How do strategic decisions and operative practices affect operating room productivity?

PubMed

Peltokorpi, Antti

2011-12-01

Surgical operating rooms are cost-intensive parts of health service production. Managing operating units efficiently is essential when hospitals and healthcare systems aim to maximize health outcomes with limited resources. Previous research about operating room management has focused on studying the effect of management practices and decisions on efficiency by utilizing mainly modeling approach or before-after analysis in single hospital case. The purpose of this research is to analyze the synergic effect of strategic decisions and operative management practices on operating room productivity and to use a multiple case study method enabling statistical hypothesis testing with empirical data. 11 hypotheses that propose connections between the use of strategic and operative practices and productivity were tested in a multi-hospital study that included 26 units. The results indicate that operative practices, such as personnel management, case scheduling and performance measurement, affect productivity more remarkably than do strategic decisions that relate to, e.g., units' size, scope or academic status. Units with different strategic positions should apply different operative practices: Focused hospital units benefit most from sophisticated case scheduling and parallel processing whereas central and ambulatory units should apply flexible working hours, incentives and multi-skilled personnel. Operating units should be more active in applying management practices which are adequate for their strategic orientation.

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.

Practice management for academic dermatology departments.

PubMed

Eaglstein, W H

2000-09-01

Practice management in the academic medical center (AMC) is different than in other environments. Practice is only a part of the practitioner's mission within an AMC. Practice revenue will be subject to a tax or overhead by both the school and the department. Contract and practice guidelines cannot be tailored to the needs of the dermatology practice, because contracts and guidelines are negotiated globally for all of the practices within the AMC. Personnel, on which the practice depends, may report to hospitals and clinics rather than to the practice's management. Even control of the practice's manager may be diluted by a dual or "dotted line" reporting relationship between the department manager and the school practice manager. Although more constraints exist within the AMC, there are some strategic and operational choices that affect a practice's success. Among these are: (1) selection of services offered; (2) creation of satellites; (3) stimulation of faculty effort; (4) enhancement of faculty billing knowledge; and (5) creation of a "tie" between staff and the practice.

Physical activity and metabolic disease among people with affective disorders: Prevention, management and implementation.

PubMed

Vancampfort, Davy; Stubbs, Brendon

2017-12-15

One in ten and one in three of people with affective disorders experience diabetes and metabolic syndrome respectively. Physical activity (PA) and sedentary behaviour (SB) are key risk factors that can ameliorate the risk of metabolic disease among this population. However, PA is often seen as luxury and/or a secondary component within the management of people with affective disorders. The current article provides a non-systematic best-evidence synthesis of the available literature, detailing a number of suggestions for the implementation of PA into clinical practice. Whilst the evidence is unequivocal for the efficacy of PA to prevent and manage metabolic disease in the general population, it is in its infancy in this patient group. Nonetheless, action must be taken now to ensure that PA and reducing SB are given a priority to prevent and manage metabolic diseases and improve wider health outcomes. PA should be treated as a vital sign and all people with affective disorders asked about their activity levels and if appropriate advised to increase this. There is a need for investment in qualified exercise specialists in clinical practice such as physiotherapists to undertake and oversee PA in practice. Behavioural strategies such as the self-determined theory should be employed to encourage adherence. Funding is required to develop the evidence base and elucidate the optimal intervention characteristics. PA interventions should form an integral part of the multidisciplinary management of people with affective disorders and our article outlines the evidence and strategies to implement this in practice. Copyright © 2016 Elsevier B.V. All rights reserved.

Individual differences in temperament and behavioral management practices for nonhuman primates

PubMed Central

Coleman, Kristine

2011-01-01

Effective behavioral management plans are tailored to unique behavioral patterns of each individual species. However, even within a species behavioral needs of individuals can vary. Factors such as age, sex, and temperament can affect behavioral needs of individuals. While some of these factors, such as age and sex, are taken into account, other factors, such as an individual’s temperament, are rarely specifically provided for in behavioral management plans. However, temperament may affect how animals respond to socialization, positive reinforcement training and other forms of enrichment. This review will examine how individual differences in temperament might affect, or be affected by, behavioral management practices for captive primates. Measuring temperament may help us predict outcome of social introductions. It can also predict which animals may be difficult to train using traditional methods. Further, knowledge of temperament may be able to help identify individuals at risk for development of behavioral problems. Taken together, understanding individual differences in temperament of captive primates can help guide behavioral management decisions. PMID:22518067

Development, Implementation, and Evaluation of a Strategic Plan for Improving Physical Plant Management at Southwest Texas Junior College.

ERIC Educational Resources Information Center

Box, Wilford Winston

A study was conducted at Southwest Texas Junior College (STJC) to assess current management practices used by the physical plant maintenance department (PPMD) and to develop a strategic plan for physical plant management. Procedures included an analysis of current management practices and systems that affect physical resources, and periodic and…

Vineyard soil bacterial diversity and composition revealed by 16S rRNA genes: Differentiation by vineyard management

USDA-ARS?s Scientific Manuscript database

Here, we demonstrate how vineyard management practices influence shifts in soil resources, which in turn affects shifts in soil-borne bacterial communities. The objective is to determine the hierarchical effects of management practices, soil attributes and location factors on the structure of soil-b...

12 CFR 1261.9 - Actions affecting director elections.

Code of Federal Regulations, 2010 CFR

2010-01-01

... auditing and accounting, derivatives, financial management, organizational management, project development, risk management practices, or the law , it may identify those qualifications and so inform the members...

Vocational Education and Training Manager Discursive Practices at the Frontline: Alternative Possibilities in a Victorian Setting

ERIC Educational Resources Information Center

Foley, Annette

2011-01-01

This article looks at how the neoliberal reform process is affecting the professional identity of frontline managers in the Australian vocational education and training sector. The article examines how frontline managers are required to negotiate their working practices between their understandings and experiences as educators and the new…

Factors Affecting the Perception of Importance and Practice of Patient Safety Management among Hospital Employees in Korea.

PubMed

Kim, In-Sook; Park, MiJeong; Park, Mi-Young; Yoo, Hana; Choi, Jihea

2013-03-01

The study was undertaken to identify factors affecting perception of the importance and practice of patient safety management (PSM) among hospital employees in Korea. This study was conducted using a descriptive design and a self-report questionnaire. Two hundred and eighty employees were recruited from three hospitals using a convenience sampling method. Measures were perception of the importance, practice, and characteristics of PSM. Data were analyzed using descriptive statistics including t test, one-way analysis of variance, Pearson's correlation analysis, and multiple regression. Factors affecting perception of the importance of PSM were whether hospital employees were in contact with patients while on duty, weekly working hours, education on PSM, and perceived adequacy of PSM system construction. Factors affecting the practice of PSM were perceived adequacy of work load, perceived adequacy of PSM system construction and perception of its importance. The findings of this study indicate a need for developing strategies to improve perception of the importance and practice of PSM among all hospital employees, and provide a reference for future experimental studies. Copyright © 2013. Published by Elsevier B.V.

Human resources management and firm performance: The differential role of managerial affective and continuance commitment.

PubMed

Gong, Yaping; Law, Kenneth S; Chang, Song; Xin, Katherine R

2009-01-01

In this study, the authors developed a dual-concern (i.e., maintenance and performance) model of human resources (HR) management. The authors identified commonly examined HR practices that apply to the middle manager level and classified them into the maintenance- and performance-oriented HR subsystems. The authors found support for the 2-factor model on the basis of responses from 2,148 managers from 463 firms operating in China. Regression results indicate that the performance-oriented HR subsystems had a positive relationship with firm performance and that the relationship was mediated by middle managers' affective commitment to the firm. The maintenance-oriented HR subsystems had a positive relationship with middle managers' continuance commitment but not with their affective commitment and firm performance. This study contributes to the understanding of how HR practices relate to firm performance and offers an improved test of the argument that valuable and firm-specific HR provide a source of competitive advantage. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

2015 AAHA Canine and Feline Behavior Management Guidelines.

PubMed

Hammerle, Marcy; Horst, Christine; Levine, Emily; Overall, Karen; Radosta, Lisa; Rafter-Ritchie, Marcia; Yin, Sophia

2015-01-01

The 2015 AAHA Canine and Feline Behavior Management Guidelines were developed to provide practitioners and staff with concise, evidence-based information to ensure that the basic behavioral needs of feline and canine patients are understood and met in every practice. Some facility in veterinary behavioral and veterinary behavioral medicine is essential in modern veterinary practice. More cats and dogs are affected by behavioral problems than any other condition. Behavioral problems result in patient suffering and relinquishment and adversely affect staff morale. These guidelines use a fully inclusive team approach to integrate basic behavioral management into everyday patient care using standardized behavioral assessments; create a low-fear and low-stress environment for patients, staff and owners; and create a cooperative relationship with owners and patients so that the best care can be delivered. The guidelines' practical, systematic approach allows veterinary staff to understand normal behavior and recognize and intervene in common behavioral problems early in development. The guidelines emphasize that behavioral management is a core competency of any modern practice.

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.

Factors affecting reproductive performance of dairy cows.

PubMed

Coleman, D A; Thayne, W V; Dailey, R A

1985-07-01

We conducted two studies to determine how herd management practices and traits of individual cows affect performance of the herd and of the cow within a herd. Management practices, reproductive performance of the herd, and relationships between management and reproductive performance were characterized on 83 dairy farms with 7596 cows. Data included 21 management variables (e.g., facilities, herd health program, estrous detection program) and 8 performance variables obtained from Dairy Herd Improvement or unofficial records (e.g., size of herd, production, days open). Although varying among herds, annual average herd incidences of reproductive disorders and reproductive performance were similar to those reported. Managerial practices influenced incidences of retained placenta and uterine infection, days open of cows not bred and of all cows, services per conception, and percentages of herd open more than 100 days and culled for low production. Veterinarian was the most consistent variable influencing herd reproductive performance. Data also were collected from production and lifetime records of 2532 cows in 19 herds. Reproductive performance was affected by season of calving, production, maturity, and reproductive disorders. Several cows with extremely poor reproductive records were maintained.

Algorithms for the assessment and management of insomnia in primary care

PubMed Central

Hilty, Donald; Young, Julie S; Bourgeois, James A; Klein, Sally; Hardin, Kimberly A

2009-01-01

Insomnia is a leading cause of sleep disturbance in primary care practice affecting >30% of people in the United States and can result in psychological and physiological consequences. We aim for a focused discussion of some of the underpinnings of insomnia and practical tips for management (eg, algorithms). A PubMed search was conducted using English language papers between 1997–2007, with the terms “sleep,” “insomnia”; “primary care” and “clinics”; “comorbid conditions”; “treatment” and “management.” Sleep, psychiatric and medical disorders significantly affect sleep, causing patient suffering, potentially worsening of other disorders and increasing the use of primary care services. We provide an outline for practical assessment and treatment of insomnia in primary care, including the strengths and weaknesses of medications. PMID:19936140

Cultivar and Year Rather than Agricultural Practices Affect Primary and Secondary Metabolites in Apple Fruit

PubMed Central

Renard, Catherine M. G. C.; Plenet, Daniel; Gautier, Hélène; Touloumet, Line; Girard, Thierry; Simon, Sylvaine

2015-01-01

Many biotic and abiotic parameters affect the metabolites involved in the organoleptic and health value of fruits. It is therefore important to understand how the growers' decisions for cultivar and orchard management can affect the fruit composition. Practices, cultivars and/or year all might participate to determine fruit composition. To hierarchize these factors, fruit weight, dry matter, soluble solids contents, titratable acidity, individual sugars and organics acids, and phenolics were measured in three apple cultivars (‘Ariane’, ‘Melrose’ and ‘Smoothee’) managed under organic, low-input and conventional management. Apples were harvested at commercial maturity in the orchards of the cropping system experiment BioREco at INRA Gotheron (Drôme, 26) over the course of three years (2011, 2012 and 2013). The main factors affecting primary and secondary metabolites, in both apple skin and flesh, were by far the cultivar and the yearly conditions, while the management system had a very limited effect. When considering the three cultivars and the year 2011 to investigate the effect of the management system per se, only few compounds differed significantly between the three systems and in particular the total phenolic content did not differ significantly between systems. Finally, when considering orchards grown in the same pedoclimatic conditions and of the same age, instead of the usual organic vs. conventional comparison, the effect of the management system on the apple fruit quality (Fruit weight, dry matter, soluble solids content, titratable acidity, individual sugars, organic acids, and phenolics) was very limited to non-significant. The main factors of variation were the cultivar and the year of cropping rather than the cropping system. More generally, as each management system (e.g. conventional, organic…) encompasses a great variability of practices, this highlights the importance of accurately documenting orchard practices and design beside the generic type of management in such studies. PMID:26618711

Influence of Different Forest System Management Practices on Leaf Litter Decomposition Rates, Nutrient Dynamics and the Activity of Ligninolytic Enzymes: A Case Study from Central European Forests

PubMed Central

Schulz, Elke; Schloter, Michael; Buscot, François; Hofrichter, Martin; Krüger, Dirk

2014-01-01

Leaf litter decomposition is the key ecological process that determines the sustainability of managed forest ecosystems, however very few studies hitherto have investigated this process with respect to silvicultural management practices. The aims of the present study were to investigate the effects of forest management practices on leaf litter decomposition rates, nutrient dynamics (C, N, Mg, K, Ca, P) and the activity of ligninolytic enzymes. We approached these questions using a 473 day long litterbag experiment. We found that age-class beech and spruce forests (high forest management intensity) had significantly higher decomposition rates and nutrient release (most nutrients) than unmanaged deciduous forest reserves (P<0.05). The site with near-to-nature forest management (low forest management intensity) exhibited no significant differences in litter decomposition rate, C release, lignin decomposition, and C/N, lignin/N and ligninolytic enzyme patterns compared to the unmanaged deciduous forest reserves, but most nutrient dynamics examined in this study were significantly faster under such near-to-nature forest management practices. Analyzing the activities of ligninolytic enzymes provided evidence that different forest system management practices affect litter decomposition by changing microbial enzyme activities, at least over the investigated time frame of 473 days (laccase, P<0.0001; manganese peroxidase (MnP), P = 0.0260). Our results also indicate that lignin decomposition is the rate limiting step in leaf litter decomposition and that MnP is one of the key oxidative enzymes of litter degradation. We demonstrate here that forest system management practices can significantly affect important ecological processes and services such as decomposition and nutrient cycling. PMID:24699676

Influence of different forest system management practices on leaf litter decomposition rates, nutrient dynamics and the activity of ligninolytic enzymes: a case study from central European forests.

PubMed

Purahong, Witoon; Kapturska, Danuta; Pecyna, Marek J; Schulz, Elke; Schloter, Michael; Buscot, François; Hofrichter, Martin; Krüger, Dirk

2014-01-01

Leaf litter decomposition is the key ecological process that determines the sustainability of managed forest ecosystems, however very few studies hitherto have investigated this process with respect to silvicultural management practices. The aims of the present study were to investigate the effects of forest management practices on leaf litter decomposition rates, nutrient dynamics (C, N, Mg, K, Ca, P) and the activity of ligninolytic enzymes. We approached these questions using a 473 day long litterbag experiment. We found that age-class beech and spruce forests (high forest management intensity) had significantly higher decomposition rates and nutrient release (most nutrients) than unmanaged deciduous forest reserves (P<0.05). The site with near-to-nature forest management (low forest management intensity) exhibited no significant differences in litter decomposition rate, C release, lignin decomposition, and C/N, lignin/N and ligninolytic enzyme patterns compared to the unmanaged deciduous forest reserves, but most nutrient dynamics examined in this study were significantly faster under such near-to-nature forest management practices. Analyzing the activities of ligninolytic enzymes provided evidence that different forest system management practices affect litter decomposition by changing microbial enzyme activities, at least over the investigated time frame of 473 days (laccase, P<0.0001; manganese peroxidase (MnP), P = 0.0260). Our results also indicate that lignin decomposition is the rate limiting step in leaf litter decomposition and that MnP is one of the key oxidative enzymes of litter degradation. We demonstrate here that forest system management practices can significantly affect important ecological processes and services such as decomposition and nutrient cycling.

Does TQM Affect Teaching and Learning?

ERIC Educational Resources Information Center

Mauriel, John J.; And Others

Many schools and school districts are attempting to introduce principles and practices of Total Quality Management (TQM). These attempts take many forms with varying degrees of commitment of resources and management attention. This paper describes the research design of a study intended to identify best current practices in applying TQM concepts…

Groundwater and stream response times to fertility management changes in pastures

USDA-ARS?s Scientific Manuscript database

To assess the effectiveness of best-management practices (BMPs), measurements need to be made to determine how the implementation of BMPs affect water quality and soil loss from the areas receiving the practices. For large watersheds (multiple square miles in area) this is a difficult, expensive, a...

Water quality effects and placement of pasture best management practices in the Spring Creek Watershed (Centre County, PA)

USDA-ARS?s Scientific Manuscript database

Pasture-based best management practices (BMPs), including stream bank fencing, stream crossings, and bank stabilization, improved water quality ten years after installation by reducing sediment, but did not affect nitrogen concentration. Abundance and diversity of aquatic macroinvertebrates increas...

Upland hardwood silviculture DVD

Treesearch

Claire Payne; Donna Burnett

2010-01-01

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

European Top Managers' Age-Related Workplace Norms and Their Organizations' Recruitment and Retention Practices Regarding Older Workers.

PubMed

Oude Mulders, Jaap; Henkens, Kène; Schippers, Joop

2017-10-01

Top managers guide organizational strategy and practices, but their role in the employment of older workers is understudied. We study the effects that age-related workplace norms of top managers have on organizations' recruitment and retention practices regarding older workers. We investigate two types of age-related workplace norms, namely age equality norms (whether younger and older workers should be treated equally) and retirement age norms (when older workers are expected to retire) while controlling for organizational and national contexts. Data collected among top managers of 1,088 organizations from six European countries were used for the study. Logistic regression models were run to estimate the effects of age-related workplace norms on four different organizational outcomes: (a) recruiting older workers, (b) encouraging working until normal retirement age, (c) encouraging working beyond normal retirement age, and (d) rehiring retired former employees. Age-related workplace norms of top managers affect their organizations' practices, but in different ways. Age equality norms positively affect practices before the boundary of normal retirement age (Outcomes a and b), whereas retirement age norms positively affect practices after the boundary of normal retirement age (Outcomes c and d). Changing age-related workplace norms of important actors in organizations may be conducive to better employment opportunities and a higher level of employment participation of older workers. However, care should be taken to target the right types of norms, since targeting different norms may yield different outcomes. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Managed care penetration and other factors affecting computerized physician order entry in the ambulatory setting.

PubMed

Menachemi, Nir; Ford, Eric W; Chukmaitov, Askar; Brooks, Robert G

2006-12-01

To estimate the current uses level of ambulatory computerized physician order entry (A-CPOE) among physicians and to examine the relationship of managed care penetration as well as other market and practice characteristics to use of A-CPOE by physicians. This study uses both primary and secondary data sources. The primary data source was a large-scale survey of physicians' use of information technologies in Florida. Secondary data on managed care penetration were obtained from the Florida Agency for Health Care Administration, and other market-level data were extracted from the area resource file. A hierarchical logistic regression model was used to examine the correlation of county-level and practice-level characteristics with physicians' self-reported use of A-CPOE systems. Overall, 1360 physicians (32.4%) indicated use of an A-CPOE system. Findings suggest that 1% more managed care penetration was associated with 2.1% lower use of A-CPOE (P = .003). Additionally, practice size, multispecialty affiliation, and primary care practice were significantly and positively correlated with the use of A-CPOE. Physician age was negatively associated with A-CPOE use. Managed care organizations may experience significant financial savings from A-CPOE use by physicians; however, managed care penetration in a community negatively affects A-CPOE use among physicians in their practices. Further study regarding the causal nature of this association is warranted.

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…

Factors affecting implementation of an evidence-based practice in the Veterans Health Administration: Illness management and recovery.

PubMed

McGuire, Alan B; Salyers, Michelle P; White, Dominique A; Gilbride, Daniel J; White, Laura M; Kean, Jacob; Kukla, Marina

2015-12-01

Illness management and recovery (IMR) is an evidence-based practice that assists consumers in managing their illnesses and pursuing personal recovery goals. Although research has examined factors affecting IMR implementation facilitated by multifaceted, active roll-outs, the current study attempted to elucidate factors affecting IMR implementation outside the context of a research-driven implementation. Semi-structured interviews with 20 local recovery coordinators and 18 local IMR experts were conducted at 23 VA medical centers. Interviews examined perceived and experienced barriers and facilitators to IMR implementation. Data were analyzed via thematic inductive/deductive analysis in the form of crystallization/immersion. Six factors differed between sites implementing IMR from those not providing IMR: awareness of IMR, importer-champions, autonomy-supporting leadership, veteran-centered care, presence of a sensitive period, and presence of a psychosocial rehabilitation and recovery center. Four factors were common in both groups: recovery orientation, evidence-based practices orientation, perceived IMR fit within program structure, and availability of staff time. IMR can be adopted in lieu of active implementation support; however, knowledge dissemination appears to be key. Future research should examine factors affecting the quality of implementation. (c) 2015 APA, all rights reserved).

Variables affecting the financial viability of your practice.

PubMed

Binderman, J

2001-01-01

Financial viability of physician practices depends upon multiple variables: capacity of the practice, the mix of managed care contracts, cost of care, make-up of patient population, patient visit rates, and utilization of alternate methods of patient interaction. This article presents an introduction to these ideas; the second in this series will expand on the groundwork with a case scenario for a typical family practice. The articles present basic financial information in a practical manner, utilizing a series of worksheets to determine how these various items affect the bottom line.

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

PubMed

Calway, R C

2001-01-01

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

Sustainability of Evidence-Based Acute Pain Management Practices for Hospitalized Older Adults.

PubMed

Shuman, Clayton J; Xie, Xian-Jin; Herr, Keela A; Titler, Marita G

2017-11-01

Little is known regarding sustainability of evidence-based practices (EBPs) following implementation. This article reports sustainability of evidence-based acute pain management practices in hospitalized older adults following testing of a multifaceted Translating Research Into Practice (TRIP) implementation intervention. A cluster randomized trial with follow-up period was conducted in 12 Midwest U.S. hospitals (six experimental, six comparison). Use of evidence-based acute pain management practices and mean pain intensity were analyzed using generalized estimating equations across two time points (following implementation and 18 months later) to determine sustainability of TRIP intervention effects. Summative Index scores and six of seven practices were sustained. Experimental and comparison group differences for mean pain intensity over 72 hours following admission were sustained. Results revealed most evidence-based acute pain management practices were sustained for 18 months following implementation. Further work is needed to identify factors affecting sustainability of EBPs to guide development and testing of sustainability strategies.

Management practices affect soil nutrients and bacterial populations in backgrounding beef feedlot

USDA-ARS?s Scientific Manuscript database

Contaminants associated with manure in animal production sites are of significant concern. Unless properly managed, high soil nutrient concentrations in feedlots can deteriorate soil and water quality. This three year study tested a nutrient management strategy with three sequentially imposed manage...

Interdisciplinarity in an Era of New Public Management: A Case Study of Graduate Business Schools

ERIC Educational Resources Information Center

Ryan, Suzanne; Neumann, Ruth

2013-01-01

In an era of rapid knowledge transmission and creation spurred on by advances in technology and globalisation, calls for interdisciplinarity to solve "wicked" problems are common. In the same era, universities are increasingly adopting new public management practices. The extent to which these practices affect knowledge production is an…

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

Treesearch

Mike Curran; Pat Green; Doug Maynard

2007-01-01

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

Antibiotic Types and Handling Practices in Disease Management among Pig Farms in Ashanti Region, Ghana

PubMed Central

Osei Sekyere, John

2014-01-01

Antibiotic resistance in bacteria is affected by the type of antibiotics used and how they are handled. The types of antibiotics used by 110 pig farms in the Ashanti region and the handling practices of the farmers during disease management were assessed. Injectable tetracycline, sulphadimidine, benzylpenicillin, and dihydrostreptomycin containing antibiotics were overly used by the farmers especially in the management of diarrhea, rashes, and coughs. Unsafe storage and disposal practices observed among the farms reflected the abysmal knowledge on appropriate use of antibiotics. Misdiagnosis and inadequate protection during antibiotic handling in the farms increased the risk of antibiotic resistance development and spread. The factors affecting antibiotic resistance development and spread are rife in pig farms in Ashanti region and appropriate education and veterinary interventions are needed to prevent resistant bacteria from becoming endemic in pork and pig farm communities. PMID:26464936

Relating management practices and nutrient export in agricultural watersheds of the United States

USGS Publications Warehouse

Sprague, Lori A.; Gronberg, Jo Ann M.

2012-01-01

Relations between riverine export (load) of total nitrogen (N) and total phosphorus (P) from 133 large agricultural watersheds in the United States and factors affecting nutrient transport were evaluated using empirical regression models. After controlling for anthropogenic inputs and other landscape factors affecting nutrient transport-such as runoff, precipitation, slope, number of reservoirs, irrigated area, and area with subsurface tile drains-the relations between export and the area in the Conservation Reserve Program (CRP) (N) and conservation tillage (P) were positive. Additional interaction terms indicated that the relations between export and the area in conservation tillage (N) and the CRP (P) progressed from being clearly positive when soil erodibility was low or moderate, to being close to zero when soil erodibility was higher, to possibly being slightly negative only at the 90th to 95th percentile of soil erodibility values. Possible explanations for the increase in nutrient export with increased area in management practices include greater transport of soluble nutrients from areas in conservation tillage; lagged response of stream quality to implementation of management practices because of nitrogen transport in groundwater, time for vegetative cover to mature, and/or prior accumulation of P in soils; or limitations in the management practice and stream monitoring data sets. If lags are occurring, current nutrient export from agricultural watersheds may still be reflecting the influence of agricultural land-use practices that were in place before the implementation of these management practices.

27 CFR 70.701 - Rules and regulations.

Code of Federal Regulations, 2010 CFR

2010-04-01

...). Procedures relating solely to matters of internal management are not published; however, regulations appearing in internal management documents and statements of internal practices and procedures that affect... management document or communication as is necessary for an understanding of the procedure. TTB Procedures...

25 CFR 163.41 - Postgraduation recruitment, continuing education and training programs.

Code of Federal Regulations, 2012 CFR

2012-04-01

... orientation program designed to increase awareness and understanding of Indian culture and its effect on forest management practices and on Federal laws that affect forest management operations and...

25 CFR 163.41 - Postgraduation recruitment, continuing education and training programs.

Code of Federal Regulations, 2013 CFR

2013-04-01

... orientation program designed to increase awareness and understanding of Indian culture and its effect on forest management practices and on Federal laws that affect forest management operations and...

25 CFR 163.41 - Postgraduation recruitment, continuing education and training programs.

Code of Federal Regulations, 2014 CFR

2014-04-01

... orientation program designed to increase awareness and understanding of Indian culture and its effect on forest management practices and on Federal laws that affect forest management operations and...

Writing business communications. Are nurse managers prepared?

PubMed

Spears, L A

1997-12-01

Based on interviews, this study indicates that writing business communications is a key task for nurse managers, affecting their professional success and power. However, most of the nurse managers interviewed felt they needed more education in business communications. Several ways of bringing this training to nursing students and practicing managers are suggested.

Soil microbiome characteristics and soilborne disease development associated with long-term potato cropping system practices

USDA-ARS?s Scientific Manuscript database

Potato cropping system practices substantially affect soil microbial communities and the development of soilborne diseases. Cropping systems incorporating soil health management practices, such as longer rotations, disease-suppressive crops, reduced tillage, and/or organic amendments can potentially...

Smothering in UK free-range flocks. Part 2: investigating correlations between disease, housing and management practices.

PubMed

Rayner, A C; Gill, R; Brass, D; Willings, T H; Bright, A

2016-09-10

Smothering, when birds group together in a way that results in death from suffocation, is a welfare and economic concern for the egg industry. This questionnaire-based study explored correlations between disease, housing, management practices and smothering on free-range farms. A binomial logistic regression approach was used to test whether question responses predicted occurrence of nest box smothers (NBS) and panic and recurring smothers (PSRS) on farms. Breed (P=0.008) and nest box manufacturer (P=0.014) predicted NBS. Breed and nest box design have been previously reported to affect nesting behaviour. The affect of nest box manufacturer found in this study may illustrate the effect of nest box design features or house layouts. Nest box manufacturer (P=0.009), feeding oyster grit or grain on the litter (P<0.001) and range use on a sunny day (P<0.001) also predicted PSRS. Implementing some management practices to encourage desirable behaviours (eg ranging) may contribute to smothering, whereas some management practices such as those aimed at occupying birds may be beneficial, illustrating the delicate balance of factors involved in free-range egg production. It is hoped that these results will stimulate further work exploring the suitability of housing design and management of laying hens in light of smothering. British Veterinary Association.

Pine straw harvesting, fire, and fertilization affect understory vegetation within a Louisiana longleaf pine stand

Treesearch

James D. Haywood

2012-01-01

Pine straw harvesting can provide an economic benefit to landowners, but the practice may also change the composition of plant communities. This research was initiated in a 34-year-old stand of longleaf pine (Pinus palustris Mill.) established in 1956 to study how pine straw management practices (fertilization, prescribed fire, and straw harvesting) affected plant...

Comparison of net global warming potential and greenhouse gas intensity affected by management practices in two dryland cropping sites

USDA-ARS?s Scientific Manuscript database

Little is known about the effect of management practices on net global warming potential (GWP) and greenhouse gas intensity (GHGI) that account for all sources and sinks of greenhouse gas (GHG) emissions in dryland cropping systems. The objective of this study was to compare the effect of a combinat...

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

PubMed

Hanna, Lisa; May, Carl; Fairhurst, Karen

2011-01-01

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

Career stress and female managers' health in Taiwan's hospitals: a multilevel model approach.

PubMed

Chen, Duan-Rung; Lin, Yeh-Yun; Chung, Kuo-Piao

2008-01-01

This study investigates how perception-induced stress (barrier) and social capital (facilitator) affect the health of female managers. On the basis of the responses of 229 valid questionnaires of middle- and high-level female managers in large-scale hospitals, using a multilevel data analysis approach, this study investigates how perception-induced stress and social capital influence self-reported poor health of female managers. Analysis results indicate that all 3 perception-induced stresses (i.e., promotion-related procedural justice, promotion rate, and work-family conflict) and 2 social capital variables (i.e., mentor-assisted promotion and higher ranking mentor in other departments) are significantly associated with the health of female mangers. Factors involving the career success of women also affect their health. Health care organizations expecting to benefit from the long-term contribution of female elites must promote organizational equity and more heavily emphasize flexible work schedules, family-friendly policies, and perception management practices. In addition, adequately designed mentorship practices can greatly benefit female managers.

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

ERIC Educational Resources Information Center

Ginsburg, Sigmund G., Ed.

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

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.

Burning questions for managers: Fuels management practices in riparian areas

Treesearch

Kristen E. Meyer; Kathleen A. Dwire; Patricia A. Champ; Sandra E. Ryan; Gregg M. Riegel; Timothy A. Burton

2012-01-01

Vegetation treatment projects for fuel reduction in riparian areas can pose distinct challenges to resource managers. Riparian areas are protected by administrative regulations, many of which are largely custodial and restrict active management. Like uplands, however, riparian areas have been affected by fire suppression, land use, and multiple types of disturbance....

Doctor-patient relationships (DPR) in China.

PubMed

Ma, Shaozhuang; Xu, Xuehu; Trigo, Virginia; Ramalho, Nelson J C

2017-03-20

Purpose The purpose of this paper is twofold: first, to develop and test theory on how commitment human resource (HR) practices affect hospital professionals' job satisfaction that motivates them to generate desirable patient care and subsequently improve doctor-patient relationships (DPR) and second, to examine how commitment HR practices influence hospital managers and clinicians in different ways. Design/methodology/approach Using a cross-sectional survey, the authors collected data from 508 clinicians and hospital managers from 33 tertiary public hospitals in China. Structural equation model was employed to test the relationships of the variables in the study. Findings Commitment HR practices positively affect the job satisfaction of the healthcare professionals surveyed and a positive relationship is perceived between job satisfaction and DPR. Overall, the model shows a reversal on the strongest path linking job satisfaction and DPR whereby managers' main association operates through extrinsic job satisfaction while for clinicians it occurs through intrinsic satisfaction only. Practical implications DPR might be improved by applying commitment HR practices to increase healthcare professional's intrinsic and extrinsic satisfaction. In addition, while recognizing the importance of compensation and benefits to address the underpayment issue of Chinese healthcare professionals, empowerment and autonomy in work, and the use of subjects' expertise and skills may serve as stronger motivators for clinicians rather than hard economic incentives in achieving DPR improvements. Originality/value This study contributes to the small but growing body of research on human resource management (HRM) in the healthcare sector with new evidence supporting the link between commitment HR practice and work attitudes, as well as work attitudes and patient care from the perspective of clinicians and hospital managers. This study represents an initial attempt to examine the associations among commitment HR practices, job satisfaction and DPR in the Chinese healthcare sector. The findings provide evidence to support the value of commitment HR practices in Chinese hospital context, and demonstrate the importance of effective HRM in improving both hospital managers and clinicians' work attitudes.

The stakeholder preference for best management practices in the Three Gorges Reservoir Region.

PubMed

Qiu, Jiali; Shen, Zhenyao; Chen, Lei; Xie, Hui; Sun, Chengchun; Huang, Qin

2014-11-01

A qualitative analysis of in-depth interviews with 92 farmers and 42 policy managers in Wuxi County, the Three Gorges Reservoir Region, was conducted to identify stakeholder preferences for alternative best management practices (BMPs) and to determine the factors that affect their acceptance. Policy manager support for most of the practices was relatively stronger than support by farmers, except for the grade stabilization structure (GSS), hillside ditch (HD) and constructed wetland alternative, owing to their perceptions of soil benefits, economic advantages and environmental advantages. Farmers opposed those practices that occupied cultivated lands or changed the conventional planting methods, such as field border, conservation tillage (CT) and contour buffer strips. They tended to accept the BMPs with off-farm pollution reduction, such as GSS, riparian forest buffer and HD, and the BMPs associated with soil benefits, such as nutrient management and Terrace. The result that almost all respondents did not accept CT differed from reports in the existing literature. There is a significant correlation between the acceptance of some BMPs and the townships where the farmers lived (P ≤ 0.05). The environmental conditions and social factors would affect farmer support for BMPs, including local soil conditions, farming methods, economic income, education level and age. The economic advantages of the BMPs were the main motivation for farmers to accept the practices. Furthermore, intensive education efforts, financial incentives or economic subsidies may promote the adoption of the BMPs in our study area.

The Stakeholder Preference for Best Management Practices in the Three Gorges Reservoir Region

NASA Astrophysics Data System (ADS)

Qiu, Jiali; Shen, Zhenyao; Chen, Lei; Xie, Hui; Sun, Chengchun; Huang, Qin

2014-11-01

A qualitative analysis of in-depth interviews with 92 farmers and 42 policy managers in Wuxi County, the Three Gorges Reservoir Region, was conducted to identify stakeholder preferences for alternative best management practices (BMPs) and to determine the factors that affect their acceptance. Policy manager support for most of the practices was relatively stronger than support by farmers, except for the grade stabilization structure (GSS), hillside ditch (HD) and constructed wetland alternative, owing to their perceptions of soil benefits, economic advantages and environmental advantages. Farmers opposed those practices that occupied cultivated lands or changed the conventional planting methods, such as field border, conservation tillage (CT) and contour buffer strips. They tended to accept the BMPs with off-farm pollution reduction, such as GSS, riparian forest buffer and HD, and the BMPs associated with soil benefits, such as nutrient management and Terrace. The result that almost all respondents did not accept CT differed from reports in the existing literature. There is a significant correlation between the acceptance of some BMPs and the townships where the farmers lived ( P ≤ 0.05). The environmental conditions and social factors would affect farmer support for BMPs, including local soil conditions, farming methods, economic income, education level and age. The economic advantages of the BMPs were the main motivation for farmers to accept the practices. Furthermore, intensive education efforts, financial incentives or economic subsidies may promote the adoption of the BMPs in our study area.

33 CFR 151.2035 - What are the required ballast water management practices for my vessel?

Code of Federal Regulations, 2011 CFR

2011-07-01

... SUBSTANCES, GARBAGE, MUNICIPAL OR COMMERCIAL WASTE, AND BALLAST WATER Ballast Water Management for Control of... ballast water in areas within or that may directly affect marine sanctuaries, marine preserves, marine...

Coordinating cancer care: patient and practice management processes among surgeons who treat breast cancer.

PubMed

Katz, Steven J; Hawley, Sarah T; Morrow, Monica; Griggs, Jennifer J; Jagsi, Reshma; Hamilton, Ann S; Graff, John J; Friese, Christopher R; Hofer, Timothy P

2010-01-01

The Institute of Medicine has called for more coordinated cancer care models that correspond to initiatives led by cancer providers and professional organizations. These initiatives parallel those underway to integrate the management of patients with chronic conditions. We developed 5 breast cancer patient and practice management process measures based on the Chronic Care Model. We then performed a survey to evaluate patterns and correlates of these measures among attending surgeons of a population-based sample of patients diagnosed with breast cancer between June 2005 and February 2007 in Los Angeles and Detroit (N = 312; response rate, 75.9%). Surgeon practice specialization varied markedly with about half of the surgeons devoting 15% or less of their total practice to breast cancer, whereas 16.2% of surgeons devoted 50% or more. There was also large variation in the extent of the use of patient and practice management processes with most surgeons reporting low use. Patient and practice management process measures were positively associated with greater levels of surgeon specialization and the presence of a teaching program. Cancer program status was weakly associated with patient and practice management processes. Low uptake of patient and practice management processes among surgeons who treat breast cancer patients may indicate that surgeons are not convinced that these processes matter, or that there are logistical and cost barriers to implementation. More research is needed to understand how large variations in patient and practice management processes might affect the quality of care for patients with breast cancer.

Managing Southern Pine Plantations for Wildlife

Treesearch

Ronald E. Thill

1990-01-01

This paper reviews available information on how intensive management of pine plantations affects wildlife in the southeastern United States. Practices discussed and evaluated in this paper include harvesting, site preparation, planting, thinning, burning, and fertilizing. Management of special habitat features (e.g., standing dead trees and down woody material) is...

Human Resource Management in Selected Japanese Firms, Their Foreign Subsidiaries and Locally Owned Counterparts.

ERIC Educational Resources Information Center

Jain, Hem C.

1990-01-01

Examines differences between Japanese and North American personnel management philosophies. Considers to what extent practices of Japanese corporations have been transferred to subsidiaries in Canada, India, Malaysia, and Singapore, compared to locally owned firms. Shows how cultural factors affect styles of personnel management. (SK)

The National Study of Charter Management Organization (CMO) Effectiveness. Report on Interim Findings

ERIC Educational Resources Information Center

Lake, Robin; Dusseault, Brianna; Bowen, Melissa; Demeritt, Allison; Hill, Paul

2010-01-01

The National Study of CMO (charter management organizations) Effectiveness is a national, longitudinal research effort designed to measure how nonprofit charter school management organizations (CMOs) affect student achievement, and to examine the internal structures, practices, and policy contexts that may influence these outcomes. The study began…

Shifting patterns of practice: nurse practitioners in a managed care environment.

PubMed

Johnson, Rosemary

2005-01-01

The purpose of this qualitative study was to uncover patterns across nurse practitioner (NP) experiences that contribute to understanding their perceptions of managed care, how it affects daily practice, and how NPs respond to a changing managed care workplace. In-depth interviews were conducted with 14 NPs representing primary care, specialty, and independent practices. Over an 18-month period, data collection and analysis occurred simultaneously using standard methods of purposive sampling, constant comparison, memoing, and member checks. This study illuminates the tension NPs experience between a business and a professional ethic and the strategies they use to reconcile this difference with core nursing values. Type of setting, workplace dynamics, and length of time in practice contributed to variation in NP perspectives.

Road weather management best practices : version 3.0.

DOT National Transportation Integrated Search

2013-01-01

The impacts of weather on the nations road system greatly affect safety, mobility, and productivity. Weather affects roadway safety through increased crash risk, as well as exposure to weather-related hazards. On average 7,130 fatalities and 629,0...

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.

Factors influencing healthcare service quality

PubMed Central

Mosadeghrad, Ali Mohammad

2014-01-01

Background: The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods: Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results: Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment. Personal factors of the provider and the patient, and factors pertaining to the healthcare organisation, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers. Conclusion: This article contributes to healthcare theory and practice by developing a conceptual framework that provides policy-makers and managers a practical understanding of factors that affect healthcare service quality. PMID:25114946

Simulated soil organic carbon responses to crop rotation, tillage, and climate change in North Dakota

USDA-ARS?s Scientific Manuscript database

Understanding how agricultural management and climate change affect soil organic carbon (SOC) stocks is particularly important for dryland agriculture regions that have been losing SOC over time due to fallow and tillage practices, and it can lead to development of agricultural practice(s) that redu...

75 FR 37353 - Endangered and Threatened Wildlife and Plants; Listing the Mountain Plover as Threatened

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-29

... rule proposed to allow the incidental take of mountain plovers during routine farming practices on... agricultural practices in the winter range; (4) Effects of range management on mountain plover habitat; (5... techniques, or changes in cultivation practices could further affect the availability and quality of...

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

ERIC Educational Resources Information Center

Hanson, Paul W.

1983-01-01

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

Management of arthropod pathogen vectors in North America: Minimizing adverse effects on pollinators

USGS Publications Warehouse

Ginsberg, Howard; Bargar, Timothy A.; Hladik, Michelle L.; Lubelczyk, Charles

2017-01-01

Tick and mosquito management is important to public health protection. At the same time, growing concerns about declines of pollinator species raise the question of whether vector control practices might affect pollinator populations. We report the results of a task force of the North American Pollinator Protection Campaign (NAPPC) that examined potential effects of vector management practices on pollinators, and how these programs could be adjusted to minimize negative effects on pollinating species. The main types of vector control practices that might affect pollinators are landscape manipulation, biocontrol, and pesticide applications. Some current practices already minimize effects of vector control on pollinators (e.g., short-lived pesticides and application-targeting technologies). Nontarget effects can be further diminished by taking pollinator protection into account in the planning stages of vector management programs. Effects of vector control on pollinator species often depend on specific local conditions (e.g., proximity of locations with abundant vectors to concentrations of floral resources), so planning is most effective when it includes collaborations of local vector management professionals with local experts on pollinators. Interventions can then be designed to avoid pollinators (e.g., targeting applications to avoid blooming times and pollinator nesting habitats), while still optimizing public health protection. Research on efficient targeting of interventions, and on effects on pollinators of emerging technologies, will help mitigate potential deleterious effects on pollinators in future management programs. In particular, models that can predict effects of integrated pest management on vector-borne pathogen transmission, along with effects on pollinator populations, would be useful for collaborative decision-making.

Opportunities for improving management of advanced chronic kidney disease.

PubMed

Patwardhan, Meenal B; Matchar, David B; Samsa, Gregory P; Haley, William E

2008-01-01

Evidence suggests that management of advanced chronic kidney disease affects patient outcomes. To identify clinical areas that demand attention from a quality improvement perspective, we sought to examine the extent of conformance to an advanced chronic kidney disease guideline in a range of practices. A total of 237 patient medical records were abstracted from 4 primary care providers and 4 nephrology private practices across the country. In the practices studied, management of advanced chronic kidney disease patients was suboptimal for patients managed by primary care providers as well as those managed by nephrologists (overall conformance 27% and 42%, respectively), specifically for anemia, bone disease, and timing for renal replacement therapy. The current exercise (in conjunction with a literature search and focused and individual interviews with providers and patients) offered valuable information that was used to develop a toolkit for optimizing management of advanced chronic kidney disease.

Soil biodiversity and human health

NASA Astrophysics Data System (ADS)

Wall, Diana H.; Nielsen, Uffe N.; Six, Johan

2015-12-01

Soil biodiversity is increasingly recognized as providing benefits to human health because it can suppress disease-causing soil organisms and provide clean air, water and food. Poor land-management practices and environmental change are, however, affecting belowground communities globally, and the resulting declines in soil biodiversity reduce and impair these benefits. Importantly, current research indicates that soil biodiversity can be maintained and partially restored if managed sustainably. Promoting the ecological complexity and robustness of soil biodiversity through improved management practices represents an underutilized resource with the ability to improve human health.

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...

Streamside Management Zones Affect Movement of Silvicultural Nitrogen and Phosphorus Fertilizers to Piedmont Streams

Treesearch

Joseph M. Secoges; Wallace M. Aust; John R. Seiler; C. Andrew Dolloff; William A. Lakel

2013-01-01

Forestry best management practices (BMP) recommendations for streamside management zones (SMZs) are based on limited data regarding SMZ width, partial harvests, and nutrient movements after forest fertilization. Agricultural fertilization is commonly linked to increased stream nutrients. However, less is known about effectiveness of SMZ options for controlling nutrient...

Let the market help prescribe forest management practices

Treesearch

Gary W. Zinn; Edward Pepke

1989-01-01

To obtain the best economic returns from a hardwood forest, you must consider markets. Management decisions made now will affect a stand's future character and value, whether or not the decision results in immediate timber sales. Progressive forest landowners will have a management plan for their woodlots. Typically, such plans are largely land- and resource-...

Treating without Seeing: Pain Management Practice in a Thai Context.

PubMed

Chatchumni, Manaporn; Namvongprom, Ampaporn; Eriksson, Henrik; Mazaheri, Monir

2016-01-01

Pain management is a core nursing function, and it plays a key role in postoperative care. It is important to understand the cultural context of nursing practices and how this affects effective pain management. The aim of this study was to describe the professional and cultural framework within which pain management is practiced on a Thai surgical ward. Spradley's ethnographic methodology was used. Data were collected through 98.5 hours of field observations and interviews at a surgical ward in Thailand. Three themes were constructed that describe the way Thai nurses practiced pain management: (i) complex communications system to address pain and to respond to it, (ii) the essence of Thai-ness, and (iii) a passive approach to pain management. The results indicate that, in the response to discomfort and pain, better pain management will result if there is a shift from functional to patient-centered care. The nursing culture needs to be further researched and discussed, in order to set priorities in line with the goals of national and international organizations for improving postoperative care and promoting patient comfort.

Does tree harvesting in streamside management zones adversely affect stream turbidity? - preliminary observations from an Australian case study

Treesearch

Daniel G. Neary; Philip J. Smethurst; Brenda R. Baillie; Kevin C. Petrone; William E. Cotching; Craig C. Baillie

2010-01-01

In Australia, farmers and natural resource managers are striving to enhance environmental outcomes at farm and catchment scales by planting streamside management zones (SMZs) on farms with trees and other perennial vegetation. Lack of sound information on and funding for establishing and managing trees in SMZs is hindering widescale adoption of this practice....

Competitive marketing strategies. A challenge for academic practices.

PubMed

Sinioris, M E

1985-01-01

A special challenge has been presented to academic medical practices by the new healthcare environment. While increased competition for patients and resources affects all medical groups, it is the academic practices who are responsible for training the physicians of tomorrow. Not only must they sharpen their students' awareness of the new environment and teach them to incorporate effective management strategies into their practices, but they must set an example in effective management as well. The basic concepts of competitive marketing strategy, along with helpful exhibits, are presented here, and strategies for effectively maximizing position are discussed from the viewpoints of product mix, process market, and financing.

Metabolic differences in temperamental Brahman cattle can affect productivity

USDA-ARS?s Scientific Manuscript database

Many factors may adversely affect the growth and productivity of livestock. These include stressors associated with management practices, such as weaning, handling relative to transportation, and vaccination, that can modulate growth through the production of stress-related hormones (i.e., cortisol,...

Detection and Management of Diabetes during Pregnancy in Low Resource Settings: Insights into Past and Present Clinical Practices.

PubMed

Utz, Bettina; Delamou, Alexandre; Belaid, Loubna; De Brouwere, Vincent

2016-01-01

Background. Timely and adequate treatment is important to limit complications of diabetes affecting pregnancy, but there is a lack of knowledge on how these women are managed in low resource settings. Objective . To identify modalities of gestational diabetes detection and management in low and lower middle income countries. Methods . We conducted a scoping review of published literature and searched the databases PubMed, Web of Science, Embase, and African Index Medicus. We included all articles published until April 24, 2016, containing information on clinical practices of detection and management of gestational diabetes irrespective of publication date or language. Results . We identified 23 articles mainly from Asia and sub-Saharan Africa. The majority of studies were conducted in large tertiary care centers and hospital admission was reported in a third of publications. Ambulatory follow-up was generally done by weekly to fortnightly visits, whereas self-monitoring of blood glucose was not the norm. The cesarean section rate for pregnancies affected by diabetes ranged between 20% and 89%. Referral of newborns to special care units was common. Conclusion . The variety of reported provider practices underlines the importance of promoting latest consensus guidelines on GDM screening and management and the dissemination of information regarding their implementation.

Learning, Changing and Managing in Mental Health.

ERIC Educational Resources Information Center

Henderson, Jeanette

2001-01-01

Examined factors affecting the application of learning to practice in British mental health services, considering the role of administrators and emphasizing distance education. Data from administrators and health professionals indicated that workers who studied mental health often felt disempowered and isolated when introducing new practice ideas…

Integrated Pest Management of Poplar Species

Treesearch

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

1979-01-01

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

Changing landowners, changing ecosystem? Land-ownership motivations as drivers of land management practices.

