different values.

Corporate Civil Disobedience in the Consumer Interest.

ERIC Educational Resources Information Center

Dennis, Michael R.; And Others

1994-01-01

Through catalytic issue management, corporations proactively seek to affect resolutions of issues in which they have some interest. Corporations now catalyze legal changes by purposely disobeying existing law, facing the associated consequences, and lobbying for desired changes. (Author)

15 CFR 930.36 - Consistency determinations for proposed activities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... coastal management issues and have similar enforceable policies, e.g., protection of a particular coastal... AND COASTAL RESOURCE MANAGEMENT FEDERAL CONSISTENCY WITH APPROVED COASTAL MANAGEMENT PROGRAMS...) Federal agencies shall review their proposed Federal agency activities which affect any coastal use or...

15 CFR 930.36 - Consistency determinations for proposed activities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... coastal management issues and have similar enforceable policies, e.g., protection of a particular coastal... AND COASTAL RESOURCE MANAGEMENT FEDERAL CONSISTENCY WITH APPROVED COASTAL MANAGEMENT PROGRAMS...) Federal agencies shall review their proposed Federal agency activities which affect any coastal use or...

15 CFR 930.36 - Consistency determinations for proposed activities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... coastal management issues and have similar enforceable policies, e.g., protection of a particular coastal... AND COASTAL RESOURCE MANAGEMENT FEDERAL CONSISTENCY WITH APPROVED COASTAL MANAGEMENT PROGRAMS...) Federal agencies shall review their proposed Federal agency activities which affect any coastal use or...

15 CFR 930.36 - Consistency determinations for proposed activities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... coastal management issues and have similar enforceable policies, e.g., protection of a particular coastal... AND COASTAL RESOURCE MANAGEMENT FEDERAL CONSISTENCY WITH APPROVED COASTAL MANAGEMENT PROGRAMS...) Federal agencies shall review their proposed Federal agency activities which affect any coastal use or...

15 CFR 930.36 - Consistency determinations for proposed activities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... coastal management issues and have similar enforceable policies, e.g., protection of a particular coastal... AND COASTAL RESOURCE MANAGEMENT FEDERAL CONSISTENCY WITH APPROVED COASTAL MANAGEMENT PROGRAMS...) Federal agencies shall review their proposed Federal agency activities which affect any coastal use or...

Nursing management and organizational ethics in the intensive care unit.

PubMed

Wlody, Ginger Schafer

2007-02-01

This article describes organizational ethics issues involved in nursing management of an intensive care unit. The intensive care team and medical center management have the dual responsibility to create an ethical environment in which to provide optimum patient care. Addressing organizational ethics is key to creating that ethical environment in the intensive care unit. During the past 15-20 yrs, increasing costs in health care, competitive markets, the effect of high technology, and global business changes have set the stage for business and healthcare organizational conflicts that affect the ethical environment. Studies show that critical care nurses experience moral distress and are affected by the ethical climate of both the intensive care unit and the larger organization. Thus, nursing moral distress may result in problems related to recruitment and retention of staff. Other issues with organizational ethics ramifications that may occur in the intensive care unit include patient safety issues (including those related to disruptive behavior), intensive care unit leadership style, research ethics, allocation of resources, triage, and other economic issues. Current organizational ethics conflicts are discussed, a professional practice model is described, and multidisciplinary recommendations are put forth.

Issues, benefits, and problems associated with fishing tournaments in inland waters of the United States: A survey of fishery agency administrators

USGS Publications Warehouse

Schramm, H.L.; Hunt, K.M.

2007-01-01

A web-based survey was administered to state fisheries agency administrators in 2005 to assess and prioritize the impacts of tournament fishing on management of inland fishery resources. Surveys were completed by fishery administrators of 48 state agencies and the District of Columbia. Respondents rated tournaments as neither strongly benefiting nor adversely affecting fishery management. Benefits of tournaments to fishery management grouped into four factors (in order of decreasing impact) characterized as enhancing fishery management agency effectiveness, stimulating interest in fishing and fishery resources, measuring economic value, and collecting biological information. Adverse impacts grouped into six factors (in order of decreasing impact), characterized as resource crowding, user-group conflicts, costs of tournaments to fishery agencies, non-traditional uses of fisheries resources, fish introductions, and adverse affects on fish populations. Tournament issues and impacts generally did not differ regionally and suggested the effects of tournaments do not vary among different fisheries. Comparison with previous surveys indicates that the prevalence of some benefits and problems have changed since 1989. Social issues remained paramount problems, but biological impacts were considered a lesser problem. Agencies recognized that tournaments can benefit fisheries management efforts and angler recruitment. Future management of tournaments should consider a management team approach.

Paving the Way for the 21st Century: The Human Factor in Higher Education Financial Management.

ERIC Educational Resources Information Center

Ginsburg, Sigmund G., Ed.

This book presents human resources issues that will affect the financial management of colleges and universities as they move into the 21st century. It examines how business managers and human resources managers must balance human resources management policies and practices against the financial demands on the institution. It discusses the…

Invasion Science: A Horizon Scan of Emerging Challenges and Opportunities

Treesearch

Anthony Ricciardi; Tim M. Blackburn; James T. Carlton; Jaimie T.A. Dick; Philip E. Hulme; Josephine C. Iacarella; Jonathan M. Jeschke; Andrew M. Liebhold; Julie L. Lockwood; Hugh J. MacIsaac; Petr Pyšek; David M. Richardson; Gregory M. Ruiz; Daniel Simberloff; William J. Sutherland; David A. Wardle; David C. Aldridge

2017-01-01

We identified emerging scientific, technological, and sociopolitical issues likely to affect how biological invasions are studied and managed over the next two decades. Issues were ranked according to their probability of emergence, pervasiveness, potential impact, and novelty. Top-ranked issues include the application of genomic modification tools to control invasions...

Performance Indicators and the Management of Quality in Education.

ERIC Educational Resources Information Center

Cuttance, Peter

Issues that affect the use of performance indicators in managing educational quality are discussed in this paper. Recent changes in public-sector organizational management include the development of strategies for the management of change itself and the changing role of the public sector. A trend within the public sector is an increase in the…

Study of systems and techniques for data base management

NASA Technical Reports Server (NTRS)

1976-01-01

Data management areas were studied to identify pertinent problems and issues that will affect future NASA data users in terms of performance and cost. Specific topics discussed include the identifications of potential NASA data users other than those normally discussed, consideration affecting the clustering of minicomputers, low cost computer system for information retrieval and analysis, the testing of minicomputer based data base management systems, ongoing work related to the use of dedicated systems for data base management, and the problems of data interchange among a community of NASA data users.

EPA Growing DASEES (Decision Analysis For A Sustainable Environment, Economy & Society) - To Aid In Making Decisions On Complex Environmental Issues

EPA Science Inventory

Having a framework and tools to help sort through complicated environmental issues in an objective way would be useful to communities and risk managers, and all the stakeholders affected by these issues. This is one need that DASEES (Decision Analysis for a Sustainable En...

A guide to wound managment in palliative care.

PubMed

Naylor, Wayne A

2005-11-01

Wound management in palliative patients is often a very challenging area of care. There are many unique issues that can combine to produce complicated wound management scenarios, including the types of wounds and wound symptoms most commonly affecting palliative care patients, as well as the presence of concurrent disease and associated treatment. Problems exist with the availability of suitable dressings and balancing life expectancy with the goals of wound care. A significant, and possibly under-recognized, issue is the emotional and social distress experienced by these patients, which can be directly attributed to their wound. These problems must all be recognized and addressed in order to manage wounds effectively in this patient population. This article aims to explore these issues and offer advice on the management of wound-related symptoms, with the ultimate goal of improving patients' quality of life.

36 CFR 219.4 - Identification and consideration of issues.

Code of Federal Regulations, 2010 CFR

2010-07-01

... AGRICULTURE PLANNING National Forest System Land and Resource Management Planning The Framework for Planning... interested in or affected by National Forest System management; Presidential, Departmental, and Forest Service conservation leadership initiatives; cooperatively developed landscape goals (§ 219.12(b...

Transitional Patterns of Adolescent Females in Non-Traditional Career Paths.

ERIC Educational Resources Information Center

Ciccocioppo, Anna-Lisa; Stewin, Leonard L.; Madill, Helen M.; Montgomerie, T. Craig; Tovell, Dorothy R.; Armour, Margaret-Ann; Fitzsimmons, George W.

2002-01-01

Examines the factors that affected the career decision-making of adolescent females and young women in undergraduate science, engineering, and technology programs. Qualitative analysis was used to uncover seven themes: transition from high school, educational influences, family influences, academic issues, coursework management, gender issues, and…

Legal Liabilities of Administrators.

ERIC Educational Resources Information Center

Underwood, Julie

This chapter of "Principles of School Business Management" discusses the implications of several court cases for legal issues affecting the role of the school business official. The issues addressed include civil rights, negligence, contracts, criminal liability, tuition and fees, and student records. The chapter opens with a brief overview of…

Social justice considerations in neonatal care for nurse managers and executives.

PubMed

Yoder, Linda; Walden, Marlene; Verklan, M Terese

2010-01-01

This article presents the struggle between social justice and market justice within the current health care system, specifically issues affecting neonatal care. Community benefit is described and discussed as an aspect of social justice demonstrated by hospitals. The federal and state Children's Health Insurance Program also is discussed in relation to social justice and health care costs. Implications for managers and executives overseeing neonatal care are presented in relation to the economic and social issues.

Applying the ED QUEST Planning Model in a School of Management: A Case Study.

ERIC Educational Resources Information Center

Ptaszynski, James Garner; Morrison, James L.

1990-01-01

The Strategic Planning Committee at the Graduate School of Management, Wake Forest University, identified what issues, trends, and possible events might affect the school in the future. The implementation of the ED QUEST planning model is described. (MLW)

The impact of prescription charges on asthma patients is uneven and unpredictable: evidence from qualitative interviews.

PubMed

Schafheutle, Ellen I

2009-12-01

To explore whether, and how, prescription charges affect asthma patients' disease management behaviour. Thirty qualitative interviews. Interviewees were aged between 21 and 59, 21 were women, 24 were paying individual prescription charges, and six had prepayment certificates (PPCs). Most had a beta2-agonist 'reliever' and a steroid 'preventer' inhaler. Prescription charges posed affordability issues for some, and for two patients cost-related reduction in 'preventer' use affected asthma control negatively. Many described various ways of keeping medication cost down. Affordability issues, negative views on paying charges, and whether interviewees viewed their asthma medication as essential, were influential factors. Steroid inhalers were viewed more commonly as being less essential and affected by cost. The episodic nature of asthma meant that predicting benefit from PPCs was difficult. This study strengthens existing evidence that medication cost is a factor in asthma patients' management decisions, with a potential cost-related impact on asthma control.

The Politics of Invasive Weed Management: Gender, Race, and Risk Perception in Rural California

ERIC Educational Resources Information Center

Norgaard, Kari Marie

2007-01-01

"Biological invasions" are now recognized as the cause of significant ecological and economic damage. They also raise a series of less visible social issues. Management of invasive species is often a political process raising questions such as who decides which organisms are to be managed, and who benefits or is affected by different…

Simulation-Based Testing of Pager Interruptions During Laparoscopic Cholecystectomy.

PubMed

Sujka, Joseph A; Safcsak, Karen; Bhullar, Indermeet S; Havron, William S

2018-01-30

To determine if pager interruptions affect operative time, safety, or complications and management of pager issues during a simulated laparoscopic cholecystectomy. Twelve surgery resident volunteers were tested on a Simbionix Lap Mentor II simulator. Each resident performed 6 randomized simulated laparoscopic cholecystectomies; 3 with pager interruptions (INT) and 3 without pager interruptions (NO-INT). The pager interruptions were sent in the form of standardized patient vignettes and timed to distract the resident during dissection of the critical view of safety and clipping of the cystic duct. The residents were graded on a pass/fail scale for eliciting appropriate patient history and management of the pager issue. Data was extracted from the simulator for the following endpoints: operative time, safety metrics, and incidence of operative complications. The Mann-Whitney U test and contingency table analysis were used to compare the 2 groups (INT vs. NO-INT). Level I trauma center; Simulation laboratory. Twelve general surgery residents. There was no significant difference between the 2 groups in any of the operative endpoints as measured by the simulator. However, in the INT group, only 25% of the time did the surgery residents both adequately address the issue and provide effective patient management in response to the pager interruption. Pager interruptions did not affect operative time, safety, or complications during the simulated procedure. However, there were significant failures in the appropriate evaluations and management of pager issues. Consideration for diversion of patient care issues to fellow residents not operating to improve quality and safety of patient care outside the operating room requires further study. Copyright © 2018. Published by Elsevier Inc.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-28

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

Discovering Your Personality: A Group Exercise in Personal Sensemaking

ERIC Educational Resources Information Center

Anderson, Marc H.

2008-01-01

Personality affects a wide variety of issues in organizational behavior, human resource management, and strategic management. Instructors teaching personality often have students take personality tests and then give them their scores. This passive approach to giving test feedback suffers from several weaknesses dealing with distinct perceptual…

The ecology of forest insect invasions and advances in their management

Treesearch

Eckehard G. Brockerhoff; Andrew M. Liebhold; Herv& #233; Jactel

2006-01-01

Invasions by nonindigenous forest insects can have spectacular effects on the biodiversity, ecology, and economy of affected areas. This introduction explores several critical issues that are generally relevant to invasions by forest insects to provide an extended background for this special issue of the Canadian Journal of Forest Research and...

Microblogging for Class: An Analysis of Affective, Cognitive, Personal Integrative, and Social Integrative Gratifications

ERIC Educational Resources Information Center

Gant, Camilla; Hadley, Patrick D.

2014-01-01

This study shows that undergraduate students can gratify cognitive, affective, social integrative, and personal integrative needs microblogging via a learning management system discussion tool. Moreover, the researchers find that microblogging about news regarding mass media events and issues via Blackboard heightened engagement, expanded…

Integrated inventory and monitoring

Treesearch

George Lightner; Hans T. Schreuder; Barry Bollenbacher; Kerry McMenus

2001-01-01

Understanding and inventorying our ecological systems is key to addressing how issues, questions, and management actions will affect the composition, structure, and function of these systems. Taking an ecological systems approach to the inventory and monitoring framework, is one which we feel will allow answers to currently identified management questions and new ones...

Evaluation of Natural Resource Education Materials: Implications for Resource Management.

ERIC Educational Resources Information Center

Pomerantz, Gerri A.

1991-01-01

An analysis of elementary school natural resource lessons (n=700) that focus on ecological principles, on resource management issues, and on analytical skill development affecting students' environmental behavior is presented. The fundamental conclusion is that very few of the lesson materials help to develop critical thinking skills and behaviors…

Proceedings of the tenth biennial southern silvicultural research conference

Treesearch

James D. Haywood; [Editor

1999-01-01

One hundred and twenty-two papers and three poster summaries address a range of issues affecting southern forests. Papers are grouped in 15 sessions that included upland hardwoods, intensive management of bottomland hardwoods, intermediate hardwood management, hardwood and bottomland regeneration, ecological relationships, water and soil hydrology, site preparation for...

Advancing knowledge for proactive drought planning and enhancing adaptive management for drought on rangelands: Introduction to a special issue

USDA-ARS?s Scientific Manuscript database

Drought is a prolonged period of abnormally low rainfall that adversely affects vegetation growth and negatively impacts land managers, ranching enterprises, and pastoral systems. As an ecological driver, drought historically shaped vegetation composition, structure, diversity, and productivity of r...

Upland hardwood silviculture DVD

Treesearch

Claire Payne; Donna Burnett

2010-01-01

The Upland Hardwood Ecology and Management unit of the Southern Research Station offers a week-long course that provides practicing foresters with information about current silvicultural practices and emerging issues based on scientific research and applied techniques that affect managing upland hardwoods. This DVD captures the course that took place in July 2007....

76 FR 9001 - Availability of Seat for the Gulf of the Farallones National Marine Sanctuary Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-16

... and professional affiliations; philosophy regarding the protection and management of marine resources... provide advice to the Superintendent on issues affecting resource protection, the Sanctuary's primary... and acts as a conduit, relaying the community's interests, concerns, and management needs to the...

Patients speak out: development of an evidence-based model for managing orthopaedic postoperative pain.

PubMed

Pulido, Pamela; Hardwick, Mary E; Munro, Michelle; May, Laura; Dupies-Rosa, Denise

2010-01-01

Perioperative pain management after total joint replacement continues to be a concern for orthopaedic nurses. In our institution, the results of routine post-hospital stay surveys had shown below average scores in the area of pain management. This began as a quality management issue, became a pain subcommittee issue, and drew in the research nurses to ask what we can learn from this process. Changing the method of handling pain management is not easy, but it makes a difference in patients' hospital experiences. We learned that cooperation and expertise from multiple departments within the institution and some organizations outside the institution is needed to bring about change. We learned that education of not just staff members but also patients on pain management affected the outcome. This article describes our journey to enhance pain management in our institution.

Is It Ethical for Patents to Be Issued for the Computer Algorithms that Affect Course Management Systems for Distance Learning?

ERIC Educational Resources Information Center

Moreau, Nancy

2008-01-01

This article discusses the impact of patents for computer algorithms in course management systems. Referring to historical documents and court cases, the positive and negative aspects of software patents are presented. The key argument is the accessibility to algorithms comprising a course management software program such as Blackboard. The…

Reduce--recycle--reuse: guidelines for promoting perioperative waste management.

PubMed

Laustsen, Gary

2007-04-01

The perioperative environment generates large amounts of waste, which negatively affects local and global ecosystems. To manage this waste health care facility leaders must focus on identifying correctable issues, work with relevant stakeholders to promote solutions, and adopt systematic procedural changes. Nurses and managers can moderate negative environmental effects by promoting reduction, recycling, and reuse of materials in the perioperative setting.

Landscape management in an area affected by surface brown coal mining

NASA Astrophysics Data System (ADS)

Vráblíková, J.; Wildová, E.; Vráblík, P.; Blažková, M.

2017-10-01

The contribution summarizes results of a project concentrated on landscape management of an area affected by brown coal mining located in northern Bohemia (The Most basin) focusing on restoration and reclamation processes. It describes in particular the shares of individual types of reclamations in the area of interest. A strategic document that also supports landscape restoration in anthropogenically burdened regions was written within the project called “Restart” and the second part of the contribution is focused on its chapters which address this issue.

CHALLENGES OF DSD: DIVERSE PERCEPTIONS ACROSS STAKEHOLDERS

PubMed Central

Kogan, Barry A.; Gardner, Melissa; Alpern, Adrianne N.; Cohen, Laura M.; Grimley, Mary Beth; Quittner, Alexandra L.; Sandberg, David E.

2012-01-01

Background/Aims Disorders of Sex Development (DSD) are congenital conditions in which chromosomal, gonadal, or anatomic sex development is atypical. Optimal management is patient- and family-centered and delivered by interdisciplinary teams. The present pilot study elicits concerns held by important stakeholders on issues affecting young patients with DSD and their families. Methods Content from focus groups with expert clinicians (pediatric urologists [n=7], pediatric endocrinologists [n=10], mental health professionals [n=4]), DSD patient advocates (n=4), and interviews with parents of DSD-affected children (newborn to 6 yrs; n=11) was coded and content-analyzed to identify health-related quality of life issues. Results Key stressors varied across stakeholder groups. In general, family-centered issues were noted more than child-centered. In the child-centered domain, providers worried more about physical functioning; family and advocates emphasized gender concerns and body image. In the family-centered domain, parental concerns about medication management outweighed those of providers. Advocates reported more stressors regarding communication/information than other stakeholders. Conclusion Variability exists across stakeholder groups in the key concerns affecting young children/families with DSD. Interdisciplinary DSD healthcare team development should account for varying perspectives when counseling families and planning treatment. PMID:22832323

Climate Change Adaptation Training

EPA Pesticide Factsheets

A list of on-line training modules to help local government officials and those interested in water management issues better understand how the changing climate affects the services and resources they care about

Critical Issues in College System Management: Conference Proceedings (Toronto, Ontario, October, 1981).

ERIC Educational Resources Information Center

Hamblin, Fred, Ed.

These proceedings contain all of the formal presentations made at a conference focusing on policy issues affecting the Colleges of Applied Arts and Technology of Ontario. Introductory remarks by Harry Fisher are followed by an outline by Blair Tully of the Ontario government's focus on high technology and the projects of the Board of Industrial…

Close the Gate, Lock the Windows, Bolt the Doors: Securing Library Computers. Online Treasures

ERIC Educational Resources Information Center

Balas, Janet

2005-01-01

This article, written by a systems librarian at the Monroeville Public Library, discusses a major issue affecting all computer users, security. It indicates that while, staying up-to-date on the latest security issues has become essential for all computer users, it's more critical for network managers who are responsible for securing computer…

Decision Making Policies and Worker Influence in Employee Owned Firms.

ERIC Educational Resources Information Center

Hammer, Tove Helland

A study of a small employee-owned furniture company indicated that the three occupational groups agreed that management should have more influence in decisions affecting the future of the organization. On the other hand, issues which would directly affect employee welfare are seen as areas where control should be fairly evenly divided, with…

Climate analyses to assess risks from invasive forest insects: Simple matching to advanced models

Treesearch

Robert C. Venette

2017-01-01

Purpose of Review. The number of invasive alien insects that adversely affect trees and forests continues to increase as do associated ecological, economic, and sociological impacts. Prevention strategies remain the most cost-effective approach to address the issue, but risk management decisions, particularly those affecting international trade,...

77 FR 50085 - Rookery Bay, FL and Kachemak Bay, AK National Estuarine Research Reserve Management Plan Revisions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-20

... priority issues including climate change and harvested species, such as salmon and shellfish. The reserve... land use changes affecting freshwater inflow, loss of native biodiversity, lack of public awareness and... change events. Since the last management plan, the reserve has constructed additional exhibits and a...

Proceedings of the 17th biennial southern silvicultural research conference

Treesearch

A. Gordon Holley; Kristina F. Connor; James D. Haywood

2015-01-01

A range of issues affecting southern forests are addressed in 108 papers or extended abstracts. Papers are grouped in 13 sections that cover the topics of hardwood regeneration, best management practices for stream crossings, pine regeneration and genetics, fire effects, eco-physiology, forest nutrition, vegetation management, forest threats, biomass, biometrics,...

Directions in Postsecondary Vocational Education. Occasional Paper No. 125.

ERIC Educational Resources Information Center

Ellison, Nolen M.

The issues of postsecondary governance, management, and finances relate very strongly to the topic of direction for and trends in postsecondary vocational education. There are three major areas for the research agenda. The first two have to do with the national trends in external agencies that affect campus governance, management, and finance and…

The Influence of Management on the Cost of Fire Protection

ERIC Educational Resources Information Center

Donahue, Amy K.

2004-01-01

An important and unresolved issue central to the study of government performance is how the actions of managers and the nature of organizations affect the cost of public services. This paper presents an empirical analysis of fire departments that estimates the influence of managerial choices on per capita spending within a simultaneous public…

Ethics and risk management in administrative child and adolescent psychiatry.

PubMed

Sondheimer, Adrian

2010-01-01

This article examines ethics (the philosophic study of "doing the right thing") and risk management (the practice that seeks to manage the likelihood of "doing the wrong thing") and the relationship between them in the context of administrative child and adolescent psychiatry. Issues that affect child and adolescent psychiatrists who manage staff and business units and clinical practitioners who treat and manage individual patients are addressed. Malpractice, budgeting, credentialing, boundaries, assessment, documentation, treatment, research, dangerousness, and confidentiality are among the topics reviewed.

Genitourinary issues during spaceflight: a review.

PubMed

Jones, J A; Jennings, R; Pietryzk, R; Ciftcioglu, N; Stepaniak, P

2005-12-01

The genitourinary (GU) system is not uncommonly affected during previous spaceflights. GU issues that have been observed during spaceflight include urinary calculi, infections, retention, waste management, and reproductive. In-flight countermeasures for each of these issues are being developed to reduce the likelihood of adverse sequelae, due to GU issues during exploration-class spaceflight, to begin in 2018 with flights back to the Moon and on to Mars, according to the February 2004 Presendent's Vision for US Space Exploration. With implementation of a robust countermeasures program, GU issues should not have a significant threat for mission impact during future spaceflights.

Fine sediment in pools: An index of how sediment is affecting a stream channel

Treesearch

Tom Lisle; Sue Hilton

1991-01-01

One of the basic issues facing managers of fisheries watersheds is how inputs of sediment affect stream channels. In some cases we can measure and even roughly predict effects of land use on erosion and delivery of sediment from hillslopes to streams. But we are at a loss about how a given increase in sediment load will affect channel morphology, flow conditions, and...

Urban hydrology—Science capabilities of the U.S. Geological Survey

USGS Publications Warehouse

Bell, Joseph M.; Simonson, Amy E.; Fisher, Irene J.

2016-04-29

Urbanization affects streamflow characteristics, coastal flooding, and groundwater recharge. Increasing impervious areas, streamflow diversions, and groundwater pumpage are some of the ways that the natural water cycle is affected by urbanization. Assessment of the relations among these factors and changes in land use helps water-resource managers with issues such as stormwater management and vulnerability to flood and drought. Scientists with the U.S. Geological Survey (USGS) have the expertise to monitor and model urban hydrologic systems. Streamflow and groundwater data are available in national databases, and analyses of these data, including identification of long-term streamflow trends and the efficacy of management practices, are published in USGS reports.

The medical care of the neovagina of transgender women: a review.

PubMed

Cornelisse, Vincent J; Jones, Rosemary A; Fairley, Christopher K; Grover, Sonia R

2017-10-01

For transgender women, genital adjustment surgery involves removal of the natal reproductive organs and creation of a neovagina, vulva and clitoris. We conducted a review of the medical literature in order to summarise the issues that can affect the health of the neovagina in the long term, and to make recommendations on how to manage these issues.

From conception to delivery: managing the pregnant inflammatory bowel disease patient.

PubMed

Huang, Vivian W; Habal, Flavio M

2014-04-07

Inflammatory bowel disease (IBD) typically affects patients during their adolescent and young adult years. As these are the reproductive years, patients and physicians often have concerns regarding the interaction between IBD, medications and surgery used to treat IBD, and reproduction, pregnancy outcomes, and neonatal outcomes. Studies have shown a lack of knowledge among both patients and physicians regarding reproductive issues in IBD. As the literature is constantly expanding regarding these very issues, with this review, we provide a comprehensive, updated overview of the literature on the management of the IBD patient from conception to delivery, and provide action tips to help guide the clinician in the management of the IBD patient during pregnancy.

How do we Remain Us in a Time of Change: Culture and Knowledge Management at NASA

NASA Technical Reports Server (NTRS)

Linde, Charlotte

2003-01-01

This viewgraph representation presents an overview of findings of a NASA agency-wide Knowledge Management Team considering culture and knowledge management issues at the agency. Specific issues identified by the team include: (1) NASA must move from being a knowledge hoarding culture to a knowledge sharing culture; (2) NASA must move from being center focused to being Agency focused; (3) NASA must capture the knowledge of a departing workforce. Topics considered include: what must NASA know to remain NASA, what were previous forms of knowledge reproduction and how has technological innovations changed these systems, and what changes in funding and relationships between contractors and NASA affected knowledge reproduction.

Movement of people across the landscape: a blurring of distinctions between areas, interests, and issues affecting natural resource management

Treesearch

John F. Dwyer; Gina Childs

2004-01-01

The spread of development from cities into surrounding forests and farms continues to receive a great deal of attention from the media and resource managers in the US and other countries. However, suburban sprawl is just one of many interlinked components of the movement of people across the landscape that influence resource management. Substantial changes are taking...

Proceedings of the 2002 fire conference: managing fire and fuels in the remaining wildlands and open spaces of the Southwestern United States

Treesearch

Marcia G. Narog

2008-01-01

Many issues confront scientists, land managers, policymakers, and the public who deal with or are affected by management of fire and fuels across the southwestern United States (Utah, Colorado, Arizona, Nevada, New Mexico, and California). The 2002 Fire Conference was convened to tackle these concerns. It began with a plenary session addressing the central problems of...

Management of the assaultive adolescent.

PubMed

Marohn, R C

1992-06-01

Evaluation and treatment of the assaultive adolescent is an important but difficult process. From a psychodynamic perspective, the author reviews factors associated with adolescent violence, including alcohol and substance use, depression and suicidality, overstimulation, sociocultural and family ambience, property damage, threats of violence, and alexythymia. Management and treatment issues are surveyed, such as the necessity to recognize that in some adolescents violence erupts not from narcissitic rage but from strong wishes for affectionate contact. Violent adolescents have little awareness of an inner psychological world, cannot name affects or differentiate one from another, and often confuse thought, feeling, and deed. In psychodynamic treatment, adolescents are helped to experience affect as part of themselves and to develop the capacity to manage affect and use it as a basis for communication and self-understanding.

Volcanic Ash Soils: Sustainable Soil Management Practices, With Examples of Harvest Effects and Root Disease Trends

Treesearch

Mike Curran; Pat Green; Doug Maynard

2007-01-01

Sustainability protocols recognize forest soil disturbance as an important issue at national and international levels. At regional levels continual monitoring and testing of standards, practices, and effects are necessary for successful implementation of sustainable soil management. Volcanic ash-cap soils are affected by soil disturbance and changes to soil properties...

Predictive mapping of seabirds, pinnipeds and cetaceans off the Pacific Coast of Washington

USGS Publications Warehouse

Menza, Charles; Leirness, Jeffery B.; White, Tim; Winship, Arliss; Kinlan, Brian P.; Kracker, Laura; Zamon, Jeannette E.; Ballance, Lisa; Becker, Elizabeth; Forney, Karin A.; Barlow, Jay; Adams, Josh; Pereksta, David; Pearson, Scott; Pierce, John; Jeffries, Steven J.; Calambokidis, John; Douglas, Annie; Hanson, Bradford C.; Benson, Scott R.; Antrim, Liam

2016-01-01

This research supports the National Oceanic and Atmospheric Administration (NOAA) Coastal Zone Management Program, a voluntary partnership between the federal government and U.S. coastal and Great Lakes states and territories authorized by the Coastal Zone Management Act (CZMA) of 1972 to address national coastal issues. The act provides the basis for protecting, restoring, and responsibly developing our nation’s diverse coastal communities and resources. To meet the goals of the CZMA, the national program takes a comprehensive approach to coastal resource management – balancing the often competing and occasionally conflicting demands of coastal resource use, economic development, and conservation. A wide range of issues are addressed through the program, including coastal development, water quality, public access, habitat protection, energy facility siting, ocean governance and planning, coastal hazards, and climate change. Accurate maps of seabird and marine mammal distributions are an important tool for making informed management decisions that affect all of these issues. 

Wyoming Basin Rapid Ecoregional Assessment

USGS Publications Warehouse

Carr, Natasha B.; Melcher, Cynthia P.

2015-08-28

We evaluated Management Questions (Core and Integrated) for each species and community for the Wyoming Basin REA. Core Management Questions address primary management issues, including (1) where is the Conservation Element, and what are its key ecological attributes (characteristics of species and communities that may affect their long-term persistence or viability); (2) what and where are the Change Agents; and (3) how do the Change Agents affect the key ecological attributes? Integrated Management Questions synthesize the Core Management Questions as follows: (1) where are the areas with high landscape-level ecological values; (2) where are the areas with high landscape-level risks; and (3) where are the potential areas for conservation, restoration, and development? The associated maps and key findings for each Management Question are summarized for each Conservation Element in individual chapters. Additional chapters on landscape intactness and an REA synthesis are included.

Endangered species and nature conservation: science issues and challenges.

PubMed

Szaro, Robert C

2008-06-01

The issues and challenges facing us in ensuring the survival of as many species and ecosystems as possible call for a renewed research focus to address how to improve management strategies and policy making now and into the future. The key issues to be addressed by activities of the International Union of Forest Research Organization's (IUFRO) Task Force on Endangered Species and Nature Conservation include such issues as: (i) preventing species from being listed by maintaining species populations at sufficient levels that they do not require listing; (ii) recovering threatened and endangered species; (iii) developing management practices and strategies; (iv) balancing actions affecting suites of threatened or endangered species; (v) developing conservation strategies for species without definitive taxonomic treatments; (vi) dealing with global change; (vii) dealing with invasive species; and (viii) restoring critical habitats. © 2008 ISZS, Blackwell Publishing and IOZ/CAS.

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

PubMed

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

2015-04-01

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

Gynaecological issues affecting the obese adolescent.

PubMed

Wood, Paul L; Bauman, Dvora

2015-05-01

The implications of obesity in childhood and adolescence resonate into adulthood and have implications at different levels that include psychosocial and health issues that impact beyond reproductive performance. This chapter explores the various facets and consequences on gynaecological issues of increased Body Mass Index in childhood, including the link with puberty, pubertal menorrhagia (also affecting children with complex needs) and the all too common problems surrounding hyperandrogenism, insulin resistance and the polycystic ovarian syndrome in particular which need to be seen in the specific context of the adolescent years. The wider ramifications of obesity on the psychosocial welfare of adolescents merits special attention. Finally management strategies are considered in the context of the needs of adolescents. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Review on Malaysian Rail Transit Operation and Management System: Issues and Solution in Integration

NASA Astrophysics Data System (ADS)

Masirin, Mohd Idrus Mohd; Salin, Aminah Mohd; Zainorabidin, Adnan; Martin, David; Samsuddin, Norshakina

2017-08-01

In any context, operation and management of transportation systems are key issues which may affect both life quality and economic development. In large urban agglomerations, an efficient public transportation system may help abate the negative externalities of private car use such as congestion, air and noise pollution, accident and fuel consumption, without excessively penalizing user travel times or zone accessibility. Thus, this study is conducted to appraise the Malaysian rural rail transit operation and management system, which are considered important as there are many issues and solution in integration of the services that need to be tackled more conscientiously. The purpose of this paper is to describe some of the most important issues on integration of services and rail transit system in Malaysian and how to solve or reduce these problems and conflicts. In this paper, it consists of the historical development of rail transit construction in Malaysia. This paper also attempts to identify the important issues related to rail transit services and integration in Malaysian rural rail operation and management system. Comparison is also conducted with other countries such as UK, France, and Japan. Finally, a critical analysis is presented in this paper by looking at the possible application for future Malaysian rail transit operation system and management, especially focusing on enhancing the quality of Malaysian rural rail transit. In conclusion, this paper is expected to successfully review and appraise the existing Malaysian rural rail transit operation and management system pertaining to issues & solution in integration. It is also hoped that reformation or transformation of present service delivery quality of the rail transit operation and management will enable Malaysia to succeed in transforming Malaysian transportation system to greater heights.

Legal Aspects: Civilians/Contractors in the War Zone And Disaster Relief Support Joint Center for Operational Analysis Journal, Volume 10, Issue 2, June 2008

DTIC Science & Technology

2008-06-01

operations . The JSC, however, has analyzed the new legislation and their JCOA Journal, June 2008 13 recommendations for managing how these cases are...CBRNE) consequence management operations . 4 While the Department of Homeland Security’s (DHS) Federal Emergency Management Agency (FEMA) 5 is...affect the Department of Defense’s consequence management operations in support of a primary federal agency. Although the U.S. Constitution’s Supremacy

Major New Issues Currently Affecting Government Acquisition.

DTIC Science & Technology

1987-06-01

Acquisition Regulation (FAR) and the Competition in Contracting Act (CICA) of 1984, Thybony, Inc., 1985. 5. Brechtel, Donald L., Brost , Edward J. and...of Government Contracts, The George Washington Univer- sity, 1986. 3. White, Kevin L., Issues in Navy Management of Major Weapon Systems Warranties...L. Thesis, The National Law Center of George Washington University, Washington, D.C.. February 1982. 2. Federal Acquisition Regulation (FAR), 1984

Information Resources Management: Systems Communicating with Systems. A Session Especially Designed by Senior Managers for Senior Management Officials. Viewgraphs and Presentations. Intensive One-Day Symposium (Gaithersburg, Maryland, December 3, 1987).

ERIC Educational Resources Information Center

General Services Administration, Washington, DC.

Summaries of the welcoming and opening remarks for a symposium on the standards issues that will affect the federal government's planning, acquisition, and use of integrated computer and telecommunications systems over the next five years set the stage for the keynote address by Joseph Timko of IBM entitled "Standards--Perspectives and Evolution."…

Commentary on "Finance, Management, and Costs of Public and Private Schools in Indonesia" and "Do Local Contributions Affect the Efficiency of Public Primary Schools?"

ERIC Educational Resources Information Center

Berger, Mark C.

1996-01-01

Studies on Indonesia and the Philippines in this special issue examine how local financial control affects costs of providing primary schooling. In both countries, schools with greater financial decentralization operated more efficiently. These results have important implications for U.S. schools, where decentralization reforms in Kentucky and…

Sexual Health Issues in Men

Cancer.gov

Cancer treatments such as chemotherapy, radiation therapy and prostate surgery may affect a man’s sexual function, lower libido, and make it difficult to get an erection. Learn how to manage and treat these sexual problems, during cancer treatment.

Proceedings of the National Silviculture Workshop: Hardwood Management; Roanoke, Virginia; June 1-5, 1981

Treesearch

Robert Gillespie; Dan Cramsey; Dick Miller; Dennis Hamel; Carl Puuri; F. Bryan Clark; John Erickson; Nelson Loftus; Lloyd Casey; H. Clay Smith; Bob Marquis; Martin Dale; Charles E. McGee; Robert D. Williams; Gayne G. Erdmann; R. M. Godman; Stephen G. Boyce; Paul A. Schrauder; DonaId E. Beck; David A. Marquis; James L. McConnell; Paul S. Debald; David R. Houston; Walter Knapp; Tom Turpin; Warren Bacon; Arnold Schulz

1981-01-01

This year's National Silviculture Workshop was held in Roanoke, Virginia and the Monongahela National Forest. The purpose of the meetings were to discuss current silvicultural issues affecting all Regions and to review in detail the state-of-the-art application of hardwood management in the United States. These proceedings include the presentations of individuals...

Democratic and Republican physicians provide different care on politicized health issues.

PubMed

Hersh, Eitan D; Goldenberg, Matthew N

2016-10-18

Physicians frequently interact with patients about politically salient health issues, such as drug use, firearm safety, and sexual behavior. We investigate whether physicians' own political views affect their treatment decisions on these issues. We linked the records of over 20,000 primary care physicians in 29 US states to a voter registration database, obtaining the physicians' political party affiliations. We then surveyed a sample of Democratic and Republican primary care physicians. Respondents evaluated nine patient vignettes, three of which addressed especially politicized health issues (marijuana, abortion, and firearm storage). Physicians rated the seriousness of the issue presented in each vignette and their likelihood of engaging in specific management options. On the politicized health issues-and only on such issues-Democratic and Republican physicians differed substantially in their expressed concern and their recommended treatment plan. We control for physician demographics (like age, gender, and religiosity), patient population, and geography. Physician partisan bias can lead to unwarranted variation in patient care. Awareness of how a physician's political attitudes might affect patient care is important to physicians and patients alike.

Relationships of three species of bats impacted by white-nose syndrome to forest condition and management

USGS Publications Warehouse

Silvis, Alexander; Perry, Roger W.; Ford, W. Mark

2016-01-01

Forest management activities can have substantial effects on forest structure and community composition and response of wildlife therein. Bats can be highly influenced by these structural changes, and understanding how forest management affects day-roost and foraging ecology of bats is currently a paramount conservation issue. With populations of many cave-hibernating bat species in eastern North America declining as a result of white-nose syndrome (WNS), it is increasingly critical to understand relationships among bats and forest-management activities. Herein, we provide a comprehensive literature review and synthesis of: (1) responses of northern long-eared (Myotis septentrionalis) and tri-colored (Perimyotis subflavus) bats—two species affected by WNS that use forests during summer—to forest management, and (2) an update to a previous review on the ecology of the endangered Indiana bat (Myotis sodalis).

Information flow in the pharmaceutical supply chain.

PubMed

Yousefi, Nazila; Alibabaei, Ahmad

2015-01-01

Managing the supply chain plays an important role in creating competitive advantages for companies. Adequate information flow in supply chain is one of the most important issues in SCM. Therefore, using certain Information Systems can have a significant role in managing and integrating data and information within the supply chain. Pharmaceutical supply chain is more complex than many other supply chains, in the sense that it can affect social and political perspectives. On the other hand, managing the pharmaceutical supply chain is difficult because of its complexity and also government regulations in this field. Although, Iran has progressed a lot in pharmaceutical manufacturing, still there are many unsolved issues in managing the information flow in the pharmaceutical supply chain. In this study, we reviewed the benefits of using different levels of an integrated information system in the supply chain and the possible challenges ahead.

Critical role of ethics in clinical management and public health response to the West Africa Ebola epidemic.

PubMed

Folayan, Morenike O; Haire, Bridget G; Brown, Brandon

2016-01-01

The devastation caused by the Ebola virus disease (EVD) outbreak in West Africa has brought to the fore a number of important ethical debates about how best to respond to a health crisis. These debates include issues related to prevention and containment, management of the health care workforce, clinical care, and research design, all of which are situated within the overarching moral problem of severe transnational disadvantage, which has very real and specific impacts upon the ability of citizens of EVD-affected countries to respond to a disease outbreak. Ethical issues related to prevention and containment include the appropriateness and scope of quarantine and isolation within and outside affected countries. The possibility of infection in health care workers impelled consideration of whether there is an obligation to provide health services where personal protection equipment is inadequate, alongside the issue of whether the health care workforce should have special access to experimental treatment and care interventions under development. In clinical care, ethical issues include the standards of care owed to people who comply with quarantine and isolation restrictions. Ethical issues in research include appropriate study design related to experimental vaccines and treatment interventions, and the sharing of data and biospecimens between research groups. The compassionate use of experimental drugs intersects both with research ethics and clinical care. The role of developed countries also came under scrutiny, and we concluded that developed countries have an obligation to contribute to the containment of EVD infection by contributing to the strengthening of local health care systems and infrastructure in an effort to provide fair benefits to communities engaged in research, ensuring that affected countries have ready and affordable access to any therapeutic or preventative interventions developed, and supporting affected countries on their way to recovery from the impact of EVD on their social and economic lives.

Green reconstruction of the tsunami-affected areas in India using the integrated coastal zone management concept.

PubMed

Sonak, Sangeeta; Pangam, Prajwala; Giriyan, Asha

2008-10-01

A tsunami, triggered by a massive undersea earthquake off Sumatra in Indonesia, greatly devastated the lives, property and infrastructure of coastal communities in the coastal states of India, Andaman and Nicobar Islands, Indonesia, Sri Lanka, Malaysia and Thailand. This event attracted the attention of environmental managers at all levels, local, national, regional and global. It also shifted the focus from the impact of human activities on the environment to the impacts of natural hazards. Recovery/reconstruction of these areas is highly challenging. A clear understanding of the complex dynamics of the coast and the types of challenges faced by the several stakeholders of the coast is required. Issues such as sustainability, equity and community participation assume importance. The concept of ICZM (integrated coastal zone management) has been effectively used in most parts of the world. This concept emphasizes the holistic assessment of the coast and a multidisciplinary analysis using participatory processes. It integrates anthropocentric and eco-centric approaches. This paper documents several issues involved in the recovery of tsunami-affected areas and recommends the application of the ICZM concept to the reconstruction efforts.

Dimensions of Counselor Stress.

ERIC Educational Resources Information Center

Morris, Joan, Ed.

1981-01-01

The nine articles in this issue deal with different aspects of stress that affect school counselors. Discusses environmental and occupational causes of stress, stress management, and methods for dealing with counselor burnout. Emphasizes self-help measures and techniques for increasing counselor effectiveness. (JAC)

Strategies for individualizing management of patients with metastatic melanoma: a managed care perspective.

PubMed

Goldstein, Daniel A; Zeichner, Simon B

2015-09-01

The management of metastatic melanoma has been revolutionized in recent years with the development of both targeted therapy and immunotherapy. Although potentially extending the life expectancy for patients, these therapies also significantly increase the healthcare expenditure. In this paper, we review the monthly costs for drugs approved by the FDA since 2011. Additionally, factors that affect the cost, such as dosing strategies, biomarkers, combination therapies, and political/legislative issues, will be discussed.

Anatomic and physiopathologic changes affecting the airway of the elderly patient: implications for geriatric-focused airway management

PubMed Central

Johnson, Kathleen N; Botros, Daniel B; Groban, Leanne; Bryan, Yvon F

2015-01-01

There are many anatomical, physiopathological, and cognitive changes that occur in the elderly that affect different components of airway management: intubation, ventilation, oxygenation, and risk of aspiration. Anatomical changes occur in different areas of the airway from the oral cavity to the larynx. Common changes to the airway include tooth decay, oropharyngeal tumors, and significant decreases in neck range of motion. These changes may make intubation challenging by making it difficult to visualize the vocal cords and/or place the endotracheal tube. Also, some of these changes, including but not limited to, atrophy of the muscles around the lips and an edentulous mouth, affect bag mask ventilation due to a difficult face-mask seal. Physiopathologic changes may impact airway management as well. Common pulmonary issues in the elderly (eg, obstructive sleep apnea and COPD) increase the risk of an oxygen desaturation event, while gastrointestinal issues (eg, achalasia and gastroesophageal reflux disease) increase the risk of aspiration. Finally, cognitive changes (eg, dementia) not often seen as related to airway management may affect patient cooperation, especially if an awake intubation is required. Overall, degradation of the airway along with other physiopathologic and cognitive changes makes the elderly population more prone to complications related to airway management. When deciding which airway devices and techniques to use for intubation, the clinician should also consider the difficulty associated with ventilating the patient, the patient’s risk of oxygen desaturation, and/or aspiration. For patients who may be difficult to bag mask ventilate or who have a risk of aspiration, a specialized supralaryngeal device may be preferable over bag mask for ventilation. Patients with tumors or decreased neck range of motion may require a device with more finesse and maneuverability, such as a flexible fiberoptic broncho-scope. Overall, geriatric-focused airway management is necessary to decrease complications in this patient population. PMID:26673904

Women, work and health: issues and implications for worksite health promotion.

PubMed

Collins, B S; Hollander, R B; Koffman, D M; Reeve, R; Seidler, S

1997-01-01

This paper identifies issues related to worksite health promotion programs for women by examining ways that work factors, health behaviors, family roles and responsibilities, and women's health are linked. Work conditions may affect women uniquely, as in the case of chemical exposure affecting reproductive health; disproportionately, such as the interaction between work and family roles; or differently from men, as in women's experience of stress in the workplace. The focus is on the differences and uniqueness of working women's health. Drawing on a public health perspective, implications for consideration by worksite health promotion programs specialist, human resource managers, and researchers are presented.

Clinical ethics issues in HIV care in Canada: an institutional ethnographic study.

PubMed

Kaposy, Chris; Greenspan, Nicole R; Marshall, Zack; Allison, Jill; Marshall, Shelley; Kitson, Cynthia

2017-02-06

This is a study involving three HIV clinics in the Canadian provinces of Newfoundland and Labrador, and Manitoba. We sought to identify ethical issues involving health care providers and clinic clients in these settings, and to gain an understanding of how different ethical issues are managed by these groups. We used an institutional ethnographic method to investigate ethical issues in HIV clinics. Our researcher conducted in-depth semi-structured interviews, compiled participant observation notes, and studied health records in order to document ethical issues in the clinics, and to understand how health care providers and clinic clients manage and resolve these issues. We found that health care providers and clinic clients have developed work processes for managing ethical issues of various types: conflicts between client-autonomy and public health priorities ("treatment as prevention"), difficulties associated with the criminalization of nondisclosure of HIV positive status, challenges with non-adherence to HIV treatment, the protection of confidentiality, barriers to treatment access, and negative social determinants of health and well-being. Some ethical issues resulted from structural disadvantages experienced by clinic clients. The most striking findings in our study were the negative social determinants of health and well-being experienced by some clinic clients - such as experiences of violence and trauma, poverty, racism, colonization, homelessness, and other factors affecting well-being such as problematic substance use. These negative determinants were at the root of other ethical issues, and are themselves of ethical concern.

Using SCOR as a Supply Chain Management Framework for Government Agency Contract Requirements

NASA Technical Reports Server (NTRS)

Paxton, Joe

2010-01-01

Enterprise Supply Chain Management consists of: Specifying suppliers to support inter-program and inter-agency efforts. Optimizing inventory levels and locations throughout the supply chain. Executing corrective actions to improve quality and lead time issues throughout the supply chain. Processing reported data to calculate and make visible supply chain performance (provide information for decisions and actions). Ensuring the right hardware and information is provided at the right time and in the right place. Monitoring the industrial base while developing, producing, operating and retiring a system. Seeing performance deep in the supply chain that could indicate issues affecting system availability and readiness.

Bibliotherapy Revisited: Issues in Classroom Management. Developing Teachers' Awareness and Techniques to Help Children Cope Effectively with Stressful Situations

ERIC Educational Resources Information Center

Jackson, Marilyn N. Malloy

2006-01-01

Are teachers aware of the stress in their classrooms? Do teachers plan for stress control? Educators need to understand why stress is a part of classroom life and how it affects the teacher-student relationship. Bibliotherapy can be an intervention in stress management through books. The use of appropriate reading material to help solve emotional…

Traffic Incident Management in the Presence of Hazards

NASA Astrophysics Data System (ADS)

Wang, Z.; Zlatanova, S.; Steenbruggen, J.

2016-09-01

Traffic incidents can result in different kinds of hazards (e.g., plumes) that influence the status of road networks, therefore there is a great need for incident management in the presence of the hazards. When incidents occur, the created hazards not only affect the normal road users (make them detour or blocked), but also influence the movement of first responders. Traffic managers, who are responsible for maintaining the road safety and traffic stability, should carry out quick and effective measures to manage the incidents. In this paper, we present four issues to help people better understand the situations that could occur in the management of incidents with hazards: 1). Evacuation in the presence of hazards; 2). 3D incident management; 3). Navigation support for first responders; 4). Navigation support for road users. To address these issues, we propose a solution which combines agent technology, geo-database, hazard simulation, and traffic simulation. Further research would be needed to investigate the potentials of the proposed solution in real applications.

Ethical issues when using social media for health outside professional relationships.

PubMed

DeCamp, Matthew

2015-04-01

Social media have the potential to revolutionize health and healthcare, but fulfilling this potential requires attention to the ethical issues social media may raise. This article reviews the major ethical issues arising when social media are used for research, public health, mobile health applications, and global health. It focuses on social media use outside fiduciary relationships between healthcare professionals and patients. Emphasis is given to the potential of social media in these contexts, the ethical issues relatively unique to each, and where possible how existing ethical principles and frameworks could help navigate these issues. In some cases social media create the circumstance for particular ethical issues but also facilitate managing them, such as in informed consent for research. In other cases, disagreement exists about whether social media - despite their potential - should be used for certain purposes, such as in public health surveillance (where confidentiality represents a significant ethical concern). In still others, ethical uncertainty exists about how social media will affect ethical issues, such as inequality in global health. As social media technologies continue to develop, identifying and managing the ethical issues they raise will be critical to their success in improving health while preserving fundamental ethical values.

Position Paper: Dental General Practice Residency Programs: Financing and Operations.

ERIC Educational Resources Information Center

Hanson, Paul W.

1983-01-01

A discussion of changeable economic issues that can affect dental general practice residency program planning includes costs and resource allocation, maximizing efficiency and productivity, ambulatory and inpatient revenue sources, management functions, faculty as practitioners, faculty appointments, and marketing. (MSE)

Development of resource shed delineation in aquatic ecosystems

EPA Science Inventory

Environmental issues in aquatic ecosystems of high management priority involve spatially explicit phenomena that occur over vast areas. A "landscape" perspective is thus necessary, including an understanding of how ecological phenomena at a local scale are affected by physical fo...

Effect of poverty on eye health and implications for nursing practice.

PubMed

Williamson, Swapna; Seewoodhary, Ramesh; Dampies, Lavona

2016-08-10

Poverty is a global issue that affects the health and quality of life of millions of people. It predisposes people to many health conditions, including sight loss or blindness as a result of the immune system becoming compromised. Blindness is common in areas of the world where there is extreme poverty. In the UK, poverty has become a major social issue, contributing to many health problems, including eye conditions. These eye conditions can result in sight loss if they are not managed effectively. Psychosocial care is an essential aspect of patient care, because poverty and sight loss are interrelated. Healthcare practitioners have a significant role in the management and prevention of blindness. Blindness caused by poverty is largely preventable, and health promotion is an important strategy in care management.

Using Risk Assessment Methodologies to Meet Management Objectives

NASA Technical Reports Server (NTRS)

DeMott, D. L.

