Possible global environmental impacts of solid waste practices

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

Davis, M.M.; Holter, G.M.; DeForest, T.J.

1994-09-01

Pollutants resulting from the management of solid waste have been shown to affect the air, land, oceans, and waterways. In addition, solid wastes have other, more indirect impacts such as reduction in feedstocks of natural resources, because useful materials are disposed of rather than recycled. The objective of this study is to evaluate solid waste management practices that have negative implications on the global environment and develop recommendations for reducing such impacts. Recommendations identifying needed changes are identified that will reduce global impacts of solid waste practices in the future. The scope of this study includes the range of non-hazardousmore » solid wastes produced within our society, including municipal solid waste (MSW) and industrial solid waste (ISW), as well as industry-specific wastes from activities such as construction, demolition, and landclearing. Most solid waste management decisions continue to be made and implemented at very local levels, predominantly with a short-term focus to respond to relatively immediate pressures of landfill shortages, funding problems, political considerations, and the like. In this rush to address immediate local problems, little consideration is being given to potential impacts, either short- or long-term, at the national or global level resulting from solid waste management practices. More and more, the cumulative impacts from local decisions concerning solid waste management are beginning to manifest themselves in broader, longer-term impacts than are being addressed by the decision-makers or, at the very least, are presenting a greater and greater potential for such impacts.« less

Chronic Disease Management in Family Practice: Clinical Note.

DTIC Science & Technology

1998-03-01

disease management in the family practice selling. This paper discusses chronic disease management in the family practice selling....Chronic disease management is the process of evaluating and treating a medical condition or disease state which can not be readily cured so as to...minimize it’s negative impact on the individual. Examples of chronic disease management include the treatment of hypertension, diabetes, osteoporosis

76 FR 72718 - Notice of Availability of the Draft Baker Resource Management Plan and Environmental Impact...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-25

....HAG11-0127] Notice of Availability of the Draft Baker Resource Management Plan and Environmental Impact... Draft Resource Management Plan (RMP) and Draft Environmental Impact Statement (EIS) for the Baker... conditions, and changes in resource management practices since the Baker RMP of 1989. The Draft RMP/EIS was...

Impact of Crop Conversions on Runoff and Sediment Output in the Lower Mississippi River Basin

NASA Astrophysics Data System (ADS)

Momm, H.; Bingner, R. L.; Elkadiri, R.; Yaraser, L.; Porter, W.

2017-12-01

Farming management practices influence sediment and agrochemical loads exiting fields and entering downstream water bodies. These practices impact multiple physical processes responsible for sediment and nutrient detachment, transport, and deposition. Recent changes in farming practices in the Southern United States coincide with increased grain production, replacing traditional crops such as cotton with corn and soybeans. To grow these crops in the South, adapted crop management practices are needed (irrigation, fertilizer, etc.). In this study, the impact of grain crop adoption on hydrologic processes and non-point source pollutant production is quantified. A watershed located in the Big Sunflower River drainage basin (14,179 km2) - a part of the greater Lower Mississippi River basin - was selected due to its economic relevance, historical agricultural output, and depiction of recent farming management trends. Estimates of runoff and sediment loads were produced using the U.S. Department of Agriculture supported Annualized Agriculture Non-Point Source Pollution (AnnAGNPS) watershed pollution and management model. Existing physical conditions during a 16-year period (2000-2015) were characterized using 3,992 sub-catchments and 1,602 concentrated flow paths. Algorithms were developed to integrate continuous land use/land cover information, variable spatio-temporal irrigation practices, and crop output yield in order to generate a total of 2,922 unique management practices and corresponding soil-disturbing operations. A simulation representing existing conditions was contrasted with simulations depicting alternatives of management, irrigation practices, and temporal variations in crop yield. Quantification of anthropogenic impacts to water quality and water availability at a watershed scale supports the development of targeted pollution mitigation and custom conservation strategies.

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

PubMed

Kumar, Ramesh; Somrongthong, Ratana; Ahmed, Jamil

2016-01-01

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

Impact of disease management programs on hospital and community nursing practice.

PubMed

Goldstein, Perry C

2006-01-01

The impact of disease management progrmms on the role of the nursing profession in the evolving U.S. health care system is reviewed. Needed changes in educational and training programs are discussed in relation to demands for changing clinical and administrative skills in nursing with an emphasis on increasing demand for advanced practice nurses.

Impact of managed MediCal on California family practice programs.

PubMed

Zweifler, J A

2001-05-01

An important source of patients for California's family practice program is MediCal. During the past 5 years, MediCal has established a variety of capitated managed care plans. To assess the impact of California's managed MediCal program on the state's 38 family practice training programs. A cross-sectional, retrospective descriptive survey. A 3-page, 11-question survey was developed by family practice residency directors and staff from the California Academy of Family Physicians, San Francisco. The 38 family practice programs in existence in California in September 1997 were stratified by type of managed MediCal in their county and by type of sponsoring institution--university, county, community based, staff-model health maintenance organization, or managed care system. Of the 38 family practice programs, 27 responded; 19 of 27 programs participated in managed MediCal. The total number of family health center patients, and the percentage of MediCal patients (48%-60%) at family practice programs was similar when stratified by programs with and without managed MediCal and by type of sponsorship. Most programs reported that they were able to compete effectively, although most also reported increased administrative, nursing, and front office costs. Managed MediCal patients were directly assigned to residents in only 3 of 19 programs. The introduction of managed MediCal has not adversely affected the number of patients cared for in California's family practice programs. Continued vigilance regarding California family practice programs' involvement in managed MediCal, including collection of accurate data on the number of MediCal patients and the financial and educational implications for California's family practice programs, is warranted.

Agricultural policy environmental eXtender model simulation of climate change impacts on runoff from a small no-till watershed

USDA-ARS?s Scientific Manuscript database

Long-term hydrologic data sets are required to quantify the impacts of management, and climate on runoff at the field scale where management practices are applied. This study was conducted to evaluate the impacts of long-term management and climate on runoff from a small watershed managed with no-ti...

Optimization of greenhouse gas emissions in second-hand consumer product recovery through reuse platforms.

PubMed

Fortuna, Lorena M; Diyamandoglu, Vasil

2017-08-01

Product reuse in the solid waste management sector is promoted as one of the key strategies for waste prevention. This practice is considered to have favorable impact on the environment, but its benefits have yet to be established. Existing research describes the perspective of "avoided production" only, but has failed to examine the interdependent nature of reuse practices within an entire solid waste management system. This study proposes a new framework that uses optimization to minimize the greenhouse gas emissions of an integrated solid waste management system that includes reuse strategies and practices such as reuse enterprises, online platforms, and materials exchanges along with traditional solid waste management practices such as recycling, landfilling, and incineration. The proposed framework uses material flow analysis in combination with an optimization model to provide the best outcome in terms of GHG emissions by redistributing product flows in the integrated solid waste management system to the least impacting routes and processes. The optimization results provide a basis for understanding the contributions of reuse to the environmental benefits of the integrated solid waste management system and the exploration of the effects of reuse activities on waste prevention. A case study involving second-hand clothing is presented to illustrate the implementation of the proposed framework as applied to the material flow. Results of the case study showed the considerable impact of reuse on GHG emissions even for small replacement rates, and helped illustrate the interdependency of the reuse sector with other waste management practices. One major contribution of this study is the development of a framework centered on product reuse that can be applied to identify the best management strategies to reduce the environmental impact of product disposal and to increase recovery of reusable products. Copyright © 2017 Elsevier Ltd. All rights reserved.

Land management practices to become important as biofuels use grows |

Science.gov Websites

Media Photos Videos Fact Sheets, Brochures and Reports Summer Science Writing Internship Land management , making land management practices increasingly important, especially under a scenario where cellulosic impact of agricultural land use and management on U.S. carbon budgets," recently published in the

The Relationship between Teachers' Implementation of Classroom Management Practices and Student Behavior in Elementary School

ERIC Educational Resources Information Center

Gage, Nicholas A.; Scott, Terrance; Hirn, Regina; MacSuga-Gage, Ashley S.

2018-01-01

Teachers' classroom management practices have a direct impact on their students' probability of success. Evidence-based classroom management practices include (a) active instruction and supervision of students (i.e., teaching), (b) opportunities for students to respond, and (c) feedback to students. In this study, we examined the degree to which…

Grants Management in Education: Federal Impact on State Agencies.

ERIC Educational Resources Information Center

Friedman, Burton D.; Dunbar, Laird J.

This monograph examines the impact of grants management on State education from the perspectives of public administration, public finance, governmental accounting and auditing, and intergovernmental relations. Chapter I depicts the context within which OE grants management takes place. Chapter II describes existing grants management practices and…

Impact of urbanization and gardening practices on common butterfly communities in France.

PubMed

Fontaine, Benoît; Bergerot, Benjamin; Le Viol, Isabelle; Julliard, Romain

2016-11-01

We investigated the interacting impacts of urban landscape and gardening practices on the species richness and total abundance of communities of common butterfly communities across France, using data from a nationwide monitoring scheme. We show that urbanization has a strong negative impact on butterfly richness and abundance but that at a local scale, such impact could be mitigated by gardening practices favoring nectar offer. We found few interactions among these landscape and local scale effects, indicating that butterfly-friendly gardening practices are efficient whatever the level of surrounding urbanization. We further highlight that species being the most negatively affected by urbanization are the most sensitive to gardening practices: Garden management can thus partly counterbalance the deleterious effect of urbanization for butterfly communities. This holds a strong message for park managers and private gardeners, as gardens may act as potential refuge for butterflies when the overall landscape is largely unsuitable.

A Secondary Analysis of the Impact of School Management Practices on School Performance

ERIC Educational Resources Information Center

Talbert, Dale A.

2009-01-01

The purpose of this study was to conduct a secondary analysis of the impact of school management practices on school performance utilizing a survey design of School and Staffing (SASS) data collected by the National Center for Education Statistics (NCES) of the U.S. Department of Education, 1999-2000. The study identifies those school management…

Monitoring trail conditions: New methodological considerations

USGS Publications Warehouse

Marion, Jeffrey L.; Leung, Yu-Fai; Nepal, Sanjay K.

2006-01-01

The U.S. National Park Service (NPS) accommodates nearly 300 million visitors per year, visitation that has the potential to produce negative effects on fragile natural and cultural resources. The policy guidance from the NPS Management Policies recognizes the legitimacy of providing opportunities for public enjoyment of parks while acknowledging the need for managers to “seek ways to avoid, or to minimize to the greatest degree practicable, adverse impacts on park resources and values” (NPS 2001). Thus, relative to visitor use, park managers must evaluate the types and extents of resource impacts associated with recreational activities, and determine to what extent they are unacceptable and constitute impairment. Visitor impact monitoring programs can assist managers in making objective evaluations of impact acceptability and impairment and in selecting effective impact management practices by providing quantitative documentation of the types and extent of recreationrelated impacts on natural resources. Monitoring programs are explicitly authorized in Section 4.1 of the Management Policies: Natural systems in the national park system, and the human influences upon them, will be monitored to detect change. The Service will use the results of monitoring and research to understand the detected change and to develop appropriate management actions.

Paradise nearly Gained. Volume 2: Case Studies of Impact and Diversity for Frontline Management Initiative Practice.

ERIC Educational Resources Information Center

Barratt-Pugh, Llandis; Soutar, Geoffrey N.

This document presents the case studies from a multi-phase study of the impact of Australia's Frontline Management Initiative (FMI), which provides a framework for competency-based development of frontline managers in Australian enterprises. Nineteen organizational case studies and one individual case study of the FMI's impacts are included. The…

Putting social impact assessment to the test as a method for implementing responsible tourism practice

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

McCombes, Lucy, E-mail: l.mccombes@leedsbeckett.ac.uk; Vanclay, Frank, E-mail: frank.vanclay@rug.nl; Evers, Yvette, E-mail: y.evers@tft-earth.org

The discourse on the social impacts of tourism needs to shift from the current descriptive critique of tourism to considering what can be done in actual practice to embed the management of tourism's social impacts into the existing planning, product development and operational processes of tourism businesses. A pragmatic approach for designing research methodologies, social management systems and initial actions, which is shaped by the real world operational constraints and existing systems used in the tourism industry, is needed. Our pilot study with a small Bulgarian travel company put social impact assessment (SIA) to the test to see if itmore » could provide this desired approach and assist in implementing responsible tourism development practice, especially in small tourism businesses. Our findings showed that our adapted SIA method has value as a practical method for embedding a responsible tourism approach. While there were some challenges, SIA proved to be effective in assisting the staff of our test case tourism business to better understand their social impacts on their local communities and to identify actions to take. - Highlights: • Pragmatic approach is needed for the responsible management of social impacts of tourism. • Our adapted Social impact Assessment (SIA) method has value as a practical method. • SIA can be embedded into tourism businesses existing ‘ways of doing things’. • We identified challenges and ways to improve our method to better suit small tourism business context.« less

The Impact of Management Decision-Making on Student Success in Community Colleges: A Case Study

ERIC Educational Resources Information Center

Alt, Albert G.

2012-01-01

This case study examined a multi-college community college district in northern California in a primarily rural area, to understand how their practices compared to management best practices designed to improve student success, barriers that may exist in implementing best practices, and how the institution may improve its own practices. The problem…

78 FR 12347 - Notice of Availability of the Proposed Resource Management Plan and Final Environmental Impact...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-22

... Historic trails. The four alternatives were: Alternative A: Continues existing management practices (no... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLWYR05000 L16100000.DQ0000 LXSS04 K0000] Notice of Availability of the Proposed Resource Management Plan and Final Environmental Impact Statement...

The impact of union elections on human resources management practices in hospitals.

PubMed

Deshpande, Satish P

2002-06-01

The purpose of this article is to explore top management's perceptions of how various human resources management (HRM) practices changed in hospitals (n = 101) after union elections. Significant increases in many HRM practices that are believed to lead to competitive advantage through human resources were reported in firms in which unions lost elections but not in firms where unions were certified.

Stakeholder perceptions of collaboration for managing nature-based recreation in a coastal protected area in Alaska

Treesearch

Emily F. Pomeranz; Mark D. Needham; Linda E. Kruger

2013-01-01

Voluntary codes of conduct and best management practices are increasingly popular methods for addressing impacts of recreation and tourism in protected areas. In southeast Alaska, for example, a collaborative stakeholder process has been used for creating, implementing, and managing the voluntary Wilderness Best Management Practices (WBMP) for the Tracy Arm- Fords...

Solid-waste management in Jalandhar city and its impact on community health

PubMed Central

Puri, Avinash; Kumar, Manoj; Johal, Eonkar

2008-01-01

In this study, solid-waste management practices were evaluated in order to find out its link with occurrence of vector-borne disease. Strategies for solid-waste management were employed as practical model to solve the problems regarding pollution which is originated by solid-waste. PMID:20040983

People Management Practices in the Public Health Sector: Developments from Victoria, Australia

ERIC Educational Resources Information Center

Stanton, Pauline; Bartram, Timothy; Harbridge, Raymond

2004-01-01

This study investigates the impact on human resource management (HRM) practices in the public health sector in Victoria, Australia of two different government policy environments. First, it explores the Liberal Coalition Government's decentralisation of public health sector management, from 1992-1999 and second, the Labor Government's…

Assessing the effectiveness of green infrastructure stormwater best management practices in New England at the small watershed scale.

EPA Science Inventory

Methods are needed to evaluate the effectiveness of existing Stormwater Best Management Practices (BMPs) and Low Impact Development and to predict the relative effectiveness of proposed stormwater management plans in maintaining the habitat and biotic integrity of streams in New ...

Environmental management practices and engineering science: a review and typology for future research.

PubMed

Evangelinos, Konstantinos I; Allan, Stuart; Jones, Keith; Nikolaou, Ioannis E

2014-04-01

Current literature describes a number of environmental management practices and cleaner production methods that facilitate different industrial sectors to address their various environmental impacts. The high number of present practices makes their use especially difficult and complicated. This paper aims to shed light on this field by providing a typology of those environmental management practices (such as environmental management systems, environmental indicators assessment methodologies, and cleaner productions methods) and their limitations. It also describes the strengths and weaknesses of using such tools and thoughts for future research. © 2013 SETAC.

Reconciling Biodiversity Conservation and Timber Production in Mixed Uneven-Aged Mountain Forests: Identification of Ecological Intensification Pathways.

PubMed

Lafond, Valentine; Cordonnier, Thomas; Courbaud, Benoît

2015-11-01

Mixed uneven-aged forests are considered favorable to the provision of multiple ecosystem services and to the conciliation of timber production and biodiversity conservation. However, some forest managers now plan to increase the intensity of thinning and harvesting operations in these forests. Retention measures or gap creation are considered to compensate potential negative impacts on biodiversity. Our objectives were to assess the effect of these management practices on timber production and biodiversity conservation and identify potential compensating effects between these practices, using the concept of ecological intensification as a framework. We performed a simulation study coupling Samsara2, a simulation model designed for spruce-fir uneven-aged mountain forests, an uneven-aged silviculture algorithm, and biodiversity models. We analyzed the effect of parameters related to uneven-aged management practices on timber production, biodiversity, and sustainability indicators. Our study confirmed that the indicators responded differently to management practices, leading to trade-offs situations. Increasing management intensity had negative impacts on several biodiversity indicators, which could be partly compensated by the positive effect of retention measures targeting large trees, non-dominant species, and deadwood. The impact of gap creation was more mitigated, with a positive effect on the diversity of tree sizes and deadwood but a negative impact on the spruce-fir mixing balance and on the diversity of the understory layer. Through the analysis of compensating effects, we finally revealed the existence of possible ecological intensification pathways, i.e., the possibility to increase management intensity while maintaining biodiversity through the promotion of nature-based management principles (gap creation and retention measures).

Managing visitor impacts in parks: A multi-method study of the effectiveness of alternative management practices

USGS Publications Warehouse

Park, L.O.; Marion, J.L.; Manning, R.E.; Lawson, S.R.; Jacobi, C.

2008-01-01

How can recreation use be managed to control associated environmental impacts? What management practices are most effective and why? This study explored these and related questions through a series of experimental ?treatments? and associated ?controls? at the summit of Cadillac Mountain in Acadia National Park, a heavily used and environmentally fragile area. The treatments included five management practices designed to keep visitors on maintained trails, and these practices ranged from ?indirect? (information/education) to ?direct? (a fence bordering the trail). Research methods included unobtrusive observation of visitors to determine the percentage of visitors who walked off-trail and a follow-up visitor survey to explore why management practices did or didn?t work. All of the management practices reduced the percentage of visitors who walked off-trail. More aggressive applications of indirect practices were more effective than less aggressive applications, and the direct management practice of fencing was the most effective of all. None of the indirect management practices reduced walking off-trail to a degree that is likely to control damage to soil and vegetation at the study site. Study findings suggest that an integrated suite of direct and indirect management practices be implemented on Cadillac Mountain (and other, similar sites) that includes a) a regulation requiring visitors to stay on the maintained trail, b) enforcement of this regulation as needed, c) unobtrusive fencing along the margins of the trail, d) redesign of the trail to extend it, widen it in key places, and provide short spur trails to key ?photo points?, and e) an aggressive information/education program to inform visitors of the regulation to stay on the trail and the reasons for it. These recommendations are a manifestation of what may be an emerging principle of park and outdoor recreation management: intensive use requires intensive management.

76 FR 67130 - Bridger-Teton National Forest; Big Piney Ranger District; Wyoming; Environmental Impact Statement...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-31

... Management Project AGENCY: Forest Service, USDA. ACTION: Notice of intent to prepare an environmental impact... current levels is appropriate, and to determine if current livestock management practices are sufficient for achieving and maintaining compliance with the 1990 Bridger-Teton Land and Resource Management Plan...

An Investigation of the Ecological and Social Impacts Caused by Rock Climbers.

ERIC Educational Resources Information Center

Attarian, Aram

This study examined the ecological and social impacts of rock climbing. The survey included climbing sites in 10 federal areas, 2 state parks, 1 private area, and 1 city park. Resource managers provided information on the observed impacts of rock climbing and current management practices to minimize impacts. Survey results indicate: (1) 71 percent…

Regulatory Aspects Of Implementing Electrokinetic Remediation

EPA Science Inventory

A better understanding of the environmental impact of hazardous waste management practices has led to new environmental laws and a comprehensive regulatory program. This program is designed to address remediation of past waste management practices and to ensure that the hazardou...

Quantifying human impact on hydrological drought using an Earth System Model

NASA Astrophysics Data System (ADS)

van Huijgevoort, Marjolein; Chaney, Nathaniel; Malyshev, Sergey; Shevliakova, Elena; Milly, Chris

2017-04-01

Predicting the human impact on the present and future hydrological cycle remains a significant scientific challenge. Anthropogenic impact includes water management practices like diverting water for irrigation, abstraction of groundwater, and reservoirs. Hydrological extremes, in particular, are heavily affected by water management practices, due to the existing stress on the system during droughts and floods. Therefore, to prepare adaptation plans for hydrological extremes in the future, it is essential to account for water management and other human influences in Earth System Models. In this study we have implemented water management practices in the state-of-the-art GFDL land model, which includes terrestrial water, energy, and carbon balances. Both irrigation practices and reservoirs have been added in the land surface model component of the model. Irrigation amounts are determined from the soil water balance, the evaporative demand of the vegetation and fractional coverage of croplands. The resulting water demand is fulfilled by abstractions from surface water and groundwater. Reservoir outflow is dynamically coupled to the downstream water demand and available reservoir storage. Retrospective model simulations over the contiguous United States indicate a strong human influence on hydrological drought. A water management attribution analysis shows a significant impact on the water availability, mostly in the Midwest of the United States and California. Implementation of reservoirs alters the flow regime, thereby decreasing the short-term drought impact, however, in the case of multi-year drought, impacts are delayed due to the dependency on the reservoir outflow. Irrigation, on the other hand, decreases the water availability in rivers due to increased evapotranspiration leading to a higher drought impact. The average increase in evapotranspiration amounted up to 2 mm/day for cropland areas in California and Texas. Overall, the results show the importance of including water management in global scale models. This new modelling framework can be used to understand how humans will impact future water availability, water scarcity, and drought. Next steps will include coupled model simulations to investigate the human impact on feedbacks in land-atmosphere interactions.

The relationship between quality management practices and organisational performance: A structural equation modelling approach

NASA Astrophysics Data System (ADS)

Jamaluddin, Z.; Razali, A. M.; Mustafa, Z.

2015-02-01

The purpose of this paper is to examine the relationship between the quality management practices (QMPs) and organisational performance for the manufacturing industry in Malaysia. In this study, a QMPs and organisational performance framework is developed according to a comprehensive literature review which cover aspects of hard and soft quality factors in manufacturing process environment. A total of 11 hypotheses have been put forward to test the relationship amongst the six constructs, which are management commitment, training, process management, quality tools, continuous improvement and organisational performance. The model is analysed using Structural Equation Modeling (SEM) with AMOS software version 18.0 using Maximum Likelihood (ML) estimation. A total of 480 questionnaires were distributed, and 210 questionnaires were valid for analysis. The results of the modeling analysis using ML estimation indicate that the fits statistics of QMPs and organisational performance model for manufacturing industry is admissible. From the results, it found that the management commitment have significant impact on the training and process management. Similarly, the training had significant effect to the quality tools, process management and continuous improvement. Furthermore, the quality tools have significant influence on the process management and continuous improvement. Likewise, the process management also has a significant impact to the continuous improvement. In addition the continuous improvement has significant influence the organisational performance. However, the results of the study also found that there is no significant relationship between management commitment and quality tools, and between the management commitment and continuous improvement. The results of the study can be used by managers to prioritize the implementation of QMPs. For instances, those practices that are found to have positive impact on organisational performance can be recommended to managers so that they can allocate resources to improve these practices to get better performance.

Current issues in billing and coding in interventional pain medicine.

PubMed

Manchikanti, L

2000-10-01

Interventional pain management is a dynamic field with changes occurring on a daily basis, not only with technology but also with regulations that have a substantial financial impact on practices. Regulations are imposed not only by the federal government and other regulatory agencies, and also by a multitude of other payors, state governments and medical boards. Documentation of medical necessity with coding that correlates with multiple components of the patient's medical record, operative report, and billing statement is extremely important. Numerous changes which have occurred in the practice of interventional pain management in the new millennium continue to impact the financial viability of interventional pain practices along with patient access to these services. Thus, while complying with regulations of billing, coding and proper, effective, and ethical practice of pain management, it is also essential for physicians to understand financial aspects and the impact of various practice patterns. This article provides guidelines which are meant to provide practical considerations for billing and coding of interventional techniques in the management of chronic pain based on the current state of the art and science of interventional pain management. Hence, these guidelines do not constitute inflexible treatment, coding, billing or documentation recommendations. It is expected that a provider will establish a plan of care on a case-by-case basis taking into account an individual patient's medical condition, personal needs, and preferences, along with physician's experience and in a similar manner, billing and coding practices will be developed. Based on an individual patient's needs, treatment, billing and coding, different from what is outlined here is not only warranted but essential.

The Impact of Organisational Change on the Nature and Extent of Training in Australian Enterprises

ERIC Educational Resources Information Center

Smith, Andrew; Oczkowski, Edward; Noble, Charles; Macklin, Robert

2004-01-01

This article reports on a study investigating the relationship between the introduction of new management practices and the training provided by Australian enterprises for their employees. The new management practices investigated include teamworking, total quality management, lean production, business process re-engineering and the learning…

Effects of long-term soil management on the mutual interaction among soil organic matter, microbial activity and aggregates in vineyard

USDA-ARS?s Scientific Manuscript database

Vineyard management practices to enhance soil conservation principally focus on increasing carbon (C) input, whereas mitigating impacts of disturbance through reduced tillage has been rarely considered. Furthermore, information is lacking on the effects of soil management practices adopted in the un...

The fear factor of risk - clinical governance and midwifery talk and practice in the UK.

PubMed

Scamell, Mandie

2016-07-01

Through the critical application of social theory, this paper will scrutinise how the operations of risk management help to constitute midwives׳ understandings of childbirth in a particular way. Drawing from rich ethnographic data, collected in the southeast of England, the paper presents empirical evidence to critically explore how institutional concerns around risk and risk management impact upon the way midwives can legitimately imagine and manage labour and childbirth. Observational field notes, transcribed interviews with various midwives, along with material culture in the form of documentary evidence will be used to explore the unintended consequences of clinical governance and its risk management technologies. Through this analysis the fear factor of risk in midwifery talk and practice will be introduced to provide an insight into how risk management impacts midwifery practice in the UK. Copyright © 2016. Published by Elsevier Ltd.

Impact of an educational program on knowledge and practice of health care staff toward pharmaceutical waste management in Gaza, Palestine.

PubMed

Tabash, Mohammed I; Hussein, Rim A; Mahmoud, Aleya H; El-Borgy, Mohamed D; Abu-Hamad, Bassam A

2016-04-01

In health care facilities, pharmaceutical waste is generally discharged down the drain or sent to landfill. Poor knowledge about their potential downstream impacts may be a primary factor for improper disposal behavior. The objective of this study was to determine the impact of an intervention program on knowledge and practice of health care staff regarding pharmaceutical waste management. The study was designed as a pre/posttest intervention study. Total sample size was 530 in the pre-intervention phase, and then a subsample of 69 individuals was selected for the intervention and the post-intervention phases. Paired-sample t test was used to assess the difference between pretest and follow-up test results. A statistically significant improvement in knowledge and practice was achieved (P<0.001). Poor knowledge and poor practice levels (scores<50%) were found to improve to satisfactory levels (scores≥75%). Therefore, educational programs could be considered as an effective tool for changing health care staff practice in pharmaceutical waste management. In health care facilities, pharmaceutical waste is generally discharged down the drain or sent to landfill. A lack of knowledge about the potential impacts of this type of waste may be a leading factor in improper disposal behavior. Following an educational program, statistically significant improvement in knowledge and practice of health care staff as regards to pharmaceutical waste management (PWM) was achieved. It is thus recommended that authorities implement training-of-trainers (TOT) programs to educate health care staff on PWM and organize refreshment workshops regularly.

Human impacts on terrestrial hydrology: climate change versus pumping and irrigation

NASA Astrophysics Data System (ADS)

Ferguson, Ian M.; Maxwell, Reed M.

2012-12-01

Global climate change is altering terrestrial water and energy budgets, with subsequent impacts on surface and groundwater resources; recent studies have shown that local water management practices such as groundwater pumping and irrigation similarly alter terrestrial water and energy budgets over many agricultural regions, with potential feedbacks on weather and climate. Here we use a fully-integrated hydrologic model to directly compare effects of climate change and water management on terrestrial water and energy budgets of a representative agricultural watershed in the semi-arid Southern Great Plains, USA. At local scales, we find that the impacts of pumping and irrigation on latent heat flux, potential recharge and water table depth are similar in magnitude to the impacts of changing temperature and precipitation; however, the spatial distributions of climate and management impacts are substantially different. At the basin scale, the impacts on stream discharge and groundwater storage are remarkably similar. Notably, for the watershed and scenarios studied here, the changes in groundwater storage and stream discharge in response to a 2.5 °C temperature increase are nearly equivalent to those from groundwater-fed irrigation. Our results imply that many semi-arid basins worldwide that practice groundwater pumping and irrigation may already be experiencing similar impacts on surface water and groundwater resources to a warming climate. These results demonstrate that accurate assessment of climate change impacts and development of effective adaptation and mitigation strategies must account for local water management practices.

The impact of risk management practice upon the implementation of recovery-oriented care in community mental health services: a qualitative investigation.

PubMed

Holley, Jessica; Chambers, Mary; Gillard, Steven

2016-08-01

Recovery-oriented care has become guiding principle for mental health policies and practice in the UK and elsewhere. However, a pre-existing culture of risk management practice may impact upon the provision of recovery-oriented mental health services. To explore how risk management practice impacts upon the implementation of recovery-oriented care within community mental health services. Semi-structured interviews using vignettes were conducted with eight mental health worker and service user dyads. Grounded theory techniques were used to develop explanatory themes. Four themes arose: (1) recovery and positive risk taking; (2) competing frameworks of practice; (3) a hybrid of risk and recovery; (4) real-life recovery in the context of risk. In abstract responses to the vignettes, mental health workers described how they would use a positive-risk taking approach in support of recovery. In practice, this was restricted by a risk-averse culture embedded within services. Mental health workers set conditions with which service users complied to gain some responsibility for recovery. A lack of strategic guidance at policy level and lack of support and guidance at practice level may result in resistance to implementing ROC in the context of RMP. Recommendations are made for policy, training and future research.

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

PubMed

Wickramasinghe, Nilmini; Silvers, J B

2003-05-01

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

Integrating impact assessment and conflict management in urban planning: Experiences from Finland

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

Peltonen, Lasse, E-mail: lasse.peltonen@tkk.f; Sairinen, Rauno, E-mail: rauno.sairinen@joensuu.f

2010-09-15

The article examines the interlinkages between recent developments in conflict management and impact assessment procedures in the context of urban planning in Finland. It sets out by introducing the fields of impact assessment and conflict mediation. It then proceeds to discuss the development of impact assessment practices and the status of conflict mediation in Finnish land use planning. The case of Korteniitty infill development plan in Jyvaeskylae is used to demonstrate how the Finnish planning system operates in conflict situations - and how social impact assessment can contribute to managing planning conflicts. The authors ask how the processes of impactmore » assessment contribute to conflict management. Based on the Finnish experience, it is argued that social impact assessment of land use plans can contribute to conflict management, especially in the absence of institutionalised conflict mediation processes. In addition, SIA may acquire features of conflict mediation, depending on extent and intensity of stakeholder participation in the process, and the quality of linkages it between knowledge production and decision-making. Simultaneously, conflict mediation practices and theoretical insights can inform the application of SIA to help it address land use conflicts more consciously.« less

The Missouri Ozark Forest Ecosystem Project: past, present, and future

Treesearch

Brian L. Brookshire; Randy Jensen; Daniel C. Dey

1997-01-01

In 1989, the Missouri Department of Conservation initiated a research project to examine the impacts of forest management practices on multiple ecosystem components. The Missouri Ozark Forest Ecosystem Project (MOFEP) is a landscape experiment comparing the impacts of even-aged management, uneven-aged management, and no harvesting on a wide array of ecosystem...

Impacts of drainage water management on subsurface drain flow, nitrate concentration, and nitrate loads in Indiana

EPA Science Inventory

Drainage water management is a conservation practice that has the potential to reduce drainage outflow and nitrate (NO3) loss from agricultural fields while maintaining or improving crop yields. The goal of this study was to quantify the impact of drainage water management on dra...

Understanding the Impacts of Soil, Climate, and Farming Practices on Soil Organic Carbon Sequestration: A Simulation Study in Australia.

PubMed

Godde, Cécile M; Thorburn, Peter J; Biggs, Jody S; Meier, Elizabeth A

2016-01-01

Carbon sequestration in agricultural soils has the capacity to mitigate greenhouse gas emissions, as well as to improve soil biological, physical, and chemical properties. The review of literature pertaining to soil organic carbon (SOC) dynamics within Australian grain farming systems does not enable us to conclude on the best farming practices to increase or maintain SOC for a specific combination of soil and climate. This study aimed to further explore the complex interactions of soil, climate, and farming practices on SOC. We undertook a modeling study with the Agricultural Production Systems sIMulator modeling framework, by combining contrasting Australian soils, climates, and farming practices (crop rotations, and management within rotations, such as fertilization, tillage, and residue management) in a factorial design. This design resulted in the transposition of contrasting soils and climates in our simulations, giving soil-climate combinations that do not occur in the study area to help provide insights into the importance of the climate constraints on SOC. We statistically analyzed the model's outputs to determinate the relative contributions of soil parameters, climate, and farming practices on SOC. The initial SOC content had the largest impact on the value of SOC, followed by the climate and the fertilization practices. These factors explained 66, 18, and 15% of SOC variations, respectively, after 80 years of constant farming practices in the simulation. Tillage and stubble management had the lowest impacts on SOC. This study highlighted the possible negative impact on SOC of a chickpea phase in a wheat-chickpea rotation and the potential positive impact of a cover crop in a sub-tropical climate (QLD, Australia) on SOC. It also showed the complexities in managing to achieve increased SOC, while simultaneously aiming to minimize nitrous oxide (N2O) emissions and nitrate leaching in farming systems. The transposition of contrasting soils and climates in our simulations revealed the importance of the climate constraints on SOC.

Understanding the Impacts of Soil, Climate, and Farming Practices on Soil Organic Carbon Sequestration: A Simulation Study in Australia

PubMed Central

Godde, Cécile M.; Thorburn, Peter J.; Biggs, Jody S.; Meier, Elizabeth A.

2016-01-01

Carbon sequestration in agricultural soils has the capacity to mitigate greenhouse gas emissions, as well as to improve soil biological, physical, and chemical properties. The review of literature pertaining to soil organic carbon (SOC) dynamics within Australian grain farming systems does not enable us to conclude on the best farming practices to increase or maintain SOC for a specific combination of soil and climate. This study aimed to further explore the complex interactions of soil, climate, and farming practices on SOC. We undertook a modeling study with the Agricultural Production Systems sIMulator modeling framework, by combining contrasting Australian soils, climates, and farming practices (crop rotations, and management within rotations, such as fertilization, tillage, and residue management) in a factorial design. This design resulted in the transposition of contrasting soils and climates in our simulations, giving soil–climate combinations that do not occur in the study area to help provide insights into the importance of the climate constraints on SOC. We statistically analyzed the model’s outputs to determinate the relative contributions of soil parameters, climate, and farming practices on SOC. The initial SOC content had the largest impact on the value of SOC, followed by the climate and the fertilization practices. These factors explained 66, 18, and 15% of SOC variations, respectively, after 80 years of constant farming practices in the simulation. Tillage and stubble management had the lowest impacts on SOC. This study highlighted the possible negative impact on SOC of a chickpea phase in a wheat–chickpea rotation and the potential positive impact of a cover crop in a sub-tropical climate (QLD, Australia) on SOC. It also showed the complexities in managing to achieve increased SOC, while simultaneously aiming to minimize nitrous oxide (N2O) emissions and nitrate leaching in farming systems. The transposition of contrasting soils and climates in our simulations revealed the importance of the climate constraints on SOC. PMID:27242862

Microsimulation of the Impact of Access Management Practices to Pedestrians

DOT National Transportation Integrated Search

2018-12-31

The study applied microsimulation to analyze the impact of access management (AM) to the operational performances of vehicles and pedestrians. A conceptual model was developed in VISSIM and VISWALK to examine the effect of access and signals density ...

How Does Education and Training Impact on Management Practices? CRLRA Discussion Paper Series.

ERIC Educational Resources Information Center

Kilpatrick, Sue

A study examined the impact of agricultural education and training on farm business practice and the influence of training on changes to farming practice in Australia. Data were from an additional set of questions on the Australian Bureau of Statistics' 1993-94 Agricultural Financial Survey and an interview survey of 65 Tasmanian farmers. Findings…

Nurse managers describe their practice environments.

PubMed

Warshawsky, Nora E; Lake, Sharon W; Brandford, Arica

2013-01-01

Hospital work environments that support the professional practice of nurses are critical to patient safety. Nurse managers are responsible for creating these professional practice environments for staff nurses, yet little is known about the environments needed to support nurse managers. Domains of nurse managers' practice environment have recently been defined. This is a secondary analysis of 2 cross-sectional studies of organizational characteristics that influence nurse manager practice. Content analysis of the free text comments from 127 nurse managers was used to illustrate the 8 domains of nurse managers' practice environments. Nurse managers valued time spent with their staff; therefore, workloads must permit meaningful interaction. Directors demonstrated trust when they empowered nurse managers to make decisions. Administrative leaders should build patient safety cultures on the basis of shared accountability and mutual respect among the health care team. The expectations of nurse managers have greatly expanded in the volume and complexity of direct reports, patient care areas, and job functions. The nurse managers in this analysis reported characteristics of their practice environments that limit their role effectiveness and may negatively impact organizational performance. Further research is needed to understand the effects of nurse managers' practice environments on staff and patient outcomes.

The impact of broiler production system practices on consumer perceptions of animal welfare.

PubMed

de Jonge, Janneke; van Trijp, Hans C M

2013-12-01

This research explores the extent to which different farm management practices influence the perceived animal friendliness of broiler production systems, and how this differs between individuals. Using a conjoint design with paired comparisons, respondents evaluated broiler production systems that were described on the basis of 7 animal welfare-related practices. It was found that practices in the area of outdoor access, stocking density, and day-night rhythm were overall perceived to have a larger impact on perceptions of animal friendliness than other practices, such as transport duration or the type of breed used. However, individuals differed regarding the extent to which they believed the different farm management practices influenced the animal friendliness of the production system. Differences between individuals regarding their knowledge about and familiarity with livestock farming, degree of anthropomorphism, and their moral beliefs regarding animal welfare partly explained the relative importance individuals attached to farm management practices. The obtained insight into which welfare-related farm management practices, in consumers' minds, most strongly contribute to animal welfare, and the existence of differences between consumers, can be helpful in the development of animal welfare-based certification schemes that are appealing to consumers, as well as the positioning of welfare concepts in the market.

Spatial impact assessment of conifer stands in the Hoosier National Forest

Treesearch

Richard Thurau; Craig Wayson; Dale Weigel; Jeff Ehman

2011-01-01

Forest management decisions on Federal lands must be administered at many spatial and temporal scales. Forest condition, size class, and cover type at the stand level determine how silvicultural practices today will impact management area and overall forest goals in the future. The Hoosier National Forest (HNF) Land Resource Management Plan lists eight goals for...

Does performance management affect nurses' well-being?

PubMed

Decramer, Adelien; Audenaert, Mieke; Van Waeyenberg, Thomas; Claeys, Tine; Claes, Claudia; Vandevelde, Stijn; van Loon, Jos; Crucke, Saskia

2015-04-01

This article focuses on employee performance-management practices in the healthcare sector. We specifically aim to contribute to a better understanding of the impact of employee performance-management practices on affective well-being of nurses in hospitals. Theory suggests that the features of employee-performance management (planning and evaluation of individual performances) predict affective well-being (in this study: job satisfaction and affective commitment). Performance-management planning and evaluation and affective well-being were drawn from a survey of nurses at a Flemish hospital. Separate estimations were performed for different aspects of affective well-being. Performance planning has a negative effect on job satisfaction of nurses. Both vertical alignment and satisfaction with the employee performance-management system increase the affective well-being of nurses; however, the impact of vertical alignment differs for different aspects of affective well-being (i.e. job satisfaction and affective commitment). Performance-management planning and evaluation of nurses are associated with attitudinal outcomes. The results indicate that employee performance-management features have different impacts on different aspects of well-being. Copyright © 2014 Elsevier Ltd. All rights reserved.

Assessment of forestry best management practices II: patterns in stream biological endpoints in terms of natural variability and fertilization

Treesearch

Camille Flinders; Daniel L. McLaughlin; Larry Korhnak; William J. Arthurs; Joan Ikoma; Matthew J. Cohen; Erik B. Schilling

2016-01-01

Watersheds dominated by forest cover typically have high quality water. In managed forests, fertilizers may be periodically applied during the growing period. The Florida Forest Service has developed Best Management Practices (BMPs) for managed forests to minimize the potential impacts of forestry operations, including fertilization, to forest streams and maintain ...

Mulch and fertilizer management practices for organic production of highbush blueberry. II. Impact on plant and soil nutrients during establishment

USDA-ARS?s Scientific Manuscript database

A systems trial was established to evaluate management practices for organic production of highbush blueberry. The practices included two bed types (flat and raised), two sources and rates of fertilizer (feather meal and fish emulsion applied at 29 and 57 kg/ha N), three mulches [sawdust, compost to...

Managed care. What is its impact on nursing education and practice?

PubMed

Malloy, C

1997-08-01

Market forces present the nursing profession with an urgency to prepare gerontological nurses to assume significant roles in the managed care industry. An understanding of the current managed care environment underscores the need for training. Nurses require a "managed care" skill-set encompassing a firm grasp of the organization, financing, delivery, and policy implications of managed care as well as advanced practice clinical skills and a sound business orientation. The importance of the consumer as a significant player in managed care is highlighted.

Agricultural management impact on greenhouse gas emissions

USDA-ARS?s Scientific Manuscript database

Management practices used on croplands to enhance crop yields and quality can contribute about 10 to 20% of global greenhouse gases (GHGs: carbon dioxide [CO2], nitrous oxide [N2O], and methane [CH4]). Some of these practices are tillage, cropping systems, N fertilization, organic fertilizer applica...

Developing an advanced practice nurse-led liver clinic.

PubMed

McAfee, Jean L

2012-01-01

End-stage liver disease (ESLD) is a leading cause of digestive disease deaths in the United States and continues to increase exponentially every year. Best practice does not currently recognize or utilize a clinic practice model for ESLD management. Advanced practice registered nurses (APRNs) can impact ESLD disease management by implementing an outpatient clinic care model to focus on treatment compliance, patient education, improvement of patient outcomes, and reduction in hospital admission rates for ESLD patients. A review of 15 research articles was completed to determine the impact APRNs can make on chronic care of ESLD patients. Results from the review support APRN analysis, assessment, diagnosis, treatment, intervention, and evaluation of ESLD patients. The literature reviewed also demonstrates that ESLD patients have improved symptom management when maintained in an outpatient setting, allowing for decreased hospital and insurance expenditures. Following evaluation of the evidence, it was concluded that an APRN-led ESLD clinic merits further study.

Human Impacts on the Hydrologic Cycle: Comparing Global Climate Change and Local Water Management

NASA Astrophysics Data System (ADS)

Ferguson, I. M.; Maxwell, R. M.

2010-12-01

Anthropogenic climate change is significantly altering the hydrologic cycle at global and regional scales, with potentially devastating impacts on water resources. Recent studies demonstrate that hydrologic response to climate change will depend on local-scale feedbacks between groundwater, surface water, and land surface processes. These studies suggest that local water management practices that alter the quantity and distribution of water in the terrestrial system—e.g., groundwater pumping and irrigation—may also feed back across the hydrologic cycle, with impacts on land-atmosphere fluxes and thus weather and climate. Here we use an integrated hydrologic model to compare the impacts of large-scale climate change and local water management practices on water and energy budgets at local and watershed scales. We consider three climate scenarios (hot, hot+wet, and hot+dry) and three management scenarios (pumping only, irrigation only, and pumping+irrigation). Results demonstrate that impacts of local water management on basin-integrated groundwater storage, evapotranspiration, and stream discharge are comparable to those of changing climate conditions. However, impacts of climate change are shown to have a smaller magnitude and greater spatial extent, while impacts of pumping and irrigation are shown to have a greater magnitude but are local to areas where pumping and irrigation occur. These results have important implications regarding the scales of human impacts on both water resources and climate and the sustainability of water resources.

Site establishment practices influence loblolly pine mortality throughout the stand rotation

Treesearch

Felipe G. Sanchez; Robert J. Eaton

2010-01-01

During a rotation, land managers need to estimate yields, update inventories, and evaluate stand dynamics. All of these factors in land management are heavily influenced by tree mortality. Tree mortality can, in turn, be influenced by land management practices from the inception of the stand and throughout the rotation. We describe the impact of organic matter removal...

Organizational Learning, Knowledge Management Practices and Firm's Performance: An Empirical Study of a Heavy Engineering Firm in India

ERIC Educational Resources Information Center

Jain, Ajay K.; Moreno, Ana

2015-01-01

Purpose: The study aims at investigating the impact of organizational learning (OL) on the firm's performance and knowledge management (KM) practices in a heavy engineering organization in India. Design/Methodology/Approach: The data were collected from 205 middle and senior executives working in the project engineering management division of a…

Monitoring protocols: options, approaches, implementation, benefits

USDA-ARS?s Scientific Manuscript database

Monitoring and adaptive management are fundamental concepts to rangeland management across land management agencies and embodied as best management practices for private landowners. Historically, rangeland monitoring was limited to determining impacts or maximizing the potential of specific land use...

Research for the development of best management practices for minimizing horse trail impacts on the Hoosier National Forest

USGS Publications Warehouse

Aust, M.W.; Marion, J.L.; Kyle, K.

2005-01-01

This research investigates horse trail impacts to gain an improved understanding of the relationship between various levels of horse use, horse trail management alternatives, and subsequent horse trail degradation. A survey of existing horse trails on the Hoosier National Forest was used to collect data on use-related, environmental and management factors to model horse trail impacts. Results are analyzed to identify which factors are most easily manipulated by managers to effectively avoid and minimize horse trail impacts. A specific focus includes evaluating the relative effect of trail use level, surfacing, grade, and water control on indices of erosion and trafficability such as trail cross sectional area, estimated erosion, muddiness, and incision. Overall, the Hoosier National Forest horse trails could be significantly improved by relocating or closing inherited trails that directly ascend slope or are excessively steep, reducing the distance between water control structures, and by applying gravel to harden trail surfaces and reduce soil erosion. A set of Best Management Practices for trails are included as a product of this work, with recommendations based on this research.

Epidemiology and clinical impact of major comorbidities in patients with COPD

PubMed Central

Smith, Miranda Caroline; Wrobel, Jeremy P

2014-01-01

Comorbidities are frequent in chronic obstructive pulmonary disease (COPD) and significantly impact on patients’ quality of life, exacerbation frequency, and survival. There is increasing evidence that certain diseases occur in greater frequency amongst patients with COPD than in the general population, and that these comorbidities significantly impact on patient outcomes. Although the mechanisms are yet to be defined, many comorbidities likely result from the chronic inflammatory state that is present in COPD. Common problems in the clinical management of COPD include recognizing new comorbidities, determining the impact of comorbidities on patient symptoms, the concurrent treatment of COPD and comorbidities, and accurate prognostication. The majority of comorbidities in COPD should be treated according to usual practice, and specific COPD management is infrequently altered by the presence of comorbidities. Unfortunately, comorbidities are often under-recognized and under-treated. This review focuses on the epidemiology of ten major comorbidities in patients with COPD. Further, we emphasize the clinical impact upon prognosis and management considerations. This review will highlight the importance of comorbidity identification and management in the practice of caring for patients with COPD. PMID:25210449

Plain Language Summary: Earwax (Cerumen Impaction)

PubMed

Krouse, Helene J; Magit, Anthony E; O'Connor, Sarah; Schwarz, Seth R; Walsh, Sandra A

2017-01-01

This plain language summary serves as an overview in explaining earwax (cerumen). The summary applies to patients older than 6 months with a clinical diagnosis of earwax impaction and is based on the 2017 update of the Clinical Practice Guideline: Earwax (Cerumen Impaction). The evidence-based guideline includes research that supports diagnosis and treatment of earwax impaction. The guideline was developed to improve care by health care providers for managing earwax impaction by creating clear recommendations to use in medical practice.

Greenhouse gas emissions and management practices that impact them in US rice systems

USDA-ARS?s Scientific Manuscript database

Previous reviews have quantified factors affecting greenhouse gas (GHG) emissions from Asian rice (Oryza sativa L.) systems, but not from rice systems typical for the United States, which often vary considerably particularly in practices (i.e., water and carbon management) that affect emissions. Usi...

SUSTAIN – A Framework for Placement of Best Management Practices in Urban Watersheds to Protect Water Quality

EPA Science Inventory

SUSTAIN (System for Urban Stormwater Treatment and Analysis INtegration) is a decision support system to facilitate selection and placement of best management practices (BMPs) and low impact development (LID) techniques at strategic locations in urban watersheds. It was develope...

Simulating runoff from small grazed pasture watersheds located at North Appalachian Experimental Watershed in Ohio

USDA-ARS?s Scientific Manuscript database

Runoff from grazing pasture lands can impact water quality in receiving streams if not well managed. Management consists of conservation practices to reduce runoff and pollutants transport. Simulation models have been effectively used to design and implement these conservation practices. The Agricul...

RECONCILING ON-SITE STORMWATER BEST MANAGEMENT PRACTICE (BMP) EFFECTIVENESS AND PERFORMANCE WITH CURRENT HYDROLOGIC AND ECONOMIC PERCEPTIONS

EPA Science Inventory

There is currently a dearth of data characterizing best management practice impacts on runoff production at the parcel-level. This data is of critical importance insofar as judging the effectiveness and reliability of on-site stormwater BMPs, with significant implications for bot...

A Review of Applicability and Effectiveness of Low Impact Development/Green Infrastructure Practices in Arid/Semi-Arid United States

EPA Science Inventory

Southwestern/Western United States is among the fastest growing urbanized area and faces multiple water resource challenges. Low Impact Development (LID) /Green Infrastructure (GI) practices are increasingly popular technologies for managing stormwater; however, LID is often not ...

Impact of tillage and fertilizer application method on gas emissions in a corn cropping system

USDA-ARS?s Scientific Manuscript database

Tillage and fertilization practices used in row crop production are thought to alter greenhouse gas emissions from soil. This study was conducted to determine the impact of fertilizer sources, land management practices, and fertilizer placement methods on greenhouse gas emissions. A new prototype i...

Developing a Web-Based Nursing Practice and Research Information Management System: A Pilot Study.

PubMed

Choi, Jeeyae; Lapp, Cathi; Hagle, Mary E

2015-09-01

Many hospital information systems have been developed and implemented to collect clinical data from the bedside and have used the information to improve patient care. Because of a growing awareness that the use of clinical information improves quality of care and patient outcomes, measuring tools (electronic and paper based) have been developed, but most of them require multiple steps of data collection and analysis. This necessitated the development of a Web-based Nursing Practice and Research Information Management System that processes clinical nursing data to measure nurses' delivery of care and its impact on patient outcomes and provides useful information to clinicians, administrators, researchers, and policy makers at the point of care. This pilot study developed a computer algorithm based on a falls prevention protocol and programmed the prototype Web-based Nursing Practice and Research Information Management System. It successfully measured performance of nursing care delivered and its impact on patient outcomes successfully using clinical nursing data from the study site. Although Nursing Practice and Research Information Management System was tested with small data sets, results of study revealed that it has the potential to measure nurses' delivery of care and its impact on patient outcomes, while pinpointing components of nursing process in need of improvement.

Incident management successful practices : a cross-cutting study : improving mobility and saving lives

DOT National Transportation Integrated Search

2000-04-01

Incident management is the process of managing multi-agency, multi-jurisdictional responses to highway traffic disruptions. Efficient and coordinated management of incidents reduces their adverse impacts on public safety, traffic conditions, and the ...

Issues for small businesses with waste management.

PubMed

Redmond, Janice; Walker, Elizabeth; Wang, Calvin

2008-07-01

Participation by small and medium enterprise (SME) in corporate social responsibility issues has been found to be lacking. This is a critical issue, as individually SMEs may have little impact on the environment but their collective footprint is significant. The management style and ethical stance of the owner-manager affects business decision making and therefore has a direct impact on the environmental actions of the business. Although adoption of environmental practices to create competitive advantage has been advocated, many businesses see implementation as a cost which cannot be transferred to their customers. After a brief review of pertinent literature this paper reports on an exploratory investigation into the issue. Results show that whereas owner-managers of small enterprises express concern regarding the environment, this does not then translate into better waste management practices.

Selective versus comprehensive emergency management in Korea.

PubMed

Ha, Kyoo-Man; Oh, Hyeon-Mun

2014-01-01

In spite of Korean governments' efforts, many emergency management practitioners wonder whether what is actually being practiced is selective or comprehensive management. Using a qualitative content analysis and experiences in practice, the article analyzes the barriers to selective emergency management and the paths to comprehensive emergency management via the same three management elements: stakeholders, phases of the emergency management lifecycle, and hazards and impacts. Four analytical levels are considered: central government level, industry level, community level, and household level. Korea, despite its self-praise, has to transform its selective emergency management into comprehensive emergency management in time.