PubMed

Sorice, Michael G; Kreuter, Urs P; Wilcox, Bradford P; Fox, William E

2014-01-15

Motivations for owning rural land are shifting from an agricultural-production orientation to a preference for natural and cultural amenities. Resultant changes in land management have significant implications for the type and distribution of landscape-level disturbances that affect the delivery of ecosystem services. We examined the relationship between motivations for owning land and the implementation of conservation land management practices by landowners in the Southern Great Plains of the United States. Using a mail survey, we classified landowners into three groups: agricultural production, multiple-objective, and lifestyle-oriented. Cross tabulations of landowner group with past, current, and future use of 12 different land management practices (related to prescribed grazing, vegetation management, restoration, and water management) found that lifestyle-oriented landowners were overall less likely to adopt these practices. To the degree that the cultural landscape of rural lands transitions from production-oriented to lifestyle-oriented landowners, the ecological landscape and the associated flow of ecosystem services will likely change. This poses new challenges to natural resource managers regarding education, outreach, and policy; however, a better understanding about the net ecological consequences of lower rates of adoption of conservation management practices requires consideration of the ecological tradeoffs associated with the changing resource dependency of rural landowners. Copyright © 2013 Elsevier Ltd. All rights reserved.

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.

Value gaps in dental practice: understanding how differences in core values can adversely affect the practice.

PubMed

Newsome, Philip; Wolfe, Ira S

2003-11-01

The authors explore the importance of human values in dental practice, an area often overlooked as we struggle to deal with the everyday demands of treating patients and managing staff members. Such values are, however, fundamental to the success of any practice; therefore, it is important to understand their significance. Problems arise in dental practices when gaps develop between the values held by the various players involved (that is, between the entire dental team and patients, the dentist/owner's personal values and business goals, the dentist/owner and staff members, and the dental practice and any third-party funding organizations). By understanding the potentially damaging consequences of value gaps for practice viability, dental practice owners and managers can take steps to create a more harmonious workplace in which all parties strive to reach common goals.

A Comparison of Preservice Teachers' Beliefs on Education and Classroom Management

ERIC Educational Resources Information Center

Tertemiz, Nese; Okut, Levent

2014-01-01

The beliefs held by preservice teachers will affect their classroom perceptions and behaviors. Therefore, understanding these beliefs is necessary to better understand preservice teachers, manage educational reforms successfully, and improving their teaching practice. From another perspective, understanding the belief structures of preservice…

Defoliation effects on pasture photosynthesis and respiration

USDA-ARS?s Scientific Manuscript database

Ecosystem C gain or loss from managed grasslands can depend on the type and intensity of management practices that are employed. However, limited information is available at the field scale on how the type of defoliation, specifically grazing vs. cutting, affects gross primary productivity (GPP) an...

Managing Organizational Commitment: Insights from Longitudinal Research

ERIC Educational Resources Information Center

Morrow, Paula C.

2011-01-01

This article summarizes what is known about the "active" management of affective organizational commitment (AOC) through a review of 58 studies employing longitudinal research designs. The review yields six broad categories of antecedents that have empirically demonstrated effects on AOC: socialization practices, organizational changes, human…

Confronting Disparities in Diabetes Care: The Clinical Effectiveness of Redesigning Care Management for Minority Patients in Rural Primary Care Practices

ERIC Educational Resources Information Center

Bray, Paul; Thompson, Debra; Wynn, Joan D.; Cummings, Doyle M.; Whetstone, Lauren

2005-01-01

Context: Diabetes mellitus and its complications disproportionately affect minority citizens in rural communities, many of whom have limited access to comprehensive diabetes management services. Purpose: To explore the efficacy of combining care management and interdisciplinary group visits for rural African American patients with diabetes…

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...

Adolescent Nutrition: Needs and Recommendations for Practice.

ERIC Educational Resources Information Center

Massey-Stokes, Marilyn

2002-01-01

Discusses the importance of healthy dietary behaviors in youth. Lists many ways in which diet can significantly affect the health of adolescents including: nutrition and learning, chronic disease risk, overweight and obesity, unhealthy weight management practices and eating disorders, barriers to healthy eating habits, and overcoming barriers in…

Common Problems That Can Affect Your Voice

MedlinePlus

... Programs Professional Development Home AcademyU Home Study Course Maintenance of Certification Conferences & Events Practice Management Home Resources Quality Clinical Data Registry Research Reimbursement ...

The influence of ethics on leadership.

PubMed

Kraemer, A M

1995-05-01

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

Factors influencing the perception of medical staff and outpatients of dual practice in Shanghai, People's Republic of China.

PubMed

Chen, Haiping; Li, Meina; Dai, Zhixin; Deng, Qiangyu; Zhang, Lulu

2016-01-01

Dual practice is defined as a physician's performance of medical activities in different health care institutions (two or more) simultaneously. This study aimed to examine the perception and acceptance of medical staff and outpatients of dual practice and explore the possible factors affecting people's perception. A cross-sectional study was conducted in 13 public hospitals in Shanghai. Participants included medical staff and outpatients. We distributed 1,000 questionnaires to each participant group, and the response rates were 66.7% and 69.4%, respectively. Statistical differences in variables were tested, and multinomial logistic regression methods were employed for statistical analysis. The study included two parts: medical staff survey and outpatient survey. The results of medical staff survey showed that 63.0% of the respondents supported dual practice. Medical staff who belonged to the surgical department or held positive belief of dual practice were more willing to participate in dual practice. Moreover, the publicity activities of dual practice and hospitals' human resource management system were important factors affecting the willingness of the medical staff. The results of outpatient survey showed that 44.5% of respondents believed that dual practice could reduce difficulty in consulting a doctor. Regarding the perceived benefits of dual practice, the proportion of outpatients who believed that dual practice could meet the demand for health convenience, minor illness, and chronic disease were 45.4%, 42.4%, and 53.7%, respectively. Additionally, demographic characteristics significantly influenced the perception of outpatients. This study confirmed that both medical staff and outpatients generally held positive attitudes toward dual practice. Medical staff who belonged to the surgical department or held positive belief of dual practice were more willing to participate in dual practice. Moreover, the existence of publicity activities and more flexible management system of hospitals' human resource would promote physicians' willingness to participate in dual practice. In addition, perception of outpatients of dual practice was affected by demographic characteristics.

Factors influencing the perception of medical staff and outpatients of dual practice in Shanghai, People’s Republic of China

PubMed Central

Chen, Haiping; Li, Meina; Dai, Zhixin; Deng, Qiangyu; Zhang, Lulu

2016-01-01

Objective Dual practice is defined as a physician’s performance of medical activities in different health care institutions (two or more) simultaneously. This study aimed to examine the perception and acceptance of medical staff and outpatients of dual practice and explore the possible factors affecting people’s perception. Methods A cross-sectional study was conducted in 13 public hospitals in Shanghai. Participants included medical staff and outpatients. We distributed 1,000 questionnaires to each participant group, and the response rates were 66.7% and 69.4%, respectively. Statistical differences in variables were tested, and multinomial logistic regression methods were employed for statistical analysis. Results The study included two parts: medical staff survey and outpatient survey. The results of medical staff survey showed that 63.0% of the respondents supported dual practice. Medical staff who belonged to the surgical department or held positive belief of dual practice were more willing to participate in dual practice. Moreover, the publicity activities of dual practice and hospitals’ human resource management system were important factors affecting the willingness of the medical staff. The results of outpatient survey showed that 44.5% of respondents believed that dual practice could reduce difficulty in consulting a doctor. Regarding the perceived benefits of dual practice, the proportion of outpatients who believed that dual practice could meet the demand for health convenience, minor illness, and chronic disease were 45.4%, 42.4%, and 53.7%, respectively. Additionally, demographic characteristics significantly influenced the perception of outpatients. Conclusion This study confirmed that both medical staff and outpatients generally held positive attitudes toward dual practice. Medical staff who belonged to the surgical department or held positive belief of dual practice were more willing to participate in dual practice. Moreover, the existence of publicity activities and more flexible management system of hospitals’ human resource would promote physicians’ willingness to participate in dual practice. In addition, perception of outpatients of dual practice was affected by demographic characteristics. PMID:27621600

Integrated watershed management for saturation excess generated runoff, erosion and nutrient control

USDA-ARS?s Scientific Manuscript database

Understanding the basic hydrology and erosion is vital for effective management and utilization of water resources and soil conservation planning. An important question for judging effectiveness of soil and water conservation practices is whether runoff erosion and nutrient loss is affected by infil...

Cotton production as affected by irrigation level and transitioning tillage systems

USDA-ARS?s Scientific Manuscript database

Identifying management practices that conserve and protect water resources are very important to a wide variety of stakeholders within semi-arid environments. The objective of this research was to develop conservation tillage and water management strategies that enhance lint yields in subsurface dri...

Rice rhizosphere soil and root surface bacterial community response to water management changes

USDA-ARS?s Scientific Manuscript database

Different water management practices could affect microbial populations in the rice rhizosphere. A field-scale study was conducted to evaluate microbial populations in the root plaque and rhizosphere of rice in response to continuous and intermittent flooding conditions. Microbial populations in rhi...

The Use of Leadership Standards in the Hiring Practices of Effective Principals

ERIC Educational Resources Information Center

Kracht, Ritchie E.; Hensley, Melissa A.; Strange, Martha A.

2013-01-01

This is a problem based learning project focusing on superintendent use of ISSLC standards in hiring practices for human resource management. Research notes student achievement is affected by effective leadership of principals. School district superintendents charged with hiring effective principals must determine the best candidate for that…

"Managed" Teacher Turnover: A Strategy for School Improvement

ERIC Educational Resources Information Center

Lewis, Jessica L.; London, Tim D.

2009-01-01

Given the negative implications of unmanaged teacher attrition for student learning and the potential of leadership actions to affect this dynamic, this article highlights the practices of one principal in the Chicago Public School (CPS) system who used teacher attrition to her school's advantage. Her actions reveal leadership practices that can…

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

ERIC Educational Resources Information Center

Ireson, Judith; Clark, Helen; Hallam, Susan

2002-01-01

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

The School Nurse's Role in Homeopathic Interventions.

ERIC Educational Resources Information Center

Selekman, Janice; Thomas, Elizabeth; McLean, Kay

1998-01-01

Describes the practices of homeopathy and how they affect the scope of practice of school nurses. Includes a definition of homeopathy, a discussion of remedies and the specific symptoms for which they are effective, and an examination of conditions treatable by homeopathic physicians. Nine guidelines for managing homeopathic products in the school…

Mutilating Procedures, Management Practices, and Housing Conditions That May Affect the Welfare of Farm Animals: Implications for Welfare Research.

PubMed

Nordquist, Rebecca E; van der Staay, Franz Josef; van Eerdenburg, Frank J C M; Velkers, Francisca C; Fijn, Lisa; Arndt, Saskia S

2017-02-21

A number of mutilating procedures, such as dehorning in cattle and goats and beak trimming in laying hens, are common in farm animal husbandry systems in an attempt to prevent or solve problems, such as injuries from horns or feather pecking. These procedures and other practices, such as early maternal separation, overcrowding, and barren housing conditions, raise concerns about animal welfare. Efforts to ensure or improve animal welfare involve adapting the animal to its environment, i.e., by selective breeding (e.g., by selecting "robust" animals) adapting the environment to the animal (e.g., by developing social housing systems in which aggressive encounters are reduced to a minimum), or both. We propose adapting the environment to the animals by improving management practices and housing conditions, and by abandoning mutilating procedures. This approach requires the active involvement of all stakeholders: veterinarians and animal scientists, the industrial farming sector, the food processing and supply chain, and consumers of animal-derived products. Although scientific evidence about the welfare effects of current practices in farming such as mutilating procedures, management practices, and housing conditions is steadily growing, the gain in knowledge needs a boost through more scientific research. Considering the huge number of animals whose welfare is affected, all possible effort must be made to improve their welfare as quickly as possible in order to ban welfare-compromising procedures and practices as soon as possible.

Nurse managers and the sandwich support model.

PubMed

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

2018-03-01

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

Controlling solar light and heat in a forest by managing shadow sources

Treesearch

Howard G. Halverson; James L. Smith

1974-01-01

Control of solar light and heat to develop the proper growth environment is a desirable goal in forest management. The amount of sunlight and heat reaching the surface is affected by shadows cast by nearby objects, including trees. In timbered areas, the type of forest management practiced can help develop desired microclimates. The results depend on the size and...

Calibration of Daycent biogeochemical model for rice paddies in three agro-ecological zones in Peninsular India to optimize cropping practices and predict GHG emissions

NASA Astrophysics Data System (ADS)

Rajan, S.; Kritee, K.; Keough, C.; Parton, W. J.; Ogle, S. M.

2014-12-01

Rice is a staple for nearly half of the world population with irrigated and rainfed lowland rice accounting for about 80% of the worldwide harvested rice area. Increased atmospheric CO2 and rising temperatures are expected to adversely affect rice yields by the end of the 21st century. In addition, different crop management practices affect methane and nitrous oxide emissions from rice paddies antagonistically warranting a review of crop management practices such that farmers can adapt to the changing climate and also help mitigate climate change. The Daily DayCent is a biogeochemical model that operates on a daily time step, driven by four ecological drivers, i.e. climate, soil, vegetation, and management practices. The model is widely used to simulate daily fluxes of various gases, plant productivity, nutrient availability, and other ecosystem parameters in response to changes in land management and climate. We employed the DayCent model as a tool to optimize rice cropping practices in Peninsular India so as to develop a set of farming recommendations to ensure a triple win (i.e. higher yield, higher profit and lower GHG emissions). We applied the model to simulate both N2O and CH4 emissions, and crop yields from four rice paddies in three different agro-ecological zones under different management practices, and compared them with measured GHG and yield data from these plots. We found that, like all process based models, the biggest constraint in using the model was input data acquisition. Lack of accurate documentation of historic land use and management practices, missing historical daily weather data, and difficulty in obtaining digital records of soil and crop/vegetation parameters related to our experimental plots came in the way of our execution of this model. We will discuss utilization of estimates based on available literature, or knowledge-based values in lieu of missing measured parameters in our simulations with DayCent which could prove to be a solution to overcome data limitations in modeling with DayCent and other process based models for developing regions of the world.

Is it working? A look at the changing nutrient practices in the Southern Willamette Valley’s Groundwater Management Area

EPA Science Inventory

Groundwater nitrate contamination affects thousands of households in the southern Willamette Valley and many more across the Pacific Northwest. The southern Willamette Valley Groundwater Management Area (SWV GWMA) was established in 2004 to address the occurrence of high groundw...

Sediment yield along an actively managed riparian buffer

Treesearch

Ferhat Kara; Edward F. Loewenstein; Latif Kalin

2012-01-01

High quality water is generally associated with forested watersheds. However, intensive forestry activities within these watersheds can negatively affect water quality. In order to mitigate negative effects of forestry operations on water quality, best management practices (BMPs) are recommended. In this study, effects of silvicultural treatments on water quality are...

Quantification of turfgrass buffer performance in reducing transport of pesticides in surface runoff

USDA-ARS?s Scientific Manuscript database

Pesticides are used to control pests in managed biological system such as agricultural crops and golf course turf. Off-site transport of pesticides with runoff and their potential to adversely affect non-target aquatic organisms has inspired the evaluation of management practices to minimize pestic...

Robust manipulations of pest insect behavior using repellents and practical application for integrated pest management

USDA-ARS?s Scientific Manuscript database

In agricultural settings, examples of effective control strategies using repellent chemicals in integrated pest management (IPM) are relatively scarce compared to those using attractants. This may be partly due to a poor understanding of how repellents affect insect behavior once they are deployed. ...

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...

Evaluating agricultural management effects on alachlor availability: Tillage, green manure, and biochar

USDA-ARS?s Scientific Manuscript database

Agricultural and soil management practices have been reported to affect alachlor sorption-desorption and degradation rates. The objectives of this study were to: (a) assess differences in alachlor sorption due to tillage treatments (chisel plow and ridge tillage) on soils from three Midwestern U.S. ...

Is it working? A look at the changing nutrient practices in the Southern Willamette Valley's Groundwater Management Area

EPA Science Inventory

Groundwater nitrate contamination affects thousands of households in the southern Willamette Valley and many more across the Pacific Northwest. The southern Willamette Valley Groundwater Management Area (SWV GWMA) was established in 2004 due to nitrate levels in the groundwater ...

Common Problems That Can Affect Your Voice

MedlinePlus

... Humanitarian Efforts International Outreach Advocacy Board of Governors Industry Programs Professional Development Home AcademyU Home Study Course Maintenance of Certification Conferences & Events Practice Management Home Resources ...

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

PubMed Central

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

2018-01-01

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

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

PubMed

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

2016-09-01

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

Incidence of laminitis and survey of dietary and management practices in pleasure horses and ponies in south-eastern Australia.

PubMed

Potter, S J; Bamford, N J; Harris, P A; Bailey, S R

2017-10-01

The aims of this study were to (1) report the incidence of laminitis among a population of horses and ponies attending Pony Clubs in Victoria, Australia, and (2) describe the dietary and management practices of the sample population. Researchers visited 10 Pony Clubs over a 10-month period. Horse and pony owners completed a questionnaire to provide information on management relating to diet and exercise. Owners were also asked to report their animal's history of laminitis, if any. From a survey population of 233 horses and ponies, 15.0% of animals (35 individuals) were reported to have suffered from at least one episode of laminitis. Of the animals that had suffered from laminitis, more than half had experienced multiple episodes. The majority of previously laminitic horses and ponies (71.4%) had not experienced an episode of laminitis within the past 12 months; however, 14.2% had experienced an incident within the past month. The proportion of ponies affected by laminitis (31/142; 21.8%) was significantly higher (P < 0.001) than the proportion of horses affected by laminitis (4/91; 4.4%). The incidence of laminitis within the pony group sampled was 6.5 cases per 100 pony years, while the incidence in horses was 0.55 cases per 100 horse years. This study provided information on the incidence of laminitis in the general population of pleasure horses and ponies in south-eastern Australia. It also provided an overview of dietary and management practices. Given the high incidence of animals that had been affected by laminitis (and the associated welfare implications), this study highlights the importance of owner education regarding appropriate feeding and management strategies to reduce the risk of laminitis. © 2017 Australian Veterinary Association.

24 CFR 583.235 - Renewal grants.

Code of Federal Regulations, 2010 CFR

2010-04-01

... will affect HUD's decision to approve a renewal request include the following: a continuing history of inadequate financial management accounting practices, indications of mismanagement on the part of the...

Primary Care Physicians' Experience with Disease Management Programs

PubMed Central

Fernandez, Alicia; Grumbach, Kevin; Vranizan, Karen; Osmond, Dennis H; Bindman, Andrew B

2001-01-01

OBJECTIVE To examine primary care physicians' perceptions of how disease management programs affect their practices, their relationships with their patients, and overall patient care. DESIGN Cross-sectional mailed survey. SETTING The 13 largest urban counties in California. PARTICIPANTS General internists, general pediatricians, and family physicians. MEASUREMENTS AND MAIN RESULTS Physicians' self-report of the effects of disease management programs on quality of patient care and their own practices. Respondents included 538 (76%) of 708 physicians: 183 (34%) internists, 199 (38%) family practitioners, and 156 (29%) pediatricians. Disease management programs were available 285 to (53%) physicians; 178 had direct experience with the programs. Three quarters of the 178 physicians believed that disease management programs increased the overall quality of patient care and the quality of care for the targeted disease. Eighty-seven percent continued to provide primary care for their patients in these programs, and 70% reported participating in major patient care decisions. Ninety-one percent reported that the programs had no effect on their income, decreased (38%) or had no effect (48%) on their workload, and increased (48%)) their practice satisfaction. CONCLUSIONS Practicing primary care physicians have generally favorable perceptions of the effect of voluntary, primary care-inclusive, disease management programs on their patients and on their own practice satisfaction. PMID:11318911

Social learning in the Anthropocene: Novel challenges, shadow networks, and ethical practices.

PubMed

Schmidt, Jeremy J

2017-05-15

The Anthropocene presents novel challenges for environmental management. This paper considers the challenges that the Anthropocene poses for social learning techniques in adaptive management. It situates these challenges with respect to how anthropogenic forcing on the Earth system affects the conditions required for: (1) The cooperative exercises of social learning; (2) The techniques used for assessing the fit of institutions to social-ecological systems; and, (3) The strategies employed for identifying management targets that are transformed by human action. In view of these challenges, the paper then examines how the practices of shadow networks may provide paths for incorporating a broader, more robust suite of social learning practices in the Anthropocene. The paper emphasizes how novel challenges in the Anthropocene demand increased attention to ethical practices, particularly those that establish center-periphery relationships between social learning communities and shadow networks. Copyright © 2017 Elsevier Ltd. All rights reserved.

Exploring leadership and team communication within the organizational environment of a dental practice.

PubMed

Chilcutt, Alexa Stough

2009-10-01

A lack of training in leadership and communication skills can place dentists at a disadvantage, leading to high degrees of staff-related stress and turnover. A dentist's leadership style directly affects an office's communication practices, and specific leadership behaviors affect the degree of team identity, interdependence and social distance (a measure of the influential power of team members). The author recruited 10 dental offices to take part in a study. Qualitative methods included in-depth interviews of one dentist, one senior staff member and one newer staff member from each office. The interview findings show that clear and definable relationships exist between leadership behaviors--hierarchical or team-oriented organizational perspectives, proactive or laissez-faire leadership styles, and autocratic or participative decision-making processes--and the team's communication practices. Decision-making processes directly affect the degree of team identification experienced by staff members, and conflict-management tactics affect team members' sense of interdependence and social distance. The findings of this study indicate that dentists should engage in participative decision-making processes that include staff members, thereby communicating their value to the practice and empowering employees. They also must become proactive in facilitating an environment that encourages collaboration and confrontation as healthy forms of conflict management. These leadership and communication behaviors are the most significant in creating a real rather than nominal team culture, which, in turn, leads to increased overall productivity, an enhanced level of services provided to patients and improved team member satisfaction.

Cultural practices in Appalachian hardwood sapling stands--are they worthwhile?

Treesearch

Gary W. Miller

1986-01-01

Forest managers often question the economic feasibility of cultural practices in hardwood sapling stands. Investment factors, including initial treatment cost, required rate of return, investment period, and stand response to treatment are discussed in terms of how they affect the outcome of early investments in even-aged hardwood stands. Attention is focused on...

Succession Planning and Management: A Guide to Organizational Systems and Practices

ERIC Educational Resources Information Center

Berke, David

2005-01-01

The purpose of succession-related practices is to ensure that there are ready replacements for key positions in an organization so that turnover will not negatively affect the organization's performance. CCL first published an annotated bibliography on succession planning in 1995. That bibliography focused primarily on the link between succession…

From Game Protection to Wildlife Management: Frame Shifts, Organizational Development, and Field Practices

ERIC Educational Resources Information Center

Brulle, Robert J.; Benford, Robert D.

2012-01-01

One enduring question in social movements research is the relationship between cultural representations and organizational structure. In this article, we examine the development of different discursive frames over time, and how such frame shifts affect movement structure and practices. This approach seeks to illuminate the dialectical interplay…

Blended Learning: Communication, Locations and Work-Life Practices

ERIC Educational Resources Information Center

Moe, Carl Erik; Rye, Stale Angen

2011-01-01

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

"Further Education, Future Prosperity? The Implications of Marketisation on Further Education Working Practices"

ERIC Educational Resources Information Center

Illsley, Rachael; Waller, Richard

2017-01-01

This paper examines how the marketised funding system of vocational further education is affecting lecturers' working practices and professional integrity. Semi-structured interviews were conducted with a number of lecturing staff and managers within two vocational areas at an English FE college to examine the implications of working under the…

Institutional Regimes and Induced Dependency in Homes for the Aged.

ERIC Educational Resources Information Center

Booth, Tim

1986-01-01

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

Improving Soil Seed Bank Management.

PubMed

Haring, Steven C; Flessner, Michael L

2018-05-08

Problems associated with simplified weed management motivate efforts for diversification. Integrated weed management uses fundamentals of weed biology and applied ecology to provide a framework for diversified weed management programs; the soil seed bank comprises a necessary part of this framework. By targeting seeds, growers can inhibit the propagule pressure on which annual weeds depend for agricultural invasion. Some current management practices affect weed seed banks, such as crop rotation and tillage, but these tools are often used without specific intention to manage weed seeds. Difficulties quantifying the weed seed bank, understanding seed bank phenology, and linking seed banks to emerged weed communities challenge existing soil seed bank management practices. Improved seed bank quantification methods could include DNA profiling of the soil seed bank, mark and recapture, or 3D LIDAR mapping. Successful and sustainable soil seed bank management must constrain functionally diverse and changing weed communities. Harvest weed seed controls represent a step forward, but over-reliance on this singular technique could make it short-lived. Researchers must explore tools inspired by other pest management disciplines, such as gene drives or habitat modification for predatory organisms. Future weed seed bank management will combine multiple complementary practices that enhance diverse agroecosystems. This article is protected by copyright. All rights reserved.

Abortions: Does It Affect Subsequent Pregnancies?

MedlinePlus

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

Alcohol: Does It Affect Blood Pressure?

MedlinePlus

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

Water Contamination

MedlinePlus

... the increase in population and advances made in farming technology has increased the demand for crops and ... activities are not well-monitored and managed, certain practices can negatively affect water quality. Agricultural Runoff According ...

Modeling best practices in chronic disease management: the Arthritis Program at Southlake Regional Health Centre.

PubMed

Bain, Lorna; Mierdel, Sandra; Thorne, Carter

2012-01-01

Researchers, hospital administrators and governments are striving to define competencies in interprofessional care and education, as well as to identify effective models in chronic disease management. For more than 25 years The Arthritis Program (TAP) at Southlake Regional Health Centre in Newmarket, Ontario, has actively practiced within these two interrelated priorities, which are now at the top of the healthcare agenda in Ontario and Canada. The approximately 135 different rheumatic conditions are the primary cause of long-term disability in Canada, affecting those from youth to the senior years, with an economic burden estimated at $4.4 billion (CAD$) annually, and growing. For the benefit of healthcare managers and their clients with chronic conditions, this article discusses TAP's history and demonstrable success, predicated on an educational model of patient self-management and self-efficacy. Also outlined are TAP's contributions in supporting evidence-based best practices in interprofessional collaboration and chronic disease management; approaches that are arguably understudied and under-practiced. Next steps for TAP include a larger role in empirical research in chronic-disease management and integration of a formal training program to benefit health professionals launching or expanding their interprofessional programs using TAP as the dynamic clinical example.

Principles and Practices of Water Quality Monitoring

Treesearch

J.L. Michael

2001-01-01

There are many activities in forest management that may affect water quality, i.e., timber harvestine, road building,mechanical and chemical site preparation, release operations, fuel reduction,wildlife opening maintenance, etc. How severely they affect water quality depends on how well the person in charge of the operation understands the activity itself, 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.

Evaluating the impact of abrupt changes in forest policy and management practices on landscape dynamics: analysis of a Landsat image time series in the Atlantic Northern Forest.

PubMed

Legaard, Kasey R; Sader, Steven A; Simons-Legaard, Erin M

2015-01-01

Sustainable forest management is based on functional relationships between management actions, landscape conditions, and forest values. Changes in management practices make it fundamentally more difficult to study these relationships because the impacts of current practices are difficult to disentangle from the persistent influences of past practices. Within the Atlantic Northern Forest of Maine, U.S.A., forest policy and management practices changed abruptly in the early 1990s. During the 1970s-1980s, a severe insect outbreak stimulated salvage clearcutting of large contiguous tracts of spruce-fir forest. Following clearcut regulation in 1991, management practices shifted abruptly to near complete dependence on partial harvesting. Using a time series of Landsat satellite imagery (1973-2010) we assessed cumulative landscape change caused by these very different management regimes. We modeled predominant temporal patterns of harvesting and segmented a large study area into groups of landscape units with similar harvest histories. Time series of landscape composition and configuration metrics averaged within groups revealed differences in landscape dynamics caused by differences in management history. In some groups (24% of landscape units), salvage caused rapid loss and subdivision of intact mature forest. Persistent landscape change was created by large salvage clearcuts (often averaging > 100 ha) and conversion of spruce-fir to deciduous and mixed forest. In groups that were little affected by salvage (56% of landscape units), contemporary partial harvesting caused loss and subdivision of intact mature forest at even greater rates. Patch shape complexity and edge density reached high levels even where cumulative harvest area was relatively low. Contemporary practices introduced more numerous and much smaller patches of stand-replacing disturbance (typically averaging <15 ha) and a correspondingly large amount of edge. Management regimes impacted different areas to different degrees, producing different trajectories of landscape change that should be recognized when studying the impact of policy and management practices on forest ecology.

Evaluating the Impact of Abrupt Changes in Forest Policy and Management Practices on Landscape Dynamics: Analysis of a Landsat Image Time Series in the Atlantic Northern Forest

PubMed Central

Legaard, Kasey R.; Sader, Steven A.; Simons-Legaard, Erin M.

2015-01-01

Sustainable forest management is based on functional relationships between management actions, landscape conditions, and forest values. Changes in management practices make it fundamentally more difficult to study these relationships because the impacts of current practices are difficult to disentangle from the persistent influences of past practices. Within the Atlantic Northern Forest of Maine, U.S.A., forest policy and management practices changed abruptly in the early 1990s. During the 1970s-1980s, a severe insect outbreak stimulated salvage clearcutting of large contiguous tracts of spruce-fir forest. Following clearcut regulation in 1991, management practices shifted abruptly to near complete dependence on partial harvesting. Using a time series of Landsat satellite imagery (1973-2010) we assessed cumulative landscape change caused by these very different management regimes. We modeled predominant temporal patterns of harvesting and segmented a large study area into groups of landscape units with similar harvest histories. Time series of landscape composition and configuration metrics averaged within groups revealed differences in landscape dynamics caused by differences in management history. In some groups (24% of landscape units), salvage caused rapid loss and subdivision of intact mature forest. Persistent landscape change was created by large salvage clearcuts (often averaging > 100 ha) and conversion of spruce-fir to deciduous and mixed forest. In groups that were little affected by salvage (56% of landscape units), contemporary partial harvesting caused loss and subdivision of intact mature forest at even greater rates. Patch shape complexity and edge density reached high levels even where cumulative harvest area was relatively low. Contemporary practices introduced more numerous and much smaller patches of stand-replacing disturbance (typically averaging <15 ha) and a correspondingly large amount of edge. Management regimes impacted different areas to different degrees, producing different trajectories of landscape change that should be recognized when studying the impact of policy and management practices on forest ecology. PMID:26106893

Special Education Teacher Preparation in Classroom Management: Implications for Students with Emotional and Behavioral Disorders

ERIC Educational Resources Information Center

Oliver, Regina M.; Reschly, Daniel J.

2010-01-01

Special education teachers' skills with classroom organization and behavior management affect the emergence and persistence of behavior problems as well as the success of inclusive practice for students with emotional and behavioral disorders (EBD). Adequate special education teacher preparation and strong classroom organization and behavior…

Proceedings of the 17th biennial southern silvicultural research conference

Treesearch

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

2015-01-01

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

Atypical forest products, processes, and uses: a developing component of National Forest management

Treesearch

Mike Higgs; John Sebelius; Mike Miller

1995-01-01

The silvicultural practices prescribed under an ecosystem management regimen will alter the volume and character of National Forests' marketable raw material base. This alteration will affect forest-dependent communities that have traditionally relied upon these resources for their economic and social well being. Community based atypical forest products, processes...

Total Quality Management Practices and Their Effects on Organizational Performance

ERIC Educational Resources Information Center

Hung, Richard Yu-Yuan; Lien, Bella Ya-Hui

2004-01-01

This paper reports a study designed to examine the key concepts of Total Quality Management (TQM) implementation and their effects on organizational performance. Process Alignment and People Involvement are two key concepts for successful implementation of TQM. The purpose of this paper is to discuss how these two constructs affect organizational…

Price projections for selected grades of Douglas-fir, coast hem-fir, inland hem-fir, and ponderosa pine lumber.

Treesearch

Richard W. Haynes; Roger D. Fight

1992-01-01

Grade-specific price projections were developed for Douglas-fir, coast hem-fir, inland hem-fir, and ponderosa pine lumber. These grade-specific price projections can be used in evaluating management practices that will affect the quality of saw logs produced under various management regimes.

33 CFR 320.3 - Related laws.

Code of Federal Regulations, 2012 CFR

2012-07-01

... operation of the facility. (b) Section 307(c) of the Coastal Zone Management Act of 1972, as amended (16 U.S..., directly affecting a state's coastal zone, to comply to the maximum extent practicable with an approved state coastal zone management program. Indian tribes doing work on federal lands will be treated as a...

33 CFR 320.3 - Related laws.

Code of Federal Regulations, 2013 CFR

2013-07-01

... operation of the facility. (b) Section 307(c) of the Coastal Zone Management Act of 1972, as amended (16 U.S..., directly affecting a state's coastal zone, to comply to the maximum extent practicable with an approved state coastal zone management program. Indian tribes doing work on federal lands will be treated as a...

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,…

Classroom Behaviour: A Practical Guide to Effective Teaching, Behaviour Management and Colleague Support.

ERIC Educational Resources Information Center

Rogers, William A.

This book explores the relationship between effective teaching, behavior management, discipline, and colleague support. After an introduction, "I Never Thought I'd Become a Teacher," eight chapters include: (1) "The Dynamics of Classroom Behavior" (how student and teacher behavior affect each other, and control for the purpose…

Use of molecular genetic markers in forest management

Treesearch

Craig S. Echt

1997-01-01

When managing forests for biodiversity or sustainability, attention must be given to how silvicultural practices affect genetic diversity. A new generation of DNA-based markers affords a greater detail of genetic analysis than previously possible. These new markers, SSRs or microsatellites, have been used to demonstrate genetic diversity and infer evolutionary history...

Effect of understory management on phenological responses of eastern black walnut on an alluvial Arkansas soil

USDA-ARS?s Scientific Manuscript database

Black walnut (Juglans nigra L.) is commonly grown in agroforestry practices for nuts and/or timber with little knowledge of how understory herbage management might affect tree phenology. We compared black walnut plant type (variety and wild-type) for phenological response in date of budburst, leaf ...

33 CFR 320.3 - Related laws.

Code of Federal Regulations, 2011 CFR

2011-07-01

... operation of the facility. (b) Section 307(c) of the Coastal Zone Management Act of 1972, as amended (16 U.S..., directly affecting a state's coastal zone, to comply to the maximum extent practicable with an approved state coastal zone management program. Indian tribes doing work on federal lands will be treated as a...

Management and techniques for riparian restorations: roads field guide, vol. I

Treesearch

Roads/Riparian Restoration Team

2002-01-01

Improperly constructed or maintained roads near riparian and wetland areas may degrade these valuable sites. Degradation affects many aspects of the riparian and wetland ecosystems. This field guide presents information in a practical, user friendly format to help resource managers and professionals. Well-documented evaluation and monitoring strategies are critical in...

Management and techniques for riparian restorations: roads field guide, vol. II

Treesearch

Roads/Riparian Restoration Team

2002-01-01

Improperly constructed or maintained roads near riparian and wetland areas may degrade these valuable sites. Degradation affects many aspects of the riparian and wetland ecosystems. This field guide presents information in a practical, user friendly format to help resource managers and professionals. Well-documented evaluation and monitoring strategies are critical in...

Ethics and risk management in administrative child and adolescent psychiatry.

PubMed

Sondheimer, Adrian

2010-01-01

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

Socio-emotional support in French hospitals: Effects on French nurses' and nurse aides' affective commitment.

PubMed

Ruiller, Caroline; Van Der Heijden, Beatrice I J M

2016-02-01

In spite of the differences in human resource management (HRM) practices between the non-profit health care sector and business life, the majority of health care sector research appears to be based on the HRM (for human resources management) blueprint for business life staff policy and practice. This study is aimed to better understand the impact of workplace social support in the context of French hospitals. Concrete, the first objective of this article comprises a thorough conceptualization and operationalization of workplace social support (i.e. both professional and personal social support). Data were collected in a French hospital among a sample of 62 respondents (for the qualitative part of our study), and among a sample of 171 health care professionals (nurses and nurse aids) (for the quantitative part of our study). Our outcomes indicate that, especially, personal support given by one's supervisor is strongly and positively related to nurses' and nurse aides' affective commitment. After a discussion about the outcomes, followed by some recommendations for future research, the article concludes with some practical implications for management in hospitals. Copyright © 2015 Elsevier Inc. All rights reserved.

Improving the health care work environment: implications for research, practice, and policy.

PubMed

Harrison, Michael I; Henriksen, Kerm; Hughes, Ronda G

2007-11-01

Despite the gains to date, we need better understanding of practices for implementing and sustaining improvements in health care work environments and further study of organizational conditions affecting implementation of improvements. Limiting work hours, improving schedules, and providing sleep hygiene training will help combat clinician fatigue. Hospital crowding can be reduced through systemwide improvement of patient flow and capacity management, coupled with management support, measurement, and reporting on crowding. Long-term solutions to nurse staffing shortfalls include process redesign to enhance efficiency. Improvement of organizational climate, human resource management, and interoccupational relations will also contribute to staff retention. Evidence-based enhancements to patient rooms and other physical features in hospitals contribute directly to safety and quality and also affect staff performance. POLICY: Landrigan and his colleagues call for external restrictions on residents' work shifts. Clarke examines prospects for mandated nursing-staff ratios. Public reporting on staffing, crowding, and other risks may incent change. Reporting and pay for performance require standardized measures of targeted conditions. Organizations promoting care quality can help spread safe work practices; they can also support collaborative learning and other strategies that may enhance implementation of improvements in work environments.

The importance of human resources management in health care: a global context.

PubMed

Kabene, Stefane M; Orchard, Carole; Howard, John M; Soriano, Mark A; Leduc, Raymond

2006-07-27

This paper addresses the health care system from a global perspective and the importance of human resources management (HRM) in improving overall patient health outcomes and delivery of health care services. We explored the published literature and collected data through secondary sources. Various key success factors emerge that clearly affect health care practices and human resources management. This paper will reveal how human resources management is essential to any health care system and how it can improve health care models. Challenges in the health care systems in Canada, the United States of America and various developing countries are examined, with suggestions for ways to overcome these problems through the proper implementation of human resources management practices. Comparing and contrasting selected countries allowed a deeper understanding of the practical and crucial role of human resources management in health care. Proper management of human resources is critical in providing a high quality of health care. A refocus on human resources management in health care and more research are needed to develop new policies. Effective human resources management strategies are greatly needed to achieve better outcomes from and access to health care around the world.

The importance of human resources management in health care: a global context

PubMed Central

Kabene, Stefane M; Orchard, Carole; Howard, John M; Soriano, Mark A; Leduc, Raymond

2006-01-01

Background This paper addresses the health care system from a global perspective and the importance of human resources management (HRM) in improving overall patient health outcomes and delivery of health care services. Methods We explored the published literature and collected data through secondary sources. Results Various key success factors emerge that clearly affect health care practices and human resources management. This paper will reveal how human resources management is essential to any health care system and how it can improve health care models. Challenges in the health care systems in Canada, the United States of America and various developing countries are examined, with suggestions for ways to overcome these problems through the proper implementation of human resources management practices. Comparing and contrasting selected countries allowed a deeper understanding of the practical and crucial role of human resources management in health care. Conclusion Proper management of human resources is critical in providing a high quality of health care. A refocus on human resources management in health care and more research are needed to develop new policies. Effective human resources management strategies are greatly needed to achieve better outcomes from and access to health care around the world. PMID:16872531

Self-management experiences among men and women with type 2 diabetes mellitus: a qualitative analysis

PubMed Central

2012-01-01

Background The purpose of this study is to better understand differences in diabetes self-management, specifically needs, barriers and challenges among men and women living with type 2 diabetes mellitus (T2DM). Methods 35 participants were recruited from a diabetes education center (DEC) in Toronto, Canada. Five focus groups and nine individual interviews were conducted to explore men and women's diabetes self-management experiences. Results The average age of participants was 57 years and just over half (51.4%) were female. Analyses revealed five themes: disclosure and identity as a person living with diabetes; self-monitoring of blood glucose (SMBG); diet struggles across varying contexts; utilization of diabetes resources; and social support. Women disclosed their diabetes more readily and integrated management into their daily lives, whereas men were more reluctant to tell friends and family about their diabetes and were less observant of self-management practices in social settings. Men focused on practical aspects of SMBG and experimented with various aspects of management to reduce reliance on medications whereas women focused on affective components of SMBG. Women restricted foods from their diets perceived as prohibited whereas many men moderated their intake of perceived unhealthy foods, except in social situations. Women used socially interactive resources, like education classes and support groups whereas men relied more on self-directed learning but also described wanting more guidance to help navigate the healthcare system. Finally, men and women reported wanting physician support for both affective and practical aspects of self-management. Conclusions Our findings highlight the differences in needs and challenges of diabetes self-management among men and women, which may inform gender-sensitive diabetes, care, counseling and support. PMID:23249410

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

USGS Publications Warehouse

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

2016-04-29

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

Communication management between architects and clients

NASA Astrophysics Data System (ADS)

Taleb, Hala; Ismail, Syuhaida; Wahab, Mohammad Hussaini; Rani, Wan Nurul Mardiah Wan Mohd.

2017-10-01

Architectural projects are initiated with the designing phase, that tends to translate and materialize the client's requirements and needs. This phase is highly and directly affected by the exchanged information and communication between architects with their clients. Nevertheless, despite of its importance, studies have proven that communication management, being a significant field of project management, is distinctly overlooked by architects in the architectural industry. Thus, this paper highlights the current practices and attributes of communication management in the context of architectural design phase. It outlines the different aspects' definitions of communication, as well as communication management standards and practices. By the end of this paper, the findings are expected to increase the communication management knowledge amongst architects to achieve success in projects by promoting the relationships between them and their clients. Finally, this paper uncover the architects' need for significant improvement of communication management as an insistent matter to ultimately fulfill project success.

New accounting rules: asset allocation and portfolio management.

PubMed

Andrew, B K

1997-01-01

New accounting rules went into effect at the end of 1995 that are now starting to affect how medical practices must report income from equity and fixed income investments. This article explores the new accounting rules and considers the other factors that help practices determine investment strategies, including desired investment return, comfort with level of risk, appropriate time horizons, liquidity needs and legal restrictions. The author also presents an example that examines the different considerations that may affect an asset allocation decision, including endowments and operating reserve funds.

Blood Pressure: Is It Affected by Cold Weather?

MedlinePlus

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

36 CFR 212.5 - Road system management.

Code of Federal Regulations, 2014 CFR

2014-07-01

... responsible official must incorporate a science-based roads analysis at the appropriate scale and, to the degree practicable, involve a broad spectrum of interested and affected citizens, other state and federal...

36 CFR 212.5 - Road system management.

Code of Federal Regulations, 2012 CFR

2012-07-01

... responsible official must incorporate a science-based roads analysis at the appropriate scale and, to the degree practicable, involve a broad spectrum of interested and affected citizens, other state and federal...

Emerging communities of child-healthcare practice in the management of long-term conditions such as chronic kidney disease: qualitative study of parents' accounts.

PubMed

Carolan, Ian; Smith, Trish; Hall, Andy; Swallow, Veronica M

2014-07-07

Parents of children and young people with long-term conditions who need to deliver clinical care to their child at home with remote support from hospital-based professionals, often search the internet for care-giving information. However, there is little evidence that the information available online was developed and evaluated with parents or that it acknowledges the communities of practice that exist as parents and healthcare professionals share responsibility for condition management. The data reported here are part of a wider study that developed and tested a condition-specific, online parent information and support application with children and young people with chronic-kidney disease, parents and professionals. Semi-structured interviews were conducted with 19 fathers and 24 mothers who had recently tested the novel application. Data were analysed using Framework Analysis and the Communities of Practice concept. Evolving communities of child-healthcare practice were identified comprising three components and several sub components: (1) Experiencing (parents making sense of clinical tasks) through Normalising care, Normalising illness, Acceptance & action, Gaining strength from the affected child and Building relationships to formalise a routine; (2) Doing (Parents executing tasks according to their individual skills) illustrated by Developing coping strategies, Importance of parents' efficacy of care and Fear of the child's health failing; and (3) Belonging/Becoming (Parents defining task and group members' worth and creating a personal identity within the community) consisting of Information sharing, Negotiation with health professionals and Achieving expertise in care. Parents also recalled factors affecting the development of their respective communities of healthcare practice; these included Service transition, Poor parent social life, Psycho-social affects, Family chronic illness, Difficulty in learning new procedures, Shielding and avoidance, and Language and cultural barriers. Health care professionals will benefit from using the communities of child-healthcare practice model when they support parents of children with chronic kidney disease. Understanding some of the factors that may influence the development of communities of child-healthcare practice will help professionals to tailor information and support for parents learning to manage their child's healthcare. Our results are potentially transferrable to professionals managing the care of children and young people with other long-term conditions.

Human resource management and performance in healthcare organisations.

PubMed

Harris, Claire; Cortvriend, Penny; Hyde, Paula

2007-01-01

The purpose of this paper is to compare the evidence from a range of reviews concerned with the links between human resource management (HRM) and performance. The aim of the paper is to review this diverse literature, and to derive human resource (HR) implications for healthcare researchers, policy makers and managers. Recent reviews of the human resource management and performance literature are examined, in addition to the inclusion of a previously unpublished review. Their methods, HRM focus, findings and recommendations are contrasted in order to produce this review. The paper finds that relationships have been found between a range of HRM practices, policies systems and performance. Despite being an important concern for HR professionals, there is little research exploring the link between HRM and performance in the health sector. The paper sees that recent studies have found HRM practices to be associated with patient outcomes such as mortality, yet they yield little information regarding the processes through which HRM affects individual performance and its consequent impact on patient care. The use of approaches that seek to gain an understanding of workers' interpretations of their experience, i.e. the psychological process through which HRM can affect individual performance, may shed some light on how these processes work in practice. The paper shows that increasing autonomy for healthcare organisations in the UK, i.e. Foundation Trusts, may offer increased opportunity for locally tailored HR systems and practices. The paper presents findings drawn from a review of previous research on a subject of increasing relevance to HR researchers and practitioners in healthcare organisations. The paper indicates alternative approaches to research and practice in light of extant research.

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...

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

ERIC Educational Resources Information Center

Nicholas, George P.

2006-01-01

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

Reducing Risks of Birth Defects

MedlinePlus

... Physicians Contact Us My ACOG ACOG Departments Donate Shop Career Connection Home Clinical Guidance & Publications Practice Management ... its website: www.aa.org . How can recreational drug use affect my pregnancy? Using substances—including heroin, ...

Ecology and management of grapevine leafroll disease.

PubMed

Almeida, Rodrigo P P; Daane, Kent M; Bell, Vaughn A; Blaisdell, G Kai; Cooper, Monica L; Herrbach, Etienne; Pietersen, Gerhard

2013-01-01

Grapevine leafroll disease (GLD) is caused by a complex of vector-borne virus species in the family Closteroviridae. GLD is present in all grape-growing regions of the world, primarily affecting wine grape varieties. The disease has emerged in the last two decades as one of the major factors affecting grape fruit quality, leading to research efforts aimed at reducing its economic impact. Most research has focused on the pathogens themselves, such as improved detection protocols, with limited work directed toward disease ecology and the development of management practices. Here we discuss the ecology and management of GLD, focusing primarily on Grapevine leafroll-associated virus 3, the most important virus species within the complex. We contextualize research done on this system within an ecological framework that forms the backbone of the discussion regarding current and potential GLD management strategies. To reach this goal, we introduce various aspects of GLD biology and ecology, followed by disease management case studies from four different countries and continents (South Africa, New Zealand, California-USA, and France). We review ongoing regional efforts that serve as models for improved strategies to control this economically important and worldwide disease, highlighting scientific gaps that must be filled for the development of knowledge-based sustainable GLD management practices.

Ecology and management of grapevine leafroll disease

PubMed Central

Almeida, Rodrigo P. P.; Daane, Kent M.; Bell, Vaughn A.; Blaisdell, G. Kai; Cooper, Monica L.; Herrbach, Etienne; Pietersen, Gerhard

2013-01-01

Grapevine leafroll disease (GLD) is caused by a complex of vector-borne virus species in the family Closteroviridae. GLD is present in all grape-growing regions of the world, primarily affecting wine grape varieties. The disease has emerged in the last two decades as one of the major factors affecting grape fruit quality, leading to research efforts aimed at reducing its economic impact. Most research has focused on the pathogens themselves, such as improved detection protocols, with limited work directed toward disease ecology and the development of management practices. Here we discuss the ecology and management of GLD, focusing primarily on Grapevine leafroll-associated virus 3, the most important virus species within the complex. We contextualize research done on this system within an ecological framework that forms the backbone of the discussion regarding current and potential GLD management strategies. To reach this goal, we introduce various aspects of GLD biology and ecology, followed by disease management case studies from four different countries and continents (South Africa, New Zealand, California-USA, and France). We review ongoing regional efforts that serve as models for improved strategies to control this economically important and worldwide disease, highlighting scientific gaps that must be filled for the development of knowledge-based sustainable GLD management practices. PMID:23630520

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.

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.

A descriptive study of 'kangaroo gait' in sheep in northern Britain.

PubMed

Clements, A C A; Mellor, D J; Innocent, G T; Fitzpatrick, J L

2003-10-15

Two questionnaires were undertaken to obtain improved knowledge of the signalment, incidence and risk factors of the condition termed 'kangaroo gait' (KG; a forelimb locomotor disorder of adult female sheep). The first survey was mailed to 221 veterinary surgeons in practices in northern Britain which provided veterinary care for sheep, and the second was mailed to 438 sheep-flock owners and managers located in the Scottish Borders, who were recruited via their veterinary surgeons. Responses of 84.7 and 30.7% were achieved, respectively. In total, 29.7% of veterinary practices and 24.1% of flock owners and managers had identified one or more cases of KG in their practice area or flocks since the first case was reported in 1976. Almost all respondents indicated that adult females were affected-usually during lactation (and less commonly during late gestation). KG was more common among commercial crossbreeds and less common among sheep grazing hill pasture (than sheep grazing upland or lowland pasture). Cases usually occurred between March and June while sheep were at grass, although it was unclear whether the temporal pattern was associated with grazing or lambing patterns. Stocking densities were significantly higher among affected flocks than among non-affected flocks. The annual number of individuals and flocks identified as being affected had increased since the condition first was identified. Most cases of locomotor disorders resembling KG were not reported to veterinary surgeons.