2015-01-01

Corporate and program objectives focus on desired performance and results. ?Management decisions that affect how to meet these objectives now involve a complex mix of: technology, safety issues, operations, process considerations, employee considerations, regulatory requirements, financial concerns and legal issues. ?Risk Assessments are a tool for decision makers to understand potential consequences and be in a position to reduce, mitigate or eliminate costly mistakes or catastrophic failures. Using a risk assessment methodology is only a starting point. ?A risk assessment program provides management with important input in the decision making process. ?A pro-active organization looks to the future to avoid problems, a reactive organization can be blindsided by risks that could have been avoided. ?You get out what you put in, how useful your program is will be up to the individual organization.

Mismanagement of Oil and Gas Resource Revenues in Africa: Lessons for Ghana’s Budding Oil and Gas Industry

DTIC Science & Technology

2013-06-13

insurgency in the Niger Delta region of Nigeria has direct linkages to the mismanagement of petroleum sector revenues in that country. The insurgency...International 2010, 2011 and 2012a). In the area of governance and public sector management, Nigeria has issues with corruption, which ultimately affects the...Federal Government of Nigeria embarked on a scheme to privatize sectors of petroleum management ostensibly to improve efficiency in the management of

In-home behavioral health case management: an integrated model for high-risk populations.

PubMed

Theis, Gerald A; Kozlowski, Deirdre; Behrens, Jenna

2006-01-01

The escalating health care costs attributed to high-risk populations have fueled a need for a proactive approach to deal with people affected by complex mental health issues that often coexist with chronic medical conditions. Through an in-home behavioral health case management (CM) program, patients with mental illnesses (some with coexisting medical conditions) receive integrated medical and mental health services through a disease-management approach that has proven effective in treating high-risk patients.

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

Environmental agreements, EIA follow-up and aboriginal participation in environmental management: The Canadian experience

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

O'Faircheallaigh, Ciaran

2007-05-15

During the last decade a number of environmental agreements (EAs) have been negotiated in Canada involving industry, government and Aboriginal peoples. This article draws on the Canadian experience to consider the potential of such negotiated agreements to address two issues widely recognised in academic and policy debates on environmental impact assessment (EIA) and environmental management. The first relates to the need to secure indigenous participation in environmental management of major projects that affect indigenous peoples. The second and broader issue involves the necessity for specific initiatives to ensure effective follow-up of EIA. The Canadian experience indicates that negotiated environmental agreementsmore » have considerable potential to address both issues. However, if this potential is to be realized, greater effort must be made to develop structures and processes specifically designed to encourage Aboriginal participation; and EAs must themselves provide the financial and other resource required to support EIA follow-up and Aboriginal participation.« less

Intelligent Decentralized Control In Large Distributed Computer Systems

DTIC Science & Technology

1988-04-01

decentralized. The goal is to find a way for the agents to coordinate their actions to maximize some index of system performance. (Our main...shown in Figure 4.13. The controller observes the environ- ment through sensors, and then may issue a command (i.e., take action ) to affect the...the Hypothesis Generator and the Belief Manager, and finally actions are issued by the Action Generator, the Experiment Generator, or the Reflex

Information flow in the pharmaceutical supply chain

PubMed Central

Yousefi, Nazila; Alibabaei, Ahmad

2015-01-01

Managing the supply chain plays an important role in creating competitive advantages for companies. Adequate information flow in supply chain is one of the most important issues in SCM. Therefore, using certain Information Systems can have a significant role in managing and integrating data and information within the supply chain. Pharmaceutical supply chain is more complex than many other supply chains, in the sense that it can affect social and political perspectives. On the other hand, managing the pharmaceutical supply chain is difficult because of its complexity and also government regulations in this field. Although, Iran has progressed a lot in pharmaceutical manufacturing, still there are many unsolved issues in managing the information flow in the pharmaceutical supply chain. In this study, we reviewed the benefits of using different levels of an integrated information system in the supply chain and the possible challenges ahead. PMID:26664401

50 CFR 530.3 - Typical classes of action.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Federal agency; and (b) Research contracts relating to policy issues, biological-ecological data needed to make sound management decisions, and better methods for collecting and analyzing data. These activities are not, by themselves, major Federal actions significantly affecting the quality of the human...

Framework for measuring sustainable development in catchment systems.

PubMed

Walmsley, Jay J

2002-02-01

Integrated catchment management represents an approach to managing the resources of a catchment by integrating environmental, economic, and social issues. It is aimed at deriving sustainable benefits for future generations, while protecting natural resources, particularly water, and minimizing possible adverse social, economic, and environmental consequences. Indicators of sustainable development, which summarize information for use in decision-making, are invaluable when trying to assess the diverse, interacting components of catchment processes and resource management actions. The Driving-Forces--Pressure--State--Impact--Response (DPSIR) indicator framework is useful for identifying and developing indicators of sustainable development for catchment management. Driving forces have been identified as the natural conditions occurring in a catchment and the level of development and economic activity. Pressures include the natural and anthropogenic supply of water, water demand, and water pollution. State indicators can be split into those of quantity and those of quality. Impacts include those that affect the ecosystems directly and those that impact the use value of the resource. It core indicators are identified within each of the categories given in the framework, most major catchment-based management issues can be evaluated. This framework is applied to identify key issues in catchment management in South Africa, and develop a set of indicators for evaluating catchments throughout the country.

Toward fisheries sustainability in North America: Issues, challenges, and strategies for action

USGS Publications Warehouse

MacDonald, D.D.; Knudsen, E.E.

2004-01-01

Many fisheries in North America are severely depleted and trending downwards. In an effort to find ways of reversing this disturbing situation, the American Fisheries Society and the Sustainable Fisheries Foundation invited leading experts in fisheries science and aquatic resource management to share their thoughts and insights in this book. These experts were asked to identify the factors that are currently impairing our ability to effectively manage fisheries resources and propose creative solutions for addressing the most challenging issues affecting fisheries sustainability. Based on the information that was provided by the experts (i.e., as presented in the earlier chapters of this book), it is apparent that a wide range of human activities are adversely affecting our shared fisheries resources and the aquatic habitats upon which they depend. The most challenging problems stem from causes that are largely beyond the scope of traditional fisheries management (e.g., human population growth, resource consumption patterns, global climate change, broad land-use patterns). It is also apparent that resolution of these challenges will require a new approach to fisheries management - one that effectively integrates economic, social, and environmental interests into a decision-making framework that supports fisheries sustainability. The key strategies for supporting such a transition toward a more holistic and comprehensive approach to managing the human activities that influence fisheries and aquatic resources are summarized in this chapter. ?? 2004 by the American Fisheries Society.

Understanding the local socio-political processes affecting conservation management outcomes in Corbett Tiger Reserve, India.

PubMed

Rastogi, Archi; Hickey, Gordon M; Badola, Ruchi; Hussain, Syed Ainul

2014-05-01

Several measures have been recommended to guarantee a sustainable population of tigers: sufficient inviolate spaces for a viable population, sufficient prey populations, trained and skilled manpower to guard against poaching and intrusion, banning trade in tiger products to reduce poaching, and importantly, the political will to precipitate these recommendations into implementation. Of these, the creation of sufficient inviolate spaces (generally in the form of protected areas) has created the most issues with local resource-dependent communities, often resulting in significant challenges for tiger conservation policy and management. Very little empirical research has, however, been done to understand and contextualize the local-level socio-political interactions that may influence the efficacy of tiger conservation in India. In this paper, we present the results of exploratory research into the ways in which local-stakeholder groups affect the management of Corbett Tiger Reserve (CTR). Using a combined grounded theory-case study research design, and the Institutional Analysis and Development framework for analysis, we identify the socio-political processes through which local-stakeholder groups are able to articulate their issues and elicit desirable actions from the management of CTR. Increasing our awareness of these processes can help inform the design and implementation of more effective tiger conservation management and policy strategies that have the potential to create more supportive coalitions of tiger conservation stakeholders at the local level.

Understanding the Local Socio-political Processes Affecting Conservation Management Outcomes in Corbett Tiger Reserve, India

NASA Astrophysics Data System (ADS)

Rastogi, Archi; Hickey, Gordon M.; Badola, Ruchi; Hussain, Syed Ainul

2014-05-01

Several measures have been recommended to guarantee a sustainable population of tigers: sufficient inviolate spaces for a viable population, sufficient prey populations, trained and skilled manpower to guard against poaching and intrusion, banning trade in tiger products to reduce poaching, and importantly, the political will to precipitate these recommendations into implementation. Of these, the creation of sufficient inviolate spaces (generally in the form of protected areas) has created the most issues with local resource-dependent communities, often resulting in significant challenges for tiger conservation policy and management. Very little empirical research has, however, been done to understand and contextualize the local-level socio-political interactions that may influence the efficacy of tiger conservation in India. In this paper, we present the results of exploratory research into the ways in which local-stakeholder groups affect the management of Corbett Tiger Reserve (CTR). Using a combined grounded theory-case study research design, and the Institutional Analysis and Development framework for analysis, we identify the socio-political processes through which local-stakeholder groups are able to articulate their issues and elicit desirable actions from the management of CTR. Increasing our awareness of these processes can help inform the design and implementation of more effective tiger conservation management and policy strategies that have the potential to create more supportive coalitions of tiger conservation stakeholders at the local level.

Improved Management of Water and Natural Resources Requires Open, Cognizant, Adaptive Science and Policy

NASA Astrophysics Data System (ADS)

Glynn, P. D.; Voinov, A. A.; Shapiro, C. D.; Jenni, K. E.

2017-12-01

Water issues impact the availability and use of other natural resources as well as environmental conditions. In an increasingly populated hyper-connected world, water issues are increasingly "wicked problems": complex problems with high uncertainties and no independent observers. Water is essential to life, and life affects water quality and availability. Scientists, managers, decision-makers, and the greater public all have a stake in improving the management of water resources. In turn, they are part of the systems that they are studying, deciding on, affecting, or trying to improve. Governance of water issues requires greater accessibility, traceability, and accountability (ATA) in science and policy. Water-related studies and decision-making need transdisciplinary science, inclusive participatory processes, and consideration and acceptance of multiple perspectives. Biases, Beliefs, Heuristics, and Values (BBHV) shape much of our perceptions and knowledge, and inevitably, affect both science and policy. Understanding the role of BBHV is critical to (1) understanding individual and group judgments and choices, (2) recognizing potential differences between societal "wants" and societal "needs", and (3) identifying "winners" and "losers" of policy decisions. Societal acceptance of proposed policies and actions can be fostered by enhancing participatory processes and by providing greater ATA in science, in policy, and in development of the laws, rules, and traditions that constrain decision-making. An adaptive science-infused governance framework is proposed that seeks greater cognizance of the role of BBHV in shaping science and policy choices and decisions, and that also seeks "Open Traceable Accountable Policy" to complement "Open Science". We discuss the limitations of the governance that we suggest, as well as tools and approaches to help implementation.

HIV/AIDS issues in the workplace of nurses.

PubMed

Minnaar, A

2005-08-01

HIV/AIDS is a global problem with an estimated 40 million infected people. In less than two years, this figure will leap to 100 million according to the World Health Organisation (WHO). By 2005, 65 million people will be infected. Half of the number of people in this group will be under 25 years old, and will die before they reach the age of 35. In a South African study done by the Human Science Research Council and published in 2003, regarding the impact of HIV/AIDS on the health sector, the findings were that 15% of health workers in public and private hospitals tested positive for HIV antibodies. Together with these facts above it was found that 46.2 percent of patients served in medical and paediatric wards tested positive for HIV. These factors have major implication for staffing in the future and the role of the nurse manager in South Africa. To explore the management of HIV/AIDS in the workplace of nurses in selected health services in KwaZulu-Natal. This research was part of a greater study on the exploration of the presence of caring as part of nursing management. THE METHODOLOGY: The qualitative research approach was used with a phenomenological design, which ensured that the richness and the complexities are reflected in the study. The data was collected by means of an open-ended question to nurse managers during an interview. The first question posed was; How do you or your services care for nurses in this hospital? Secondly nurse managers were asked, To explain their role in caring for HIV/AIDS positive nurses on their staff establishment. A qualitative analysis of the interviews with nurse managers indicated that they rate HIV/AIDS issues as an important part of their management task. Four main themes were identified, namely HIV/AIDS, counselling, dying of AIDS and funerals. Rich descriptions of these themes are given in this paper. Nurse managers in the health services are managing HIV/AIDS affected nurses, but are doing so without any formal policy on HIV/AIDS in the workplace. It is recommended that nurse managers deal with HIV/AIDS issues in the workplace by raising HIV/AIDS awareness regarding HIV/AIDS issues and HIV/AIDS in the workplace. Nurse managers saw their role regarding nurses with HIV/AIDS mainly as supportive--being involved in family problems and counselling and guiding nurses that live with HIV/AIDS. The health services in KwaZulu-Natal, and especially nurses, are currently affected by HIV/AIDS in a significant way.

Understanding food security issues in remote Western Australian Indigenous communities.

PubMed

Pollard, Christina M; Nyaradi, Anett; Lester, Matthew; Sauer, Kay

2014-08-01

Food insecurity in remote Western Australian (WA) Indigenous communities. This study explored remote community store managers' views on issues related to improving food security in order to inform health policy. A census of all remote WA Indigenous community store managers was conducted in 2010. Telephone interviews sought managers' perceptions of community food insecurity, problems with their store, and potential policy options for improving the supply, accessibility, affordability and consumption of nutritious foods. Descriptive analyses were conducted using SPSS for Windows version 17.0. Managers stated that freight costs and irregular deliveries contributed to high prices and a limited range of foods. Poor store infrastructure, compromised cold chain logistics, and commonly occurring power outages affected food quality. Half of the managers said there was hunger in their community because people did not have enough money to buy food. The role of nutritionists beyond a clinical and educational role was not understood. Food security interventions in remote communities need to take into consideration issues such as freight costs, transport and low demand for nutritious foods. Store managers provide important local knowledge regarding the development and implementation of food security interventions. SO WHAT? Agencies acting to address the issue of food insecurity in remote WA Indigenous communities should heed the advice of community store managers that high food prices, poor quality and limited availability are mainly due to transport inefficiencies and freight costs. Improving healthy food affordability in communities where high unemployment and low household income abound is fundamental to improving food security, yet presents a significant challenge.

A Map for Clinical Laboratories Management Indicators in the Intelligent Dashboard.

PubMed

Azadmanjir, Zahra; Torabi, Mashallah; Safdari, Reza; Bayat, Maryam; Golmahi, Fatemeh

2015-08-01

management challenges of clinical laboratories are more complicated for educational hospital clinical laboratories. Managers can use tools of business intelligence (BI), such as information dashboards that provide the possibility of intelligent decision-making and problem solving about increasing income, reducing spending, utilization management and even improving quality. Critical phase of dashboard design is setting indicators and modeling causal relations between them. The paper describes the process of creating a map for laboratory dashboard. the study is one part of an action research that begins from 2012 by innovation initiative for implementing laboratory intelligent dashboard. Laboratories management problems were determined in educational hospitals by the brainstorming sessions. Then, with regard to the problems key performance indicators (KPIs) specified. the map of indicators designed in form of three layered. They have a causal relationship so that issues measured in the subsequent layers affect issues measured in the prime layers. the proposed indicator map can be the base of performance monitoring. However, these indicators can be modified to improve during iterations of dashboard designing process.

Crohn's disease in adolescence: presentation and treatment.

PubMed

Cullen, Mick; Barnes, Claire

2015-05-13

Crohn's disease is a chronic inflammatory bowel condition that affects more than 115,000 people in the UK. This article focuses on Crohn's disease in adolescents. Management of the condition in this group should address adolescent-specific characteristics and treatment goals. Key elements include optimising growth, pubertal development and social functioning, including education. The condition can affect an individual's mental and emotional wellbeing significantly, as well as their physical health. As adolescence is a time of great change, the additional burden of a chronic illness can prove difficult to manage. The authors provide information on the presentation of Crohn's disease in adolescence and insights into the particular issues encountered by this group.

Lessons learned and their application to program development and cultural issues

NASA Technical Reports Server (NTRS)

Roth, Gilbert L.

1991-01-01

The main objectives of space product assurance are, in effect, the same as those of Total Quality Management (TQM) or its many variants. The most significant ingredients are the lessons learned and their application to ongoing and future programs as they are affected by changes in the cultural environment. The cultural issues which affect almost everything done in technical programs and projects are considered. Understanding the lessons learned and the synergism which results from this combination of knowledge, culture, and lessons learned is identified as crucial. A brief discussion of the closed loop linkage that should exist between the world of hands on activities and that of educational institutions is presented.

Cultural Diversity in the Workplace: Managing a Multicultural Work Force.

ERIC Educational Resources Information Center

Martin, Larry G.; Ross-Gordon, Jovita M.

1990-01-01

The influx of minorities into the workplace requires attention to their participation in workplace training, to race relations and organizational culture, and to potential communication difficulties. Human resource professionals must address cultural diversity issues as they affect the attainment of organizational goals. (SK)

Research Administration: Lessons Learned.

ERIC Educational Resources Information Center

Dummer, George H.

1995-01-01

The ways in which accountability issues have affected federal-university relationships, particularly in the area of academic research, are examined. Lessons university administrators have learned since issuance of Office of Management and Budget Circular A-21 in 1958, Congressional hearings on the operations of the National Institutes of Health…

Disclosure of psychosocial stressors affecting diabetes care among uninsured young adults with Type 1 diabetes.

PubMed

Pyatak, E A; Sequeira, P; Peters, A L; Montoya, L; Weigensberg, M J

2013-09-01

To determine the disclosure rates of psychosocial issues affecting routine diabetes care. A total of 20 young adults were interviewed regarding the impact of psychosocial stressors on their diabetes care. The interviewer, endocrinologist and case manager reported the prevalence rates of psychosocial stressors. Disclosure rates were compared to determine the prevalence of psychosocial issues and the different patterns of disclosure. Participants reported a high number of psychosocial stressors, which were associated with poorer glycaemic control (r = 0.60, P = 0.005). Approximately half of all disclosed stressors (50.9%) were identified in routine care; other stressors were identified only through intensive case management and/or in-depth interviews. Identifying psychosocial stressors in routine care, and providing referrals to psychological or social services, is a significant unmet need and may improve glycaemic control among certain populations with diabetes. Systematic mechanisms of capturing this information, such as by screening surveys, should be considered. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

Joint NOAA/NWS/USGS prototype debris flow warning system for recently burned areas in Southern California

USGS Publications Warehouse

Restrepo, P.; Jorgensen, D.P.; Cannon, S.H.; Costa, J.; Laber, J.; Major, J.; Martner, B.; Purpura, J.; Werner, K.

2008-01-01

Debris flows, also known as mudslides, are composed gravity-driven mixtures of sediment and water that travel through steep channels, over open hillslopes, and the like. Addressing this issue, US Geological Survey (USGS) and NOAA have established a debris-flow warning system that has the ability to monitor and forecast precipitation and issue timely weather hazard warning. In 2005, this joint NOAA-USGS prototype debris-flow warning system was issued in Southern California and as a result, it has provided valuable information to emergency managers in affected communities.

Staying in the Hood: Black Lesbian and Transgender Women and Identity Management in North Philadelphia.

PubMed

Brooks, Siobhan

2016-12-01

The concept Don't Ask, Don't Tell regarding Black LGBT sexuality in Black communities has been an acceptable form of identity management for Black LGBT people. In other words, Black LGBT people are accepted as long as they are not vocal about their sexuality. However, this is changing with the issue of gay marriage, which is creating a space where Black LGBT people are more open about their gender identity and sexuality in heterosexual Black spaces. This new form of openness allows Black LGBT people to "stay in" their communities, as opposed to coming out. In this article I examine how Black LGBT women in North Philadelphia stay in their communities: being politically active regarding LGBT issues, disengaging from LGBT issues, passing, and educating straight Black people about issues affecting the Black LGBT community. I conclude with implications of staying in and intersectionality among Black heterosexual and LGBT women fighting for social change.

Democratic and Republican physicians provide different care on politicized health issues

PubMed Central

Hersh, Eitan D.; Goldenberg, Matthew N.

2016-01-01

Physicians frequently interact with patients about politically salient health issues, such as drug use, firearm safety, and sexual behavior. We investigate whether physicians’ own political views affect their treatment decisions on these issues. We linked the records of over 20,000 primary care physicians in 29 US states to a voter registration database, obtaining the physicians’ political party affiliations. We then surveyed a sample of Democratic and Republican primary care physicians. Respondents evaluated nine patient vignettes, three of which addressed especially politicized health issues (marijuana, abortion, and firearm storage). Physicians rated the seriousness of the issue presented in each vignette and their likelihood of engaging in specific management options. On the politicized health issues—and only on such issues—Democratic and Republican physicians differed substantially in their expressed concern and their recommended treatment plan. We control for physician demographics (like age, gender, and religiosity), patient population, and geography. Physician partisan bias can lead to unwarranted variation in patient care. Awareness of how a physician’s political attitudes might affect patient care is important to physicians and patients alike. PMID:27698126

Innovative solutions for intractable water problems in the face of climate change in southern and East African sub regions

NASA Astrophysics Data System (ADS)

Mapani, Benjamin; Makurira, Hodson; Magole, Lapologang; Meck, Maideyi; Mkandawire, Theresa; Mul, Marloes; Ngongondo, Cosmo

2018-06-01

This issue has a total of thirty-two (32) papers; and covers the IWRM sub themes of Hydrology, Land and People, Water Resources Management, Water and Environment and Wastewater and Sanitation. Water issues have become more and more complex as the supply side is affected by issues of quantity, availability and vulnerability due to natural factors such as climate change and urbanization. These challenges call for new management strategies and governance styles. Access to clean freshwater is a basic requirement for enhanced quality of life and development by all. However, this access has three main components that must be met adequately as this issue illustrates. These components are firstly, the quantity of water available; secondly, the quality and thirdly supply and appropriate delivery of this precious resource to domestic, commercial and industrial users. The demand side has also become more challenging, especially in urban areas as more and more people move from the rural areas to the cities. It has become a daily challenge in many African cities to supply water to these new urban dwellers and more so in unplanned settlements. These issues require a way and manner of delivering solutions and new innovative ideas. The topics in this issue vary from climate variability and how we are to improve our management strategies to mitigation, through to vulnerability of water resources and how to strengthen governance issues that plague some institutions in our region.

Impact of age on cardiovascular risk: implications for cardiovascular disease management.

PubMed

Tuomilehto, Jaakko

2004-05-01

Cardiovascular disease (CVD) represents a major global healthcare problem. The prevalence of this condition increases with age. As many countries around the world are experiencing an increase in the proportion of elderly people in the population, this raises serious issues for cardiac and cerebrovascular disease prevention and management. A wealth of data has established smoking, dyslipidemia, hypertension and type 2 diabetes as major risk factors for cardiac and cerebrovascular events. This article reviews the evidence that links these metabolic risk factors with an increased risk of complications, and assesses the data concerning how risk changes with age. This review also focuses on how these conditions can be optimally managed and whether treatment outcomes are affected by age. The current status of research is assessed and issues which remain to be resolved are highlighted.

Issues in Delivering Morbidity Management for Lymphatic Filariasis Elimination: A Study in Pondicherry, South India

PubMed Central

Kumari, A. Krishna; J, Yuvaraj; Das, L. K

2012-01-01

Lymphatic filariasis is a vector borne parasitic disease causing long term disability. The Global Programme to Eliminate Lymphatic Filariasis aims to achieve its objective through two strategies; Mass Drug Administration (MDA) to interrupt transmission and Morbidity Management (MM) to manage disability for those already affected. MDA is going on in full swing in endemic areas; but MM is lagging behind. An exploratory study was conducted in Pondicherry through focus group discussions to find out whether there are delivery issues if any, in the MM programme and get suggestions from end users. The study results show that MM has not received the same attention as MDA and there are shortcomings in the delivery mechanism of the programme. The importance of these findings are discussed and suggestions given for improving the programme. PMID:22654597

Synthesis and review: Tackling the nitrogen management challenge: from global to local scales

NASA Astrophysics Data System (ADS)

Reis, Stefan; Bekunda, Mateete; Howard, Clare M.; Karanja, Nancy; Winiwarter, Wilfried; Yan, Xiaoyuan; Bleeker, Albert; Sutton, Mark A.

2016-12-01

One of the ‘grand challenges’ of this age is the anthropogenic impact exerted on the nitrogen cycle. Issues of concern range from an excess of fixed nitrogen resulting in environmental pressures for some regions, while for other regions insufficient fixed nitrogen affects food security and may lead to health risks. To address these issues, nitrogen needs to be managed in an integrated fashion, at a variety of scales (from global to local). Such management has to be based on a thorough understanding of the sources of reactive nitrogen released into the environment, its deposition and effects. This requires a comprehensive assessment of the key drivers of changes in the nitrogen cycle both spatially, at the field, regional and global scale and over time. In this focus issue, we address the challenges of managing reactive nitrogen in the context of food production and its impacts on human and ecosystem health. In addition, we discuss the scope for and design of management approaches in regions with too much and too little nitrogen. This focus issue includes several contributions from authors who participated at the N2013 conference in Kampala in November 2013, where delegates compiled and agreed upon the ‘Kampala Statement-for-Action on Reactive Nitrogen in Africa and Globally’. These contributions further underline scientifically the claims of the ‘Kampala Statement’, that simultaneously reducing pollution and increasing nitrogen available in the food system, by improved nitrogen management offers win-wins for environment, health and food security in both developing and developed economies. The specific messages conveyed in the Kampala Statement focus on improving nitrogen management (I), including the reduction of nitrogen losses from agriculture, industry, transport and energy sectors, as well as improving waste treatment and informing individuals and institutions (II). Highlighting the need for innovation and increased awareness among stakeholders (III) and the identification of policy and technology solutions to tackle global nitrogen management issues (IV), this will enable countries to fulfil their regional and global commitments.

A bottom up approach for engineering catchments through sustainable runoff management

NASA Astrophysics Data System (ADS)

Wilkinson, M.; Quinn, P. F.; Jonczyk, J.; Burke, S.

2010-12-01

There is no doubt that our catchments are under great stress. There have been many accounts around the world of severe flood events and water quality issues within channels. As a result of these, ecological habitats in rivers are also under pressure. Within the United Kingdom, all these issues have been identified as key target areas for policy. Traditionally this has been managed by a policy driven top down approach which is usually ineffective. A one ‘size fits all’ attitude often does not work. This paper presents a case study in northern England whereby a bottom up approach is applied to multipurpose managing of catchments at the source (in the order of 1-10km2). This includes simultaneous tackling of water quality, flooding and ecological issues by creating sustainable runoff management solutions such as storage ponds, wetlands, beaver dams and willow riparian features. In order to identify the prevailing issues in a specific catchment, full and transparent stakeholder engagement is essential, with everybody who has a vested interest in the catchment being involved from the beginning. These problems can then be dealt with through the use of a novel catchment management toolkit, which is transferable to similar scale catchments. However, evidence collected on the ground also allows for upscaling of the toolkit. The process gathers the scientific evidence about the effectiveness of existing or new measures, which can really change the catchment functions. Still, we need to get better at communicating the science to policy makers and policy therefore must facilitate a bottom up approach to land and water management. We show a test site for this approach in the Belford burn catchment (6km2), northern England. This catchment has problems with flooding and water quality. Increased sediment loads are affecting the nearby estuary which is an important ecological zone and numerous floods have affected the local village. A catchment engineering toolkit has been developed that puts in place novel measures to tackle diffuse pollution and reduce flood risk whilst collecting the science needed to influence the policy about these measures. This has been possible through four key practices: full stakeholder engagement, a problem solving agenda set in place, a bottom up approach to solving problems, and the collection of the appropriate science to support the benefits. Hands on, multi-objective work is the most cost effective way to manage catchments. Tackling water quality issues and controlling fast pathway runoff at the source in partnership with farmers and local landowners has proved to be the key to success. Tackling issues in sub-catchments can lead to solving problems at the catchment scale.

Urban sprawl and you: how sprawl adversely affects worker health.

PubMed

Pohanka, Mary; Fitzgerald, Sheila

2004-06-01

Urban sprawl, once thought of as just an environmental issue, is currently gaining momentum as an emerging public health issue worthy of research and political attention. Characteristics seen in sprawling communities include increasing traffic volumes; inadequate public transportation; pedestrian unfriendly streets; and the division of businesses, shops, and homes. These characteristics can affect health in many ways. Greater air pollution contributes to higher asthma and other lung disorder rates. An increased dependence on the automobile encourages a more sedentary lifestyle and can potentially contribute to obesity. The increased danger and stress of long commutes can lead to more accidents, anxiety, and social isolation. Occupational health nurses can become involved by promoting physical activity in the workplace, creating programs for injury prevention and stress management, becoming involved in political smart growth measures, and educating and encouraging colleagues to become active in addressing this issue.

Guidelines of care for the management of acne vulgaris.

PubMed

Zaenglein, Andrea L; Pathy, Arun L; Schlosser, Bethanee J; Alikhan, Ali; Baldwin, Hilary E; Berson, Diane S; Bowe, Whitney P; Graber, Emmy M; Harper, Julie C; Kang, Sewon; Keri, Jonette E; Leyden, James J; Reynolds, Rachel V; Silverberg, Nanette B; Stein Gold, Linda F; Tollefson, Megha M; Weiss, Jonathan S; Dolan, Nancy C; Sagan, Andrew A; Stern, Mackenzie; Boyer, Kevin M; Bhushan, Reva

2016-05-01

Acne is one of the most common disorders treated by dermatologists and other health care providers. While it most often affects adolescents, it is not uncommon in adults and can also be seen in children. This evidence-based guideline addresses important clinical questions that arise in its management. Issues from grading of acne to the topical and systemic management of the disease are reviewed. Suggestions on use are provided based on available evidence. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

The Relationships between Human Fatigue and Public Health: A Brief Commentary on Selected Papers from the 9th International Conference on Managing Fatigue in Transportation, Resources and Health.

PubMed

Sargent, Charli; Roberts, Paul; Dawson, Drew; Ferguson, Sally; Meuleners, Lynn; Brook, Libby; Roach, Gregory D

2016-08-24

The 9th International Conference on Managing Fatigue in Transportation, Resources and Health was held in Fremantle, Western Australia in March 2015. The purpose of the conferences in this series is to provide a forum for industry representatives, regulators, and scientists to discuss recent advances in the field of fatigue research. We have produced a Special Issue of the International Journal of Environmental Research and Public Health based on papers from the conference that were focused on various aspects of public health. First, the Special Issue highlights the fact that working long shifts and/or night shifts can affect not only cognitive functioning, but also physical health. In particular, three papers examined the potential relationships between shiftwork and different aspects of health, including the cardiovascular system, sleep disordered breathing, and eating behaviour. Second, the Special Issue highlights the move away from controlling fatigue through prescriptive hours of service rules and toward the application of risk management principles. In particular, three papers indicated that best-practice fatigue risk management systems should contain multiple redundant layers of defense against fatigue-related errors and accidents.

Problems with provision: barriers to drinking water quality and public health in rural Tasmania, Australia.

PubMed

Whelan, Jessica J; Willis, Karen

2007-01-01

Access to safe drinking water is essential to human life and wellbeing, and is a key public health issue. However, many communities in rural and regional parts of Australia are unable to access drinking water that meets national standards for protecting human health. The aim of this research was to identify the key issues in and barriers to the provision and management of safe drinking water in rural Tasmania, Australia. Semi-structured interviews were conducted with key local government employees and public health officials responsible for management of drinking water in rural Tasmania. Participants were asked about their core public health duties, regulatory responsibilities, perceptions and management of risk, as well as the key barriers that may be affecting the provision of safe drinking water. This research highlights the effect of rural locality on management and safety of fresh water in protecting public health. The key issues contributing to problems with drinking water provision and quality identified by participants included: poor and inadequate water supply infrastructure; lack of resources and staffing; inadequate catchment monitoring; and the effect of competing land uses, such as forestry, on water supply quality. This research raises issues of inequity in the provision of safe drinking water in rural communities. It highlights not only the increasing need for greater funding by state and commonwealth government for basic services such as drinking water, but also the importance of an holistic and integrated approach to managing drinking water resources in rural Tasmania.

Worldwide Emerging Environmental Issues Affecting the U.S. Military. Summarizing Environmental Security Monthly Scanning January 2008 - June 2008

DTIC Science & Technology

2008-06-01

yearly, billion $, various years, 2003–2007) Protecting the Environment Due to Its Inherent Moral Value Plant and animal species are being...a liability and redress regime concerning potential damage caused by the movements of GMOs , which will be further discussed in October 2010 at the...risk management issues of GMOs . UNESCO‘s Man and the Biosphere network is expanding, comprising now 529 sites in 105 countries. The UN notes that

Therapy with Law Enforcement Couples: Clinical Management of the "High-Risk Lifestyle."

ERIC Educational Resources Information Center

Borum, Randy; Philpot, Carol

1993-01-01

Reviews three primary ways in which law enforcement can affect relationships (organizational influences, peer/socialization influences, and police role influences). Identifies some common difficulties encountered by law enforcement couples and provides some basic goals and strategies for engaging them in treatment and addressing these issues in…

Proceedings of the 13th Biennial Southern Silvicultural Research Conference

Treesearch

Kristina F. Connor; [Editor

2006-01-01

A range of issues affecting southern forests are addressed in 109 papers and 39 poster summaries. Papers are grouped in 14 sessions that include wildlife ecology; pine silviculture; longleaf pine; nutritional amendments; vegetation management; site preparation; hardwoods: artificial regeneration; hardwoods: midstory competition control; growth and yield; water quality...

Proceedings of the 12th biennial southern silvicultural research conference

Treesearch

Kristina F. Connor; [Editor

2004-01-01

Ninety-two papers and thirty-six poster summaries address a range of issues affecting southern forests. Papers are grouped in 15 sessions that include wildlife ecology; fire ecology; natural pine management; forest health; growth and yield; upland hardwoods - natural regeneration; hardwood intermediate treatments; longleaf pine; pine plantation silviculture; site...

Financial Reporting by Selected Defense Agencies of Government Property in the Custody of Contractors.

DTIC Science & Technology

1997-12-16

The Inspector General, DoD, has issued several reports regarding the inadequacy of financial reporting for Government property in the custody of...We also assessed management controls affecting the financial reporting of Government property, and we assessed compliance with applicable laws and regulations.

Planning and the School Business Office.

ERIC Educational Resources Information Center

Johnston, A. P.; Hood, Kenneth

This chapter of "Principles of School Business Management" focuses on issues and organizational realities that affect the planning conducted by school business offices. The chapter deals first with theories of planning and then considers their relationship to the organizational context in which they will be implemented. Among the theories reviewed…

An Examination of Preservice Teachers' Perceptions of Cyberbullying

ERIC Educational Resources Information Center

Yilmaz, Harun

2010-01-01

Today, in parallel with the increase of technology use, cyberbullying becomes one of the major issues in schools affecting students' lives negatively similar to bullying. To minimize the negative effects of cyberbullying and to get preservice teachers ready for managing cyberbullying, it is necessary to examine preservice teachers' perception…

Sexual Harassment and Organizational Outcomes

DTIC Science & Technology

2011-04-01

harassment and unwanted sexual attention) appear to affect job satisfaction and organizational commitment more than the overt quid pro quo type of... Sexual Harassment and Organizational Outcomes Charlie L. Law DEFENSE EQUAL OPPORTUNITY MANAGEMENT...No. 99-11 Sexual harassment and Organizational, 2 Executive Summary Issue Sexual harassment continues to be a

Empowering Principals to Lead and Manage Public Schools Effectively in the 21st Century

ERIC Educational Resources Information Center

Mestry, Raj

2017-01-01

Globally, education systems have been affected by radical social, political and economic changes. Although school principals play a pivotal role in improving student learning and attaining educational outcomes, they work under strenuous conditions to deal with multifaceted transformational issues. Principals experience great difficulty in coping…

Constructing Ability Groups in the Secondary School: Issues in Practice.

ERIC Educational Resources Information Center

Ireson, Judith; Clark, Helen; Hallam, Susan

2002-01-01

Examines grouping practices in 45 secondary schools in England based on information provided by curriculum managers and department heads about allocation procedures, factors affecting the size and number of student groups, movement between groups, pressures and constraints on movement, and behavioral and motivational factors. Finds wide variety of…

Relationship between time management in construction industry and project management performance

NASA Astrophysics Data System (ADS)

Nasir, Najuwa; Nawi, Mohd Nasrun Mohd; Radzuan, Kamaruddin

2016-08-01

Nowadays, construction industry particularly in Malaysia struggle in achieving status of eminent time management for construction project. Project managers have a great responsibility to keep the project success under time of project completion. However, studies shows that delays especially in Malaysian construction industry still unresolved due to weakness in managing the project. In addition, quality of time management on construction projects is generally poor. Due to the progressively extended delays issue, time performance becomes an important subject to be explored to investigate delay factors. The method of this study is review of literature towards issues in construction industry which affecting time performance of project in general by focusing towards process involved for project management. Based on study, it was found that knowledge, commitment, cooperation are the main criteria as an overall to manage the project into a smooth process during project execution until completion. It can be concluded that, the strength between project manager and team members in these main criteria while conducting the project towards good time performance is highly needed. However, there is lack of establishment towards factors of poor time performance which strongly related with project management. Hence, this study has been conducted to establish factors of poor time performance and its relations with project management.

Team-based efforts to improve quality of care, the fundamental role of ethics, and the responsibility of health managers: monitoring and management strategies to enhance teamwork.

PubMed

Kossaify, A; Hleihel, W; Lahoud, J-C

2017-12-01

Highlight the importance of teamwork in health care institutions by performing a review and discussion of the relevant literature. Review paper. A MEDLINE/Pubmed search was performed starting from 1990, and the terms 'team, teamwork, managers, healthcare, and cooperation' were searched in titles, abstracts, keywords, and conclusions; other terms 'patient safety, ethics, audits and quality of care' were specifically searched in abstracts and were used as additional filters criteria to select relevant articles. Thirty-three papers were found relevant; factors affecting the quality of care in health care institutions are multiple and varied, including issues related to individual profile, to administrative structure and to team-based effort. Issues affecting teamwork include mainly self-awareness, work environment, leadership, ethics, cooperation, communication, and competition. Moreover, quality improvement plans aiming to enhance and expand teams are essential in this context. Team monitoring and management are vital to achieve efficient teamwork with all the required qualities for a safer health system. In all cases, health managers' responsibility plays a fundamental role in creating and sustaining a teamwork atmosphere. Teamwork is known to improve outcomes in medicine, whether at the clinical, organizational, or scientific level. Teamwork in health care institutions must increasingly be encouraged, given that individual effort is often insufficient for optimal clinical outcome. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Mental health and retirement savings: Confounding issues with compounding interest.

PubMed

Bogan, Vicki L; Fertig, Angela R

2018-02-01

The questionable ability of the U.S. pension system to provide for the growing elderly population combined with the rising number of people affected by depression and other mental health issues magnifies the need to understand how these household characteristics affect retirement. Mental health problems have a large and significant negative effect on retirement savings. Specifically, psychological distress is associated with decreasing the probability of holding retirement accounts by as much as 24 percentage points and decreasing retirement savings as a share of financial assets by as much as 67 percentage points. The magnitude of these effects underscores the importance of employer management policy and government regulation of these accounts to help ensure households have adequate retirement savings. Copyright © 2017 John Wiley & Sons, Ltd.

Using GIS in ecological management: green assessment of the impacts of petroleum activities in the state of Texas.

PubMed

Merem, Edmund; Robinson, Bennetta; Wesley, Joan M; Yerramilli, Sudha; Twumasi, Yaw A

2010-05-01

Geo-information technologies are valuable tools for ecological assessment in stressed environments. Visualizing natural features prone to disasters from the oil sector spatially not only helps in focusing the scope of environmental management with records of changes in affected areas, but it also furnishes information on the pace at which resource extraction affects nature. Notwithstanding the recourse to ecosystem protection, geo-spatial analysis of the impacts remains sketchy. This paper uses GIS and descriptive statistics to assess the ecological impacts of petroleum extraction activities in Texas. While the focus ranges from issues to mitigation strategies, the results point to growth in indicators of ecosystem decline.

Using GIS in Ecological Management: Green Assessment of the Impacts of Petroleum Activities in the State of Texas

PubMed Central

Merem, Edmund; Robinson, Bennetta; Wesley, Joan M.; Yerramilli, Sudha; Twumasi, Yaw A.

2010-01-01

Geo-information technologies are valuable tools for ecological assessment in stressed environments. Visualizing natural features prone to disasters from the oil sector spatially not only helps in focusing the scope of environmental management with records of changes in affected areas, but it also furnishes information on the pace at which resource extraction affects nature. Notwithstanding the recourse to ecosystem protection, geo-spatial analysis of the impacts remains sketchy. This paper uses GIS and descriptive statistics to assess the ecological impacts of petroleum extraction activities in Texas. While the focus ranges from issues to mitigation strategies, the results point to growth in indicators of ecosystem decline. PMID:20623014

Pregnancy and autoimmune connective tissue diseases

PubMed Central

Marder, Wendy; Littlejohn, Emily A

2016-01-01

The autoimmune connective tissue diseases predominantly affect women and often occur during the reproductive years. Thus, specialized issues in pregnancy planning and management are commonly encountered in this patient population. This chapter provides a current overview of pregnancy as a risk factor for onset of autoimmune disease, considerations related to the course of pregnancy in several autoimmune connective tissue diseases, and disease management and medication issues before and during pregnancy and the postpartum period. A major theme that has emerged across these inflammatory diseases is that active maternal disease during pregnancy is associated with adverse pregnancy outcomes, and that maternal and fetal health can be optimized when conception is planned during times of inactive disease and through maintaining treatment regimens compatible with pregnancy. PMID:27421217

Overactive Bladder Syndrome: Evaluation and Management.

PubMed

Leron, Elad; Weintraub, Adi Y; Mastrolia, Salvatore A; Schwarzman, Polina

2018-03-01

Overactive bladder (OAB) syndrome is a chronic medical condition which has a major influence on the quality of life in a significant amount of the population. OAB affects performance of daily activities and has an estimated prevalence of 16.5%. Many sufferers do not seek medical help. Moreover, many family physicians and even gynecologists are not familiar with this issue. Usually patients suffer from OAB in advanced age. Nocturia is reported as the most bothersome symptom in the elderly population. The aim of our review was to discuss all aspects of this challenging disorder and suggest tools for assessment and management strategies. Practitioners can easily overlook urinary complains if they not directly queried. We would like to encourage practitioners to give more attention to this issue.

Considerations in pharmaceutical conversion: focus on antihistamines.

PubMed

Garbus, S B; Moulton, B W; Meltzer, E O; Reich, P R; Weinreb, L F; Friedman, J A; Orland, B I

1997-04-01

The practice of pharmaceutical conversion, which encompasses three types of drug interchange (generic, brand, and therapeutic substitution), is increasing in managed care settings. Pharmaceutical conversion has numerous implications for managed care organizations, their healthcare providers, and their customers. Although drug cost may be a driving consideration in pharmaceutical conversion, a number of other considerations are of equal or greater importance in the decision-making process may affect the overall cost of patient care. Among these considerations are clinical, psychosocial, and safety issues; patient adherence; patient satisfaction; and legal implications of pharmaceutical conversion. Patient-centered care must always remain central to decisions about pharmaceutical conversion. This article discusses the issues related to, and implications of, pharmaceutical conversion utilizing the antihistamines class of drugs as the case situation.

Latest Developments and Future Perspectives in the Field Of Obesity.

PubMed

Pérez-Pevida, Belén; Miras, Alexander D

2017-04-01

The prevalence of obesity is increasing exponentially worldwide, becoming an international public health issue that affects quality of life, increases the risk of illness and raises healthcare costs in countries in all parts of the world. In this editorial, we analyse the latest progress in the management of obesity and associated cardiovascular risk factors, and summarise the latest randomised controlled trials that have had the biggest influence on the current changes we are experiencing in obesity management.

Dealing with largemouth bass virus: benefits of multisector collaboration

USGS Publications Warehouse

Terre, David R.; Schramm, Harold; Grizzle , John M.; Fries, Loraine T.

2015-01-01

Largemouth bass virus (LMBV), a recently identified pathogen, affected largemouth bass (Micropterus salmoides) in the southeastern United States beginning in the 1990s. Concern about the impacts of this little-known pathogen on largemouth bass populations, effects on fisheries management, and the need to provide anglers and the media with consistent and accurate information prompted a private organization (Bass Anglers Sportsman Society) to invite managers and researchers from state and federal agencies and universities to a series of five annual public workshops beginning in 2000. These workshops provided a mechanism to share information, identify and prioritize action items, and develop consensus information and outreach materials that could be provided to bass anglers and the media. Regionalizing the LMBV issue and collaboration among researchers, managers, and a fishing organization may also have allayed angler and media concerns. The process embodied in these workshops is offered as a successful example of multi-agency, multi-sector collaboration to facilitate information acquisition and guide action to address a regional fisheries management issue.

Self-amputation of the hand: issues in diagnosis and general hospital management.

PubMed

Crawford, Alison; Wand, Anne Pf; Smith, Michelle A

2016-04-01

To detail a diagnostic dilemma of intentional hand amputation in a man with a history of substance misuse and associated psychosis, depression and traumatic brain injury and to highlight issues in joint psychiatric and surgical management of such a complex patient in a general hospital setting. Deliberate limb self-amputation is a rare event with the majority of reported cases occurring during an episode of psychosis. This case illustrates the diagnostic utility of the literature supporting that a person who has self-inflicted amputation of a limb should be treated as psychotic until proven otherwise. The presence of a traumatic brain injury, with associated cognitive and psychosocial sequelae, affected diagnosis and management. Early and ongoing involvement of consultation-liaison psychiatry collaborating with a multidisciplinary general hospital team may improve mental and physical health outcomes for such patients. © The Royal Australian and New Zealand College of Psychiatrists 2015.

U.S. Department of Energy Office of Legacy Management's Tribal Interactions - 12513

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

Gil, April; Shafer, David; Elmer, John

2012-07-01

Effective government-to-government interactions with tribal nations and maintaining stakeholder relations with members of tribes are increasingly important to the U.S. Department of Energy (DOE) Office of Legacy Management (LM). As of October 2011, LM was responsible for long-term surveillance and maintenance of 87 sites and facilities in the continental U.S. and Puerto Rico, including some sites on tribal lands. The sites on tribal lands can affect natural resources that are managed or used by tribes, or the sites can potentially affect areas of cultural significance to tribal nations in Alaska, Arizona, Colorado, New Mexico, Utah, Washington, and Wyoming. Tribes aremore » separate sovereign governments recognized in the U.S. Constitution and are significant stakeholders for LM sites. The tribes are individual nations with diverse histories, cultures, customs, religions, and laws. LM has regular communication with the affected tribes to inform members of issues, to allow the tribe to participate in decision making, to provide technical reviews, and to ensure tribal concerns are addressed. Four LM sites are in the Navajo Nation. Three of those sites contain uranium mill tailings disposal cells regulated under long-term surveillance and maintenance programs that require monitoring and annual inspections. The fourth site was remediated but still has a groundwater plume that LM is responsible for. DOE and LM have worked with the Navajo Nation for almost 30 years on technical issues and to ensure tribal concerns are addressed. (authors)« less

Learning to think strategically.

PubMed

1994-01-01

Strategic thinking focuses on issues that directly affect the ability of a family planning program to attract and retain clients. This issue of "The Family Planning Manager" outlines the five steps of strategic thinking in family planning administration: 1) define the organization's mission and strategic goals; 2) identify opportunities for improving quality, expanding access, and increasing demand; 3) evaluate each option in terms of its compatibility with the organization's goals; 4) select an option; and 5) transform strategies into action. Also included in this issue is a 20-question test designed to permit readers to assess their "strategic thinking quotient" and a list of sample questions to guide a strategic analysis.

Indirect Effects of Field Management on Pollination Service and Seed Set in Hybrid Onion Seed Production.

PubMed

Gillespie, Sandra; Long, Rachael; Williams, Neal

2015-12-01

Pollination in crops, as in native ecosystems, is a stepwise process that can be disrupted at any stage. Healthy pollinator populations are critical for adequate visitation, but pollination still might fail if crop management interferes with the attraction and retention of pollinators. Farmers must balance the direct benefits of applying insecticide and managing irrigation rates against their potential to indirectly interfere with the pollination process. We investigated these issues in hybrid onion seed production, where previous research has shown that high insecticide use reduces pollinator attraction. We conducted field surveys of soil moisture, nectar production, pollinator visitation, pollen-stigma interactions, and seed set at multiple commercial fields across 2 yr. We then examined how management actions, such as irrigation rate (approximated by soil moisture), or insecticide use could affect the pollination process. Onions produced maximum nectar at intermediate soil moisture, and high nectar production attracted more pollinators. Insecticide use weakly affected pollinator visitation, but when applied close to bloom reduced pollen germination and pollen tube growth. Ultimately, neither soil moisture nor insecticide use directly affected seed set, but the high correlation between pollinator visitation and seed set suggests that crop management will ultimately affect yields via indirect effects on the pollination process. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A Map for Clinical Laboratories Management Indicators in the Intelligent Dashboard

PubMed Central

Azadmanjir, Zahra; Torabi, Mashallah; Safdari, Reza; Bayat, Maryam; Golmahi, Fatemeh

2015-01-01

Introduction: management challenges of clinical laboratories are more complicated for educational hospital clinical laboratories. Managers can use tools of business intelligence (BI), such as information dashboards that provide the possibility of intelligent decision-making and problem solving about increasing income, reducing spending, utilization management and even improving quality. Critical phase of dashboard design is setting indicators and modeling causal relations between them. The paper describes the process of creating a map for laboratory dashboard. Methods: the study is one part of an action research that begins from 2012 by innovation initiative for implementing laboratory intelligent dashboard. Laboratories management problems were determined in educational hospitals by the brainstorming sessions. Then, with regard to the problems key performance indicators (KPIs) specified. Results: the map of indicators designed in form of three layered. They have a causal relationship so that issues measured in the subsequent layers affect issues measured in the prime layers. Conclusion: the proposed indicator map can be the base of performance monitoring. However, these indicators can be modified to improve during iterations of dashboard designing process. PMID:26483593

The balancing act: key issues in the lives of women general practitioners in Australia.

PubMed

Kilmartin, Margaret R; Newell, Christopher J; Line, Martin A

2002-07-15

To identify key issues affecting women general practitioners in their professional and non-professional lives. A qualitative study using the Delphi technique, with three rounds of data provision circulated to each participant. Coding was used to ensure anonymity. The participants were a purposive sample of 40 women GPs drawn from all Australian States and Territories. The study was conducted between October 1996 and January 1997. Key issues affecting the professional and non-professional lives of women GPs. Some of the key professional issues for women GPs were job satisfaction, balancing work and personal life, autonomy, availability of flexible and part-time work and training, affordability of professional expenses, fair remuneration, and having a voice in decision-making. Key non-professional issues included self-care; time for relationships with a partner, children, family and friends; and time management to allow pursuit of non-medical interests. The conflicting demands made on women GPs diminish their job satisfaction and lead to stress and imbalance in their lives. Recommendations to ameliorate the problems for women GPs include appropriate training, policy formation, financial and other support, and a change in cultural expectations of women GPs by the community, the profession and governments.

Patient accounting: vital for financial survival.

PubMed

Puhala, J M; Barrett, M J

1987-09-01

The implementation of the prospective payment system has affected the financial stability of hospitals. It has forced them to take a closer look at their patient accounting function as it affects cash flow and patient service revenue. This article addresses several new issues relating to patient accounts processing that have created a need for more emphasis on the patient accounting function. Efficient operations and effective accounts receivable management may be the difference between the success or failure of a hospital in today's competitive environment.

The Politics of Information: Building a Relational Database To Support Decision-Making at a Public University.

ERIC Educational Resources Information Center

Friedman, Debra; Hoffman, Phillip

2001-01-01

Describes creation of a relational database at the University of Washington supporting ongoing academic planning at several levels and affecting the culture of decision making. Addresses getting started; sharing the database; questions, worries, and issues; improving access to high-demand courses; the advising function; management of instructional…

IPM eAcademy - National Site for the Regional IPM Centers

Science.gov Websites

Events Sonny Ramaswamy's State of NIFA Address USDA National Institute of Food and Agriculture Director species issues affecting the United States United States Department of Agriculture - National Institute of Food and Agriculture Website managed by the Southern IPM Center. Design adapted from work by the

Pedagogical Renewal: Improving the Quality of Classroom Interaction in Nigerian Primary Schools

ERIC Educational Resources Information Center

Hardman, Frank; Abd-Kadir, Jan; Smith, Fay

2008-01-01

This study reports on an investigation of classroom interaction and discourse practices in Nigerian primary schools. Its purpose was to identify key issues affecting patterns of teacher-pupil interaction and discourse as research suggests managing the quality of classroom interaction will play a central role in improving the quality of teaching…

Effect of harvesting on forest soil and water in an organic soil watershed

Treesearch

J.M. Grace; R.W. Skaggs

2006-01-01

Timber harvest operations are necessary and common in forest management to provide profitability and satisfy demands for timber products. Harvesting operations, as with most forest operations, have received much attention in regards to soil and water issues. Harvesting operations have been reported to affect soil physical properties and hydrological characteristics...