78 FR 52909 - Consumer Financial Protection Bureau Notice of Availability of Final Environmental Assessment...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-27

...: [email protected] . Mail/Hand Delivery/Courier: Michael Davis, Project Manager, Consumer Financial... application of best management practices (BMP) to minimize short term air quality and noise impact during... of Final Environmental Assessment (FINAL EA) and a Finding of No Significant Impact (FONSI) for...

Phosphorous Attenuation in Urban Best Management (BMP) and Low Impact Development (LID) Practices

EPA Science Inventory

While all living organisms require phosphorous (P) to live and grow, adding too much P to the environment can cause unintended and undesirable effects, such as eutrophication of surface waters and harmful algal blooms. Urban best management (BMP) and low impact development (LI...

Finding Time for Quality Teaching: An Ethnographic Study of Academic Workloads in the Social Sciences and Their Impact on Teaching Practices

ERIC Educational Resources Information Center

Hemer, Susan R.

2014-01-01

University workloads, their impact on staff and how they can be managed, are the subject of considerable research and discussion. This paper addresses strategies to deal with the impact of workloads on teaching practices in higher education. In particular, it aims to discover the implicit theories and tacit assumptions that underlie perceptions of…

The impact of new forms of large-scale general practice provider collaborations on England's NHS: a systematic review.

PubMed

Pettigrew, Luisa M; Kumpunen, Stephanie; Mays, Nicholas; Rosen, Rebecca; Posaner, Rachel

2018-03-01

Over the past decade, collaboration between general practices in England to form new provider networks and large-scale organisations has been driven largely by grassroots action among GPs. However, it is now being increasingly advocated for by national policymakers. Expectations of what scaling up general practice in England will achieve are significant. To review the evidence of the impact of new forms of large-scale general practice provider collaborations in England. Systematic review. Embase, MEDLINE, Health Management Information Consortium, and Social Sciences Citation Index were searched for studies reporting the impact on clinical processes and outcomes, patient experience, workforce satisfaction, or costs of new forms of provider collaborations between general practices in England. A total of 1782 publications were screened. Five studies met the inclusion criteria and four examined the same general practice networks, limiting generalisability. Substantial financial investment was required to establish the networks and the associated interventions that were targeted at four clinical areas. Quality improvements were achieved through standardised processes, incentives at network level, information technology-enabled performance dashboards, and local network management. The fifth study of a large-scale multisite general practice organisation showed that it may be better placed to implement safety and quality processes than conventional practices. However, unintended consequences may arise, such as perceptions of disenfranchisement among staff and reductions in continuity of care. Good-quality evidence of the impacts of scaling up general practice provider organisations in England is scarce. As more general practice collaborations emerge, evaluation of their impacts will be important to understand which work, in which settings, how, and why. © British Journal of General Practice 2018.

Implementing clinical process management of vascular wounds in a tertiary facility: impact evaluation of a performance improvement project.

PubMed

Avruscio, Giampiero; Tocco-Tussardi, Ilaria; Bordignon, Greta; Vindigni, Vincenzo

2017-01-01

Chronic vascular wounds have a significant economic and social impact on our society calling for allocation of a great deal of attention and resources. Efforts should be oriented toward the achievement of the most effective and efficient clinical management. The Angiology Unit at the University Hospital of Padova, Italy, developed a performance improvement project to enhance the quality of practice for vascular ulcers. The project consisted in a multistep process comprising a critical revision of the previous clinical process management, staff education, tightening connections between operators and services, and creation of a position for a wound care nurse. The previous standard of practice was modified according to the results of revision and the current evidence-based practice. The new standard of practice reached its full application in September 2015. The number of patients treated and the number of visits in 2015 remained almost unvaried from 2014. However, the total annual expenditure for treating vascular ulcers was reduced by ~60% from the previous year. Standardization of guidelines and practice is effective in creating an efficient clinical management and in reducing the economic burden of vascular ulcers.

Large area comparisons of forest management practices in West Virginia (1951-present)

Treesearch

Thomas M. Schuler; W. Mark Ford; Mary Beth Adams; James N. Kochenderfer; Pamela J. Edwards

2006-01-01

Changes in species composition and possible associated changes in forest productivity after timber harvesting have important implications with respect to forest management options for landowners and for regional wood using industries. To better understand partial harvesting and its impacts, a study employing three different partial cutting practices, with monitoring of...

Weed management, training, and irrigation practices for organic production of trailing blackberry: II. Soil and plant nutrient concentrations

USDA-ARS?s Scientific Manuscript database

Organic production of blackberries is increasing, but there is relatively little known about how production practices affect plant and soil nutrient status. The impact of cultivar (‘Black Diamond’ and ‘Marion’), weed management (weed mat, hand weeding, and no weeding), primocane training time (Augus...

A Changing Health Care Environment: Its Impact on UCSF Graduates' Practice Patterns and Perceptions.

ERIC Educational Resources Information Center

Sauer, Barbara L.; Koda-Kimble, Mary Anne

1998-01-01

A survey of 754 University of California at San Francisco doctoral pharmacy graduates from 1980 to 1994 investigated how managed care affected practice patterns and perceptions of the profession. Graduates generally remained satisfied with their education and were optimistic about the profession. Although managed care has created a stressful…

Mining Information form a Coupled Air Quality Model to Examine the Impacts of Agricultural Management Practices on Air and Groundwater Quality

EPA Science Inventory

Attributing nitrogen (N) in the environment to emissions from agricultural management practices is difficult because of the complex and inter-related chemical and biological reactions associated with N and its cascading effects across land, air and water. Such analyses are criti...

THE ECOLOGICAL EFFECTIVENESS OF PONDS AND WETLANDS AS "BEST MANAGEMENT PRACTICES (BMPS)" FOR STREAMS IN DEVELOPING LANDSCAPES

EPA Science Inventory

Ponds and constructed wetlands, also referred to as detention/retention basins, have a long history as best management practices (BMPs) used to mitigate the impacts of stormwater runoff from developed lands on receiving waters. Initially designed for flood control by peak flow at...

Design in Practice: Scenarios for Improving Management Education

ERIC Educational Resources Information Center

Schlenker, Lee; Chantelot, Sébastien

2014-01-01

Despite the increasing attention given to design in business, Design Thinking has had little impact on the quality of business school education. Building upon the foundations of long-standing critiques of management education and the potential for student-centric learning, the authors propose that the use of Design in Practice can significantly…

How the Organizational Learning Process Mediates the Impact of Strategic Human Resource Management Practices on Performance in Korean Organizations

ERIC Educational Resources Information Center

Cho, Sei Hyoung; Song, Ji Hoon; Yun, Suk Chun; Lee, Cheol Ki

2013-01-01

The primary purpose of this research is to examine the structural relationships among several workplace-related constructs, including strategic human resource management (HRM) practices, organizational learning processes, and performance improvement in the Korean business context. More specifically, the research examined the mediating effect of…

Application of PACE Principles for Population Health Management of Frail Older Adults.

PubMed

Stefanacci, Richard G; Reich, Shelley; Casiano, Alex

2015-10-01

To determine which practices would have the most impact on reducing hospital and emergency department admissions and nursing home placement among older adults with multiple comorbid conditions, a literature search and survey were conducted to identify and prioritize comprehensive care principles as practiced in the Program of All-inclusive Care for the Elderly (PACE). PACE medical directors and members of the PACE interdisciplinary team (IDT) were surveyed to gain their insights on the most impactful practices, which were identified as: End-of-Life Management, Caregiver Support, Management of Red Flags, Medication Management, Participant and Caregiver Health Care System Literacy, and Care Coordination. In addition, this research evaluated measures that could be used to assess an organization's level of success with regard to each of the 6 PACE practices identified. The results reported in this article, found through a survey with PACE medical directors and IDT members concerning effective interventions, can be viewed as strategies to improve care for older adults, enabling them to maintain their independence in the community, avoid the expense of facility-based care, and enhance their quality of life.

Increasing water productivity on Vertisols: implications for environmental sustainability.

PubMed

Jiru, Mintesinot; Van Ranst, Eric

2010-10-01

The availability and quality of irrigation water have become a serious concern because of global climate change and an increased competition for water by industry, domestic users and the environment. Therefore, exploring environmentally friendly water-saving irrigation strategies is essential for achieving food and environmental security. In northern Ethiopia, where traditional furrow irrigation is widely practiced, water mismanagement and its undesirable environmental impact are rampant. A 2-year field study was undertaken to compare the traditional irrigation management with surge and deficit irrigation practices on a Vertisol plot. Results have shown that surge and deficit irrigation practices increase water productivity by 62% and 58%, respectively, when compared to traditional management. The study also found out that these practices reduce the adverse environmental impacts (waterlogging and salinity) of traditional management by minimizing deep percolation and tail water losses. Total irrigation depth was reduced by 12% (for surge) and 27% (for deficit) when compared to traditional management. Based on the results, the study concluded that surge and deficit irrigation technologies not only improve water productivity but also enhance environmental sustainability. Copyright © 2010 Society of Chemical Industry.

Influence of Variable Streamside Management Zone Configurations on Water Quality after Forest Harvest

Treesearch

Emma L. Witt; Christopher D. Barton; Jeffrey W. Stringer; Randy Kolka; Mac A. Cherry

2016-01-01

Streamside management zones (SMZs) are a common best management practice (BMP) used to reduce water quality impacts from logging. The objective of this research was to evaluate the impact of varying SMZ configurations on water quality. Treatments (T1, T2, and T3) that varied in SMZ width, canopy retention within the SMZ, and BMP utilization were applied at the...

Scaling Forest Management Practices in Earth System Models: Case Study of Southeast and Pacific Northwest Forests

NASA Astrophysics Data System (ADS)

Pourmokhtarian, A.; Becknell, J. M.; Hall, J.; Desai, A. R.; Boring, L. R.; Duffy, P.; Staudhammer, C. L.; Starr, G.; Dietze, M.

2014-12-01

A wide array of human-induced disturbances can alter the structure and function of forests, including climate change, disturbance and management. While there have been numerous studies on climate change impacts on forests, interactions of management with changing climate and natural disturbance are poorly studied. Forecasts of the range of plausible responses of forests to climate change and management are need for informed decision making on new management approaches under changing climate, as well as adaptation strategies for coming decades. Terrestrial biosphere models (TBMs) provide an excellent opportunity to investigate and assess simultaneous responses of terrestrial ecosystems to climatic perturbations and management across multiple spatio-temporal scales, but currently do not represent a wide array of management activities known to impact carbon, water, surface energy fluxes, and biodiversity. The Ecosystem Demography model 2 (ED2) incorporates non-linear impacts of fine-scale (~10-1 km) heterogeneity in ecosystem structure both horizontally and vertically at a plant level. Therefore it is an ideal candidate to incorporate different forest management practices and test various hypotheses under changing climate and across various spatial scales. The management practices that we implemented were: clear-cut, conversion, planting, partial harvest, low intensity fire, restoration, salvage, and herbicide. The results were validated against observed data across 8 different sites in the U.S. Southeast (Duke Forest, Joseph Jones Ecological Research Center, North Carolina Loblolly Pine, and Ordway-Swisher Biological Station) and Pacific Northwest (Metolius Research Natural Area, H.J. Andrews Experimental Forest, Wind River Field Station, and Mount Rainier National Park). These sites differ in regards to climate, vegetation, soil, and historical land disturbance as well as management approaches. Results showed that different management practices could successfully and realistically be implemented in the ED2 model at a site level. Moreover, sensitivity analyses determined the most important processes at different spatial scales, and also those which could be ignored while minimizing overall error.

"Managing" Managerialism: The Impact of Educational Auditing on an Academic "Specialist" School

ERIC Educational Resources Information Center

Hardy, Ian

2012-01-01

This article seeks to nuance arguments about the impact of broad policy technologies of auditing processes upon teachers' practices by providing empirical evidence of the effects of such processes, in context. Specifically, the article draws upon a cross section of teachers' accounts of schooling practices in a specialist, academically oriented…

Effects of forest harvest on biogeochemical processes in the Caspar Creek watershed

Treesearch

Randy A. Dahlgren

1998-01-01

Water quality and long-term sustainability are major components addressed within the ecosystem approach to forest management. Forest harvest practices are often implicated as having adverse impacts on sensitive aquatic communities and on the long-term sustainability of forest ecosystems. While careless harvest practices can certainly cause adverse impacts, proper...

The impact of nursing leadership and management on the control of HIV/AIDS: an ethnographic study.

PubMed

Nawafleh, Hani; Francis, Karen; Chapman, Ysanne

2012-10-01

This paper reports on an aspect of a larger ethnographic study that sought to investigate the impact of HIV/AIDS on the practice of primary care nurses in Jordan. Nursing leadership and the style of management adopted by senior nursing and medical administrators at the Ministry of Heath were identified as factors impacting on the practice of the nurses and their capacity to raise community awareness and contribute to the prevention and control of HIV/AIDS. The study was undertaken in three rural and three urban primary health care centres (PHCC). Data collection included participant observation, key informant interviews, and document analysis. These data informed the development of descriptive ethnographic accounts that allowed for the subsequent identification of common and divergent themes reflective of factors recognized as influencing the practice of the nurse participants.

Impact of the 5As Team study on clinical practice in primary care obesity management: a qualitative study

PubMed Central

Asselin, Jodie; Salami, Eniola; Osunlana, Adedayo M.; Ogunleye, Ayodele A.; Cave, Andrew; Johnson, Jeffrey A.; Sharma, Arya M.; Campbell-Scherer, Denise L.

2017-01-01

Background: The 5As [Ask, Assess, Advise, Agree, Assist] of Obesity Management Team study was a randomized controlled trial of an intervention that was implemented and evaluated to help primary care providers improve clinical practice for obesity management. This paper presents health care provider perspectives of the impacts of the intervention on individual provider and team practices. Methods: This study reports a thematic network analysis of qualitative data collected during the 5As Team study, which involved 24 chronic disease teams affiliated with family practices in a Primary Care Network in Alberta. Qualitative data from 28 primary care providers (registered nurses/nurse practitioners [n = 14], dietitians [n = 7] and mental health workers [n = 7]) in the intervention arm were collected through semistructured interviews, field notes, practice facilitator diaries and 2 evaluation workshop questionnaires. Results: Providers internalized 5As Team intervention concepts, deepening self-evaluation and changing clinical reasoning around obesity. Providers perceived that this internalization changed the provider-patient relationship positively. The intervention changed relations between providers, increasing interdisciplinary understanding, collaboration and discovery of areas for improvement. This personal and interpersonal evolution effected change to the entire Primary Care Network. Interpretation: The 5As Team intervention had multiple impacts on providers and teams to improve obesity management in primary care. Improved provider confidence and capability is a precondition of developing effective patient interventions. Trial registration: ClinicalTrials.gov, no.: NCT01967797. PMID:28450428

Final Environmental Assessment: Mental Health Clinic Hanscom Air Force Base Massachusetts

DTIC Science & Technology

2010-08-19

the environmental assessment. QAULITY ASSURANCE LEADER Cravedi, Gregory. 66 MSG/CE. B.S. in Management ; As an Environmental Protection...are insignificant and can be minimized further by using the best management practices described in this EA. iii There are positive impacts that...thus the total volume of storm water runoff from the site will be reduced. It is anticipated that the following best management practices would be

Access to laboratory testing: the impact of managed care in the Pacific Northwest.

PubMed

LaBeau, K M; Simon, M; Steindel, S J

1999-01-01

Patient access to health-care services has become an important issue owing to the growth of managed care organizations and the number of patients enrolled. To better understand the current issues related to access to laboratory testing, with a particular focus on the impact of managed care, we gathered information from a network of clinical laboratories in the Pacific Northwest. Two questionnaires were sent to the 257 Laboratory Medicine Sentinel Monitoring Network participants in November 1995 and March 1996 to investigate trends in the availability and utilization of laboratory testing services and changes in onsite testing menus. Although laboratories reported that managed care was a factor in their decisions about laboratory practices, testing decisions were more likely made for business reasons, based on medical practice changes and marketplace influences not associated with managed care.

Using knowledge management practices to develop a state-of-the-art digital library.

PubMed

Williams, Annette M; Giuse, Nunzia Bettinsoli; Koonce, Taneya Y; Kou, Qinghua; Giuse, Dario A

2004-01-01

Diffusing knowledge management practices within an organization encourages and facilitates reuse of the institution's knowledge commodity. Following knowledge management practices, the Eskind Biomedical Library (EBL) has created a Digital Library that uses a holistic approach for integration of information and skills to best represent both explicit and tacit knowledge inherent in libraries. EBL's Digital Library exemplifies a clear attempt to organize institutional knowledge in the field of librarianship, in an effort to positively impact clinical, research, and educational processes in the medical center.

Preliminary study on enhancing waste management best practice model in Malaysia construction industry

NASA Astrophysics Data System (ADS)

Jamaludin, Amril Hadri; Karim, Nurulzatushima Abdul; Noor, Raja Nor Husna Raja Mohd; Othman, Nurulhidayah; Malik, Sulaiman Abdul

2017-08-01

Construction waste management (CWM) is the practice of minimizing and diverting construction waste, demolition debris, and land-clearing debris from disposal and redirecting recyclable resources back into the construction process. Best practice model means best choice from the collection of other practices that was built for purpose of construction waste management. The practice model can help the contractors in minimizing waste before the construction activities will be started. The importance of minimizing wastage will have direct impact on time, cost and quality of a construction project. This paper is focusing on the preliminary study to determine the factors of waste generation in the construction sites and identify the effectiveness of existing construction waste management practice conducted in Malaysia. The paper will also include the preliminary works of planned research location, data collection method, and analysis to be done by using the Analytical Hierarchy Process (AHP) to help in developing suitable waste management best practice model that can be used in the country.

Implementing practice management strategies to improve patient care: the EPIC project.

PubMed

Attwell, David; Rogers-Warnock, Leslie; Nemis-White, Joanna

2012-01-01

Healthcare gaps, the difference between usual care and best care, are evident in Canada, particularly with respect to our aging, ailing population. Primary care practitioners are challenged to identify, prevent and close care gaps in their practice environment given the competing demands of informed, litigious patients with complex medical needs, ever-evolving scientific evidence with new treatment recommendations across many disciplines and an enhanced emphasis on quality and accountability in healthcare. Patient-centred health and disease management partnerships using measurement, feedback and communication of practice patterns and outcomes have been shown to narrow care gaps. Practice management strategies such as the use of patient registries and recall systems have also been used to help practitioners better understand, follow and proactively manage populations of patients in their practice. The Enhancing Practice to Improve Care project was initiated to determine the impact of a patient-centred health and disease management partnership using practice management strategies to improve patient care and outcomes for patients with chronic kidney disease (CKD). Forty-four general practices from four regions of British Columbia participated and, indeed, demonstrated that care and outcomes for patients with CKD could be improved via the implementation of practice management strategies in a patient-centred partnership measurement model of health and disease management.

Temporal variability of CO2 and N2O emissions in an agricultural long-term field trial regarding effects of different management practices and extreme weather effects

NASA Astrophysics Data System (ADS)

Koal, Philipp; Schilling, Rolf; Gerl, Georg; Pritsch, Karin; Munch, Jean Charles

2016-04-01

In order to achieve a reduction of greenhouse gas emissions, modern agronomic management practices need to be established. Therefore, to assess the effect of different farming practices on greenhouse gas emissions, reliable data are required. The experiment covers and compares main aspects of agricultural management for a better implementation of sustainable land use. The focus lies on the determination and interpretation of greenhouse gas emissions, where the effects of diverse tillage systems and fertilisation practices of an integrated farming system as well as the impacts of extreme weather conditions are observed. In addition, with analysis of the alterable biological, physical and chemical soil properties a link between the impact of different management systems on greenhouse gas emissions and the observed cycle of matter in the soil, especially the nitrogen and carbon cycle, is enabled. Measurements have been carried out on long-term field trials at the Research Farm Scheyern located in a Tertiary hilly landscape approximately 40 km north of Munich (South Germany). The long-term integrated farming system trial was started in 1992. Since then parcels of land (each around 0.2-0.4 ha) with a particular interior plot set-up have been conducted with the same crop rotation, tillage and fertilisation practice referring to integrated farming management. Thus, the management impacts on the soil of more than 20 years have been examined. Fluxes of CH4, N2O and CO2 have been monitored since 2007 for the integrated farming system trial using an automated system which consists of chambers (0.4 m2 area) with a motor-driven lid, an automated gas sampling unit, an on-line gas chromatographic analysis system, and a control and data logging unit. Precipitation and temperature data have been observed for the experimental field to include weather effects. The main outcomes are the analysis of temporal and spatial dynamics of greenhouse gas emissions influenced by management practice events (i.a. fertilisation, crop incorporation and tillage) and weather effects (drying-rewetting, freezing-thawing, intense rainfall and dry periods) and the creation of impact studies comparing the management practices (minimum tillage vs conventional tillage; high vs low fertilisation). Physical, chemical and biological soil properties (i.a. texture, mineral nitrogen, soil organic carbon and microbial biomass) have been examined in short time intervals to aggregate the parameters and processes influencing the greenhouse gas emissions and to build a linkage between soil organic matter and greenhouse gas emissions. Moreover, with the collected soil and agronomic data (harvest, tillage and fertilisation practices) the study contributes to a process quantification supporting modelling approaches.

Impact of the "Guidelines for infection prevention in dentistry" (2006) by the Commission of Hospital Hygiene and Infection Prevention at the Robert Koch-Institute (KRINKO) on hygiene management in dental practices - analysis of a survey from 2009.

PubMed

Hübner, Nils-Olaf; Handrup, Stephan; Meyer, Georg; Kramer, Axel

2012-01-01

To assess trends in hygiene management in dental practices in comparison to an earlier survey in 2002/2003 and to point out key aspects for future efforts. The infection prevention management of all dental practices in Greifswald (n=35) was determined by a questionnaire in a personal interview in 2008/2009. 26% of the dentists did not use sufficient personal protective equipment during the general examination of the patient. In conservative and prosthetic dentistry, 15% still did not use adequate measures and 9% did not even in surgical interventions. Vaccination coverage was clearly too low, as only 35% of dentists were vaccinated against influenza and coverage with other vaccinations was also quite low. 11% of the dentists did not perform a documented anamnesis and in 29% of the dental practices no appointment system for risk patients existed.There were significant deficiencies in the reprocessing of medical devices and in the equipment needed for reprocessing. The opportunity to participate in further training in this field was rejected by 23% of the dentists.In 10 dental practices, the colony count in the dental unit water-conducting system was five times higher than the limit. A contamination with P. aeruginosa was discovered in 4 practices. All units were renovated. Overall, both the hygiene management and hygiene equipment in the practices have improved considerably compared to the previous survey in 2002/2003. This demonstrates the positive effect of the KRINKO guidelines from 2006. However, the survey again showed relevant deficiences in the hygiene management of dental practices, which agrees with a Germany-wide online survey from 2009. While the study revealed persistent deficiencies in hygiene management, especially in reprocessing, it confirms that the KRINKO guidelines for dental practices from 2006 led to significant improvements in hygiene management. Doubts about the impact of the guidelines are not backed by evidence.

Consumer responses to communication about food risk management.

PubMed

van Dijk, Heleen; Houghton, Julie; van Kleef, Ellen; van der Lans, Ivo; Rowe, Gene; Frewer, Lynn

2008-01-01

Recent emphasis within policy circles has been on transparent communication with consumers about food risk management decisions and practices. As a consequence, it is important to develop best practice regarding communication with the public about how food risks are managed. In the current study, the provision of information about regulatory enforcement, proactive risk management, scientific uncertainty and risk variability were manipulated in an experiment designed to examine their impact on consumer perceptions of food risk management quality. In order to compare consumer reactions across different cases, three food hazards were selected (mycotoxins on organically grown food, pesticide residues, and a genetically modified potato). Data were collected from representative samples of consumers in Germany, Greece, Norway and the UK. Scores on the "perceived food risk management quality" scale were subjected to a repeated-measures mixed linear model. Analysis points to a number of important findings, including the existence of cultural variation regarding the impact of risk communication strategies-something which has obvious implications for pan-European risk communication approaches. For example, while communication of uncertainty had a positive impact in Germany, it had a negative impact in the UK and Norway. Results also indicate that food risk managers should inform the public about enforcement of safety laws when communicating scientific uncertainty associated with risks. This has implications for the coordination of risk communication strategies between risk assessment and risk management organizations.

Modeling the impact of agricultural land use and management on US carbon budgets

DOE PAGES

Drewniak, B. A.; Mishra, U.; Song, J.; ...

2014-09-22

Cultivation of the terrestrial land surface can create either a source or sink of atmospheric CO 2, depending on land management practices. The Community Land Model (CLM) provides a useful tool to explore how land use and management impact the soil carbon pool at regional to global scales. CLM was recently updated to include representation of managed lands growing maize, soybean, and spring wheat. In this study, CLM-Crop is used to investigate the impacts of various management practices, including fertilizer use and differential rates of crop residue removal, on the soil organic carbon (SOC) storage of croplands in the continentalmore » United States over approximately a 170 year period. Results indicate that total US SOC stocks have already lost over 8 Pg C (10%) due to land cultivation practices (e.g., fertilizer application, cultivar choice, and residue removal), compared to a land surface composed of native vegetation (i.e., grasslands). After long periods of cultivation, individual plots growing maize and soybean lost up to 65% of the carbon stored, compared to a grassland site. Crop residue management showed the greatest effect on soil carbon storage, with low and medium residue returns resulting in additional losses of 5% and 3.5%, respectively, in US carbon storage, while plots with high residue returns stored 2% more carbon. Nitrogenous fertilizer can alter the amount of soil carbon stocks significantly. Under current levels of crop residue return, not applying fertilizer resulted in a 5% loss of soil carbon. Our simulations indicate that disturbance through cultivation will always result in a loss of soil carbon, and management practices will have a large influence on the magnitude of SOC loss.« less

Modeling the impact of agricultural land use and management on US carbon budgets

DOE PAGES

Drewniak, B. A.; Mishra, U.; Song, J.; ...

2015-04-09

Cultivation of the terrestrial land surface can create either a source or sink of atmospheric CO₂, depending on land management practices. The Community Land Model (CLM) provides a useful tool for exploring how land use and management impact the soil carbon pool at regional to global scales. CLM was recently updated to include representation of managed lands growing maize, soybean, and spring wheat. In this study, CLM-Crop is used to investigate the impacts of various management practices, including fertilizer use and differential rates of crop residue removal, on the soil organic carbon (SOC) storage of croplands in the continental Unitedmore » States over approximately a 170-year period. Results indicate that total US SOC stocks have already lost over 8 Pg C (10%) due to land cultivation practices (e.g., fertilizer application, cultivar choice, and residue removal), compared to a land surface composed of native vegetation (i.e., grasslands). After long periods of cultivation, individual subgrids (the equivalent of a field plot) growing maize and soybean lost up to 65% of the carbon stored compared to a grassland site. Crop residue management showed the greatest effect on soil carbon storage, with low and medium residue returns resulting in additional losses of 5 and 3.5%, respectively, in US carbon storage, while plots with high residue returns stored 2% more carbon. Nitrogenous fertilizer can alter the amount of soil carbon stocks significantly. Under current levels of crop residue return, not applying fertilizer resulted in a 5% loss of soil carbon. Our simulations indicate that disturbance through cultivation will always result in a loss of soil carbon, and management practices will have a large influence on the magnitude of SOC loss.« less

Impacts and management implications of ice storms on forests in the southern United States

Treesearch

Don C. Bragg; Michael G Shelton; Boris Zeide

2003-01-01

Abstract: This review explores the ecological and silvicultural impacts of ice storms on forests in the southern United States. Different environmental factors like weather conditions, topography, vegetation, stand density, and management practices influence the degree of glaze damage a particular forest may experience. Additionally, the frequent...

Management systems, patient quality improvement, resource availability, and substance abuse treatment quality.

PubMed

Fields, Dail; Roman, Paul M; Blum, Terry C

2012-06-01

To examine the relationships among general management systems, patient-focused quality management/continuous process improvement (TQM/CPI) processes, resource availability, and multiple dimensions of substance use disorder (SUD) treatment. Data are from a nationally representative sample of 221 SUD treatment centers through the National Treatment Center Study (NTCS). The design was a cross-sectional field study using latent variable structural equation models. The key variables are management practices, TQM/continuous quality improvement (CQI) practices, resource availability, and treatment center performance. Interviews and questionnaires provided data from treatment center administrative directors and clinical directors in 2007-2008. Patient-focused TQM/CQI practices fully mediated the relationship between internal management practices and performance. The effects of TQM/CQI on performance are significantly larger for treatment centers with higher levels of staff per patient. Internal management practices may create a setting that supports implementation of specific patient-focused practices and protocols inherent to TQM/CQI processes. However, the positive effects of internal management practices on treatment center performance occur through use of specific patient-focused TQM/CPI practices and have more impact when greater amounts of supporting resources are present. © Health Research and Educational Trust.

Management Systems, Patient Quality Improvement, Resource Availability, and Substance Abuse Treatment Quality

PubMed Central

Fields, Dail; Roman, Paul M; Blum, Terry C

2012-01-01

Objective To examine the relationships among general management systems, patient-focused quality management/continuous process improvement (TQM/CPI) processes, resource availability, and multiple dimensions of substance use disorder (SUD) treatment. Data Sources/Study Setting Data are from a nationally representative sample of 221 SUD treatment centers through the National Treatment Center Study (NTCS). Study Design The design was a cross-sectional field study using latent variable structural equation models. The key variables are management practices, TQM/continuous quality improvement (CQI) practices, resource availability, and treatment center performance. Data Collection Interviews and questionnaires provided data from treatment center administrative directors and clinical directors in 2007–2008. Principal Findings Patient-focused TQM/CQI practices fully mediated the relationship between internal management practices and performance. The effects of TQM/CQI on performance are significantly larger for treatment centers with higher levels of staff per patient. Conclusions Internal management practices may create a setting that supports implementation of specific patient-focused practices and protocols inherent to TQM/CQI processes. However, the positive effects of internal management practices on treatment center performance occur through use of specific patient-focused TQM/CPI practices and have more impact when greater amounts of supporting resources are present. PMID:22098342

Management Training in Business and Industry: A Multimodal Approach to Supervision.

ERIC Educational Resources Information Center

O'Keefe, Edward J.

Historically, a close working relationship has existed between psychology and management. The holistic approach emerging in psychology from Lazarus' multimodal model will have a major impact on management practices, ultimately leading to the development of multidmodal management. The scientific psychology most managers are familiar with was based…

The impact of a haemophilia education intervention on the knowledge and health related quality of life of parents of Indian children with haemophilia.

PubMed

Phadnis, S; Kar, A

2017-01-01

The impact of haemophilia education on the quality of life of parents of children with haemophilia from low income settings has not been studied. The purpose of this study was to determine the impact of an education intervention on health related quality of life (HRQOL) of parents of children with haemophilia, parent's knowledge about haemophilia and its management, and to determine whether education about haemophilia can positively impact these outcomes. One hundred thirty-three parents from across Maharashtra state, India were provided information about haemophilia, care of child and self-care. The impact of the intervention was measured as changes occurring from baseline to 6 months and 1 year after intervention. Knowledge and practice of management of bleeding was measured using pretested structured questionnaires. HRQOL was measured using a validated Peds Quality of Life ™ Family Impact Module (PedsQL ™ FIM) tool. There was improvement in knowledge scores immediately after intervention, which remained significantly higher than baseline 1 year after intervention. HRQOL showed significant improvement at 6 months but reduced to baseline levels 1 year after intervention. There were statistically significant changes in terms of practice of management of bleeding episodes at 6 months and 1 year after intervention. Education about haemophilia resulted in improvement of knowledge, and practice of management of bleeding which was retained till a year after the intervention. However, a long-term effect on the HRQOL of parents could not be observed after administration of a single education intervention. © 2016 John Wiley & Sons Ltd.

Efficacy and efficiency of Agri-environmental payments in impacts of crops' management

NASA Astrophysics Data System (ADS)

Blasi, Emanuele; Martella, Angelo; Passeri, Nicolo; Ghini, Paolo

2015-04-01

Since the 90s, in Europe the Common Agricultural Policy (CAP) started to activate measures for improving the sustainability of European agriculture, these measures were systematized in 2000 with the tools of rural development, pursuing a synergistic environmental action trough the agri-environmental payments. Since their definition, those payments were designed to ensure the protection, maintenance and enhancement of natural resources (water, soil, forests), biodiversity (species and habitat), and landscape. In particular initiatives as set aside, afforestation, organic agriculture, integrated pest management, low input and precision agriculture have enriched the agricultural management practices. The aim of this work is to check the trend between agro-environmental subsidies and environmental performance (based on Ecological Indicators and CO2 evaluation) at country level in EU, in order to study the regulatory framework impact in addressing the European cropping system towards sustainability. In particular soils and their land use can storage CO2 as pool and so provide environmental services and, on the other hand the agricultural practices can stimulate the emission and the environmental footprint. Impacts (so called emissions/footprints and storage/environmental services) will be compared with the Agri-environmental Payments for calculating performances due to environmental management practices, supported by political initiatives. Such analysis sustains the European policy makers towards more suitable agricultural policies and in particular it can address national sustainability through agricultural practices.

A nurse-led model of chronic disease management in general practice: Patients' perspectives.

PubMed

Young, Jacqueline; Eley, Diann; Patterson, Elizabeth; Turner, Catherine

2016-12-01

Evidence suggests that current models of chronic disease management within general practice are not effective in meeting the needs of the community. The objective of this article is to examine patients' perceptions of a nurse-led collaborative model of care trialled in three general practices in Australia. This article reports on the second phase of a mixed-methods study in which semi-structured interviews with purposively selected patients were conducted to elicit information about their perceptions of nurse-led care. Three themes emerged from the data - time, ambiance and dimensions of the nurse role. The results suggest that general practice nurses had a positive impact on patients' ability to manage their chronic disease. This infers that there is scope for general practice nurses to expand their role in chronic disease management to assist patients to better self-manage their chronic diseases.

Paediatric fever management: continuing education for clinical nurses.

PubMed

Walsh, Anne M; Edwards, Helen E; Courtney, Mary D; Wilson, Jenny E; Monaghan, Sarah J

2006-01-01

This study examined the influence of level of practice, additional paediatric education and length of paediatric and current experience on nurses' knowledge of and beliefs about fever and fever management. Fifty-one nurses from medical wards in an Australian metropolitan paediatric hospital completed a self-report descriptive survey. Knowledge of fever management was mediocre (Mean 12.4, SD 2.18 on 20 items). Nurses practicing at a higher level and those with between one and four years paediatric or current experience were more knowledgeable than novices or more experienced nurses. Negative beliefs that would impact nursing practice were identified. Interestingly, beliefs about fever, antipyretic use in fever management and febrile seizures were similar; they were not influenced by nurses' knowledge, experience, education or level of practice. Paediatric nurses are not expert fever managers. Knowledge deficits and negative attitudes influence their practice irrespective of additional paediatric education, paediatric or current experience or level of practice. Continuing education is therefore needed for all paediatric nurses to ensure the latest clear evidence available in the literature for best practice in fever management is applied.

Management impacts on forest floor and soil organic carbon in northern temperate forests of the US

Treesearch

Coeli M. Hoover

2011-01-01

The role of forests in the global carbon cycle has been the subject of a great deal of research recently, but the impact of management practices on forest soil dynamics at the stand level has received less attention. This study used six forest management experimental sites in five northern states of the US to investigate the effects of silvicultural treatments (light...

What to do when trust has been breached in your practice.

PubMed

Hills, Laura

2013-01-01

We've all experienced gossiping, missed deadlines, someone taking credit for another's work, and little white lies. These and other breaches of trust are commonplace. However, they do more damage in the medical practice than many practice managers realize. This article argues that medical practice employees need to trust their managers, patients, doctors, one another, and even the security of their jobs so they are able to focus on their daily tasks and perform well. It defines trust as both a logical and emotional act and describes common breaches of workplace trust. It defines three characteristics of high-trust organizations and illustrates through examples how practice managers can demonstrate their trustworthiness through their actions, not only through their words. This article also offers seven steps for rebuilding trust that has been breached. It offers readers two instruments: a survey tool practice managers can use to assess the trust in their practices and a self-quiz practice managers can take to assess their own trustworthiness. Finally, this article offers research about the impact of trust on the bottom line and 10 truths about trust that medical practice managers can share with their employees.

76 FR 23538 - Notice of Intent To Reinstate a Previously Approved Information Collection.

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-27

... management, and conservation practices in order to quantify and assess current impacts of farming practices... (USDA) in 2003 as a multi-agency effort to quantify the environmental effects of conservation practices...) conducted on-site interviews with farmers during 2003-2006 to document tillage and irrigation practices...

Forestry best management practices and sediment control at skidder stream crossings

Treesearch

Laura R. Wear; W. Michael Aust; M. Chad Bolding; Brian D. Strahm; Andrew C. Dolloff

2015-01-01

Stream crossings for skid trails have high sediment delivery ratios. Forestry Best Management Practices (BMPs) have proven to be effective for erosion control, but few studies have quantified the impact of various levels of BMPs on sedimentation. In this study, three skid-trail stream-crossing BMP treatments were installed on nine operational stream crossings (three...

NASA Spacecraft Fault Management Workshop Results

NASA Technical Reports Server (NTRS)

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

2010-01-01

Fault Management is a critical aspect of deep-space missions. For the purposes of this paper, fault management is defined as the ability of a system to detect, isolate, and mitigate events that impact, or have the potential to impact, nominal mission operations. The 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 5 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 4 out of the 5 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, 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, as well as opportunities identified for future investment in tools, processes, and products to facilitate the development of space flight fault management capabilities.

Innovation Practices in Schools: The Impact of Different Models of Organization on the Practice of Norwegian Municipalities

ERIC Educational Resources Information Center

Jentoft, Nina

2017-01-01

Services provided by primary schools have a significant impact on citizens' living conditions. We need more knowledge of how innovation activities in primary schools should be organized and managed. This article addresses this gap by raising the following question: "Why do municipalities have different ways of organizing preventive work in…

Complex ambulatory settings demand scheduling systems.

PubMed

Ross, K M

1998-01-01

Practice management systems are becoming more and more complex, as they are asked to integrate all aspects of patient and resource management. Although patient scheduling is a standard expectation in any ambulatory environment, facilities and equipment resource scheduling are additional functionalities of scheduling systems. Because these functions were not typically managed in manual patient scheduling, often the result was resource mismanagement, along with a potential negative impact on utilization, patient flow and provider productivity. As ambulatory organizations have become more seasoned users of practice management software, the value of resource scheduling has become apparent. Appointment scheduling within a fully integrated practice management system is recognized as an enhancement of scheduling itself and provides additional tools to manage other information needs. Scheduling, as one component of patient information management, provides additional tools in these areas.

Final A Street Pond Expansion Environmental Assessment at Beale Air Force Base, California

DTIC Science & Technology

2008-09-01

Beale AFB Habitat Conservation and Management Plan and the environmental protection measures listed in Table 2-3 in the Environmental Assessment (EA...drainage systems that are of sufficient capacity. With adherence to best management practices (Table 2-3 in the EA), adverse effects from erosion...impacts would be minimized by using best management practices (Table 2-3). In addition, the Proposed Action would be designed to allow adequate storm

Stormwater Management Decision Support System for Using Low Impact Development Best Management Practices in Industrial Areas

DTIC Science & Technology

2015-05-30

particulates can be trapped in the inlet then washed into the drainage system in a large storm event...and P. Matin. 2005. Performance and Whole-Life Costs of Best Management Practices and Sustainable Urban Drainage Systems . Report #01CTS21TA. Water...subsurface drainage system consisting of a parallel perforated PVC pipe system in a stone bed that connects to the third chamber, which is the discharge

The Impacts of Various Environments Factors and Adaptive Management Strategies on Food Crops in the 21st Century Based on a Land Surface Model

NASA Astrophysics Data System (ADS)

Jain, A. K.; Lin, T. S.; Lawrence, P.; Kheshgi, H. S.

2017-12-01

Environmental factors - characterized by increasing levels of CO2, and changes in temperature and precipitation patterns - present potential risks to global food supply. To date, understanding of environmental factors' effects on crop production remains uncertain due to (1) uncertainties in projected trends of these factors and their spatial and temporal variability; (2) uncertainties in the physiological, genetic and molecular basis of crop adaptation to adaptive management practices (e.g. change in planting time, irrigation and N fertilization etc.) and (3) uncertainties in current land surface models to estimate the response of crop production to changes in environmental factors and management strategies. In this study we apply a process-based land surface model, the Integrated Science Assessment model (ISAM), to assess the impact of various environmental factors and management strategies on the production of row crops (corn, soybean and wheat) at regional and global scales. Results are compared to corresponding simulations performed with the crop model in the Community Land Model (CLM4.5). Each model is driven with historical atmospheric forcing data (1901-2005), and projected atmospheric forcing data under RCP 4.5 or RCP 8.5 (2006-2100) from CESM CMIP5 simulations to estimate the effects of different climate change projections on potential productivity of food crops at a global scale. For each set of atmospheric forcing data, production of each crop is simulated with and without inclusion of adaptive management practices (e.g. application of irrigation, N fertilization, change in planting time and crop cultivars etc.) to assess the effect of adaptation on projected crop production over the 21st century. In detail, three questions are addressed: (1) what is the impact of different climate change projections on global crop production; (2) what is the effect of adaptive management practices on projected crop production; and (3) how do differences in model mechanisms in ISAM and CLM4.5 impact projected global crop production and adaptive management practices (irrigation and N fertilizer) over the 21st century. The major outcomes of this study will help to understand the uncertainties in potential productivity of food crops under different environmental conditions and management practices.

The impact of extensive loss of telecommunications on general practice: A case study in rural Victoria.

PubMed

Tran, Nancy H; Pedler, Daryl

2017-04-01

To describe the impact of major loss of telecommunications on general practice in a rural region of Australia. A multi-stage qualitative study. Purposively selected participants were invited to contribute to initial data collection using an online survey, followed by interviews with selected participants. Thematic analysis of the data was performed by both research team members. South-western Victoria, Australia. Individuals from organisations involved in Telstra recovery efforts, disaster management, health care and general practice staff. The survey collected freeform responses from participants. Semi-structured interviews further explored a variety of experiences from purposively selected participants. Organisations and practices in the region were prepared for major disasters, but not for the unusual and 'limited' disaster of losing telecommunications, including lack of Internet access and loss of telephone services. Although alternative measures were found for telecommunications, there was still a significant impact on many health-care-related activities and general practice functionality during the outage period. In particular, there was an increase in duties for administrative staff to compensate for loss of telecommunications. Patient traffic for many services decreased due to uncertainty about availability and continuation of business. The Warrnambool outage could be used as a case study illustrating the dramatic impact of communication loss. Major impacts include changes in patient traffic, increased administrative duties and slowing of patient care. When developing or assessing disaster management plans, general practices should consider the impact of telecommunication loss on functionality and prepare appropriate alternative, accessible and reliable measures. © 2016 National Rural Health Alliance Inc.

Collaborating for care: initial experience of embedded case managers across five medical homes.

PubMed

Treadwell, Janet; Giardino, Angelo

2014-01-01

The purpose of this intervention was to answer the following question: Does an embedded nurse case manager from a health plan performing embedded care coordination and supporting a quality improvement project impact medical home service use, role satisfaction, and per member per month expense? The setting for this study was primary care medical home practices with a minimum of 1,000 lives, contracted with a health plan delivering Medicaid and Children's Health Insurance coverage. Five medical home practice sites were selected for the intervention. The study began with case manager training and project permission in 5 medical homes, followed by implementation of care coordination with health plan clients. The nurse case manager performed care coordination functions for clients and initiated a Lean Six Sigma quality improvement project at the medical home site. The analysis strategy was to compare each medical home with itself before and after the intervention, as well as to obtain satisfaction information from medical home staff and care coordinators. Reductions in expense, as demonstrated by decreased per member per month claim cost, admissions per thousand, and reduced variation in days per thousand, were documented. Quality projects attained significant improvements in 4 out of 5 sites, and practice staff as well as case managers described satisfaction with the embedded nurse case manager role. These findings support medical homes as being an effective delivery model of the Affordable Care Act. Case managers who practice in primary care sites can make a significant difference in patient outcomes and practice efficiencies. Embedded case managers have the ability to impact the population being served through modeling and supporting interprofessional relationships and case management expertise. Use of motivational interviewing, assessment skills, advocacy, and joint care planning engage patients in their own care, whereas quality initiatives bring efficiencies and effectiveness to overall operations. There is need for research to be conducted across a larger number of practice sites and diverse populations to substantiate the effect of embedded case management in medical home.

Whole-tree clearcutting in New England: manager's guide to impacts on soils, streams, and regeneration

Treesearch

Robert S. Pierce; James W. Hornbeck; Wayne C. Martin; Louise M. Tritton; Tattersall C. Smith; Anthony C. Federer; Harry W. Yawney

1993-01-01

Studies of impacts of whole-tree clearcutting in spruce-fir, northern hardwood, and central hardwood forest types are summarized for use by practicing foresters, land managers, environmental protection agencies and organizations, and the general public. Guidelines are given for protecting soils, stream water quality, nutrient cycles, and site productivity.

Learning from Charter School Management Organizations: Strategies for Student Behavior and Teacher Coaching

ERIC Educational Resources Information Center

Lake, Robin; Bowen, Melissa; Demeritt, Allison; McCullough, Moira; Haimson, Joshua; Gill, Brian

2012-01-01

The National Study of Charter Management Organization (CMO) Effectiveness is a four-year study designed to assess the impact of CMOs on student achievement and to identify effective structures and practices. An earlier report from this study documented the substantial variation in CMO student achievement impacts as well as variation in CMOs' use…

The watershed-riparian connection: A recent concern?

Treesearch

Warren Clary; Larry Schmidt; Leonard DeBano

2000-01-01

Management impacts on a watershed can cause a variety of complex responses by the encompassed riparian-stream system. Information about these responses will help land managers select practices that provide the riparian area with the best chance for future health and stability. Since we now recognize that people have been impacting riparian areas for a long time through...

The applicability of terrestrial visitor impact management strategies to the protection of coral reefs

USGS Publications Warehouse

Marion, J.L.; Rogers, C.S.

1994-01-01

A dramatic expansion in nature-based tourism to tropical coastal destinations has occurred in the past 20 years. Tourism development, combined with intense recreational pressures, has irreversibly transformed and degraded many popular scenic natural environments. This paper examines the management of recreational impacts to coral reefs using Virgin Islands National Park as a case study. A review of terrestrial recreational ecology research explores the implications and potential applicability of some principal findings to the protection of coral reefs. Visitor impact management recommendations for the protection of coral reefs are offered. Managers can minimize coral reef recreational impacts by (1) restricting high-impact uses, (2) containing rather than dispersing recreational use, (3) encouraging the use of resistant environments, (4) teaching low-impact recreational practices, and (5) enforcing park rules and regulations.

Impacts of agricultural management practices on soil quality in Europe and China - an assessment within the framework of the EU iSQAPER project

NASA Astrophysics Data System (ADS)

Alaoui, Abdallah; Schwilch, Gudrun; Barão, Lúcia; Basch, Gottlieb; Sukkel, Wijnand; Lemesle, Julie; Ferreira, Carla; Garcia-Orenes, Fuensanta; Morugan, Alicia; Mataix, Jorge; Kosmas, Costas; Glavan, Matjaž; Tóth, Brigitta; Petrutza Gate, Olga; Lipiec, Jerzy; Reintam, Endla; Xu, Minggang; Di, Jiaying; Fan, Hongzhu; Geissen, Violette

2017-04-01

Agricultural soils are under a wide variety of pressures, including from increasing global demand for food associated with population growth, changing diets, land degradation, and associated productivity reductions potentially exacerbated by climate change. To manage the use of agricultural soils well, decision-makers need science-based, easily applicable, and cost-effective tools for assessing soil quality and soil functions. Since a practical assessment of soil quality requires the integrated consideration of key soil properties and their variations in space and time, providing such tools remains a challenging task. This study aims to assess the impact of innovative agricultural management practices on soil quality in 14 study sites across Europe (10) and China (4), covering the major pedo-climatic zones. The study is part of the European H2020 project iSQAPER, which involves 25 partners across Europe and China and is coordinated by Wageningen University, The Netherlands. iSQAPER is aimed at interactive soil quality assessment in Europe and China for agricultural productivity and environmental resilience. The study began with a thorough literature analysis to inform the selection of indicators for the assessment of soil structure and soil functions. A manual was then developed in order to standardize and facilitate the task of inventorying soil quality and management practices at the case study sites. The manual provides clear and precise instructions on how to assess the 11 selected soil quality indicators based on a visual soil assessment methodology. A newly developed infiltrometer was used to easily assess the soil infiltration capacity in the field and investigate hydrodynamic flow processes. Based on consistent calibration, the infiltrometer enables reliable prediction of key soil hydraulic properties. The main aim of this inventory is to link agricultural management practices to the soil quality status at the case study sites, and to identify innovative practices that have improved soil quality. The inventory and the scoring of soil quality are done together with land users at each study site. The idea is to compare the soil quality on a farm where management practices have changed 3 or more years ago with that on a control farm where practices have not changed, with both farms located in the same pedo-climatic zone and having comparable soil conditions. The case study partners were requested to identify at least 3 newly adopted management practices (or combinations thereof) and 3 related control farms. First results show that among 88 sets of paired plots, 60 pairs (68 %) show a positive impact of innovative agricultural management practices on soil quality. 18 pairs (21 %) do not show any difference in soil quality between soils under innovative practices and soils in the control plots, and the remaining 10 plots (11 %) show an inverse effect. The non-detectable effect of the innovative practices on soil quality are due to type of tillage management, soil type and fertility that mask the effect of management practices on soil and also due to time of the assessment. This assessment will be repeated in the coming years, with the aim of providing sound data on soil quality and its improvement through innovative management practices across Europe and China.

Managing the Social Determinants of Health: Part I: Fundamental Knowledge for Professional Case Management.

PubMed

Fink-Samnick, Ellen

PRIMARY PRACTICE SETTING(S):: Applicable to health and behavioral health settings, wherever case management is practiced. The SDH pose major challenges to the health care workforce in terms of effective resource provision, health and behavioral health treatment planning plus adherence, and overall coordination of care. Obstacles and variances to needed interventions easily lead to less than optimal outcomes for case managers and their health care organizations. Possessing sound knowledge and clear understanding of each SDH, the historical perspectives, main theories, and integral dynamics, as well as creative resource solutions, all support a higher level of intentional and effective professional case management practice. Those persons and communities impacted most by the SDH comprise every case management practice setting. These clients can be among the most vulnerable and disenfranchised members of society, which can easily engender biases on the part of the interprofessional workforce. They are also among the costliest to care for with 50% of costs for only 5% of the population. Critical attention to knowledge about managing the SDH leverages and informs case management practice, evolves more effective programming, and enhances operational outcomes across practice settings.

Impact of engaging middle management in practice interventions on staff support and learning culture: a quasi-experimental design.

PubMed

Henderson, Amanda; Burmeister, Liz; Schoonbeek, Sue; Ossenberg, Christine; Gneilding, Julieanne

2014-11-01

This study evaluated the impact of different levels of engaging middle management in ward based strategies implemented by a project educator. The challenge for learning in practice is to develop effective teams where experienced staff engage and foster learning with students and other novice staff. A quasi-experimental pre- and post- intervention four group design was conducted from November 2009 to May 2010 across four general surgical and four general medical inpatient matched units in two settings in South East Queensland, Australia. Staff survey data was used to compare control and intervention groups (one actively engaging nurse managers) before and after 'practice learning' interventions. The survey comprised demographic data and data from two validated scales (support instrument for nurses facilitating learning and clinical learning organisational culture). Number of surveys returned pre- and post-intervention was 336 from 713 (47%). There were significant differences across many subscales pertaining to staff perception of support in the intervention groups, with only one change in the control group. The number of significant different subscales in the learning culture was also greater when middle management supported the intervention. Middle management should work closely with facilitators to assist embedding practice interventions. © 2013 John Wiley & Sons Ltd.

Illusion or delusion--Lean management in the health sector.

PubMed

McIntosh, Bryan; Sheppy, Bruce; Cohen, Ivan

2014-01-01

There has been considerable interest in the implementation of practices imported from manufacturing into healthcare as a solution to rising healthcare spending and disappointing patient safety indicators. One approach that has attracted particular interest is Lean management and the purpose of this paper is to engage with this topic. Secondary research. Despite widespread enthusiasm about the potential of Lean management processes, evidence about its contribution to higher organisational performance remains inconsistent. This paper engages with the major Lean concepts of operations management and human resource management, including just-in-time, total quality management, total productive maintenance and does not engage in-depth with concepts related to employee empowerment, and training This paper contributes to the organisational management literature in healthcare by showing that although Lean management seems to have the potential to improve organisational performance it is far from a panacea against under performing hospitals. It informs policy making by suggesting that a progressive managerial philosophy has a stronger impact on healthcare performance than the adoption of practices from any particular managerial approach. This paper provides a critical evaluation of the impact of Lean practices in informing healthcare policy. The paper contributes to the organisational management literature in healthcare by showing that even though Lean management in healthcare appears to have the potential to improve organisational performance; there remain problems with its application.

Marsh management plans in practice: Do they work in coastal Louisiana, USA?

NASA Astrophysics Data System (ADS)

Cowan, James H.; Turner, R. Eugene; Cahoon, Donald R.

