Sample records for management practices guide

  1. Routine road maintenance water quality and habitat guide : best management practices

    DOT National Transportation Integrated Search

    2009-01-01

    Since June 9, 1999 the Oregon Department of Transportation (ODOT) has implemented the Routine Road Maintenance: Water Quality and Habitat Guide Best Management Practices (the Guide), and is considered the cornerstone of the ODOT'd Office of Maintenan...

  2. A Practical Guide for Personnel Management: The Essential Elements.

    ERIC Educational Resources Information Center

    Todaro, Julie B.

    The essential elements of personnel management are outlined. Personnel management may be called by various names and may be practiced by various levels of management, but in any case it is one of the most important elements of a management position. While sample forms generally relate to Texas community colleges and libraries, the guide is written…

  3. Resource Management Resource Guide. A Resource for Teaching the Resource Management Core Course Area of Ohio's Work and Family Life Program.

    ERIC Educational Resources Information Center

    Kister, Joanna; And Others

    This Resource Management Resource Guide is intended to help teachers implement Ohio's Work and Family Life Program. Course content focuses on the practical problems related to managing human and material resources, making consumer decisions, and feeding, clothing, and housing the family. These practical problems are posed through case studies and…

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

    PubMed

    2012-02-10

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

  5. A patient-focused framework integrating self-management and informatics.

    PubMed

    Knight, Elizabeth P; Shea, Kimberly

    2014-03-01

    This article introduces a framework to (a) guide chronic illness self-management interventions through the integration of self-management and nursing informatics, (b) focus self-management research, and (c) promote ethical, patient-empowering technology use by practicing nurses. Existing theory and research focusing on chronic illness, self-management, health-enabling technology, and nursing informatics were reviewed and examined and key concepts were identified. A care paradigm focusing on concordance, rather than compliance, served as the overall guiding principle. This framework identifies key relationships among self-management (patient behaviors), health force (patient characteristics), and patient-defined goals. The role of health-enabling technology supporting these relationships is explored in the context of nursing informatics. The Empowerment Informatics framework can guide intervention design and evaluation and support practicing nurses' ethical use of technology as part of self-management support. Nurses worldwide provide support to patients who are living with chronic illnesses. As pressures related to cost and access to care increase, technology-enabled self-management interventions will become increasingly common. This patient-focused framework can guide nursing practice using technology that prioritizes patient needs. © 2013 Sigma Theta Tau International.

  6. Operations & Maintenance Best Practices - A Guide to Achieving Operational Efficiency Release 3.0

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

    None

    This Operations and Maintenance (O&M) Best Practices Guide was developed under the direction of the U.S. Department of Energy’s Federal Energy Management Program (FEMP). The mission of FEMP is to facilitate the Federal Government’s implementation of sound, cost effective energy management and investment practices to enhance the nation’s energy security and environmental stewardship.

  7. A guide for local agency pavement managers

    DOT National Transportation Integrated Search

    1994-12-01

    The purpose of this guide is to provide Washington's local agencies with a practical document that will assist pavement managers in understanding the pavement management process and the steps necessary to implement their own pavement management syste...

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

    PubMed

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

    2012-12-01

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

  9. STORMWATER BEST MANAGEMENT PRACTICES DESIGN GUIDE VOLUME 3 - BASIN BEST MANAGEMENT PRACTICES

    EPA Science Inventory

    This manual provides design guidelines for a group of stormwater management (SWM) best management practices (BMPs) broadly referred to as basin or pond BMPs. Basin BMPs are the mainstay of stormwater management. Water resources engineers have designed small and large ponds for ma...

  10. Implementing Strategic Change: A Practical Guide for Business.

    ERIC Educational Resources Information Center

    Grundy, Tony

    This book is designed to serve as a practical guide to planning and managing change within a business, and as a text for graduate business students studying change strategies. It focuses on the rationale for change, managing the change process, tools for change, creating a strategic vision for change, and checklists for implementing strategic…

  11. Keeping the Best: A Practical Guide to Retaining Key Employees.

    ERIC Educational Resources Information Center

    Bevan, Stephen; Barber, Linda; Robinson, Dilys

    This book, which is intended to assist human resource professionals and line managers in the United Kingdom, is a practical guide to retaining key employees. Discussed in the introduction are the relationship between downsizing and retention, problems that retention difficulties pose for human resource management, and the effects of retention…

  12. Evaluation of a Modified User Guide for Hearing Aid Management.

    PubMed

    Caposecco, Andrea; Hickson, Louise; Meyer, Carly; Khan, Asaduzzaman

    2016-01-01

    This study investigated if a hearing aid user guide modified using best practice principles for health literacy resulted in superior ability to perform hearing aid management tasks, compared with the user guide in the original form. This research utilized a two-arm study design to compare the original manufacturer's user guide with a modified user guide for the same hearing aid--an Oticon Acto behind-the-ear aid with an open dome. The modified user guide had a lower reading grade level (4.2 versus 10.5), used a larger font size, included more graphics, and had less technical information. Eighty-nine adults ages 55 years and over were included in the study; none had experience with hearing aid use or management. Participants were randomly assigned either the modified guide (n = 47) or the original guide (n = 42). All participants were administered the Hearing Aid Management test, designed for this study, which assessed their ability to perform seven management tasks (e.g., change battery) with their assigned user guide. The regression analysis indicated that the type of user guide was significantly associated with performance on the Hearing Aid Management test, adjusting for 11 potential covariates. In addition, participants assigned the modified guide required significantly fewer prompts to perform tasks and were significantly more likely to perform four of the seven tasks without the need for prompts. The median time taken by those assigned the modified guide was also significantly shorter for three of the tasks. Other variables associated with performance on the Hearing Aid Management test were health literacy level, finger dexterity, and age. Findings indicate that the need to design hearing aid user guides in line with best practice principles of health literacy as a means of facilitating improved hearing aid management in older adults.

  13. Best Practices for Real Property Management

    DTIC Science & Technology

    2016-04-21

    organizations and are experienced in creating reliable and actionable solutions to complex management issues guided by proven best business practices...DEFENSE BUSINESS BOARD For the Secretary of Defense Best Practices for Real Property Management DBB...FY16-02 Recommendations on the best practices for management of Department of Defense real property assets Defense Business

  14. Summer-Jobs-for-Youth Program Guide. How to Develop and Manage a Summer Youth Jobs Program. A Technical Assistance Guide.

    ERIC Educational Resources Information Center

    National Alliance of Business, Inc., Washington, DC.

    This guide offers a practical approach for operating summer youth employment programs that involves cooperation among private businesses and local organizations. A timetable provides a month-by-month schedule. Seven sections discuss management responsibilities. Program Planning covers scope, goals, and coordination. Program Management addresses…

  15. Silvicultural guide for northern hardwood types in the Northeast (revised)

    Treesearch

    William B. Leak; Dale S. Solomon; Paul S. DeBald

    1987-01-01

    A practical guide to the management of northern hardwoods for timber production in New England and New York. Both even-aged management are considered, and specific treatments are prescribed for a range of stand conditions and management objectives.

  16. A residency clinic chronic condition management quality improvement project.

    PubMed

    Halverson, Larry W; Sontheimer, Dan; Duvall, Sharon

    2007-02-01

    Quality improvement in chronic disease management is a major agenda for improving health and reducing health care costs. A six-component chronic disease management model can help guide this effort. Several characteristics of the "new model" of family medicine described by the Future of Family Medicine (FFM) Project Leadership Committee are promulgated to foster practice changes that improve quality. Our objective was to implement and assess a quality improvement project guided by the components of a chronic disease management model and FFM new model characteristics. Diabetes was selected as a model chronic disease focus. Multiple practice changes were implemented. A mature electronic medical record facilitated data collection and measurement of quality improvement progress. Data from the diabetes registry demonstrates that our efforts have been effective. Significant improvement occurred in five out of six quality indicators. Multidisciplinary teamwork in a model residency practice guided by chronic disease management principles and the FFM new model characteristics can produce significant management improvements in one important chronic disease.

  17. Managing Highway Maintenance: Instructor's Guide: For Training in Managing Highway Maintenance.

    ERIC Educational Resources Information Center

    Federal Highway Administration (DOT), Washington, DC. Offices of Research and Development.

    The guide, intended for use by training officers and field instructors in highway maintenance management, contains five courses with a combined total of 17 units of instruction for maintenance engineers and supervisors. The curriculum incorporates management concepts and practices of State, county, and city maintenance agencies which have…

  18. A Practical Guide to Enrollment and Retention Management in Higher Education.

    ERIC Educational Resources Information Center

    Dennis, Marguerite J.

    This book offers a guide to designing and implementing an enrollment and retention management program for colleges and universities. Emphasis is on a system which integrates the activities of the offices of enrollment management, retention management, admission, financial aid, registration, research, and public relations, including publications…

  19. An ecological basis for ecosystem management

    Treesearch

    M. R. Kaufmann; R. T. Graham; D. A. Boyce; W. H. Moir; L. Perry; R. T. Reynolds; R. L. Bassett; P. Mehlhop; C. B. Edminster; W. M. Block; P. S. Corn

    1994-01-01

    Guiding principles based on conservation biology are applied in assessing ecosystem needs. Ecosystem, economic, and social needs are integrated in a decision model in which the guiding principles are used as a primary filter for evaluating proposed actions. Management practices consistent with the guiding principles are likely to lead to ecological, economic, and...

  20. Making a Difference: Leading and Managing for Quality Improvement in Adult and Community Learning.

    ERIC Educational Resources Information Center

    Ravenhall, Mark; Kenway, Mike

    This guide looks at demands on leaders and managers in adult and community learning (ACL) in the roles and issues they face in the context of quality improvement (QI). It suggests practical approaches for improving the quality of provision for adults. The guide's design builds on current practice toward the desired state of excellence in all…

  1. A silvicultural guide for northern hardwoods in the northeast

    Treesearch

    William B. Leak; Dale S. Solomon; Stanley M. Filip; Stanley M. Filip

    1969-01-01

    The purpose of this paper is to provide a practical guide to the management of northern hardwoods - principally beech, birch, and maple-in the Northeast. The guide was designed to provide the kind of information that is needed not only for long-term management planning, but also for short-term silvicultural prescriptions for specific timber stand conditions. The guide...

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

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

    NONE

    1998-06-01

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

  3. STORMWATER BEST MANAGEMENT PRACTICES DESIGN GUIDE VOLUME 2 - VEGETATIVE BIOFILTERS

    EPA Science Inventory

    This document is Volume 2 of a three volume document that provides guidance on the selection and design of stormwater management Best Management Practices (BMPs). This second volume provides specific design guidance for a group of onsite BMP control practices that are referred t...

  4. Farm & Ranch Business Management. Second Edition.

    ERIC Educational Resources Information Center

    Steward, Jim; Jobes, Raleigh

    This practical guide for the agribusiness manager (the farmer, rancher, and other agribusiness people who work with agricultural commodities, supplies, and services) gives a basic understanding of modern management practices. It provides guidelines that can help them make practical business decisions. Chapter 1 is an introduction that highlights…

  5. Best Practices for Environmental Site Management: A Practical Guide for Applying Environmental Sequence Stratigraphy to Improve Conceptual Site Models

    EPA Science Inventory

    Presented here is a practical guide on the application of the geologic principles of sequence stratigraphy and facies models to the characterization of stratigraphic heterogeneity at hazardous waste sites. This technology is applicable to sites underlain by clastic aquifers (int...

  6. Cash Management/Data Matching. Training Guide.

    ERIC Educational Resources Information Center

    Office of Student Financial Assistance (ED), Washington, DC.

    This training guide for financial aid staff explains the process of direct loan reconciliation and suggests appropriate cash management accounting practices. Chapter 1 explains the importance of cash management, the role of data matching, and reviews basic reconciliation concepts and terms and direct loan reporting requirements. Chapter 2 reviews…

  7. Going Dotty: a practical guide for installing new hand hygiene products.

    PubMed

    Bush, Kathryn; Mah, Manuel W; Meyers, Gwyneth; Armstrong, Pamela; Stoesz, Janice; Strople, Sally

    2007-12-01

    This report distills our experiences coordinating the installation of a new commercial line of hand hygiene products in a large, integrated health care region in Western Canada into a practical guide that can benefit infection control professionals. Some key considerations while managing such a large hand hygiene products installation are stakeholder collaboration, management of occupational hand dermatitis, housekeeping support, and communication.

  8. A Study of the Impact of Default Management Practices and Other Factors on Student Loan Default Rates in Public Two-Year Community Colleges

    ERIC Educational Resources Information Center

    Daniels, Randell W.

    2013-01-01

    Default management practices and their relationship to the student loan default rate in public two-year community colleges was the focus of this investigation. Five research questions regarding written default management plans, default management practices, process management, accountability, and other factors impacting default guided the study.…

  9. Solar Access Public Capital (SAPC) Working Group: Best Practices in PV Operations and Maintenance; Version 1.0, March 2015; Period of Performance, January 1, 2014 - December 31, 2015

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

    Keating, T. J.; Walker, A.; Ardani, K.

    2015-03-01

    This PV O&M Best Practices Guide is designed to improve solar asset transparency for investors and rating agencies, provide an industry framework for quality management, and reduce transaction costs in the solar asset securitization process. The PV O&M Best Practices Guide is intended to outline the minimum requirements for third-party ownership providers (“Providers”). Adherence to the guide is voluntary. Providers that adhere to the guide are responsible for selfcertifying that they have fulfilled the guide requirements.

  10. O&M Best Practices - A Guide to Achieving Operational Efficiency (Release 2.0)

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

    Sullivan, Gregory P.; Pugh, Ray; Melendez, Aldo P.

    2004-07-31

    This guide, sponsored by DOE's Federal Energy Management Program, highlights operations and maintenance (O&M) programs targeting energy efficiency that are estimated to save 5% to 20% on energy bills without a significant capital investment. The purpose of this guide is to provide the federal O&M energy manager and practitioner with useful information about O&M management, technologies, energy efficiency and cost-reduction approaches.

  11. Doing Qualitative Research Using Your Computer: A Practical Guide

    ERIC Educational Resources Information Center

    Hahn, Chris

    2008-01-01

    This book is a practical, hands-on guide to using commonly available everyday technology, including Microsoft software, to manage and streamline research projects. It uses straight-forward, everyday language to walk readers through this process, drawing on a wide range of examples to demonstrate how easy it is to use such software. This guide is…

  12. Beyond the Award Letter: Fund Management for Leaders of Small Youth-Serving Organizations

    ERIC Educational Resources Information Center

    Gager, Jenifer; Marchand, Vicky

    2009-01-01

    This paper was created for executive directors, directors of finance and administration, and program managers of small youth-serving non-profit organizations. This guide supports and enhances the systems they use to manage grants and contracts. This guide is organized to use as a quick self-assessment of their fund management practices: (1) seven…

  13. Emergency management training program: Guide to good practice

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

    Not Available

    1991-07-01

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

  14. Bug Off: A Guide for Integrated Pest Management in Granville Schools.

    ERIC Educational Resources Information Center

    2001

    This guide describes options for the Granville schools when dealing with pests. It is based on Integrated Pest Management (IPM), a philosophy that employs safe and practical pest control methods. The guide can be used to incorporate IPM philosophy into the school systems. The first section provides the environmental context for an interest in…

  15. Emergency management training program: Guide to good practice

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

    Not Available

    1991-07-01

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

  16. Alcohol Outlet Workers and Managers: Focus Groups on Responsible Service Practices.

    ERIC Educational Resources Information Center

    Gehan, John P.; Toomey, Traci L.; Jones-Webb, Rhonda; Rothstein, Catherine; Wagenaar, Alexander C.

    1999-01-01

    Reports on focus group discussions with managers, bartenders, waitstaff, and security staff of retail alcohol establishments. Purpose of the focus groups was to identify beliefs, attitudes, behaviors, and practices among management and staff to guide development of training programs. Results indicate that, compared to management, staff had…

  17. Water Resource Management. [Student Guide] and Teacher's Guide.

    ERIC Educational Resources Information Center

    Young, Donald B.; Pottenger, Francis M.

    This student guide and accompanying teacher's guide are a product of the Foundational Approaches in Science Teaching (FAST) curriculum development project at the University of Hawaii. In the teaching guide, the introduction gives a description of the underlying theory and practice in FAST and includes the FAST instructional model, descriptions of…

  18. Library of Michigan: Financial Management Reference Guide.

    ERIC Educational Resources Information Center

    Michigan Library, Lansing.

    Developed to provide library directors, staff, and board members with information for performing accounting and financial management functions, this guide answers frequently asked questions, describes common practices and processes, provides examples and suggested formats for selected financial reports, and identifies issues that may require…

  19. Life Management: Moving Out! Solving Practical Problems for Independent Living. Utah Home Economics and Family Life Curriculum Guide.

    ERIC Educational Resources Information Center

    Utah State Office of Education, Salt Lake City.

    This guide, which has been developed for Utah's home economics and family life education program, contains materials for use in teaching a life management course emphasizing the problem-solving skills required for independent living. Discussed first are the assumptions underlying the curriculum, development of the guide, and suggestions for its…

  20. Development and Validation of the Texas Best Management Practice Evaluation Tool (TBET)

    USDA-ARS?s Scientific Manuscript database

    Conservation planners need simple yet accurate tools to predict sediment and nutrient losses from agricultural fields to guide conservation practice implementation and increase cost-effectiveness. The Texas Best management practice Evaluation Tool (TBET), which serves as an input/output interpreter...

  1. Development of a Self-Management Theory-Guided Discharge Intervention for Parents of Hospitalized Children.

    PubMed

    Sawin, Kathleen J; Weiss, Marianne E; Johnson, Norah; Gralton, Karen; Malin, Shelly; Klingbeil, Carol; Lerret, Stacee M; Thompson, Jamie J; Zimmanck, Kim; Kaul, Molly; Schiffman, Rachel F

    2017-03-01

    Parents of hospitalized children, especially parents of children with complex and chronic health conditions, report not being adequately prepared for self-management of their child's care at home after discharge. No theory-based discharge intervention exists to guide pediatric nurses' preparation of parents for discharge. To develop a theory-based conversation guide to optimize nurses' preparation of parents for discharge and self-management of their child at home following hospitalization. Two frameworks and one method influenced the development of the intervention: the Individual and Family Self-Management Theory, Tanner's Model of Clinical Judgment, and the Teach-Back method. A team of nurse scientists, nursing leaders, nurse administrators, and clinical nurses developed and field tested the electronic version of a nine-domain conversation guide for use in acute care pediatric hospitals. The theory-based intervention operationalized self-management concepts, added components of nursing clinical judgment, and integrated the Teach-Back method. Development of a theory-based intervention, the translation of theoretical knowledge to clinical innovation, is an important step toward testing the effectiveness of the theory in guiding clinical practice. Clinical nurses will establish the practice relevance through future use and refinement of the intervention. © 2017 Sigma Theta Tau International.

  2. STORMWATER BEST MANAGEMENT PRACTICES DESIGN GUIDE VOLUME 1 - GENERAL CONSIDERATIONS

    EPA Science Inventory

    This document is Volume 1 of a three volume series that provides guidance on the selection and design of stormwater management Best Management Practices (BMPs). This first volume provides general considerations associated with the selection and design of BMPs.
    Volume I provi...

  3. Dermatology practice management assures practice development and efficiency.

    PubMed

    Wagener, D L

    2000-09-01

    This article provides an overview of the disciplines involved in managing a dermatology practice today. Several key management processes, including strategic planning, financial analysis, advertising and public relations, information systems management, and compliance program development and monitoring are addressed. This article explores several possible tactics that can be used to help guide your practice in the right direction without overtaxing your resources. Also offered are possible solutions for creating an organization that is poised for success, and a management team capable of steering the practice through the sea of change ahead.

  4. A DRDC Management Accountability Framework

    DTIC Science & Technology

    2009-09-01

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

  5. Science You Can Use Bulletin: Revisiting disturbance: A new guide for keeping dry mixed conifer forests healthy through fuel management

    Treesearch

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

    2014-01-01

    Planning for hazardous fuels reduction can be challenging, given that land managers must balance multiple resource objectives. To help managers with planning and implementing fuel treatments, the Rocky Mountain Research Station, with support from the Joint Fire Science Program, has published A Comprehensive Guide to Fuel Management Practices for Dry Mixed Conifer...

  6. Analysing Mentoring Dialogues for Developing a Preservice Teacher's Classroom Management Practices

    ERIC Educational Resources Information Center

    Sempowicz, Tracey; Hudson, Peter

    2011-01-01

    A key concern for preservice teachers is classroom management, including student behaviour management, which also has been a factor associated with teachers leaving the profession within the first five years. This study investigates the mentoring practices used to guide the mentee's classroom management. Using multiple data sources (e.g., lesson…

  7. Practical Project Management for Education and Training.

    ERIC Educational Resources Information Center

    Lockitt, Bill

    This booklet provides a succinct guide to effective management procedures, including whether and how to take on projects, estimation of costs prior to project bids, project management tools, case studies, and practical exercises for staff development activities. Chapter 1 investigates why institutions take on projects, issues involved, benefits…

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

    PubMed

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

    2017-11-01

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

  9. The Ventilator-Assisted Child: A Practical Resource Guide.

    ERIC Educational Resources Information Center

    Driver, Lynn E.; Nelson, Virginia Simson; Warschausky, Seth A.

    The 16 chapters comprising this manual are intended to provide a practical guide for meeting the needs of ventilator-assisted children. Chapters have the following titles and authors: (1)"Spectrum of Care" (Virginia Simson Nelson and Lynn E. Driver); (2) "Long-Term Airway Management for the Ventilator-Assisted Child" (Ann Marie…

  10. Preparing for an Aging Work Force: A Practical Guide for Employers.

    ERIC Educational Resources Information Center

    AARP, Washington, DC.

    This booklet, which is intended for human resource managers, provides practical guidance regarding preparing for an aging work force. Chapter 1 concerns the relationship between business practices and age neutrality and offers checklists that human resource managers can use to assess their company's general policy development, training,…

  11. Fundamentals of Managing Reference Collections

    ERIC Educational Resources Information Center

    Singer, Carol A.

    2012-01-01

    Whether a library's reference collection is large or small, it needs constant attention. Singer's book offers information and insight on best practices for reference collection management, no matter the size, and shows why managing without a plan is a recipe for clutter and confusion. In this very practical guide, reference librarians will learn:…

  12. AACRAO's Basic Guide to Enrollment Management

    ERIC Educational Resources Information Center

    Westman, Craig

    2005-01-01

    The sole purpose of this book is to provide a primer or "how-to" resource for new or seasoned enrollment managers. Its core chapters are practical applications of Strategic Enrollment Management (SEM) best practices. While incorporating some secondary source referencing, the dialogue primarily outlines how making some basic adjustments to business…

  13. Proceedings-1979 third annual practical conference on communication

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

    Not Available

    1981-04-01

    Topics covered at the meeting include: nonacademic writing, writer and editor training in technical publications, readability of technical documents, guide for beginning technical editors, a visual aids data base, newsletter publishing, style guide for a project management organization, word processing, computer graphics, text management for technical documentation, and typographical terminology.