Environmental Education, Drought and the Rural Man: Implications for Policy-Makers and Farmers in Sub-Saharan Africa.

ERIC Educational Resources Information Center

Ladele, Ademola A.

2001-01-01

Examines issues related to the nexus of some factors affecting the environment, specifically drought. Suggests that because small farmers are usually at the mercy of unpredictable weather, even simple tips on resource management, when properly packaged, could make tremendous change. (Contains 27 references.) (Author/YDS)

Factors affecting potential for Palmer amaranth (Amaranthus palmeri) suppression by winter rye in Georgia, USA

USDA-ARS?s Scientific Manuscript database

Herbicide resistant Palmer amaranth (Amaranthus palmeri) has rapidly become a dominant weed management issue in agronomic crops of the Southeast US. The small size of Palmer amaranth seeds, relative to other common weeds, provides an opportunity to use physical weed control through high-residue, ro...

Impacts of fire on hydrology and erosion in steep mountain big sagebrush communities

Treesearch

Frederick B. Pierson; Peter R. Robichaud; Kenneth E. Spaeth; Corey A. Moffet

2003-01-01

Wildfire is an important ecological process and management issue on western rangelands. Major unknowns associated with wildfire are its affects on vegetation and soil conditions that influence hydrologic processes including infiltration, surface runoff, erosion, sediment transport, and flooding. Post wildfire hydrologic response was studied in big sagebrush plant...

A Study of the Predictability of School District Bond Ratings.

ERIC Educational Resources Information Center

Vedra, Kenneth David

School district bond ratings, issued on request by Standard and Poor's Corporation or Moody's Investors Service, hold implications for school districts' financial management. Ultimately, the bond rating assigned is a factor affecting the total cost of the bond issuance, related to the principal and interest payments over the life of the debt. A…

Factors affecting potential for Palmer amaranth (Amaranthus palmeri) suppression by winter rye in Georgia, USA

USDA-ARS?s Scientific Manuscript database

Herbicide resistant Palmer amaranth has rapidly become a dominant weed management issue in agronomic crops of the Southeast U. S. The small size of Palmer amaranth seeds, relative to other common weeds, provides an opportunity to use physical weed control through high-biomass, rolled cover crop mul...

The Attorney-Client Relationship as a Business Law-Legal Environment Topic

ERIC Educational Resources Information Center

Levin, Murray S.

2004-01-01

Business school law courses should promote understanding of legal processes affecting business, help students learn to recognize legal issues and manage legal risks, increase ethical sensitivity, and help students to develop critical thinking skills. To this end, business law and legal environment textbooks tend to focus on ethical and legal…

Psychosocial Issues that Affect Youth with Diabetes

ERIC Educational Resources Information Center

Cammarata, Christina; Meyer, Kara J.; Geffken, Gary; Felipe, Dania; Franz, Diane; Vargas, Alfonso; Kamps, Jodi L.

2009-01-01

Type 1 diabetes, one of the most common diseases of childhood, requires adherence to a complicated regimen which is often times difficult to manage resulting in stress for children, siblings, and caregivers. Many children with diabetes are nonadherent, likely due to the difficulty and complexity of the tasks required, and, thus, are at greater…

Curriculum Change Management and Workload

ERIC Educational Resources Information Center

Alkahtani, Aishah

2017-01-01

This study examines the ways in which Saudi teachers have responded or are responding to the challenges posed by a new curriculum. It also deals with issues relating to workload demands which affect teachers' performance when they apply a new curriculum in a Saudi Arabian secondary school. In addition, problems such as scheduling and sharing space…

Motivational Issues of Faculty in Saudi Arabia

ERIC Educational Resources Information Center

Abdul-Cader, Akram; Anthony, Peter John

2014-01-01

This study focused on the factors that affect motivation of faculty in Saudi Arabia. It included two surveys and open-ended queries to a focus group of five academic managers and 25 faculty members of varying nationalities, rank, and institutes in Saudi Arabia. The research showed that the faculties in Saudi Arabia's highest education industry…

Blended Learning: Communication, Locations and Work-Life Practices

ERIC Educational Resources Information Center

Moe, Carl Erik; Rye, Stale Angen

2011-01-01

The article discusses blended learning and how various delivery formats affect the way learning is situated in work-life practices. The authors approached this issue through an empirical study of an in-service training programme for middle-level managers in a number of case organisations. The programme used a combination of e-learning, textbooks…

Management of Children Using Cochlear Implants and Hearing Aids.

ERIC Educational Resources Information Center

Ching, Teresa Y. C.; Psarros, Colleen; Incerti, Paula; Hill, Mandy

2001-01-01

Four case studies identify six factors affecting successful use of a hearing aid with a cochlear implant: duration of hearing aid use prior to implantation, amount of residual hearing in the non-implanted ear, educational and listening demands, cosmetic issues, hearing aid rejection, and extended period of non-use of hearing aid. (Contains…

Conservation Reserve Program (CRP) contributions to wildlife habitat, management issues, challenges and policy choices--an annotated bibliography

USGS Publications Warehouse

Allen, Arthur W.; Vandever, Mark W.

2012-01-01

The following bibliography presents brief summaries of documents relevant to Conservation Reserve Program relations to wildlife habitat, habitat management in agriculturally dominated landscapes, and conservation policies potentially affecting wildlife habitats in agricultural ecosystems. Because the literature summaries furnished provide only sweeping overviews, users are urged to obtain and evaluate those papers appearing useful to obtain a more complete understanding of study findings and their implications to conservation in agricultural ecosystems. The bibliography contains references to reports that reach beyond topics that directly relate to the Conservation Reserve Program. Sections addressing grassland management and landowner surveys/opinions, for example, furnish information useful for enhancing development and administration of conservation policies affecting lands beyond those enrolled in conservation programs. Some sections of the bibliography (for example, agricultural conservation policy, economics, soils) are far from inclusive of all relevant material written on the subject. Hopefully, these sections will serve as fundamental introductions to related issues. In a few instances, references may be presented in more than one section of the bibliography. For example, individual papers specifically addressing both non-game and game birds are included in respective sections of the bibliography. Duplication of citations and associated notes has, however, been kept to a minimum.

Improving the integration of recreation management with management of other natural resources by applying concepts of scale from ecology.

PubMed

Morse, Wayde C; Hall, Troy E; Kruger, Linda E

2009-03-01

In this article, we examine how issues of scale affect the integration of recreation management with the management of other natural resources on public lands. We present two theories used to address scale issues in ecology and explore how they can improve the two most widely applied recreation-planning frameworks. The theory of patch dynamics and hierarchy theory are applied to the recreation opportunity spectrum (ROS) and the limits of acceptable change (LAC) recreation-planning frameworks. These frameworks have been widely adopted internationally, and improving their ability to integrate with other aspects of natural resource management has significant social and conservation implications. We propose that incorporating ecologic criteria and scale concepts into these recreation-planning frameworks will improve the foundation for integrated land management by resolving issues of incongruent boundaries, mismatched scales, and multiple-scale analysis. Specifically, we argue that whereas the spatially explicit process of the ROS facilitates integrated decision making, its lack of ecologic criteria, broad extent, and large patch size decrease its usefulness for integration at finer scales. The LAC provides explicit considerations for weighing competing values, but measurement of recreation disturbances within an LAC analysis is often done at too fine a grain and at too narrow an extent for integration with other recreation and resource concerns. We suggest that planners should perform analysis at multiple scales when making management decisions that involve trade-offs among competing values. The United States Forest Service is used as an example to discuss how resource-management agencies can improve this integration.

Project delivery in HIV/AIDS and TB in Southern Africa: the cross-cultural management imperative.

PubMed

Claeyé, Frederik; Jackson, Terence

2011-01-01

The purpose of this paper is to report the findings of a broad-based study that initially investigated a possible gap in global inputs into the fight against HIV/AIDS and TB co-infection, and outputs in terms of results achieved. It is proposed that such a gap may be hypothesized to be due, at least in part, to inappropriate management regimes within the global health governance structure. The research does not simply question the effectiveness of the management of programs and projects, but rather the inappropriateness resulting from the lack of addressing cross-cultural issues. The factors facilitating or hampering project service delivery were examined, by looking at 12 case studies in Botswana and South Africa. These data were complemented with seven semi-structured interviews with donor organizations and NGOs, conducted in the North. Cultural interactions were investigated by using the concept of "interfaces". The results suggest that there is a disjuncture between the global and local level that affects project delivery. The main issues hampering project outcomes can be summarized as systemic, structural and cultural. The article's main contributions are both theoretical, looking at global project delivery from a cross-cultural management perspective, as well as to development praxis by highlighting the need to focus more critically on cross-cultural management issues within the global health governance structure, and indeed within international development as a whole.

Proceedings of the DOD (Department of Defense) Standardization and Data Management Conference Supporting the Acquisition Process Held in Linthicum, Maryland on August 22-24, 1988

DTIC Science & Technology

1988-01-01

for this conference’s success goes to the panel chairmen and their panelists who gave generously of their time , effort, and talent, to the...Conference is the fourth in a series of bi-annual meetings convened to address timely issues affecting defense acquisition. Complementary goals are...the perspective on that issue has been clarified. o A lot of times we tend to look at acquisition, standardization, logistics, quality and other

Assessing the whole person: case managers take a holistic approach to physical and mental health.

PubMed

Carter, Jolynne Jo; Zawalski, Sandra; Sminkey, Patrice V; Christopherson, Bruce

2015-01-01

Given the prevalence of mental health issues, particularly depressive disorders, in the U.S. population, professional case managers should increase their sensitivity to and awareness of mental illnesses, as well as their impact on physical health. Throughout the case management process, case managers frequently observe behaviors and symptoms such as those associated with depressive disorders. Case managers need to have, at a minimum, a working knowledge of mental and behavioral health issues and be familiar with basic screening tools. This will enable them to become more attuned to symptoms and behaviors that indicate that the individual should be further assessed and diagnosed by a physician. Across the case management spectrum, including acute care, accountable care organizations, patient-centered medical homes, physician practices, clinics, occupational health clinics, workers' compensation, and other settings in which case managers work with individuals (clients who receive case management services) and their families/support systems. With more than one quarter of the U.S. population affected by a depressive disorder, professional case managers who practice holistically bring together the mental and physical aspects of health. This is particularly important in a health care system and among payer sources that continue to divide the two. Case managers elevate their practice by demonstrating a greater understanding of the interconnectedness of mental and physical health and can positively influence the transdisciplinary care team to take a person-centered approach to address all health issues, in pursuit of the individual's health goals. Professional case managers must increase their understanding of mental health, becoming more aware of "red flags" that may necessitate a further evaluation and assessment by a mental health professional. They should also hone their communication skills, particularly the use of motivational interviewing techniques, to encourage individuals to discuss their feelings, worries, fears, and anxiety, as well as any potential symptoms of depression, which may range from mild to severe. Without judgment or bias, the case manager, as the advocate, can provide the information, support, or other services needed to address mental health issues, to support and further the individual's health goals.

Occupational health issues affecting the pharmaceutical sales force.

PubMed

Harris, G; Mayho, G; Page, L

2003-09-01

The sales force forms a significant sub-population in the pharmaceutical industry workforce. Role and organizational characteristics, such as isolation, peripatetic working and car travel and the psychosocial and ergonomic hazards related to work tasks, present particular occupational health risks. To review the occupational risks associated with peripatetic sales force work and evidence for the effectiveness of preventive interventions. We carried out a review of the available literature between 1990 and 2003. The following hazards were identified as significant and worthy of further investigation for this occupational group: driving on company business; violence in the workplace; stress; ergonomic issues; and mobile phone use. To ensure effective prevention and management of employee health problems, specific health management strategies and interventions must be developed to meet the occupational health needs of this group.

Development and implementation of web based infrastructure for problem management at UNPRI

NASA Astrophysics Data System (ADS)

WijayaDewantoro, Rico; Wardani, Sumita; Rudy; Surya Perdana Girsang, Batara; Dharma, Abdi

2018-04-01

Information technology drastically affects human way of thinking. It has entered every part of human life and also became one of the most significant contributors to make human life more manageable. Reporting a problem of facilities and infrastructure in Universitas Prima Indonesia was done manually where the complainant have to meet the responsible person directly and describe how the problem looks like. Then, the responsible person only solve the problem but have no good documentation on it like Five Ws and How. Moreover, the other issue is to avoid a person who is mischievous for giving false reports. In this paper, we applied a set of procedures called Universitas Prima Indonesia Problem Management System (UNPRI-PMS) which also integrated with academic information system. Implemetation of UNPRI-PMS affects all of the problems about facilities and infrastructure at Universitas Prima Indonesia can be solved more efficient, structured, and accurate.

Respiratory disease in pregnancy.

PubMed

Mehta, Niharika; Chen, Kenneth; Hardy, Erica; Powrie, Raumond

2015-07-01

Many physiological and anatomical changes of pregnancy affect the respiratory system. These changes often affect the presentation and management of the various respiratory illnesses in pregnancy. This article focuses on several important respiratory issues in pregnancy. The management of asthma, one of the most common chronic illnesses in pregnancy, remains largely unchanged compared to the nonpregnant state. Infectious respiratory illness, including pneumonia and tuberculosis, are similarly managed in pregnancy with antibiotics, although special attention may be needed for antibiotic choices with more pregnancy safety data. When mechanical ventilation is necessary, consideration should be given to the maternal hemodynamics of pregnancy and fetal oxygenation. Maintaining maternal oxygen saturation above 95% is recommended to sustain optimal fetal oxygenation. Cigarette smoking has known risks in pregnancy, and current practice guidelines recommend offering cognitive and pharmacologic interventions to pregnant women to assist in smoking cessation. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Evaluation and Office Management of Hemorrhoids for the Gastroenterologist.

PubMed

Guttenplan, Mitchel

2017-07-01

Hemorrhoid disease is extremely common, and seldom requires surgical intervention. The vast majority of patients can be cared for in the office setting and by the gastroenterologist. This piece aims to summarize the epidemiology and pathophysiology of hemorrhoid disease, along with the proper evaluation and office-based treatment of these patients. Most GI fellowship training programs spend little time on these topics, and the recommendation has been made to include anorectal care in the GI's "core curriculum." The use of the anoscope and a proper anorectal examination are keys to evaluating these patients, and the techniques available to treat these patients are described. Often overlooked in these patients are other anorectal issues that occur alongside hemorrhoidal issues very commonly-the most common being anal fissure. Comprehensive management of all of these issues will allow all but the most severely affected patients to avoid the expense and morbidity of surgical intervention. The anatomy, etiology, pathophysiology, diagnosis, and non-surgical treatment of hemorrhoid disease are presented with the gastroenterologist in mind.

Latin-American guidelines for cancer pain management.

PubMed

Lara-Solares, Argelia; Ahumada Olea, Marisol; Basantes Pinos, Amparito de Los Ángeles; Bistre Cohén, Sara; Bonilla Sierra, Patricia; Duarte Juárez, Eva Rossina; Símon Escudero, Omar A; Santacruz Escudero, Juan Guillermo; Flores Cantisani, José Alberto

2017-07-01

Cancer is a major public health issue. Poor pain management has devastating consequences that seriously affect quality of life, diminish functionality and place a huge emotional burden on patients and their relatives. A group of Latin American opinion leaders were invited to participate in a meeting to discuss areas associated with cancer pain. The expert panel reviewed the latest literature to draft region-specific guidelines for effective pain management. The guidelines make recommendations on tailoring treatment to the specific type of pain and provide local physicians with the state-of-the art findings in the field. Management should be with pharmacological approaches (nonopioid, adjuvant and opioid analgesics, as well as oncologic therapies and interventional procedures) and nonpharmacological approaches.

Urine and oral fluid drug testing in support of pain management.

PubMed

Kwong, Tai C; Magnani, Barbarajean; Moore, Christine

2017-09-01

In recent years, the abuse of opioid drugs has resulted in greater prevalence of addiction, overdose, and deaths attributable to opioid abuse. The epidemic of opioid abuse has prompted professional and government agencies to issue practice guidelines for prescribing opioids to manage chronic pain. An important tool available to providers is the drug test for use in the initial assessment of patients for possible opioid therapy, subsequent monitoring of compliance, and documentation of suspected aberrant drug behaviors. This review discusses the issues that most affect the clinical utility of drug testing in chronic pain management with opioid therapy. It focuses on the two most commonly used specimen matrices in drug testing: urine and oral fluid. The advantages and disadvantages of urine and oral fluid in the entire testing process, from specimen collection and analytical methodologies to result interpretation are reviewed. The analytical sensitivity and specificity limitations of immunoassays used for testing are examined in detail to draw attention to how these shortcomings can affect result interpretation and influence clinical decision-making in pain management. The need for specific identification and quantitative measurement of the drugs and metabolites present to investigate suspected aberrant drug behavior or unexpected positive results is analyzed. Also presented are recent developments in optimization of test menus and testing strategies, such as the modification of the standard screen and reflexed-confirmation testing model by eliminating some of the initial immunoassay-based tests and proceeding directly to definitive testing by mass spectrometry assays.

Saving the superstar: a review of the social factors affecting tiger conservation in India.

PubMed

Rastogi, Archi; Hickey, Gordon M; Badola, Ruchi; Hussain, Syed Ainul

2012-12-30

Tiger conservation in India represents an excellent case study of the many challenges facing conservation programs internationally. It is well understood that tigers are sensitive to human disturbances and large areas of habitat need to be protected for their conservation. Such protected areas in India are managed by the governments using an exclusionary approach. However, this approach is known to create several issues with local communities, including historical, legal, livelihood and management issues; with a volume of literature suggesting the inclusion of local communities in management. Yet, other evidence suggests that inclusion of communities in tiger conservation may lead to anthropogenic disturbances that can jeopardize tigers. The gravity of the situation is reflected in the recent disappearance of tigers from two key protected areas in India, the Sariska and Panna Tiger Reserves. This review paper connects the key literature from conservation biology, environmental history, management sciences, policy and political sciences to underline the gridlock of tiger conservation: it needs exclusive protected areas that antagonize communities, and it depends on the support of the same communities for success. We examine the possibility of reconciliation between these disciplines, and assert that research on tiger conservation needs to allow for an increasingly interdisciplinary approach. We call for a more integrated approach to tiger conservation, to examine the values inherent in conservation and to shed more light on the social factors that affect tiger conservation schemes. Copyright © 2012 Elsevier Ltd. All rights reserved.

Telemedicine for wound management

PubMed Central

Chittoria, Ravi K.

2012-01-01

The escalating physiological, psychological, social and financial burdens of wounds and wound care on patients, families and society demand the immediate attention of the health care sector. Many forces are affecting the changes in health care provision for patients with chronic wounds, including managed care, the limited number of wound care therapists, an increasingly ageing and disabled population, regulatory and malpractice issues, and compromised care. The physician is also faced with a number of difficult issues when caring for chronic wound patients because their conditions are time consuming and high risk, represent an unprofitable part of care practice and raise issues of liability. Telemedicine enhances communication with the surgical wound care specialist. Digital image for skin lesions is a safe, accurate and cost-effective referral pathway. The two basic modes of telemedicine applications, store and forward (asynchronous transfer) and real-time transmission (synchronous transfer, e.g. video conference), are utilized in the wound care setting. Telemedicine technology in the hands of an experienced physician can streamline management of a problem wound. Although there is always an element of anxiety related to technical change, the evolution of wound care telemedicine technology has demonstrated a predictable maturation process. PMID:23162242

Management of adolescents with congenital adrenal hyperplasia

PubMed Central

Merke, Deborah P; Poppas, Dix P

2014-01-01

The management of congenital adrenal hyperplasia involves suppression of adrenal androgen production, in addition to treatment of adrenal insufficiency. Management of adolescents with congenital adrenal hyperplasia is especially challenging because changes in the hormonal milieu during puberty can lead to inadequate suppression of adrenal androgens, psychosocial issues often affect adherence to medical therapy, and sexual function plays a major part in adolescence and young adulthood. For these reasons, treatment regimen reassessment is indicated during adolescence. Patients with non-classic congenital adrenal hyperplasia require reassessment regarding the need for glucocorticoid drug treatment. No clinical trials have compared various regimens for classic congenital adrenal hyperplasia in adults, thus therapy is individualised and based on the prevention of adverse outcomes. Extensive patient education is key during transition from paediatric care to adult care and should include education of females with classic congenital adrenal hyperplasia regarding their genital anatomy and surgical history. Common issues for these patients include urinary incontinence, vaginal stenosis, clitoral pain, and cosmetic concerns; for males with classic congenital adrenal hyperplasia, common issues include testicular adrenal rest tumours. Transition from paediatric to adult care is most successful when phased over many years. Education of health-care providers on how to successfully transition patients is greatly needed. PMID:24622419

Manitoba Health's emerging work on wildland fire smoke

Treesearch

Jeffrey Joaquin; Darlene Oshanski

2015-01-01

Smoke caused by wildland fire events is an important public health issue, involving major risks to the health of people and the environment. Smoke from wildland fires can travel hundreds of kilometers, affecting air quality far from the flames. Through a partnership with Health Canada, Manitoba Health's Office of Disaster Management (ODM) has undertaken a number...

Health of eastern North American sugar maple forests and factors affecting decline

Treesearch

Stephen B. Horsley; Robert P. Long; Scott W. Bailey; Richard A. Hallett; Philip M. Wargo

2002-01-01

Sugar maple (Acer saccharum) is a keystone species in the forests of the northeastern and Midwestern United States and eastern Canada. Its sustained health is an important issue in both managed and unmanaged forests. While sugar maple generally is healthy throughout its range, decline disease of sugar maple has occurred sporadically during the past...

A View from the Trenches. Postsecondary Education Finance: The Institutional View.

ERIC Educational Resources Information Center

Zemsky, Robert

Issues pertaining to educational finance in colleges and universities are considered. It is suggested that solving problems of organization will lead to shifts in management style, which in turn may affect flows of funds to disciplines. The outcome may be a change in academic scope and either limiting or expanding institutional opportunities. The…

Agricultural Trends and Resource Conservation: Implications and Issues. A Symposium Proceedings (Washington, D.C., November 3-5, 1986).

ERIC Educational Resources Information Center

Soil Conservation Service (USDA), Washington, DC.

The purpose of this paper is to highlight some of the most significant trends likely to affect agricultural resource conservation activities, to discuss their significance to policy development and program management and implementation, and to make policy and program recommendations. In November 1986, 25 representatives from academia, farming…

Genome-based approach to discover new livestock pest control technologies: The horn fly (Haematobia irritans) genome sequencing project

USDA-ARS?s Scientific Manuscript database

Invasion of the Americas by the horn fly, H. irritans, has resulted in control issues throughout the continent. Insecticide resistance is a major complicating factor with efforts to manage this pest. Stakeholder focus groups identified the horn fly as the top priority arthropod pest affecting cattle...

Decolonizing the Archaeological Landscape: The Practice and Politics of Archaeology in British Columbia

ERIC Educational Resources Information Center

Nicholas, George P.

2006-01-01

In British Columbia, Canada, the practice of archaeology has been strongly influenced by issues of First Nations rights and the ways government and industry have chosen to address them. In turn, this situation has affected academic (i.e., research-based) and consulting (i.e., cultural resource management) archaeology, which have had to respond to…

Focusing biodiversity research on the needs of decision makers

NASA Astrophysics Data System (ADS)

Smythe, Katie D.; Bernabo, J. Christopher; Carter, Thomas B.; Jutro, Peter R.

1996-11-01

The project on Biodiversity Uncertainties and Research Needs (BURN) ensures the advancement of usable knowledge on biodiversity by obtaining input from decision makers on their priority information needs about biodiversity and then using this input to engage leading scientists in designing policy-relevant research. Decision makers articulated concerns related to four issues: significance of biodiversity; status and trends of biodiversity; management for biodiversity; and the linkage of social, cultural, economic, legal, and biological objectives. Leading natural and social scientists then identified the research required to address the decision makers' needs and determined the probability of success. The diverse group of experts reached consensus on several fundamental issues, helping to clarify the role of biodiversity in land and resource management. The BURN participants identified several features that should be incorporated into policy-relevant research plans and management strategies for biodiversity. Research and assessment efforts should be: multidisciplinary and integrative, participatory with stakeholder involvement, hierarchical (multiple scales), and problem- and region-specific. The activities should be focused regionally within a global perspective. Meta-analysis of existing data is needed on all fronts to assess the state of the science. More specifically, the scientists recommended six priority research areas that should be pursued to address the information needs articulated by decision makers: (1) characterization of biodiversity, (2) environmental valuation, (3) management for sustainability—for humans and the environment (adaptive management), (4) information management strategies, (5) governance and stewardship issues, and (6) communication and outreach. Broad recommendations were developed for each research area to provide direction for research planning and resource management strategies. The results will directly benefit those groups that require biodiversity research to address their needs—whether to develop policy, manage natural resources, or make other decisions affecting biodiversity.

A qualitative study exploring issues related to medication management in residential aged care facilities

PubMed Central

Ahmad Nizaruddin, Mariani; Omar, Marhanis-Salihah; Mhd-Ali, Adliah; Makmor-Bakry, Mohd

2017-01-01

Background Globally, the population of older people is on the rise. As families are burdened with the high cost of care for aging members, demand is increasing for medical care and nursing homes. Thus, medication management is crucial to ensure that residents in a care center benefit and assist the management of the care center in reducing the burden of health care. This study is aimed to qualitatively explore issues related to medication management in residential aged care facilities (RACFs). Participants and methods A total of 11 stakeholders comprising health care providers, administrators, caretakers and residents were recruited from a list of registered government, nongovernmental organization and private RACFs in Malaysia from September 2016 to April 2017. An exploratory qualitative study adhering to Consolidated Criteria for Reporting Qualitative Studies was conducted. In-depth interview was conducted with consent of all participants, and the interviews were audio recorded for later verbatim transcription. Observational analysis was also conducted in a noninterfering manner. Results and discussion Three themes, namely medication use process, personnel handling medications and culture, emerged in this study. Medication use process highlighted an unclaimed liability for residents’ medication by the RACFs, whereas personnel handling medications were found to lack sufficient training in medication management. Culture of the organization did affect the medication safety and quality improvement. The empowerment of the residents in their medication management was limited. There were unclear roles and responsibility of who manages the medication in the nongovernment-funded RACFs, although they were well structured in the private nursing homes. Conclusion There are important issues related to medication management in RACFs which require a need to establish policy and guidelines. PMID:29138540

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

PubMed

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

2012-05-01

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

Soliciting scientific information and beliefs in predictive modeling and adaptive management

NASA Astrophysics Data System (ADS)

Glynn, P. D.; Voinov, A. A.; Shapiro, C. D.

2015-12-01

Post-normal science requires public engagement and adaptive corrections in addressing issues with high complexity and uncertainty. An adaptive management framework is presented for the improved management of natural resources and environments through a public participation process. The framework solicits the gathering and transformation and/or modeling of scientific information but also explicitly solicits the expression of participant beliefs. Beliefs and information are compared, explicitly discussed for alignments or misalignments, and ultimately melded back together as a "knowledge" basis for making decisions. An effort is made to recognize the human or participant biases that may affect the information base and the potential decisions. In a separate step, an attempt is made to recognize and predict the potential "winners" and "losers" (perceived or real) of any decision or action. These "winners" and "losers" include present human communities with different spatial, demographic or socio-economic characteristics as well as more dispersed or more diffusely characterized regional or global communities. "Winners" and "losers" may also include future human communities as well as communities of other biotic species. As in any adaptive management framework, assessment of predictions, iterative follow-through and adaptation of policies or actions is essential, and commonly very difficult or impossible to achieve. Recognizing beforehand the limits of adaptive management is essential. More generally, knowledge of the behavioral and economic sciences and of ethics and sociology will be key to a successful implementation of this adaptive management framework. Knowledge of biogeophysical processes will also be essential, but by definition of the issues being addressed, will always be incomplete and highly uncertain. The human dimensions of the issues addressed and the participatory processes used carry their own complexities and uncertainties. Some ideas and principles are provided that may help guide and implement the proposed adaptive management framework and its public and stakeholder engagement processes. Examples and characteristics of issues that could be beneficially addressed through the proposed framework will also be presented.

Managing the transcription revolution. Industry forces shape future of field.

PubMed

Faulkner, Scott D

2003-01-01

You may be struggling with contract issues with a vendor. Or maybe you're contemplating the pros and cons of working with outsource, at-home, or overseas transcriptionists. It's a fact: if transcription processes aren't working efficiently, the entire HIM department may be adversely affected. Factor in additional concerns such as data capture for electronic health records, compliance, and patient safety, and the importance of ensuring quality and cost-efficient transcription becomes even more apparent. To help you answer some of these questions, the Journal of AHIMA is launching a four-part series dedicated to transcription issues from the HIM professional's point of view. In this issue, we begin with MTIA president Scott Faulkner's overview of the industry and where it's going next. In upcoming issues, other experts will look at controlling cost and monitoring quality, navigating new technologies, and dealing with contract-related issues.

Outpatient dermatology consultation impacts the diagnosis and management of pediatric oncology patients: A retrospective study.

PubMed

Song, Hannah; Robinson, Sarah N; Huang, Jennifer T

2017-11-01

The impact of dermatology consultation on the care of children with oncologic conditions is unknown. To review outpatient dermatology visits and the resulting impact on diagnosis and management of pediatric oncology patients. Retrospective review of pediatric oncology patients with outpatient dermatology visits at a tertiary care center from 2008 to 2015. The most common dermatologic diagnoses in 516 patients were skin infections (21.3%) and nonmalignant skin eruptions (33.4%). A diagnosis of significant impact (ie, malignancy, adverse cutaneous drug reaction, graft-versus-host disease, varicella-zoster virus, or herpes simplex virus infection), was made at the dermatology clinic in 14.7% of visits. Consultation resulted in a change in diagnosis in 59.8% of patients, change in dermatologic management in 72.4% of patients, and change in management of noncutaneous issues in 12.4% of patients. The use of electronic medical records, the nongeneralizable study population, and the retrospective design represent potential limitations. Outpatient dermatology consultation can affect the care of pediatric oncology patients with respect to diagnosis and treatment of skin conditions and management of nondermatologic issues. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

14 CFR 91.1017 - Amending program manager's management specifications.

Code of Federal Regulations, 2014 CFR

2014-01-01

... proposed amendment. (2) The Flight Standards District Office that issued the program manager's management... presented, the Flight Standards District Office that issued the program manager's management specifications... Standards District Office that issued the program manager's management specifications issues an amendment of...

14 CFR 91.1017 - Amending program manager's management specifications.

Code of Federal Regulations, 2012 CFR

2012-01-01

... proposed amendment. (2) The Flight Standards District Office that issued the program manager's management... presented, the Flight Standards District Office that issued the program manager's management specifications... Standards District Office that issued the program manager's management specifications issues an amendment of...

A review of passive thermal management of LED module

NASA Astrophysics Data System (ADS)

Huaiyu, Ye; Koh, Sau; van Zeijl, Henk; Gielen, A. W. J.; Guoqi, Zhang

2011-01-01

Recently, the high-brightness LEDs have begun to be designed for illumination application. The increased electrical currents used to drive LEDs lead to thermal issues. Thermal management for LED module is a key design parameter as high operation temperature directly affects their maximum light output, quality, reliability and life time. In this review, only passive thermal solutions used on LED module will be studied. Moreover, new thermal interface materials and passive thermal solutions applied on electronic equipments are discussed which have high potential to enhance the thermal performance of LED Module.

Appropriate glove use in dermatitis prevention.

PubMed

Gallagher, Rose; Sunley, Kim

Work-related skin problems in nursing staff have risen in recent years, and inspections by the Health and Safety Executive in 2011 found a number of NHS trusts failing in their duties to prevent and manage the risks of work-related dermatitis. In response, the Royal College of Nursing issued guidelines on glove use and the prevention of contact dermatitis in nursing (RCN, 2012). These involved close collaboration between the professional and trade union parts of the RCN because failure to prevent and manage skin problems affects the safety of both staff and patients.

Strategic management of the health workforce in developing countries: what have we learned?

PubMed

Fritzen, Scott A

2007-02-26

The study of the health workforce has gained in prominence in recent years, as the dynamic interconnections between human resource issues and health system effectiveness have come into sharper focus. This paper reviews lessons relating to strategic management challenges emerging from the growing literature in this area. Workforce issues are strategic: they affect overall system performance as well as the feasibility and sustainability of health reforms. Viewing workforce issues strategically forces health authorities to confront the yawning gaps between policy and implementation in many developing countries. Lessons emerge in four areas. One concerns imbalances in workforce structure, whether from a functional specialization, geographical or facility lens. These imbalances pose a strategic challenge in that authorities must attempt to steer workforce distribution over time using a limited range of policy tools. A second group of lessons concerns the difficulties of central-level steering of the health workforce, often critically weak due to the lack of proper information systems and the complexities of public sector decentralization and service commercialization trends affecting the grassroots.A third cluster examines worker capacity and motivation, often shaped in developing countries as much by the informal norms and incentives as by formal attempts to support workers or to hold them accountable. Finally, a range of reforms centering on service contracting and improvements to human resource management are emerging. Since these have as a necessary (but not sufficient) condition some flexibility in personnel practices, recent trends towards the sharing of such functions with local authorities are promising. The paper identifies a number of current lines of productive research, focusing on the relationship between health policy reforms and the local institutional environments in which the workforce, both public and private, is deployed.

Risk management and post-marketing surveillance of CNS drugs.

PubMed

Henningfield, Jack E; Schuster, Charles R

2009-12-01

Drugs affecting the central nervous system span a broad range of chemical entities, dosage forms, indications, and risks. Unintended consequences include potential abuse and overdose in non-patient drug abusers, deliberate tampering of drug dosage forms, and criminal behavior associated with diversion. Regulators must consider diverse factors to find the appropriate conditions of approval to minimize unintended consequences while enabling a level of access desired by health care providers and patients. This commentary appears as part of a special issue of Drug and Alcohol Dependence that focuses on risk management and post-marketing surveillance and addresses key issues that pose real-world challenges to pharmaceutical sponsors and regulators in particular. For example, in the U.S., Controlled Substances Act drug scheduling can be considered a risk management strategy but its legal authorities and administrative processes are independent from those of risk management (including Risk Evaluation and Mitigation Strategies or REMS); better harmonization of these approaches is vital from drug development and regulatory perspectives. Risk management would ideally be implemented on a strong science foundation demonstrating that the tools employed to mitigate risks and ensure safe use are effective. In reality, research and evaluation of tools in this area is in its infancy and will necessarily be an evolutionary process; furthermore, there is little precedent for linking interventions and program evolution to unintended consequences such as regional outbreaks of abuse and diversion. How such issues are resolved has the potential to stimulate or stifle innovations in drug development and advance or imperil health care.

The effectiveness of risk communication regarding drug safety information: a nationwide survey by the Japanese public health insurance claims data.

PubMed

Hagiwara, Hiromi; Nakano, Shun; Ogawa, Yoshihiro; Tohkin, Masahiro

2015-06-01

We evaluated the effectiveness of warning letters published by the pharmaceutical regulatory agency in Japan on communication of drug safety and risk by quantitative analysis of the national health insurance claims database (NHICD). We then explored what factors may have affected risk communication. We measured the implementation rate of the hepatitis virus-monitoring test among methotrexate (MTX)-treated patients; a warning letter had been issued regarding the use of MTX, as it apparently activates the hepatitis virus. Data from the NHICD, which include 99·3% of Japanese residents, were used. A total of 4,933,481 patients with rheumatoid arthritis (RA) (January-June, 2010) were the focus of this study. The implementation rate of the hepatitis virus-monitoring test increased from 1·4% before to 1·8% after the warning letter announcement. Logistic regression analysis suggested that the installation of a drug information management room is one of the important factors affecting risk communication. Further analysis revealed that the hepatitis virus monitoring rates in hospitals without drug information management rooms increased from 2·3% to 4·1% due to the issue of the warning letter. The warning letter from the regulatory agency plays an important role in risk communication in hospitals without drug information management rooms. © 2015 John Wiley & Sons Ltd.

Practicing participative management in the clinical laboratory. Foster a productive and satisfying staff.

PubMed

Boissoneau, R; McPherson, J

1991-01-01

Employee participation and involvement are at the leading edge of management thinking today. Not only behaviorally oriented managers, but managers of all styles include personnel in decision-making. The purpose of this article is to communicate to clinical laboratory managers some recent developments in people management. Several suggestions for team building and the desired outcome of worker participation are included. Although employee participation has been a major issue in management for 10 years, many business schools still emphasize only the traditional quantitative subjects of accounting, finance, statistics, and systems engineering. Obviously, these subjects are important, but modern managers must learn qualitative or behavioral material as well. Students are affected by the lack of a notable behavioral emphasis. Unfortunately, some students think that learning in the behavioral domain is unimportant. Too often, these students encounter problems later in their careers with employees and can only wish for greater knowledge.

Using intensive case management to reduce violence by mentally ill persons in the community.

PubMed

Dvoskin, J A; Steadman, H J

1994-07-01

Aggressive and intensive case management and a comprehensive array of community support services are the keys to reducing the risk of violence by people with serious mental illness in the community. The authors describe the elements of intensive case management for potentially violent clients, including use of individual case managers responsible for small caseloads, 24-hour availability of case managers, and strong linkages to agencies providing mental health services, substance abuse treatment, and social services as well as to the criminal justice system. They summarize the results of three recent studies of intensive case management programs suggesting that this intervention is effective in reducing clients' dangerousness in the community. They discuss cultural and human resource issues that affect planning of intensive case management services. Intensive case managers need to be "boundary spanners" with the training, experience, and personality to bridge the often-broad gap between human service and criminal justice systems.

Information management challenges of the EOS Data and Information System

NASA Technical Reports Server (NTRS)

Mcdonald, Kenneth R.; Blake, Deborah J.

1991-01-01

An overview of the current information management concepts that are embodied in the plans for the Earth Observing System Data and Information System (EOSDIS) is presented, and some of the technology development and application areas that are envisioned to be particularly challenging are introduced. The Information Management System (IMS) is the EOSDIS element that provides the primary interface between the science users and the data products and services of EOSDIS. The goals of IMS are to define a clear and complete set of functional requirements and to apply innovative methods and technologies to satisfy them. The information management functions are described in detail, and some applicable technolgies are discussed. Some of the general issues affecting the successful development and operation of the information management element are addressed.

Development of a Short-Form Version of the Physical Education Classroom Instrument: Measuring Secondary Pupils' Disruptive Behaviours

ERIC Educational Resources Information Center

Krech, Paul R.; Kulinna, Pamela H.; Cothran, Donetta

2010-01-01

Background: Effective classroom management is the cornerstone of successful teaching. Behavioural issues affect the classroom climate as well as the time available for learning. Pupil misbehaviours can also contribute to teacher stress and burn out resulting in teachers leaving the profession. It is important for us to understand more about pupil…

Missing Link: Integrated Individual Leadership Development, Employee Engagement, and Customer Value-Added Improvement

ERIC Educational Resources Information Center

Heldenbrand, Lois; Simms, Michael S.

2012-01-01

Long-term care is a key public issue that affects all of us in some way at some time of our lives. Nowhere is performance improvement and quality management more imperative. Through an 8-month field study and follow-up case study, we discuss how using an integrated approach to individual leadership development, employee engagement, and customer…

Institutional Governance and Management Systems in Sub-Saharan Africa Higher Education: Developments and Challenges in a Ghanaian Research University

ERIC Educational Resources Information Center

Abugre, James B.

2018-01-01

This article examines the developments and challenges of higher education in developing countries. Using a thorough qualitative interview of deans, directors and heads of Department of the University of Ghana, this paper draws on their analysis to discover unexplored issues that affect the universities in developing countries. The study identifies…

The Non-Participation Survey: Understanding Why High School Students Choose Not to Eat School Lunch

ERIC Educational Resources Information Center

Asperin, Amelia Estepa; Nettles, Mary Frances; Carr, Deborah H.

2010-01-01

Purpose/Objectives: The purpose of this project was to develop and validate a survey that will enable school nutrition (SN) directors and managers to identify and address issues affecting the non-participation of high school students in the National School Lunch Program (NSLP). Methods: The research was conducted in two phases. Qualitative data…

Wilderness fire science: A state of knowledge review

Treesearch

James K. Agee

2000-01-01

Wilderness fire science has progressed since the last major review of the topic, but it was significantly affected by the large fire events of 1988. Strides have been made in both fire behavior and fire effects, and in the issues of scaling, yet much of the progress has not been specifically tied to wilderness areas or funding. Although the management of fire in...

30 CFR 219.415 - How will bonus and royalty credits affect revenues allocated to Gulf producing States?

Code of Federal Regulations, 2010 CFR

2010-07-01

... revenues allocated to Gulf producing States? 219.415 Section 219.415 Mineral Resources MINERALS MANAGEMENT... allocated to Gulf producing States? If bonus and royalty credits issued under Section 104(c) of the Gulf of Mexico Energy Security Act are used to pay bonuses or royalties on leases in the 181 Area located in the...

76 FR 36515 - Rangeland Allotment Management Planning on the Fall River and Oglala Geographic Areas, Pine Ridge...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-22

... full environmental analysis and decision-making process that will occur on the proposal so interested and affected people may become aware of how they may participate in the process and contribute to the... issued to update the project schedule. There will be a record of decision (ROD) for each geographic area...

Invertebrates, ecosystem services and climate change.

PubMed

Prather, Chelse M; Pelini, Shannon L; Laws, Angela; Rivest, Emily; Woltz, Megan; Bloch, Christopher P; Del Toro, Israel; Ho, Chuan-Kai; Kominoski, John; Newbold, T A Scott; Parsons, Sheena; Joern, A

2013-05-01

The sustainability of ecosystem services depends on a firm understanding of both how organisms provide these services to humans and how these organisms will be altered with a changing climate. Unquestionably a dominant feature of most ecosystems, invertebrates affect many ecosystem services and are also highly responsive to climate change. However, there is still a basic lack of understanding of the direct and indirect paths by which invertebrates influence ecosystem services, as well as how climate change will affect those ecosystem services by altering invertebrate populations. This indicates a lack of communication and collaboration among scientists researching ecosystem services and climate change effects on invertebrates, and land managers and researchers from other disciplines, which becomes obvious when systematically reviewing the literature relevant to invertebrates, ecosystem services, and climate change. To address this issue, we review how invertebrates respond to climate change. We then review how invertebrates both positively and negatively influence ecosystem services. Lastly, we provide some critical future directions for research needs, and suggest ways in which managers, scientists and other researchers may collaborate to tackle the complex issue of sustaining invertebrate-mediated services under a changing climate. © 2012 The Authors. Biological Reviews © 2012 Cambridge Philosophical Society.

Sustainable WEE management in Malaysia: present scenarios and future perspectives

NASA Astrophysics Data System (ADS)

Rezaul Hasan Shumon, Md; Ahmed, S.

2013-12-01

Technological advances have resulted development of a lot of electronic products for continuously increasing number of customers. As the customer taste and features of these products change rapidly, the life cycles have come down tremendously. Therefore, a large volume of e-wastes are now emanated every year. This scenario is very much predominant in Malaysia. On one hand e-wastes are becoming environmental hazards and affecting the ecological imbalance. On the other, these wastes are remaining still economically valuable. In Malaysia, e-waste management system is still in its nascent state. This paper describes the current status of e-waste generation and recycling and explores issues for future e-waste management system in Malaysia from sustainable point of view. As to draw some factual comparisons, this paper reviews the e-waste management system in European Union, USA, Japan, as a benchmark. Then it focuses on understanding the Malaysian culture, consumer discarding behavior, flow of the materials in recycling, e-waste management system, and presents a comparative view with the Swiss e-waste system. Sustainable issues for e-waste management in Malaysia are also presented. The response adopted so far in collection and recovery activities are covered in later phases. Finally, it investigates the barriers and challenges of e-waste system in Malaysia.

Could Wearable and Mobile Technology Improve the Management of Essential Tremor?

PubMed Central

Daneault, Jean-Francois

2018-01-01

Essential tremor (ET) is the most common movement disorder. Individuals exhibit postural and kinetic tremor that worsens over time and patients may also exhibit other motor and non-motor symptoms. While millions of people are affected by this disorder worldwide, several barriers impede an optimal clinical management of symptoms. In this paper, we discuss the impact of ET on patients and review major issues to the optimal management of ET; from the side-effects and limited efficacy of current medical treatments to the limited number of people who seek treatment for their tremor. Then, we propose seven different areas within which mobile and wearable technology may improve the clinical management of ET and review the current state of research in these areas. PMID:29725318

Factors of accepting pain management decision support systems by nurse anesthetists

PubMed Central

2013-01-01

Background Pain management is a critical but complex issue for the relief of acute pain, particularly for postoperative pain and severe pain in cancer patients. It also plays important roles in promoting quality of care. The introduction of pain management decision support systems (PM-DSS) is considered a potential solution for addressing the complex problems encountered in pain management. This study aims to investigate factors affecting acceptance of PM-DSS from a nurse anesthetist perspective. Methods A questionnaire survey was conducted to collect data from nurse anesthetists in a case hospital. A total of 113 questionnaires were distributed, and 101 complete copies were returned, indicating a valid response rate of 89.3%. Collected data were analyzed by structure equation modeling using the partial least square tool. Results The results show that perceived information quality (γ=.451, p<.001), computer self-efficacy (γ=.315, p<.01), and organizational structure (γ=.210, p<.05), both significantly impact nurse anesthetists’ perceived usefulness of PM-DSS. Information quality (γ=.267, p<.05) significantly impacts nurse anesthetists’ perceptions of PM-DSS ease of use. Furthermore, both perceived ease of use (β=.436, p<.001, R2=.487) and perceived usefulness (β=.443, p<.001, R2=.646) significantly affected nurse anesthetists’ PM-DSS acceptance (R2=.640). Thus, the critical role of information quality in the development of clinical decision support system is demonstrated. Conclusions The findings of this study enable hospital managers to understand the important considerations for nurse anesthetists in accepting PM-DSS, particularly for the issues related to the improvement of information quality, perceived usefulness and perceived ease of use of the system. In addition, the results also provide useful suggestions for designers and implementers of PM-DSS in improving system development. PMID:23360305

On the relation between trust and fairness in environmental risk management.

PubMed

Earle, Timothy C; Siegrist, Michael

2008-10-01

In this study, we empirically examine the relations between trust, fairness, and cooperation within two environmental risk management contexts, one in which the focal issue is of high personal moral importance and the other in which the focal issue is of low moral importance. Using an experimental design embedded in two parallel survey questionnaires, one mailed to residents of Washington State, the other to German-speaking residents of Switzerland, we either manipulated or constructed three factors, issue importance (high/low), procedural fairness (fair/unfair), and policy outcome (risk averse/risk accepting). This design enabled us to compare the predictions of the standard account of procedural fairness, that trust and cooperation are determined by judgments of fairness, with the predictions of an alternative account, that trust and cooperation will be determined by judgments of procedural fairness only when the issue involved is not morally important. Results for the American case showed that under conditions of high issue importance, policy outcome affected judged fairness, trust, and cooperation. Under conditions of low issue importance, policy outcome had no effect on judged fairness or trust but did have a moderate impact on cooperation. Analyses also showed that when issue importance was high, procedural fairness had no effects. When issue importance was low, procedural fairness had moderate effects on judged fairness and trust. Results for the Swiss case replicated the main findings for the American case. Together, these results support the alternative model of the relation between trust and fairness, suggesting that the efficacy of fair procedures is strictly limited.

Safety climate in university and college laboratories: impact of organizational and individual factors.

PubMed

Wu, Tsung-Chih; Liu, Chi-Wei; Lu, Mu-Chen

2007-01-01

Universities and colleges serve to be institutions of education excellence; however, problems in the areas of occupational safety may undermine such goals. Occupational safety must be the concern of every employee in the organization, regardless of job position. Safety climate surveys have been suggested as important tools for measuring the effectiveness and improvement direction of safety programs. Thus, this study aims to investigate the influence of organizational and individual factors on safety climate in university and college laboratories. Employees at 100 universities and colleges in Taiwan were mailed a self-administered questionnaire survey; the response rate was 78%. Multivariate analysis of variance revealed that organizational category of ownership, the presence of a safety manager and safety committee, gender, age, title, accident experience, and safety training significantly affected the climate. Among them, accident experience and safety training affected the climate with practical significance. The authors recommend that managers should address important factors affecting safety issues and then create a positive climate by enforcing continuous improvements.

How Supervisor Relationships and Protection Rules Affect Employees' Attempts to Manage Health Information at Work.

PubMed

Westerman, Catherine Y K; Currie-Mueller, Jenna L; Motto, Justin S; Curti, Logan C

2017-12-01

This article explores the issue of health information sharing at work through the lens of Communication Privacy Management theory. As employees must often share some health information at work for various reasons (e.g., to obtain sick leave or accommodations), determining how much to share and how to manage health information is important. The leader-member exchange relationship, stigma, risk perceptions, and the degree of privacy of each individual's health information were investigated. The results show that leader-member exchange, stigma, and privacy contribute to an individual's willingness to disclose health information at work and that leader-member exchange impacts perceptions of risk associated with sharing health information.

78 FR 6218 - Fisheries of the Caribbean, Gulf of Mexico, and South Atlantic; Reef Fish Fishery of the Gulf of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-30

...NMFS issues this final rule to implement management measures described in Amendment 38 to the Fishery Management Plan for the Reef Fish Resources of the Gulf of Mexico (FMP) prepared by the Gulf of Mexico (Gulf) Fishery Management Council (Council). This final rule modifies post-season accountability measures (AMs) that affect the recreational harvest of shallow-water grouper species (SWG), changes the trigger for recreational sector AMs for gag and red grouper, and revises the Gulf reef fish framework procedure. The intent of this final rule is to achieve optimum yield (OY) while ensuring the Gulf reef fish fishery resources are utilized efficiently.

Dynamic tables: an architecture for managing evolving, heterogeneous biomedical data in relational database management systems.

PubMed

Corwin, John; Silberschatz, Avi; Miller, Perry L; Marenco, Luis

2007-01-01

Data sparsity and schema evolution issues affecting clinical informatics and bioinformatics communities have led to the adoption of vertical or object-attribute-value-based database schemas to overcome limitations posed when using conventional relational database technology. This paper explores these issues and discusses why biomedical data are difficult to model using conventional relational techniques. The authors propose a solution to these obstacles based on a relational database engine using a sparse, column-store architecture. The authors provide benchmarks comparing the performance of queries and schema-modification operations using three different strategies: (1) the standard conventional relational design; (2) past approaches used by biomedical informatics researchers; and (3) their sparse, column-store architecture. The performance results show that their architecture is a promising technique for storing and processing many types of data that are not handled well by the other two semantic data models.

Dental health of children with cerebral palsy

PubMed Central

Jan, Basil M.; Jan, Mohammed M.

2016-01-01

Cerebral palsy (CP) is a common chronic motor disorder with associated cognitive, communicative, and seizure disorders. Children with CP have a higher risk of dental problems creating significant morbidity that can further affect their wellbeing and negatively impact their quality of life. Screening for dental disease should be part of the initial assessment of any child with CP. The objective of this article is to present an updated overview of dental health issues in children with CP and outline important preventative and practical strategies to the management of this common comorbidity. Providing adequate oral care requires adaptation of special dental skills to help families manage the ongoing health issues that may arise. As oral health is increasingly recognized as a foundation for general wellbeing, caregivers for CP patients should be considered an important component of the oral health team and must become knowledgeable and competent in home oral health practices. PMID:27744459

Countertransference and failure to report child abuse and neglect.

PubMed

Pollak, J; Levy, S

1989-01-01

Though every state has laws requiring the report of suspected child abuse and neglect, failure to report remains a significant problem. Review of previous research on failure to report suggests that the reporters' anxieties about disrupting their relationship with the child's family as well as the reporters' gender, experience, and training affect willingness to report. Countertransference fear, guilt, shame, and sympathy are discussed as a basis for understanding the reporter's anxieties. We suggest that countertransference issues should be addressed in the training and ongoing practice of mandated reporters. The following mechanisms are offered to deal with this issue in training and practice: (1) teaching professionals about how countertransference reactions may arise during the reporting process (this training may include the use of risk management groups for private practitioners); (2) identification of a community child abuse expert for consultation; and (3) educating child protection workers about psychodynamics aspects of case management.