1988-01-01

Louisiana's coastal wetlands represent about 41% of the nation's total and are extensively managed for fish, fur, and waterfowl. Marsh management plans (MMPs) are currently used to avoid potential user conflicts and are believed to be a best management practice for specific management goals. In this article, we define MMPs and examine their variety, history, impacts, and future. A MMP is an organized written plan submitted to state and federal permitting agencies for approval and whose purpose is to regulate wetland habitat quantity and quality (control land loss and enhance productivity). MMPs are usually implemented by making structural modifications in the marsh, primarily by using a variety of water control structures in levees to impound or semi-impound managed areas. It appears that MMPs using impoundments are only marginally successful in achieving and often contradict management goals. Although 20% of coastal Louisiana may be in MMPs by the year 2000, conflict resolution of public and private goals is compromised by a surfeit of opinion and dearth of data and experience. Based on interpretation of these results, we believe the next phase of management should include scientific studies of actual impacts, utilization of post-construction monitoring data, inventory of existing MMPs, development of new techniques, and determination of cumulative impacts.

Practical approach to exercise-induced bronchoconstriction in athletes.

PubMed

Ansley, Les; Rae, Glen; Hull, James H

2013-03-01

Exercise-induced bronchoconstriction (EIB) is highly prevalent in athletes of all abilities and can impact on their health and performance. The majority of athletes with exertional dyspnoea will be initially assessed and managed in primary care. This report provides a practical and pragmatic approach to the assessment and management of a young athlete presenting with suspected EIB in this setting.

What Informs Practice and What Is Valued in Corporate Instructional Design? A Mixed Methods Study

ERIC Educational Resources Information Center

Thompson-Sellers, Ingrid N.

2012-01-01

This study used a two-phased explanatory mixed-methods design to explore in-depth what factors are perceived by Instructional Design and Technology (IDT) professionals as impacting instructional design practice, how these factors are valued in the field, and what differences in perspectives exist between IDT managers and non-managers. For phase 1…

Evaluating Best Management Practices for ephemeral channel protection following forest harvest in the Cumberland Plateau - preliminary findings

Treesearch

Emma L. Witt; Christopher D. Barton; Jeffrey W. Stringer; Daniel W. Bowker; Randall K. Kolka

2011-01-01

Most states in the United States have established forestry best management practices to protect water quality and maintain aquatic habitat in streams. However, guidelines are generally focused on minimizing impacts to perennial streams. Ephemeral channels (or streams), which function as important delivery systems for carbon, nutrients, and sediment to perennial streams...

Estrogenicity and Nutrient Concentration of Surface Waters Surrounding a Large Confinement Dairy Operation Using Best Management Practices for Land Application of Animal Wastes

USDA-ARS?s Scientific Manuscript database

The impact of a confinement dairy operation (> 2,000 head) using best management practices for land application of animal wastes, on estrogenic activity (E-Screen), estrogens, and nutrients of associated surface waters and tile drain runoff were evaluated. Farm tile drain and creek samples were col...

"Another Link in the Chain" Update: State Policies and Practices for Case Management and Environmental Investigation for Lead-Poisoned Children.

ERIC Educational Resources Information Center

McLaine, Pat; Gaitens, Joanna

This report details a national survey, conducted in 2000, to document changes since 1998 in policies and practices for case management and environmental investigation for lead poisoned children; the study also investigated the impact of the previous national survey in precipitating change. Participating in the survey were program directors or…

Effect of Drainage and Management Practices on Hydrology of Pine Plantation

Treesearch

R. Wayne Skaggs; Devendra M. Amatya; G. M. Chescheir; C. D. Blanton; J. W. Gilliam

2006-01-01

This paper reviews results of long-term studies, initiated in the late 1980s, to determine the hydrologic and water quality impacts of drainage and related water and forest management practices on a poorly drained site in Carteret County, North Carolina. Three watersheds, each approximately 25 ha, were instrumented to measure and record drainage rate, water table depth...

The net fiscal impact of a chronic disease management program: Indiana Medicaid.

PubMed

Holmes, Ann M; Ackermann, Ronald D; Zillich, Alan J; Katz, Barry P; Downs, Stephen M; Inui, Thomas S

2008-01-01

In 2003 the Indiana Office of Medicaid Policy and Planning implemented the Indiana Chronic Disease Management Program (ICDMP). This paper reports on the fiscal impact of the ICDMP from the state's perspective, as estimated from the outcomes of a randomized trial. Medicaid members with congestive heart failure (CHF) or diabetes, or both, were randomly assigned by practice site to chronic disease management services or standard care. The effect of the ICDMP varied by disease group and risk class: while cost savings were achieved in the CHF subgroup, disease management targeted to patients with only diabetes resulted in no significant fiscal impact.

Crop Establishment Practices Are a Driver of the Plant Microbiota in Winter Oilseed Rape (Brassica napus)

PubMed Central

Rathore, Ridhdhi; Dowling, David N.; Forristal, Patrick D.; Spink, John; Cotter, Paul D.; Bulgarelli, Davide; Germaine, Kieran J.

2017-01-01

Gaining a greater understanding of the plant microbiota and its interactions with its host plant heralds a new era of scientific discovery in agriculture. Different agricultural management practices influence soil microbial populations by changing a soil’s physical, chemical and biological properties. However, the impact of these practices on the microbiota associated with economically important crops such as oilseed rape, are still understudied. In this work we investigated the impact of two contrasting crop establishment practices, conventional (plow based) and conservation (strip–tillage) systems, on the microbiota inhabiting different plant microhabitats, namely rhizosphere, root and shoot, of winter oilseed rape under Irish agronomic conditions. Illumina 16S rRNA gene sequence profiling showed that the plant associated microhabitats (root and shoot), are dominated by members of the bacterial phyla Proteobacteria, Actinobacteria and Bacteroidetes. The root and shoot associated bacterial communities displayed markedly distinct profiles as a result of tillage practices. We observed a very limited ‘rhizosphere effect’ in the root zone of WOSR, i.e., there was little or no increase in bacterial community richness and abundance in the WOSR rhizosphere compared to the bulk soil. The two tillage systems investigated did not appear to lead to any major long term differences on the bulk soil or rhizosphere bacterial communities. Our data suggests that the WOSR root and shoot microbiota can be impacted by management practices and is an important mechanism that could allow us to understand how plants respond to different management practices and environments. PMID:28848510

Management of Esophageal Food Impaction Varies Among Gastroenterologists and Affects Identification of Eosinophilic Esophagitis.

PubMed

Hiremath, Girish; Vaezi, Michael F; Gupta, Sandeep K; Acra, Sari; Dellon, Evan S

2018-06-01

Esophageal food impaction (EFI) is a gastrointestinal emergency requiring immediate evaluation in the emergency room (ER) and an esophagogastroduodenoscopy (EGD) for disimpaction. EFI is also a distinct presenting feature of eosinophilic esophagitis (EoE). This study aimed at understanding the management of EFI among gastroenterologists (GIs) and estimated its impact on identification of EoE in USA. GIs associated with three major gastroenterology societies based in USA were invited to participate in a web-based survey. Information on the resources available and utilized, and the clinical decision-making process related to management of EFI cases was collected and analyzed. Of 428 responses, 49% were from pediatric GIs, 86% practiced in the USA, and 78% practiced in an academic setting. Compared to the pediatric GIs, adult GIs were more likely to perform EGD in the emergency room [OR 87.96 (25.43-304.16)] and advance the food bolus into stomach [5.58 (3.08-10.12)]. Only 34% of respondents obtained esophageal biopsies during EGD, and pediatric GIs were more likely to obtain esophageal biopsies [3.49 (1.12-10.84)] compared to adult GIs. In USA, by our conservative estimates, 10,494 patients presenting to ER with EFI and at risk of EoE are likely being missed each year. EFI management varies substantially among GIs associated with three major gastroenterology societies in USA. Based on their practice patterns, the GIs in USA are likely to miss numerous EoE patients presenting to ER with EFI. Our findings highlight the need for developing and disseminating evidence-based EFI management practice guidelines.

Principals' Perceptions of the Impact of the APPR on Instructional Practices in New York State Public School Districts

ERIC Educational Resources Information Center

Mangeri, Richard

2017-01-01

The purpose of this study was to investigate principals' perceptions of the impact of the New York State Annual Professional Performance Review on instructional practices. Dr. Philip Hallinger's Principal Instructional Management Rating Scale (PIMRS) was used to examine principal behaviors as they relate to school mission/goals, instruction and…

A nurse-led clinic for patients consulting with osteoarthritis in general practice: development and impact of training in a cluster randomised controlled trial.

PubMed

Healey, Emma L; Main, Chris J; Ryan, Sarah; McHugh, Gretl A; Porcheret, Mark; Finney, Andrew G; Morden, Andrew; Dziedzic, Krysia S

2016-12-21

Despite a lack of service provision for people with osteoarthritis (OA), each year 1 in 5 of the general population consults a GP about a musculoskeletal condition such as OA. Consequently this may provide an opportunity for practice nurses to take an active role in helping patients manage their condition. A nurse led clinic for supporting patients with OA was developed for the MOSAICS study investigating how to implement the NICE 2014 OA Guideline core recommendations. This paper has two main objectives, firstly to provide an overview of the nurse-led OA clinic, and secondly to describe the development, key learning objectives, content and impact of the training to support its delivery. A training programme was developed and delivered to provide practice nurses with the knowledge and skill set needed to run the nurse-led OA clinic. The impact of the training programme on knowledge, confidence and OA management was evaluated using case report forms and pre and post training questionnaires. The pre-training questionnaire identified a gap between what practice nurses feel they can do and what they should be doing in line with NICE OA guidelines. Evaluation of the training suggests that it enabled practice nurses to feel more knowledgeable and confident in supporting patients to manage their OA and this was reflected in the clinical management patients received in the nurse-led OA clinics. A significant gap between what is recommended and what practice nurses feel they can currently provide in terms of OA management was evident. The development of a nurse training programme goes some way to develop a system in primary care for delivering the core recommendations by NICE. The cluster trial linked to this training was conducted from May 2012 through February 2014 by the Arthritis Research UK Primary Care Centre, Keele University, UK (Trial registration number ISRCTN06984617 ).

WATERSHEDSS

EPA Science Inventory

To adequately control nonpoint source pollution of a water resource, water quality managers must focus on minimizing the impacts of individual nonpoint source pollutants. The strategic choice and placement of best management practices (BMPs) in the watershed can successfully redu...

Moving towards Total Water Management

EPA Science Inventory

The presentation will discuss the following topics: Stormwater Best Management Practice (BMP) Placement (SUSTAIN); Sanitary Sewer Overflow Toolbox (SSOAP); BMP and Low Impact Development (LID) Performance; Green/Grey Infrastructure for Stormwater; Combined Sewers and Reuse; Infra...

Environmental management and labour productivity: The moderating role of capital intensity.

PubMed

Lannelongue, Gustavo; Gonzalez-Benito, Javier; Quiroz, Idaisa

2017-04-01

Recent years have seen firms improve their environmental practices, although the question still remains as to whether or not investing in such practices is or is not beneficial or simply a matter of image. This study focuses on labour productivity as a measure of performance, and we argue that the impact of greater environmental performance on that productivity is moderated by capital intensity. A sample of 2823 plants provides empirical evidence to support our approach. Specifically, the analyses, making use of estimates based on multiple regression models, reveal that environmental management has a positive impact on labour productivity in organisations with low capital intensity, although that impact becomes negative in cases of high capital intensity. Copyright © 2016 Elsevier Ltd. All rights reserved.

Responses of Aquatic Saproxylic Macroinvertebrates to Reduced-Impact Logging in Central Amazonia.

PubMed

Roque, F O; Escarpinati, S C; Valente-Neto, F; Hamada, N

2015-08-01

Reduced-impact logging (RIL) is an alternative land use because it reduces damage to forest cover in comparison with clear-cut practices. However, management practices adopted in RIL can affect wood availability and, consequently, fauna associated with dead wood during part of their life cycle (saproxylic). In this study, we evaluated whether aquatic saproxylic macroinvertebrates are affected by reduced-impact logging in Central Amazonia. We selected six streams in areas under reduced-impacted logging and six in primary forest areas and collected submerged woody debris. We did not find any differences in water pH, conductivity, and wood availability between reduced-impacted forest and primary forest streams. We found 248 saproxylic aquatic macroinvertebrates belonging to 37 taxa. We found five wood specialist (Dryops, Lutrochus, Stenochironomus, Oukuriella, and Endotribelos) and 32 generalists, totalling 98 and 150 individuals, respectively. In general, our results show that reduced-impact logging does not affect richness, abundance, and composition of saproxylic macroinvertebrates. The main explanation for this pattern is that management practices do not change important macroinvertebrate niche dimensions, including wood availability and the water's chemical and physical variables. Thus, controlled logging, such as applied in the area of the Central Amazonian streams studied, opens a new prospect for insect conservation and commercial exploitation of wood, which is not possible when clear-cut practices are adopted.

The Relationship Between Provider Competence, Content Exposure, and Consumer Outcomes in Illness Management and Recovery Programs.

PubMed

McGuire, Alan B; White, Dominique A; Bartholomew, Tom; Flanagan, Mindy E; McGrew, John H; Rollins, Angela L; Mueser, Kim T; Salyers, Michelle P

2017-01-01

Provider competence may affect the impact of a practice. The current study examined this relationship in sixty-three providers engaging in Illness Management and Recovery with 236 consumers. Improving upon previous research, the present study utilized a psychometrically validated competence measure in the ratings of multiple Illness Management and Recovery sessions from community providers, and mapped outcomes onto the theory underlying the practice. Provider competence was positively associated with illness self-management and adaptive coping. Results also indicated baseline self-management skills and working alliance may affect the relationship between competence and outcomes.

Program impact pathway analysis of a social franchise model shows potential to improve infant and young child feeding practices in Vietnam.

PubMed

Nguyen, Phuong H; Menon, Purnima; Keithly, Sarah C; Kim, Sunny S; Hajeebhoy, Nemat; Tran, Lan M; Ruel, Marie T; Rawat, Rahul

2014-10-01

By mapping the mechanisms through which interventions are expected to achieve impact, program impact pathway (PIP) analysis lays out the theoretical causal links between program activities, outcomes, and impacts. This study examines the pathways through which the Alive & Thrive (A&T) social franchise model is intended to improve infant and young child feeding (IYCF) practices in Vietnam. Mixed methods were used, including qualitative interviews with franchise management board members (n = 12), surveys with health providers (n = 120), counseling observations (n = 160), and household surveys (n = 2045). Six PIP components were assessed: 1) franchise management, 2) training and IYCF knowledge of health providers, 3) service delivery, 4) program exposure and utilization, 5) maternal behavioral determinants (knowledge, beliefs, and intentions) toward optimal IYCF practices, and 6) IYCF practices. Data were collected from A&T-intensive areas (A&T-I; mass media + social franchise) and A&T-nonintensive areas (A&T-NI; mass media only) by using a cluster-randomized controlled trial design. Data from 2013 were compared with baseline where similar measures were available. Results indicate that mechanisms are in place for effective management of the franchise system, despite challenges to routine monitoring. A&T training was associated with increased capacity of providers, resulting in higher-quality IYCF counseling (greater technical knowledge and communication skills during counseling) in A&T-I areas. Franchise utilization increased from 10% in 2012 to 45% in 2013 but fell below the expected frequency of 9-15 contacts per mother-child dyad. Improvements in breastfeeding knowledge, beliefs, intentions, and practices were greater among mothers in A&T-I areas than among those in A&T-NI areas. In conclusion, there are many positive changes along the impact pathway of the franchise services, but challenges in utilization and demand creation should be addressed to achieve the full intended impact. © 2014 American Society for Nutrition.

ASSESSING EFFECTS OF ALTERNATIVE AGRICULTURAL PRACTICES ON WILDLIFE HABITAT IN IOWA, USA

EPA Science Inventory

A habitat-change model was used to compare past, present, and future land cover and management practices to assess potential impacts of alternative agricultural practices on wildlife in two agricultural watersheds, Walnut Creek and Buck Creek, in central Iowa, USA. This approach ...

American Society of Clinical Oncology Multidisciplinary Cancer Management Course: Connecting Lives, Cancer Care, Education, and Compassion in Zimbabwe—A Pilot for Efforts of Sustainable Benefit?

PubMed Central

Nyakabau, Anna Mary; Chagpar, Anees B.; Raben, David; Ndlovu, Ntokozo; Kadzatsa, Webster; Eaton, Vanessa J.; Mafunda, Paida; Razis, Evangelia

2017-01-01

The burden of cancer in low- to middle-income countries is growing and is expected to rise dramatically while resources to manage this disease remain inadequate. All authorities for the management of cancer recommend multidisciplinary care. Educational efforts by international organizations to assist local professionals in caring for their patients tend to have a lasting impact because they empower local professionals and enhance their skills. A multidisciplinary cancer management course was designed by American Society of Clinical Oncology staff and local experts to provide a roadmap for cross-specialty interaction and coordination of care in Zimbabwe. The outcome of the course was measured through feedback obtained from participants and impact on local workforce. The cancer management course was relevant to daily practice and fostered long-lasting partnerships and collaborations. Furthermore, it resulted in a more motivated local workforce and strengthened existing multidisciplinary practices. Cancer care is in a critical state in low- to middle-income countries. Educational efforts and collaborative partnerships may provide a cost-effective strategy with sustainable benefits. A multidisciplinary approach to optimize therapy is desirable. Evaluation of the course impact after a period of 6 months to 1 year is needed to determine the sustainability and impact of such efforts. PMID:28831449

Air quality impacts from prescribed forest fires under different management practices.

PubMed

Tian, Di; Wang, Yuhang; Bergin, Michelle; Hu, Yongtao; Liu, Yongqiang; Russell, Armistead G

2008-04-15

Large amounts of air pollutants are emitted during prescribed forest fires. Such emissions and corresponding air quality impacts can be modulated by different forest management practices. The impacts of changing burning seasons and frequencies and of controlling emissions during smoldering on regional air quality in Georgia are quantified using source-oriented air quality modeling, with modified emissions from prescribed fires reflecting effects of each practice. Equivalent fires in the spring and winter are found to have a greater impact on PM2.5 than those in summer, though ozone impacts are larger from spring and summer fires. If prescribed fires are less frequent more biofuel is burnt in each fire, leading to larger emissions and air quality impacts per fire. For example, emissions from a fire with a 5-year fire return interval (FRI) are 72% larger than those from a fire of the same acreage with a 2-year FRI. However, corresponding long-term regional impacts are reduced with the longer FRI since the annual burned area is reduced. Total emissions for fires in Georgia with a 5-year FRI are 32% less than those with a 2-year FRI. Smoldering emissions can lead to approximately 1.0 or 1.9 microg/m3 of PM2.5 in the Atlanta PM2.5 nonattainment area during March 2002.

A Fair Go for All? The Impact of Intragroup Diversity and Diversity-Management Skills on Student Experiences and Outcomes in Team-Based Class Projects

ERIC Educational Resources Information Center

Shaw, James B.

2004-01-01

A longitudinal study of 390 students in 64 Practical Organizational Behavior Education (PROBE) project teams was conducted on the effects of intragroup diversity and student diversity-management skills. The impact of gender, age, and nationality variables on student grades, cognitive processes, perceptions of team effectiveness, and satisfaction…

GWOT Vascular Injury Study 2 Supplemental Project: Impact of Prophylactic Fasciotomy

DTIC Science & Technology

2017-10-01

of the project ? The overall goal is to determine the impact of the widespread use of fasciotomies on current medical/surgical practices, management ...Diane Miller Project Role: Program Manager Nearest person month worked: 12 Contribution to Project : Ms. Miller is responsible for the day-to-day...each branch of service. Goals/Milestones CY14 Goal – Protocol/Staffing  Write and submit protocol to IRB  Hire project manager CY15 Goals – Data

Greening the work force in Brazilian hotels: the role of environmental training.

PubMed

Dias-Angelo, Fernanda; Jabbour, Charbel J C; Calderaro, José Armando

2014-01-01

Organizations are increasingly required to reduce their environmental impact through the adoption of environmental management, which requires the support of human resource practices. The objective of this study is to determine whether human resource management practices, especially training, are supporting environmental management practices at four hotels located in Brazil. This research is qualitative, based on the analysis of four hotels in Brazil. Based on the systematized empirical evidence collected from four hotels (Hotels A, B, C, and D), it can be concluded that: (1) human resource management is still not fully aligned with environmental objectives at the hotels studied; (2) only Hotel B has implemented environmental management practices and aligned with human resource management in a more developed manner, which may indicate that these two variables of analysis could have interrelations; (3) environmental training as a human resource management practice was verified in all hotels analyzed. The greening of human resources practices is not fully aligned with environmental objectives in the hotels studied. If these hotels really wish to "go green," environmental training will be necessary. Hotel stakeholders play a major role in implementing the greening of the hotel industry.

Evaluation and Management Strategies for Per- and Polyfluoroalkyl Substances (PFASs) in Drinking Water Aquifers: Perspectives from Impacted U.S. Northeast Communities.

PubMed

Guelfo, Jennifer L; Marlow, Thomas; Klein, David M; Savitz, David A; Frickel, Scott; Crimi, Michelle; Suuberg, Eric M

2018-06-01

Multiple Northeast U.S. communities have discovered per- and polyfluoroalkyl substances (PFASs) in drinking water aquifers in excess of health-based regulatory levels or advisories. Regional stakeholders (consultants, regulators, and others) need technical background and tools to mitigate risks associated with exposure to PFAS-affected groundwater. The aim was to identify challenges faced by stakeholders to extend best practices to other regions experiencing PFAS releases and to establish a framework for research strategies and best management practices. Management challenges were identified during stakeholder engagement events connecting attendees with PFAS experts in focus areas, including fate/transport, toxicology, and regulation. Review of the literature provided perspective on challenges in all focus areas. Publicly available data were used to characterize sources of PFAS impacts in groundwater and conduct a geospatial case study of potential source locations relative to drinking water aquifers in Rhode Island. Challenges in managing PFAS impacts in drinking water arise from the large number of relevant PFASs, unconsolidated information regarding sources, and limited studies on some PFASs. In particular, there is still considerable uncertainty regarding human health impacts of PFASs. Frameworks sequentially evaluating exposure, persistence, and treatability can prioritize PFASs for evaluation of potential human health impacts. A regional case study illustrates how risk-based, geospatial methods can help address knowledge gaps regarding potential sources of PFASs in drinking water aquifers and evaluate risk of exposure. Lessons learned from stakeholder engagement can assist in developing strategies for management of PFASs in other regions. However, current management practices primarily target a subset of PFASs for which in-depth studies are available. Exposure to less-studied, co-occurring PFASs remains largely unaddressed. Frameworks leveraging the current state of science can be applied toward accelerating this process and reducing exposure to total PFASs in drinking water, even as research regarding health effects continues. https://doi.org/10.1289/EHP2727.

Managing Stormwater and Dust at Demolition Sites

EPA Pesticide Factsheets

Learn how to manage stormwater and dust at demolition sites, including developing a stormwater solution prevention plan, best practices for erosion, runoff and sediment control to reduce environmental impacts and comply with environmental regulations.

Integrating Self-Management and Exercise for People Living with Arthritis

ERIC Educational Resources Information Center

Mendelson, A. D.; McCullough, C.; Chan, A.

2011-01-01

The Program for Arthritis Control through Education and Exercise, PACE-Ex[TM}, is an arthritis self-management program incorporating principles and practice of self-management, goal setting and warm water exercise. The purpose of this program review is to examine the impact of PACE-Ex on participants' self-efficacy for condition management,…

Best practices: applying management analysis of excellence to immunization.

PubMed

Wishner, Amy; Aronson, Jerold; Kohrt, Alan; Norton, Gary

2005-01-01

The authors applied business management tools to analyze and promote excellence and to evaluate differences between average and above-average immunization peformers in private practices. The authors conducted a pilot study of 10 private practices in Pennsylvania using tools common in management to assess practices' organizational climate and managerial style. Authoritative and coaching styles of physician leaders were common to both groups. Managerial styles that emphasized higher levels of clarity and responsibility managerial styles were evident in the large practices; and rewards and flexibility styles were higher in the small above-average practices. The findings of this pilot study match results seen in high performers in other industries. It concludes that the authoritative style appears to have the most impact on performance. It has interesting implications for training/behavior change to improve immunization rates, along with traditional medical interventions.

Final Environmental Assessment: Decommissioning of the Minuteman Village Mobile Home Park and Restoration of the Site, Hanscom Air Force Base, Massachusetts

DTIC Science & Technology

2009-04-29

minimized further by using the best management practices described in this EA. There are a few positive impacts that would occur as a result of the...telecommunications, or natural gas at the site, and there will be substantially reduced electric demand. It is anticipated that the following best management ...accordance with Hanscom AFB’s best management practices (BMPs) to prevent adverse effects to receiving waters. Also, all hazardous materials used during

Impact of nursery management practices on heritability estimates and frequency distributions of first-order lateral roots of loblolly pine.

Treesearch

Paul P. Kormanik; H.D. Muse; S.J Sung

1991-01-01

Frequency distribution and heritability of first-order later root (FOLR) numbers in 1-0 seedlings were followed for 5 years for 115 different half-sib seedlots from the Georgia Forestry Commission's Arrowhead and Baldwin Seed Orchards. In 1986 and 1987, seedlings were permitted unrestricted growth under management conditions similar to those practiced in most...

Management Practices. U.S. Companies Improve Performance through Quality Efforts. Report to the Honorable Donald Ritter, House of Representatives.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. National Security and International Affairs Div.

The General Accounting Office (GAO) examined the impact of formal total quality management (TQM) practices on the performance of 20 selected U.S. companies that were among the highest-scoring applicants in 1988 and 1989 for the Malcolm Baldridge National Quality Award. Several key indicators used by companies to measure performance were analyzed.…

Interaction of ice storms and management practices on current carbon sequestration in forests with potential mitigation under future CO2 atmosphere

Treesearch

Heather R. McCarthy; Ram Oren; Hyun-Seok Kim; Kurt H. Johnsen; Chris Maier; Seth G. Pritchard; Michael A. Davis

2006-01-01

Ice storms are disturbance events with potential impacts on carbon sequestration. Common forest management practices, such as fertilization and thinning, can change wood and stand properties and thus may change vulnerability to ice storm damage. At the same time, increasing atmospheric CO2 levels may also influence ice storm vulnerability. Here...

Comparative Impact of Two Training Packages on Awareness and Practices of First Aid for Injuries and Common Illnesses among High School Students in India

ERIC Educational Resources Information Center

Goel, Sonu; Singh, Amarjeet

2008-01-01

Knowledge about various illnesses and their management is not satisfactory among high school students especially in rural areas in India. Various incorrect practices and myths associated with illnesses and injuries still exit. Training and education about correct management of injuries and illnesses for students is a sound and logical investment.…

A review of best management practices and the mitigation of stream-breeding salamanders in the eastern deciduous forest

Treesearch

Thomas A. Maigret; John J. Cox

2014-01-01

Timber harvest has been implicated as a causative factor in the decline of amphibian populations and diversity in many areas of the world. The adoption of best management practices (BMPs) is intended to minimize the impacts of timber harvest on the biotic community, including amphibians and their habitat requirements. Herein, we synthesize the current scientific...

Listening in the Multicultural Workplace: A Dialogue of Theory and Practice

ERIC Educational Resources Information Center

Purdy, Michael W.; Manning, Linda M.

2015-01-01

This article consists of a dialogue focused on listening philosophy, theory, and inclusive management practices for maximum productivity and performance in multicultural workplaces. The discussion illustrates that listening both influences cultural interactions and is impacted by cultural values and practices. This focus is broadly framed by an…

The Changing Character of Dental Practice and Its Impact on Dental Education.

ERIC Educational Resources Information Center

Kerr, I. Lawrence

1981-01-01

The "practice" aspect of the dental profession is reviewed. It is suggested that there is no way to separate education, practice, research, financing, government, science, business, management, motivation, and the public from one another. Retail dentistry, health maintenance organizations, franchising, advertising, and denturism are…

Effect of different agronomic management practices on greenhouse gas emissions and nutrient cycling in a long-term field trial

NASA Astrophysics Data System (ADS)

Koal, Philipp; Schilling, Rolf; Gerl, Georg; Pritsch, Karin; Munch, Jean Charles

2015-04-01

In order to achieve a reduction of greenhouse gas emissions, modern agronomic management practices need to be established. Therefore, to assess the effect of different farming practices on greenhouse gas emissions, reliable data are required. The experiment covers and compares two main aspects of agricultural management for a better implementation of sustainable land use. The focus lies on the determination and interpretation of greenhouse gas emissions, however, regarding in each case a different agricultural management system, namely an organic farming system and an integrated farming system where the effect of diverse tillage systems and fertilisation practices are observed. In addition, with analysis of the alterable biological, physical and chemical soil properties a link between the impact of different management systems on greenhouse gas emissions and the observed cycle of matter in the soil, especially the nitrogen and carbon cycle, will be enabled. Measurements have been carried out on long-term field trials at the Research Farm Scheyern located in a Tertiary hilly landscape approximately 40 km north of Munich (South Germany). The long-term field trials of the organic and integrated farming system were started in 1992. Since then parcels of land (each around 0.2-0.4 ha) with a particular interior plot set-up have been conducted with the same crop rotation, tillage and fertilisation practice referring to organic and integrated farming management. Thus, the management impacts on the soil of more than 20 years are being examined. Fluxes of CH4, N2O and CO2 have been monitored since 2007 for the integrated farming system trial and since 2012 for the organic farming system trial using an automated system which consists of chambers (0.4 m2 area) with a motor-driven lid, an automated gas sampling unit, an on-line gas chromatographic analysis system, and a control and data logging unit. Precipitation and temperature data have been observed for each experimental field to include weather effects. The main outcomes are the analysis of temporal and spatial dynamics of greenhouse gas emissions influenced by management practice events (i.a. fertilisation, crop incorporation and tillage) and weather effects (drying-rewetting, freezing-thawing, intense rainfall and dry periods) and the creation of impact studies comparing the farming systems (organic vs integrated) and the management practices (minimum tillage vs conventional tillage; high vs low fertilisation). Physical, chemical and biological soil properties (i.a. texture, mineral nitrogen, soil organic carbon and microbial biomass) have been examined in short time intervals to aggregate the parameters and processes influencing the greenhouse gas emissions and to build a linkage between soil organic matter and greenhouse gas emissions. Moreover, with the comparison of the investigated similar long-term field experiments and the collected agronomic data (harvest, tillage and fertilisation practices) the study could contribute to a contemporary set of "best management practices" and could provide a help to create decision tools for stakeholders such as farmers.

A nurse led model of chronic disease care - an interim report.

PubMed

Eley, Diann S; Del Mar, Chris B; Patterson, Elizabeth; Synnott, Robyn L; Baker, Peter G; Hegney, Desley

2008-12-01

Chronic condition management in general practice is projected to account for 50% of all consultations by 2051. General practices under present workforce conditions will be unable to meet this demand. Nurse led collaborative care models of chronic disease management have been successful overseas and are proposed as one solution. This article provides an interim report on a prospective randomised trial to investigate the acceptability, cost effectiveness and feasibility of a nurse led model of care for chronic conditions in Australian general practice. A qualitative study focused on the impact of this model of care through the perceptions of practice staff from one urban and one regional practice in Queensland, and one Victorian rural practice. Primary benefits of the collaborative care model focused on increased efficiency and communication between practice staff and patients. The increased degree of patient self responsibility was noted by all and highlights the motivational aspect of chronic disease management.

The Impact of Reason for Training on the Relationship between "Best Practices" and Sexual Harassment Training Effectiveness

ERIC Educational Resources Information Center

Perry, Elissa L.; Kulik, Carol T.; Bustamante, Jennifer; Golom, Frank D.

2010-01-01

The current study explored the use of best training practices on human resources managers' perceptions of sexual harassment training success and frequency of sexual harassment complaints. Results revealed no main effects of best training practices on sexual harassment training success. However, effects of best training practices on sexual…

Pain Assessment and Management After a Knowledge Translation Booster Intervention.

PubMed

Stevens, Bonnie J; Yamada, Janet; Promislow, Sara; Barwick, Melanie; Pinard, Marie

2016-10-01

Inadequate pain treatment leaves hospitalized children vulnerable to immediate and long-term sequelae. A multidimensional knowledge translation intervention (ie, the Evidence-based Practice for Improving Quality [EPIQ]) improved pain assessment, management, and intensity outcomes in 16 units at 8 Canadian pediatric hospitals. The sustained effectiveness of EPIQ over time is unknown, however. The goals of this study were to determine the following: (1) sustainability of the impact of EPIQ on pain assessment, management, and intensity outcomes 12, 24, and 36 months after EPIQ; (2) effectiveness of a pain practice change booster (Booster) intervention to sustain EPIQ outcomes over time; and (3) influence of context on sustainability. A prospective, repeated measures, cluster randomized controlled trial was undertaken in the 16 EPIQ units, 12 months after EPIQ completion, to determine the effectiveness of a practice change booster (Booster) to sustain EPIQ outcomes. Generalized estimating equation models examined outcomes controlling for child and unit contextual factors. Outcomes achieved during EPIQ were sustained in the use of any pain assessment measure (P = .01) and a validated pain assessment measure in the EPIQ units (P = .02) up to 36 months after EPIQ. Statistically significant improvements in pain management practices persisted in EPIQ units; results varied across time. There were no significant differences in outcomes after implementation of the Booster between the Booster and Nonbooster groups. Improved pain assessment and management practices were sustained after EPIQ; however, the Booster did not seem to provide additional impact. Copyright © 2016 by the American Academy of Pediatrics.

Commentary on Becoming a Daughter: Trauma is a powerful teacher.

PubMed

Veach, Patricia McCarthy

2006-06-01

Personal life crises profoundly impact genetic counselor practice. In this commentary, themes from Matloff's (in press) article, Becoming a Daughter are highlighted and expanded upon. These themes include: personal impact of a life crisis, and professional impact vis a vis empathy countertransference, self-disclosure, nondirectiveness, and self-confidence. Strategies that help genetic counselors manage personal life crises within their clinical practice and also promote their professional development are emphasized, including normalization of life crises, self-reflection, boundary-setting, and use of peer supervision and consultation.

14 CFR 1216.200 - Scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Management; and, (h) Establish internal management controls to monitor NASA actions to assure compliance with... Wetlands Management § 1216.200 Scope. This subpart 1216.2 prescribes procedures to: (a) Avoid long- and... practicable alternative; (c) Reduce the risk of flood loss; (d) Minimize the impact of floods on human health...

Concepts of sustainability, motivations for pest management approaches, and implications for communicating change

USDA-ARS?s Scientific Manuscript database

Effective communication with farmers is an essential component of impacting their decision processes and encouraging changes in pest management practices, but requires a system of research and extension management that differs from that to which most biological scientists are accustomed. We present...

Evaluating the impacts of agricultural land management practices on water resources: A probabilistic hydrologic modeling approach.

PubMed

Prada, A F; Chu, M L; Guzman, J A; Moriasi, D N

2017-05-15

Evaluating the effectiveness of agricultural land management practices in minimizing environmental impacts using models is challenged by the presence of inherent uncertainties during the model development stage. One issue faced during the model development stage is the uncertainty involved in model parameterization. Using a single optimized set of parameters (one snapshot) to represent baseline conditions of the system limits the applicability and robustness of the model to properly represent future or alternative scenarios. The objective of this study was to develop a framework that facilitates model parameter selection while evaluating uncertainty to assess the impacts of land management practices at the watershed scale. The model framework was applied to the Lake Creek watershed located in southwestern Oklahoma, USA. A two-step probabilistic approach was implemented to parameterize the Agricultural Policy/Environmental eXtender (APEX) model using global uncertainty and sensitivity analysis to estimate the full spectrum of total monthly water yield (WYLD) and total monthly Nitrogen loads (N) in the watershed under different land management practices. Twenty-seven models were found to represent the baseline scenario in which uncertainty of up to 29% and 400% in WYLD and N, respectively, is plausible. Changing the land cover to pasture manifested the highest decrease in N to up to 30% for a full pasture coverage while changing to full winter wheat cover can increase the N up to 11%. The methodology developed in this study was able to quantify the full spectrum of system responses, the uncertainty associated with them, and the most important parameters that drive their variability. Results from this study can be used to develop strategic decisions on the risks and tradeoffs associated with different management alternatives that aim to increase productivity while also minimizing their environmental impacts. Copyright © 2017 Elsevier Ltd. All rights reserved.

Interpretation of Landscape Scale SWAT Model Outputs in the Western Lake Erie Basin: Potential Implications for Conservation Decision-Making

NASA Astrophysics Data System (ADS)

Johnson, M. V. V.; Behrman, K. D.; Atwood, J. D.; White, M. J.; Norfleet, M. L.

2017-12-01

There is substantial interest in understanding how conservation practices and agricultural management impact water quality, particularly phosphorus dynamics, in the Western Lake Erie Basin (WLEB). In 2016, the US and Canada accepted total phosphorus (TP) load targets recommended by the Great Lakes Water Quality Agreement Annex 4 Objectives and Targets Task Team; these were 6,000 MTA delivered to Lake Erie and 3,660 MTA delivered to WLEB. Outstanding challenges include development of metrics to determine achievement of these goals, establishment of sufficient monitoring capacity to assess progress, and identification of appropriate conservation practices to achieve the most cost-effective results. Process-based modeling can help inform decisions to address these challenges more quickly than can system observation. As part of the NRCS-led Conservation Effects Assessment Project (CEAP), the Soil Water Assessment Tool (SWAT) was used to predict impacts of conservation practice adoption reported by farmers on TP loss and load delivery dynamics in WLEB. SWAT results suggest that once the conservation practices in place in 2003-06 and 2012 are fully functional, TP loads delivered to WLEB will average 3,175 MTA and 3,084 MTA, respectively. In other words, SWAT predicts that currently adopted practices are sufficient to meet Annex 4 TP load targets. Yet, WLEB gauging stations show Annex 4 goals are unmet. There are several reasons the model predictions and current monitoring efforts are not in agreement: 1. SWAT assumes full functionality of simulated conservation practices; 2. SWAT does not simulate changing management over time, nor impacts of past management on legacy loads; 3. SWAT assumes WLEB hydrological system equilibrium under simulated management. The SWAT model runs used to construct the scenarios that informed the Annex 4 targets were similarly constrained by model assumptions. It takes time for a system to achieve equilibrium when management changes and it takes time for monitoring efforts to measure meaningful changes over time. Careful interpretation of model outputs is imperative for appropriate application of current scientific knowledge to inform decision making, especially when models are used to set spatial and temporal goals around conservation practice adoption and water quality.

76 FR 59159 - Record of Decision; Apostle Islands National Lakeshore, WI

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-23

... Impact Statement (EIS) for the General Management Plan (GMP)/Wilderness Management Plan for Apostle... approved the ROD for the Final GMP/EIS. As soon as practicable, the NPS will begin to implement the...

Eastern Washington steep slope research for management of highway stormwater.

DOT National Transportation Integrated Search

2011-05-01

Highway embankments can provide an ideal location for integrating low impact development (LID) stormwater best management practices (BMPs) into a highway setting, specifically sheet flow BMPs such as vegetated filter strips (VFS) and dispersion. Howe...

A social-ecological systems approach for environmental management.

PubMed

Virapongse, Arika; Brooks, Samantha; Metcalf, Elizabeth Covelli; Zedalis, Morgan; Gosz, Jim; Kliskey, Andrew; Alessa, Lilian

2016-08-01

Urgent environmental issues are testing the limits of current management approaches and pushing demand for innovative approaches that integrate across traditional disciplinary boundaries. Practitioners, scholars, and policy-makers alike call for increased integration of natural and social sciences to develop new approaches that address the range of ecological and societal impacts of modern environmental issues. From a theoretical perspective, social-ecological systems (SES) science offers a compelling approach for improved environmental management through the application of transdisciplinary and resilience concepts. A framework for translating SES theory into practice, however, is lacking. In this paper, we define the key components of an SES-based environmental management approach. We offer recommendations for integrating an SES approach into existing environmental management practices. Results presented are useful for management professionals that seek to employ an SES environmental management approach and scholars aiming to advance the theoretical foundations of SES science for practical application. Published by Elsevier Ltd.

Unresolved pain in children: a relational ethics perspective.

PubMed

Olmstead, Deborah L; Scott, Shannon D; Austin, Wendy J

2010-11-01

It is considered the right of children to have their pain managed effectively. Yet, despite extensive research findings, policy guidelines and practice standard recommendations for the optimal management of paediatric pain, clinical practices remain inadequate. Empirical evidence definitively shows that unrelieved pain in children has only harmful consequences, with no benefits. Contributing factors identified in this undermanaged pain include the significant role of nurses. Nursing attitudes and beliefs about children's pain experiences, the relationships nurses share with children who are suffering, and knowledge deficits in pain management practices are all shown to impact unresolved pain in children. In this article, a relational ethics perspective is used to explore the need for nurses to engage in authentic relationships with children who are experiencing pain, and to use evidence-based practices to manage that pain in order for this indefensible suffering of children to end.

A methodological approach for deriving regional crop rotations as basis for the assessment of the impact of agricultural strategies using soil erosion as example.

PubMed

Lorenz, Marco; Fürst, Christine; Thiel, Enrico

2013-09-01

Regarding increasing pressures by global societal and climate change, the assessment of the impact of land use and land management practices on land degradation and the related decrease in sustainable provision of ecosystem services gains increasing interest. Existing approaches to assess agricultural practices focus on the assessment of single crops or statistical data because spatially explicit information on practically applied crop rotations is mostly not available. This provokes considerable uncertainties in crop production models as regional specifics have to be neglected or cannot be considered in an appropriate way. In a case study in Saxony, we developed an approach to (i) derive representative regional crop rotations by combining different data sources and expert knowledge. This includes the integration of innovative crop sequences related to bio-energy production or organic farming and different soil tillage, soil management and soil protection techniques. Furthermore, (ii) we developed a regionalization approach for transferring crop rotations and related soil management strategies on the basis of statistical data and spatially explicit data taken from so called field blocks. These field blocks are the smallest spatial entity for which agricultural practices must be reported to apply for agricultural funding within the frame of the European Agricultural Fund for Rural Development (EAFRD) program. The information was finally integrated into the spatial decision support tool GISCAME to assess and visualize in spatially explicit manner the impact of alternative agricultural land use strategies on soil erosion risk and ecosystem services provision. Objective of this paper is to present the approach how to create spatially explicit information on agricultural management practices for a study area around Dresden, the capital of the German Federal State Saxony. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Role of Dietary Protein and Fat in Glycaemic Control in Type 1 Diabetes: Implications for Intensive Diabetes Management.

PubMed

Paterson, Megan; Bell, Kirstine J; O'Connell, Susan M; Smart, Carmel E; Shafat, Amir; King, Bruce

2015-09-01

A primary focus of the management of type 1 diabetes has been on matching prandial insulin therapy with carbohydrate amount consumed. However, even with the introduction of more flexible intensive insulin regimes, people with type 1 diabetes still struggle to achieve optimal glycaemic control. More recently, dietary fat and protein have been recognised as having a significant impact on postprandial blood glucose levels. Fat and protein independently increase the postprandial glucose excursions and together their effect is additive. This article reviews how the fat and protein in a meal impact the postprandial glycaemic response and discusses practical approaches to managing this in clinical practice. These insights have significant implications for patient education, mealtime insulin dose calculations and dosing strategies.

Bioenergy Development Policy and Practice Must Recognize Potential Hydrologic Impacts: Lessons from the Americas.

PubMed

Watkins, David W; de Moraes, Márcia M G Alcoforado; Asbjornsen, Heidi; Mayer, Alex S; Licata, Julian; Lopez, Jose Gutierrez; Pypker, Thomas G; Molina, Vivianna Gamez; Marques, Guilherme Fernandes; Carneiro, Ana Cristina Guimaraes; Nuñez, Hector M; Önal, Hayri; da Nobrega Germano, Bruna

2015-12-01

Large-scale bioenergy production will affect the hydrologic cycle in multiple ways, including changes in canopy interception, evapotranspiration, infiltration, and the quantity and quality of surface runoff and groundwater recharge. As such, the water footprints of bioenergy sources vary significantly by type of feedstock, soil characteristics, cultivation practices, and hydro-climatic regime. Furthermore, water management implications of bioenergy production depend on existing land use, relative water availability, and competing water uses at a watershed scale. This paper reviews previous research on the water resource impacts of bioenergy production-from plot-scale hydrologic and nutrient cycling impacts to watershed and regional scale hydro-economic systems relationships. Primary gaps in knowledge that hinder policy development for integrated management of water-bioenergy systems are highlighted. Four case studies in the Americas are analyzed to illustrate relevant spatial and temporal scales for impact assessment, along with unique aspects of biofuel production compared to other agroforestry systems, such as energy-related conflicts and tradeoffs. Based on the case studies, the potential benefits of integrated resource management are assessed, as is the need for further case-specific research.

Insurers' policies on coverage for behavior management services and the impact of the Affordable Care Act.

PubMed

Edelstein, Burton L

2014-01-01

The impact of the Affordable Care Act (ACA) on dental insurance coverage for behavior management services depends upon the child's source of insurance (Medicaid, CHIP, private commercial) and the policies that govern each such source. This contribution describes historical and projected sources of pediatric dental coverage, catalogues the seven behavior codes used by dentists, compares how often they are billed by pediatric and general dentists, assesses payment policies and practices for behavioral services across coverage sources, and describes how ACA coverage policies may impact each source. Differences between Congressional intent to ensure comprehensive oral health services with meaningful consumer protections for all legal-resident children and regulatory action by the Departments of Treasury and Health and Human Services are explored to explain how regulations fail to meet Congressional intent as of 2014. The ACA may additionally impact pediatric dentistry practice, including dentists' behavior management services, by expanding pediatric dental training and safety net delivery sites and by stimulating the evolution of novel payment and delivery systems designed to move provider incentives away from procedure-based payments and toward health outcome-based payments.

Bioenergy Development Policy and Practice Must Recognize Potential Hydrologic Impacts: Lessons from the Americas

NASA Astrophysics Data System (ADS)

Watkins, David W.; de Moraes, Márcia M. G. Alcoforado; Asbjornsen, Heidi; Mayer, Alex S.; Licata, Julian; Lopez, Jose Gutierrez; Pypker, Thomas G.; Molina, Vivianna Gamez; Marques, Guilherme Fernandes; Carneiro, Ana Cristina Guimaraes; Nuñez, Hector M.; Önal, Hayri; da Nobrega Germano, Bruna

2015-12-01

Large-scale bioenergy production will affect the hydrologic cycle in multiple ways, including changes in canopy interception, evapotranspiration, infiltration, and the quantity and quality of surface runoff and groundwater recharge. As such, the water footprints of bioenergy sources vary significantly by type of feedstock, soil characteristics, cultivation practices, and hydro-climatic regime. Furthermore, water management implications of bioenergy production depend on existing land use, relative water availability, and competing water uses at a watershed scale. This paper reviews previous research on the water resource impacts of bioenergy production—from plot-scale hydrologic and nutrient cycling impacts to watershed and regional scale hydro-economic systems relationships. Primary gaps in knowledge that hinder policy development for integrated management of water-bioenergy systems are highlighted. Four case studies in the Americas are analyzed to illustrate relevant spatial and temporal scales for impact assessment, along with unique aspects of biofuel production compared to other agroforestry systems, such as energy-related conflicts and tradeoffs. Based on the case studies, the potential benefits of integrated resource management are assessed, as is the need for further case-specific research.

Impact of the QOF and the NICE guideline in the diagnosis andmanagement of depression: a qualitative study

PubMed Central

Mitchell, Caroline; Dwyer, Rachel; Hagan, Teresa; Mathers, Nigel

2011-01-01

Background The National Institute for Health and clinical Excellence (NICE) depression guideline (2004) and the updated Quality and Outcomes Framework (QOF) ( 2006) in general practice have introduced the concepts of screening severity assessment, for example using the Patient Health Questionnaire 9 (PHQ-9), and ‘stepped care’ for depression. Aim To explore primary care practitioner perspectives on the clinical utility of the NICE guideline and the impact of the QOF on diagnosis and management of depression in routine practice. Design and setting Qualitative study using focus groups from four multidisciplinary practice teams with diverse populations in south Yorkshire. Method Four focus groups were conducted, using a topic guide and audiotaping. There were 38 participants: GPs, nurses, doctors in training, mental health workers, and a manager. Data analysis was iterative and thematic. Results The NICE guideline, with its embedded principles of holism and evidence-based practice, was viewed positively but its impact was compromised by resource and practitioner barriers to implementation. The perceived imposition of the screening questions and severity assessments (PHQ-9) with no responsive training had required practitioners to work hard to minimise negative impacts on their work, for example: constantly adapting consultations to tick boxes; avoiding triggering open displays of distress without the time to offer appropriate care; positively managing how their patients were labelled. Further confusion was experienced around the evolving content of psychological interventions for depression. Conclusion Organisational barriers to the implementation of the NICE guideline and the limited scope of the QOF highlight the need for policy makers to work more effectively with the complex realities of general practice in order to systematically improve the quality and delivery of ‘managed’ care for depression. PMID:21619752

Cultural practices updates

USDA-ARS?s Scientific Manuscript database

Cultural practice updates from 2013 included the effects of shredding in spring, residue management, periodic flooding, no-till fertilizer applications, and billet planting on cane tonnage and sugar yield. Shredding, whether high or low, had little impacts in 2013. However, burning following shreddi...

AGRICULTURAL DRAINAGE WELLS: IMPACT ON GROUND WATER

EPA Science Inventory

This document discusses agricultural drainage well practices, potential contamination problems that may occur, and possible management practices or regulatory solutions that could be used to alleviate those problems. The document has been written for use by state and Agency deci...

Improving the Success of Strategic Management Using Big Data.

PubMed

Desai, Sapan S; Wilkerson, James; Roberts, Todd

2016-01-01

Strategic management involves determining organizational goals, implementing a strategic plan, and properly allocating resources. Poor access to pertinent and timely data misidentifies clinical goals, prevents effective resource allocation, and generates waste from inaccurate forecasting. Loss of operational efficiency diminishes the value stream, adversely impacts the quality of patient care, and hampers effective strategic management. We have pioneered an approach using big data to create competitive advantage by identifying trends in clinical practice, accurately anticipating future needs, and strategically allocating resources for maximum impact.

Stage I Final Report for the Study of Program Management Procedures in the Campus-Based and Basic Grant Programs. (Volume I).

ERIC Educational Resources Information Center

Puma, Michael J.; And Others

The third phase of SISFAP (Study on the Impact of Student Financial Aid Programs), the primary purpose of this study is to evaluate federal and institutional management policies and practices for Basic Educational Opportunity Grant (BEOG) and campus-based programs as they impact on the extent to which the programs are meeting their legislative…

Transformational and abusive leadership practices: impacts on novice nurses, quality of care and intention to leave.

PubMed

Lavoie-Tremblay, Mélanie; Fernet, Claude; Lavigne, Geneviève L; Austin, Stéphanie

2016-03-01

To investigate the impact of nurse managers exercising transformational vs. abusive leadership practices with novice nurses. In a nursing shortage context, it is important to understand better the factors that potentially influence the retention of nurses in the early stages of their career. A large body of research has found that transformational leadership practices have a positive influence on employee functioning. However, very little research exists about the detrimental impact of abusive leadership practices, much less in a nursing context. A cross-sectional design where 541 nurses from the province of Quebec (Canada) were questioned in the fall of 2013. A self-administered questionnaire was completed by nurses with less than five years of nursing experience. Results from three linear regression analysis indicated that transformational leadership practices potentially lead to high quality care and weak intention to quit the healthcare facilities. Conversely, abusive leadership practices potentially lead to poorer quality care and to strong intention to quit the healthcare facilities and the nursing profession. Paying close attention to the leadership practices of nurse managers could prove effective in improving patient care and increasing the retention of new nurses, which is helpful in resolving the nursing shortage. Our results specifically suggest not only that we promote supportive leadership practices (transformational leadership) but, most of all, that we spread the word that abusive leadership creates working conditions that could be detrimental to the practice of nursing at career start. © 2015 John Wiley & Sons Ltd.

Impact of managed care on healthcare delivery practices: the perception of healthcare administrators and clinical practitioners.

PubMed

Tietze, Mari F

2003-01-01

Managed care has introduced changes, such as cost effectiveness, access to care, and quality of care, to many components of the U.S. healthcare delivery system. These changes have affected how healthcare administrators and clinical practitioners perceive the impact of managed care on healthcare delivery practices. A survey was initiated to explore whether the perceptions of administrators differed from those of practitioners and to discover which organizational variables could explain the difference. A descriptive, cross-sectional survey design was used for the target population of administrators and practitioners in high, moderate, and low managed-care-penetration markets. Two investigator-developed instruments--the Managed Care Perceptions Inventory (MCPI) and the MCPI-Demographic--and an intact centralization of decision-making assessment subscale were used for data collection. Administrators had a statistically significant, more positive perception of the impact of managed care on healthcare delivery than did practitioners. When the distinction between administrator and practitioner was not used as a grouping factor, managed care market penetration, nonprofit status, and years in current employment position were factors that had statistically significant associations with a more positive perception of managed care. Based on these findings, both administrators and practitioners have a role in maintaining awareness regarding their perceptions and should work collaboratively to address issues of concern. Similarly, promoting trust and commitment at the organizational level is important. Recommendations for further research are also provided.

Watershed Management Optimization Support Tool: An approach for incorporating LID into integrated water management plans

EPA Science Inventory

To assist communities in the evaluation of green infrastructure, low impact development, and land conservation practices as part of an Integrated Water Resources Management (IWRM) approach, the U.S. Environmental Protection Agency (US EPA) has supported the development of the Wat...

Impacts of forest and land management on biodiversity and carbon

Treesearch

Valerie Kapos; Werner A. Kurz; Toby Gardner; Joice Ferreira; Manuel Guariguata; Lian Pin Koh; Stephanie Mansourian; John A. Parrotta; Nokea Sasaki; Christine B. Schmitt; Jos Barlow; Markku Kanninen; Kimiko Okabe; Yude Pan; Ian D. Thompson; Nathalie van Vliet

2012-01-01

Changes in the management of forest and non-forest land can contribute significantly to reducing emissions from deforestation and forest degradation. Such changes can include both forest management actions - such as improving the protection and restoration of existing forests, introducing ecologically responsible logging practices and regenerating forest on degraded...