  14. A Practical Guide to Management of Common Pests in Schools. Integrated Pest Management.

    ERIC Educational Resources Information Center

    Illinois State Dept. of Public Health, Springfield.

    This 3-part manual is designed to assist school officials understand the principles of Integrated Pest Management and aid them in implementing those principles into a comprehensive pest control program in their facilities. Developed for Illinois, this guide can be applied in part or in total to other areas of the country. Part 1 explains what an…

  15. Grounded Theory: A practical guide for management, business and market researchers Christina Goulding Grounded Theory: A practical guide for management, business and market researchers Sage Publications No of pages: 186 £18.99 0761966838 0761966838 [Formula: see text].

    PubMed

    Woods, Leslie

    2003-10-01

    Much has been written about the grounded theory approach to qualitative research, however the number of books devoted solely to this methodology remains relatively few. Therefore, any new book dedicated to the subject is always likely to attract attention - especially given the increasing popularity of grounded theory in healthcare research.

  16. What roles do middle managers play in implementation of innovative practices?

    PubMed Central

    Engle, Ryann L.; Lopez, Emily R.; Gormley, Katelyn E.; Chan, Jeffrey A.; Charns, Martin P.; Lukas, Carol VanDeusen

    2017-01-01

    Background: Middle managers play key roles in hospitals as the bridge between senior leaders and frontline staff. Yet relatively little research has focused on their role in implementing new practices. Purpose: The aim of this study was to expand the understanding of middle managers’ influence in organizations by looking at their activities through the lens of two complementary conceptual frameworks. Methodology/Approach: We analyzed qualitative data from 17 Veterans Affairs Medical Centers with high and low potential to change organizational practices. We analyzed 98 interviews with staff ranging from senior leaders to frontline staff to identify themes within an a priori framework reflecting middle manager activities. Findings: Analyses yielded 14 emergent themes that allowed us to classify specific expressions of middle manager commitment to implementation of innovative practices (e.g., facilitate improvement innovation, garner staff buy-in). In comparing middle manager behaviors in high and low change potential sites, we found that most emergent themes were present in both groups. However, the activities and interactions described differed between the groups. Practice Implications: Middle managers can use the promising strategies identified by our analyses to guide and improve their effectiveness in implementing new practices. These strategies can also inform senior leaders striving to guide middle managers in those efforts. PMID:26488239

  17. Solar Access to Public Capital (SAPC) Working Group: Best Practices in Commercial and Industrial (C&I) Solar Photovoltaic System Installation; Period of Performance: November 28, 2014-September 1, 2015

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

    Doyle, Chris; Loomans, Len; Truitt, Andrew

    2015-12-29

    This Best Practices in Commercial and Industrial Solar Photovoltaic System Installation Guide is the second of a series of guides designed to standardize and improve solar asset transparency for investors and rating agencies, provide an industry framework for quality management, and reduce transaction costs in the solar asset securitization process. The Best Practices in C&I PV System Installation Guide is intended to outline the minimum requirements for commercial and industrial solar project developments. Adherence to the guide is voluntary. Providers that adhere to the guide are responsible for self-certifying that they have fulfilled the guide requirements. Investors and rating agenciesmore » should verify compliance.« less

  18. Understanding ADHD: A Practical Guide for Teachers and Parents.

    ERIC Educational Resources Information Center

    Bender, William N.

    This book is intended as a practical guide for parents and teachers in managing children or students with attention deficit hyperactivity disorder (ADHD). Specific strategies and techniques are presented that will facilitate learning for individuals with ADHD in both the home and school environment. Chapters include: "ADHD at Home and in the…

  19. Asperger Syndrome--Practical Strategies for the Classroom: A Teacher's Guide.

    ERIC Educational Resources Information Center

    Thomas, George; Barratt, Penny; Clewley, Heather; Joy, Helen; Potter, Mo; Whitaker, Philip

    This guide to Asperger syndrome for teachers describes the underlying impairments of the condition, explains how these may lead to problems in school, and offers practical management suggestions. The first part gives an overview of Asperger syndrome and outlines the three core areas of impairment--social interaction, communication, and lack of…

  20. Green Revolving Funds: An Introductory Guide to Implementation & Management

    ERIC Educational Resources Information Center

    Indvik, Joe; Foley, Rob; Orlowski, Mark

    2013-01-01

    The goal of this introductory implementation guide is to provide practical guidance for designing, implementing, and managing a green revolving fund (GRF) at a college, university, or other institution. The GRF model is widespread in higher education, with at least 79 funds in operation in North America representing over $111 million in committed…

  1. 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...

  2. 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...

  3. NTL Data Management Planning "Greenout" Bingo Self Assessment Tool

    DOT National Transportation Integrated Search

    2016-08-11

    This tool is designed to help assess your current data management practices. Pick a dataset or research project, sit down with your data collection team, and discuss each prompt below. This tool can guide DMP improvement by revealing best practices t...

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

    EPA Pesticide Factsheets

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

  5. Practical Concerns of Limited Income Families: An Adult Home Economics Curriculum.

    ERIC Educational Resources Information Center

    Williams, Sally K.; Bertelson, Laura Winslow

    Based on focus group research in five locations in Iowa, this curriculum guide was developed to help meet the educational needs of families facing economic problems as a result of job or farm loss. The curriculum guide, which is organized in three modules that cover self-esteem, parenting, and resource management, uses a practical problem-solving…

  6. Metering Best Practices, A Guide to Achieving Utility Resource Efficiency, Release 2.0

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

    Sullivan, Greg; Hunt, W. D.; Pugh, Ray

    2011-08-31

    This release is an update and expansion of the information provided in Release 1.0 of the Metering Best Practice Guide that was issued in October 2007. This release, as was the previous release, was developed under the direction of the U.S. Department of Energy's Federal Energy Management Program (FEMP). The mission of FEMP is to facilitate the Federal Government's implementation of sound cost-effective energy management and investment practices to enhance the nation's energy security and environmental stewardship. Each of these activities is directly related to achieving requirements set forth in the Energy Policy Acts of 1992 and 2005, the Energymore » Independence and Security Act (EISA) of 2007, and the goals that have been established in Executive Orders 13423 and 13514 - and also those practices that are inherent in sound management of Federal financial and personnel resources.« less

  7. Practical Solutions for Pesticide Safety: A Farm and Research Team Participatory Model

    PubMed Central

    Galvin, Kit; Krenz, Jen; Harrington, Marcy; Palmández, Pablo; Fenske, Richard A.

    2018-01-01

    Development of the Practical Solutions for Pesticide Safety guide used participatory research strategies to identify and evaluate solutions that reduce pesticide exposures for workers and their families and to disseminate these solutions. Project principles were (1) workplace chemicals belong in the workplace, and (2) pesticide handlers and farm managers are experts, with direct knowledge of production practices. The project’s participatory methods were grounded in self-determination theory. Practical solutions were identified and evaluated based on five criteria: practicality, adaptability, health and safety, novelty, and regulatory compliance. Research activities that had more personal contact provided better outcomes. The Expert Working Group, composed of farm managers and pesticide handlers, was key to the identification of solutions, as were farm site visits. Audience participation, hands-on testing, and orchard field trials were particularly effective in the evaluation of potential solutions. Small work groups in a Regional Advisory Committee provided the best direction and guidance for a “user-friendly” translational document that provided evidence-based practical solutions. The “farmer to farmer” format of the guide was endorsed by both the Expert Working Group and the Regional Advisory Committee. Managers and pesticide handlers wanted to share their solutions in order to “help others stay safe,” and they appreciated attribution in the guide. The guide is now being used in educational programs across the region. The fundamental concept that farmers and farmworkers are innovators and experts in agricultural production was affirmed by this study. The success of this process demonstrates the value of participatory industrial hygiene in agriculture. PMID:26488540

  8. Practical Solutions for Pesticide Safety: A Farm and Research Team Participatory Model.

    PubMed

    Galvin, Kit; Krenz, Jen; Harrington, Marcy; Palmández, Pablo; Fenske, Richard A

    2016-01-01

    Development of the Practical Solutions for Pesticide Safety guide used participatory research strategies to identify and evaluate solutions that reduce pesticide exposures for workers and their families and to disseminate these solutions. Project principles were (1) workplace chemicals belong in the workplace, and (2) pesticide handlers and farm managers are experts, with direct knowledge of production practices. The project's participatory methods were grounded in self-determination theory. Practical solutions were identified and evaluated based on five criteria: practicality, adaptability, health and safety, novelty, and regulatory compliance. Research activities that had more personal contact provided better outcomes. The Expert Working Group, composed of farm managers and pesticide handlers, was key to the identification of solutions, as were farm site visits. Audience participation, hands-on testing, and orchard field trials were particularly effective in the evaluation of potential solutions. Small work groups in a Regional Advisory Committee provided the best direction and guidance for a "user-friendly" translational document that provided evidence-based practical solutions. The "farmer to farmer" format of the guide was endorsed by both the Expert Working Group and the Regional Advisory Committee. Managers and pesticide handlers wanted to share their solutions in order to "help others stay safe," and they appreciated attribution in the guide. The guide is now being used in educational programs across the region. The fundamental concept that farmers and farmworkers are innovators and experts in agricultural production was affirmed by this study. The success of this process demonstrates the value of participatory industrial hygiene in agriculture.

  9. A silvicultural Guide for Spruce-Fir in the Northeast

    Treesearch

    Robert M. Frank; John C. Bjorkbom

    1973-01-01

    A practical guide to the silvicultural treatment of spruce-fir stands for timber production in New England and New York. Both evenaged and uneven-aged management are considered, covering both the establishment of new stands and the culture of existing stands. Includes a set of prescriptions describing specific treatments for a range of stand conditions and management...

  10. Leading the Way: Disabilities Services and the Management Team. Training Guides for the Head Start Learning Community.

    ERIC Educational Resources Information Center

    Education Development Center, Inc., Newton, MA.

    This guide is designed to provide Head Start managers with the skills and knowledge needed to plan and implement integrated services for children with disabilities and their families. Module 1, "Identifying Shared Responsibilities," assists participants in identifying how current roles and collaboration practices as a team affect…

  11. Beyond the Paycheck: A Human Resources Management Guide for Leaders of Small Youth-Serving Organizations

    ERIC Educational Resources Information Center

    Casey, Thomas P.

    2009-01-01

    This guide aims to help organization leaders develop the tools and knowledge they need to create and use sound human resources management (HRM) systems and practices that support program success and sustainability. It identifies key components of HRM systems and discusses important considerations in designing HRM policies, procedures, and…

  12. Applying Best Business Practices from Corporate Performance Management to DoD

    DTIC Science & Technology

    2013-01-01

    leading or governing large, complex corporations and are experienced in creating reliable solutions to complex management issues guided by best business ...recommendations and effective solutions aimed at improving DoD. Defense Business Board Corporate Performance Management REPORT FY13-03 Task...Group 1 Applying Best Business Practices from Corporate Performance Management to DoD TASK The Deputy Secretary of Defense (DEPSECDEF

  13. Managing Productive Schools: Toward an Ecology.

    ERIC Educational Resources Information Center

    Snyder, Karolyn J.; Anderson, Robert H.

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

  14. [A practical guide for the management of gliomas].

    PubMed

    Stupp, Roger; Pica, Alessia; Mirimanoff, René O; Michielin, Olivier

    2007-09-01

    The management of gliomas in daily clinical practice is challenging. It requires a multidisciplinary and coordinated approach involving neurosurgery, radiotherapy and, finally, chemotherapy. Important progress has been made during the last years with the introduction of a combined treatment associating standard radiotherapy with concomitant chemotherapy using temozolomide, a novel alkylating agent. For the first time in many years a new treatment strategy translated into a significant prolongation of survival. In parallel, molecular markers (e.g. loss of heterozygosity on chromosomes 1p and 19q or methylation of the methyl-guanine methyl transferase [MGMT] gene promoter) allowed for identification of distinct subtypes of glioma or prediction of treatment response. In this "Practical Guide", we describe the daily practice and aim at answering some common questions in the management of patients suffering from glioblastoma, astrocytoma, oligodendroglioma and low grade glioma. The therapeutic options presented here are based on evidences from the literature. In the absence of documented evidence, the empirical choices from our local practice are explained and justified.

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

    PubMed

    Schreter, Robert K

    2010-01-01

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

  16. Practical Nursing Curriculum Guide. Including the Expanded Functions of I.V. Therapy and LPN Management. Invest in Success.

    ERIC Educational Resources Information Center

    Idaho State Dept. of Education, Boise. Div. of Vocational Education.

    Under the Idaho state system for curriculum development in vocational education, Technical Committees made up solely of industry personnel are responsible for drawing up task lists for each program. The first part of this guide contains a curriculum for instruction of practical nurses who are eligible to sit for the license examination upon…

  17. The Quick-Reference Handbook for School Leaders: A Practical Guide for Principals

    ERIC Educational Resources Information Center

    Corwin Press, 2005

    2005-01-01

    This ready-reference school management tool is a practical guide that provides an answer to the questions "Where do I start?" and "Where do I look for direction?" Written in an easy-to-read, bulleted format, the handbook is an excellent resource for all principals, assistant principals, and aspiring school administrators. With words of wisdom from…

  18. Responses of Southeastern amphibians and reptiles to forest management: A review

    Treesearch

    Kevin R. Russell; T. Bently Wigley; William M. Baughman; Hugh G. Hanlin; W. Mark Ford

    2004-01-01

    Forest managers in the Southeast increasingly need information about amphibian and reptile responses to silvicultural practices in order to guide sustainable forestry programs. A review of existing literature indicates that effects of silvicultural practices on herpetofauna often are region- and species-specific, with individual taxa responding positively, negatively,...

  19. Building Blocks for School IPM: A Least-Toxic Pest Management Manual.

    ERIC Educational Resources Information Center

    Crouse, Becky, Ed.; Owens, Kagan, Ed.

    This publication is a compilation of original and republished materials from numerous individuals and organizations working on pesticide reform and integrated pest management (IPM)--using alternatives to prevailing chemical-intensive practices. The manual provides comprehensive information on implementing school IPM, including a practical guide to…

  20. Recommended practices for DSRC licensing and spectrum management : a guide for management, regulation, deployment, and administration for a connected vehicle environment.

    DOT National Transportation Integrated Search

    2015-12-01

    The goal of this document is to make licensing requirements transparent and best practices accessible to any organization, public or private, seeking to deploy Connected Vehicle Dedicated Short Range Communications (DSRC) Roadside Units (RSU) a...

  1. Power Parenting for Children with ADD/ADHD: A Practical Parent's Guide for Managing Difficult Behaviors.

    ERIC Educational Resources Information Center

    Flick, Grad L.

    The first step in dealing with an attention deficit disorder (ADD/ADHD) child's difficult behavior is to understand its origins. This book presents behavior management techniques to help parents care for their ADD child while ensuring that the child continues to develop positive, healthy self-esteem. The guide shows how to: (1) ensure an accurate…

  2. United States Fire Administration

    MedlinePlus

    ... Vehicle Fire Safety flyer PDF 234 KB Publication Risk management practices This guide contains recommended approaches to manage organizational, operational and community risk. If you are a fire department leader, our ...

  3. Library Information Desk. An Organizational and Operating Guide.

    ERIC Educational Resources Information Center

    Souza, Mary Beth

    Intended for those who manage, organize, and oversee the information desk of the State University of New York at Stony Brook Library, this guide contains practical information about staffing, acquiring materials, and operating procedures. The guide opens with a list of suggestions for recruiting and scheduling volunteers for the information desk.…

  4. Nutrition and Meal Planning in Child-Care Programs: A Practical Guide.

    ERIC Educational Resources Information Center

    Edelstein, Sari

    Designed to assist child care center managers in planning nutritious meals for children in centers or licensed home day care programs, this guide presents information on the nutritional requirements of infants and children, sample menus for child care centers, and resources for further information. The first part of the guide details the…

  5. On Being a Mentor: A Guide for Higher Education Faculty

    ERIC Educational Resources Information Center

    Johnson, Brad W.

    2006-01-01

    This book is the definitive guide for faculty in higher education who wish to mentor both students and junior faculty. It features strategies, guidelines, best practices, and recommendations for professors who wish to excel in this area. Written in a pithy style, this no-nonsense guide offers straightforward advice about managing problem mentor…

  6. Building Air Quality Guide: A Guide for Building Owners and Facility Managers

    EPA Pesticide Factsheets

    The Building Air Quality, developed by the EPA and the National Institute for Occupational Safety and Health, provides practical suggestions on preventing, identifying, and resolving indoor air quality (IAQ) problems in public and commercial buildings.

  7. Risk Management: An Accountability Guide for University and College Boards

    ERIC Educational Resources Information Center

    Abraham, Janice M.

    2013-01-01

    With proven advice and practical best practices for sound risk management, this robust publication written by the CEO of United Educators identifies how engaged board members should collaborate closely with institutional leaders on a variety of operational and strategic risks. All board members, whatever their role or committee assignment, will…

  8. A Practical Guide to Strategic Enrollment Management Planning

    ERIC Educational Resources Information Center

    Wilkinson, R. B.; Taylor, James S.; Peterson, Ange; Machado-Taylor, Maria de Lourdes

    2007-01-01

    Over the past decade, strategic enrollment management (SEM) has become a major force in the organization and practice of higher education. With limited financial resources for financial aid, institutions must balance the need to attract and admit a freshman class that fits well with the institution and also provide the necessary financial support…

  9. The management of vocal fold nodules in children: a national survey of speech-language pathologists.

    PubMed

    Signorelli, Monique E; Madill, Catherine J; McCabe, Patricia

    2011-06-01

    The purpose of this study was to determine the management options and voice therapy techniques currently being used by practicing speech-language pathologists (SLPs) to treat vocal fold nodules (VFNs) in children. The sources used by SLPs to inform and guide their clinical decisions when managing VFNs in children were also explored. Sixty-two SLPs completed a 23-item web-based survey. Data was analysed using frequency counts, content analyses, and supplementary analyses. SLPs reported using a range of management options and voice therapy techniques to treat VFNs in children. Voice therapy was reportedly the most frequently used management option across all respondents, with the majority of SLPs using a combination of indirect and direct voice therapy techniques. When selecting voice therapy techniques, the majority of SLPs reported that they did not use the limited external evidence available to guide their clinical decisions. Additionally, the majority of SLPs reported that they frequently relied on lower levels of evidence or non-evidence-based sources to guide clinical practice both in the presence and absence of higher quality evidence. Further research needs to investigate strategies to remove the barriers that impede SLPs use of external evidence when managing VFNs in children.

  10. Principles for ecologically based invasive plant management

    USDA-ARS?s Scientific Manuscript database

    Land managers long have identified a critical need for a practical and effective framework to guide the implementation of successful restoration, especially where invasive plants dominate the ecosystem. A holistic, ecologically-based invasive plant management (EBIPM) framework that integrates ecosy...

  11. Individualized Study Guide on Apiculture: Student Guide. Curriculum Materials for Agricultural Education.

    ERIC Educational Resources Information Center

    Housmam, John L.; And Others

    The study guide contains introductory level information, principles and management practices which may be applied by a hobbyist or a commercial apiary. The lessons are designed to train students for entry level jobs, to establish students in a beekeeping enterprise, and to emphasize the importance of honey bees in our daily lives and in…

  12. Ethnicity and Healthcare Practice - A Guide for the Primary Care Team Dyson Simon Culley Lorraine Ethnicity and Healthcare Practice - A Guide for the Primary Care Team 150 Quay Books 9781856423663 1856423662 [Formula: see text].

    PubMed

    2010-06-02

    How could a book exploring culture and ethnicity not interest a nurse? Chapters cover ethnicity, the diversity of UK ethnic groups, managing diversity in health care, communication, the effects of disease on family and community, mental health, substance misuse and refugees and asylum seekers.

  13. Oral immunotherapy for food allergy: A Spanish guideline. Immunotherapy egg and milk Spanish guide (items guide). Part I: Cow milk and egg oral immunotherapy: Introduction, methodology, rationale, current state, indications contraindications and oral immunotherapy build-up phase.

    PubMed

    Martorell, A; Alonso, E; Echeverría, L; Escudero, C; García-Rodríguez, R; Blasco, C; Bone, J; Borja-Segade, J; Bracamonte, T; Claver, A; Corzo, J L; De la Hoz, B; Del Olmo, R; Dominguez, O; Fuentes-Aparicio, V; Guallar, I; Larramona, H; Martín-Muñoz, F; Matheu, V; Michavila, A; Ojeda, I; Ojeda, P; Piquer, M; Poza, P; Reche, M; Rodríguez Del Río, P; Rodríguez, M; Ruano, F; Sánchez-García, S; Terrados, S; Valdesoiro, L; Vazquez-Ortiz, M

    Cow's milk and egg are the most frequent causes of food allergy in the first years of life. Treatments such as oral immunotherapy (OIT) have been investigated as an alternative to avoidance diets. No clinical practice guides on the management of OIT with milk and egg are currently available. To develop a clinical guide on OIT based on the available scientific evidence and the opinions of experts. A review was made of studies published in the period between 1984 and June 2016, Doctoral Theses published in Spain, and summaries of communications at congresses (SEAIC, SEICAP, EAACI, AAAAI), with evaluation of the opinion consensus established by a group of experts pertaining to the scientific societies SEICAP and SEAIC. Recommendations have been established regarding the indications, requirements and practical aspects of the different phases of OIT, as well as special protocols for patients at high risk of suffering adverse reactions. A clinical practice guide is presented for the management of OIT with milk and egg, based on the opinion consensus of Spanish experts. Copyright © 2017 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  14. A guide to performance management for the Health Information Manager.

    PubMed

    Leggat, Sandra G

    This paper provides a summary of human resource management practices that have been identified as being associated with better outcomes in performance management. In general, essential practices include transformational leadership and a coherent program of goal setting, performance monitoring and feedback. Some Health Information Managers may feel they require training assistance to develop the necessary skills in the establishment of meaningful work performance goals for staff and the provision of useful and timely feedback. This paper provides useful information to assist Health Information Managers enhance the performance of their staff.

  15. 7 CFR 1466.3 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... a contract, and which is operated by the producer with equipment, labor, management, and production... management facility means a structural conservation practice, implemented in the context of a Comprehensive Nutrient Management Plan and consistent with the Field Office Technical Guide, which is used for storing...

  16. A Handbook for Classroom Management that Works

    ERIC Educational Resources Information Center

    Marzano, Robert J.; Gaddy, Barbara B.; Foseid, Maria C.; Foseid, Mark P.; Marzano, Jana S.