Wood material use in the U.S. cabinet industry 1999 to 2001

Treesearch

David Olah; Robert Smith; Bruce. Hansen

2003-01-01

Fax and mail questionnaires were used to estimate consumption of wood-based products by the U.S. cabinet industry and evaluate current management issues affecting the cabinet industry. Results indicated that the cabinet industry used an estimated 484 million board feet (MMBF) of hardwood lumber. Nearly 95 percent of the hardwood lumber purchases were grade No. 1 Common...

Worldwide Emerging Environmental Issues Affecting the U.S. Military. March 2006 Report

DTIC Science & Technology

2006-03-01

and their metabolites can increase drug resistance among disease organisms and synthetic hormones can act as endocrine disruptors . Italian...The most important achievement was the adoption of the documentation requirements for LMO shipments for food , feed and processing (LMO-FFPs). The...special management areas, and policies to preserve endangered species - designation of several new protected areas - rejection of lifting the

Current practices and future opportunities for policy on climate change and invasive species.

PubMed

Pyke, Christopher R; Thomas, Roxanne; Porter, Read D; Hellmann, Jessica J; Dukes, Jeffrey S; Lodge, David M; Chavarria, Gabriela

2008-06-01

Climate change and invasive species are often treated as important, but independent, issues. Nevertheless, they have strong connections: changes in climate and societal responses to climate change may exacerbate the impacts of invasive species, whereas invasive species may affect the magnitude, rate, and impact of climate change. We argue that the design and implementation of climate-change policy in the United States should specifically consider the implications for invasive species; conversely, invasive-species policy should address consequences for climate change. The development of such policies should be based on (1) characterization of interactions between invasive species and climate change, (2) identification of areas where climate-change policies could negatively affect invasive-species management, and (3) identification of areas where policies could benefit from synergies between climate change and invasive-species management.

Improving the management of asthma in older adults.

PubMed

Carnegie, Elaine; Jones, Angela

Older people with asthma are a discrete patient group that requires specialist nursing skills and knowledge. They have specific and sometimes hidden needs that will affect their quality of life unless these are addressed by caring and competent nurses who have an interest in asthma. It is necessary to focus on both asthma and ageing to help older people achieve good asthma outcomes. This article discusses the complex physical, social and psychological issues affecting people with asthma aged 64 or older, age-related risk factors for poor control, age-related barriers to assessment and treatment, the scope of pharmacological and non-pharmacological approaches, and principal treatment outcomes. Providing high quality services and information will equip older people to manage their asthma more effectively, attain physical and mental wellbeing, and lead to fewer hospitalisations and fatal episodes in this group.

Results from the NASA Spacecraft Fault Management Workshop: Cost Drivers for Deep Space Missions

NASA Technical Reports Server (NTRS)

Newhouse, Marilyn E.; McDougal, John; Barley, Bryan; Stephens Karen; Fesq, Lorraine M.

2010-01-01

Fault Management, the detection of and response to in-flight anomalies, is a critical aspect of deep-space missions. Fault management capabilities are commonly distributed across flight and ground subsystems, impacting hardware, software, and mission operations designs. The National Aeronautics and Space Administration (NASA) Discovery & New Frontiers (D&NF) Program Office at Marshall Space Flight Center (MSFC) recently studied cost overruns and schedule delays for five missions. The goal was to identify the underlying causes for the overruns and delays, and to develop practical mitigations to assist the D&NF projects in identifying potential risks and controlling the associated impacts to proposed mission costs and schedules. The study found that four out of the five missions studied had significant overruns due to underestimating the complexity and support requirements for fault management. As a result of this and other recent experiences, the NASA Science Mission Directorate (SMD) Planetary Science Division (PSD) commissioned a workshop to bring together invited participants across government, industry, and academia to assess the state of the art in fault management practice and research, identify current and potential issues, and make recommendations for addressing these issues. The workshop was held in New Orleans in April of 2008. The workshop concluded that fault management is not being limited by technology, but rather by a lack of emphasis and discipline in both the engineering and programmatic dimensions. Some of the areas cited in the findings include different, conflicting, and changing institutional goals and risk postures; unclear ownership of end-to-end fault management engineering; inadequate understanding of the impact of mission-level requirements on fault management complexity; and practices, processes, and tools that have not kept pace with the increasing complexity of mission requirements and spacecraft systems. This paper summarizes the findings and recommendations from that workshop, particularly as fault management development issues affect operations and the development of operations capabilities.

Keeping the dream alive: Managing the Space Station Program, 1982 to 1986

NASA Technical Reports Server (NTRS)

Lewin, Thomas J.; Narayanan, V. K.

1990-01-01

The management is described and analyzed of the formative years of the NASA Space Station Program (1982 to 1986), beginning with the successful initiative for program approval by Administrator James M. Beggs through to the decision to bring program management to Reston, Virginia. Emphasis is on internal management issues related to the implementation of the various phases of the program. Themes examined are the problem of bringing programmatic and institutional interests together and focusing them to forward the program; centralized versus decentralized control of the program; how the history of NASA and of the individual installations affected the decisions made; and the pressure from those outside NASA. The four sections are: (1) the decision to build the space station, (2) the design of the management experiment, (3) the experiment comes to life, and (4) the decision reversal.

Management issues of congenital adrenal hyperplasia during the transition from pediatric to adult care.

PubMed

Choi, Jin-Ho; Yoo, Han-Wook

2017-02-01

Steroid 21-hydroxylase deficiency is the most prevalent form of congenital adrenal hyperplasia (CAH), accounting for approximately 95% of cases. With the advent of newborn screening and hormone replacement therapy, most children with CAH survive into adulthood. Adolescents and adults with CAH experience a number of complications, including short stature, obesity, infertility, tumor, osteoporosis, and reduced quality of life. Transition from pediatric to adult care and management of long-term complications are challenging for both patients and health-care providers. Psychosocial issues frequently affect adherence to glucocorticoid treatment. Therefore, the safe transition of adolescents to adult care requires regular follow-up of patients by a multidisciplinary team including pediatric and adult endocrinologists. The major goals for management of adults with 21-hydroxylase deficiency are to minimize the long-term complications of glucocorticoid therapy, reduce hyperandrogenism, prevent adrenal or testicular adrenal rest tumors, maintain fertility, and improve quality of life. Optimized medical or surgical treatment strategies should be developed through coordinated care, both during transition periods and throughout patients' lifetimes. This review will summarize current knowledge on the management of adults with CAH, and suggested appropriate approaches to the transition from pediatric to adult care.

The Impact of Positive and Negative Affect and Issue Framing on Issue Interpretation and Risk Taking.

PubMed

Mittal; Ross

1998-12-01

Two studies examined the influence of transient affective states and issue framing on issue interpretation and risk taking within the context of strategic decision making. In Study 1, participants in whom transient positive or negative affective states were induced by reading a short story showed systematic differences in issue interpretation and risk taking in a strategic decision making context. Compared to negative mood participants, those in a positive mood were more likely to interpret the strategic issue as an opportunity and displayed lower levels of risk taking. Study 2 replicated and extended these results by crossing affective states with threat and opportunity frames. Results showed that framing an issue (as a threat or an opportunity) had a stronger impact on issue interpretation among negative affect participants than among positive affect participants. Affective states also moderated the impact of issue framing on risk taking: the effect of framing on risk-taking was stronger under negative rather than positive affect. These results are interpreted via information-processing and motivational effects of affect on a decision maker. Copyright 1998 Academic Press.

Managed care and critical pathway development: the joint replacement experience.

PubMed

Benham, A J

1999-01-01

This article examines the economic, social, ethical, and political issues affecting total joint replacement patients in a managed care environment. Using general systems theory as a framework, it examines the interrelated historical events that have shaped the development of both joint replacement procedures and managed care, and discusses the extent to which these two phenomena have been mutually influential. Specifically, the article examines the initial development, implementation, and continuing evolution of clinical pathways as an easily identified and relatively discrete manifestation of managed care for the joint replacement population. While the overall impact of managed care is beyond the scope of this presentation, it is hoped that a focus on the practical application of clinical pathways to joint replacement will allow some general principles to emerge that may be useful for both patients and practitioners operating in other aspects of the managed care environment.

Values, attitudes and perceptions of managers as predictors of corporate environmental responsiveness.

PubMed

Papagiannakis, Giorgos; Lioukas, Spyros

2012-06-15

We examine whether managers' values, attitudes, and perceptions influence the greening of organizations. To that purpose, we specify and test a model of corporate environmental responsiveness (CER), drawing upon a modified version of the theory of planned behavior and the value-belief-norm theory. Based on survey data from 142 Greek companies, we find that top managers' personal values influence responses indirectly, through shaping their environmental attitudes, while direct relationship is not significant. Subjective norms, expressing stakeholder expectations, do affect CER, with their effect being stronger than that of attitudes. Managers' perceived ability to handle environmental issues also appears to influence responses. Results have theoretical implications, indicating the significant role of managers' values, attitudes and perceptions in a firm's environmental response. Practical implications are discussed in relation to selection of managers and training. Copyright © 2012 Elsevier Ltd. All rights reserved.

Theory and Practice Meets in Industrial Process Design -Educational Perspective-

NASA Astrophysics Data System (ADS)

Aramo-Immonen, Heli; Toikka, Tarja

Software engineer should see himself as a business process designer in enterprise resource planning system (ERP) re-engineering project. Software engineers and managers should have design dialogue. The objective of this paper is to discuss the motives to study the design research in connection of management education in order to envision and understand the soft human issues in the management context. Second goal is to develop means of practicing social skills between designers and managers. This article explores the affective components of design thinking in industrial management domain. In the conceptual part of this paper are discussed concepts of network and project economy, creativity, communication, use of metaphors, and design thinking. Finally is introduced empirical research plan and first empirical results from design method experiments among the multi-disciplined groups of the master-level students of industrial engineering and management and software engineering.

Rheumatic diseases and sexuality: Disease impact and self-management strategies.

PubMed

Helland, Ylva; Kjeken, Ingvild; Steen, Eldri; Kvien, Tore K; Hauge, Mona-Iren; Dagfinrud, Hanne

2011-05-01

To explore how intimate relationships and sexuality are influenced by rheumatic diseases and to describe self-management strategies used to manage disease consequences. To ensure that data were grounded in patients' language and experiences, individual and focus group interviews were conducted. Purposeful sampling was used to ensure variation in age, sex, disease duration, diagnosis, and marital status among the informants. Participants were men and women ages 18 years or older, were diagnosed with inflammatory rheumatic disease by a rheumatologist, and had a disease duration of ≥2 years. The mean age of the 23 participants was 44 years, the mean disease duration was 13.6 years, and the mean ± SD modified Health Assessment Questionnaire score was 1.58 ± 0.46. Four key themes summarized the main issues described by the informants: between disease and normality, relational aspects, disease-related sexual challenges, and self-management strategies. The results reveal that the disease constituted a disruption in life, requiring a new orientation of sexual identity and relationship. Participants' experiences of sexuality went beyond specific sexual activity, including aspects such as body image and relational issues, illustrating a multidimensional perception of sexuality. A large inter- and intrapersonal variety of impact and a wide range of management strategies were reported. This study shows that sexuality is a vital area of life for people living with arthritis. It is a source of physical pleasure and intimacy with their partner, but may cause anxiety and distress when affected by rheumatic disease. However, various self-management strategies are applied to enhance intimate relationships and sexual activity. Knowledge and openness concerning sexual issues need to be emphasized as part of the competence of health professionals and researchers. Copyright © 2011 by the American College of Rheumatology.

Quality of Diabetes Management in Saudi Arabia: A Review of Existing Barriers.

PubMed

Almutairi, Khalid M

2015-12-01

Diabetes mellitus is a complex disorder that requires continuous management and medical care. The purpose of this review is to identify and summarize the barriers that affect diabetes management in Saudi Arabia. Studies that have examined the quality of diabetes management in Saudi Arabia were identified through online and manual literature searches. Two researchers independently searched and assessed for inclusion/exclusion criteria. All studies were screened by a specialist for the significance of the review. Studies that were included were evaluated for relevance, methodological rigor, and credibility by giving a quality score based on Russell and Gregory's criteria. This review presents an overview of the quality of diabetes management and issues and barriers concerning the improvement of diabetes care in Saudi Arabia. The online literature search yielded 11 studies which met the inclusion criteria. Factors affecting the quality of diabetes care can be categorized into patient factors (such as adherence, compliance, attitudes, beliefs, knowledge, financial resources and co-morbidities) and healthcare providers' factors (including beliefs, attitudes and knowledge, patient - provider interaction and communication). The identified barriers, both from patients and healthcare providers, will help healthcare authorities to improve diabetes management in Saudi Arabia. Improvement of health awareness about disease and disease management should be tailored through continuous patient education. Continuous training and seminars will also expand providers' knowledge that will ensure quality and effective diabetes management.

Conflict in community pharmacy practice

PubMed Central

Gregory, Paul A. M.; Austin, Zubin

2016-01-01

Background: Intraprofessional conflict among pharmacists, regulated technicians and assistants may undermine attempts to advance patient care in community pharmacy. There is no available research examining this issue in light of the evolution of the profession and roles within the profession. Methods: A combination of interviews and focus groups involving pharmacists, technicians and assistants was undertaken. Each participant completed the Conflict Management Scale as a way of identifying conflict management style. Data were analyzed and coded using a constant-comparative, iterative method. Results: A total of 41 pharmacy team members participated in this research (14 pharmacists, 14 technicians and 13 assistants). Four key themes were identified that related to conflict within community pharmacy: role misunderstanding, threats to self-identity, differences in conflict management style and workplace demotivation. Interpretation: As exploratory research, this study highlighted the need for greater role clarity and additional conflict management skills training as supports for the pharmacy team. The impact of conflict in the workplace was described by participants as significant, adverse and multifactorial. Conclusions: To support practice change, there has been major evolution of roles and responsibilities of pharmacists, technicians and assistants. Conflict among pharmacy team members has the potential to adversely affect the quality of care provided to patients and is an issue for managers, owners, regulators and educators. PMID:28286591

Evaluation and review of the safety management system implementation in the Royal Thai Air Force

NASA Astrophysics Data System (ADS)

Chaiwan, Sakkarin

This study was designed to determine situation and effectiveness of the safety management system currently implemented in the Royal Thai Air Force. Reviewing the ICAO's SMS and the RTAF's SMS was conducted to identify similarities and differences between the two safety management systems. Later, the researcher acquired safety statistics from the RTAF Safety Center to investigate effectiveness of its safety system. The researcher also collected data to identify other factors affecting effectiveness of the safety system during conducting in-depth interviews. Findings and Conclusions: The study shows that the Royal Thai Air Force has never applied the International Civil Aviation Organization's Safety management System to its safety system. However, the RTAF's SMS and the ICAO's SMS have been developed based on the same concepts. These concepts are from Richard H. Woods's book, Aviation safety programs: A management handbook. However, the effectiveness of the Royal Thai Air Force's safety system is in good stance. An accident rate has been decreasing regularly but there are no known factors to describe the increasing rate, according to the participants' opinion. The participants have informed that there are many issues to be resolved to improve the RTAF's safety system. Those issues are cooperation among safety center's staffs, attitude toward safety of the RTAF senior commanders, and safety standards.

The OSHA hazardous chemical occupational exposure standard for laboratories.

PubMed

Armbruster, D A

1991-01-01

OSHA's chemical occupational exposure standard for laboratories is an outgrowth of the previously issued Hazard Communication Standard. The standard relieves laboratories from complying with general industry standards but does require compliance with specific laboratory guidelines. The heart of the standard is the creation of a Chemical Hygiene Plan (CHP). The CHP addresses major issues such as safety equipment and procedures, work practices, training, the designation of a chemical hygiene officer, and the provision of medical consultation and examination for affected employees. This new standard, in full effect as of January 31, 1991, presents yet another regulatory challenge to laboratory managers but also ensures a safer environment for laboratory workers.

Potential Follow on Experiments for the Zero Boil Off Tank Experiment

NASA Technical Reports Server (NTRS)

Chato, David; Kassemi, Mohammad

2014-01-01

Cryogenic Storage &Transfer are enabling propulsion technologies in the direct path of nearly all future human or robotic missions; It is identified by NASA as an area with greatest potential for cost saving; This proposal aims at resolving fundamental scientific issues behind the engineering development of the storage tanks; We propose to use the ISS lab to generate & collect archival scientific data:, raise our current state-of-the-art understanding of transport and phase change issues affecting the storage tank cryogenic fluid management (CFM), develop and validate state-of-the-art CFD models to innovate, optimize, and advance the future engineering designs

Perioperative management of patients with congenital or acquired disorders of the QT interval.

PubMed

O'Hare, M; Maldonado, Y; Munro, J; Ackerman, M J; Ramakrishna, H; Sorajja, D

2018-04-01

QT prolongation can be attributable to various causes that can be categorised as acquired or congenital. Arrhythmias related to QT prolongation can result in clinical presentations, such as syncope and sudden cardiac death. The perioperative period presents a number of issues that may affect a patient's risk of developing polymorphic ventricular tachycardia or torsades de pointes. Although most patients may have an unremarkable perioperative course, some may have complications; this review article aims to help clinicians avoid potential complications, and to help them address treatment for perioperative issues that may occur. Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

Socio-economic appraisal of fishing community in Pulicat lagoon, south east coast of India: case study.

PubMed

Devi, V Vandhana; Krishnaveni, M

2012-10-01

Assessment of socio-economic issues of fishing community is an important aspect in framing a strategy for the preservation of eco-systems which leads to sustainable lagoon management. The present investigation analyses the current potential socio-economic status of the fishing community of Pulicat lagoon, the second largest lagoon in India. The socio-economic indicators considered in the study include demography, economic aspects, social aspects and occupation details. The relevant details were collected from 300 fisher folk family by conducting field survey through a well prepared questionnaire in the villages around Pulicat lagoon. The data analysis was done using Statistical Program for Social Sciences (SPSS) to assess the adequacy and precision of the collected data. The important and encouraging socio-economic indicators identified from the field survey for effective lagoon management includes significant presence of younger generation in the region; affinity and self-belongingness of fisher folk towards the lake; better economic status and moderate education level; appreciable fishing income and affinity towards fishing profession. It is emphasized to motivate the fisher folk to improve their work attitude for betterment in economic status. The pertinent lagoon issues, comprising seasonal variation, local fishing issues, pollution from industries, water intake to thermal power plant which directly or indirectly affects the socio-economic status of fishing community, also need much emphasis while proposing sustainable lagoon management system. The information and observation from this study will be very helpful in formulating management policies on the conservation of the Pulicat lagoon ecosystem.

From data to decisions: Processing information, biases, and beliefs for improved management of natural resources and environments

NASA Astrophysics Data System (ADS)

Glynn, Pierre D.; Voinov, Alexey A.; Shapiro, Carl D.; White, Paul A.

2017-04-01

Our different kinds of minds and types of thinking affect the ways we decide, take action, and cooperate (or not). Derived from these types of minds, innate biases, beliefs, heuristics, and values (BBHV) influence behaviors, often beneficially, when individuals or small groups face immediate, local, acute situations that they and their ancestors faced repeatedly in the past. BBHV, though, need to be recognized and possibly countered or used when facing new, complex issues or situations especially if they need to be managed for the benefit of a wider community, for the longer-term and the larger-scale. Taking BBHV into account, we explain and provide a cyclic science-infused adaptive framework for (1) gaining knowledge of complex systems and (2) improving their management. We explore how this process and framework could improve the governance of science and policy for different types of systems and issues, providing examples in the area of natural resources, hazards, and the environment. Lastly, we suggest that an "Open Traceable Accountable Policy" initiative that followed our suggested adaptive framework could beneficially complement recent Open Data/Model science initiatives.

Issues Management and the Role of Strategic Planning. AIR 1985 Annual Forum Paper.

ERIC Educational Resources Information Center

Lozier, G. Gregory; Chittipeddi, Kumar

The integration of issues management into the institutional strategic planning process at Pennsylvania State University is discussed. The significance of issues management as an organizational process is also considered. Stages of the issues management process are: (1) scanning the external environment to identify strategic issues; (2) analyzing…

Distributed Information System Development: Review of Some Management Issues

NASA Astrophysics Data System (ADS)

Mishra, Deepti; Mishra, Alok

Due to the proliferation of the Internet and globalization, distributed information system development is becoming popular. In this paper we have reviewed some significant management issues like process management, project management, requirements management and knowledge management issues which have received much attention in distributed development perspective. In this literature review we found that areas like quality and risk management issues could get only scant attention in distributed information system development.

The Views of School Administrators and Educational Authorities Concerning the Management of Multiculturalism in a Regional Unity of Northern Greece

ERIC Educational Resources Information Center

Matziouri, Apostolia; Tsioumis, Konstantinos; Kyridis, Argyris

2014-01-01

By this research--part only of the findings we expose here--we attempted to investigate the degree up to which the financial crisis that has stricken Greece the latest years and the ascension of the nationalist party "Golden Dawn" have affected the concepts of school principals on multicultural issues. Such a change in the profile of…

Responses to canopy loss and debris deposition in a tropical forest ecosystem: Synthesis from an experimental manipulation simulating effects of hurricane disturbance

Treesearch

A.B. Shiels; Grizelle Gonzalez; M.R. Willig

2014-01-01

Hurricanes, cyclones, or typhoons are intense and broad-scale disturbances that affect many island and coastal ecosystems throughout the world. We summarize the findings of the articles that compose this special issue of Forest Ecology and Management, which focuses on a manipulative experiment (the Canopy Trimming Experiment, CTE) that simulates two key aspects of...

Asymptomatic Bacteriuria in Clinical Urological Practice: Preoperative Control of Bacteriuria and Management of Recurrent UTI.

PubMed

Cai, Tommaso; Mazzoli, Sandra; Lanzafame, Paolo; Caciagli, Patrizio; Malossini, Gianni; Nesi, Gabriella; Wagenlehner, Florian M E; Köves, Bela; Pickard, Robert; Grabe, Magnus; Bjerklund Johansen, Truls E; Bartoletti, Riccardo

2016-01-05

Asymptomatic bacteriuria (ABU) is a common clinical condition that often leads to unnecessary antimicrobial use. The reduction of antibiotic overuse for ABU is consequently an important issue for antimicrobial stewardship and to reduce the emergence of multidrug resistant strains. There are two issues in everyday urological practice that require special attention: the role of ABU in pre-operative prophylaxis and in women affected by recurrent urinary tract infections (rUTIs). Nowadays, this is the time to think over our practice and change our way of thinking. Here, we aimed to summarize the current literature knowledge in terms of ABU management in patients undergoing urological surgery and in patients with rUTIs. In the last years, the approach to patient with ABU has changed totally. Prior to all surgical procedures that do not enter the urinary tract, ABU is generally not considered as a risk factor, and screening and treatment are not considered necessary. On the other hand, in the case of all procedures entering the urinary tract, ABU should be treated in line with the results of a urine culture obtained before the procedure. In patients affected by rUTIs, ABU can even have a protective role in preventing symptomatic recurrence, particularly when Enterococcus faecalis (E. faecalis) has been isolated.

Variables of job satisfaction in medical assistant profession.

PubMed

Duma, Olga-Odetta; Roşu, Solange Tamara; Manole, M; Manole, Alina; Constantin, Brânduşa

2013-01-01

To identify the key favorable issues, showing a high degree of job satisfaction, and also the adverse issues that may affect the work performance among medical assistants. This research is a type of inquiry-based opinion survey carried out by administering a self-managed, anonymous questionnaire, consisting of five sections with 25 items. The study group included 175 medical assistants from all specialties, working in public hospitals in the city of Iasi, who answered the questionnaires. A number of 167 subjects have responded, the return rate being of 95.4%. The respondents were asked to indicate the amount of agreement or disagreement on a typical five-level Likert scale. The study has identified some positive aspects: positive perception of the medical assistant profession (76.6%); concern about personal growth and career development (86.3%); good rel ationships established with other colleagues (71.2%), and some negative aspects: inappropriate work conditions and equipments (70%); the income compared to the volume of work was perceived by majority as an important source of dissatisfaction (80.8%); willingness to work abroad (53.9%). The findings of the present research focused on the variables of job satisfaction in the medical assistant profession and should be a real concern for managers, because the job dissatisfaction may affect the employee's productivity.

The Organizational Decision Making Climate of Issues Management Programs: A Case Study.

ERIC Educational Resources Information Center

Wills, Sandra

A study examined the decision making climate of organizations that are using issues management and what type of model of issues management is followed--theorists have been attempting to define issues management since it began appearing 20 year ago. Subjects, 112 males and 30 females who were professionals working in the area of issues management…

Tsunami Risk Management in Pacific Island Countries and Territories (PICTs): Some Issues, Challenges and Ways Forward

NASA Astrophysics Data System (ADS)

Dominey-Howes, Dale; Goff, James

2013-09-01

The Pacific is well known for producing tsunamis, and events such as the 2011 Tōhoku-oki, Japan disaster demonstrate the vulnerability of coastal communities. We review what is known about the current state of tsunami risk management for Pacific Island countries and territories (PICTs), identify the issues and challenges associated with affecting meaningful tsunami disaster risk reduction (DRR) efforts and outline strategies and possible ways forward. Small island states are scattered across the vast Pacific region and these states have to varying degrees been affected by not only large tsunamis originating in circum-Pacific subduction zones, but also more regionally devastating events. Having outlined and described what is meant by the risk management process, the various problems associated with our current understanding of this process are examined. The poorly understood hazard related to local, regional and distant sources is investigated and the dominant focus on seismic events at the expense of other tsunami source types is noted. We reflect on the challenges of undertaking numerical modelling from generation to inundation and specifically detail the problems as they relate to PICTs. This is followed by an exploration of the challenges associated with mapping exposure and estimating vulnerability in low-lying coastal areas. The latter part of the paper is devoted to exploring what mitigation of the tsunami risk can look like and draw upon good practice cases as exemplars of the actions that can be taken from the local to regional level. Importantly, given the diversity of PICTs, no one approach will suit all places. The paper closes by making a series of recommendations to assist PICTs and the wider tsunami research community in thinking through improvements to their tsunami risk management processes and the research that can underpin these efforts.

5 CFR 2421.21 - Affected by issues raised.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Affected by issues raised. 2421.21 Section 2421.21 Administrative Personnel FEDERAL LABOR RELATIONS AUTHORITY, GENERAL COUNSEL OF THE FEDERAL... § 2421.21 Affected by issues raised. The phrase affected by issues raised, as used in part 2422, should...

A pilot study investigating the effects of trauma, experiential avoidance, and disease management in HIV-positive MSM using methamphetamine.

PubMed

Chartier, Maggie; Vinatieri, Trisha; Delonga, Kathryn; McGlynn, Lawrence M; Gore-Felton, Cheryl; Koopman, Cheryl

2010-01-01

With high rates of trauma among HIV-positive men who have sex with men (MSM) who use methamphetamine, this preliminary pilot study examined the associations between experiential avoidance, trauma symptoms, and management of a chronic illness. Among a small sample of HIV-positive, methamphetamine-using MSM in a California Bay Area County, greater reported experiential avoidance was significantly related to greater reported trauma and symptoms of traumatic stress. Furthermore, greater reported experiential avoidance was significantly related to reduced self-efficacy of illness management and more frequent methamphetamine use. Although further research is needed, these data suggest that addressing issues of experiential avoidance and trauma could affect behavioral choices and treatment outcomes in this high-risk population.

Earnings Management before Rights Issues and the Subsequent Cash Transfer in Chinese Firms

NASA Astrophysics Data System (ADS)

Tsai, Bi-Huei

2009-08-01

Unlike private enterprises in developed markets, political influence is profound upon Chinese state-dominated firms. Under this consideration, this paper demonstrates how political impact interferes in Chinese managers' decisions. State-assigned managers were found to deliberately transfer cash raised via rights issues from the public shareholders to the state by cash dividends in order to please Chinese politicians. Especially, to meet the regulatory requirement of rights issues, managers from firms which distributed more cash dividends in the same year of rights issues were more likely to inflate earnings before rights issues. The earnings inflation which managers use to boost firm's incomes is defined as "earnings management." Furthermore, the empirical results also exhibit that firm's close relationship with the state enables managers to obtain approvals of rights issues easily, which reduces the firm's earnings management tendency. The manager's incentives of earnings management is closely attributed to the political intervention.

The economy of smiles: affect, labour and the contemporary deserving poor.

PubMed

Gerrard, Jessica

2018-02-14

This paper examines the affective dimensions of new forms of informal entrepreneurial work carried out in spaces of unemployment. Situating the analysis within contemporary scholarship on deservingness and on affect and labour, I shed light on the forms of entrepreneurial labour that rely upon affect-driven economies of exchange underpinned by moral judgements of deservingness, value and worth. In particular, this paper draws on a multi-city (Melbourne, London, San Francisco) study of homeless street press sellers (The Big Issue and Street Sheet) to explore the ways in which contemporary practices of charity and care are carried out through individualized market-place exchanges. Sellers' accounts of their work reveal how smiling and being (or looking) happy is a performative expectation that must be managed in the face of poverty and precarity. © London School of Economics and Political Science 2018.

A qualitative study of work-life balance amongst specialist orthodontists in the United Kingdom.

PubMed

Bateman, Lindsey E; Collins, Joanne M; Cunningham, Susan J

2016-12-01

To identify factors affecting work-life balance amongst male and female orthodontists in the UK. A qualitative interview-based study with a cross-sectional design. Specialist orthodontists working in specialist practice and the hospital service in the UK were selected by purposive sampling. In-depth semi-structured interviews were conducted with 18 orthodontic specialists. Interview transcripts were analyzed using Framework Analysis. Four main themes pertaining to work-life balance in orthodontics were identified: work factors affecting work-life balance, life factors affecting work-life balance, perception and effects of work-life balance and suggestions for managing work-life balance within the profession. There was substantial variation in the work-life balance of the orthodontists interviewed in this study; however the majority reported high levels of career satisfaction despite difficulties maintaining a good work-life balance. Whilst there were some clear distinctions in the factors affecting work-life balance between the hospital environment and specialist practice (including additional professional commitments and teaching/training-related issues), there were also a number of similarities. These included, the lack of flexibility in the working day, managing patient expectations, taking time off work at short notice and the ability to work part-time.

Developmental endocrine influences on gender identity: implications for management of disorders of sex development.

PubMed

Byne, William

2006-11-01

When a baby is born, the first medical pronouncement is usually, "It's a boy," or "It's a girl." In most cases, this pronouncement is based simply upon the appearance of the child's external genitalia. Due to variations in the process of sexual differentiation, sometimes the gender that should be assigned is not apparent from inspection of the external genitalia, either because they are "ambiguous" or because their appearance is not congruent with the internal anatomy. Decisions must be made not only about the most appropriate gender to assign the infant but also about the medical and rearing practices that will facilitate optimal psychological development and quality of life for the affected individual. This article will review the approach to managing gender disorders that has evolved since the 1950s. Three issues are identified as central to current shifts that are occurring in the management of these disorders: (a) increased understanding of the biological substrates of gender identity; (b) questions regarding the indications for irreversible cosmetic genital surgeries as a means of reinforcing gender assignments in infancy, and (c) ethical issues pertaining to informed consent and who is entitled to give it, particularly with regard to surgical gender reassignments in infancy. In keeping with the neuropsychiatry theme of this issue, the focus of this article is on prenatal sexual differentiation of the brain as it pertains to the question of psychosexual neutrality at birth.

Cardio-Facio-Cutaneous Syndrome: Clinical Features, Diagnosis, and Management Guidelines

PubMed Central

Magoulas, Pilar L.; Adi, Saleh; Kavamura, Maria Ines; Neri, Giovanni; Noonan, Jacqueline; Pierpont, Elizabeth I.; Reinker, Kent; Roberts, Amy E.; Shankar, Suma; Sullivan, Joseph; Wolford, Melinda; Conger, Brenda; Santa Cruz, Molly; Rauen, Katherine A.

2014-01-01

Cardio-facio-cutaneous syndrome (CFC) is one of the RASopathies that bears many clinical features in common with the other syndromes in this group, most notably Noonan syndrome and Costello syndrome. CFC is genetically heterogeneous and caused by gene mutations in the Ras/mitogen-activated protein kinase pathway. The major features of CFC include characteristic craniofacial dysmorphology, congenital heart disease, dermatologic abnormalities, growth retardation, and intellectual disability. It is essential that this condition be differentiated from other RASopathies, as a correct diagnosis is important for appropriate medical management and determining recurrence risk. Children and adults with CFC require multidisciplinary care from specialists, and the need for comprehensive management has been apparent to families and health care professionals caring for affected individuals. To address this need, CFC International, a nonprofit family support organization that provides a forum for information, support, and facilitation of research in basic medical and social issues affecting individuals with CFC, organized a consensus conference. Experts in multiple medical specialties provided clinical management guidelines for pediatricians and other care providers. These guidelines will assist in an accurate diagnosis of individuals with CFC, provide best practice recommendations, and facilitate long-term medical care. PMID:25180280

Multidisciplinary study on anthropogenic landslides in Nepal

NASA Astrophysics Data System (ADS)

Puglia, Christopher; Derron, Marc-Henri; Nicolet, Pierrick; Sudmeier-Rieux, Karen; Jaboyedoff, Michel; Devkota, Sanjay

2013-04-01

Nepal is a country in which shallow landslide is a frequent phenomenon. Monsoon is the main triggering factor but anthropogenic influence is often significant too. Indeed, many infrastructures, such as roads or water pipes, are not built in a rigorous way because of a lack of funds and knowledge. In the present study we examine the technical, social and economic issues of landslide management for two sites in Nepal. The first site is located in Sanusiruwari VDC (Sindhupalchock district, central Nepal) and the second one in Namadi VDC (Ramecchap district, central Nepal). Both sites are affected by landslides induced by the construction of hydropower plants. These landslides may threaten the viability of the hydropower plants. At both sites the problems are quite similar, but the first site project is a private one and the second one is a public one implemented by the United Nations Development Programme (UNDP). For both sites, bioengineering methods using Vetiver (Vetyveria zizanioides) plantations is the main stabilization measure. To follow the progression of both landslides, fieldwork observations were conducted before and after the 2012 rainy season, including photogrammetric and distancemeter acquisitions. Main issues were discussed with communities and stakeholders of the hydropower projects through interviews and participatory risk mapping. Main issues include: lack of communication between the project managers and communities leading to conflict and the lack of maintenance of the bio-engineering sites, leading to less effective Vetiver growth and slope stabilization. Comparing the landslide management (technical, social and economic) of the two projects allows to point out some specific issues within an integrated risk perspective.

Photovoltaic system criteria documents. Volume 1: Guidelines for evaluating the management and operations planning of photovoltaic applications

NASA Technical Reports Server (NTRS)

Koenig, John C.; Billitti, Joseph W.; Tallon, John M.

1979-01-01

Guidelines are provided to the Field Centers for organization, scheduling, project and cost control, and performance in the areas of project management and operations planning for Photovoltaics Test and Applications. These guidelines may be used in organizing a T and A Project Team for system design/test, site construction and operation, and as the basis for evaluating T and A proposals. The attributes are described for project management and operations planning to be used by the Field Centers. Specifically, all project management and operational issues affecting costs, schedules and performance of photovoltaic systems are addressed. Photovoltaic tests and applications include residential, intermediate load center, central station, and stand-alone systems. The sub-categories of system maturity considered are: Initial System Evaluation Experiments (ISEE); System Readiness Experiments (SRE); and Commercial Readiness Demonstration Projects (CRDP).

Managing biodiversity for a competitive ecotourism industry in tropical developing countries: New opportunities in biological fields

NASA Astrophysics Data System (ADS)

Hakim, Luchman

2017-11-01

Managing biodiversity for sustainable and competitive ecotourism destinations requires a basic understanding of the principles of biology, which are poorly understood in tropical developing countries, including Indonesia. This paper describes the current status of tourism in Indonesia, identifies environment and biodiversity vulnerability in tourism destinations, and explores the challenges of the biological field in supporting ecotourism development. This review found that tourism, especially nature-based and ecotourism, has grown significantly in Indonesia, and the contribution of Indonesian biodiversity has been identified as significant. Threats to biodiversity, however, are found in nature-based tourism destinations. Issues related to pollution, exotic plant species invasion, habitat changes and degradation, habitat loss, and wildlife disturbance are widely reported, indicating the importance of such issues in destination management. Pollution is found in both terrestrial and aquatic ecosystems. Water pollution is an important issue among lakes and rivers. To date, there are few assessments of the impact of tourism activities on aquatic ecosystems, resulting in the management of aquatic ecosystems facing numerous difficulties. These studies identify the invasive plants found, which become a crucial problem in many nature-based tourism destinations, and which significantly contribute to a reduction in the existence of many flora-fauna in a wild habitat. Habitat changes and degradation are mostly influenced by tourism infrastructure development. Massive infrastructure development often leads to habitat loss, which is a crucial step in local biodiversity extinction. Increasing and uncontrolled visitor behaviors influence animal behavior changes, which is recognized as a dangerous phenomenon affecting animal survival in the future. An agenda for future integrative biological research is needed to improve resource management, to increase sustainability and the competitiveness of the tourism industry in Indonesia.

Gastrointestinal Traumatic Injuries: Gastrointestinal Perforation.

PubMed

Revell, Maria A; Pugh, Marcia A; McGhee, Melanie

2018-03-01

The abdomen is a big place even in a small person. Gastrointestinal trauma can result in injury to the stomach, small bowel, colon, or rectum. Traumatic causes include blunt or penetrating trauma, such as gunshot wounds, stabbings, motor vehicle collisions, and crush injuries. Nontraumatic causes include appendicitis, Crohn disease, cancer, diverticulitis, ulcerative colitis, blockage of the bowel, and chemotherapy. The mechanism of injury will affect both the nature and severity of any resulting injuries. Treatment must address the critical and emergent nature of these injuries as well as issues that affect all trauma situations, which include management of hemodynamic instability. Copyright © 2017 Elsevier Inc. All rights reserved.

Race, Racism, and Health Disparities: What Can I Do About It?

PubMed

Nelson, Stephen

2016-08-01

Disparities based on race that target communities of color are consistently reported in the management of many diseases. Barriers to health care equity include the health care system, the patient, the community, and health care providers. This article focuses on the health care system as well as health care providers and how racism and our implicit biases affect our medical decision making. Health care providers receive little or no training on issues of race and racism. As a result, awareness of racism and its impact on health care delivery is low. I will discuss a training module that helps improve awareness around these issues. Until racial issues are honestly addressed by members of the health care team, it is unlikely that we will see significant improvements in racial health care disparities for Americans.

Identifying emerging issues in forestry as a tool for research planning.

Treesearch

Hans M. Gregersen; Allen L. Lundgren; Pamela J. Jakes; David N. Bengston

1989-01-01

A Delphi exercise is used to identify emerging issues in National Forest management and use, the relative importance of the issues, and barriers to resolving issues. USDA Forest Service managers agree on the importance of the 11 issues identified; however, researchers and National Forest managers do not always agree on the importance of issues or barriers.

Flashes and floaters - a practical approach to assessment and management.

PubMed

Kahawita, Shyalle; Simon, Sumu; Gilhotra, Jolly

2014-04-01

Flashes and floaters are common ophthalmic issues for which patients may initially present to their general practitioner. It may be a sign of benign, 
age-related changes of the vitreous or more serious retinal detachment. This article provides a guide to the assessment and management of a patient presenting with flashes and floaters. Although most patients presenting with flashes and floaters have benign 
age-related changes, they must be referred to an ophthalmologist to rule out sight-threatening conditions. Key examination features include the nature of the flashes and floaters, whether one or both eyes are affected and changes in visual acuity or visual field.

Confirmatory Factor Analysis of a Questionnaire Measure of Managerial Stigma Towards Employee Depression.

PubMed

Martin, Angela J; Giallo, Rebecca

2016-12-01

Managers' attitudes play a key role in how organizations respond to employees with depression. We examine the measurement properties of a questionnaire designed to assess managerial stigma towards employees with depression. Using data from a sample of 469 Australian managers representing a wide range of industries and work settings, we conducted a confirmatory factor analysis to assess three proposed subscales representing affective, cognitive and behavioural forms of stigma. Results were equivocal indicating acceptable fit for two-factor (affective and cognitive + behavioural), three-factor (affective, cognitive and behavioural) and higher order models. Failure to demonstrate the discriminant validity of the cognitive and behavioural dimensions, even though they are theoretically distinct, suggests that further work on the scale is warranted. These results provide an extension to the psychometric profile of this measure (exploratory factor analysis; Martin, ). Development of strategies to operationalize this construct will benefit occupational health research and practice, particularly in interventions that aim to reduce the stigma of mental health issues in the workplace or where managers' attitudes are a key mechanism in intervention efficacy. We encourage future research on this measure pertaining in particular to further enhancing all aspects of its construct validity. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Nurse Manager Behaviors That RNs Perceive to Affect Their Job Satisfaction.

PubMed

Feather, Rebecca A; Ebright, Patricia; Bakas, Tamilyn

2015-01-01

Nurse manager behaviors and job satisfaction are commonly addressed in the literature; however, registered nurse (RN) perceptions of nurse manager behaviors provide a unique perspective that may inform future strategies designed to enhance RN job satisfaction. In this paper, the perceptions of RNs were explored through focus groups to learn the behaviors of nurse managers that most influence RNs' job satisfaction. Five focus groups were conducted through semi-structured interviews of a total of 28 RNs to provide data that were coded through qualitative content analysis for themes. The findings provide nurse managers with data related to the perceptions of RNs and the behaviors of managers that influence job satisfaction. The findings identified two conceptual categories of RN perceptions of nurse manager behaviors: manager behaviors supportive of RNs (communication, respect, and feeling cared for) plus the RNs' perceived disconnect of work issues from the manager's role. Findings support past research in relation to the perceptions of RNs wanting to be respected, included in communication, and the need to feel cared for by nurse managers to have higher levels of job satisfaction. © 2014 Wiley Periodicals, Inc.

Nurse managers' experience with ethical issues in six government hospitals in Malaysia: a cross-sectional study.

PubMed

Musa, Maizura binti; Harun-Or-Rashid, M D; Sakamoto, Junichi

2011-11-16

Nurse managers have the burden of experiencing frequent ethical issues related to both their managerial and nursing care duties, according to previous international studies. However, no such study was published in Malaysia. The purpose of this study was to explore nurse managers' experience with ethical issues in six government hospitals in Malaysia including learning about the way they dealt with the issues. A cross-sectional study was conducted in August-September, 2010 involving 417 (69.2%) of total 603 nurse managers in the six Malaysian government hospitals. Data were collected using three-part self-administered questionnaire. Part I was regarding participants' demographics. Part II was about the frequency and areas of management where ethical issues were experienced, and scoring of the importance of 11 pre-identified ethical issues. Part III asked how they dealt with ethical issues in general; ways to deal with the 11 pre-identified ethical issues, and perceived stress level. Data were analyzed using descriptive statistics, cross-tabulations and Pearson's Chi-square. A total of 397 (95.2%) participants experienced ethical issues and 47.2% experienced them on weekly to daily basis. Experiencing ethical issues were not associated with areas of practice. Top area of management where ethical issues were encountered was "staff management", but "patient care" related ethical issues were rated as most important. Majority would "discuss with other nurses" in dealing generally with the issues. For pre-identified ethical issues regarding "patient care", "discuss with doctors" was preferred. Only 18.1% referred issues to "ethics committees" and 53.0% to the code of ethics. Nurse managers, regardless of their areas of practice, frequently experienced ethical issues. For dealing with these, team-approach needs to be emphasized. Proper understanding of the code of ethics is needed to provide basis for reasoning.

Opioid addiction and misuse in adult and adolescent patients with cancer.

PubMed

Pinkerton, Ross; Hardy, Janet R

2017-06-01

In the context of a therapeutic opioid epidemic, particularly in the USA, where increasingly stringent screening for 'at risk' individuals and close monitoring of opioid prescription and use is strongly recommended, the issue of misuse within the cancer population must be addressed. Most patients with advanced cancer will have pain requiring opioid therapy at some stage during their disease course. In the majority, this will provide good pain relief with no short- or longer-term adverse sequelae. A subset will present with substance misuse issues that will influence management and prescribing practice. The potential ethical issues of limiting effective analgesia on the basis of addiction risk or history must be acknowledged. Both a judgemental or 'relaxed' approach to such patients is problematic. Ignoring the situation will not be in the patient's best interest, but an undue focus on this aspect may damage therapeutic relationships with clinicians and adversely affect a holistic approach to care. Clinical practitioners must be aware of the risk factors for opioid misuse and in patients who are not under palliative care consider screening prior to commencing opioids. Clinicians must be able to manage and monitor those identified as having an opioid misuse problem. © 2017 Royal Australasian College of Physicians.

Indications and Warning Analysis Management System IWAMS. A Design Study

DTIC Science & Technology

1980-03-01

First, we must understand the process of warning analysis; we must develop an -;adequate functional model. In the present research we have divided ...and changeable). (In subsequent discussions, considerable attention will be focused on these issues.) -77-7-12Z ’m,77+-U 21 WARNING ANALYSIS MODEL...have charted limitations in man’s memory, attention span, reasoning capability and other cognitive functions. These limitations considerably affect man’s

Worldwide Emerging Environmental Issues Affecting the U.S. Military. November 2005 Report

DTIC Science & Technology

2005-11-01

rapid development. At the program’s launch festivity, the need for developing an international e- waste recycling systems along with transparent...electronic equipment. Sources: Roadmap Set for the Environmentally Sound Management of Electronic Waste in Asia-Pacific under the Basel Convention...34 Tom Dunne, of the agency’s Office of Solid Waste and Emergency Response, wrote in an e-mail message. 4.5 Sunk Weapons Represent a Growing

Influence of Heat Input on the Content of Delta Ferrite in the Structure of 304L Stainless Steel GTA Welded Joints

NASA Astrophysics Data System (ADS)

Sejč, Pavol; Kubíček, Rastislav

2011-12-01

Welding of austenitic stainless steel has its specific issues, even when the weldability is considered good. The main problems of austenitic stainless steel welding are connected with its metallurgical weldability. The amount of the components presented in the structure of stainless steel welded joint affect its properties, therefore the understanding of the behavior of stainless steel during its welding is important for successful processing and allows the fabricators the possibility to manage the resulting issues. This paper is focused on the influence of heat input on the structural changes in GTA welded joints of austenitic stainless steel designated: ASTM SA TP 304L.

The impact of gender-blindness on social-ecological resilience: The case of a communal pasture in the highlands of Ethiopia.

PubMed

Aregu, Lemlem; Darnhofer, Ika; Tegegne, Azage; Hoekstra, Dirk; Wurzinger, Maria

2016-12-01

We studied how the failure to take into account gendered roles in the management of a communal pasture can affect the resilience of this social-ecological system. Data were collected using qualitative methods, including focus group discussions, in-depth interviews, and participant observations from one community in the highlands of Ethiopia. The results show that women are excluded from the informal institution that defines the access and use rules which guide the management of the communal pasture. Consequently, women's knowledge, preferences, and needs are not taken into account. This negatively affects the resilience of the communal pasture in two ways. Firstly, the exclusion of women's knowledge leads to future adaptation options being overlooked. Secondly, as a result of the failure to address women's needs, they start to question the legitimacy of the informal institution. The case study thus shows how excluding women, i.e., side-lining their knowledge and needs, weakens social learning and the adaptiveness of the management rules. Being blind to gender-related issues may thus undermine the resilience of a social-ecological system.

Overlooked issues of snakebite management: time for strategic approach.

PubMed

Girish, K S; Kemparaju, K

2011-01-01

Snakebite is a medical emergency in many parts of the world, particularly in the temperate regions. According to 2007 World Health Organization (WHO) report, there are about 5 million snakebite incidences resulting in 2.5 million envenoming, and 125,000 deaths occur annually. Most affected are the healthy individuals like children and farming populations with resource poor settings and away from health care centers in low-income countries of Africa, Asia and Latin America. In view of this, the WHO has declared snakebite as an ignored health crisis and a tropical disease. Although the death rate has reduced markedly due to anti-venom regiment, several limitations of it offer scope for better understanding of various ignored issues. Currently, snakebite therapeutics facing plethora of scientific, technological and public health challenges, including secondary/long term complications that have not been given importance so far. Because of dearth of knowledge, venom researchers and medical practitioners from affected countries worldwide should join together to accomplish this scenario. In view of this, the present review provides a broader perspective on the possible production and application of highly effective therapeutic master anti-venom, designing master diagnostic kit and also to deal with the inefficacy of anti-venom therapy against local manifestations and secondary complications of snakebite. The review demands thorough understanding of venom pharmacology, inculcating new strategies to handle and to enhance the efficacy of snakebite management and urge the governing systems of affected countries to take steps to curtail accidental debilitation and death rate of healthy individuals due to snakebite.

Impact of climate change and anthropogenic pressure on the water resources of India: challenges in management

NASA Astrophysics Data System (ADS)

Shadananan Nair, K.

2016-10-01

Freshwater resources of India are getting fast degraded and depleted from the changing climate and pressure of fast rising population. Changing intensity and seasonality of rainfall affect quantity and quality of water. Most of the rivers are polluted far above safety limits from the untreated domestic, industrial and agricultural effluents. Changes in the intensity, frequency and tracks of storms salinate coastal aquifers. Aquifers are also under the threat from rising sea level. Groundwater in urban limits and industrial zones are far beyond safety limits. Large-scale destruction of wetlands for industries and residential complexes has affected the quality of surface and groundwater resources in most parts of India. Measures to maintain food security and the new developments schemes such as river linking will further deteriorate the water resources. Falling water availability leads to serious health issues and various socio-economic issues. India needs urgent and appropriate adaptation strategies in the water sector.

Task 7.1 - Strategic Planning: Semi-annual report, July 1- December 31, 1996.

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

Daly, D.J.

As directed by the EERC senior management, activities during the reporting period have focused on research in support of the development of a series of white papers dealing with the status and future direction of select areas of environmental policy. These areas include (1) brownfields, (2) onshore solid waste management, (3) water related policy, (4) climate change, (5) nuclear facility cleanup and waste disposition, and (6) air emissions. Each white paper is designed to consist of two parts: (1) a summary of status and future directions and (2) an evaluation of a select group of key issues. The EERC believesmore » that energy and environmental issues are inseparable and the environmental policy evaluations are considered to be a continuation of the activities begun at the EERC in 1989 focused on the assessment of trends and policies affecting energy industries. The conclusions reached are our own, based on a broad list of sources with certain findings attributed by reference.« less

Understanding cultural issues in the diabetes self-management behaviors of Korean immigrants.

PubMed

Cha, EunSeok; Yang, Kyeongra; Lee, Jia; Min, Jiwon; Kim, Kevin H; Dunbar, Sandra B; Jennings, Bonnie Mowinski

2012-01-01

The purpose of this study was to explore potential factors affecting the self-management behaviors of Korean immigrants with type 2 diabetes mellitus (KIT2Ds). A qualitative descriptive design guided this study. Semistructured interviews lasting 45 to 60 minutes were conducted with 20 KIT2Ds in the participants' preferred language; in all cases, this was Korean. Each interview was audiotaped, transcribed, and analyzed using conventional content analysis. Data analysis was performed in two steps. The data written in Korean were initially analyzed by 3 bilingual researchers. A qualitative researcher then participated in the analysis to refine the findings for presentation to an English-speaking audience while staying true to the data and preserving the nuanced Korean meanings. The mean age of the sample was 64. 5 ± 11.6 years (9 men and 11 women). The mean years of staying in the United States and age at diabetes mellitus diagnosis were 23.6 ± 9.7 years and 52.5 ± 12.3 years, respectively. Three major ideas were identified: (1) issues on treatment regimen related to medications and diet, (2) resources that helped or hindered ability to manage diabetes, and (3) the physician-patient relationship. Important cultural nuances need to be addressed to better prepare KIT2Ds to manage their diabetes more effectively. A culture-specific program should extend beyond a diabetes self-management education delivered in Korean language. Rather, content and education methods need to consider acculturation effects on diabetes management behaviors.

In acceptance we trust? Conceptualising acceptance as a viable approach to NGO security management.