Managing Abiotic Factors of Compost to Increase Soilborne Disease Suppression

ERIC Educational Resources Information Center

Griffin, Deirdre E.

2012-01-01

Soilborne pathogens can devastate crops, causing economic losses for farmers due to reduced yields and expensive management practices. Fumigants and fungicides have harmful impacts on the surrounding environment and can be toxic to humans. Therefore, alternative methods of disease management are important. The disease suppressive abilities of…

Consumer Protection in Managed Care: A Third-Generation Approach.

ERIC Educational Resources Information Center

Rother, John

1996-01-01

Discusses three generations of consumer protection issues related to managed care: (1) individual treatment decisions--individuals wanting treatment their plan does not cover or deems unnecessary; (2) insurance practices and risk selection--impact of health management organizations on the rest of the health insurance system; and (3) health plan…

77 FR 14414 - Notice of Intent To Revise Resource Management Plans and an Associated Environmental Impact...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-09

... and resource allocations, levels of resource use, production, and related management practices. Issues...? Economics and Community Support--How should BLM- administered-lands be managed to contribute to local... consider withholding lands with important resource values and/or significant levels of investment from...

A Critique of Externally Oriented Behavior Management Approaches as Applied to Exceptional Black Children.

ERIC Educational Resources Information Center

Patton, James M.

The paper looks at philosophical, heuristic, and practical reasons why behavior management approaches have failed to positively impact on the lives of exceptional Black children. Critiqued are behavior modification techniques, contingency management strategies, suspensions, expulsions, and positive and negative reinforcement. Noted among the…

Individualized Anesthetic Management for Patients Undergoing Electroconvulsive Therapy: A Review of Current Practice.

PubMed

Bryson, Ethan O; Aloysi, Amy S; Farber, Kate G; Kellner, Charles H

2017-06-01

Electroconvulsive therapy (ECT) remains an indispensable treatment for severe psychiatric illness. It is practiced extensively in the United States and around the world, yet there is little guidance for anesthesiologists involved with this common practice. Communication between the anesthesiologist and the proceduralist is particularly important for ECT, because the choice of anesthetic and management of physiologic sequelae of the therapeutic seizure can directly impact both the efficacy and safety of the treatment. In this review, we examine the literature on anesthetic management for ECT. A casual or "one-size-fits-all" approach may lead to less-than-optimal outcomes; customizing the anesthetic management for each patient is essential and can significantly increase treatment success rate and patient satisfaction.

Agriculture and stream water quality: A biological evaluation of erosion control practices

NASA Astrophysics Data System (ADS)

Lenat, David R.

1984-07-01

Agricultural runoff affects many streams in North Carolina. However, there is is little information about either its effect on stream biota or any potential mitigation by erosion control practices. In this study, benthic macroinvertebrates were sampled in three different geographic areas of North Carolina, comparing control watersheds with well-managed and poorly managed watersheds. Agricultural streams were characterized by lower taxa richness (especially for intolerant groups) and low stability. These effects were most evident at the poorly managed sites. Sedimentation was the apparent major problem, but some changes at agricultural sites implied water quality problems. The groups most intolerant of agricultural runoff were Ephemeroptera, Plecoptera and Trichoptera. Tolerant species were usually filter-feeders or algal grazers, suggesting a modification of the food web by addition of particulate organic matter and nutrients. This study clearly indicates that agricultural runoff can severely impact stream biota. However, this impact can be greatly mitigated by currently recommended erosion control practices.

Examining the impact of succession management practices on organizational performance: A national study of U.S. hospitals.

PubMed

Groves, Kevin S

2017-08-03

Spearheaded by the industry's transition from volume- to value-based care, the health care reform movement has spurred both unprecedented challenges and opportunities for developing more effective and sustainable health care delivery organizations. Whereas the formidable challenges of leading hospitals and health systems have been widely discussed, including reimbursement degradation, the rapidly aging workforce, and the imminent wave of executive retirements, the opportunity to leverage succession management and talent development capabilities to overcome these challenges has been largely overlooked. To address this key research and practice need, this multiphase study develops and validates an assessment of succession management practices for health care organizations. Utilizing data collected from two national samples of hospital organizations, the results provide a 32-item succession management assessment comprising seven distinct sets of succession management practices. The results indicate that succession management practices are strongly associated with multiple hospital performance metrics, including patient satisfaction and Medicare Spending per Beneficiary, leadership bench strength, and internal/external placement rate for executive level positions. The author concludes this article with a discussion of several practical implications for health care executives and boards, including employing the succession management assessment for diagnosing development opportunities, benchmarking succession planning and talent development practices against similar hospitals or health systems, and elevating the profile of succession management as a strategic priority in today's increasingly uncertain health care landscape.

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

NASA Astrophysics Data System (ADS)

Darma Tarigan, Suria

2016-01-01

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

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

PubMed

Lebel, Louis; Lebel, Phimphakan; Lebel, Boripat

2016-12-01

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

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

NASA Astrophysics Data System (ADS)

Lebel, Louis; Lebel, Phimphakan; Lebel, Boripat

2016-12-01

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

Long-term no-tillage and organic input management enhanced the diversity and stability of soil microbial community.

PubMed

Wang, Yi; Li, Chunyue; Tu, Cong; Hoyt, Greg D; DeForest, Jared L; Hu, Shuijin

2017-12-31

Intensive tillage and high inputs of chemicals are frequently used in conventional agriculture management, which critically depresses soil properties and causes soil erosion and nonpoint source pollution. Conservation practices, such as no-tillage and organic farming, have potential to enhance soil health. However, the long-term impact of no-tillage and organic practices on soil microbial diversity and community structure has not been fully understood, particularly in humid, warm climate regions such as the southeast USA. We hypothesized that organic inputs will lead to greater microbial diversity and a more stable microbial community, and that the combination of no-tillage and organic inputs will maximize soil microbial diversity. We conducted a long-term experiment in the southern Appalachian mountains of North Carolina, USA to test these hypotheses. The results showed that soil microbial diversity and community structure diverged under different management regimes after long term continuous treatments. Organic input dominated the effect of management practices on soil microbial properties, although no-tillage practice also exerted significant impacts. Both no-tillage and organic inputs significantly promoted soil microbial diversity and community stability. The combination of no-tillage and organic management increased soil microbial diversity over the conventional tillage and led to a microbial community structure more similar to the one in an adjacent grassland. These results indicate that effective management through reducing tillage and increasing organic C inputs can enhance soil microbial diversity and community stability. Copyright © 2017 Elsevier B.V. All rights reserved.

A comparison of current practice patterns of US dermatologists versus published guidelines for the biopsy, initial management, and follow up of patients with primary cutaneous melanoma.

PubMed

Farberg, Aaron S; Rigel, Darrell S

2016-12-01

Guidelines exist for the management of cutaneous malignant melanoma, but their adoption, prevalence, and impact have not yet been determined. To determine current melanoma clinical management practices of US dermatologists and the variance from guidelines that might exist. A cross-sectional e-mail survey study assessing preferred biopsy methods for lesions suspicious for melanoma, margins used for excision, and recommended follow-up intervals were sent to 6177 US dermatologists (540 responding). The representative nature of the responding subset was verified by comparing their demographics to that from the American Academy of Dermatology (AAD) membership. Management varied from published guidelines. Shave biopsy (35%) was the most commonly used method followed by narrow excisional biopsy (31%), saucerization/scoop shave (12%), punch (11%), and wide excision (3%). Excisional margins narrower than recommended were noted and follow-up intervals varied. There were significant management differences noted for dermatologists by practice setting and by years in practice. The impact of patient history, lesion anatomic site, and size of lesion were not assessed. Recall and nonresponder sampling bias may exist. Variations in dermatologists' approaches to melanoma management and variance from current guidelines suggest that a knowledge gap may exist representing an educational opportunity. However, emerging data may also justify deviations from existing guidelines, suggesting a reassessment of the guidelines may be indicated. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Impact of implementing electronic clinical practice guidelines for the diagnosis, control and treatment of cardiovascular risk factors: A pre-post controlled study.

PubMed

Comin, Eva; Catalan-Ramos, Arantxa; Iglesias-Rodal, Manuel; Grau, Maria; Del Val, Jose Luis; Consola, Alicia; Amado, Ester; Pons, Angels; Mata-Cases, Manel; Franzi, Alicia; Ciurana, Ramon; Frigola, Eva; Cos, Xavier; Davins, Josep; Verdu-Rotellar, Jose M

To evaluate the impact of computerized clinical practice guidelines on the management, diagnosis, treatment, control, and follow-up of the main cardiovascular risk factors: hypertension, hypercholesterolaemia, and type 2 diabetes mellitus. Pre-post controlled study. Catalonia, autonomous community located in north-eastern Spain. Individuals aged 35-74 years assigned to general practitioners of the Catalan Health Institute. The intervention group consisted of individuals whose general practitioners had accessed the computerized clinical practice guidelines at least twice a day, while the control group consisted of individuals whose general practitioner had never accessed the computerized clinical practice guidelines platform. The Chi-squared test was used to detect significant differences in the follow-up, control, and treatment variables for all three disorders (hypertension, hypercholesterolaemia, and type 2 diabetes mellitus) between individuals assigned to users and non-users of the computerized clinical practice guidelines, respectively. A total of 189,067 patients were included in this study, with a mean age of 56 years (standard deviation 12), and 55.5% of whom were women. Significant differences were observed in hypertension management, treatment and control; type 2 diabetes mellitus management, treatment and diagnoses, and the management and control of hypercholesterolaemia in both sexes. Computerized clinical practice guidelines are an effective tool for the control and follow-up of patients diagnosed with hypertension, type 2 diabetes mellitus, and hypercholesterolaemia. The usefulness of computerized clinical practice guidelines to diagnose and adequately treat individuals with these disorders remains unclear. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Managing anorexia nervosa.

PubMed

Nicholls, Dasha; Hudson, Lee; Mahomed, Fermeda

2011-10-01

Clinical confidence and coordinated multidisciplinary care can influence the course of anorexia nervosa in children and adolescents. Sicker and younger patients with anorexia nervosa often present first to a paediatrician, requiring early recognition and appropriate management. Paediatric knowledge and skills are also needed to manage the impact of eating disorders on growth and development. This review provides practical guidance on the management of anorexia nervosa for paediatricians, in the areas of assessment, acute management and re-feeding, and long-term monitoring. In the absence of a strong evidence base for some of these recommendations, local protocols based on best practice guidelines can reduce anxiety, increase cooperation and reduce risk.

Factors affecting the innovative practice of nurse managers in health organisations.

PubMed

Williams, Lindy; McMurray, Adela J

This exploratory study reports on two surveys conducted in metropolitan and rural health organisations. Two questionnaires consisting of open and closed questions were distributed to a total of 340 respondents resulting in 176 usable responses, yielding a response rate of 53%. The findings revealed that nurse managers require fairness, trust, recognition, supervisory encouragement, organisational support, and reward for efforts. These are key aspects of organisational climate, which support innovative practice. Experience and innovation were significantly related and other factors such as, management structures and management styles, also had an impact on nurse managers' ability to exhibit innovative behaviour in the 21st Century workplace.

The Future of Management as Design: A Thought Experiment

ERIC Educational Resources Information Center

Bouchard, Veronique; del Forno, Leon

2012-01-01

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

A Systematic Review of the Impact of Educational Programs on Factors That Affect Nurses' Post-Operative Pain Management for Children.

PubMed

AlReshidi, Nahar; Long, Tony; Darvill, Angela

2018-03-01

Despite extensive research in the international arena into pain and its management, there is, as yet, little research on the topic of pain in children in Saudi Arabia and in the Gulf countries generally. A systematic review was conducted to explore the impact of education programs on factors affecting paediatric nurses' postoperative pain management practice. This was done in order to advise the creation of an educational program for nurses in Saudi Arabia. Knowledge about pain, attitudes towards pain, beliefs about children's pain, perceptions of children's reports of pain, self-efficacy with regard to pain management, and perceptions of barriers to optimal practice were all considered to be relevant factors. The review was restricted to randomized controlled trials and quasi-experimental designs, excluding studies focussed on chronic pain or populations other than solely children. Studies published in English between 2000 and 2016 were identified using CINAHL, MEDLINE, Ovid SP, The Cochrane Library, ProQuest, and Google Scholar databases. Of 499 published studies identified by the search, 14 met the inclusion criteria and were included in the review. There was evidence of educational programs exerting a postive impact on enhancing pediatric nurses' knowledge of pain and modifing their attitudes towards it, but only limited evidence was available about the impact on nurses' beliefs and perceptions of children's reports of pain, nurses' self-efficacy, or barriers to optimal practice. None of the studies was conducted in Saudi Arabia. Studies were needed to address additional aspects of preparedness for effective postperative pain management. Details of educational programs used as experimental intervention must be included in reports.

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

Treesearch

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

2012-01-01

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

A Global Meta-Analysis on the Impact of Management Practices on Net Global Warming Potential and Greenhouse Gas Intensity from Cropland Soils.

PubMed

Sainju, Upendra M

2016-01-01

Management practices, such as tillage, crop rotation, and N fertilization, may affect net global warming potential (GWP) and greenhouse gas intensity (GHGI), but their global impact on cropland soils under different soil and climatic conditions need further evaluation. Available global data from 57 experiments and 225 treatments were evaluated for individual and combined effects of tillage, cropping systems, and N fertilization rates on GWP and GHGI which accounted for CO2 equivalents from N2O and CH4 emissions with or without equivalents from soil C sequestration rate (ΔSOC), farm operations, and N fertilization. The GWP and GHGI were 66 to 71% lower with no-till than conventional till and 168 to 215% lower with perennial than annual cropping systems, but 41 to 46% greater with crop rotation than monocroppping. With no-till vs. conventional till, GWP and GHGI were 2.6- to 7.4-fold lower when partial than full accounting of all sources and sinks of greenhouse gases (GHGs) were considered. With 100 kg N ha-1, GWP and GHGI were 3.2 to 11.4 times greater with partial than full accounting. Both GWP and GHGI increased curvilinearly with increased N fertilization rate. Net GWP and GHGI were 70 to 87% lower in the improved combined management that included no-till, crop rotation/perennial crop, and reduced N rate than the traditional combined management that included conventional till, monocopping/annual crop, and recommended N rate. An alternative soil respiration method, which replaces ΔSOC by soil respiration and crop residue returned to soil in the previous year, similarly reduced GWP and GHGI by 133 to 158% in the improved vs. the traditional combined management. Changes in GWP and GHGI due to improved vs. traditional management varied with the duration of the experiment and inclusion of soil and climatic factors in multiple linear regressions improved their relationships. Improved management practices reduced GWP and GHGI compared with traditional management practices and combined management practices were even more effective than individual management practices in reducing net GHG emissions from cropland soils. Partial accounting overestimated GWP and GHGI values as sinks or sources of net GHGs compared with full accounting when evaluating the effect of management practices.

A Global Meta-Analysis on the Impact of Management Practices on Net Global Warming Potential and Greenhouse Gas Intensity from Cropland Soils

PubMed Central

Sainju, Upendra M.

2016-01-01

Management practices, such as tillage, crop rotation, and N fertilization, may affect net global warming potential (GWP) and greenhouse gas intensity (GHGI), but their global impact on cropland soils under different soil and climatic conditions need further evaluation. Available global data from 57 experiments and 225 treatments were evaluated for individual and combined effects of tillage, cropping systems, and N fertilization rates on GWP and GHGI which accounted for CO2 equivalents from N2O and CH4 emissions with or without equivalents from soil C sequestration rate (ΔSOC), farm operations, and N fertilization. The GWP and GHGI were 66 to 71% lower with no-till than conventional till and 168 to 215% lower with perennial than annual cropping systems, but 41 to 46% greater with crop rotation than monocroppping. With no-till vs. conventional till, GWP and GHGI were 2.6- to 7.4-fold lower when partial than full accounting of all sources and sinks of greenhouse gases (GHGs) were considered. With 100 kg N ha-1, GWP and GHGI were 3.2 to 11.4 times greater with partial than full accounting. Both GWP and GHGI increased curvilinearly with increased N fertilization rate. Net GWP and GHGI were 70 to 87% lower in the improved combined management that included no-till, crop rotation/perennial crop, and reduced N rate than the traditional combined management that included conventional till, monocopping/annual crop, and recommended N rate. An alternative soil respiration method, which replaces ΔSOC by soil respiration and crop residue returned to soil in the previous year, similarly reduced GWP and GHGI by 133 to 158% in the improved vs. the traditional combined management. Changes in GWP and GHGI due to improved vs. traditional management varied with the duration of the experiment and inclusion of soil and climatic factors in multiple linear regressions improved their relationships. Improved management practices reduced GWP and GHGI compared with traditional management practices and combined management practices were even more effective than individual management practices in reducing net GHG emissions from cropland soils. Partial accounting overestimated GWP and GHGI values as sinks or sources of net GHGs compared with full accounting when evaluating the effect of management practices. PMID:26901827

Watershed Management Optimization Support Tool (WMOST) Workshop

EPA Science Inventory

To assist communities in the evaluation of green infrastructure, low impact development, and land conservation practices as part of an Integrated Water Resources Management (IWRM) approach, the U.S. Environmental Protection Agency (US EPA) supported the development of the Watersh...

SUSTAIN - A BMP Process and Placement Tool for Urban Watersheds (Poster)

EPA Science Inventory

To assist stormwater management professionals in planning for best management practices (BMPs) and low-impact developments (LIDs) implementation, USEPA is developing a decision support system, called the System for Urban Stormwater Treatment and Analysis INtegration (SUSTAIN). ...

Survey of UK Speech and Language Therapists' Assessment and Treatment Practices for People with Progressive Dysarthria

ERIC Educational Resources Information Center

Collis, Jessica; Bloch, Steven

2012-01-01

Background: Dysarthria knowledge is predominantly impairment-based. As a result, speech and language therapists (SLTs) have traditionally adopted impairment-focused management practices. However, guidance for best practice suggests that SLTs should consider the client holistically, including the impact of dysarthria beyond the impairment. Aims: To…

Mining Environmental Data from a Coupled Modelling System to Examine the Impact of Agricultural Management Practices on Groundwater and Air Quality

NASA Astrophysics Data System (ADS)

Garcia, V.; Cooter, E. J.; Hayes, B.; Murphy, M. S.; Bash, J. O.

2014-12-01

Excess nitrogen (N) resulting from current agricultural management practices can leach into sources of drinking water as nitrate, increasing human health risks of 'blue baby syndrome', hypertension, and some cancers and birth defects. Nitrogen also enters the atmosphere from land surfaces forming air pollution increasing human health risks of pulmonary and cardio-vascular disease. Characterizing and attributing nitrogen from agricultural management practices is difficult due to the complex and inter-related chemical and biological reactions associated with the nitrogen cascade. Coupled physical process-based models, however, present new opportunities to investigate relationships among environmental variables on new scales; particularly because they link emission sources with meteorology and the pollutant concentration ultimately found in the environment. In this study, we applied a coupled meteorology (NOAA-WRF), agricultural (USDA-EPIC) and air quality modelling system (EPA-CMAQ) to examine the impact of nitrogen inputs from corn production on ecosystem and human health and wellbeing. The coupled system accounts for the nitrogen flux between the land surface and air, and the soil surface and groundwater, providing a unique opportunity to examine the effect of management practices such as type and timing of fertilization, tilling and irrigation on both groundwater and air quality across the conterminous US. In conducting the study, we first determined expected relationships based on literature searches and then identified model variables as direct or surrogate variables. We performed extensive and methodical multi-variate regression modelling and variable selection to examine associations between agricultural management practices and environmental condition. We then applied the regression model to predict and contrast pollution levels between two corn production scenarios (Figure 1). Finally, we applied published health functions (e.g., spina bifida and cardio-vascular mortality rates) and economic impact functions (e.g., loss of work/school days, decontamination of drinking water wells). The results of this analysis will be presented at the conference.

Mapping for the management of diffuse pollution risks related to agricultural plant protection practices: case of the Etang de l'Or catchment area in France.

PubMed

Mghirbi, Oussama; Bord, Jean-Paul; Le Grusse, Philippe; Mandart, Elisabeth; Fabre, Jacques

2018-03-08

Faced with health, environmental, and socio-economic issues related to the heavy use of pesticides, diffuse phytosanitary pollution becomes a major concern shared by all the field actors. These actors, namely the farmers and territorial managers, have expressed the need to implement decision support tools for the territorial management of diffuse pollution resulting from the plant protection practices and their impacts. To meet these steadily increasing requests, a cartographic analysis approach was implemented based on GIS which allows the spatialization of the diffuse pollution impacts related to plant protection practices on the Etang de l'Or catchment area in the South of France. Risk mapping represents a support-decision tool that enables the different field actors to identify and locate vulnerable areas, so as to determine action plans and agri-environmental measures depending on the context of the natural environment. This work shows that mapping is helpful for managing risks related to the use of pesticides in agriculture by employing indicators of pressure (TFI) and risk on the applicator's health (IRSA) and on the environment (IRTE). These indicators were designed to assess the impact of plant protection practices at various spatial scales (field, farm, etc.). The cartographic analysis of risks related to plant protection practices shows that diffuse pollution is unequally located in the North (known for its abundant garrigues and vineyards) and in the South of the Etang de l'Or catchment area (the Mauguio-Lunel agricultural plain known for its diversified cropping systems). This spatial inequity is essentially related to land use and agricultural production system. Indeed, the agricultural lands cover about 60% of the total catchment area. Consequently, this cartographic analysis helps the territorial actors with the implementation of strategies for managing risks of diffuse pollution related to pesticides use in agriculture, based on environmental and socio-economic issues and the characteristics of the natural environment.

Recreation impacts and management in wilderness: A state-of-knowledge review

USGS Publications Warehouse

Leung, Y.-F.; Marion, J.L.

2000-01-01

This paper reviews the body of literature on recreation resource impacts and their management in the United States, with a primary focus on research within designated wildernesses during the past 15 years since the previous review (Cole 1987b). Recreation impacts have become a salient issue among wilderness scientists, managers and advocates alike. Studies of recreation impacts, referred to as recreation ecology, have expanded and diversified. Research has shifted its focus more towards questions driven by wilderness and park planning frameworks such the Limits of Acceptable Change and the Visitor Experience and Resource Protection. This paper begins by providing an overview of recreation impacts and their significance in wilderness, followed by a review of research approaches and methods. Major findings from recent studies are summarized. The contribution of this knowledge base to management decisionmaking and practices is examined. The paper concludes with a discussion of major knowledge gaps and suggested areas for future research.

Goal setting education and counseling practices of diabetes educators.

PubMed

Malemute, Charlene L; Shultz, Jill Armstrong; Ballejos, Miriam; Butkus, Sue; Early, Kathaleen Briggs

2011-01-01

The purpose of this study was to identify goal setting education practices used by diabetes educators working with type 2 diabetes patients. Data were collected by a mail questionnaire with 179 diabetes educators purposively selected from the 2008 American Association of Diabetes Educators membership listing. Many diabetes educators (52%) reported that more than 75% of their patients set goals for diabetes control. Independent factor patterns for the frequency of information collected from the patient for the first diabetes education session showed that educators either focused on patients' self-management practices (exercise and dietary practices, knowledge, and social impacts of diabetes) or issues with learning about self-management, such as understanding the patient's learning style and motivation for managing diabetes. Factor patterns overall showed diverse approaches to working with patients, including strategies used with patients struggling with dietary goals and the importance of tasks to complete during the first patient session. Although most educators reported practices that were largely patient centered as promoted by the American Diabetes Association (ADA) and models of chronic disease management, patterns of practice suggest that diabetes educators vary considerably in how they apply education practices, especially with dietary self-management education.

Availability and training of seafarers

DOT National Transportation Integrated Search

2003-01-01

The prime objective of this study is to evaluate how recent developments in ship technology and management practices have impacted, and will continue to impact, on maritime crewing and training, in OECD countries, both ashore and at sea, over the nex...

77 FR 67665 - Draft Environmental Impact Statement and Notice of Scoping Meeting for the Proposed 20-Year...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-13

... the amount of water for farming activities but would continue to replace water allocated for other... management practices, impacts to environmental resources such as surface water, groundwater levels, land...

A typology of intellectual property management for public health innovation and access: design considerations for policymakers.

PubMed

Taubman, Antony

2010-01-19

This paper seeks to set the practical discipline of public interest intellectual property (IP) management in public health into its broader policy context. The most immediate and direct impact of IP systems on public welfare results not from international standards nor from national legislation - though these norms are fundamentally important - but rather from the accumulated impact of numerous practical choices whether or not to seek IP protection; where and where not; and how any exclusive rights are deployed, by whom, and to what end. IP management is the essentially practical exercise of limited exclusive rights over protected subject matter, the judicious use of those rights to leverage outcomes that advance an institution's or a firm's objectives. Exclusive rights are used to construct and define knowledge-based relationships, to leverage access to technology and other necessary resources, and to enhance market-based incentives. IP management choices range across a broad spectrum, spanning public domain strategies, open or exclusive licensing, and strong exclusivity. The idea of 'exclusive rights', as a specific legal mechanism, can run counter to expectations of greater openness and accessibility, but actual outcomes will depend very much on how these mechanisms are used in practice. For public interest or public sector institutions concerned with health research and development, particularly the development of new medicines, IP management choices can be just as critical as they are for private firms, although a predominant institutional concentration on advancing direct public interest objectives may lead to significantly different approaches in weighing and exercising practical choices for IP management: even so, a private sector approach should not be conflated with exclusivity as an end in itself, nor need public interest IP management eschew all leverage over IP. This paper offers a tentative framework for a richer typology of those choices, to give a sense of practical options available and the factors that might guide their application, but without advocating any particular approach.

A Typology of Intellectual Property Management for Public Health Innovation and Access: Design Considerations for Policymakers§

PubMed Central

Taubman, Antony

2010-01-01

This paper seeks to set the practical discipline of public interest intellectual property (IP) management in public health into its broader policy context. The most immediate and direct impact of IP systems on public welfare results not from international standards nor from national legislation – though these norms are fundamentally important - but rather from the accumulated impact of numerous practical choices whether or not to seek IP protection; where and where not; and how any exclusive rights are deployed, by whom, and to what end. IP management is the essentially practical exercise of limited exclusive rights over protected subject matter, the judicious use of those rights to leverage outcomes that advance an institution's or a firm's objectives. Exclusive rights are used to construct and define knowledge-based relationships, to leverage access to technology and other necessary resources, and to enhance market-based incentives. IP management choices range across a broad spectrum, spanning public domain strategies, open or exclusive licensing, and strong exclusivity. The idea of ‘exclusive rights’, as a specific legal mechanism, can run counter to expectations of greater openness and accessibility, but actual outcomes will depend very much on how these mechanisms are used in practice. For public interest or public sector institutions concerned with health research and development, particularly the development of new medicines, IP management choices can be just as critical as they are for private firms, although a predominant institutional concentration on advancing direct public interest objectives may lead to significantly different approaches in weighing and exercising practical choices for IP management: even so, a private sector approach should not be conflated with exclusivity as an end in itself, nor need public interest IP management eschew all leverage over IP. This paper offers a tentative framework for a richer typology of those choices, to give a sense of practical options available and the factors that might guide their application, but without advocating any particular approach. PMID:20517487

Prevalence, predictors, and patient outcomes associated with physician co-management: findings from the Los Angeles Women's Health Study.

PubMed

Rose, Danielle E; Tisnado, Diana M; Tao, May L; Malin, Jennifer L; Adams, John L; Ganz, Patricia A; Kahn, Katherine L

2012-06-01

Physician co-management, representing joint participation in the planning, decision-making, and delivery of care, is often cited in association with coordination of care. Yet little is known about how physicians manage tasks and how their management style impacts patient outcomes. To describe physician practice style using breast cancer as a model. We characterize correlates and predictors of physician practice style for 10 clinical tasks, and then test for associations between physician practice style and patient ratings of care. We queried 347 breast cancer physicians identified by a population-based cohort of women with incident breast cancer regarding care using a clinical vignette about a hypothetical 65-year-old diabetic woman with incident breast cancer. To test the association between physician practice style and patient outcomes, we linked medical oncologists' responses to patient ratings of care (physician n=111; patient n=411). After adjusting for physician and practice setting characteristics, physician practice style varied by physician specialty, practice setting, financial incentives, and barriers to referrals. Patients with medical oncologists who co-managed tasks had higher patient ratings of care. Physician practice style for breast cancer is influenced by provider and practice setting characteristics, and it is an important predictor of patient ratings. We identify physician and practice setting factors associated with physician practice style and found associations between physician co-management and patient outcomes (e.g., patient ratings of care). © Health Research and Educational Trust.

Sharing evidence of sustainable land management impacts

NASA Astrophysics Data System (ADS)

Schwilch, Gudrun; Mekdaschi Studer, Rima; Providoli, Isabelle; Liniger, Hanspeter

2015-04-01

Ensuring sustainable use of natural resources is crucial for maintaining the basis for our livelihoods. With threats from climate change, disputes over water, biodiversity loss, competing claims on land, and migration increasing worldwide, the demands for sustainable land management (SLM) practices will only increase in the future. For years already, various national and international organizations (GOs, NGOs, donors, research institutes, etc.) have been working on alternative forms of land management. And numerous land users worldwide - especially small farmers - have been testing, adapting, and refining new and better ways of managing land. All too often, however, the resulting SLM knowledge has not been sufficiently evaluated, documented and shared. Among other things, this has often prevented valuable SLM knowledge from being channelled into evidence-based decision-making processes. Indeed, proper knowledge management is crucial for SLM to reach its full potential. Since more than 20 years, the international WOCAT network documents and promotes SLM through its global platform. As a whole, the WOCAT methodology comprises tools for documenting, evaluating, and assessing the impact of SLM practices, as well as for knowledge sharing, analysis and use for decision support in the field, at the planning level, and in scaling up identified good practices. In early 2014, WOCAT's growth and ongoing improvement culminated in its being officially recognized by the UNCCD as the primary recommended database for SLM best practices. Over the years, the WOCAT network confirmed that SLM helps to prevent desertification, to increase biodiversity, enhance food security and to make people less vulnerable to the effects of climate variability and change. In addition, it plays an important role in mitigating climate change through improving soil organic matter and increasing vegetation cover. In-depth assessments of SLM practices from desertification sites enabled an evaluation of how SLM addresses prevalent dryland threats. The impacts mentioned most were diversified and enhanced production and better management of water and soil degradation, whether through water harvesting, improving soil moisture, or reducing runoff. Among others, favourable local-scale cost-benefit relationships of SLM practices play a crucial role in their adoption. An economic analysis from the WOCAT database showed that land users perceive a large majority of the technologies as having benefits that outweigh costs in the long term. The high investment costs associated with some practices may constitute a barrier to adoption, however, where appropriate, short-term support for land users can help to promote these practices. The increased global concerns on climate change, disaster risks and food security redirect attention to, and trigger more funds for SLM. To provide the necessary evidence-based rationale for investing in SLM and to reinforce expert and land users assessments of SLM impacts, more field research using inter- and transdisciplinary approaches is needed. This includes developing methods to quantify and value ecosystem services, both on-site and off-site, and assess the resilience of SLM practices, as currently aimed at within the EU FP7 projects CASCADE and RECARE.

Determining the barriers and facilitators to adopting best practices in the management of poststroke unilateral spatial neglect: results of a qualitative study.

PubMed

Petzold, Anita; Korner-Bitensky, Nicol; Salbach, Nancy M; Ahmed, Sara; Menon, Anita; Ogourtsova, Tatiana

2014-01-01

A gap exists between best and actual management of poststroke unilateral spatial neglect (USN). Given the negative impact of USN on poststroke recovery, knowledge translation efforts are needed to optimize USN management. To date, no study has investigated the specific barriers and facilitators affecting USN management during the acute care process. To identify the facilitators and barriers that affect evidence-based practice use by occupational therapists (the primary discipline managing USN) when treating individuals with acute poststroke USN. Focus group methodology elicited information from 9 acute care occupational therapists. Key barriers identified included lack of basic evidence-based practice skills specific to USN treatment and personal motivation to change current practices and engrained habits. Key facilitators included the presence of a multidisciplinary stroke team, recent graduation, and an environment with access to learning time and resources. Synthesized Web-based learning was also seen as important to uptake of best practices. It is estimated that upwards of 40% of patients experience poststroke USN in the acute phase, and we have evidence of poor early management. This study identified several modifiable factors that prepare the ground for the creation and testing of a multimodal knowledge translation intervention aimed at improving clinicians' best practice management of poststroke USN.

Soil management practice in Croatian vineyard affect CO2 fluxes and soil degradation in trafficking zones. First results

NASA Astrophysics Data System (ADS)

Bogunovic, Igor; Bilandzija, Darija; Andabaka, Zeljko; Stupic, Domagoj; Cacic, Marija; Brezinscak, Luka; Maletic, Edi; Pereira, Paulo; Kisic, Ivica

2017-04-01

Vineyards represent one of the most degradation prone types of intensively managed land on Earth. Steep slopes encourage grape producers to adopt environmental friendly soil management like mulching or continuous no-tillage. In this context, producers have concerns about efficient fertilisation practices and water competitions between vine and grasses in continuous no-tillage inter rows. Vineyards in semi-humid areas like Continental Croatia mostly not suffer from water deficit during growth. Nevertheless, lack of research of different soil management practices open dilemma about soil compaction concerns in intensively trafficked soils in vineyard of semi-humid areas. Soil compaction, determined by bulk density (BD), soil water content (SWC) and CO2 fluxes from trafficked inter row positions were recorded in 2016 in an experiment in which four different soil management systems were compared in a vineyard raised on a silty clay loam soil, near Zagreb, Croatia: No-tillage (NT) system, continuous tillage (CT) and yearly inversed grass covered (INV-GC) and tillage managed (INV-T) inter rows are subjected to intensive traffic. Grape yield and must quality of grape variety Chardonnay was also monitored. Tractor traffic increased the soil BD at 0-10 and 10-20 cm, but especially at the 0-10 cm depth. CT treatment record lowest compaction at 0-10 cm because of tillage. Soil water content showed better conservation possibilities of INV-GC in drier period. In wet period SWC possibilities are similar between treatments. The results of soil compaction under different management indicate that vineyard soil differently response to traffic intensity and impact on microfauna activity and CO2 emissions. INV-GC and NT managed soils record lower CO2 fluxes from vineyard soil compared to CT and INV-T treatments. Management treatments did not statistically influenced on grape yields. Several years of investigation is needed to confirm the overall impact of different management treatments on the proportion of degradation process and their response to proportion of tractor circulation impacts.

'Lending the space': midwives' perceptions of birth space and clinical risk management.

PubMed

Seibold, Carmel; Seibold, Camel; Licqurish, Sharon; Rolls, Colleen; Hopkins, Finbar

2010-10-01

to explore and describe midwives perceptions of birth space and clinical risk management and their impact on practice both before and after a move to a new facility. an exploratory descriptive study utilising a modified participatory approach and observation and focus groups for data collection. a major metropolitan maternity hospital in Victoria, Australia. 18 midwives, including graduate year midwives, caseload midwives and hospital midwives working normal shifts, employed within a hospital. the major themes identified were perceptions of birth space, perceptions of risk management, influence of birth space and risk management on practice and moving but not changing: geographical space and practice. Midwives desire to create the ideal birth space was hampered by a prevailing biomedical discourse which emphasised risk. Midwives in all three groups saw themselves as the gatekeepers, 'holding the space' or 'providing a bridge' for women, often in the face of a hierarchical hospital structure with obstetricians governing practice. This situation did not differ significantly after the relocation to the new hospital. Despite a warmer, more spacious and private birth space midwives felt the care was still influenced by the old hierarchical hospital culture. Caseload midwives felt they had the best opportunity to make a difference to women's experience because they were able, through continuity of care, to build trusting relationships with women during the antenatal period. although the physical environment can make a marginal contribution to an optimal birth space, it has little effect on clinical risk management practices within a major public hospital and the way in which this impacts midwives' practice. The importance of place and people are the key to providing an optimal birth space, as are women centred midwifery models of care and reasonable workloads. Copyright © 2010 Elsevier Ltd. All rights reserved.

Hospital administrative characteristics and volunteer resource management practices.

PubMed

Intindola, Melissa; Rogers, Sean; Flinchbaugh, Carol; Della Pietra, Doug

2016-05-16

Purpose - The purpose of this paper is to explore the links between various characteristics of hospital administration and the utilization of classes of volunteer resource management (VRM) practices. Design/methodology/approach - This paper uses original data collected via surveys of volunteer directors in 122 hospitals in five Northeastern and Southern US states. Findings - Structural equation modeling results suggest that number of paid volunteer management staff, scope of responsibility of the primary volunteer administrator, and hospital size are positively associated with increased usage of certain VRM practices. Research limitations/implications - First, the authors begin the exploration of VRM antecedents, and encourage others to continue this line of inquiry; and second, the authors assess dimensionality of practices, allowing future researchers to consider whether specific dimensions have a differential impact on key individual and organizational outcomes. Practical implications - Based on the findings of a relationship between administrative characteristics and the on-the-ground execution of VRM practice, a baseline audit comparing current practices to those VRM practices presented here might be useful in determining what next steps may be taken to focus investments in VRM that can ultimately drive practice utilization. Originality/value - The exploration of the dimensionality of volunteer management adds a novel perspective to both the academic study, and practice, of volunteer management. To the authors' knowledge, this is the first empirical categorization of VRM practices.

Impacts of marsh management on coastal-marsh bird habitats

USGS Publications Warehouse

Mitchell, L.R.; Gabrey, S.; Marra, P.P.; Erwin, R.M.

2006-01-01

The effects of habitat-management practices in coastal marshes have been poorly evaluated. We summarize the extant literature concerning whether these manipulations achieve their goals and the effects of these manipulations on target (i.e., waterfowl and waterfowl food plants) and non-target organisms (particularly coastal-marsh endemics). Although we focus on the effects of marsh management on birds, we also summarize the scant literature concerning the impacts of marsh manipulations on wildlife such as small mammals and invertebrates. We address three common forms of anthropogenic marsh disturbance: prescribed fire, structural marsh management, and open-marsh water management. We also address marsh perturbations by native and introduced vertebrates.

Healthcare waste management: current practices in selected healthcare facilities, Botswana.

PubMed

Mbongwe, Bontle; Mmereki, Baagi T; Magashula, Andrew

2008-01-01

Healthcare waste management continues to present an array of challenges for developing countries, and Botswana is no exception. The possible impact of healthcare waste on public health and the environment has received a lot of attention such that Waste Management dedicated a special issue to the management of healthcare waste (Healthcare Wastes Management, 2005. Waste Management 25(6) 567-665). As the demand for more healthcare facilities increases, there is also an increase on waste generation from these facilities. This situation requires an organised system of healthcare waste management to curb public health risks as well as occupational hazards among healthcare workers as a result of poor waste management. This paper reviews current waste management practices at the healthcare facility level and proposes possible options for improvement in Botswana.

Empirical Analysis of Green Supply Chain Management Practices in Indian Automobile Industry

NASA Astrophysics Data System (ADS)

Luthra, S.; Garg, D.; Haleem, A.

2014-04-01

Environmental sustainability and green environmental issues have an increasing popularity among researchers and supply chain practitioners. An attempt has been made to identify and empirically analyze green supply chain management (GSCM) practices in Indian automobile industry. Six main GSCM practices (having 37 sub practices) and four expected performance outcomes (having 16 performances) have been identified by implementing GSCM practices from literature review. Questionnaire based survey has been made to validate these practices and performance outcomes. 123 complete questionnaires were collected from Indian automobile organizations and used for empirical analysis of GSCM practices in Indian automobile industry. Descriptive statistics have been used to know current implementation status of GSCM practices in Indian automobile industry and multiple regression analysis has been carried out to know the impact on expected organizational performance outcomes by current GSCM practices adopted by Indian automobile industry. The results of study suggested that environmental, economic, social and operational performances improve with the implementation of GSCM practices. This paper may play an important role to understand various GSCM implementation issues and help practicing managers to improve their performances in the supply chain.

Feasibility and impact of a computer-guided consultation on guideline-based management of COPD in general practice.

PubMed

Angus, Robert M; Thompson, Elizabeth B; Davies, Lisa; Trusdale, Ann; Hodgson, Chris; McKnight, Eddie; Davies, Andrew; Pearson, Mike G

2012-12-01

Applying guidelines is a universal challenge that is often not met. Intelligent software systems that facilitate real-time management during a clinical interaction may offer a solution. To determine if the use of a computer-guided consultation that facilitates the National Institute for Health and Clinical Excellence-based chronic obstructive pulmonary disease (COPD) guidance and prompts clinical decision-making is feasible in primary care and to assess its impact on diagnosis and management in reviews of COPD patients. Practice nurses, one-third of whom had no specific respiratory training, undertook a computer-guided review in the usual consulting room setting using a laptop computer with the screen visible to them and to the patient. A total of 293 patients (mean (SD) age 69.7 (10.1) years, 163 (55.6%) male) with a diagnosis of COPD were randomly selected from GP databases in 16 practices and assessed. Of 236 patients who had spirometry, 45 (19%) did not have airflow obstruction and the guided clinical history changed the primary diagnosis from COPD in a further 24 patients. In the 191 patients with confirmed COPD, the consultations prompted management changes including 169 recommendations for altered prescribing of inhalers (addition or discontinuation, inhaler dose or device). In addition, 47% of the 55 current smokers were referred for smoking cessation support, 12 (6%) for oxygen assessment, and 47 (24%) for pulmonary rehabilitation. Computer-guided consultations are practicable in general practice. Primary care COPD databases were confirmed to contain a significant proportion of incorrectly assigned patients. They resulted in interventions and the rationalisation of prescribing in line with recommendations. Only in 22 (12%) of those fully assessed was no management change suggested. The introduction of a computer-guided consultation offers the prospect of comprehensive guideline quality management.

Physiotherapy for cystic fibrosis in Australia and New Zealand: A clinical practice guideline*

PubMed Central

Wilson, Christine; Dentice, Ruth; Cox, Narelle S.; Middleton, Anna; Tannenbaum, Esta; Bishop, Jennifer; Cobb, Robyn; Burton, Kate; Wood, Michelle; Moran, Fiona; Black, Ryan; Bowen, Summar; Day, Rosemary; Depiazzi, Julie; Doiron, Katherine; Doumit, Michael; Dwyer, Tiffany; Elliot, Alison; Fuller, Louise; Hall, Kathleen; Hutchins, Matthew; Kerr, Melinda; Lee, Annemarie L.; Mans, Christina; O'Connor, Lauren; Steward, Ranjana; Potter, Angela; Rasekaba, Tshepo; Scoones, Rebecca; Tarrant, Ben; Ward, Nathan; West, Samantha; White, Dianne; Wilson, Lisa; Wood, Jamie; Holland, Anne E.

2016-01-01

Abstract Physiotherapy management is a key element of care for people with cystic fibrosis (CF) throughout the lifespan. Although considerable evidence exists to support physiotherapy management of CF, there is documented variation in practice. The aim of this guideline is to optimize the physiotherapy management of people with CF in Australia and New Zealand. A systematic review of the literature in key areas of physiotherapy practice for CF was undertaken. Recommendations were formulated based on National Health and Medical Research Council (Australia) guidelines and considered the quality, quantity and level of the evidence; the consistency of the body of evidence; the likely clinical impact; and applicability to physiotherapy practice in Australia and New Zealand. A total of 30 recommendations were made for airway clearance therapy, inhalation therapy, exercise assessment and training, musculoskeletal management, management of urinary incontinence, managing the newly diagnosed patient with CF, delivery of non‐invasive ventilation, and physiotherapy management before and after lung transplantation. These recommendations can be used to underpin the provision of evidence‐based physiotherapy care to people with CF in Australia and New Zealand. PMID:27086904

AN HISTORICAL PERSPECTIVE ON LIFE CYCLE MANAGEMENT AND CURRENT PRACTICES WORLDWIDE

EPA Science Inventory

Environmental life cycle management looks at products, processes, and activities by recognizing all the "cradle to grave" stages that are involved and identifying where potential environmental and economic impacts occur. Government, industry and non-governmental organizations can...

Application of Green Infrastructure for Combined Sewer Overflow, Kansas City, MO

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) encourages communities to adopt environmentally friendly design practices and other “green” management techniques when addressing stormwater control and management. Advanced design concepts such as Low Impact Development (LID) and Gr...

75 FR 26921 - South Atlantic Fishery Management Council; Public Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-13

... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration RIN 0648-XW43 South...), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of public meetings..., social and economic impacts of management measures, and sustainability of fishing practices. On January...

Stormwater Management for Federal Facilities under Section 438 of the Energy Independence and Security Act

EPA Pesticide Factsheets

Federal agencies are required to reduce stormwater runoff from federal development and redevelopment projects to protect water resources. Options include a variety of stormwater management practices like green infrastructure or low impact development

A watershed scale assessment of the impacts of suburban turf management on runoff water quality

NASA Astrophysics Data System (ADS)

Bachman, M.; Inamdar, S. P.; Barton, S.; Duke, J.; Tallamy, D.; Bruck, J.

2014-12-01

Steadily increasing rates of urbanization have raised concerns about the negative impacts of urban runoff on receiving surface water quality. These concerns have been further amplified by landscaping paradigms that encourage high-input, intensively-managed and mono-culture turf and lawn landscapes. We conducted a watershed-scale assessment of turf management practices on water quality vis-à-vis less-intensive management practices that preserve and enhance more diverse and native vegetation. The study treatments with existing/established vegetation and landscaping practices included turf, urban, forest, meadow, and a mixed site with a professional golf course. Stream water sampling was performed during baseflow and storm events. Highest nutrient (nitrate and total nitrogen) concentrations in runoff were observed for the mixed watershed draining the golf course. In contrast, nutrient concentrations in baseflow from the turf watershed were lower than expected and were comparable to those measured in the surrounding meadow and forest sites. Runoff losses from the turf site may have been minimal due to the optimal quality of management implemented. Total nitrogen concentrations from the turf site increased sharply during the first storms following fertilization, suggesting that despite optimal management there exists a risk for nutrient runoff following fertilization. Dissolved organic carbon (DOC) concentrations from the turf site were elevated and aromatic in content while the mixed watershed site yielded more labile DOM. Overall, this study suggests that turf lawns, when managed properly, pose minimal environmental risk to surrounding surface waters. Based on the results of this study, providing homeowners with increased information regarding best management practices for lawn maintenance may serve as a cost-efficient method for reducing suburban runoff pollution.

The Microbiome Structure of Oklahoma Cropland and Prairie Soils and its Response to Seasonal Forcing and Management Practices

NASA Astrophysics Data System (ADS)

Cornell, C. R.; Peterson, B.; Zhou, J.; Xiao, X.; Wawrik, B.

2017-12-01

Greenhouse gases (GHG) emissions from soils are primarily the consequence of microbial processes. Agricultural management of soils is known to affect the structure of microbial communities, and it is likely that dominant GHG emitting microbial activities are impacted via requisite practices. To gain better insight into the impact of seasonal forcing and management practices on the microbiome structure in Oklahoma agricultural soils, a seasonal study was conducted. Over a year period, samples were collected bi-weekly during wet months, and monthly during dry months from two grassland and two managed agricultural sites in El Reno, Oklahoma. Microbial community structure was determined in quadruplicate for each site and time point via 16S rRNA gene sequencing. Measures of soil water content, subsoil nitrate, ammonium, organic matter, total nitrogen, and biomass were also taken for each time point. Data analysis revealed several important trends, indicating greater microbial diversity in native grassland and distinct microbial community changes in response to management practices. The native grassland soils also contained greater microbial biomass than managed soils and both varied in response to rainfall events. Native grassland soils harbor more diverse microbial communities, with the diversity and biomass decreasing along a gradient of agricultural management intensity. These data indicate that microbial community structure in El Reno soils occurs along a continuum in which native grasslands and highly managed agricultural soils (tilling and manure application) form end members. Integration with measurements from eddy flux towers into modelling efforts using the DeNitrification-DeComposition (DNDC) model is currently being explored to improve predictions of GHG emissions from grassland soils.

Enhancing Supply Chain Performance with Environmental Cost Information: Examples from Commonwealth Edison, Andersen Corporation, and Ashland Chemical

EPA Pesticide Factsheets

This collection of case studies illustrates how supply chain management practices can be improved by determining the financial impact of business activities that have an impact on a company’s environmental performance.

Woody plants and woody plant management: ecology, safety, environmental impact

Treesearch

James H. Miller

2001-01-01

Wise and effective woody plant management is an increasing necessity for many land uses and conservation practices, especially on forests and rangelands where native or exotic plants are affecting productivity, access, or critical habitat. Tools and approaches for managing woody plants have been under concerted development for the past 50 years, integrating mechanical...

Can forest watershed management mitigate climate change impacts on water resources?

Treesearch

James M. Vose; Chelcy R. Ford; Stephanie Laseter; Salli Dymond; GE Sun; Mary Beth Adams; Stephen Sebestyen; John Campbell; Charles Luce; Devendra Amatya; Kelly Elder; Tamara. Heartsill-Scalley

2012-01-01

Long-term hydrology and climate data from United States Forest Service Experimental Forests and Ranges (EFR) provide critical information on the interactions among climate, streamflow, and forest management practices. We examined the relationships among streamflow responses to climate variation and forest management using long-term data. Analysis of climate data from a...

The Heartland Region P-Index Conservation Innovation Grant: protecting water quality through improved phosphorus management

USDA-ARS?s Scientific Manuscript database

Reducing phosphorus loss from agricultural land is important for improvement and protection of surface water quality. Agricultural models can be used to determine management impacts on P loss and therefore serve as a guide for recommending best management practices. However, the models must be comp...

Impact of management practices on water extractable organic carbon and nitrogen from 12-year poultry litter amended soils

USDA-ARS?s Scientific Manuscript database

Water extractable organic carbon (WEOC) and organic N (WEON) are two key parameters of soil water extractable organic matter (WEOM). Proper management of manure application rate in combination with tillage and cropping management could maintain appropriate WEOC and WEON concentrations in soils while...

Watershed management perspectives in the Southwest: Past, present, and future

Treesearch

Peter F. Ffolliott; Malchus B. Baker; Vicente L. Lopes

2000-01-01

Watershed management perspectives in the Southwest have been, are, and will be reflected by the nature of watershed management practices. Past perspectives evolved from considerations of increasing water yields and water quality concerns. Present perspectives are centered on minimizing adverse impacts to soil and water resources, sustaining high-quality water flows,...

75 FR 65995 - Biomass Crop Assistance Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-27

... practices approved through conservation planning would be periodically monitored by USDA to determine the... negative impacts, through reduced purchases of inputs for traditional farming, within a region ranging from... changes in land management associated with the adoption of dedicated biomass energy cropping practices and...

Discourse of 'transformational leadership' in infection control.

PubMed

Koteyko, Nelya; Carter, Ronald

2008-10-01

The article explores the impact of the ;transformational leadership' style in the role of modern matron with regards to infection control practices. Policy and guidance on the modern matron role suggest that it is distinctive in its combination of management and clinical components, and in its reliance on transformational leadership. Senior nurses are therefore expected to motivate staff by creating high expectations, modelling appropriate behaviour, and providing personal attention to followers by giving respect and responsibility. In this article, we draw on policy documents and interview data to explore the potential impact of this new management style on infection control practices. Combining the techniques of discourse analysis and corpus linguistics, we identify examples where matrons appear to disassociate themselves from the role of ;an empowered manager' who has control over human and financial resources to resolve problems in infection control efficiently.

Impact of environmental policies on the adoption of manure management practices in the Chesapeake Bay watershed.

PubMed

Savage, Jeff A; Ribaudo, Marc O

2013-11-15

Pollution in the Chesapeake Bay is a problem and has been a focus of federal and state initiatives to reduce nutrient pollution from agriculture and other sources since 1983. In 2010 EPA established a TMDL for the watershed. Producers may voluntarily respond to intense and focused policy scrutiny by adopting best management practices. A detailed analysis of water quality best management practices by animal feeding operations inside and outside the watershed yield insight into this relationship. Our findings support the hypothesis that farmers will adopt water quality measures if links are made clear and there is an expectation of future regulations. Published by Elsevier Ltd.

Review of LCA studies of solid waste management systems – Part II: Methodological guidance for a better practice

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

Laurent, Alexis, E-mail: alau@dtu.dk; Clavreul, Julie; Bernstad, Anna

Highlights: • We perform a critical review of 222 LCA studies of solid waste management systems. • We analyse the past LCA practice against the ISO standard and ILCD Handbook guidance. • Malpractices exist in many methodological aspects with large variations among studies. • Many of these aspects are important for the reliability of the results. • We provide detailed recommendations to practitioners of waste management LCAs. - Abstract: Life cycle assessment (LCA) is increasingly used in waste management to identify strategies that prevent or minimise negative impacts on ecosystems, human health or natural resources. However, the quality of themore » provided support to decision- and policy-makers is strongly dependent on a proper conduct of the LCA. How has LCA been applied until now? Are there any inconsistencies in the past practice? To answer these questions, we draw on a critical review of 222 published LCA studies of solid waste management systems. We analyse the past practice against the ISO standard requirements and the ILCD Handbook guidelines for each major step within the goal definition, scope definition, inventory analysis, impact assessment, and interpretation phases of the methodology. Results show that malpractices exist in several aspects of the LCA with large differences across studies. Examples are a frequent neglect of the goal definition, a frequent lack of transparency and precision in the definition of the scope of the study, e.g. an unclear delimitation of the system boundaries, a truncated impact coverage, difficulties in capturing influential local specificities such as representative waste compositions into the inventory, and a frequent lack of essential sensitivity and uncertainty analyses. Many of these aspects are important for the reliability of the results. For each of them, we therefore provide detailed recommendations to practitioners of waste management LCAs.« less

Project management office in health care: a key strategy to support evidence-based practice change.