Project management practice and its effects on project success in Malaysian construction industry

NASA Astrophysics Data System (ADS)

Haron, N. A.; Devi, P.; Hassim, S.; Alias, A. H.; Tahir, M. M.; Harun, A. N.

2017-12-01

The rapid economic development has increased the demand for construction of infrastructure and facilities globally. Sustainable development and globalization are the new ‘Zeitgeist’ of the 21st century. In order to implement these projects successfully and to meet the functional aim of the projects within their lifetime, an efficient project management practice is needed. The aim of this study is to identify the critical success factors (CSFs) and the extent of use of project management practice which affects project success, especially during the implementation stage. Data were obtained from self-administered questionnaires with 232 respondents. A mixed method of data collection was adopted using semi-structured interview and questionnaire approach. The result of the analysis of data obtained showed that new and emerging criteria such as customer satisfaction, competency of the project team, and performance of subcontractors/suppliers are becoming measures of success in addition to the classic iron triangle’s view of time, cost and quality. An insight on the extent of use of different project management practice in the industry was also achieved from the study.

Faculty Technology Usage Resulting from Institutional Migration to a New Learning Management System

ERIC Educational Resources Information Center

Rucker, Ryan; Downey, Steve

2016-01-01

Research literature is flush with articles discussing how teachers use individual learning management systems. However, very few studies examine how faculty are affected as they move from one platform to another. This study addresses that gap and examines how faculty adapt their online teaching practices as they migrate systems. In doing so,…

Effects of long-term forest management on a regional avifauna

Treesearch

John C. Kilgo; Kathleen E. Franzreb; Sidney A. Gauthreaux; Karl V. Miller; Brian R. Chapman

2000-01-01

We compared breeding bird populations on and off of the Savannah River Site, SC, to determine whether management practices have affected abundance and composition of the resident avifauna. We assessed relative abundance by comparing Breeding Bird Survey (BBS) data from six routes off the Savannah River Site with three surrogate routes generated using point-count data...

Mineralogical and micromorphological modifications in soil affected by slash pile burn

Treesearch

M. M. Nobles; W. J. Massman; M. Mbila; G. Butters

2010-01-01

Silvicultural practices, such as slash pile burning, are commonly used for fire and ecosystem management. This management technique can drastically alter chemical, physical and biological soil properties due to the high temperatures achieved during the prolonged severe burn. Little is known, however, about the impact of high-temperature slash pile burning on soil...

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.

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.

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

NASA Astrophysics Data System (ADS)

Aramo-Immonen, Heli; Toikka, Tarja

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

Influence of grazing and land use on stream-channel characteristics among small dairy farms in the Eastern United States

USGS Publications Warehouse

Brand, Genevieve; Vondracek, Bruce C.; Jordan, Nicholas R.

2015-01-01

Rotational grazing (RG) is a livestock management practice that rotates grazing cattle on a scale of hours to days among small pastures termed paddocks. It may beneficially affect stream channels, relative to other livestock management practices. Such effects and other beneficial effects on hydrology are important to RG's potential to provide a highly multifunctional mode of livestock farming. Previous comparisons of effects of RG and confinement dairy (CD) on adjoining streams have been restricted in scale and scope. We examined 11 stream-channel characteristics on a representative sample of 37 small dairy farms that used either RG or CD production methods. Our objectives were: (1) to compare channel characteristics on RG and CD farms, as these production methods are implemented in practice, in New York, Pennsylvania and Wisconsin, USA; and (2) to examine land use on these farms that may affect stream-channel characteristics. To help interpret channel characteristic findings, we examined on-farm land use in riparian areas 50 m in width along both sides of stream reaches and whole-farm land use. In all states, stream-channel characteristics on RG and CD farms did not differ. Whole-farm land use differed significantly between farm types; CD farms allocated more land to annual row crops, whereas RG farms allocated more land to pasture and grassland. However, land cover in 50 m riparian areas was not different between farm types within states; in particular, many RG and CD farms had continuously grazed pastures in riparian areas, typically occupied by juvenile and non-lactating cows, which may have contributed sediment and nutrients to streams. This similarity in riparian management practices may explain the observed similarity of farm types with respect to stream-channel characteristics. To realize the potential benefits of RG on streams, best management practices that affect stream-channel characteristics, such as protection of riparian areas, may improve aggregate effects of RG on stream quality and also enhance other environment, economic and social benefits of RG.

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

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

Iveson, Steven W.

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

How do land management practices affect net ecosystem CO2 exchange of an invasive plant infestation?

NASA Astrophysics Data System (ADS)

Sonnentag, O.; Detto, M.; Runkle, B.; Kelly, M.; Baldocchi, D. D.

2009-12-01

Ecosystem gas and energy exchanges of invasive plant infestations under different land management practices have been subject of few studies and thus little is known. Our goal is to characterize seasonal changes in net ecosystem CO2 exchange (NEE) through the processes of photosynthesis (GEP) and ecosystem respiration (Reco) of a grassland used as pasture yet infested by perennial pepperweed (Lepidium latifolium) in California’s Sacramento-San Joaquin River Delta. We analyze eddy-covariance supported by environmental and canopy-scale hyperspectral reflectance measurements acquired in 2007-2009. Our study covers three summer drought periods with slightly different land management practices. Over the study period the site was subject to year-round grazing, and in 2008 the site was additionally mowed. Specific questions we address are a) how does pepperweed flowering affect GEP, b) does a mowing event affect NEE mainly through GEP or Reco, and c) can the combined effects of phenology and mowing on pepperweed NEE potentially be tracked using routinely applied remote sensing techniques? Preliminary results indicate that pepperweed flowering drastically decreases photosynthetic CO2 uptake due to shading by the dense arrangement of white flowers at the canopy top, causing the infestation to be almost CO2 neutral. In contrast, mowing causes the infestation to act as moderate net CO2 sink, mainly due to increased CO2 uptake during regrowth. We demonstrate that spectral regions other than commonly-used red and near-infrared might be more promising for pepperweed monitoring because of its spectral uniqueness during the flowering phase. Our results have important implications for land-use land-cover (LULC) change studies when biological invasions and their management alter ecosystem structure and functioning but not necessarily the respective LULC class.

Increased Use of Care Management Processes and Expanded Health Information Technology Functions by Practice Ownership and Medicaid Revenue.

PubMed

Rodriguez, Hector P; McClellan, Sean R; Bibi, Salma; Casalino, Lawrence P; Ramsay, Patricia P; Shortell, Stephen M

2016-06-01

Practice ownership and Medicaid revenue may affect the use of care management processes (CMPs) for chronic conditions and expansion of health information technology (HIT). Using a national cohort of medical practices, we compared the use of CMPs and HIT from 2006/2008 to 2013 by practice ownership and level of Medicaid revenue. Poisson regression models estimated changes in CMP use, and linear regression estimated changes in HIT, by practice ownership and Medicaid patient revenue, controlling for other practice characteristics. Compared with physician-owned practices, system-owned practices adopted a greater number of CMPs and HIT functions over time (p < .001). High Medicaid revenue (≥30.0%) was associated with less adoption of CMPs (p < .001) and HIT (p < .01). System-owned practices (p < .001) and community health centers (p < .001) with high Medicaid revenue were more likely than physician-owned practices with high Medicaid revenue to adopt CMPs over time. System and community health center ownership appear to help high Medicaid practices overcome CMP adoption constraints. © The Author(s) 2015.

Compassionate listening - managing psychological trauma in refugees.

PubMed

Gardiner, Joanne; Walker, Kate

2010-04-01

The physical and psychosocial effects of trauma in refugees are wide ranging and long lasting. They can affect symptom presentation, the patient-doctor relationship and management of refugee victims of trauma. This article discusses how refugees survivors of trauma may present to the general practitioner and gives an approach to psychological assessment and management. A strong therapeutic relationship built by patient led, sensitive assessment over time is the foundation to care. A management framework based on trauma recovery stages and adapted for general practice, is presented.

The Role of the Family Context in the Development of Emotion Regulation

PubMed Central

Morris, Amanda Sheffield; Silk, Jennifer S.; Steinberg, Laurence; Myers, Sonya S.; Robinson, Lara Rachel

2008-01-01

This article reviews current literature examining associations between components of the family context and children and adolescents’ emotion regulation (ER). The review is organized around a tripartite model of familial influence. Firstly, it is posited that children learn about ER through observational learning, modeling and social referencing. Secondly, parenting practices specifically related to emotion and emotion management affect ER. Thirdly, ER is affected by the emotional climate of the family via parenting style, the attachment relationship, family expressiveness and the marital relationship. The review ends with discussions regarding the ways in which child characteristics such as negative emotionality and gender affect ER, how socialization practices change as children develop into adolescents, and how parent characteristics such as mental health affect the socialization of ER. PMID:19756175

Investigating solid waste production and associated management practices in private dental units

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

Kontogianni, S.; Xirogiannopoulou, A.; Karagiannidis, A.

In the municipality of Thessaloniki in 2006 mercury-bearing dental wastes were not managed properly by 80% of dentists and metal-bearing waste was handled in accordance with internationally established best management practices by less than 50% of dentists. Those results were documented through a biennial field-based research study that took place in private dental units within the Thessaloniki Urban Area. For quantifying the waste produced, structured questionnaires were used and interviews with dentists were performed. In the present work, results of this survey are presented; critical parameters and factors affecting the quantity and quality of the dental waste stream are reportedmore » together with the analysis and classification of dominant conditions and needs of the dental sector in the waste management field.« less

Alliances of cooperation: negotiating New Hampshire nurse practitioners' prescribing practice.

PubMed

Sampson, Deborah A

2009-01-01

Nurse practitioner legislation varies among states, particularly in relation to practice without physician oversight, altering the legal environment within which nurse practitioners can use knowledge and skills to meet patient needs. Using New Hampshire as a case study, this historical analysis of nurse practitioners' negotiations over time for independent practice, defined in state practice acts, illuminates the complex social and economic factors affecting nurses' struggle to gain legal rights over their own professional practice without supervision and intervention from another profession. In New Hampshire, not only did organized medicine oppose nurses rights to practice, but pharmacists demanded the right to control all aspects of medication management, including who could prescribe and under what circumstances prescribing could occur. Shifting social and political terrain as well as changes in legislative and state professional board leadership affected the environment and negotiations of a small group of nurses who were ultimately successful in obtaining the right to define their own professional practice.

Heat-Affected Zone Studies Of Thermally Cut Structural Steels

DOT National Transportation Integrated Search

1999-12-01

According to this primer, asset management is a systematic process of maintaining, upgrading, and operating physical assets cost-effectively. It combines engineering principles with sound business practices and economic theory, and it provides tools ...

Pollution and sanitation problems as setbacks to sustainable water resources management in Freetown.

PubMed

Kallon, Senesie B

2008-12-01

The civil conflict in Sierra Leone (1991-2001) caused a dramatic increase in the population of Freetown. This population increase overstretched housing facilities, leading to the creation of camps and many squatter settlements with poor sanitation practices. Overcrowding has become a serious concern in light of the acute water shortage that struck Freetown in May and June 2006. Some of the numerous small water bodies that could have been used to augment the public water supply were contaminated by the disposal of solid and industrial waste and poor sewage management. Improper disposal practices have a direct impact on public health. This paper recommends addressing the policy gap, establishing clear threshold criteria for all water bodies and wastewater discharge, and integrating the above issues in the ongoing review process of draft water sanitation policy. Public education of the negative consequences of poor waste management practices on water quality and public health can also positively affect general sanitation practices

Sustained transfer of knowledge to practice in long-term care: facilitators and barriers of a mental health learning initiative.

PubMed

Stolee, Paul; McAiney, Carrie A; Hillier, Loretta M; Harris, Diane; Hamilton, Pam; Kessler, Linda; Madsen, Victoria; Le Clair, J Kenneth

2009-01-01

This article explores facilitators and barriers to the impact and sustainability of a learning initiative to increase capacity of long-term care (LTC) homes to manage the mental health needs of older persons, through development of in-house Psychogeriatric Resource Persons (PRPs). Twenty interviews were conducted with LTC staff. Management support, particularly designation of time for PRP activities, development of PRP teams, and supportive learning strategies were significant factors affecting sustained knowledge transfer. Continuing education that is provided and evaluated on an ongoing basis, secures management commitment, is integrated within a broader system strategy, and provides on-the-job support has the greatest potential to affect care.

Herding: a new phenomenon affecting medical decision-making in multiple sclerosis care? Lessons learned from DIScUTIR MS.

PubMed

Saposnik, Gustavo; Maurino, Jorge; Sempere, Angel P; Ruff, Christian C; Tobler, Philippe N

2017-01-01

Herding is a phenomenon by which individuals follow the behavior of others rather than deciding independently on the basis of their own private information. A herding-like phenomenon can occur in multiple sclerosis (MS) when a neurologist follows a therapeutic recommendation by a colleague even though it is not supported by best practice clinical guidelines. Limited information is currently available on the role of herding in medical care. The objective of this study was to determine the prevalence (and its associated factors) of herding in the management of MS. We conducted a study among neurologists with expertise in MS care throughout Spain. Participants answered questions regarding the management of 20 case scenarios commonly encountered in clinical practice and completed 3 surveys and 4 experimental paradigms based on behavioral economics. The herding experiment consisted of a case scenario of a 40-year-old woman who has been stable for 3 years on subcutaneous interferon and developed a self-limited neurological event. There were no new magnetic resonance imaging (MRI) lesions. Her neurological examination and disability scores were unchanged. She was advised by an MS neurologist to switch from interferon to fingolimod against best practice guidelines. Multivariable logistic regression analysis was conducted to evaluate factors associated with herding. Out of 161 neurologists who were invited to participate, 96 completed the study (response rate: 60%). Herding was present in 75 (78.1%), having a similar prevalence in MS experts and general neurologists (68.8% vs 82.8%; P =0.12). In multivariate analyses, the number of MS patients seen per week was positively associated with herding (odds ratio [OR] 1.08, 95% CI 1.01-1.14). Conversely, physician's age, gender, years of practice, setting of practice, or risk preferences were not associated with herding. Herding was a common phenomenon affecting nearly 8 out of 10 neurologists caring for MS patients. Herding may affect medical decisions and lead to poorer outcomes in the management of MS.

Prelicensure Employment and Student Nurse Self-Efficacy.

PubMed

Grimm, Khristina L

There is a lack of literature regarding how prelicensure employment affects self-efficacy in nursing practice. The purpose of this study was to examine the relationship among prelicensure employment and self-efficacy in nursing practice of senior student nurses. Healthcare experience was identified as the best predictor of positive self-efficacy in managing an assignment of three and four patients. Findings of this study provide insight for providing orientation for newly licensed nurses regarding their readiness to practice.

Mutilating Procedures, Management Practices, and Housing Conditions That May Affect the Welfare of Farm Animals: Implications for Welfare Research

PubMed Central

Nordquist, Rebecca E.; van der Staay, Franz Josef; van Eerdenburg, Frank J. C. M.; Velkers, Francisca C.; Fijn, Lisa; Arndt, Saskia S.

2017-01-01

Simple summary Intensive farming systems are confronted with a number of animal welfare issues such as injuries from horns in cattle and feather pecking in poultry. To solve these problems, mutilating procedures, such as dehorning in cattle and goats and beak trimming in laying hens, are applied routinely. These and other procedures such as early maternal separation, overcrowding, and barren housing conditions impair animal welfare. Scientific underpinning of the efficacy of these interventions and management practices is poor. We advocate that all stakeholders, in particular animal scientists and veterinarians, take the lead in evaluating common, putative mutilating and welfare reducing procedures and management practices to develop better, scientifically supported alternatives, focused on adaptation of the environment to the animals, to ensure uncompromised animal welfare. Abstract A number of mutilating procedures, such as dehorning in cattle and goats and beak trimming in laying hens, are common in farm animal husbandry systems in an attempt to prevent or solve problems, such as injuries from horns or feather pecking. These procedures and other practices, such as early maternal separation, overcrowding, and barren housing conditions, raise concerns about animal welfare. Efforts to ensure or improve animal welfare involve adapting the animal to its environment, i.e., by selective breeding (e.g., by selecting “robust” animals) adapting the environment to the animal (e.g., by developing social housing systems in which aggressive encounters are reduced to a minimum), or both. We propose adapting the environment to the animals by improving management practices and housing conditions, and by abandoning mutilating procedures. This approach requires the active involvement of all stakeholders: veterinarians and animal scientists, the industrial farming sector, the food processing and supply chain, and consumers of animal-derived products. Although scientific evidence about the welfare effects of current practices in farming such as mutilating procedures, management practices, and housing conditions is steadily growing, the gain in knowledge needs a boost through more scientific research. Considering the huge number of animals whose welfare is affected, all possible effort must be made to improve their welfare as quickly as possible in order to ban welfare-compromising procedures and practices as soon as possible. PMID:28230800

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.

Practice recommendations for pain assessment by self-report with African American older adults.

PubMed

Booker, Staja Star; Pasero, Chris; Herr, Keela A

2015-01-01

Despite decades of education and clinical practice guidelines underscoring disparities in pain management, pain continues to be inadequately managed in older African American adults as a result of patient, provider, and systems factors. Critical factors influencing pain assessment in older African American adults has not been extensively examined, contributing to a lack of data to inform health care providers' knowledge on culturally-responsive pain assessment in older African Americans. Assessing pain in older African Americans is unique because differences in language, cultural beliefs, and practices moderate how they report and express pain. This paper presents an overview of patient-provider factors that affect pain assessment in older African Americans with a focus on this population's unique cultural beliefs and practices. Recommendations for best practices for performance of a culturally-responsive pain assessment with older African Americans are provided. Copyright © 2015 Elsevier Inc. All rights reserved.

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

PubMed

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

2016-12-01

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

An argument for competency-based training in pelvic floor physiotherapy practice.

PubMed

Frawley, Helena C; Neumann, Patricia; Delany, Clare

2018-05-10

Pelvic floor dysfunction has been described as "a silent epidemic," affecting many people in the community yet under-recognized and insufficiently managed. There is evidence that pelvic floor physiotherapy can manage many of these disorders, however a competency framework to guide and inform pelvic floor physiotherapy training and practice is lacking. The assessment and management of the pelvic floor complex is not addressed as a core component of most entry-to-practice physiotherapy programs despite being within the scope of physiotherapy practice which is in contrast with the knowledge and skills that physiotherapists graduate with in core areas of clinical practice. This results in a registration-competency gap, and the need for post-graduation training to ensure clinicians are appropriately skilled to practice safely and effectively in this area. In addition, there are potential ethical and legal issues unique to this area of physiotherapy practice to be considered. We use a series of clinical scenarios to highlight the domains of knowledge, skills and communication required for practice in this area, based on our experience in Australia. We propose a framework for the future which defines competence in pelvic floor physiotherapy to provide clarity to clinicians about their clinical, ethical and legal obligations to the public, our referrers and third-party payers.

Role stressors and coping strategies among nurse managers.

PubMed

Udod, Sonia; Cummings, Greta G; Care, W Dean; Jenkins, Megan

2017-02-06

Purpose The purpose of this paper is to share preliminary evidence about nurse managers' (NMs) role stressors and coping strategies in acute health-care facilities in Western Canada. Design/methodology/approach A qualitative exploratory inquiry provides deeper insight into NMs' perceptions of their role stressors, coping strategies and factors and practices in the organizational context that facilitate and hinder their work. A purposeful sample of 17 NMs participated in this study. Data were collected through individual interviews and a focus group interview. Braun and Clarke's (2006) six phase approach to thematic analysis guided data analysis. Findings Evidence demonstrates that individual factors, organizational practices and structures affect NMs stress creating an evolving role with unrealistic expectations, responding to continuous organizational change, a fragmented ability to effectively process decisions because of work overload, shifting organizational priorities and being at risk for stress-related ill health. Practical implications These findings have implications for organizational support, intervention programs that enhance leadership approaches, address individual factors and work processes and redesigning the role in consideration of the role stress and work complexity affecting NMs health. Originality/value It is anticipated that health-care leaders would find these results concerning and inspire them to take action to support NMs to do meaningful work as a way to retain existing managers and attract front line nurses to positions of leadership.

Understanding the Epidemiology of Heart Failure to Improve Management Practices: An Asia-Pacific Perspective.

PubMed

Rajadurai, Jeyamalar; Tse, Hung-Fat; Wang, Chao-Hung; Yang, Ning-I; Zhou, Jingmin; Sim, David

2017-04-01

Heart failure (HF) is a major global healthcare problem with an estimated prevalence of approximately 26 million. In Asia-Pacific regions, HF is associated with a significant socioeconomic burden and high rates of hospital admission. Epidemiological data that could help to improve management approaches to address this burden in Asia-Pacific regions are limited, but suggest patients with HF in the Asia-Pacific are younger and have more severe signs and symptoms of HF than those of Western countries. However, local guidelines are based largely on the European Society of Cardiology and American College of Cardiology Foundation/American Heart Association guidelines, which draw their evidence from studies where Western patients form the major demographic and patients from the Asia-Pacific region are underrepresented. Furthermore, regional differences in treatment practices likely affect patient outcomes. In the following review, we examine epidemiological data from existing regional registries, which indicate that these patients represent a distinct subpopulation of patients with HF. In addition, we highlight that patients with HF are under-treated in the region despite the existence of local guidelines. Finally, we provide suggestions on how data can be enriched throughout the region, which may positively affect local guidelines and improve management practices. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Mapping vegetation structure in the Pinaleno Mountains using lidar-phase 3: Forest inventory modeling

Treesearch

Brent Mitchell; Mike Walterman; Tom Mellin; Craig Wilcox; Ann M. Lynch; John Anhold; Donald A. Falk; John Koprowski; Denise Laes; Don Evans; Haans Fisk

2012-01-01

Understanding forest structure and how it is affected by management practices and natural events is a critical part of managing natural resources within the Forest Service, U.S. Department of Agriculture. The Pinaleno Mountains of southeastern Arizona represent a Madrean sky island ecosystem and the last remaining habitat for the Mt. Graham red squirrel. This unique...

Understanding and Reducing the Impact of Defensiveness on Management Learning: Some Lessons from Neuroscience

ERIC Educational Resources Information Center

Holmer, Leanna L.

2014-01-01

The neurosciences have expanded our understanding of the role of the "old" brain in generating defensive reactions to threat. Because the learning and practice of management skills pose various forms of threat to would-be practitioners, the question of how individuals respond to threat and how this affects their ability to learn has also…

JPRS Report, East Europe

DTIC Science & Technology

1987-11-05

opinion research. practice in surveys. Poorly prepared surveys also affect They are inclined to attribute refusals more to the low the essential level of...order to achieve the most essential national the one hand, and on the other, on the right to elect the economic priorities, managers. Self-management... essential reproductive contribution to the through innovation. Under the circumstances, innova- implementation of SED economic strategy. This contri

Demand management and case management: a conservation strategy.

PubMed

Bryant, C D R Anna K

2007-01-01

This article reviews the history and development of managed competition, and explores the possibilities of a new demand management strategy in the context of nurse case management to offer less costly, higher quality care for a greater number of patients. The article examines the history and principles of healthcare demand management, its implementation in the hospital and clinical practices of nurse case managers, and its impacts in reducing costs while maintaining care levels. The article develops and analyzes the conflicts and common ground between demand management and case management. First, demand-side strategies can be effective in reducing costs while maintaining quality of nursing care; second, nurse case managers should employ patient education, self-care, and staffing solutions to manage demand. Nurse case managers must apply demand management principles carefully. Their goal is not to restrict care, but to maintain the highest levels of care possible within the limits of their practice's resources and staffing. Two critical themes emerge: (1) demand management is a potential alternative to market-driven managed competition and (2) nursing case management can affect an effective form of demand management. However, the long-term implications of these nursing case management strategies on healthcare staffing need further exploration.

Conservation tillage versus conventional tillage on carbon stock in a Mediterranean dehesa (southern Spain)

NASA Astrophysics Data System (ADS)

Parras-Alcántara, Luis; Lozano-García, Beatriz

2014-05-01

Understanding soil dynamics is essential for making appropriate land management decisions, as soils can affect the carbon content from the atmosphere, emitting large quantities of CO2 or storing carbon. This property is essential for climate change mitigation strategies as agriculture and forestry soil management can affect the carbon cycle. The dehesa is a Mediterranean silvopastoral system formed by grasslands with scattered oaks (Quercus ilex or Q. suber). The dehesa is a pasture where the herbaceous layer is comprised of either cultivated cereals such as oat, barley and wheat or native vegetation dominated by annual species, which are used as grazing resources. In addition, the dehesa is a practice dedicated to the combined production of Iberian swine, sheep, fuel wood, coal and cork, as well as hunting. The dehesa is characterized by the preservation of forest oaks. In this work, we compared two management practices such as organic farming (OF) and conventional tillage (CT) on soil organic carbon stocks (SOC-S) in Cambisols (CM) and Leptosols (LP), and we analyzed the quality of these soils based on stratification ratio (SR) in a Mediterranean dehesa. MATERIAL AND METHODS An analysis of 85 soil profiles was performed in 2009 in Los Pedroches Valley (Cordoba, southern Spain). Two soil management practices were selected: OF (isolated trees of variable densities —15-25— trees ha-1, mostly holm and cork oaks, and patches of shrubs — cistaceae, fabaceae and lamiaceae— with a herbaceous pasture layer mostly composed of therophytic species and livestock are introduced to provide organic fertilizer to the soil, without ploughing and animal manure from the farms may be incorporated) for 20 years and CT (similar to OF, with ploughing —annual passes with a disc harrow and/or cultivator— is aimed at growing grain for livestock or at clearing the encroaching shrubs) in CM and LP. The dehesas studied were silvopastoral systems without cropping. Soil properties determined were: soil particle size, bulk density, SOC, TN, C:N ratio, stocks and SR. The statistical significance of the differences in the variables between management practices was tested using the Anderson-Darling test at each horizon or a combination of horizons for each soil type. RESULTS The SOC-S was greater in CM (75.64 Mg ha-1) than in LP (44.01 Mg ha-1). SOC-S was very similar in OF and CT (CM [74.90 Mg ha-1-CT; 76.39 Mg ha-1-OF] and LP [44.77 Mg ha-1-CT; 43.25 Mg ha-1-OF]). Data analysis showed that management practices had little effect on SOC storage. Significant differences between soil types and management practices were found in SOC content for different horizons. The SR index was >2 in both soils types (CM and LP) and management systems (OF and CT). These results indicate that the soil is of high quality and that management practices have little influence on SOC-S (Parras-Alcántara et al., 2014) and do not affect SOC storage. REFERENCES Parras-Alcántara, L., Díaz-Jaimes, L., Lozano-García, B., Fernández Rebollo, P., Moreno Elcure, F., Carbonero Muñoz, M.D. 2014. Organic farming has little effect on carbon stock in a Mediterranean dehesa (southern Spain). Catena, 113: 9-17.

Ground beetles in Mediterranean olive agroecosystems: Their significance and functional role as bioindicators (Coleoptera, Carabidae)

PubMed Central

Mazzei, Antonio; Bonacci, Teresa; Scalercio, Stefano; Iannotta, Nino; Brandmayr, Pietro

2018-01-01

The impact of agricultural practices and soil management on the communities of arthropods living in the agricultural landscape is acknowledged as a critical issue by the literature, and it needs to be better investigated to improve the ecological sustainability of agriculture. In the present study, we aimed to study how soil management affect carabid species distribution in one of the most typical agroecosystem of the Mediterranean region, i.e. the olive grove. In South Italy olive plantations feature different types of soil management, from tillage to half- or full-cover cropping. Species distribution has been examined for a total of 10,189 individuals and 62 species collected from 17 sites. Notably from our analysis we have observed that three factors (climax vegetation, soil features and soil management) explained half of the data variability. The composition of species groupings mirrors both bioclimatic conditions (climax vegetation) and soil features, especially watering, while soil management affects the species distribution, with different intensity from site to site. Eleven species have been recognized as the most abundant in the different facets of the studied olive groves and consequently designated as characteristics of the olive agroecosystem. The species traits of the sampled species have been weighted for a compelling evaluation of the effects of agricultural management on biodiversity, showing uniform traits distribution when coping with the ecological factors that characterize the different plantation facets. We have found that carabid beetles can be used as model organisms for studying the effects of agricultural practices. Our study suggests that the interaction of man-induced trasformation with the natural background of the olive agroecosystem may be difficult to disentangle, so that such complexity must be taken into account when carabid beetles are expected to provide an ecosystem service for good agricultural practices. PMID:29558493

Plant community composition and biomass in Gulf Coast Chenier Plain marshes: Responses to winter burning and structural marsh management

USGS Publications Warehouse

Gabrey, S.W.; Afton, A.D.

2001-01-01

Many marshes in the Gulf Coast Chenier Plain, USA, are managed through a combination of fall or winter burning and structural marsh management (i.e., levees and water control structures; hereafter SMM). The goals of winter burning and SMM include improvement of waterfowl and furbearer habitat, maintenance of historic isohaline lines, and creation and maintenance of emergent wetlands. Although management practices are intended to influence the plant community, effects of these practices on primary productivity have not been investigated. Marsh processes, such as vertical accretion and nutrient cycles, which depend on primary productivity may be affected directly or indirectly by winter burning or SMM. We compared Chenier Plain plant community characteristics (species composition and above- and belowground biomass) in experimentally burned and unburned control plots within impounded and unimpounded marshes at 7 months (1996), 19 months (1997), and 31 months (1998) after burning. Burning and SMM did not affect number of plant species or species composition in our experiment. For all three years combined, burned plots had higher live above-ground biomass than did unburned plots. Total above-ground and dead above-ground biomasses were reduced in burned plots for two and three years, respectively, compared to those in unburned control plots. During all three years, belowground biomass was lower in impounded than in unimpounded marshes but did not differ between burn treatments. Our results clearly indicate that current marsh management practices influence marsh primary productivity and may impact other marsh processes, such as vertical accretion, that are dependent on organic matter accumulation and decay.

A systematic review of collaboration and network research in the public affairs literature: implications for public health practice and research.

PubMed

Varda, Danielle; Shoup, Jo Ann; Miller, Sara

2012-03-01

We explored and analyzed how findings from public affairs research can inform public health research and practice, specifically in the area of interorganizational collaboration, one of the most promising practice-based approaches in the public health field. We conducted a systematic review of the public affairs literature by following a grounded theory approach. We coded 151 articles for demographics and empirical findings (n = 258). Three primary findings stand out in the public affairs literature: network structure affects governance, management strategies exist for administrators, and collaboration can be linked to outcomes. These findings are linked to priorities in public health practice. Overall, we found that public affairs has a long and rich history of research in collaborations that offers unique organizational theory and management tools to public health practitioners.

Cropping practices manipulate abundance patterns of root and soil microbiome members paving the way to smart farming.

PubMed

Hartman, Kyle; van der Heijden, Marcel G A; Wittwer, Raphaël A; Banerjee, Samiran; Walser, Jean-Claude; Schlaeppi, Klaus

2018-01-16

Harnessing beneficial microbes presents a promising strategy to optimize plant growth and agricultural sustainability. Little is known to which extent and how specifically soil and plant microbiomes can be manipulated through different cropping practices. Here, we investigated soil and wheat root microbial communities in a cropping system experiment consisting of conventional and organic managements, both with different tillage intensities. While microbial richness was marginally affected, we found pronounced cropping effects on community composition, which were specific for the respective microbiomes. Soil bacterial communities were primarily structured by tillage, whereas soil fungal communities responded mainly to management type with additional effects by tillage. In roots, management type was also the driving factor for bacteria but not for fungi, which were generally determined by changes in tillage intensity. To quantify an "effect size" for microbiota manipulation, we found that about 10% of variation in microbial communities was explained by the tested cropping practices. Cropping sensitive microbes were taxonomically diverse, and they responded in guilds of taxa to the specific practices. These microbes also included frequent community members or members co-occurring with many other microbes in the community, suggesting that cropping practices may allow manipulation of influential community members. Understanding the abundance patterns of cropping sensitive microbes presents the basis towards developing microbiota management strategies for smart farming. For future targeted microbiota management-e.g., to foster certain microbes with specific agricultural practices-a next step will be to identify the functional traits of the cropping sensitive microbes.

Demographics, farm and reproductive management strategies used in Australian automatic milking systems compared with regionally proximal conventional milking systems.

PubMed

Keeper, D M; Kerrisk, K L; House, J K; Garcia, S C; Thomson, P

2017-09-01

To determine the management practices utilised in automatic milking systems (AMS) that affect reproductive management and performance and how these compare with the management practices used in regionally proximal conventional milking systems (CMS). This study examined demographic and management data from AMS and CMS dairy farms through a survey, with a specific focus on reproductive management procedures. Overall, responses from AMS and CMS dairy farms showed little difference in terms of respondent demographics, farm size, herd structure and most farm management strategies. AMS dairies were more likely to use activity meters or other electronic oestrus detection aids than CMS dairies (P < 0.001) and were also more likely to have changed to electronic recording systems (P = 0.007). Although many respondents indicated that they used key monitoring parameters to assess reproductive performance (e.g. days in milk, conception vs pregnancy rate etc.), the format of responses varied significantly, indicating a relatively widespread (among the respondents) lack of knowledge regarding the meaning and usage of some of these common parameters/terminology. Ultimately, reproductive management practices of AMS dairies were largely similar to those of CMS dairies, indicating that such practices can be implemented in a practical sense, even though the resultant reproductive performance is not yet understood. Understanding that the key reproductive management strategies do not need to change vastly is important to ensure that new adoptees are well informed. Further work is needed to objectively measure AMS performance to increase the knowledge base and generate the confidence that will facilitate further adoption of this innovation. © 2017 Australian Veterinary Association.

Exploring Cultural Influences of Self-Management of Diabetes in Coastal Kenya

PubMed Central

Abdulrehman, Munib Said; Woith, Wendy; Jenkins, Sheryl; Kossman, Susan; Hunter, Gina Louise

2016-01-01

In spite of increasing prevalence of diabetes among Kenyans and evidence suggesting Kenyans with diabetes maintain poor glycemic control, no one has examined the role of cultural attitudes, beliefs, and practices in their self-management of diabetes. The purpose of this ethnographic study was to describe diabetes self-management among the Swahili of coastal Kenya, and explore factors that affect diabetes self-management within the context of Swahili culture. Thirty men and women with type 2 diabetes from Lamu town, Kenya, participated in this study. Diabetes self-management was insufficiently practiced, and participants had limited understanding of diabetes. Economic factors such as poverty and the high cost of biomedical care appear to have more influence in self-management behavior than socio-cultural and educational factors do. Economic and socio-cultural influences on diabetes self-management should not be underestimated, especially in a limited resource environment like coastal Kenya, where biomedical care is not accessible or affordable to all. PMID:28462335

How family members manage risk around functional decline: the autonomy management process in households facing dementia.

PubMed

Berry, Brandon; Apesoa-Varano, Ester Carolina; Gomez, Yarin

2015-04-01

Most dementia research investigates the social context of declining ability through studies of decision-making around medical treatment and end-of-life care. This study seeks to fill an important gap in research about how family members manage the risks of functional decline at home. Drawing on three waves of in-depth interviewing in 2012-2014, it investigates how family members in US households manage decline in an affected individual's natural range of daily activities over time. The findings show that early on in the study period affected individuals were perceived to have awareness of their decline and routinely drew on family members for support. Support transformed when family members detected that the individual's deficit awareness had diminished, creating a corresponding increase in risk of self-harm around everyday activities. With a loss of confidence in the individual's ability to regulate his or her own activities to avoid these risks, family members employed unilateral practices to manage the individual's autonomy around his or her activity involvements. These practices typically involved various deceits and ruses to discourage elders from engaging in activities perceived as potentially dangerous. The study concludes by discussing the implications that the social context of interpretive work around awareness and risk plays an important role in how families perceive an elder's functional ability and manage his or her activity involvements. Copyright © 2015 Elsevier Ltd. All rights reserved.

How family members manage risk around functional decline: The autonomy management process in households facing dementia

PubMed Central

Berry, Brandon; Apesoa-Varano, Ester Carolina; Gomez, Yarin

2015-01-01

Most dementia research investigates the social context of declining ability through studies of decision-making around medical treatment and end-of-life care. This study seeks to fill an important gap in research about how family members manage the risks of functional decline at home. Drawing on three waves of retrospective interviewing in 2012–2014, it investigates how family members in US households manage decline in an affected individual’s natural range of daily activities over time. The findings show that early on in the study period affected individuals were perceived to have awareness of their decline and routinely drew on family members for support. Support transformed when family members detected that the individual’s deficit awareness had diminished, creating a corresponding increase in risk of self-harm around everyday activities. With a loss of confidence in the individual’s ability to regulate his or her own activities to avoid these risks, family members employed unilateral practices to manage the individual’s autonomy around his or her activity involvements. These practices typically involved various deceits and ruses to discourage elders from engaging in activities perceived as potentially dangerous. The study concludes by discussing the implications that the social context of interpretive work around awareness and risk plays an important role in how families perceive an elder’s functional ability and manage his or her activity involvements. PMID:25697634

Meditation-induced neuroplastic changes in amygdala activity during negative affective processing.

PubMed

Leung, Mei-Kei; Lau, Way K W; Chan, Chetwyn C H; Wong, Samuel S Y; Fung, Annis L C; Lee, Tatia M C

2018-06-01

Recent evidence suggests that the effects of meditation practice on affective processing and resilience have the potential to induce neuroplastic changes within the amygdala. Notably, literature speculates that meditation training may reduce amygdala activity during negative affective processing. Nonetheless, studies have thus far not verified this speculation. In this longitudinal study, participants (N = 21, 9 men) were trained in awareness-based compassion meditation (ABCM) or matched relaxation training. The effects of meditation training on amygdala activity were examined during passive viewing of affective and neutral stimuli in a non-meditative state. We found that the ABCM group exhibited significantly reduced anxiety and right amygdala activity during negative emotion processing than the relaxation group. Furthermore, ABCM participants who performed more compassion practice had stronger right amygdala activity reduction during negative emotion processing. The lower right amygdala activity after ABCM training may be associated with a general reduction in reactivity and distress. As all participants performed the emotion processing task in a non-meditative state, it appears likely that the changes in right amygdala activity are carried over from the meditation practice into the non-meditative state. These findings suggest that the distress-reducing effects of meditation practice on affective processing may transfer to ordinary states, which have important implications on stress management.

Learning management by self-employed occupational therapists in private practice.

PubMed

Millsteed, Jeannine; Redmond, Janice; Walker, Elizabeth

2017-04-01

This study explored how occupational therapists in private practice developed the business skills needed to operate a successful private practice. The literature shows that many small-business owner-managers have poorly developed business skills, and some experience high rates of failure. This indicates that to be successful in private practice, occupational therapists need to gain mastery of management competencies in addition to their professional clinical competencies. A qualitative study, using in-depth interviews, collected data from twenty-six self-employed occupational therapists on their experiences of becoming a small-business owner-manager. A narrative analysis built an understanding about how these therapists developed their business competencies. Analysis revealed the factors affecting the development of business competencies were interactions between the initial motivations for start-up, growth aspirations and engagement with external business environments. Business competencies developed through a combination of formal learning prior to starting their businesses, and informal learning once their businesses were in operation. Lower level learning occurred in the routine and operational processes, with higher level learning through discontinuous events resulting in a transformation in the therapists' understanding about themselves as business owner-managers. Findings led to a proposition that occupational therapists make the transition to becoming successful small-business owner-manager through management learning that includes elements of self-reflection, identifying environmental opportunities and risks, developing capabilities, and strategic planning for growth and development. It provides insights on what occupational therapists need to consider to become successful small-business owner-managers. © 2016 Occupational Therapy Australia.

Implementing Role-Changing Versus Time-Changing Innovations in Health Care: Differences in Helpfulness of Staff Improvement Teams, Management, and Network for Learning.

PubMed

Nembhard, Ingrid M; Morrow, Christopher T; Bradley, Elizabeth H

2015-12-01

Health care organizations often fail in their effort to implement care-improving innovations. This article differentiates role-changing innovations, altering what workers do, from time-changing innovations, altering when tasks are performed or for how long. We examine our hypothesis that the degree to which access to groups that can alter organizational learning--staff, management, and external network--facilitates implementation depends on innovation type. Our longitudinal study using ordinal logistic regression and survey data on 517 hospitals' implementation of evidence-based practices for treating heart attack confirmed our thesis for factors granting access to each group: improvement team's representativeness (of affected staff), senior management engagement, and network membership. Although team representativeness and network membership were positively associated with implementing role-changing practices, senior management engagement was not. In contrast, senior management engagement was positively associated with implementing time-changing practices, whereas team representativeness was not, and network membership was not unless there was limited management engagement. These findings advance implementation science by explaining mixed results across past studies: Nature of change for workers alters potential facilitators' effects on implementation. © The Author(s) 2015.

Preventative Disease Management and Grower Decision Making: A Case Study of California Wine-Grape Growers.

PubMed

Hillis, Vicken; Lubell, Mark; Kaplan, Jonathan; Baumgartner, Kendra

2017-06-01

Preventative disease management is challenging to farmers because it requires paying immediate costs in the hopes of returning uncertain future benefits. Understanding farmer decision making about prevention has the potential to reduce disease incidence and minimize the need for more costly postinfection practices. For example, the grapevine trunk-disease complex (esca, Botryosphaeria dieback, Eutypa dieback, and Phomopsis dieback) significantly affects vineyard productivity and longevity. Given the chronic nature of the infections and inability to eradicate the fungal pathogens, the preventative practices of delayed pruning, applications of pruning-wound protectants, and double pruning (also known as prepruning) are the most effective means of management. We surveyed wine-grape growers in six regions of California on their use of these three practices. In spite of acknowledging the yield impacts of trunk diseases, a substantial number of respondents either choose not to use preventative practices or incorrectly adopted them in mature vineyards, too late in the disease cycle to be effective. Growers with more negative perceptions of cost efficacy were less likely to adopt preventative practices or were more likely to time adoption incorrectly in mature vineyards. In general, preventative management may require strong intervention in the form of policy or extension to motivate behavioral change.

Nurse managed occupational health services: a primary care model in practice.

PubMed

Childre, F

1997-10-01

1. Managed care focus on delivering health care which values prevention, early intervention, continuity of care, commitment to quality care, and outcomes, as well as client satisfaction. Occupational health nurses routinely integrate these values into their practice. 2. An on-site model of primary health care delivery, incorporating the fundamentals of occupational health nursing, can bring significant savings to the organization in health related costs. 3. Case management may provide the greatest potential for growth in occupational health nursing. It is a method that can be used together with managed care to maximize quality health care services. 4. Viewing health related costs as an investment as opposed to part of a benefit plan, influences employees to make positive choices. It also impacts the delivery of health care services on a systematic, global level, which affects total health care costs.

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

PubMed

Dairo, David M; Osizimete, Oyarebu E

2016-06-01

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

The physician's office: can it influence adult immunization rates?

PubMed

Nowalk, Mary Patricia; Bardella, Inis Jane; Zimmerman, Richard Kent; Shen, Shunhua

2004-01-01

To determine which office and patient factors affect adult influenza and pneumococcal vaccination rates. Patient interviews and self-administered surveys of office managers. In a 2-stage random cluster sample, 22 practices in 4 strata (Veterans' Affairs, rural, urban/suburban, and inner city) and 15 patients per physician in each practice (n = 946) were selected. Office managers completed a questionnaire regarding office practices and logistics affecting immunizations. Data were examined using chi2 and regression analyses without and with patient factors in the models. Practice factors significantly related to influenza vaccination status were stratum (VA OR = 2.04; 95% CI = 1.18, 3.53; P < .05 vs inner-city), time allotted for acute care visits (16-20 min vs 10-15 min OR = 2.49; 95% CI = 1.68, 3.09; P < .001), the practice not having a source of free vaccines (OR = .43; 95% CI = .3, .62; P < .001), and the interaction between being an urban/suburban practice and having a source of free flu vaccines (OR = 4.0; 95% CI = 2.63, 6.09; P < .001). Practice factors related to pneumococcal vaccination status were the number of immunization promotion activities (> or = 3 vs 0-2 OR = 1.97; 95% CI = 1.33, 2.94; P = .002) and the time allotted for acute care visits (16-20 min vs 10-15 min OR = 1.94; 95% CI = 1.18, 3.19; P = .011). When practice and patient factors were combined in the analyses, patient factors were more important. Although patient factors are more important than practice factors, practices that allot more time for acute care visits and use more immunization promotion activities have higher vaccination rates.

Work zone traffic management synthesis : work zone pedestrian protection

DOT National Transportation Integrated Search

1997-08-01

This Long Term Pavement Performance (LTPP) data analysis was intended to examine, in a practical way, the LTPP database and to identify the site conditions and design features that significantly affect transverse joint faulting. Key products develope...

Production practices affecting worker task demands in concrete operations: A case study.

PubMed

Memarian, Babak; Mitropoulos, Panagiotis

2015-01-01

Construction work involves significant physical, mental, and temporal task demands. Excessive task demands can have negative consequences for safety, errors and production. This exploratory study investigates the magnitude and sources of task demands on a concrete operation, and examines the effect of the production practices on the workers' task demands. The NASA Task Load Index was used to measure the perceived task demands of two work crews. The operation involved the construction of a cast-in-place concrete building under high schedule pressures. Interviews with each crew member were used to identify the main sources of the perceived demands. Extensive field observations and interviews with the supervisors and crews identified the production practices. The workers perceived different level of task demands depending on their role. The production practices influenced the task demands in two ways: (1) practices related to work organization, task design, resource management, and crew management mitigated the task demands; and (2) other practices related to work planning and crew management increased the crew's ability to cope with and adapt to high task demands. The findings identify production practices that regulate the workers' task demands. The effect of task demands on performance is mitigated by the ability to cope with high demands.

Resilient Practices in Maintaining Safety of Health Information Technologies

PubMed Central

Ash, Joan S.; Sittig, Dean F.; Singh, Hardeep

2014-01-01

Electronic health record systems (EHRs) can improve safety and reliability of health care, but they can also introduce new vulnerabilities by failing to accommodate changes within a dynamic EHR-enabled health care system. Continuous assessment and improvement is thus essential for achieving resilience in EHR-enabled health care systems. Given the rapid adoption of EHRs by many organizations that are still early in their experiences with EHR safety, it is important to understand practices for maintaining resilience used by organizations with a track record of success in EHR use. We conducted interviews about safety practices with 56 key informants (including information technology managers, chief medical information officers, physicians, and patient safety officers) at two large health care systems recognized as leaders in EHR use. We identified 156 references to resilience-related practices from 41 informants. Framework analysis generated five categories of resilient practices: (a) sensitivity to dynamics and interdependencies affecting risks, (b) basic monitoring and responding practices, (c) management of practices and resources for monitoring and responding, (d) sensitivity to risks beyond the horizon, and (e) reflecting on risks with the safety and quality control process itself. The categories reflect three functions that facilitate resilience: reflection, transcending boundaries, and involving sharp-end practitioners in safety management. PMID:25866492

Integrated management of depression: improving system quality and creating effective interfaces.

PubMed

Myette, Thomas L

2008-04-01

Depression is a chronic recurrent condition and is a leading cause of work disability. Improving occupational outcomes for depression will require an integrated approach that incorporates best practices from the clinical, community, and workplace systems. This article briefly reviews recent quality improvement initiatives and promising practices in each system and then shifts to the importance of systems integration. An integrated chronic care model uses a sophisticated case management process to support essential relationships, facilitate key plans, and efficiently link the three systems to optimize clinical, economic, and occupational outcomes. An expanded role for employers and their agents in the management of depression and other chronic diseases is seen as fundamental to maintaining a healthy and productive workforce. To improve occupational outcomes for depression by integrating best practices from the clinical, community, and workplace systems. After a brief review of quality improvement initiatives and promising practices in each system, an integrated chronic care model is introduced. A case management process that links critical systems, supports essential relationships, and facilitates key plans is expected to result in improvements in clinical, economic, and occupational outcomes. Employers should be more engaged with clinical and community partners in the prevention and control of depression in affected employees.

Current status of waste management in Botswana: A mini-review.

PubMed

Mmereki, Daniel

2018-05-01

Effective waste management practices are not all about legislative solutions, but a combination of the environmental, social, technical, technically skilled human resources, financial and technological resources, resource recycling, environmental pollution awareness programmes and public participation. As a result of insufficient resources, municipal solid waste (MSW) in transition and developing countries like Botswana remains a challenge, and it is often not yet given highest priority. In Botswana, the environment, public health and other socio-economic aspects are threatened by waste management practices due to inadequate implementation and enforcement mechanisms of waste management policy. This mini-review paper describes the panorama of waste management practices in Botswana and provides information to competent authorities responsible for waste management and to researchers to develop and implement an effective waste management system. Waste management practices in Botswana are affected by: lack of effective implementation of national waste policy, fragmented tasks and overlapping mandates among relevant institutions; lack of clear guidelines on the responsibilities of the generators and public authorities and on the associated economic incentives; and lack of consistent and comprehensive solid waste management policies; lack of intent by decision-makers to prepare national waste management plans and systems, and design and implement an integrated sustainable municipal solid waste management system. Due to these challenges, there are concerns over the growing trend of the illegal dumping of waste, creating mini dumping sites all over the country, and such actions jeopardize the efforts of lobbying investors and tourism business. Recommendations for concerted efforts are made to support decision makers to re-organize a sustainable waste management system, and this paper provides a reference to other emerging economies in the region and the world.