    2005-01-01

    Use this handbook in self-help, study group, and teacher workshop situations to implement the research-based classroom management practices from the ASCD best-seller "Classroom Management That Works". The authors guide you through the classroom management approaches that support higher student achievement and provide you with hundreds of…

  17. Shaping Case Management in Minnesota: In Theory, Reality and Practice.

    ERIC Educational Resources Information Center

    Lang, Joyce; Kragthorpe, Candice

    This monograph reports the conclusions of seven 6-month projects addressing issues of case management in the field of developmental disabilities in Minnesota. First, the theory supporting case management is reviewed and alternative definitions and guiding principles are offered. Next, the Minnesota rule on case management is detailed, noting…

  18. Listen to Me Listen to You: A Step-By-Step Guide to Communication Skills Training

    ERIC Educational Resources Information Center

    Kotzman, Mandy; Kotzman, Anne

    2008-01-01

    This step-by-step guide is a companion to the popular "Listen to Me, Listen to You: A Practical Guide to Self-Awareness, Communication Skills and Conflict Management" (New Expanded Edition, Penguin Books, 2007). It is designed for use by anyone working in communication skills and personal development training. Resource material is grouped under…

  19. SNL Mechanical Computer Aided Design (MCAD) guide 2007.

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

    Moore, Brandon; Pollice, Stephanie L.; Martinez, Jack R.

    2007-12-01

    This document is considered a mechanical design best-practice guide to new and experienced designers alike. The contents consist of topics related to using Computer Aided Design (CAD) software, performing basic analyses, and using configuration management. The details specific to a particular topic have been leveraged against existing Product Realization Standard (PRS) and Technical Business Practice (TBP) requirements while maintaining alignment with sound engineering and design practices. This document is to be considered dynamic in that subsequent updates will be reflected in the main title, and each update will be published on an annual basis.

  20. 75 FR 62759 - Notice of Proposed Change to Section IV of the Virginia State Technical Guide

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-13

    ... following practice standards: 314, Brush Management, 324, Deep Tillage, 330, Contour Farming, 332, Contour.... These practices will be used to plan and install conservation practices. DATES: Comments will be...-1737. Copies of the practice standards will be made available upon written request to the address shown...

  1. Achieving organizational change in pediatric pain management

    PubMed Central

    Dowden, Stephanie; McCarthy, Maria; Chalkiadis, George

    2008-01-01

    BACKGROUND: Pain in hospitalized children is often under-treated. Little information exists to guide the process of organizational change with a view to improving pain management practices. OBJECTIVES: To describe the process and results of a hospital-wide review of pain management practices designed to identify deficiencies in service provision and recommend directions for change in a pediatric hospital. DESIGN: Prospective consultation of the clinical staff of a specialist pediatric hospital, using qualitative research methodology involving semistructured individual and group interviews. Recommendations based on the interview findings were made by a hospital-appointed working party. RESULTS: A total of 454 staff (27% of all clinical staff) from a variety of professional backgrounds, representing almost every hospital unit or department, were interviewed. Procedural and persistent (chronic) pain was identified as the area needing the most improvement. Barriers to improving pain management included variability in practice, outmoded beliefs and inadequate knowledge, factors which were seen to contribute to a culture of slow or no change. Recommendations of the working party and changes achieved after the review are described. CONCLUSION: The review process identified deficiencies in the management of pain in children, and barriers to its effective management. With institutional support, the present review has guided improvement. PMID:18719714

  2. WSDOT pavement preservation guide for local agencies.

    DOT National Transportation Integrated Search

    2012-11-01

    This report was intended to address two key objectives: (1) identify usage and implementation gaps : found in local agency asset management practices due to decreased resources and develop guidance for : local agencies on recommended practices and to...

  3. Part II: The Effects of Aromatherapy and Guided Imagery for the Symptom Management of Anxiety, Pain, and Insomnia in Critically Ill Patients: An Integrative Review of Current Literature.

    PubMed

    Meghani, Naheed; Tracy, Mary Fran; Hadidi, Niloufar Niakosari; Lindquist, Ruth

    This review is part II of a 2-part series that presents evidence on the effectiveness of aromatherapy and guided imagery for the symptom management of anxiety, pain, and insomnia in adult critically ill patients. Evidence from this review supports the use of aromatherapy for management of pain, insomnia, and anxiety in critically ill patients. Evidence also supports the use of guided imagery for managing these symptoms in critical care; however, the evidence is sparse, mixed, and weak. More studies with larger samples and stronger designs are needed to further establish efficacy of guided imagery for the management of anxiety, pain, and insomnia of critically ill patients; to accomplish this, standardized evidence-based intervention protocols to ensure comparability and to establish optimal effectiveness are needed. Discussion and recommendations related to the use of these therapies in practice and needs for future research in these areas were generated.

  4. Research Gaps in Practice Guidelines for Acute Postoperative Pain Management in Adults: Findings From a Review of the Evidence for an American Pain Society Clinical Practice Guideline.

    PubMed

    Gordon, Debra B; de Leon-Casasola, Oscar A; Wu, Christopher L; Sluka, Kathleen A; Brennan, Timothy J; Chou, Roger

    2016-02-01

    Acute postoperative pain is a common clinical condition that, when poorly controlled, can result in a number of significant negative consequences. The American Pain Society commissioned an evidence-based guideline on the management of postoperative pain to promote evidence-based, safe, and effective perioperative pain management. An interdisciplinary panel developed 31 key questions and inclusion criteria to guide the evidence review. Investigators reviewed 6556 abstracts from multiple electronic databases up to November 2012, an updated evidence review to October 2014, and key references suggested by expert reviewers. More than 800 primary studies not included in a systematic review and 107 systematic reviews were included. Despite a large body of evidence, a number of critical research gaps were identified where only low-quality or insufficient evidence was found to help guide clinical practice recommendations. This report identifies evidence gaps including optimal methods and timing of perioperative patient education, nonpharmacological modalities, combinations of analgesic techniques, monitoring of patient response to treatment, techniques for neuraxial and regional analgesia, and organizational care delivery models. Recommendations to help guide the design of future perioperative studies are offered. Acute postoperative pain is a common clinical condition requiring an evidence-based, planned, and multimodal approach. Despite the plethora of published evidence, much of it is weak and key questions remain unanswered. Researchers are encouraged to work together to produce strong evidence to help guide clinical decisions in perioperative pain management. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  5. Managing Teacher Stress and Burnout.

    ERIC Educational Resources Information Center

    Sparks, Dennis; Hammond, Janice

    This monograph offers a practical guide for identifying and managing those stressors that are in the specific domain of the individual--exercise, diet, sleep, interpersonal relations, time and conflict management, and relaxation. The first section covers stress theory; methods to identify and clarify stressors; restoration of a balanced…

  6. Implementation of Health Information Technology in Routine Care for Fibromyalgia: Pilot Study.

    PubMed

    Sparks, Toni; Kawi, Jennifer; Menzel, Nancy Nivison; Hartley, Kendall

    2016-02-01

    Fibromyalgia management remains complicated and challenging. Health information technology is an evidence-based, nonpharmacological self and symptom management strategy, but few studies have evaluated its feasibility for managing fibromyalgia patients in clinical practice. FibroGuide is an example of an evidence-based, interactive, and computer-based program comprised of 10 educational modules on fibromyalgia. Study aims were to: (1) develop a process for implementing FibroGuide into the routine care of patients with fibromyalgia, (2) evaluate the overall impact on fibromyalgia before and after a 12-week implementation, and (3) assess patient perspectives on using FibroGuide health information technology to assist in self-management. In this pilot study, 35 participants with fibromyalgia were recruited from an Advanced Practice Registered Nurse's outpatient clinic. Using a descriptive design, quantitative data analysis was employed to address study aims. Based on data collection pre- and post-intervention using paired samples testing, a statistically significant change (p = .017) was observed in overall fibromyalgia impact (improved symptom severity, activity, and function). Majority felt that FibroGuide was helpful as part of their routine care, and nearly half reported that it assisted in their self-management. Although 65% noted that technology was an effective and efficient way to receive education for fibromyalgia management, 57% preferred talking to healthcare providers. Larger longitudinal studies are needed on the use of health information technology in fibromyalgia, evaluating both statistical and clinical significance, while decreasing barriers to participant use for this promising adjunct to clinical management. Providers need to be well educated on supporting self-management strategies and health information technology. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  7. Principals Management Support Practices to Promote Teachers' Instructional Improvement for Sustainable Development in Secondary Education in Anambra State, Nigeria

    ERIC Educational Resources Information Center

    Victor, Akinfolarin Akinwale; Emetarom, Uche Grace

    2017-01-01

    This study ascertained the principals management support practices to promote teachers instructional improvement for sustainable development in secondary education in Anambra State. Two specific purposes were formulated and two research questions guided the study. The study adopted a descriptive survey design. The study was conducted in the six…

  8. Readying the Health Education Specialist for Emergencies

    ERIC Educational Resources Information Center

    Geiger, Brian F.; Firsing, Stephen L., III; Beric, Bojana; Rodgers, Joel B.

    2013-01-01

    This article provides a resourceful guide for the health education specialist to improve emergency management knowledge and skills specific to their setting, including training and preparing for emergencies and providing adequate support to students, clients, and colleagues. Five steps guide competent health education practice before, during, and…

  9. Practical Advice for Guiding the Gifted.

    ERIC Educational Resources Information Center

    Cross, Tracy

    1998-01-01

    Among 11 ideas for guiding gifted students are to: recognize and respect the relationship between social/emotional needs and academic needs; teach pro-social skill development; teach ways to manage stress; model the behavior desired in students; embrace diversity; expose students to knowledgeable counseling; and provide opportunities for down…

  10. Greening Federal Facilities: An Energy, Environmental, and Economic Resource Guide for Federal Facility Managers and Designers; Second Edition

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

    Wilson, A.

    2001-05-16

    Greening Federal Facilities, Second Edition, is a nuts-and-bolts resource guide compiled to increase energy and resource efficiency, cut waste, and improve the performance of Federal buildings and facilities. The guide highlights practical actions that facility managers, design and construction staff, procurement officials, and facility planners can take to save energy and money, improve the comfort and productivity of employees, and benefit the environment. It supports a national effort to promote energy and environmental efficiency in the nation's 500,000 Federal buildings and facilities. Topics covered include current Federal regulations; environmental and energy decision-making; site and landscape issues; building design; energy systems;more » water and wastewater; materials; waste management, and recycling; indoor environmental quality; and managing buildings.« less

  11. Development and utility of the front line manager's quick reference guide.

    DOT National Transportation Integrated Search

    2013-05-01

    Air traffic control Front Line Managers (FLMs) influence the prevention of operational incidents (OIs) and runway incursions (RIs) through practices that enable safe controller performance and mitigate problems related to specific contributing fac...

  12. Base-level management of radio-frequency radiation-protection program. Final report

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

    Rademacher, S.E.; Montgomery, N.D.

    1989-04-01

    AFOEHL developed this report to assist the base-level aerospace medical team manage their radio-frequency radiation-protection program. This report supersedes USAFOEHL Report 80-42, 'A Practical R-F Guide for BEES.'

  13. Base-level management of radio-frequency radiation-protection program. Final report

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

    Rademacher, S.E.; Montgomery, N.D.

    1989-04-01

    AFOEHL developed this report to assist the base-level aerospace medical team manage their radio-frequency radiation protection program. This report supersedes USAFOEHL Report 80-42, 'A practical R-F Guide for BEES.'

  14. A procedure to evaluate environmental rehabilitation in limestone quarries.

    PubMed

    Neri, Ana Claudia; Sánchez, Luis Enrique

    2010-11-01

    A procedure to evaluate mine rehabilitation practices during the operational phase was developed and validated. It is based on a comparison of actually observed or documented practices with internationally recommended best practices (BP). A set of 150 BP statements was derived from international guides in order to establish the benchmark. The statements are arranged in six rehabilitation programs under three categories: (1) planning (2) operational and (3) management, corresponding to the adoption of the plan-do-check-act management systems model to mine rehabilitation. The procedure consists of (i) performing technical inspections guided by a series of field forms containing BP statements; (ii) classifying evidences in five categories; and (iii) calculating conformity indexes and levels. For testing and calibration purposes, the procedure was applied to nine limestone quarries and conformity indexes were calculated for the rehabilitation programs in each quarry. Most quarries featured poor planning practices, operational practices reached high conformity levels in 50% of the cases and management practices scored moderate conformity. Despite all quarries being ISO 14001 certified, their management systems pay low attention to issues pertaining to land rehabilitation and biodiversity. The best results were achieved by a quarry whose expansion was recently submitted to the environmental impact assessment process, suggesting that public scrutiny may play a positive role in enhancing rehabilitation practices. Conformity indexes and levels can be used to chart the evolution of rehabilitation practices at regular intervals, to establish corporate goals and for communication with stakeholders. Copyright 2010 Elsevier Ltd. All rights reserved.

  15. Addressing Prediabetes in Childhood Obesity Treatment Programs: Support from Research and Current Practice

    PubMed Central

    Grow, H. Mollie; Fernandez, Cristina; Lukasiewicz, Gloria J.; Rhodes, Erinn T.; Shaffer, Laura A.; Sweeney, Brooke; Woolford, Susan J.; Estrada, Elizabeth

    2014-01-01

    Abstract Background: Type 2 diabetes mellitus (T2DM) and prediabetes have increased in prevalence among overweight and obese children, with significant implications for long-term health. There is little published evidence on the best approaches to care of prediabetes among overweight youth or the current practices used across pediatric weight management programs. Methods: This article reviews the literature and summarizes current practices for screening, diagnosis, and treatment of prediabetes at childhood obesity treatment centers. Findings regarding current practice were based on responses to an online survey from 28 pediatric weight management programs at 25 children's hospitals in 2012. Based on the literature reviewed, and empiric data, consensus support statements on prediabetes care and T2DM prevention were developed among representatives of these 25 children's hospitals' obesity clinics. Results: The evidence reviewed demonstrates that current T2DM and prediabetes diagnostic parameters are derived from adult-based studies with little understanding of clinical outcomes among youth. Very limited evidence exists on preventing progression of prediabetes. Some evidence suggests that a significant proportion of obese youth with prediabetes will revert to normoglycemia without pharmacological management. Evidence supports lifestyle modification for children with prediabetes, but further study of specific lifestyle changes and pharmacological treatments is needed. Conclusion: Evidence to guide management of prediabetes in children is limited. Current practice patterns of pediatric weight management programs show areas of variability in practice, reflecting the limited evidence base. More research is needed to guide clinical care for overweight youth with prediabetes. PMID:25055134

  16. Translating Knowledge Into Practice Through an Academic-Practice Partnership for Exploring Barriers That Impact Management of Homebound Patients With Heart Failure.

    PubMed

    Echevarria, Mercedes

    A knowledge translation project involving an academic-practice partnership and guided by action-oriented research was used for exploring barriers that impact management of homebound heart failure patients. The intervention process followed an action research model of interaction, self-reflection, response, and change in direction. External facilitators (academia) and internal facilitators (practice) worked with clinicians to identify a topic for improvement, explore barriers, locate the evidence compare current practice against evidence-based practice recommendations, introduce strategies to "close the gap" between actual practice and the desired practice, develop audit criteria, and reevaluate the impact.

  17. Liability and Safety in Physical Education and Sport: A Practitioner's Guide to the Legal Aspects of Teaching and Coaching in Elementary and Secondary Schools.

    ERIC Educational Resources Information Center

    Hart, James E.; Ritson, Robert J.

    Physical education and athletic staffs have numerous opportunities to become entangled in legal disputes. The information in this guide offers guidance for safer athletic programs and management of risk while reinforcing sound educational practice. The guide provides an overview of tort liability and negligence theory, followed by a discussion of…

  18. Contracting for Efficiency. A Best Practices Guide for Energy-Efficient Product Procurement

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

    Bunch, Saralyn; Payne, Christopher

    2016-04-01

    The requirement to buy energy- and water-efficient products applies to federal purchases made through any procurement pathway (e.g., purchase cards, e-retailers, and solicitations) and to a wide variety of federal projects. The Federal Energy Management Program’s (FEMP's) Buy Energy-Efficient Products buyer overview fact sheet and Contracting for Efficiency best practices guide for product procurement are designed to support federal buyers in the purchase of energy- and water-efficient products.

  19. Contracting for Efficiency: A Best Practices Guide for Energy Efficient Product Procurement

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

    Bunch, Saralyn; Payne, Christopher

    The requirement to buy energy- and water-efficient products applies to federal purchases made through any procurement pathway (e.g., purchase cards, e-retailers, and solicitations) and to a wide variety of federal projects. The Federal Energy Management Program’s (FEMP's) Buy Energy-Efficient Products buyer overview fact sheet and Contracting for Efficiency best practices guide for product procurement are designed to support federal buyers in the purchase of energy- and water-efficient products.

  20. Key Skills Portfolio Assessment: Good Practice Guide

    ERIC Educational Resources Information Center

    Rolfe, Martin; Wilson, Lorraine

    2007-01-01

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

  1. A Guide to Collaboration for IEP Teams

    ERIC Educational Resources Information Center

    Martin, Nicholas R. M.

    2005-01-01

    With so many complex, challenging, and emotionally charged decisions involved, participating in an IEP meeting can seem like navigating through a minefield. But now there is a practical guide to managing these meetings with a high level of awareness, safety, and confidence. Developed for administrators, teachers, resource professionals, and…

  2. Contemporary management of pericardial effusion: practical aspects for clinical practice.

    PubMed

    Imazio, Massimo; Gaido, Luca; Battaglia, Alberto; Gaita, Fiorenzo

    2017-03-01

    A pericardial effusion (PE) is a relatively common finding in clinical practice. It may be either isolated or associated with pericarditis with or without an underlying disease. The aetiology is varied and may be either infectious (especially tuberculosis as the most common cause in developing countries) or non-infectious (cancer, systemic inflammatory diseases). The management is essentially guided by the hemodynamic effect (presence or absence of cardiac tamponade), the presence of concomitant pericarditis or underlying disease, and its size and duration. The present paper reviews the current knowledge on the aetiology, classification, diagnosis, management, therapy, and prognosis of PE in clinical practice.

  3. Impoverishment of practice: analysis of effects of economic discourses in home care case management practice.

    PubMed

    Ceci, Christine

    2006-03-01

    Home care is a health sector under increasing pressure. Demand is often said to be outstripping capacity, with constant change and retrenchment distinguishing features of the current context. This paper takes a reading of the current conditions of home care using data gathered during a field study of home care case management practices conducted in 2004. As economic discourses become increasingly influential in determining responses to client situations, case managers (and their managers) find themselves with limited capacity to exercise control over their practices. A growing gap between professionally influenced discourses--those presumably intended to guide practice--and organizational priorities creates a dissonance for case managers as the political-ethical dimensions of their practices are displaced by budget "realities." For front-line workers, such displacement cannot be sustained in their face-to-face encounters with clients, leading to a growing sense of frustration and powerlessness among these highly skilled practitioners.

  4. A guided interview process to improve student pharmacists' identification of drug therapy problems.

    PubMed

    Rovers, John; Miller, Michael J; Koenigsfeld, Carrie; Haack, Sally; Hegge, Karly; McCleeary, Erin

    2011-02-10

    To measure agreement between advanced pharmacy practice experience students using a guided interview process and experienced clinical pharmacists using standard practices to identify drug therapy problems. Student pharmacists enrolled in an advanced pharmacy practice experience (APPE) and clinical pharmacists conducted medication therapy management interviews to identify drug therapy problems in elderly patients recruited from the community. Student pharmacists used a guided interview tool, while clinical pharmacists' interviews were conducted using their usual and customary practices. Student pharmacists also were surveyed to determine their perceptions of the interview tool. Fair to moderate agreement was observed on student and clinical pharmacists' identification of 4 of 7 drug therapy problems. Of those, agreement was significantly higher than chance for 3 drug therapy problems (adverse drug reaction, dosage too high, and needs additional drug therapy) and not significant for 1 (unnecessary drug therapy). Students strongly agreed that the interview tool was useful but agreed less strongly on recommending its use in practice. The guided interview process served as a useful teaching aid to assist student pharmacists to identify drug therapy problems.

  5. A Guided Interview Process to Improve Student Pharmacists' Identification of Drug Therapy Problems

    PubMed Central

    Miller, Michael J.; Koenigsfeld, Carrie; Haack, Sally; Hegge, Karly; McCleeary, Erin

    2011-01-01

    Objective To measure agreement between advanced pharmacy practice experience students using a guided interview process and experienced clinical pharmacists using standard practices to identify drug therapy problems. Methods Student pharmacists enrolled in an advanced pharmacy practice experience (APPE) and clinical pharmacists conducted medication therapy management interviews to identify drug therapy problems in elderly patients recruited from the community. Student pharmacists used a guided interview tool, while clinical pharmacists' interviews were conducted using their usual and customary practices. Student pharmacists also were surveyed to determine their perceptions of the interview tool. Results Fair to moderate agreement was observed on student and clinical pharmacists' identification of 4 of 7 drug therapy problems. Of those, agreement was significantly higher than chance for 3 drug therapy problems (adverse drug reaction, dosage too high, and needs additional drug therapy) and not significant for 1 (unnecessary drug therapy). Students strongly agreed that the interview tool was useful but agreed less strongly on recommending its use in practice. Conclusions The guided interview process served as a useful teaching aid to assist student pharmacists to identify drug therapy problems. PMID:21451770

  6. An Effective Time and Management Strategy in Quality Circles.

    ERIC Educational Resources Information Center

    Halverson, Don E.

    Contending that participation in quality circles enhances effective time management by school administrators and teachers, this guide provides both a theoretical briefing and practical recommendations for better time management. A pre- posttest prefaces a review of basic concepts of quality circles with reference to the work of Abraham Maslow,…

  7. 76 FR 31590 - Endangered and Threatened Species; Take of Anadromous Fish

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-01

    ... proposed research programs are intended to increase knowledge of the species and to help guide management... management efforts, and to determine what salmonid life stages suffer the lowest survival and should be a focus of future management practices. Study 1 is a summer/fall juvenile salmonid population abundance...

  8. Ponderosa pine managed-yield simulator: PPSIM users guide.

    Treesearch

    D.J. DeMars; J.W. Barrett

    1987-01-01

    PPSIM simulates yields of natural and managed ponderosa pine stands. Management practices and effects that can be simulated include commercial thinning, fertilization, genetic improvement, and presence of dwarf mistletoe. An option is available that adjusts growth to simulate local conditions. Equations used in PPSIM describe growth of natural...

  9. Guide to data collection

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Guidelines and recommendations are presented for the collection of software development data. Motivation and planning for, and implementation and management of, a data collection effort are discussed. Topics covered include types, sources, and availability of data; methods and costs of data collection; types of analyses supported; and warnings and suggestions based on software engineering laboratory (SEL) experiences. This document is intended as a practical guide for software managers and engineers, abstracted and generalized from 5 years of SEL data collection.

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

    ERIC Educational Resources Information Center

    Poduska, Jeanne M.; Kurki, Anja

    2014-01-01

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

  11. Using fractional exhaled nitric oxide (FeNO) to diagnose steroid-responsive disease and guide asthma management in routine care.