PubMed

Lavoie-Tremblay, Mélanie; Bonneville-Roussy, Arielle; Richer, Marie-Claire; Aubry, Monique; Vezina, Michel; Deme, Mariama

2012-01-01

This article describes the contribution of a Transition Support Office (TSO) in a health care center in Canada to supporting changes in practice based on evidence and organizational performance in the early phase of a major organizational change. Semistructured individual interviews were conducted with 11 members of the TSO and 13 managers and clinicians from an ambulatory sector in the organization who received support from the TSO. The main themes addressed in the interviews were the description of the TSO, the context of implementation, and the impact. Using the Competing Value Framework by Quinn and Rohrbaugh [Public Product Rev. 1981;5(2):122-140], results revealed that the TSO is a source of expertise that facilitates innovation and implementation of change. It provides material support and human expertise for evidence-based projects. As a single organizational entity responsible for managing change, it gives a sense of cohesiveness. It also facilitates communication among human resources of the entire organization. The TSO is seen as an expertise provider that promotes competency development, training, and evidence-based practices. The impact of a TSO on change in practices and organizational performance in a health care system is discussed.

Electronic health records in four community physician practices: impact on quality and cost of care.

PubMed

Welch, W Pete; Bazarko, Dawn; Ritten, Kimberly; Burgess, Yo; Harmon, Robert; Sandy, Lewis G

2007-01-01

To assess the impact of the electronic health record (EHR) on cost (i.e., payments to providers) and process measures of quality of care. Retrospective before-after-study-control. From the database of a large managed care organization (MCO), we obtained the claims of patients from four community physician practices that implemented the EHR and from about 50 comparison practices without the EHR in the same counties. The diverse patient and practice populations were chosen to be a sample more representative of typical private practices than has previously been studied. For four chronic conditions, we used commercially-available software to analyze cost per episode over a year and the rate of adherence to clinical guidelines as a measure of quality. The implementation of the EHR had a modest positive impact on the quality measure of guideline adherence for hypertension and hyperlipidemia, but no significant impact for diabetes and coronary artery disease. No measurable impact on the short-term cost per episode was found. Discussions with the study practices revealed that the timing and comprehensiveness of EHR implementation varied across practices, creating an intervention variable that was heterogeneous. Guideline adherence increased across practices without EHRs and slightly faster in practices with EHRs. Measuring the impact of EHRs on cost per episode was challenging, because of the difficulty of completely capturing the long-term episodic costs of a chronic condition. Few practices associated with the study MCO had implemented EHRs in any form, much less utilizing standardized protocols.

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.

Messages, limitations and future needs of research into environmental impacts and mitigating and remediation measures of oil palm and forest land-use and land management in SE Asia

NASA Astrophysics Data System (ADS)

Walsh, Rory; Bidin, Kawi; Nurhidayu, Siti; Nainar, Anand; Annammala, Kogilavani; Blake, William; Higton, Sam; Wall, Katy; Darling, Isabella

2017-04-01

Oil palm and forest logging land-uses have expanded immensely in recent decades in SE Asia and other parts of the humid tropics - and increasingly into steeplands where adverse biophysical in situ and downstream impacts are particularly severe. With a focus on recent and current projects in Sabah (Malaysian Borneo) and Peninsular Malaysia, this paper examines the changing nature of research foci and approaches of research projects to assess impacts and develop and test mitigation strategies. Early projects focussed on comparing slope- and catchment-scale hydrology and erosion of selectively logged forest and primary forest and on ways of reducing logging impacts. The second phase of research focussed increasingly on (1) longer-term recovery from logging and (2) the likely impacts of climate change. With repeat logging and conversion of areas of forest to oil palm (and conservation of remaining primary forest was secured), the focus of attention has moved to (1) assessing impacts of oil palm conversion and land management practices, (2) testing existing (and potentially more effective) Roundtable for Sustainable Palm Oil (RSPO) guidelines and Government Regulations aimed at reducing impacts and (3) developing and testing ways of restoring and rehabilitating forest within both badly degraded logged forest areas and largely oil palm landscapes - with attention focussed on the landscape scale, the long-term, downstream as well as in situ impacts and the more vulnerable steepland areas. Two multidisciplinary umbrella projects - the SAFE (Stability of Altered Forest Ecosystems) Project and the SEnSOR Programme - have formed the backbone of this latest phase. The SAFE Project is a ten-year programme assessing the effectiveness of retention of differing widths of riparian forest buffers and different- sized forest 'islands' within converted oil palm landscapes in reducing their adverse ecological, emissions, hydrological, erosional and water pollution impacts. The SEnSOR Programme is specifically testing the effectiveness of RSPO guidelines and possible improved land management measures. After a brief overview of some of the approaches and key findings of these studies, the paper focuses on some of the advantages, limitations and future needs of these studies. Important features of the projects are (1) the involvement of industry, Government and local people from the start in the projects, (2) the focus on the landscape scale and long-term (for example with use of current monitoring as well as a historical approach involving sediment dating and fingerprinting), (3) simultaneous consideration of impacts on a wide variety of environmental impacts, as impacts of land management practices can be beneficial to some but adverse to others. Key limitations and needs are then identified and discussed. The most important of these include how to reconcile the sometimes conflicting impacts of land management practices (and remedial measures) on different environmental parameters and concerns - what is good for Peter is sometimes very bad for Paul. A key need identified, therefore, is for methodologies to evaluate comparative environmental and socioeconomic benefits and costs of sometimes conflicting or alternative land management practices and options that emerge from usually separate scientific investigations of how to reduce impacts of, for example, soil erosion, landslide risk, streamwater pollution, atmospheric emissions, river ecology and landscape biodiversity (and its components). There is also a key need for involvement of social scientists in projects.

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

PubMed

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

2008-05-01

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

Shipboard Experiences Unite Scientists with Educators and Decision-Makers for Lasting Impacts

EPA Science Inventory

The confined, immersive, and hands-on environment aboard a ship is an excellent venue for building a community of practice related to researching, teaching about, and managing aquatic resources and surrounding lands. Communities of practice bring people together around collective...

An economic case for early adoption of preventative practices for management of grapevine trunk diseases

USDA-ARS?s Scientific Manuscript database

The trunk diseases Botryosphaeria dieback, Esca, Eutypa dieback, and Phomopsis dieback, significantly decrease yields and vineyard longevity in California. Despite high disease prevalence and substantial yield impacts, most growers routinely wait to adopt preventative practices until vineyards are ...

Analysis of air quality management with emphasis on transportation sources

NASA Technical Reports Server (NTRS)

English, T. D.; Divita, E.; Lees, L.

1980-01-01

The current environment and practices of air quality management were examined for three regions: Denver, Phoenix, and the South Coast Air Basin of California. These regions were chosen because the majority of their air pollution emissions are related to mobile sources. The impact of auto exhaust on the air quality management process is characterized and assessed. An examination of the uncertainties in air pollutant measurements, emission inventories, meteorological parameters, atmospheric chemistry, and air quality simulation models is performed. The implications of these uncertainties to current air quality management practices is discussed. A set of corrective actions are recommended to reduce these uncertainties.

Do management practices support or constrain safe driving behaviour? A multi-level investigation in a sample of occupational drivers.

PubMed

Newnam, Sharon; Warmerdam, Amanda; Sheppard, Dianne; Griffin, Mark; Stevenson, Mark

2017-05-01

It has been estimated that one-third of all work-related deaths occur while driving for work-related purposes. Despite this, many organisations are unaware of the practices, beyond those that identify and control the impact of unforeseen events (i.e., risk management), that predispose drivers to risk. This study addresses the issue by identifying the management practices operationalised as, High Performance Workplace Systems (HPWS) that influence safe driver behaviour. The study also explores the value given to safety by senior level management as a moderator of the relationship between HPWS practices and driver behaviour. Each factor was tested within a two level hierarchical model consisting of 911 drivers, nested within 161 supervisors and 83 organisations. The findings highight that under conditions of high investment in job and work design, communication and selection practices, drivers reported poorer driving behaviour. An interaction effect also demonstrated that under conditions of high investment in remuneration, drivers reported safer behaviour, but only when they perceived that managers valued and prioritised safety. The findings challenge current thinking in the management of workplace road safety. Copyright © 2017 Elsevier Ltd. All rights reserved.

Mapping Farming Practices in Belgian Intensive Cropping Systems from Sentinel-1 SAR Time Series

NASA Astrophysics Data System (ADS)

Chome, G.; Baret, P. V.; Defourny, P.

2016-08-01

The environmental impact of the so-called conventional farming system calls for new farming practices reducing negative externalities. Emerging farming practices such as no-till and new inter-cropping management are promising tracks. The development of methods to characterize crop management across an entire region and to understand their spatial dimension offers opportunities to accompany the transition towards a more sustainable agriculture.This research takes advantage of the unmatched polarimetric and temporal resolutions of Sentinel-1 SAR C- band to develop a method to identify farming practices at the parcel level. To this end, the detection of changes in backscattering due to surface roughness modification (tillage, inter-crop cover destruction ...) is used to detect the farming management. The final results are compared to a reference dataset collected through an intensive field campaign. Finally, the performances are discussed in the perspective of practices monitoring of cropping systems through remote sensing.

Human resource management practices in a medical complex in the Eastern Cape, South Africa: assessing their impact on the retention of doctors.

PubMed

Longmore, Bruce; Ronnie, Linda

2014-03-26

Human resource management (HRM) practices have the potential to influence the retention of doctors in the public health sector. To explore the key human resource (HR) practices affecting doctors in a medical complex in the Eastern Cape, South Africa. We used an open-ended questionnaire to gather data from 75 doctors in this setting. The most important HR practices were paying salaries on time and accurately, the management of documentation, communication, HR staff showing that they respected and valued the doctors, and reimbursement for conferences and special leave requests. All these practices were judged to be poorly administered. Essential HR characteristics were ranked in the following order: task competence of HR staff, accountability, general HR efficiency, occupation-specific dispensation adjustments and performance management and development system efficiency, and availability of HR staff. All these characteristics were judged to be poor. HRM practices in this Eastern Cape medical complex were inadequate and a source of frustration. This lack of efficiency could lead to further problems with regard to retaining doctors in public sector service.

Normal tension glaucoma management: a survey of contemporary practice.

PubMed

Symes, Richard J; Mikelberg, Frederick S

2017-08-01

The aim of this study was to investigate contemporary practice patterns with respect to normal tension glaucoma (NTG) management and to determine whether the 2 largest NTG trials have influenced ophthalmologists' clinical practice. A survey questionnaire was sent to ophthalmologists via the American Glaucoma Society, the Canadian Glaucoma Society, and the Canadian Ophthalmological Society. The questionnaire was designed to investigate ophthalmologists' usual practice with respect to NTG and the extent to which practice has been influenced by the Collaborative Normal Tension Glaucoma Study (CNTGS) and the Low pressure Glaucoma Treatment Study (LoGTS). In total, 419 ophthalmologists completed the survey. Of these, 264 respondents were glaucoma subspecialists. The survey showed that 95% and 64% of ophthalmologists were familiar with the CNTGS and the LoGTS, respectively. Of the respondents, 70% indicated that they would initiate treatment in mild-to-moderate NTG without waiting for documented disease progression. Of the respondents, 61% of the total surveyed and 50% of the glaucoma subspecialists felt that the LoGTS results had no impact on their usual clinical practice. The first-choice topical drug for NTG was a prostaglandin analogue (88% of respondents) or brimonidine (10% of respondents). Most ophthalmologists treat NTG more aggressively than recommended by the CTNGS protocol. Most ophthalmologists felt that the LoGTS results had no impact on their normal clinical practice. The prostaglandin analogues are, by far, the most popular choice of drug for contemporary management of NTG. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

A simple method to identify areas of environmental risk due to manure application.

PubMed

Flores, Héctor; Arumí, José Luis; Rivera, Diego; Lagos, L Octavio

2012-06-01

The management of swine manure is becoming an important environmental issue in Chile. One option for the final disposal of manure is to use it as a biofertilizer, but this practice could impact the surrounding environment. To assess the potential environmental impacts of the use of swine manure as a biofertilizer, we propose a method to identify zones of environmental risk through indices. The method considers two processes: nutrient runoff and solute leaching, and uses available information about soils, crops and management practices (irrigation, fertilization, and rotation). We applied the method to qualitatively assess the environmental risk associated with the use of swine manure as a biofertilizer in an 8,000-pig farm located in Central Chile. Results showed that the farm has a moderate environmental risk, but some specific locations have high environmental risks, especially those associated with impacts on areas surrounding water resources. This information could assist the definition of better farm-level management practices, as well as the preservation of riparian vegetation acting as buffer strips. The main advantage of our approach is that it combines qualitative and quantitative information, including particular situations or field features based on expert knowledge. The method is flexible, simple, and can be easily extended or adapted to other processes.

Impact of atrazine prohibition on the sustainability of weed management in Wisconsin maize production.

PubMed

Dong, Fengxia; Mitchell, Paul D; Davis, Vince M; Recker, Ross

2017-02-01

Controversy has surrounded atrazine owing to its susceptibility to leaching and run-off, with regular calls for a ban or restrictions on its use. In the context of a decreasing trend in the percentage of US maize using no-till since 2008, coinciding with the trend of glyphosate-resistant weeds becoming problematic in the Midwestern United States, we empirically examine how atrazine use restrictions have impacted the diversity of weed management practices used by Wisconsin maize farmers. Using survey data from farms inside and outside atrazine prohibition areas, we found that prohibiting atrazine did not directly impact tillage practices, but rather it increased the adoption of herbicide-resistant seed, which then increased adoption of conservation tillage systems. We also found that prohibiting atrazine and using herbicide-resistant seed reduced the number of herbicide sites of action used. The results indicate that prohibiting atrazine reduced the diversity of weed management practices, which increased the risk of herbicide resistance. Our concern is that a regulatory policy to address one issue (atrazine in groundwater) has induced farmer responses that increase problems with another issue (herbicide-resistant weeds) that longer term will contribute to water quality problems from increased soil erosion and offset the initial benefits. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

Improving and ensuring best practice continence management in residential aged care.

PubMed

Heckenberg, Gayle

2008-06-01

Background  Continence Management within residential aged care is an every day component of care that requires assessment, implementation of strategies, resource allocation and evaluation. At times the management of incontinence of aged residents can be challenging and unsuccessful. The project chosen through the Clinical Fellowship program was Continence Management with the aim of raising awareness of best practice to assist in improving and providing person-centred resident care. Aims/objectives •  Review the literature on best practice management of incontinence •  Evaluate current practice in continence management for elderly residents within residential aged care services •  Improve adherence to best practice strategies of care for incontinence •  Raise awareness within the nursing home of the best practice management of incontinence •  Promote appropriate and effective use of resources for continence management •  Deliver individualised person-centred care to residents. •  Ensure best practice in continence management Methods  The Joanna Briggs Institute (JBI) Practical Application of Clinical Evidence System clinical audit tool was utilised to measure current practice against best practice. The results identify gaps that require improvement. The Getting Research into Practice process then allowed analysis of the level of compliance with each of the audit criteria, which would identify any barriers in implementing a selected course of action and aim to improve compliance. The project team was consulted with additional stakeholder consultation to form an action plan and implement strategies to improve practice. Results  Although 100% compliance with all audit criteria in audit 1 and 2 was not achieved, there was improvement in the criteria concerning the documented fluid intake for residents. Further strategies have been identified and implemented and this continues to be a 'work in progress'. Staff now have an acute awareness of what best practice means and the impact their practices have on continence management. The JBI clinical audit and feedback cycle will continue to facilitate the measuring and implementation of best practice for resident outcomes in residential aged care. © 2008 The Author. Journal Compilation © Blackwell Publishing Asia Pty Ltd.

Evaluation of ecofriendly management practices of french beanrust (Uromyces appendiculatus) in organic farming system

NASA Astrophysics Data System (ADS)

Chhetry, G. K. N.; Mangang, H. C.

2012-09-01

Organic farming system emphasises on sustainable development of agriculture. The traditional agriculture system was much akin to the organic system but modernization of agriculture made a shift to this trend. The north east region of India is potential organic farming sites. Most of the farming systems are traditional and are organic by default; however crops in organic farming are prone to many fungal diseases. Hence for validation of the impact of organic practices on the disease development of plants, a study has been conducted for three years under natural environmental conditions on bean rust (Uromyces appendiculatus). Study includes ecofriendly practices like: plant extract treatment, intercropping of beans with maize, organic manure application, influence of cropping season and Trichoderma treatment. Rust is a major prevalent disease in the cultivation of beans as in other parts of the world. Detailed study of the disease in the organic environment and the impact of various treatments and agricultural agronomic practices would help in validation of the practices for the management of the disease in the organic farming system. In our study for three consecutive years it has been revealed that the practices of the traditional farmers likeplant extract application, intercropping, and manure application were found to have significant positive effects in reducing rust development in the bean fields. The treatment of farm yard manure resulted in development of lesser area under disease progress curve. The plant extract of Artemisia vulgaris has marked positive impact on reducing rust disease parameters. Foliar application of Trichoderma reduces the disease parameters of rust. This study would enhance information in understanding the impact of organic farming system on bean rust and would help in validitation of sustainable agricultural practices for use in organic farming system.

How updating textual clinical practice guidelines impacts clinical decision support systems: a case study with bladder cancer management.

PubMed

Bouaud, Jacques; Séroussi, Brigitte; Brizon, Ambre; Culty, Thibault; Mentré, France; Ravery, Vincent

2007-01-01

Guideline-based clinical decision support systems (CDSSs) can be effective in increasing physician compliance with recommendations. However, the ever growing pace at which medical knowledge is produced requires that clinical practice guidelines (CPGs) be updated regularly. It is therefore mandatory that CDSSs be revised accordingly. The French Association for Urology publishes CPGs on bladder cancer management every 2 years. We studied the impact of the 2004 revision of these guidelines, with respect to the 2002 version with a CDSS, UroDoc. We proposed a typology of knowledge base modifications resulting from the update of CPGs making the difference between practice, clinical conditions and recommendations refinement as opposed to new practice and new recommendations. The number of formalized recommendations increased from 577 in 2002 to 1,081 in 2004. We evaluated the two versions of UroDoc on a randomized sample of patient records. A single new practice that modifies a decision taken in 49% of all recorded decisions leads to a fall from 67% to 46% of the compliance rate of decisions.

Reducing nitrogen export from the corn belt to the Gulf of Mexico: agricultural strategies for remediating hypoxia

USGS Publications Warehouse

McLellan, Eileen; Robertson, Dale M.; Schilling, Keith; Tomer, Mark; Kostel, Jill; Smith, Douglas G.; King, Kevin

2015-01-01

SPAtially Referenced Regression on Watershed models developed for the Upper Midwest were used to help evaluate the nitrogen-load reductions likely to be achieved by a variety of agricultural conservation practices in the Upper Mississippi-Ohio River Basin (UMORB) and to compare these reductions to the 45% nitrogen-load reduction proposed to remediate hypoxia in the Gulf of Mexico (GoM). Our results indicate that nitrogen-management practices (improved fertilizer management and cover crops) fall short of achieving this goal, even if adopted on all cropland in the region. The goal of a 45% decrease in loads to the GoM can only be achieved through the coupling of nitrogen-management practices with innovative nitrogen-removal practices such as tile-drainage treatment wetlands, drainage–ditch enhancements, stream-channel restoration, and floodplain reconnection. Combining nitrogen-management practices with nitrogen-removal practices can dramatically reduce nutrient export from agricultural landscapes while minimizing impacts to agricultural production. With this approach, it may be possible to meet the 45% nutrient reduction goal while converting less than 1% of cropland in the UMORB to nitrogen-removal practices. Conservationists, policy makers, and agricultural producers seeking a workable strategy to reduce nitrogen export from the Corn Belt will need to consider a combination of nitrogen-management practices at the field scale and diverse nitrogen-removal practices at the landscape scale.

Soft governance, restratification and the 2004 general medical services contract: the case of UK primary care organisations and general practice teams.

PubMed

Grant, Suzanne; Ring, Adele; Gabbay, Mark; Guthrie, Bruce; McLean, Gary; Mair, Frances S; Watt, Graham; Heaney, David; O'Donnell, Catherine

2015-01-01

In the UK National Health Service, primary care organisation (PCO) managers have traditionally relied on the soft leadership of general practitioners based on professional self-regulation rather than direct managerial control. The 2004 general medical services contract (nGMS) represented a significant break from this arrangement by introducing new performance management mechanisms for PCO managers to measure and improve general practice work. This article examines the impact of nGMS on the governance of UK general practice by PCO managers through a qualitative analysis of data from an empirical study in four UK PCOs and eight general practices, drawing on Hood's four-part governance framework. Two hybrids emerged: (i) PCO managers emphasised a hybrid of oversight, competition (comptrol) and peer-based mutuality by granting increased support, guidance and autonomy to compliant practices; and (ii) practices emphasised a broad acceptance of increased PCO oversight of clinical work that incorporated a restratified elite of general practice clinical peers at both PCO and practice levels. Given the increased international focus on the quality, safety and efficiency in primary care, a key issue for PCOs and practices will be to achieve an effective, contextually appropriate balance between the counterposing governance mechanisms of peer-led mutuality and externally led comptrol. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

The impact of emotional intelligent leadership on staff nurse empowerment: the moderating effect of span of control.

PubMed

Lucas, Victoria; Laschinger, Heather K Spence; Wong, Carol A

2008-11-01

To test a model linking nurses' perceptions of their nurse manager's emotionally intelligent leadership style and nurses' structural empowerment, and the impact of nurse manager span of control (number of direct reports) on the emotional intelligence/empowerment relationship. Hospital restructuring in the 1990s resulted in a dramatic reduction in nurse manager positions, yet nurse managers are critical to empowering nurses for professional practice. A descriptive correlational survey design was used to test the hypothesized model in two community hospitals in Ontario. Two hundred and three nurses from two hospitals returned useable questionnaires (68% response rate). Span of control was a significant moderator of the relationship between nurses perceptions of their managers' emotionally intelligent behaviour and feelings of workplace empowerment. The results suggest that even managers with strong emotional intelligence may not be able to empower their staff if their span of control is large. Every effort must be made to ensure that managers have reasonable spans of control that allow them to develop and use the leadership skill necessary for empowering their staff to practice to the full scope of their professional role.

"It breaks your soul": An in-depth exploration of workplace injustice in nursing.

PubMed

Skinner, Natalie; Van Dijk, Paul; Stothard, Christina; Fein, Erich C

2018-03-01

To understand nurses' experiences of injustice in the workplace and to identify the impact of injustice on well-being. Little is known about how nurses view injustice or its effects on their well-being, although research indicates that such perceptions are central to workplace practices such as performance management and outcomes such as employee well-being. A qualitative study was conducted with semi-structured interviews for nurses employed in Australian public hospitals. Data were analysed using content analysis. Experiences of injustice and unfairness negatively impacted on performance and the personal health of nurses. Unfair treatment was met with reduced effort and commitment. This study provides valuable insights into how nurses perceive and experience injustice at work and supports the link between injustice and nurses' decreased well-being and effectiveness. Implications for nurse managers include the need for managers to engage in regular conversations regarding systemic barriers to performance and implementing performance management as an ongoing dialogue designed for employee voice and relationship management. This process also suggests a need for leadership development in nursing management. Using such steps and strategies would significantly enhance best practice in nursing management. © 2018 John Wiley & Sons Ltd.

Differential effectiveness of depression disease management for rural and urban primary care patients.

PubMed

Adams, Scott J; Xu, Stanley; Dong, Fran; Fortney, John; Rost, Kathryn

2006-01-01

Federally qualified health centers across the country are adopting depression disease management programs following federally mandated training; however, little is known about the relative effectiveness of depression disease management in rural versus urban patient populations. To explore whether a depression disease management program has a comparable impact on clinical outcomes over 2 years in patients treated in rural and urban primary care practices and whether the impact is mediated by receiving evidence-based care (antidepressant medication and specialty care counseling). A preplanned secondary analysis was conducted in a consecutively sampled cohort of 479 depressed primary care patients recruited from 12 practices in 10 states across the country participating in the Quality Enhancement for Strategic Teaming study. Depression disease management improved the mental health status of urban patients over 18 months but not rural patients. Effects were not mediated by antidepressant medication or specialty care counseling in urban or rural patients. Depression disease management appears to improve clinical outcomes in urban but not rural patients. Because these programs compete for scarce resources, health care organizations interested in delivering depression disease management to rural populations need to advocate for programs whose clinical effectiveness has been demonstrated for rural residents.

Human Health Impacts of Forest Fires in the Southern United States: A Literature Review

Treesearch

Cynthia T. Fowler

2003-01-01

Forestry management practices can shape patterns of health, illness, and disease. A primary goal for owners federal, state, andprivate forests is to crap ecosystem management plans that simultaneously optimize forest health and human health. Fire-a major forest management issue in the United States-complicates these goals. Wildfires are natural phenomena with...

SCIENCE FOR INTEGRATED WATERSHED MANAGEMENT: A MULTI-SCALE EXPERIMENTAL CASE STUDY LINKING LAND USE MANAGEMENT PRACTICES AND WATER QUALITY IN SOUTHERN OHIO

EPA Science Inventory

Although it is routine for watershed management programs to coincide the monitoring of land use impacts and water quality at different spatial scales, rarely are the data collected in a manner to elucidate the linkages among ecological systems across a drainage network. There rem...

Perception of scale in forest management planning: Challenges and implications

Treesearch

Swee May Tang; Eric J. Gustafson

1997-01-01

Forest management practices imposed at one spatial scale may affect the patterns and processes of ecosystems at other scales. These impacts and feedbacks on the functioning of ecosystems across spatial scales are not well understood. We examined the effects of silvicultural manipulations simulated at two spatial scales of management planning on landscape pattern and...

The Impact of Knowledge Management and Technology: An Analysis of Administrative Behaviours

ERIC Educational Resources Information Center

Nurluoz, Ozdem; Birol, Cem

2011-01-01

Knowledge management is crucial in higher education practices that refer knowledge sharing, feedback and communication process as part of the quality improvements. In this process, technology has a role to diffuse knowledge and create a link for sharing within the knowledge management process. In this respect, this research study aims to examine…

Are current efforts sufficient to ensure healthy fish populations?

Treesearch

Bob Danehy; Andy Dolloff

2013-01-01

The maintenance and conservation of fish and wildlife populations in landscapes managed for timber production is a contemporary stewardship requirement and a challenge for forest managers. Best management practices (BMPs) have been developed to meet these challenges. Most BMPs were developed starting in the 1970s so the full impact and the success of those BMPs are not...

Impact on clinical practice of the implementation of guidelines for the toxicity management of targeted therapies in kidney cancer. The protect-2 study.

PubMed

Lainez, Nuria; García-Donas, Jesús; Esteban, Emilio; Puente, Javier; Sáez, M Isabel; Gallardo, Enrique; Pinto-Marín, Álvaro; Vázquez-Estévez, Sergio; León, Luis; García-Carbonero, Icíar; Suárez-Rodríguez, Cristina; Molins, Carmen; Climent-Duran, Miguel A; Lázaro-Quintela, Martín; González Del Alba, Aranzazu; Méndez-Vidal, María José; Chirivella, Isabel; Afonso, Francisco J; López-Brea, Marta; Sala-González, Nuria; Domenech, Montserrat; Basterretxea, Laura; Santander-Lobera, Carmen; Gil-Arnáiz, Irene; Fernández, Ovidio; Caballero-Díaz, Cristina; Mellado, Begoña; Marrupe, David; García-Sánchez, José; Sánchez-Escribano, Ricardo; Fernández Parra, Eva; Villa Guzmán, José C; Martínez-Ortega, Esther; Belén González, María; Morán, Marina; Suarez-Paniagua, Beatriz; Lecumberri, María J; Castellano, Daniel

2016-02-22

The impact of such recommendations after their implementation of guidelines has not usually been evaluated. Herein, we assessed the impact and compliance with the Spanish Oncology Genitourinary Group (SOGUG) Guidelines for toxicity management of targeted therapies in metastatic renal cell carcinoma (mRCC) in daily clinical practice. Data on 407 mRCC patients who initiated first-line targeted therapy during the year before and the year after publication and implementation of the SOGUG guideline program were available from 34 Spanish Hospitals. Adherence to SOGUG Guidelines was assessed in every cycle. Adverse event (AE) management was consistent with the Guidelines as a whole for 28.7% out of 966 post-implementation cycles compared with 23.1% out of 892 pre-implementation cycles (p = 0.006). Analysis of adherence by AE in non-compliant cycles showed significant changes in appropriate management of hypertension (33% pre-implementation vs. 44.5% post-implementation cycles; p < 0.0001), diarrhea (74.0% vs. 80.5%; p = 0.011) and dyslipemia (25.0% vs. 44.6%; p < 0.001). Slight but significant improvements in AE management were detected following the implementation of SOGUG recommendations. However, room for improvement in the management of AEs due to targeted agents still remains and could be the focus for further programs in this direction.

ESTABLISHING MINIMUM FLOWS AND LEVELS OF FRESHWATER IN THE CALOOSAHATCHEE RIVER, FLORIDA, USING RESPONSES OF OYSTERS.

EPA Science Inventory

Alterations in freshwater inflow resulting from watershed development and water management practices have impacted salinity and water quality and led to declines in oyster populations within southwest Florida estuaries. In the Caloosahatchee Estuary, Florida watershed management ...

BEST PRACTICES TO SUPPORT AND IMPROVE PAVEMENT MANAGEMENT SYSTEMS FOR LOW-VOLUME PAVED ROADS – PHASE I

DOT National Transportation Integrated Search

2018-02-02

The Colorado Department of Transportation (CDOT) has been trying to identify the most effective methods for managing low-volume roads (LVRs). These roads are facing multiple challenges including: reductions in maintenance budgets, impact of industria...

A Streamlined Monitoring Framework for Low Impact Development Stormwater Management Practices - Cleveland

EPA Science Inventory

Suburban development surrounding extant urban cores provides watershed managers with two distinct scenarios. The first is abandonment of urban residential zones and problems associated with revitalization in areas where aquatic resources are in poor condition. The second is new d...

Modeling flood reduction effects of low impact development at a watershed scale.

PubMed

Ahiablame, Laurent; Shakya, Ranish

2016-04-15

Low impact development (LID) is a land development approach that seeks to mimic a site's pre-development hydrology. This study is a case study that assessed flood reduction capabilities of large-scale adoption of LID practices in an urban watershed in central Illinois using the Personal Computer Storm Water Management Model (PCSWMM). Two flood metrics based on runoff discharge were developed to determine action flood (43 m(3)/s) and major flood (95 m(3)/s). Four land use scenarios for urban growth were evaluated to determine the impacts of urbanization on runoff and flooding. Flood attenuation effects of porous pavement, rain barrel, and rain garden at various application levels were also evaluated as retrofitting technologies in the study watershed over a period of 30 years. Simulation results indicated that increase in urban land use from 50 to 94% between 1992 and 2030 increased average annual runoff and flood events by more than 30%, suggesting that urbanization without sound management would increase flood risks. The various implementation levels of the three LID practices resulted in 3-47% runoff reduction in the study watershed. Flood flow events that include action floods and major floods were also reduced by 0-40%, indicating that LID practices can be used to mitigate flood risk in urban watersheds. The study provides an insight into flood management with LID practices in existing urban areas. Copyright © 2016 Elsevier Ltd. All rights reserved.

Professional Development through Clinical Supervision

ERIC Educational Resources Information Center

Farhat, Amal

2016-01-01

Studies have shown that clinical supervisory practices result in implementation of new skills in teachers' classroom performance. This study examines the impact of two clinical supervisory cycles on teachers' performance in classroom management. Multiple data collection tools were used to determine the impact of clinical supervisory interventions…

Beware Emotional Maltreatment

ERIC Educational Resources Information Center

King, Margaret A.; Janson, Gregory R.

2011-01-01

Emotional maltreatment is a less visible form of abuse that frequently occurs in schools, but is often ignored or dismissed as an acceptable form of discipline or sanctioned classroom-management practice. The impact of emotional maltreatment on children is significant and impacts personality development, relationships, and learning. Principals, as…

Evaluating Benefits of LID Practices at Multiple Spatial Scales Using SUSTAIN

EPA Science Inventory

Low impact development (LID) is a storm water management approach that essentially mimics the way nature works: infiltrate, filter, store, evaporate, and detain runoff close to its source. LID practices are distributed in nature, and they work on decentralized micro-scales and m...

Statistical learning algorithms for identifying contrasting tillage practices with landsat thematic mapper data

USDA-ARS?s Scientific Manuscript database

Tillage management practices have direct impact on water holding capacity, evaporation, carbon sequestration, and water quality. This study examines the feasibility of two statistical learning algorithms, such as Least Square Support Vector Machine (LSSVM) and Relevance Vector Machine (RVM), for cla...

The Ability of American Football Helmets to Manage Linear Acceleration With Repeated High-Energy Impacts.

PubMed

Cournoyer, Janie; Post, Andrew; Rousseau, Philippe; Hoshizaki, Blaine

2016-03-01

Football players can receive up to 1400 head impacts per season, averaging 6.3 impacts per practice and 14.3 impacts per game. A decrease in the capacity of a helmet to manage linear acceleration with multiple impacts could increase the risk of traumatic brain injury. To investigate the ability of football helmets to manage linear acceleration with multiple high-energy impacts. Descriptive laboratory study. Laboratory. We collected linear-acceleration data for 100 impacts at 6 locations on 4 helmets of different models currently used in football. Impacts 11 to 20 were compared with impacts 91 to 100 for each of the 6 locations. Linear acceleration was greater after multiple impacts (91-100) than after the first few impacts (11-20) for the front, front-boss, rear, and top locations. However, these differences are not clinically relevant as they do not affect the risk for head injury. American football helmet performance deteriorated with multiple impacts, but this is unlikely to be a factor in head-injury causation during a game or over a season.

Improving the implementation of responsible alcohol management practices by community sporting clubs: A randomised controlled trial.

PubMed

Kingsland, Melanie; Wolfenden, Luke; Tindall, Jennifer; Rowland, Bosco; Sidey, Maree; McElduff, Patrick; Wiggers, John H

2015-07-01

Despite an increased prevalence of risky alcohol consumption and alcohol-related harm among members of sporting groups and at sporting venues, sporting clubs frequently fail to implement alcohol management practices consistent with liquor legislation and best practice guidelines. The aim of this study was to assess the impact of a multi-strategy intervention in improving the implementation of responsible alcohol management practices by sports clubs. A randomised controlled trial was conducted with 87 football clubs, with half randomised to receive a multi-strategy intervention to support clubs to implement responsible alcohol management practices. The 2-year intervention, which was based on implementation and capacity building theory and frameworks, included project officer support, funding, accreditation rewards, printed resources, observational audit feedback, newsletters, training and support from state sporting organisations. Interviews were undertaken with club presidents at baseline and post-intervention to assess alcohol management practice implementation. Post-intervention, 88% of intervention clubs reported implementing '13 or more' of 16 responsible alcohol management practices, which was significantly greater than the proportion of control groups reporting this level of implementation (65%) [odds ratio: 3.7 (95% confidence interval: 1.1-13.2); P = 0.04]. All intervention components were considered highly useful and three-quarters or more of clubs rated the amount of implementation support to be sufficient. The multi-strategy intervention was successful in improving alcohol management practices in community sports clubs. Further research is required to better understand implementation barriers and to assess the long-term sustainability of the change in club alcohol management practices. © 2015 Australasian Professional Society on Alcohol and other Drugs.

The impact of ED nurse manager leadership style on staff nurse turnover and patient satisfaction in academic health center hospitals.

PubMed

Raup, Glenn H

2008-10-01

Nurse managers with effective leadership skills are an essential component to the solution for ending the nursing shortage. Empirical studies of existing ED nurse manager leadership styles and their impact on key nurse management outcomes such as staff nurse turnover and patient satisfaction have not been performed. The specific aims of this study were to determine what types of leadership styles were used by ED nurse managers in academic health center hospitals and examine their influence on staff nurse turnover and patient satisfaction. ED nurse managers were asked to complete the Multifactor Leadership Questionnaire and a 10-item researcher defined nurse manager role and practice demographics survey. Completed surveys (15 managers and 30 staff nurses) representing 15 out of 98 possible U.S. academic health centers were obtained. Fisher's exact test with 95% confidence intervals were used to analyze the data. The sample percentage of managers who exhibited Transformational leadership styles and demographic findings of nurse manager age, total years experience and length of time in current position matched current reports in the literature. A trend of lower staff nurse turnover with Transformational leadership style compared to non-Trasformational leadership styles was identified. However, the type of leadership style did not appear to have an effect on patient satisfaction. The ED is an ever-changing, highly regulated, critical-care environment. Effective ED nurse manager leadership strategies are vital to maintaining the standards of professional emergency nursing practice to create an environment that can produce management outcomes of decreased staff nurse turnover, thereby enhancing staff nurse retention and potentially impacting patient satisfaction.

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

PubMed

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

2005-03-01

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

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

PubMed

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

2018-01-01

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

Innovation characteristics and intention to adopt sustainable facilities management practices.

PubMed

Lee, So Young; Kang, Mihyun

2013-01-01

Sustainable facilities management (SFM) is important because typical buildings consume more resources and energy than necessary, negatively impact the environment and generate lots of waste (US Department of Energy, 2003, Green Buildings). This study examined innovation characteristics that relate to facility managers' intention to adopt SFM practices. Based on the diffusion of innovations theory (Rogers 1962, 1995, Diffusion of Innovations. 4th ed. New York: The Free Press), an SFM innovation and adoption model was proposed. A survey was conducted with a convenience sample of 240 public facilities managers in 25 facilities management divisions in Seoul, Korea, and its metropolitan areas. Structural equation modelling was employed to analyse the data. The results showed that economic advantage and human comfort aspects are predictors for the intention of SFM adoption. Observability is positively relevant to the intention of SFM adoption. Complexity, however, is not a significant predictor for the intention of SFM adoption. Practical implications for sustainable products and systems and the built environment are suggested. To incorporate an innovation like sustainable practices, it is required to meet the needs of potential adopters. Innovation characteristics that influence facility managers' intention to adopt sustainable facilities management were examined. A survey was conducted. Economic advantage, human comfort and observability are predictors for the intention of adoption of sustainable practice.

Impact of practice leadership management style on staff experience in services for people with intellectual disability and challenging behaviour: A further examination and partial replication.

PubMed

Deveau, Roy; McGill, Peter

2016-09-01

Practice leadership (PL) style of frontline management has been shown to be associated with better experiences for staff working with people who may exhibit challenging behaviours (Deveau & McGill, 2014). This study aimed to examine additional staff experience factors with a different, larger sample and to partially replicate the findings of (Deveau & McGill, 2014). This study was a survey of staff self-reported data collected as part of a larger study. Information was collected on PL and staff experiences of: stress, turnover, job satisfaction and positive work experiences. The results broadly supported Deveau and McGill (2014) and demonstrated an association between PL and greater job satisfaction and positive experiences for staff. Results on staff turnover were inconsistent. The positive impact of PL on staff experience was further supported by this study. Suggestions are made for further research. These findings suggest further research is needed to examine the potential of interventions in frontline management/leadership practice to improve staff experience of working in challenging environments. Copyright © 2016 Elsevier Ltd. All rights reserved.

Review of LCA studies of solid waste management systems--part II: methodological guidance for a better practice.

PubMed

Laurent, Alexis; Clavreul, Julie; Bernstad, Anna; Bakas, Ioannis; Niero, Monia; Gentil, Emmanuel; Christensen, Thomas H; Hauschild, Michael Z

2014-03-01

Life cycle assessment (LCA) is increasingly used in waste management to identify strategies that prevent or minimise negative impacts on ecosystems, human health or natural resources. However, the quality of the provided support to decision- and policy-makers is strongly dependent on a proper conduct of the LCA. How has LCA been applied until now? Are there any inconsistencies in the past practice? To answer these questions, we draw on a critical review of 222 published LCA studies of solid waste management systems. We analyse the past practice against the ISO standard requirements and the ILCD Handbook guidelines for each major step within the goal definition, scope definition, inventory analysis, impact assessment, and interpretation phases of the methodology. Results show that malpractices exist in several aspects of the LCA with large differences across studies. Examples are a frequent neglect of the goal definition, a frequent lack of transparency and precision in the definition of the scope of the study, e.g. an unclear delimitation of the system boundaries, a truncated impact coverage, difficulties in capturing influential local specificities such as representative waste compositions into the inventory, and a frequent lack of essential sensitivity and uncertainty analyses. Many of these aspects are important for the reliability of the results. For each of them, we therefore provide detailed recommendations to practitioners of waste management LCAs. Copyright © 2013 Elsevier Ltd. All rights reserved.

Views of practice managers and general practitioners on implementing NHS Health Checks.

PubMed

Krska, Janet; du Plessis, Ruth; Chellaswamy, Hannah

2016-03-01

As part of an evaluation of a contract with general practices to deliver the national NHS Health Checks programme in Sefton, North West England, we surveyed general practitioners (GPs) and practice managers (PMs) in all 55 practices. The contract required practices to identify individuals from their practice registers with potentially high cardiovascular disease risk, and provide annual reviews. Responses were obtained from 43/178 GPs and 40/55 PMs representing 56 and 73% of practices, respectively. There was variation in many aspects of implementation. Time and software were viewed as barriers to implementation, the increased nurse workload impacted on other services and payments were insufficient to cover costs. The main enabler for successful implementation was IT support. Fewer than half the respondents viewed the programme as beneficial to their practice. Findings have been used to address many issues raised. Practices need more support from commissioners to help implement NHS Health Checks.

Integrating Clinical Practice Guidelines into Daily Practice: Impact of an Interactive Workshop on Drafting of a Written Action Plan for Asthma Patients

ERIC Educational Resources Information Center

Labelle, Martin; Beaulieu, Michele; Renzi, Paolo; Rahme, Elham; Thivierge, Robert L.

2004-01-01

Introduction: Written action plans (WAPs) are instructions that enable asthmatics to manage their condition appropriately and are recommended by current asthma clinical practice guidelines (CPGs). However, general practitioners (GPs) rarely draft WAPs for their patients. An interactive, case-based workshop for asthma, combined with an objective…

What's in a bin: A case study of dental clinical waste composition and potential greenhouse gas emission savings.

PubMed

Richardson, J; Grose, J; Manzi, S; Mills, I; Moles, D R; Mukonoweshuro, R; Nasser, M; Nichols, A

2016-01-22

Dental practices have a unique position as dental staff use a high number of dental materials and instruments on a daily basis. It is unclear how dentists' and dental care professionals' choices and behaviours around selecting and using materials impact on the amount of unnecessary waste production. Although there are a number of articles exploring the quality and quantity of waste in dental practices, there are no studies on organisational strategies to decrease unnecessary waste. There is no clear economic analysis of the impact on associated cost to dental practices which consequently can affect the access of dental care for disadvantaged groups. This study used an audit approach to explore the potential for sustainability in dental practice by measuring the nature and quantity of dental clinical waste, and assessing the feasibility of measuring the financial costs and potential carbon savings in the management of dental clinical waste. The data from our study would appear to support the view that it is possible to reduce carbon emissions and increase profitability. Successful implementation of an environmentally sustainable approach to waste management will be dependent on the practicalities involved and the financial incentives for adopting such practices.

Integrated hydro-environmental impact assessment and alternative selection of low impact development practices in small urban catchments.

PubMed

Yang, Yang; Chui, Ting Fong May

2018-06-20

Attention is increasingly being paid to low impact development (LID) practices in urban stormwater management. Because LID practices offer a wide variety of hydro-environmental benefits, it is often necessary to account for these benefits collectively in cost-benefit analysis and LID alternative selection. The conventional methods of quantifying these benefits, however, can hardly incorporate the preferences of decision makers, and commonly involve tedious parameter estimations. To address these shortcomings, this study adopts a relative performance evaluation method to assess the various hydro-environmental impacts of LID alternatives in small urban catchments. This study considers several categories of hydro-environmental impacts, including water balance impact, surface pollutant load abatement, and combined sewer overflow and flood risk mitigation. Several performance indicators are used for each impact category. The system-wide effectiveness of an LID alternative is then derived by the weighted aggregation of its indicator scores, which are obtained by comparing its performance with that of all of the other alternatives. The hydro-environmental impact of green roofs and bioretention cells of varying areas in New York City, U.S. are investigated in detail. The results suggest that a green roof that covers the whole catchment is as effective as a bioretention cell that covers 3%-5% of the catchment in terms of stormwater management, and that the effectiveness of a bioretention cell doubles when its surface area increases from 2% to 10% of the catchment area. These assessment results are influenced by catchment-specific assessment criteria (e.g., the high flow threshold) and management interests, which suggests that design guidelines for different catchments should be tailored to their natural and drainage characteristics. The framework used in this study allows stakeholders' interests to be reflected in LID alternative selections and the implications of different design guidelines to be thoroughly investigated. Copyright © 2018 Elsevier Ltd. All rights reserved.

A systems approach to identify adaptation strategies for Midwest US cropping systems under increased climate variability and change.

NASA Astrophysics Data System (ADS)

Basso, B.; Dumont, B.

2015-12-01

A systems approach was implemented to assess the impact of management strategies and climate variability on crop yield, nitrate leaching and soil organic carbon across the the Midwest US at a fine scale spatial resolution. We used the SALUS model which designed to simulated yield and environmental outcomes of continous crop rotations under different agronomic management, soil, weather. We extracted soil parameters from the SSURGO (Soil Survey Geographic) data of nine Midwest states (IA, IL, IN, MI, MN, MO, OH, SD, WI) and weather from NARR (North American Regional Reanalysis). State specific management itineraries were extracted from USDA-NAS. We present the results different cropping systems (continuous corn, corn-soybean and extended rotations) under different management practices (no-tillage, cover crops and residue management). Simulations were conducted under both the baseline (1979-2014) and projected climatic projections (RCP2.5, 6). Results indicated that climate change would likely have a negative impact on corn yields in some areas and positive in others. Soil N, and C losses can be reduced with the adoption of conservation practices.

Implementation of a real option in a sustainable supply chain: an empirical study of alkaline battery recycling

NASA Astrophysics Data System (ADS)

Cucchiella, Federica; D'Adamo, Idiano; Gastaldi, Massimo; Lenny Koh, S. C.

2014-06-01

Green supply chain management (GSCM) has emerged as a key approach for enterprises seeking to become environmentally sustainable. This paper aims to evaluate and describe the advantages of a GSCM approach by analysing practices and performance consequences in the battery recycling sector. It seeks to integrate works in supply chain management (SCM), environmental management, performance management and real option (RO) theory into one framework. In particular, life cycle assessment (LCA) is applied to evaluate the environmental impact of a battery recycling plant project, and life cycle costing (LCC) is applied to evaluate its economic impact. Firms, also understanding the relevance of GSCM, have often avoided applying the green principles because of the elevated costs that such management involved. Such costs could also seem superior to the potential advantages since standard performance measurement systems are internally and business focused; for these reasons, we consider all the possible value deriving also by uncertainty associated to a green project using the RO theory. This work is one of the few and pioneering efforts to investigate GSCM practices in the battery recycling sector.

Perceived Impact of Care Managers’ Work on Patient and Clinician Outcomes

PubMed Central

Carayon, Pascale; Hundt, Ann Schoofs; Hoonakker, Peter; Kianfar, Sarah; Alyousef, Bashar; Salek, Doreen; Cartmill, Randi; Walker, James M.; Tomcavage, Janet

2015-01-01

Objectives The aim of this study is to assess the contributions of care management as perceived by care managers themselves. Study Design Focus groups and interviews with care managers who coordinate care for chronic obstructive pulmonary disease and congestive heart failure patients, as well as patients undergoing major surgery. Methods We collected data in focus groups and interviews with 12 care managers working in the Keystone Beacon Community project, including 5 care managers working in hospitals, 2 employed in outpatient clinics and 4 telephoning discharged patients from a Transitions of Care (TOC) call center. Results Inpatient care managers believe that (1) ensuring primary care provider follow-up, (2) coordinating appropriate services, (3) providing patient education, and (4) ensuring accurate medication reconciliation have the greatest impact on patient clinical outcomes. In contrast, outpatient and TOC care managers believe that (1) teaching patients the signs and symptoms of acute exacerbations and (2) building effective relationships with patients improve patient outcomes most. Some care management activities were perceived to have greater impact on patients with certain conditions (e.g., outpatient and TOC care managers saw effective relationships as having more impact on patients with COPD). All care managers believed that relationships with patients have the greatest impact on patient satisfaction, while the support they provide clinicians has the greatest impact on clinician satisfaction. Conclusions These findings may improve best practice for care managers by focusing interventions on the most effective activities for patients with specific medical conditions. PMID:26273476

Predicting the impact of logging activities on soil erosion and water quality in steep, forested tropical islands

NASA Astrophysics Data System (ADS)

Wenger, Amelia S.; Atkinson, Scott; Santini, Talitha; Falinski, Kim; Hutley, Nicholas; Albert, Simon; Horning, Ned; Watson, James E. M.; Mumby, Peter J.; Jupiter, Stacy D.

2018-04-01

Increasing development in tropical regions provides new economic opportunities that can improve livelihoods, but it threatens the functional integrity and ecosystem services provided by terrestrial and aquatic ecosystems when conducted unsustainably. Given the small size of many islands, communities may have limited opportunities to replace loss and damage to the natural resources upon which they depend for ecosystem service provisioning, thus heightening the need for proactive, integrated management. This study quantifies the effectiveness of management strategies, stipulated in logging codes-of-practice, at minimizing soil erosion and sediment runoff as clearing extent increases, using Kolombangara Island, Solomon Islands as a case study. Further, we examine the ability of erosion reduction strategies to maintain sustainable soil erosion rates and reduce potential downstream impacts to drinking water and environmental water quality. We found that increasing land clearing—even with best management strategies in place—led to unsustainable levels of soil erosion and significant impacts to downstream water quality, compromising the integrity of the land for future agricultural uses, consistent access to clean drinking water, and important downstream ecosystems. Our results demonstrate that in order to facilitate sustainable development, logging codes of practice must explicitly link their soil erosion reduction strategies to soil erosion and downstream water quality thresholds, otherwise they will be ineffective at minimizing the impacts of logging activities. The approach taken here to explicitly examine soil erosion rates and downstream water quality in relation to best management practices and increasing land clearing should be applied more broadly across a range of ecosystems to inform decision-making about the socioeconomic and environmental trade-offs associated with logging, and other types of land use change.

Factors that influence producer decisions to implement management strategies.

PubMed

Field, Thomas G

2014-12-01

Cow-calf enterprises in the USA are widely divergent in size, locale, resource availability, management skill, and market focus. Furthermore, variation exists in dependence on the cow-calf enterprise as a primary source of income, perception about the utility of a particular management practice or technology, and assessment of cost: benefit resulting from implementation impact decisions. Enterprises with larger cow inventories, greater dependence on income from the cattle enterprise, and that retain ownership further into the supply chain beyond the cow-calf operation are more likely to institute management protocols such as vaccination programs, defined calving seasons, and reproductive technologies. Successful cow-calf managers place the highest priority on herd nutrition, pasture and range management, herd health, financial management marketing, production management, and genetics. Management practices are more likely to be adopted when they align with a manager's perception of the utility, labor availability, favorable cost: benefit outcomes and profit motivation.

Towards person-centredness in aged care - exploring the impact of leadership.

PubMed

Backman, Annica; Sjögren, Karin; Lindkvist, Marie; Lövheim, Hugo; Edvardsson, David

2016-09-01

To explore the association between leadership behaviours among managers in aged care, and person-centredness of care and the psychosocial climate. Theory suggests that leadership is important for improving person-centredness in aged care, however, empirical evidence is lacking. A cross-sectional design was used to collect data from Swedish aged care staff (n = 3661). Valid and reliable questionnaires assessing leadership behaviours, person-centeredness of care and the psychosocial climate were used. Data were analysed using multiple linear regression including interaction terms. Leadership behaviours were significantly related to the person-centredness of care and the psychosocial climate. The level of person-centredness of care moderated the impact of leadership on the psychosocial climate. The leadership behaviour of managers significantly impacts person-centred care practice and contributes to the psychosocial climate for both staff and residents in aged care. This study is the first empirically to confirm that middle managers have a central leadership role in developing and supporting person-centred care practice, thereby creating a positive psychosocial climate and high quality care. © 2016 John Wiley & Sons Ltd.

Simulating changes in cropping practices in conventional and glyphosate-resistant maize. II. Weed impacts on crop production and biodiversity.

PubMed

Colbach, Nathalie; Darmency, Henri; Fernier, Alice; Granger, Sylvie; Le Corre, Valérie; Messéan, Antoine

2017-05-01

Overreliance on the same herbicide mode of action leads to the spread of resistant weeds, which cancels the advantages of herbicide-tolerant (HT) crops. Here, the objective was to quantify, with simulations, the impact of glyphosate-resistant (GR) weeds on crop production and weed-related wild biodiversity in HT maize-based cropping systems differing in terms of management practices. We (1) simulated current conventional and probable HT cropping systems in two European regions, Aquitaine and Catalonia, with the weed dynamics model FLORSYS; (2) quantified how much the presence of GR weeds contributed to weed impacts on crop production and biodiversity; (3) determined the effect of cultural practices on the impact of GR weeds and (4) identified which species traits most influence weed-impact indicators. The simulation study showed that during the analysed 28 years, the advent of glyphosate resistance had little effect on plant biodiversity. Glyphosate-susceptible populations and species were replaced by GR ones. Including GR weeds only affected functional biodiversity (food offer for birds, bees and carabids) and weed harmfulness when weed effect was initially low; when weed effect was initially high, including GR weeds had little effect. The GR effect also depended on cultural practices, e.g. GR weeds were most detrimental for species equitability when maize was sown late. Species traits most harmful for crop production and most beneficial for biodiversity were identified, using RLQ analyses. None of the species presenting these traits belonged to a family for which glyphosate resistance was reported. An advice table was built; the effects of cultural practices on crop production and biodiversity were synthesized, explained, quantified and ranked, and the optimal choices for each management technique were identified.