Security Vulnerability and Patch Management in Electric Utilities: A Data-Driven Analysis

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

Li, Qinghua; Zhang, Fengli

This paper explores a real security vulnerability and patch management dataset from an electric utility in order to shed light on characteristics of the vulnerabilities that electric utility assets have and how they are remediated in practice. Specifically, it first analyzes the distribution of vulnerabilities over software, assets, and other metric. Then it analyzes how vulnerability features affect remediate actions.

Understanding the work done by NHS commissioning managers: an exploration of the microprocesses underlying day-to-day sensemaking in UK primary care organisations.

PubMed

Checkland, Kath; Harrison, Stephen; Snow, Stephanie; Coleman, Anna; McDermott, Imelda

2013-01-01

The purpose of this paper is to explore the practical daily work undertaken by middle-level managers in Primary Care Trusts (PCTs), focusing upon the micro-processes by which these managers enact sensemaking in their organisations. The research took a case study approach, undertaking detailed case studies in four PCTs in England. Data collection included shadowing managers, meeting observations and interviews. The research elucidated two categories of enactment behaviour exhibited by PCT managers: presence/absence; and the production of artefacts. Being "present" in or "absent" from meetings enacted sensemaking over and above any concrete contribution to the meeting made by the actors involved. This paper explores the factors affecting these processes, and describes the situations in which enactment of sense is most likely to occur. Producing artefacts such as meeting minutes or PowerPoint slides also enacted sense in the study sites in addition to the content of the artefact. The factors affecting this are explored. The study has practical implications for all managers seeking to maximise their influence in their organisations. It also provides specific evidence relevant to managers working in the new Clinical Commissioning Groups currently being formed in England. The study expands the understanding of sensemaking in organisations in two important ways. Firstly, it moves beyond discourse to explore the ways in which behaviours can enact sense. Secondly, it explores the distinction between active and unconscious sensemaking.

Mood alterations during deanol therapy.

PubMed

Casey, D E

1979-04-11

An imbalance between central cholinergic and adrenergic influences may affect mood disorders. Of 38 patients taking high doses of deanol, a putative acetylcholine precursor, eight developed changes in mood: five became depressed and three became hypomanic. A predisposition is suggested as seven of these eight patients had histories of affective symptoms. There was no relationship between the changes in dyskinesias and mood. These observations have both practical and heuristic implications for the management of patients and for further research into the pharmacology of affective disorders and deanol.

Practice Patterns of Speech-Language Pathologists in Pediatric Vocal Health.

PubMed

Hartley, Naomi A; Braden, Maia; Thibeault, Susan L

2017-05-17

The purpose of this study was to investigate current practices of speech-language pathologists (SLPs) in the management of pediatric vocal health, with specific analysis of the influence of clinical specialty and workplace setting on management approaches. American Speech-Language-Hearing Association-certified clinicians providing services within the United States (1%-100% voice caseload) completed an anonymous online survey detailing clinician demographics; employment location and service delivery models; approaches to continuing professional development; and specifics of case management, including assessment, treatment, and discharge procedures. Current practice patterns were analyzed for 100 SLPs (0-42 years of experience; 77 self-identifying as voice specialists) providing services in 34 U.S. states across a range of metropolitan and nonmetropolitan workplace settings. In general, SLPs favored a multidisciplinary approach to management; included perceptual, instrumental, and quality of life measures during evaluation; and tailored intervention to the individual using a combination of therapy approaches. In contrast with current practice guidelines, only half reported requiring an otolaryngology evaluation prior to initiating treatment. Both clinical specialty and workplace setting were found to affect practice patterns. SLPs in school settings were significantly less likely to consider themselves voice specialists compared with all other work environments. Those SLPs who considered themselves voice specialists were significantly more likely to utilize voice-specific assessment and treatment approaches. SLP practice largely mirrors current professional practice guidelines; however, potential exists to further enhance client care. To ensure that SLPs are best able to support children in successful communication, further research, education, and advocacy are required.

Upper Colorado River Basin Climate Effects Network

USGS Publications Warehouse

Belnap, Jayne; Campbell, Donald; Kershner, Jeff

2011-01-01

The Upper Colorado River Basin (UCRB) Climate Effects Network (CEN) is a science team established to provide information to assist land managers in future decision making processes by providing a better understanding of how future climate change, land use, invasive species, altered fire cycles, human systems, and the interactions among these factors will affect ecosystems and the services they provide to human communities. The goals of this group are to (1) identify science needs and provide tools to assist land managers in addressing these needs, (2) provide a Web site where users can access information pertinent to this region, and (3) provide managers technical assistance when needed. Answers to the team's working science questions are intended to address how interactions among climate change, land use, and management practices may affect key aspects of water availability, ecosystem changes, and societal needs within the UCRB.

Chronic oedema: its prevalence, effects and management.

PubMed

Cooper, Garry

2016-10-01

Ageing affects not only individuals but also society. It occurs throughout the western world. The ageing process may lead to the development of conditions, such as chronic oedema, as well as comorbidities such as osteoarthritis. These comorbidities can make the management of chronic oedema even more difficult. This is an especially important consideration when tailoring individualised care plans, such as exercise, as conditions such as rheumatoid arthritis can limit patients' ability to manage their oedema. Despite challenges, education can improve patient outcomes when evidence-based practice is used.

Promoting a culture of disaster preparedness.

PubMed

Medina, Angeli

2016-01-01

Disasters from all hazards, ranging from natural disasters, human-induced disasters, effects of climate change to social conflicts can significantly affect the healthcare system and community. This requires a paradigm shift from a reactive approach to a disaster risk management 'all-hazards' approach. Disaster management is a joint effort of the city, state, regional, national, multi-agencies and international organisations that requires effective communication, collaboration and coordination. This paper offers lessons learned and best practices, which, when taken into consideration, can strengthen the phases of disaster risk management.

Acquainting Future Office Employees with Productivity-Improvement Techniques.

ERIC Educational Resources Information Center

Quible, Zane K.

1982-01-01

Examines factors affecting productivity (government regulations, energy costs, decline in the work ethic, capital investment, number of service workers, work force characteristics, management practices, and unions), and techniques to improve productivity (employee involvement, job structure, communication, flexitime, employee upgrading, incentive…

Guidelines for maintaining and managing the vaccine cold chain.

PubMed

2003-10-24

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

A Systematic Review of Collaboration and Network Research in the Public Affairs Literature: Implications for Public Health Practice and Research

PubMed Central

Shoup, Jo Ann; Miller, Sara

2012-01-01

Objectives. We explored and analyzed how findings from public affairs research can inform public health research and practice, specifically in the area of interorganizational collaboration, one of the most promising practice-based approaches in the public health field. Methods. We conducted a systematic review of the public affairs literature by following a grounded theory approach. We coded 151 articles for demographics and empirical findings (n = 258). Results. Three primary findings stand out in the public affairs literature: network structure affects governance, management strategies exist for administrators, and collaboration can be linked to outcomes. These findings are linked to priorities in public health practice. Conclusions. Overall, we found that public affairs has a long and rich history of research in collaborations that offers unique organizational theory and management tools to public health practitioners. PMID:22021311

Changes in water budgets and sediment yields from a hypothetical agricultural field as a function of landscape and management characteristics--A unit field modeling approach

USGS Publications Warehouse

Roth, Jason L.; Capel, Paul D.

2012-01-01

Crop agriculture occupies 13 percent of the conterminous United States. Agricultural management practices, such as crop and tillage types, affect the hydrologic flow paths through the landscape. Some agricultural practices, such as drainage and irrigation, create entirely new hydrologic flow paths upon the landscapes where they are implemented. These hydrologic changes can affect the magnitude and partitioning of water budgets and sediment erosion. Given the wide degree of variability amongst agricultural settings, changes in the magnitudes of hydrologic flow paths and sediment erosion induced by agricultural management practices commonly are difficult to characterize, quantify, and compare using only field observations. The Water Erosion Prediction Project (WEPP) model was used to simulate two landscape characteristics (slope and soil texture) and three agricultural management practices (land cover/crop type, tillage type, and selected agricultural land management practices) to evaluate their effects on the water budgets of and sediment yield from agricultural lands. An array of sixty-eight 60-year simulations were run, each representing a distinct natural or agricultural scenario with various slopes, soil textures, crop or land cover types, tillage types, and select agricultural management practices on an isolated 16.2-hectare field. Simulations were made to represent two common agricultural climate regimes: arid with sprinkler irrigation and humid. These climate regimes were constructed with actual climate and irrigation data. The results of these simulations demonstrate the magnitudes of potential changes in water budgets and sediment yields from lands as a result of landscape characteristics and agricultural practices adopted on them. These simulations showed that variations in landscape characteristics, such as slope and soil type, had appreciable effects on water budgets and sediment yields. As slopes increased, sediment yields increased in both the arid and humid environments. However, runoff did not increase with slope in the arid environment as was observed in the humid environment. In both environments, clayey soils exhibited the greatest amount of runoff and sediment yields while sandy soils had greater recharge and lessor runoff and sediment yield. Scenarios simulating the effects of the timing and type of tillage practice showed that no-till, conservation, and contouring tillages reduced sediment yields and, with the exception of no-till, runoff in both environments. Changes in land cover and crop type simulated the changes between the evapotransporative potential and surface roughness imparted by specific vegetations. Substantial differences in water budgets and sediment yields were observed between most agricultural crops and the natural covers selected for each environment: scrub and prairie grass for the arid environment and forest and prairie grass for the humid environment. Finally, a group of simulations was performed to model selected agricultural management practices. Among the selected practices subsurface drainage and strip cropping exhibited the largest shifts in water budgets and sediment yields. The practice of crop rotation (corn/soybean) and cover cropping (corn/rye) were predicted to increase sediment yields from a field planted as conventional corn.

Transcultural Pain Management: Theory, Practice, and Nurse-Client Partnerships.

PubMed

Rosa, William E

2018-02-01

Nursing is becoming increasingly aware of its impact as a global profession. Part of this evolution is the understanding that the Western evidence-based construct may not be reliably or universally applicable to transcultural settings and clients. In a global world, no 'one size fits all' and no singular approach to pain management is appropriate; there are, quite literally, infinite variations in cross-cultural dynamics. Nurses working in the field of pain management must be able to navigate their responsibilities within the global health context. The role of the pain management nurse in the global world is to provide individualized and culturally relevant pain management for clients, which is mindful of multifactorial contributors to the pain experience, such as the physiologic, affective, cognitive, behavioral, sociocultural, and environmental, and to view adequate pain management as an international human right. Through the skillful integration of theory, practice, and the ability to build respectful and responsible nurse-client partnerships, pain management nurses can deliver contextually relevant care that promotes safety, quality, and healing. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Children's experiences of managing Type 1 diabetes in everyday life: a thematic synthesis of qualitative studies.

PubMed

Rankin, D; Harden, J; Jepson, R; Lawton, J

2017-08-01

To explore the everyday experiences of children (aged ≤ 12 years) with Type 1 diabetes to identify factors that help or hinder diabetes self-management practices. Eight databases (Embase, Medline, CINAHL, Web of Science, PsychInfo, ASSIA, ERIC and ProQuest Dissertations) were searched in 2016 to identify qualitative studies exploring children's views about self-managing diabetes. Data were extracted, coded and analysed using thematic synthesis. Eighteen studies from five countries were included in the review. Synthesis of studies' findings resulted in the identification of three overarching analytical themes. The first theme, 'Understandings of diabetes and involvement in self-management', outlines ways in which children understand diabetes and develop self-management responsibilities. The second theme, 'Disruption to life and getting on with it', reports children's frustrations at disruptions to everyday life when managing diabetes, and how attempts to appear normal to family and friends affect self-management practices. The third theme, 'Friends' support', describes how friends' reactions and responses to diabetes affect children's ability to appear normal and willingness to disclose information about diabetes, and support provided by 'informed friends', or peers with diabetes. Although the synthesis has identified how children's everyday life experiences inform ways in which they undertake diabetes self-management, it was not possible to determine new ways to provide support. To help children optimise their glycaemic control, further work should be undertaken to identify their need for support and which takes into account the potential ways in which parents, friends and peers can offer assistance. © 2017 Diabetes UK.

An assessment of nitrogen-based manure application rates on 39 U.S. swine operations.

PubMed

Lory, John A; Massey, Raymond E; Zulovich, Joseph M; Hoehne, John A; Schmidt, Amy M; Carlson, Marcia S; Fulhage, Charles D

2004-01-01

Water quality concerns and revised regulations are changing how confined animal feeding operations manage manure. Devising acceptable and feasible changes in manure practices requires a full understanding of the forces shaping current manure management decisions. Previous theoretical models have shown that a wide range of factors influence the lowest cost solution for manure management. We used a mechanistic model to characterize the manure management practices on 39 swine operations (20 unagitated lagoon and 19 slurry operations) in five states (Iowa, Missouri, North Carolina, Oklahoma, and Pennsylvania). Information was collected from each operation about animal numbers, feed and water use, manure handling and storage characteristics, field locations, crop rotation, fertilizer need, and equipment inventory and usage. Collected data were used as input and to validate results from a mechanistic model that determined acres required for manure application, manure application rate, time required for manure application, value of manure, and costs of manure management. The 39 farms had a mean of 984 animal units (AU) per operation, 18.2 AU ha(-1) (7.4 AU acre(-1)), and manure application costs of dollar 10.49 AU(-1) yr(-1). Significant factors affecting manure management included operation size, manure handling system, state, and ownership structure. Larger operations had lower manure management costs (r2 = 0.32). Manure value potentially exceeded manure application costs on 58% of slurry and 15% of lagoon operations. But 38% of slurry operations needed to apply manure off the farm whereas all lagoon operations had sufficient land for N-based manure management. Manure management was a higher percentage of gross income on contract operations compared with independents (P < 0.01). This research emphasized the importance of site-specific factors affecting manure management decisions and the economics of U.S. swine operations.

EFO-LCI: A New Life Cycle Inventory Database of Forestry Operations in Europe

NASA Astrophysics Data System (ADS)

Cardellini, Giuseppe; Valada, Tatiana; Cornillier, Claire; Vial, Estelle; Dragoi, Marian; Goudiaby, Venceslas; Mues, Volker; Lasserre, Bruno; Gruchala, Arkadiusz; Rørstad, Per Kristian; Neumann, Mathias; Svoboda, Miroslav; Sirgmets, Risto; Näsärö, Olli-Pekka; Mohren, Frits; Achten, Wouter M. J.; Vranken, Liesbet; Muys, Bart

2018-06-01

Life cycle assessment (LCA) has become a common methodology to analyze environmental impacts of forestry systems. Although LCA has been widely applied to forestry since the 90s, the LCAs are still often based on generic Life Cycle Inventory (LCI). With the purpose of improving LCA practices in the forestry sector, we developed a European Life Cycle Inventory of Forestry Operations (EFO-LCI) and analyzed the available information to check if within the European forestry sector national differences really exist. We classified the European forests on the basis of "Forest Units" (combinations of tree species and silvicultural practices). For each Forest Unit, we constructed the LCI of their forest management practices on the basis of a questionnaire filled out by national silvicultural experts. We analyzed the data reported to evaluate how they vary over Europe and how they affect LCA results and made freely available the inventory data collected for future use. The study shows important variability in rotation length, type of regeneration, amount and assortments of wood products harvested, and machinery used due to the differences in management practices. The existing variability on these activities sensibly affect LCA results of forestry practices and raw wood production. Although it is practically unfeasible to collect site-specific data for all the LCAs involving forest-based products, the use of less generic LCI data of forestry practice is desirable to improve the reliability of the studies. With the release of EFO-LCI we made a step toward the construction of regionalized LCI for the European forestry sector.

EFO-LCI: A New Life Cycle Inventory Database of Forestry Operations in Europe.

PubMed

Cardellini, Giuseppe; Valada, Tatiana; Cornillier, Claire; Vial, Estelle; Dragoi, Marian; Goudiaby, Venceslas; Mues, Volker; Lasserre, Bruno; Gruchala, Arkadiusz; Rørstad, Per Kristian; Neumann, Mathias; Svoboda, Miroslav; Sirgmets, Risto; Näsärö, Olli-Pekka; Mohren, Frits; Achten, Wouter M J; Vranken, Liesbet; Muys, Bart

2018-06-01

Life cycle assessment (LCA) has become a common methodology to analyze environmental impacts of forestry systems. Although LCA has been widely applied to forestry since the 90s, the LCAs are still often based on generic Life Cycle Inventory (LCI). With the purpose of improving LCA practices in the forestry sector, we developed a European Life Cycle Inventory of Forestry Operations (EFO-LCI) and analyzed the available information to check if within the European forestry sector national differences really exist. We classified the European forests on the basis of "Forest Units" (combinations of tree species and silvicultural practices). For each Forest Unit, we constructed the LCI of their forest management practices on the basis of a questionnaire filled out by national silvicultural experts. We analyzed the data reported to evaluate how they vary over Europe and how they affect LCA results and made freely available the inventory data collected for future use. The study shows important variability in rotation length, type of regeneration, amount and assortments of wood products harvested, and machinery used due to the differences in management practices. The existing variability on these activities sensibly affect LCA results of forestry practices and raw wood production. Although it is practically unfeasible to collect site-specific data for all the LCAs involving forest-based products, the use of less generic LCI data of forestry practice is desirable to improve the reliability of the studies. With the release of EFO-LCI we made a step toward the construction of regionalized LCI for the European forestry sector.

Survey of diagnostic and treatment practices for multiple sclerosis (MS) in Europe. Part 2: Progressive MS, paediatric MS, pregnancy and general management.

PubMed

Fernández, O; Delvecchio, M; Edan, G; Fredrikson, S; Giovannoni, G; Hartung, H-P; Havrdova, E; Kappos, L; Pozzilli, C; Soerensen, P S; Tackenberg, B; Vermersch, P; Comi, G

2018-05-01

The European Charcot Foundation supported the development of a set of surveys to understand current practice patterns for the diagnosis and management of multiple sclerosis (MS) in Europe. Part 2 of the report summarizes survey results related to secondary progressive MS (SPMS), primary progressive MS (PPMS), pregnancy, paediatric MS and overall patient management. A steering committee of MS neurologists developed case- and practice-based questions for two sequential surveys distributed to MS neurologists throughout Europe. Respondents generally favoured changing rather than stopping disease-modifying treatment (DMT) in patients transitioning from relapsing-remitting MS to SPMS, particularly with active disease. Respondents would not initiate DMT in patients with typical PPMS symptoms, although the presence of ≥1 spinal cord or brain gadolinium-enhancing lesion might affect that decision. For patients considering pregnancy, respondents were equally divided on whether to stop treatment before or after conception. Respondents strongly favoured starting DMT in paediatric MS with active disease; recommended treatments included interferon, glatiramer acetate and, in John Cunningham virus negative patients, natalizumab. Additional results regarding practice-based questions and management are summarized. Results of part 2 of the survey of diagnostic and treatment practices for MS in Europe largely mirror results for part 1, with neurologists in general agreement about the treatment and management of SPMS, PPMS, pregnancy and paediatric MS as well as the general management of MS. However, there are also many areas of disagreement, indicating the need for evidence-based recommendations and/or guidelines. © 2018 EAN.

Negative core affect and employee silence: How differences in activation, cognitive rumination, and problem-solving demands matter.

PubMed

Madrid, Hector P; Patterson, Malcolm G; Leiva, Pedro I

2015-11-01

Employees can help to improve organizational performance by sharing ideas, suggestions, or concerns about practices, but sometimes they keep silent because of the experience of negative affect. Drawing and expanding on this stream of research, this article builds a theoretical rationale based on core affect and cognitive appraisal theories to describe how differences in affect activation and boundary conditions associated with cognitive rumination and cognitive problem-solving demands can explain employee silence. Results of a diary study conducted with professionals from diverse organizations indicated that within-person low-activated negative core affect increased employee silence when, as an invariant factor, cognitive rumination was high. Furthermore, within-person high-activated negative core affect decreased employee silence when, as an invariant factor, cognitive problem-solving demand was high. Thus, organizations should manage conditions to reduce experiences of low-activated negative core affect because these feelings increase silence in individuals high in rumination. In turn, effective management of experiences of high-activated negative core affect can reduce silence for individuals working under high problem-solving demand situations. (c) 2015 APA, all rights reserved).

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.

Evaluation of serum trace mineral, vitamin D, and sex steroid hormone concentration, and survey data in llamas and alpacas with metacarpophalangeal and metatarsophalangeal hyperextension.

PubMed

Semevolos, Stacy A; Reed, Shannon K; Schultz, Loren G

2013-01-01

To characterize serum trace mineral, sex steroid hormone, and vitamin D concentrations and identify factors associated with metacarpophalangeal and metatarsophalangeal hyperextension in llamas and alpacas. Serum samples from 79 llamas and 15 alpacas and owner survey data for 573 llamas and 399 alpacas. Serum samples were stored at -20°C until analysis and were evaluated for trace mineral, vitamin D, estradiol, progesterone, and testosterone concentrations. Information regarding age of onset, number of affected animals in herd, feed and supplements given, type of housing, and management practices was obtained in an owner survey. Higher serum zinc and iron concentrations were associated with metacarpophalangeal and metatarsophalangeal hyperextension in camelids, compared with controls. In summer and fall months, vitamin D concentrations were significantly higher in affected camelids than controls. Overall prevalence was 13.3% in llamas, compared with 0.7% in alpacas. No management factors were found to be predictive of this condition. No other factors examined were associated with metacarpophalangeal and metatarsophalangeal hyperextension. Despite similar supplementation practices and environmental conditions between affected and unaffected animals, an association of high serum zinc, iron, and vitamin D concentrations in affected camelids, compared with controls, may indicate differences of intake or absorption of dietary supplements.

Kansas State Briefing Book on low-level radioactive waste management

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

Not Available

1981-07-01

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

The impact of non-IPA HMOs on the number of hospitals and hospital capacity.

PubMed

Chernew, M

1995-01-01

Concentration in the hospital market could limit the success of health care reform strategies that rely on managed care to constrain costs. Hospital market capacity also is important because capacity affects both costs and the degree of price competition. Because managed care plans, particularly non-individual practice association (non-IPA) model HMOs, practice a less hospital-intensive style of care, consolidation and downsizing in the hospital market potentially will accompany managed care growth, influencing the long-run effectiveness of managed care cost-containment strategies. Using Standard Metropolitan Statistical Area (SMSA) data from 1982 and 1987, a 10-percentage point increase in non-IPA HMO market share is estimated to reduce the number of hospitals by about 4%, causing an approximate 5% reduction in the number of hospital beds. No statistically significant relationship is found between non-IPA HMO penetration rates and hospital occupancy rates.

Vermont State Briefing Book on low-level radioactive waste management

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

Not Available

1981-07-01

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

Smart Practices In Building Interorganizational Collaborative Capacity to Strengthen the Florida Comprehensive Disaster Management Enterprise

DTIC Science & Technology

2011-12-01

private company , homeland security and disaster response affects most organizations and networks of people at specific periods of their existence...Preparedness and Assistance Trust Fund, due to controversy over a $2.00 assessment on homeowners’ insurance policies and a $4.00 assessment on commercial...fuel management strategies while taking into consideration rules for traffic safety, insurance and liability factors, right-of-ways and land

Wound management.

PubMed

Moreira, Maria E; Markovchick, Vincent J

2007-08-01

Wound management makes up an important part of the emergency physician's practice. Understanding the physiology of wound healing and the patient and wound factors affecting this process is essential for the proper treatment of wounds. There are many options available for wound closure. Each modality has its benefits and its drawbacks, and some are appropriate only for certain types of wounds. The goal is to achieve the best functional and cosmetically appealing scar while avoiding complications.

2017 National Standards for Diabetes Self-Management Education and Support.

PubMed

Beck, Joni; Greenwood, Deborah A; Blanton, Lori; Bollinger, Sandra T; Butcher, Marcene K; Condon, Jo Ellen; Cypress, Marjorie; Faulkner, Priscilla; Fischl, Amy Hess; Francis, Theresa; Kolb, Leslie E; Lavin-Tompkins, Jodi M; MacLeod, Janice; Maryniuk, Melinda; Mensing, Carolé; Orzeck, Eric A; Pope, David D; Pulizzi, Jodi L; Reed, Ardis A; Rhinehart, Andrew S; Siminerio, Linda; Wang, Jing

2018-02-01

Purpose The purpose of this study is to review the literature for Diabetes Self-Management Education and Support (DSMES) to ensure the National Standards for DSMES (Standards) align with current evidence-based practices and utilization trends. Methods The 10 Standards were divided among 20 interdisciplinary workgroup members. Members searched the current research for diabetes education and support, behavioral health, clinical, health care environment, technical, reimbursement, and business practice for the strongest evidence that guided the Standards revision. Results Diabetes Self-Management Education and Support facilitates the knowledge, skills, and ability necessary for diabetes self-care as well as activities that assist a person in implementing and sustaining the behaviors needed to manage their condition on an ongoing basis. The evidence indicates that health care providers and people affected by diabetes are embracing technology, and this is having a positive impact of DSMES access, utilization, and outcomes. Conclusion Quality DSMES continues to be a critical element of care for all people with diabetes. The DSMES services must be individualized and guided by the concerns, preferences, and needs of the person affected by diabetes. Even with the abundance of evidence supporting the benefits of DSMES, it continues to be underutilized, but as with other health care services, technology is changing the way DSMES is delivered and utilized with positive outcomes.

2017 National Standards for Diabetes Self-Management Education and Support.

PubMed

Beck, Joni; Greenwood, Deborah A; Blanton, Lori; Bollinger, Sandra T; Butcher, Marcene K; Condon, Jo Ellen; Cypress, Marjorie; Faulkner, Priscilla; Fischl, Amy Hess; Francis, Theresa; Kolb, Leslie E; Lavin-Tompkins, Jodi M; MacLeod, Janice; Maryniuk, Melinda; Mensing, Carolé; Orzeck, Eric A; Pope, David D; Pulizzi, Jodi L; Reed, Ardis A; Rhinehart, Andrew S; Siminerio, Linda; Wang, Jing

2017-10-01

Purpose The purpose of this study is to review the literature for Diabetes Self-Management Education and Support (DSMES) to ensure the National Standards for DSMES (Standards) align with current evidence-based practices and utilization trends. Methods The 10 Standards were divided among 20 interdisciplinary workgroup members. Members searched the current research for diabetes education and support, behavioral health, clinical, health care environment, technical, reimbursement, and business practice for the strongest evidence that guided the Standards revision. Results Diabetes Self-Management Education and Support facilitates the knowledge, skills, and ability necessary for diabetes self-care as well as activities that assist a person in implementing and sustaining the behaviors needed to manage their condition on an ongoing basis. The evidence indicates that health care providers and people affected by diabetes are embracing technology, and this is having a positive impact of DSMES access, utilization, and outcomes. Conclusion Quality DSMES continues to be a critical element of care for all people with diabetes. The DSMES services must be individualized and guided by the concerns, preferences, and needs of the person affected by diabetes. Even with the abundance of evidence supporting the benefits of DSMES, it continues to be underutilized, but as with other health care services, technology is changing the way DSMES is delivered and utilized with positive outcomes.

River management impacts on riparian forest vegetation along the Middle Rio Grande: 1935-2014

NASA Astrophysics Data System (ADS)

Petrakis, Roy E.

Riparian ecosystems of the southwestern United States are highly valuable to both the ecological and human communities which surround them. Over the past century, they have been subject to shifting management practices to maximize human use, control, ecosystem service, and conservation. This creates a complex relationship between water policy, management, and the natural ecosystem necessitating research on spatial and temporal dynamics of riparian vegetation. The San Acacia Reach of the Middle Rio Grande, a 60 mile stretch from the San Acacia Diversion Dam to San Marcial, has experienced multiple management and river flow fluctuations over the past 80 years, resulting in threats to riparian and aquatic ecosystems. This research was completed through the use and analysis of multi-source remote sensing data, GIS, and a review of the on-the-ground management decisions to better understand how the location and composition of the riparian vegetation has been affected by these shifting practices. This research focused on four phases, each highlighting different management practices and river flow patterns during the last 80-years. Each of these periods provides a unique opportunity to observe a direct relationship between river management and riparian land cover response and change. Overall, management practices reduced surface river flows and limited overbank flooding and resulted in changes in the composition, density, and spatial patterns of the vegetation, including increased non-native vegetation growth. Restoration efforts over the past few decades have begun to reduce the presence of non-native species. Despite these changes, this ecosystem was shown to be extremely resilient in maintaining its function/service throughout the entire study time frame.

Price projections for selected grades of Douglas-fir lumber.

Treesearch

Richard W. Haynes; Thomas D. Fahey; Roger D. Fight

1988-01-01

Grade-specific price projections were developed for Douglas-fir lumber produced in the Douglas-fir region. These grade-specific price projections can be used as an aid in evaluating management practices that will affect the quality of saw logs that are produced.

Cancer Pain (PDQ®)—Health Professional Version

Cancer.gov

Cancer pain can be a complication of cancer or its treatment, and can negatively affect the functional status and quality of life of cancer patients. Get comprehensive, practical information on the screening, assessment, and management of cancer-related pain in this summary for clinicians.

Genetic principles

Treesearch

Ronald P. Overton; David T. Funk

1989-01-01

Tree growth is a function of both environment and genetic makeup. All forest management activities during a rotation from establishment to harvest affect the genetic composition and the environment of a stand. Silvicultural practices which fail to take both of these factors into account will reduce forest productivity.

Landscape influence on soil carbon and nutrient levels

USDA-ARS?s Scientific Manuscript database

Past runoff, erosion, and management practices influence nutrient levels on the landscape. These starting levels affect future nutrient transport due to runoff, erosion, and leaching events. The purpose of this study was to examine closed-depression landscape effects on surface soil organic matter, ...

Is it working? A look at the changing nutrient practices in Oregon's Southern Willamette Valley Groundwater Management Area

NASA Astrophysics Data System (ADS)

Pearlstein, S.; Compton, J.; Eldridge, A.; Henning, A.; Selker, J. S.; Brooks, J. R.; Schmitz, D.

2016-12-01

Groundwater nitrate contamination affects thousands of households in the southern Willamette Valley and many more across the Pacific Northwest. The southern Willamette Valley Groundwater Management Area (SWV GWMA) was established in 2004 due to nitrate levels in the groundwater exceeding the human health standard of 10 mg nitrate-N L-1. Much of the nitrogen inputs to the GWMA comes from agricultural nitrogen use, and thus efforts to reduce N inputs to groundwater are focused upon improving N management. Previous work in the 1990s in the Willamette Valley by researchers at Oregon State University determined the importance of cover crops and irrigation practices and made recommendations to the local farm community for reducing nitrogen (N) leaching. We are currently re-sampling many of the same fields studied by OSU to examine the influence of current crops and nutrient management practices on nitrate leaching below the rooting zone. This study represents important crops currently grown in the GWMA and includes four grass fields, three vegetable row-crop fields, two peppermint and wheat fields, and one each of hazelnuts and blueberries. New nutrient management practices include slow release fertilizers and precision agriculture approaches in some of the fields. Results from the first two years of sampling show nitrate leaching is lower in some crops like row crops grown for seed and higher in others like perennial rye grass seed when compared to the 1990s data. We will use field-level N input-output balances in order to determine the N use efficiency and compare this across crops and over time. The goal of this project is to provide information and tools that will help farmers, managers and conservation groups quantify the water quality benefits of management practices they are conducting or funding.

Benchmark study on glyphosate-resistant cropping systems in the United States. Part 7: Effects of weed management strategy (grower practices versus academic recommendations) on the weed soil seedbank over 6 years.

PubMed

Gibson, David J; Young, Bryan G; Owen, Micheal D K; Gage, Karla L; Matthews, Joseph L; Jordan, David L; Shaw, David R; Weller, Stephen C; Wilson, Robert G

2016-04-01

Shifts in weed species composition and richness resulting from near-exclusive reliance on herbicides in glyphosate-resistant (GR) cropping systems has necessitated the implementation of alternative weed management tactics to reduce selection pressures of herbicides. We contrasted the response of the weed soil seedbank to effects of weed management strategy, comparing grower practices with academic recommendations for best management practices (BMPs) over 6 years and across five weed hardiness zones in the US Midwest at sites subject to GR cropping systems. Total weed population density and species richness varied according to cropping system, location and prior year's crop, but less so to weed management strategy. The seedbank population density for 11 of the 14 most frequent weed species was affected by weed management strategy either alone or in an interaction with hardiness zone or year, or both. In only 29% of comparisons was weed population density lower following academic recommendations, and this depended upon prior crop and cropping system. The population density of high-risk weed species was reduced by academic recommendations, but only in two of six years and under continuous GR maize. Overall, the weed population density was decreasing in field halves subject to the BMPs in the academic recommendations relative to grower practices. The soil seedbank is slow to respond to academic recommendations to mitigate glyphosate-resistant weeds, but represents a biological legacy that growers need to keep in mind even when management practices reduce emerged field weed population densities. © 2015 Society of Chemical Industry.

Practice change in community pharmacy: using change-management principles when implementing a pharmacy asthma management service in NSW, Australia.

PubMed

Feletto, Eleonora; Lui, Grace Wan Ying; Armour, Carol; Saini, Bandana

2013-02-01

This study aimed to investigate the application of a research-based change-management tool, the Pharmacy Change Readiness Wheel (PCRW), in practice, and the impact it had on the implementation of an asthma service (Pharmacy Asthma Management Service or PAMS). All pharmacists implementing the PAMS in the state of New South Wales, Australia, were provided training using a custom-designed module explaining change readiness as it applied to the PAMS. This training and a self-administered PCRW checklist were completed before PAMS implementation. Following PAMS service delivery, semi-structured phone interviews were conducted with the pharmacists and any additional staff involved regarding their experiences of change management. Interviews were transcribed verbatim and content analysed. Thirty seven of the forty five pharmacies who delivered PAMS returned the PCRW checklist (82% response rate) and participants from 29 pharmacies were interviewed (29 pharmacists and six additional staff). Perception of readiness for change before service delivery was remarkably high. From the interviews conducted after service delivery it was evident that systematic management of the practice change using theoretical concepts had not really been undertaken and that many challenges were faced in the implementation of practice change (PAMS). The results of the content analysis from the interviews revealed that factors external or internal to the pharmacy or those related to the individual pharmacist could affect implementation of practice change. Change is not as straightforward as it may appear and is a multi-step process over time. Pharmacists were unaware of this. A change-management framework should be applied to specific services with enough flexibility so that pharmacists can individualise them for their pharmacies. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

Is Managed Care Leading to Consolidation in Health-care Markets?

PubMed Central

David, Dranove; Simon, Carol J; White, William D

2002-01-01

Objective To determine the extent to which managed care has led to consolidation among hospitals and physicians. Data Sources We use data from the American Hospital Association, American Medical Association, and government censuses. Study Design Two stage least squares regression analysis examines how cross-section variation in managed care penetration affects provider consolidation, while controlling for the endogeneity of managed-care penetration. Specifically, we examine inpatient hospital markets and physician practice size in large metropolitan areas. Data Collection Methods All data are from secondary sources, merged at the level of the Primary Metropolitan Statistical Area. Principal Findings We find that higher levels of local managed-care penetration are associated with substantial increases in consolidation in hospital and physician markets. In the average market (managed-care penetration equaled 34 percent in 1994), managed care was associated with an increase in the Herfindahl of .054 between 1981 and 1994, moving from .096 in 1981 to .154. This is equivalent to moving from 10.4 equal-size hospitals to 6.5 equal-sized hospitals. In the physician market place, we estimate that at the mean, managed care resulted in a 14 percentage point decrease of physicians in solo practice between 1986 and 1995. This implies a decrease in the percentage of doctors in solo practice from 38 percent in 1986 to 24 percent by 1995. PMID:12132596

Temporal Variation in Honey Production by the Stingless Bee Melipona subnitida (Hymenoptera: Apidae): Long-Term Management Reveals its Potential as a Commercial Species in Northeastern Brazil.

PubMed

Koffler, Sheina; Menezes, Cristiano; Menezes, Paulo Roberto; Kleinert, Astrid de Matos Peixoto; Imperatriz-Fonseca, Vera Lucia; Pope, Nathaniel; Jaffé, Rodolfo

2015-06-01

Even though stingless beekeeping has a great potential as a sustainable development tool, the activity remains essentially informal, technical knowledge is scarce, and management practices lack the sophistication and standardization found in apiculture. Here, we contributed to the further development of stingless beekeeping by investigating the long-term impact of management and climate on honey production and colony survival in the stingless bee Melipona subnitida Ducke (1910). We analyzed a 10-yr record of 155 M. subnitida colonies kept by a commercial honey producer of northeastern Brazil. This constitutes the longest and most accurate record available for a stingless bee. We modeled honey production in relation to time (years), age, management practices (colony division and food supplementation), and climatic factors (temperature and precipitation), and used a model selection approach to identify which factors best explained honey production. We also modeled colony mortality in relation to climatic factors. Although the amount of honey produced by each colony decreased over time, we found that the probability of producing honey increased over the years. Colony divisions decreased honey production, but did not affect honey presence, while supplementary feeding positively affected honey production. In warmer years, the probability of producing honey decreased and the amount of honey produced was lower. In years with lower precipitation, fewer colonies produced honey. In contrast, colony mortality was not affected by climatic factors, and some colonies lived up to nine years, enduring extreme climatic conditions. Our findings provide useful guidelines to improve management and honey production in stingless bees. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Conventional and organic soil fertility management practices affect corn plant nutrition and Ostrinia nubilalis (Lepidoptera: Crambidae) larval performance.

PubMed

Murrell, Ebony G; Cullen, Eileen M

2014-10-01

Few studies compare how different soil fertilization practices affect plant mineral content and insect performance in organic systems. This study examined: 1) The European corn borer, Ostrinia nubilalis (Hübner), larval response on corn (Zea mays L.) grown in field soils with different soil management histories; and 2) resilience of these plants to O. nubilalis herbivory. Treatments included: 1) standard organic--organically managed soil fertilized with dairy manure and 2 yr of alfalfa (Medicago sativa L.) in the rotation; 2) basic cation saturation ratio--organically managed soil fertilized with dairy manure and alfalfa nitrogen credits, plus addition of gypsum (CaSO4·2H2O) according to the soil balance hypothesis; and 3) conventional--conventionally managed soil fertilized with synthetic fertilizers. Corn plants were reared to maturity in a greenhouse, and then infested with 0-40 O. nubilalis larvae for 17 d. O. nubilalis exhibited negative competitive response to increasing larval densities. Mean development time was significantly faster for larvae consuming basic cation saturation ratio plants than those on standard organic plants, with intermediate development time on conventional plants. Neither total yield (number of kernels) nor proportion kernels damaged differed among soil fertility treatments. Soil nutrients differed significantly in S and in Ca:Mg and Ca:K ratios, but principal components analysis of plant tissue samples taken before O. nubilalis infestation showed that S, Fe, and Cu contributed most to differences in plant nutrient profiles among soil fertility treatments. Results demonstrate that different fertilization regimens can significantly affect insect performance within the context of organic systems, but the effects in this study were relatively minor compared with effects of intraspecific competition.

Substance Abuse and Addiction: Implications for Pain Management in Patients With Cancer
.

PubMed

Compton, Peggy; Chang, Yu-Ping

2017-04-01

Substance use disorders (SUDs) are chronic diseases that may complicate the nursing care of patients with cancer, affecting their ability to adhere to treatment protocols, responses to cancer pain, and use of opioids for analgesia. This article explores how the presence of an SUD may affect oncology nursing care and pain management. The PubMed and CINAHL® databases were searched for articles from 1980-2016 using the keywords cancer, cancer pain, addiction, substance abuse, and alcoholism.
. SUD is a common comorbidity in patients with cancer that may play a role in disease etiology. Practice guidelines are suggested for the assessment and management of addiction to improve overall outcomes for patients. Effective treatments for SUDs and cancer pain exist, and recovery can lead to improvements in multiple aspects of patients' lives.

A quality improvement project to improve the effectiveness and patient-centredness of management of people with mild-to-moderate kidney disease in primary care.

PubMed

Thomas, Nicola; Gallagher, Hugh; Jain, Neerja

2014-01-01

Chronic kidney disease (CKD) stages 3 to 5, affects 6-7% of the adult population and is an important risk factor for both advanced kidney disease and cardiovascular disease. This paper describes a quality improvement project that aimed to establish consistent implementation of best practice in people with stage 3-5 kidney disease who were managed in primary care. The intervention was a Care Bundle for CKD. The bundle included three evidence-based, high impact interventions based on National Institute for Care Excellence (NICE, 2008) guidance, with an additional and novel self-management element. 29 GP Practices in England and Wales began the study. They undertook training in clinical management of CKD and in facilitation of self-management, with the self-management content designed and led by patients. Practices were asked to report baseline and then monthly outcome data extracted from practice computer systems. The project team provided implementation and ongoing quality improvement support for participating Practices. Ten Practices dropped out of the study following the training. Data submissions were incomplete in six Practices who continued to apply the care bundle. At the project end, a decision was taken by the study team to perform the final analysis on those thirteen Practices which completed the project and submitted at least six sets of monthly Practice-level outcome data. In these Practices the Care Bundle was applied to under 20% of the registered CKD stage 3 to 5 population in 5 Practices, 20-29% in 3 Practices, 30-49% in 2 Practices and ≥50% in 3 Practices (998 patients in total). Of these, 671 patients (75%) agreed to the self-management component of the intervention. The reliability (at project end) in those who received the Bundle was 100%. The Bundle was applied to an additional 315 patients in the six Practices who completed the project but did not submit regular practice-level monthly data. In the thirteen remaining Practices, the achievement of NICE (2008) blood pressure targets at the start of the project was 74.8% in people with CKD stage 3-5 and no diabetes and 48% in people with CKD stage 3-5 and diabetes. At the project end these figures in the same Practices were 76.7% and 49.2% respectively. These improvements were achieved in spite of Practices increasing their recording of prevalence rate (that is, identifying and recording more patients with CKD on the Practice CKD Register). In conclusion, a care bundle can be implemented in primary care. However, maintaining engagement with primary care health care professionals and maximising exposure to an intervention in patients seen infrequently are significant challenges to generalisation and sustainability.

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.

Modeling factors explaining physicians’ satisfaction with competence

PubMed Central

Lepnurm, Rein; Dobson, Roy Thomas; Peña-Sánchez, Juan-Nicolás; Nesdole, Robert

2015-01-01

Objective: Attention to physician wellness has increased as medical practice gains in complexity. Physician satisfaction with practice is critical for quality of care and practice growth. The purpose of this study was to model physicians’ self-reported Satisfaction with Competence as a function of their perceptions of the Quality of Health Services, Distress, Coping, Practice Management, Personal Satisfaction and Professional Equity. Methods: Comprehensive questionnaires were sent to a stratified sample of 5300 physicians across Canada. This cross-sectional study focused on physicians who examined and treated individual patients for a final study population of 2639 physicians. Response bias was negligible. The questionnaires contained measures of Satisfaction with Competence, Quality of Health Services, Distress, Coping, Personal Satisfaction, Practice Management and Professional Equity. Exploring relationships was done using Pearson correlations and one-way analysis of variance. Modeling was by hierarchical regressions. Results: The measures were reliable: Satisfaction with Competence (α = .86), Quality (α = .86), Access (α = .82), Distress (α = .82), Coping (α = .76), Personal Satisfaction (α = .78), Practice Management (α = .89) and the dimensions of Professional Equity (Fulfillment, α = .81; Financial, α = .93; and Recognition, α = .75) with comparative validity. Satisfaction with Competence was positively correlated with Quality (r = .32), Efficiency (r = .37) and Access (r = .32); negatively correlated with Distress (r = −.54); and positively correlated with Coping strategies (r = .43), Personal Satisfaction (r = .57), Practice Management (r = .17), Fulfillment (r = .53), Financial (r = .36) and Recognition (r = .54). Physicians’ perceptions on Quality, Efficiency, Access, Distress, Coping, Personal Satisfaction, Practice Management, Fulfillment, Pay and Recognition explained 60.2% of the variation in Satisfaction with Competence, controlling for years in practice, self-reported health and duties of physicians. Conclusion: Satisfaction with Competence could be affected by excessive accumulation of duties, concerns about quality, efficiency, access, excessive distress, inadequate coping abilities, personal satisfaction with life as a physician, challenges in managing practices and persistent inequities among physicians. PMID:27092256

Modeling factors explaining physicians' satisfaction with competence.

PubMed

Lepnurm, Rein; Dobson, Roy Thomas; Peña-Sánchez, Juan-Nicolás; Nesdole, Robert

2015-01-01

Attention to physician wellness has increased as medical practice gains in complexity. Physician satisfaction with practice is critical for quality of care and practice growth. The purpose of this study was to model physicians' self-reported Satisfaction with Competence as a function of their perceptions of the Quality of Health Services, Distress, Coping, Practice Management, Personal Satisfaction and Professional Equity. Comprehensive questionnaires were sent to a stratified sample of 5300 physicians across Canada. This cross-sectional study focused on physicians who examined and treated individual patients for a final study population of 2639 physicians. Response bias was negligible. The questionnaires contained measures of Satisfaction with Competence, Quality of Health Services, Distress, Coping, Personal Satisfaction, Practice Management and Professional Equity. Exploring relationships was done using Pearson correlations and one-way analysis of variance. Modeling was by hierarchical regressions. The measures were reliable: Satisfaction with Competence (α = .86), Quality (α = .86), Access (α = .82), Distress (α = .82), Coping (α = .76), Personal Satisfaction (α = .78), Practice Management (α = .89) and the dimensions of Professional Equity (Fulfillment, α = .81; Financial, α = .93; and Recognition, α = .75) with comparative validity. Satisfaction with Competence was positively correlated with Quality (r = .32), Efficiency (r = .37) and Access (r = .32); negatively correlated with Distress (r = -.54); and positively correlated with Coping strategies (r = .43), Personal Satisfaction (r = .57), Practice Management (r = .17), Fulfillment (r = .53), Financial (r = .36) and Recognition (r = .54). Physicians' perceptions on Quality, Efficiency, Access, Distress, Coping, Personal Satisfaction, Practice Management, Fulfillment, Pay and Recognition explained 60.2% of the variation in Satisfaction with Competence, controlling for years in practice, self-reported health and duties of physicians. Satisfaction with Competence could be affected by excessive accumulation of duties, concerns about quality, efficiency, access, excessive distress, inadequate coping abilities, personal satisfaction with life as a physician, challenges in managing practices and persistent inequities among physicians.

A prospective survey of chiropractic student experiences with pediatric care and variability of case mix while on clinical placement in Rarotonga.

PubMed

Todd, Angela J; Carroll, Matthew T; Russell, David G; Mitchell, Eleanor K L

2017-03-01

To compare chiropractic students' perceptions of preparedness for practice before and after a clinical placement in Rarotonga and to report demographics from these experiences. The students completed deidentified pre- and postplacement surveys assessing pediatric practice preparedness. Students tallied the patient numbers, age, and chiropractic techniques used per visit for each day of clinic placement. On completion of the program, participating students (27/34, or 79% of the student cohort) did a postplacement survey on their perception of practice preparedness. Data were analyzed with the Spearman rho correlation, the Mann-Whitney U test, and regression analysis. There was an increase in perceived preparedness for pediatric practice, ranging from 24.1% of the student cohort at the start of the study to 82.1% following clinical placement in Rarotonga. The change in student preparedness to practice with children was positively correlated with the total number of children managed (r s = .05, p = .01) and the number of children managed who were under 10 years of age (r s = .60, p = .001). Multiple regression analysis demonstrated a medium positive effect for postprogram preparedness (F [4, 20] = 3.567, p = .024). Clinical outreach to Rarotonga provided a broad case mix of patients and a change in student perceptions of preparedness to practice with children, which was positively affected by the total number of children managed and the number of children managed who were under 10 years of age.

Herding: a new phenomenon affecting medical decision-making in multiple sclerosis care? Lessons learned from DIScUTIR MS

PubMed Central

Saposnik, Gustavo; Maurino, Jorge; Sempere, Angel P; Ruff, Christian C; Tobler, Philippe N

2017-01-01

Purpose Herding is a phenomenon by which individuals follow the behavior of others rather than deciding independently on the basis of their own private information. A herding-like phenomenon can occur in multiple sclerosis (MS) when a neurologist follows a therapeutic recommendation by a colleague even though it is not supported by best practice clinical guidelines. Limited information is currently available on the role of herding in medical care. The objective of this study was to determine the prevalence (and its associated factors) of herding in the management of MS. Methods We conducted a study among neurologists with expertise in MS care throughout Spain. Participants answered questions regarding the management of 20 case scenarios commonly encountered in clinical practice and completed 3 surveys and 4 experimental paradigms based on behavioral economics. The herding experiment consisted of a case scenario of a 40-year-old woman who has been stable for 3 years on subcutaneous interferon and developed a self-limited neurological event. There were no new magnetic resonance imaging (MRI) lesions. Her neurological examination and disability scores were unchanged. She was advised by an MS neurologist to switch from interferon to fingolimod against best practice guidelines. Multivariable logistic regression analysis was conducted to evaluate factors associated with herding. Results Out of 161 neurologists who were invited to participate, 96 completed the study (response rate: 60%). Herding was present in 75 (78.1%), having a similar prevalence in MS experts and general neurologists (68.8% vs 82.8%; P=0.12). In multivariate analyses, the number of MS patients seen per week was positively associated with herding (odds ratio [OR] 1.08, 95% CI 1.01–1.14). Conversely, physician’s age, gender, years of practice, setting of practice, or risk preferences were not associated with herding. Conclusion Herding was a common phenomenon affecting nearly 8 out of 10 neurologists caring for MS patients. Herding may affect medical decisions and lead to poorer outcomes in the management of MS. PMID:28203061

Managing health care organizations in an age of rapid change.