PubMed

Fast, Larissa A; Freeman, C Faith; O'Neill, Michael; Rowley, Elizabeth

2013-04-01

This paper documents current understanding of acceptance as a security management approach and explores issues and challenges non-governmental organisations (NGOs) confront when implementing an acceptance approach to security management. It argues that the failure of organisations to systematise and clearly articulate acceptance as a distinct security management approach and a lack of organisational policies and procedures concerning acceptance hinder its efficacy as a security management approach. The paper identifies key and cross-cutting components of acceptance that are critical to its effective implementation in order to advance a comprehensive and systematic concept of acceptance. The key components of acceptance illustrate how organisational and staff functions affect positively or negatively an organisation's acceptance, and include: an organisation's principles and mission, communications, negotiation, programming, relationships and networks, stakeholder and context analysis, staffing, and image. The paper contends that acceptance is linked not only to good programming, but also to overall organisational management and structures. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

Awareness of Stress-Reduction Interventions on Work Attitudes: The Impact of Tenure and Staff Group in Australian Universities.

PubMed

Pignata, Silvia; Winefield, Anthony H; Provis, Chris; Boyd, Carolyn M

2016-01-01

This study explored the impact of staff group role and length of organizational tenure in the relationship between the awareness of stress interventions (termed intervention awareness: IA) and the work-related attitudinal outcomes of university employees. A two-wave longitudinal study of a sample of 869 employees from 13 universities completed a psychosocial work factors and health questionnaire. Hierarchical regression analyses examined the contribution of staff role and different lengths of organizational tenure with IA and employees' reports of job satisfaction, affective organizational commitment, trust in senior management, and perceived procedural justice. Employees' length of tenure affected the relation between IA and work attitudes, and there were also differences between academic and non-academic staff groups. For non-academic employees, IA predicted job satisfaction, affective organizational commitment, trust in senior management, and perceived procedural justice. However, for academics, IA only predicted job satisfaction and trust which identifies a need to increase the visibility of organizational interventions. Across the tenure groups, IA predicted: (1) perceived procedural justice for employees with five or less years of tenure; (2) job satisfaction for employees with 0-19 years of tenure; (3) trust in senior management for employees with 6-19 years of tenure; and (4) affective organizational commitment for employees with a tenure length of 6-10 years. Employees working at the university for an intermediate period had the most positive perceptions of their organization in terms of IA, job satisfaction, trust in senior management, and affective organizational commitment, whereas employees with 20-38 years of tenure had the least positive perceptions. Results suggest that employees in the middle of their careers report the most positive perceptions of their university. The findings highlight the need to attend to contextual issues in organizational stress and wellbeing interventions and suggest that management may need to implement new strategies and/or promote existing stress-management and reduction strategies to academics, and employees whom are either new to the university or those who have been working for the organization for longer periods of time to ensure that they are aware of organizational strategies to promote employee wellbeing and morale within their work environments.

Financial management and dental school equity, Part II: Tactics.

PubMed

Chambers, David W; Bergstrom, Roy

2004-04-01

Financial management includes all processes that build organizations' equity through accumulating assets in strategically important areas. The tactical aspects of financial management are budget deployment and monitoring. Budget deployment is the process of making sure that costs are fairly allocated. Budget monitoring addresses issues of effective uses and outcomes of resources. This article describes contemporary deployment and monitoring mechanisms, including revenue positive and marginal analysis, present value, program phases, options logic, activity-based costing, economic value added, cost of quality, variance reconciliation, and balanced scorecards. The way financial decisions are framed affects comparative decision-making and even influences the arithmetic of accounting. Familiarity with these concepts should make it possible for dental educators to more fully participate in discussions about the relationships between budgeting and program strategy.

Update on role of agalsidase alfa in management of Fabry disease

PubMed Central

Ramaswami, Uma

2011-01-01

Fabry disease (FD) is an X-linked lysosomal storage disorder that affects both men and women. The manifestations of this heterogeneous disease are multisystemic and progressive. Prior to the development of enzyme replacement therapy, the management and treatment for Fabry disease was largely nonspecific and supportive. Because enzyme replacement therapy became commercially available in 2001, a variety of clinical benefits in Fabry patients have been consistently reported, including improved renal pathology and cardiac function, and reduced severity of neuropathic pain and improved pain-related quality of life. This update focuses on published data on the efficacy and tolerability of enzyme replacement therapy with agalsidase alfa, and gives a brief overview on some of the outstanding management issues in the treatment of this complex disease. PMID:21552486

From data to decisions: Processing information, biases, and beliefs for improved management of natural resources and environments

USGS Publications Warehouse

Glynn, Pierre D.; Voinov, Alexey A.; Shapiro, Carl D.; White, Paul A.

2017-01-01

Our different kinds of minds and types of thinking affect the ways we decide, take action, and cooperate (or not). Derived from these types of minds, innate biases, beliefs, heuristics, and values (BBHV) influence behaviors, often beneficially, when individuals or small groups face immediate, local, acute situations that they and their ancestors faced repeatedly in the past. BBHV, though, need to be recognized and possibly countered or used when facing new, complex issues or situations especially if they need to be managed for the benefit of a wider community, for the longer-term and the larger-scale. Taking BBHV into account, we explain and provide a cyclic science-infused adaptive framework for (1) gaining knowledge of complex systems and (2) improving their management. We explore how this process and framework could improve the governance of science and policy for different types of systems and issues, providing examples in the area of natural resources, hazards, and the environment. Lastly, we suggest that an “Open Traceable Accountable Policy” initiative that followed our suggested adaptive framework could beneficially complement recent Open Data/Model science initiatives.

Clinical management issues vary by specialty in the Victorian Audit of Surgical Mortality: a retrospective observational study

PubMed Central

Vinluan, Jessele; Retegan, Claudia; Chen, Andrew; Beiles, Charles Barry

2014-01-01

Objective Clinical management issues are contributory factors to mortality. The aim of this study was to use data from the Victorian Audit of Surgical Mortality (VASM), an educational peer-review process for surgeons, to discover differences in the incidence of these issues between surgical specialties in order to focus attention to areas of care that might be improved. Design This study used retrospectively analysed observational data from VASM. Clinical management issues between eight specialties were assessed using χ2 analysis. Data sources VASM data were reported by participating public and private health services, the Coroner and self-reporting surgeons across Victoria. Results A total of 2946 specific clinical issues as deficiencies of care were reported. 15% of cases had significant issues of care. The most common clinical management issue was the delay in delivery of treatment. Other clinical issues included the quality of communication and documentation, preoperative and postoperative care, adverse events and protocol issues. There were significant differences in issues between specialties. Conclusions The clinical management issues presented across surgical specialties were similar; however, five issues of clinical care differed significantly in frequency across surgical specialties. The three main issues varying among specialties were complications after operation, communication and postoperative care. Addressing these clinical management issues via the peer-review process may impact positively on patient care. PMID:24980043

Fuzzy Multicriteria Decision Analysis for Adaptive Watershed Management

NASA Astrophysics Data System (ADS)

Chang, N.

2006-12-01

The dramatic changes of societal complexity due to intensive interactions among agricultural, industrial, and municipal sectors have resulted in acute issues of water resources redistribution and water quality management in many river basins. Given the fact that integrated watershed management is more a political and societal than a technical challenge, there is a need for developing a compelling method leading to justify a water-based land use program in some critical regions. Adaptive watershed management is viewed as an indispensable tool nowadays for providing step-wise constructive decision support that is concerned with all related aspects of the water consumption cycle and those facilities affecting water quality and quantity temporally and spatially. Yet the greatest challenge that decision makers face today is to consider how to leverage ambiguity, paradox, and uncertainty to their competitive advantage of management policy quantitatively. This paper explores a fuzzy multicriteria evaluation method for water resources redistribution and subsequent water quality management with respect to a multipurpose channel-reservoir system--the Tseng- Wen River Basin, South Taiwan. Four fuzzy operators tailored for this fuzzy multicriteria decision analysis depict greater flexibility in representing the complexity of various possible trade-offs among management alternatives constrained by physical, economic, and technical factors essential for adaptive watershed management. The management strategies derived may enable decision makers to integrate a vast number of internal weirs, water intakes, reservoirs, drainage ditches, transfer pipelines, and wastewater treatment facilities within the basin and bring up the permitting issue for transboundary diversion from a neighboring river basin. Experience gained indicates that the use of different types of fuzzy operators is highly instructive, which also provide unique guidance collectively for achieving the overarching goals of sustainable development on a regional scale.

Strategic marketing in the NHS: Kwik-health NHS Trust.

PubMed

Laing, A W; Galbraith, A

1995-01-01

Unlike managers in most service organizations, hospital managers do not have significant control over the shape or cost of the service product or the manner of its delivery. Hence, the crucial issue for hospital management to address is how to develop the marketing of a service the control of which is divorced from those with the strategic market perspective. While the internal management of hospital care in NHS is in its infancy, initial developments such as clinical directorates point the way forward in creating a market orientation within provider units. Ultimately, it must be considered what degree of influence over clinical decisions affecting hospital services is realistic, ethical and desirable for strategic marketing and business services. Arguably there is a case for the adoption of some middle ground, with both sides moving from their present positions but perhaps with the clinicians moving furthest.

Kansas State Briefing Book on low-level radioactive waste management

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

Not Available

1981-07-01

The Kansas State Briefing Book is one of a series of state briefing books on low-level radioactive waste management practices. It has been prepared to assist state and federal agency officials in planning for safe low-level radioactive waste disposal. The report contains a profile of low-level radioactive waste generators in Kansas. The profile is the result of a survey of radioactive material licensees in Kansas. The briefing book also contains a comprehensive assessment of low-level radioactive waste management issues and concerns as defined by all major interested parties including industry, government, the media, and interest groups. The assessment was developedmore » through personal communications with representatives of interested parties, and through a review of media sources. Lastly, the briefing book provides demographic and socioeconomic data and a discussion of relevant government agencies and activities, all of which may affect waste management practices in Kansas.« less

Elements affecting food waste in the food service sector.

PubMed

Heikkilä, Lotta; Reinikainen, Anu; Katajajuuri, Juha-Matti; Silvennoinen, Kirsi; Hartikainen, Hanna

2016-10-01

Avoidable food waste is produced in the food service sector, with significant ecological and economical impacts. In order to understand and explain better the complex issue of food waste a qualitative study was conducted on the reasons for its generation in restaurants and catering businesses. Research data were collected during three participatory workshops for personnel from three different catering sector companies in Finland. Based on synthesized qualitative content analysis, eight elements influencing production and reduction of food waste were identified. Results revealed the diversity of managing food waste in the food service sector and how a holistic approach is required to prevent and reduce it. It is crucial to understand that food waste is manageable and should be an integral component of the management system. The model of eight factors provides a framework for recognition and management of food waste in the food service sector. Copyright © 2016 Elsevier Ltd. All rights reserved.

An ethical framework for the management of pain in the emergency department.

PubMed

Venkat, Arvind; Fromm, Christian; Isaacs, Eric; Ibarra, Jordan

2013-07-01

Pain is a ubiquitous problem, affecting more than 100 million individuals in the United States chronically and many more in the acute setting. Up to three-quarters of patients presenting to the emergency department (ED) report pain as a key component of their reasons for requiring acute care. While pain management is a fundamental component of emergency medicine (EM), there are numerous attitudinal and structural barriers that have been identified to effectively providing pain control in the ED. Coupled with public demands and administrative mandates, concerns surrounding ED pain management have reached a crisis level that should be considered an ethical issue in the profession of EM. In this article, the authors propose an ethical framework based on a combination of virtue, narrative, and relationship theories that can be used to address the clinical dilemmas that arise in managing pain in ED patients. © 2013 by the Society for Academic Emergency Medicine.

Challenges of managing child behavior in the 21st century dental setting.

PubMed

Sheller, Barbara

2004-01-01

This paper discussed factors influencing behavior management of the child dental patient. Pediatric dentists are affected by changes in: (1) society; (2) marketing and media; (3) communications and technology; and (4) parenting practices. Behavior of pediatric patients reflects fewer boundaries, less discipline and self-control, and lowered behavioral expectations by parents and contemporary culture. The insurance industry, regulatory bodies, legal system, dental staff, and pediatric dentist education are other influences on behavior management. Responses of the American Academy of Pediatric Dentistry (AAPD), which could support the pediatric dentist in the changing environment, include: (1) research; (2) continuing education for staff and dentists; (3) development of Internet accessible materials for the public; (4) legislative activity; (5) partnering with pediatric medicine to develop new behavior management strategies; (6) establishment of an AAPD Council on Child Behavior; and (7) ongoing critical reassessment of behavior issues by the AAPD.

Are unions an anachronism?

PubMed

Schrank, R

1979-01-01

The labor movement in the United States has its roots deep in the soil of worker discontent over grueling working conditions, low pay, and indifference of bosses, who profited from others' sweaty labor. As more and more grubby jobs are replaced by technological innovations, as work becomes more abstract and everyone wears a white shirt, and as managers schooled in motivation theory and humane ideals of participation replace the owner-bosses of yesterday, what role will the unions have left to play? The author of this article, who has been in both the labor force and management, explores what the changes in the labor market will be in the future and what these changes will mean for labor-management relations. He does not conclude that there is no role for unions-only that it will be very different and that to survive unions will have to tackle new issues in the workplace. That adaptation will affect management's stance as well.

Vermont State Briefing Book on low-level radioactive waste management

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

Not Available

1981-07-01

The Vermont State Briefing Book is one of a series of state briefing books on low-level radioactive waste management practices. It has been prepared to assist state and federal agency officials in planning for safe low-level radioactive waste disposal. The report contains a profile of low-level radioactive waste generators in Vermont. The profile is the result of a survey of Nuclear Regulatory Commission licensees in Vermont. The briefing book also contains a comprehensive assessment of low-level radioactive waste management issues and concerns as defined by all major interested parties including industry, government, the media, and interest groups. The assessment wasmore » developed through personal communications with representatives of interested parties, and through a review of media sources. Lastly, the briefing book provides demographic and socioeconomic data and a discussion of relevant government agencies and activities, all of which may affect waste management practices in Vermont.« less

The peculiarities of process-based approach realization in transport sector company management

NASA Astrophysics Data System (ADS)

Khripko, Elena; Sidorov, Gennadiy

2017-10-01

In the present article we study the phenomena of multiple meaning in understanding process-based management method in construction of transport infrastructure facilities. The idea of multiple meaning is in distortions which appear during reception of the management process paradigm in organizational environment of transport sector. The cause of distortion in process management is organizational resistance. The distortions of management processes are discovered at the level of diffusion among spheres of responsibility, collision in forms of functional, project and process interaction between the owner of the process and its participants. The level of distortion is affected by the attitude towards the result of work which means that process understanding of the result is replaced by the functional one in practice of management. This transfiguration is the consequence of regressive defensive mechanisms of the organizational environment. On the base of experience of forming process management in construction of transport infrastructure facilities company of the issues of diagnostics of various forms of organizational resistance and ways of reducing the destructive influence on managing processes are reviewed.

Nurse managers' experience with ethical issues in six government hospitals in Malaysia: A cross-sectional study

PubMed Central

2011-01-01

Background Nurse managers have the burden of experiencing frequent ethical issues related to both their managerial and nursing care duties, according to previous international studies. However, no such study was published in Malaysia. The purpose of this study was to explore nurse managers' experience with ethical issues in six government hospitals in Malaysia including learning about the way they dealt with the issues. Methods A cross-sectional study was conducted in August-September, 2010 involving 417 (69.2%) of total 603 nurse managers in the six Malaysian government hospitals. Data were collected using three-part self-administered questionnaire. Part I was regarding participants' demographics. Part II was about the frequency and areas of management where ethical issues were experienced, and scoring of the importance of 11 pre-identified ethical issues. Part III asked how they dealt with ethical issues in general; ways to deal with the 11 pre-identified ethical issues, and perceived stress level. Data were analyzed using descriptive statistics, cross-tabulations and Pearson's Chi-square. Results A total of 397 (95.2%) participants experienced ethical issues and 47.2% experienced them on weekly to daily basis. Experiencing ethical issues were not associated with areas of practice. Top area of management where ethical issues were encountered was "staff management", but "patient care" related ethical issues were rated as most important. Majority would "discuss with other nurses" in dealing generally with the issues. For pre-identified ethical issues regarding "patient care", "discuss with doctors" was preferred. Only 18.1% referred issues to "ethics committees" and 53.0% to the code of ethics. Conclusions Nurse managers, regardless of their areas of practice, frequently experienced ethical issues. For dealing with these, team-approach needs to be emphasized. Proper understanding of the code of ethics is needed to provide basis for reasoning. PMID:22085735

Nurse managers and the sandwich support model.

PubMed

Chisengantambu, Christine; Robinson, Guy M; Evans, Nina

2018-03-01

To explore the interplay between the work of nurse managers and the support they receive and provide. Support is the cornerstone of management practices and is pivotal in employees feeling committed to an organisation. Support for nurse managers is integral to effective health sector management; its characteristics merit more attention. The experiences of 15 nurse managers in rural health institutions in South Australia were explored using structured interviews, observation and document review. Effective decision making requires adequate support, which influences the perceptions and performance of nurse managers, creating an environment in which they feel appreciated and valued. An ideal support system is proposed, the "sandwich support model," to promote effective functioning and desirable patient outcomes via support "from above" and "from below." The need to support nurse managers effectively is crucial to how they function. The sandwich support model can improve management practices, more effectively assisting nurse managers. Organisations should revisit and strengthen support processes for nurse managers to maximize efficiencies. This paper contributes to understanding the importance of supporting nurse managers, identifying the processes used and the type of support offered. It highlights challenges and issues affecting support practices within the health sector. © 2017 John Wiley & Sons Ltd.

Prophylactic use of olanzapine and quetiapine from pregnancy to the postpartum period in women with bipolar disorder: a case series.

PubMed

Uguz, Faruk

2017-11-01

The management of bipolar disorder in pregnant and postpartum women is one of the most difficult issues in clinical practice. Data on the efficacy of mood stabilizers, except lithium and antipsychotics, in the maintenance treatment of bipolar disorders during pregnancy and postpartum period are very limited. This report presents results of prophylaxis with olanzapine and quetiapine with regard to affective episodes in pregnancy to the postpartum period.

Women's Health

MedlinePlus

Women have unique health issues. And some of the health issues that affect both men and women can affect women differently. Unique issues ... and men also have many of the same health problems. But these problems can affect women differently. ...

Twenty years of research on water management issues in the Danube Macro-region - past developments and future directions.

PubMed

Feldbacher, Eva; Paun, Mihaela; Reckendorfer, Walter; Sidoroff, Manuela; Stanica, Adrian; Strimbu, Bogdan; Tusa, Iris; Vulturescu, Viorel; Hein, Thomas

2016-12-01

The Danube River-Danube Delta-Black Sea (DBS) region has witnessed major political, social and economic changes during the past three decades, which have profoundly affected the riverine, coastal and marine systems, their water management situation and the development of related research programmes. We reviewed the research activities in the DBS system of the past twenty years to determine the main funding bodies and to assess key research areas and how they varied over time and geographic region. As data basis we used a metadatabase filled with 478 projects addressing environmental and water management issues in the Danube River Basin, covering also the Danube Delta and the north-western Black Sea. As overall outcome extensive research efforts in the field of water management could be proven for the past two decades, despite the tumultuous times of political and economic transformations. One of the main findings was that EU funded projects played a key role for the development of transboundary research collaboration and were also the scientifically most productive one's. Historically, nutrient pollution was the main problem addressed, shifting to pollution in a broader sense and hydromorphological alterations in recent years. The newly arising challenges of climate change impacts and sediment management became important research questions in the last years, too. Most research was performed in the thematic field of navigation, followed by restoration and biodiversity issues. To meet all of the already identified and newly emerging challenges in the DBS System, cross-border and integrated (river-delta-sea) research activities are of major importance and have to be further promoted. We thus suggest drawing up a regional DBS Research Agenda linked to key challenges in water management to strengthen research collaboration and advance targeted scientific projects, an approach fostering also the scientific capacity in the region. Copyright © 2015 Elsevier B.V. All rights reserved.

Third-world development: urbanizing for the future.

PubMed

Mcilwaine, C

1997-01-01

This article reviews some issues reflected in the 1996 UN Habitat II agenda and recent research on urbanization. The themes of the 1996 Habitat conference were urban development, urban poverty, and governance, civil society, and social capital. It is expected that over 50% of total world population will live in cities in the year 2000. Cities are viewed both as engines of economic growth and centers of severe economic, environmental, and social problems. There is some disagreement about whether cities are rational economic structures or what the World Bank's urban agenda is and its relationship with macroeconomic policy. Discussions of global urban issues are criticized for their neglect of issues of equity and poverty, cultural diversity, and identity and representation. Habitat II also stressed urban sustainability. There is growing recognition that urban management involves more than the "Brown Agenda" of environmental and physical aspects of urban growth. Recent studies identify how politics and power affect people's access to basic urban services. Urban economic activity can also contribute to environmental problems. Urban growth affects the provision of health services. Although there is not a consensus on the role of cities in expanding economic and social development and the best management practices, there is sufficient evidence to indicate that urban processes are varied throughout the developing world. The links between urban and rural areas differentiate cities and expose the need to understand the role of intermediate urban areas surrounding and between larger cities. Poverty has become increasingly urbanized, but the extent of poverty is unknown. Habitat II was an unprecedented effort to engage nongovernment groups, local government staff, trade unions, and the private sector and to emphasize community participation. Networks of trust and reciprocity are key to solving poverty, inequality, and disempowerment problems.

Adjustment Issues Affecting Employment for Immigrants from the Former Soviet Union.

ERIC Educational Resources Information Center

Yost, Anastasia Dimun; Lucas, Margaretha S.

2002-01-01

Describes major issues, including culture shock and loss of status, that affect general adjustment of immigrants and refugees from the former Soviet Union who are resettling in the United States. Issues that affect career and employment adjustment are described and the interrelatedness of general and career issues is explored. (Contains 39…

Environmental health science at the U.S. Geological Survey

USGS Publications Warehouse

Buxton, Herbert T.; Bright, Patricia R.

2013-01-01

USGS environmental health science focuses on the environment-health interface. Research characterizes the processes that affect the interaction among the physical environment, the living environment, and people, as well as the factors that affect ecological and human exposure to disease agents and the resulting toxicologic or infectious disease. The mission of USGS in environmental health science is to contribute scientific information to environmental, natural resource, agricultural, and public-health managers, who use that information to support sound decisionmaking. Coordination with partners and stakeholders will enable USGS to focus on the highest priority environmental health issues, to make relevant, timely, and useable contributions, and to become a “partner of first choice” for environmental health science.

Executive roundtable on coal-fired generation

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

NONE

2009-09-15

Power Engineering magazine invited six industry executives from the coal-fired sector to discuss issues affecting current and future prospects of coal-fired generation. The executives are Tim Curran, head of Alstom Power for the USA and Senior Vice President and General Manager of Boilers North America; Ray Kowalik, President and General Manager of Burns and McDonnell Energy Group; Jeff Holmstead, head of Environmental Strategies for the Bracewell Giuliani law firm; Jim Mackey, Vice President, Fluor Power Group's Solid Fuel business line; Tom Shelby, President Kiewit Power Inc., and David Wilks, President of Energy Supply for Excel Energy Group. Steve Blankinship, themore » magazine's Associate Editor, was the moderator. 6 photos.« less

Methods for evaluating riparian habitats with applications to management

USGS Publications Warehouse

Platts, William S.; Armour, C.L.; Booth, G.D.; Bryant, M.; Bufford, J.L.; Cuplin, P.; Jensen, S.; Lienkaemper, G.W.; Minshall, G.W.; Monsen, S.T.; Nelson, R.L.; Sedell, J.R.; Tuhy, J.S.

1987-01-01

Riparian area planning and management is a major national issues today--something that should have been the case a century ago. A century of additive effects of land use has resulted in major impacts on many riparian stream habitats and their fisheries, wildlife, and domestic livestock use. Before scientists can evaluate the influences of various land and water uses on riparian environments, they must first understand these environments. This means being able to detect and measure with confidence the natural and artificial variation and instantaneous conditions of the riparian habitat. These conditions must then be related to the production capability of riparian habitat and any extraneous factors affecting this production potential.

Prevention and management of pelvic organ prolapse

PubMed Central

Giarenis, Ilias

2014-01-01

Pelvic organ prolapse is a highly prevalent condition in the female population, which impairs the health-related quality of life of affected individuals. Despite the lack of robust evidence, selective modification of obstetric events or other risk factors could play a central role in the prevention of prolapse. While the value of pelvic floor muscle training as a preventive treatment remains uncertain, it has an essential role in the conservative management of prolapse. Surgical trends are currently changing due to the controversial issues surrounding the use of mesh and the increasing demand for uterine preservation. The evolution of laparoscopic and robotic surgery has increased the use of these techniques in pelvic floor surgery. PMID:25343034

Managing atopic eczema in childhood: the health visitor and school nurse role.

PubMed

Robinson, Jean

2008-06-01

Atopic eczema affects up to 20% of children in the UK. It is a disease of varying severity, and health visitors and school nurses have a vital role in educating and supporting children and their parents and carers in its management. Diagnosis and assessment needs to consider atopic eczema severity, effect on quality of life and contributing trigger factors. Treatment should be tailored to the individual child and should include education on emollient therapy, the use of topical corticosteroids and other measures. A case study is included to highlight practical issues and the support of the child and family in coping with atopic eczema at home and in school.

Beef alliances: motivations, extent, and future prospects.

PubMed

Schroeder, Ted C; Kovanda, Joseph

2003-07-01

With their growth, it is important to consider how alliances will impact the beef industry in the future. Alliances have the potential to make sweeping changes to cattle production, live and feeder cattle marketing, food safety protocols, use of government grades and standards, ownership structure, supply chain management, wholesale and retail product marketing, risk management, and many other industry activities. In an effort to address these issues, this article addresses the following questions: What is an alliance? What has motivated their proliferation? What have we learned from alliances? What aspects of alliances affect their likelihood of success or failure? What is the future of alliances? Are they a fad or a long-term evolving industry structural change?

Outcomes of weight management in obese pet dogs: what can we do better?

PubMed

German, Alexander J

2016-08-01

Obesity is arguably the biggest health and welfare issue affecting pet dogs. Although successful weight loss has health benefits, current strategies are far from ideal. Many obese dogs that start a weight programme fail to lose weight, or subsequently regain the weight they have lost. Given that current weight loss strategies are not perfect, clinicians need to focus carefully on tailoring the programme, perhaps setting a pragmatic target for weight loss, so as to ensure the benefits are maximised. This review will summarise key findings from recent clinical research into pet obesity, and present a framework for improving success, by better tailoring weight management regimens and end points to the individual.

Psychosocial Issues in Acne Management: Disease Burden, Treatment Adherence, and Patient Support.

PubMed

Zaenglein, Andrea L

2015-09-01

Physical and emotional scarring are equally important burdens of acne vulgaris in patients of any age. Effective therapeutic regimens are readily available, and the consistent and correct use of these medications results in effective disease management, reduced risk for scarring, as well as improvement in various factors that affect quality of life. Nevertheless, adherence to treatment recommendations generally is poor. Clinicians can help improve adherence with a variety of strategies, including counseling, education, and choosing treatment options that are most consistent with a patient's lifestyle. Semin Cutan Med Surg 34(supp5):S92-S94 © 2015 published by Frontline Medical Communications. 2015 published by Frontline Medical Communications.

Origins and consequences of congenital heart defects affecting the right ventricle.

PubMed

Woudstra, Odilia I; Ahuja, Suchit; Bokma, Jouke P; Bouma, Berto J; Mulder, Barbara J M; Christoffels, Vincent M

2017-10-01

Congenital heart disease is a major health issue, accounting for a third of all congenital defects. Improved early surgical management has led to a growing population of adults with congenital heart disease, including patients with defects affecting the right ventricle, which are often classified as severe. Defects affecting the right ventricle often cause right ventricular volume or pressure overload and affected patients are at high risk for complications such as heart failure and sudden death. Recent insights into the developmental mechanisms and distinct developmental origins of the left ventricle, right ventricle, and the outflow tract have shed light on the common features and distinct problems arising in specific defects. Here, we provide a comprehensive overview of the current knowledge on the development into the normal and congenitally malformed right heart and the clinical consequences of several congenital heart defects affecting the right ventricle. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

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

Hurlbut, D. J.; Haase, S.; Brinkman, G.

Pursuant to the Clean Air Act, the U.S. Environmental Protection Agency (EPA) announced in 2009 its intent to issue rules for controlling emissions from Navajo Generating Station that could affect visibility at the Grand Canyon and at several other national parks and wilderness areas. The final rule will conform to what EPA determines is the best available retrofit technology (BART) for the control of haze-causing air pollutants, especially nitrogen oxides. While EPA is ultimately responsible for setting Navajo Generating Station's BART standards in its final rule, it will be the U.S. Department of the Interior's responsibility to manage compliance andmore » the related impacts. This study aims to assist both Interior and EPA by providing an objective assessment of issues relating to the power sector.« less

Chronic diseases are not being managed effectively in either high-risk or low-risk populations in South Africa.

PubMed

Brand, Martin; Woodiwiss, Angela J; Michel, Frederic; Booysens, Hendrik L; Majane, Olebogeng H I; Maseko, Muzi J; Veller, Martin G; Norton, Gavin R

2013-07-29

Primary healthcare is the foundation of a country's healthcare system. Without an efficient and cost-effective programme, the level of healthcare offered across all levels of health management is adversely affected. To analyse the effectiveness of the management of hypertension and diabetes mellitus (DM) among two distinct patient populations, one with significant cardiovascular risk factors and the other without. We performed a case control study of a high-risk group of patients presenting with chronic critical limb ischaemia (CLI) to the Divisions of Vascular Surgery at Charlotte Maxeke Johannesburg Academic Hospital and Chris Hani Baragwanath Academic Hospital, and a randomly selected group of 'healthy' community participants from Johannesburg's South Western Townships (Soweto). We assessed 217 patients with CLI and 1 030 participants from the community. We assessed the number of patients who were not achieving their therapeuatic targets, among those known to be hypertensive (CLI: 44.7%; community: 59.9%) and diabetic (CLI: 83.5%; community: 66%). Undiagnosed diabetes affected 10.8% of patients with CLI and 11% of the community sample. Traditional vascular risk factors are managed poorly at both primary healthcare and at tertiary care levels. There is a need to identify factors that will address this issue.

The effect of federal health policy on occupational medicine.

PubMed

McCunney, R J; Cikins, W

1990-01-01

All three branches of the federal government affect occupational medicine. Notable examples include: 1) the Department of Transportation ruling (1988) requiring drug testing in diverse areas of the transportation industry (executive branch); 2) the Workplace Drug Act (1988) calling for organizations to have a policy towards drug and alcohol abuse (legislative branch); and 3) the Supreme Court ruling on the constitutionality of drug testing in the transportation industry (1989) and that infectious diseases are a handicap in accordance with the 1973 Federal Rehabilitation Act (1987). The executive branch plays a major role in occupational medicine primarily through the Occupational Safety and Health Administration (OSHA), which issues standards based on a rule making process; the executive branch can also affect occupational medicine indirectly, as evidenced by President Reagan's Executive Order 12291 calling for Office of Management and Budget oversight of regulatory initiatives. The legislative branch enacts laws, conducts hearings, and requests reports on the operations of federal agencies. The judicial branch addresses occupational health issues when people affected by an executive ruling want to challenge the ruling; or in the case of the Supreme Court, when deliberating an issue over which two circuit courts of appeal have come to divergent opinions. The Occupational Medicine profession can participate in the political process through awareness of proposed legislation and by responding accordingly with letters, resolutions, or testimony. Similar options exist within the executive branch by participating in the rule-making process. A representative of the Governmental Affairs Committee, through periodic visits with key Washington representatives, can keep members of the American College of Occupational Medicine informed about federal legislative and regulatory activities. In appropriate cases, the organization can then take a formal position on governmental activities that affect the speciality.

How do cancer patients manage unattainable personal goals and regulate their emotions?

PubMed

Schroevers, Maya; Kraaij, Vivian; Garnefski, Nadia

2008-09-01

This article addressed the role of goal adjustment (i.e. disengagement from unattainable goals and reengagement in alternative goals) and cognitive emotion-regulation strategies (i.e. rumination, catastrophizing, positive refocusing) in cancer patients' psychological well-being. We expected that patients who are better able to disengage from unattainable goals, identify alternative goals, and regulate their emotions by positive refocusing and not engaging in rumination and catastrophizing would experience less negative and more positive affect. In this cross-sectional study, data were collected using a self-report questionnaire. Cancer patients (N=108) were recruited on a psychoeducational meeting aimed to inform them about the illness and its consequences. To examine the relationships between goal adjustment, cognitive emotion-regulation strategies, and affect, Pearson correlations were calculated and regression analyses were performed. Regression analyses showed that reengaging in meaningful goals and focusing on pleasant issues were significantly associated with more positive affect. Focusing on pleasant issues was also significantly associated with less negative affect, whereas rumination and catastrophizing were significantly associated with more negative affect. Goal reengagement as well as cognitive emotion-regulation strategies seems to play an important role in cancer patients' psychological well-being. Health care professionals may assist patients in paying more attention to positive experiences in their daily life and in finding new meaningful goals. Techniques based on mindfulness may be used to assist cancer patients in decreasing the repetitive negative thinking about causes, meanings, and consequences of the illness and helping them to focus attention on the present moment.

Treatment of severe non-infectious uveitis in high-risk conditions (Part I): pregnancy and malignancies, management and safety issues.

PubMed

Cordero-Coma, Miguel; Salazar-Méndez, Raquel; Yilmaz, Taygan

2015-07-01

Management of patients with severe immune-mediated uveitis requires the use of immunosuppressive drugs in selected cases. This may be especially challenging in certain patients with concomitant conditions, which could increase the risk of side effects or modify guidelines for the use of such drugs. Therapeutic decision-making and management may be of particular difficulty in pregnancy as well as in patients with associated malignancies unrelated to a specific ophthalmic inflammatory condition. The main aim of this review is to provide an updated comprehensive practical guide for practitioners regarding the therapeutic decision-making and management of patients with severe immune-mediated uveitis in the context of pregnancy and malignancies. Management of patients with immune-mediated uveitis requiring immunosuppressive/immunomodulatory drugs might be particularly complicated by other conditions affecting their health and immune status. Clinicians should take into account such conditions, which might influence treatment response and the clinical outcome of these patients.

Ambiguous meanings of projects as facilitators of sensegiving.

PubMed

Lunkka, Nina; Suhonen, Marjo

2015-10-01

To describe mid-level nurse managers' experiences of sensegiving in the context of hospital projects. Sensegiving is about shaping and affecting how employees see themselves, their work and issues related to their work. It has been little studied in the context of hospital projects from mid-level nurse managers' point of view. Mid-level nurse managers (n = 10) were interviewed about their experiences of projects from the viewpoint of sensegiving during change processes. Data was analysed using discourse analysis. Three repertoires were constructed from the data: the repertoires of regeneration, control and humane. Projects were considered as appropriate ways for sensegiving in hospitals from the viewpoint of mid-level nurse managers. In order to use projects effectively in hospitals as means for change management mid-level nurse managers ought to enhance their role as interpreters during the change process (i.e. strengthen their visioning, talk and dialogue skills). Training on the nature of change as a social and interactive process could deepen mid-level nurse managers' understanding of the change process in the context of hospital projects. © 2014 John Wiley & Sons Ltd.

Issues affecting therapist workforce and service delivery in the disability sector in rural and remote New South Wales, Australia: perspectives of policy-makers, managers and senior therapists.

PubMed

Veitch, Craig; Dew, Angela; Bulkeley, Kim; Lincoln, Michelle; Bundy, Anita; Gallego, Gisselle; Griffiths, Scott

2012-01-01

The disability sector encompasses a broad range of conditions and needs, including children and adults with intellectual and developmental disabilities, people with acquired disabilities, and irreversible physical injuries. Allied health professionals (therapists), in the disability sector, work within government and funded or charitable non-government agencies, schools, communities, and private practice. This article reports the findings of a qualitative study of therapist workforce and service delivery in the disability sector in rural and remote New South Wales (NSW), Australia. The aim was to investigate issues of importance to policy-makers, managers and therapists providing services to people with disabilities in rural and remote areas. The project gathered information via semi-structured interviews with individuals and small groups. Head office and regional office policy-makers, along with managers and senior therapists in western NSW were invited to participate. Participants included 12 policy-makers, 28 managers and 10 senior therapists from NSW government agencies and non-government organisations (NGOs) involved in providing services and support to people with disabilities in the region. Information was synthesised prior to using constant comparative analysis within and across data sets to identify issues. Five broad themes resonated across participants' roles, locations and service settings: (1) challenges to implementing policy in rural and remote NSW; (2) the impact of geographic distribution of workforce and clients; (3) workforce issues - recruitment, support, workloads, retention; (4) equity and access issues for rural clients; and (5) the important role of the NGO sector in rural service delivery and support. Although commitment to providing best practice services was universal, policy-related information transfer between organisations and employees was inconsistent. Participants raised some workforce and service delivery issues that are similar to those reported in the rural health literature but rarely in the context of allied health and disability services. Relatively recent innovations such as therapy assistants, information technology, and trans-disciplinary approaches, were raised as important service delivery considerations within the region. These and other innovations were expected to extend the coverage provided by therapists. Non-government organisations played a significant role in service delivery and support in the region. Participants recognised the need for therapists working for different organisations, in rural areas, to collaborate both in terms of peer support and service delivery to clients.

Case managers and the use of Medicare, Part D.

PubMed

Hensley, Melissa Anne

2011-01-01

The purpose of this study was to examine the experiences and opinions of community-based mental health case managers with the Medicare prescription drug benefit. A qualitative approach, consisting of analysis of data from 3 case manager focus groups, was used to achieve an understanding of the role that case managers played in beneficiaries' access to and use of prescription medicines. Two urban nonprofit community-based mental health agencies. Adults who are disabled by mental illness depend on case managers for information about their prescription drug insurance, help with formulary and plan switching information, and assistance with tasks related to medication adherence in the community. Common themes in the case managers' discussion were managing beneficiary problems, stress for beneficiaries, information and paperwork issues, and cynicism regarding health care reform. The critical role of case managers in the use of Medicare Part D is not well understood or appreciated. Case managers need to be informed about Medicare Part D and ready to advocate for their clients in the community. In addition, it is important for case managers to understand how Medicare Part D affects not only older adults, but also adults living with serious and persistent mental illness.

Financial management challenges for general hospital psychiatry 2001.

PubMed

Goldberg, R J

2001-01-01

Psychiatry programs are facing significant business and financial challenges. This paper provides an overview of these management challenges in five areas: departmental, hospital, payment system, general finance, and policy. Psychiatric leaders will require skills in a variety of business management areas to ensure their program success. Many programs will need to develop new compensation models with more of an emphasis on revenue collection and overhead management. Programs which cannot master these areas are likely to go out of business. For academic programs, incentive systems must address not only clinical productivity, but academic and teaching output as well. General hospital programs will need to develop increased sophistication in differential cost accounting in order to be able to advocate for their patients and program in the current management climate. Clinical leaders will need the skills (ranging from actuarial to negotiations) to be at the table with contract development, since those decisions are inseparable from clinical care issues. Strategic planning needs to consider the value of improving integration with primary care, along with the ability to understand the advantages and disadvantages of risk-sharing models. Psychiatry leaders need to define and develop useful reports shared with clinical division leadership to track progress and identify problems and opportunities. Leaders should be responsible for a strategy for developing appropriate information system architecture and infrastructure. Finally, it is hoped that some leaders will emerge who can further our needs to address inequities in mental health fee schedules and parity issues which affect our program viability.

TQM and lean strategy deployment in Italian hospitals.

PubMed

Chiarini, Andrea; Baccarani, Claudio

2016-10-03

Purpose This paper aims to contribute to the debate concerning total quality management (TQM)-Lean strategy in public healthcare by analyzing the deployment path for implementation, the possible benefits that can be achieved and the encountered pitfalls. Design/methodology/approach Three case studies are drawn from three large Italian hospitals with more than 500 beds each and structured with many departments. The hospitals are located in Tuscany, Italy. These three hospitals have embraced TQM and Lean, starting from strategic objectives and their deployment. At the same time, they have also implemented many TQM-Lean tools. The case studies are based on interviews held with four managers in each of these three public hospitals. Findings Results from the interviews show that there is a specific deployment path for TQM-Lean implementation. The hospitals have also achieved benefits linked to patient satisfaction and improved organizational performances. Problems related to organizational and cultural issues, such as senior managers' commitment, staff management, manufacturing culture and tools adaptation, could affect the benefits. Research limitations/implications The research has been carried out in just three Italian public hospitals. Hence, similar investigations could be managed in other countries. Researchers could also use a larger sample and investigate these issues by means of quantitative inquiry. Practical implications Practitioners could try to apply the deployment path revealed by these case studies in other public and private hospitals. Originality/value The results of this research show that there is a specific, new deployment path for implementing TQM-Lean strategy in some public hospitals.

Comparison of mosquito control programs in seven urban sites in Africa, the Middle East, and the Americas.

PubMed

Impoinvil, Daniel E; Ahmad, Sajjad; Troyo, Adriana; Keating, Joseph; Githeko, Andrew K; Mbogo, Charles M; Kibe, Lydiah; Githure, John I; Gad, Adel M; Hassan, Ali N; Orshan, Laor; Warburg, Alon; Calderón-Arguedas, Olger; Sánchez-Loría, Victoria M; Velit-Suarez, Rosanna; Chadee, Dave D; Novak, Robert J; Beier, John C

2007-10-01

Mosquito control programs at seven urban sites in Kenya, Egypt, Israel, Costa Rica, and Trinidad are described and compared. Site-specific urban and disease characteristics, organizational diagrams, and strengths, weaknesses, obstacles and threats (SWOT) analysis tools are used to provide a descriptive assessment of each mosquito control program, and provide a comparison of the factors affecting mosquito abatement. The information for SWOT analysis is collected from surveys, focus-group discussions, and personal communication. SWOT analysis identified various issues affecting the efficiency and sustainability of mosquito control operations. The main outcome of our work was the description and comparison of mosquito control operations within the context of each study site's biological, social, political, management, and economic conditions. The issues identified in this study ranged from lack of inter-sector collaboration to operational issues of mosquito control efforts. A lack of sustainable funding for mosquito control was a common problem for most sites. Many unique problems were also identified, which included lack of mosquito surveillance, lack of law enforcement, and negative consequences of human behavior. Identifying common virtues and shortcomings of mosquito control operations is useful in identifying "best practices" for mosquito control operations, thus leading to better control of mosquito biting and mosquito-borne disease transmission.

Comparison of mosquito control programs in seven urban sites in Africa, the Middle East, and the Americas

PubMed Central

Impoinvil, Daniel E.; Ahmad, Sajjad; Troyo, Adriana; Keating, Joseph; Githeko, Andrew K.; Mbogo, Charles M; Kibe, Lydiah; Githure, John I.; Gad, Adel M.; Hassan, Ali N.; Orshan, Laor; Warburg, Alon; Calderón-Arguedas, Olger; Sánchez-Loría, Victoria M.; Velit-Suarez, Rosanna; Chadee, Dave D.; Novak, Robert J.; Beier, John C.

2007-01-01

Mosquito control programs at seven urban sites in Kenya, Egypt, Israel, Costa Rica, and Trinidad are described and compared. Site-specific urban and disease characteristics, organizational diagrams, and strengths, weaknesses, obstacles and threats (SWOT) analysis tools are used to provide a descriptive assessment of each mosquito control program, and provide a comparison of the factors affecting mosquito abatement. The information for SWOT analysis is collected from surveys, focus group discussions, and personal communication. SWOT analysis identified various issues affecting the efficiency and sustainability of mosquito control operations. The main outcome of our work was the description and comparison of mosquito control operations within the context of each study site’s biological, social, political, management, and economic conditions. The issues identified in this study ranged from lack of inter-sector collaboration to operational issues of mosquito control efforts. A lack of sustainable funding for mosquito control was a common problem for most sites. Many unique problems were also identified, which included lack of mosquito surveillance, lack of law enforcement, and negative consequences of human behavior. Identifying common virtues and shortcomings of mosquito control operations is useful in identifying “best practices” for mosquito control operations, thus leading to better control of mosquito biting and mosquito-borne disease transmission. PMID:17316882

Interplay between Public Attention and Public Emotion toward Multiple Social Issues on Twitter

PubMed Central

Peng, Tai-Quan; Sun, Guodao; Wu, Yingcai

2017-01-01

This study aims to elucidate the intricate interplay between public attention and public emotion toward multiple social issues. A theoretical framework is developed based on three perspectives including endogenous affect hypothesis, affect transfer hypothesis, and affective intelligence theory. Large-scale longitudinal data with 265 million tweets on five social issues are analyzed using a time series analytical approach. Public attention on social issues can influence public emotion on the issue per se. Social issues interact with one another to attract public attention in both cooperative and competitive ways. Instead of a direct transfer from public emotion to public attention, the public emotion toward a social issue moderates the interaction between the issue and other issue(s). PMID:28081117

Water quality degradation effects on freshwater availability: Impacts to human activities

USGS Publications Warehouse

Peters, N.E.; Meybeck, Michel

2000-01-01

The quality of freshwater at any point on the landscape reflects the combined effects of many processes along water pathways. Human activities on all spatial scales affect both water quality and quantity. Alteration of the landscape and associated vegetation has not only changed the water balance, but typically has altered processes that control water quality. Effects of human activities on a small scale are relevant to an entire drainage basin. Furthermore, local, regional, and global differences in climate and water flow are considerable, causing varying effects of human activities on land and water quality and quantity, depending on location within a watershed, geology, biology, physiographic characteristics, and climate. These natural characteristics also greatly control human activities, which will, in turn, modify (or affect) the natural composition of water. One of the most important issues for effective resource management is recognition of cyclical and cascading effects of human activities on the water quality and quantity along hydrologic pathways. The degradation of water quality in one part of a watershed can have negative effects on users downstream. Everyone lives downstream of the effects of some human activity. An extremely important factor is that substances added to the atmosphere, land, and water generally have relatively long time scales for removal or clean up. The nature of the substance, including its affinity for adhering to soil and its ability to be transformed, affects the mobility and the time scale for removal of the substance. Policy alone will not solve many of the degradation issues, but a combination of policy, education, scientific knowledge, planning, and enforcement of applicable laws can provide mechanisms for slowing the rate of degradation and provide human and environmental protection. Such an integrated approach is needed to effectively manage land and water resources.

Ground equipment for the support of packet telemetry and telecommand

NASA Technical Reports Server (NTRS)

Hell, Wolfgang

1994-01-01

This paper describes ground equipment for packet telemetry and telecommand which has been recently developed by industry for the European Space Agency. The architectural concept for this type of equipment is outlined and the actual implementation is presented. Focus is put on issues related to cross support and telescience as far as they affect the design of the interfaces to the users of the services provided by the equipment and to the management entities in charge of equipment control and monitoring.

High Frontier: The Journal for Space and Missile Professionals. Volume 7, Number 4, August 2011

DTIC Science & Technology

2011-08-01

assess the role of space assets in military operations and the relationship between “white” and “ black ” space—those programs acknowledged and...economize, ratio- nalize, and eventually re-energize the “ black ” space programs in relationship to the “white” programs managed by DoD. Fi- nally, it...Negroponte. Significant issues related to national security space, primarily those affecting the “ black ” programs, were resolved by this EXCOM. By all

Planning, budgeting, and controlling--one look at the future: case-mix cost accounting.

PubMed Central

Thompson, J D; Averill, R F; Fetter, R B

1979-01-01

This paper outlines the system for cost accounting and managerial control which is an extension of the usually accepted departmental costing systems and takes as its units the 383 Diagnosis Related Groups (DRGs) considered to be the hospital's products. It is held that such an approach offers hospital managers a more powerful, analytic, budgeting, and cost-finding tool and offers the opportunity to involve the medical staff in the issues of how their practice patterns are affecting hospital costs. PMID:511578

Streamwater Quality Data from the 2002 Hayman, Hinman, and Missionary Ridge Wildfires, Colorado, 2003

USGS Publications Warehouse

Ranalli, Anthony J.; Stevens, Michael R.

2003-01-01

Concern about water-quality issues related to wildfires in Colorado has intensified because of the wildfires that occurred in Colorado during the summer of 2002. In 2003, the U.S. Geological Survey (USGS) conducted water-quality sampling of burned and unburned watersheds in the areas affected by the Hayman, Hinman, and Missionary Ridge wildfires to provide information to scientists, watershed managers, and public-water suppliers regarding the extent to which wildfires may cause water-quality degradation.

Y2K: prepare, don't panic.

PubMed

Russo, R

1999-04-01

Y2K issues could affect anyone, so it is important for HIV-positive people to make preparations to ensure their health and security. There are wide-ranging opinions about the effects of the so-called Millennium Bug, but some planning will make any changes more manageable. Patients should have adequate supplies of food, water, and medications at home in case of shortages or production problems. Other prudent steps include keeping extra cash on hand and obtaining copies of medical records and benefit plans. Internet resources are listed.

Planning, budgeting, and controlling--one look at the future: case-mix cost accounting.

PubMed

Thompson, J D; Averill, R F; Fetter, R B

1979-01-01

This paper outlines the system for cost accounting and managerial control which is an extension of the usually accepted departmental costing systems and takes as its units the 383 Diagnosis Related Groups (DRGs) considered to be the hospital's products. It is held that such an approach offers hospital managers a more powerful, analytic, budgeting, and cost-finding tool and offers the opportunity to involve the medical staff in the issues of how their practice patterns are affecting hospital costs.

Management of bone disease in women after breast cancer.

PubMed

Milat, F; Vincent, A J

2015-01-01

Breast cancer and osteoporosis are common conditions affecting women, particularly following menopause. With increasing breast cancer incidence, effects of therapies and decreasing mortality, issues relating to the preservation of bone health with breast cancer therapy have become a priority. Contributing factors to bone loss and fractures in women with breast cancer include tumor effects, estrogen deprivation secondary to breast cancer therapies (chemotherapy, ovarian ablation or aromatase inhibitors), natural menopause and secondary causes of bone loss, typically from concurrently prescribed medications. Management of osteoporosis and other survivorship care is complex, and a multi-disciplinary approach is recommended with assessment of risk factors for bone loss, optimization of bone health through lifestyle approaches and pharmacological interventions based on evidence-based algorithms. This review examines the pathophysiology of bone loss and gives guidelines for the management of bone disease in women with breast cancer.

Management of Nursing Workplace Incivility in the Health Care Settings: A Systematic Review.

PubMed

Armstrong, Nancy

2018-05-01

Workplace incivility is a well-documented issue in nursing in the health care setting. It has the potential to cause emotional and physical distress in victims and potentially affects the quality of care provided. The purpose of this study was to critique and summarize the most recent, available evidence related to interventions in assisting nursing staff working in health care settings in managing incivility. This systematic review of literature yielded 10 studies meeting the criteria. The studies were mostly identified as lower quality research. Despite the lower quality of research, the collection of evidence suggests the use of a combination of educational training about workplace incivility, training about effective responses to uncivil workplace behaviors, and active learning activities to practice newly learned communication skills, in assisting nurses in improving their ability to manage incivility in the workplace.

The management of household hazardous waste in the United Kingdom.

PubMed

Slack, R J; Gronow, J R; Voulvoulis, N

2009-01-01

Waste legislation in the United Kingdom (UK) implements European Union (EU) Directives and Regulations. However, the term used to refer to hazardous waste generated in household or municipal situations, household hazardous waste (HHW), does not occur in UK, or EU, legislation. The EU's Hazardous Waste Directive and European Waste Catalogue are the principal legislation influencing HHW, although the waste categories described are difficult to interpret. Other legislation also have impacts on HHW definition and disposal, some of which will alter current HHW disposal practices, leading to a variety of potential consequences. This paper discusses the issues affecting the management of HHW in the UK, including the apparent absence of a HHW-specific regulatory structure. Policy and regulatory measures that influence HHW management before disposal and after disposal are considered, with particular emphasis placed on disposal to landfill.

Practical guidelines for managing adults with 22q11.2 deletion syndrome

PubMed Central

Fung, Wai Lun Alan; Butcher, Nancy J.; Costain, Gregory; Andrade, Danielle M.; Boot, Erik; Chow, Eva W.C.; Chung, Brian; Cytrynbaum, Cheryl; Faghfoury, Hanna; Fishman, Leona; García-Miñaúr, Sixto; George, Susan; Lang, Anthony E.; Repetto, Gabriela; Shugar, Andrea; Silversides, Candice; Swillen, Ann; van Amelsvoort, Therese; McDonald-McGinn, Donna M.; Bassett, Anne S.