    PubMed

    Price, David; Ryan, Dermot; Burden, Annie; Von Ziegenweidt, Julie; Gould, Shuna; Freeman, Daryl; Gruffydd-Jones, Kevin; Copland, Anne; Godley, Clifford; Chisholm, Alison; Thomas, Mike

    2013-11-07

    Fractional exhaled nitric oxide (FeNO) is a surrogate marker of eosinophilic airway inflammation and good predictor of corticosteroid response. To evaluate how FeNO is being used to guide primary care asthma management in the United Kingdom (UK) with a view to devising practical algorithms for the use of FeNO in the diagnosis of steroid-responsive disease and to guide on-going asthma management. Eligible patients (n = 678) were those in the Optimum Patient Care Research Database (OPCRD) aged 4-80 years who, at an index date, had their first FeNO assessment via NIOX MINO® or Flex®. Eligible practices were those using FeNO measurement in at least ten patients during the study period. Patients were characterized over a one-year baseline period immediately before the index date. Outcomes were evaluated in the year immediately following index date for two patient cohorts: (i) those in whom FeNO measurement was being used to identify steroid-responsive disease and (ii) those in whom FeNO monitoring was being used to guide on-going asthma management. Outcomes for cohort (i) were incidence of new ICS initiation at, or within the one-month following, their first FeNO measurement, and ICS dose during the outcome year. Outcomes for cohort (ii) were adherence, change in adherence (from baseline) and ICS dose. In cohort (i) (n = 304) the higher the FeNO category, the higher the percentage of patients that initiated ICS at, or in the one month immediately following, their first FeNO measurement: 82%, 46% and 26% of patients with high, intermediate and low FeNO, respectively. In cohort (ii) (n = 374) high FeNO levels were associated with poorer baseline adherence (p = 0.005) but greater improvement in adherence in the outcome year (p = 0.017). Across both cohorts, patients with high FeNO levels were associated with significantly higher ICS dosing (p < 0.001). In the UK, FeNO is being used in primary practice to guide ICS initiation and dosing decisions and to identify poor ICS adherence. Simple algorithms to guide clinicians in the practical use of FeNO could improved diagnostic accuracy and better tailored asthma regimens.

  12. 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.

  13. Working Together to Promote Diabetes Control: A Practical Guide for Diabetes Health Care Providers in Establishing a Working Alliance to Achieve Self-Management Support.

    PubMed

    Jones, Allan; Vallis, Michael; Cooke, Debbie; Pouwer, François

    2016-01-01

    The quality of the "patient-carer" relationship is the foundation of self-management support and has been shown to influence treatment outcome in relation to psychological and somatic illness, including diabetes. It has long been accepted within applied psychology that the quality of the client-therapist relationship--termed the working alliance--is of central importance to treatment outcome and may account for a significant degree of the overall treatment effect. Diabetes healthcare providers have recently expressed a need for further training in communication techniques and in the psychological aspects of diabetes. Could we take a page from the psychological treatment manual on working alliance in therapy to guide the diabetes healthcare provider in their role of supporting the person with diabetes achieve and maintain better metabolic control? This paper examines the role of the working alliance in diabetes care and offers a practical guide to the diabetes healthcare provider in establishing a working alliance with the person with diabetes in managing diabetes.

  14. Information Security Assessment of SMEs as Coursework -- Learning Information Security Management by Doing

    ERIC Educational Resources Information Center

    Ilvonen, Ilona

    2013-01-01

    Information security management is an area with a lot of theoretical models. The models are designed to guide practitioners in prioritizing management resources in companies. Information security management education should address the gap between the academic ideals and practice. This paper introduces a teaching method that has been in use as…

  15. Serials Management: A Practical Guide. Frontiers of Access to Library Materials No. 3.

    ERIC Educational Resources Information Center

    Chen, Chiou-Sen Dora

    This book advises librarians, paraprofessional library supervisors, and library school students on problems unique to the management of serials. Chapter 1 explains the character and publication patterns of serials. Chapter 2 discusses the scope and the organizational structure of serials management, and the role of the serials manager. Chapter 3…

  16. 16 CFR 1018.3 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Policy. 1018.3 Section 1018.3 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL ADVISORY COMMITTEE MANAGEMENT General Provisions § 1018.3 Policy. In application of this part, Commission officials shall be guided by the Advisory...

  17. Relax for Success: An Educator's Guide to Stress Management. [With CD-ROM].

    ERIC Educational Resources Information Center

    Glanz, Jeffrey

    This book is designed as a practical, concise, easy-to-read guide for relieving stress. It is written specifically for educators, with examples and anecdotes that relate to professional educators' experiences. It assumes a holistic approach to stress relief that incorporates thought, verbal and action strategies and techniques. The harm that…

  18. A silvicultural guide for developing a sugarbush

    Treesearch

    Kenneth F. Lancaster; Russell S. Walters; Frederick M. Laing; Raymond T. Foulds

    1974-01-01

    A practical guide for the management of a sugarbush. Guidelines are established for the manipulation of stand density and stocking to promote the development of healthy vigorous trees with deep, wide crowns, the necessary attributes for highest possible yield of sugar-rich sap. Specific treatments are prescribed for sapling, poletimber and small sawtimber stands and a...

  19. Wage and Salary Administration for Smaller Institutions of Higher Education. A Basic Guide to Management Practice.

    ERIC Educational Resources Information Center

    National Association of College and University Business Officers, Washington, DC.

    This manual provides a basic guide to wage and salary administration at smaller institutions of higher education--institutions with 400 or fewer full-time nonacademic employees and a relatively uncomplicated administrative organization. Emphasis is placed on definitions and benefits of the process, assigning responsibility and authority, deciding…

  20. Managing Asthma: A Guide for Schools.

    ERIC Educational Resources Information Center

    National Heart, Lung, and Blood Inst. (DHHS/NIH), Bethesda, MD.

    This guide was developed to provide school personnel with practical ways to help students with asthma participate fully in all school activities. It begins by noting the prevalence of asthma and stating that asthma is a leading cause of absenteeism among students. This is followed by a brief description of asthma as a chronic lung disease…

  1. The Effective Teacher's Guide: 50 Ways to Engage Students and Promote Interactive Learning. Second Edition

    ERIC Educational Resources Information Center

    Frey, Nancy

    2010-01-01

    This popular guide offers a wealth of innovative, research-based strategies for making K-12 classrooms the best learning environments they can be. Easy-to-implement best practices are presented for establishing a classroom management plan, organizing procedures and materials, building a respectful community, fostering peer collaboration, and…

  2. A Helpful Guide in the Training of a Mentally Retarded Child.

    ERIC Educational Resources Information Center

    Blanton, Elsie

    The guide offers numerous practical suggestions for training mentally retarded children in self care skills, and catalogs developmental characteristics of children from birth to a mental age of 11 years. Included are brief sections on the management of neurologically impaired children and mongoloid babies, the importance of speech stimulation, and…

  3. Storm Water Management Model Applications Manual

    EPA Science Inventory

    The EPA Storm Water Management Model (SWMM) is a dynamic rainfall-runoff simulation model that computes runoff quantity and quality from primarily urban areas. This manual is a practical application guide for new SWMM users who have already had some previous training in hydrolog...

  4. An uneven-aged management strategy: lessons learned

    Treesearch

    Mark T. Smith; John D. Exline

    2002-01-01

    Use of an ecosystem approach at a landscape scale to program and guide accomplishments of multi-resource and social objectives has been discussed between researchers and natural resource managers for many years. Presently, great interest exists in the applicability of uneven-aged management practices for such an approach in conifer forests of the Sierra Nevada of...

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

    USDA-ARS?s Scientific Manuscript database

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

  6. Small Business Management Volume III: Curriculum. An Adult Education Program.

    ERIC Educational Resources Information Center

    Persons, Edgar A.; Swanson, Gordon I.

    The small business management adult education program outlined in this curriculum guide is designed to help small business entrepreneurs solve their business management problems and attain the goals they have established for their businesses and their families. (An instructor's manual and practice problems are in separate volumes.) The 3-year…

  7. Diagnosing and Managing Violence

    PubMed Central

    2011-01-01

    Available categorization systems for violence encountered in medical practice do not constitute optimal tools to guide management. In this article, 4 common patterns of violence across psychiatric diagnoses are described (defensive, dominance-defining, impulsive, and calculated) and management implications are considered. The phenomenologic and neurobiological rationale for a clinical classification system of violence is also presented. PMID:22295257

  8. An Overview of Total Quality Management (TQM) practice in Construction Sector

    NASA Astrophysics Data System (ADS)

    Likita, A. J.; Zainun, N. Y.; Rahman, I. Abdul; Awal, A. S. M. Abdul; Alias, A. R.; Rahman, M. Q. Abdul; Ghazali, F. E. Mohamed

    2018-04-01

    In construction sector TQM can be termed as a philosophy which guides construction professionals on the proper execution of construction projects in terms of quality. The aim of this paper is to discuss on quality management practice in construction sector. This paper evaluated five previous researches and the findings were discussed to find a conclusion of TQM practise in construction sector. The study found that TQM had been successfully practice in construction sector at Saudi Arabia, India, US and South Africa. Application of Artificial Neural Network (ANN) help to improve the implementation of TQM in construction sector. In conclusion, quality management practices will give better control of processes in construction sector.

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

    PubMed Central

    Poduska, Jeanne M.; Kurki, Anja

    2015-01-01

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

  10. Operations & Maintenance Best Practices - A Guide to Achieving Operational Efficiency (Release 3)

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

    Sullivan, Greg; Pugh, Ray; Melendez, Aldo P.

    This guide highlights operations and maintenance programs targeting energy and water efficiency that are estimated to save 5% to 20% on energy bills without a significant capital investment. The purpose of this guide is to provide you, the Operations and Maintenance (O&M)/Energy manager and practitioner, with useful information about O&M management, technologies, energy and water efficiency, and cost-reduction approaches. To make this guide useful and to reflect your needs and concerns, the authors met with O&M and Energy managers via Federal Energy Management Program (FEMP) workshops. In addition, the authors conducted extensive literature searches and contacted numerous vendors and industrymore » experts. The information and case studies that appear in this guide resulted from these activities. It needs to be stated at the outset that this guide is designed to provide information on effective O&M as it applies to systems and equipment typically found at Federal facilities. This guide is not designed to provide the reader with step-by-step procedures for performing O&M on any specific piece of equipment. Rather, this guide first directs the user to the manufacturer's specifications and recommendations. In no way should the recommendations in this guide be used in place of manufacturer's recommendations. The recommendations in this guide are designed to supplement those of the manufacturer, or, as is all too often the case, provide guidance for systems and equipment for which all technical documentation has been lost. As a rule, this guide will first defer to the manufacturer's recommendations on equipment operation and maintenance.« less

  11. Building America Best Practices Series, Volume 6: High-Performance Home Technologies: Solar Thermal & Photovoltaic Systems

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

    Baechler, Michael C.; Gilbride, Theresa L.; Ruiz, Kathleen A.

    This guide is was written by PNNL for the US Department of Energy's Building America program to provide information for residential production builders interested in building near zero energy homes. The guide provides indepth descriptions of various roof-top photovoltaic power generating systems for homes. The guide also provides extensive information on various designs of solar thermal water heating systems for homes. The guide also provides construction company owners and managers with an understanding of how solar technologies can be added to their homes in a way that is cost effective, practical, and marketable. Twelve case studies provide examples of productionmore » builders across the United States who are building energy-efficient homes with photovoltaic or solar water heating systems.« less

  12. Project Overview: A Reef Manager's Guide to Coral Bleaching ...

    EPA Pesticide Factsheets

    The purpose of this report is to provide the latest scientific knowledge and discuss available management options to assist local and regional managers in responding effectively to mass coral bleaching events. Background A Reef Manager’s Guide to Coral Bleaching is the result of a collaborative effort by over 50 scientists and managers to: (1) share the best available scientific information on climate-related coral bleaching; and (2) compile a tool kit of currently available strategies for adaptive management of coral reefs in a changing climate. The result is a compendium of current information, tools, and practical suggestions to aid managers in their efforts to protect reefs in a way that maximizes reef resilience in the face of continuing climate change. The Guide is a joint publication of the National Oceanic and Atmospheric Administration, the Great Barrier Reef Marine Park Authority, and The World Conservation Union, with author contributions from a variety of international partners from government agencies, non-governmental organizations, and academic institutions. EPA’s Office of Research and Development was a major contributor to the Guide through authorship and participation in the final review and editing process for the entire report. A Reef Manager’s Guide to Coral Bleaching is the result of a collaborative effort by over 50 scientists and managers to: (1) share the best available scientific information on climate-related coral blea

  13. Emerging Role of Quality Indicators in Physical Therapist Practice and Health Service Delivery

    PubMed Central

    Klemm, Alexandria; Li, Linda C.; Jones, C. Allyson

    2016-01-01

    Quality-based care is a hallmark of physical therapy. Treatment effectiveness must be evident to patients, managers, employers, and funders. Quality indicators (QIs) are tools that specify the minimum acceptable standard of practice. They are used to measure health care processes, organizational structures, and outcomes that relate to aspects of high-quality care of patients. Physical therapists can use QIs to guide clinical decision making, implement guideline recommendations, and evaluate and report treatment effectiveness to key stakeholders, including third-party payers and patients. Rehabilitation managers and senior decision makers can use QIs to assess care gaps and achievement of benchmarks as well as to guide quality improvement initiatives and strategic planning. This article introduces the value and use of QIs to guide clinical practice and health service delivery specific to physical therapy. A framework to develop, select, report, and implement QIs is outlined, with total joint arthroplasty rehabilitation as an example. Current initiatives of Canadian and American physical therapy associations to develop tools to help clinicians report and access point-of-care data on patient progress, treatment effectiveness, and practice strengths for the purpose of demonstrating the value of physical therapy to patients, decision makers, and payers are discussed. Suggestions on how physical therapists can participate in QI initiatives and integrate a quality-of-care approach in clinical practice are made. PMID:26089040

  14. MANAGEMENT AND TREATMENT OF WATER FROM HARD-ROCK MINES {ENGINEERING ISSUE}

    EPA Science Inventory

    This Engineering Issue document on treatment of mining waters is a practical guide to understanding and selecting technologies for the environmental management of waste materials and effluents at hard-rock mines. For the purposes of this discussion, hard-rock mining primarily ref...

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

    PubMed

    Crozier, Gkd; Schulte-Hostedde, Albrecht I

    2014-08-01

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

  16. Sound therapy for tinnitus management: practicable options.

    PubMed

    Hoare, Derek J; Searchfield, Grant D; El Refaie, Amr; Henry, James A

    2014-01-01

    The authors reviewed practicable options of sound therapy for tinnitus, the evidence base for each option, and the implications of each option for the patient and for clinical practice. To provide a general guide to selecting sound therapy options in clinical practice. Practicable sound therapy options. Where available, peer-reviewed empirical studies, conference proceedings, and review studies were examined. Material relevant to the purpose was summarized in a narrative. The number of peer-reviewed publications pertaining to each sound therapy option reviewed varied significantly (from none to over 10). Overall there is currently insufficient evidence to support or refute the routine use of individual sound therapy options. It is likely, however, that sound therapy combined with education and counseling is generally helpful to patients. Clinicians need to be guided by the patient's point of care, patient motivation and expectations of sound therapy, and the acceptability of the intervention both in terms of the sound stimuli they are to use and whether they are willing to use sound extensively or intermittently. Clinicians should also clarify to patients the role sound therapy is expected to play in the management plan. American Academy of Audiology.

  17. Financial Accounting and Reporting by Institutionally Owned and Operated College Stores.

    ERIC Educational Resources Information Center

    College Store Journal, 1984

    1984-01-01

    A National Association of College Stores (NACS) guide to practices is provided. These practices were designed to furnish administrators with data on store operations and to provide administrators and store managers with data required to assess the quality and effectiveness of store performance. (MLW)

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

    ERIC Educational Resources Information Center

    May, Gary L.; Short, Darren

    2003-01-01

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

  19. Advanced Energy Retrofit Guide: Practical Ways to Improve Energy Performance; Grocery Stores (Revised) (Book)

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

    Hendron, B.

    2013-07-01

    The U.S. Department of Energy developed the Advanced Energy Retrofit Guides (AERGs) to provide specific methodologies, information, and guidance to help energy managers and other stakeholders successfully plan and execute energy efficiency improvements. Detailed technical discussion is fairly limited in these guides. Instead, we emphasize actionable information, practical methodologies, diverse case studies, and unbiased evaluations of the most promising retrofit measures for each building type. A series of AERGs is under development, addressing key segments of the commercial building stock. Grocery stores were selected as one of the highest priority sectors, because they represent one of the most energy-intensive marketmore » segments.« less

  20. Oncology Gold Standard™ practical consensus recommendations 2016 for treatment of advanced clear cell renal cell carcinoma.

    PubMed

    Batra, U; Parikh, P M; Prabhash, K; Tongaonkar, H B; Chibber, P; Dabkara, D; Deshmukh, C; Ghadyalpatil, N; Hingmire, S; Joshi, A; Raghunath, S K; Rajappa, S; Rajendranath, R; Rawal, S K; Singh, Manisha; Singh, R; Somashekhar, S P; Sood, R

    2016-01-01

    The Oncology Gold Standard (OGS) Expert Group on renal cell carcinoma (RCC) developed the consensus statement to provide community oncologists practical guidelines on the management of advanced clear cell (cc) RCC using published evidence, practical experience of experts in real life management, and results of a nationwide survey involving 144 health-care professionals. Six broad question categories containing 33 unique questions cover major situations in the routine management of RCC. This document serves as a ready guide for the standard of care to optimize outcome. The table of "Take Home Messages" at the end is a convenient tool for busy practitioners.

  1. ADHD Diagnosis and Management: A Practical Guide for the Clinic and the Classroom

    ERIC Educational Resources Information Center

    Wolraich, Mark L.; DuPaul, George J.

    2010-01-01

    Effective, "integrated" care across clinical, classroom, and home settings: that's what every student with ADHD needs to achieve academic and social success. Now professionals have one complete, highly accessible guide to delivering this kind of coordinated treatment for children in Grades 1-8. Aligned with the AAP's new guidelines for ADHD…

  2. Urban Stormwater Runoff. Instructor Guide. Working for Clean Water: An Information Program for Advisory Groups.

    ERIC Educational Resources Information Center

    Simko, Robert A.

    Urban stormwater runoff collects pollutants from many parts of a city and is an important consideration in water quality planning. Presented is an instructor's guide for a learning session covering various aspects of urban runoff including pollutant sources, management practices, and regulatory programs. Intended for citizen advisory groups, this…

  3. Reinventing Your Board: A Step-by-Step Guide to Implementing Policy Governance. The Jossey-Bass Nonprofit and Public Management Series.

    ERIC Educational Resources Information Center

    Carver, John; Carver, Miriam Mayhew

    This guide provides practical advice regarding implementation of the Policy Governance model for school boards. Chapter 1, "Setting the Stage," explores questions commonly raised by boards prior to implementation of the Policy Governance model. Chapter 2, "The Theoretical Foundation," reviews the key theoretical principles of…

  4. The Teacher's Role: Children and Epilepsy. A Guide for School Personnel. Revised Edition.

    ERIC Educational Resources Information Center

    Epilepsy Foundation of America, Landover, MD.

    The brief guide offers information on epilepsy to teachers and other school personnel. Types of seizures are defined (e.g., simple and complex partial seizures, generalized tonic clonic seizures), and management practices in the classroom setting for each type of seizure are described. Signs indicating that a seizure requires immediate medical…

  5. Public health program planning logic model for community engaged type 2 diabetes management and prevention.

    PubMed

    West, Joseph F

    2014-02-01

    Diabetes remains a growing epidemic with widening health inequity gaps in disease management, self-management knowledge, access to care and outcomes. Yet there is a paucity of evaluation tools for community engaged interventions aimed at closing the gaps and improving health. The Guide to Community Preventive Services (the Community Guide) developed by the Task Force on Community Preventive Services (the Task Force) at the Centers for Disease Control and Prevention (CDC) recommends two healthcare system level interventions, case management interventions and disease management programs, to improve glycemic control. However, as a public health resource guide for diabetes interventions a model for community engagement is a glaringly absent component of the Community Guide recommendations. In large part there are few evidence-based interventions featuring community engagement as a practice and system-level focus of chronic disease and Type 2 diabetes management. The central argument presented in this paper is that the absence of these types of interventions is due to the lack of tools for modeling and evaluating such interventions, especially among disparate and poor populations. A conceptual model emphasizing action-oriented micro-level community engagement is needed to complement the Community Guide and serve as the basis for testing and evaluation of these kinds of interventions. A unique logic model advancing the Community Guide diabetes recommendations toward measureable and sustainable community engagement for improved Type 2 diabetes outcomes is presented. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Toward a System of Total Quality Management: Applying the Deming Approach to the Education Setting.

    ERIC Educational Resources Information Center

    McLeod, Willis B.; And Others

    1992-01-01

    Recently, the Petersburg (Virginia) Public Schools have moved away from a highly centralized organizational structure to a Total Quality Management system featuring shared decision making and school-based management practices. The district was guided by Deming's philosophy that all stakeholders should be involved in defining the level of products…

  7. Solar Access to Public Capital (SAPC) Working Group: Best Practices in PV System Installation; Version 1.0, March 2015; Period of Performance, October 2014 - September 2015

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

    Doyle, C.; Truitt, A.; Inda, D.

    The following Photovoltaics Installation Best Practices Guide is one of several work products developed by the Solar Access to Public Capital (SAPC) working group, which works to open capital market investment. SAPC membership includes over 450 leading solar developers, financiers and capital managers, law firms, rating agencies, accounting and engineering firms, and other stakeholders engaged in solar asset deployment. SAPC activities are directed toward foundational elements necessary to pool project cash flows into tradable securities: standardization of power purchase and lease contracts for residential and commercial end customers; development of performance and credit data sets to facilitate investor due diligencemore » activities; comprehension of risk perceived by rating agencies; and the development of best practice guides for PV system installation and operations and maintenance (O&M) in order to encourage high-quality system deployment and operation that may improve lifetime project performance and energy production. This PV Installation Best Practices Guide was developed through the SAPC Installation Best Practices subcommittee, a subgroup of SAPC comprised of a wide array of solar industry leaders in numerous fields of practice. The guide was developed over roughly one year and eight months of direct engagement by the subcommittee and two working group comment periods.« less

  8. Evidence-based management of otitis media: a 5S model approach.

    PubMed

    Wasson, J D; Yung, M W

    2015-02-01

    The 5S model proposes five hierarchical levels (systems, summaries, synopses, syntheses and studies) of pre-appraised evidence to guide evidence-based practice. This review aimed to identify and summarise pre-appraised evidence at the highest available 5S level for the management of different subsets of otitis media: acute otitis media, otitis media with effusion, chronic suppurative otitis media and cholesteatoma in both adults and children. Data sources were pre-appraised evidence resources. Evidence freely available from sources at the highest available level of the 5S model were summarised for this review. System level evidence exists for acute otitis media and otitis media with effusion. Summary level evidence exists for recurrent acute otitis media and medical management of chronic suppurative otitis media. There is an absence of randomised controlled trials to prove the efficacy of surgical management of chronic suppurative otitis media and cholesteatoma. Until randomised controlled trial data are generated, consensus publications on the surgical management of chronic suppurative otitis media and cholesteatoma should be used to guide best practice.