A Streamlined Monitoring Framework for Sustainable and Low Impact Development Stormwater Management Practices - 2

EPA Science Inventory

The problems of urbanization and stormwater management, as they pertain to monitoring the condition of water and environmental resources, are grounded in issues of scale, connectivity, temporal and non-linear change. Given our current understanding of these issues, the challenge ...

SUSTAINABILITY AND ITS IMPACT ON SOLID WASTE MANAGEMENT

EPA Science Inventory

The MSW DST was initially developed in the 1990s and has evolved over the years to better account for changes in waste management practices, waste composition, and improvements in decision support tool design and functionality. The most recent version of the tool is publicly ava...

Proposed chemical mechanismsManagement practices impacts soil nutrients and bacterial populations in backgrounding beef feedlot

USDA-ARS?s Scientific Manuscript database

Intensive beef backgrounding often accumulate manure born soil nutrients, microbes, and pharmaceuticals at different site locations. Unless properly managed, such waste materials can pollute surrounding soil and water sources. Soil sampling from these sites helps determining waste material levels bu...

Physiotherapy for cystic fibrosis in Australia and New Zealand: A clinical practice guideline.

PubMed

Button, Brenda M; Wilson, Christine; Dentice, Ruth; Cox, Narelle S; Middleton, Anna; Tannenbaum, Esta; Bishop, Jennifer; Cobb, Robyn; Burton, Kate; Wood, Michelle; Moran, Fiona; Black, Ryan; Bowen, Summar; Day, Rosemary; Depiazzi, Julie; Doiron, Katherine; Doumit, Michael; Dwyer, Tiffany; Elliot, Alison; Fuller, Louise; Hall, Kathleen; Hutchins, Matthew; Kerr, Melinda; Lee, Annemarie L; Mans, Christina; O'Connor, Lauren; Steward, Ranjana; Potter, Angela; Rasekaba, Tshepo; Scoones, Rebecca; Tarrant, Ben; Ward, Nathan; West, Samantha; White, Dianne; Wilson, Lisa; Wood, Jamie; Holland, Anne E

2016-05-01

Physiotherapy management is a key element of care for people with cystic fibrosis (CF) throughout the lifespan. Although considerable evidence exists to support physiotherapy management of CF, there is documented variation in practice. The aim of this guideline is to optimize the physiotherapy management of people with CF in Australia and New Zealand. A systematic review of the literature in key areas of physiotherapy practice for CF was undertaken. Recommendations were formulated based on National Health and Medical Research Council (Australia) guidelines and considered the quality, quantity and level of the evidence; the consistency of the body of evidence; the likely clinical impact; and applicability to physiotherapy practice in Australia and New Zealand. A total of 30 recommendations were made for airway clearance therapy, inhalation therapy, exercise assessment and training, musculoskeletal management, management of urinary incontinence, managing the newly diagnosed patient with CF, delivery of non-invasive ventilation, and physiotherapy management before and after lung transplantation. These recommendations can be used to underpin the provision of evidence-based physiotherapy care to people with CF in Australia and New Zealand. © 2016 The Authors Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology.

Trust in management, communication and organisational commitment: Factors influencing readiness for change management in organisation

NASA Astrophysics Data System (ADS)

Ahmad, Mohd Hafis; Ismail, Syuhaida; Rani, Wan Nurul Mardiah Wan Mohd; Wahab, Mohammad Hussaini

2017-10-01

Organisational change occurs when an organisation makes a transition from its current state to some desired future state in minimising employee resistance and cost to the organisation while simultaneously maximising the effectiveness of the change effort. This paper, aims at appraising the change management of organisation in Malaysia since limited research has been done to examine readiness for change by the employees in the organisation. This paper is materialising its objectives of (1) investigating the current practice of organisation and employees in the organisation towards change management and (2) assessing the factors influencing readiness of organisation and employees in the organisation towards change management. It is found via literature review that change management is a structured approach for ensuring that changes are thoroughly and smoothly implemented to transitioning individuals, teams, and organisations to a desired future state by focusing on the wider impacts of change, particularly on people, where change does not happen in isolation and it impacts the whole organisation. Furthermore, it is found that current practice of organisation and employees in the organisation towards change management involved in three main factors, namely trust in management, communication and organisational commitment; with the factor for trust in management is the positive vision for the future by management team, meanwhile for communication, it is found that there is good communication between supervisors and employees about the organisation's policy toward the changes. The factor found in organisational commitment is employees enjoying discussing about their organisation with outsiders. The findings of this paper provide a positive impact on change management planning, which ultimately help in ensuring more effective change programme implementation in the organisation in Malaysia.

Multisite evaluation of APEX for water quality: 1. Best professional judgement parameterization

USDA-ARS?s Scientific Manuscript database

The Agricultural and Policy Environmental Extender (APEX) model is capable of estimating edge-of-field water, nutrient, and sediment transport and is used to assess the environmental impacts of management practices. The current practice is to fully calibrate the model for each site simulation, a tas...

Workplace Learning: Dilemmas for the European Steel Industry

ERIC Educational Resources Information Center

Stroud, Dean; Fairbrother, Peter

2006-01-01

The focus in recent studies of workplace learning has been on "communities of practice" and the ways that learning is shaped by such communities. In the process, there has been a downplaying of the importance of broader institutional arrangements, including the impact of organisational structures and management practice, as well as…

The impacts of no-till practice on nitrate and phosphorus loss: A meta-analysis

NASA Astrophysics Data System (ADS)

Wang, L.; Daryanto, S.; Jacinthe, P. A.

2017-12-01

Although no-till (NT) has been promoted as an alternative land management practice to conventional tillage (CT), its impact on water quality, especially nitrate (NO3-) and phosphorus (P) loss remain controversial. We conducted a meta-analysis to compare NO3- and P (dissolved P, particulate P and total P) concentration and load in NT and CT systems, including the co-varying physical (e.g., climate region, rainfall variability, transport pathways, slope gradient) and management variables (e.g., NT duration, crop species). In general, NT increased the amount of dissolved nutrient loss (both NO3- and P), but reduced that of particulate nutrient (particulate P). Specifically, NT resulted in an overall increase of runoff NO3- concentration in comparison to CT, but similar runoff NO3- load. In contrast, NO3- load via leaching was greater under NT than under CT, although NO3- concentration in leachate was similar under both tillage practices, indicating that the effect of NT on NO3- load was largely determined by changes in water flux. NT adoption, in comparison to CT, reduced particulate P concentration by 45% and load by 55%, but increased dissolved P loss by 35% (for both concentration and load). Some variations, however, were recorded with different co-varying variables. NT was, for example, least effective in reducing leachate NO3- concentration in fields planted with wheat, but generated lower leachate NO3- concentration from soybean fields (no N fertilizer applied). In contrast, total P concentration was similar with CT at NT fields planted with soybean and at sites under prolonged NT duration ( 10 years). The limited impact of NT on dissolved nutrient loss (both NO3- and P) remains a serious impediment toward harnessing the water quality benefits of this management practice and suggests that NT needs to be complemented with other management practices (e.g., cover crops, split fertilizer application, occasional tillage).

A decade of precision agriculture impacts on grain yield and yield variation

USDA-ARS?s Scientific Manuscript database

Targeting management practices and inputs with precision agriculture has high potential to meet some of the grand challenges of sustainability in the coming century, including simultaneously improving crop yields and reducing environmental impacts. Although the potential is high, few studies have do...

78 FR 43898 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-22

... volume control credits were added to Stormwater Management. Incorporating low impact development practices will result in cleaner rainwater runoff. It will also delay urban runoff into floodplains, resulting in reduced stormwater volume that can otherwise have a detrimental scouring impact on a stream's...

Impact of model development, calibration and validation decisions on hydrological simulations in West Lake Erie Basin

USDA-ARS?s Scientific Manuscript database

Watershed simulation models are used extensively to investigate hydrologic processes, landuse and climate change impacts, pollutant load assessments and best management practices (BMPs). Developing, calibrating and validating these models require a number of critical decisions that will influence t...

Modeling crop residue burning experiments to evaluate smoke emissions and plume transport

EPA Science Inventory

Crop residue burning is a common land management practice that results in emissions of a variety of pollutants with negative health impacts. Modeling systems are used to estimate air quality impacts of crop residue burning to support retrospective regulatory assessments and also ...

Water Resources Management and Hydrologic Design Under Uncertain Climate Change Scenarios

NASA Astrophysics Data System (ADS)

Teegavarapu, R. S.

2008-05-01

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

Formative evaluation of practice changes for managing depression within a Shared Care model in primary care.

PubMed

Beaulac, Julie; Edwards, Jeanette; Steele, Angus

2017-01-01

Aim To investigate the implementation and initial impact of the Physician Integrated Network (PIN) mental health indicators, which are specific to screening and managing follow-up for depression, in three primary care practices with Shared Mental Health Care in Manitoba. Manitoba Health undertook a primary care renewal initiative in 2006 called the PIN, which included the development of mental health indicators specific to screening and managing follow-up for depression. These indicators were implemented in three PIN group practice sites in Manitoba, which are also part of Shared Mental Health Care. The design was a non-experimental longitudinal design. A formative evaluation investigated the implementation and initial impact of the mental health indicators using mixed methods (document review, survey, and interview). Quantitative data was explored using descriptive and comparative statistics and a content and theme analysis of the qualitative interviews was conducted. Survey responses were received from 32 out of 36 physicians from the three sites. Interviews were conducted with 15 providers. Findings This evaluation illustrated providers' perceived attitudes, knowledge, skills, and behaviours related to recognizing and treating depression and expanded our understanding of primary care processes related to managing depression related to the implementation of a new initiative. Depression is viewed as an important problem in primary care practice that is time consuming to diagnose, manage and treat and requires further investigation. Implementation of the PIN mental health indicators was variable across sites and providers. There was an increase in use of the indicators across time and a general sentiment that benefits of screening outweigh the costs; however, the benefit of screening for depression remains unclear. Consistent with current guidelines, a question the findings of this evaluation suggests is whether there are more effective ways of having an impact on depression within primary care than screening.

Application of BIOME-BGC to Managed Forest Ecosystems in Europe

NASA Astrophysics Data System (ADS)

Pietsch, S. A.; Petritsch, R.; Hasenauer, H.

2007-05-01

European forests have been severely modified by humans resulting in a reduction of forest covered land area, a change in tree species distribution and the deterioration of forest soils. One option to assess forest management impacts on the cycling of carbon, nitrogen and water is the use of BGC-Models. Such models are considered as diagnostic tools for studying sustainability of forest ecosystems and have been used for climate change impact studies on forest growth and carbon sequestration issues. In our efforts to develop an appropriate diagnostic tool to assess the dynamics of carbon, nitrogen, water and energy flux for sustainable forest ecosystem management and climate change studies, we have selected BIOME-BGC. The main reason was that the general model structure is flexible enough to integrate large scale, regional as well as forest stand level information. During the last years we worked on the following extensions: (1) Tested and extended algorithms to interpolate daily climate input data as they are needed to run the model for any location within the country; (2) We developed a set of species specific parameters for all major tree species in Central Europe: Norway spruce (two variants highland and lowlands), Scots pine, Stone pine, larch, common beech and oak forests. These parameters sets are important since in BIOME-BGC vegetation is distinguished in biomes or plant functional types but the impacts of forest management (e.g. changes in stand density) may differ substantially among the tree species assigned to a single biome. (3) We extended the model to cover the full variation ranging from conditions including temperature extremes at the timberline to periodic ground water access or flooding in lowlands. (4) We adapted the spinup procedure to ensure unbiased predictions on forest status in the absence of past and present management impacts. (5) Explicitly addressed the effects of past and present forest management as they may differ by species and silvicultural practice. (6) We assess climate change impacts on managed forests and discuss the impacts of our results on forest management practices.

Impact of human resource management practices on nursing home performance.

PubMed

Rondeau, K V; Wagar, T H

2001-08-01

Management scholars and practitioners alike have become increasingly interested in learning more about the ability of certain 'progressive' or 'high-performance' human resource management (HRM) practices to enhance organizational effectiveness. There is growing evidence to suggest that the contribution of various HRM practices to impact firm performance may be synergistic in effect yet contingent on a number of contextual factors, including workplace climate. A contingency theory perspective suggests that in order to be effective, HMR policies and practices must be consistent with other aspects of the organization, including its environment. This paper reports on empirical findings from research that examines the relationship between HRM practices, workplace climate and perceptions of organizational performance, in a large sample of Canadian nursing homes. Data from 283 nursing homes were collected by means of a mail survey that included questions on HRM practices, programmes, and policies, on human resource aspects of workplace climate, as well as a variety of indicators that include employee, customer/resident and facility measures of organizational performance. Results derived from ordered probit analysis suggest that nursing homes in our sample which had implemented more 'progressive' HRM practices and which reported a workplace climate that strongly values employee participation, empowerment and accountability tended to be perceived to generally perform better on a number of valued organizational outcomes. Nursing homes in our sample that performed best overall were found to be more likely to not only have implemented more of these HRM practices, but also to report having a workplace climate that reflects the seminal value that it places on its human resources. This finding is consistent with the conclusion that simply introducing HRM practices or programmes, in the absence of an appropriately supportive workplace climate, will be insufficient to attain optimal organizational performance.

Evaluation of welfare advice in primary care: effect on practice workload and prescribing for mental health.

PubMed

Krska, Janet; Palmer, Sharon; Dalzell-Brown, Annette; Nicholl, Pat

2013-07-01

To determine Citizen's Advice Bureaux (CAB) and general practice staff perceptions on the impact of a CAB Health Outreach (CABHO) service on staff workload. To quantify the frequency of mental health issues among patients referred to the CABHO service. To measure any impact of the CABHO service on appointments, referrals and prescribing for mental health. GPs and practice managers perceive that welfare rights services, provided by CAB, reduce practice staff workload, but this has not been quantified. Interviews with practice managers and GPs hosting and CAB staff providing an advisory service in nine general practices. Comparison of frequency of GP and nurse appointments, mental health referrals and prescriptions for hypnotics/anxiolytics and antidepressants issued before and after referral to the CABHO service, obtained from medical records of referred patients. Most GPs and CAB staff perceived the service reduced practice staff workload, although practice managers were less certain. CAB staff believed that many patients referred to them had mental health issues. Data were obtained for 148/250 referrals of whom 46% may have had a mental health issue. There were statistically significant reductions in the number of GP appointments and prescriptions for hypnotics/anxiolytics during the six months after referral to CABHO compared with six months before. There were also non-significant reductions in nurse appointments and prescriptions for antidepressants, but no change in appointments or referrals for mental health problems. The quantitative findings therefore confirmed perceptions among both CAB and practice staff of reduced workload and in addition suggest that prescribing may be reduced, although further larger-scale studies are required to confirm this.

The impact of evidence-based sepsis guidelines on emergency department clinical practice: a pre-post medical record audit.

PubMed

Romero, Bernadine; Fry, Margaret; Roche, Michael

2017-11-01

To explore the number of patients presenting with sepsis before and after guideline implementation; the impact of sepsis guidelines on triage assessment, emergency department management and time to antibiotics. Sepsis remains one of the leading causes of mortality and morbidity within hospitals. Globally, strategies have been implemented to reduce morbidity and mortality rates, which rely on the early recognition and management of sepsis. To improve patient outcomes, the New South Wales government in Australia introduced sepsis guidelines into emergency departments. However, the impact of the guidelines on clinical practice remains unclear. A 12-month pre-post retrospective randomised medical record audit of adult patients with a sepsis diagnosis. Data were extracted from the emergency department database and paper medical record. Data included patient demographic (age, gender), clinical information (time of arrival, triage code, seen by time, disposition, time to antibiotic, pathology, time to intravenous fluids) and patient assessment data (heart rate, respiratory rate, blood pressure, temperature, oxygen saturations, medication). This study demonstrated a statistically significant 230-minute reduction in time to antibiotics post implementation of the guidelines. The post group (n = 165) received more urgent triage categories (n = 81; 49·1%), a 758-minute reduction in mean time to second litre of intravenous fluids and an improvement in collection of lactate (n = 112, 67·9%), also statistically significant. The findings highlight the impact the guidelines can have on clinician decision-making and behaviour that support best practice and positive patient outcomes. The sepsis guidelines improved the early assessment, recognition and management of patients presenting with sepsis in one tertiary referral emergency department. The use of evidenced-based guidelines can impact clinical decision-making and behaviour, resulting in the translation and support of best practice and improving patient care. © 2017 John Wiley & Sons Ltd.

Teaching medical management and operations engineering for systems-based practice to radiology residents.

PubMed

Brandon, Catherine J; Mullan, Patricia B

2013-03-01

To better prepare radiology residents for providing care within the context of the larger health care system, this study evaluated the feasibility and impact of a curriculum to enhance radiology residents' understanding and ability to apply concepts from medical management and industrial and operational engineering to systems-based practice problems in radiology practice. A multiprofessional team including radiology, medical education, and industrial and operational engineering professionals collaborated in developing a seven-module curriculum, including didactic lectures, interactive large-group analysis, and small-group discussions with case-based radiology examples, which illustrated real-life management issues and the roles physicians held. Residents and faculty participated in topic selection. Pre- and post-instruction formative assessments were administered, and results were shared with residents during teaching sessions. Attendance and participation in case-based scenario resolutions indicate the feasibility and impact of the interactive curriculum on residents' interest and ability to apply curricular concepts to systems-based practice in radiology. Paired t test analyses (P < .05) and effect sizes showed residents significantly increased their knowledge and ability to apply concepts to systems-based practice issues in radiology. Our iterative curriculum development and implementation process demonstrated need and support for a multiprofessional team approach to teach management and operational engineering concepts. Curriculum topics are congruent with Accreditation Council for Graduate Medical Education requirements for systems-based practice. The case-based curriculum using a mixed educational format of didactic lectures and small-group discussion and problem analysis could be adopted for other radiology programs, for both residents and continuing medical education applications. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

COLLABORATE©: A Universal Competency-Based Paradigm for Professional Case Management, Part II: Competency Clarification.

PubMed

Treiger, Teresa M; Fink-Samnick, Ellen

2013-01-01

The purpose of this second article of a 3-article series is to clarify the competencies for a new paradigm of case management built upon a value-driven foundation that : Applicable to all health care sectors where case management is practiced. In moving forward, the one fact that rings true is that there will be a constant change in our industry. As the health care terrain shifts and new influences continually surface, there will be consequences for case management practice. These impacts require nimble clinical professionals in possession of recognized and firmly established competencies. They must be agile to frame (and reframe) their professional practice to facilitate the best possible outcomes for their patients. Case managers can choose to be Gumby™ or Pokey™. This is exactly the time to define a competency-based case management model, highlighting one sufficiently fluid to fit into any setting of care. The practice of case management transcends the vast array of representative professional disciplines and educational levels. A majority of current models are driven by business priorities rather than the competencies critical to successful practice and quality patient outcomes. This results in a fragmented professional case management identity. Although there is an inherent value in what each discipline brings to the table, this advanced model unifies behind case management's unique, strengths-based identity instead of continuing to align within traditional divisions (e.g., discipline, work setting, population served). This model fosters case management's expanding career advancement opportunities, including a reflective clinical ladder.

The assessment and management of chemotherapy-induced nausea and vomiting among cancer patients in a chemotherapy ward: a best practice implementation project.

PubMed

Gu, Lingli; Li, Jing

2016-03-01

Chemotherapy-induced nausea and vomiting (CINV) are considered to be two of the most distressing side-effects of chemotherapy. They have a negative impact on a patient's quality of life and can influence the continuance of treatment. Owing to the lack of effective management of CINV, regular assessment and management of CINV is recommended for patients undergoing chemotherapy. The aim of this project was to integrate the available evidence on the assessment and management of CINV into practice, and implement strategies to improve compliance with evidence-based practice. The project carried out a pre- and post-implementation audit procedure using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice programs. Five audit criteria were established according to the best available evidence on the assessment and management of CINV. The program was divided into three phases and conducted over four months in the chemotherapy ward, Fudan University Shanghai Cancer Center, Shanghai, China. Sixty patients and 14 oncology nurses were involved in this project. The results of the follow-up cycle showed that the compliance rates regarding patient education, risk factors evaluation and non-pharmacologic managements were 100%, 100% and 80%, respectively. The rate of validated tools being used by patients and nurses improved by 93% and 97%, respectively. This project demonstrated that the use of pre- and post-best practice audits is an effective method for incorporating evidence into practice in a chemotherapy ward. The practice of assessing and managing CINV was significantly improved. The next step is to develop strategies for sustaining the new procedures of CINV assessment and management.

Federal Nursing Service Award. Impact of TriCare/managed care on total force readiness.

PubMed

Ray, M A; Turkel, M C

2001-04-01

Mission readiness is dependent on a healthy total force and the response of military medical and nursing services. Managed care has become the norm in U.S. health care, including the Department of Defense Military Health System. Cost management, health maintenance organizations, and other health plans are defined as "managed care," an aggressive cost-control effort by health care purchasers and insurers to limit health care spending and services and advance a market-oriented, profit-driven system. The impact of managed care on mission readiness and retention of active and reserve personnel is and will continue to be profound. The purpose of this research was to conduct a qualitative, phenomenological study (life experiences) of TriCare/managed care to explore the impact and the meaning of the experience on total force mission readiness of the U.S. Air Force and how managed care has changed nursing practice. The results reveal the significance of the impact of TriCare/managed care on total force readiness by identifying, through themes, meta-themes, and a representative model, the negative effect that economics is having on active duty and reserve force health and well-being.

The Impact of E-Learning on Adherence to Guidelines for Acute Gastroenteritis: A Single-Arm Intervention Study.

PubMed

Nicastro, Emanuele; Lo Vecchio, Andrea; Liguoro, Ilaria; Chmielewska, Anna; De Bruyn, Caroline; Dolinsek, Jernej; Doroshina, Elena; Fessatou, Smaragdi; Pop, Tudor Lucian; Prell, Christine; Tabbers, Merit Monique; Tavares, Marta; Urenden-Elicin, Pinar; Bruzzese, Dario; Zakharova, Irina; Sandhu, Bhupinder; Guarino, Alfredo

2015-01-01

E-learning is a candidate tool for clinical practice guidelines (CPG) implementation due to its versatility, universal access and low costs. We aimed to assess the impact of a five-module e-learning course about CPG for acute gastroenteritis (AGE) on physicians' knowledge and clinical practice. This work was conceived as a pre/post single-arm intervention study. Physicians from 11 European countries registered for the online course. Personal data, pre- and post-course questionnaires and clinical data about 3 to 5 children with AGE managed by each physician before and after the course were collected. Primary outcome measures included the proportion of participants fully adherent to CPG and number of patients managed with full adherence. Among the 149 physicians who signed up for the e-learning course, 59 took the course and reported on their case management of 519 children <5 years of age who were referred to their practice because of AGE (281 and 264 children seen before and after the course, respectively). The course improved knowledge scores (pre-course 8.6 ± 2.7 versus post-course 12.8 ± 2.1, P < 0.001), average adherence (from 87.0 ± 7.7% to 90.6 ± 7.1%, P = 0.001) and the number of patients managed in full adherence with the guidelines (from 33.6 ± 31.7% to 43.9 ± 36.1%, P = 0.037). E-learning is effective in increasing knowledge and improving clinical practice in paediatric AGE and is an effective tool for implementing clinical practice guidelines.

Management of tinnitus in English NHS audiology departments: an evaluation of current practice

PubMed Central

Hoare, Derek J; Gander, Phillip E; Collins, Luke; Smith, Sandra; Hall, Deborah A

2012-01-01

Rationale, aim and objective In 2009, the UK Department of Health formalized recommended National Health Service practices for the management of tinnitus from primary care onwards. It is timely therefore to evaluate the perceived practicality, utility and impact of those guidelines in the context of current practice. Methods We surveyed current practice by posting a 36-item questionnaire to all audiology and hearing therapy staff that we were able to identify as being involved in tinnitus patient care in England. Results In total, 138 out of 351 clinicians responded (39% response rate). The findings indicate a consensus opinion that management should be tailored to individual symptom profiles but that there is little standardization of assessment procedures or tools in use. Conclusions While the lack of standardized practice might provide flexibility to meet local demand, it has drawbacks. It makes it difficult to ascertain key standards of best practice, it complicates the process of clinical audit, it implies unequal patient access to care, and it limits the implementation of translational research outcomes. We recommend that core elements of practice should be standardized, including use of a validated tinnitus questionnaires and an agreed pathway for decision making to better understand the rationale for management strategies offered. PMID:21087449

Food and Drug Administration upscheduling of hydrocodone and the effects on nurse practitioner pain management practices.

PubMed

Mack, Rachel

2018-06-01

In 2013, the Advisory Committee of the Food and Drug Administration determined hydrocodone combination medications (HCMs) needed tighter regulation due to high abuse potential; they recommended upscheduling HCMs from Schedule III to II. The purpose of this study was to examine the effect of upscheduling of HCMs on pain management practices of advanced practiced registered nurses (APRNs) in Oklahoma. In this qualitative study, 25 participants described their primary care experiences after the upscheduling. A thematic analysis was used to understand the effects on APRN pain management practices. The upscheduling of HCMs has greatly affected the pain management practices of APRNs in a state where Schedule II narcotic prescribing is forbidden. Findings will assist APRNs with improving patient access to care, implementing practice regulations, and exploring options for alternative pain therapies in primary care. Upscheduling of HCMs has had a severe impact on APRNs, affecting their prescribing practices and leading to increased referrals. They noted limited treatment options, increased health care costs, and decreased access to care. The APRNs understand the problem of prescription opioid abuse, diversion, and misuse. A consensus model could standardize the regulatory process for APRNs, increase interstate mobility for practice, and increase access to APRN care nationwide.

Rehabilitating slash pile burn scars in upper montane forests of the Colorado Front Range

Treesearch

Paula J. Fornwalt; Charles C. Rhoades

2011-01-01

Slash pile burning is widely conducted by land managers to dispose of unwanted woody fuels, yet this practice typically has undesirable ecological impacts. Simple rehabilitation treatments may be effective at ameliorating some of the negative impacts of pile burning on plants and soils. Here, we investigated: (1) the impacts of slash pile burning on soil nitrogen and...

Climbers' attitudes toward recreation resource impacts in the Adirondack Park

Treesearch

Christopher A. Monz; Katherine E. Smith; Leah Knickerbocker

2006-01-01

Climbers arriving at trailheads to popular climbing areas in Adirondack Park, NY were surveyed as to the types of resource impacts they found to be offensive. Climbers were also asked about their degree of concern regarding crowding, noise and management of climbing areas. Some resource impacts, such as damage to trees as a result of poor climbing practices, are...

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

Wood, Craig; Halpern, Jonathan; Wrons, Ralph

This Supplemental Information Source Document for Waste Management was prepared in support of future analyses including those that may be performed as part of the Sandia National Laboratories, New Mexico (SNL/NM) Site-Wide Environmental Impact Statement. This document presents information about waste management practices at SNL/NM, including definitions, inventory data, and an overview of current activities.

Applications of harvesting system simulation to timber management and utilization analyses

Treesearch

John E. Baumgras; Chris B. LeDoux

1990-01-01

Applications of timber harvesting system simulation to the economic analysis of forest management and wood utilization practices are presented. These applications include estimating thinning revenue by stand age, estimating impacts of minimum merchantable tree diameter on harvesting revenue, and evaluating wood utilization alternatives relative to pulpwood quotas and...

A Streamlined Monitoring Framework for Low Impact Development Stormwater Management Practices - Albuquerque

EPA Science Inventory

In many respects, the collection, of monitoring data has become standard "boilerplate" in grant proposals that fund non point source management projects. This approach typically calls for a full suite of parameters to be measured, even if the grant objectives are such that hydrol...

Do plant population and planting date make a difference in corn production?

USDA-ARS?s Scientific Manuscript database

One management practice that can positively or negatively impact corn yield is plant population. Yield potential can also be influenced by the date of planting, which is strongly linked to the at-planting and in-season weather and climatic conditions. Even when considering management changes, we nee...

Thiamethoxam seed treatments hav no impact on pest numbers or yield in cultivated sunflowers

USDA-ARS?s Scientific Manuscript database

The use of neonicotinoid seed treatments is a nearly ubiquitous practice in sunflower (Helianthus annuus) pest management. Sunflowers have a speciose pest complex, but also harbor a diverse and abundant community of beneficial, non-target organisms which may be negatively affected by pest management...

Financial Knowledge and Aptitudes: Impacts on College Students' Financial Well-Being

ERIC Educational Resources Information Center

Chan, S. Fiona; Chau, Albert Wai-Lap; Chan, Kim Yin-Kwan

2012-01-01

The study examines relationship between college students' money-related aptitudes, financial management practices and financial well-being. By integrating Kidwell, Brinberg and Turrisi's model of money management (2003) and other research on financial well-being, we surveyed 802 university students in Hong Kong. Our findings confirm the hypothesis…

A Comparative Study between U.S. and Brazilian Acquisition Regulations and Practices

DTIC Science & Technology

2011-03-01

to describe continuous improvements efforts ( Render and Heizer , 2008). Caddick and Dale (1998) on their paper ‘The impact of quality management on...2002). Outsourcing in Edinburgh and the Lothians. European Journal of Purchasing and Supply Chain Management 8 (2) 83-95. Render , Barry; Heizer , Jay

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

ERIC Educational Resources Information Center

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

2010-01-01

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

Organizational technologies of chronic disease management programs in large rural multispecialty group practice systems.

PubMed

Gamm, Larry; Bolin, Jane Nelson; Kash, Bita A

2005-01-01

Four large rural multispecialty group practice systems employ a mix of organizational technologies to provide chronic disease management with measurable impacts on their patient populations and costs. Four technologies-administrative, clinical, information, and social-are proposed as key dimensions for examining disease management programs. The benefits of disease management are recognized by these systems despite marked variability in the organization of the programs. Committees spanning health plans and clinics in the 4 systems and electronic medical records and/or other disease management information systems are important coordinating mechanisms. Increased reliance on nurses for patient education and care coordination in all 4 systems reflects significant extension of clinical and social technologies in the management of patient care. The promise of disease management as offered by these systems and other auspices are considered.

A new framework for modeling decentralized low impact developments using Soil and Water Assessment Tool

USDA-ARS?s Scientific Manuscript database

Assessing the performance of Low Impact Development (LID) practices at a catchment scale is important in managing urban watersheds. Few modeling tools exist that are capable of explicitly representing the hydrological mechanisms of LIDs while considering the diverse land uses of urban watersheds. ...

On Being More Accountable: The Push and Pull of Risk in School Leadership

ERIC Educational Resources Information Center

McWilliam, Erica; Perry, Lea-Anne

2006-01-01

This article addresses risk and its minimization as a powerful rationality for driving leadership practices in contemporary schools. It explores risk-consciousness as "a moral climate of politics" (Giddens 2002) and as a management imperative that impacts on any contemporary organization, including schools. The impact of…

Nitrogen source and application method impact on corn yield and nutrient uptake

USDA-ARS?s Scientific Manuscript database

Farmers are looking for better management practices to enhance production and reduce negative environmental impact from nitrogen (N) fertilizer application since N is one of the most important and costly nutrient inputs for crop production. In this field experiment pre-plant swine effluent applicati...

Modeling crop residue burning experiments and assessing the fire impacts on air quality

EPA Science Inventory

Prescribed burning is a common land management practice that results in ambient emissions of a variety of primary and secondary pollutants with negative health impacts. The community Multiscale Air Quality (CMAQ) model is used to conduct 2 km grid resolution simulations of prescr...

Impact of surface coal mining on soil hydraulic properties

Treesearch

X. Liu; J. Q. Wu; P. W. Conrad; S. Dun; C. S. Todd; R. L. McNearny; William Elliot; H. Rhee; P. Clark

2016-01-01

Soil erosion is strongly related to soil hydraulic properties. Understanding how surface coal mining affects these properties is therefore important in developing effective management practices to control erosion during reclamation. To determine the impact of mining activities on soil hydraulic properties, soils from undisturbed areas, areas of roughly graded mine...

Nursing as a scientific undertaking and the intersection with science in undergraduate studies: implications for nursing management.

PubMed

Logan, Patricia A; Angel, Lyndall

2011-04-01

To explore the science-nursing tension and impact for nursing students studying bioscience. Several studies have examined why nursing students struggle to be successful in bioscience subjects. Undeveloped science background and theory-practice gaps are noted as contributing factors. A qualitative study explored the science-nursing tension with 100 Australian Registered Nurses using focus groups and a survey. The survey response rate was 85 from 550. Of survey respondents, 88% viewed nursing as an applied science. An emphasis on procedural skills and task busyness undermines theoretical understanding of care and can be a negative influence upon the student bioscience experience. Practicum mentors confident in scientific knowledge enhance the student experience of bioscience by providing opportunities for integration with practice. Competing philosophies that reinforce the science-nursing tension have an impact upon student endeavours yet the nexus created by practice can be used to activate student curiosity and scientific understanding. Nurse managers need to structure the student practicum to encompass scientific theory applied to practice with equal emphasis on task efficiency. This improves student attitudes to learning bioscience and potentially minimizes the impact of the science-nursing tension on student learning. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

Are there financial savings associated with supplementing current diagnostic practice for preeclampsia with a novel test? Learnings from a modeling analysis from a German payer perspective.

PubMed

Hadker, Nandini; Garg, Suchita; Costanzo, Cory; van der Helm, Wim; Creeden, James

2013-05-01

To quantify the financial impact of adding a novel serum test to the current diagnostic toolkit for preeclampsia (PE) detection in Germany. A decision-analytic model was created to quantify the economic impact of adding a recently developed novel diagnostic test for PE (Roche Diagnostics, Rotkreuz, Switzerland) to current diagnostic practice in Germany. The model simulated a cohort of 1000 pregnant patients receiving obstetric care and quantified the budget impact of adding the novel test to current German PE detection and management practices. The model estimates that the costs associated with managing a typical pregnancy in Germany are €941 when the novel test is used versus €1579 with standard practice. This represents savings of €637 per pregnant woman, even when the test is used as a supplementary diagnostic tool. The savings are attributed to the novel test's ability to better classify patients relative to current practice, specifically, its ability to reduce false negatives by 67% and false positives by 71%. The novel PE test has the potential to provide substantial cost savings to German healthcare payers, even when used as an addition to standard practice. Better classification of patients at risk for developing PE and declassification of those that are not compared to current practice leads to economic savings for the healthcare system. Furthermore, by reducing the rates of false-positive and false-negative classification relative to current standard of care, the test helps better target healthcare spending and lowers overall costs associated with PE care.

A linear regression approach to evaluate the green supply chain management impact on industrial organizational performance.

PubMed

Mumtaz, Ubaidullah; Ali, Yousaf; Petrillo, Antonella

2018-05-15

The increase in the environmental pollution is one of the most important topic in today's world. In this context, the industrial activities can pose a significant threat to the environment. To manage problems associate to industrial activities several methods, techniques and approaches have been developed. Green supply chain management (GSCM) is considered one of the most important "environmental management approach". In developing countries such as Pakistan the implementation of GSCM practices is still in its initial stages. Lack of knowledge about its effects on economic performance is the reason because of industries fear to implement these practices. The aim of this research is to perceive the effects of GSCM practices on organizational performance in Pakistan. In this research the GSCM practices considered are: internal practices, external practices, investment recovery and eco-design. While, the performance parameters considered are: environmental pollution, operational cost and organizational flexibility. A set of hypothesis propose the effect of each GSCM practice on the performance parameters. Factor analysis and linear regression are used to analyze the survey data of Pakistani industries, in order to authenticate these hypotheses. The findings of this research indicate a decrease in environmental pollution and operational cost with the implementation of GSCM practices, whereas organizational flexibility has not improved for Pakistani industries. These results aim to help managers regarding their decision of implementing GSCM practices in the industrial sector of Pakistan. Copyright © 2017 Elsevier B.V. All rights reserved.

Outcomes of a Seven Practice Pilot in a Pay For Performance (P4P)-Based Program in Pennsylvania

PubMed Central

Johnson, Rhonda M.; Johnson, Twyla; Zimmerman, Sarah D.; Marsh, Gary M.; Garcia-Dominic, Oralia

2014-01-01

Objectives To examine how a targeted six-month interventions impacted Best Practice/Patient Outcomes for minority patients receiving primary care in physician practices participating in a pay-for-performance (P4P) program. Methods P4P Practices were invited to participate in a pilot intervention study designed to improve care for minority patients with hypertension, diabetes or pediatric asthma. Patient medical records were reviewed to assess how the interventions impacted (n=7 practices): Body mass index, diet and exercise, smoking, compliance with visits as recommended, blood pressure, sodium intake and weight management counseling, medication reconciliation, HbA1c testing, annual lipid profile, and anti-inflammatory medications. Results Significant improvements in various clinical quality measures were observed in all seven practices. Of the 19 specified interventions, 13 were statistically significant at α=0.05 level and 14 met the target proportion. This suggests that the best practice intervention had a significant impact on some of the health care processes in the physician practices. Conclusions The most impactful interventions were those related to face-to-face educational discussions, patient medical chart documentations rather than those pertaining to medication adherence. Improvements in measuring reporting and recording of data at post-intervention were also observed. PMID:25893158

Systematic review of the links between human resource management practices and performance.

PubMed

Patterson, M; Rick, J; Wood, S; Carroll, C; Balain, S; Booth, A

2010-10-01

In recent years human resource management (HRM) has been seen as an important factor in the successful realisation of organisational change programmes. The UK NHS is undergoing substantial organisational change and there is a need to establish which human resource (HR) initiatives may be most effective. To assess the results from a wide-ranging series of systematic reviews of the evidence on HRM and performance. The first part assesses evidence on use of HRM in the UK and fidelity of practice implemented. The second part considers evidence for the impact of HRM practices on intermediate outcomes, which can impact on final outcomes, such as organisational performance or patient care. The following databases were searched: Applied Social Sciences Index and Abstracts (ASSIA), British Nursing Index (BNI), Business Source Premier, Campbell Collaboration, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews (CDSR), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Database of Abstracts of Reviews of Effectiveness (DARE), DH-Data, EMBASE, Health Management Information Consortium (HMIC), International Bibliography of the Social Sciences (IBSS), King's Fund database, MEDLINE, NHS Economic Evaluation Database (NHS EED), National Research Register (NRR), PREMEDLINE, PsycINFO, ReFeR, Social Sciences Citation Index (SSCI) and Science Citation Index (SCI). The searches were conducted in May/June 2006. Broad categories of HRM interventions and intermediate outcomes were generated: 10 HRM categories and 12 intermediate outcome categories. Seven patient final outcomes were derived from the NHS Performance Indicators and the NHS Improvement Plan. The quality criteria used to select papers incorporated a longitudinal study design filter to provide evidence of the causal direction of relationships between HRM and relevant outcomes. Single HRM practices were considered. Within the health-specific literature, focus was on the impact of HRM on patient outcomes. Information is presented on the reliability of measures in each of the intermediate outcome areas. Work design practices that enhance employee autonomy and control influenced a number of outcomes and there was consistent evidence for the positive impact of increased job control on employee outcomes, such as job satisfaction, absence and health. For employee participation, the small number of studies reviewed supported the involvement of employees in design/implementation of changes that affect their work. In health literature in particular, employee involvement through quality improvement teams resulted in improved patient outcomes. Findings were positive for the impact of training on the intended outcomes of the initiatives. Support for the impact of performance management practices was apparent, in particular feedback on performance outcomes and the use of participative goal setting. Strong associations were found among all intermediate outcomes, and the relationship between most intermediate behaviours and outcomes were significant. Limited evidence was available on the use of HRM and on the implementation of policy. Also, the specific practices studied within each HRM category differ so there was little evidence to show whether similar practices have the same effects in health and non-health settings. Some potentially effective practices for both health and non-health areas were identified, and HRM methods could be used to support change processes within the NHS; the findings relating to work organisation are particularly promising with regard to changes in methods of service delivery. Using training to support the implementation of change is highlighted. However, future multilevel studies that embrace the individual, team and organisational level are needed. Studies should look into interventions aimed at improving HR outcomes and performance, and allow for pre- and post-intervention measurement of practices and outcomes.

On Management Matters: Why We Must Improve Public Health Management Through Action: Comment on "Management Matters: A Leverage Point for Health Systems Strengthening in Global Health".

PubMed

Willacy, Erika; Bratton, Shelly

2015-09-30

Public health management is a pillar of public health practice. Only through effective management can research, theory, and scientific innovation be translated into successful public health action. With this in mind, the U.S. Centers for Disease Control and Prevention (CDC) has developed an innovative program called Improving Public Health Management for Action (IMPACT) which aims to address this critical need by building an effective cadre of public health managers to work alongside scientists to prepare for and respond to disease threats and to effectively implement public health programs. IMPACT is a 2-year, experiential learning program that provides fellows with the management tools and opportunities to apply their new knowledge in the field, all while continuing to serve the Ministry of Health (MoH). IMPACT will launch in 2016 in 2 countries with the intent of expanding to additional countries in future years resulting in a well-trained cadre of public health managers around the world. © 2016 by Kerman University of Medical Sciences.

Effects of grassland management practices and environmental conditions on nutrient concentrations in overland flow

NASA Astrophysics Data System (ADS)

Kurz, Isabelle; Coxon, Catherine; Tunney, Hubert; Ryan, Declan

2005-03-01

The loss of nutrients from agricultural land to water bodies is a serious concern in river basin management in many countries. To gain information on the contributions of agricultural grassland to the eutrophication of water bodies, this study set out to assess phosphorus (P) loss from grassland areas on poorly drained soils. A second aim was to look at the impact of grassland management practices on nutrient concentrations in overland flow. Edge-of-field measurements of overland flow quantity and of P and nitrogen (N) concentrations in overland flow were carried out at three study sites with different soil P levels. The amounts of overland flow and the P concentrations in overland flow varied considerably during events, and among sites and events. Despite this variability, there was a clear increase in P loss in overland flow from the low to the medium and high soil P sites. The inter-site variability of the P concentrations in overland flow greatly exceeded the variability of the amounts of overland flow from the different sites. Thus, P concentrations had a larger impact than the volume of overland flow on the differences in P exports from the three sites. Management practices which, at times, influenced the P and N concentrations in overland flow were grazing and N fertilisation.

Determining and broadening the definition of impact from implementing a rational priority setting approach in a healthcare organization.

PubMed

Cornelissen, Evelyn; Mitton, Craig; Davidson, Alan; Reid, Colin; Hole, Rachelle; Visockas, Anne-Marie; Smith, Neale

2014-08-01

Techniques to manage scarce healthcare resources continue to evolve in response to changing, growing and competing demands. Yet there is no standard definition in the priority setting literature of what might constitute the desired impact or success of resource management activities. In this 2006-09 study, using action research methodology, we determined the impact of implementing a formal priority setting model, Program Budgeting and Marginal Analysis (PBMA), in a Canadian health authority. Qualitative data were collected through post year-1 (n = 12) and year-2 (n = 9) participant interviews, meeting observation and document review. Interviews were analyzed using a constant comparison technique to identify major themes. Impact can be defined as effects at three levels: system, group, and individual. System-level impact can be seen in the actual selection of priorities and resource re-allocation. In this case, participants prioritized a list of $760,000 worth of investment proposals and $38,000 of disinvestment proposals; however, there was no clear evidence as to whether financial resources were reallocated as a result. Group and individual impacts, less frequently reported in the literature, included changes in priority setting knowledge, attitudes and practice. PBMA impacts at these three levels were found to be interrelated. This work argues in favor of attempts to expand the definition of priority setting success by including both desired system-level outcomes like resource re-allocation and individual or group level impacts like changes to priority setting knowledge, attitudes and practice. These latter impacts are worth pursuing as they appear to be intrinsic to successful system-wide priority setting. A broader definition of PBMA impact may also suggest conceptualizing PBMA as both a priority setting approach and as a tool to develop individual and group priority setting knowledge and practice. These results should be of interest to researchers and decision makers using or considering a formal priority setting approach to manage scarce healthcare resources. Copyright © 2014 Elsevier Ltd. All rights reserved.

Digital technologies and chronic disease management.

PubMed

Georgeff, Michael

2014-12-01

Digital technologies will become a major part of our healthcare system, with particular impact in primary care. However, many healthcare professionals are not sufficiently informed of the digital technologies available today and how they and their patients can gain substantial benefit from adoption of these technologies. To raise awareness of the potential benefits of using digital technologies for improving practice efficiencies and patient health outcomes. Implementing best practice care for patients with chronic and complex conditions is one of the greatest challenges facing general practice and other primary care providers. It has been suggested that digital technologies could assist by decreasing the administrative burden of care delivery, improving quality of care, increasing practice efficiencies and better supporting patient self-management. In this paper, we consider some areas in the management of chronic and long-term conditions where digital and mobile health solutions can make a difference today.

Understanding influential factors on implementing green supply chain management practices: An interpretive structural modelling analysis.

PubMed

Agi, Maher A N; Nishant, Rohit

2017-03-01

In this study, we establish a set of 19 influential factors on the implementation of Green Supply Chain Management (GSCM) practices and analyse the interaction between these factors and their effect on the implementation of GSCM practices using the Interpretive Structural Modelling (ISM) method and the "Matrice d'Impacts Croisés Multiplication Appliquée à un Classement" (MICMAC) analysis on data compiled from interviews with supply chain (SC) executives based in the Gulf countries (Middle East region). The study reveals a strong influence and driving power of the nature of the relationships between SC partners on the implementation of GSCM practices. We especially found that dependence, trust, and durability of the relationship with SC partners have a very high influence. In addition, the size of the company, the top management commitment, the implementation of quality management and the employees training and education exert a critical influence on the implementation of GSCM practices. Contextual elements such as the industry sector and region and their effect on the prominence of specific factors are also highlighted through our study. Finally, implications for research and practice are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Modelling the effect of agricultural management practices on soil organic carbon stocks: does soil erosion matter?

NASA Astrophysics Data System (ADS)

Nadeu, Elisabet; Van Wesemael, Bas; Van Oost, Kristof

2014-05-01

Over the last decades, an increasing number of studies have been conducted to assess the effect of soil management practices on soil organic carbon (SOC) stocks. At regional scales, biogeochemical models such as CENTURY or Roth-C have been commonly applied. These models simulate SOC dynamics at the profile level (point basis) over long temporal scales but do not consider the continuous lateral transfer of sediment that takes place along geomorphic toposequences. As a consequence, the impact of soil redistribution on carbon fluxes is very seldom taken into account when evaluating changes in SOC stocks due to agricultural management practices on the short and long-term. To address this gap, we assessed the role of soil erosion by water and tillage on SOC stocks under different agricultural management practices in the Walloon region of Belgium. The SPEROS-C model was run for a 100-year period combining three typical crop rotations (using winter wheat, winter barley, sugar beet and maize) with three tillage scenarios (conventional tillage, reduced tillage and reduced tillage in combination with additional crop residues). The results showed that including soil erosion by water in the simulations led to a general decrease in SOC stocks relative to a baseline scenario (where no erosion took place). The SOC lost from these arable soils was mainly exported to adjacent sites and to the river system by lateral fluxes, with magnitudes differing between crop rotations and in all cases lower under conservation tillage practices than under conventional tillage. Although tillage erosion plays an important role in carbon redistribution within fields, lateral fluxes induced by water erosion led to a higher spatial and in-depth heterogeneity of SOC stocks with potential effects on the soil water holding capacity and crop yields. This indicates that studies assessing the effect of agricultural management practices on SOC stocks and other soil properties over the landscape should account for the impact of soil erosion (both by water and tillage).

Leading a change process to improve health service delivery.

PubMed Central

Bahamon, Claire; Dwyer, Joseph; Buxbaum, Ann

2006-01-01

In the fields of health and development, donors channel multiple resources into the design of new practices and technologies, as well as small-scale programmes to test them. But successful practices are rarely scaled up to the level where they beneficially impact large, impoverished populations. An effective process for change is to use the experiences of new practices gained at the programme level for full-scale implementation. To make an impact, new practices need to be applied, and supported by management systems, at many organizational levels. At every level, potential implementers and likely beneficiaries must first recognize some characteristics that would benefit them in the new practices. An effective change process, led by a dedicated internal change agent, comprises several well-defined phases that successively broaden and institutionalize the use of new practices. PMID:16917654

The impact of electronic health record use on physician productivity.

PubMed

Adler-Milstein, Julia; Huckman, Robert S

2013-11-01

To examine the impact of the degree of electronic health record (EHR) use and delegation of EHR tasks on clinician productivity in ambulatory settings. We examined EHR use in primary care practices that implemented a web-based EHR from athenahealth (n = 42) over 3 years (695 practice-month observations). Practices were predominantly small and spread throughout the country. Data came from athenahealth practice management system and EHR task logs. We developed monthly measures of EHR use and delegation to support staff from task logs. Productivity was measured using work relative value units (RVUs). Using fixed effects models, we assessed the independent impacts on productivity of EHR use and delegation. We then explored the interaction between these 2 strategies and the role of practice size. Greater EHR use and greater delegation were independently associated with higher levels of productivity. An increase in EHR use of 1 standard deviation resulted in a 5.3% increase in RVUs per clinician workday; an increase in delegation of EHR tasks of 1 standard deviation resulted in an 11.0% increase in RVUs per clinician workday (P <.05 for both). Further, EHR use and delegation had a positive joint impact on productivity in large practices (coefficient, 0.058; P <.05), but a negative joint impact on productivity in small practices (coefficient, -0.142; P <.01). Clinicians in practices that increased EHR use and delegated EHR tasks were more productive, but practice size determined whether the 2 strategies were complements or substitutes.

Embattled and embittered or empowered and evolving: nurse practitioner attitudes toward managed care.

PubMed

Hayes, Eileen F

2007-03-01

To explore the attitudes of nurse practitioners (NPs) toward managed care and to identify the sources of negative attitudes and the factors that may ameliorate them. NPs, members of the Massachusetts Coalition of NPs, participated in in-depth interviews about the impact of managed care on their practice. The sources of NP negativity about managed care for many study participants lay in their not appreciating the importance of the business aspects of practice and the provider's role in controlling healthcare costs, reluctance to work with what they perceived as a rigid "system," and lack of support for them to navigate it. They felt pressured by productivity issues, time constraints, practice restrictions, and documentation demands associated with reimbursement. Those who sustained a more positive attitude were realistic about healthcare economics, were willing and able to negotiate the system, were creative and flexible, and felt empowered by knowledge of the business of practice. Some NPs, however, chose to work in practices where they did not feel as pressured as their counterparts in large, busy primary care practices. IMPLICATIONS FOR NP PRACTICE AND EDUCATION: Understanding experiences that have influenced NP attitudes regarding managed care may assist NP faculty to better prepare NP students for their future roles. NPs must be able to challenge, yet be part of, an evolving system that promotes cost-effective health care for everyone, which was what managed care originally was intended to do.

Best Management Practices for sediment control in a Mediterranean agricultural watershed

NASA Astrophysics Data System (ADS)

Abdelwahab, Ossama M. M.; Bingner, Ronald L.; Milillo, Fabio; Gentile, Francesco

2015-04-01

Soil erosion can lead to severe destruction of agricultural sustainability that affects not only productivity, but the entire ecosystem in the neighboring areas. Sediments transported together with the associated nutrients and chemicals can significantly impact downstream water bodies. Various conservation and management practices implemented individually or integrated together as a system can be used to reduce the negative impacts on agricultural watersheds from soil erosion. Hydrological models are useful tools for decision makers when selecting the most effective combination of management practices to reduce pollutant loads within a watershed system. The Annualized Agricultural Non-point Source (AnnAGNPS) pollutant loading management model can be used to analyze the effectiveness of diverse management and conservation practices that can control or reduce the impact of soil erosion processes and subsequent sediment loads in agricultural watersheds. A 506 km2 Mediterranean medium-size watershed (Carapelle) located in Apulia, Southern Italy was used as a case study to evaluate the model and best management practices (BMPs) for sediment load control. A monitoring station located at the Ordona bridge has been instrumented to continuously monitor stream flow and suspended sediment loads. The station has been equipped with an ultrasound stage meter and a stage recorder to monitor stream flow. An infrared optic probe was used to measure suspended sediment concentrations (Gentile et al., 2010 ). The model was calibrated and validated in the Carapelle watershed on an event basis (Bisantino et al., 2013), and the validated model was used to evaluate the effectiveness of BMPs on sediment reduction. Various management practices were investigated including evaluating the impact on sediment load of: (1) converting all cropland areas into forest and grass covered conditions; (2) converting the highest eroding cropland areas to forest or grass covered conditions; and (3) utilizing a crop rotation of wheat and forage crops (Abdelwahab et al., 2014). Further evaluations include scenarios with additional improvements in the input data, in particular better reflecting the management operations within model input parameters used to represent the current conditions applied in the watershed, and the study of the efficiency of the model in predicting runoff and sediment loads at a monthly and annual scale using un-calibrated parameters. The effect of riparian buffers as a natural trap that reduce runoff and increase the in-situ sediment deposition are also investigated. Acknowledgements This work is carried out in the framework of the Italian Research Project of Relevant Interest (PRIN2010-2011), prot. 20104ALME4, "National network for monitoring, modeling, and sustainable management of erosion processes in agricultural land and hilly-mountainous area" National Coordinator prof. Mario Lenzi (University of Padova). References Gentile F., Bisantino T., Corbino R., Milillo F., Romano G., Trisorio Liuzzi G. (2010) Monitoring and analysis of suspended sediment transport dynamics in the Carapelle torrent (southern Italy). Catena 80, 1-8, doi:10.1016/j.catena.2009.08.004. Bisantino T., Bingner R., Chouaib W., Gentile F., Trisorio Liuzzi G. (2013) Estimation of runoff, peak discharge and sediment load at the event scale in a medium-size Mediterranean watershed using the AnnAGNPS model. Land Degradation & Development, wileyonlinelibrary.com, doi: 10.1002/ldr.2213. Abdelwahab O.M.M., Bingner R.L., Milillo F., Gentile F. (2014) Effectiveness of alternative management scenarios on the sediment load in a Mediterranean agricultural watershed. Journal of Agricultural Engineering, vol. XLV:430, 125-136, doi: 10.4081/jae.2014.430.