2015-01-01

22q11.2 Deletion syndrome (22q11.2DS) is the most common microdeletion syndrome in humans, estimated to affect up to 1 in 2,000 live births. Major features of this multisystem condition include congenital anomalies, developmental delay, and an array of early- and later-onset medical and psychiatric disorders. Advances in pediatric care ensure a growing population of adults with 22q11.2DS. Informed by an international panel of multidisciplinary experts and a comprehensive review of the existing literature concerning adults, we present the first set of guidelines focused on managing the neuropsychiatric, endocrine, cardiovascular, reproductive, psychosocial, genetic counseling, and other issues that are the focus of attention in adults with 22q11.2DS. We propose practical strategies for the recognition, evaluation, surveillance, and management of the associated morbidities. PMID:25569435

Biomarkers of susceptibility: State of the art and implications for occupational exposure to engineered nanomaterials

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

Iavicoli, Ivo, E-mail: ivo.iavicoli@unina.it

Rapid advances and applications in nanotechnology are expected to result in increasing occupational exposure to nano-sized materials whose health impacts are still not completely understood. Scientific efforts are required to identify hazards from nanomaterials and define risks and precautionary management strategies for exposed workers. In this scenario, the definition of susceptible populations, which may be at increased risk of adverse effects may be important for risk assessment and management. The aim of this review is to critically examine available literature to provide a comprehensive overview on susceptibility aspects potentially affecting heterogeneous responses to nanomaterials workplace exposure. Genetic, genotoxic and epigeneticmore » alterations induced by nanomaterials in experimental studies were assessed with respect to their possible function as determinants of susceptibility. Additionally, the role of host factors, i.e. age, gender, and pathological conditions, potentially affecting nanomaterial toxicokinetic and health impacts, were also analysed. Overall, this review provides useful information to obtain insights into the nanomaterial mode of action in order to identify potentially sensitive, specific susceptibility biomarkers to be validated in occupational settings and addressed in risk assessment processes. The findings of this review are also important to guide future research into a deeper characterization of nanomaterial susceptibility in order to define adequate risk communication strategies. Ultimately, identification and use of susceptibility factors in workplace settings has both scientific and ethical issues that need addressing. - Highlights: • To define susceptible populations is important for risk assessment and management; • Genetic susceptibility may influence the individual response to nanomaterial exposure; • Susceptibility factors in workplace settings have both scientific and ethical issues.« less

A retrospective study of mortality in varanid lizards (Reptilia: Squamata: Varanidae) at the Bronx Zoo: implications for husbandry and reproductive management in zoos.

PubMed

Mendyk, Robert W; Newton, Alisa L; Baumer, Megan

2013-03-01

Varanid lizards have been maintained in zoological parks for more than a century, yet few studies to date have attempted to pinpoint significant health issues affecting their management or areas of captive husbandry that are in need of improvement. In an effort to identify and better understand some of the husbandry-related challenges and health issues specifically affecting varanids in zoos, this study examined mortality in 16 species maintained at the Bronx Zoo between 1968 and 2009. Out of 108 records reviewed, complete necropsy reports were available for 85 individuals. Infection-related processes including bacterial (15.3%), protozoal (12.9%), nematode (9.4%), and fungal (3.5%) infections accounted for the greatest number of deaths (47.1%). Noninfectious diseases including female reproductive disorders (7.1%), neoplasia (7.1%), gout (10.8%), and hemipenal prolapse (1.3%) accounted for 29.4% of deaths. Multiple disease agents were responsible for 5.9% of deaths, and a cause for death could not be determined for 17.7% of individuals. Reproductive complications accounted for 11.5% of female deaths, but were identified in 23.1% of females. Although not necessarily the cause for death, gout was present in 18.8% of individuals. Differences in mortality between species, genders, and origin (captive-bred vs. wild-caught) were also evaluated. The results of this study corroborate earlier findings that identify bacterial infections, neoplasia, female reproductive disorders, gout, and endoparasitism as major sources of mortality in captive varanids. In light of these results, we discuss potential etiologies and offer recommendations for improving captive management practices in zoos. © 2012 Wiley Periodicals, Inc.

Availability and utilization of opioids for pain management: global issues.

PubMed

Manjiani, Deepak; Paul, D Baby; Kunnumpurath, Sreekumar; Kaye, Alan David; Vadivelu, Nalini

2014-01-01

Pain can significantly influence an individual's health status and can have serious negative consequences: poor nutrition, decreased appetite, abnormal sleep patterns, fatigue, and impairment of daily living activities. Pain can cause psychological impairment and decrease healing and recovery from injuries and illness. A hallmark of many chronic conditions, pain affects more patients' lives than diabetes mellitus, heart disease, and cancer combined. However, many chronic sufferers do not have access to effective pain management for a variety of reasons, including limited access, restrictions, and personal and cultural biases. This review summarizes issues of access, distribution, and cultural bias with regard to opioid agents and seeks to clarify the challenges related to opioid delivery. The considerable negative physical and mental consequences of chronic pain are discussed for the general and palliative care population. Opioids are an effective treatment for various intractable painful conditions, but problems in global opioid access for safe and rational use in pain management contribute to unnecessary suffering. These problems persist despite increased understanding in recent years of the pathophysiology of pain. Comprehensive guidelines for goal-directed and patient-friendly chronic opiate therapy will potentially enhance the outlook for future chronic pain management. The improvement of pain education in undergraduate and postgraduate training will benefit patients and clinicians. The promise of new medications, along with the utilization of multimodal approaches, has the potential to provide effective pain relief to future generations of sufferers.

ERCMExpress. Volume 3, Issue 4

ERIC Educational Resources Information Center

Taymans, Mary Frances; McDonald, Dale

2007-01-01

The Emergency Response and Crisis Management (ERCM) Technical Assistance Center's "ERCMExpress" is a newsletter that provides comprehensive information on key issues in school emergency management. This issue, entitled "Emergency Management Opportunities and Challenges for Non-Public Schools," examines integrating non-public…

Understanding Cultural Issues in Diabetes Self-Management Behaviors of Korean Immigrants

PubMed Central

Cha, Eun Seok; Yang, Kyeongra; Lee, Jia; Min, Jiwon; Kim, Kevin H.; Dunbar, Sandra B.; Jennings, Bonnie Mowinski

2013-01-01

Purpose The purpose of this study was to explore potential factors affecting self-management behaviors in Korean immigrants with type 2 diabetes mellitus (KIT2Ds). Methods A qualitative descriptive design guided this study. Semi-structured interviews lasting 45-60 minutes were conducted with 20 KIT2Ds in the participant’s preferred language; in all cases this was Korean. Each interview was audio-taped, transcribed, and analyzed using conventional content analysis. Data analysis was performed in two steps. The data written in Korean were initially analyzed by three bilingual researchers. A qualitative researcher then participated in the analysis to refine the findings for presentation to an English speaking audience while staying true to the data and preserving the nuanced Korean meanings. Results The mean age of the sample was 64. 5 ± 11.6 years (9 men and 11 women). The mean years of staying in the U. S. and age at diabetes mellitus diagnosis were 23.6 ± 9.7 years and 52.5 ± 12.3 years, respectively. Three major ideas were identified: (a) issues on treatment regimen related to both medications and diet, (b) resources that helped or hindered their ability to manage diabetes, and (c) the physician/patient relationship. Conclusions There were important cultural nuances that need to be addressed to better prepare KIT2Ds to manage their diabetes more effectively. A culture specific program should extend beyond a diabetes self-management education delivered in Korean language. Rather, content and education methods need to consider acculturation effects on diabetes management behaviors. PMID:23019236

Using Spatial, Economic, and Ecological Opinion Data to Inform Gray Wolf Conservation

PubMed Central

Berry, Meredith S.; Nickerson, Norma P.; Metcalf, Elizabeth Covelli

2018-01-01

Public opinion can be an influential factor in wildlife management decisions. Evaluating public opinions can help legitimize, or delegitimize, management and facilitate long-term conservation goals. This is especially true for the controversial issues surrounding the management of predators. We surveyed Montana, USA, residents during summer of 2013 to measure public opinion regarding economic and ecological impacts of the gray wolf (Canis lupus), and current management of this species. Although opinions were polarized in some areas, a greater percentage of Montanans think that wolves negatively affect the economy, but impact tourism (which contributes to the economy) positively. These differences may reflect the belief that rancher economic losses from wolf predation of cattle is greater than overall tourism gains related to wolves (e.g., wolf-watching), in addition to the perception of wolves negatively affecting big game (e.g., elk [Cervus canadensis]). Results also show that a slightly greater percentage of Montanans feel that wolves positively rather than negatively affect the ecosystem. Regarding specific practices, more Montanans than not have a positive opinion of maintaining wolves on the landscape and also support hunting of wolves. More Montanans hold negative rather than positive opinions, however, regarding wolf trapping. This result was most evident in western Montana as assessed by a spatial distribution of opinions by county and has implications for current wolf management and nontarget species. Results of ordinal regression analyses revealed that big game hunters, males, and those who held negative opinions of the effect of wolves on the Montana ecosystem and economy were significantly more likely to support both hunting and trapping practices. Living in western Montana predicted positive opinions of hunting, but alternatively, negative opinions of trapping. These results provide an understanding of public opinion of wolf management by county as well as statistical inferences that can be useful for informing more regionally oriented management practices. PMID:29706677

Using Spatial, Economic, and Ecological Opinion Data to Inform Gray Wolf Conservation.

PubMed

Berry, Meredith S; Nickerson, Norma P; Metcalf, Elizabeth Covelli

2016-09-01

Public opinion can be an influential factor in wildlife management decisions. Evaluating public opinions can help legitimize, or delegitimize, management and facilitate long-term conservation goals. This is especially true for the controversial issues surrounding the management of predators. We surveyed Montana, USA, residents during summer of 2013 to measure public opinion regarding economic and ecological impacts of the gray wolf ( Canis lupus ), and current management of this species. Although opinions were polarized in some areas, a greater percentage of Montanans think that wolves negatively affect the economy, but impact tourism (which contributes to the economy) positively. These differences may reflect the belief that rancher economic losses from wolf predation of cattle is greater than overall tourism gains related to wolves (e.g., wolf-watching), in addition to the perception of wolves negatively affecting big game (e.g., elk [ Cervus canadensis ]). Results also show that a slightly greater percentage of Montanans feel that wolves positively rather than negatively affect the ecosystem. Regarding specific practices, more Montanans than not have a positive opinion of maintaining wolves on the landscape and also support hunting of wolves. More Montanans hold negative rather than positive opinions, however, regarding wolf trapping. This result was most evident in western Montana as assessed by a spatial distribution of opinions by county and has implications for current wolf management and nontarget species. Results of ordinal regression analyses revealed that big game hunters, males, and those who held negative opinions of the effect of wolves on the Montana ecosystem and economy were significantly more likely to support both hunting and trapping practices. Living in western Montana predicted positive opinions of hunting, but alternatively, negative opinions of trapping. These results provide an understanding of public opinion of wolf management by county as well as statistical inferences that can be useful for informing more regionally oriented management practices.

Effects of abiotic stress and crop management on cereal grain composition: implications for food quality and safety.

PubMed

Halford, Nigel G; Curtis, Tanya Y; Chen, Zhiwei; Huang, Jianhua

2015-03-01

The effects of abiotic stresses and crop management on cereal grain composition are reviewed, focusing on phytochemicals, vitamins, fibre, protein, free amino acids, sugars, and oils. These effects are discussed in the context of nutritional and processing quality and the potential for formation of processing contaminants, such as acrylamide, furan, hydroxymethylfurfuryl, and trans fatty acids. The implications of climate change for cereal grain quality and food safety are considered. It is concluded that the identification of specific environmental stresses that affect grain composition in ways that have implications for food quality and safety and how these stresses interact with genetic factors and will be affected by climate change needs more investigation. Plant researchers and breeders are encouraged to address the issue of processing contaminants or risk appearing out of touch with major end-users in the food industry, and not to overlook the effects of environmental stresses and crop management on crop composition, quality, and safety as they strive to increase yield. © The Author 2014. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Dry period management and optimization of post-partum reproductive management in dairy cattle.

PubMed

Gumen, A; Keskin, A; Yilmazbas-Mecitoglu, G; Karakaya, E; Wiltbank, Mc

2011-09-01

Dry period and early post-partum management are decisive factors for fertility in lactating dairy cows. Previous studies have shown that decreased dry matter intake (DMI) and increased non-esterified fatty acids (NEFA) negatively affect fertility and subsequent milk production. The traditional dry period decreases DMI prior to parturition, resulting in a decrease in energy intake. A negative energy balance increases NEFA concentration, and increased NEFA may impair the immune system, especially by decreasing neutrophil function prior to parturition. Earlier studies have shown that post-partum health disorders, including retained placenta and metritis, were correlated with periparturient neutrophil function. In addition, decreased DMI is also linked to a reduced body condition score (BCS) in dairy cows. These events in the periparturient period negatively affect fertility. Some manipulation, such as shortening the dry period, may be a solution to increased DMI in the periparturient period, preventing post-partum disorders and subsequent fertility issues. This article aims to explain the effects of shortening the dry period on reproduction and early post-partum treatments to improve fertility. In addition, timed artificial insemination protocols will be discussed for use during the post-partum period to improve fertility in dairy cows. © 2011 Blackwell Verlag GmbH.

Impact of Past Land Use Changes on Drinking Water Quantity and Quality in Ljubljana Aquifer

NASA Astrophysics Data System (ADS)

Bracic Zeleznik, Branka; Cencur Curk, Barbara

2010-05-01

Most of the practical problems that we face today with the on-site management of drinking water sources and distribution of healthy drinking water, originate from past actions, interventions and political decisions. In Ljubljana, the capital of the Republic of Slovenia, underlying groundwater is the main drinking water source. The main threat to drinking water sources is constant input of pollutant loads from roads, roofs, sewers, industry and agricultural areas. The main problems are directly and indirectly related to the significant decrease of groundwater level and deterioration of groundwater quality observed in the last decades as an effect of land use practices under varying climate conditions. The Vodovod-Kanalizacija Public Utility is responsible for water supply of the city residents as well as for management of the water supply system, its surveillance and maintenance. In the past, the Ljubljana Municipality was responsible for the protection of water resources and the first delineation of groundwater protection areas was issued in Decree in 1955. In 2004 a Decree on the water protection zones for the aquifer of Ljubljansko polje on the state level was issued and passed the competences of proclamation of the water protection zones to the state. Spatial planning is a domain of The Municipality and land use is limited according to water protection legislation. For several observation wells long-time data sets about groundwater levels and quality are available, which enable us to analyse changes in groundwater quantity and quality parameters. From the data it is obvious that climate variations are affecting groundwater recharge. In addition, changing of land use affects groundwater quality. In spite of the Decree on the water protection there is a heavy pressure of investors to change land use plans and regulations on protection zones, which causes every day problems in managing the drinking water source. Groundwater management in Ljubljana demands strong and effective co-operation between state, municipality, public water supply company and consumers.

The state of human dimensions capacity for natural resource management: needs, knowledge, and resources

USGS Publications Warehouse

Sexton, Natalie R.; Leong, Kirsten M.; Milley, Brad J.; Clarke, Melinda M.; Teel, Tara L.; Chase, Mark A.; Dietsch, Alia M.

2013-01-01

The social sciences have become increasingly important in understanding natural resource management contexts and audiences, and are essential in design and delivery of effective and durable management strategies. Yet many agencies and organizations do not have the necessary resource management. We draw on the textbook definition of HD: how and why people value natural resources, what benefits people seek and derive from those resources, and how people affect and are affected by those resources and their management (Decker, Brown, and Seimer 2001). Clearly articulating how HD information can be used and integrated into natural resource management planning and decision-making is an important challenge faced by the HD field. To address this challenge, we formed a collaborative team to explore the issue of HD capacity-building for natural resource organizations and to advance the HD field. We define HD capacity as activities, efforts, and resources that enhance the ability of HD researchers and practitioners and natural managers and decision-makers to understand and address the social aspects of conservation.Specifically, we sought to examine current barriers to integration of HD into natural resource management, knowledge needed to improve HD capacity, and existing HD tools, resources, and training opportunities. We conducted a needs assessment of HD experts and practitioners, developed a framework for considering HD activities that can contribute both directly and indirectly throughout any phase of an adaptive management cycle, and held a workshop to review preliminary findings and gather additional input through breakout group discussions. This paper provides highlights from our collaborative initiative to help frame and inform future HD capacity-building efforts and natural resource organizations and also provides a list of existing human dimensions tools and resources.

Ecological and management implications of climate-driven changes in spatial and temporal distributions of marine species

NASA Astrophysics Data System (ADS)

Mills, K.; Pershing, A. J.; Nye, J. A.; Henderson, M. E.; Thomas, A. C.; Hernandez, C.; Alexander, M. A.; Schuetz, J.; Allyn, A.

2016-02-01

Ocean temperatures in the Gulf of Maine have warmed rapidly over the past decade, and the seasonal cycle of temperatures has shifted towards earlier warming in the spring and later cooling in the fall. Warming temperatures have been associated with northward shifts in spatial distributions of many marine fish and invertebrate species in the region. In addition, changing phenology—particularly of migratory species—is also being observed. The rates at which species distributions change in space and time vary by species, and these differential rates have important implications for trophic interactions and fisheries. In this presentation, we will identify groups of species on the Northeast Shelf based on whether their distribution responses to warming temperatures lead, lag, or track temperature signals. Life history and population characteristics provide a basis for understanding how species cluster in these groups. Differential rates of changes in spatial and temporal distributions affect trophic interactions. American lobster provides one example of a prey species that may be affected by changes in the spatial distribution and migration phenology of its predators. Changes in natural mortality on important commercial species may affect fisheries by altering stock dynamics and allowable catch levels, but fisheries will also be affected by the need to change their fishing locations, times, or target species. Some of these fishery responses are already being observed in the Northeast, but many are constrained by the management system. Our presentation will conclude by identifying some ways in which fisheries management adjustments might help address issues of stock sustainability and fishery access for species that are experiencing climate-related distribution shifts.

Ethical management in the constitution of a European database for leukodystrophies rare diseases.

PubMed

Duchange, Nathalie; Darquy, Sylviane; d'Audiffret, Diane; Callies, Ingrid; Lapointe, Anne-Sophie; Loeve, Boris; Boespflug-Tanguy, Odile; Moutel, Grégoire

2014-09-01

The EU LeukoTreat program aims to connect, enlarge and improve existing national databases for leukodystrophies (LDs) and other genetic diseases affecting the white matter of the brain. Ethical issues have been placed high on the agenda by pairing the participating LD expert research teams with experts in medical ethics and LD patient families and associations. The overarching goal is to apply core ethics principles to specific project needs and ensure patient rights and protection in research addressing the context of these rare diseases. This paper looks at how ethical issues were identified and handled at project management level when setting up an ethics committee. Through a work performed as a co-construction between health professionals, ethics experts, and patient representatives, we expose the major ethical issues identified. The committee acts as the forum for tackling specific issues tied to data sharing and patient participation: the thin line between care and research, the need for a charter establishing the commitments binding health professionals and the information items to be delivered. Ongoing feedback on the database, including delivering global results in a broad-audience format, emerged as a key recommendation. Information should be available to all patients in the partner countries developing the database and should be scaled to different patient profiles. This work led to a number of recommendations for ensuring transparency and optimizing the partnership between scientists and patients. Copyright © 2014 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Management of pregnancy in women with genetic disorders, Part 1: Disorders of the connective tissue, muscle, vascular, and skeletal systems.

PubMed

Chetty, Shilpa Prema; Shaffer, Brian L; Norton, Mary E

2011-11-01

Due to early diagnosis and increasingly effective medical advances, the number of women with various genetic syndromes who are undergoing pregnancy is increasing, and this represents an important issue for providers of obstetric care. Each year more women with genetic disease reach childbearing age. Advances in assisted reproductive technology have enabled pregnancy in a cohort of woman who may experience impaired fertility due to their underlying diagnosis. Management of these women requires coordination of care by healthcare providers from multiple specialties to optimize outcomes. Potentially serious medical issues specific to each diagnosis often exist in the preconception, antepartum, intrapartum, and postpartum periods, all of which must be recognized to allow timely diagnosis and treatment. The fetus may also face issues related to risk for inheritance of the genetic disorder itself, as well as risks related to the chronic disease status of the mother. This article will explore the issues faced by women with various genetic disorders that may affect connective tissue, muscular, vascular, and skeletal systems. Obstetricians & Gynecologists and Family Physicians. After the completing the CME activity, physicians should be better able to classify the cardiovascular manifestations observed in Marfan syndrome and Ehlers-Danlos, evaluate prenatal diagnostic options and limitations for various genetic syndromes, assess the risks to the fetus in women with various genetic syndromes. Determine whether there is a preferred mode of delivery for pregnant patients with various genetic syndromes described in this paper.

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

DOT National Transportation Integrated Search

1997-03-06

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

Orthotic management of the neuropathic foot: an interdisciplinary care perspective.

PubMed

Robinson, Christopher; Major, Matthew J; Kuffel, Charles; Hines, Kevin; Cole, Pamela

2015-02-01

Clinical management of the patient with neuropathic foot is becoming commonplace in orthotic clinics worldwide. The presentations that can result from neuropathic foot are diverse, requiring clinicians to understand the pathomechanics of ulceration, infection, and Charcot joint arthropathy to provide effective interventions. The purpose of this clinical perspective is to provide a review of the literature regarding clinical concepts associated with orthotic management of neuropathic foot. Literature review and clinical case study. Relevant literature were reviewed and summarized, and a clinical case study synthesizing reviewed concepts was presented. Given the multifactorial nature of the neuropathic foot, treatments must be multifaceted and patient-specific to effectively address the underlying disease processes. While systemic issues such as peripheral arterial disease are treated by physicians, local issues such as foot deformity are managed by orthotists. Orthotic interventions commonly include custom footwear to reduce the risk of ulceration through creation of a protective environment or targeted plantar offloading. Patient and caregiver education to encourage management compliance is equally as important to ensure successful treatment. Patients with neuropathic foot benefit from an interdisciplinary care approach which engages physicians, wound care practitioners, and orthotists to treat and manage systemic and local problems. Addressing this pathology through interdisciplinary care may positively affect the patient's health status while lowering associated healthcare costs through improved treatment efficacy. The commonality of neuropathic foot and associated complications including ulceration, infection, and Charcot joint arthropathy requires that the patient care team have a fundamental understanding of these pathologies and common treatment modalities. We review orthotic treatment modalities to assist clinicians with the management of patients with neuropathic foot. © The International Society for Prosthetics and Orthotics 2014.

Managing Senegalese water resources: Definition and relative importance of information needs

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

Engi, D.

1998-09-01

This report provides an overview of the results of the Vital Issues process as implemented for the Senegal Water Resources Management Initiative, a collaborative effort between the Senegalese Ministry of Water Resources and Sandia National Laboratories. This Initiative is being developed to assist in the development of an efficient and sustainable water resources management system for Senegal. The Vital Issues process was used to provide information for the development of a proposal that will recommend actions to address the key management issues and establish a state-of-the-art decision support system (DSS) for managing Senegal`s water resources. Three Vital Issues panel meetingsmore » were convened to (1) develop a goal statement and criteria for identifying and ranking the issues vital to water resources management in Senegal; (2) define and rank the issues, and (3) identify and prioritize a preliminary list of information needed to address the vital issues. The selection of panelists from the four basic institutional perspectives (government, industry, academe, and citizens` interest groups) ensured a high level of stakeholder representation on the panels.« less

[Case study: school meals' management in Santiago de Cali and Bogota].

PubMed

Díaz, Mónica del Pilar; Montoya, Iván A; Montoya, Luz A

2011-10-01

This research was aimed at ascertaining the state's role regarding hunger and how it manages to combat this matter; a food security program in two Colombian cities was thus assessed (i.e. school meals' provision in Cali and Bogota). A qualitative approach was adopted; documentary analysis, participant observation and in-depth interviews with various actors for both selected cases were used as data collection techniques. It was found that several measures taken in this area were not covered by regulatory principles aimed at covering all the dimensions of food security. Serious weaknesses in school meals' management in Cali were associated with a weak environment regarding the fight against hunger. School meals' management in Bogotá was aimed at recognizing the right to food as being supported by an institutional process where the issue of reducing hunger has become a firm purpose. School meals' program management was associated with the characteristics of its product, thereby affecting the program and the population's food and nutritional status; state management thus becomes another dimension of food security.

Caring for women living with HIV: gaps in the evidence

PubMed Central

Loutfy, Mona R; Sherr, Lorraine; Sonnenberg-Schwan, Ulrike; Walmsley, Sharon L; Johnson, Margaret; d'Arminio Monforte, Antonella

2013-01-01

Introduction In the management of HIV, women and men generally undergo the same treatment pathway, with gender differences being given limited consideration. This is in spite of accumulating evidence that there are a number of potential differences between women and men which may affect response to treatment, pharmacokinetics, toxicities and coping. There are also notable psychological, behavioural, social and structural factors that may have a unique impact on women living with HIV (WLWH). Despite our increasing knowledge of HIV and advances in treatment, there are significant gaps in the data relating specifically to women. One of the factors contributing to this situation is the under-representation of women in all aspects of HIV clinical research. Furthermore, there are clinical issues unique to women, including gynaecologic and breast diseases, menopause-related factors, contraception and other topics related to women's and sexual health. Methods Using scoping review methodology, articles from the literature from 1980 to 2012 were identified using appropriate MeSH headings reflecting the clinical status of WLWH, particularly in the areas of clinical management, sexual health, emotional wellbeing and treatment access. Titles and abstracts were scanned to determine whether they were relevant to non-reproductive health in WLWH, and papers meeting inclusion criteria were reviewed. Results This review summarizes our current knowledge of the clinical status of WLWH, particularly in the areas of clinical management, sexual health, emotional wellbeing and treatment access. It suggests that there are a number of gender differences in disease and treatment outcomes, and distinct women-specific issues, such as menopause and co-morbidities, that pose significant challenges to the care of WLWH. Conclusions Based on a review of this evidence, outstanding questions and areas where further studies are required to determine gender differences in the efficacy and safety of treatment and other clinical and psychological issues specifically affecting WLWH have been identified. Well-controlled and adequately powered clinical studies are essential to help provide answers to these questions and to contribute to activities aimed at improving the health and wellbeing of WLWH. PMID:24088395

Survivorship in Non-Small Cell Lung Cancer: Challenges Faced and Steps Forward.

PubMed

Vijayvergia, Namrata; Shah, Prashant C; Denlinger, Crystal S

2015-09-01

Improvements in curative therapies and the advent of screening have led to increased numbers of non-small cell lung cancer (NSCLC) survivors. Most survivors have undergone invasive treatment (surgery, radiation therapy, and/or chemotherapy) and carry a higher comorbidity burden than survivors of other cancers. Overall quality of life (QOL) and health-related quality of life (HRQOL) suffer during the treatment phase, with the potential for long-term decline, and both clinical characteristics and treatment impact these measures. Physical and mental components of HRQOL seem to be most at risk for decline. The issues faced by survivors include physical symptoms such as respiratory issues, fatigue, hearing loss, neuropathy, and postsurgical pain; psychological distress leading to depression, financial issues, and poor compliance with recommended guidelines; and fear or risk of recurrence and secondary malignancies. This article summarizes the major issues faced by NSCLC survivors and suggests appropriate management. Future collaborative efforts are needed to further elucidate the complex issues that affect overall QOL and HRQOL in NSCLC survivors and to develop appropriate interventions in this large and diverse survivor population. Copyright © 2015 by the National Comprehensive Cancer Network.

Identity Management Systems in Healthcare: The Issue of Patient Identifiers

NASA Astrophysics Data System (ADS)

Soenens, Els

According to a recent recommendation of the European Commission, now is the time for Europe to enhance interoperability in eHealth. Although interoperability of patient identifiers seems promising for matters of patient mobility, patient empowerment and effective access to care, we see that today there is indeed a considerable lack of interoperability in the field of patient identification. Looking from a socio-technical rather than a merely technical point of view, one can understand the fact that the development and implementation of an identity management system in a specific healthcare context is influenced by particular social practices, affected by socio-economical history and the political climate and regulated by specific data protection legislations. Consequently, the process of making patient identification in Europe more interoperable is a development beyond semantic and syntactic levels. In this paper, we gives some examples of today’s patient identifier systems in Europe, discuss the issue of interoperability of (unique) patient identifiers from a socio-technical point of view and try not to ignore the ‘privacy side’ of the story.

Common Elements in Rare Kidney Diseases: Conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.

PubMed

Aymé, Ségolène; Bockenhauer, Detlef; Day, Simon; Devuyst, Olivier; Guay-Woodford, Lisa M; Ingelfinger, Julie R; Klein, Jon B; Knoers, Nine V A M; Perrone, Ronald D; Roberts, Julia; Schaefer, Franz; Torres, Vicente E; Cheung, Michael; Wheeler, David C; Winkelmayer, Wolfgang C

2017-10-01

Rare kidney diseases encompass at least 150 different conditions, most of which are inherited. Although individual rare kidney diseases raise specific issues, as a group these rare diseases can have overlapping challenges in diagnosis and treatment. These challenges include small numbers of affected patients, unidentified causes of disease, lack of biomarkers for monitoring disease progression, and need for complex care. To address common clinical and patient issues among rare kidney diseases, the KDIGO Controversies Conference entitled, Common Elements in Rare Kidney Diseases, brought together a panel of multidisciplinary clinical providers and patient advocates to address five central issues for rare kidney diseases. These issues encompassed diagnostic challenges, management of kidney functional decline and progression of chronic kidney disease, challenges in clinical study design, translation of advances in research to clinical care, and provision of practical and integrated patient support. Thus, by a process of consensus, guidance for addressing these challenges was developed and is presented here. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

Measuring competition in health care markets.

PubMed Central

Baker, L C

2001-01-01

OBJECTIVE: Measuring competition is increasingly important for analysis of health care markets and policies. Measurement of competition in health care is made complex by the breadth of potential issues under study, by the lack of necessary data, and by rapid changes in health care financing and delivery. This study reviews key issues in the measurement of competition and is designed to familiarize researchers and policymakers interested in competition measurement, but not steeped in its practice, with key concepts, data sources, and ways of adapting measures to fit ongoing changes in health care markets. PRINCIPAL FINDINGS: Attention to several key issues will strengthen measurement. Important components of successful measurement are: careful identification of the products and market areas for study; selection of Herfindahl-Hirschman or other indices to fit the issues being considered; consideration of econometric problems, like endogeneity, with common measures; and attention to the ways that current marketplace changes, like growth in managed care, affect the performance of classic measures. Data needed for constructing measures are also frequently scarce, insufficient, or both. Measurement could be improved with access to better data. PMID:11327175

Monitoring the condition of natural resources in US national parks.

PubMed

Fancy, S G; Gross, J E; Carter, S L

2009-04-01

The National Park Service has developed a long-term ecological monitoring program for 32 ecoregional networks containing more than 270 parks with significant natural resources. The monitoring program assists park managers in developing a broad-based understanding of the status and trends of park resources as a basis for making decisions and working with other agencies and the public for the long-term protection of park ecosystems. We found that the basic steps involved in planning and designing a long-term ecological monitoring program were the same for a range of ecological systems including coral reefs, deserts, arctic tundra, prairie grasslands, caves, and tropical rainforests. These steps involve (1) clearly defining goals and objectives, (2) compiling and summarizing existing information, (3) developing conceptual models, (4) prioritizing and selecting indicators, (5) developing an overall sampling design, (6) developing monitoring protocols, and (7) establishing data management, analysis, and reporting procedures. The broad-based, scientifically sound information obtained through this systems-based monitoring program will have multiple applications for management decision-making, research, education, and promoting public understanding of park resources. When combined with an effective education program, monitoring results can contribute not only to park issues, but also to larger quality-of-life issues that affect surrounding communities and can contribute significantly to the environmental health of the nation.

Reducing Livestock Effects on Public Lands in the Western United States as the Climate Changes: A Reply to Svejcar et al

NASA Astrophysics Data System (ADS)

Beschta, Robert L.; Donahue, Debra L.; DellaSala, Dominick A.; Rhodes, Jonathan J.; Karr, James R.; O'Brien, Mary H.; Fleischner, Thomas L.; Williams, Cindy Deacon

2014-06-01

Svejcar et al. (Environ Manage, 2014) offered several perspectives regarding Beschta et al. (Environ Manage 51:474-491, 2013)—a publication that addressed the interacting ecological effects of climate change and domestic, wild, and feral ungulates on public lands in the western United States (US)—by largely focusing on three livestock grazing issues: (1) legacy versus current day impacts; (2) grazing as a fire reduction tool; and (3) the complexity of grazing. Regarding these issues, we indicate that (1) legacy effects to western ecosystems were indeed significant and contemporary livestock use on public lands generally maintains or exacerbates many of those effects; (2) livestock grazing has been a major factor affecting fire frequency, fire severity, and ecosystem trajectories in the western US for over a century; and (3) the removal or reduction of grazing impacts in these altered ecosystems is the most effective means of initiating ecological recovery. Svejcar et al. (Environ Manage, 2014) offer no evidence that livestock use is consistent with the timely recovery of grazing-degraded uplands, riparian areas, or stream systems. We thus conclude that public-land ecosystems can best persist or cope with a changing climate by significantly reducing ungulate grazing and related impacts.

Using pupil size and heart rate to infer affective states during behavioral neurophysiology and neuropsychology experiments

PubMed Central

Mitz, Andrew R.; Chacko, Ravi V.; Putnam, Philip T.; Rudebeck, Peter H.; Murray, Elisabeth A.

2017-01-01

Background Nonhuman primates (NHPs) are a valuable research model because of their behavioral, physiological and neuroanatomical similarities to humans. In the absence of language, autonomic activity can provide crucial information about cognitive and affective states during single-unit recording, inactivation and lesion studies. Methods standardized for use in humans are not easily adapted to NHPs and detailed guidance has been lacking. New Method We provide guidance for monitoring heart rate and pupil size in the behavioral neurophysiology setting by addressing the methodological issues, pitfalls and solutions for NHP studies. The methods are based on comparative physiology to establish a rationale for each solution. We include examples from both electrophysiological and lesion studies. Results Single-unit recording, pupil responses and heart rate changes represent a range of decreasing temporal resolution, a characteristic that impacts experimental design and analysis. We demonstrate the unexpected result that autonomic measures acquired before and after amygdala lesions are comparable despite disruption of normal autonomic function. Comparison with Existing Methods Species and study design differences can render standard techniques used in human studies inappropriate for NHP studies. We show how to manage data from small groups typical of NHP studies, data from the short behavioral trials typical of neurophysiological studies, issues associated with longitudinal studies, and differences in anatomy and physiology. Conclusions Autonomic measurement to infer cognitive and affective states in NHP is neither off-the-shelf nor onerous. Familiarity with the issues and solutions will broaden the use of autonomic signals in NHP single unit and lesion studies. PMID:28089759

Neurodevelopmental attributes of joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type: Update and perspectives.

PubMed

Ghibellini, Giulia; Brancati, Francesco; Castori, Marco

2015-03-01

In the last decade, increasing attention has been devoted to the extra-articular and extra-cutaneous manifestations of joint hypermobility syndrome, also termed Ehlers-Danlos syndrome, hypermobility type (i.e., JHS/EDS-HT). Despite the fact that the current diagnostic criteria for both disorders remain focused on joint hypermobility, musculoskeletal pain and skin changes, medical practice and research have started investigating a wide spectrum of visceral, neurological and developmental complications, which represent major burdens for affected individuals. In particular, children with generalized joint hypermobility often present with various neurodevelopmental issues and can be referred for neurological consultation. It is common that investigations in these patients yield negative or inconsistent results, eventually leading to the exclusion of any structural neurological or muscle disorder. In the context of specialized clinics for connective tissue disorders, a clear relationship between generalized joint hypermobility and a characteristic neurodevelopmental profile affecting coordination is emerging. The clinical features of these patients tend to overlap with those of developmental coordination disorder and can be associated with learning and other disabilities. Physical and psychological consequences of these additional difficulties add to the chief manifestations of the pre-existing connective tissue disorder, affecting the well-being and development of children and their families. In this review, particular attention is devoted to the nature of the link between joint hypermobility, coordination difficulties and neurodevelopmental issues in children. Presumed pathogenesis and management issues are explored in order to attract more attention on this association and nurture future clinical research. © 2015 Wiley Periodicals, Inc.

Awareness of Stress-Reduction Interventions on Work Attitudes: The Impact of Tenure and Staff Group in Australian Universities

PubMed Central

Pignata, Silvia; Winefield, Anthony H.; Provis, Chris; Boyd, Carolyn M.

2016-01-01

This study explored the impact of staff group role and length of organizational tenure in the relationship between the awareness of stress interventions (termed intervention awareness: IA) and the work-related attitudinal outcomes of university employees. A two-wave longitudinal study of a sample of 869 employees from 13 universities completed a psychosocial work factors and health questionnaire. Hierarchical regression analyses examined the contribution of staff role and different lengths of organizational tenure with IA and employees' reports of job satisfaction, affective organizational commitment, trust in senior management, and perceived procedural justice. Employees' length of tenure affected the relation between IA and work attitudes, and there were also differences between academic and non-academic staff groups. For non-academic employees, IA predicted job satisfaction, affective organizational commitment, trust in senior management, and perceived procedural justice. However, for academics, IA only predicted job satisfaction and trust which identifies a need to increase the visibility of organizational interventions. Across the tenure groups, IA predicted: (1) perceived procedural justice for employees with five or less years of tenure; (2) job satisfaction for employees with 0–19 years of tenure; (3) trust in senior management for employees with 6–19 years of tenure; and (4) affective organizational commitment for employees with a tenure length of 6–10 years. Employees working at the university for an intermediate period had the most positive perceptions of their organization in terms of IA, job satisfaction, trust in senior management, and affective organizational commitment, whereas employees with 20–38 years of tenure had the least positive perceptions. Results suggest that employees in the middle of their careers report the most positive perceptions of their university. The findings highlight the need to attend to contextual issues in organizational stress and wellbeing interventions and suggest that management may need to implement new strategies and/or promote existing stress-management and reduction strategies to academics, and employees whom are either new to the university or those who have been working for the organization for longer periods of time to ensure that they are aware of organizational strategies to promote employee wellbeing and morale within their work environments. PMID:27588011

Using Online Databases in Corporate Issues Management.

ERIC Educational Resources Information Center

Thomsen, Steven R.

1995-01-01

Finds that corporate public relations practitioners felt they were able, using online database and information services, to intercept issues earlier in the "issue cycle" and thus enable their organizations to develop more "proactionary" or "catalytic" issues management repose strategies. (SR)

Introduction

Treesearch

Sheila E. Ward; David Boshier; James Grogan

2008-01-01

This special issue of Forest Ecology and Management addresses management issues for the tropical timber species of the Meliaceae. The concept for this issue originated from a technical session entitled ..Sustainable management of highvalue timber species of the Meliaceae: a global perspective.., held at the 2005 World Congress of the International Union of Forest...

Debris flow hazards in plantation forests in New Zealand: what we know and need to know

NASA Astrophysics Data System (ADS)

Phillips, Chris; Basher, Les; Marden, Michael; Harrison, Duncan; Heaphy, Marie

2015-04-01

In recent years, extensive storm-induced landsliding has mobilised woody residue during or after plantation forest harvesting and caused debris flows that have affected houses, roads and bridges downstream of forests in several parts of New Zealand. In part, this relates to increasing levels of harvesting activity as many plantations originally planted for soil conservation purposes have reached merchantable size but could also be in response to an increasing incidence of high intensity storms affecting parts of New Zealand. In several cases these incidents have featured on national television and in newspaper headlines with members of the public complaining about the consequences of forestry operations on steep erodible hill country. Forestry companies have responded by developing more detailed environmental impact assessment and erosion and sediment control planning approaches, and by assisting with clean-up operations. Similarly regional councils (the regulatory bodies) have looked more closely at the environmental impacts of forest harvesting and some have modified erosion and sediment control guidelines, previously largely applied to urban earthworks, for forestry application. As part of a wider research programme that aims to raise the profitability and improve the sustainability of New Zealand's forestry sector, we collected information from both forestry companies and regional and unitary councils via survey and interviews to determine the size and scope of the issue, how individual forest companies were identifying and managing the risk, and to determine if national threshold conditions or standards could be established. Even with risk management and good management practices in place, it will not be possible to entirely avoid slope failures and debris flows following harvesting in the future. Thus the need to determine a national level of understanding of what can and can't be managed for is important to allow the development of risk management approaches that all parties can agree with. This paper reports preliminary survey results and discusses company-, regional-, and national-level approaches to begin to address how this issue might be approached in the future on steep eroding hill country in New Zealand.

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

Sliwinski, B.J.; Kermath, D.; Kemme, M.R.

There is a growing body of information related to facility indoor air quality (IAQ) and its affect on the health and productivity of building occupants. Indoor air pollution can increase employee absenteeism and reduce productivity. Poor IAQ may be a result of poor building or ventilation design, improper maintenance, or inappropriate energy conservation strategies. To help ensure the health, welfare, and productivity of Army personnel and the performance of Army facilities, installation operations and maintenance (O and M) personnel need access to relevant and useful information about IAQ issues. This report includes background information for O and M managers andmore » staff, an installation-level IAQ management plan, and practical O and M procedures for correcting the problems that most commonly lead to IAQ-related complaints.« less

Nonoperative treatment of low back pain.

PubMed

Malanga, G A; Nadler, S F

1999-11-01

Low back pain is a common problem with substantial social and economic issues. Physicians continue to have difficulty managing this condition despite an increased awareness of its magnitude. In addition, there is a misperception about the outcome of patients affected with low back pain; most continue to suffer from pain. We present a nonoperative approach and review various diagnostic and treatment strategies with respect to both scientific and clinical merit. Although many treatment strategies have not been well proved in the scientific literature, thoughtful review of the available information provides a basis for the use of these treatment methods in the patient with refractory pain. This approach can be used in conjunction with existing information to assist clinicians in the management of patients with acute low back pain.

The society of thoracic surgeons.

PubMed

Alley, R D

1976-11-01

The opportunity to discuss evolving socioeconomic issues affecting the medical profession as a whole was rejected in favor of personalizing The Society of Thoracic Surgeons for a membership that has grown to almost 1,500 persons. Drawing on historical insights gained through participation in the origin, growth, and development of The Society, I take readers behind the scenes and introduce to them the many people and vast resources that serve our membership. Particular attention is focused on the services of The Society's headquarters office, which is housed and managed by Smith, Bucklin and Associates, Inc, of Chicago, a multiple-association management firm that serves 60 national organizations; on our prestigious publisher, Little, Brown and Company of Boston; and on its link with our Editorial Office in Ann Arbor.

An alternative framework for responding to the amphibian crisis

USGS Publications Warehouse

Muths, Erin L.; Fisher, Robert N.

2017-01-01

Volumes of data illustrate the severity of the crisis affecting amphibians, where > 32% of amphibians worldwide are threatened with declining populations. Although there have been isolated victories, the current approach to the issue is unsuccessful. We suggest that a radically different approach, something akin to human emergency response management (i.e. the Incident Command System), is one alternative to addressing the inertia and lack of cohesion in responding to amphibian issues. We acknowledge existing efforts and the useful research that has been conducted, but we suggest that a change is warranted and that the identification of a new amphibian chytrid provides the impetus for such a change. Our goal is to recognize that without a centralized effort we (collectively) are likely to fail in responding to this challenge.

Administrative issues involved in disaster management in India.

PubMed

Kaur, Jagdish

2006-12-01

India as a country is vulnerable to a number of disasters, from earthquakes to floods. Poor and weaker members of the society have always been more vulnerable to various types of disasters. Disasters result in unacceptably high morbidity and mortality amongst the affected population. Damage to infrastructure and reduction in revenues from the affected region due to low yield add to the economic losses. Poor co-ordination at the local level, lack of early-warning systems, often very slow responses, paucity of trained dedicated clinicians, lack of search and rescue facilities and poor community empowerment are some of the factors, which have been contributing to poor response following disasters in the past. The first formal step towards development of policies relating to disaster care in India was the formulation of the National Disaster Response Plan (NDRP) which was formulated initially by the Government of India for managing natural disasters only. However, this was subsequently amended to include man-made disasters as well. It sets the scene for formulating state and district level plans in all states to bring cohesiveness and a degree of uniform management in dealing with disasters. A National Disaster Management Authority has been constituted which aims to provide national guidelines and is headed by the Prime Minister of India. It is the highest decision-making body for the management of disasters in the country. The authority has the responsibility for co-ordinating response and post-disaster relief and rehabilitation. Each state is required to set up Disaster Management Authorities and District Disaster Management Committees for co-ordination and close supervision of activities and efforts related to the management of disasters.

Issues in NASA Program and Project Management:: A Collection of Papers on Aerospace Management Issues (Supplement 11)

NASA Technical Reports Server (NTRS)

Hoffman, Edward J. (Editor); Lawbaugh, William M. (Editor)

1996-01-01

Papers address the following topics: NASA's project management development process; Better decisions through structural analysis; NASA's commercial technology management system; Today's management techniques and tools; Program control in NASA - needs and opportunities; and Resources for NASA managers.

The value of using top-down and bottom-up approaches for building trust and transparency in biobanking.

PubMed

Meslin, Eric M

2010-01-01

With the domestic and international proliferation of biobanks and their associated connections to health information databases, scholarly attention has been turning from the ethical issues arising from the construction of biobanks to the ethical issues that emerge in their operation and management. Calls for greater transparency in governance structures, coupled with stern reminders of the value of maintaining public trust, are seen as critical components in the success of these resources. Two different approaches have been adopted for addressing these types of ethical issues: the first is a 'top-down' approach which focuses on developing policy, procedures, regulations and guidelines to aid decision-makers. The second is a 'bottom-up' approach, which begins with those who are most affected by the issues and attempts to inductively develop consensus recommendations and policy. While both approaches have merit, I argue that more work needs to be done on 'bottom-up' strategies if trust and transparency are to be more than mere slogans. Using 2 case examples from Indiana, the paper summarizes data from a set of surveys we recently conducted that address issues arising from biobanks that provide some insight into issues associated with trust and transparency. Copyright 2010 S. Karger AG, Basel.

Letter from Chile: Re-establishing health care in Chile

PubMed Central

Jiménez, Jorge

1993-01-01

Chile's long term social policy has produced very impressive outcomes in general health indicators, with a national health service established as early as 1952. During the years of the Pinochet dictatorship (1973-89) public health institutions were greatly affected, with sharp diminution in financing which affected investment and salaries. The democratic government initiated in 1990 faced a difficult situation, with underpaid staff and decrepit hospitals. The ministry took immediate action to improve salaries and start an ambitious health sector reform including investment in infrastructure, technology, and modern management. Decentralisation and autonomy, changes in payment for service mechanisms, and a public-private mix are the main objectives of this reform, keeping the public role as predominant in the proposed structure. This process has been affected by union unrest and public opinion dissatisfaction, which tend to present obstacles to progress in this complicated issue. Imagesp729-ap730-a

Patient and disease factors affecting the choice and adherence to active surveillance.

PubMed

Dall'Era, Marc A

2015-05-01

Treatment decisions for low-risk prostate cancer are arguably some of the most challenging in oncology. Active surveillance has emerged as an important option for many men with tumors estimated to have a low metastatic potential. Multiple complex patient and physician factors affect the recommendation, selection, and adherence to active surveillance. While baseline clinical criteria are used to identify candidates for this approach, it is important to identify and understand other forces that may influence the management of prostate cancer with active surveillance. Patient perceptions and acceptance of active surveillance have improved over time. Treatment decisions for prostate cancer are strongly associated with physician recommendations, and a high-quality relationship between the patient and his healthcare system is critical to successful active surveillance. Patient understanding of prostate cancer and consistency of information received from separate physicians can affect a decision to pursue active surveillance. Psychological symptoms, most notably regarding anxiety and distress, can affect adherence to active surveillance over time. In general, anxiety for men on active surveillance is low, and lifestyle interventions and self-management strategies may be helpful for increasing quality of life and limiting abandonment of active surveillance in the absence of disease progression. Multiple factors may affect the decision for and adherence to active surveillance for prostate cancer. It is important for both physicians and patients to be aware of these issues and work towards individualized approaches and interventions as needed to increase adoption of active surveillance in the future.

Incentive Issues in Information Security Management

ERIC Educational Resources Information Center

Lee, Chul Ho

2012-01-01

This dissertation studies three incentive issues in information security management. The first essay studies contract issues between a firm that outsources security functions and a managed security service provider (MSSP) that provides security functions to the firm. Since MSSP and firms cannot observe each other's actions, both can suffer…

Ethical issues in the diagnosis and management of fetal disorders.

PubMed

Chadwick, Ruth; Childs, Richardo

2012-10-01

The ethics of diagnosis and management of fetal genetic disorders are particularly controversial because of the contested status of the fetus and perceptions of genetics. An additional complicating factor is the potential conflict between mother and fetus. Ethical issues in diagnosis include the nature and purpose of the diagnosis itself, and management of the information. Management of the disorder includes issues of termination as an option, and the emerging field of fetal gene therapy with associated issues of somatic versus germ-line interventions. Copyright © 2012 Elsevier Ltd. All rights reserved.

Hypothyroidism: challenges when treating older adults.

PubMed

Pearson, Tamera

2013-01-01

Hypothyroidism frequently affects older adults' general sense of health, their cognitive abilities, and quality of life. Management decisions regarding when to start treatment and at what dosage to begin medication are influenced by both laboratory values and patient symptoms. Although specific guidelines regarding management of hypothyroidism in older adults do not exist, general recommendations include initiating hormone replacement with levothyroxine (Levoxyl(®), Synthroid(®), and others) at 12.5 mcg to 25 mcg and titrating the dose slowly based on response at 6-week intervals. Multiple medications and certain foods can interact with levothyroxine; therefore, the best dosage time is when a person is fasting or 4 hours postprandial. Using a consistent brand-name drug for hormone replacement with levothyroxine is important due to variations in the active ingredient in generic formulations. Providers need to be aware of the prevalence of hypothyroidism and management issues when caring for older adults. Copyright 2013, SLACK Incorporated.

Coronary artery disease in the military patient.

PubMed

Parsons, Iain; White, S; Gill, R; Gray, H H; Rees, P

2015-09-01

Ischaemic heart disease is the most common cause of sudden death in the UK, and the most common cardiac cause of medical discharge from the Armed Forces. This paper reviews current evidence pertaining to the diagnosis and management of coronary artery disease from a military perspective, encompassing stable angina and acute coronary syndromes. Emphasis is placed on the limitations inherent in the management of acute coronary syndromes in the deployed environment. Occupational issues affecting patients with coronary artery disease are reviewed. Consideration is also given to the potential for coronary artery disease screening in the military, and the management of modifiable cardiovascular disease risk factors, to help decrease the prevalence of coronary artery disease in the military population. 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.

Urban forests and pollution mitigation: analyzing ecosystem services and disservices.

PubMed

Escobedo, Francisco J; Kroeger, Timm; Wagner, John E

2011-01-01

The purpose of this paper is to integrate the concepts of ecosystem services and disservices when assessing the efficacy of using urban forests for mitigating pollution. A brief review of the literature identifies some pollution mitigation ecosystem services provided by urban forests. Existing ecosystem services definitions and typologies from the economics and ecological literature are adapted and applied to urban forest management and the concepts of ecosystem disservices from natural and semi-natural systems are discussed. Examples of the urban forest ecosystem services of air quality and carbon dioxide sequestration are used to illustrate issues associated with assessing their efficacy in mitigating urban pollution. Development of urban forest management alternatives that mitigate pollution should consider scale, contexts, heterogeneity, management intensities and other social and economic co-benefits, tradeoffs, and costs affecting stakeholders and urban sustainability goals. Copyright © 2011 Elsevier Ltd. All rights reserved.

Money and trust: relationships between patients, physicians, and health plans.

PubMed

Goold, S D

1998-08-01

In response to three articles on managed care by Allen Buchanan, David Mechanic, and Ezekiel Emanual and Lee Goldman (this issue), I discuss doctor-patient and organization-member trust and the moral obligations of those relationships. Trust in managed care organizations (providers of and payers for health care) stands in stark contrast to the current contractual model of health insurance purchase, but is more coherent with consumer expectations and with the provider role of such organizations. Such trust is likely to differ from that between doctors and patients. Financial reimbursement systems for physicians, one example of organizational change in our health system, can be evaluated for their impact on both kinds of trust according to their intrusiveness, openness, and goals. Although involving managed care enrollees in value-laden decisions that affect them is commendable, restrictions on or regulation of physician incentive systems may be better accomplished on a national level.

Value-driven process management: using value to improve processes.