  9. A Middle-Range Explanatory Theory of Self-Management Behavior for Collaborative Research and Practice.

    PubMed

    Blok, Amanda C

    2017-04-01

    To report an analysis of the concept of self-management behaviors. Self-management behaviors are typically associated with disease management, with frequent use by nurse researchers related to chronic illness management and by international health organizations for development of disease management interventions. A concept analysis was conducted within the context of Orem's self-care framework. Walker and Avant's eight-step concept analysis approach guided the analysis. Academic databases were searched for relevant literature including CIHAHL, Cochrane Databases of Systematic Reviews and Register of Controlled Trials, MEDLINE, PsycARTICLES and PsycINFO, and SocINDEX. Literature using the term "self-management behavior" and published between April 2001 and March 2015 was analyzed for attributes, antecedents, and consequences. A total of 189 journal articles were reviewed. Self-management behaviors are defined as proactive actions related to lifestyle, a problem, planning, collaborating, and mental support, as well as reactive actions related to a circumstantial change, to achieve a goal influenced by the antecedents of physical, psychological, socioeconomic, and cultural characteristics, as well as collaborative and received support. The theoretical definition and middle-range explanatory theory of self-management behaviors will guide future collaborative research and clinical practice for disease management. © 2016 Wiley Periodicals, Inc.

  10. A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy.

    PubMed

    Liu, Dora; Ahmet, Alexandra; Ward, Leanne; Krishnamoorthy, Preetha; Mandelcorn, Efrem D; Leigh, Richard; Brown, Jacques P; Cohen, Albert; Kim, Harold

    2013-08-15

    Systemic corticosteroids play an integral role in the management of many inflammatory and immunologic conditions, but these agents are also associated with serious risks. Osteoporosis, adrenal suppression, hyperglycemia, dyslipidemia, cardiovascular disease, Cushing's syndrome, psychiatric disturbances and immunosuppression are among the more serious side effects noted with systemic corticosteroid therapy, particularly when used at high doses for prolonged periods. This comprehensive article reviews these adverse events and provides practical recommendations for their prevention and management based on both current literature and the clinical experience of the authors.

  11. Understanding Ambitious Mathematics Teaching Practice through Instructional Activities

    ERIC Educational Resources Information Center

    Kelley-Peterson, Megan Marie

    2010-01-01

    Research in the field of math education continues to press teachers guide instruction based on students' needs and contributions, focusing on student learning through facilitation of whole-group discussions. This dissertation presents the findings of a qualitative study of two elementary teachers managing such "ambitious" teaching practices across…

  12. Leading the Wired Organization: The Information Professional's Guide to Managing Technological Change.

    ERIC Educational Resources Information Center

    Stover, Mark

    This book explains through descriptive narrative, illustrative examples, and practical suggestions how today's information specialists can navigate in the new "wired" organizations. The emphasis is on practical, useful, relevant advice. The following ten chapters are included: (1) "Communicating Online: The Heart of the Wired Organization"…

  13. Ecological Engineering Practices for the Reduction of Excess Nitrogen in Human-Influenced Landscapes: A Guide for Watershed Managers

    EPA Science Inventory

    Excess nitrogen (N) in freshwater systems, estuaries, and coastal areas has well-documented deleterious effects on ecosystems. Ecological engineering practices (EEPs) may be effective at decreasing nonpoint source N leaching to surface and groundwater. However, few studies have s...

  14. 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

  15. Corneal Laceration

    MedlinePlus Videos and Cool Tools

    ... Member Services Advocacy Foundation About Subspecialties & More Eye Health Home Annual Meeting Clinical Education Practice Management Member ... Center Redmond Ethics Center Global Ophthalmology Guide Eye Health Find an Ophthalmologist Academy Store Eye Health A- ...

  16. A comparison of the self-reported dry eye practices of New Zealand optometrists and ophthalmologists.

    PubMed

    Xue, Ally L; Downie, Laura E; Ormonde, Susan E; Craig, Jennifer P

    2017-03-01

    The aim of this cross-sectional survey was to evaluate the self-reported clinical practices of New Zealand optometrists and ophthalmologists with respect to the diagnosis and management of dry eye disease. It also sought to compare these behaviours with the current research evidence base. An anonymous survey was distributed electronically to New Zealand eye care clinicians (optometrists n = 614, ophthalmologists n = 113) to determine practitioner interest in dry eye disease, practice experience, practice modality, preferred diagnostic and management strategies, and information used to guide patient care. Respondents from both professions (response rates, optometrists: 26%, ophthalmologists: 26%) demonstrated similarly strong knowledge of tear film assessment. Ninety percent of respondents ranked patient symptoms and meibomian gland evaluation as the most valuable and common diagnostic approaches. Conversely, standardised grading scales and validated dry eye questionnaires were infrequently adopted. Both professions tailored dry eye management according to severity, indicating eyelid hygiene and non-preserved lubricants as mainstay therapies. Ophthalmologists prescribed systemic tetracyclines significantly more often than optometrists for moderate (48% vs 11%) and severe (72% vs 32%) dry eye (p < 0.05). Continuing education conferences were acknowledged as the primary information source used to guide dry eye management practices by both professions. Consistent with evidence-based guidelines, New Zealand eye care professionals combine subjective and objective techniques to diagnose and stratify dry eye management according to disease severity. There is potential to improve dissemination of research evidence into clinical practice, with continuing education via professional conferences the favoured mode of delivery. © 2017 The Authors Ophthalmic & Physiological Optics © 2017 The College of Optometrists.

  17. Reducing Behavior Problems Among Students with Autism Spectrum Disorder: Coaching Teachers in a Mixed-Reality Setting.

    PubMed

    Pas, Elise T; Johnson, Stacy R; Larson, Kristine E; Brandenburg, Linda; Church, Robin; Bradshaw, Catherine P

    2016-12-01

    Most approaches aiming to reduce behavior problems among youth with Autism Spectrum Disorder (ASD) focus on individual students; however, school personnel also need professional development to better support students. This study targeted teachers' skill development to promote positive outcomes for students with ASD. The sample included 19 teachers in two non-public special education settings serving students with moderate to severe ASD. Participating teachers received professional development and coaching in classroom management, with guided practice in a mixed-reality simulator. Repeated-measures ANOVAs examining externally-conducted classroom observations revealed statistically significant improvements in teacher management and student behavior over time. Findings suggest that coaching and guided practice in a mixed-reality simulator is perceived as acceptable and may reduce behavior problems among students with ASD.

  18. Business Management for Independent Schools. Fourth Edition.

    ERIC Educational Resources Information Center

    National Association of Independent Schools, Boston, MA.

    This fourth edition of a guide for independent school business managers has been produced in looseleaf format so that changes may be made promptly as decisions of regulatory bodies require modifications in current practice. Fourteen chapters are organized under three broad topic headings. Chapters in part 1, Accounting and Financial Reporting,…

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

    ERIC Educational Resources Information Center

    Freeman, Brigid

    2014-01-01

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

  20. Numerical visitor capacity: a guide to its use in wilderness

    Treesearch

    David Cole; Thomas Carlson

    2010-01-01

    Despite decades of academic work and practical management applications, the concept of visitor capacity remains controversial and inconsistently operationalized. Nevertheless, there are situations where development of a numerical estimate of capacity is important and where not doing so has resulted in land management agencies being successfully litigated. This report...

  1. Measuring farmer conservation behaviors: Challenges and best practices

    Treesearch

    Kristin Floress; Adam Reimer; Aaron Thompson; Mark Burbach; Cody Knutson; Linda Prokopy; Marc Ribaudo; Jessica Ulrich-Schad

    2018-01-01

    This article presents a guide for understanding the purposes and appropriate uses of different measures of conservation behavior. While applicable across natural resource management contexts, we primarily draw upon agricultural conservation research to illustrate our points. Farmers are often of interest to researchers, program managers, extension professionals, and...

  2. Using Financial Information in Continuing Education. Accepted Methods and New Approaches.

    ERIC Educational Resources Information Center

    Matkin, Gary W.

    This book, which is intended as a resource/reference guide for experienced financial managers and course planners, examines accepted methods and new approaches for using financial information in continuing education. The introduction reviews theory and practice, traditional and new methods, planning and organizational management, and technology.…

  3. Sustainable Materials Management (SMM) Web Academy Webinar Series: A Step-by-Step Guide to Conducting a Wasted Food Assessment with the Reducing Wasted Food & Packaging Toolkit

    EPA Pesticide Factsheets

    This is a webinar page for the Sustainable Management of Materials (SMM) Web Academy webinar titled Let’s WRAP (Wrap Recycling Action Program): Best Practices to Boost Plastic Film Recycling in Your Community

  4. 41 CFR 50-210.0 - General enforcement policy.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true General enforcement policy. 50-210.0 Section 50-210.0 Public Contracts and Property Management Other Provisions Relating to... at this time the practices and policies which will guide the administration and enforcement of the...

  5. 41 CFR 50-210.0 - General enforcement policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true General enforcement policy. 50-210.0 Section 50-210.0 Public Contracts and Property Management Other Provisions Relating to... at this time the practices and policies which will guide the administration and enforcement of the...

  6. Small Business Management. Part I, A Suggested Course Outline.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Bureau of Continuing Education Curriculum Development.

    In this curriculum guide on small business management, lessons (including specific course content and teaching suggestions) are developed around general traits and practices conducive to success in small businesses, loans and other sources of capital, budgeting and planning, recordkeeping, marketing and selling, advertising and sales promotion,…

  7. A Bibliographic Guide to Small and Minority Business Management.

    ERIC Educational Resources Information Center

    Popovich, Charles J.

    1979-01-01

    Lists publications that help the small and/or minority entrepreneur cope with practical problems and provides access to background and government resources as well as relevant bibliographies and directories. Publications follow the steps one would take establishing a small business: starting, financing, managing, and other requirements (record…

  8. Guiding New Product Idea Generation

    ERIC Educational Resources Information Center

    Park, Y.

    2003-01-01

    The creation of innovative ideas is the initial step in entrepreneurial practice and venture management. As the management of technology is now on the priority agenda of higher education institutions, there is a need to develop pedagogic schemes for idea generation. Despite its importance, the idea generation process is hard to systematize or to…

  9. Timber management guide for shortleaf pine and oak-pine types in Missouri.

    Treesearch

    K.A. Brinkman; N.F. Rogers

    1967-01-01

    Summarizes recommended management practices for the shortleaf pine and oak-pine types in Missouri. Describes sites and soils, and silvical characteristics of pine; discusses rotations, cutting cycles, stocking levels, growing space requirements, and regeneration techniques; and prescribes treatments for stands with specified characteristics to maximize returns from...

  10. MRI-guided stereotactic neurosurgical procedures in a diagnostic MRI suite: Background and safe practice recommendations.

    PubMed

    Larson, Paul S; Willie, Jon T; Vadivelu, Sudhakar; Azmi-Ghadimi, Hooman; Nichols, Amy; Fauerbach, Loretta Litz; Johnson, Helen Boehm; Graham, Denise

    2017-07-01

    The development of navigation technology facilitating MRI-guided stereotactic neurosurgery has enabled neurosurgeons to perform a variety of procedures ranging from deep brain stimulation to laser ablation entirely within an intraoperative or diagnostic MRI suite while having real-time visualization of brain anatomy. Prior to this technology, some of these procedures required multisite workflow patterns that presented significant risk to the patient during transport. For those facilities with access to this technology, safe practice guidelines exist only for procedures performed within an intraoperative MRI. There are currently no safe practice guidelines or parameters available for facilities looking to integrate this technology into practice in conventional MRI suites. Performing neurosurgical procedures in a diagnostic MRI suite does require precautionary measures. The relative novelty of technology and workflows for direct MRI-guided procedures requires consideration of safe practice recommendations, including those pertaining to infection control and magnet safety issues. This article proposes a framework of safe practice recommendations designed for assessing readiness and optimization of MRI-guided neurosurgical interventions in the diagnostic MRI suite in an effort to mitigate patient risk. The framework is based on existing clinical evidence, recommendations, and guidelines related to infection control and prevention, health care-associated infections, and magnet safety, as well as the clinical and practical experience of neurosurgeons utilizing this technology. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

  11. A comprehensive guide to fuel management practices for dry mixed conifer forests in the northwestern United States

    Treesearch

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

    2012-01-01

    This guide describes the benefits, opportunities, and trade-offs concerning fuel treatments in the dry mixed conifer forests of northern California and the Klamath Mountains, Pacific Northwest Interior, northern and central Rocky Mountains, and Utah. Multiple interacting disturbances and diverse physical settings have created a forest mosaic with historically low- to...

  12. Handbook of Institutional Advancement. A Practical Guide to College and University Relations, Fund Raising, Alumni Relations, Government Relations, Publications, and Executive Management for Continued Advancement.

    ERIC Educational Resources Information Center

    Rowland, A. Westley, Ed.

    The guide's purpose is to provide administrators with essential information that will maintain public confidence in higher education and ensure continued financial support. Six major aspects of institutional advancement are considered: (1) institutional relation (programs to improve communication and understanding among students, administrators,…

  13. Action Learning. A Guide for Professional, Management and Educational Development. Second Edition.

    ERIC Educational Resources Information Center

    McGill, Ian; Beaty, Liz

    Action learning is a process of learning and reflection that happens with the support of a group of colleagues ("set") working with real problems with the intention of getting things done. This guide is for those who want to practice action learning. It can be used to introduce the concepts of action learning to others and as a manual…

  14. Strategic Planning in Higher Education: A Guide for Heads of Institutions, Senior Managers and Members of Governing Bodies.

    ERIC Educational Resources Information Center

    Higher Education Funding Council for England, Bristol.

    This guide provides examples of good practice in strategic planning within higher education, particularly as it applies to Northern Ireland. Examples are drawn from the experiences of 13 case study universities and colleges. Sections of the report include a summary; an introduction and overview of the strategic planning process; and a discussion…

  15. Ten Things New Teachers Need To Succeed. A SkyLight Guide.

    ERIC Educational Resources Information Center

    Fogarty, Robin

    This guide for novice teachers includes ten sections: (1) "A Knowing Colleague as Counsel...About the Policies, Practices, and Politics!" (proactively seek a mentor); (2) "A Place Called 'My Room' for Students To Grow, To Groom, and To Zoom!" (create a climate that fosters growth and pride); (3) "A Method for Managing 1,500 Decisions: On Your…

  16. A survey of California public school districts' ant and weed management practices and a review of their use of IPM.

    PubMed

    Barnes, Carole; Sutherland, Sandra; Brattesani, Madeline; Wilhoit, Larry; Messenger, Belinda

    2012-04-01

    The U.S. Environmental Protection Agency encourages school officials to adopt integrated pest management (IPM) to reduce children's exposure to potentially harmful pesticides. In California, the Healthy Schools Act of 2000 (HSA) establishes right-to-know requirements for pesticide use in public schools; requires school districts to designate an IPM coordinator; and requires the California Department of Pesticide Regulation (DPR) to collect pesticide-use information from pest control businesses, conduct IPM training workshops, and promote least-toxic pest management practices. DPR periodically surveys school districts statewide to measure compliance with the HSA and the use of least-toxic management practices compatible with IPM and to guide DPR's training and outreach efforts. Results from three surveys, conducted in 2001, 2002, and 2004, show that an increasing number of districts use ant management practices compatible with IPM; however, fewer districts use IPM-compatible weed management practices. DPR's California School IPM program plans to develop technical materials and to conduct training workshops that will provide districts with more information about how to use an IPM program to prevent and manage weeds.

  17. Operationalizing Dynamic Ocean Management (DOM): Understanding the Incentive Structure, Policy and Regulatory Context for DOM in Practice

    NASA Astrophysics Data System (ADS)

    Lewison, R. L.; Saumweber, W. J.; Erickson, A.; Martone, R. G.

    2016-12-01

    Dynamic ocean management, or management that uses near real-time data to guide the spatial distribution of commercial activities, is an emerging approach to balance ocean resource use and conservation. Employing a wide range of data types, dynamic ocean management in a fisheries context can be used to meet multiple objectives - managing target quota, bycatch reduction, and reducing interactions with species of conservation concern. There is a growing list of DOM applications currently in practice in fisheries around the world, yet the approach is new enough that both fishers and fisheries managers are unclear how DOM can be applied to their fishery. Here, we use the experience from dynamic ocean management applications that are currently in practice to address the commonly asked question "How can dynamic management approaches be implemented in a traditionally managed fishery?". Combining knowledge from the DOM participants with a review of regulatory frameworks and incentive structures, stakeholder participation, and technological requirements of DOM in practice, we identify ingredients that have supported successful implementation of this new management approach.

  18. Harvest-created canopy gaps increase species and functional trait diversity of the forest ground-layer community

    Treesearch

    Christel C. Kern; Rebecca A. Montgomery; Peter B. Reich; Terry F. Strong

    2014-01-01

    Biodiversity conservation within managed forests depends, in part, on management practices that restore or maintain plant community diversity and function. Because many plant communities are adapted to natural disturbances, gap-based management has potential to meet this need by using the historical range of variation in canopy disturbances to guide elements of harvest...

  19. What Is Dry Eye?

    MedlinePlus Videos and Cool Tools

    ... Member Services Advocacy Foundation About Subspecialties & More Eye Health Home Annual Meeting Clinical Education Practice Management Member ... Center Redmond Ethics Center Global Ophthalmology Guide Eye Health Find an Ophthalmologist Academy Store Eye Health A- ...

  20. What Is Macular Edema?

    MedlinePlus Videos and Cool Tools

    ... Member Services Advocacy Foundation About Subspecialties & More Eye Health Home Annual Meeting Clinical Education Practice Management Member ... Center Redmond Ethics Center Global Ophthalmology Guide Eye Health Find an Ophthalmologist Academy Store Eye Health A- ...

  1. Colored Contact Lens Dangers

    MedlinePlus Videos and Cool Tools

    ... Member Services Advocacy Foundation About Subspecialties & More Eye Health Home Annual Meeting Clinical Education Practice Management Member ... Center Redmond Ethics Center Global Ophthalmology Guide Eye Health Find an Ophthalmologist Academy Store Eye Health A- ...

  2. Oncology Gold Standard™ practical consensus recommendations 2016 for treatment of advanced clear cell renal cell carcinoma

    PubMed Central

    Batra, U; Parikh, PM; Prabhash, K; Tongaonkar, HB; Chibber, P; Dabkara, D; Deshmukh, C; Ghadyalpatil, N; Hingmire, S; Joshi, A; Raghunath, SK; Rajappa, S; Rajendranath, R; Rawal, SK; Singh, Manisha; Singh, R; Somashekhar, SP; Sood, R

    2016-01-01

    The Oncology Gold Standard (OGS) Expert Group on renal cell carcinoma (RCC) developed the consensus statement to provide community oncologists practical guidelines on the management of advanced clear cell (cc) RCC using published evidence, practical experience of experts in real life management, and results of a nationwide survey involving 144 health-care professionals. Six broad question categories containing 33 unique questions cover major situations in the routine management of RCC. This document serves as a ready guide for the standard of care to optimize outcome. The table of “Take Home Messages” at the end is a convenient tool for busy practitioners. PMID:28032079

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

    PubMed Central

    Crozier, GKD; Schulte-Hostedde, Albrecht I

    2014-01-01

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

  4. Implementing AORN recommended practices for surgical attire.

    PubMed

    Braswell, Melanie L; Spruce, Lisa

    2012-01-01

    Surgical attire is intended to protect both patients and perioperative personnel. AORN published the "Recommended practices for surgical attire" to guide perioperative RNs in establishing protocols for selecting, wearing, and laundering surgical attire. Perioperative RNs should work with vendors and managers to ensure appropriate surgical attire is available, model the correct practices for donning and wearing surgical attire, and teach team members about evidence-based practices. The recommendation that surgical attire not be home laundered is supported by evidence that perioperative nurses can share with their colleagues and managers to help support appropriate practices. Hospital and ambulatory surgery center scenarios have been included as examples of appropriate execution of these recommended practices. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  5. 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…

  6. Mentoring the Next Generation of Nonprofit Leaders: A Practical Guide for Managers

    ERIC Educational Resources Information Center

    Williams, Ken

    2005-01-01

    This monograph outlines 12 best practices in workplace mentoring. It reflects findings from the New Voices National Fellowship Program, a human rights leadership development initiative funded by the Ford Foundation and administered by AED (Academy for Educational Development). It is hoped that readers will find the ideas developed here and the…

  7. Management of immune thrombocytopenia: Korean experts recommendation in 2017.

    PubMed

    Jang, Jun Ho; Kim, Ji Yoon; Mun, Yeung-Chul; Bang, Soo-Mee; Lim, Yeon Jung; Shin, Dong-Yeop; Choi, Young Bae; Yhim, Ho-Young; Lee, Jong Wook; Kook, Hoon

    2017-12-01

    Management options for patients with immune thrombocytopenia (ITP) have evolved substantially over the past decades. The American Society of Hematology published a treatment guideline for clinicians referring to the management of ITP in 2011. This evidence-based practice guideline for ITP enables the appropriate treatment of a larger proportion of patients and the maintenance of normal platelet counts. Korean authority operates a unified mandatory national health insurance system. Even though we have a uniform standard guideline enforced by insurance reimbursement, there are several unsolved issues in real practice in ITP treatment. To optimize the management of Korean ITP patients, the Korean Society of Hematology Aplastic Anemia Working Party (KSHAAWP) reviewed the consensus and the Korean data on the clinical practices of ITP therapy. Here, we report a Korean expert recommendation guide for the management of ITP.

  8. Managing problem employees: a model program and practical guide.

    PubMed

    Miller, Laurence

    2010-01-01

    This article presents a model program for managing problem employees that includes a description ofthe basic types of problem employees and employee problems, as well as practical recommendations for. (1) selection and screening, (2) education and training, (3) coaching and counseling, (4) discipline, (5) psychological fitness-for-duty evaluations, (6) mental health services, (7) termination, and (8) leadership and administrative strategies. Throughout, the emphasis on balancing the need for order and productivity in the workplace with fairness and concern for employee health and well-being.

  9. Advanced Energy Retrofit Guide: Practical Ways to Improve Energy Performance, K-12 Schools (Book)

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

    Not Available

    The U.S. Department of Energy developed the K-12 Advanced Energy Retrofit Guide to provide specific methodologies, information, and guidance to help energy managers and other stakeholders plan and execute energy efficiency improvements. We emphasize actionable information, practical methodologies, diverse case studies, and unbiased evaluation of the most promising retrofit measure for each building type. K-12 schools were selected as one of the highest priority building sectors, because schools affect the lives of most Americans. They also represent approximately 8% of the energy use and 10% of the floor area in commercial buildings.