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

PubMed

Pulsford, D; Duxbury, J

2006-10-01

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

Results of a survey to determine demographic and business management factors associated with size and growth rate of rural mixed-animal veterinary practices.

PubMed

Brusk, Amy M; White, Brad J; Goehl, Dan R; Dhuyvetter, Kevin C

2010-12-15

To determine potential associations between demographic and business management factors and practice size and growth rate in rural mixed-animal veterinary practices. Cross-sectional survey. 54 mixed-animal practitioners. A cross-sectional survey (96 questions) was electronically disseminated. Responses were collected, and outcomes (number of veterinarians [NV], growth in number of veterinarians [NVG], gross practice income [GPI], growth in gross practice income [GPIG], gross practice income per veterinarian [GPIV], and growth in gross practice income per veterinarian [GPIVG]) were calculated. Bivariate analyses were performed and multivariable models created to determine associations between survey responses and outcomes of interest. Survey respondents were from mixed-animal practices, and most (46/54 [85.2%]) practiced in small communities (< 25,000 people). Study practices had a median ± SD NV of 2.3 ± 1.9 veterinarians, median GPI of $704,547 ± 754,839, and median GPIV of $282,065 ± 182,344. Multivariable regression analysis revealed several factors related to practice size, including the number of associate veterinarians and veterinary technicians in the practice, service fee structure, and employment of a business manager. Typically, practices had positive mean growth in NVG (4.4%), GPIG (8.5%), and GPIVG (8.1%), but growth rate was highly variable among practices. Factors associated with growth rate included main species interest, frequency for adjusting prices, use of a marketing plan, service fee structure, and sending a client newsletter. Mixed-animal practices had a large range in size and growth rate. Economic indices were impacted by common business management practices.

Economic implications of cardiovascular disease management programs: moving beyond one-off experiments.

PubMed

Maru, Shoko; Byrnes, Joshua; Carrington, Melinda J; Stewart, Simon; Scuffham, Paul A

2015-01-01

Substantial variation in economic analyses of cardiovascular disease management programs hinders not only the proper assessment of cost-effectiveness but also the identification of heterogeneity of interest such as patient characteristics. The authors discuss the impact of reporting and methodological variation on the cost-effectiveness of cardiovascular disease management programs by introducing issues that could lead to different policy or clinical decisions, followed by the challenges associated with net intervention effects and generalizability. The authors conclude with practical suggestions to mitigate the identified issues. Improved transparency through standardized reporting practice is the first step to advance beyond one-off experiments (limited applicability outside the study itself). Transparent reporting is a prerequisite for rigorous cost-effectiveness analyses that provide unambiguous implications for practice: what type of program works for whom and how.

The influence of flexible management practices on the sharing of experiential knowledge in the workplace: a case study of food service helpers.

PubMed

Ledoux, Elise; Cloutier, Esther; Fournier, Pierre-Sébastien

2012-01-01

Previous studies have shown that the job knowledge and prudent knowledge of experienced workers constitute a wealth that needs to be shared in workplaces to promote worker integration, job retention and occupational health and safety. It appears, however, that certain management practices undermine this knowledge sharing process. This case study of food service helpers in institutional food service departments is part of a research project aimed at comparing the impact of different work organization methods on knowledge sharing in the workplace on the basis of case studies carried out in several organizations. The results of this case study reveal that by destabilizing and weakening the work teams, flexible management practices create an environment that is not conducive to experiential knowledge sharing.

Multi-site evaluation of APEX for crop and grazing land in the Heartland region of the US

USDA-ARS?s Scientific Manuscript database

The Agricultural and Policy Environmental Extender (APEX) is capable of estimating edge-of-field water, nutrient, and sediment transport and is used to assess the environmental impacts of management practices. Current practice is to fully calibrate the model for each site simulation, which requires ...

Soil nitrogen dynamics and leaching under conservation tillage in the Atlantic Coastal Plain, Georgia, USA

USDA-ARS?s Scientific Manuscript database

Conservation tillage (CsT) involves management that reduces soil erosion by maintaining crop residue cover on farm fields. Typically, both infiltration and soil organic matter increase over time with CsT practices. We compared the impact of a commonly used CsT practice, strip tillage (ST), to conven...

Differentiating impacts of land use changes from pasture management in a CEAP watershed using the SWAT model

USDA-ARS?s Scientific Manuscript database

Due to intensive farm practices, nonpoint-source (NPS) pollution has become one of the most challenging environmental problems in agricultural and mixed land use watersheds. Usually, various conservation practices are implemented in the watershed to control the NPS pollution problem. However, land u...

Can conservation tillage reduce N20 emissions on cropland transitioning to organic vegetable production?

USDA-ARS?s Scientific Manuscript database

Conservation soil management practices such as no-till (NT) and strip-till (ST) are effective ways to sequester carbon and increase soil organic matter in agricultural lands. However, the impact of these practices on other greenhouse gases (GHG) such as nitrous oxide (N2O) varies depending on soil ...

Reducing the Environmental Impact of Clinical Laboratories.

PubMed

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

2017-02-01

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

Review of Ecologically-Based Pest Management in California Vineyards

PubMed Central

Wilson, Houston

2017-01-01

Grape growers in California utilize a variety of biological, cultural, and chemical approaches for the management of insect and mite pests in vineyards. This combination of strategies falls within the integrated pest management (IPM) framework, which is considered to be the dominant pest management paradigm in vineyards. While the adoption of IPM has led to notable and significant reductions in the environmental impacts of grape production, some growers are becoming interested in the use of an explicitly non-pesticide approach to pest management that is broadly referred to as ecologically-based pest management (EBPM). Essentially a subset of IPM strategies, EBPM places strong emphasis on practices such as habitat management, natural enemy augmentation and conservation, and animal integration. Here, we summarize the range and known efficacy of EBPM practices utilized in California vineyards, followed by a discussion of research needs and future policy directions. EBPM should in no way be seen in opposition, or as an alternative to the IPM framework. Rather, the further development of more reliable EBPM practices could contribute to the robustness of IPM strategies available to grape growers. PMID:29019946

Review of Ecologically-Based Pest Management in California Vineyards.

PubMed

Wilson, Houston; Daane, Kent M

2017-10-11

Grape growers in California utilize a variety of biological, cultural, and chemical approaches for the management of insect and mite pests in vineyards. This combination of strategies falls within the integrated pest management (IPM) framework, which is considered to be the dominant pest management paradigm in vineyards. While the adoption of IPM has led to notable and significant reductions in the environmental impacts of grape production, some growers are becoming interested in the use of an explicitly non-pesticide approach to pest management that is broadly referred to as ecologically-based pest management (EBPM). Essentially a subset of IPM strategies, EBPM places strong emphasis on practices such as habitat management, natural enemy augmentation and conservation, and animal integration. Here, we summarize the range and known efficacy of EBPM practices utilized in California vineyards, followed by a discussion of research needs and future policy directions. EBPM should in no way be seen in opposition, or as an alternative to the IPM framework. Rather, the further development of more reliable EBPM practices could contribute to the robustness of IPM strategies available to grape growers.

Impact of fishing and stocking practices on Coregonid diversity

USGS Publications Warehouse

Anneville, Orlane; Lasne, Emilien; Guillard, Jean; Eckmann, Reiner; Stockwell, Jason D.; Gillet, Christian; Yule, Daniel

2015-01-01

Fish species diversity can be lost through interacting stressors including habitat loss, stocking and overfishing. Although a multitude of stressors have played a role in the global decline of coregonid (Coregonus spp.) diversity, a number of contemporary studies have identified habitat loss stemming from eutrophication as the primary cause. Unfortunately, reconstructing the role of fishing and stocking practices can be difficult, because these records are incomplete or appear only in hard-to-access historic grey literature. Based on an illustrative set of historic and contemporary studies, we describe how fisheries management practices may have contributed to coregonid diversity loss in European and North American lakes. We provide case studies examining how fishing and stocking may reduce coregonid diversity through demographic decline and introgressive hybridization. In some lakes, fisheries management practices may have led to a loss of coregonid diversity well before issues with habitat degradation manifested. Our review suggests that fish conservation policies could beneficially consider the relative importance of all stressors, including management practices, as potential drivers of diversity loss.

Principles of disease management in neonatology.

PubMed

Bowen, F W; Gwiazdowski, S

1998-06-01

This article emphasizes the emerging facets of disease-management practice that impact directly on establishing a measured care system that can produce the information needed to establish a continuous quality improvement program. The areas discussed are risk assessment, clinical management guidelines and carepaths, and the measurement of system output known as clinical outcomes. The remainder of the article details the aspects of risk assessment, guideline function, and outcome assessment, critical in a disease-managed measured care system.

Genetic discoveries and nursing implications for complex disease prevention and management.

PubMed

Frazier, Lorraine; Meininger, Janet; Halsey Lea, Dale; Boerwinkle, Eric

2004-01-01

The purpose of this article is to examine the management of patients with complex diseases, in light of recent genetic discoveries, and to explore how these genetic discoveries will impact nursing practice and nursing research. The nursing science processes discussed are not comprehensive of all nursing practice but, instead, are concentrated in areas where genetics will have the greatest influence. Advances in genetic science will revolutionize our approach to patients and to health care in the prevention, diagnosis, and treatment of disease, raising many issues for nursing research and practice. As the scope of genetics expands to encompass multifactorial disease processes, a continuing reexamination of the knowledge base is required for nursing practice, with incorporation of genetic knowledge into the repertoire of every nurse, and with advanced knowledge for nurses who select specialty roles in the genetics area. This article explores the impact of this revolution on nursing science and practice as well as the opportunities for nursing science and practice to participate fully in this revolution. Because of the high proportion of the population at risk for complex diseases and because nurses are occupied every day in the prevention, assessment, treatment, and therapeutic intervention of patients with such diseases in practice and research, there is great opportunity for nurses to improve health care through the application (nursing practice) and discovery (nursing research) of genetic knowledge.

Bending strength and stiffness of loblolly pine lumber from intensively managed stands located on the Georgia Lower Coastal Plain

Treesearch

Mark Alexander Butler; Joseph Dahlen; Richard F. Daniels; Thomas L. Eberhardt; Finto Antony

2016-01-01

Loblolly pine is increasingly grown on intensively managed plantation forests that yield excellent growth; however, lumber cut from these trees often contains a large percentage of juvenile wood which negatively impacts strength and stiffness. Because of changing forest management and mill practices the design values for visually graded southern pine were updated in...

Command Leadership DEOCS 4.1 Construct Validity Summary

DTIC Science & Technology

2017-08-01

One way in which senior leaders impact organizational performance is through the effective design and practice of management information systems...Lord and Maher, 1991). The management of knowledge and information with the organization is a critical role for leaders and, in particular, for leaders...effective management of knowledge and information through these means were linked with higher perceptions of leadership effectiveness, and was even linked to

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

PubMed Central

Dobke, Marek; Mackert, Gina A.

2017-01-01

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

A tool to measure whether business management capacity in general practice impacts on the quality of chronic illness care.

PubMed

Holton, Christine H; Proudfoot, Judith G; Jayasinghe, Upali W; Grimm, Jane; Bubner, Tanya K; Winstanley, Julie; Harris, Mark F; Beilby, Justin J

2010-11-01

Our aim was to develop a tool to identify specific features of the business and financial management of practices that facilitate better quality care for chronic illness in primary care. Domains of management were identified, resulting in the development of a structured interview tool that was administered in 97 primary care practices in Australia. Interview items were screened and subjected to factor analysis, subscales identified and the overall model fit determined. The instrument's validity was assessed against another measure of quality of care. Analysis provided a four-factor solution containing 21 items, which explained 42.5% of the variance in the total scores. The factors related to administrative processes, human resources, marketing analysis and business development. All scores increased significantly with practice size. The business development subscale and total score were higher for rural practices. There was a significant correlation between the business development subscale and quality of care. The indicators of business and financial management in the final tool appear to be useful predictors of the quality of care. The instrument may help inform policy regarding the structure of general practice and implementation of a systems approach to chronic illness care. It can provide information to practices about areas for further development.

Managers' use of nursing workforce planning and deployment technologies: protocol for a realist synthesis of implementation and impact.

PubMed

Burton, Christopher; Rycroft-Malone, Jo; Williams, Lynne; Davies, Siân; McBride, Anne; Hall, Beth; Rowlands, Anne-M; Jones, Adrian

2016-08-26

Nursing staffing levels in hospitals appear to be associated with improved patient outcomes. National guidance indicates that the triangulation of information from workforce planning and deployment technologies (WPTs; eg, the Safer Nursing Care Tool) and 'local knowledge' is important for managers to achieve appropriate staffing levels for better patient outcomes. Although WPTs provide managers with predictive information about future staffing requirements, ensuring patient safety and quality care also requires the consideration of information from other sources in real time. Yet little attention has been given to how to support managers to implement WPTs in practice. Given this lack of understanding, this evidence synthesis is designed to address the research question: managers' use of WPTs and their impacts on nurse staffing and patient care: what works, for whom, how and in what circumstances? To explain how WPTs may work and in what contexts, we will conduct a realist evidence synthesis through sourcing relevant evidence, and consulting with stakeholders about the impacts of WPTs on health and relevant public service fields. The review will be in 4 phases over 18 months. Phase 1: we will construct an initial theoretical framework that provides plausible explanations of what works about WPTs. Phase 2: evidence retrieval, review and synthesis guided by the theoretical framework; phase 3: testing and refining of programme theories, to determine their relevance; phase 4: formulating actionable recommendations about how WPTs should be implemented in clinical practice. Ethical approval has been gained from the study's institutional sponsors. Ethical review from the National Health Service (NHS) is not required; however research and development permissions will be obtained. Findings will be disseminated through stakeholder engagement and knowledge mobilisation activities. The synthesis will develop an explanatory programme theory of the implementation and impact of nursing WPTs, and practical guidance for nurse managers. CRD42016038132. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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

PubMed

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

2017-02-01

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

Modelling Management Practices in Viticulture while Considering Resource Limitations: The Dhivine Model

PubMed Central

Martin-Clouaire, Roger; Rellier, Jean-Pierre; Paré, Nakié; Voltz, Marc; Biarnès, Anne

2016-01-01

Many farming-system studies have investigated the design and evaluation of crop-management practices with respect to economic performance and reduction in environmental impacts. In contrast, little research has been devoted to analysing these practices in terms of matching the recurrent context-dependent demand for resources (labour in particular) with those available on the farm. This paper presents Dhivine, a simulation model of operational management of grape production at the vineyard scale. Particular attention focuses on representing a flexible plan, which organises activities temporally, the resources available to the vineyard manager and the process of scheduling and executing the activities. The model relies on a generic production-system ontology used in several agricultural production domains. The types of investigations that the model supports are briefly illustrated. The enhanced realism of the production-management situations simulated makes it possible to examine and understand properties of resource-constrained work-organisation strategies and possibilities for improving them. PMID:26990089

Career Decision-Making Self-Efficacy, Integration, and the Likelihood of Managerial Retention in Governmental Agencies

ERIC Educational Resources Information Center

Peterson, Shari

2009-01-01

Results based on responses from 679 managers in three governmental agencies confirmed that career-related organizational practices and relationships impacted their staying in the organization. Specifically, managers who scored higher in career decision-making self efficacy, a relatively new variable to the turnover literature, career integration,…

Climate Project Screening Tool

Treesearch

Forest Service U.S. Department of Agriculture

2011-01-01

Climate change poses a challenge for resource managers as they review current management practices. Adaptation is a critical means of addressing climate change in the near future because, due to inherent time lags in climate impacts, the effects of increased atmospheric greenhouse gases will be felt for decades even if effective mitigation begins now. To address the...

Stormwater Management Impacts on Urban Stream Water Quality and Quantity During and After Development in Clarksburg, MD

EPA Science Inventory

Urbanization and urban land use leads to degradation of local stream habitat generally termed as ‘urban stream syndrome.’ Best Management Practices (BMPs) are often used in an attempt to mitigate water quality and water quantity degradation in urban streams. Traditional developme...

Availability of Education and Training for Medical Specialists about the Impact of Dementia on Comorbid Disease Management

ERIC Educational Resources Information Center

Ibrahim, Joseph Elias; Davis, Marie-Claire

2013-01-01

Individuals with dementia carry an additional health burden of multiple comorbid conditions. Effectively assessing and treating these comorbid conditions requires the medical specialist to be aware of, understand, and manage the effects of dementia on their clinical subspecialty practice. This ecological study describes the dementia-related…

Impact of Crop Management Diagnostic Clinics on Advisors' Recommendations and Producer Practices

ERIC Educational Resources Information Center

Wortmann, Charles S.; Glewen, Keith L.; Williams, Susan N.

2011-01-01

Adoption resulting from University of Nebraska-Lincoln Crop Management Diagnostic Clinic (CMDC) field days was evaluated using an on-line survey. Respondents reported significant gains in skills because of CMDC, but the gains were similar across skill areas. Adoption was affected by compatibility with the cropping system, relative advantage,…

78 FR 25762 - Notice of Availability of the Final Trail Management Plan/Final Environmental Impact Statement...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-02

... DEPARTMENT OF THE INTERIOR National Park Service [NPS-MWR-CUVA-12176; PPMWMWROW2/PPMPSAS1Y.YP0000... Cuyahoga Valley National Park, Ohio AGENCY: National Park Service, Interior. ACTION: Notice of availability... design for new trails and trail facilities, and maintenance and best management practices. The Guidelines...

The Film as Visual Aided Learning Tool in Classroom Management Course

ERIC Educational Resources Information Center

Altinay Gazi, Zehra; Altinay Aksal, Fahriye

2011-01-01

This research aims to investigate the impact of the visual aided learning on pre-service teachers' co-construction of subject matter knowledge in teaching practice. The study revealed the examination of film as an active cognizing and learning tool in classroom management course within teacher education programme. Within the framework of action…

Effects of management, soil attributes and region on soil microbial communities in vineyards (Napa, California, USA)

USDA-ARS?s Scientific Manuscript database

Soil microorganisms play an important role in soil health. However, little is known about the relationship between soil microbial community composition and diversity and commercially significant aspects of soil health. The purpose of this study is to: (1) assess the impact of management practices on...

43 CFR 3809.5 - How does BLM define certain terms used in this subpart?

Code of Federal Regulations, 2011 CFR

2011-10-01

... (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINING CLAIMS... may determine that it is practical to avoid or eliminate particular impacts. Mining claim means any unpatented mining claim, millsite, or tunnel site located under the mining laws. The term also applies to...

43 CFR 3809.5 - How does BLM define certain terms used in this subpart?

Code of Federal Regulations, 2012 CFR

2012-10-01

... (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINING CLAIMS... may determine that it is practical to avoid or eliminate particular impacts. Mining claim means any unpatented mining claim, millsite, or tunnel site located under the mining laws. The term also applies to...

43 CFR 3809.5 - How does BLM define certain terms used in this subpart?

Code of Federal Regulations, 2013 CFR

2013-10-01

... (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINING CLAIMS... may determine that it is practical to avoid or eliminate particular impacts. Mining claim means any unpatented mining claim, millsite, or tunnel site located under the mining laws. The term also applies to...

43 CFR 3809.5 - How does BLM define certain terms used in this subpart?

Code of Federal Regulations, 2014 CFR

2014-10-01

... (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINING CLAIMS... may determine that it is practical to avoid or eliminate particular impacts. Mining claim means any unpatented mining claim, millsite, or tunnel site located under the mining laws. The term also applies to...

Improving the Resilience of Best Management Practices in a Changing Environment: Urban Stormwater Modeling Studies (Final Report)

EPA Science Inventory

The purpose of this report is to respond to EPA's identified need for an improved understanding of the potential impacts of changes in long term weather conditions on the occurrence and management of urban stormwater runoff. EPA conducted continuous simulation modeling of the hy...

Meta-analysis constrained by data: Recommendations to improve relevance of nutrient management research

USDA-ARS?s Scientific Manuscript database

Five research teams received funding through the North American 4R Research Fund to conduct meta-analyses of the air and water quality impacts of on-farm 4R nutrient management practices. In compiling or expanding databases for these analyses on environmental and crop production effects, researchers...

The Impact of Faculty Perceived Reconfigurability of Learning Management Systems on Effective Teaching Practices

ERIC Educational Resources Information Center

Wang, Jianfeng; Doll, William J.; Deng, Xiaodong; Park, Kihyun; Yang, Ma Ga

2013-01-01

This study explores whether learning management systems (LMSs) enable faculty course developers to use the reconfigurable characteristics of the software to implement the seven principles of effective teaching (Chickering & Gamson, 1987). If LMSs are to be considered pedagogically effective, these systems must help engage faculty in effective…

Timber management simulated field trip

Treesearch

Ronald M. Walters; Warren R. Bacon; Asa D. Twombly

1979-01-01

Timber Management techniques are changing the appearance of our nation's wildlands. Standard harvest practices often result in harsh visual impacts and public outcry. In some cases, subtle harvesting has been done, but without adequate thought as to what the visual result will be over time. Better visual results can be obtained by careful harvest design which...

Managing Annual Flood Risk and Reducing Socioeconomic Flood Impacts in Rural Arctic through Science-Community Collaborations

NASA Astrophysics Data System (ADS)

Kontar, Y. Y.

2016-12-01

Multiple Arctic riverine communities face flood risk every spring. Within hours floodwater and ice debris destroy entire communities, displacing hundreds of people. In FY 2015-2016 an international project entitled Reducing Spring Flood Impacts for Wellbeing of Communities of the North was successfully conducted with the goal to identify best practices in managing the risk and reducing the socioeconomic impacts of floods associated with spring river ice breakup. In this presentation, we will elaborate on socioeconomic impacts of breakup floods, including long-term evacuation of population, loss of means of livelihoods, and ecosystem resource loss. We will also compare and contrast spring flood risk management and reduction strategies and their effectiveness in Alaska and Sakha Republic (Siberia), Russia. The findings are based on surveys completed by the representatives of adverse populations in two flood-prone communities in Alaska and Sakha Republic, as well as a series of roundtable discussions and interviews between social and geoscientists, emergency managers, and community leaders.

50 CFR 600.133 - Scientific and Statistical Committee (SSC).

Code of Federal Regulations, 2010 CFR

2010-10-01

..., and achieving rebuilding targets, and reports on stock status and health, bycatch, habitat status, social and economic impacts of management measures, and sustainability of fishing practices. (c) Members...

Impact of an intervention programme on knowledge, attitude and practice of healthcare staff regarding pharmaceutical waste management, Gaza, Palestine.

PubMed

Tabash, M I; Hussein, R A; Mahmoud, A H; El-Borgy, M D; Abu-Hamad, B A

2016-09-01

To assess knowledge, attitude and practice (KAP) of healthcare staff regarding pharmaceutical waste management; and to determine the impact of an educational programme on the KAP survey items. Pre-post-test intervention study. The pre-intervention phase was performed using a sample of 530 out of 1500 healthcare workers. A predesigned interview questionnaire was used to assess KAP. Next, an educational programme was designed and offered to a subsample of 69 healthcare workers. KAP were re-assessed for the programme attendees using the same interview questionnaire, both immediately (post-test) and six months after the end of the programme (follow-up test). The parametric paired sample t-test was used to assess the difference between pre-test and follow-up test results. Poor knowledge and poor practice levels (scores 50%) detected in the pre-intervention phase were found to improve to satisfactory levels (scores ≥75%) in the follow-up phase. Attitude was found to be positive (score ≥75%) in all phases of the study. The educational programme led to a significant improvement in KAP of healthcare staff regarding pharmaceutical waste management (P<0.001). Copyright © 2016. Published by Elsevier Ltd.

Introducing Advanced Clinical Reasoning to an Adult Learning Disability Service

ERIC Educational Resources Information Center

Stansfield, Jois; Matthews, Alison

2014-01-01

The advanced clinical reasoning approach is widely adopted in speech and language therapy practice. This article reports on the introduction of the approach across a multidisciplinary adult learning disability service and staff reports on the impact of this initiative. Staff and team managers reported that the training had a positive impact on…

Biosphere and atmosphere interactions in Sierra Nevada forests

Treesearch

Allen H. Goldstein

2004-01-01

In the Sierra Nevada, studies are being conducted to assess the impacts of both anthropogenic and biogenic hydrocarbon emissions on regional tropospheric ozone and fine aerosol production. Impacts of ozone deposition and management practices on ecosystem health are also being studied. Human-induced changes in regional air quality have consequences for Sierra Nevada...

Assessing and Predicting the Effectiveness of Stormwater BMPs on Water Quality, Flow, Thermal Regime, and Substrate Integrity in the Delaware River Basin

EPA Science Inventory

Assessments of the effectiveness of stormwater best management practices (BMPs) have focused on measurement of load or concentration reductions, which can be translated to predict biological impacts based on chemical water quality criteria. However, many of the impacts of develo...

Concepts about forests and water

Treesearch

Gordon W. Stuart; Pamela J. Edwards

2006-01-01

Six concepts concerning forests, forestry, and water resources are discussed: (1) the role of the forest canopy in erosion control; (2) the impact of disturbance on soils; (3) the variability of natural water quality; (4) the impact of harvesting on water quality;( 5) the role of extreme experiments; and (6) the effectiveness of forestry best management practices (BMP...

Impact of Adolescents' Filial Self-Efficacy on Quality of Family Functioning and Satisfaction

ERIC Educational Resources Information Center

Caprara, Gian Vittorio; Pastorelli, Concetta; Regalia, Camillo; Scabini, Eugenia; Bandura, Albert

2005-01-01

In this prospective study, we tested a structural model in which adolescents' perceived self-efficacy to manage parental relationships affected their satisfaction with family life both directly, and indirectly, through its impact on family practices. Findings based on 380 Italian adolescents showed that perceived filial self-efficacy was linked…

TVET Reform in Chongqing: Big Steps on a Long March

ERIC Educational Resources Information Center

Comyn, Paul; Barnaart, Antoine

2010-01-01

The introduction of outcomes-based vocational education in schools can have significant impact on the management and delivery of education and training. These impacts are not limited to classroom practice, and extend to the fields of policy and system coordination. This article reports on the results of a major trial of outcomes-oriented…

To Be or Not to Be (Stressed): The Critical Role of a Psychologically Healthy Workplace in Effective Stress Management.

PubMed

Grawitch, Matthew J; Ballard, David W; Erb, Kaitlyn R

2015-10-01

This article explains how key practices pertaining to the psychologically healthy workplace can be used to develop a comprehensive approach to stress management in contemporary organizations. Specifically, we demonstrate the ways in which employee involvement, recognition, work-life balance, health and safety, and growth and development practices can be used to assist in the reduction of work stress and the proactive management of strain. Although many organizations strive to establish a positive environment conducive to work and well-being, identifying where to begin can often seem like a daunting task. Currently, many stress management efforts emphasize individual-level interventions that are simply implemented alongside existing organizational practices. We propose that a broader perspective allows for a better understanding of the stress process, resulting in the ability to consider a wider range of changes to organizational processes. Combining knowledge regarding psychologically healthy workplace practices, stress management intervention levels and the personal resource allocation framework, we present a comprehensive framework for approaching workplace stress management, which can be tailored to the unique needs of various organizations, departments and employees. By adopting this broader perspective, we believe organizations can more strategically address employee stress, resulting in more effective stress management and a profound impact on stress-related outcomes. Copyright © 2014 John Wiley & Sons, Ltd.

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

PubMed

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

2013-05-21

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

Anthropogenic Reorganization of Critical Zone in Intensively Managed Landscapes

NASA Astrophysics Data System (ADS)

Kumar, P.; Anders, A. M.; Bettis, E. A., III; Blair, N. E.; Filley, T. R.; Grimley, D. A.; Le, P. V.; Lin, H.; Lin, Y. F. F.; Keefer, D. A.; Keefer, L. L.; Muste, M.; Packman, A. I.; Papanicolaou, T.; Rhoads, B. L.; Richardson, M.; Schnoebelen, D. J.; Stumpf, A.; Ward, A. S.; Wilson, C. G.; Woo, D.; Yan, Q.; Goodwell, A. E.

2016-12-01

Intensification of industrial agricultural practices has resulted in some of the most profound global impacts in the Anthropocene. These include eutrophication of lakes, rivers, and oceans from nutrient loading, degradation of arable land from the loss of fertile organic soils through erosion, and loss and degradation of soil organic matter from mechanical impacts on the soil, among others. As we prepare to feed additional 2 billion people by 2050 along with the emerging practices of farming for bioenergy production, these practices will intensify further whose goal is to overcome bio-geo-physical rate limitations and rate limiting states to enhance agricultural productivity. These rate-enhancing efforts generally target the fast response production processes, creating an imbalance with the slower assimilative processes in the Critical Zone that cascade through complex inter-dependencies across carbon, soil, water, nutrient and ecological systems. These imbalances modify stores and create gradients for flux, which over time reorganize the landscape, both in structure and function. In this presentation we show how these reorganizations are occurring in the Critical Zone of intensively managed landscapes, and argue that an integrated understanding of such profound changes are necessary for developing sustainable solutions for maintaining agricultural productivity and mitigating agriculture based environmental impacts.

COLLABORATE©: a universal competency-based paradigm for professional case management, part i: introduction, historical validation, and competency presentation.

PubMed

Treiger, Teresa M; Fink-Samnick, Ellen

2013-01-01

The purpose of this first of a three-article series is to provide context and justification for a new paradigm of case management built upon a value-driven foundation that Applicable to all health care sectors where case management is practiced. In moving forward, the one fact that rings true is there will be constant change in our industry. As the health care terrain shifts and new influences continually surface, there will be consequences for case management practice. These impacts require nimble clinical professionals in possession of recognized and firmly established competencies. They must be agile to frame (and reframe) their professional practice to facilitate the best possible outcomes for their patients. Case managers can choose to be Gumby or Pokey. This is exactly why the definition of a competency-based case management model's time has come, one sufficiently fluid to fit into any setting of care. The practice of case management transcends the vast array of representative professional disciplines and educational levels. A majority of current models are driven by business priorities rather than by the competencies critical to successful practice and quality patient outcomes. This results in a fragmented professional case management identity. While there is inherent value in what each discipline brings to the table, this advanced model unifies behind case management's unique, strengths-based identity instead of continuing to align within traditional divisions (e.g., discipline, work setting, population served). This model fosters case management's expanding career advancement opportunities, including a reflective clinical ladder.

Ungulate management in national parks of the United States and Canada

USGS Publications Warehouse

Demarais, S.; Cornicelli, L.; Kahn, R.; Merrill, E.; Miller, C.; Peek, J.M.; Porter, W.F.; Sargeant, G.A.

2012-01-01

Enabling legislation—that which gives appropriate officials the authority to implement or enforce the law—impacts management of ungulates in national parks of Canada and the United States (U.S.). The initial focus of such legislation in both countries centered on preserving natural and culturally significant areas for posterity. Although this objective remains primary, philosophies and practices have changed. A Canadian vision for ungulate management emerged during the latter half of the 20th century to protect and maintain or restore the ecological integrity of representative samples of the country’s 39 distinct landscapes, and to include provisions for traditional hunting and fishing practices representative of past cultural impacts on the environment. The current ungulate management approach in the U.S. relies on natural (ecological) processes, as long as normal conditions are promoted and there is no impairment of natural resources. Emphasizing natural processes as the basis has been a challenge because ecosystem dynamics are complex and management is multi-jurisdictional. Additionally, natural regulation typically will not prevent ungulates from reaching and sustaining densities that are incompatible with preservation or restoration of native flora and fauna, natural processes, or historical landscapes.

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

PubMed

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

2014-09-01

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

Enhanced solid waste management by understanding the effects of gender, income, marital status, and religious convictions on attitudes and practices related to street littering in Nablus - Palestinian territory

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

Al-Khatib, Issam A.; Arafat, Hassan A.; Daoud, Raeda

Litter is recognized as a form of street pollution and a key issue for solid waste managers. Nablus district (West Bank, Palestinian Territory), which has an established network of urban and rural roads, suffers from a wide-spread litter problem that is associated with these roads and is growing steadily with a well-felt negative impact on public health and the environment. The purpose of this research was to study the effects of four socio-economic characteristics (gender, income, marital status, and religious convictions) of district residents on their attitudes, practices, and behavior regarding street litter generation and to suggest possible remedial actions.more » All four characteristics were found to have strong correlations, not only with littering behavior and practices, but also with potential litter prevention strategies. In particular, the impact of religious convictions of the respondents on their littering habits and attitudes was very clear and interesting to observe.« less

Enhanced solid waste management by understanding the effects of gender, income, marital status, and religious convictions on attitudes and practices related to street littering in Nablus - Palestinian territory.

PubMed

Al-Khatib, Issam A; Arafat, Hassan A; Daoud, Raeda; Shwahneh, Hadeel

2009-01-01

Litter is recognized as a form of street pollution and a key issue for solid waste managers. Nablus district (West Bank, Palestinian Territory), which has an established network of urban and rural roads, suffers from a wide-spread litter problem that is associated with these roads and is growing steadily with a well-felt negative impact on public health and the environment. The purpose of this research was to study the effects of four socio-economic characteristics (gender, income, marital status, and religious convictions) of district residents on their attitudes, practices, and behavior regarding street litter generation and to suggest possible remedial actions. All four characteristics were found to have strong correlations, not only with littering behavior and practices, but also with potential litter prevention strategies. In particular, the impact of religious convictions of the respondents on their littering habits and attitudes was very clear and interesting to observe.

Analysis on LID for highly urbanized areas' waterlogging control: demonstrated on the example of Caohejing in Shanghai.

PubMed

Liao, Z L; He, Y; Huang, F; Wang, S; Li, H Z

2013-01-01

Although a commonly applied measure across the United States and Europe for alleviating the negative impacts of urbanization on the hydrological cycle, low impact development (LID) has not been widely used in highly urbanized areas, especially in rapidly urbanizing cities in developing countries like China. In this paper, given five LID practices including Bio-Retention, Infiltration Trench, Porous Pavement, Rain Barrels, and Green Swale, an analysis on LID for highly urbanized areas' waterlogging control is demonstrated using the example of Caohejing in Shanghai, China. Design storm events and storm water management models are employed to simulate the total waterlogging volume reduction, peak flow rate reduction and runoff coefficient reduction of different scenarios. Cost-effectiveness is calculated for the five practices. The aftermath shows that LID practices can have significant effects on storm water management in a highly urbanized area, and the comparative results reveal that Rain Barrels and Infiltration Trench are the two most suitable cost-effective measures for the study area.

The Productive Ward program™: a longitudinal multilevel study of nurse perceived practice environment, burnout, and nurse-reported quality of care and job outcomes.

PubMed

Van Bogaert, Peter; Van heusden, Danny; Somers, Annemie; Tegenbos, Muriel; Wouters, Kristien; Van der Straeten, Johnny; Van Aken, Paul; Havens, Donna Sullivan

2014-09-01

The objective of this study was to investigate the impact of The Productive Ward-Releasing Time to Care™ program implemented in a hospital transformation process on nurse perception related to practice environment, burnout, quality of care, and job outcomes. To address the continuously evolving complex challenges of patient care, high-performance nursing care is necessary. A longitudinal survey design was used to conduct a study in a 600-bed acute care university hospital with 3 measurement periods: T0: base line in 2006, T1 in 2011, and T2 in 2013. As part of the hospital transformation process, the productive ward program was introduced between T1 and T2. Relevant impact on nurse-physician relations, nurse management, hospital management-organizational support, nurse-reported quality of care, and job outcomes were identified. Hospital strategies and policies should be aligned with daily practices so that engaged and committed staff can promote excellent outcomes.

Examining the contradiction in 'sustainable urban growth': an example of groundwater sustainability

USGS Publications Warehouse

Zellner, Moira L.; Reeves, Howard W.

2012-01-01

The environmental planning literature proposes a set of 'best management practices' for urban development that assumes improvement in environmental quality as a result of specific urban patterns. These best management practices, however, often do not recognise finite biophysical limits and social impacts that urban patterns alone cannot overcome. To shed light on this debate, we explore the effects of different degrees of urban clustering on groundwater levels using a coupled land-use change and groundwater-flow model. Our simulations show that specific urban forms only slow down the impact on groundwater. As population increases, the pattern in which it is accommodated ceases to matter, and widespread depletion ensues. These results are predictable, yet current planning practice tends to take growth for granted and is reluctant to envision either no-growth scenarios or the prospect of depletion. We propose to use simulations such as those presented here to aid in policy discussions that allow decision makers to question the assumption of sustainable growth and suggest alternative forms of development.

Emerging geomorphic approaches to guide river management practices

NASA Astrophysics Data System (ADS)

Brierley, Gary; Hooke, Janet

2015-12-01

Humans have been modifying river systems across much of the world for many thousands of years. Initially, piecemeal impacts inadvertently affected particular parts of landscapes. Subsequently, many rivers have been subjected to multiple layers of human disturbance, and changes have become widespread and systematic. Increasingly, human impacts reflect deliberative actions as part of river management programmes. These activities entail significant choices in determining the desirable (or acceptable) state and behavioural regime of a river. Typically, contemporary decision-making reflects negotiations among multiple stakeholders, seeking to provide balanced approaches to the management of socio-economic, cultural, and environmental values (e.g. Jähnig et al., 2011).

Juggling confidentiality and safety: a qualitative study of how general practice clinicians document domestic violence in families with children.

PubMed

Drinkwater, Jessica; Stanley, Nicky; Szilassy, Eszter; Larkins, Cath; Hester, Marianne; Feder, Gene

2017-06-01

Domestic violence and abuse (DVA) and child safeguarding are interlinked problems, impacting on all family members. Documenting in electronic patient records (EPRs) is an important part of managing these families. Current evidence and guidance, however, treats DVA and child safeguarding separately. This does not reflect the complexity clinicians face when documenting both issues in one family. To explore how and why general practice clinicians document DVA in families with children. A qualitative interview study using vignettes with GPs and practice nurses (PNs) in England. Semi-structured telephone interviews with 54 clinicians (42 GPs and 12 PNs) were conducted across six sites in England. Data were analysed thematically using a coding frame incorporating concepts from the literature and emerging themes. Most clinicians recognised DVA and its impact on child safeguarding, but struggled to work out the best way to document it. They described tensions among the different roles of the EPR: a legal document; providing continuity of care; information sharing to improve safety; and a patient-owned record. This led to strategies to hide information, so that it was only available to other clinicians. Managing DVA in families with children is complex and challenging for general practice clinicians. National integrated guidance is urgently needed regarding how clinicians should manage the competing roles of the EPR, while maintaining safety of the whole family, especially in the context of online EPRs and patient access. © British Journal of General Practice 2017.

Stretching the managed care dollar in the new millennium: the practice of detailing primary care physicians.

PubMed

Hill, Cynthia D; Bunn, Douglas N; Hawkins, Jenny Rae

2002-01-01

Pharmaceutical expenditures in this country are on the rise and the increase is expected to continue at double-digit rates in the foreseeable future. This study focuses on the ways in which the managed care industry can impact pharmaceutical costs through peer-to-peer data sharing or academic detailing. Making use of analysis in conjunction with a major Midwestern Health Maintenance Organization, we evaluate the immediate impacts of academic detailing efforts, and find it to have a substantial mitigating impact on pharmaceutical trends. Moreover, we find academic detailing to be cost-effective means of altering physician-prescribing behavior.

Stormwater Calculator (SWC) webinar

EPA Pesticide Factsheets

Jason Berner presents EPA’s National Stormwater Calculator developed to help support local, state and national stormwater management objectives and regulatory efforts to reduce runoff using green infrastructure practices as low impact development controls.

78 FR 65963 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-04

... Branch seeks to collect data on distribution networks and business practices from fish processors that... analysis on the economic impacts of potential fishery management actions, consistent with the Magnuson...

The science of sustainable supply chains.

PubMed

O'Rourke, Dara

2014-06-06

Recent advances in the science and technology of global supply chain management offer near-real-time demand-response systems for decision-makers across production networks. Technology is helping propel "fast fashion" and "lean manufacturing," so that companies are better able to deliver products consumers want most. Yet companies know much less about the environmental and social impacts of their production networks. The failure to measure and manage these impacts can be explained in part by limitations in the science of sustainability measurement, as well as by weaknesses in systems to translate data into information that can be used by decision-makers inside corporations and government agencies. There also remain continued disincentives for firms to measure and pay the full costs of their supply chain impacts. I discuss the current state of monitoring, measuring, and analyzing information related to supply chain sustainability, as well as progress that has been made in translating this information into systems to advance more sustainable practices by corporations and consumers. Better data, decision-support tools, and incentives will be needed to move from simply managing supply chains for costs, compliance, and risk reduction to predicting and preventing unsustainable practices. Copyright © 2014, American Association for the Advancement of Science.

The Impact of E-Learning on Adherence to Guidelines for Acute Gastroenteritis: A Single-Arm Intervention Study

PubMed Central

Nicastro, Emanuele; Lo Vecchio, Andrea; Liguoro, Ilaria; Chmielewska, Anna; De Bruyn, Caroline; Dolinsek, Jernej; Doroshina, Elena; Fessatou, Smaragdi; Pop, Tudor Lucian; Prell, Christine; Tabbers, Merit Monique; Tavares, Marta; Urenden-Elicin, Pinar; Bruzzese, Dario; Zakharova, Irina; Sandhu, Bhupinder; Guarino, Alfredo

2015-01-01

Objective E-learning is a candidate tool for clinical practice guidelines (CPG) implementation due to its versatility, universal access and low costs. We aimed to assess the impact of a five-module e-learning course about CPG for acute gastroenteritis (AGE) on physicians’ knowledge and clinical practice. Study design This work was conceived as a pre/post single-arm intervention study. Physicians from 11 European countries registered for the online course. Personal data, pre- and post-course questionnaires and clinical data about 3 to 5 children with AGE managed by each physician before and after the course were collected. Primary outcome measures included the proportion of participants fully adherent to CPG and number of patients managed with full adherence. Results Among the 149 physicians who signed up for the e-learning course, 59 took the course and reported on their case management of 519 children <5 years of age who were referred to their practice because of AGE (281 and 264 children seen before and after the course, respectively). The course improved knowledge scores (pre-course 8.6 ± 2.7 versus post-course 12.8 ± 2.1, P < 0.001), average adherence (from 87.0 ± 7.7% to 90.6 ± 7.1%, P = 0.001) and the number of patients managed in full adherence with the guidelines (from 33.6 ± 31.7% to 43.9 ± 36.1%, P = 0.037). Conclusions E-learning is effective in increasing knowledge and improving clinical practice in paediatric AGE and is an effective tool for implementing clinical practice guidelines. PMID:26148301

Integrated soil fertility management in sub-Saharan Africa: unravelling local adaptation

NASA Astrophysics Data System (ADS)

Vanlauwe, B.; Descheemaeker, K.; Giller, K. E.; Huising, J.; Merckx, R.; Nziguheba, G.; Wendt, J.; Zingore, S.

2014-12-01

Intensification of smallholder agriculture in sub-Saharan Africa is necessary to address rural poverty and natural resource degradation. Integrated Soil Fertility Management (ISFM) is a means to enhance crop productivity while maximizing the agronomic efficiency (AE) of applied inputs, and can thus contribute to sustainable intensification. ISFM consists of a set of best practices, preferably used in combination, including the use of appropriate germplasm, the appropriate use of fertilizer and of organic resources, and good agronomic practices. The large variability in soil fertility conditions within smallholder farms is also recognised within ISFM, including soils with constraints beyond those addressed by fertilizer and organic inputs. The variable biophysical environments that characterize smallholder farming systems have profound effects on crop productivity and AE and targeted application of limited agro-inputs and management practices is necessary to enhance AE. Further, management decisions depend on the farmer's resource endowments and production objectives. In this paper we discuss the "local adaptation" component of ISFM and how this can be conceptualized within an ISFM framework, backstopped by analysis of AE at plot and farm level. At plot level, a set of four constraints to maximum AE is discussed in relation to "local adaptation": soil acidity, secondary nutrient and micro-nutrient (SMN) deficiencies, physical constraints, and drought stress. In each of these cases, examples are presented whereby amendments and/or practices addressing these have a significantly positive impact on fertilizer AE, including mechanistic principles underlying these effects. While the impact of such amendments and/or practices is easily understood for some practices (e.g., the application of SMNs where these are limiting), for others, more complex interactions with fertilizer AE can be identified (e.g., water harvesting under varying rainfall conditions). At farm scale, adjusting fertilizer applications within-farm soil fertility gradients has the potential to increase AE compared with blanket recommendations, in particular where fertility gradients are strong. In the final section, "local adaption" is discussed in relation to scale issues and decision support tools are evaluated as a means to create a better understanding of complexity at farm level and to communicate best scenarios for allocating agro-inputs and management practices within heterogeneous farming environments.

Integrated soil fertility management in sub-Saharan Africa: unravelling local adaptation

NASA Astrophysics Data System (ADS)

Vanlauwe, B.; Descheemaeker, K.; Giller, K. E.; Huising, J.; Merckx, R.; Nziguheba, G.; Wendt, J.; Zingore, S.

2015-06-01

Intensification of smallholder agriculture in sub-Saharan Africa is necessary to address rural poverty and natural resource degradation. Integrated soil fertility management (ISFM) is a means to enhance crop productivity while maximizing the agronomic efficiency (AE) of applied inputs, and can thus contribute to sustainable intensification. ISFM consists of a set of best practices, preferably used in combination, including the use of appropriate germplasm, the appropriate use of fertilizer and of organic resources, and good agronomic practices. The large variability in soil fertility conditions within smallholder farms is also recognized within ISFM, including soils with constraints beyond those addressed by fertilizer and organic inputs. The variable biophysical environments that characterize smallholder farming systems have profound effects on crop productivity and AE, and targeted application of agro-inputs and management practices is necessary to enhance AE. Further, management decisions depend on the farmer's resource endowments and production objectives. In this paper we discuss the "local adaptation" component of ISFM and how this can be conceptualized within an ISFM framework, backstopped by analysis of AE at plot and farm level. At plot level, a set of four constraints to maximum AE is discussed in relation to "local adaptation": soil acidity, secondary nutrient and micronutrient (SMN) deficiencies, physical constraints, and drought stress. In each of these cases, examples are presented whereby amendments and/or practices addressing these have a significantly positive impact on fertilizer AE, including mechanistic principles underlying these effects. While the impact of such amendments and/or practices is easily understood for some practices (e.g. the application of SMNs where these are limiting), for others, more complex processes influence AE (e.g. water harvesting under varying rainfall conditions). At farm scale, adjusting fertilizer applications to within-farm soil fertility gradients has the potential to increase AE compared with blanket recommendations, in particular where fertility gradients are strong. In the final section, "local adaption" is discussed in relation to scale issues and decision support tools are evaluated as a means to create a better understanding of complexity at farm level and to communicate appropriate scenarios for allocating agro-inputs and management practices within heterogeneous farming environments.

Aviation security cargo inspection queuing simulation model for material flow and accountability

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

Olama, Mohammed M; Allgood, Glenn O; Rose, Terri A

Beginning in 2010, the U.S. will require that all cargo loaded in passenger aircraft be inspected. This will require more efficient processing of cargo and will have a significant impact on the inspection protocols and business practices of government agencies and the airlines. In this paper, we develop an aviation security cargo inspection queuing simulation model for material flow and accountability that will allow cargo managers to conduct impact studies of current and proposed business practices as they relate to inspection procedures, material flow, and accountability.

Primary care in an era of hospital bed reduction: what can we infer from QOF and PBC?

PubMed

Checkland, Kath; Harrison, Stephen

2010-12-01

The Quality and Outcomes Framework (QOF) has been efficiently and effectively incorporated into practice routines. One possible negative effect of this has been a move towards a more biomedical form of practice.There has been patchy but real engagement with practice-based commissioning (PBC), with significant moves in some areas towards GPs acting collectively to improve services across the health economy, including engaging in performance management of each others' practice.Together, responses to QOF and PBC suggest that GPs may be willing and able to act both individually and collectively to try to mitigate the negative impacts of future spending reductions. General practice will be under a great deal of pressure in the next few years. Understanding the impact of past policy changes is essential if we are to ensure that the core values of general practice are maintained.

Practice guidelines need to address the 'how' and the 'what' of implementation.

PubMed

McKillop, Ann; Crisp, Jackie; Walsh, Kenneth

2012-01-01

The aim of this study was to explore the realities of everyday nursing practice associated with the implementation of a guideline for the assessment and management of cardiovascular risk. The use of clinical practice guidelines is pivotal to improving health outcomes. However, the implementation of guidelines into practice is complex, unpredictable and, in spite of much investigation, remains resistant to explanation of what works and why. Exploration of the nature of guideline implementation has the potential to illuminate the complexities of guideline implementation by focussing on the nature of practice. Nurses are well placed at the front line of primary health care to contribute to an understanding of how guideline implementation plays out in their everyday practice. Qualitative description was used, involving focus groups and interviews with 32 participants (20 nurses, four doctors, five managers and three funder/planners), to explore the use of a guideline in everyday primary health-care practice. Thematic analysis of data was managed through an inductive process of familiarisation, coding, categorising and generation of themes. Four themes were generated from the data portraying the realities of guideline implementation for primary health-care nurses: self-managing patient, everyday nursing practice, developing new relationships in the health team and impact on health-care delivery. The findings reveal that, even with the best of intentions to implement the guideline, health professionals were frustrated and at a loss as to how to achieve that in practice. Consequently, cardiovascular risk assessment and management was uneven and fragmented. Primary health-care practice environments vary so much that solutions to the difficulties of implementing evidence into practice requires context-specific solution-finding through collaborative teamwork. Furthermore, the attention of guideline developers, health-care policymakers, funders and researchers requires direct focus on the 'how' and the 'what' of evidence implementation.

Medication management and practices in prison for people with mental health problems: a qualitative study.

PubMed

Bowen, Robert A; Rogers, Anne; Shaw, Jennifer

2009-10-20

Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS). Medication management is a key aspect of treatment for patients with a mental health problem. The medication practices of patients and staff are therefore a key marker of the extent to which the health practices in prison settings equate with those of the NHS. The research reported here considers the influences on medication management during the early stages of custody and the impact it has on prisoners. The study employed a qualitative design incorporating semi-structured interviews with 39 prisoners and 71 staff at 4 prisons. Participant observation was carried out in key internal prison locations relevant to the management of vulnerable prisoners to support and inform the interview process. Thematic analysis of the interview data and interpretation of the observational field-notes were undertaken manually. Emergent themes included the impact that delays, changes to or the removal of medication have on prisoners on entry to prison, and the reasons that such events take place. Inmates accounts suggested that psychotropic medication was found a key and valued form of support for people with mental health problems entering custody. Existing regimes of medication and the autonomy to self-medicate established in the community are disrupted and curtailed by the dominant practices and prison routines for the taking of prescribed medication. The continuity of mental health care is undermined by the removal or alteration of existing medication practice and changes on entry to prison which exacerbate prisoners' anxiety and sense of helplessness. Prisoners with a dual diagnosis are likely to be doubly vulnerable because of inconsistencies in substance withdrawal management. Changes to medication management which accompany entry to prison appear to contribute to poor relationships with prison health staff, disrupts established self-medication practices, discourages patients from taking greater responsibility for their own conditions and detrimentally affects the mental health of many prisoners at a time when they are most vulnerable. Such practices are likely to inhibit the integration and normalisation of mental health management protocols in prison as compared with those operating in the wider community and may hinder progress towards improving the standard of mental health care available to prisoners suffering from mental disorder.

Physical space and its impact on waste management in the neonatal care setting

PubMed Central

Manzi, Sean

2014-01-01

This paper reports an investigation intended to obtain some understanding of how the working environment might influence the practice and knowledge of those involved in the management of healthcare waste. The National Health Service (NHS) has a continuing waste problem, and the way it manages waste harms the environment and consumes resources. It has been estimated that the carbon footprint of the NHS in England is approximately 20 million tons of CO2e. It has been suggested that better waste segregation could lead to more effective recycling, saving up to 42,000 tonnes of CO2. This qualitative study employed non-participant observation and semi-structured interviews. The interviews were carried out with the key informants within the participating neonatal intensive care unit. Findings from this study indicate that space and the physical arrangement of the environment are significant and influential factors in clinical practice. Where the clinical environment is not supportive, poor infection control and waste management practice is likely to occur. However, proximity of staff caused by a lack of physical space might facilitate situated learning and a collective development of knowledge in practice. The implementation of sustainable waste management practices would be more likely to succeed in an environment that facilitates correct waste segregation. PMID:28989373

Sedimentation of prairie wetlands

USGS Publications Warehouse

Gleason, Robert A.; Euliss, Ned H.