PubMed

Melnyk, S A; Christensen, R T

2000-08-01

Every firm can be viewed as consisting of various processes. These processes affect everything that the firm does from accepting orders and designing products to scheduling production. In many firms, the management of processes often reflects considerations of efficiency (cost) rather than effectiveness (value). In this article, we introduce a well-structured process for managing processes that begins not with the process, but rather with the customer and the product and the concept of value. This process progresses through a number of steps which include issues such as defining value, generating the appropriate metrics, identifying the critical processes, mapping and assessing the performance of these processes, and identifying long- and short-term areas for action. What makes the approach presented in this article so powerful is that it explicitly links the customer to the process and that the process is evaluated in term of its ability to effectively serve the customers.

Information technologies and the sharing of disaster knowledge: the critical role of professional culture.

PubMed

Marincioni, Fausto

2007-12-01

A comparative survey of a diverse sample of 96 US and Italian emergency management agencies shows that the diffusion of new information technologies (IT) has transformed disaster communications. Although these technologies permit access to and the dissemination of massive amounts of disaster information with unprecedented speed and efficiency, barriers rooted in the various professional cultures still hinder the sharing of disaster knowledge. To be effective the available IT must be attuned to the unique settings and professional cultures of the local emergency management communities. Findings show that available technology, context, professional culture and interaction are key factors that affect the knowledge transfer process. Cultural filters appear to influence emergency managers' perceptions of their own professional roles, their vision of the applicability of technology to social issues, and their perspective on the transferability of disaster knowledge. Four cultural approaches to the application of IT to disaster communications are defined: technocentric; geographic,; anthropocentric; and ecocentric.

Bonneville - Hood River Vegetation Management Environmental Assessment

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

N /A

1998-08-01

To maintain the reliability of its electrical system, BPA, in cooperation with the U.S. Forest Service, needs to expand the range of vegetation management options used to clear unwanted vegetation on about 20 miles of BPA transmission line right-of-way between Bonneville Dam and Hood River; Oregon, within the Columbia Gorge National Scenic Area (NSA). We propose to continue controlling undesirable vegetation using a program of Integrated Vegetation Management (IVM) which includes manual, biological and chemical treatment methods. BPA has prepared an Environmental Assessment (EA) (DOE/EA-1257) evaluating the proposed project. Based on the analysis in the EA, BPA has determined thatmore » the proposed action is not a major Federal action significantly affecting the quality of the human environment, within the meaning of the National Environmental Policy Act (NEPA) of 1969. Therefore, the preparation of an Environmental Impact Statement (EIS) is not required and BPA is issuing this FONSI.« less

Key Value Considerations for Consultant Pharmacists.

PubMed

Meyer, Lee; Perry, Ronald G; Rhodus, Susan M; Stearns, Wendy

2016-07-01

Managing the efficiency and costs of residents' drug regimens outside the acute-care hospital and through transitions of care requires a toolbox filled with cost-control tools and careful collaboration among the pharmacy provider(s), facility staff, and the consultant/senior care pharmacist. This article will provide the reader with key long-term care business strategies that affect the profitability of the pharmacy provider in various care settings while, at the same time, ensuring optimal therapy for residents as they transition across levels of care. Readers can take away ideas on how to access critical information, what they can do with this information, and how they can improve the overall care process. Four experts in various aspects of pharmacy management share their insights on pharmacy practice issues including formulary management, performance metrics, short-cycle dispensing challenges/solutions, cost-control measures, facility surveys, billing practices, medication reconciliation, prospective medication reviews, and transitions of care.

Pediatric sepsis

PubMed Central

Randolph, Adrienne G; McCulloh, Russell J

2014-01-01

Sepsis is the leading cause of death in children worldwide. Although the diagnosis and management of sepsis in infants and children is largely influenced by studies done in adults, there are important considerations relevant for pediatrics. This article highlights pediatric-specific issues related to the definition of sepsis and its epidemiology and management. We review how the capacity of the immune system to respond to infection develops over early life. We also bring attention to primary immune deficiencies that should be considered in children recurrently infected with specific types of organisms. The management of pediatric sepsis must be tailored to the child’s age and immune capacity, and to the site, severity, and source of the infection. It is important for clinicians to be aware of infection-related syndromes that primarily affect children. Although children in developed countries are more likely to survive severe infections than adults, many survivors have chronic health impairments. PMID:24225404

Modelling Associations between Public Understanding, Engagement and Forest Conditions in the Inland Northwest, USA

PubMed Central

Hartter, Joel; Stevens, Forrest R.; Hamilton, Lawrence C.; Congalton, Russell G.; Ducey, Mark J.; Oester, Paul T.

2015-01-01

Opinions about public lands and the actions of private non-industrial forest owners in the western United States play important roles in forested landscape management as both public and private forests face increasing risks from large wildfires, pests and disease. This work presents the responses from two surveys, a random-sample telephone survey of more than 1500 residents and a mail survey targeting owners of parcels with 10 or more acres of forest. These surveys were conducted in three counties (Wallowa, Union, and Baker) in northeast Oregon, USA. We analyze these survey data using structural equation models in order to assess how individual characteristics and understanding of forest management issues affect perceptions about forest conditions and risks associated with declining forest health on public lands. We test whether forest understanding is informed by background, beliefs, and experiences, and whether as an intervening variable it is associated with views about forest conditions on publicly managed forests. Individual background characteristics such as age, gender and county of residence have significant direct or indirect effects on our measurement of understanding. Controlling for background factors, we found that forest owners with higher self-assessed understanding, and more education about forest management, tend to hold more pessimistic views about forest conditions. Based on our results we argue that self-assessed understanding, interest in learning, and willingness to engage in extension activities together have leverage to affect perceptions about the risks posed by declining forest conditions on public lands, influence land owner actions, and affect support for public policies. These results also have broader implications for management of forested landscapes on public and private lands amidst changing demographics in rural communities across the Inland Northwest where migration may significantly alter the composition of forest owner goals, understanding, and support for various management actions. PMID:25671619

Menstrual Management for Adolescents With Disabilities.

PubMed

Quint, Elisabeth H; O'Brien, Rebecca F

2016-07-01

The onset of menses for adolescents with physical or intellectual disabilities can affect their independence and add additional concerns for families at home, in schools, and in other settings. The pediatrician is the primary health care provider to explore and assist with the pubertal transition and menstrual management. Menstrual management of both normal and abnormal cycles may be requested to minimize hygiene issues, premenstrual symptoms, dysmenorrhea, heavy or irregular bleeding, contraception, and conditions exacerbated by the menstrual cycle. Several options are available for menstrual management, depending on the outcome that is desired, ranging from cycle regulation to complete amenorrhea. The use of medications or the request for surgeries to help with the menstrual cycles in teenagers with disabilities has medical, social, legal, and ethical implications. This clinical report is designed to help guide pediatricians in assisting adolescent females with intellectual and/or physical disabilities and their families in making decisions related to successfully navigating menarche and subsequent menstrual cycles. Copyright © 2016 by the American Academy of Pediatrics.

Definition of management zones for enhancing cultivated land conservation using combined spatial data.

PubMed

Li, Yan; Shi, Zhou; Wu, Hao-Xiang; Li, Feng; Li, Hong-Yi

2013-10-01

The loss of cultivated land has increasingly become an issue of regional and national concern in China. Definition of management zones is an important measure to protect limited cultivated land resource. In this study, combined spatial data were applied to define management zones in Fuyang city, China. The yield of cultivated land was first calculated and evaluated and the spatial distribution pattern mapped; the limiting factors affecting the yield were then explored; and their maps of the spatial variability were presented using geostatistics analysis. Data were jointly analyzed for management zone definition using a combination of principal component analysis with a fuzzy clustering method, two cluster validity functions were used to determine the optimal number of cluster. Finally one-way variance analysis was performed on 3,620 soil sampling points to assess how well the defined management zones reflected the soil properties and productivity level. It was shown that there existed great potential for increasing grain production, and the amount of cultivated land played a key role in maintaining security in grain production. Organic matter, total nitrogen, available phosphorus, elevation, thickness of the plow layer, and probability of irrigation guarantee were the main limiting factors affecting the yield. The optimal number of management zones was three, and there existed significantly statistical differences between the crop yield and field parameters in each defined management zone. Management zone I presented the highest potential crop yield, fertility level, and best agricultural production condition, whereas management zone III lowest. The study showed that the procedures used may be effective in automatically defining management zones; by the development of different management zones, different strategies of cultivated land management and practice in each zone could be determined, which is of great importance to enhance cultivated land conservation, stabilize agricultural production, promote sustainable use of cultivated land and guarantee food security.

The future of anticoagulation management in atrial fibrillation in Europe: An assessment of today's challenges with recommendations for the future.

PubMed

Lichten, Catherine A; Castle-Clarke, Sophie; Manville, Catriona; Horvath, Veronika; Robin, Enora; Krapels, Joachim; Parks, Sarah; Sim, Megan; van Zijverden, Olga; Chataway, Joanna

2015-11-30

Atrial fibrillation (AF) is the most common type of cardiac arrhythmia, affecting approximately 1-2 per cent of the population worldwide. Those who suffer from AF have a five times higher risk of stroke. AF prevalence increases with age and it affects roughly 18 per cent of the population over 85. Consequently, as populations age, AF is becoming an increasingly significant public health issue. Over recent years there have been developments in treatment and management options, both for treating the arrhythmia directly, and assessing and reducing the risk of AF-related stroke, but there is a need to ensure that available knowledge is applied optimally to benefit patients so that opportunities to prevent AF-related stroke are not missed. The aims of this project were to assess the current landscape and explore the direction of future developments in AF management in Europe, with a focus on the use of anticoagulants in the prevention of AF-related stroke. Through rapid evidence assessment, key informant interviews, PESTLE analysis and the development and exploration of future scenarios, we have developed sets of shorter- and longer-term recommendations for improving AF-related patient outcomes. The short-term recommendations are: i) improve AF awareness among the public and policymakers; ii) support education about AF management for healthcare professionals and patients; and iii) maintain engagement in AF-related research across the health services.

Strategic Issues for Training.

ERIC Educational Resources Information Center

Pollitt, David, Ed.

1999-01-01

Contains precis of 18 articles on strategic management issues, including management development, on-the-job training, corporate scholarship, educational technology, coaching, investing in intellectual capital, and knowledge management. (SK)

Reflections: Management Morphology--How We Got To Be Who We Are.

ERIC Educational Resources Information Center

Hoadley, Irene B.

1999-01-01

Reviews library management issues over the past 25 years. Highlights include library education for managerial skills; on the job training; gender issues; societal factors; Total Quality Management; management changes; and future possibilities, including managerial roles, management models, and organizational structure. (LRW)

Experiences of a Community-Based Lymphedema Management Program for Lymphatic Filariasis in Odisha State, India: An Analysis of Focus Group Discussions with Patients, Families, Community Members and Program Volunteers.

PubMed

Cassidy, Tali; Worrell, Caitlin M; Little, Kristen; Prakash, Aishya; Patra, Inakhi; Rout, Jonathan; Fox, LeAnne M

2016-02-01

Globally 68 million people are infected with lymphatic filariasis (LF), 17 million of whom have lymphedema. This study explores the effects of a lymphedema management program in Odisha State, India on morbidity and psychosocial effects associated with lymphedema. Focus groups were held with patients (eight groups, separated by gender), their family members (eight groups), community members (four groups) and program volunteers (four groups) who had participated in a lymphedema management program for the past three years. Significant social, physical, and economic difficulties were described by patients and family members, including marriageability, social stigma, and lost workdays. However, the positive impact of the lymphedema management program was also emphasized, and many family and community members indicated that community members were accepting of patients and had some improved understanding of the etiology of the disease. Program volunteers and community members stressed the role that the program had played in educating people, though interestingly, local explanations and treatments appear to coexist with knowledge of biomedical treatments and the mosquito vector. Local and biomedical understandings of disease can co-exist and do not preclude individuals from participating in biomedical interventions, specifically lymphedema management for those with lymphatic filariasis. There is a continued need for gender-specific psychosocial support groups to address issues particular to men and women as well as a continued need for improved economic opportunities for LF-affected patients. There is an urgent need to scale up LF-related morbidity management programs to reduce the suffering of people affected by LF.

Information superhighway: Issues affecting development

NASA Astrophysics Data System (ADS)

1994-09-01

Technological advances in the transmission of voice, video, and data are fostering fundamental changes in the telecommunications industry. For example, large local telephone companies plan to offer video services in competition with cable and broadcast television, while cable television companies plan to offer local telephone service over their wires in competition with the local telephone companies. The administration believes that these technological changes provide the opportunity to develop an 'Information Superhighway' that could provide every element of society with ready access to data, voice, and video communications. Concurrently, the Congress is considering sweeping changes to telecommunications regulations to keep pace with this dynamic industry. GAO prepared this report to serve as an overview of three key issues that decisionmakers may face as they deliberate telecommunications legislation; it focuses on three pivotal issues they face in formulating new telecommunications legislation: (1) managing the transition to a more competitive local telecommunications marketplace; (2) ensuring that all consumers have access to affordable telecommunications as competition develops; and (3) ensuring that the Information Superhighway provides adequate security, privacy, reliability, and interoperability.

Approaches to acceptable risk

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

Whipple, C

Several alternative approaches to address the question {open_quotes}How safe is safe enough?{close_quotes} are reviewed and an attempt is made to apply the reasoning behind these approaches to the issue of acceptability of radiation exposures received in space. The approaches to the issue of the acceptability of technological risk described here are primarily analytical, and are drawn from examples in the management of environmental health risks. These include risk-based approaches, in which specific quantitative risk targets determine the acceptability of an activity, and cost-benefit and decision analysis, which generally focus on the estimation and evaluation of risks, benefits and costs, inmore » a framework that balances these factors against each other. These analytical methods tend by their quantitative nature to emphasize the magnitude of risks, costs and alternatives, and to downplay other factors, especially those that are not easily expressed in quantitative terms, that affect acceptance or rejection of risk. Such other factors include the issues of risk perceptions and how and by whom risk decisions are made.« less

Intersectionality at Work: South Asian Muslim Women's Experiences of Employment and Leadership in the United Kingdom.

PubMed

Tariq, Memoona; Syed, Jawad

2017-01-01

Drawing on qualitative interviews with 20 South Asian heritage, Muslim, female leaders, managers, and supervisors in the United Kingdom, we examine the multi-layered issues and challenges they face in pursuit of employment and leadership positions. The paper offers an intersectional perspective taking into account interconnected and overlapping factors (gender, ethnicity, religion, and family status) that affect not only the issues and challenges these women face in the labour market but also the individual agency and strategies they use to overcome any obstacles in the way of their employment and career. The results show that although Muslim women continue to face a myriad of challenges in the workplace, they are also able to tackle some of these issues through their individual strategies and networks, such as personal networks and further education. The study highlights the need for policymakers and employers to consider intersectionality to enable ethnic minority women's inclusion and leadership within and outside the workplace.

Managing the Mississippi River floodplain: Achieving ecological benefits requires more than hydrological connection to the river: Chapter

USGS Publications Warehouse

Schramm, Harold; Richardson, William B.; Knights, Brent C.

2015-01-01

Floodplains are vital to the structure and function of river-floodplain ecosystems. Among the many ecological services provided by floodplains are nutrient cycling and seasonal habitats for fish, including spawning, nursery, foraging and wintering habitats. Connections between the river channel and floodplain habitats are essential to realize these ecological services, but spatial and temporal aspects of the connection and contemporary geomorphology must also be considered in restoration efforts. This chapter synthesizes available information to compare floodplain function and needed management strategies in two extensive reaches (upper impounded and lower free-flowing) of the Mississippi River, USA. The upper impounded reach is the 523-km reach from about Minneapolis, Minnesota to Clinton, Iowa. This reach has been impounded and channelized for navigation. Mean annual water-level fluctuation ranges from 1 to 2 m in the navigation pools in this reach. Floodplain environmental conditions that affect nitrogen cycling and fish production vary seasonally and longitudinally within and among navigation pools. Significant issues affecting ecological services include sedimentation, constrained water level fluctuations, island erosion and seasonal hypoxia. The lower free-flowing reach, the 1570-km reach from the confluence of the Ohio and Mississippi rivers to the Gulf of Mexico, has no dams and average annual fluctuations of 7 m throughout most of the reach. Despite the substantial flood pulse, floodplain inundation is often brief and may not occur annually. Significant issues affecting floodplain ecological function are the short duration and thermal asynchrony of the flood pulse, sedimentation and loss of connection between the river channel and permanent/semi-permanent floodplain water bodies due to channel incision. Needs and strategies for floodplain enhancement to increase ecological services, particularly nitrogen cycling and fish production, differ along the longitudinal gradient of the Mississippi River and provide informative contrasts to guide floodplain management. Prediction of the effects of climate change on this system will be complicated by the magnitude of the watershed that encompasses 41 % of the continental USA and multiple climatic regions.

System Wide Information Management (SWIM)

NASA Technical Reports Server (NTRS)

Hritz, Mike; McGowan, Shirley; Ramos, Cal

2004-01-01

This viewgraph presentation lists questions regarding the implementation of System Wide Information Management (SWIM). Some of the questions concern policy issues and strategies, technology issues and strategies, or transition issues and strategies.

Principles and practices board. Issue Analysis 98-1. Compliance with laws and regulations for healthcare organizations. Healthcare Financial Management Association.

PubMed

1998-09-01

This is the third Issue Analysis of HFMA's Principles and Practices (P&P) Board. The P&P Board writes an Issue Analysis in response to the need for practical information on emerging issues in healthcare financial management. An Issue Analysis is factual but not authoritative. It is not sent out for public comment and provides the healthcare industry short-term assistance on emerging issues. The purpose of P&P Board Issue Analysis 98-1, Compliance with Laws and Regulations for Healthcare Organizations, is to help healthcare financial managers understand their responsibility to implement and maintain an effective internal control system to ensure compliance with laws and regulations.

13 CFR 107.250 - Exclusion of stock options issued by Licensee from Management Expenses.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Sbic § 107.250 Exclusion of stock options issued by Licensee from Management Expenses. Stock options... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Exclusion of stock options issued by Licensee from Management Expenses. 107.250 Section 107.250 Business Credit and Assistance SMALL...

The Colorado Plateau II: biophysical, socioeconomic, and cultural research

USGS Publications Warehouse

Mattson, David J.; van Riper, Charles

2005-01-01

The publication of The Colorado Plateau: Cultural, Biological, and Physical Research in 2004 marked a timely summation of current research in the Four Corners states. This new volume, derived from the seventh Biennial Conference on the Colorado Plateau in 2003, complements the previous book by focusing on the integration of science into resource management issues. The 32 chapters range in content from measuring human impacts on cultural resources, through grazing and the wildland-urban interface issues, to parameters of climate change on the Plateau. The book also introduces economic perspectives by considering shifting patterns and regional disparities in the Colorado Plateau economy. A series of chapters on mountain lions explores the human-wildland interface. These chapters deal with the entire spectrum of challenges associated with managing this large mammal species in Arizona and on the Colorado Plateau, conveying a wealth of timely information of interest to wildlife managers and enthusiasts. Another provocative set of chapters on biophysical resources explores the management of forest restoration, from the micro scale all the way up to large-scale GIS analyses of ponderosa pine ecosystems on the Colorado Plateau. Given recent concerns for forest health in the wake of fires, severe drought, and bark-beetle infestation, these chapters will prove enlightening for forest service, park service, and land management professionals at both the federal and state level, as well as general readers interested in how forest management practices will ultimately affect their recreation activities. With broad coverage that touches on topics as diverse as movement patterns of rattlesnakes, calculating watersheds, and rescuing looted rockshelters, this volume stands as a compendium of cutting-edge research on the Colorado Plateau that offers a wealth of insights for many scholars.

The impact of nursing leadership on patient safety in a developing country.

PubMed

Stewart, Lee; Usher, Kim

2010-11-01

This article is a report of a study to identify the ways nursing leaders and managers in a developing country have an impact on patient safety. The attempt to address the problem of patient safety in health care is a global issue. Literature addressing the significant impact that nursing leadership has on patient safety is extensive and focuses almost exclusively on the developed world. A critical ethnography was conducted with senior registered nursing leaders and managers throughout the Fiji Islands, specifically those in the Head Office of the Fiji Ministry of Health and the most senior nurse in a hospital or community health service. Semi-structured interviews were conducted with senior nursing leaders and managers in Fiji. Thematic analysis of the interviews was undertaken from a critical theory perspective, with reference to the macro socio-political system of the Fiji Ministry of Health. Four interrelated issues regarding the nursing leaders and managers' impact on patient safety emerged from the study. Empowerment of nursing leaders and managers, an increased focus on the patient, the necessity to explore conditions for front-line nurses and the direct relationship between improved nursing conditions and increased patient safety mirrored literature from developed countries. The findings have significant implications for developing countries and it is crucial that support for patient safety in developing countries become a focus for the international nursing community. Nursing leaders and managers' increased focus on their own place in the hierarchy of the health care system and on nursing conditions as these affect patient safety could decrease adverse patient outcomes. The findings could assist the global nursing community to better support developing countries in pursuing a patient safety agenda. © 2010 Blackwell Publishing Ltd.

The Corporate Library and Issues Management.

ERIC Educational Resources Information Center

Lancaster, F. W.; Loescher, Jane

1994-01-01

Discussion of corporate library services and the role of the librarian focuses on the recognition and tracking of issues of potential significance to the corporation, or issues management. Topics addressed include environmental scanning of relevant literature, and the use of databases to track issues. (16 references) (LRW)

Issues Management and the Use of Technologies in Public Relations.

ERIC Educational Resources Information Center

Ramsey, Shirley A.

1993-01-01

Finds that members of the Issues Management Association were more positively involved with two procedures--"environmental scanning for emerging issues" and "developing communication plans about the issues"--than were other public relations practitioners. Finds that respondents were highly likely to use advanced communication…

Qualitative and quantitative aspects of drinking water supply in Sardinia, Italy. A descriptive analysis of the ordinances and public notices issued during the years 2010-2015.

PubMed

Dettori, M; Piana, A; Castiglia, P; Loria, E; Azara, A

2016-01-01

The aim of the study is to analyze the regional district ordinances and the warnings regarding qualitative and quantitavive drinking water abnormalities discovered by the Sardinian Municipalities and the Water Managing Authority between 2010 and 2015 in order to describe and identify the causes leading to an interruption or a limitation of the drinking water supply. We carefully reviewed all ordinances and warnings of non-potable water and service interruption published between 2010 and 2015 by the websites of 377 Sardinian Municipalities and by the main regional newspapers, the Water Managing Authority and the Regional Health Trusts. From 2010 to 2015, 738 warnings/ordinances regarding drinking water supply limitation or interruption were issued. The warnings involved more than half (n. 191, 50.7%) of the 377 Sardinian Municipalities. Considering that these Municipalities included the main Sardinian cities we estimated that 80.3% of the population was affected by the issue. During the 6 years we observed a progressive increase of Municipalities involved beginning with 25 and reaching up 110 in 2014. The initial 29 warnings rose to 256 in 2014 along with an increased number of abnormal values, parameters and standards of the drinking water. Regarding the ordinances issued by the 191 Mayors we noticed that the legal limits were exceeded in 23 cases. Among those, we underline the abnormal levels of chlorites and trihalomethanes (22% of cases), the turbidity, the abnormal concentration of total chemical substances and the abnormal level of coliforms, Escherichia coli, manganese, aluminum, nitrites and iron. According to our observations, the Sardinian drinking water supply system is affected by a major inconvenience and the data suggest that qualitative abnormalities are mainly due to water purification treatments used in addition to the poor water supply network in existence. Considering these results, a cooperation between all Authorities involved would be desirable in order to analyze official data and provide a careful evaluation of population exposure and real risks related to the level of every parameter considered.

Heart Disease Affects Women of All Ages

MedlinePlus

Skip Navigation Bar Home Current Issue Past Issues Heart Disease Affects Women of All Ages Past Issues / Winter ... weeks of a heart attack. For Women with Heart Disease: About 6 million American women have coronary heart ...

Identifying management and disease priorities of Canadian dairy industry stakeholders.

PubMed

Bauman, C A; Barkema, H W; Dubuc, J; Keefe, G P; Kelton, D F

2016-12-01

The objective of this study was to identify the key management and disease issues affecting the Canadian dairy industry. An online questionnaire (FluidSurveys, http://fluidsurveys.com/) was conducted between March 1 and May 31, 2014. A total of 1,025 responses were received from across Canada of which 68% (n=698) of respondents were dairy producers, and the remaining respondents represented veterinarians, university researchers, government personnel, and other allied industries. Participants were asked to identify their top 3 management and disease priorities from 2 lists offered. Topics were subsequently ranked from highest to lowest using 3 different ranking methods based on points: 5-3-1 (5 points for first priority, 3 for second, and 1 for first), 3-2-1, and 1-1-1 (equal ranking). The 5-3-1 point system was selected because it minimized the number of duplicate point scores. Stakeholder groups showed general agreement with the top management issue identified as animal welfare and the number one health concern as lameness. Other areas identified as priorities were reproductive health, antibiotic use, bovine viral diarrhea, and Staphylococcus aureus mastitis with these rankings influenced by region, herd size, and stakeholder group. This is the first national comprehensive assessment of priorities undertaken in the Canadian dairy industry and will assist researchers, policymakers, program developers, and funding agencies make future decisions based on direct industry feedback. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Ten key research issues for integrated and sustainable wastewater reuse in the Middle East.

PubMed

Shomar, Basem; Dare, Anne

2015-04-01

Wastewater management is not limited to the technology used to collect and treat wastewater. It begins with the early planning phase of building a society and includes considerations of how that society will grow. Therefore, history, culture, religion, and socioeconomy are important components to include in any relevant and integrated studies of wastewater management and reuse. Engineering, health, chemistry, biology, food production, cultural heritage, and the needs of people of all ages should be considered together when making management decisions regarding issues so intimately tied with humanity as water and sanitation. Other escalating challenges such as poverty, food, and water scarcity, migration and instability, flooding and catastrophes, diseases and mortality, etc. should also be considered as part of wastewater management and reuse planning. Emerging contaminants could be associated with the urbanization, modernization, and industrialization of several countries. Several arid countries have developed water security strategies where wastewater reuse is a major component. The existing wastewater treatment technologies in these countries are, in most cases, unable to remove such contaminants which may affect irrigation waters, industrial products, groundwater, etc. People would have to accept that the food on their tables could be irrigated with treated wastewater that they generated a few months ago, even if very advanced technologies were used to treat it. The purpose of this review is to highlight multidisciplinary areas of research on wastewater and to propose applicable and affordable mechanisms by which we may consider wastewater as a legitimate resource.

Availability and Utilization of Opioids for Pain Management: Global Issues

PubMed Central

Manjiani, Deepak; Paul, D. Baby; Kunnumpurath, Sreekumar; Kaye, Alan David; Vadivelu, Nalini

2014-01-01

Background Pain can significantly influence an individual's health status and can have serious negative consequences: poor nutrition, decreased appetite, abnormal sleep patterns, fatigue, and impairment of daily living activities. Pain can cause psychological impairment and decrease healing and recovery from injuries and illness. A hallmark of many chronic conditions, pain affects more patients' lives than diabetes mellitus, heart disease, and cancer combined. However, many chronic sufferers do not have access to effective pain management for a variety of reasons, including limited access, restrictions, and personal and cultural biases. Methods This review summarizes issues of access, distribution, and cultural bias with regard to opioid agents and seeks to clarify the challenges related to opioid delivery. The considerable negative physical and mental consequences of chronic pain are discussed for the general and palliative care population. Results Opioids are an effective treatment for various intractable painful conditions, but problems in global opioid access for safe and rational use in pain management contribute to unnecessary suffering. These problems persist despite increased understanding in recent years of the pathophysiology of pain. Conclusions Comprehensive guidelines for goal-directed and patient-friendly chronic opiate therapy will potentially enhance the outlook for future chronic pain management. The improvement of pain education in undergraduate and postgraduate training will benefit patients and clinicians. The promise of new medications, along with the utilization of multimodal approaches, has the potential to provide effective pain relief to future generations of sufferers. PMID:24940131

Evaluation of existing district health management information systems a case study of the district health systems in Kenya.

PubMed

Odhiambo-Otieno, George W

2005-09-01

This paper discusses some of the issues and challenges of implementing appropriate and coordinated District Health Management Information System (DHMIS) in environments dependent on external support especially when insufficient attention has been given to the sustainability of systems. It also discusses fundamental issues which affect the usability of DHMIS to support District Health System (DHS), including meeting user needs and user education in the use of information for management; and the need for integration of data from all health-providing and related organizations in the district. This descriptive cross-sectional study was carried out in three DHSs in Kenya. Data was collected through use of questionnaires, focus group discussions and review of relevant literature, reports and operational manuals of the studied DHMISs. Key personnel at the DHS level were not involved in the development and implementation of the established systems. The DHMISs were fragmented to the extent that their information products were bypassing the very levels they were created to serve. None of the DHMISs was computerized. Key resources for DHMIS operation were inadequate. The adequacy of personnel was 47%, working space 40%, storage space 34%, stationery 20%, 73% of DHMIS staff were not trained, management support was 13%. Information produced was 30% accurate, 19% complete, 26% timely, 72% relevant; the level of confidentiality and use of information at the point of collection stood at 32% and 22% respectively and information security at 48%. Basic DHMIS equipment for information processing was not available. This inhibited effective and efficient provision of information services. An effective DHMIS is essential for DHS planning, implementation, monitoring and evaluation activities. Without accurate, timely, relevant and complete information the existing information systems are not capable of facilitating the DHS managers in their day-today operational management. The existing DHMISs were found not supportive of the DHS managers' strategic and operational management functions. Consequently DHMISs were found to be plagued by numerous designs, operational, resources and managerial problems. There is an urgent need to explore the possibilities of computerizing the existing manual systems to take advantage of the potential uses of microcomputers for DHMIS operations within the DHS. Information system designers must also address issues of cooperative partnership in information activities, systems compatibility and sustainability.

Local Government Capacity to Respond to Environmental Change: Insights from Towns in New York State.

PubMed

Larson, Lincoln R; Lauber, T Bruce; Kay, David L; Cutts, Bethany B

2017-07-01

Local governments attempting to respond to environmental change face an array of challenges. To better understand policy responses and factors influencing local government capacity to respond to environmental change, we studied three environmental issues affecting rural or peri-urban towns in different regions of New York State: climate change in the Adirondacks (n = 63 towns), loss of open space due to residential/commercial development in the Hudson Valley (n = 50), and natural gas development in the Southern Tier (n = 62). Our analysis focused on towns' progression through three key stages of the environmental policy process (issue awareness and salience, common goals and agenda setting, policy development and implementation) and the factors that affect this progression and overall capacity for environmental governance. We found that-when compared to towns addressing open space development and natural gas development-towns confronted with climate change were at a much earlier stage in the policy process and were generally less likely to display the essential resources, social support, and political legitimacy needed for an effective policy response. Social capital cultivated through collaboration and networking was strongly associated with towns' policy response across all regions and could help municipalities overcome omnipresent resource constraints. By comparing and contrasting municipal responses to each issue, this study highlights the processes and factors influencing local government capacity to address a range of environmental changes across diverse management contexts.

Chemotherapy safety in clinical veterinary oncology.

PubMed

Klahn, Shawna

2014-09-01

Exposure to chemotherapy is a health hazard for all personnel in facilities that store, prepare, or administer antineoplastic agents. Contamination levels have been measured as much as 15 times higher in the veterinary medicine sector than in human facilities. Recent publications in human and veterinary medicine indicate that exposure extends beyond the clinic walls to affect the patient's home and family. This article provides an update on the advances in chemotherapy safety, the current issues, and the impact on cancer management in veterinary medicine. Copyright © 2014 Elsevier Inc. All rights reserved.

HIV Infection and Older Americans: The Public Health Perspective

PubMed Central

Buchacz, Kate; Gebo, Kelly A.; Mermin, Jonathan

2012-01-01

HIV disease is often perceived as a condition affecting young adults. However, approximately 11% of new infections occur in adults aged 50 years or older. Among persons living with HIV disease, it is estimated that more than half will be aged 50 years or older in the near future. In this review, we highlight issues related to HIV prevention and treatment for HIV-uninfected and HIV-infected older Americans, and outline unique considerations and emerging challenges for public health and patient management in these 2 populations. PMID:22698038

[Nuclear energy and environment: review of the IAEA environmental projects].

PubMed

Fesenko, S; Fogt, G

2012-01-01

The review of the environmental projects of the International Atomic Energy Agency is presented. Basic IAEA documents intended to protect humans and the Environment are considered and their main features are discussed. Some challenging issues in the area of protection of the Environment and man, including the impact of nuclear facilities on the environment, radioactive waste management, and remediation of the areas affected by radiological accidents, nuclear testing and sites of nuclear facilities are also discussed. The need to maintain the existing knowledge in radioecology and protection of the environment is emphasised.

Evaluation of some significant issues affecting trajectory and control management for air-breathing hypersonic vehicles

NASA Technical Reports Server (NTRS)

Hattis, Philip D.; Malchow, Harvey L.

1992-01-01

Horizontal takeoff airbreathing-propulsion launch vehicles require near-optimal guidance and control which takes into account performance sensitivities to atmospheric characteristics while satisfying physically-derived operational constraints. A generic trajectory/control analysis tool that deepens insight into these considerations has been applied to two versions of a winged-cone vehicle model. Information that is critical to the design and trajectory of these vehicles is derived, and several unusual characteristics of the airbreathing propulsion model are shown to have potentially substantial effects on vehicle dynamics.

The Current Working Conditions in Ugandan Apparel Assembly Plants.

PubMed

Tebyetekerwa, Mike; Akankwasa, Nicholus Tayari; Marriam, Ifra

2017-12-01

The present rapid shift of industrialization from developed to developing countries requires developing countries to understand issues related to work organization, management, and working conditions. There are many factors slackening production, of which working conditions is part. A complete inquiry into the workers' working conditions can enable managements to reduce risks in the workplaces and improve productivity. Understanding and awareness of the benefits of workplace research and a probe into the working conditions in the Ugandan apparel assembly plants are urgently required. A total of 103 (70 women and 33 men) workers from five different plants were interviewed. Together with the top management of various plants, questionnaires about the workers' opinions of their physical working conditions were prepared. Data was collected using two methods: (1) questionnaire; and (2) observation of the workers during their work. The results indicated that poor plant working conditions were mainly contributed by the workers' social factors and the management policies. The government, together with the management, should work to improve the working conditions in the apparel assembly plants, as it greatly affects both.

Management of pediatric mandible fractures.

PubMed

Goth, Stephen; Sawatari, Yoh; Peleg, Michael

2012-01-01

The pediatric mandible fracture is a rare occurrence when compared with the number of mandible fractures that occur within the adult population. Although the clinician who manages facial fractures may never encounter a pediatric mandible fracture, it is a unique injury that warrants a comprehensive discussion. Because of the unique anatomy, dentition, and growth of the pediatric patient, the management of a pediatric mandible fracture requires true diligence with a variance in treatment ranging from soft diet to open reduction and internal fixation. In addition to the variability in treatment, any trauma to the face of a child requires additional management factors including child abuse issues and long-term sequelae involving skeletal growth, which may affect facial symmetry and occlusion. The following is a review of the incidence, relevant anatomy, clinical and radiographic examination, and treatment modalities for specific fracture types of the pediatric mandible based on the clinical experience at the University of Miami/Jackson Memorial Hospital Oral and Maxillofacial Surgery program. In addition, a review of the literature regarding the management of the pediatric mandible fracture was performed to offer a more comprehensive overview of this unique subset of facial fractures.

Personality Assessment of Global Talent: Conceptual and Methodological Issues

ERIC Educational Resources Information Center

van de Vijver, Fons J. R.

2008-01-01

The recruitment of managers who will operate in a culturally heterogeneous context (as expatriate managers, managers in a global company, or managers of a multicultural workforce) is increasingly important in an age of globalization. This article describes conceptual and methodological issues in the assessment of such managers, notably in the…

Approaches of Improving University Assets Management Efficiency

ERIC Educational Resources Information Center

Wang, Jingliang

2015-01-01

University assets management, as an important content of modern university management, is generally confronted with the issue of low efficiency. Currently, to address the problems exposed in university assets management and take appropriate modification measures is an urgent issue in front of Chinese university assets management sectors. In this…

Through the Eyes of Higher Education Attorneys: How Department Chairs Are Navigating the Waters of Legal Issues and Risk Management

ERIC Educational Resources Information Center

Hustoles, Carol L. J.

2012-01-01

Legal and risk management issues substantially impact the operations of colleges and universities, which face escalating compliance requirements in an increasingly litigious environment. Failing to assess legal liability issues and to constructively address them with risk management processes create vulnerability to claims and litigation,…

76 FR 53414 - Pacific Fishery Management Council; Public Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-26

... Trailing Actions 7. Consider Inseason Adjustments--Part I 8. Emerging Issues Under Trawl Rationalization... Run Chinook Management Issues 2. 2011 Methodology Review I. Pacific Halibut Management 1. 2012 Pacific...

Coping with birthparent loss in adopted children.

PubMed

Smith, Daniel W; Brodzinsky, David M

2002-02-01

Relationships among adopted children's appraisals of birthparent loss, their coping strategies for managing such loss, and child and parent reports of child adjustment were investigated within the context of a stress and coping model of adoption adjustment. Eighty-two 8-12-year-old adopted children and one of their parents participated. Children completed questionnaires assessing their negative affect about birthparent loss, their curiosity about birthparents, their use of coping strategies to manage birthparent-related distress, and their levels of depression, anxiety, and global self-worth. Parents reported on children's externalizing and internalizing behavior problems and social competence. Children who reported higher levels of negative affect about birthparent loss also reported higher levels of depression and lower self-worth. Curiosity about birthparents predicted parent-rated externalizing behavior. Behavioral avoidant coping was associated with greater self-reported anxiety and parent-rated externalizing behavior, whereas problem solving coping was associated with increased parent-rated social competence. The findings, though limited by issues of measurement and sampling, add to the knowledge base regarding adopted children's appraisal and coping behaviors, and provide partial support for a stress and coping model of adopted children's adjustment.

Intra and post-operative complications of esophageal achalasia.

PubMed

Pugliese, Luigi; Peri, Andrea; Tinozzi, Francesco Paolo; Zonta, Sandro; di Stefano, Michele; Meloni, Federica; Pietrabissa, Andrea

2013-01-01

To evaluate and discuss all the potential complications affecting morbidity of patients treated with surgery for primary achalasia. A review of the available English literature published to date has been conducted. All articles reporting surgical experience in achalasia were examined and then were selected only those specifically inherent to the topic at issue. Mucosal perforation is the main intra-operative complication while persistence or recurrence of the disease and gastro-esophageal reflux are those mostly affecting patients afterwards, even at long-term follow-up. A few other less common morbidities, as well as the technical considerations useful to minimize and manage each complication mentioned, are reported. Minimally invasive surgery for achalasia consent to treat patients with a low rate of perioperative complications that can be managed with conservative approach in the majority of cases. Risk of esophageal cancer exists in these patients and remains although surgical therapy. Laparoscopic Heller myotomy along with partial fundoplication is a safe and effective procedure that should be considered as the treatment of choice at first evaluation of achalasic patients rather than endoscopic techniques. Robotic technology may add further contribution in diminishing perioperative complications.

Saving the limb in diabetic patients with ischemic foot lesions complicated by acute infection.

PubMed

Clerici, Giacomo; Faglia, Ezio

2014-12-01

Ischemia and infection are the most important factors affecting the prognosis of foot ulcerations in diabetic patients. To improve the outcome of these patients, it is necessary to aggressively treat 2 important pathologies--namely, occlusive arterial disease affecting the tibial and femoral arteries and infection of the ischemic diabetic foot. Each of these 2 conditions may lead to major limb amputation, and the presence of both critical limb ischemia (CLI) and acute deep infection is a major risk factor for lower-extremity amputation. Thus, the management of diabetic foot ulcers requires specific therapeutic approaches that vary significantly depending on whether foot lesions are complicated by infection and/or ischemia. A multidisciplinary team approach is the key to successful treatment of a diabetic foot ulcer: ischemic diabetic foot ulcers complicated by acute deep infection pose serious treatment challenges because high levels of skill, organization, accuracy, and timing of intervention are required to maximize the chances of limb salvage: these complex issues are better managed by a multidisciplinary clinical group. © The Author(s) 2014.

The management of pediatric systemic lupus erythematosus.

PubMed

Ardoin, Stacy P; Schanberg, Laura E

2005-12-01

Most children and adolescents with systemic lupus erythematosus (SLE) now survive into adulthood, leading the pediatric rheumatology community to focus on preventing long-term complications of SLE, including atherosclerosis, obesity, and osteoporosis, and their treatment. Unfortunately, because of the paucity of data in pediatric SLE, little is known about epidemiology, long-term outcome, and optimal treatment. Most research focuses on adults with SLE, but pediatric SLE differs significantly from adult SLE in many aspects, including disease expression, approaches to pharmacologic intervention, management of treatment toxicity, and psychosocial issues. Children and adolescents with SLE require specialized, multidisciplinary care. Treatment can be optimized by early recognition of disease flares and complications, minimizing medication toxicity, educating families about prevention, promoting school performance, addressing concerns about reproductive health, and negotiating the transition to adult-centered medical care. Developmentally appropriate concerns about pain, appearance, and peers often affect treatment adherence and must be addressed by the health-care team. Research in pediatric SLE is desperately needed and provides a unique opportunity to understand how developmental immunology and the hormonal changes associated with puberty affect the pathophysiology of SLE.

77 FR 40817 - Low-Level Radioactive Waste Regulatory Management Issues

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-11

...-2011-0012] RIN-3150-AI92 Low-Level Radioactive Waste Regulatory Management Issues AGENCY: Nuclear... Materials and Environmental Management Programs, U.S. Nuclear Regulatory Commission, Washington, DC 20555... State Materials and Environmental Management Programs, U.S. Nuclear Regulatory Commission, Washington...

Telemental Health for Children and Adolescents: An Overview of Legal, Regulatory, and Risk Management Issues.

PubMed

Kramer, Gregory M; Luxton, David D

2016-04-01

The use of technology to provide telemental healthcare continues to increase; however, little has been written about the legal and regulatory issues involved in providing this form of care to children and adolescents. This article reviews existing laws and regulations to summarize the risk management issues relevant to providing telemental healthcare to children and adolescents. There are several legal and regulatory areas in which telemental health clinicians need to have awareness. These areas include: 1) Licensure, 2) malpractice liability, 3) credentialing and privileging, 4) informed consent, 5) security and privacy, and 6) emergency management. Although legal and regulatory challenges remain in providing telemental healthcare to children and adolescents, it is possible to overcome these challenges with knowledge of the issues and appropriate risk management strategies. We provide general knowledge of these key legal and regulatory issues, along with some risk management recommendations.

Importance x dissatisfaction = a formula for managerial action.

PubMed

Carson, Kerry D; Carson, Paula Phillips; Fontenot, Gwen; Toma, Alfred G

2005-01-01

Management should not only survey employees about their satisfaction with an issue but should also inquire about how important that issue is to them. If the issue is very important to employees and they are very dissatisfied, then management action may be urgent. However, if staff members are dissatisfied with an issue that is unimportant to them, then no management action may be required. Rank ordering the items by importance and then subtracting satisfaction from importance to get a performance-gap score is insufficient. The decision maker still may have to use intuition to determine which items have priority. Rather than gap analysis, it is better to multiply the importance score by the dissatisfaction score. This will yield a clear rank order of the issues to which the management must attend. The authors used the multiplicative method with a health care organization. These results are analyzed, and management actions are recommended.

General principles of institutional risks influence on pension systems

NASA Astrophysics Data System (ADS)

Nepp, A. N.; Shilkov, A. A.; Sheveleva, A. Y.; Mamedbakov, M. R.

2016-12-01

This paper examines the tools used to study the influence of institutional factors on investment returns. The research object are the tools used in the evaluation of institutional risks in the pension system, in particular, the correlation model of factors impacting on the `anti-director' index, econometric estimates combining the different determinants of savings, the model of endogenous institutional change, etc. Research work focusing on issues of institutional factors affecting pension systems (authored by La Porta, Guiso, Gianetti, El-Mekkaouide Freitas, Neyapti B., and others) is reviewed. The model is examined in terms of the impact of institutional risks on pension systems, especially with regard to the funded part. The study identified the following factors that affect financial institutions, including pension institutions: management quality, regulation quality, rule of law, political stability, and corruption control.

Paediatric genomics: diagnosing rare disease in children.

PubMed

Wright, Caroline F; FitzPatrick, David R; Firth, Helen V

2018-05-01

The majority of rare diseases affect children, most of whom have an underlying genetic cause for their condition. However, making a molecular diagnosis with current technologies and knowledge is often still a challenge. Paediatric genomics is an immature but rapidly evolving field that tackles this issue by incorporating next-generation sequencing technologies, especially whole-exome sequencing and whole-genome sequencing, into research and clinical workflows. This complex multidisciplinary approach, coupled with the increasing availability of population genetic variation data, has already resulted in an increased discovery rate of causative genes and in improved diagnosis of rare paediatric disease. Importantly, for affected families, a better understanding of the genetic basis of rare disease translates to more accurate prognosis, management, surveillance and genetic advice; stimulates research into new therapies; and enables provision of better support.

Evidence-based management - healthcare manager viewpoints.

PubMed

Janati, Ali; Hasanpoor, Edris; Hajebrahimi, Sakineh; Sadeghi-Bazargani, Homayoun

2018-06-11

Purpose Hospital manager decisions can have a significant impact on service effectiveness and hospital success, so using an evidence-based approach can improve hospital management. The purpose of this paper is to identify evidence-based management (EBMgt) components and challenges. Consequently, the authors provide an improving evidence-based decision-making framework. Design/methodology/approach A total of 45 semi-structured interviews were conducted in 2016. The authors also established three focus group discussions with health service managers. Data analysis followed deductive qualitative analysis guidelines. Findings Four basic themes emerged from the interviews, including EBMgt evidence sources (including sub-themes: scientific and research evidence, facts and information, political-social development plans, managers' professional expertise and ethical-moral evidence); predictors (sub-themes: stakeholder values and expectations, functional behavior, knowledge, key competencies and skill, evidence sources, evidence levels, uses and benefits and government programs); EBMgt barriers (sub-themes: managers' personal characteristics, decision-making environment, training and research system and organizational issues); and evidence-based hospital management processes (sub-themes: asking, acquiring, appraising, aggregating, applying and assessing). Originality/value Findings suggest that most participants have positive EBMgt attitudes. A full evidence-based hospital manager is a person who uses all evidence sources in a six-step decision-making process. EBMgt frameworks are a good tool to manage healthcare organizations. The authors found factors affecting hospital EBMgt and identified six evidence sources that healthcare managers can use in evidence-based decision-making processes.

Nontechnical issues in waste management: ethical, institutional, and political concerns

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

Hebert, J.A.; Rankin, W.L.; Brown, P.G.

1978-05-01

The report consists of a presentation and distillation of major nontechnical issues surrounding commercial waste management, followed by ethical, institutional, and political analyses of these issues. The ethical analysis consists of a discusson of what is meant by ''ethics'' and ''morality'' in the waste management context and an illustrative attempt at an ethical analysis of the commercial nuclear waste problem. Two institutional analyses are presented: one is an analysis of the possible problems of long-term human institutions in waste management; the other is a presentation of institutional arrangements for the short term. A final chapter discusses issues and concerns involvingmore » intergovernmental relations--that is, local, state, and federal interface problems in waste management.« less

Problems associated with noise measurements in the mining industry

NASA Astrophysics Data System (ADS)

Bauer, Eric R.; Vipperman, Jeffrey S.

2002-05-01

In response to the continuing problem of noise-induced hearing loss (NIHL) among mine workers, the National Institute for Occupational Safety and Health (NIOSH) has been conducting numerous noise- and hearing-loss research efforts in the mining industry. Research is underway to determine worker noise exposure, equipment noise, hearing loss and hearing protection use, and to evaluate engineering controls. Issues that are peculiar to the mining industry have complicated these efforts. A few of the issues that must be overcome to conduct meaningful research include constantly moving equipment, changing work environments, confined space, varying production rates, multiple noise sources, and electronic permissibility of instrumentation. This presentation will address the factors that affect the measurement and analysis of noise in the mining industry and how these factors are managed. In addition, some examples of research results will be included.

Desired mental health resources for urban, ethnically diverse, impoverished women struggling with anxiety and depression.

PubMed

Doornbos, Mary Molewyk; Zandee, Gail Landheer; DeGroot, Joleen; Warpinski, Mary

2013-01-01

Depression and anxiety are mental health issues that disproportionately affect women-particularly when access to culturally sensitive care is limited. The purpose of this study was to identify mental health concerns in three urban, ethnically diverse, underserved, and impoverished neighborhoods using the ideological perspective of community-based participatory research. In the context of long-term partnerships between a department of nursing and these neighborhoods, we recruited 61 women aged 18 to 69 years and collected data via homogeneous focus groups comprised of Black, Hispanic, and White women, respectively. We conducted five of the focus groups in English and one in Spanish. The women perceived anxiety and depression as significant concerns for themselves, their families, and their communities. They used unique community resources to manage mental health issues and desired new resources, including support groups and education.

Does the Department of Defense Possess Solutions for the Department of Homeland Security’s Personnel Management Issues?

DTIC Science & Technology

2015-12-01

DEPARTMENT OF DEFENSE POSSESS SOLUTIONS FOR THE DEPARTMENT OF HOMELAND SECURITY’S PERSONNEL MANAGEMENT ISSUES? by Joshua D. Frizzell December 2015...22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. 1. AGENCY USE ONLY (Leave blank...SOLUTIONS FOR THE DEPARTMENT OF HOMELAND SECURITY’S PERSONNEL MANAGEMENT ISSUES? 5. FUNDING NUMBERS 6. AUTHOR(S) Joshua D. Frizzell 7

Scaling up antiretroviral therapy in Uganda: using supply chain management to appraise health systems strengthening.

PubMed

Windisch, Ricarda; Waiswa, Peter; Neuhann, Florian; Scheibe, Florian; de Savigny, Don

2011-08-01

Strengthened national health systems are necessary for effective and sustained expansion of antiretroviral therapy (ART). ART and its supply chain management in Uganda are largely based on parallel and externally supported efforts. The question arises whether systems are being strengthened to sustain access to ART. This study applies systems thinking to assess supply chain management, the role of external support and whether investments create the needed synergies to strengthen health systems. This study uses the WHO health systems framework and examines the issues of governance, financing, information, human resources and service delivery in relation to supply chain management of medicines and the technologies. It looks at links and causal chains between supply chain management for ART and the national supply system for essential drugs. It combines data from the literature and key informant interviews with observations at health service delivery level in a study district. Current drug supply chain management in Uganda is characterized by parallel processes and information systems that result in poor quality and inefficiencies. Less than expected health system performance, stock outs and other shortages affect ART and primary care in general. Poor performance of supply chain management is amplified by weak conditions at all levels of the health system, including the areas of financing, governance, human resources and information. Governance issues include the lack to follow up initial policy intentions and a focus on narrow, short-term approaches. The opportunity and need to use ART investments for an essential supply chain management and strengthened health system has not been exploited. By applying a systems perspective this work indicates the seriousness of missing system prerequisites. The findings suggest that root causes and capacities across the system have to be addressed synergistically to enable systems that can match and accommodate investments in disease-specific interventions. The multiplicity and complexity of existing challenges require a long-term and systems perspective essentially in contrast to the current short term and program-specific nature of external assistance.

Commentary: Medicaid reform issues affecting the Indian health care system.

PubMed Central

Wellever, A; Hill, G; Casey, M

1998-01-01

Substantial numbers of Indian people rely on Medicaid for their primary health insurance coverage. When state Medicaid programs enroll Indians in managed care programs, several unintended consequences may ensue. This paper identifies some of the perverse consequences of Medicaid reform for Indians and the Indian health care system and suggests strategies for overcoming them. It discusses the desire of Indian people to receive culturally appropriate services, the need to maintain or improve Indian health care system funding, and the duty of state governments to respect tribal sovereignty. Because of their relatively small numbers, Indians may be treated differently under Medicaid managed care systems without significantly endangering anticipated program savings. Failure of Medicaid programs to recognize the uniqueness of Indian people, however, may severely weaken the Indian health care system. PMID:9491006

Extending the university into the community to address healthcare disparities.

PubMed

Fitch, Cindy; Donato, Louise; Strawder, Paula

2013-01-01

Healthcare disparities in rural areas contribute to poor health outcomes, but health outcomes are also affected by social determinants of health and lifestyle behaviors. There is a compelling need to promote physical, mental, and financial health through community-based programs that lead to behavior change. The objective of this article is to disseminate information about West Virginia University Extension Service programming as it relates to health issues in rural communities. There is a WVU Extension office in each county with one or more faculty and staff members. They deliver research-based educational programs that promote diabetes self-management, moderate physical activity, healthier food choices, stress management, fall prevention, and financial competency. Healthcare providers are encouraged to refer clients to their local Extension office for educational programs that put knowledge to work.