  10. Management Guide for the black spruce type in the Lake States.

    Treesearch

    William F. Johnston

    1971-01-01

    Summarizes information on: (1) soil-site relations; (2) associated vegetation; (3) methods and requirements for reproduction; (4) stand development; (5) yield and 10-year net growth; (6) damaging agents. A key to recommended management practices is given for pulpwood and Christmas tree stands, and requirements for successful broadcast burning are included.

  11. Managing the Cycle of Meltdowns for Students with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Colvin, Geoff; Sheehan, Martin R.

    2012-01-01

    This book outlines practical steps for preventing and responding to the various phases of meltdown behavior in students with Autism Spectrum Disorder. Based on Geoff Colvin's best-selling book, "Managing the Cycle of Acting Out Behavior in the Classroom," this practitioner-friendly guide provides special and general education teachers of autistic…

  12. Silviculture for the 21st century--objective and subjective standards to guide successful practice

    Treesearch

    James M. Guldin; Russell T. Graham

    2007-01-01

    Silviculture is increasingly being applied in ways that go beyond traditional timber management objectives. Across the National Forest System, on other public lands, and increasingly on private lands as well, foresters are working with professional colleagues and landowners to develop innovative silvicultural prescriptions designed to meet diverse resource management...

  13. 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…

  14. What to Do Regarding Economics and Managing Resources.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Instructional Materials Lab.

    These materials for the curriculum area of economics and managing resources comprise one of six such packages that are part of the Ohio Vocational Consumer/Homemaking Curriculum Guide. The curriculum area or perennial problem taken up in this document is divided into three practical problems about what to do regarding: (1) decision making; (2)…

  15. Managing Staff Development in Adult and Community Learning: Reflection to Practice.

    ERIC Educational Resources Information Center

    Ewens, David

    This document is intended to assist individuals responsible for managing staff development in adult and community learning (ACL) in the United Kingdom. The guide presents step-by-step advice for designing and implementing an approach based on the belief that staff development should do the following things: (1) relate holistically to the…

  16. Career and Life Management 20: Interim Curriculum Guide, 1987.

    ERIC Educational Resources Information Center

    Alberta Dept. of Education, Edmonton. Curriculum Branch.

    The Career and Life Management Program was prescribed within the Secondary Education in Alberta policy statement as a core course for senior high school students to provide students with opportunities to develop and practice communicating and thinking skills in situations that will help them to build confidence in their ability to cope with the…

  17. Doing the Groundwork: From Stopping Misbehavior to Teaching Skills. Reframing Discipline, Unit 1. [Teaching Video, Practice Video, Facilitator's Guide, and Viewer's Guide].

    ERIC Educational Resources Information Center

    1997

    The first of three interactive staff development units on discipline in early childhood classrooms, this multi-media pack explores how to evaluate the attitudes teachers take into the classroom, and how to "reframe" those attitudes so teachers can effectively manage--rather than try to eliminate--conflict. The 25-minute teaching videotape examines…

  18. Building Villages To Raise Our Children: Staffing. Guides to Comprehensive Family Support Services.

    ERIC Educational Resources Information Center

    Hochberg, Mona R.

    This volume, part five of a six-part report, is a three-part guide that offers practical advice for recruiting, training, and managing staff for a family-support program; it includes discussions about typical problems and the ways practitioners have chosen to resolve them. Part 1 discusses how to determine the type of staff needed and how to hire…

  19. A Guide for the Management of Special Education Programs. 3.0 Educational Simulations. Newday Operations Guide for Drug Dependent Minor Programs.

    ERIC Educational Resources Information Center

    Santa Cruz County Superintendent of Schools, CA.

    Presented is the third component, Educational Simulations, of a special day class educational program for drug dependent minors. One objective of the project is said to have been the identification of instructional methods and materials suited to drug dependent minors. Educational games and simulations designed to provide practice in reading and…

  20. Give Water a Hand. Leader Guidebook. Youth Action Program. Promoting Good Water Management Practices at Home and in the Community.

    ERIC Educational Resources Information Center

    Wisconsin Univ., Madison. Coll. of Agricultural and Life Sciences.

    Educators of students grades 4-8 can use this guide to lead a community service project using the "Give Water a Hand" youth action program. Youth groups investigate water and water conservation within the home, farm, ranch, school, or community, with the help of local experts. The guide contains six chapters that cover: (1) an…

  1. IPM Standards for Schools: A Program for Reducing Pest and Pesticide Risks in Schools and Other Sensitive Environments. Version 2.0.

    ERIC Educational Resources Information Center

    Green, Thomas A., Ed.

    This guide presents Integrated Pest Management (IPM) practice standards for educational facilities to help schools become certified in providing effective and safe pest control. The guide is divided into two parts with three modules each for both buildings and grounds. The first module addresses building the IPM foundation to meet all legal…

  2. A Practical Guide to Alcohol Abuse Prevention: A Campus Case Study in Implementing Social Norms and Environmental Management Approaches.

    ERIC Educational Resources Information Center

    Johannessen, Koreen; Collins, Carolyn; Glider, Peggy; Mills-Novoa, Beverly

    Despite increased attention given to alcohol use and its negative consequences on college campuses, national data indicates that there have been only small decreases in levels of alcohol consumption for over two decades. This guide describes how one university was able to decrease heavy drinking on campus by 29.2% during a four-year period. Their…

  3. A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy

    PubMed Central

    2013-01-01

    Systemic corticosteroids play an integral role in the management of many inflammatory and immunologic conditions, but these agents are also associated with serious risks. Osteoporosis, adrenal suppression, hyperglycemia, dyslipidemia, cardiovascular disease, Cushing’s syndrome, psychiatric disturbances and immunosuppression are among the more serious side effects noted with systemic corticosteroid therapy, particularly when used at high doses for prolonged periods. This comprehensive article reviews these adverse events and provides practical recommendations for their prevention and management based on both current literature and the clinical experience of the authors. PMID:23947590

  4. IT Workforce: Key Practices Help Ensure Strong Integrated Program Teams; Selected Departments Need to Assess Skill Gaps

    DTIC Science & Technology

    2016-11-01

    personnel, career paths for program managers, plans to strengthen program management, and use of special hiring authorities) Monitor and report...agencies with direct hiring authority for program managers and directed OPM to create a specialized career path. OMB also tasked agencies with...guidance for developing career paths for IT program managers.14 OPM’s career path guide was to build upon its IT Program Management Competency Model

  5. Building America Best Practices Series Volume 11. Builders Challenge Guide to 40% Whole-House Energy Savings in the Marine Climate

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

    Baechler, Michael C.; Gilbride, Theresa L.; Hefty, Marye G.

    2010-09-01

    This best practices guide is the eleventh in a series of guides for builders produced by the U.S. Department of Energy’s Building America Program. This guide book is a resource to help builders design and construct homes that are among the most energy-efficient available, while addressing issues such as building durability, indoor air quality, and occupant health, safety, and comfort. With the measures described in this guide, builders in the marine climate (portions of Washington, Oregon, and California) can achieve homes that have whole house energy savings of 40% over the Building America benchmark (a home built to mid-1990s buildingmore » practices roughly equivalent to the 1993 Model Energy Code) with no added overall costs for consumers. These best practices are based on the results of research and demonstration projects conducted by Building America’s research teams. The guide includes information for managers, designers, marketers, site supervisors, and subcontractors, as well as case studies of builders who are successfully building homes that cut energy use by 40% in the marine climate. This document is available on the web at www.buildingamerica.gov. This report was originally cleared 06-29-2010. This version is Rev 1 cleared in Nov 2010. The only change is the reference to the Energy Star Windows critieria shown on pg 8.25 was updated to match the criteria - Version 5.0, 04/07/2009, effective 01/04/2010.« less

  6. Coping Skills Practice and Symptom Change: A Secondary Analysis of a Pilot Telephone Symptom Management Intervention for Lung Cancer Patients and Their Family Caregivers.

    PubMed

    Winger, Joseph G; Rand, Kevin L; Hanna, Nasser; Jalal, Shadia I; Einhorn, Lawrence H; Birdas, Thomas J; Ceppa, DuyKhanh P; Kesler, Kenneth A; Champion, Victoria L; Mosher, Catherine E

    2018-05-01

    Little research has explored coping skills practice in relation to symptom outcomes in psychosocial interventions for cancer patients and their family caregivers. To examine associations of coping skills practice to symptom change in a telephone symptom management (TSM) intervention delivered concurrently to lung cancer patients and their caregivers. This study was a secondary analysis of a randomized pilot trial. Data were examined from patient-caregiver dyads (n = 51 dyads) that were randomized to the TSM intervention. Guided by social cognitive theory, TSM involved four weekly sessions where dyads were taught coping skills including a mindfulness exercise, guided imagery, pursed lips breathing, cognitive restructuring, problem solving, emotion-focused coping, and assertive communication. Symptoms were assessed, including patients' and caregivers' psychological distress and patients' pain interference, fatigue interference, and distress related to breathlessness. Multiple regression analyses examined associations of coping skills practice during the intervention to symptoms at six weeks after the intervention. For patients, greater practice of assertive communication was associated with less pain interference (β = -0.45, P = 0.02) and psychological distress (β = -0.36, P = 0.047); for caregivers, greater practice of guided imagery was associated with less psychological distress (β = -0.30, P = 0.01). Unexpectedly, for patients, greater practice of a mindfulness exercise was associated with higher pain (β = 0.47, P = 0.07) and fatigue interference (β = 0.49, P = 0.04); greater practice of problem solving was associated with higher distress related to breathlessness (β = 0.56, P = 0.01) and psychological distress (β = 0.36, P = 0.08). Findings suggest that the effectiveness of TSM may have been reduced by competing effects of certain coping skills. Future interventions should consider focusing on assertive communication training for patients and guided imagery for caregivers. Copyright © 2018 American Academy of Hospice and Palliative Medicine. All rights reserved.

  7. Studying the Practical Rationality of Mathematics Teaching: What Goes into "Installing" a Theorem in Geometry?

    ERIC Educational Resources Information Center

    Herbst, Patricio; Nachlieli, Talli; Chazan, Daniel

    2011-01-01

    This article presents a way of studying the rationality that mathematics teachers utilize in managing the teaching of theorems in high-school geometry. More generally, the study illustrates how to elicit the rationality that guides teachers in handling the demands of teaching practice. In particular, it illustrates how problematic classroom…

  8. Executive Function in the Classroom: Practical Strategies for Improving Performance and Enhancing Skills for All Students

    ERIC Educational Resources Information Center

    Kaufman, Christopher

    2010-01-01

    Students with strong executive function skills hold the keys to school and social success--from attention and impulse control to time management and organization. Now K-12 teachers have a practical, highly readable guide to enhancing these critical skills for "all" students, with and without learning disabilities. Through the author's memorable…

  9. Using Interactions among In-Service Music Teachers in a Graduate Programme for Teacher Support

    ERIC Educational Resources Information Center

    Shin, Jihae

    2018-01-01

    The purpose of this study was to examine interactions among in-service music teachers in a graduate music teacher education programme using Wenger, McDermott, and Snyder's [2002. "Cultivating Communities of Practice: A Guide to Managing Knowledge." Boston, MA: Harvard Business School Press] Communities of Practice (CoPs) framework. The…

  10. Planning and Conducting Needs Assessments: A Practical Guide.

    ERIC Educational Resources Information Center

    Witkin, Belle Ruth; Altschuld, James W.

    This book describes a structure for understanding and managing the process and options for gathering and analyzing data on needs. The three-phase model that forms the basis for the structure grew from both theory and practical experience in many settings. The focus is on assessing the needs of organizations rather than individuals. It is stressed…

  11. Low-volume road engineering : Best Management Practices : Field Guide

    DOT National Transportation Integrated Search

    2003-07-01

    Improperly constructed roads can negatively impact everything from terrestrial plant populations and soil conservation efforts to water quality and populations of aquatic organisms in receiving waters. This Low-Volume Roads Engineering Best Managemen...

  12. New Possibilities in Life with Type 2 Diabetes: Experiences from Participating in a Guided Self-Determination Programme in General Practice.

    PubMed

    Karlsen, Bjørg; Rasmussen Bruun, Bettina; Oftedal, Bjørg

    2018-01-01

    Research suggests that guided self-determination programmes can support self-management of diabetes by empowering self-determined goal setting and competence building. As most research in this area has focused on people with type 1 diabetes, knowledge is lacking on how adults with type 2 diabetes mellitus experience participation in such programmes. This study reports the modelling phase of a complex intervention design that explored the experiences of adults with type 2 diabetes who participated in a nurse-led guided self-determination programme in general practice and examines how the programme affected patients' motivation to self-manage diabetes. The qualitative design with semistructured interviews included 9 adults with type 2 diabetes who participated in the programme. Qualitative content analysis was used to analyse the data. The findings indicate that the participants experienced new life possibilities after participating in the programme, which seemed to have a positive influence on their motivation for self-management. Through reflections about how to live with diabetes, the participants reinterpreted their life with diabetes by gradually developing a closer relationship with the disease, moving towards acceptance. The fact that dialogue with the nurses was seen to be on an equal footing helped support the participants to become more self-determined.

  13. Factors influencing practice variation in the management of nephrotic syndrome: a qualitative study of pediatric nephrology care providers

    PubMed Central

    Samuel, Susan M.; Flynn, Rachel; Zappitelli, Michael; Dart, Allison; Parekh, Rulan; Pinsk, Maury; Mammen, Cherry; Wade, Andrew; Scott, Shannon D.

    2017-01-01

    Background: Treatment protocols for childhood nephrotic syndrome are highly variable between providers and care centres. We conducted a qualitative study to understand the complex multilevel processes that lead to practice variation and influence provider management of nephrotic syndrome. Methods: Focus groups with multidisciplinary pediatric nephrology care providers (n = 67) from 10 Canadian pediatric nephrology centres that had more than 1 pediatric nephrologist were conducted between September 2013 and April 2015. Focus group discussions were guided by the Ottawa Model for Research Use. We used a semistructured interview guide to elicit participants' perspectives regarding 1) the work setting and context of the clinical environment, 2) reasons for variation at the provider level and 3) clinical practice guidelines for nephrotic syndrome. Focus group discussions were transcribed and analyzed concurrently with the use of qualitative content analysis. Results: Emerging themes were grouped into 2 categories: centre-level factors and provider-level factors. At the centre level, the type of care model used, clinic structures and resources, and lack of communication and collaboration within and between Canadian centres influenced care variation. At the provider level, use of experiential knowledge versus empirical knowledge and interpretation of patient characteristics influenced provider management of nephrotic syndrome. Interpretation: Centre- and provider-level factors play an important role in shaping practice differences in the management of childhood nephrotic syndrome. Further research is needed to determine whether variation in care is associated with disparities in outcomes. PMID:28592406

  14. TWRS technical baseline database manager definition document

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

    Acree, C.D.

    1997-08-13

    This document serves as a guide for using the TWRS Technical Baseline Database Management Systems Engineering (SE) support tool in performing SE activities for the Tank Waste Remediation System (TWRS). This document will provide a consistent interpretation of the relationships between the TWRS Technical Baseline Database Management software and the present TWRS SE practices. The Database Manager currently utilized is the RDD-1000 System manufactured by the Ascent Logic Corporation. In other documents, the term RDD-1000 may be used interchangeably with TWRS Technical Baseline Database Manager.

  15. Equality in the Workplace. An Equal Opportunities Handbook for Trainers. Human Resource Management in Action Series.

    ERIC Educational Resources Information Center

    Collins, Helen

    This workbook, which is intended as a practical guide for human resource managers, trainers, and others concerned with developing and implementing equal opportunities training programs in British workplaces, examines issues in and methods for equal opportunities training. The introduction gives an overview of current training trends and issues.…

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

    Treesearch

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

    1993-01-01

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

  17. Principles of Classroom Management: A Professional Decision-Making Model, 7th Edition

    ERIC Educational Resources Information Center

    Levin, James; Nolan, James F.

    2014-01-01

    This text takes a decision-making model approach to classroom management. It provides teachers with a very practical system to influence students to choose to behave productively and to strive for academic success. This widely used text presents an array of decision-making options that guide teachers in developing positive, pro-social classroom…

  18. Pharmacy benefit managers, pharmacies, and pharmacogenomic testing: prescription for progress?

    PubMed

    Topol, Eric J

    2010-08-11

    Few would argue that the ability to match individual patients with the safest and most effective drugs and doses would be a major advance for clinical medicine. But while clinicians have been reluctant to routinely use pharmacogenomic analyses to guide their prescribing practices, pharmacy benefit managers and drugstores are proceeding with major pharmacogenetic initiatives.

  19. A Guide to the Management of Curriculum Materials Centers for the 21st Century: The Promise and the Challenge.

    ERIC Educational Resources Information Center

    Carr, Jo Ann, Ed.

    Curriculum Materials Centers (CMCs), resource centers that support teacher education programs, are facing many challenges, including maintaining funding, meeting increased expectations, and coping with changes in technology. This volume covers a wide range of management issues from the perspective of 18 librarians, including practical advice on…

  20. Photo series for quantifying forest residues in managed lands of the Medicine Bow National Forest

    Treesearch

    John B. Popp; John E. Lundquist

    2006-01-01

    This photo series presents a visual representation of a range of fuel loading conditions specifically found on the Medicine Bow National Forest. The photos are grouped by forest type and past management practices. This field guide describes the distribution of different types of woody fuels and includes some vegetation data.

  1. Bowel obstruction: Differential diagnosis and clinical management

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

    Welch, J.P.

    1987-01-01

    This book presents a practical guide to the diagnosis and management of obstruction, both mechanical and organic, of the large and small bowel. Obstruction is a common problem for surgeons, and this text emphasizes differential diagnosis and the use of all radiologic modalities. It presents the surgical and medical considerations involved with gallstones, bezoars, parasites, tumors, inflammation, trauma, intussusception, more.

  2. Positive Classroom Management: A Step-By-Step Guide to Successfully Running the Show without Destroying Student Dignity.

    ERIC Educational Resources Information Center

    DiGiulio, Robert

    This publication provides practical, step-by-step guidance for teachers on becoming more effective in classroom management by using a positive and constructive, rather than negative and punitive, approach to foster prosocial student behavior. The publication is divided into an introduction and three parts. The Introduction examines why effective…

  3. Develop the Worker: Develop the Business. A Guide for Smaller Businesses.

    ERIC Educational Resources Information Center

    McGivney, Veronica

    This document, which was developed on the basis of recent research and testimony of small business owners, managers and employees, and training providers, is a basic practical manual for those owners and managers of British small and medium-sized enterprises (SMEs) who want to initiate or improve staff training and development activities. The…

  4. Randomized trial of guiding hypertension management using central aortic blood pressure compared with best-practice care: principal findings of the BP GUIDE study.

    PubMed

    Sharman, James E; Marwick, Thomas H; Gilroy, Deborah; Otahal, Petr; Abhayaratna, Walter P; Stowasser, Michael

    2013-12-01

    Arm cuff blood pressure (BP) may overestimate cardiovascular risk. Central aortic BP predicts mortality and could be a better method for patient management. We sought to determine the usefulness of central BP to guide hypertension management. This was a prospective, open-label, blinded-end point study in 286 patients with hypertension randomized to treatment decisions guided by best-practice usual care (n=142; using office, home, and 24-hour ambulatory BP) or, in addition, by central BP intervention (n=144; using SphygmoCor). Therapy was reviewed every 3 months for 12 months, and recommendations were provided to each patient and his/her doctor on antihypertensive medication titration. Outcome measures were as follows: medication quantity (daily defined dose), quality of life, and left ventricular mass (3-dimensional echocardiography). There was 92% compliance with recommendations on medication titration, and quality of life improved in both groups (post hoc P<0.05). For usual care, there was no change in daily defined dose (all P>0.10), but with intervention there was a significant stepwise decrease in daily defined dose from baseline to 3 months (P=0.008) and each subsequent visit (all P<0.001). Intervention was associated with cessation of medication in 23 (16%) patients versus 3 (2%) in usual care (P<0.001). Despite this, there were no differences between groups in left ventricular mass index, 24-hour ambulatory BP, home systolic BP, or aortic stiffness (all P>0.05). We conclude that guidance of hypertension management with central BP results in a significantly different therapeutic pathway than conventional cuff BP, with less use of medication to achieve BP control and no adverse effects on left ventricular mass, aortic stiffness, or quality of life.

  5. Managing Your Team's Weakest Link.

    PubMed

    Hills, Laura

    2015-01-01

    Do you have a poor-performing employee on your medical practice team? If so, you're not alone. Unfortunately, this is a problem that many medical practice managers face. This article describes the best strategies for managing your team's weakest link. It explores common yet very difficult circumstances that cause low employee performance and that test the patience, heart, and skills of a practice manager. It guides readers through a process of self-discovery to determine whether their negative biases or grudges may be causing employees to perform poorly. It suggests several possible other reasons for weak employee performance, including problems with the job, practice, leadership, communication, and fit between the employee and the job. This article also suggests the best strategy for communicating concerns about performance to the weakest-link employee. It offers guidance to practice managers about protecting their time and energy when handling a poor performer. It provides a simple formula for calculating the cost of a low-performing employee, 10 possible personal reasons for the employee's poor work performance, specific questions to ask to uncover the reasons for poor performance, and an eight-rule strategy for confronting poor performance effectively. Finally, this article offers practice managers a practical strategy for handling resistance from their weakest link, illustrated with a sample dialogue.

  6. Integrating Agriculture and Conservation

    USGS Publications Warehouse

    Vandever, Mark W.

    2010-01-01

    The USGS produces the needed science-based information to guide management actions and policy decisions that support wildlife habitat and other environmental services compatible with USDA conservation goals and farm operations. The Policy Analysis and Science Assistance Branch of the Fort Collins Science Center (FORT) has conducted research involving a national landowner survey and numerous short- and long-term evaluations regarding vegetation responses to land management practices. This research helps land and resource managers to make informed decisions and resolve resource management conflicts.

  7. The Development of a Quality Management Framework for Evaluating Medical Device Reprocessing Practice in Healthcare Facilities.

    PubMed

    Lorv, Bailey; Horodyski, Robin; Welton, Cynthia; Vail, John; Simonetto, Luca; Jokanovic, Danilo; Sharma, Richa; Mahoney, Angela Rea; Savoy-Bird, Shay; Bains, Shalu

    2017-01-01

    There is increasing awareness of the importance of medical device reprocessing (MDR) for the provision of safe patient care. Although industry service standards are available to guide MDR practices, there remains a lack of published key performance indicators (KPIs) and targets that are necessary to evaluate MDR quality for feedback and improvement. This article outlines the development of an initial framework that builds on established guidelines and includes service standards, KPIs and targets for evaluating MDR operations. This framework can support healthcare facilities in strengthening existing practices and enables a platform for collaboration towards better MDR performance management.

  8. Management and treatment of hepatitis C virus in patients with HIV and hepatitis C virus coinfection: A practical guide for health care professionals.