PubMed

Benjamin, S; al-Alaiwat, S

1998-03-01

Health care managers find their work increasingly difficult, due in part to rapid environmental change that plagues organizational life. Management practices and attitudes that may have been appropriate in previous eras are ineffective today. A study was conducted among managers in the Ministry of Health, State of Bahrain, seeking information about current trends in the macro or external environment that affect the Ministry of Health, as well as internal environmental pressures that may be similar or different. This article provides a clear picture of the context in which managers perform their work and offers recommendations for coping with change in dynamic, complex organizations.

Insights into water managers' perception and handling of uncertainties - a study of the role of uncertainty in practitioners' planning and decision-making

NASA Astrophysics Data System (ADS)

Höllermann, Britta; Evers, Mariele

2017-04-01

Planning and decision-making under uncertainty is common in water management due to climate variability, simplified models, societal developments, planning restrictions just to name a few. Dealing with uncertainty can be approached from two sites, hereby affecting the process and form of communication: Either improve the knowledge base by reducing uncertainties or apply risk-based approaches to acknowledge uncertainties throughout the management process. Current understanding is that science more strongly focusses on the former approach, while policy and practice are more actively applying a risk-based approach to handle incomplete and/or ambiguous information. The focus of this study is on how water managers perceive and handle uncertainties at the knowledge/decision interface in their daily planning and decision-making routines. How they evaluate the role of uncertainties for their decisions and how they integrate this information into the decision-making process. Expert interviews and questionnaires among practitioners and scientists provided an insight into their perspectives on uncertainty handling allowing a comparison of diverse strategies between science and practice as well as between different types of practitioners. Our results confirmed the practitioners' bottom up approach from potential measures upwards instead of impact assessment downwards common in science-based approaches. This science-practice gap may hinder effective uncertainty integration and acknowledgement in final decisions. Additionally, the implementation of an adaptive and flexible management approach acknowledging uncertainties is often stalled by rigid regulations favouring a predict-and-control attitude. However, the study showed that practitioners' level of uncertainty recognition varies with respect to his or her affiliation to type of employer and business unit, hence, affecting the degree of the science-practice-gap with respect to uncertainty recognition. The level of working experience was examined as a cross-cutting property of science and practice with increasing levels of uncertainty awareness and integration among more experienced researchers and practitioners. In conclusion, our study of water managers' perception and handling of uncertainties provides valuable insights for finding routines for uncertainty communication and integration into planning and decision-making processes by acknowledging the divers perceptions among producers, users and receivers of uncertainty information. These results can contribute to more effective integration of hydrological forecast and improved decisions.

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

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

PubMed

Longo, Maria Cristina

2015-01-01

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

Classroom Practice in Reading.

ERIC Educational Resources Information Center

Earle, Richard A., Ed.

Each of the five sections in this book deals with one of the five major components in a diagnostic/prescriptive model of classroom reading instruction: instructional purpose, evaluation, materials, methods, and classroom management. Articles in the "Instructional Purpose" section discuss the affective component of instruction and the relationship…

Long-term effects of potato cropping system strategies on soilborne diseases and soil microbial communities

USDA-ARS?s Scientific Manuscript database

Cropping systems incorporating soil health management practices, such as longer rotations, disease-suppressive crops, reduced tillage, and/or organic amendments can substantially affect soil microbial communities, and potentially reduce soilborne potato diseases and increase productivity, but long-t...

Uncertainty Analysis of Ozone Formation and Response to Emission Controls Using Higher-Order Sensitivities

EPA Science Inventory

Understanding ozone response to its precursor emissions is crucial for effective air quality management practices. This nonlinear response is usually simulated using chemical transport models, and the modeling results are affected by uncertainties in emissions inputs. In this stu...

Antibiotic effects on microbial community characteristics in soils under conservation management practices

USDA-ARS?s Scientific Manuscript database

Veterinary antibiotics (VAs) administered to livestock are introduced to agroecosystems via land application of manure, posing a potential human and environmental health risk. These Antibiotics may adversely affect soil microbial communities. The objectives of this research were to investigate poten...

The Role of Parents' Critical Thinking About Media in Shaping Expectancies, Efficacy and Nutrition Behaviors for Families.

PubMed

Austin, Erica Weintraub; Pinkleton, Bruce E; Radanielina-Hita, Marie Louise; Ran, Weina

2015-01-01

A convenience survey completed online by 137 4-H parents in Washington state explored their orientation toward critical thinking regarding media sources and content and its implications for family dietary behaviors. Parents' critical thinking toward media sources predicted their information efficacy about content. Critical thinking toward media content predicted information efficacy about sources, expectancies for parental mediation, and expectancies for family receptiveness to lower-fat dietary changes. Expectancies for receptiveness to dietary changes and expectancies for parental mediation predicted efficacy for implementing healthy dietary practices; this strongly predicted healthy dietary practices. Media-related critical thinking, therefore, indirectly but consistently affected self-reported family dietary behaviors through its effects on efficacy for managing media and expectancies for the family's receptiveness to healthy dietary changes. The results suggest parents' media literacy skills affect their family's dietary behavior. Health campaigns that help parents interpret and manage the media environment may benefit all family members.

Factors Affecting Public Preferences for Grassland Landscape Heterogeneity in the Great Plains

NASA Astrophysics Data System (ADS)

Joshi, Omkar; Becerra, Terrie A.; Engle, David M.; Fuhlendorf, Samuel D.; Elmore, R. Dwayne

2017-11-01

Agricultural intensification has fragmented rangelands in the Great Plains, which has contributed to uniform and homogeneous landscapes and decreased biodiversity. Alternative land management practices involving fire-grazing interactions can help maintain biodiversity without affecting livestock productivity. A survey was designed to understand the factors that influence preferences among the general population towards grassland landscape heterogeneity. Given the ordinal nature of survey responses, requisite data were analyzed using a generalized ordinal logit model. Results suggested that respondents who valued open space and those who recognized a need for a varying mix of uniform grasses and grasslands preferred landscape heterogeneity. Female respondents were about two times as likely to prefer heterogeneous landscapes compared to male respondents. In contrast, population groups that preferred wildlife habitat did not desire heterogeneous landscapes. Results suggest the need for extension and outreach activities to educate certain segments of the general population regarding benefits of alternative management practices that support landscape heterogeneity in the Great Plains.

The Challenges and Recommendations for Gestational Diabetes Mellitus Care in India: A Review

PubMed Central

Morampudi, Suman; Balasubramanian, Gayathri; Gowda, Arun; Zomorodi, Behsad; Patil, Anand Shanthanagowd

2017-01-01

Gestational diabetes mellitus (GDM) is a primary concern in India affecting approximately five million women each year. Existing literature indicate that prediabetes and diabetes affect approximately six million births in India alone, of which 90% are due to GDM. Studies reveal that there is no consensus among physicians and health-care providers in India regarding management of GDM prepartum and postpartum despite available guidelines. Also, there is no consensus among physicians as to when a woman should undergo oral glucose tolerance test after delivery. This clearly shows that management of GDM is challenging and controversial in India due to conflicting guidelines and treatment protocols, despite availability of straightforward protocols for screening and management. Also, a collaborative approach remains a key for GDM management, as patient compliance and proper educational interventions promote better pregnancy outcomes. Management of GDM plays a pivotal role, as women with GDM have an increased chance of developing diabetes mellitus 5–10 years after pregnancy. Also, children born in GDM pregnancies face an increased risk for obesity and type 2 diabetes. The cornerstone for the management of GDM is glycemic control and quality nutritional intake. GDM management is complex in India, and existing challenges are multifactorial. However, there are little published data outlining these challenges. This review gives an account of some of the key challenges from self-management and health-care provider perspective. The recommendations in this review provide insights for building a more structured model for GDM care in India. This research has several practical applications. First, it points out to reaching a consensus on approaches for screening, diagnosis, and treatment of care across clinical practices in the nation that can aid in overcoming certain challenges observed. Second, it highlights the importance to build capacities and capabilities, especially in resource-limited settings. Health education among pregnant women remains a priority to resolve issues related to self-management. More broadly, further research, specifically qualitative is vital to determine forthcoming challenges with respect to patients, caregivers, providers, and policy makers and to provide solutions fitted to practice setting and demographic background. PMID:28392778

What about Us? Economic and Policy Changes Affecting Rural HIV/AIDS Services and Care.

PubMed

Albritton, Tashuna; Martinez, Isabel; Gibson, Crystal; Angley, Meghan; Grandelski, Valen R

2017-01-01

Health care budgets and policies are chief drivers in the delivery and access to health services. Place is also a factor that affects patient and provider experiences within the health care system. We examine the impact of policy changes and subsequent budget cuts on rural HIV/AIDS care, support services, and prevention. We interviewed 11 social workers, case managers, and outreach workers who serve rural people living with HIV/AIDS. We conducted telephone interviews inquiring about the effect of economics and policies on direct practice with rural clients. We analyzed data using a content analysis approach. We found several themes from the data. Ryan White funding and policy changes shifted direct practice to a medical case management model. Changes in federal and state poverty levels affected client eligibility for the AIDS Drugs Assistance Program. Policy banning financial support for syringe service programs hindered prevention efforts to reduce HIV/AIDS transmission. Ancillary services were reduced, such as housing assistance, transportation, and emergency financial assistance. In conclusion, we highlight the importance of place-based policies to improve access to healthcare and services. We also provide recommendations for greater inclusion in HIV/AIDS-related policy development, care, and service planning for rural workers.

Can Managed Grazing be Part of Healthy Agroecosystems? Impacts of Various Systems on Soil Water and other Ecosystem Services

NASA Astrophysics Data System (ADS)

DeLonge, M. S.; Basche, A.; Gonzalez, J.

2016-12-01

Due to the vast extent of grazing lands, value of grassland ecosystems, and environmental impacts of the agricultural sector, it is becoming increasingly important to understand to what extent managed grazing can be part of healthy agroecosystems. For example, grazing systems can degrade soils, pollute water, and result in substantial direct and indirect animal emissions. On the other hand, well-managed grasslands can store more carbon, support more biodiversity, and require fewer inputs than croplands or other land uses. Systems analyses are needed to evaluate how much grazing management (e.g., altering stocking rate intensity or regime, integrating versus separating crops and livestock, adopting silvopasture techniques) can affect agroecosystem properties and farm viability. As a result of climate change and likely increases to rainfall variability, the effects of grazing systems on soil water properties are particularly important. The primary goal of this study is to use meta-analytic techniques to better understand how changes to grazing systems affect soil water properties, focusing on soil water infiltration rates. Another goal is to conduct a literature survey to assess how similar changes to grazing have influenced other ecosystem services (e.g., soil carbon, farm profitability) and to identify gaps in knowledge. To date, our meta-analysis includes over 100 paired comparisons (>30 studies) related to grazing. The analysis is a subset of a broader study of agroecological practices that to date includes >350 paired observations. Preliminary results point to significant variability, but suggest that integrating livestock into croplands decreases infiltration (12%), whereas other changings to grazing (decreasing stocking rates, moving from continuous to rotational grazing, or converting to a silvopasture system) can improve infiltration (by an average of 223% including all practices). Findings also suggest that removing livestock tends to increase infiltration rates over time. In cases where infiltration rates are negatively affected by grazing, soil conservation practices such as planting perennials or rotating crops) might mitigate those effects. However, the magnitude of these effects may depend on variables such as time since management change and rainfall regime.

Can knowledge-based N management produce more staple grain with lower greenhouse gas emission and reactive nitrogen pollution? A meta-analysis.

PubMed

Xia, Longlong; Lam, Shu Kee; Chen, Deli; Wang, Jinyang; Tang, Quan; Yan, Xiaoyuan

2017-05-01

Knowledge-based nitrogen (N) management, which is designed for a better synchronization of crop N demand with N supply, is critical for global food security and environmental sustainability. Yet, a comprehensive assessment on how these N management practices affect food production, greenhouse gas emission (GHG), and N pollution in China is lacking. We compiled the results of 376 studies (1166 observations) to evaluate the overall effects of seven knowledge-based N management practices on crop productivity, nitrous oxide (N 2 O) emission, and major reactive N (Nr) losses (ammonia, NH 3 ; N leaching and runoff), for staple grain (rice, wheat, and corn) production in China. These practices included the application of controlled-release N fertilizer, nitrification inhibitor (NI) and urease inhibitor (UI), higher splitting frequency of fertilizer N application, lower basal N fertilizer (BF) proportion, deep placement of N fertilizer, and optimal N rate based on soil N test. Our results showed that, compared to traditional N management, these knowledge-based N practices significantly increased grain yields by 1.3-10.0%, which is attributed to the higher aboveground N uptake (5.1-12.1%) and N use efficiency in grain (8.0-48.2%). Moreover, these N management practices overall reduced GHG emission and Nr losses, by 5.4-39.8% for N 2 O emission, 30.7-61.5% for NH 3 emission (except for the NI application), 13.6-37.3% for N leaching, and 15.5-45.0% for N runoff. The use of NI increased NH 3 emission by 27.5% (9.0-56.0%), which deserves extra-attention. The cost and benefit analysis indicated that the yield profit of these N management practices exceeded the corresponding input cost, which resulted in a significant increase of the net economic benefit by 2.9-12.6%. These results suggest that knowledge-based N management practice can be considered an effective way to ensure food security and improve environmental sustainability, while increasing economic return. © 2016 John Wiley & Sons Ltd.

Factors affecting professional ethics in nursing practice in Iran: a qualitative study.

PubMed

Dehghani, Ali; Mosalanejad, Leili; Dehghan-Nayeri, Nahid

2015-09-09

Professional ethics refers to the use of logical and consistent communication, knowledge, clinical skills, emotions and values in nursing practice. This study aimed to explore and describe factors that affect professional ethics in nursing practice in Iran. This qualitative study was conducted using conventional content analysis approach. Thirty nurses with at least 5 years of experience participated in the study; they were selected using purposive sampling. Data were collected through semi-structured interviews and analyzed using thematic analysis. After encoding and classifying the data, five major categories were identified: individual character and responsibility, communication challenges, organizational preconditions, support systems, educational and cultural development. Awareness of professional ethics and its contributing factors could help nurses and healthcare professionals provide better services for patients. At the same time, such understanding would be valuable for educational administrators for effective planning and management.

Direct access: factors that affect physical therapist practice in the state of Ohio.

PubMed

McCallum, Christine A; DiAngelis, Tom

2012-05-01

Direct access to physical therapist services is permitted by law in the majority of states and across all practice settings. Ohio enacted such legislation in 2004; however, it was unknown how direct access had affected actual clinical practice. The purpose of this study was to describe physical therapist and physical therapist practice environment factors that affect direct access practice. A 2-phase, mixed-method descriptive study was conducted. In the first phase, focus group interviews with 32 purposively selected physical therapists were completed, which resulted in 8 themes for an electronically distributed questionnaire. In the second phase, survey questionnaires were distributed to physical therapists with an e-mail address on file with the Ohio licensing board. An adjusted return rate of 23% was achieved. Data were analyzed for descriptive statistics. A constant comparative method assessed open-ended questions for common themes and patterns. Thirty-one percent of the respondents reported using direct access in physical therapist practice; however, 80% reported they would practice direct access if provided the opportunity. Physical therapists who practiced direct access were more likely to be in practice 6 years or more and hold advanced degrees beyond the entry level, were American Physical Therapy Association members, and had supportive management and organizational practice policies. The direct access physical therapist practice was generally a locally owned suburban private practice or a school-based clinic that saw approximately 6% to 10% of its patients by direct access. The majority of patients treated were adults with musculoskeletal or neuromuscular impairments. Nonresponse from e-mail may be associated with sample frame bias. Implementation of a direct access physical therapist practice model is evident in Ohio. Factors related to reimbursement and organizational policy appear to impede the process.

Management of pre-eclampsia/eclampsia.

PubMed

Ababneh, Mo

2004-06-01

Preclampsia/eclampsia affects only a small proportion of all pregnancies, yet it is associated with significant morbidity and mortality for mother and baby, with post partum resolution. The disorder is triggered by a placental pathology followed by a wide spectrum of maternal systemic response. However, there remains controversy in practically every aspect of the condition. A full understanding of the condition, its variable presentation allows the consulting anesthetist to optimize a plan for anesthetic management.

Reframing climate change assessments around risk: recommendations for the US National Climate Assessment

DOE PAGES

Weaver, C. P.; Moss, Richard H.; Ebi, Kristie L.; ...

2017-07-21

Climate change is a risk management challenge for society, with uncertain but potentially severe outcomes affecting natural and human systems, across generations. Managing climate-related risks will be more difficult without a base of knowledge and practice aimed at identifying and evaluating specific risks, and their likelihood and consequences, as well as potential actions to promote resilience in the face of these risks. Here, we suggest three improvements to the process of conducting climate change assessments to better characterize risk and inform risk management actions.

Reframing climate change assessments around risk: recommendations for the US National Climate Assessment

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

Weaver, C. P.; Moss, Richard H.; Ebi, Kristie L.

Climate change is a risk management challenge for society, with uncertain but potentially severe outcomes affecting natural and human systems, across generations. Managing climate-related risks will be more difficult without a base of knowledge and practice aimed at identifying and evaluating specific risks, and their likelihood and consequences, as well as potential actions to promote resilience in the face of these risks. Here, we suggest three improvements to the process of conducting climate change assessments to better characterize risk and inform risk management actions.

Factor Analysis of Therapist-Identified Treatment Targets in Community-Based Children's Mental Health.

PubMed

Love, Allison R; Okado, Izumi; Orimoto, Trina E; Mueller, Charles W

2018-01-01

The present study used exploratory and confirmatory factor analyses to identify underlying latent factors affecting variation in community therapists' endorsement of treatment targets. As part of a statewide practice management program, therapist completed monthly reports of treatment targets (up to 10 per month) for a sample of youth (n = 790) receiving intensive in-home therapy. Nearly 75 % of youth were diagnosed with multiple co-occurring disorders. Five factors emerged: Disinhibition, Societal Rules Evasion, Social Engagement Deficits, Emotional Distress, and Management of Biodevelopmental Outcomes. Using logistic regression, primary diagnosis predicted therapist selection of Disinhibition and Emotional Distress targets. Client age predicted endorsement of Societal Rules Evasion targets. Practice-to-research implications are discussed.

Organizational climate and hospital nurses' caring practices: a mixed-methods study.

PubMed

Roch, Geneviève; Dubois, Carl-Ardy; Clarke, Sean P

2014-06-01

Organizational climate in healthcare settings influences patient outcomes, but its effect on nursing care delivery remains poorly understood. In this mixed-methods study, nurse surveys (N = 292) were combined with a qualitative case study of 15 direct-care registered nurses (RNs), nursing personnel, and managers. Organizational climate explained 11% of the variation in RNs' reported frequency of caring practices. Qualitative data suggested that caring practices were affected by the interplay of organizational climate dimensions with patients and nurses characteristics. Workload intensity and role ambiguity led RNs to leave many caring practices to practical nurses and assistive personnel. Systemic interventions are needed to improve organizational climate and to support RNs' involvement in a full range of caring practices. © 2014 Wiley Periodicals, Inc.

Productivity of sodic soils can be enhanced through the use of salt tolerant rice varieties and proper agronomic practices.

PubMed

Singh, Y P; Mishra, V K; Singh, Sudhanshu; Sharma, D K; Singh, D; Singh, U S; Singh, R K; Haefele, S M; Ismail, A M

2016-04-01

Regaining the agricultural potential of sodic soils in the Indo-Gangetic plains necessitates the development of suitable salt tolerant rice varieties to provide an entry for other affordable agronomic and soil manipulation measures. Thus selection of high yielding rice varieties across a range of sodic soils is central. Evaluation of breeding lines through on-station and on-farm farmers' participatory varietal selection (FPVS) resulted in the identification of a short duration (110-115 days), high yielding and disease resistant salt-tolerant rice genotype 'CSR-89IR-8', which was later released as 'CSR43' in 2011. Several agronomic traits coupled with good grain quality and market value contributed to commercialization and quick adoption of this variety in the sodic areas of the Indo-Gangetic plains of eastern India. Management practices required for rice production in salt affected soils are evidently different from those in normal soils and practices for a short duration salt tolerant variety differ from those for medium to long duration varieties. Experiments were conducted at the Indian Council of Agricultural Research-Central Soil Salinity Research Institute (ICAR-CSSRI), Regional Research Station, Lucknow, Uttar Pradesh, India during 2011 and 2013 wet seasons, to test the hypothesis that combining matching management practices (Mmp) with an improved genotype would enhance productivity and profitability of rice in sodic soils. Mmp were developed on-station by optimizing existing best management practices (Bmp) recommended for the region to match the requirements of CSR43. The results revealed that transplanting 4 seedlings hill -1 at a spacing of 15 × 20 cm produced significantly higher yield over other treatments. The highest additional net gain was US$ 3.3 at 90 kg ha -1  N, and the lowest was US$ 0.4 at 150 kg ha -1  N. Above 150 kg ha -1 , the additional net gain became negative, indicating decreasing returns from additional N. Hence, 150 kg N ha -1 was considered the economic optimum N application rate for CSR43 in these sodic soils. Using 150-60-40-25 kg N-P 2 O 5 -K 2 O-ZnSO 4 ·7H 2 O ha -1 in farmers' fields grown to CSR43 produced an average of 5.5 t ha -1 grain. The results of on-farm evaluation trials of CSR43 showed that matching management practices (Mmp) increased yield by 8% over existing best management practices (Bmp) recommended by ICAR-CSSRI for sodic soils and by 16% over framers' management practices; however, combining Mmp with CSR43 resulted in 35% higher yields over farmers' current varieties and management. This approach of combining cost effective crop and nutrient management options and a salt-tolerant variety can maximize the productivity and profitability of sodic soils in the alluvial Indo-Gangetic plains and in neighboring salt-affected areas of the Ganges mega delta in South Asia.

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

PubMed Central

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

2015-01-01

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

Biological control of soilborne diseases in organic potato production as affected by varying environmental conditions

USDA-ARS?s Scientific Manuscript database

Soilborne diseases are persistent problems in potato production and alternative management practices are needed, particularly in organic production, where control options are limited. Selected biocontrol organisms, including two naturally-occurring hypovirulent strains of Rhizoctonia solani (Rhs1a1 ...

Understanding community-forest relations.

Treesearch

Linda E. Kruger

2003-01-01

Improved understanding of the relationships between human communities and forests is necessary to understanding how alternative forest management policies and practices can affect different communities. This knowledge also enhances our ability to formulate plans that are responsive to the needs and concerns of local communities, thus reducing polarization and related...

Soil-Structural Stability as Affected by Clay Mineralogy, Soil Texture and Polyacrylamide Application

USDA-ARS?s Scientific Manuscript database

Soil-structural stability (expressed in terms of aggregate stability and pore size distribution) depends on (i) soil inherent properties, (ii) extrinsic condition prevailing in the soil that may vary temporally and spatially, and (iii) addition of soil amendments. Different soil management practices...

Phosphorus concentrations in sequentially fractionated soil samples as affected by digestion methods

USDA-ARS?s Scientific Manuscript database

Sequential fractionation has been used for several decades for improving our understanding on the effects of agricultural practices and management on the lability and bioavailability of phosphorus in soil, manure, and other soil amendments. Nevertheless, there have been no reports on how manipulatio...

Best practice in wound assessment.

PubMed

Benbow, Maureen

2016-03-02

Accurate and considered wound assessment is essential to fulfil professional nursing requirements and ensure appropriate patient and wound management. This article describes the main aspects of holistic assessment of the patient and the wound, including identifying patient risk factors and comorbidities, and factors affecting wound healing to ensure optimal outcomes.

Microbial mineralization of organic nitrogen forms in poultry litters

USDA-ARS?s Scientific Manuscript database

Ammonia volatilization from the mineralization of uric acid and urea has a major impact on the poultry industry and the environment. Dry acids are a common management practice to reduce ammonia emissions from poultry houses, however little is known about how acidification affects the litter biologic...

Factors affecting strategic plan implementation using interpretive structural modeling (ISM).

PubMed

Bahadori, Mohammadkarim; Teymourzadeh, Ehsan; Tajik, Hamidreza; Ravangard, Ramin; Raadabadi, Mehdi; Hosseini, Seyed Mojtaba

2018-06-11

Purpose Strategic planning is the best tool for managers seeking an informed presence and participation in the market without surrendering to changes. Strategic planning enables managers to achieve their organizational goals and objectives. Hospital goals, such as improving service quality and increasing patient satisfaction cannot be achieved if agreed strategies are not implemented. The purpose of this paper is to investigate the factors affecting strategic plan implementation in one teaching hospital using interpretive structural modeling (ISM). Design/methodology/approach The authors used a descriptive study involving experts and senior managers; 16 were selected as the study sample using a purposive sampling method. Data were collected using a questionnaire designed and prepared based on previous studies. Data were analyzed using ISM. Findings Five main factors affected strategic plan implementation. Although all five variables and factors are top level, "senior manager awareness and participation in the strategic planning process" and "creating and maintaining team participation in the strategic planning process" had maximum drive power. "Organizational structure effects on the strategic planning process" and "Organizational culture effects on the strategic planning process" had maximum dependence power. Practical implications Identifying factors affecting strategic plan implementation is a basis for healthcare quality improvement by analyzing the relationship among factors and overcoming the barriers. Originality/value The authors used ISM to analyze the relationship between factors affecting strategic plan implementation.

Storyboarding used as an aid to explore grief.

PubMed

2016-07-06

Yvonne Dexter, writing in Nursing Children and Young People, discusses the use of storyboarding and its use as a reflective practice aid. As children's nurses are among the child health professionals most directly affected by childhood death, storyboarding can provide nursing students with a safe environment to reflect on their feelings about the death of a child. Ms Dexter considers the potential for its use in practice, for example in clinical supervision and classroom settings, to manage grief.

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.

Participatory innovation process for testing new practices for soil fertility management in Chókwè Irrigation Scheme (Mozambique)

NASA Astrophysics Data System (ADS)

Sánchez Reparaz, Maite; de Vente, Joris; Famba, Sebastiao; Rougier, Jean-Emmanuel; Ángel Sánchez-Monedero, Miguel; Barberá, Gonzalo G.

2015-04-01

Integrated water and nutrient management are key factors to increase productivity and to reduce the yield gap in irrigated systems in Sub-Saharan Africa. These two elements are affected by an ensemble of abiotic, biotic, management and socio-economic factors that need to be taken into account to reduce the yield gap, as well as farmers' perceptions and knowledge. In the framework of the project European Union and African Union cooperative research to increase Food production in irrigated farming systems in Africa (EAU4Food project) we are carrying out a participatory innovation process in Chókwè irrigation scheme (Mozambique) based on stakeholders engagement, to test new practices for soil fertility management that can increase yields reducing costs. Through a method combining interviews with three farmers' associations and other relevant stakeholders and soil sampling from the interviewed farmers' plots with the organization of Communities of Practices, we tried to capture how soil fertility is managed by farmers, the constraints they find as well as their perceptions about soil resources. This information was the basis to design and conduct a participatory innovation process where compost made with rice straw and manure is being tested by a farmers' association. Most important limitations of the method are also evaluated. Our results show that socio-economic characteristics of farmers condition how they manage soil fertility and their perceptions. The difficulties they face to adopt new practices for soil fertility management, mainly related to economic resources limitations, labour availability, knowledge time or farm structure, require a systemic understanding that takes into account abiotic, biotic, management and socio-economic factors and their implication as active stakeholders in all phases of the innovation process.

Multidisciplinary management of chronic heart failure: principles and future trends.

PubMed

Davidson, Patricia M; Newton, Phillip J; Tankumpuan, Thitipong; Paull, G; Dennison-Himmelfarb, Cheryl

2015-10-01

Globally, the management of chronic heart failure (CHF) challenges health systems. The high burden of disease and the costs associated with hospitalization adversely affect individuals, families, and society. Improved quality, access, efficiency, and equity of CHF care can be achieved by using multidisciplinary care approaches if there is adherence and fidelity to the program's elements. The goal of this article was to summarize evidence and make recommendations for advancing practice, education, research, and policy in the multidisciplinary management of patients with CHF. Essential elements of multidisciplinary management of CHF were identified from meta-analyses and clinical practice guidelines. The study factors were discussed from the perspective of the health care system, providers, patients, and their caregivers. Identified gaps in evidence were used to identify areas for future focus in CHF multidisciplinary management. Although there is high-level evidence (including several meta-analyses) for the efficacy of management programs for CHF, less evidence exists to determine the benefit attributable to individual program components or to identify the specific content of effective components and the manner of their delivery. Health care system, provider, and patient factors influence health care models and the effective management of CHF and require focus and attention. Extrapolating trial findings to clinical practice settings is limited by the heterogeneity of study populations and the implementation of models of intervention beyond academic health centers, where practice environments differ considerably. Ensuring that individual programs are both developed and assessed that consider these factors is integral to ensuring adherence and fidelity with the core dimensions of disease management necessary to optimize patient and organizational outcomes. Recognizing the complexity of the multidisciplinary CHF interventions will be important in advancing the design, implementation, and evaluation of the interventions. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

A medical home: value and implications of knowledge management.

PubMed

Orzano, A John; McInerney, Claire R; McDaniel, Reuben R; Meese, Abigail; Alajmi, Bibi; Mohr, Stewart M; Tallia, Alfred F

2009-01-01

Central to the "medical home" concept is the premise that the delivery of effective primary care requires a fundamental shift in relationships among practice members and between practice members and patients. Primary care practices can potentially increase their capacity to deliver effective care through knowledge management (KM), a process of sharing and making existing knowledge available or by developing new knowledge among practice members and patients. KM affects performance by influencing work relationships to enhance learning, decision making, and task execution. We extend our previous work to further characterize, describe, and contrast how primary care practices exhibit KM and explain why KM deserves attention in medical home redesign initiatives. Case studies were conducted, drawn from two higher and lower performing practices, which were purposely selected based on disease management, prevention, and productivity measures from an improvement trial. Observations of operations, clinical encounters, meetings, and interviews with office members and patients were transcribed and coded independently using a KM template developed from a previous secondary analysis. Face-to-face discussions resolved coding differences among research team members. Confirmation of findings was sought from practice participants. Practices manifested varying degrees of KM effectiveness through six interdependent processes and multiple overlapping tools. Social tools, such as face-to-face-communication for sharing and developing knowledge, were often more effective than were expensive technical tools such as an electronic medical record. Tool use was tailored for specific outcomes, interacted with each other, and leveraged by other organizational capacities. Practices with effective KM were more open to adopting and sustaining new ways of functioning, ways reflecting attributes of a medical home. Knowledge management differences occur within and between practices and can explain differences in performance. By relying more on social tools rather than costly, high-tech investment, KM leverages primary care's relationship-centered strength, facilitating practice redesign as a medical home.

Young people's food practices and social relationships. A thematic synthesis.

PubMed

Neely, Eva; Walton, Mat; Stephens, Christine

2014-11-01

Food practices are embedded in everyday life and social relationships. In youth nutrition promotion little attention is awarded to this centrality of food practices, yet it may play a pivotal role for young people's overall health and wellbeing beyond the calories food provides. Limited research is available explicitly investigating how food practices affect social relationships. The aim of this synthesis was therefore to find out how young people use everyday food practices to build, strengthen, and negotiate their social relationships. Using a thematic synthesis approach, we analysed 26 qualitative studies exploring young people's food practices. Eight themes provided insight into the ways food practices affected social relationships: caring, talking, sharing, integrating, trusting, reciprocating, negotiating, and belonging. The results showed that young people use food actively to foster connections, show their agency, and manage relationships. This synthesis provides insight into the settings of significance for young people where more research could explore the use of food in everyday life as important for their social relationships. A focus on social relationships could broaden the scope of nutrition interventions to promote health in physical and psychosocial dimensions. Areas for future research are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Anesthesia Practices for Interventional Radiology in Europe.

PubMed

Vari, Alessandra; Gangi, Afshin

2017-06-01

The Cardiovascular and Interventional Radiological Society of Europe (CIRSE) prompted an initiative to frame the current European status of anesthetic practices for interventional radiology, in consideration of the current variability of IR suite settings, staffing and anesthetic practices reported in the literature and of the growing debate on sedation administered by non-anesthesiologists, in Europe. Anonymous online survey available to all European CIRSE members to assess IR setting, demographics, peri-procedural care, anesthetic management, resources and staffing, pain management, data collection, safety, management of emergencies and personal opinions on the role CIRSE should have in promoting anesthetic care for interventional radiology. Predictable differences between countries and national regulations were confirmed, showing how significantly many "local" factors (type and size of centers, the availability of dedicated inpatient bed, availability of anesthesia staff) can affect the routine practice and the expansion of IR as a subspecialty. In addition, the perception of the need for IR to acquire more sedation-related skills is definitely stronger for those who practice with the lowest availability of anesthesia care. Significant country variations and regulations along with a controversial position of the anesthesia community on the issue of sedation administered by non-anesthesiologists substantially represent the biggest drawbacks for the expansion of peri-procedural anesthetic care for IR and for potential initiatives at an European level.

Spatial variation in soil properties and diffuse losses between and within grassland fields with similar short-term management.

PubMed

Peukert, S; Griffith, B A; Murray, P J; Macleod, C J A; Brazier, R E

2016-07-01

One of the major challenges for agriculture is to understand the effects of agricultural practices on soil properties and diffuse pollution, to support practical farm-scale land management. Three conventionally managed grassland fields with similar short-term management, but different ploughing histories, were studied on a long-term research platform: the North Wyke Farm Platform. The aims were to (i) quantify the between-field and within-field spatial variation in soil properties by geostatistical analysis, (ii) understand the effects of soil condition (in terms of nitrogen, phosphorus and carbon contents) on the quality of discharge water and (iii) establish robust baseline data before the implementation of various grassland management scenarios. Although the fields sampled had experienced the same land use and similar management for at least 6 years, there were differences in their mean soil properties. They showed different patterns of soil spatial variation and different rates of diffuse nutrient losses to water. The oldest permanent pasture field had the largest soil macronutrient concentrations and the greatest diffuse nutrient losses. We show that management histories affect soil properties and diffuse losses. Potential gains in herbage yield or benefits in water quality might be achieved by characterizing every field or by area-specific management within fields (a form of precision agriculture for grasslands). Permanent pasture per se cannot be considered a mitigation measure for diffuse pollution. The between- and within-field soil spatial variation emphasizes the importance of baseline characterization and will enable the reliable identification of any effects of future management change on the Farm Platform. Quantification of soil and water quality in grassland fields with contrasting management histories.Considerable spatial variation in soil properties and diffuse losses between and within fields.Contrasting management histories within and between fields strongly affected soil and water quality.Careful pasture management needed: the oldest pasture transferred the most nutrients from soil to water.

Not afraid to blame: the neglected role of blame attribution in medical consumerism and some implications for health policy.

PubMed

Rosenthal, Marsha; Schlesinger, Mark

2002-01-01

A crucial aspect of medical consumerism has been overlooked in past research and policymaking: how consumers decide whom to "blame" for bad outcomes. This study explores how, in a system increasingly dominated by managed care, these attributions affect consumers' attitudes and behavior. Using data from the experiences of people with serious mental illness, hypotheses are tested regarding the origins and consequences of blaming for medical consumerism. Blame was allocated to health plans in a manner similar, but not identical, to the way in which blame was allocated to health care professionals. Both allocations are shaped by enrollment in managed care, with blame allocation affecting consumers' subsequent willingness to talk about adverse events. Policy implications include the need for more finely tuned grievance procedures and better consumer education about managed care practices.

Knowledge, attitudes, beliefs and behaviour intentions for three bowel management practices in intensive care: effects of a targeted protocol implementation for nursing and medical staff.

PubMed

Knowles, Serena; Lam, Lawrence T; McInnes, Elizabeth; Elliott, Doug; Hardy, Jennifer; Middleton, Sandy

2015-01-01

Bowel management protocols have the potential to minimize complications for critically ill patients. Targeted implementation can increase the uptake of protocols by clinicians into practice. The theory of planned behaviour offers a framework in which to investigate clinicians' intention to perform the behaviour of interest. This study aimed to evaluate the effect of implementing a bowel management protocol on intensive care nursing and medical staffs' knowledge, attitude, subjective norms, perceived behavioural control, behaviour intentions, role perceptions and past behaviours in relation to three bowel management practices. A descriptive before and after survey using a self-administered questionnaire sent to nursing and medical staff working within three intensive care units before and after implementation of our bowel management protocol (pre: May - June 2008; post: Feb - May 2009). Participants had significantly higher knowledge scores post-implementation of our protocol (pre mean score 17.6; post mean score 19.3; p = 0.004). Post-implementation there was a significant increase in: self-reported past behaviour (pre mean score 5.38; post mean score 7.11; p = 0.002) and subjective norms scores (pre mean score 3.62; post mean score 4.18; p = 0.016) for bowel assessment; and behaviour intention (pre mean score 5.22; post mean score 5.65; p = 0.048) for administration of enema. This evaluation, informed by the theory of planned behaviour, has provided useful insights into factors that influence clinician intentions to perform evidence-based bowel management practices in intensive care. Addressing factors such as knowledge, attitudes and beliefs can assist in targeting implementation strategies to positively affect clinician behaviour change. Despite an increase in clinicians' knowledge scores, our implementation strategy did not, however, significantly change clinician behaviour intentions for all three bowel management practices. Further research is required to explore the influence of opinion leaders and organizational culture on clinicians' behaviour intentions related to bowel management for intensive care patients.

Conserving and managing the subnivium.

PubMed

Zuckerberg, Benjamin; Pauli, Jonathan N

2018-02-08

In regions where snowfall historically has been a defining seasonal characteristic of the landscape, warming winters have reduced the depth, duration, and extent of snowpack. However, most management and conservation has focused on how aboveground wildlife will be affected by altered snow conditions, even though the majority of species that persist through the winter do so under the snowpack in a thermally stable refugium: the subnivium. Shortened winters, forest management practices, and winter recreation can alter subnivium conditions by increasing snow compaction and compromising thermal stability at the soil-snow interface. To help slow the loss of the subnivium in the face of rapidly changing winter conditions, we suggest managers adopt regional conservation plans for identifying threatened snow-covered environments; measure and predict the effects land cover and habitat management has on local subnivium conditions; and control the timing and distribution of activities that disturb and compact snow cover (e.g., silvicultural practices, snow recreation, and road and trail maintenance). As a case study, we developed a spatially explicit model of subnivium presence in a working landscape of the Chequamegon National Forest, Wisconsin. We identified landscapes where winter recreation and management practices could threaten potentially important areas for subnivium persistence. Similar modeling approaches could inform management decisions related to subnivium conservation. Current climate projections predict that snow seasons will change rapidly in many regions, and as result, we advocate for the immediate recognition, conservation, and management of the subnivium and its dependent species. © 2018 Society for Conservation Biology.

A comparison of food safety knowledge among restaurant managers, by source of training and experience, in Oklahoma County, Oklahoma.

PubMed

Lynch, Robert A; Elledge, Brenda L; Griffith, Charles C; Boatright, Daniel T

2003-09-01

The annual incidence of illness related to food consumption continues to present a challenge to environmental health management. A significant fraction of cases have been attributed to consumption of food in restaurants, and as the number of meals eaten away from the home continues to rise, the potential for large-scale foodborne-disease outbreaks will continue to increase. Food handlers in retail establishments contribute to the incidence of foodborne disease; therefore, it is essential that workers and management staff have a thorough understanding of safe food practices. Since the training, certification, and experience of food service managers vary greatly, it is also likely that managers' knowledge base may differ. In the study reported here, restaurant managers were administered a survey designed to measure their understanding of basic food safety principles. The sources of training, certification, and experience were found to significantly affect the level of food safety knowledge; however, increased hours of training did not increase knowledge. In addition, the time lapsed since training did not significantly affect the level of knowledge.

Networking our science to characterize the state, vulnerabilities, and management opportunities of soil organic matter

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

Harden, Jennifer W.; Hugelius, Gustaf; Ahlstrom, Anders

Here, soil organic matter supports the Earth’s ability to sustain terrestrial ecosystems, provide food and fiber, and retain the largest pool of actively cycling carbon (C). Over 75% of the soil organic carbon (SOC) in the top meter of soil is directly affected by human land use. Large land areas have lost SOC as a result of land use practices, yet there are compensatory opportunities to enhance land productivity and SOC storage in degraded lands through improved management practices. Large areas with and without intentional management are also being subjected to rapid changes in climate, making many SOC stocks vulnerablemore » to losses by decomposition or disturbance. In order to quantify potential SOC losses or sequestration at field, regional, and global scales, measurements for detecting changes in SOC are needed. Such measurements and soil-management best practices should be based on well-established and emerging scientific understanding of processes of C stabilization and destabilization over various timescales, soil types, and spatial scales. As newly engaged members of the International Soil Carbon Network, we have identified gaps in data, modeling, and communication that underscore the need for an open, shared network to frame and guide the study of soil organic matter and C and their management for sustained production and climate regulation.« less

Networking our science to characterize the state, vulnerabilities, and management opportunities of soil organic matter

USGS Publications Warehouse

Harden, Jennifer W.; Hugelius, Gustaf; Ahlström, Anders; Blankinship, Joseph C.; Bond-Lamberty, Ben; Lawrence, Corey; Loisel, Julie; Malhotra, Avni; Jackson, Robert B.; Ogle, Stephen M.; Phillips, Claire; Ryals, Rebecca; Todd-Brown, Katherine; Vargas, Rodrigo; Vergara, Sintana E.; Cotrufo, M. Francesca; Keiluweit, Marco; Heckman, Katherine; Crow, Susan E.; Silver, Whendee L.; DeLonge, Marcia; Nave, Lucas E.

2018-01-01

Soil organic matter (SOM) supports the Earth's ability to sustain terrestrial ecosystems, provide food and fiber, and retains the largest pool of actively cycling carbon. Over 75% of the soil organic carbon (SOC) in the top meter of soil is directly affected by human land use. Large land areas have lost SOC as a result of land use practices, yet there are compensatory opportunities to enhance productivity and SOC storage in degraded lands through improved management practices. Large areas with and without intentional management are also being subjected to rapid changes in climate, making many SOC stocks vulnerable to losses by decomposition or disturbance. In order to quantify potential SOC losses or sequestration at field, regional, and global scales, measurements for detecting changes in SOC are needed. Such measurements and soil-management best practices should be based on well established and emerging scientific understanding of processes of C stabilization and destabilization over various timescales, soil types, and spatial scales. As newly engaged members of the International Soil Carbon Network, we have identified gaps in data, modeling, and communication that underscore the need for an open, shared network to frame and guide the study of SOM and SOC and their management for sustained production and climate regulation.

Networking our science to characterize the state, vulnerabilities, and management opportunities of soil organic matter

DOE PAGES

Harden, Jennifer W.; Hugelius, Gustaf; Ahlstrom, Anders; ...

2017-10-05

Here, soil organic matter supports the Earth’s ability to sustain terrestrial ecosystems, provide food and fiber, and retain the largest pool of actively cycling carbon (C). Over 75% of the soil organic carbon (SOC) in the top meter of soil is directly affected by human land use. Large land areas have lost SOC as a result of land use practices, yet there are compensatory opportunities to enhance land productivity and SOC storage in degraded lands through improved management practices. Large areas with and without intentional management are also being subjected to rapid changes in climate, making many SOC stocks vulnerablemore » to losses by decomposition or disturbance. In order to quantify potential SOC losses or sequestration at field, regional, and global scales, measurements for detecting changes in SOC are needed. Such measurements and soil-management best practices should be based on well-established and emerging scientific understanding of processes of C stabilization and destabilization over various timescales, soil types, and spatial scales. As newly engaged members of the International Soil Carbon Network, we have identified gaps in data, modeling, and communication that underscore the need for an open, shared network to frame and guide the study of soil organic matter and C and their management for sustained production and climate regulation.« less

Domestic food practices: A study of food management behaviors and the role of food preparation planning in reducing waste.

PubMed

Romani, Simona; Grappi, Silvia; Bagozzi, Richard P; Barone, Ada Maria

2018-02-01

Recent research has started to show the key role of daily food provision practices in affecting household food waste. Building on and extending these previous contributions, the objective of this paper is to investigate how individuals' everyday practices regarding food (e.g., shopping, cooking, eating, etc.) lead to food waste, and how policy makers and the food industry can implement effective strategies to influence such practices and ultimately help consumers reduce food waste. The research performs three Studies; a critical incident qualitative study (Study 1; N = 514) and a quantitative, survey-based study (Study 2; N = 456) to identify and examine relevant food management behaviors associated with domestic waste. Lastly, findings from a field experiment (Study 3; N = 210) suggest that a specific educational intervention, directed at increasing consumers' perceived skills related to food preparation planning behaviors, reduces domestic food waste. Implications of the research for policy makers and the food industry are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Ending disruptive behavior: staff nurse recommendations to nurse educators.

PubMed

Lux, Kathleen M; Hutcheson, Jane B; Peden, Ann R

2014-01-01

The purpose of this qualitative descriptive study was to identify educational strategies that can prepare new graduates to manage disruptive behavior (DB) in the workplace. DB is any inappropriate behavior, confrontation, or conflict - ranging from verbal abuse to sexual harassment - that harms or intimidates others to the extent that quality of care or patient safety could be compromised. Individual interviews were conducted with nine staff nurses currently in practice in acute care settings in the United States. Staff nurses recommended educational strategies that focused on communication skills for professional practice. These included learning how to communicate with hostile individuals, and giving and receiving constructive criticism. Descriptions that participants provided about their work culture were an unexpected finding that has relevance for nurse educators as they prepare students for transition to practice Nurses described lack of management support and intervention for DB situations, personality clashes with coworkers, and devaluation of nursing work as affecting professional practice. Copyright © 2013 Elsevier Ltd. All rights reserved.

Exitus: An Agent-Based Evacuation Simulation Model for Heterogeneous Populations

ERIC Educational Resources Information Center

Manley, Matthew T.

2012-01-01

Evacuation planning for private-sector organizations is an important consideration given the continuing occurrence of both natural and human-caused disasters that inordinately affect them. Unfortunately, the traditional management approach that is focused on fire drills presents several practical challenges at the scale required for many…

Universities, Reflexivity and Critique: Uneasy Parallels in Practice

ERIC Educational Resources Information Center

May, Tim; Perry, Beth

2013-01-01

There are profound changes affecting universities. Under pressure from the forward march of neo-liberalism, there is a process of forgetting about the origins of the university and its distinctive place in society. Whilst responses by university management often amplify these consequences, there are similar tendencies within academic professional…

40 CFR 63.7886 - What are the general standards I must meet for my affected remediation material management units?

Code of Federal Regulations, 2013 CFR

2013-07-01

... required air pollution controls or have implemented the required work practice to reduce HAP emissions to... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for...

40 CFR 63.7886 - What are the general standards I must meet for my affected remediation material management units?

Code of Federal Regulations, 2012 CFR

2012-07-01

... required air pollution controls or have implemented the required work practice to reduce HAP emissions to... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for...

40 CFR 63.7886 - What are the general standards I must meet for my affected remediation material management units?

Code of Federal Regulations, 2014 CFR

2014-07-01

... required air pollution controls or have implemented the required work practice to reduce HAP emissions to... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for...

40 CFR 63.7886 - What are the general standards I must meet for my affected remediation material management units?

Code of Federal Regulations, 2011 CFR

2011-07-01

... required air pollution controls or have implemented the required work practice to reduce HAP emissions to... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for...

Enhancing wildlife habitat when regenerating stands

Treesearch

Frank R., III Thompson

1989-01-01

Forest regeneration cuttings affect wildlife habitat more drastically than most forest management practices because a mature forest stand is replaced by a young sapling stand. Regeneration cuttings quickly provide habitat for many wildlife species but they also influence wildlife use of the new stand and adjacent areas throughout the rotation. Retaining snags, cavity...

The effect of total carbon on microscopic soil properties and implications for crop production

USDA-ARS?s Scientific Manuscript database

Soil structure is a dynamic property affected by physical, chemical, and microbiological processes. Addition of organic matter to soils and the use of different management practices have been reported to impact soil structure and crop production. Moderation in soil temperature and increases in mic...

Phosphorus concentrations in sequentially fractionated soil samples as affected by digestion methods

USDA-ARS?s Scientific Manuscript database

Sequential fractionation has been used for several decades for improving our understanding on the effects of agricultural practices and management on the lability and bioavailability of P in soil, manure, and other soil amendments. Nevertheless, there have been no reports on how manipulation of diff...

Manure storage capacity and application timing influence watershed-level nutrient losses

USDA-ARS?s Scientific Manuscript database

Current concerns over water quality requires best management practices for land-applied manure. One important strategy is to apply manure at right timing, which though is often greatly affected by manure generation and storage capacities in a given watershed. This study was to test the hypotheses: (...

Life-cycle analysis of dryland greenhouse gases affected by cropping sequence and nitrogen fertilization

USDA-ARS?s Scientific Manuscript database

Little information is available about management practices effect on net global warming potential (GWP) and greenhouse gas intensity (GHGI) under dryland cropping systems. We evaluated the effects of cropping sequences (conventional till malt barley-fallow [CTB-F], no-till malt barley-pea [NTB-P], a...

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...

Use of a Laboratory Field Project in an Introductory Crop Science Course.

ERIC Educational Resources Information Center

Lane, Robert A.