Considerations for planning and conducting clinic-based research in physical therapy.

PubMed

Fitzgerald, G K; Delitto, A

2001-08-01

There is growing demand to increase the volume of clinic-based research in physical therapy. Special considerations, unique to the planning and conduct of clinic-based research, need to be addressed to increase the likelihood that these studies will be completed successfully. The purposes of this perspective are to discuss factors affecting clinic-based research and to offer suggestions for addressing these problems when designing and conducting research studies in a clinical setting. This perspective discusses issues such as patient management, determining the availability of target patient populations, acquiring support from physical therapists and physicians, reporting and managing research-related injury or illness, and modifying or terminating projects. Some of the points made in this perspective are illustrated using examples from the authors' experiences in conducting clinical research.

Environmental, Disaster and Crisis Management Strategies: Interdisciplinarity and Synergy in Postgraduate Studies

NASA Astrophysics Data System (ADS)

Lekkas, Efthymis; Andreadakis, Emmanouil; Nomikou, Paraskevi; Antoniou, Varvara; Kapourani, Eleni; Papaspyropoulos, Konstantinos

2017-04-01

Environmental issues, disasters and crises have been showing an increasing complexity and interconnections in every level and aspect, thus requiring a holistic approach from simple problem solving to emergency management. Recent challenges include geographical and affected population escalation, complex or cascading disasters and interconnection of regional conflicts to transboundary social, political and environmental impact. One of the issues concerning the traditional management is competition or even antagonism between organizations, services and disciplines, from science to operations. In this context, a postgraduate program answering to these issues was designed in Greece, applying multidisciplinarity, crossdisciplinarity and interdisiplinarity, from teaching staff and tutors, to students, objects and fields of knowledge and research. The program offers a curriculum of lessons and disciplines integrating science, humanities, legislation, institutions and operations. Geosciences carry an inherent interdisciplinarity culture and a long tradition in the research of environment and disasters, along with their familiarity with the complexity of such issues. That is why the program "Environmental, Disaster and Crisis Management Strategies" was organized by the Department of Geology and Geoenvironment of the National and Kapodistrian University of Athens, but involves social scientists, emergency operators, medical scientists etc. The program aims at the diffusion of basic principles and tools of all related disciplines and develops a common ground and a communication language with the least barriers, and the building of trust and understanding between all parties involved. The curriculum is designed so that professionals of all disciplines and industries are able to attend without interrupting their other activities, while pursuing their personal scientific and professional educational goals and interests through selection of lessons and thesis subject. As a result, admitted students come, in a large percentage, from services and authorities involved in environmental, disaster and crisis management issues (for example fire service, police, armed forces, ministries, local administration etc) apart from graduate students continuing their studies. An added value of the program has been observed the development of a critical mass of personnel of these organizations and young scientists with increased connectivity, extending from simple acquaintance to cooperation and trust and synergy development of the services themselves. This is a promising condition for a more effective risk and emergency management in a context of ethical and responsible practices. The curriculum comprises live or online lectures, asynchronous education with exercises and essay writing, seminars on tools such as related GIS and SPSS applications, and applied field exercises on both scientific and emergency management subjects. The program completed the second year of function, and was upgraded after internal and external evaluation, to adjust to new fields, ideas and challenges and include students' suggestions. More than one hundred students have graduated so far, and another 350 are currently attending. The program, which originally available in Greek, is going to be available in English starting September 2017, and is open for applications, and presented at: http://www.edcm.edu.gr

Traffic Management for Satellite-ATM Networks

NASA Technical Reports Server (NTRS)

Goyal, Rohit; Jain, Raj; Fahmy, Sonia; Vandalore, Bobby; Goyal, Mukul

1998-01-01

Various issues associated with "Traffic Management for Satellite-ATM Networks" are presented in viewgraph form. Specific topics include: 1) Traffic management issues for TCP/IP based data services over satellite-ATM networks; 2) Design issues for TCP/IP over ATM; 3) Optimization of the performance of TCP/IP over ATM for long delay networks; and 4) Evaluation of ATM service categories for TCP/IP traffic.

The impact of quality of work life on job embeddedness and affective commitment and their co-effect on turnover intention of nurses.

PubMed

Zhao, XiaoWen; Sun, Tao; Cao, QiuRu; Li, Ce; Duan, XiaoJian; Fan, LiHua; Liu, Yan

2013-03-01

To verify with empirical evidence the hypothesised relation and the effect of quality of work life, job embeddedness and affective commitment on turnover intention of clinical nurses in China. High turnover of the nursing workforce in healthcare organisations is a difficult and recurring problem in China as well as in many other countries in the world. It leads to great waste of resources and increases management cost. Developing and retaining the nursing workforce, which is a major challenge faced by human resources practitioners in hospitals and public health agencies, also becomes a subject of interest for management studies. Most of the literature about voluntary turnover focused on such traditional measures as job satisfaction and job alternatives in the past. The introduction of such new concepts as quality of work life, job embeddedness and affective commitment, which views the issue from a much broader and comprehensive spectrum, made a great breakthrough in the turnover study. In this study, we selected quality of work life, job embeddedness and affective commitment - three of the most important factors in employer-employee relations - and analysed the interaction between each one of them, as well as their co-effect on turnover intention of Chinese nurses. Cross-sectional survey and structural equation modelling were applied in studying the self-report questionnaires distributed to 1000 nurses employed in five large-scale government-owned hospitals in Heilongjiang Province, Northeast China. Our study confirmed the hypothesised positive relation of quality of work life with job embeddedness and affective commitment and the hypothesised negative relation of quality of work life with turnover intention, that is, high quality of work life perceived by the nurses enhances their job embeddedness and affective commitment and thus reduces their intention to leave the job. The effect of quality of work life is positive on job embeddedness and affection commitment and negative on turnover intention. Nurse managers should pay great attention to the nurses' perception of quality of work life, and make great efforts in developing strategies and projects that can strengthen the nurses' embeddedness or connection with the job. © 2012 Blackwell Publishing Ltd.

The middle manager role in energy company environmental efforts

NASA Astrophysics Data System (ADS)

Fischhoff, Maya E.

2005-12-01

This research examines the internal organizational processes determining corporate environmental action. Corporations have a tremendous environmental impact, yet relatively little is known about how employees within them view and work on these issues. The research focused on middle managers, a level of the company whose value is often questioned. Interviews were conducted with 70 middle managers at two energy companies (comprising utilities and unregulated businesses). Interviews examined the shape and significance of middle manager involvement in environmental issues, looking specifically at what issues middle managers deal with, what goals they pursue, and what approaches they use. The research finds middle managers' roles with respect to environmental issues to be far-reaching and complex. Much of their effort is focused on meeting regulatory requirements ("complying"). They are committed to compliance, in part for ethical reasons, but often find regulations frustrating and costly. Compliance is more challenging than commonly thought; it demands time, knowledge, and substantial creativity. In pursuing it, interviewees work with employees throughout the organization. This research shows middle managers interacting with those hierarchically above and below them in ways that greatly modify earlier portrayals of middle managers. Earlier portrayals often emphasized struggles for power within the organization. Here, middle managers work in ways best characterized as collaborative and supportive. Middle managers also have extensive involvement laterally within the company and with groups outside the company. These links have received modest attention in literature, yet are found to be terribly important. Middle managers' lateral efforts inside the company, often on teams, allow diverse expertise (e.g., from people in different functions) to be applied to environmental issues. Documenting middle managers' involvement externally, with governmental officials and sectors of the public, illuminates areas of very visible corporate impact. External interactions are also settings in which middle managers encounter alternative views about environmental issues. The study reveals the importance of middle managers in the challenge of environmental compliance. It provides knowledge that can be used by external entities seeking to connect with companies, and by companies seeking to address environmental issues better. It thus aids understanding of a critical societal challenge and opportunity.

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.

Health-based Provisional Advisory Levels (PALs) for homeland security.

PubMed

Adeshina, Femi; Sonich-Mullin, Cynthia; Ross, Robert H; Wood, Carol S

2009-12-01

The Homeland Security Presidential Directive #8 (HSPD-8) for National Emergency Preparedness was issued to " establish policies to strengthen the preparedness of the United States to prevent and respond to threatened or actual domestic terrorist attacks, major disasters, and other emergencies by requiring a national domestic all- hazards preparedness goal. "In response to HSPD-8 and HSPD-22 (classified) on Domestic Chemical Defense, the US Environmental Protection Agency (US EPA) National Homeland Security Research Center (NHSRC) is developing health-based Provisional Advisory Levels (PALs) for priority chemicals (including chemical warfare agents, pesticides, and toxic industrial chemicals) in air and drinking water. PALs are temporary values that will neither be promulgated, nor be formally issued as regulatory guidance. They are intended to be used at the discretion of risk managers in emergency situations. The PAL Program provides advisory exposure levels for chemical agents to assist in emergency planning and response decision-making, and to aid in making informed risk management decisions for evacuation, temporary re-entry into affected areas, and resumed-use of infrastructure, such as water resources. These risk management decisions may be made at the federal, state, and local levels. Three exposure levels (PAL 1, PAL 2, and PAL 3), distinguished by severity of toxic effects, are developed for 24-hour, 30-day, 90-day, and 2-year durations for potential exposure to drinking water and ambient air by the general public. Developed PALs are evaluated both by a US EPA working group, and an external multidisciplinary panel to ensure scientific credibility and wide acceptance. In this Special Issue publication, we present background information on the PAL program, the methodology used in deriving PALs, and the technical support documents for the derivation of PALs for acrylonitrile, hydrogen sulfide, and phosgene.

Obesity in Women: Insights for the Clinician.

PubMed

Tauqeer, Zujaja; Gomez, Gricelda; Stanford, Fatima Cody

2018-04-01

As a leading cause of morbidity and mortality in the United States and worldwide, obesity is a disease that is frequently encountered in clinical practice today and requires a range of medical interventions. While obesity affects both men and women across all ages, multiple issues are particularly germane to women's health, particularly as obesity is more prevalent among women than men in the United States and obesity among women of reproductive health relates to the growing issue of childhood obesity. Discussed herein are the epidemiology and pathophysiology of obesity along with the impact of perinatal obesity on fetal programming. Guidance on screening and management of obesity through lifestyle intervention, pharmacologic therapy, and bariatric surgery, as well as avoidance of weight-promoting medications wherever possible, is elaborated. Particular attention is paid to the contribution of these modalities to weight loss as well as their impact on obesity-related comorbidities that affect a woman's overall health, such as type 2 diabetes and hypertension, and her reproductive and gynecologic health. With modest weight loss, women with obesity can achieve notable improvements in chronic medical conditions, fertility, pregnancy outcomes, and symptoms of pelvic floor disorders. Moreover, as children born to women after bariatric surgery-induced weight loss show improved metabolic outcomes, this demonstrates a role for maternal weight loss in reducing risk of development of metabolic disturbances in children. In light of the immense cost burden and mortality from obesity, it is important to emphasize the role of lifestyle intervention, pharmacologic management, and bariatric surgery for weight loss in clinical practice to mitigate the impact of obesity on women's health.

A systematic review of research on culturally relevant issues for Hispanics with diabetes.

PubMed

Caban, Arlene; Walker, Elizabeth A

2006-01-01

The purpose of this review is to provide a description of current research on culturally relevant issues among Hispanics subgroups with diabetes throughout the United States. A search of 2655 abstracts was conducted using Medline, PubMed, and Psychlit. Sixty articles were identified, and 33 were reviewed. Most studies focused on Mexican Americans, and little is known about the unique and shared health beliefs of different Hispanics subgroups within the United States. Personal models of illness varied across groups and were influenced by levels of acculturation. Definitions and treatments for susto varied considerably: Puerto Ricans did not identify it as a cause of diabetes. Patients' thoughts about God and diabetes differed, and little is known about how these thoughts affect diabetes self-management. There is also limited research on Hispanics' use of curanderos (folk healers) for diabetes-related care, and only some participants reported using alternative treatments in conjunction with standard medical care. There is limited evidence that fatalistic thinking is unique to Hispanic culture, and its relationship to diabetes self-management remains unclear. More research is needed to determine how cultural factors influence Hispanics' approaches to diabetes self-management. Clinicians and educators would benefit from exploring cultural belief systems with patients, as they may enhance the patient-provider relationship and serve as tools in identifying appropriate treatment strategies.

[Case Study] CityCenter and Cosmopolitan Construction Projects, Las Vegas, Nevada: lessons learned from the use of multiple sources and mixed methods in a safety needs assessment.

PubMed

Gittleman, Janie L; Gardner, Paige C; Haile, Elizabeth; Sampson, Julie M; Cigularov, Konstantin P; Ermann, Erica D; Stafford, Pete; Chen, Peter Y

2010-06-01

The present study describes a response to eight tragic deaths over an eighteen month times span on a fast track construction project on the largest commercial development project in U.S. history. Four versions of a survey were distributed to workers, foremen, superintendents, and senior management. In addition to standard Likert-scale safety climate scale items, an open-ended item was included at the end of the survey. Safety climate perceptions differed by job level. Specifically, management perceived a more positive safety climate as compared to workers. Content analysis of the open-ended item was used to identify important safety and health concerns which might have been overlooked with the qualitative portion of the survey. The surveys were conducted to understand workforce issues of concern with the aim of improving site safety conditions. Such efforts can require minimal investment of resources and time and result in critical feedback for developing interventions affecting organizational structure, management processes, and communication. The most important lesson learned was that gauging differences in perception about site safety can provide critical feedback at all levels of a construction organization. Implementation of multi-level organizational perception surveys can identify major safety issues of concern. Feedback, if acted upon, can potentially result in fewer injuries and fatal events. (c) 2010 Elsevier Ltd. All rights reserved.

Management of ethical issues related to care of seriously ill dialysis patients in free-standing facilities.

PubMed

Song, Mi-Kyung; Hanson, Laura C; Gilet, Constance A; Jo, Minjeong; Reed, Teresa J; Hladik, Gerald A

2014-09-01

There are few data on the frequency and current management of clinical ethical issues related to care of seriously ill dialysis patients in free-standing dialysis facilities. To examine the extent of clinical ethical challenges experienced by care providers in free-standing facilities and their perceptions about how those issues are managed. A total of 183 care providers recruited from 15 facilities in North Carolina completed a survey regarding the occurrence and management of ethical issues in the past year. Care plan meetings were observed at four of the facilities for three consecutive months. Also, current policies and procedures at each of the facilities were reviewed. The two most frequently experienced challenges involved dialyzing frail patients with multiple comorbidities and caring for disruptive/difficult patients. The most common ways of managing ethical issues were discussions in care plan meetings (n = 47) or discussions with the clinic manager (n = 47). Although policies were in place to guide management of some of the challenges, respondents were often not aware of those policies. Also, although participants reported that ethical issues related to dialyzing undocumented immigrants were fairly common, no facility had a policy for managing this challenge. Participants suggested that all staff obtain training in clinical ethics and communication skills, facilities develop ethics teams, and there be clear policies to guide management of ethical challenges. The scope of ethical challenges was extensive, how these challenges were managed varied widely, and there were limited resources for assistance. Multifaceted efforts, encompassing endeavors at the individual, facility, organization, and national levels, are needed to support staff in improving the management of ethical challenges in dialysis facilities. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Emerging ICT implementation issues in aged care.

PubMed

Kapadia, Vasvi; Ariani, Arni; Li, Junhua; Ray, Pradeep K

2015-11-01

Demand for aged care services continues to soar as a result of an aging population. This increasing demand requires more residential aged care facilities and healthcare workforce. One recommended solution is to keep older people in their homes longer and support their independent life through the use of information and communication technologies (ICT). However, the aged care sector is still in the early stages of adopting ICT. The aim of this study was to identify the key issues that affect the adoption of ICT in the aged care sector. A systematic literature review was undertaken and involved four steps. The first two steps aimed to identify and select relevant articles. Data was then extracted from the selected articles and identified issues were analyzed and grouped into three major categories. ICT adoption issues were categorized into different perspectives, representing older people, health professionals and management. Our findings showed that all three groups were mostly concerned with issues around behavior, cost and lack of technical skills. Findings reported in this study will help decision makers at aged care settings to systematically understand issues related to ICT adoption and thus proactively introduce interventions to improve use of ICT in this sector. On the basis of our findings, we suggest future research focus on the examination of aged care workflow and assessment of return on ICT investment. Copyright © 2015. Published by Elsevier Ireland Ltd.

A QRM Discussion of Microbial Contamination of Non-sterile Drug Products, Using FDA and EMA Warning Letters Recorded between 2008 and 2016.

PubMed

Santos, Ana M C; Doria, Mara S; Meirinhos-Soares, Luís; Almeida, António J; Menezes, José C

2018-01-01

Microbial quality control of non-sterile drug products has been a concern to regulatory agencies and the pharmaceutical industry since the 1960s. Despite being an old challenge to companies, microbial contamination still affects a high number of manufacturers of non-sterile products. Consequences go well beyond the obvious direct costs related to batch rejections or product recalls, as human lives and a company's reputation are significantly impacted if such events occur. To better manage risk and establish effective mitigation strategies, it is necessary to understand the microbial hazards involved in non-sterile drug products manufacturing, be able to evaluate their potential impact on final product quality, and apply mitigation actions. Herein we discuss the most likely root causes involved in microbial contaminations referenced in warning letters issued by US health authorities and non-compliance reports issued by European health authorities over a period of several years. The quality risk management tools proposed were applied to the data gathered from those databases, and a generic risk ranking was provided based on a panel of non-sterile drug product manufacturers that was assembled and given the opportunity to perform the risk assessments. That panel identified gaps and defined potential mitigation actions, based on their own experience of potential risks expected for their processes. Major findings clearly indicate that the manufacturers affected by the warning letters should focus their attention on process improvements and microbial control strategies, especially those related to microbial analysis and raw material quality control. Additionally, the WLs considered frequently referred to failures in quality-related issues, which indicates that the quality commitment should be reinforced at most companies to avoid microbiological contaminations. LAY ABSTRACT: Microbial contamination of drug products affects the quality of non-sterile drug products produced by numerous manufacturers, representing a major risk to patients. It is necessary to understand the microbial hazards involved in the manufacturing process and evaluate their impact on final product quality so that effective prevention strategies can be implemented. A risk-based classification of most likely root causes for microbial contamination found in the warning letters issued by the US Food and Drug Administration and the European Medicines Agency is proposed. To validate the likely root causes extracted from the warning letters, a subject matter expert panel made of several manufacturers was formed and consulted. A quality risk management approach to assess microbiological contamination of non-sterile drug products is proposed for the identification of microbial hazards involved in the manufacturing process. To enable ranking of microbial contamination risks, quality risk management metrics related to criticality and overall risk were applied. The results showed that manufacturers of non-sterile drug products should improve their microbial control strategy, with special attention to quality controls of raw materials, primary containers, and closures. Besides that, they should invest in a more robust quality system and culture. As a start, manufacturers may consider investigating their specific microbiological risks, adressing their sites' own microbial ecology, type of manufacturing processes, and dosage form characteristics, as these may lead to increased contamination risks. Authorities should allow and enforce innovative, more comprehensive, and more effective approaches to in-process contamination monitoring and controls. © PDA, Inc. 2018.

Issues in Identification and Assessment of Children with Autism and a Proposed Resource Toolkit for Speech-Language Pathologists.

PubMed

Hus, Yvette

2017-01-01

The prevalence of autism spectrum disorder (ASD) has increased significantly in the last decade as have treatment choices. Nonetheless, the vastly diverse autism topic includes issues related to naming, description, iden-tification, assessment, and differentiation from other neu-rodevelopmental conditions. ASD issues directly impact speech-language pathologists (SLPs) who often see these children as the second contact, after pediatric medical practitioners. Because of shared symptomology, differentiation among neurodevelopmental disorders is crucial as it impacts treatment, educational choices, and the performance trajectory of affected children. To highlight issues in: identification and differentiation of ASD from other communication and language challenges, the prevalence differences between ASD gender phenotypes, and the insufficient consideration of cultural factors in evaluating ASD in children. A second objective was to propose a tool to assist SLPs in the management of autism in children. A universal resource toolkit development project for SLP communities at large is proposed. The resource is comprised of research-based observation and screening tools for caregivers and educators, as well as parent questionnaires for portraying the children's function in the family, cultural com-munity, and educational setting. © 2017 S. Karger AG, Basel.

ELECTIONS: Issues Affecting Military and Overseas Absentee Voters

DTIC Science & Technology

2001-05-09

Office GAO For Release on Delivery Expected at 2:30 p.m., EDT Wednesday, May 9, 2001 ELECTIONS Issues Affecting Military and Overseas Absentee Voters...Type N/A Dates Covered (from... to) ("DD MON YYYY") Title and Subtitle ELECTIONS: Issues Affecting Military and Overseas Absentee Voters Contract or...Grant Number Program Element Number Authors David M. Walker Project Number Task Number Work Unit Number Performing Organization Name(s) and

Learning Technologies: Affective and Social Issues in Computer-Supported Collaborative Learning

ERIC Educational Resources Information Center

Jones, Ann; Issroff, Kim

2005-01-01

This paper is concerned with "affective" issues in learning technologies in a collaborative context. Traditionally in learning there has been a division between cognition and affect: where cognition is concerned with skills and processes such as thinking and problem-solving and affect with emotional areas such as motivation, attitudes, feelings.…

Structural marsh management research priorities

USGS Publications Warehouse

Cahoon, Donald R.; Groat, Charles G.

1989-01-01

The paper presents a prioritized list of research issues related to structural marsh management developed by a multidisciplinary panel of regulatory agency representatives, landowners, and scientists. More than 75 issues were identified concerning landscape changes, influence on ecological processes (i.e., hydrologic, biologic, and edaphic factors), habitat quality, cumulative impacts, and management approach. These issues were prioritized and organized around six basic questions regulatory personnel must try to answer for each marsh management plan application. The six questions deal with the influence of marsh management on, in order of most immediate need, marsh loss and health, fisheries, wildlife, habitat change, water quality, and cumulative effects.

41 CFR 109-27.5104-5 - Control and issue of stock.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Control and issue of stock. 109-27.5104-5 Section 109-27.5104-5 Public Contracts and Property Management Federal Property Management Regulations System (Continued) DEPARTMENT OF ENERGY PROPERTY MANAGEMENT REGULATIONS SUPPLY AND...

17 CFR 274.13 - Form N-8B-3, registration statement of unincorporated management investment companies currently...

Code of Federal Regulations, 2010 CFR

2010-04-01

... statement of unincorporated management investment companies currently issuing periodic payment plan...-8B-3, registration statement of unincorporated management investment companies currently issuing..., pursuant to section 8(b) of the Investment Company Act of 1940, by unincorporated management investment...

University Management Education and Research in Canada: Some Unresolved Issues.

ERIC Educational Resources Information Center

von Zur-Muehlen, Max

An historical overview of university management education and research in Canada is presented and issues relevant to the present status of management education and research opportunities are discussed. Management and administrative studies schools in Canada receive, on the average, about four percent of the operating budget of the university…

Disturbance, scale, and boundary in wilderness management

Treesearch

Peter S. White; Jonathan Harrod; Joan L. Walker; Anke Jentsch

2000-01-01

Natural disturbances are critical to wilderness management. This paper reviews recent research on natural disturbance and addresses the problem of managing for disturbances in a world of human-imposed scales and boundaries. The dominant scale issue in disturbance management is the question of patch dynamic equilibrium. The dominant boundary issue in disturbance...

41 CFR 101-39.208 - Vehicles removed from defined areas.

Code of Federal Regulations, 2010 CFR

2010-07-01

... VEHICLES 39-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.2-GSA Interagency Fleet Management System Services... operated outside the geographical area served by the issuing GSA IFMS fleet management center. However... shall notify the issuing GSA IFMS fleet management center of the following: (1) The location at which...

Disturbance, Scale, and Boundary in Wilderness Management

Treesearch

Peter S. White; Jonathan Harrod; Joan L. Walker; Anke Jentsch

2000-01-01

Natural disturbances are critical to wilderness management. This paper reviews recent research on natural disturbance and addresses the problem of managing for disturbances in a world of human-imposed scales and boundaries. The dominant scale issue in disturbance management is the question of patch dynamic equilibrium. The dominant boundary issue in disturbance...

Impacts of climate change on marine top predators: Advances and future challenges

NASA Astrophysics Data System (ADS)

Hobday, Alistair J.; Arrizabalaga, Haritz; Evans, Karen; Nicol, Simon; Young, Jock W.; Weng, Kevin C.

2015-03-01

Oceanic top predators are the subject of studies by researchers under the international Climate Impacts on Oceanic Top Predators (CLIOTOP) program. A wide range of data sets have shown that environmental conditions, such as temperature and marine productivity, affect the distribution and biological processes of these species, and thus the activities of the humans that depend on them. In this special issue, 25 papers arising from the 2nd CLIOTOP symposium, held in Noumea, New Caledonia in February 2013 report the importance of realistic physical descriptions of oceanic processes for climate change projections, demonstrate a wide range of predator responses to historical climate variability, describe new analytical approaches for understanding the physiology, behaviour and trophodynamics, and project future distributions for a range of species. Several contributions discuss the implications for conservation and fisheries and show that resolving ecosystem management challenges and conflicts in the face of climate change is possible, but will require attention by decision-makers to issues that are broader than their traditional mandate. In the coming years, an increased focus on the development of management options to reduce the impacts of climate change on top predators and their dependent industries is needed.

Motives as predictors of the public's attitudes toward solid waste issues

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

Ebreo, A.; Vining, J.

2000-02-01

Surveys focusing on solid-waste-related issues, conducted over a period of several years, provided data from independent samples of residents of a Midwestern, USA, community. The collection of these data yielded useful information about the relationship between residents' recycling motives and their attitudes toward solid waste management in light of several changes in the solid waste infrastructure of the community over that time. The initial survey assessed baseline beliefs and attitudes, while later surveys were conducted after the implementation of a community educational program and a curbside recycling program. The findings indicated that for recyclers and nonrecyclers, different motives predicted endorsementmore » of solid waste programs and policies. Although a similar percentage of recyclers and nonrecyclers were in support of various proposed programs and policies, concern for the environment was found to be positively related to nonrecyclers' support of proposed programs, particularly before these programs were implemented. Prior to program implementation, motives other than environmental altruism were found to be related to recyclers' support of the programs. Additional findings support the idea that educational programs and increased accessibility to recycling opportunities affect the relationship between people's attitudes toward solid waste management and their recycling motives.« less

Coastal risk forecast system

NASA Astrophysics Data System (ADS)

Sabino, André; Poseiro, Pedro; Rodrigues, Armanda; Reis, Maria Teresa; Fortes, Conceição J.; Reis, Rui; Araújo, João

2018-03-01

The run-up and overtopping by sea waves are two of the main processes that threaten coastal structures, leading to flooding, destruction of both property and the environment, and harm to people. To build early warning systems, the consequences and associated risks in the affected areas must be evaluated. It is also important to understand how these two types of spatial information integrate with sensor data sources and the risk assessment methodology. This paper describes the relationship between consequences and risk maps, their role in risk management and how the HIDRALERTA system integrates both aspects in its risk methodology. It describes a case study for Praia da Vitória Port, Terceira Island, Azores, Portugal, showing that the main innovations in this system are twofold: it represents the overtopping flow and consequent flooding, which are critical for coastal and port areas protected by maritime structures, and it works also as a risk assessment tool, extremely important for long-term planning and decision-making. Moreover, the implementation of the system considers possible known variability issues, enabling changes in its behaviour as needs arise. This system has the potential to become a useful tool for the management of coastal and port areas, due to its capacity to effectively issue warnings and assess risks.

Coastal risk forecast system

NASA Astrophysics Data System (ADS)

Sabino, André; Poseiro, Pedro; Rodrigues, Armanda; Reis, Maria Teresa; Fortes, Conceição J.; Reis, Rui; Araújo, João

2018-04-01

The run-up and overtopping by sea waves are two of the main processes that threaten coastal structures, leading to flooding, destruction of both property and the environment, and harm to people. To build early warning systems, the consequences and associated risks in the affected areas must be evaluated. It is also important to understand how these two types of spatial information integrate with sensor data sources and the risk assessment methodology. This paper describes the relationship between consequences and risk maps, their role in risk management and how the HIDRALERTA system integrates both aspects in its risk methodology. It describes a case study for Praia da Vitória Port, Terceira Island, Azores, Portugal, showing that the main innovations in this system are twofold: it represents the overtopping flow and consequent flooding, which are critical for coastal and port areas protected by maritime structures, and it works also as a risk assessment tool, extremely important for long-term planning and decision-making. Moreover, the implementation of the system considers possible known variability issues, enabling changes in its behaviour as needs arise. This system has the potential to become a useful tool for the management of coastal and port areas, due to its capacity to effectively issue warnings and assess risks.

Water transfer projects and the role of fisheries biologists

USGS Publications Warehouse

Meador, M.R.

1996-01-01

Water transfer projects are commonly considered important mechanisms for meeting increasing water demands. However, the movement of water from one area to another may have broad ecosystem effects, including on fisheries. The Southern Division of the American Fisheries Society held a symposium in 1995 at Virginia Beach, Virginia, to discuss the ecological consequences of water transfer and identify the role of fisheries biologists in such projects. Presenters outlined several case studies, including the California State Water Project, Garrison Diversion Project (North Dakota), Lake Texoma Water Transfer Project (Oklahoma-Texas), Santee-Cooper Diversion and Re-diversion projects (South Carolina), and Tri-State Comprehensive Study (Alabama-Florida-Georgia). Results from these studies suggest that fisheries biologists have provided critical information regarding potential ecological consequences of water transfer. If these professionals continue to be called for information regarding the ecological consequences of water transfer projects, developing a broader understanding of the ecological processes that affect the fish species they manage may be necessary. Although the traditional role of fisheries biologists has focused on the fishing customer base, fisheries management issues are only one component of the broad spectrum of ecosystem issues resulting from water transfer.

Research issues: the food environment and obesity.

PubMed

Mattes, Richard; Foster, Gary D

2014-12-01

"Research Issues: The Food Environment and Obesity" is an article series commissioned by the American Society for Nutrition and The Obesity Society in an attempt to consider the state of understanding on this topic and identify key knowledge gaps. Roberts and Karl focus on the role of energy density in the regulation of energy intake and body weight and offer recommendations for prioritizing research. Finkelstein et al examine food and beverage purchases as a function of price changes and conclude that targeted food taxes and subsidies alone are unlikely to substantially affect obesity. Pereira points out the difficulty in establishing the strength of the association between intake of sugar-sweetened beverages and weight gain and obesity. Johnson and Wardle review the effects of palatability and variety on eating behavior and weight. Livingstone and Pourshahidi examine the impact of portion size manipulations on energy intake and weight management and find that consumers generally tend to eat proportionally more as portion size increases. Kant focuses on the efficacy and effectiveness of eating frequency manipulation for body weight management and finds that such manipulation has consistently yielded null results. Finally, Gordon-Larsen identifies several limitations of the existing literature regarding neighborhood access to healthy foods. © 2014 American Society for Nutrition.

Hydropower licensing and evolving climate: climate knowledge to support risk assessment for long-term infrastructure decisions

NASA Astrophysics Data System (ADS)

Ray, A. J.; Walker, S. H.; Trainor, S. F.; Cherry, J. E.

2014-12-01

This presentation focuses on linking climate knowledge to the complicated decision process for hydropower dam licensing, and the affected parties involved in that process. The U.S. Federal Energy Regulatory Commission issues of licenses for nonfederal hydroelectric operations, typically 30-50 year licenses, and longer infrastructure lifespan, a similar time frame as the anticipated risks of changing climate and hydrology. Resources managed by other federal and state agencies such as the NOAA National Marine Fisheries Service may be affected by new or re-licensed projects. The federal Integrated Licensing Process gives the opportunity for affected parties to recommend issues for consultative investigation and possible mitigation, such as impacts to downstream fisheries. New or re-licensed projects have the potential to "pre-adapt" by considering and incorporating risks of climate change into their planned operations as license terms and conditions. Hundreds of hydropower facilities will be up for relicensing in the coming years (over 100 in the western Sierra Nevada alone, and large-scale water projects such as the proposed Lake Powell Pipeline), as well as proposed new dams such as the Susitna project in Alaska. Therefore, there is a need for comprehensive guidance on delivering climate analysis to support understanding of risks of hydropower projects to other affected resources, and decisions on licensing. While each project will have a specific context, many of the questions will be similar. We also will discuss best practices for the use of climate science in water project planning and management, and how creating the best and most appropriate science is also still a developing art. We will discuss the potential reliability of that science for consideration in long term planning, licensing, and mitigation planning for those projects. For science to be "actionable," that science must be understood and accepted by the potential users. This process is a negotiation, with climate scientists needing to understand the concerns of users and respond, and users developing a better understanding of the state of climate science in order to make an informed choice. We will also discuss what is needed to streamline providing that analysis for the many re-licensing decisions expected in the upcoming years.

Experiences of a Community-Based Lymphedema Management Program for Lymphatic Filariasis in Odisha State, India: An Analysis of Focus Group Discussions with Patients, Families, Community Members and Program Volunteers

PubMed Central

Cassidy, Tali; Worrell, Caitlin M.; Little, Kristen; Prakash, Aishya; Patra, Inakhi; Rout, Jonathan; Fox, LeAnne M.

2016-01-01

Background Globally 68 million people are infected with lymphatic filariasis (LF), 17 million of whom have lymphedema. This study explores the effects of a lymphedema management program in Odisha State, India on morbidity and psychosocial effects associated with lymphedema. Methodology/Principal Findings Focus groups were held with patients (eight groups, separated by gender), their family members (eight groups), community members (four groups) and program volunteers (four groups) who had participated in a lymphedema management program for the past three years. Significant social, physical, and economic difficulties were described by patients and family members, including marriageability, social stigma, and lost workdays. However, the positive impact of the lymphedema management program was also emphasized, and many family and community members indicated that community members were accepting of patients and had some improved understanding of the etiology of the disease. Program volunteers and community members stressed the role that the program had played in educating people, though interestingly, local explanations and treatments appear to coexist with knowledge of biomedical treatments and the mosquito vector. Conclusions/Significance Local and biomedical understandings of disease can co-exist and do not preclude individuals from participating in biomedical interventions, specifically lymphedema management for those with lymphatic filariasis. There is a continued need for gender-specific psychosocial support groups to address issues particular to men and women as well as a continued need for improved economic opportunities for LF-affected patients. There is an urgent need to scale up LF-related morbidity management programs to reduce the suffering of people affected by LF. PMID:26849126

Ground beetles in Mediterranean olive agroecosystems: Their significance and functional role as bioindicators (Coleoptera, Carabidae)

PubMed Central

Mazzei, Antonio; Bonacci, Teresa; Scalercio, Stefano; Iannotta, Nino; Brandmayr, Pietro

2018-01-01

The impact of agricultural practices and soil management on the communities of arthropods living in the agricultural landscape is acknowledged as a critical issue by the literature, and it needs to be better investigated to improve the ecological sustainability of agriculture. In the present study, we aimed to study how soil management affect carabid species distribution in one of the most typical agroecosystem of the Mediterranean region, i.e. the olive grove. In South Italy olive plantations feature different types of soil management, from tillage to half- or full-cover cropping. Species distribution has been examined for a total of 10,189 individuals and 62 species collected from 17 sites. Notably from our analysis we have observed that three factors (climax vegetation, soil features and soil management) explained half of the data variability. The composition of species groupings mirrors both bioclimatic conditions (climax vegetation) and soil features, especially watering, while soil management affects the species distribution, with different intensity from site to site. Eleven species have been recognized as the most abundant in the different facets of the studied olive groves and consequently designated as characteristics of the olive agroecosystem. The species traits of the sampled species have been weighted for a compelling evaluation of the effects of agricultural management on biodiversity, showing uniform traits distribution when coping with the ecological factors that characterize the different plantation facets. We have found that carabid beetles can be used as model organisms for studying the effects of agricultural practices. Our study suggests that the interaction of man-induced trasformation with the natural background of the olive agroecosystem may be difficult to disentangle, so that such complexity must be taken into account when carabid beetles are expected to provide an ecosystem service for good agricultural practices. PMID:29558493

Need of risk management practice amongst bumiputera contractors in Malaysia construction industries

NASA Astrophysics Data System (ADS)

Syuhada Fadzil, Nur; Noor, Nurazuwa Md; Rahman, Ismail Abdul

2017-11-01

Malaysia construction industry has been growing continuously with double-digit growth for the past two decades. There are many issues surrounded the industry such as delay in delivery, cost overrun, quality and safety. In bumiputera contractor’s context, the literature review found that 32 issues were encountered in the construction project. These issues can be handled properly with the application of risk management. According to previous researchers, application of risk management in Malaysia construction industry is at the low level where it is implemented in traditional ways that are brainstorming and checklist. These were due to lack of knowledge, the high cost of hiring experts and avoiding extra cost. Besides that, this study also intentions to analyse the risk categories in the construction industry as well as identify risk management process to resolve the construction issues. Hence, this paper presents issues engulfed by Bumiputera contractors which can partly be resolved by applying risk management practice in carrying out the construction activity. This may inspire the contractors to apply the risk management practice in ensuring the success of their construction project.

The munitions provisions of the Federal Facility Compliance Act

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

Kimmell, T.A.; Green, D.R.; Queen, R.

1994-03-01

The Federal Facility Compliance Act (FFCA) was signed by President Bush on October 6, 1992. This Act amends the Resource Conservation and Recovery Act (RCRA), the primary law governing hazardous waste management in the US The most significant provision of the FFCA was the waiver of sovereign immunity. This waiver subjects Federal facilities to the same ``incentives`` as the private sector for compliance. While the waiver has broad implications for all Federal facilities, other provisions of the FFCA impact specific sectors of the Federal complex. The focus of this paper is the FFCA Munitions Provisions, which have the potential tomore » change some aspects of the structure of munitions management within the military. The Munitions Provisions, contained in Section 107 of the FFCA, modifies Section 3004 of RCRA by adding a new subsection (y) on Munitions. Section 107 requires the Environmental Protection Agency (EPA) to develop, after consultation with the Department of Defense (DOD) and appropriate State officials, regulations identifying when military munitions (including conventional and chemical munitions) become hazardous waste, and to provide for the safe transportation and storage of such waste. The FFCA requires EPA to promulgate the final ``Munitions Rule`` by October 6, 1994. These are the only provisions of the FFCA that require a new rulemaking. It is clear that the Munitions Rule could have a significant effect on the way in which DOD manages munitions. Demilitarization, range management, training activities, and emergency response actions may be affected. It is important for DOD, the Services, and individual installations, to be aware of potential impacts of the FFCA on munitions management operations. The purpose of this paper is to review several important munitions Rule issues, and to discuss potential impacts of these issues.« less

Data management issues in mobile ad hoc networks

PubMed Central

HARA, Takahiro

2017-01-01

Research on mobile ad hoc networks (MANETs) has become a hot research topic since the middle 1990’s. Over the first decade, most research focused on networking techniques, ignoring data management issues. We, however, realized early the importance of data management in MANETs, and have been conducting studies in this area for 15 years. In this review, we summarize some key technical issues related to data management in MANETs, and the studies we have done in addressing these issues, which include placement of data replicas, update management, and query processing with security management. The techniques proposed in our studies have been designed with deep considerations of MANET features including network partitioning, node participation/disappearance, limited network bandwidth, and energy efficiency. Our studies published in early 2000’s have developed a new research field as data management in MANETs. Also, our recent studies are expected to be significant guidelines of new research directions. We conclude the review by discussing some future directions for research. PMID:28496052

Data management issues in mobile ad hoc networks.

PubMed

Hara, Takahiro

2017-01-01

Research on mobile ad hoc networks (MANETs) has become a hot research topic since the middle 1990's. Over the first decade, most research focused on networking techniques, ignoring data management issues. We, however, realized early the importance of data management in MANETs, and have been conducting studies in this area for 15 years. In this review, we summarize some key technical issues related to data management in MANETs, and the studies we have done in addressing these issues, which include placement of data replicas, update management, and query processing with security management. The techniques proposed in our studies have been designed with deep considerations of MANET features including network partitioning, node participation/disappearance, limited network bandwidth, and energy efficiency. Our studies published in early 2000's have developed a new research field as data management in MANETs. Also, our recent studies are expected to be significant guidelines of new research directions. We conclude the review by discussing some future directions for research.

Effects of endogenous factors on regional land-use carbon emissions based on the Grossman decomposition model: a case study of Zhejiang Province, China.

PubMed

Wu, Cifang; Li, Guan; Yue, Wenze; Lu, Rucheng; Lu, Zhangwei; You, Heyuan

2015-02-01

The impact of land-use change on greenhouse gas emissions has become a core issue in current studies on global change and carbon cycle. However, a comprehensive evaluation of the effects of land-use changes on carbon emissions is very necessary. This paper attempted to apply the Grossman decomposition model to estimate the scale, structural, and management effects of land-use carbon emissions based on final energy consumption by establishing the relationship between the types of land use and carbon emissions in energy consumption. It was shown that land-use carbon emissions increase from 169.5624 million tons in 2000 to 637.0984 million tons in 2010, with an annual average growth rate of 14.15%. Meanwhile, land-use carbon intensity increased from 17.59 t/ha in 2000 to 64.42 t/ha in 2010, with an average annual growth rate of 13.86%. The results indicated that rapid industrialization and urbanization in Zhejiang Province promptly increased urban land and industrial land, which consequently affected land-use extensive emissions. The structural and management effects did not mitigate land-use carbon emissions. By contrast, both factors evidently affected the growth of carbon emissions because of the rigid demands of energy-intensive land-use types and the absence of land management. Results called for the policy implications of optimizing land-use structures and strengthening land-use management.

Effects of Endogenous Factors on Regional Land-Use Carbon Emissions Based on the Grossman Decomposition Model: A Case Study of Zhejiang Province, China

NASA Astrophysics Data System (ADS)

Wu, Cifang; Li, Guan; Yue, Wenze; Lu, Rucheng; Lu, Zhangwei; You, Heyuan

2015-02-01

The impact of land-use change on greenhouse gas emissions has become a core issue in current studies on global change and carbon cycle. However, a comprehensive evaluation of the effects of land-use changes on carbon emissions is very necessary. This paper attempted to apply the Grossman decomposition model to estimate the scale, structural, and management effects of land-use carbon emissions based on final energy consumption by establishing the relationship between the types of land use and carbon emissions in energy consumption. It was shown that land-use carbon emissions increase from 169.5624 million tons in 2000 to 637.0984 million tons in 2010, with an annual average growth rate of 14.15 %. Meanwhile, land-use carbon intensity increased from 17.59 t/ha in 2000 to 64.42 t/ha in 2010, with an average annual growth rate of 13.86 %. The results indicated that rapid industrialization and urbanization in Zhejiang Province promptly increased urban land and industrial land, which consequently affected land-use extensive emissions. The structural and management effects did not mitigate land-use carbon emissions. By contrast, both factors evidently affected the growth of carbon emissions because of the rigid demands of energy-intensive land-use types and the absence of land management. Results called for the policy implications of optimizing land-use structures and strengthening land-use management.

Causal Factors and Adverse Events of Aviation Accidents and Incidents Related to Integrated Vehicle Health Management

NASA Technical Reports Server (NTRS)

Reveley, Mary S.; Briggs, Jeffrey L.; Evans, Joni K.; Jones, Sharon M.; Kurtoglu, Tolga; Leone, Karen M.; Sandifer, Carl E.

2011-01-01

Causal factors in aviation accidents and incidents related to system/component failure/malfunction (SCFM) were examined for Federal Aviation Regulation Parts 121 and 135 operations to establish future requirements for the NASA Aviation Safety Program s Integrated Vehicle Health Management (IVHM) Project. Data analyzed includes National Transportation Safety Board (NSTB) accident data (1988 to 2003), Federal Aviation Administration (FAA) incident data (1988 to 2003), and Aviation Safety Reporting System (ASRS) incident data (1993 to 2008). Failure modes and effects analyses were examined to identify possible modes of SCFM. A table of potential adverse conditions was developed to help evaluate IVHM research technologies. Tables present details of specific SCFM for the incidents and accidents. Of the 370 NTSB accidents affected by SCFM, 48 percent involved the engine or fuel system, and 31 percent involved landing gear or hydraulic failure and malfunctions. A total of 35 percent of all SCFM accidents were caused by improper maintenance. Of the 7732 FAA database incidents affected by SCFM, 33 percent involved landing gear or hydraulics, and 33 percent involved the engine and fuel system. The most frequent SCFM found in ASRS were turbine engine, pressurization system, hydraulic main system, flight management system/flight management computer, and engine. Because the IVHM Project does not address maintenance issues, and landing gear and hydraulic systems accidents are usually not fatal, the focus of research should be those SCFMs that occur in the engine/fuel and flight control/structures systems as well as power systems.

Issues in Coastal Zone Management.

ERIC Educational Resources Information Center

Davis, Derrin

1992-01-01

Addresses the following issues relevant to coastal zone management: overcrowding, resource exploitation, pollution, agriculture, fisheries, industrial, and other uses. Describes conflicts and trade-offs in management typified by fragmented agency decision making. Discusses implications of the greenhouse effect, sustainable development, and the…

Special Issue: Book Reviews 2002-2003.

ERIC Educational Resources Information Center

Grauer, Barbara Ellman, Ed.

2003-01-01

This special issue reviews 71 books on the following topics: career management; career opportunities for people with disabilities; federal government career information; college career development/counseling; job search strategies, tools, methods; coaching; retirement issues; strategies for managers; women and careers; general career books; and…

Building on common ground to address biodiversity conflicts and foster collaboration in environmental management.

PubMed

Lecuyer, Lou; White, Rehema M; Schmook, Birgit; Calmé, Sophie

2018-08-15

Conservation biology faces critical challenges that require collaborative approaches, including novel strategies to support interactions among actors in biodiversity conflicts. The goals of this study were to investigate the concept of common ground across multiple issues and to explore its practical application for the support of environmental management. We conceptually defined common ground as the areas of relevance underlying the suite of issues expressed by people regarding environmental management in a particular context. We then empirically tested this in the Calakmul region of Mexico, where the complex socio-historical context and high biodiversity have created environmental management challenges that are now being addressed by a local, multi-stakeholder management board. We conducted 26 open interviews with members of the board and a further round of quantitative prioritisation of issues raised. Using a coding process designed to reveal common ground, we categorized the issues at four levels ranging from coarse to fine (themes, topics, sub-topics and perspectives). We then analysed two levels, topics (n = 14 issues) and sub-topics (n = 51 issues). To do so, we built common ground matrices to identify and analyze common ground among actors and across issues. First, cluster and non-metrical data analyses revealed the diversity of actor positions and the lack of consistent grouping among actors by occupational activity. This demonstrated that focusing on actors' differences might be misleading, and that actors' views were not closely aligned with their roles. Second, we located issues according to their levels of common ground and importance among actors. We showed that by not focusing on single issue conflicts, the identification of common ground across multiple issues can pinpoint synergies. We then proposed a framework for collaboration that prioritizes issues of high importance with greater common ground (e.g. sustainable resource use activities), to support the development of trust and norms of reciprocity among actors, strengthening the potential for future cooperation. By adopting this approach, environmental managers could support the initial stages of collaborative conservation strategies, engaging with other actors to seek common ground, avoid the creation of polarised groups and help effectively manage biodiversity conflicts. Copyright © 2018 Elsevier Ltd. All rights reserved.

Issues in NASA program and project management

NASA Technical Reports Server (NTRS)

Hoban, Francis T. (Editor)

1989-01-01

This new collection of papers on aerospace management issues contains a history of NASA program and project management, some lessons learned in the areas of management and budget from the Space Shuttle Program, an analysis of tools needed to keep large multilayer programs organized and on track, and an update of resources for NASA managers. A wide variety of opinions and techniques are presented.

Mountain biking: issues and actions for USDA Forest Service managers

Treesearch

Deborah J. Chavez

1996-01-01

Managers of National Forests are faced with many challenges related to the growing use of mountain bikes. To determine the issues and management actions associated with this growth, USDA Forest Service managers from across the United States were surveyed. Managers from at least two National Forests from every Region (except Alaska) reported annual use of trails by 10,...

Space station human productivity study. Volume 5: Management plans

NASA Technical Reports Server (NTRS)

1985-01-01

The 67 Management Plans represent recommended study approaches for resolving 108 of the 305 Issues which were identified. Each study Management Plan is prepared in three formats: Management Plan Overview (lists the subsumed Issues, study background, and related overview information); Study Plan (details the study approach by tasks, lists special needs, and describes expected study products); Schedule-Task Flow (provides a time-lined schedule for the study tasks and resource requirements). The Management Relationships Matrix, included in this volume, shows the data input-output relationships among all recommended studies. A listing is also included which cross-references the unresolved requirements to Issues to management plans. A glossary of all abbreviations utilized is provided.

Identifying nurse and health visitor priorities in a PCT using the Delphi technique.

PubMed

Brooks, Nicky; Barrett, Anna

2003-08-01

A three-stage Delphi investigation was undertaken over a 4-month period in a primary care trust to identify the perceived clinical needs of nurses. Practice nurses, district nurses, health visitors and community hospital nurses all participated. In round 1, there were 28 replies from these groups of nurses, in round 2 there were 31, and in round 3 there were 25 replies. In round 1, 77 issues (excluding duplications) were identified. These were separated into three themes according to the most appropriate method for addressing the issue: education (29 issues), research (16 issues) and management (32). In round 2, the issues were redistributed in the three areas and staff were asked to choose the ten most important issues from education, research and management. Finally, in round 3 the ten issues in education, research and management were prioritized in terms of the "most pressing". The most pressing education need was recognizing accountability; the most pressing research need was caseload/dependency scoring--matching staff levels to workload, and the most pressing management need was risk management, e.g. staff safety. The results have identified locally that there is a gap between the modernization agenda and what nursing staff consider to be the issues that need addressing locally. If measures are not put in place to address these local issues, there is a danger that nurses will not take a full and active role in the modernization of the NHS.

The impact of middle manager affective commitment on perceived improvement program implementation success.

PubMed

Fryer, Ashley-Kay; Tucker, Anita L; Singer, Sara J

Recent literature suggests that middle manager affective commitment (emotional attachment, identification, and involvement) to an improvement program may influence implementation success. However, less is known about the interplay between middle manager affective commitment and frontline worker commitment, another important driver of implementation success. We contribute to this research by surveying middle managers who directly manage frontline workers on nursing units. We assess how middle manager affective commitment is related to their perceptions of implementation success and whether their perceptions of frontline worker support mediate this relationship. We also test whether a set of organizational support factors foster middle manager affective commitment. We adapt survey measures of manager affective commitment to our research context of hospitals. We surveyed 67 nurse managers from 19 U.S. hospitals. We use hierarchical linear regression to assess relationships among middle manager affective commitment to their units' falls reduction program and their perceptions of three constructs related to the program: frontline worker support, organizational support, and implementation success. Middle manager affective commitment to their unit's falls reduction program is positively associated with their perception of implementation success. This relationship is mediated by their perception of frontline worker support for the falls program. Moreover, middle managers' affective commitment to their unit's falls program mediates the relationship between perceived organizational support for the program and perceived implementation success. We, through this research, offer an important contribution by providing empirical support of factors that may influence successful implementation of an improvement program: middle manager affective commitment, frontline worker support, and organizational support for an improvement program. Increasing levels of middle manager affective commitment to an improvement program could strengthen program implementation success by facilitating frontline worker support for the program. Furthermore, providing the organizational support items in our survey construct may bolster middle manager affective commitment.

41 CFR 101-26.301-2 - Issue of used, repaired, and rehabilitated items in serviceable condition.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Issue of used, repaired... and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 26-PROCUREMENT SOURCES AND PROGRAM 26.3-Procurement of GSA Stock Items...

Implementing a Group Contingency Behavior-Management System in Physical Education

ERIC Educational Resources Information Center

Healy, Sean; Hirsch, Shanna E.; Lloyd, John W.

2017-01-01

Behavior management issues may impede learning in physical education (PE), yet there is a paucity of evidence-based behavior-management programs studied in the PE environment to assist PE teachers to be better prepared to handle these issues. Classwide-function intervention teams (CW-FIT) is a group contingency procedure for managing student…

41 CFR 101-25.101-2 - Supply through storage and issue.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Supply through storage and issue. 101-25.101-2 Section 101-25.101-2 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 25-GENERAL 25.1...

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

PubMed

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

2003-01-01

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