    PubMed

    Côté, Pierre; Baril, Jean-Guy; Hébert, Marie-Nicole; Klein, Marina; Lalonde, Richard; Poliquin, Marc; Rouleau, Danielle; Therrien, Rachel; Vézina, Sylvie; Willems, Bernard; Dion, Harold; Junod, Patrice; Lapointe, Normand; Lévesque, Dominic; Pinault, Lyse; Tremblay, Cécile; Trottier, Benoît; Trottier, Sylvie; Tsoukas, Chris; Piché, Alain

    2007-09-01

    Concomitant HIV and hepatitis C virus (HCV) is a common yet complex coinfection. The present document is a practical guide for treating HCV infection in people coinfected with HIV. Effective antiretroviral therapies have prolonged survival rates for HIV-infected people over the past decade, which have made latent complications of HCV major causes of morbidity and mortality in these patients. Advances in the treatment of HCV (eg, combined pegylated interferon and ribavirin) offer the possibility of eradicating HCV infection in coinfected persons. The treatment of HCV must be considered in all cases. Intensive management of the adverse effects of HCV treatment is one of the factors for the success of these therapies. HCV eradication is predicted to decrease the mortality associated with coinfection and reduce the toxicity of HIV treatment.

  9. Management and treatment of hepatitis C virus in patients with HIV and hepatitis C virus coinfection: A practical guide for health care professionals

    PubMed Central

    Côté, Pierre; Baril, Jean-Guy; Hébert, Marie-Nicole; Klein, Marina; Lalonde, Richard; Poliquin, Marc; Rouleau, Danielle; Therrien, Rachel; Vézina, Sylvie; Willems, Bernard; Dion, Harold; Junod, Patrice; Lapointe, Normand; Lévesque, Dominic; Pinault, Lyse; Tremblay, Cécile; Trottier, Benoît; Trottier, Sylvie; Tsoukas, Chris; Piché, Alain

    2007-01-01

    Concomitant HIV and hepatitis C virus (HCV) is a common yet complex coinfection. The present document is a practical guide for treating HCV infection in people coinfected with HIV. Effective antiretroviral therapies have prolonged survival rates for HIV-infected people over the past decade, which have made latent complications of HCV major causes of morbidity and mortality in these patients. Advances in the treatment of HCV (eg, combined pegylated interferon and ribavirin) offer the possibility of eradicating HCV infection in coinfected persons. The treatment of HCV must be considered in all cases. Intensive management of the adverse effects of HCV treatment is one of the factors for the success of these therapies. HCV eradication is predicted to decrease the mortality associated with coinfection and reduce the toxicity of HIV treatment. PMID:18923731

  10. Comparing Practice Management Courses in Canadian Dental Schools.

    PubMed

    Schonwetter, Dieter J; Schwartz, Barry

    2018-05-01

    Practice management has become an increasingly important aspect of dental education over the years in order to better prepare students for the reality of practice. The aim of this study was to quantify and describe practice management courses taught at the ten Canadian dental schools in order to identify common approaches, compare hours, determine types of instructors, and assess the relationship between courses' learning objectives and the Association of Canadian Faculties of Dentistry (ACFD) competencies and Bloom's cognitive levels. The academic deans at these ten schools were surveyed in 2016; all ten schools responded for a 100% response rate. The authors also gathered syllabi and descriptions of the courses and analyzed them for themes. The results showed a total of 22 practice management courses in the ten Canadian dental schools. The courses provided 27 to 109 hours of teaching and were mostly taught in the third and fourth years and by dentists on three main topics: ethics, human resource management, and running a private practice. The courses were correlated to the ACFD competencies related to ethics, professionalism, application of basic principles of business practices, and effective interpersonal communication. Most of the courses' learning objectives addressed comprehension and knowledge in Bloom's cognitive levels of learning. These results can help to guide discussions on how practice management courses can be developed, improved, and refined to meet the challenges of preparing students for dental practice.

  11. Effect of care management program structure on implementation: a normalization process theory analysis.

    PubMed

    Holtrop, Jodi Summers; Potworowski, Georges; Fitzpatrick, Laurie; Kowalk, Amy; Green, Lee A

    2016-08-15

    Care management in primary care can be effective in helping patients with chronic disease improve their health status, however, primary care practices are often challenged with implementation. Further, there are different ways to structure care management that may make implementation more or less successful. Normalization process theory (NPT) provides a means of understanding how a new complex intervention can become routine (normalized) in practice. In this study, we used NPT to understand how care management structure affected how well care management became routine in practice. Data collection involved semi-structured interviews and observations conducted at 25 practices in five physician organizations in Michigan, USA. Practices were selected to reflect variation in physician organizations, type of care management program, and degree of normalization. Data were transcribed, qualitatively coded and analyzed, initially using an editing approach and then a template approach with NPT as a guiding framework. Seventy interviews and 25 observations were completed. Two key structures for care management organization emerged: practice-based care management where the care managers were embedded in the practice as part of the practice team; and centralized care management where the care managers worked independently of the practice work flow and was located outside the practice. There were differences in normalization of care management across practices. Practice-based care management was generally better normalized as compared to centralized care management. Differences in normalization were well explained by the NPT, and in particular the collective action construct. When care managers had multiple and flexible opportunities for communication (interactional workability), had the requisite knowledge, skills, and personal characteristics (skill set workability), and the organizational support and resources (contextual integration), a trusting professional relationship (relational integration) developed between practice providers and staff and the care manager. When any of these elements were missing, care management implementation appeared to be affected negatively. Although care management can introduce many new changes into delivery of clinical practice, implementing it successfully as a new complex intervention is possible. NPT can be helpful in explaining differences in implementing a new care management program with a view to addressing them during implementation planning.

  12. Goal setting in diabetes self-management: Taking the baby steps to success

    PubMed Central

    DeWalt, Darren A.; Davis, Terry C.; Wallace, Andrea S.; Seligman, Hilary K.; Bryant-Shilliday, Betsy; Arnold, Connie L.; Freburger, Janet; Schillinger, Dean

    2014-01-01

    Objective To evaluate the usefulness of a diabetes self-management guide and a brief counseling intervention in helping patients set and achieve their behavioral goals. Methods We conducted a quasi-experimental study using a one group pretest posttest design to assess the effectiveness of a goal setting intervention along with a self-management guide. English- and Spanish-speaking patients with diabetes had one in-person session and two telephone follow-up calls with a non-clinical provider over a 12–16-week period. At each call and at the end of the study, we assessed success in achieving behavioral goals and problem solving toward those goals. Satisfaction with the self-management guide was assessed at the end of the study. Results We enrolled 250 patients across three sites and 229 patients completed the study. Most patients chose to set goals in diet and exercise domains. 93% of patients achieved at least one behavioral goal during the study and 73% achieved at least two behavioral goals. Many patients exhibited problem solving behavior to achieve their goals. We found no significant differences in reported achievement of behavior goals by literacy or language. Patients were very satisfied with the guide. Conclusions A brief goal setting intervention along with a diabetes self-management guide helped patients set and achieve healthy behavioral goals. Practice implications Non-clinical providers can successfully help a diverse range of patients with diabetes set and achieve behavioral goals. PMID:19359123

  13. Severe thrombocytopenia in a child with typhoid fever: a case report.

    PubMed

    Al Reesi, Mohammed; Stephens, Glenn; McMullan, Brendan

    2016-11-30

    Although thrombocytopenia is common in typhoid fever, its course, response to treatment, and need for specific therapies such as platelet transfusion are not well characterized. We report a case of typhoid fever in a 4-year-old Asian male returned traveler, admitted with prolonged fever and found to have severe thrombocytopenia (platelets 16 × 10 9 /L). Despite appropriate antibiotic therapy, his platelet recovery was slow, but did not lead to complications and he did not require platelet transfusion. There is no consensus in the medical literature guiding the optimal management of severe thrombocytopenia in typhoid fever, but it may improve with conservative management, as in our case. The epidemiology and management of this condition merits further research to guide clinical practice.

  14. Selected medical management of the older rehabilitative patient.

    PubMed

    Lin, John L; Armour, Doris

    2004-07-01

    This self-directed learning module highlights present practices of geriatric medicine that are commonly seen in an inpatient rehabilitation setting. It is a part of the study guide on geriatric rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. In particular, attention is given to update physiatrists in the geriatric medical advances in pharmacotherapeutic considerations, the management of hypertension, diabetes mellitus, urinary tract infections, and sleep disorders. To update the common present-day medical practices for older persons seen in a rehabilitation setting.

  15. Representational Approach: A Conceptual Framework to Guide Patient Education Research and Practice.

    PubMed

    Arida, Janet A; Sherwood, Paula R; Flannery, Marie; Donovan, Heidi S

    2016-11-01

    Illness representations are cognitive structures that individuals rely on to understand and explain their illnesses and associated symptoms. The Representational Approach (RA) to patient education offers a theoretically based, clinically useful model that can support oncology nurses to develop a shared understanding of patients' illness representations to collaboratively develop highly personalized plans for symptom management and other important self-management behaviors. This article discusses theoretical underpinnings, practical applications, challenges, and future directions for incorporating illness representations and the RA in clinical and research endeavors.

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

    ERIC Educational Resources Information Center

    Westgaard, Odin

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

  17. Forum Guide to Supporting Data Access for Researchers: A Local Education Agency Perspective. NFES 2014-801

    ERIC Educational Resources Information Center

    National Forum on Education Statistics, 2014

    2014-01-01

    This document recommends a set of core practices, operations, and templates that can be adopted and adapted by local education agencies (LEAs) as they consider how to respond to requests for both new and existing data about the education enterprise. These recommendations reflect core best practices for: (1) managing the flow of requests; (2)…

  18. A School Administrator's Guide to the Family and Medical Leave Act

    ERIC Educational Resources Information Center

    Bosland, Carl C.

    2007-01-01

    This book is a comprehensive, yet practical, reference for information and guidance to comply with the requirements of the Family and Medical Leave Act of 1993. It provides school administrators with the latest information to ensure that school policies and practices are up-to-date and it helps to manage leave and avoid costly legal violations.…

  19. Construction managers' perceptions of construction safety practices in small and large firms: a qualitative investigation.

    PubMed

    Gillen, Marion; Kools, Susan; McCall, Cade; Sum, Juliann; Moulden, Kelli

    2004-01-01

    Despite the institution of explicit safety practices in construction, there continue to be exceedingly high rates of morbidity and mortality from work-related injury. This study's purpose was to identify, compare and contrast views of construction managers from large and small firms regarding construction safety practices. A complementary analysis was conducted with construction workers. A semi-structured interview guide was used to elicit information from construction managers (n = 22) in a series of focus groups. Questions were designed to obtain information on direct safety practices and indirect practices such as communication style, attitude, expectations, and unspoken messages. Data were analyzed using thematic content analysis. Managers identified a broad commitment to safety, worker training, a changing workplace culture, and uniform enforcement as key constructs in maintaining safe worksites. Findings indicate that successful managers need to be involved, principled, flexible, and innovative. Best practices, as well as unsuccessful injury prevention programs, were discussed in detail. Obstacles to consistent safety practice include poor training, production schedules and financial constraints. Construction managers play a pivotal role in the definition and implementation of safety practices in the workplace. In order to succeed in this role, they require a wide variety of management skills, upper management support, and tools that will help them instill and maintain a positive safety culture. Developing and expanding management skills of construction managers may assist them in dealing with the complexity of the construction work environment, as well as providing them with the tools necessary to decrease work-related injuries.

  20. Applying change management metaphors to a national e-Health strategy.

    PubMed

    Saunders, Chad; Scott, Richard E

    2014-01-01

    Recent attempts at a collective understanding of how to develop an e-Health strategy have addressed the individual organisation, collection of organisations, and national levels. At the national level the World Health Organisation's National eHealth Strategy Toolkit serves as an exemplar that consolidates knowledge in this area, guides practical implementations, and identifies areas for future research. A key implication of this toolkit is the considerable number of organisational changes required to successfully apply their ideas in practice. This study looks critically at the confluence of change management and e-Health strategy using metaphors that underpin established models of change management. Several of Morgan's organisational metaphors are presented (highlighting varied beliefs and assumptions regarding how change is enacted, who is responsible for the change, and guiding principles for that change), and used to provide a framework. Attention is then directed to several prominent models of change management that exemplify one or more of these metaphors, and these theoretical insights are applied to evaluate the World Health Organisation's National eHealth Strategy Toolkit. The paper presents areas for consideration when using the WHO/ITU toolkit, and suggestions on how to improve its use in practice. The goal is to seek insight regarding the optimal sequence of steps needed to ensure successful implementation and integration of e-health into health systems using change management models. No single model, toolkit, or guideline will offer all the needed answers, but clarity around the underlying metaphors informing the change management models being used provides valuable insight so potentially challenging areas can be avoided or mitigated.

  1. Module 3: Workplace Policy, Practice and Culture--Employer and Employee Perspectives. Work-Family Curriculum Guide

    ERIC Educational Resources Information Center

    Kossek, Ellen Ernst; Leana, Carrie; MacDermid, Shelley; Pitt-Catsouphes, Marcie; Raskin, Patricia; Secret, Mary; Sweet, Stephen

    2006-01-01

    The contents of this module have been prepared to address some of challenges associated with teaching about work-family issues from a human resource management and employment perspective. The goals of this module are: (1) To develop an understanding that work-family policies are part of a human resource management system and the employment…

  2. Current Evidence of Best Practice in Whole-School Bullying Intervention and Its Potential to Inform Cyberbullying Interventions

    ERIC Educational Resources Information Center

    Pearce, Natasha; Cross, Donna; Monks, Helen; Waters, Stacey; Falconer, Sarah

    2011-01-01

    In 2004, a set of validated guidelines for school bullying prevention and management was released by the Child Health Promotion Research Centre in Australia to guide schools' action to prevent and manage bullying behaviours. At this time little was known about cyber and other forms of covert bullying behaviours. These guidelines were updated in…

  3. Guide for the Management of Multinational Programs. A Handbook for Managers Entering the World of International Acquisition. Second Edition

    DTIC Science & Technology

    1987-05-11

    Labor Stability and Ccupensation Practices . . . . 4-9 Management Styles . . . . . . . . . . . . . . . . 4-12 Canadian Relationship to The US...Systýem (PAPS) Milestones and Phases ...... _ . . . 3-8 3-4 Phased Armaments Programminq System(PAPS)/ DoD Systems Acquisition Structural Relationship ...sharing o Armaments cooperation o An understanding of the relationship between economics and security. In concert with the above efforts were various allied

  4. A new perspective: a vulnerable population framework to guide research and practice for persons with traumatic brain injury.

    PubMed

    Bay, Esther; Kreulen, Grace J; Shavers, Clarissa Agee; Currier, Connie

    2006-01-01

    Recovery from traumatic brain injury (TBI) can be a tumultuous lifelong and expensive process. Guided therapies for community integration within community systems are a focus of treating therapists around the world, yet there are no published discussions concerning the most fitting community context. We propose a theoretical approach for practice and research using Flaskerud and Winslow's conceptual model of vulnerable populations. Using the model constructs of health status, resource availability, and increased relative risk, we offer empirical support for proposed construct relationships applied to persons with traumatic brain injury. We then propose that interventions for health promotion, acute care, and rehabilitation or chronic disease management have a community focus, and we identify relevant goals for community-based practice and research.

  5. Management of acute lymphoblastic leukemia in young adults.

    PubMed

    Muffly, Lori S; Reizine, Natalie; Stock, Wendy

    2018-02-01

    Substantial interest in acute lymphoblastic leukemia (ALL) in young adults (YAs) and investigations focused on this patient population have resulted in therapeutic advancements that are changing the management paradigm and improving outcomes. The pediatric ALL approach is feasible and effective when administered by medical oncologists. Advanced diagnostics and minimal residual disease measurements aid in prognostication and have resulted in shifting recommendations regarding allogeneic hematopoietic cell transplant in first remission. Blinatumomab, inotuzumab, and chimeric antigen receptor T-cell therapies are transforming the treatment of relapsed/refractory ALL. This comprehensive review of the current management of ALL in YAs summarizes recent scientific developments and clinical trial findings related to ALL biology, frontline management approaches, novel therapies, and supportive care specific to this patient population. Finally, a practical guide to modern YA management for practicing clinicians is provided.

  6. Development of a Mapped Diabetes Community Program Guide for a Safety Net Population

    PubMed Central

    Zallman, Leah; Ibekwe, Lynn; Thompson, Jennifer W.; Ross-Degnan, Dennis; Oken, Emily

    2014-01-01

    Purpose Enhancing linkages between patients and community programs is increasingly recognized as a method for improving physical activity, nutrition and weight management. Although interactive mapped community program guides may be beneficial, there remains a dearth of articles that describe the processes and practicalities of creating such guides. This article describes the development of an interactive, web-based mapped community program guide at a safety net institution and the lessons learned from that process. Conclusions This project demonstrated the feasibility of creating two maps – a program guide and a population health map. It also revealed some key challenges and lessons for future work in this area, particularly within safety-net institutions. Our work underscores the need for developing partnerships outside of the health care system and the importance of employing community-based participatory methods. In addition to facilitating improvements in individual wellness, mapping community programs also has the potential to improve population health management by healthcare delivery systems such as hospitals, health centers, or public health systems, including city and state departments of health. PMID:24752180

  7. Long-term pavement performance information management system : pavement performance database user reference guide

    DOT National Transportation Integrated Search

    1995-02-01

    This paper (1) summarizes the most relevant current experience and practice regarding permits (provisions, administrative requirements) and highway use pricing mechanisms (use taxes, permit fees, tolls) of importance for truck size and weight (TS&W) ...

  8. A Decision-Making Framework for Cleanup of Sites Impacted with Light Non-Aqueous Phase Liquids (LNAPL)

    EPA Pesticide Factsheets

    This document has been prepared by the Remediation Technologies Development Forum (RTDF) NAPL Cleanup Alliance to provide a guide to practicable and reasonable approaches for management of LNAPL petroleum hydrocarbons in the subsurface.

  9. Concussion Care Practices and Utilization of Evidence-Based Guidelines in the Evaluation and Management of Concussion: A Survey of New England Emergency Departments.

    PubMed

    Stern, Robert A; Seichepine, Daniel; Tschoe, Christine; Fritts, Nathan G; Alosco, Michael L; Berkowitz, Oren; Burke, Peter; Howland, Jonathan; Olshaker, Jonathan; Cantu, Robert C; Baugh, Christine M; Holsapple, James W

    2017-02-15

    Evidence-based clinical practice guidelines can facilitate proper evaluation and management of concussions in the emergency department (ED), often the initial and primary point of contact for concussion care. There is no universally adopted set of guidelines for concussion management, and extant evidence suggests that there may be variability in concussion care practices and limited application of clinical practice guidelines in the ED. This study surveyed EDs throughout New England to examine current practices of concussion care and utilization of evidence-based clinical practice guidelines in the evaluation and management of concussions. In 2013, a 32-item online survey was e-mailed to 149/168 EDs throughout New England (Connecticut, Rhode Island, Massachusetts, Vermont, New Hampshire, Maine). Respondents included senior administrators asked to report on their EDs use of clinical practice guidelines, neuroimaging decision-making, and discharge instructions for concussion management. Of the 72/78 respondents included, 35% reported absence of clinical practice guidelines, and 57% reported inconsistency in the type of guidelines used. Practitioner preference guided neuroimaging decision-making for 57%. Although 94% provided written discharge instructions, there was inconsistency in the recommended time frame for follow-up care (13% provided no specific time frame), the referral specialist to be seen (25% did not recommend any specialist), and return to activity instructions were inconsistent. There is much variability in concussion care practices and application of evidence-based clinical practice guidelines in the evaluation and management of concussions in New England EDs. Knowledge translational efforts will be critical to improve concussion management in the ED setting.

  10. Effectiveness of Directional Preference to Guide Management of Low Back Pain in Canadian Armed Forces Members: A Pragmatic Study.

    PubMed

    Franz, Anja; Lacasse, Anaïs; Donelson, Ronald; Tousignant-Laflamme, Yannick

    2017-11-01

    Low-back pain (LBP) is a leading cause for disability in military personnel. Consequently, effective management strategies are required to maintaining operational capabilities. Physical therapy clinical practice guidelines recommend the use of directional preference (DP) to guide management. The effectiveness of this approach has not been tested in military personnel using a pragmatic study design. Pragmatic studies are ideal to inform clinicians and policymakers about the usefulness of proven interventions in real-life clinical conditions. The purpose of this study was therefore to determine, in clinical practice, the effectiveness of a management approach guided by DP vs. usual care (UC) physical therapy in Canadian Armed Forces (CAF) members with LBP. A pragmatic study was conducted among 44 consecutive CAF members with LBP who received management guided by DP (n = 22) or UC (n = 22). Outcomes were pain intensity (primary outcome), pain location and frequency, perceived disability, medication use, perceived global effect (pain, function, overall status), work loss, and health care utilization. The effectiveness of the intervention was assessed at 1-month and 3-months follow-up. Statistically significant differences favoring the DP group were observed for pain intensity (Δ 1 month: 1.9/10; 95% confidence interval [CI]; 0.97-2.89; Δ 3 months: 1.3/10; 95% CI: 0.35-2.31), pain location at 1 month (54.5% vs. 19.0%; p = 0.02) and 3 months (68.2% vs. 38.1%; p = 0.01), disability (Δ 1 month: 4.3/24; 95% CI: 2.12-6.38; Δ 3 months: 3.5/24; 95% CI; 1.59-5.33), perceived global effect at 1 month (pain: 86.4% vs. 57.1%; function: 81.8% vs. 47.6%; overall status: 86.4% vs. 57.1%) and 3 months (pain: 95.5% vs. 71.1%; overall status: 95.5% vs. 66.7%) with p values < 0.05, and improvement in work status at 3 months (54.5% vs. 23.8%; p = 0.04). DP-guided management appears more effective than UC physical therapy to reduce pain and improve function in CAF members with LBP. Rapid improvements and the patient's ability to self-manage may prove especially advantageous in deployed settings. Our findings are particularly useful to inform military policymakers and clinicians on optimal management for CAF members. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  11. Reaching consensus on the physiotherapeutic management of patients following upper abdominal surgery: a pragmatic approach to interpret equivocal evidence.

    PubMed

    Hanekom, Susan D; Brooks, Dina; Denehy, Linda; Fagevik-Olsén, Monika; Hardcastle, Timothy C; Manie, Shamila; Louw, Quinette

    2012-02-06

    Postoperative pulmonary complications remain the most significant cause of morbidity following open upper abdominal surgery despite advances in perioperative care. However, due to the poor quality primary research uncertainty surrounding the value of prophylactic physiotherapy intervention in the management of patients following abdominal surgery persists. The Delphi process has been proposed as a pragmatic methodology to guide clinical practice when evidence is equivocal. The objective was to develop a clinical management algorithm for the post operative management of abdominal surgery patients. Eleven draft algorithm statements extracted from the extant literature by the primary research team were verified and rated by scientist clinicians (n=5) in an electronic three round Delphi process. Algorithm statements which reached a priori defined consensus-semi-interquartile range (SIQR)<0.5-were collated into the algorithm. The five panelists allocated to the abdominal surgery Delphi panel were from Australia, Canada, Sweden, and South Africa. The 11 draft algorithm statements were edited and 5 additional statements were formulated. The panel reached consensus on the rating of all statements. Four statements were rated essential. An expert Delphi panel interpreted the equivocal evidence for the physiotherapeutic management of patients following upper abdominal surgery. Through a process of consensus a clinical management algorithm was formulated. This algorithm can now be used by clinicians to guide clinical practice in this population.