1986-01-01

Assesses the benefits resulting from a laboratory field project and report for agricultural students in an introductory crop science course. Student responses to evaluation statements indicated that the project helped them identify crops, understand cultural and management practices, and recognize environmental influences that affect crop…

How will the changing industrial forest landscape affect forest sustainability?

Treesearch

Eric J. Gustafson; Craig Loehle

2008-01-01

Large-scale divestiture of commercial forestlands is occurring in the United States. Furthermore, increasing demand for cellulose for bioenergy may modify forest management practices widely enough to impact the spatial characteristics of forested landscapes. We used the HARVEST timber harvest simulator to investigate the potential consequences of divestiture and...

Beyond Greening the Business School Curriculum

ERIC Educational Resources Information Center

Lancaster, Lilly M.; Rook, Sarah P.

2010-01-01

The business community is increasingly aware of the natural environmental and how a significant number of business practices are adversely affecting that environment and our planet. Businesses must take a leadership role, though economic systems, not only in recovering and preserving our planet but also managing financial and human resources with…

Crisis Management in a Primary School

ERIC Educational Resources Information Center

Barclay, Colette

2004-01-01

Dunblane Primary School, Scotland, and Columbine High School, USA. Two headline tragedies that have led to trauma for their pupils and staff. Trauma that could be devastating because of the psychological impact and the practical requirements a crisis brings. Children's social and personal development can be negatively affected, their academic…

Comparing carbon to carbon: Organic and inorganic carbon balances across nitrogen fertilization gradients in rainfed vs. irrigated Midwest US cropland

NASA Astrophysics Data System (ADS)

Hamilton, S. K.; McGill, B.

2017-12-01

The top meter of the earth's soil contains about twice the amount of carbon than the atmosphere. Agricultural management practices influence whether a cropland soil is a net carbon source or sink. These practices affect both organic and inorganic carbon cycling although the vast majority of studies examine the former. We will present results from several rarely-compared carbon fluxes: carbon dioxide emissions and sequestration from lime (calcium carbonate) weathering, dissolved gases emitted from groundwater-fed irrigation, dissolved organic carbon (DOC) leaching to groundwater, and soil organic matter storage. These were compared in a corn-soybean-wheat rotation under no-till management across a nitrogen fertilizer gradient where half of the replicated blocks are irrigated with groundwater. DOC and liming fluxes are also estimated from a complementary study in neighboring plots comparing a gradient of management practices from conventional to biologically-based annuals and perennials. These studies were conducted at the Kellogg Biological Station Long Term Ecological Research site in Michigan where previous work estimated that carbon dioxide emissions from liming accounted for about one quarter of the total global warming impact (GWI) from no-till systems—our work refines that figure. We will present a first time look at the GWI of gases dissolved in groundwater that are emitted when the water equilibrates with the atmosphere. We will explore whether nitrogen fertilizer and irrigation increase soil organic carbon sequestration by producing greater crop biomass and residues or if they enhance microbial activity, increasing decomposition of organic matter. These results are critical for more accurately estimating how intensive agricultural practices affect the carbon balance of cropping systems.

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

DTIC Science & Technology

2012-12-01

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

Methodology for the assessment of brucellosis management practices and its vaccination campaign: example in two Argentine districts.

PubMed

Aznar, M N; Arregui, M; Humblet, M F; Samartino, L E; Saegerman, C

2017-09-07

In Argentina, vaccination with Brucella abortus Strain 19 vaccine is mandatory. The objective of the study was to develop and test a method for evaluating, in an innovative way, some farmers' and veterinarians' management practices in relation to brucellosis and to assess the vaccination campaign and coverage. The work took place in Brandsen and Navarro districts. Four questionnaires were designed (for officials from Local Sanitary Entities, vaccinators, vet practitioners and farmers). Responses were coded as "ideal" (0) and "not ideal" (1). To assess the relative weight of each question ("item"), experts ranked the items according to their impact on management practices and vaccination. A weighted score was then calculated. A higher weighted score was assigned to the worse practices. Farmers obtaining a global weighted score above the third quartile were classified as "inappropriately managed farms", to be compared per type of production system and district. To assess the immunization coverage, female calves were sampled 30 to 50 days post vaccination; they were expected to react positively to serological diagnostic tests (DT+). There were significantly more inappropriately managed farms and higher global scores among beef farmers and in Brandsen. Eighty three percent (83%) of female calves were DT+, significantly under the ideal immunization coverage (95%). Only 48% of farms were considered well vaccinated. DT+ results were positively associated with the Brandsen district (OR = 25.94 [4.60-1146.21] and with the farms having more than 200 cow heads ((OR = 78.34 [4.09-1500.00]). On the contrary, DT+ were less associated with vaccinators being veterinary practitioners (OR = 0.07 [0.006-0.78]). Farmers are well advised by their veterinary practitioners but they should improve some management practices. The vaccination campaign is globally well implemented, but the immunization coverage and some vaccinators' practices should be improved. This study leads to a better understanding of the most common used management and control practices regarding brucellosis, which affect its epidemiology. Any vaccination campaign should be periodically assessed to highlight possible fails. The described methodology can be extrapolated to other countries and different contexts.

A comprehensive guide to fuel management practices for dry mixed conifer forests in the northwestern United States: Mechanical, chemical, and biological fuel treatment methods

Treesearch

Theresa B. Jain; Mike A. Battaglia; Han-Sup Han; Russell T. Graham; Christopher R. Keyes; Jeremy S. Fried; Jonathan E. Sandquist

2014-01-01

Several mechanical approaches to managing vegetation fuels hold promise when applied to the dry mixed conifer forests in the western United States. These are most useful to treat surface, ladder, and crown fuels. There are a variety of techniques to remove or alter all kinds of plant biomass (live, dead, or decomposed) that affect forest resilience. It is important for...

Large-scale survey to describe acne management in Brazilian clinical practice

PubMed Central

Seité, Sophie; Caixeta, Clarice; Towersey, Loan

2015-01-01

Background Acne is a chronic disease of the pilosebaceous unit that mainly affects adolescents. It is the most common dermatological problem, affecting approximately 80% of teenagers between 12 and 18 years of age. Diagnosis is clinical and is based on the patient’s age at the time the lesions first appear, and on its polymorphism, type of lesions, and their anatomical location. The right treatment for the right patient is key to treating acne safely. The aim of this investigational survey was to evaluate how Brazilian dermatologists in private practice currently manage acne. Materials and methods Dermatologists practicing in 12 states of Brazil were asked how they manage patients with grades I, II, III, and IV acne. Each dermatologist completed a written questionnaire about patient characteristics, acne severity, and the therapy they usually prescribe for each situation. Results In total, 596 dermatologists were interviewed. Adolescents presented as the most common acneic population received by dermatologists, and the most common acne grade was grade II. The doctors could choose more than one type of treatment for each patient, and treatment choices varied according to acne severity. A great majority of dermatologists considered treatment with drugs as the first alternative for all acne grades, choosing either topical or oral presentation depending on the pathology severity. Dermocosmetics were chosen mostly as adjunctive therapy, and their inclusion in the treatment regimen decreased as acne grades increased. Conclusion This survey illustrates that Brazilian dermatologists employ complex treatment regimens to manage acne, choosing systemic drugs, particularly isotretinoin, even in some cases of grade I acne, and heavily prescribe antibiotics. Because complex regimens are harder for patients to comply with, this result notably raises the question of adherence, which is a key factor in successful treatment. PMID:26609243

The management of advanced practitioner preparation: a work-based challenge.

PubMed

Livesley, Joan; Waters, Karen; Tarbuck, Paul

2009-07-01

This paper explores the collaborative development of a Master's level advanced practice programme in the context of the radical reform and remodelling of the UK's National Health Service. Some of the educational, managerial and practice challenges are discussed. Changes to education and training in response to key strategic reviews undertaken by the Greater Manchester Strategic Health Authority (North West of England) established a need to develop nurses and allied health care practitioners to advanced practitioner level. This paper considers how employers, commissioners and educationalists worked together to produce a Master's level programme to prepare nurses and other health care practitioners for sustainable advanced practice roles. Developing innovative and effective curricula to meet the needs of post graduate students from varied backgrounds preparing to practice in different contexts with different client groups is challenging. However, the development of individual learning pathways and work-based learning ensures that the student's work and intended advanced practice role remains at the centre of their learning. Analysis of each student's knowledge and skill deficits alongside an analysis of the organization's readiness to support them as qualified advanced practitioners (APs) is instrumental in ensuring that organizations are ready to support practitioners in new roles. Work-based learning and collaboration between students, employers and higher education institutions can be used to enable managers and students to unravel the network of factors which affect advanced practice in health and social care. Additionally, collaborative working can help to create opportunities to develop strategies that will facilitate change. Implications for nursing management Sustainable change concerned with the introduction of advanced practitioner roles present a real challenge for managers at a strategic and operational level. Commissioning flexible, collaborative and service-led educational programmes can assist in ensuring that change is sustainable and produce practitioners who are fit for practice, purpose and award.

Playing doctor: Simulation in medical school as affective practice.

PubMed

Underman, Kelly

2015-07-01

Simulated patient encounters, in which a trained layperson role-plays a patient, have become increasingly important in medical education. One such type is the gynecological teaching associate (GTA), who teaches medical students how to perform the pelvic examination using her own body. This paper considers the role that simulation like the GTA session plays in medical students' professional socialization. Drawn from interviews and archival sources gathered from medical students, medical faculty, and GTAs, this paper explores the tensions between artificiality and authenticity in order to understand how, through pedagogical practice, medical students come to embody medical culture through simulation. This paper uses the theoretical framework of the medical habitus to understand the role of emotion in medical student socialization. It argues that simulation is an example of affective practice: any rehearsal of techniques or styles of expressing, experiencing, or managing emotion that reshape the body's capacity to feel. Copyright © 2015 Elsevier Ltd. All rights reserved.

Managers' practices related to work-family balance predict employee cardiovascular risk and sleep duration in extended care settings.

PubMed

Berkman, Lisa F; Buxton, Orfeu; Ertel, Karen; Okechukwu, Cassandra

2010-07-01

An increasing proportion of U.S. workers have family caregiving responsibilities. The purpose of this study was to determine whether employees in extended care settings whose managers are supportive, open, and creative about work-family needs, such as flexibility with work schedules, have lower cardiovascular disease (CVD) risk and longer sleep than their less supported counterparts. From semistructured interviews with managers, we constructed a work-family balance score of manager openness and creativity in dealing with employee work-family needs. Trained interviewers collected survey and physiologic outcome data from 393 employees whose managers had a work-family score. Employee outcomes are sleep duration (actigraphy) and CVD risk assessed by blood cholesterol, high glycosylated hemoglobin/diabetes, blood pressure/hypertension, body-mass index, and tobacco consumption. Employees whose managers were less supportive slept less (29 min/day) and were over twice as likely to have 2 or more CVD risk factors (ORs = 2.1 and 2.03 for low and middle manager work-family scores, respectively) than employees whose managers were most open and creative. Employees who provide direct patient care exhibited particularly elevated CVD risk associated with low manager work-family score. Managers' attitudes and practices may affect employee health, including sleep duration and CVD risk.

Shrimp farming practices in the puttallam district of sri lanka: implications for disease control, industry sustainability, and rural development.

PubMed

Munasinghe, M Nalaka; Stephen, Craig; Abeynayake, Preeni; Abeygunawardena, Indra S

2010-08-12

Shrimp farming has great potential to diversify and secure income in rural Sri Lanka, but production has significantly declined in recent years due to civil conflicts, some unsustainable practices and devastating outbreaks of disease. We examined management practices affecting disease prevention and control in the Puttalam district to identify extension services outputs that could support sustainable development of Sri Lankan shrimp farming. A survey on 621 shrimp farms (603 operational and 18 nonoperational) was conducted within the Puttalam district over 42 weeks comprising a series of three-day field visits from August 2008 to October 2009, covering two consecutive shrimp crops. Fundamental deficits in disease control, management, and biosecurity practices were found. Farmers had knowledge of biosecurity but the lack of financial resources was a major impediment to improved disease control. Smallholder farmers were disproportionately constrained in their ability to enact basic biosecurity practices due to their economic status. Basic breaches in biosecurity will keep disease as the rate limiting step in this industry. Plans to support this industry must recognize the socioeconomic reality of rural Sri Lankan aquaculture.

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

CULTURAL COMPETENCE IN OUTPATIENT SUBSTANCE ABUSE TREATMENT: MEASUREMENT AND RELATIONSHIP TO WAIT TIME AND RETENTION

PubMed Central

Guerrero, Erick; Andrews, Christina M.

2011-01-01

BACKGROUND Culturally competent practice is broadly acknowledged to be an important strategy to increase the quality of services for racial/ethnic minorities in substance abuse treatment. However, few empirically derived measures of organizational cultural competence exist, and relatively little is known about how these measures affect treatment outcomes. METHOD Using a nationally representative sample of outpatient substance abuse treatment (OSAT) programs, this study used item response theory to create two measures of cultural competence-organizational practices and managers' culturally sensitive beliefs—and examined their relationship to client wait time and retention using Poisson regression modeling RESULTS The most common and precisely measured organizational practices reported by OSAT managers included matching providers and clients based on language/dialect; offering cross-cultural training; and fostering connections with community and faith-based organizations connected to racial and ethnic minority groups. The most culturally sensitive belief among OSAT managers was support for language/dialect matching for racial and ethnic minority clients. Results of regression modeling indicate that organizational practices were not related to either outcome. However, managers' culturally sensitive beliefs were negatively associated with average wait time (p < 0.05), and positively associated with average retention (p < 0.01). CONCLUSIONS Managers' culturally sensitive beliefs—considered to be influential for effective implementation of culturally competent practices—may be particularly relevant in influencing wait time and retention in OSAT organizations that treat Latinos and African American clients. PMID:21680111

Clinical factors affecting physicians' management decisions in cases of female partner abuse.

PubMed

Ferris, L E; Norton, P; Dunn, E V; Gort, E H

1999-06-01

This study determined which clinical factors influence Canadian primary care physicians' management decisions in cases of female partner abuse. We used a cross-sectional survey design and randomly sampled (n = 2,014) English-speaking Canadian physicians with a primary interest in family or general practice who were practicing in any of the 12 provinces and territories in Canada and who were active in private practice and registered to prescribe. Respondents completed a questionnaire that required them to score management decision plans in response to case scenarios illustrating typical office-based situations that might involve domestic violence. The response rate was 50.7% (n = 1,022). Using forward stepwise regression analysis, the strongest predictor of whether a physician endorsed a management plan in response to violence was whether the woman acknowledged or revealed the abuse. Male physicians were more likely than females to endorse talking with the suspected abuser if he was known to them, regardless of the quality of this patient-physician relationship with the abuser. Decisions about whether to deal with the abuse or the selection of a management plan are not dependent on the severity of the physical abuse and the emotional consequences. Whether a woman acknowledges or reveals the abuse, as well as whether both the male and female patients are in the physician's practice, are predictive of whether a physician's response to a case scenario involves dealing with spousal abuse and how he/she will address it.

Self-management practices among primary care patients with musculoskeletal pain and depression.

PubMed

Damush, Teresa M; Wu, Jingwei; Bair, Matthew J; Sutherland, Jason M; Kroenke, Kurt

2008-08-01

The objective of this study was to assess the effect of clinical depression on pain self-management practices. We employed a cross-sectional analysis of baseline data from the Stepped Care for Affective disorders and Musculoskeletal Pain (SCAMP) study. Participants included 250 patients with pain and comorbid depression and 250 patients with pain only and were enrolled from urban university and VA primary care clinics. Musculoskeletal pain was defined as low back, hip or knee pain present >or=3 months and with at least a moderate, Brief Pain Inventory severity score >or=5. Depression was defined as a PHQ-9 score >or=10. We used multiple logistic and Poisson regression to assess the relationship between individual and combined effects of depression and pain severity on two core pain self-management skills: exercise duration and cognitive strategies. Depressed patients exercised less per week than did nondepressed patients but showed a trend towards more frequent use of cognitive strategies. On multivariable analysis, depression severity substantially decreased the use of exercise as a pain self-management strategy. In contrast, depression and pain severity interacted to increase the use of cognitive strategies. Depression and pain severity have differential effects on self-management practices. Understanding the differences between preferential strategies of pain patients with and without depression may be useful in tailoring pain self-management programs.

Why farmers adopt best management practice in the United States: A meta-analysis of the adoption literature

USGS Publications Warehouse

Baumgart-Getz, Adam; Stalker Prokopy, Linda; Floress, Kristin

2012-01-01

This meta-analysis of both published and unpublished studies assesses factors believed to influence adoption of agricultural Best Management Practices in the United States. Using an established statistical technique to summarize the adoption literature in the United States, we identified the following variables as having the largest impact on adoption: access to and quality of information, financial capacity, and being connected to agency or local networks of farmers or watershed groups. This study shows that various approaches to data collection affect the results and comparability of adoption studies. In particular, environmental awareness and farmer attitudes have been inconsistently used and measured across the literature. This meta-analysis concludes with suggestions regarding the future direction of adoption studies, along with guidelines for how data should be presented to enhance the adoption of conservation practices and guide research.

Forest management strategy affects saproxylic beetle assemblages: A comparison of even and uneven-aged silviculture using direct and indirect sampling.

PubMed

Joelsson, Klara; Hjältén, Joakim; Gibb, Heloise

2018-01-01

Management of forest for wood production has altered ecosystem structures and processes and led to habitat loss and species extinctions, worldwide. Deadwood is a key resource supporting forest biodiversity, and commonly declines following forest management. However, different forest management methods affect dead wood differently. For example, uneven-aged silviculture maintains an age-stratified forest with ongoing dead wood production, while even-aged silviculture breaks forest continuity, leading to long periods without large trees. We asked how deadwood-dependent beetles respond to different silvicultural practices and if their responses depend on deadwood volume, and beetles preference for decay stages of deadwood. We compared beetle assemblages in five boreal forest types with different management strategies: clearcutting and thinning (both representing even-aged silviculture), selective felling (representing uneven-aged silviculture), reference and old growth forest (both uneven-aged controls without a recent history [~50 years] of management, but the latter with high conservation values). We collected beetles using window traps and by sieving the bark from experimental logs (bolts). Beetle assemblages on clear-cuts differed from all other stand types, regardless of trapping method or decay stage preference. Thinning differed from reference stands, indicating incomplete recovery after clear-cutting, while selective felling differed only from clear-cuts. In contrast to our predictions, early and late successional species responded similarly to different silvicultural practices. However, there were indications of marginal assemblage differences both between thinned stands and selective felling and between thinned and old growth stands (p = 0.10). The stand volume of early decay stage wood influenced assemblage composition of early, but not late successional species. Uneven-aged silviculture maintained species assemblages similar to those of the reference and old growth stands and might therefore be a better management option when considering biodiversity conservation.

Effect of management and soil moisture regimes on wetland soils total carbon and nitrogen in Tanzania

NASA Astrophysics Data System (ADS)

Kamiri, Hellen; Kreye, Christine; Becker, Mathias

2013-04-01

Wetland soils play an important role as storage compartments for water, carbon and nutrients. These soils implies various conditions, depending on the water regimes that affect several important microbial and physical-chemical processes which in turn influence the transformation of organic and inorganic components of nitrogen, carbon, soil acidity and other nutrients. Particularly, soil carbon and nitrogen play an important role in determining the productivity of a soil whereas management practices could determine the rate and magnitude of nutrient turnover. A study was carried out in a floodplain wetland planted with rice in North-west Tanzania- East Africa to determine the effects of different management practices and soil water regimes on paddy soil organic carbon and nitrogen. Four management treatments were compared: (i) control (non weeded plots); (ii) weeded plots; (iii) N fertilized plots, and (iv) non-cropped (non weeded plots). Two soil moisture regimes included soil under field capacity (rainfed conditions) and continuous water logging compared side-by-side. Soil were sampled at the start and end of the rice cropping seasons from the two fields differentiated by moisture regimes during the wet season 2012. The soils differed in the total organic carbon and nitrogen between the treatments. Soil management including weeding and fertilization is seen to affect soil carbon and nitrogen regardless of the soil moisture conditions. Particularly, the padddy soils were higher in the total organic carbon under continuous water logged field. These findings are preliminary and a more complete understanding of the relationships between management and soil moisture on the temporal changes of soil properties is required before making informed decisions on future wetland soil carbon and nitrogen dynamics. Keywords: Management, nitrogen, paddy soil, total carbon, Tanzania,

Managing waste from confined animal feeding operations in the United States: the need for sanitary reform.

PubMed

Graham, Jay P; Nachman, Keeve E

2010-12-01

Confined food-animal operations in the United States produce more than 40 times the amount of waste than human biosolids generated from US wastewater treatment plants. Unlike biosolids, which must meet regulatory standards for pathogen levels, vector attraction reduction and metal content, no treatment is required of waste from animal agriculture. This omission is of concern based on dramatic changes in livestock production over the past 50 years, which have resulted in large increases in animal waste and a high degree of geographic concentration of waste associated with the regional growth of industrial food-animal production. Regulatory measures have not kept pace with these changes. The purpose of this paper is to: 1) review trends that affect food-animal waste production in the United States, 2) assess risks associated with food-animal wastes, 3) contrast food-animal waste management practices to management practices for biosolids and 4) make recommendations based on existing and potential policy options to improve management of food-animal waste.

Benchmark study on glyphosate-resistant crop systems in the United States. Economics of herbicide resistance management practices in a 5 year field-scale study.

PubMed

Edwards, C Blake; Jordan, David L; Owen, Michael Dk; Dixon, Philip M; Young, Bryan G; Wilson, Robert G; Weller, Steven C; Shaw, David R

2014-12-01

Since the introduction of glyphosate-resistant (GR) crops, growers have often relied on glyphosate-only weed control programs. As a result, multiple weeds have evolved resistance to glyphosate. A 5 year study including 156 growers from Illinois, Iowa, Indiana, Nebraska, North Carolina and Mississippi in the United States was conducted to compare crop yields and net returns between grower standard weed management programs (SPs) and programs containing best management practices (BMPs) recommended by university weed scientists. The BMPs were designed to prevent or mitigate/manage evolved herbicide resistance. Weed management costs were greater for the BMP approach in most situations, but crop yields often increased sufficiently for net returns similar to those of the less expensive SPs. This response was similar across all years, geographical regions, states, crops and tillage systems. Herbicide use strategies that include a diversity of herbicide mechanisms of action will increase the long-term sustainability of glyphosate-based weed management strategies. Growers can adopt herbicide resistance BMPs with confidence that net returns will not be negatively affected in the short term and contribute to resistance management in the long term. © 2014 Society of Chemical Industry.

Social support, stress, and practice of prenatal care in married immigrant women in Korea.

PubMed

Kim, Yeon A; Choi, So Young; Ryu, Eunjung

2010-10-01

This study aimed to identify the correlations among social support, stress, and practice of prenatal care and elucidate the predictors affecting the practice of prenatal care in married immigrant women in Korea. This study employed a descriptive correlational Social support and prenatal-care practice were positively correlated, and stress was negatively correlated with both prenatal-care practice and social support. The practice of prenatal care in married immigrant women was most influenced by social support. As such, there is a need for nursing intervention that fosters social support for pregnant immigrant women. Concerted efforts are also required to reduce their stressors. This study could form the basis for developing childbirth management programs for pregnant women who have immigrated to Korea in order to marry.

Managing Systemic Change: Future Roles for Social Learning Systems and Communities of Practice?

NASA Astrophysics Data System (ADS)

Blackmore, Chris

The Open University course that prompted this book, and for which it is part of the required reading, focuses on managing systemic change. The course is designed for people who want to develop their skills and understanding in systems thinking and practice, to be used in a range of different domains. Most of the examples in the course come from work-based settings. The idea of managing in this context is mainly about appreciating situations with others, recognising what actions are desirable and feasible and for whom, and getting organised, in order to affect or respond to change in a positive way. It has little to do with control. As Vickers (1978, p. 81) said 'I do not think it too much to hope that an understanding of systemic relations may bring us a better understanding of our limitations and even our possibilities.'

Physicians' attitude and practices in sickle cell disease pain management.

PubMed

Labbé, Elise; Herbert, Donald; Haynes, Johnson

2005-01-01

Many physicians believe that patients with sickle cell disease (SCD) are more likely to become addicted to pain medication than are other patient populations. This study hypothesizes that physicians' attitudes towards addiction in patients with SCD affects pain management practices. The Physician Attitudes Survey was sent to 286 physicians at seven National Institutes of Health-funded university-based comprehensive sickle cell centres. The survey assessed demographic information; and physician's attitudes toward and knowledge of pain, pain treatment, and drug addiction and abuse. Significant Pearson product-moment correlations were found between attitudes towards pain and beliefs regarding addiction to prescribed opioids. Physicians reported varied pain management strategies, however, many believe that attitudes toward addiction and to patients in pain crises may result in undertreatment of pain. These results indicate that physicians might benefit from additional education regarding sickle cell disease, addiction to pain medication, the pharmacology of opioids, and the assessment and treatment of pain.

Concussion evaluation and management in pediatrics.

PubMed

Rivera, Robin G; Roberson, Susan P; Whelan, Margaret; Rohan, Annie

2015-01-01

Concussions are among the most complex injuries to assess and manage in sports medicine and primary care. Sports concussion in youth has received much attention in recent years because research shows that improperly managed concussion can lead to long-term cognitive deficits and mental health problems. There are several notable risk factors affecting the incidence and severity of concussion in school-age children and adolescents, including a history of a previous concussion. A more conservative approach for return to activities following concussion has been proposed for children and adolescents. Programs of individualized, stepwise increases in physical activity have largely replaced use of algorithms for assigning a grade and activity expectations to concussions. Although validity and reliability testing is ongoing to support use of concussion assessment instruments in pediatric patients, it is practical and appropriate that clinicians incorporate symptom checklists, sideline and balance assessment tools, and neurocognitive assessment instruments into their practice in accordance with evidence-based guidelines.

Key Value Considerations for Consultant Pharmacists.

PubMed

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

2016-07-01

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

Society and the Carbon Cycle: A Social Science Perspective

NASA Astrophysics Data System (ADS)

Romero-Lankao, P.

2017-12-01

Societal activities, actions, and practices affect the carbon cycle and the climate of North America in complex ways. Carbon is a key component for the functioning of croplands, grasslands, forests. Carbon fuels our industry, transportation (vehicles and roadways), buildings, and other structures. Drawing on results from the SOCCR-2, this presentation uses a social science perspective to address three scientific questions. How do human actions and activities affect the carbon cycle? How human systems such as cities, agricultural field and forests are affected by changes in the carbon cycle? How is carbon management enabled and constraint by socio-political dynamics?

Virtual reality or real virtuality: the space of flows and nursing practice.

PubMed

Barnes, Lynne; Rudge, Trudy

2005-12-01

The use of virtual environments for the provision of health-care is on the increase, and with each new development brings debates about their impact on care, nursing and nursing practice. Such environments offer opportunities for extending care and improvements in communication. Others believe these developments threaten aspects of nursing they hold sacrosanct. This paper explores the development of an assemblage of computer networks, databases, information systems, software programs and management systems that together work to manage health-care in Australia, namely casemix. We contend that spatial theories on network society show how this assemblage co-ordinates and operates to manage care. We discuss how this assemblage affects care and suggest that changes in organisation may be a part of the shift in how bodily organisation occurs more generally, but more specifically in health-care. We also suggest how nurses are enrolled in and by such networks, leading to transformation in nurses' practices. Finally, we argue that using spatial forms of analysis allows an interpretation of such assemblages that may account for their strengths and their shortcomings.

Use of care management practices in small- and medium-sized physician groups: do public reporting of physician quality and financial incentives matter?

PubMed

Alexander, Jeffrey A; Maeng, Daniel; Casalino, Lawrence P; Rittenhouse, Diane

2013-04-01

To examine the effect of public reporting (PR) and financial incentives tied to quality performance on the use of care management practices (CMPs) among small- and medium-sized physician groups. Survey data from The National Study of Small and Medium-sized Physician Practices were used. Primary data collection was also conducted to assess community-level PR activities. The final sample included 643 practices engaged in quality reporting; about half of these practices were subject to PR. We used a treatment effects model. The instrumental variables were the community-level variables that capture the level of PR activity in each community in which the practices operate. (1) PR is associated with increased use of CMPs, but the estimate is not statistically significant; (2) financial incentives are associated with greater use of CMPs; (3) practices' awareness/sensitivity to quality reports is positively related to their use of CMPs; and (4) combined PR and financial incentives jointly affect CMP use to a greater degree than either of these factors alone. Small- to medium-sized practices appear to respond to PR and financial incentives by greater use of CMPs. Future research needs to investigate the appropriate mix and type of incentive arrangements and quality reporting. © Health Research and Educational Trust.

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

PubMed

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

2016-01-05

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

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

PubMed

Chan, Jimmy Y W

2013-06-01

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

Predictors of Success for Electronic Health Record Implementation in Small Physician Practices

PubMed Central

Ancker, J.S.; Singh, M.P.; Thomas, R.; Edwards, A.; Snyder, A.; Kashyap, A.; Kaushal, R.

2013-01-01

Background The federal government is promoting adoption of electronic health records (EHRs) through financial incentives for EHR use and implementation support provided by regional extension centers. Small practices have been slow to adopt EHRs. Objectives Our objective was to measure time to EHR implementation and identify factors associated with successful implementation in small practices receiving financial incentives and implementation support. This study is unique in exploiting quantitative implementation time data collected prospectively as part of routine project management. Methods This mixed-methods study includes interviews of key informants and a cohort study of 544 practices that had worked with the Primary Care Information Project (PCIP), a publicly funded organization that since 2007 has subsidized EHRs and provided implementation support similar to that supplied by the new regional extension centers. Data from a project management database were used for a cohort study to assess time to implementation and predictors of implementation success. Results Four hundred and thirty practices (79%) implemented EHRs within the analysis period, with a median project time of 24.7 weeks (95% CI: 23.3 – 26.4). Factors associated with implementation success were: fewer providers, practice sites, and patients; fewer Medicaid and uninsured patients; having previous experience with scheduling software; enrolling in 2010 rather than earlier; and selecting an integrated EHR plus practice management product rather than two products. Interviews identified positive attitude toward EHRs, resources, and centralized leadership as additional practice-level predictors of success. Conclusions A local initiative similar to current federal programs successfully implemented EHRs in primary care practices by offsetting software costs and providing implementation assistance. Nevertheless, implementation success was affected by practice size and other characteristics, suggesting that the federal programs can reduce barriers to EHR implementation but may not eliminate them. PMID:23650484

Surgical management of tricuspid stenosis

PubMed Central

Cevasco, Marisa

2017-01-01

Tricuspid valve stenosis (TS) is rare, affecting less than 1% of patients in developed nations and approximately 3% of patients worldwide. Detection requires careful evaluation, as it is almost always associated with left-sided valve lesions that may obscure its significance. Primary TS is most frequently caused by rheumatic valvulitis. Other causes include carcinoid, radiation therapy, infective endocarditis, trauma from endomyocardial biopsy or pacemaker placement, or congenital abnormalities. Surgical management of TS is not commonly addressed in standard cardiac texts but is an important topic for the practicing surgeon. This paper will elucidate the anatomy, pathophysiology, and surgical management of TS. PMID:28706872

Effectiveness of community-based mangrove management for sustainable resource use and livelihood support: A case study of four villages in Central Java, Indonesia.

PubMed

Damastuti, Ekaningrum; de Groot, Rudolf

2017-12-01

Community-Based Mangrove Management (CBMM) is implemented with different approaches and outcomes. This study examined the effectiveness of various CBMM practices to achieve sustainable management of mangrove resources. We analyzed local mangrove resource management strategies in four coastal villages (e.g. Sriwulan, Bedono, Timbulsloko, and Surodadi) on Central Java, Indonesia. Local data on institutions, socio-economic conditions and mangrove resources utilization was collected through participatory resource mapping and interviews with 16 key actors and 500 households. The main differences in CBMM-practices that affect the outcomes in each village were the type of community participation, the level of organizational and economic assistance from external institutions, the magnitude of the rehabilitation project, the time selected for rehabilitation and the maintenance strategies applied in each village. Surodadi achieved most in terms of both efficient resource utilization and local livelihood improvement. Bedono's management strategy was most effective in extending and maintaining the rehabilitated mangrove areas but less in terms of livelihood support while the strategy applied in Timbulsloko resulted in higher resource utilization compared to Surodadi. Sriwulan failed on most criteria. This study suggests that combining the management strategies practiced in Bedono and Surodadi and adding external scientific and technological assistance, income diversification, institutional reinforcement and continuous monitoring of the functioning of local institutions can improve the CBMM performance to sustainably manage mangrove resources and improve livelihoods. Copyright © 2017 Elsevier Ltd. All rights reserved.

Assessment of healthy behaviors for metabolic syndrome among Korean adults: a modified information-motivation-behavioral skills with psychological distress.

PubMed

Lee, Guna; Yang, Sook Ja; Chee, Yeon Kyung

2016-06-18

Since the worldwide incidence of metabolic syndrome (Mets) has rapidly increased, healthy behaviors such as weight control, engaging in physical activity, and healthy diet have been crucial in the management of Mets. The purpose of this study was to examine healthy behaviors practice and factors that affect the practice in relation to Mets on the basis of a modified Information-Motivation-Behavioral skills model (IMB) with psychological distress, which is a well-known factor affecting healthy behaviors among individuals with Mets. Study participants were 267 community dwelling adults (M age: 54.0 ± 8.1 years) with Mets who were attending public health centers located in Seoul, South Korea. A structured questionnaire was administered in the areas of information, motivation, behavioral skills, and practice of Mets healthy behaviors and levels of psychological distress from May 2014 to September 2014. Structural equation modeling was used to test the modified IMB model. The modified IMB model had a good fit with the data, indicating that motivation and behavioral skills directly influenced the practice of Mets healthy behaviors, whereas information and psychological distress directly influenced motivation and influenced the practice of healthy behaviors through behavioral skills. These components of the modified IMB model explained 29.8 % of the variance in healthy behaviors for Mets. Findings suggested that strengthening motivation and behavioral skills for healthy behaviors can directly enhance healthy behavior practice. Providing information about Mets related healthy behaviors and strategies for psychological distress management can be used as the first line evidence based intervention to systemically enhance motivation and behavioral skills among individuals with Mets.

Which interventions are used by health care professionals to enhance medication adherence in cardiovascular patients? A survey of current clinical practice.

PubMed

Berben, Lut; Bogert, Laura; Leventhal, Marcia E; Fridlund, Bengt; Jaarsma, Tiny; Norekvål, Tone M; Smith, Karen; Strömberg, Anna; Thompson, David R; De Geest, Sabina

2011-03-01

Complex medication regimens are often required to manage cardiovascular diseases. As non-adherence, which can have severe negative outcomes, is common among cardiovascular patients, various interventions to improve adherence should be implemented in daily practice. To assess which strategies cardiovascular nurses and allied health professionals utilize to (1) assess patients' adherence to medication regimen, and (2) enhance medication adherence via educational/cognitive, counseling/behavioral, and psychological/affective interventions. A 45-item questionnaire to assess adherence assessment and interventional strategies utilized by health care professionals in daily clinical practice was distributed to a convenience sample of attendants of the 10th Annual Spring Meeting of the European Society of Cardiology Council on Cardiovascular Nursing and Allied Professions conference in Geneva (Switzerland) in March 2010. Respondents not in direct clinical practice were excluded. Descriptive statistics were used to describe practice patterns regarding adherence management. Of 276 distributed questionnaires, 171 (62%) were returned, of which 34 (20%) were excluded as respondents performed no direct patient care. Questioning patients about non-adherence during follow-up was the most frequently reported assessment strategy (56%). Educational/cognitive adherence enhancing interventions were used most frequently, followed by counseling/behavioral interventions. Psychological/affective interventions were less frequently used. The most frequent intervention used was providing reading materials (66%) followed by training patients regarding medication taking during inpatient recovery (48%). Slightly over two-thirds (69%) reported using a combination of interventions to improve patient's adherence. Educational interventions are used most in clinical practice, although evidence shows they are less effective than behavioral interventions at enhancing medication adherence. Copyright © 2010 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.

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.

Sustainable agriculture, soil management and erosion from prehistoric times to 2100

NASA Astrophysics Data System (ADS)

Vanwalleghem, Tom; Gómez, Jose Alfonso; Infante Amate, Juan; González Molina, Manuel; Fernández, David Soto; Guzmán, Gema; Vanderlinden, Karl; Laguna, Ana; Giráldez, Juan Vicente

2015-04-01

The rational use of soil requires the selection of management practices to take profit of the beneficial functions of plant growth, water and nutrient storage, and pollutants removal by filtering and decomposition without altering its properties. However, the first evidence of important and widespread erosion peaks can generally be found with the arrival of the first farmers all over the world. In areas with a long land-use history such as the Mediterranean, clear signs indicating the advanced degradation status of the landscape, such as heavily truncated soils, are visible throughout. Soil conservation practices are then aimed at reducing erosion to geological rates, in equilibrium with long-term soil formation rates, while maximizing agricultural production. The adoption of such practices in most areas of the world are as old as the earliest soil erosion episodes themselves. This work firstly reviews historical evidence linking soil management and soil erosion intensity, with examples from N Europe and the Mediterranean. In particular, work by the authors in olive orchards will be presented that shows how significant variations in soil erosion rates between could be linked to the historical soil management. The potential of historical documents for calibrating a soil erosion model is shown as the model, in this case RUSLE-based and combining tillage and water erosion, adequately represents the measured erosion rate dynamics. Secondly, results from present-day, long-term farm experiments in the EU are reviewed to evaluate the effect of different soil management practices on physical soil properties, such as bulk density, penetration resistance, aggregate stability, runoff coefficient or sediment yield. Finally, we reflect upon model and field data that indicate how future global climate change is expected to affect soil management and erosion and how the examples used above hold clues about sustainable historical management practices that can be used successfully in the future.

Foodborne parasites from wildlife: how wild are they?

PubMed

Kapel, Christian M O; Fredensborg, Brian L

2015-04-01

The majority of wild foods consumed by humans are sourced from intensively managed or semi-farmed populations. Management practices inevitably affect wildlife density and habitat characteristics, which are key elements in the transmission of parasites. We consider the risk of transmission of foodborne parasites to humans from wildlife maintained under natural or semi-natural conditions. A deeper understanding will be useful in counteracting foodborne parasites arising from the growing industry of novel and exotic foods. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effects of Landscape Conditions and Management Practices ...

EPA Pesticide Factsheets

Lakes continue to face escalating pressures associated with land cover change and growing human populations. The U.S. EPA National Lakes Assessment, which sampled 1,028 lakes during the summer of 2007 using a probabilistic survey, was the first large scale effort to determine the condition of lakes across the country. In addition to broad trends, these data offer an abundance of new opportunities to examine biodiversity patterns, drivers of ecosystem change, and effectiveness of management practices that aim to reduce adverse effects of land cover change. Here, we use 2006 National Land Cover Data and sediment diatom samples collected from the tops of cores to examine how land cover at different spatial extents affects the habitat and diatom communities of lakes. We are examining the effects of land cover in basins, buffers in upstream networks, and buffers adjacent to 188 lakes in regions extending from the Mid-Atlantic to New England. Identifying relationships of diatom communities with land cover and physico-chemical parameters, along with generating stressor-response curves, will help with (1) developing diatom indicators responsive to anthropogenic impacts, (2) identifying how spatial locations of land cover affect lake conditions and diatoms, (3) informing future assessments and management efforts, and (4) characterizing potentially different patterns across regions and the effects of natural variation. Comparisons of study lakes to reference lake conditio

Silage review: Factors affecting dry matter and quality losses in silages.

PubMed

Borreani, G; Tabacco, E; Schmidt, R J; Holmes, B J; Muck, R E

2018-05-01

An overview was made of dry matter (DM) and quality losses that occur during the ensiling process from the field through the feeding phase. The aim was to review the relevant published literature of the last 15 yr focusing on developments achieved after the publication of the book Silage Science and Technology. This review discusses the factors affecting DM and quality losses in terms of field and pre-ensiling conditions, respiration and temperature at ensiling, fermentation patterns, methods of covering and weighting the silage cover, and management of aerobic deterioration. The possibility of reducing DM and quality losses during the ensiling process requires knowledge of how to measure losses on farm and establish the status of the silage during the feed-out phase, implementing the most effective management practices to avoid air exposure during conservation and reduce silage aerobic deterioration during feeding. The paper concludes with future perspectives and recommended management practices to reduce losses and increase efficiency over the whole ensiling process in view of increasing sustainability of the livestock production chain. The Authors. Published by FASS Inc. and Elsevier Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).

Respiratory disease in pregnancy.

PubMed

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

2015-07-01

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

Faculty and Technology: Implications for Faculty Training and Technology Leadership

NASA Astrophysics Data System (ADS)

Keengwe, Jared; Kidd, Terry; Kyei-Blankson, Lydia

2009-02-01

The purpose of this study was to explore the factors affecting ICT adoption process and the implications for faculty training and technology leadership. Respondents represented a wide range of academic and professional positions. They identified themselves as Assistant, Associate, and Professor as well as Instructional Designer, Director of Technology, Information Manager, eLearning Manager, Assistant Department Chair, Associate Vice President of Academic Affairs and Consultant. The respondents identified Organizational Support, Leadership, Training and Development, and Resources as the predominate themes affecting Information and Communication Technology (ICT) adoption process in higher education. Evidence from this study offers insights on how higher education administrators and technology leaders could help their faculty and staff to implement appropriate ICT tools and practices to improve student learning.

Conservative management in ureteric hydronephrosis due to deep endometriosis: Could the levonorgestrel-intrauterine device be an option?

PubMed

Simón, Elisa; Tejerizo, Álvaro; Muñoz, José Luis; Álvarez, Carmen; Marqueta, Laura; Jiménez, Jesús S

2017-07-01

Endometriosis can affect up to 10% of women of reproductive age, in a wide range of clinical presentations that vary from mild to severe or deep endometriosis. Deep endometriosis can affect the urinary tract in 1-5% to 15-25% cases. Even though deep endometriosis' surgeries are usually complex with higher rate of complications, conservative management is not always considered as an option because of its high failure rates. This paper describes two cases of deep endometriosis with ureteric involvement (hydronephrosis) treated conservatively with a double-pigtail stent plus a Levonorgestrel intrauterine device, after conservative surgery, who remained symptom free with no evidence of recurrence at 3 years follow-up, avoiding radical high-risk surgery. Impact statement Several treatments have been described for endometriosis. From a symptomatic perspective, conservative medical management has been proposed with a variable response. Concerning deep endometriosis (affecting the urinary or digestive tract), the definitive treatment has always been thought to be radical surgery. However, this can lead to several complications. To illustrate a possible more conservative approach this paper describes two cases of deep infiltrating endometriosis affecting the ureter, treated conservatively with a temporary pigtail ureter stent plus a Levonorgestrel intrauterine device. The management demonstrates that, in a selected population, conservative treatment solves the urinary disease avoiding the surgical complications and, what is more, improving patients' symptoms in a permanent way. Further prospective studies are needed to confirm whether the introduction of this management in clinical practice would reduce the need for surgery thereby, avoiding high-risk surgery and improving the success rate of conservative management.

Forest Tenure Systems and Sustainable Forest Management: The Case of Ghana

Treesearch

Charles E. Owubah; Dennis C. Le Master; J. Michael Bowker; John G. Lee

2001-01-01

Adoption and implementation of sustainable forestry practices are essential for sustaining forest resources, yet development of effective policies and strategies to achieve them are problematic. Part of the difficulty stems from a limited understanding of the interaction between obtrusive forest policies and indigenous tenure systems and how this affects sustainable...

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

ERIC Educational Resources Information Center

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

2008-01-01

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

40 CFR 63.11516 - What are my standards and management practices?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Testing Air-Cleaning Devices Used in General Ventilation for Removing Particulate Matter, June 4, 1992... requirements of this section and be re-certified every 5 years. (e) [Reserved] (f) Standards for welding. If you own or operate a new or existing welding affected source, you must comply with the requirements in...

Philosophies of Leadership and Management and Its Influence on Change.

ERIC Educational Resources Information Center

Moore, Rock D.

Since the National Commission on Excellence in Education stated the nation was "at risk," there have been efforts to design and implement improved teacher delivery strategies that would enhance classroom instruction. In spite of reform efforts, crucial decisions affecting teachers' classroom practices still have a tendency to be made by…

Net global warming potential and greenhouse gas intensity influenced by irrigation, tillage, crop rotation, and nitrogen fertilization

USDA-ARS?s Scientific Manuscript database

Little information exists about sources and sinks of greenhouse gases (GHGs) affected by management practices to account for net emissions from agroecosystems. We evaluated the effects of irrigation, tillage, crop rotation, and N fertilization on net global warming potential (GWP) and greenhouse gas...

Assessing fertilizer N placement on CH4 and N2O emissions in irrigated rice systems

USDA-ARS?s Scientific Manuscript database

Improved N fertilizer management practices can increase rice yields and mitigate global warming potential (GWP). While banding N has been shown to have positive effects on yield and nitrogen use efficiency (NUE), there is little information in how it affects greenhouse gas (GHG) emissions from flood...

Musing: A Way to Inform and Inspire Pedagogy through Self-Reflection

ERIC Educational Resources Information Center

Moore, Jane; Whitfield, Vickie Fields

2008-01-01

Teaching is a complex profession that involves grappling with a variety of management styles; federal, state, and local mandates; local policies and agendas; and informed curriculum practices that affect pedagogy. Teachers work in increasingly diverse schools, and they must be reflective practitioners to deal with the many social and educational…

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…

Managing Large-Enrollment Courses in Hybrid Instruction Mode

ERIC Educational Resources Information Center

Khanna, Pooja

2016-01-01

This essay addresses the hitches and glitches in the hybrid instruction system of teaching and learning for large-enrollment courses. This new instructional methodology asks facilitators to redesign their entire traditional teaching and learning practices. The nature of subject to be taught via the hybrid mode further affects the success rate of…

Management of Bacterial Blight of Lilac Caused by Pseudomonas syringae by Growing Plants under Plastic Shelters

USDA-ARS?s Scientific Manuscript database

Pseudomonas syringae pv. syringae causes some of the most economically-important bacterial diseases affecting woody perennials grown by the nursery industry in the Pacific Northwest of the United States. In this study, we evaluated a cultural control practice, placement of plants in plastic shelter...

Seed and seedling traits affecting critical life stage transitions and recruitment outcomes in dryland grasses

USDA-ARS?s Scientific Manuscript database

1. Seeding native plants is a key management practice to counter land degradation across the globe, yet the majority of seeding efforts fail, limiting the ability of this tool to accelerate ecosystem recovery. 2. Seedling recruitment requires transitions through several life stages, some of which ma...

Developing management guidelines that balance cattle and timber production with ecological interests in the Black Hills of South Dakota

NASA Astrophysics Data System (ADS)

Chowanski, Kurt M.

Forested lands contribute to the United States (US) economy by providing livestock and timber production. Livestock grazing of forested lands has been widespread throughout the western US since the settlement era, and currently occurs on 51.4 million hectares (ha) representing 16% of all US grazing land and 22% of all US forested land (Nickerson et al. 2011). While livestock grazing and timber harvest are occurring on a substantial amount of forested land, relationships between management practices, tree stocking, timber production, forage production, livestock grazing, wildlife, aesthetics, and ecological integrity are not well documented. Whether considering timber or cattle, finding a balance between production and resource conservation is a fundamental challenge to agricultural producers, and is often a tradeoff between short term gains and long term sustainability. This dissertation aims to identify livestock and timber management practices that optimize production and are ecologically conservative. Specifically, I focused on three objectives. First, I reviewed the published literature and summarized what is known about best-practices for concurrent management of livestock and timber production in pine forests in the US. I found most studies came from the southeastern and western US where timber and livestock production on the same land unit are common. The relationship between pine cover and forage seemed fairly consistent across the US, and production was optimized when cattle grazed open canopy forests with basal areas between 5 and 14 m2 ha-1 (15-35% tree canopy cover). Second, I developed forest cover maps to estimate forage production in the Black Hills, South Dakota (SD) for the period from 1999 to 2015. I developed a regression model based on Landsat and Ikonos satellite imagery and was able to detect large changes in forest cover over time. I then used these maps in combination with maps of soil type and Palmer Drought Severity Index (PDSI) to update forage production estimates for the region. These changes in forest cover have large implications for forage production in the Black Hills. Over the 15 year period, mean tree cover decreased in 181 pastures in the Mystic Ranger District by 17.6 +/- 0.6%, and there was a corresponding 15.5 +/- 0.6% increase in mean forage production. Third, I conducted a 2 -year field experiment in the Black Hills, SD to study the relationships between management practices such as livestock stocking rates, grazing pressure, and timber harvest history, and aspects of resource condition such as tree regeneration, forage production, and plant community composition. From 2014-2015, I visited 44 pastures across a spectrum of management practices and measured seedling regeneration (590 plots), plant species richness (393 plots), primary production (246 plots), and visual obstruction (120 transects). I found that cattle grazing did not affect ponderosa pine regeneration. Grazing did affect plant diversity, and I found the highest plant diversity in areas of moderate grazing pressure. This work suggests that moderate stocking rates should have no effect on the timber industry but could positively affect native plant diversity. In the conclusion, I summarize what I learned from the literature review, mapping exercise, and field study and provide some management recommendations based on this work. Overall, I found that updated forage production estimates based on satellite imagery, and using grazing pressure index (GPI) to identify optimal stocking rates are tools that can facilitate management of livestock and timber production in the Black Hills, SD.

Role of mathematical models in assessment of risk and in attempts to define management strategy.