1998-01-01

Many wetlands in the prairie pothole region are embedded within an agricultural landscape where they are subject to varying degrees of siltation. Cultivation of wetland catchment areas has exacerbated soil erosion; wetlands in agricultural fields receive more sediment from upland areas than wetlands in grassland landscapes and hence are subject to premature filling (i.e., they have shorter topographic lives). Associated impacts from increased turbidity, sediment deposition, and increased surface water input likely have impaired natural wetland functions. Although trapping of sediments by wetlands is often cited as a water quality benefit, sediment input from agricultural fields has potential to completely fill wetlands and shorten their effective life-span. Thus, the value placed on wetlands to trap sediments is in conflict with maximizing the effective topographic life of wetlands. Herein, we provide an overview of sedimentation, identify associated impacts on wetlands, and suggest remedial management strategies. We also highlight the need to evaluate the impact of agricultural practices on wetland functions from an interdisciplinary approach to facilitate development of best management practices that benefit both wetland and agricultural interests.

Implementing the NICE osteoarthritis guidelines: a mixed methods study and cluster randomised trial of a model osteoarthritis consultation in primary care--the Management of OsteoArthritis In Consultations (MOSAICS) study protocol.

PubMed

Dziedzic, Krysia S; Healey, Emma L; Porcheret, Mark; Ong, Bie Nio; Main, Chris J; Jordan, Kelvin P; Lewis, Martyn; Edwards, John J; Jinks, Clare; Morden, Andrew; McHugh, Gretl A; Ryan, Sarah; Finney, Andrew; Jowett, Sue; Oppong, Raymond; Afolabi, Ebenezer; Pushpa-Rajah, Angela; Handy, June; Clarkson, Kris; Mason, Elizabeth; Whitehurst, Tracy; Hughes, Rhian W; Croft, Peter R; Hay, Elaine M

2014-08-27

There is as yet no evidence on the feasibility of implementing recommendations from the National Institute of Health and Care Excellence (NICE) osteoarthritis (OA) guidelines in primary care, or of the effect these recommendations have on the condition. The primary aim of this study is to determine the clinical and cost effectiveness of a model OA consultation (MOAC), implementing the core recommendations from the NICE OA guidelines in primary care. Secondary aims are to investigate the impact, feasibility and acceptability of the MOAC intervention; to develop and evaluate a training package for management of OA by general practitioners (GPs) and practice nurses; test the feasibility of deriving 'quality markers' of OA management using a new consultation template and medical record review; and describe the uptake of core NICE OA recommendations in participants aged 45 years and over with joint pain. A mixed methods study with a nested cluster randomised controlled trial. This study was developed according to a defined theoretical framework (the Whole System Informing Self-management Engagement). An overarching model (the Normalisation Process Theory) will be employed to undertake a comprehensive 'whole-system' evaluation of the processes and outcomes of implementing the MOAC intervention. The primary outcome is general physical health (Short Form-12 Physical component score [PCS]) (Ware 1996). The impact, acceptability and feasibility of the MOAC intervention at practice level will be assessed by comparing intervention and control practices using a Quality Indicators template and medical record review. Impact and acceptability of the intervention for patients will be assessed via self-completed outcome measures and semi-structured interviews. The impact, acceptability and feasibility of the MOAC intervention and training for GPs and practice nurses will be evaluated using a variety of methods including questionnaires, semi-structured interviews, and observations. The main output from the study will be to determine whether the MOAC intervention is clinically and cost effective. Additional outputs will be the development of the MOAC for patients consulting with joint pain in primary care, training and educational materials, and resources for patients and professionals regarding supported self-management and uptake of NICE guidance. ISRCTN number: ISRCTN06984617.

A stock-and-flow simulation model of the US blood supply.

PubMed

Simonetti, Arianna; Forshee, Richard A; Anderson, Steven A; Walderhaug, Mark

2014-03-01

Lack of reporting requirements for the amount of blood stored in blood banks and hospitals poses challenges to effectively monitor the US blood supply. Effective strategies to minimize collection and donation disruptions in the supply require an understanding of the daily amount of blood available in the system. A stock-and-flow simulation model of the US blood supply was developed to obtain estimates of the daily on-hand availability of blood, with uncertainty and by ABO/Rh type. The model simulated potential impact on supply of using different blood management practices for transfusion: first in-first out (FIFO), using the oldest stored red blood cell units first; non-FIFO likely oldest, preferentially selecting older blood; and non-FIFO likely newest, preferentially selecting younger blood. Simulation results showed higher estimates of the steady-state of the blood supply level for FIFO (1,630,000 units, 95% prediction interval [PI] 1,610,000-1,650,000) than non-FIFO scenarios (likely oldest, 1,530,000 units, 95% PI 1,500,000-1,550,000; and likely newest, 1,190,000 units, 95% PI 1,160,000-1,220,000), either for overall blood or by blood types. To our knowledge, this model represents a first attempt to evaluate the impact of different blood management practices on daily availability and distribution of blood in the US blood supply. The average storage time before blood is being issued was influenced by blood management practices, for preferences of blood that is younger and also that use specific blood types. The model also suggests which practice could best approximate the current blood management system and may serve as useful tool for blood management. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

Effect of farming practices for greenhouse gas mitigation and subsequent alternative land use on environmental impacts of beef cattle production systems.

PubMed

Nguyen, T T H; Doreau, M; Eugène, M; Corson, M S; Garcia-Launay, F; Chesneau, G; van der Werf, H M G

2013-05-01

This study evaluated effects of farming practice scenarios aiming to reduce greenhouse gas (GHG) emissions and subsequent alternative land use on environmental impacts of a beef cattle production system using the life cycle assessment approach. The baseline scenario includes a standard cow-calf herd with finishing heifers based on grazing, and a standard bull-fattening herd using a diet mainly based on maize silage, corresponding to current farm characteristics and management by beef farmers in France. Alternative scenarios were developed with changes in farming practices. Some scenarios modified grassland management (S1: decreasing mineral N fertiliser on permanent grassland; S2: decreasing grass losses during grazing) or herd management (S3: underfeeding of heifers in winter; S4: fattening female calves instead of being reared at a moderate growth rate; S5: increasing longevity of cows from 7 to 9 years; S6: advancing first calving age from 3 to 2 years). Other scenarios replaced protein sources (S7: partially replacing a protein supplement by lucerne hay for the cow-calf herd; S8: replacing soya bean meal with rapeseed meal for the fattening herd) or increased n-3 fatty acid content using extruded linseed (S9). The combination of compatible scenarios S1, S2, S5, S6 and S8 was also studied (S10). The impacts, such as climate change (CC, not including CO2 emissions/sequestration of land use and land-use change, LULUC), CC/LULUC (including CO2 emissions of LULUC), cumulative energy demand, eutrophication (EP), acidification and land occupation (LO) were expressed per kg of carcass mass and per ha of land occupied. Compared with the baseline, the most promising practice to reduce impacts per kg carcass mass was S10 (all reduced by 13% to 28%), followed by S6 (by 8% to 10%). For other scenarios, impact reduction did not exceed 5%, except for EP (up to 11%) and LO (up to 10%). Effects of changes in farming practices (the scenarios) on environmental impacts varied according to impact category and functional unit. For some scenarios (S2, S4, S6 and S10), permanent grassland area and LO per kg of carcass decreased by 12% to 23% and 9% to 19%, respectively. If the 'excess' permanent grassland was converted to fast-growing conifer forest to sequester carbon in tree and soil biomass, CC/LULUC per kg of carcass could be reduced by 20%, 25%, 27% and 48% for scenarios S2, S4, S6 and S10, respectively. These results illustrate the potential of farming practices and forest as an alternative land use to contribute to short- and mid-term GHG mitigation of beef cattle production systems.

Projecting the bird community response resulting from the adoption of shelterbelt agroforestry practices in Eastern Nebraska

Treesearch

R. A., II Pierce; D. T. Farrand; W. B. Kurtz

2001-01-01

Evolving agricultural policies have influenced management practices within agroecosystems, impacting available habitats for many species of wildlife. Enhancing wildlife habitat has become an explicit objective of existing agricultural policy. Thus, there is renewed focus on field borders and the use of shelterbelt agroforestry systems to achieve conservation goals in...

School Staffing and Performance Management in Newark Public Schools. Executive Summary

ERIC Educational Resources Information Center

New Teacher Project, 2009

2009-01-01

In the winter and spring of 2009, The New Teacher Project (TNTP) partnered with Newark Public Schools (NPS) to investigate the impact of the school district's policies and practices on the ability of schools to build and maintain strong instructional teams. TNTP's analysis of policy and practice in NPS, funded by The Prudential Foundation, reveals…

THE NEGRO AND EQUAL EMPLOYMENT OPPORTUNITIES, A REVIEW OF MANAGEMENT EXPERIENCES IN TWENTY COMPANIES.

ERIC Educational Resources Information Center

FERMAN, LOUIS A.

TO STUDY THE APPLICATION OF EQUAL EMPLOYMENT PRACTICES IN COMPANY SETTINGS AND TO ASSESS THE IMPACT OF THESE PRACTICES ON MINORITY GROUP EMPLOYMENT, 20 COMPANIES WITH VARYING EMPLOYMENT STRUCTURE, INDUSTRY, SIZE, NUMBER OF BRANCH UNITS, GEOGRAPHICAL SPREAD, AND PRODUCT OR SERVICE WERE STUDIED. ALL WERE TRYING TO PROMOTE EQUAL OPPORTUNITIES IN…

Adapting to climate change in United States national forests

Treesearch

G. M. Blate; L. A. Joyce; J. S. Littell; S. G. McNulty; C. I. Millar; S. C. Moser; R. P. Neilson; K. O’Halloran; D. L. Peterson

2009-01-01

Climate change is already affecting forests and other ecosystems, and additional, potentially more severe impacts are expected (IPCC, 2007; CCSP, 2008a, 2008b). As a result, forest managers are seeking practical guidance on how to adapt their current practices and, if necessary, their goals. Adaptations of forest ecosystems, which in this context refer to adjustments...

Neuroanatomy Education: The Impact on Perceptions, Attitudes, and Knowledge of an Intensive Course on General Practice Residents

ERIC Educational Resources Information Center

Arantes, Mavilde; Barbosa, Joselina Maria; Ferreira, Maria Amélia

2017-01-01

General practitioners are responsible for the management of an increasing number of patients with neurological illness, and thus a solid education in neurosciences is a necessary component of their training. This study examines the effects of an intensive clinical neuroanatomy course on twenty general practice residents' perceptions, attitudes,…

Attitudes of Canadian dairy farmers toward a voluntary Johne's disease control program.

PubMed

Sorge, U; Kelton, D; Lissemore, K; Godkin, A; Hendrick, S; Wells, S

2010-04-01

The success of Johne's disease (JD) control programs based on risk assessment (RA) depends on producers' compliance with suggested management practices. One objective of this study was to describe the perception of participating Canadian dairy farmers of the impact of JD, the RA process, and suggested management strategies. The second objective was to describe the cost of changes in management practices following the RA. A telephone survey was conducted with 238 dairy farmers in Ontario, Manitoba, Saskatchewan, Alberta, and British Columbia. The producers agreed to participate in this follow-up study after they had been enrolled in an RA-based voluntary JD control program and had tested their herd with the JD milk ELISA test in 2005 to 2007. The majority of farms had no JD test-positive cows and, although some producers thought they had experienced the economic impact of JD, many did not see JD as a current problem for their herd. The majority of producers enrolled in this program because they were concerned that Mycobacterium avium ssp. paratuberculosis could be perceived by consumers as a cause for Crohn's disease in humans, which could lead to altered purchasing behavior of milk and milk products. Fifty-two farm-specific recommendations had been made after the initial RA. Although the producers generally liked the program and found the recommendations reasonable and feasible, on average only 2 of 6 suggestions made specifically to them were implemented. The recommendation with the highest compliance was culling of JD test-positive cows. The main reasons for noncompliance were that the dairy producer did not believe a change of management practices was necessary or the available barn setting or space did not allow the change. Producers were generally uncomfortable estimating time and monetary expenses for management changes, but found that several suggested management practices actually saved time and money. In addition, 39% of the producers that implemented at least 1 recommendation thought their calf and herd health had improved subsequently. This indicates that the communication of associated benefits needs to be improved to increase the compliance of producers with recommended management practices. Copyright (c) 2010 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

The drivers of sea lice management policies and how best to integrate them into a risk management strategy: An ecosystem approach to sea lice management.

PubMed

Jackson, D; Moberg, O; Stenevik Djupevåg, E M; Kane, F; Hareide, H

2018-06-01

The control of sea lice infestations on cultivated Atlantic salmon is a major issue in many regions of the world. The numerous drivers which shape the priorities and objectives of the control strategies vary for different regions/jurisdictions. These range from the animal welfare and economic priorities of the producers, to the mitigation of any potential impacts on wild stocks. Veterinary ethics, environmental impacts of therapeutants, and impacts for organic certification of the produce are, amongst others, additional sets of factors which should be considered. Current best practice in both EU and international environmental law advocates a holistic ecosystem approach to assessment of impacts and risks. The issues of biosecurity and ethics, including the impacts on the stocks of species used as cleaner fish, are areas for inclusion in such a holistic ecosystem assessment. The Drivers, Pressures, State, Impacts, Responses (DPSIR) process is examined as a decision-making framework and potential applications to sea lice management are outlined. It is argued that this is required to underpin any integrated sea lice management (ISLM) strategy to balance pressures and outcomes and ensure a holistic approach to managing the issue of sea lice infestations on farmed stock on a medium to long-term basis. © 2017 The Authors. Journal of Fish Diseases Published by John Wiley & Sons Ltd.

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

PubMed

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

2015-01-01

To study nurse managers' perceptions and experiences of staff nurse structural empowerment and its impact on the nurse manager leadership role and style. Nurse managers' leadership roles may be viewed as challenging given the complex needs of patients and staff nurses' involvement in both clinical and organizational decision-making processes in interdisciplinary care settings. Qualitative phenomenological study. Individual semi-structured interviews were conducted with 8 medical or surgical nurse managers in a 600-bed Belgian university hospital between December 2013 and June 2014. This hospital was undergoing conversion from a classical hierarchical, departmental structure to a flat, interdisciplinary model. Nurse managers were found to be familiar with the structural empowerment of clinical nurses in the hospital and to hold positive attitudes toward it. They confirmed the positive impact of empowerment on their staff nurses, as evidenced by increased responsibility, autonomy, critical reflection and enhanced communication skills that in turn improved the quality and safety of patient care. Structural empowerment was being supported by several change initiatives at both the unit and hospital levels. Nurse managers' experiences with these initiatives were mixed, however, because of the changing demands with regard to their manager role and leadership style. In addition, pressure was being experienced by both staff nurses and nurse managers as a result of direct patient care priorities, tightly scheduled projects and miscommunication. Nurse managers reported that structural empowerment was having a favorable impact on staff nurses' professional attitudes and the safety and quality of care in their units. However, they also reported that the empowerment process had led to changes in the managers' roles as well as daily practice dilemmas related to the leadership styles needed. Clear organizational goals and dedicated support for both clinical nurses and nursing unit managers are imperative to maintaining an empowering practice environment which can ensure the best care and healthy, engaged staff.

Sustainably connecting children with nature: an exploratory study of nature play area visitor impacts and their management

USGS Publications Warehouse

Browning, Matthew H.E.M.; Marion, Jeffrey L.; Gregoire, Timothy G.

2013-01-01

Parks are developing nature play areas to improve children's health and “connect” them with nature. However, these play areas are often located in protected natural areas where managers must balance recreation with associated environmental impacts. In this exploratory study, we sought to describe these impacts. We also investigated which ages, gender, and play group sizes most frequently caused impact and where impacts most frequently occur. We measured the lineal and aerial extent and severity of impacts at three play areas in the eastern United States. Methods included soil and vegetation loss calculations, qualitative searches and tree and shrub damage classifications. Additionally, we observed 12 h of play at five play areas. Results showed that measurable negative impacts were caused during 33% of the time children play. On average, 76% of groundcover vegetation was lost at recreation sites and 100% was lost at informal trails. In addition, approximately half of all trees and shrubs at sites were damaged. Meanwhile, soil exposure was 25% greater on sites and trails than at controls. Boys and small group sizes more frequently caused impact, and informal recreation sites were most commonly used for play. No statistically significant correlations were found between age or location and impact frequency. Managers interested in developing nature play areas should be aware of, but not deterred by these impacts. The societal benefits of unstructured play in nature may outweigh the environmental costs. Recommended management strategies include selecting impact-resistant sites, improving site resistance, promoting low impact practices, and managing adaptively.

Nest survival of American Coots relative to grazing, burning, and water depths

USGS Publications Warehouse

Austin, Jane E.; Buhl, Deborah A.

2011-01-01

Water and emergent vegetation are key features influencing nest site selection and success for many marsh-nesting waterbirds. Wetland management practices such as grazing, burning, and water-level manipulations directly affect these features and can influence nest survival. We used model selection and before-after-control-impact approaches to evaluate the effects of water depth and four common land-management practices or treatments, i.e., summer grazing, fall grazing, fall burning, and idle (no active treatment) on nest survival of American coots (Fulica americana) nesting at Grays Lake, a large montane wetland in southeast Idaho. The best model included the variables year × treatment, and quadratic functions of date, water depth, and nest age; height of vegetation at the nest did not improve the best model. However, results from the before-after-control-impact analysis indicate that management practices affected nest success via vegetation and involved interactions of hydrology, residual vegetation, and habitat composition. Nest success in idled fields changed little between pre- and post-treatment periods, whereas nest success declined in fields that were grazed or burned, with the most dramatic declines the year following treatments. The importance of water depth may be amplified in this wetland system because of rapid water-level withdrawal during the nesting season. Water and land-use values for area ranchers, management for nesting waterbirds, and long-term wetland function are important considerations in management of water levels and vegetation.

Assessing the impacts of tillage and fertilization management on nitrous oxide emissions in a cornfield using the DNDC model

NASA Astrophysics Data System (ADS)

Deng, Qi; Hui, Dafeng; Wang, Junming; Yu, Chih-Li; Li, Changsheng; Reddy, K. Chandra; Dennis, Sam

2016-02-01

Quantification and prediction of N2O emissions from croplands under different agricultural management practices are vital for sustainable agriculture and climate change mitigation. We simulated N2O emissions under tillage and no-tillage,and different nitrogen (N) fertilizer types and application methods (i.e., nitrification inhibitor, chicken manure, and split applications) in a cornfield using the DeNitrification-DeComposition (DNDC) model. The model was parameterized with field experimental data collected in Nashville, Tennessee, under various agricultural management treatments and run for a short term (3 years) and a long term (100 years). Results showed that the DNDC model could adequately simulate N2O emissions as well as soil properties under different agricultural management practices. The modeled emissions of N2O significantly increased by 35% with tillage, and decreased by 24% with the use of nitrification inhibitor, compared with no-tillage and normal N fertilization. Chicken manure amendment and split applications of N fertilizer had minor impact on N2O emission in a short term, but over a long term (100 years) the treatments significantly altered N2O emission (+35%, -10%, respectively). Sensitivity analysis showed that N2O emission was sensitive to mean annual precipitation, mean annual temperature, soil organic carbon, and the amount of total N fertilizer application. Our model results provide valuable information for determining agricultural best management practice to maintain highly productive corn yield while reducing greenhouse gas emissions.

Nonsurgical scar management of the face: does early versus late intervention affect outcome?

PubMed

Parry, Ingrid; Sen, Soman; Palmieri, Tina; Greenhalgh, David

2013-01-01

Special emphasis is placed on the clinical management of facial scarring because of the profound physical and psychological impact of facial burns. Noninvasive methods of facial scar management include pressure therapy, silicone, massage, and facial exercises. Early implementation of these scar management techniques after a burn injury is typically accepted as standard burn rehabilitation practice, however, little data exist to support this practice. This study evaluated the timing of common noninvasive scar management interventions after facial skin grafting in children and the impact on outcome, as measured by scar assessment and need for facial reconstructive surgery. A retrospective review of 138 patients who underwent excision and grafting of the face and subsequent noninvasive scar management during a 10-year time frame was conducted. Regression analyses were used to show that earlier application of silicone was significantly related to lower Modified Vancouver Scar Scale scores, specifically in the subscales of vascularity and pigmentation. Early use of pressure therapy and implementation of facial exercises were also related to lower Modified Vancouver Scar Scale vascularity scores. No relationship was found between timing of the interventions and facial reconstructive outcome. Early use of silicone, pressure therapy, and exercise may improve scar outcome and accelerate time to scar maturity.

The New Age of Bullying and Violence in Health Care: Part 3: Managing the Bullying Boss and Leadership.

PubMed

Fink-Samnick, Ellen

PRIMARY PRACTICE SETTING(S):: Applicable to all health care sections where case management is practiced. This article is the third of a 4-part series on the topic of bullying in the health care workplace. Part 3 addresses the dimensions of the bullying boss and leadership, posing major implications for patient safety plus the mental health of staff members. The complex constructs and dynamics broached by the bullying boss and department leadership are explored. These include the underlying forces at play such as power, gender, leadership styles, plus weaves in assessment models. Strategic and proactive management of bullying by leadership is vital to workforce retention and well-being. The increasing incidence and impact of bullying across all sectors have made it a major workforce performance management challenge. Health care settings are especially tense environments, often making it difficult for individuals to distinguish between bullying behavior and high expectations for staff. Bullying impacts both direct targets and bystanders who witness the assaultive behaviors, with ethical implications as well.Case management is poised to promote a safe health care workplace for patients and practitioners alike amid these intricate circumstances. Understanding types of bullying bosses and leadership styles is integral to a case manager's success in the workplace.

Community owned solutions for fire management in tropical ecosystems: case studies from Indigenous communities of South America

PubMed Central

2016-01-01

Fire plays an increasingly significant role in tropical forest and savanna ecosystems, contributing to greenhouse gas emissions and impacting on biodiversity. Emerging research shows the potential role of Indigenous land-use practices for controlling deforestation and reducing CO2 emissions. Analysis of satellite imagery suggests that Indigenous lands have the lowest incidence of wildfires, significantly contributing to maintaining carbon stocks and enhancing biodiversity. Yet acknowledgement of Indigenous peoples' role in fire management and control is limited, and in many cases dismissed, especially in policy-making circles. In this paper, we review existing data on Indigenous fire management and impact, focusing on examples from tropical forest and savanna ecosystems in Venezuela, Brazil and Guyana. We highlight how the complexities of community owned solutions for fire management are being lost as well as undermined by continued efforts on fire suppression and firefighting, and emerging approaches to incorporate Indigenous fire management into market- and incentive-based mechanisms for climate change mitigation. Our aim is to build a case for supporting Indigenous fire practices within all scales of decision-making by strengthening Indigenous knowledge systems to ensure more effective and sustainable fire management. This article is part of the themed issue ‘The interaction of fire and mankind’. PMID:27216507

Community owned solutions for fire management in tropical ecosystems: case studies from Indigenous communities of South America.

PubMed

Mistry, Jayalaxshmi; Bilbao, Bibiana A; Berardi, Andrea

2016-06-05

Fire plays an increasingly significant role in tropical forest and savanna ecosystems, contributing to greenhouse gas emissions and impacting on biodiversity. Emerging research shows the potential role of Indigenous land-use practices for controlling deforestation and reducing CO2 emissions. Analysis of satellite imagery suggests that Indigenous lands have the lowest incidence of wildfires, significantly contributing to maintaining carbon stocks and enhancing biodiversity. Yet acknowledgement of Indigenous peoples' role in fire management and control is limited, and in many cases dismissed, especially in policy-making circles. In this paper, we review existing data on Indigenous fire management and impact, focusing on examples from tropical forest and savanna ecosystems in Venezuela, Brazil and Guyana. We highlight how the complexities of community owned solutions for fire management are being lost as well as undermined by continued efforts on fire suppression and firefighting, and emerging approaches to incorporate Indigenous fire management into market- and incentive-based mechanisms for climate change mitigation. Our aim is to build a case for supporting Indigenous fire practices within all scales of decision-making by strengthening Indigenous knowledge systems to ensure more effective and sustainable fire management.This article is part of the themed issue 'The interaction of fire and mankind'. © 2016 The Author(s).

Impact of production practices on physicochemical properties of rice grain quality.

PubMed

Bryant, Rolfe J; Anders, Merle; McClung, Anna

2012-02-01

Rice growers are interested in new technologies that can reduce input costs while maintaining high field yields and grain quality. The bed-and-furrow (BF) water management system benefits farmers through decreased water usage, labor, and fuel as compared to standard flood management. Fertilizer inputs can be reduced by producing rice in rotation with soybeans, a nitrogen-fixing crop, and with the use of slow-release fertilizers that reduce nitrogen volatilization and run-off. However, the influence of these cultural management practices on rice physicochemical properties is unknown. Our objective was to evaluate the influence of nitrogen fertilizer source, water management system, and crop rotation on rice grain quality. Grain protein concentration was lower in a continuous rice production system than in a rice-soybean rotation. Neither amylose content nor gelatinization temperature was altered by fertilizer source, crop rotation, or water management. BF water management decreased peak and breakdown viscosities relative to a flooded system. Peak and final paste viscosities were decreased by all fertilizer sources, whereas, crop rotation had no influence on the Rapid Visco Analyser profile. Sustainable production systems that decrease water use and utilize crop rotations and slow-release fertilizers have no major impact on rice physicochemical properties. Published 2011 by John Wiley & Sons, Ltd.

Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice.

PubMed

Slemon, Allie; Jenkins, Emily; Bungay, Vicky

2017-10-01

The discourse of safety has informed the care of individuals with mental illness through institutionalization and into modern psychiatric nursing practices. Confinement arose from safety: out of both societal stigma and fear for public safety, as well as benevolently paternalistic aims to protect individuals from self-harm. In this paper, we argue that within current psychiatric inpatient environments, safety is maintained as the predominant value, and risk management is the cornerstone of nursing care. Practices that accord with this value are legitimized and perpetuated through the safety discourse, despite evidence refuting their efficacy, and patient perspectives demonstrating harm. To illustrate this growing concern in mental health nursing care, we provide four exemplars of risk management strategies utilized in psychiatric inpatient settings: close observations, seclusion, door locking and defensive nursing practice. The use of these strategies demonstrates the necessity to shift perspectives on safety and risk in nursing care. We suggest that to re-centre meaningful support and treatment of clients, nurses should provide individualized, flexible care that incorporates safety measures while also fundamentally re-evaluating the risk management culture that gives rise to and legitimizes harmful practices. © 2017 The Authors Nursing Inquiry published by John Wiley & Sons Ltd.

The evolution of behavior guidance: a history of professional, practice, corporate and societal influences.

PubMed

Strange, David M

2014-01-01

Behavior guidance in pediatric dentistry is a composite of influences including expert opinion, historical precedent, scientific studies, and social factors including the law and the media. The early icons of pediatric dentistry injected their personal views on child management, and those often reflected the child-rearing norms of the times. The business of pediatric dentistry with its efficiency and quality orientations also shaped approaches to behavior management. Scientific studies contributed minimally. A major influence on behavior guidelines in recent years has been external scrutiny of techniques prompted by media and other exposure of both private practice and corporate management of children. Changing parenting and reaction of society to authority have also had significant impact on behavior. This paper describes in more detail the evolution of behavior guidance and the subsequent codification of practices into professionally derived guidelines.

Adaptive social impact management for conservation and environmental management.

PubMed

Kaplan-Hallam, Maery; Bennett, Nathan J

2018-04-01

Concerns about the social consequences of conservation have spurred increased attention the monitoring and evaluation of the social impacts of conservation projects. This has resulted in a growing body of research that demonstrates how conservation can produce both positive and negative social, economic, cultural, health, and governance consequences for local communities. Yet, the results of social monitoring efforts are seldom applied to adaptively manage conservation projects. Greater attention is needed to incorporating the results of social impact assessments in long-term conservation management to minimize negative social consequences and maximize social benefits. We bring together insights from social impact assessment, adaptive management, social learning, knowledge coproduction, cross-scale governance, and environmental planning to propose a definition and framework for adaptive social impact management (ASIM). We define ASIM as the cyclical process of monitoring and adaptively managing social impacts over the life-span of an initiative through the 4 stages of profiling, learning, planning, and implementing. We outline 14 steps associated with the 4 stages of the ASIM cycle and provide guidance and potential methods for social-indicator development, predictive assessments of social impacts, monitoring and evaluation, communication of results, and identification and prioritization of management responses. Successful ASIM will be aided by engaging with best practices - including local engagement and collaboration in the process, transparent communication of results to stakeholders, collective deliberation on and choice of interventions, documentation of shared learning at the site level, and the scaling up of insights to inform higher-level conservation policies-to increase accountability, trust, and perceived legitimacy among stakeholders. The ASIM process is broadly applicable to conservation, environmental management, and development initiatives at various scales and in different contexts. © 2017 Society for Conservation Biology.

Influence of gender on office staff management in orthodontics.

PubMed

Holmes, Patrick B; Shroff, Bhavna; Best, Al M; Lindauer, Steven J

2010-11-01

To examine the gender differences in managing practice and staff members in orthodontic practices. All orthodontists in Virginia and Maryland (n = 427) were surveyed and demographic information was collected. For the crude analyses of the data, a Fisher's exact test or chi(2) test was performed. For the adjusted analyses, genders were compared using a logistic regression or analysis of covariance. The covariates were adjusted for age, program length, years in practice, number of years since graduation, and practice state. The length of the residency program attended did not differ with gender. No gender differences in practice ownership or creating the practice were observed. There was a significant gender difference in implementation of performance reviews: female orthodontists were more likely to provide performance reviews and tended to accept more poor reviews before staff termination than male orthodontists. However, when provided, no gender difference was observed in the number of performance reviews. Gender has a significant impact on the implementation of performance reviews in practices. Practice ownership status was not influenced by providers' gender.

Liming impacts on soils, crops and biodiversity in the UK: A review.

PubMed

Holland, J E; Bennett, A E; Newton, A C; White, P J; McKenzie, B M; George, T S; Pakeman, R J; Bailey, J S; Fornara, D A; Hayes, R C

2018-01-01

Fertile soil is fundamental to our ability to achieve food security, but problems with soil degradation (such as acidification) are exacerbated by poor management. Consequently, there is a need to better understand management approaches that deliver multiple ecosystem services from agricultural land. There is global interest in sustainable soil management including the re-evaluation of existing management practices. Liming is a long established practice to ameliorate acidic soils and many liming-induced changes are well understood. For instance, short-term liming impacts are detected on soil biota and in soil biological processes (such as in N cycling where liming can increase N availability for plant uptake). The impacts of liming on soil carbon storage are variable and strongly relate to soil type, land use, climate and multiple management factors. Liming influences all elements in soils and as such there are numerous simultaneous changes to soil processes which in turn affect the plant nutrient uptake; two examples of positive impact for crops are increased P availability and decreased uptake of toxic heavy metals. Soil physical conditions are at least maintained or improved by liming, but the time taken to detect change varies significantly. Arable crops differ in their sensitivity to soil pH and for most crops there is a positive yield response. Liming also introduces implications for the development of different crop diseases and liming management is adjusted according to crop type within a given rotation. Repeated lime applications tend to improve grassland biomass production, although grassland response is variable and indirect as it relates to changes in nutrient availability. Other indicators of liming response in grassland are detected in mineral content and herbage quality which have implications for livestock-based production systems. Ecological studies have shown positive impacts of liming on biodiversity; such as increased earthworm abundance that provides habitat for wading birds in upland grasslands. Finally, understanding of liming impacts on soil and crop processes are explored together with functional aspects (in terms of ecosystems services) in a new qualitative framework that includes consideration of how liming impacts change with time. This holistic approach provides insights into the far-reaching impacts that liming has on ecosystems and the potential for liming to enhance the multiple benefits from agriculturally managed land. Recommendations are given for future research on the impact of liming and the implications for ecosystem services. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

The impact of municipal solid waste management on greenhouse gas emissions in the United States.

PubMed

Weitz, Keith A; Thorneloe, Susan A; Nishtala, Subba R; Yarkosky, Sherry; Zannes, Maria

2002-09-01

Technological advancements, environmental regulations, and emphasis on resource conservation and recovery have greatly reduced the environmental impacts of municipal solid waste (MSW) management, including emissions of greenhouse gases (GHGs). This study was conducted using a life-cycle methodology to track changes in GHG emissions during the past 25 years from the management of MSW in the United States. For the baseline year of 1974, MSW management consisted of limited recycling, combustion without energy recovery, and landfilling without gas collection or control. This was compared with data for 1980, 1990, and 1997, accounting for changes in MSW quantity, composition, management practices, and technology. Over time, the United States has moved toward increased recycling, composting, combustion (with energy recovery) and landfilling with gas recovery, control, and utilization. These changes were accounted for with historical data on MSW composition, quantities, management practices, and technological changes. Included in the analysis were the benefits of materials recycling and energy recovery to the extent that these displace virgin raw materials and fossil fuel electricity production, respectively. Carbon sinks associated with MSW management also were addressed. The results indicate that the MSW management actions taken by U.S. communities have significantly reduced potential GHG emissions despite an almost 2-fold increase in waste generation. GHG emissions from MSW management were estimated to be 36 million metric tons carbon equivalents (MMTCE) in 1974 and 8 MMTCE in 1997. If MSW were being managed today as it was in 1974, GHG emissions would be approximately 60 MMTCE.

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

PubMed

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

2016-09-15

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

Managing high-risk patients: the Mass General care management programme

PubMed Central

Kodner, Dennis L.

2015-01-01

The Massachusetts General Care Management Program (Mass General CMP or CMP) was designed as a federally supported demonstration to test the impact of intensive, practice-based care management on high-cost Medicare fee-for-service (FFS) beneficiaries—primarily older persons—with multiple hospitalisations and multiple chronic conditions. The Massachusetts General Care Management Program operated over a 6-year period in two phases (3 years each). It started during the first phase at Massachusetts General Hospital, a major academic medical centre in Boston, Massachusetts in collaboration with Massachusetts General Physicians Organisation. During the second phase, the programme expanded to two more affiliated sites in and around the Boston area, including a community hospital, as well as incorporated several modifications primarily focused on the management of transitions to post-acute care in skilled nursing facilities. At the close of the demonstration in July 2012, Mass General Massachusetts General Care Management Program became a component of a new Pioneer accountable care organisation (ACO). The Massachusetts General Care Management Program is focused on individuals meeting defined eligibility criteria who are offered care that is integrated by a case manager embedded in a primary care practice. The demonstration project showed substantial cost savings compared to fee-for-service patients served in the traditional Medicare system but no impact on hospital readmissions. The Massachusetts General Care Management Program does not rest upon a “whole systems” approach to integrated care. It is an excellent example of how an innovative care co-ordination programme can be implemented in an existing health-care organisation without making fundamental changes in its underlying structure or the way in which direct patient care services are paid for. The accountable care organisation version of the Massachusetts General Care Management Program includes the staffing structure, standards of practice, collaborative approach to care transitions and information technology tools that were used in the original demonstration project. PMID:26417211

Evaluating the effectiveness of management practices on hydrology and water quality at watershed scale with a rainfall-runoff model.

PubMed

Liu, Yaoze; Bralts, Vincent F; Engel, Bernard A

2015-04-01

The adverse influence of urban development on hydrology and water quality can be reduced by applying best management practices (BMPs) and low impact development (LID) practices. This study applied green roof, rain barrel/cistern, bioretention system, porous pavement, permeable patio, grass strip, grassed swale, wetland channel, retention pond, detention basin, and wetland basin, on Crooked Creek watershed. The model was calibrated and validated for annual runoff volume. A framework for simulating BMPs and LID practices at watershed scales was created, and the impacts of BMPs and LID practices on water quantity and water quality were evaluated with the Long-Term Hydrologic Impact Assessment-Low Impact Development 2.1 (L-THIA-LID 2.1) model for 16 scenarios. The various levels and combinations of BMPs/LID practices reduced runoff volume by 0 to 26.47%, Total Nitrogen (TN) by 0.30 to 34.20%, Total Phosphorus (TP) by 0.27 to 47.41%, Total Suspended Solids (TSS) by 0.33 to 53.59%, Lead (Pb) by 0.30 to 60.98%, Biochemical Oxygen Demand (BOD) by 0 to 26.70%, and Chemical Oxygen Demand (COD) by 0 to 27.52%. The implementation of grass strips in 25% of the watershed where this practice could be applied was the most cost-efficient scenario, with cost per unit reduction of $1m3/yr for runoff, while cost for reductions of two pollutants of concern was $445 kg/yr for Total Nitrogen (TN) and $4871 kg/yr for Total Phosphorous (TP). The scenario with very high levels of BMP and LID practice adoption (scenario 15) reduced runoff volume and pollutant loads from 26.47% to 60.98%, and provided the greatest reduction in runoff volume and pollutant loads among all scenarios. However, this scenario was not as cost-efficient as most other scenarios. The L-THIA-LID 2.1 model is a valid tool that can be applied to various locations to help identify cost effective BMP/LID practice plans at watershed scales. Copyright © 2014 Elsevier B.V. All rights reserved.

Buying Time: Preliminary Assessment of Biocontrol in the Recovery of Native Forest Vegetation in the Aftermath of the Invasive Emerald Ash Borer

Treesearch

Elan Margulies; Leah Bauer; Inés Ibáñez

2017-01-01

Introduced forest pests have become one of the major threats to forests, and biological control is one of the few environmentally acceptable management practices. Assessing the impacts of a biocontrol program includes evaluating the establishment of biocontrol agents, the control of target pest, the impact on the affected organism, and the indirect impacts that the...

Money matters: a resident curriculum for financial management.

PubMed

Mizell, Jason S; Berry, Katherine S; Kimbrough, Mary Katherine; Bentley, Frederick R; Clardy, James A; Turnage, Richard H

2014-12-01

A 2005 survey reported 87% of surgery program directors believed practice management training should occur during residency. However, only 8% of program directors believed residents received adequate training in practice management [1]. In addition to the gap in practice financial management knowledge, we recognized the need for training in personal finance among residents. A literature review and needs assessment led to the development of a novel curriculum for surgery residents combining principles of practice management and personal finance. An 18-h curriculum was administered over the 2012 academic year to 28 post graduate year 1-5 surgery residents and faculty. A self-assessment survey was given at the onset and conclusion of the curriculum [2]. Pre-tests and post-tests were given to objectively evaluate each twice monthly session's content. Self-perception of learning, interest, and acquired knowledge were analyzed using the Wilcoxon signed ranks test. Initial self-assessment data revealed high interest in practice management and personal finance principles but a deficiency in knowledge of and exposure to these topics. Throughout the curriculum, interest increased. Residents believed their knowledge of these topics increased after completing the curriculum, and objective data revealed various impacts on knowledge. Although surgery residents receive less exposure to these topics than residents in other specialties, their need to know is no less. We developed, implemented, and evaluated a curriculum that bridged this gap in surgery education. After the curriculum, residents reported an increase in interest, knowledge, and responsible behavior relating to personal and practice financial management. Copyright © 2014 Elsevier Inc. All rights reserved.

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

NASA Astrophysics Data System (ADS)

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

2017-10-01

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

Quality of Disease Management and Risk of Mortality in English Primary Care Practices.

PubMed

Dusheiko, Mark; Gravelle, Hugh; Martin, Stephen; Smith, Peter C

2015-10-01

To investigate whether better management of chronic conditions by family practices reduces mortality risk. Two random samples of 5 million patients registered with over 8,000 English family practices followed up for 4 years (2004/5-2007/8). Measures of the quality of disease management for 10 conditions were constructed for each family practice for each year. The outcome measure was an indicator taking the value 1 if the patient died during a specified year, 0 otherwise. Cross-section and multilevel panel data multiple logistic regressions were estimated. Covariates included age, gender, morbidity, hospitalizations, attributed socio-economic characteristics, and local health care supply measures. Although a composite measure of the quality of disease management for all 10 conditions was significantly associated with lower mortality, only the quality of stroke care was significant when all 10 quality measures were entered in the regression. The panel data results suggest that a 1 percent improvement in the quality of stroke care could reduce the annual number of deaths in England by 782 [95 percent CI: 423, 1140]. A longer study period may be necessary to detect any mortality impact of better management of other conditions. © Health Research and Educational Trust.

Budget impact analysis of sFlt-1/PlGF ratio as prediction test in Italian women with suspected preeclampsia.

PubMed

Frusca, Tiziana; Gervasi, Maria-Teresa; Paolini, Davide; Dionisi, Matteo; Ferre, Francesca; Cetin, Irene

2017-09-01

Preeclampsia (PE) is a pregnancy disease which represents a leading cause of maternal and perinatal mortality and morbidity. Accurate prediction of PE risk could provide an increase in health benefits and better patient management. To estimate the economic impact of introducing Elecsys sFlt-1/PlGF ratio test, in addition to standard practice, for the prediction of PE in women with suspected PE in the Italian National Health Service (INHS). A decision tree model has been developed to simulate the progression of a cohort of pregnant women from the first presentation of clinical suspicion of PE in the second and third trimesters until delivery. The model provides an estimation of the financial impact of introducing sFlt-1/PlGF versus standard practice. Clinical inputs have been derived from PROGNOSIS study and from literature review, and validated by National Clinical Experts. Resources and unit costs have been obtained from Italian-specific sources. Healthcare costs associated with the management of a pregnant woman with clinical suspicion of PE equal €2384 when following standard practice versus €1714 using sFlt-1/PlGF ratio test. Introduction of sFlt-1/PlGF into hospital practice is cost-saving. Savings are generated primarily through improvement in diagnostic accuracy and reduction in unnecessary hospitalization for women before PE's onset.

Impact of green supply chain management practices on firms' performance: an empirical study from the perspective of Pakistan.

PubMed

Khan, Syed Abdul Rehman; Qianli, Dong

2017-07-01

This article investigates the impact of five determinants of the green supply chain practices on organizational performance in the context of Pakistan manufacturing firms. A sample of 218 firms was collected from the manufacturing industry. The green supply chain practices were measured through five independent variables including green manufacturing, green purchasing, green information systems, cooperation with customers, and eco-design. By using exploratory factor and simultaneous regression analysis, the results indicate that except green purchasing, rests of the four independent variables have been found statistically significant to predict organizational performance. However, the eco-design of green practices followed by green information systems has revealed the greatest impact on organizational performance. Therefore, the managers of the manufacturing firms should not only implement eco-design in their supply chain but also concentrate on proper monitoring and implementation of green information systems to increase their firms' performance. A main contribution of this research from theoretical side is that it is possible to notice a negative effect of "green purchasing" towards organizational performance particularly in the scenario of Pakistan manufacturing industry. Another valuable result is that green purchasing is an important antecedent of firms economic performance in the US manufacturing firms (Green et al. 2012), although not significantly related to organizational performance in our study. In addition, we also discussed research limitations, areas for future research, and implications for practitioners.

Implications of leading crop production practices on environmental quality and human health.

PubMed

Udeigwe, Theophilus K; Teboh, Jasper M; Eze, Peter N; Stietiya, M Hashem; Kumar, Vipan; Hendrix, James; Mascagni, Henry J; Ying, Teng; Kandakji, Tarek

2015-03-15

Globally, much weight is currently being placed on agriculture to provide food for the growing population as well as feedstock for the bioenergy industry. Unfortunately, the intensification of agricultural operations to satisfy these growing needs has been associated with a number of environmental and human health risks. A review of publications on the subject was conducted and emphasis was placed on articles focusing on agriculture, environment, and public health as well as their interactions. Supporting information was also gathered from publications of various agricultural and environmental agencies. Agricultural practices with potential negative implications on the environment and human health were identified broadly as: (a) utilization of biosolids and animal manures, (b) use of agricultural chemicals, (c) management of post-harvest residue, (d) irrigation, and (e) tillage operations. Soil, water, and air contamination by nutrients, heavy metals, pathogens, and pesticides, as well as air contamination by particulate matters, noxious gases, and pathogens were among the leading environmental impacts. Some of the human-health impacts identified included neurological and reproductive defects, cardiovascular risks, cancers and other diseases (of kidney, liver, lung, and skin), skin allergies, gastroenteritis, and methemoglobinemia. Continual awareness on the impacts of the reviewed agricultural practices on environmental quality and human health and the implementation of experimentally-backed best management practices in agricultural systems remain indispensable. Copyright © 2014 Elsevier Ltd. All rights reserved.

The “Minimizing Antibiotic Resistance in Colorado” Project: Impact of Patient Education in Improving Antibiotic Use in Private Office Practices

PubMed Central

Gonzales, Ralph; Corbett, Kitty K; Leeman-Castillo, Bonnie A; Glazner, Judith; Erbacher, Kathleen; Darr, Carol A; Wong, Shale; Maselli, Judith H; Sauaia, Angela; Kafadar, Karen

2005-01-01

Objective To assess the marginal impact of patient education on antibiotic prescribing to children with pharyngitis and adults with acute bronchitis in private office practices. Data Sources/Study Setting Antibiotic prescription rates based on claims data from four managed care organizations in Colorado during baseline (winter 2000) and study (winter 2001) periods. Study Design A nonrandomized controlled trial of a household and office-based patient educational intervention was performed. During both periods, Colorado physicians were mailed antibiotic prescribing profiles and practices guidelines as part of an ongoing quality improvement program. Intervention practices (n=7) were compared with local and distant control practices. Data Collection/Extraction Methods Office visits were extracted by managed care organizations using International Classification of Diseases-9-Clinical Modification codes for acute respiratory tract infections, and merged with pharmacy claims data based on visit and dispensing dates coinciding within 2 days. Principal Findings Adjusted antibiotic prescription rates during baseline and study periods increased from 38 to 39 percent for pediatric pharyngitis at the distant control practices, and decreased from 39 to 37 percent at the local control practices, and from 34 to 30 percent at the intervention practices (p=.18 compared with distant control practices). Adjusted antibiotic prescription rates decreased from 50 to 44 percent for adult bronchitis at the distant control practices, from 55 to 45 percent at the local control practices, and from 60 to 36 percent at the intervention practices (p<.002 and p=.006 compared with distant and local control practices, respectively). Conclusions In office practices, there appears to be little room for improvement in antibiotic prescription rates for children with pharyngitis. In contrast, patient education helps reduce antibiotic use for adults with acute bronchitis beyond that achieved by physician-directed efforts. PMID:15663704

Contextual Factors Impacting a Pain Management Intervention.

PubMed

Alaloul, Fawwaz; Williams, Kimberly; Myers, John; Jones, Kayla Dlauren; Sullivan, Katelyn; Logsdon, M Cynthia

2017-09-01

To determine if findings from our preliminary study related to patient and nursing satisfaction with a pain management intervention could be replicated in a changed environment, and if contextual factors could impact the effectiveness of a pain management intervention on patient satisfaction with nursing staff's management of pain. A prospective, experimental design was used with six monthly assessments before, during, and after the intervention. Data were collected from 540 patients admitted to eight medical surgical and progressive care units and nurses that worked in these units at an academic health sciences center in the southern United States, from March to July 2015. The script-based, pain management communication intervention included three specific tactics: script-based communication, use of white boards, and hourly rounding. The Hospital Consumer Assessment of Healthcare Providers and Systems survey was used to assess two items: "pain is well controlled" and "staff did everything they could to help with pain." Contextual factors focused on the practice setting. Both scores for "pain is well controlled" (β = .028, p = 0.651) and scores for "staff did everything they could to help with pain" (β = .057,p = .385) did not change initially but then increased significantly and were sustained over time. Nurses had high levels of satisfaction with the intervention (M = 7.9, SD = 2.1) and compliance with the intervention (M = 8.0, SD = 1.9), and had little difficulty in implementing the intervention (M = 8.3, SD = 1.4). In terms of contextual factors, the number of beds on the unit and the number of patients being discharged negatively impacted scores for "pain is well controlled" and "staff did everything they could to help with pain." Hospital length of stay positively impacted scores for "pain is well controlled" by staff. Despite challenging contextual variables, the study extended the findings of an early preliminary study in showing the effectiveness of pain management intervention on patient satisfaction with staff's management of pain. In evaluating the impact of an intervention, it is essential to examine the contextual environment. Using simple, clear, and consistent communication between patients and nurses related to pain can positively impact patient satisfaction with pain management over time. The health care environment can enhance nursing practice and patients' outcomes. © 2017 Sigma Theta Tau International.

Challenges for Managed Care from 340B Contract Pharmacies.

PubMed

Fein, Adam J

2016-03-01

The federal 340B Drug Pricing Program has expanded rapidly, with important yet still unmeasured impact on both managed care practice and policies. Notably, providers increasingly rely on external, contract pharmacies to extend 340B pricing to a broad set of patients. In 2014, 1 in 4 U.S. retail, mail, and specialty pharmacy locations acted as contract pharmacies for 340B-covered entities. This commentary discusses crucial ways in which 340B growth is affecting managed care pharmacy through formulary rebates, profits from managed care paid prescriptions, disruption of retail pharmacy networks, and reduced generic dispensing rates. Managed care should become more engaged in the discussion on how the 340B program should evolve and offer policy proposals to mitigate the challenges being encountered. There is also an urgent need for objective, transparent research on the 340B program's costs, benefits, and implications for managed care pharmacy and practice.

Re-thinking pain educational strategies: Pain a new model using e-learning and PBL.

PubMed

Keyte, Donna; Richardson, Cliff

2011-02-01

Despite some high profile reorganisation including the introduction of acute pain teams, many patients still experience unnecessary pain. Traditional teaching and learning strategies seem to have made little impact in clinical practice. This paper explores the possible reasons for this and identifies the need to help postregistration students transfer (re-contextualise) what they are learning to practice. A new, more flexible pain management module utilising a blended face to face/e-learning approach within a problem-based learning philosophy was introduced to increase knowledge in pain management whilst also attempting to overcome the barriers to knowledge transfer into practice. This is done by challenging attitudes and encouraging students to explore their clinical practice alongside theoretical concepts. Copyright © 2010 Elsevier Ltd. All rights reserved.

Interventions to manage dual practice among health workers.

PubMed

Kiwanuka, Suzanne N; Rutebemberwa, Elizeus; Nalwadda, Christine; Okui, Olico; Ssengooba, Freddie; Kinengyere, Alison A; Pariyo, George W

2011-07-06

Dual practice, whereby health workers hold two or more jobs, is a common phenomenon globally. In resource constrained low- and middle-income countries dual practice poses an ongoing threat to the efficiency, quality and equity of health services, especially in the public sector. Identifying effective interventions to manage dual practice is important. To assess the effects of regulations implemented to manage dual practice. Databases searched included: The Cochrane Central Register of Controlled Trials (CENTRAL) 2011, Issue 4, part of The Cochrane Library. www.thecochranelibrary.com, including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register (searched 26 May 2011); MEDLINE In-Process & Other Non-Indexed Citations May 24, 2011 (searched 26 May 2011); MEDLINE, Ovid (1948 to May week 2 2011) (searched 26 May 2011); EMBASE, Ovid (1980 to 2011 week 20) (searched 26 May 2011); Science Citation Index and Social Sciences Citation Index, ISI Web of Science (1975 to present) (searched 04 December 2009); LILACS (searched January 2010); and AIM (December 2009) (searched 18 December 2009). Randomized controlled trials, non-randomized controlled trials, controlled before-and-after studies and interrupted-time-series studies. Dual practice was defined as holding more than one job. Studies for inclusion were those focusing on interventions to manage dual practice among health professionals employed in the public health sector. Two review authors independently applied the criteria for inclusion and exclusion of studies when scanning the identified titles and abstracts. The same two review authors independently screened full reports of selected citations. At each stage, results were compared and discrepancies settled through discussion. No studies were found which were eligible for inclusion in this review. There is a need to rigorously evaluate the effects of interventions implemented to manage dual practice among health workers. However, there is still much that is unknown about dual practice itself. The designing of studies to evaluate the effects of interventions to manage dual practice could benefit from prior studies to assess the various manifestations of dual practice, their prevalence and their likely impacts on health services delivery. These findings would then inform the design of studies to evaluate interventions to manage dual practice.

Weed management practices for organic production of trailing blackberry. II. Accumulation and loss of plant biomass and nutrients

USDA-ARS?s Scientific Manuscript database

A study was conducted to assess the impact of cultivar and weed management on accumulation and loss of plant biomass and nutrients during the first 3 years of establishment when using organic fertilizer in trailing blackberry. Treatments included two cultivars, Marion and Black Diamond, each with ei...

Social Media Technology Management in College of Technology in Oman

ERIC Educational Resources Information Center

Sharma, Himanshu; Pillai, Sunil Prakash

2017-01-01

Purpose: The purpose of this paper is to examine the impact of the constructs--utilitarian, hedonic and social value on the perceptions of the full-time instructors related to their social media technology (SMT) management for learning and teaching practices at workplace. Design/methodology/approach: A survey is used to gather the data from 180…

A risk-based approach to wildland fire budgetary planning

Treesearch

Matthew P. Thompson; David E. Calkin; Mark A. Finney; Krista M. Gebert; Michael S. Hand

2013-01-01

The financial impact of wildfire management within the USDA Forest Service challenges the ability of the agency to meet societal demands and maintain forest health. The extent of this financial crisis has been attributed to historical and continuing fire management practices, changing climatic conditions, and increasing human development in fire-prone areas, as well as...

Total Quality Management and the Higher Education Environment: Impact on Educational Leadership Theory and Practice.

ERIC Educational Resources Information Center

Munoz, Marco A.

This paper explores Total Quality Management (TQM) as an organizational theory applied to educational administration of higher education. The first part of the paper describes the principles of TQM, and the second part considers TQM in higher education. The third section is a general conclusion that takes into consideration the leadership…

Visual quality assessment of alternative silvicultural practices in upland hardwood management

Treesearch

Tim McDonald; Bryce Stokes

1997-01-01

Visual impacts of forest operations are of increasing concern to forest managers. Tools are available for evaluating, and potentially avoiding, problems in visual quality resulting from poorly designed harvest unit boundaries. One of these visualization tools is applied in comparing various harvest unit shape alternatives in an upland hardwood stand on steeply sloping...