PubMed

Flamm, W G; Winbush, J S

1984-06-01

Risk assessment of food-borne carcinogens is becoming a common practice at FDA. Actual risk is not being estimated, only the upper limit of risk. The risk assessment process involves a large number of steps and assumptions, many of which affect the numerical value estimated. The mathematical model which is to be applied is only one of the factors which affect these numerical values. To fulfill the policy objective of using the "worst plausible case" in estimating the upper limit of risk, recognition needs to be given to a proper balancing of assumptions and decisions. Interaction between risk assessors and risk managers should avoid making or giving the appearance of making specific technical decisions such as the choice of the mathematical model. The importance of this emerging field is too great to jeopardize it by inappropriately mixing scientific judgments with policy judgments. The risk manager should understand fully the points and range of uncertainty involved in arriving at the estimates of risk which must necessarily affect the choice of the policy or regulatory options available.

Anesthesia Practices for Interventional Radiology in Europe

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

Vari, Alessandra, E-mail: alessandra.vari@uniroma1.it; Gangi, Afshin, E-mail: gangi@unistra.fr

PurposeThe Cardiovascular and Interventional Radiological Society of Europe (CIRSE) prompted an initiative to frame the current European status of anesthetic practices for interventional radiology, in consideration of the current variability of IR suite settings, staffing and anesthetic practices reported in the literature and of the growing debate on sedation administered by non-anesthesiologists, in Europe.MethodsAnonymous online survey available to all European CIRSE members to assess IR setting, demographics, peri-procedural care, anesthetic management, resources and staffing, pain management, data collection, safety, management of emergencies and personal opinions on the role CIRSE should have in promoting anesthetic care for interventional radiology.ResultsPredictable differences betweenmore » countries and national regulations were confirmed, showing how significantly many “local” factors (type and size of centers, the availability of dedicated inpatient bed, availability of anesthesia staff) can affect the routine practice and the expansion of IR as a subspecialty. In addition, the perception of the need for IR to acquire more sedation-related skills is definitely stronger for those who practice with the lowest availability of anesthesia care.ConclusionSignificant country variations and regulations along with a controversial position of the anesthesia community on the issue of sedation administered by non-anesthesiologists substantially represent the biggest drawbacks for the expansion of peri-procedural anesthetic care for IR and for potential initiatives at an European level.« less

Recruitment and Hiring Strategies of Private Practitioners and Implications for Practice Management Training of Veterinary Students.

PubMed

Kogan, Lori R; Hellyer, Peter W; Stewart, Sherry M; Dowers, Kristy L

2015-01-01

Hiring new employees is one of the most important and difficult decisions all veterinary practice managers and owners face. In an effort to improve hiring decisions, many employers are choosing to screen potential employees more thoroughly through the use of interviews, background checks, personality assessments, and online research including social and professional networking websites. The current study reports results from an anonymous online survey created to evaluate practicing veterinarians' attitudes and practices related to the use of recruitment and hiring tools. Results suggest that, compared to those in other professions, veterinarians underutilize these evaluative tools. The profession could benefit from more opportunities for both practitioners and veterinary students to learn how to utilize a broader range of hiring and recruitment techniques. One area of particular and growing concern is the use of Internet social media for evaluation of potential employees. Despite the fairly low number of participants who indicated they currently research applicants online, a significant number plan to implement this practice in the future. Many students are unaware of how their online postings can affect their future job possibilities and career. It is therefore important to designate time within continuing education programs and professional veterinary curricula to educate these populations about hiring and recruitment tool options and about how to manage their personal Internet interactions (especially social media) to enhance and maintain their professional image (e-professionalism).

Postfire management in forested public lands of the western USA

USGS Publications Warehouse

Beschta, R.L.; Rhodes, J.J.; Kauffman, J.B.; Gresswell, Robert E.; Minshall, G.W.; Frissell, C.A.; Perry, D.A.; Hauer, R.

2004-01-01

Forest ecosystems in the western United States evolved over many millennia in response to disturbances such as wildfires. Land use and management practices have altered these ecosystems, however, including fire regimes in some areas. Forest ecosystems are especially vulnerable to postfire management practices because such practices may influence forest dynamics and aquatic systems for decades to centuries. Thus, there is an increasing need to evaluate the effect of postfire treatments from the perspective of ecosystem recovery. We examined, via the published literature and our collective experience, the ecological effects of some common postfire treatments. Based on this examination, promising postfire restoration measures include retention of large trees, rehabilitation of firelines and roads, and, in some cases, planting of native species. The following practices are generally inconsistent with efforts to restore ecosystem functions after fire: seeding exotic species, livestock grazing, placement of physical structures in and near stream channels, ground-based postfire logging, removal of large trees, and road construction. Practices that adversely affect soil integrity, persistence or recovery of native species, riparian functions, or water quality generally impede ecological recovery after fire. Although research provides a basis for evaluating the efficacy of postfire treatments, there is a continuing need to increase our understanding of the effects of such treatments within the context of societal and ecological goals for forested public lands of the western United States.

Nutrient Tracking Tool - A user-friendly tool for evaluating the water and air quality and quantity as affected by various agricultural management practices

NASA Astrophysics Data System (ADS)

Saleh, A.; Niraula, R.; Gallego, O.; Osei, E.; Kannan, N.

2017-12-01

The Nutrient Tracking Tool (NTT) is a user-friendly web-based computer program that estimate nutrient (nitrogen and phosphorus) and sediment losses from fields managed under a variety of cropping patterns and management practices. The NTT includes a user-friendly web-based interface and is linked to the Agricultural Policy Environmental eXtender (APEX) model. It also accesses USDA-NRCS's Web Soil Survey to obtain field, weather, and soil information. NTT provides producers, government officials, and other users with a fast and efficient method of estimating the nutrient, sediment, and atmosphoric gases (N2o, Co2, and NH4) losses, and crop production under different conservation practices regims at the farm-level. The information obtained from NTT can help producers to determine the most cost-effective conservation practice(s) to reduce the nutrient and sediment losses while optimizing the crop production. Also, the recent version of NTT (NTTg3) has been developed for those coutries without access to national databasis, such as soils and wether. The NTTg3 also has been designed as easy to use APEX interface. NTT is currently being evaluated for trading and other programs at Cheaseapea Bay regions and numerous states in US. During this presentation the new capabilities of NTTg3 will be described and demonstrated.

Occupational therapy practice in acute physical hospital settings: Evidence from a scoping review.

PubMed

Britton, Lauren; Rosenwax, Lorna; McNamara, Beverley

2015-12-01

Increased accountability and growing fiscal limitations in global health care continue to challenge how occupational therapy practices are undertaken. Little is known about how these changes affect current practice in acute hospital settings. This article reviews the relevant literature to further understanding of occupational therapy practice in acute physical hospital settings. A scoping review of five electronic databases was completed using the keywords Occupational therapy, acute hospital settings/acute physical hospital settings, acute care setting/acute care hospital setting, general medicine/general medical wards, occupational therapy service provision/teaching hospitals/tertiary care hospitals. Criteria were applied to determine suitability for inclusion and the articles were analysed to uncover key themes. In total 34 publications were included in the review. Analysis of the publications revealed four themes: (1) Comparisons between the practice of novice and experienced occupational therapists in acute care (2) Occupational therapists and the discharge planning process (3) Role of occupation in the acute care setting and (4) Personal skills needed and organisation factors affecting acute care practice. The current literature has highlighted the challenges occupational therapists face in practicing within an acute setting. Findings from this review enhance understanding of how occupational therapy department managers and educators can best support staff that practise in acute hospital settings. © 2015 Occupational Therapy Australia.

Improvement in the management of gout is vital and overdue: an audit from a UK primary care medical practice

PubMed Central

2013-01-01

Background Gout is estimated to affect 1.4% of adults in the UK. Appropriate and timely management is essential to reduce the risk of further flares, complications, and to reduce cardiovascular disease risk. The British Society for Rheumatology and British Health Professionals in Rheumatology (BSR/BHPR) and the European League Against Rheumatism (EULAR) have published guidance regarding the management of gout, thereby providing standards against which performance can be measured. This audit was designed to assess the extent to which patients diagnosed with gout in one primary care medical practice in North Staffordshire, UK, are managed in accordance with current best practice guidelines, and to identify strategies for improvement where appropriate. Methods Audit criteria were derived from the EULAR and BSR/BHPR guidelines; standards were set arbitrarily, but with consideration of patient comorbidity and other factors which may influence concordance. An electronic search of the practice records was performed to identify adults with a diagnosis of gout. Medical record review with a descriptive analysis was undertaken to assess the extent to which medical management adhered to the predefined standards. Results Of the total ≥18 year-old practice population (n = 8686), 305 (3%) patient records included a diagnosis of gout. Of these, 74% (n = 226) had an electronic record of serum uric acid (SUA), and 11% (n = 34) and 53% (n = 162) a measure of estimated glomerular filtration rate (eGFR) ever and serum glucose since diagnosis respectively. 34% (n = 105) of patients had ever taken urate-lowering therapy with 25% (n = 77) currently prescribed this at the time of data extraction. Dose adjustment and monitoring of treatment according to SUA was found to be inadequate. Provision of lifestyle advice and consideration of comorbidities was also lacking. Conclusions The primary care management of gout in this practice was not concordant with national and international guidance, a finding consistent with previous studies. This demonstrates that the provision of guidelines alone is not sufficient to improve the quality of gout management and we identify possible strategies to increase guideline adherence. PMID:24225170

Managers’ Practices Related to Work–Family Balance Predict Employee Cardiovascular Risk and Sleep Duration in Extended Care Settings

PubMed Central

Berkman, Lisa F.; Buxton, Orfeu; Ertel, Karen; Okechukwu, Cassandra

2012-01-01

An increasing proportion of U.S. workers have family caregiving responsibilities. The purpose of this study was to determine whether employees in extended care settings whose managers are supportive, open, and creative about work–family needs, such as flexibility with work schedules, have lower cardiovascular disease (CVD) risk and longer sleep than their less supported counterparts. From semistructured interviews with managers, we constructed a work–family balance score of manager openness and creativity in dealing with employee work–family needs. Trained interviewers collected survey and physiologic outcome data from 393 employees whose managers had a work–family score. Employee outcomes are sleep duration (actigraphy) and CVD risk assessed by blood cholesterol, high glycosylated hemoglobin/diabetes, blood pressure/hypertension, body-mass index, and tobacco consumption. Employees whose managers were less supportive slept less (29 min/day) and were over twice as likely to have 2 or more CVD risk factors (ORs = 2.1 and 2.03 for low and middle manager work–family scores, respectively) than employees whose managers were most open and creative. Employees who provide direct patient care exhibited particularly elevated CVD risk associated with low manager work–family score. Managers’ attitudes and practices may affect employee health, including sleep duration and CVD risk. PMID:20604637

Emergency nurses' knowledge of pain management principles.

PubMed

Tanabe, P; Buschmann, M

2000-08-01

The purpose of this study was to determine areas of emergency nurses' knowledge deficit regarding pain management, and to identify barriers to pain management as perceived by emergency nurses. Data were collected anonymously in a mail survey using a 52-item knowledge questionnaire addressing pain management principles and asking emergency nurses (Illinois Emergency Nurses Association members) to rate various barriers as to how often they affect their practice. Questionnaires were mailed to all Illinois ENA members (n = 1000). Three hundred five emergency nurses' questionnaires were returned. A significant deficit existed on 2 domains of knowledge: understanding of the terms "addiction," "tolerance," and "dependence"; and knowledge of various pharmacologic analgesic principles. Nurses with a master's degree or higher, or those who attended a 1-day seminar on pain management, achieved statistically significantly higher scores. The 2 barriers identified by emergency nurses as the most common were the inability to administer medication until a diagnosis is made (53%), and inadequate assessment of pain and pain relief (48%) (the percentage indicates how often the emergency nurses believed the barrier was present in their practice). The data indicate that emergency nurses may not have a good understanding of the management of pain with drugs, or of such issues as risk of addiction.

Postoperative Stereotactic Body Radiation Therapy (SBRT) for Spine Metastases: A Critical Review to Guide Practice

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

Redmond, Kristin J., E-mail: kjanson3@jhmi.edu; Lo, Simon S.; Fisher, Charles

Postoperative stereotactic body radiation therapy (SBRT) for metastatic spinal tumors is increasingly being performed in clinical practice. Whereas the fundamentals of SBRT practice for intact spinal metastases are established, there are as yet no comprehensive practice guidelines for the postoperative indications. In particular, there are unique considerations for patient selection and treatment planning specific to postoperative spine SBRT that are critical for safe and effective management. The purpose of this critical review is to discuss the rationale for treatment, describe those factors affecting surgical decision making, introduce modern surgical trends, and summarize treatment outcomes for both conventional postoperative external beammore » radiation therapy and postoperative spine SBRT. Lastly, an in-depth practical discussion with respect to treatment planning and delivery considerations is provided to help guide optimal practice.« less

Networking our science to characterize the state, vulnerabilities, and management opportunities of soil organic matter.

PubMed

Harden, Jennifer W; Hugelius, Gustaf; Ahlström, Anders; Blankinship, Joseph C; Bond-Lamberty, Ben; Lawrence, Corey R; Loisel, Julie; Malhotra, Avni; Jackson, Robert B; Ogle, Stephen; Phillips, Claire; Ryals, Rebecca; Todd-Brown, Katherine; Vargas, Rodrigo; Vergara, Sintana E; Cotrufo, M Francesca; Keiluweit, Marco; Heckman, Katherine A; Crow, Susan E; Silver, Whendee L; DeLonge, Marcia; Nave, Lucas E

2018-02-01

Soil organic matter (SOM) supports the Earth's ability to sustain terrestrial ecosystems, provide food and fiber, and retains the largest pool of actively cycling carbon. Over 75% of the soil organic carbon (SOC) in the top meter of soil is directly affected by human land use. Large land areas have lost SOC as a result of land use practices, yet there are compensatory opportunities to enhance productivity and SOC storage in degraded lands through improved management practices. Large areas with and without intentional management are also being subjected to rapid changes in climate, making many SOC stocks vulnerable to losses by decomposition or disturbance. In order to quantify potential SOC losses or sequestration at field, regional, and global scales, measurements for detecting changes in SOC are needed. Such measurements and soil-management best practices should be based on well established and emerging scientific understanding of processes of C stabilization and destabilization over various timescales, soil types, and spatial scales. As newly engaged members of the International Soil Carbon Network, we have identified gaps in data, modeling, and communication that underscore the need for an open, shared network to frame and guide the study of SOM and SOC and their management for sustained production and climate regulation. © 2017 The Authors. Global Change Biology Published by John Wiley & Sons Ltd.

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.

Evaluation of native bees as pollinators of cucurbit crops under floating row covers.

PubMed

Minter, Logan M; Bessin, Ricardo T

2014-10-01

Production of cucurbit crops presents growers with numerous challenges. Several severe pests and diseases can be managed through the use of rotation, trap cropping, mechanical barriers, such as row covers, and chemical applications. However, considerations must also be made for pollinating insects, as adequate pollination affects the quantity and quality of fruit. Insecticides may negatively affect pollinators; a concern enhanced in recent years due to losses in managed Apis melifera L. colonies. Row covers can be used in place of chemical control before pollination, but when removed, pests have access to fields along with the pollinators. If pollination services of native bees could be harnessed for use under continuous row covers, both concerns could be balanced for growers. The potential of two bee species which specialize on cucurbit flowers, Peponapis pruinosa Say and Xenoglossa strenua Cresson, were assessed under continuous row covers, employed over acorn squash. Experimental treatments included plots with either naturally or artificially introduced bees under row covers and control plots with row covers either permanently removed at crop flowering, or employed continuously with no added pollinating insects. Pests in plots with permanently removed row covers were managed using standard practices used in certified organic production. Marketable yields from plots inoculated with bees were indistinguishable from those produced under standard practices, indicating this system would provide adequate yields to growers without time and monetary inputs of insecticide applications. Additionally, application of this technique was investigated for muskmelon production and discussed along with considerations for farm management.

Tuberous sclerosis complex surveillance and management: recommendations of the 2012 International Tuberous Sclerosis Complex Consensus Conference.

PubMed

Krueger, Darcy A; Northrup, Hope

2013-10-01

Tuberous sclerosis complex is a genetic disorder affecting every organ system, but disease manifestations vary significantly among affected individuals. The diverse and varied presentations and progression can be life-threatening with significant impact on cost and quality of life. Current surveillance and management practices are highly variable among region and country, reflective of the fact that last consensus recommendations occurred in 1998 and an updated, comprehensive standard is lacking that incorporates the latest scientific evidence and current best clinical practices. The 2012 International Tuberous Sclerosis Complex Consensus Group, comprising 79 specialists from 14 countries, was organized into 12 separate subcommittees, each led by a clinician with advanced expertise in tuberous sclerosis complex and the relevant medical subspecialty. Each subcommittee focused on a specific disease area with important clinical management implications and was charged with formulating key clinical questions to address within its focus area, reviewing relevant literature, evaluating the strength of data, and providing a recommendation accordingly. The updated consensus recommendations for clinical surveillance and management in tuberous sclerosis complex are summarized here. The recommendations are relevant to the entire lifespan of the patient, from infancy to adulthood, including both individuals where the diagnosis is newly made as well as individuals where the diagnosis already is established. The 2012 International Tuberous Sclerosis Complex Consensus Recommendations provide an evidence-based, standardized approach for optimal clinical care provided for individuals with tuberous sclerosis complex. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

Nitrogen deposition and management practices increase soil microbial biomass carbon but decrease diversity in Moso bamboo plantations

PubMed Central

Li, Quan; Song, Xinzhang; Gu, Honghao; Gao, Fei

2016-01-01

Because microbial communities play a key role in carbon (C) and nitrogen (N) cycling, changes in the soil microbial community may directly affect ecosystem functioning. However, the effects of N deposition and management practices on soil microbes are still poorly understood. We studied the effects of these two factors on soil microbial biomass carbon (MBC) and community composition in Moso bamboo plantations using high-throughput sequencing of the 16S rRNA gene. Plantations under conventional (CM) or intensive management (IM) were subjected to one of four N treatments for 30 months. IM and N addition, both separately and in combination, significantly increased soil MBC while decreasing bacterial diversity. However, increases in soil MBC were inhibited when N addition exceeded 60 kg N∙ha−1∙yr−1. IM increased the relative abundances of Actinobacteria and Crenarchaeota but decreased that of Acidobacteria. N addition increased the relative abundances of Acidobacteria, Crenarchaeota, and Actinobacteria but decreased that of Proteobacteria. Soil bacterial diversity was significantly related to soil pH, C/N ratio, and nitrogen and available phosphorus content. Management practices exerted a greater influence over regulation of the soil MBC and microbial diversity compared to that of N deposition in Moso bamboo plantations. PMID:27302857

Nitrogen deposition and management practices increase soil microbial biomass carbon but decrease diversity in Moso bamboo plantations

NASA Astrophysics Data System (ADS)

Li, Quan; Song, Xinzhang; Gu, Honghao; Gao, Fei

2016-06-01

Because microbial communities play a key role in carbon (C) and nitrogen (N) cycling, changes in the soil microbial community may directly affect ecosystem functioning. However, the effects of N deposition and management practices on soil microbes are still poorly understood. We studied the effects of these two factors on soil microbial biomass carbon (MBC) and community composition in Moso bamboo plantations using high-throughput sequencing of the 16S rRNA gene. Plantations under conventional (CM) or intensive management (IM) were subjected to one of four N treatments for 30 months. IM and N addition, both separately and in combination, significantly increased soil MBC while decreasing bacterial diversity. However, increases in soil MBC were inhibited when N addition exceeded 60 kg N•ha-1•yr-1. IM increased the relative abundances of Actinobacteria and Crenarchaeota but decreased that of Acidobacteria. N addition increased the relative abundances of Acidobacteria, Crenarchaeota, and Actinobacteria but decreased that of Proteobacteria. Soil bacterial diversity was significantly related to soil pH, C/N ratio, and nitrogen and available phosphorus content. Management practices exerted a greater influence over regulation of the soil MBC and microbial diversity compared to that of N deposition in Moso bamboo plantations.

An ecosystem service approach to support integrated pond management: a case study using Bayesian belief networks--highlighting opportunities and risks.

PubMed

Landuyt, Dries; Lemmens, Pieter; D'hondt, Rob; Broekx, Steven; Liekens, Inge; De Bie, Tom; Declerck, Steven A J; De Meester, Luc; Goethals, Peter L M

2014-12-01

Freshwater ponds deliver a broad range of ecosystem services (ESS). Taking into account this broad range of services to attain cost-effective ESS delivery is an important challenge facing integrated pond management. To assess the strengths and weaknesses of an ESS approach to support decisions in integrated pond management, we applied it on a small case study in Flanders, Belgium. A Bayesian belief network model was developed to assess ESS delivery under three alternative pond management scenarios: intensive fish farming (IFF), extensive fish farming (EFF) and nature conservation management (NCM). A probabilistic cost-benefit analysis was performed that includes both costs associated with pond management practices and benefits associated with ESS delivery. Whether or not a particular ESS is included in the analysis affects the identification of the most preferable management scenario by the model. Assessing the delivery of a more complete set of ecosystem services tends to shift the results away from intensive management to more biodiversity-oriented management scenarios. The proposed methodology illustrates the potential of Bayesian belief networks. BBNs facilitate knowledge integration and their modular nature encourages future model expansion to more encompassing sets of services. Yet, we also illustrate the key weaknesses of such exercises, being that the choice whether or not to include a particular ecosystem service may determine the suggested optimal management practice. Copyright © 2014 Elsevier Ltd. All rights reserved.

Cultural practices affecting the skin of children.

PubMed

Ravanfar, Parisa; Dinulos, James G

2010-08-01

Cultural practices that present with dermatologic manifestations in the pediatric population are common. However, such skin manifestations are often poorly understood in western medicine and lesions are misdiagnosed, with child abuse being a common misdiagnosis. The 2000 Census counted approximately 28 million first-generation immigrants in the United States. As populations are increasing in diversity, there are an increasing number of physical presentations from diverse cultural practices. Physicians will begin to encounter skin findings that they may have never seen before. It is, therefore, imperative for physicians to be aware of such cultural practices and the cutaneous findings associated with them. Numerous cultural practices may present with skin manifestations in children. It is, therefore, important for pediatricians to be aware of such practices and their associated skin lesions for proper diagnosis and management. Various cultural practices with cutaneous findings will be covered in this article.

Managing water resources infrastructure in the face of different values

NASA Astrophysics Data System (ADS)

Mostert, Erik

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

The business management preceptorship within the nurse practitioner program.

PubMed

Wing, D M

1998-01-01

Changes in health care reimbursement practices have affected the way in which primary health care is provided. To be successful, nurse practitioners must have a proficient understanding of basic business functions, including accounting, finance, economics, marketing, and reimbursement practices. Yet, many graduates of nurse practitioner programs are not adequately prepared to make fundamental business decisions. Therefore, it is essential that nurse practitioner faculty provide learning experiences on primary practice business. Because the preceptor experience is an integral aspect of nurse practitioner education, a business preceptorship provides students with pragmatic knowledge of the clinical practice within a business framework. The University of Indianapolis School of Nursing offers a nurse practitioner business preceptorship. The implementation, challenges, and positive outcomes of the course are discussed in this article.

Effectiveness of personalised support for self-management in primary care: a cluster randomised controlled trial

PubMed Central

Eikelenboom, Nathalie; van Lieshout, Jan; Jacobs, Annelies; Verhulst, Frank; Lacroix, Joyca; van Halteren, Aart; Klomp, Maarten; Smeele, Ivo; Wensing, Michel

2016-01-01

Background Self-management support is an important component of the clinical management of many chronic conditions. The validated Self-Management Screening questionnaire (SeMaS) assesses individual characteristics that influence a patient’s ability to self-manage. Aim To assess the effect of providing personalised self-management support in clinical practice on patients’ activation and health-related behaviours. Design and setting A cluster randomised controlled trial was conducted in 15 primary care group practices in the south of the Netherlands. Method After attending a dedicated self-management support training session, practice nurses in the intervention arm discussed the results of SeMaS with the patient at baseline, and tailored the self-management support. Participants completed a 13-item Patient Activation Measure (PAM-13) and validated lifestyle questionnaires at baseline and after 6 months. Data, including individual care plans, referrals to self-management interventions, self-monitoring, and healthcare use, were extracted from patients’ medical records. Multilevel multiple regression was used to assess the effect on outcomes. Results The PAM-13 score did not differ significantly between the control (n = 348) and intervention (n = 296) arms at 6 months. In the intervention arm, 29.4% of the patients performed self-monitoring, versus 15.2% in the control arm (effect size r = 0.9, P = 0.01). In the per protocol analysis (control n = 348; intervention n = 136), the effect of the intervention was significant on the number of individual care plans (effect size r = 1.3, P = 0.04) and on self-monitoring (effect size r = 1.0, P = 0.01). Conclusion This study showed that discussing SeMaS and offering tailored support did not affect patient activation or lifestyle, but did stimulate patients to self-monitor and use individual care plans. PMID:27080318

Survey of food safety practices on small to medium-sized farms and in farmers markets.

PubMed

Harrison, Judy A; Gaskin, Julia W; Harrison, Mark A; Cannon, Jennifer L; Boyer, Renee R; Zehnder, Geoffrey W

2013-11-01

As produce consumption has increased, so have foodborne disease outbreaks associated with fresh produce. Little research has addressed food safety practices used on small to medium-sized farms selling locally or in farmers markets. This study evaluated current food safety practices used by farmers on small to medium-sized farms and managers of farmers markets in Georgia, Virginia, and South Carolina based on responses to surveys. Surveys were developed, pretested, and revised before implementation with target audiences and were implemented via mail and the Web to maximize participation, with reminders sent to nonrespondents. Data were collected from 226 farmers and 45 market managers. Frequencies and percentages were calculated for all response variables. Responses from farmers indicated that more than 56% of them use manures. Of those who use manures, 34% use raw or mixtures of raw and composted manure, and over 26% wait fewer than 90 days between application of raw manure and harvest. Over 27% use water sources that have not been tested for safety for irrigation, and 16% use such water sources for washing produce. Over 43% do not sanitize surfaces that touch produce at the farm. Only 33% of farmers always clean transport containers between uses. Responses from market managers indicated that over 42% have no food safety standards in place for the market. Only 2 to 11% ask farmers specific questions about conditions on the farm that could affect product safety. Less than 25% of managers sanitize market surfaces. Only 11% always clean market containers between uses. Over 75% of markets offer no sanitation training to workers or vendors. While farmers and market managers are using many good practices, the results indicate that some practices being used may put consumers at risk of foodborne illness. Consequently, there is a need for training for both farmers and market managers.

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

PubMed

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

2009-01-01

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

Scrub-successional bird community dynamics in young and mature longleaf pine-wiregrass savannahs

USGS Publications Warehouse

Krementz, D.G.; Christie, J.S.

1999-01-01

Public agencies are required to manage for threatened and endangered species and for biodiversity. However, at times, management for threatened and endangered species precludes consideration of other species. We investigated how managing for red-cockaded woodpeckers (Picoides borealis) and biodiversity at the Savannah River Site (SRS), South Carolina, affected communities of bird species that use early-successional scrub habitat (hereafter, scrub-successional species). Management for red-cockaded woodpeckers at the SRS involved both (1) manipulating mature longleaf pine (Pinus palustris)-wiregrass (Andropogon spp.) stands via canopy thinning, removal of midstory trees, and prescribed burning; and (2) even-aged timber harvesting. The former management practice encouraged red-cockaded woodpeckers to establish new colonies in previously unoccupied stands (hereafter, 'recruitment' stands). The latter management practice is used to remove off-site planted pines and replant with preferred longleaf pines. We conducted a constant-effort mist net study in recruitment and regenerating stands (stands clearcut and planted with longleaf pine) during the breeding seasons of 1995-96. We hypothesized that the scrub-successional bird community in recruitment stands would have greater species richness and higher survival and reproductive rates per species than in regenerating stands. However, recruitment stands always had fewer scrub-successional species (1995:36 species; 1996:31 species) than regenerating stands (1995:54 species; 1996:55 species), and all species that occurred in recruitment stands also occurred in regenerating stands. Species which commonly occurred in both recruitment and regenerating stands had similar adult:juvenile ratios (P > 0.15) and relative proportion of adults in breeding condition (P > 0.05). We detected no difference in survival rates of Bachman's sparrows (Aimophila aestivalis), indigo buntings (Passerina cyanea), and of 'combined' scrub-successional birds between stand types (P > 0.05). We found that even-aged forestry is an important management practice for maintaining and increasing avian biodiversity on public lands, as well as an acceptable management practice for red-cockaded woodpeckers.

Analysis of Regulatory Guidance for Health Monitoring

NASA Technical Reports Server (NTRS)

Munns, Thomas E.; Beard, Richard E.; Culp, Aubrey M.; Murphy, Dennis A.; Kent, Renee M.; Cooper, Eric G. (Technical Monitor)

2000-01-01

The purpose of this study was to assess the connection between current FAA regulations and the incorporation of Health Management (HM) systems into commercial aircraft. To address the overall objectives ARINC: (1) investigated FAA regulatory guidance, (2) investigated airline maintenance practices, (3) systematically identified regulations and practices that would be affected or could act as barriers to the introduction of HM technology, and (4) assessed regulatory and operational tradeoffs that should be considered for implementation. The assessment procedure was validated on a postulated structural HM capability for the B757 horizontal stabilizer.

Management practices associated with presence of Staphylococcus aureus in bulk tank milk from Ohio dairy herds.

PubMed

da Costa, L B; Rajala-Schultz, P J; Schuenemann, G M

2016-02-01

Staphylococcus aureus is the most common contagious mastitis pathogen affecting cows worldwide. Practices to control this organism have been advocated for decades, and identification of risk factors in individual herds is crucial in prevention and control of Staph. aureus. The objectives of this paper were to estimate prevalence of Staph. aureus in Ohio dairies and to determine a potential association of herd characteristics and management practices with isolation of Staph. aureus in bulk tank milk. A questionnaire about herd characteristics, milking procedures, udder health, mastitis control, and biosecurity practices was mailed to 780 dairy producers; the response rate for the survey was 49%. Staphylococcus aureus prevalence was 48, 64, and 69% when 1, 2, or 3 samples of bulk tank milk from each herd were considered, respectively. Herds practicing prestrip, pre- and postmilking teat dip, and using a single towel per cow as part of the milking routine as well as herds where owners were involved in milking were at significantly reduced odds for detection of Staph. aureus in their bulk tank milk. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Shrimp Farming Practices in the Puttallam District of Sri Lanka: Implications for Disease Control, Industry Sustainability, and Rural Development

PubMed Central

Munasinghe, M. Nalaka; Stephen, Craig; Abeynayake, Preeni; Abeygunawardena, Indra S.

2010-01-01

Shrimp farming has great potential to diversify and secure income in rural Sri Lanka, but production has significantly declined in recent years due to civil conflicts, some unsustainable practices and devastating outbreaks of disease. We examined management practices affecting disease prevention and control in the Puttalam district to identify extension services outputs that could support sustainable development of Sri Lankan shrimp farming. A survey on 621 shrimp farms (603 operational and 18 nonoperational) was conducted within the Puttalam district over 42 weeks comprising a series of three-day field visits from August 2008 to October 2009, covering two consecutive shrimp crops. Fundamental deficits in disease control, management, and biosecurity practices were found. Farmers had knowledge of biosecurity but the lack of financial resources was a major impediment to improved disease control. Smallholder farmers were disproportionately constrained in their ability to enact basic biosecurity practices due to their economic status. Basic breaches in biosecurity will keep disease as the rate limiting step in this industry. Plans to support this industry must recognize the socioeconomic reality of rural Sri Lankan aquaculture. PMID:20847956

Breaking Bad News in Healthcare Organizations: Application of the Spikes Protocol

ERIC Educational Resources Information Center

VonBergen, C. W.; Stevens, Robert E.; Loudon, David

2011-01-01

Organizational downsizing has increased exponentially worldwide and is also affecting the healthcare industry. It is one thing to speak abstractly of the need to reduce costs and quite another to actually tell a worker the bad news that he or she has been laid off. This paper offers practical advice to healthcare managers on conducting unpleasant…

Growing trees where trees grow best: short-term research sheds light on long-term productivity.

Treesearch

Jonathan Thompson

2008-01-01

In 1999, the Fall River Long-Term Site Productivity study began in coastal Washington to investigate how intensive management practices affect soil processes and forest productivity. By comparing conventional harvests to more intensive wood removal treatments, researchers are answering long-standing questions about how residual organic matter influences future growth....

Effects of experimental canopy manipulation on amphibian egg deposition

Treesearch

Zachary I. Felix; Yong Wang; Callie J. Schweitzer

2010-01-01

Although effects of forest management on amphibians are relatively well studied, few studies have examined how these practices affect egg deposition by adults, which can impact population recruitment. We quantified the effects of 4 canopy tree-retention treatments on amphibian oviposition patterns in clusters of 60-L aquatic mesocosms located in each treatment. We also...

How seed orchard culture affects seed quality: experience with the southern pines

Treesearch

James P. Barnett

1996-01-01

Tree improvement programs have influenced significantly the quality of southern pine seeds produced when compared to collections from native stands. Seed orchard management practices such as fertilization can increase seed size and reduce seed dormancy. These result in the need for less complex pregermination treatments. Repeated cone collections from the same clones...

Relative abundance and species richness of terrestrial salamanders on hardwood ecosystem experiment sites before harvesting

Treesearch

Jami E. MacNeil; Rod N. Williams

2013-01-01

Terrestrial salamanders are ideal indicators of forest ecosystem integrity due to their abundance, their role in nutrient cycling, and their sensitivity to environmental change. To understand better how terrestrial salamanders are affected by forest management practices, we monitored species diversity and abundance before implementation of timber harvests within the...

Rainfall erosivity and rainfall return period in the experimental watershed of Aracruz, in the Coastal Plain of Espirito Santo, Brazil

USDA-ARS?s Scientific Manuscript database

The knowledge of the factors influencing water erosion is relevant to land management practices. Rainfall, expressed by rainfall erosivity, is very important among the factors affecting water erosion. Thus, the objective of this study was to determine rainfall erosivity and return period for the Coa...

Soil microbial communities as affected by organic fertilizer and sunn hemp as a cover crop in organic sweet pepper production in Puerto Rico

USDA-ARS?s Scientific Manuscript database

Organic production in Puerto Rico is at an early stage and research is needed to validate the sustainability of different management practices. This research initiated evaluation of selected soil properties including the microbial communities to evaluate the effects of Tropic sunn (Crotalaria juncea...

Spray penetration and natural enemy survival in dense and sparse plant canopies treated with Carbaryl: implications for conventional and biological control

USDA-ARS?s Scientific Manuscript database

Ornamental plant producers often rely on chemical control to manage insect pests. However, cultural practices, such as pruning, can influence plant architecture which may, in turn, affect pesticide penetration. Spray penetration was studied to determine the effect of canopy density on beneficial ins...

Learning Organisations: A Literature Review and Critique

DTIC Science & Technology

2014-01-01

autocratic, laissez - faire and democratic work-group principles attributed to Lewin, provided evidence that people would learn and self-manage in an...each with their own particular emphasis on learning, leadership behaviours and organisational structure. A Learning Organisation’s salient...the organisational and structural factors that affect learning. These include the importance specific leadership actions or practices, the utility of

An Evaluation of the Adoption of Integrated Soil Fertility Management Practices among Women Farmers in Danja, Nigeria

ERIC Educational Resources Information Center

Damisa, M. A.; Igonoh, E.

2007-01-01

The relationship between technology adoption and farmers' socio-economic characteristics can never be over emphasized. This study tests the determinants of technology adoption by women farmers. The result from the Logit analysis of data from Unguwan-Madaki showed that the socio-economic characteristics of women farmers significantly affect their…

Combating Human Micronutrient Deficiencies through Soil Management Practices that Enhance Bioavailability of Nutrients to Plants

ERIC Educational Resources Information Center

O'Meara, Mary

2009-01-01

Micronutrient malnutrition affects the health and well being of 3 billion people globally. Identifying means to improve the micronutrient density in the edible portions of crops is an important way to combat nutrient deficiencies. By studying how plants obtain micronutrients from the soil, we can develop methods to enhance uptake. Although more…

Biology of bats in Douglas-fir forests.

Treesearch

Robin E. Christy; Stephen D. West

1993-01-01

Twelve species of bats occur in Douglas-fir forests of the Pacific Northwest, of which nine are known to roost in tree cavities, bark crevices, or foliage, and several are closely associated with old-growth forests. Thus bat populations may be detrimentally affected by forest management practices involving the removal of large, old trees and snags. We review the life...

Do container volume, site preparation, and field fertilization affect restoration potential of Wyoming big sagebrush?

Treesearch

Kayla R. Herriman; Anthony S. Davis; Kent G. Apostol; Olga. A. Kildisheva; Amy L. Ross-Davis; Kas Dumroese

2016-01-01

Land management practices, invasive species expansion, and changes in the fire regime greatly impact the distribution of native plants in natural areas. Wyoming big sagebrush (Artemisia tridentata ssp. wyomingensis), a keystone species in the Great Basin, has seen a 50% reduction in its distribution. For many dryland species, reestablishment efforts have...

A systematic framework for Monte Carlo simulation of remote sensing errors map in carbon assessments

Treesearch

S. Healey; P. Patterson; S. Urbanski

2014-01-01

Remotely sensed observations can provide unique perspective on how management and natural disturbance affect carbon stocks in forests. However, integration of these observations into formal decision support will rely upon improved uncertainty accounting. Monte Carlo (MC) simulations offer a practical, empirical method of accounting for potential remote sensing errors...

Implementation of the Better Jobs Better Care Demonstration: Lessons for Long-Term Care Workforce Initiatives

ERIC Educational Resources Information Center

Kemper, Peter; Brannon, Diane; Barry, Teta; Stott, Amy; Heier, Brigitt

2008-01-01

Purpose: Better Jobs Better Care (BJBC) was a long-term care workforce demonstration that sought to improve recruitment and retention of direct care workers by changing public policy and management practice. The purpose of this article is to document and assess BJBC's implementation, analyze factors affecting implementation, and draw lessons from…

Study of overlength on red oak lumber drying quality and rough mill yield

Treesearch

Brian Bond; Janice Wiedenbeck

2006-01-01

Lumber stacking practices can directly affect drying defects, drying rate, and moisture content uniformity. The effect of overlength on drying is generally thought to be detrimental, yet large volumes of overlength lumber are used by secondary manufacturers. Managers of secondary manufacturing facilities need quantitative information to assist them in determining if...

Influence of pine straw harvesting, prescribed fire, and fertilization on a Louisiana longleaf pine site

Treesearch

James D. Haywood

2009-01-01

This research was initiated in a 34-year-old, direct-seeded stand of longleaf pine (Pinus palustris Mill.) to study how pine straw management practices (harvesting, fire, and fertilization) affected the longleaf pine overstory and pine straw yields. A randomized complete block split-plot design was installed with two main plot treatments...

Proceedings of the symposium on fire and watershed management

Treesearch

Neil H. Berg

1989-01-01

Wildfires have affected the landscape since the dawn of time and will continue to do so for the foreseeable future. Policies and practices in response to fire have varied, however, contingent upon a complex mix of values and attitudes overlaid by the technical acumen available to both "fight" the fire and reclaim the land afterwards.

Raising Students' Awareness of the Implications of Multimodality for Content Design and Usability: The Web Site Project

ERIC Educational Resources Information Center

Planken, Brigitte; Kreps, Arnold J.

2006-01-01

As advances in information communication technology have continued to affect business communication, the challenge for teachers over the past decade has been to stay abreast of new developments by integrating into the curriculum current theoretical and practice-based perspectives that can inform their students how to effectively create, manage,…

Delivering team training to medical home staff to impact perceptions of collaboration.

PubMed

Treadwell, Janet; Binder, Brenda; Symes, Lene; Krepper, Rebecca

2015-01-01

The purpose of this study was to explore whether an evidence-based educational and experiential intervention to develop team skills in medical homes would positively affect team members' perceptions of interprofessional collaboration. The study population consisted of primary care medical home practices associated with the health plan sponsor of this research. All practices were located within the greater Houston region of Texas and had more than 500 patients. A cluster design experimental study was conducted between August 2013 and June 2014. Fifty medical home practices, 25 intervention and 25 attention control, were recruited as study sites. Results indicate that individual team members in the medical homes receiving the intervention were significantly more likely than the individual team members in the attention control groups to report higher levels of positive perception of team collaboration after the 12-week intervention. This research indicates that educating teams about interprofessional collaboration tools and supporting technique use may be an effective strategy to assist medical homes in developing collaborative environments. Case management experience in collaboration supports the role facilitating team training. Transforming culture from hierarchical to team-based care supports the case management approach of collaborative practice. In addition, role satisfaction attained through the respect and communication of team-based care delivery may influence retention within the case management profession. As case managers in primary care settings assume roles of embedded care coordinators, program leaders, and transition facilitators, an understanding of collaboration techniques is needed to support the entire care team to achieve desired outcomes.

Weed management practices affect the diversity and relative abundance of physic nut mites.

PubMed

Saraiva, Althiéris de Sousa; Sarmento, Renato A; Erasmo, Eduardo A L; Pedro-Neto, Marçal; de Souza, Danival José; Teodoro, Adenir V; Silva, Daniella G

2015-03-01

Crop management practices determine weed community, which in turn may influence patterns of diversity and abundance of associated arthropods. This study aimed to evaluate whether local weed management practices influence the diversity and relative abundance of phytophagous and predatory mites, as well as mites with undefined feeding habits--of the families Oribatidae and Acaridae--in a physic nut (Jatropha curcas L.) plantation subjected to (1) within-row herbicide spraying and between-row mowing; (2) within-row herbicide spraying and no between-row mowing; (3) within-row weeding and between-row mowing; (4) within-row weeding and no between-row mowing; and (5) unmanaged (control). The herbicide used was glyphosate. Herbicide treatments resulted in higher diversity and relative abundance of predatory mites and mites with undefined feeding habit on physic nut shrubs. This was probably due to the toxic effects of the herbicide on mites or to removal of weeds. Within-row herbicide spraying combined with between-row mowing was the treatment that most contributed to this effect. Our results show that within-row weeds harbor important species of predatory mites and mites with undefined feeding habit. However, the dynamics of such mites in the system can be changed according to the weed management practice applied. Among the predatory mites of the family Phytoseiidae Amblydromalus sp. was the most abundant, whereas Brevipalpus phoenicis was the most frequent phytophagous mite and an unidentified oribatid species was the most frequent mite with undefined feeding habit.

Survey of primary care providers' knowledge of screening for, diagnosing and managing prediabetes.

PubMed

Tseng, Eva; Greer, Raquel C; O'Rourke, Paul; Yeh, Hsin-Chieh; McGuire, Maura M; Clark, Jeanne M; Maruthur, Nisa M

2017-11-01

Prediabetes affects 86 million US adults, but primary care providers' (PCPs') knowledge, practices, attitudes and beliefs toward prediabetes are unclear. Assess PCPs' (1) knowledge of risk factors that should prompt prediabetes screening, laboratory criteria for diagnosing prediabetes and guidelines for management of prediabetes; (2) management practices around prediabetes; (3) attitudes and beliefs about prediabetes. Self-administered written survey of PCPs. One hundred forty of 155 PCPs (90%) attending an annual provider retreat for academically affiliated multispecialty practices in the mid-Atlantic region. Descriptive analyses of survey questions on knowledge, management, and attitudes and beliefs related to prediabetes. Multivariate logistic regression was used to determine the association between provider characteristics (gender, race/ethnicity, years since training, specialty and provider type) and knowledge, management, and attitudes and beliefs about prediabetes. Six percent of PCPs correctly identified all of the risk factors that should prompt prediabetes screening. Only 17% of PCPs correctly identified the laboratory parameters for diagnosing prediabetes based on both fasting glucose and hemoglobin A1c. Nearly 90% of PCPs reported close follow-up (within 6 months) of patients with prediabetes. Few PCPs (11%) selected referral to a behavioral weight loss program as the recommended initial management approach to prediabetes. PCPs agreed that patient-related factors are important barriers to lifestyle change and metformin use. Provider characteristics were generally not associated with knowledge, management, attitudes and beliefs about prediabetes in multivariate analyses. Addressing gaps in knowledge and the underutilization of behavioral weight loss programs in prediabetes are two essential areas where PCPs could take a lead in curbing the diabetes epidemic.

French national consensus clinical guidelines for the management of ulcerative colitis.

PubMed

Peyrin-Biroulet, Laurent; Bouhnik, Yoram; Roblin, Xavier; Bonnaud, Guillaume; Hagège, Hervé; Hébuterne, Xavier

2016-07-01

Ulcerative colitis (UC) is a chronic inflammatory bowel disease of multifactorial etiology that primarily affects the colonic mucosa. The disease progresses over time, and clinical management guidelines should reflect its dynamic nature. There is limited evidence supporting UC management in specific clinical situations, thus precluding an evidence-based approach. To use a formal consensus method - the nominal group technique (NGT) - to develop a clinical practice expert opinion to outline simple algorithms and practices, optimize UC management, and assist clinicians in making treatment decisions. The consensus was developed by an expert panel of 37 gastroenterologists from various professional organizations with experience in UC management using the qualitative and iterative NGT, incorporating deliberations based on the European Crohn's and Colitis Organisation recommendations, recent reviews of scientific literature, and pertinent discussion topics developed by a steering committee. Examples of clinical cases for which there are limited evidence-based data from clinical trials were used. Two working groups proposed and voted on treatment algorithms that were then discussed and voted for by the nominal group as a whole, in order to reach a consensus. A clinical practice guideline covering management of the following clinical situations was developed: (i) moderate and severe UC; (ii) acute severe UC; (iii) pouchitis; (iv) refractory proctitis, in the form of treatment algorithms. Given the limited available evidence-based data, a formal consensus methodology was used to develop simple treatment guidelines for UC management in different clinical situations that is now accessible via an online application. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Handling the Dilemma of Self-Determination and Dementia: A Study of Case Managers' Discursive Strategies in Assessment Meetings.

PubMed

Österholm, Johannes H; Taghizadeh Larsson, Annika; Olaison, Anna

2015-01-01

In assessment meetings concerning care services for people with dementia, Swedish case managers face a dilemma. On the one hand, according to the law, the right to self-determination of every adult citizen must be respected, but on the other hand cognitive disabilities make it difficult to fulfill obligations of being a full-fledged citizen. In this article, we examine 15 assessment meetings to identify discursive strategies used by case managers to handle this dilemma. We also examine how these affect the participation of persons with dementia, and indicate implications of our study for social work practice and research.

Management of Cleft Lip and Palate: A Team Approach

PubMed Central

Tervo, R. C.; Chudley, A. E.

1981-01-01

Cleft lip and/or palate is a common congenital malformation. The initial management of the affected infant and family begins in the delivery suite in the hands of the family physician. With patient, informed psychosocial counselling, the family should be told the origin of the malformation, practical tips on managing their child, especially feeding and attending to middle ear infections, and the work of the cleft lip and palate team. The family physician is a vital member of this team, as he is able to advocate for the best interests of the child and family. ImagesFig. 1Fig. 2Fig. 3 PMID:20469362

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).

Promoting normal development and self-efficacy in school-age children managing chronic conditions.

PubMed

Mickley, Kristyn L; Burkhart, Patricia V; Sigler, April N

2013-06-01

Chronic conditions can affect school-age children in more ways than just physically. Normal childhood maturation is critical at this age, yet daily management of chronic symptoms can be challenging. This article describes 4 common childhood chronic illnesses (asthma, seizure disorders, diabetes, and cystic fibrosis), and the impact these conditions have on the developing child. Self-efficacy, the belief that one can effectively perform necessary skills, is essential to self-management of chronic conditions and contributes in a positive way to the child's normal development. Implications for clinical practice and future research are discussed. Copyright © 2013 Elsevier Inc. All rights reserved.

Medication Management: The Macrocognitive Workflow of Older Adults With Heart Failure.

PubMed

Mickelson, Robin S; Unertl, Kim M; Holden, Richard J

2016-10-12

Older adults with chronic disease struggle to manage complex medication regimens. Health information technology has the potential to improve medication management, but only if it is based on a thorough understanding of the complexity of medication management workflow as it occurs in natural settings. Prior research reveals that patient work related to medication management is complex, cognitive, and collaborative. Macrocognitive processes are theorized as how people individually and collaboratively think in complex, adaptive, and messy nonlaboratory settings supported by artifacts. The objective of this research was to describe and analyze the work of medication management by older adults with heart failure, using a macrocognitive workflow framework. We interviewed and observed 61 older patients along with 30 informal caregivers about self-care practices including medication management. Descriptive qualitative content analysis methods were used to develop categories, subcategories, and themes about macrocognitive processes used in medication management workflow. We identified 5 high-level macrocognitive processes affecting medication management-sensemaking, planning, coordination, monitoring, and decision making-and 15 subprocesses. Data revealed workflow as occurring in a highly collaborative, fragile system of interacting people, artifacts, time, and space. Process breakdowns were common and patients had little support for macrocognitive workflow from current tools. Macrocognitive processes affected medication management performance. Describing and analyzing this performance produced recommendations for technology supporting collaboration and sensemaking, decision making and problem detection, and planning and implementation.

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

PubMed

Boissoneau, R; McPherson, J

1991-01-01

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

Help yourself: the mechanisms through which a self-leadership intervention influences strain.

PubMed

Unsworth, Kerrie L; Mason, Claire M

2012-04-01

This research reports on two field studies which demonstrate that self-leadership training decreases strain via increases in self-efficacy and positive affect. The first, an experimental study, found that strain was reduced in the randomly assigned training group, but not in the control group. The second was a longitudinal study and supported the hypotheses that self-efficacy and positive affect mediated the effect of self-leadership training on strain. Our findings extend both self-leadership and stress management literatures by providing a theoretical framework within which the effects of self-leadership on strain can be understood. Practically speaking, our findings suggest that self-leadership training offers an individual-level preventive approach to stress management. PsycINFO Database Record (c) 2012 APA, all rights reserved.

The role of production and teamwork practices in construction safety: a cognitive model and an empirical case study.

PubMed

Mitropoulos, Panagiotis Takis; Cupido, Gerardo

2009-01-01

In construction, the challenge for researchers and practitioners is to develop work systems (production processes and teams) that can achieve high productivity and high safety at the same time. However, construction accident causation models ignore the role of work practices and teamwork. This study investigates the mechanisms by which production and teamwork practices affect the likelihood of accidents. The paper synthesizes a new model for construction safety based on the cognitive perspective (Fuller's Task-Demand-Capability Interface model, 2005) and then presents an exploratory case study. The case study investigates and compares the work practices of two residential framing crews: a 'High Reliability Crew' (HRC)--that is, a crew with exceptional productivity and safety over several years, and an average performing crew from the same company. The model explains how the production and teamwork practices generate the work situations that workers face (the task demands) and affect the workers ability to cope (capabilities). The case study indicates that the work practices of the HRC directly influence the task demands and match them with the applied capabilities. These practices were guided by the 'principle' of avoiding errors and rework and included work planning and preparation, work distribution, managing the production pressures, and quality and behavior monitoring. The Task Demand-Capability model links construction research to a cognitive model of accident causation and provides a new way to conceptualize safety as an emergent property of the production practices and teamwork processes. The empirical evidence indicates that the crews' work practices and team processes strongly affect the task demands, the applied capabilities, and the match between demands and capabilities. The proposed model and the exploratory case study will guide further discovery of work practices and teamwork processes that can increase both productivity and safety in construction operations. Such understanding will enable training of construction foremen and crews in these practices to systematically develop high reliability crews.

Italian Association of Clinical Endocrinologists (AME) & Italian Association of Clinical Diabetologists (AMD) Position Statement : Diabetes mellitus and thyroid disorders: recommendations for clinical practice.

PubMed

Guastamacchia, Edoardo; Triggiani, Vincenzo; Aglialoro, Alberto; Aiello, Antimo; Ianni, Lucia; Maccario, Mauro; Zini, Michele; Giorda, Carlo; Guglielmi, Rinaldo; Betterle, Corrado; Attanasio, Roberto; Borretta, Giorgio; Garofalo, Piernicola; Papini, Enrico; Castello, Roberto; Ceriello, Antonio

2015-06-01

Thyroid disease and diabetes mellitus, the most common disorders in endocrine practice, are not infrequently associated in the same subject. An altered thyroid function may affect glucose tolerance and worsen metabolic control in patients with diabetes. Thyrotoxicosis increases the risk of hyperglycemic emergencies, while a clinically relevant hypothyroidism may have a detrimental effect on glycemic control in diabetic patients. The association of alterations in thyroid function with diabetes mellitus may adversely affect the risk of cardiovascular and microvascular complications resulting from diabetes. Moreover, the treatments used for both diabetes and thyroid disease, respectively, can impact one other. Finally, multinodular goiter, but not thyroid carcinoma, was shown to be more prevalent in type 2 diabetes mellitus. Aim of the present Position Statement is to focus on the evidence concerning the association of thyroid disease and diabetes mellitus and to provide some practical suggestions for an updated clinical management.

Why different countries manage death differently: a comparative analysis of modern urban societies.

PubMed

Walter, Tony

2012-03-01

The sociology of death, dying and bereavement tends to take as its implicit frame either the nation state or a homogenous modernity. Between-nation differences in the management of death and dying are either ignored or untheorized. This article seeks to identify the factors that can explain both similarities and differences in the management of death between different modern western nations. Structural factors which affect all modern nations include urbanization and the division of labour leading to the dominance of professionals, migration, rationality and bureaucracy, information technology and the risk society. How these sociologically familiar structural features are responded to, however, depends on national histories, institutions and cultures. Historically, key transitional periods to modernity, different in different nations, necessitated particular institutional responses in the management of dying and dead bodies. Culturally, key factors include individualism versus collectivism, religion, secularization, boundary regulation, and expressivism. Global flows of death practices depend significantly on subjugated nations' perceptions of colonialism, neo-colonialism and modernity, which can lead to a dominant power's death practices being either imitated or rejected. © London School of Economics and Political Science 2012.

Crop monoculture rather than agriculture reduces the spatial turnover of soil bacterial communities at a regional scale.

PubMed

Figuerola, Eva L M; Guerrero, Leandro D; Türkowsky, Dominique; Wall, Luis G; Erijman, Leonardo

2015-03-01

The goal of this study was to investigate the spatial turnover of soil bacterial communities in response to environmental changes introduced by the practices of soybean monoculture or crop rotations, relative to grassland soils. Amplicon sequencing of the 16S rRNA gene was used to analyse bacterial diversity in producer fields through three successive cropping cycles within one and a half years, across a regional scale of the Argentinean Pampas. Unlike local diversity, which was not significantly affected by land use type, agricultural management had a strong influence on β-diversity patterns. Distributions of pairwise distances between all soils samples under soybean monoculture had significantly lower β-diversity and narrower breadth compared with distributions of pairwise distances between soils managed with crop rotation. Interestingly, good agricultural practices had similar degree of β-diversity as natural grasslands. The higher phylogenetic relatedness of bacterial communities in soils under monoculture across the region was likely determined by the observed loss of endemic species, and affected mostly to phyla with low regional diversity, such as Acidobacteria, Verrucomicrobia and the candidates phyla SPAM and WS3. These results suggest that the implementation of good agricultural practices, including crop rotation, may be critical for the long-term conservation of soil biodiversity. © 2014 Society for Applied Microbiology and John Wiley & Sons Ltd.

Goal setting practice in chronic low back pain. What is current practice and is it affected by beliefs and attitudes?

PubMed

Gardner, Tania; Refshauge, Kathryn; McAuley, James; Hübscher, Markus; Goodall, Stephen; Smith, Lorraine

2018-01-18

Goal setting, led by the patient, is promising as an effective treatment for the management of chronic low back pain (CLBP); however, little is known about current practice. The aims of the study were to explore (1) current goal setting practice in CLBP among physiotherapists; (2) perceived barriers to goal setting in CLBP; and (3) relationship between clinician's attitudes and beliefs and goal setting practice. A cross-sectional observational survey. The majority of respondents used goal setting with the main aim of facilitating self-management. The greatest number of goals were set with 50% therapist/50% patient involvement. The most common perceived barriers to goal setting related to time constraints and lack of skill and confidence. A higher biomedical score for treatment orientation of the therapist was associated with a lower patient involvement score. Goal setting is common practice for CLBP and is perceived as a high priority. It is more often a collaboration between therapist and patient rather than patient-led with treatment orientation of the physiotherapist a predictor of patient involvement. Education of healthcare professionals needs to include better understanding of chronic pain to orient them away from a biomedical treatment approach, as well as to enhance skills in facilitating patient involvement in goal setting.

Global Breast Cancer: The Lessons to Bring Home

PubMed Central

Formenti, Silvia C.; Arslan, Alan A.; Love, Susan M.

2012-01-01

Breast cancer is the most common cancer affecting women globally. This paper discusses the current progress in breast cancer in Western countries and focuses on important differences of this disease in low- and middle-income countries (LMCs). It introduces several arguments for applying caution before globalizing some of the US-adopted practices in the screening and management of the disease. Finally, it suggests that studies of breast cancer in LMCs might offer important insights for a more effective management of the problem both in developing as well as developed countries. PMID:22295243

Swiss clinical practice guidelines on field cancerization of the skin.

PubMed

Hofbauer, Günther; Anliker, Mark; Boehncke, Wolf-Henning; Brand, Christoph; Braun, Ralph; Gaide, Olivier; Hafner, Jürg; Hunger, Robert; Itin, Peter; Kaeuper, Gina; Lautenschlager, Stephan; Mainetti, Carlo; Streit, Markus

2014-01-01

Actinic keratosis (AK) affects millions of people worldwide, and its prevalence continues to increase. AK lesions are caused by chronic ultraviolet radiation exposure, and the presence of two or more AK lesions along with photodamage should raise the consideration of a diagnosis of field cancerization. Effective treatment of individual lesions as well as field cancerization is essential for good long-term outcomes. The Swiss Registry of Actinic Keratosis Treatment (REAKT) Working Group has developed clinical practice guidelines for the treatment of field cancerization in patients who present with AK. These guidelines are intended to serve as a resource for physicians as to the most appropriate treatment and management of AK and field cancerization based on current evidence and the combined practical experience of the authors. Treatment of AK and field cancerization should be driven by consideration of relevant patient, disease, and treatment factors, and appropriate treatment decisions will differ from patient to patient. Prevention measures and screening recommendations are discussed, and special considerations related to management of immunocompromised patients are provided.

Best practices: a review of company activity on HIV / AIDS in South Africa.

PubMed

Michael, K

1999-01-01

This article presents the 1998 survey results conducted by the Health Economics and HIV/AIDS Research Division of the University of Natal in South Africa with the goal of documenting the best practices of managing HIV/AIDS in the workplace. The five key areas of the study are: HIV prevention; managing ill health; human resource development and industrial relations; employee benefits and survivor support; monitoring and planning for change in the workplace. The research comprised 14 companies used during the case studies. A few notable cases were observed among companies attempting to create awareness about HIV/AIDS. The Best Practice Survey highlighted issues about the private sectors in South Africa and their HIV management. First, companies conceptualize AIDS as either a health or poverty problem. Second, the environment is affected by the hazards of economic downturns, labor action, and economic inflation while the AIDS problem is neglected. Third, indirect costs were not considered and most companies feel that the conversion to a defined contribution arrangement compensates against escalating payouts for benefits. Fourth, long-term plans of the companies did not utilize the ill health statistics for the past 5 years.

Water management practices affect arsenic and cadmium accumulation in rice grains.

PubMed

Sun, Liming; Zheng, Manman; Liu, Hongyan; Peng, Shaobing; Huang, Jianliang; Cui, Kehui; Nie, Lixiao

2014-01-01

Cadmium (Cd) and arsenic (As) accumulation in rice grains is a great threat to its productivity, grain quality, and thus human health. Pot and field studies were carried out to unravel the effect of different water management practices (aerobic, aerobic-flooded, and flooded) on Cd and As accumulation in rice grains of two different varieties. In pot experiment, Cd or As was also added into the soil as treatment. Pots without Cd or As addition were maintained as control. Results indicated that water management practices significantly influenced the Cd and As concentration in rice grains and aerobic cultivation of rice furnished less As concentration in its grains. Nonetheless, Cd concentration in this treatment was higher than the grains of flooded rice. Likewise, in field study, aerobic and flooded rice cultivation recorded higher Cd and As concentration, respectively. However, growing of rice in aerobic-flooded conditions decreased the Cd concentration by 9.38 times on average basis as compared to aerobic rice. Furthermore, this treatment showed 28% less As concentration than that recorded in flooded rice cultivation. The results suggested that aerobic-flooded cultivation may be a promising strategy to reduce the Cd and As accumulations in rice grains simultaneously.

An exploration of the effects of clinical negligence litigation on the practice of midwives in England: A phenomenological study.

PubMed

Robertson, Judith H; Thomson, Ann M

2016-02-01

to explore how midwives׳ personal involvement in clinical negligence litigation affects their midwifery practice. descriptive phenomenological study using semi-structured interviews. in 2006-2007 in-depth interviews were conducted in participants׳ homes or at their place of work and focused on participants׳ experience of litigation. Participants were recruited from various regions of England. 22 National Health Service (NHS) midwives who had been alleged negligent. clinical practice affected was an increase in documentation, fear of practising outside clinical guidelines and electronic fetal monitoring of women at low obstetric risk; these changes were not widespread. Changes in practice were sometimes perceived negatively and sometimes positively. Forming a good relationship with childbearing women was judged to promote effective midwifery care but litigation had affected the ability of a minority of midwives to advocate for women if this relationship had not been established. Litigation could result in loss of confidence leading to self-doubt, isolation, increased readiness to seek medical assistance and avoidance of working in the labour ward, perceived as an area with a high risk of litigation. A blame culture in the NHS was perceived by several midwives. In contrast an open non-punitive culture resulted in midwives readily reporting mistakes to risk managers. Litigation lowered midwifery morale and damaged professional reputations, particularly when reported in the newspapers. Some midwives expressed thoughts of leaving midwifery or taking time off work because of litigation but only one was actively seeking other employment, another took sick leave and one had left midwifery and returned to nursing. litigation can have a negative effect on midwives׳ clinical practice and morale and fosters a culture of blame within the NHS. education regarding appropriate documentation, use or non-use of electronic fetal monitoring and the legal status of clinical guidelines will enable midwives to respond proportionately to the threat of litigation. A culture of openness and sharing the problem when adverse events occur would help to extinguish the current blame culture in the National Health Service. Litigation must be recognised by management as capable of inducing loss of confidence and reluctance to work in the labour ward. Promoting teamwork will help support these midwives. The potential for litigation in maternity care could affect retention of the midwifery workforce. Copyright © 2015 Elsevier Ltd. All rights reserved.

Project Stakeholder Management in the Clinical Research Environment: How to Do it Right

PubMed Central

Pandi-Perumal, Seithikurippu R.; Akhter, Sohel; Zizi, Ferdinard; Jean-Louis, Girardin; Ramasubramanian, Chellamuthu; Edward Freeman, R.; Narasimhan, Meera

2015-01-01

This review introduces a conceptual framework for understanding stakeholder management (ShM) in the clinical and community-based research environment. In recent years, an evolution in practice has occurred in many applicants for public and non-governmental funding of public health research in hospital settings. Community health research projects are inherently complex, have sought to involve patients and other stakeholders in the center of the research process. Substantial evidence has now been provided that stakeholder involvement is essential for management effectiveness in clinical research. Feedback from stakeholders has critical value for research managers inasmuch as it alerts them to the social, environmental, and ethical implications of research activities. Additionally, those who are directly affected by program development and clinical research, the patients, their families, and others, almost universally have a strong motivation to be involved in the planning and execution of new program changes. The current overview introduces a conceptual framework for ShM in the clinical research environment and offers practical suggestions for fostering meaningful stakeholder engagement. The fifth edition of PMBOK® of the Project Management Institute, has served as basis for many of the suggested guidelines that are put forward in this article. PMID:26042053

Integrated water resources management using engineering measures

NASA Astrophysics Data System (ADS)

Huang, Y.

2015-04-01

The management process of Integrated Water Resources Management (IWRM) consists of aspects of policies/strategies, measures (engineering measures and non-engineering measures) and organizational management structures, etc., among which engineering measures such as reservoirs, dikes, canals, etc., play the backbone that enables IWRM through redistribution and reallocation of water in time and space. Engineering measures are usually adopted for different objectives of water utilization and water disaster prevention, such as flood control and drought relief. The paper discusses the planning and implementation of engineering measures in IWRM of the Changjiang River, China. Planning and implementation practices of engineering measures for flood control and water utilization, etc., are presented. Operation practices of the Three Gorges Reservoir, particularly the development and application of regulation rules for flood management, power generation, water supply, ecosystem needs and sediment issues (e.g. erosion and siltation), are also presented. The experience obtained in the implementation of engineering measures in Changjiang River show that engineering measures are vital for IWRM. However, efforts should be made to deal with changes of the river system affected by the operation of engineering measures, in addition to escalatory development of new demands associated with socio-economic development.

Project Stakeholder Management in the Clinical Research Environment: How to Do it Right.

PubMed

Pandi-Perumal, Seithikurippu R; Akhter, Sohel; Zizi, Ferdinard; Jean-Louis, Girardin; Ramasubramanian, Chellamuthu; Edward Freeman, R; Narasimhan, Meera

2015-01-01

This review introduces a conceptual framework for understanding stakeholder management (ShM) in the clinical and community-based research environment. In recent years, an evolution in practice has occurred in many applicants for public and non-governmental funding of public health research in hospital settings. Community health research projects are inherently complex, have sought to involve patients and other stakeholders in the center of the research process. Substantial evidence has now been provided that stakeholder involvement is essential for management effectiveness in clinical research. Feedback from stakeholders has critical value for research managers inasmuch as it alerts them to the social, environmental, and ethical implications of research activities. Additionally, those who are directly affected by program development and clinical research, the patients, their families, and others, almost universally have a strong motivation to be involved in the planning and execution of new program changes. The current overview introduces a conceptual framework for ShM in the clinical research environment and offers practical suggestions for fostering meaningful stakeholder engagement. The fifth edition of PMBOK(®) of the Project Management Institute, has served as basis for many of the suggested guidelines that are put forward in this article.

Does increasing rotation length lead to greater forest carbon storage?

NASA Astrophysics Data System (ADS)

Ter-Mikaelian, M. T.; Colombo, S. J.; Chen, J.

2016-12-01

Forest management is a key factor affecting climate change mitigation by forests. Increasing the age of harvesting (also referred to as rotation length) is a management practice that has been proposed as a means of increasing forest carbon sequestration and storage. However, studies of the effects of increasing harvest age on forest carbon stocks have mostly been limited to forest plantations. In contrast, this study assesses the effects of increased harvest age of managed natural forests of Ontario (Canada) at two scales. At the stand level, we assess merchantable volume yield curves to differentiate those for which increasing the age of harvest results in an increase in total forest carbon stocks versus those for which increased harvest age reduces carbon stocks. The stand level results are then applied to forest landscapes to demonstrate that the effect of increasing the age of harvest on forest carbon storage is specific to the forest growth rates for a given forest landscape and depends on the average age at which forests are harvested under current (business-as-usual) management practice. We discuss the implications of these results for forest management aimed at mitigating climate change.

Survey of management practices related to bovine respiratory disease in preweaned calves on California dairies.

PubMed

Love, W J; Lehenbauer, T W; Karle, B M; Hulbert, Lindsey E; Anderson, Randall J; Van Eenennaam, A L; Farver, T B; Aly, S S

2016-02-01

In the spring of 2013, a survey of California (CA) dairies was performed to characterize management practices related to bovine respiratory disease in preweaned calves, compare these practices across geographic regions of the state, and determine the principal components that explain the variability in management between herds. The questionnaire consisted of 53 questions divided into 6 sections to assess management practices affecting dairy calves from precalving to weaning. The questionnaire was mailed to 1,523 grade A licensed dairies in CA and 224 responses (14.7%) were collected. Survey response rates were similar over the 3 defined regions of CA: northern CA, northern San Joaquin Valley, and the greater southern CA region. The mean size of respondent herds was 1,423 milking cows. Most dairies reported raising preweaned calves on-site (59.7%). In 93.3% of dairies, preweaned calves were raised in some form of individual housing. Nonsaleable milk was the most frequent liquid diet fed to preweaned heifers (75.2%). Several important differences were identified between calf-raising practices in CA and practices reported in recent nationwide studies, including herd sizes, housing practices, and sources of milk fed to heifers. The differences between the CA and nationwide studies may be explained by differences in herd size. Regional differences within CA were also identified. Compared with the 2 other regions, northern CA dairies were found to have smaller herds, less Holstein cattle, calves remained with dams for longer periods of time after calving, were more likely to be certified organic dairies, and raised their own calves more often. Principal component analysis was performed and identified 11 components composed of 28 variables (questions) that explained 66.5% of the variability in the data. The identified components and questions will contribute to developing a risk assessment tool for bovine respiratory disease in preweaned dairy calves. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Medication Management: The Macrocognitive Workflow of Older Adults With Heart Failure

PubMed Central

2016-01-01

Background Older adults with chronic disease struggle to manage complex medication regimens. Health information technology has the potential to improve medication management, but only if it is based on a thorough understanding of the complexity of medication management workflow as it occurs in natural settings. Prior research reveals that patient work related to medication management is complex, cognitive, and collaborative. Macrocognitive processes are theorized as how people individually and collaboratively think in complex, adaptive, and messy nonlaboratory settings supported by artifacts. Objective The objective of this research was to describe and analyze the work of medication management by older adults with heart failure, using a macrocognitive workflow framework. Methods We interviewed and observed 61 older patients along with 30 informal caregivers about self-care practices including medication management. Descriptive qualitative content analysis methods were used to develop categories, subcategories, and themes about macrocognitive processes used in medication management workflow. Results We identified 5 high-level macrocognitive processes affecting medication management—sensemaking, planning, coordination, monitoring, and decision making—and 15 subprocesses. Data revealed workflow as occurring in a highly collaborative, fragile system of interacting people, artifacts, time, and space. Process breakdowns were common and patients had little support for macrocognitive workflow from current tools. Conclusions Macrocognitive processes affected medication management performance. Describing and analyzing this performance produced recommendations for technology supporting collaboration and sensemaking, decision making and problem detection, and planning and implementation. PMID:27733331

Implications of global climate change for the assessment and management of human health risks of chemicals in the natural environment.

PubMed

Balbus, John M; Boxall, Alistair B A; Fenske, Richard A; McKone, Thomas E; Zeise, Lauren

2013-01-01

Global climate change (GCC) is likely to alter the degree of human exposure to pollutants and the response of human populations to these exposures, meaning that risks of pollutants could change in the future. The present study, therefore, explores how GCC might affect the different steps in the pathway from a chemical source in the environment through to impacts on human health and evaluates the implications for existing risk-assessment and management practices. In certain parts of the world, GCC is predicted to increase the level of exposure of many environmental pollutants due to direct and indirect effects on the use patterns and transport and fate of chemicals. Changes in human behavior will also affect how humans come into contact with contaminated air, water, and food. Dietary changes, psychosocial stress, and coexposure to stressors such as high temperatures are likely to increase the vulnerability of humans to chemicals. These changes are likely to have significant implications for current practices for chemical assessment. Assumptions used in current exposure-assessment models may no longer apply, and existing monitoring methods may not be robust enough to detect adverse episodic changes in exposures. Organizations responsible for the assessment and management of health risks of chemicals therefore need to be more proactive and consider the implications of GCC for their procedures and processes. Copyright © 2012 SETAC.

Best Practices for Use of Blended Learning

PubMed Central

Porter, Andrea L.; Pitterle, Michael E.

2017-01-01

Objective. To determine instructional best practice recommendations for use of blended learning from the students’ perspective. Methods. Three focus groups were created, one for each of the first three years at a school of pharmacy. The focus group discussions were audio recorded and transcribed for content analysis. Results. Ten instructional best practices were identified from the focus groups: setting the stage, consistency when team teaching, timeliness in posting materials, time on task, accountability for online activities, use of structured active learning, instructor use of feedback on student preparation, incorporation of student feedback into the course, short reviews of online material during class, and ensuring technologies are user friendly. Conclusion. Instructors using blended learning should consider incorporating these best practices into their course design and management. More evaluation is needed to see if implementation of these practices affects student performance. PMID:28496269

Best Practices for Use of Blended Learning.

PubMed

Margolis, Amanda R; Porter, Andrea L; Pitterle, Michael E

2017-04-01

Objective. To determine instructional best practice recommendations for use of blended learning from the students' perspective. Methods. Three focus groups were created, one for each of the first three years at a school of pharmacy. The focus group discussions were audio recorded and transcribed for content analysis. Results. Ten instructional best practices were identified from the focus groups: setting the stage, consistency when team teaching, timeliness in posting materials, time on task, accountability for online activities, use of structured active learning, instructor use of feedback on student preparation, incorporation of student feedback into the course, short reviews of online material during class, and ensuring technologies are user friendly. Conclusion. Instructors using blended learning should consider incorporating these best practices into their course design and management. More evaluation is needed to see if implementation of these practices affects student performance.

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.

Isolated Ficus trees deliver dual conservation and development benefits in a rural landscape.

PubMed

Cottee-Jones, H Eden W; Bajpai, Omesh; Chaudhary, Lal B; Whittaker, Robert J

2015-11-01

Many of the world's rural populations are dependent on the local provision of economically and medicinally important plant resources. However, increasing land-use intensity is depleting these resources, reducing human welfare, and thereby constraining development. Here we investigate a low cost strategy to manage the availability of valuable plant resources, facilitated by the use of isolated Ficus trees as restoration nuclei. We surveyed the plants growing under 207 isolated trees in Assam, India, and categorized them according to their local human-uses. We found that Ficus trees were associated with double the density of important high-grade timber, firewood, human food, livestock fodder, and medicinal plants compared to non-Ficus trees. Management practices were also important in determining the density of valuable plants, with grazing pressure and land-use intensity significantly affecting densities in most categories. Community management practices that conserve isolated Ficus trees, and restrict livestock grazing and high-intensity land-use in their vicinity, can promote plant growth and the provision of important local resources.

The Relationship Among Heart Failure Disease Management, Quality of Care, and Hospitalizations.

PubMed

Chung, Eugene S; Bartone, Cheryl; Daly, Kathleen; Menon, Santosh; McDonald, Mark

2015-01-01

Heart failure (HF) affects 5.1 million adult patients, accounting for over 1 million hospitalizations, 1.8 million office visits, and nearly 680,000 emergency department visits annually. HF hospitalizations have been incorporated into a national measure of hospital and provider quality, with associated financial penalties based on the 30-day readmission rate after an index hospitalization for HF. However, it is not clear whether the number of HF-related hospitalizations or 30-day readmissions is consistently related to quality of care. The relationships between various measures of HF care quality and hospitalization rates were evaluated by performing a cohort study of an HF disease management program in a clinical practice setting. Following the statistical analyses assessing outcomes and survival, the conclusion was that an HF disease management program in clinical practice associated with improved utilization of evidence-based medical and device therapies tends to improve ejection fraction and survival, and reduce sex and race disparities, but not with an associated reduction in hospitalizations or total hospital days.

Health Informatics via Machine Learning for the Clinical Management of Patients.

PubMed

Clifton, D A; Niehaus, K E; Charlton, P; Colopy, G W

2015-08-13

To review how health informatics systems based on machine learning methods have impacted the clinical management of patients, by affecting clinical practice. We reviewed literature from 2010-2015 from databases such as Pubmed, IEEE xplore, and INSPEC, in which methods based on machine learning are likely to be reported. We bring together a broad body of literature, aiming to identify those leading examples of health informatics that have advanced the methodology of machine learning. While individual methods may have further examples that might be added, we have chosen some of the most representative, informative exemplars in each case. Our survey highlights that, while much research is taking place in this high-profile field, examples of those that affect the clinical management of patients are seldom found. We show that substantial progress is being made in terms of methodology, often by data scientists working in close collaboration with clinical groups. Health informatics systems based on machine learning are in their infancy and the translation of such systems into clinical management has yet to be performed at scale.

Managing the effects of multiple stressors on aquatic ecosystems under water scarcity. The GLOBAQUA project.

PubMed

Navarro-Ortega, Alícia; Acuña, Vicenç; Bellin, Alberto; Burek, Peter; Cassiani, Giorgio; Choukr-Allah, Redouane; Dolédec, Sylvain; Elosegi, Arturo; Ferrari, Federico; Ginebreda, Antoni; Grathwohl, Peter; Jones, Colin; Rault, Philippe Ker; Kok, Kasper; Koundouri, Phoebe; Ludwig, Ralf Peter; Merz, Ralf; Milacic, Radmila; Muñoz, Isabel; Nikulin, Grigory; Paniconi, Claudio; Paunović, Momir; Petrovic, Mira; Sabater, Laia; Sabaterb, Sergi; Skoulikidis, Nikolaos Th; Slob, Adriaan; Teutsch, Georg; Voulvoulis, Nikolaos; Barceló, Damià

2015-01-15

Water scarcity is a serious environmental problem in many European regions, and will likely increase in the near future as a consequence of increased abstraction and climate change. Water scarcity exacerbates the effects of multiple stressors, and thus results in decreased water quality. It impacts river ecosystems, threatens the services they provide, and it will force managers and policy-makers to change their current practices. The EU-FP7 project GLOBAQUA aims at identifying the prevalence, interaction and linkages between stressors, and to assess their effects on the chemical and ecological status of freshwater ecosystems in order to improve water management practice and policies. GLOBAQUA assembles a multidisciplinary team of 21 European plus 2 non-European scientific institutions, as well as water authorities and river basin managers. The project includes experts in hydrology, chemistry, biology, geomorphology, modelling, socio-economics, governance science, knowledge brokerage, and policy advocacy. GLOBAQUA studies six river basins (Ebro, Adige, Sava, Evrotas, Anglian and Souss Massa) affected by water scarcity, and aims to answer the following questions: how does water scarcity interact with other existing stressors in the study river basins? How will these interactions change according to the different scenarios of future global change? Which will be the foreseeable consequences for river ecosystems? How will these in turn affect the services the ecosystems provide? How should management and policies be adapted to minimise the ecological, economic and societal consequences? These questions will be approached by combining data-mining, field- and laboratory-based research, and modelling. Here, we outline the general structure of the project and the activities to be conducted within the fourteen work-packages of GLOBAQUA. Copyright © 2014. Published by Elsevier B.V.

Managing the effects of multiple stressors on aquatic ecosystems under water scarcity. The GLOBAQUA project

PubMed Central

Navarro-Ortega, Alícia; Acuña, Vicenç; Bellin, Alberto; Burek, Peter; Cassiani, Giorgio; Choukr-Allah, Redouane; Dolédec, Sylvain; Elosegi, Arturo; Ferrari, Federico; Ginebreda, Antoni; Grathwohl, Peter; Jones, Colin; Rault, Philippe Ker; Kok, Kasper; Koundouri, Phoebe; Ludwig, Ralf Peter; Merz, Ralf; Milacic, Radmila; Muñoz, Isabel; Nikulin, Grigory; Paniconi, Claudio; Paunović, Momir; Petrovic, Mira; Sabater, Laia; Sabaterb, Sergi; Skoulikidis, Nikolaos Th.; Slob, Adriaan; Teutsch, Georg; Voulvoulis, Nikolaos; Barceló, Damià

2015-01-01

Water scarcity is a serious environmental problem in many European regions, and will likely increase in the near future as a consequence of increased abstraction and climate change. Water scarcity exacerbates the effects of multiple stressors, and thus results in decreased water quality. It impacts river ecosystems, threatens the services they provide, and it will force managers and policy-makers to change their current practices. The EU-FP7 project GLOBAQUA aims at identifying the prevalence, interaction and linkages between stressors, and to assess their effects on the chemical and ecological status of freshwater ecosystems in order to improve water management practice and policies. GLOBAQUA assembles a multidisciplinary team of 21 European plus 2 non-European scientific institutions, as well as water authorities and river basin managers. The project includes experts in hydrology, chemistry, biology, geomorphology, modelling, socio-economics, governance science, knowledge brokerage, and policy advocacy. GLOBAQUA studies six river basins (Ebro, Adige, Sava, Evrotas, Anglian and Souss Massa) affected by water scarcity, and aims to answer the following questions: how does water scarcity interact with other existing stressors in the study river basins? How will these interactions change according to the different scenarios of future global change? Which will be the foreseeable consequences for river ecosystems? How will these in turn affect the services the ecosystems provide? How should management and policies be adapted to minimise the ecological, economic and societal consequences? These questions will be approached by combining data-mining, field- and laboratory-based research, and modelling. Here, we outline the general structure of the project and the activities to be conducted within the fourteen work-packages of GLOBAQUA. PMID:25005236

Making the links between domestic violence and child safeguarding: an evidence-based pilot training for general practice.

PubMed

Szilassy, Eszter; Drinkwater, Jess; Hester, Marianne; Larkins, Cath; Stanley, Nicky; Turner, William; Feder, Gene

2017-11-01

We describe the development of an evidence-based training intervention on domestic violence and child safeguarding for general practice teams. We aimed - in the context of a pilot study - to improve knowledge, skills, attitudes and self-efficacy of general practice clinicians caring for families affected by domestic violence. Our evidence sources included: a systematic review of training interventions aiming to improve professional responses to children affected by domestic violence; content mapping of relevant current training in England; qualitative assessment of general practice professionals' responses to domestic violence in families; and a two-stage consensus process with a multi-professional stakeholder group. Data were collected between January and December 2013. This paper reports key research findings and their implications for practice and policy; describes how the research findings informed the training development and outlines the principal features of the training intervention. We found lack of cohesion and co-ordination in the approach to domestic violence and child safeguarding. General practice clinicians have insufficient understanding of multi-agency work, a limited competence in gauging thresholds for child protection referral to children's services and little understanding of outcomes for children. While prioritising children's safety, they are more inclined to engage directly with abusive parents than with affected children. Our research reveals uncertainty and confusion surrounding the recording of domestic violence cases in families' medical records. These findings informed the design of the RESPONDS training, which was developed in 2014 to encourage general practice clinicians to overcome barriers and engage more extensively with adults experiencing abuse, as well as responding directly to the needs of children. We conclude that general practice clinicians need more support in managing the complexity of this area of practice. We need to integrate and further evaluate responses to the needs of children exposed to domestic violence into general practice-based domestic violence training. © 2016 The Authors. Health and Social Care in the Community Published by John Wiley & Sons Ltd.

[Privatization in healthcare management: an adverse effect of the economic crisis and a symptom of bad governance. SESPAS report 2014].

PubMed

Sánchez-Martínez, Fernando I; Abellán-Perpiñán, José María; Oliva-Moreno, Juan

2014-06-01

It is often asserted that public management of healthcare facilities is inefficient. On the basis of that unproven claim, it is argued that privatization schemes are needed. In this article we review the available evidence, in Spain and other countries, on the application of private management mechanisms to publicly funded systems similar to the Spanish national health system. The evidence suggests that private management of healthcare services is not necessarily better than public management, nor vice versa. Ownership-whether public or private-of health care centers does not determine their performance which, on the contrary, depends on other factors, such as the workplace culture or the practice of suitable monitoring by the public payer. Promoting competition among centers (irrespective of the specific legal form of the management arrangements), however, could indeed lead to improvements under some circumstances. Therefore, it is advisable to cease the narrow-minded debate on the superiority of one or other model in order to focus on improving healthcare services management per se. Understanding that good governance affects health policies, the management of health care organizations, and clinical practice is, undoubtedly, an essential requirement but may not necessarily lead to policies that stimulate the solvency of the system. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

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.

The economic and environmental consequences of implementing nitrogen-efficient technologies and management practices in agriculture.

PubMed

Zhang, Xin; Mauzerall, Denise L; Davidson, Eric A; Kanter, David R; Cai, Ruohong

2015-03-01

Technologies and management practices (TMPs) that reduce the application of nitrogen (N) fertilizer while maintaining crop yields can improve N use efficiency (NUE) and are important tools for meeting the dual challenges of increasing food production and reducing N pollution. However, because farmers operate to maximize their profits, incentives to implement TMPs are limited, and TMP implementation will not always reduce N pollution. Therefore, we have developed the NUE Economic and Environmental impact analytical framework (NUE) to examine the economic and environmental consequences of implementing TMPs in agriculture, with a specific focus on farmer profits, N fertilizer consumption, N losses, and cropland demand. Our analytical analyses show that impact of TMPs on farmers' economic decision-making and the environment is affected by how TMPs change the yield ceiling and the N fertilization rate at the ceiling and by how the prices of TMPs, fertilizer, and crops vary. Technologies and management practices that increase the yield ceiling appear to create a greater economic incentive for farmers than TMPs that do not but may result in higher N application rates and excess N losses. Nevertheless, the negative environmental impacts of certain TMPs could be avoided if their price stays within a range determined by TMP yield response, fertilizer price, and crop price. We use a case study on corn production in the midwestern United States to demonstrate how NUE can be applied to farmers' economic decision-making and policy analysis. Our NUE framework provides an important tool for policymakers to understand how combinations of fertilizer, crop, and TMP prices affect the possibility of achieving win-win outcomes for farmers and the environment. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Identification, summary and comparison of tools used to measure organizational attributes associated with chronic disease management within primary care settings.

PubMed

Lukewich, Julia; Corbin, Renée; VanDenKerkhof, Elizabeth G; Edge, Dana S; Williamson, Tyler; Tranmer, Joan E

2014-12-01

Given the increasing emphasis being placed on managing patients with chronic diseases within primary care, there is a need to better understand which primary care organizational attributes affect the quality of care that patients with chronic diseases receive. This study aimed to identify, summarize and compare data collection tools that describe and measure organizational attributes used within the primary care setting worldwide. Systematic search and review methodology consisting of a comprehensive and exhaustive search that is based on a broad question to identify the best available evidence was employed. A total of 30 organizational attribute data collection tools that have been used within the primary care setting were identified. The tools varied with respect to overall focus and level of organizational detail captured, theoretical foundations, administration and completion methods, types of questions asked, and the extent to which psychometric property testing had been performed. The tools utilized within the Quality and Costs of Primary Care in Europe study and the Canadian Primary Health Care Practice-Based Surveys were the most recently developed tools. Furthermore, of the 30 tools reviewed, the Canadian Primary Health Care Practice-Based Surveys collected the most information on organizational attributes. There is a need to collect primary care organizational attribute information at a national level to better understand factors affecting the quality of chronic disease prevention and management across a given country. The data collection tools identified in this review can be used to establish data collection strategies to collect this important information. © 2014 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

Short communication: Microbiological quality of raw cow milk and its association with herd management practices in Northern China.

PubMed

Lan, X Y; Zhao, S G; Zheng, N; Li, S L; Zhang, Y D; Liu, H M; McKillip, J; Wang, J Q

2017-06-01

Contamination of raw milk with bacterial pathogens is potentially hazardous to human health. The aim of this study was to evaluate the total bacteria count (TBC) and presence of pathogens in raw milk in Northern China along with the associated herd management practices. A total of 160 raw milk samples were collected from 80 dairy herds in Northern China. All raw milk samples were analyzed for TBC and pathogens by culturing. The results showed that the number of raw milk samples with TBC <2 × 10 6 cfu/mL and <1 × 10 5 cfu/mL was 146 (91.25%) and 70 (43.75%), respectively. A total of 84 (52.50%) raw milk samples were Staphylococcus aureus positive, 72 (45.00%) were Escherichia coli positive, 2 (1.25%) were Salmonella positive, 2 (1.25%) were Listeria monocytogenes positive, and 3 (1.88%) were Campylobacter positive. The prevalence of S. aureus was influenced by season, herd size, milking frequency, disinfection frequency, and use of a Dairy Herd Improvement program. The TBC was influenced by season and milk frequency. The correlation between TBC and prevalence of S. aureus or E. coli is significant. The effect size statistical analysis showed that season and herd (but not Dairy Herd Improvement, herd size, milking frequency, disinfection frequency, and area) were the most important factors affecting TBC in raw milk. In conclusion, the presence of bacteria in raw milk was associated with season and herd management practices, and further comprehensive study will be powerful for effectively characterizing various factors affecting milk microbial quality in bulk tanks in China. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

How does pharmacogenetic testing alter the treatment course and patient response for chronic-pain patients in comparison with the current "trial-and-error" standard of care?

PubMed

DeFeo, Kelly; Sykora, Kristen; Eley, Susan; Vincent, Debra

2014-10-01

To evaluate if pharmacogenetic testing (PT) holds value for pain-management practitioners by identifying the potential applications of pharmacogenetic research as well as applications in practice. A review of the literature was conducted utilizing the databases EBSCOhost, Biomedical Reference Collection, CINAHL, Health Business: Full Text, Health Source: Nursing/Academic Edition, and MEDLINE with the keywords, personalized medicine, cytochrome P450, and phamacogenetics. Chronic-pain patients present some of the most challenging patients to manage medically. Often paired with persistent, life-altering pain, they might also have oncologic and psychological comorbidities that can further complicate their management. One-step in-office PT is now widely available to optimize management of complicated patients and affectively remove the "trial-and-error" process of medication therapy. Practitioners must be familiar with the genetic determinants that affect a patient's response to medications in order to decrease preventable morbidity and mortality associated with drug-drug and patient-drug interactions, and to provide cost-effective care through avoidance of inappropriate medications. Improved pain managements will impove patient outcomes and satisfaction. ©2014 American Association of Nurse Practitioners.

The macroeconomics of vitreoretinal diseases.

PubMed

Ko, George J; Brown, Melissa M; Brown, Gary C

2005-06-01

The purpose of this review is to examine the macroeconomics of vitreoretinal diseases. Approximately 6% of the Medicare Part B expenditure was spent on ocular diseases and 0.3% on vitreoretinal interventions. Among the 17,674 practicing ophthalmologists, 1849 (10.5%) designated themselves as specializing in the treatment of vitreoretinal diseases. Ophthalmologists receive 38% of their payments from Medicare; 13% of their total income were capitated. Age-related macular degeneration and diabetic retinopathy, two conditions commonly treated by vitreoretinal specialists, are projected to affect more than 10 million people in 2020. Vitreoretinal interventions account for only a small portion of the total health care expenditure. The rising demand from the aging population and health care costs will continue to put pressure on all physicians and society. The changes in the sources of payment and managed care will directly affect the economics of a physician's practice.

Status and prospects for renewable energy using wood pellets from the southeastern United States

DOE PAGES

Dale, Virginia H.; Kline, Keith L.; Parish, Esther S.; ...

2017-04-20

The ongoing debate about costs and benefits of wood-pellet based bioenergy production in the southeastern United States (SE USA) requires an understanding of the science and context influencing market decisions associated with its sustainability. Production of pellets has garnered much attention as US exports have grown from negligible amounts in the early 2000s to 4.6 million metric tonnes in 2015. Currently, 98% of these pellet exports are shipped to Europe to displace coal in power plants. We ask, 'How is the production of wood pellets in the SE USA affecting forest systems and the ecosystem services they provide?' To addressmore » this question, we review current forest conditions and the status of the wood products industry, how pellet production affects ecosystem services and biodiversity, and what methods are in place to monitor changes and protect vulnerable systems. Scientific studies provide evidence that wood pellets in the SE USA are a fraction of total forestry operations and can be produced while maintaining or improving forest ecosystem services. Ecosystem services are protected by the requirement to utilize loggers trained to apply scientifically based best management practices in planning and implementing harvest for the export market. Bioenergy markets supplement incomes to private rural landholders and provide an incentive for forest management practices that simultaneously benefit water quality and wildlife and reduce risk of fire and insect outbreaks. Bioenergy also increases the value of forest land to landowners, thereby decreasing likelihood of conversion to nonforest uses. Monitoring and evaluation are essential to verify that regulations and good practices are achieving goals and to enable timely responses if problems arise. Conducting rigorous research to understand how conditions change in response to management choices requires baseline data, monitoring, and appropriate reference scenarios. Furthermore, long-term monitoring data on forest conditions should be publicly accessible and utilized to inform adaptive management.« less

Nitrogen gas emissions and nitrate leaching dynamics under different tillage practices based on data synthesis and process-based modeling

NASA Astrophysics Data System (ADS)

Huang, Y.; Ren, W.; Tao, B.; Zhu, X.

2017-12-01

Nitrogen losses from the agroecosystems have been of great concern to global changes due to the effects on global warming and water pollution in the form of nitrogen gas emissions (e.g., N2O) and mineral nitrogen leaching (e.g., NO3-), respectively. Conservation tillage, particularly no-tillage (NT), may enhance soil carbon sequestration, soil aggregation and moisture; therefore it has the potential of promoting N2O emissions and reducing NO3- leaching, comparing with conventional tillage (CT). However, associated processes are significantly affected by various factors, such as soil properties, climate, and crop types. How tillage management practices affect nitrogen transformations and fluxes is still far from clear, with inconsistent even opposite results from previous studies. To fill this knowledge gap, we quantitatively investigated gaseous and leaching nitrogen losses from NT and CT agroecosystems based on data synthesis and an improved process-based agroecosystem model. Our preliminary results suggest that NT management is more efficient in reducing NO3- leaching, and meanwhile it simultaneously increases N2O emissions by approximately 10% compared with CT. The effects of NT on N2O emissions and NO3- leaching are highly influenced by the placement of nitrogen fertilizer and are more pronounced in humid climate conditions. The effect of crop types is a less dominant factor in determining N2O and NO3- losses. Both our data synthesis and process-based modeling suggest that the enhanced carbon sequestration capacity from NT could be largely compromised by relevant NT-induced increases in N2O emissions. This study provides the comprehensive quantitative assessment of NT on the nitrogen emissions and leaching in agroecosystems. It provides scientific information for identifying proper management practices for ensuring food security and minimizing the adverse environmental impacts. The results also underscore the importance of suitable nitrogen management in the NT agroecosystems for climate adaptation and mitigation.

Status and prospects for renewable energy using wood pellets from the southeastern United States

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

Dale, Virginia H.; Kline, Keith L.; Parish, Esther S.

The ongoing debate about costs and benefits of wood-pellet based bioenergy production in the southeastern United States (SE USA) requires an understanding of the science and context influencing market decisions associated with its sustainability. Production of pellets has garnered much attention as US exports have grown from negligible amounts in the early 2000s to 4.6 million metric tonnes in 2015. Currently, 98% of these pellet exports are shipped to Europe to displace coal in power plants. We ask, 'How is the production of wood pellets in the SE USA affecting forest systems and the ecosystem services they provide?' To addressmore » this question, we review current forest conditions and the status of the wood products industry, how pellet production affects ecosystem services and biodiversity, and what methods are in place to monitor changes and protect vulnerable systems. Scientific studies provide evidence that wood pellets in the SE USA are a fraction of total forestry operations and can be produced while maintaining or improving forest ecosystem services. Ecosystem services are protected by the requirement to utilize loggers trained to apply scientifically based best management practices in planning and implementing harvest for the export market. Bioenergy markets supplement incomes to private rural landholders and provide an incentive for forest management practices that simultaneously benefit water quality and wildlife and reduce risk of fire and insect outbreaks. Bioenergy also increases the value of forest land to landowners, thereby decreasing likelihood of conversion to nonforest uses. Monitoring and evaluation are essential to verify that regulations and good practices are achieving goals and to enable timely responses if problems arise. Conducting rigorous research to understand how conditions change in response to management choices requires baseline data, monitoring, and appropriate reference scenarios. Furthermore, long-term monitoring data on forest conditions should be publicly accessible and utilized to inform adaptive management.« less

Influence of Traditional Management and Environmental Variables on Mediterranean Saproxylic Beetle Assemblages.

PubMed

Ramilo, P; Martínez-Falcón, A P; García-López, A; Brustel, H; Galante, E; Micó, E

2017-12-08

Mediterranean oak forests of the Iberian Peninsula host a great diversity of saproxylic beetles. For centuries, humans have carried out traditional management practices in this area, at both habitat and tree level, causing changes in forest structure. The aim of this study was to evaluate the anthropic effect of these traditional practices on saproxylic beetle diversity by measuring a set of environmental variables related to forest structure at both plot and tree level. Fauna was collected using window traps over a period of 12 mo. Multiple regression procedures showed which variables significantly affected the diversity of the studied assemblage. Our results demonstrated that the different metrics used to assess the diversity of assemblages responded variably depending on the management strategies applied and the level at which they were carried out. Certain management practices that disrupted the landscape from its natural state, such as the introduction of livestock or the local removal of particular trees, maximized species richness but, nevertheless, had a negative effect on the rest of diversity metrics analyzed. However, other practices such as pollarding, which involves the suppression of the main branch of the tree, had a positive effect on all diversity metrics evaluated as it promoted the formation of potential microhabitats for saproxylic fauna. We concluded that not all types and degrees of traditional forest management favor saproxylic beetle diversity and that different diversity metrics should be taken into consideration in future strategies for the protection and conservation of this fauna. © The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Paradoxes and Dilemmas in Managing E-Learning in Higher Education. Research & Occasional Paper Series. CSHE.7.03

ERIC Educational Resources Information Center

Guri-Rosenblit, Sarah

2003-01-01

The new information and communication technologies (ICT) affect currently most spheres of life, including all educational levels. Their effects are most likely to grow in the future. However, many predictions in the last few years as to the sweeping impact of the ICT on restructuring the teaching/learning practices at universities and their high…

The effects of thinning intensity on snag and cavity tree abundance in an Appalachian hardwood stand

Treesearch

Aaron T. Graves; Mary Ann Fajvan; Gary W. Miller

2000-01-01

Traditional silvicultural practices focus on manipulating forest vegetation structure for commodity production. Structural features important to wildlife, such as snags, trees with decay, and cavity trees are also affected by forest management, but these effects are often not quantified. This study measured the effects of different thinning intensities (45, 60, and 75...

Database for estimating tree responses of walnut and other hardwoods to ground cover management practices

Treesearch

J.W. Van Sambeek

2010-01-01

The ground cover in plantings of walnut and other hardwoods can substantially affect tree growth and seed production. The number of alternative ground covers that have been suggested for establishment in tree plantings far exceeds the number that have already been tested with walnut and other temperate hardwoods. Knowing how other hardwood species respond to ground...

The Important Elements of LMS Design That Affect User Engagement with E-Learning Tools within LMSs in the Higher Education Sector

ERIC Educational Resources Information Center

Zanjani, Nastaran; Edwards, Sylvia L.; Nykvist, Shaun; Geva, Shlomo

2017-01-01

In recent years, universities have been under increased pressure to adopt e-learning practices for teaching and learning. In particular, the emphasis has been on learning management systems (LMSs) and associated collaboration tools to provide opportunities for sharing knowledge, building a community of learners, and supporting higher order…

Microbial biomass and soil carbon after 8 and 9 years of field applications of alum-treated and untreated poultry litter and inorganic nitrogen

USDA-ARS?s Scientific Manuscript database

Amendment with aluminum sulfate (alum) is considered a best management practice for its benefits in poultry production and increased retention of nutrients in the litter. However, little is known about how long-term applications of alum-treated litter to soil will affect the microbial community and ...