  12. Optimizing conservation strategies for a threatened tree species: In situ conservation of white ash (Fraxinus americana L.) genetic diversity through insecticide treatment

    Treesearch

    Charles Flower; Jeremie Fant; Sean Hoban; Kathleen Knight; Laura Steger; Elijah Aubihl; Miquel Gonzalez-Meler; Stephen Forry; Andrea Hille; Alejandro Royo

    2018-01-01

    Forest resources face numerous threats that require costly management. Hence, there is an increasing need for data-informed strategies to guide conservation practices. The introduction of the emerald ash borer to North America has caused rapid declines in ash populations (Fraxinus spp. L.). Natural resource managers are faced with a choice of...

  13. Training Guide for the Management Analyst Industrial Engineer Technician

    DTIC Science & Technology

    1979-07-01

    comtemporary work operations, and blending traditional and modern organization concepts, the student devwlops the facility to analyze and create organization...training, the attendee will know the functions of a computer as it processes business data to produce information for improved management. He will...action which is most cost effective when considering proposed investments. Emphasis is placed on the adaption of general business practices to

  14. Proactive Classroom Management, K-8: A Practical Guide to Empower Students and Teachers

    ERIC Educational Resources Information Center

    Denti, Louis G.

    2012-01-01

    Every teacher dreams of the perfect, well-behaved class, but the reality can be quite different. On those less-than-perfect days, having a system in place helps you and your students stay on track. This gold mine of teacher-developed and -approved strategies goes beyond classroom management theory and gives you ready-to-use tools that not only…

  15. A framework to develop a clinical learning culture in health facilities: ideas from the literature.

    PubMed

    Henderson, A; Briggs, J; Schoonbeek, S; Paterson, K

    2011-06-01

    Internationally, there is an increase in demand to educate nurses within the clinical practice environment. Clinical practice settings that encourage teaching and learning during episodes of care delivery can be powerful in educating both the existing nursing workforce and nursing students. This paper presents a framework, informed by the literature, that identifies the key factors that are needed to encourage the interactions fundamental to learning in clinical practice. Learning occurs when nurses demonstrate good practice, share their knowledge through conversations and discussions, and also provide feedback to learners, such as students and novices. These types of interactions occur when positive leadership practices encourage trust and openness between staff; when the management team provides sessions for staff to learn how to interact with learners, and also when partnerships provide support and guidance around learning in the workplace. APPLICATION OF CONCEPTS: This framework presents how the concepts of leadership, management and partnership interact to create and sustain learning environments. The feedback from proposed measurement tools can provide valuable information about the positive and negative aspects of these concepts in the clinical learning environment. Analysis of the subscales can assist in identifying appropriate recommended strategies outlined in the framework to guide nurses in improving the recognized deficits in the relationship between the concepts. Leadership, management and partnerships are pivotal for the creation and maintenance of positive learning environments. Diagnostic measurement tools can provide specific information about weaknesses across these areas. This knowledge can guide future initiatives. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

  16. Facilitating adaptive management in a government program: A household energy efficiency case study.

    PubMed

    Curtis, Jim; Graham, Alex; Ghafoori, Eraj; Pyke, Susan; Kaufman, Stefan; Boulet, Mark

    2017-02-01

    Interim evaluations of government programs can sometimes reveal lower than expected outcomes, leading to the question of how adjustments can be made while the program is still underway. Although adaptive management frameworks can provide a practical roadmap to address this question, a lack of successful learnings and poor implementation have hampered the progress and wider application of adaptive management. Using a case study involving an energy efficiency government program targeting low-income households, this article provides supporting evidence on how adaptive management can be facilitated and applied. Factors such as proactive and responsive leadership, establishing a research-practice interface, and recognizing the skills, expertise, and contributions of multiple stakeholders guided adjustments to the program, and later paved the way for longer-term organizational learning that impacted how other programs are delivered. Implications for knowledge and practice, and a discussion of the challenges faced in the program, advance current thinking in adaptive management. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. The search for underlying principles of health impact assessment: progress and prospects: Comment on "Investigating underlying principles to guide health impact assessment".

    PubMed

    Winkler, Mirko S; Utzinger, Jürg

    2014-07-01

    Health Impact Assessment (HIA) is a relatively young field of endeavour, and hence, future progress will depend on the planning, implementation and rigorous evaluation of additional HIAs of projects, programmes and policies the world over. In the June 2014 issue of the International Journal of Health Policy and Management, Fakhri and colleagues investigated underlying principles of HIA through a comprehensive review of the literature and expert consultation. With an emphasis on the Islamic Republic of Iran, the authors identified multiple issues that are relevant for guiding HIA practice. At the same time, the study unravelled current shortcomings in the understanding and definition of HIA principles and best practice at national, regional, and global levels. In this commentary we scrutinise the research presented, highlight strengths and limitations, and discuss the findings in the context of other recent attempts to guide HIA.

  18. SEWER SEDIMENT AND CONTROL: A MANAGEMENT PRACTICES REFERENCES GUIDE

    EPA Science Inventory

    Sewer-solids sediment is one of major sources of pollutants in urban wet-weather flow (WWF) discharges that include combined-sewer overflow (CSO), separate sanitary-sewer overflow (SSO), and stormwater runoff. During low-flow, dry-weather periods, sanitary wastewater solids depo...

  19. A stocking guide for eastern white pine

    Treesearch

    James S. Philbrook; James P. Barrett; William B. Leak

    1973-01-01

    A stocking chart for eastern white pine is presented and described. The chart shows basal areas and numbers of trees by mean stand diameter, representing the upper limit in stocking for practical management (A curve) and minimum stocking for full site utilization (B curve).

  20. Public Accountancy Handbook.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Office of the Professions.

    A reference guide to laws, rules, and regulations that govern public accountancy practice in New York State is presented. In addition to identifying licensing requirements/procedures for certified public accountants, general provisions of Title VIII of the Education Law are covered, along with state management, professional misconduct, and…

  1. Orthopaedic Surgeons as Clinical Leaders in the National Health Service, United Kingdom (NHS UK): Can the World Learn From Us?

    PubMed

    Javed, Mustafa; Moulder, Elizabeth; Mohsen, Amr

    2015-07-01

    This article outlines some of the key concepts in leadership (both styles and theories) to provide a platform for further learning and to help the modern day orthopaedic surgeons to apply these concepts to their current practice. It is focused on two major aspects: management of medical organizations and effective twenty-first century care by surgeons through proper leadership guide and aimed in improving patient care outcomes. Practicing proper leadership skills based on evidence resulted in effective management of organization. Thus achieving patient's satisfaction.

  2. Respiratory therapies for amyotrophic lateral sclerosis: a primer.

    PubMed

    Gruis, Kirsten L; Lechtzin, Noah

    2012-09-01

    Respiratory complications are a common cause of morbidity and mortality in amyotrophic lateral sclerosis (ALS). Treatment of respiratory insufficiency with noninvasive ventilation (NIV) improves ALS patients' quality of life and survival. Evidence-based practice guidelines for the management of ALS patients recommend treatment of respiratory insufficiency with NIV as well as consideration of insufflation/exsufflation to improve clearance of airway secretions. Despite these recommendations respiratory therapies remain underused. In this review we provide a practical guide for the clinician to prescribe and manage respiratory therapies for the patient with ALS. Copyright © 2012 Wiley Periodicals, Inc.

  3. Possible ways for Public Health Surveillance practices evaluation.

    PubMed

    Vilela, Maria Filomena de Gouveia; Santos, Dario Nunes Dos; Kemp, Brigina

    2017-10-01

    This is an evaluative and qualitative study that proposes to investigate self-assessment evaluation as a device to analyze Health Surveillance practices through a questionnaire built by researchers, adapted from the Self-Assessment of Improved Access and Primary Care Quality (AMAQ) and available on the FORMSUS platform. Forty-one Health Surveillance workers and managers of a large municipality from São Paulo State evaluated the realms of "management", "teamwork" and their respective sub-realms. Two categories were created to analyze the results: "Management" and "Team" in dialogue with references from Management, Evaluation and Health Surveillance. Most "management" and "teamwork" sub-realms were deemed satisfactory. Self-assessment evaluation through an applied evaluation tool was shown to be a powerful resource for the analysis of Health Surveillance practices in combination with other devices adopted by the Unified Health System (SUS). Unlike usual evaluation processes guided by quantitative markers, this self-assessable evaluative process included subjects and enabled the possibility of incorporating a new look at itself to the way Health Surveillance is carried out and support future management contracts between workers and managers.

  4. A practical guide to assessing clinical decision-making skills using the key features approach.

    PubMed

    Farmer, Elizabeth A; Page, Gordon

    2005-12-01

    This paper in the series on professional assessment provides a practical guide to writing key features problems (KFPs). Key features problems test clinical decision-making skills in written or computer-based formats. They are based on the concept of critical steps or 'key features' in decision making and represent an advance on the older, less reliable patient management problem (PMP) formats. The practical steps in writing these problems are discussed and illustrated by examples. Steps include assembling problem-writing groups, selecting a suitable clinical scenario or problem and defining its key features, writing the questions, selecting question response formats, preparing scoring keys, reviewing item quality and item banking. The KFP format provides educators with a flexible approach to testing clinical decision-making skills with demonstrated validity and reliability when constructed according to the guidelines provided.

  5. A roadmap for knowledge exchange and mobilization research in conservation and natural resource management.

    PubMed

    Nguyen, Vivian M; Young, Nathan; Cooke, Steven J

    2017-08-01

    Scholars across all disciplines have long been interested in how knowledge moves within and beyond their community of peers. Rapid environmental changes and calls for sustainable management practices mean the best knowledge possible is needed to inform decisions, policies, and practices to protect biodiversity and sustainably manage vulnerable natural resources. Although the conservation literature on knowledge exchange (KE) and knowledge mobilization (KM) has grown in recent years, much of it is based on context-specific case studies. This presents a challenge for learning cumulative lessons from KE and KM research and thus effectively using knowledge in conservation and natural resources management. Although continued research on the gap between knowledge and action is valuable, overarching conceptual frameworks are now needed to enable summaries and comparisons across diverse KE-KM research. We propose a knowledge-action framework that provides a conceptual roadmap for future research and practice in KE/KM with the aim of synthesizing lessons learned from contextual case studies and guiding the development and testing of hypotheses in this domain. Our knowledge-action framework has 3 elements that occur at multiple levels and scales: knowledge production (e.g., academia and government), knowledge mediation (e.g., knowledge networks, actors, relational dimension, and contextual dimension), and knowledge-based action (e.g., instrumental, symbolic, and conceptual). The framework integrates concepts from the sociology of science in particular, and serves as a guide to further comprehensive understanding of knowledge exchange and mobilization in conservation and sustainable natural resource management. © 2016 Society for Conservation Biology.

  6. Ecological and evolutionary approaches to managing honey bee disease

    PubMed Central

    Brosi, Berry J.; Delaplane, Keith S.; Boots, Michael; de Roode, Jacobus C.

    2017-01-01

    Honey bee declines are a serious threat to global agricultural security and productivity. While multiple factors contribute to these declines, parasites are a key driver. Disease problems in honey bees have intensified in recent years, despite increasing attention to addressing them. Here we argue that we must focus on the principles of disease ecology and evolution to understand disease dynamics, assess the severity of disease threats, and manage these threats via honey bee management. We cover the ecological context of honey bee disease, including both host and parasite factors driving current transmission dynamics, and then discuss evolutionary dynamics including how beekeeping management practices may drive selection for more virulent parasites. We then outline how ecological and evolutionary principles can guide disease mitigation in honey bees, including several practical management suggestions for addressing short- and long-term disease dynamics and consequences. PMID:29046562

  7. Ecological and evolutionary approaches to managing honeybee disease.

    PubMed

    Brosi, Berry J; Delaplane, Keith S; Boots, Michael; de Roode, Jacobus C

    2017-09-01

    Honeybee declines are a serious threat to global agricultural security and productivity. Although multiple factors contribute to these declines, parasites are a key driver. Disease problems in honeybees have intensified in recent years, despite increasing attention to addressing them. Here we argue that we must focus on the principles of disease ecology and evolution to understand disease dynamics, assess the severity of disease threats, and control these threats via honeybee management. We cover the ecological context of honeybee disease, including both host and parasite factors driving current transmission dynamics, and then discuss evolutionary dynamics including how beekeeping management practices may drive selection for more virulent parasites. We then outline how ecological and evolutionary principles can guide disease mitigation in honeybees, including several practical management suggestions for addressing short- and long-term disease dynamics and consequences.

  8. Asthma and Respiratory Foundation NZ child and adolescent asthma guidelines: a quick reference guide.

    PubMed

    Asher, Innes; McNamara, David; Davies, Cheryl; Demetriou, Teresa; Fleming, Theresa; Harwood, Matire; Hetaraka-Stevens, Lorraine; Ingham, Tristram; Kristiansen, John; Reid, Jim; Rickard, Debbie; Ryan, Debbie

    2017-12-01

    The purpose of the New Zealand Child and adolescent asthma guidelines: a quick reference guide is to provide simple, practical, evidence-based recommendations for the diagnosis, assessment and management of asthma in children and adolescents in New Zealand, with the aim of improving outcomes and reducing inequities. The intended users are health professionals responsible for delivering asthma care in the community and hospital emergency department settings, and those responsible for the training of such health professionals.

  9. Strategies to reduce blood product utilization in obstetric practice.

    PubMed

    Neb, Holger; Zacharowski, Kai; Meybohm, Patrick

    2017-06-01

    Patient blood management (PBM) aims to improve patient outcome and safety by reducing the number of unnecessary RBC transfusions and vitalizing patient-specific anemia reserves. Although PBM is increasingly recognized as best clinical practice in elective surgery, implementation of PBM is restrained in the setting of obstetrics. This review summarizes recent findings to reduce blood product utilization in obstetric practice. PBM-related evidence-based benefits should be urgently adopted in the field of obstetric medicine. Intravenous iron can be considered a safe, effective strategy to replenish iron stores and to correct both pregnancy-related and hemorrhage-related iron deficiency anemia. In addition to surgical techniques and the use of uterotonics, recent findings support early administration of tranexamic acid, fibrinogen and a coagulation factor concentrate-based, viscoelastically guided practice in case of peripartum hemorrhage to manage coagulopathy. In patients with cesarean section, autologous red cell blood salvage may reduce blood product utilization, although its use in this setting is controversial. Implementation of PBM in obstetric practice offers large potential to reduce blood loss and transfusion requirements of allogeneic blood products, even though large clinical trials are lacking in this specific field. Intravenous iron supplementation may be suggested to increase peripartum hemoglobin levels. Additionally, tranexamic acid and point-of-care-guided supplementation of coagulation factors are potent methods to reduce unnecessary blood loss and blood transfusions in obstetrics.

  10. 'I do the best I can': an in-depth exploration of the aphasia management pathway in the acute hospital setting.

    PubMed

    Foster, Abby M; Worrall, Linda E; Rose, Miranda L; O'Halloran, Robyn

    2016-09-01

    While research has begun to explore the management of aphasia across the continuum of care, to date there is little in-depth, context specific knowledge relating to the speech pathology aphasia management pathway. This research aimed to provide an in-depth understanding of the current aphasia management pathway in the acute hospital setting, from the perspective of speech pathologists. Underpinned by a social constructivist paradigm, the researchers implemented an interpretive phenomenological method when conducting in-depth interviews with 14 Australian speech pathologists working in the acute hospital setting. Interview transcripts and interviewer field notes were subjected to a qualitative content analysis. Analysis identified a single guiding construct and five main categories to describe the management of aphasia in the acute hospital setting. The guiding construct, First contact with the profession, informed the entire management pathway. Five additional main categories were identified: Referral processes; Screening and assessment; Therapeutic intervention; Educational and affective counselling; and Advocacy. Findings suggest significant diversity in the pathways of care for people with aphasia and their families in the acute hospital setting. Additional support mechanisms are required in order to support speech pathologists to minimise the evidence-practice gap. Implications for Rehabilitation Significant diversity exists in the current aphasia management pathway for people with acute post-stroke aphasia and their families in the acute hospital setting. Mechanisms that support speech pathologists to minimise the evidence-practice gap, and consequently reduce their sense of professional dissonance, are required.

  11. Medicine Handbook.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Office of the Professions.

    A reference guide to laws, rules, and regulations that govern medical practice in the State of New York is presented. In addition to identifying licensing requirements/procedures for physicians, general provisions of Title VIII of the Education Law are covered along with state management, professional misconduct, and authorized acts. Regulations…

  12. Simplified basic periodontal examination (BPE) in children and adolescents: a guide for general dental practitioners.

    PubMed

    Cole, Emma; Ray-Chaudhuri, Arijit; Vaidyanathan, Mina; Johnson, Joanna; Sood, Sanjeev

    2014-05-01

    Dental plaque-induced periodontal diseases are common in children and adults. Guidelines were previously not available for the periodontal screening of under 18s. However, new guidelines have been introduced by the British Society of Periodontology and the British Society of Paediatric Dentistry which set out recommendations for the periodontal screening and management of under 18s in primary dental care. This article provides a practical guide for general dental practitioners on how to use the BPE in children and adolescents, and highlights the importance of early detection and management of periodontal diseases in this age group. A failure to use the modified BPE in a young patient who is later diagnosed with periodontitis may leave a dentist vulnerable to a medico-legal complaint or claim. New BPE guidelines for children and adolescents have been introduced by the BSPD and BSP; it is important that all dentists are aware of these guidelines and how to implement them in general practice.

  13. Orthostatic hypotension: pathophysiology, assessment, treatment and the paradox of supine hypertension.

    PubMed

    Chisholm, Peter; Anpalahan, Mahesan

    2017-04-01

    Both hypertension and orthostatic hypotension (OH) are strongly age-associated and are common management problems in older people. However, unlike hypertension, management of OH has unique challenges with few well-established treatments. Not infrequently, they both coexist, further compounding the management. This review provides comprehensive information on OH, including pathophysiology, diagnostic workup and treatment, with a view to provide a practical guide to its management. Special references are made to patients with supine hypertension and postprandial hypotension and older hypertensive patients. © 2016 Royal Australasian College of Physicians.

  14. An open-source job management framework for parameter-space exploration: OACIS

    NASA Astrophysics Data System (ADS)

    Murase, Y.; Uchitane, T.; Ito, N.

    2017-11-01

    We present an open-source software framework for parameter-space exporation, named OACIS, which is useful to manage vast amount of simulation jobs and results in a systematic way. Recent development of high-performance computers enabled us to explore parameter spaces comprehensively, however, in such cases, manual management of the workflow is practically impossible. OACIS is developed aiming at reducing the cost of these repetitive tasks when conducting simulations by automating job submissions and data management. In this article, an overview of OACIS as well as a getting started guide are presented.

  15. Concussion Care Practices and Utilization of Evidence-Based Guidelines in the Evaluation and Management of Concussion: A Survey of New England Emergency Departments

    PubMed Central

    Seichepine, Daniel; Tschoe, Christine; Fritts, Nathan G.; Alosco, Michael L.; Berkowitz, Oren; Burke, Peter; Howland, Jonathan; Olshaker, Jonathan; Cantu, Robert C.; Baugh, Christine M.; Holsapple, James W.

    2017-01-01

    Abstract Evidence-based clinical practice guidelines can facilitate proper evaluation and management of concussions in the emergency department (ED), often the initial and primary point of contact for concussion care. There is no universally adopted set of guidelines for concussion management, and extant evidence suggests that there may be variability in concussion care practices and limited application of clinical practice guidelines in the ED. This study surveyed EDs throughout New England to examine current practices of concussion care and utilization of evidence-based clinical practice guidelines in the evaluation and management of concussions. In 2013, a 32-item online survey was e-mailed to 149/168 EDs throughout New England (Connecticut, Rhode Island, Massachusetts, Vermont, New Hampshire, Maine). Respondents included senior administrators asked to report on their EDs use of clinical practice guidelines, neuroimaging decision-making, and discharge instructions for concussion management. Of the 72/78 respondents included, 35% reported absence of clinical practice guidelines, and 57% reported inconsistency in the type of guidelines used. Practitioner preference guided neuroimaging decision-making for 57%. Although 94% provided written discharge instructions, there was inconsistency in the recommended time frame for follow-up care (13% provided no specific time frame), the referral specialist to be seen (25% did not recommend any specialist), and return to activity instructions were inconsistent. There is much variability in concussion care practices and application of evidence-based clinical practice guidelines in the evaluation and management of concussions in New England EDs. Knowledge translational efforts will be critical to improve concussion management in the ED setting. PMID:27112592

  16. Healthcare Financial Management Association, Principles and Practices Board. Statement no. 15: Valuation and financial statement presentation of charity service and bad debts by institutional healthcare providers.

    PubMed

    1993-02-01

    Principles and Practices Board (P&P Board) Statement No. 2, issued in 1978, provided a basis for differentiating between charity service and bad debts. The statement acknowledged that, while the differentiation was helpful, the financial accounting and reporting of charity service and bad debts were the same. In 1990, the American Institute of Certified Public Accountants (AICPA) published (after review and approval by the Financial Accounting Standards Board and the Governmental Accounting Standards Board) an extensive revision of the guide titled "Audits of Providers of Health Care Services." The revised guide substantially changed the reporting of bad debts and eliminated charity service from revenue. Disclosure of the entity's policy for providing charity service and the level of charity service provided is required by the revised guide. The P&P Board decided that a substantive revision of its Statement No. 2 was required to bring it into conformity with the revised guide and to provide direction on implementation of the revised guide's requirements. This statement supersedes Statement No. 2 and deals with the same issues, including bad debts.

  17. Managing crises through organisational development: a conceptual framework.

    PubMed

    Lalonde, Carole

    2011-04-01

    This paper presents a synthesis of the guiding principles in crisis management in accordance with the four configurational imperatives (strategy, structure, leadership and environment) defined by Miller (1987) and outlines interventions in organisational development (OD) that may contribute to their achievement. The aim is to build a conceptual framework at the intersection of these two fields that could help to strengthen the resilient capabilities of individuals, organisations and communities to face crises. This incursion into the field of OD--to generate more efficient configurations of practices in crisis management--seems particularly fruitful considering the system-wide application of OD, based on open-systems theory (Burke, 2008). Various interventions proposed by OD in terms of human processes, structural designs and human resource management, as well as strategy, may help leaders, members of organisations and civil society apply effectively, and in a more sustainable way, the crisis management guiding principles defined by researchers. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

  18. Isohaline position as a habitat indicator for estuarine populations

    USGS Publications Warehouse

    Jassby, Alan D.; Kimmerer, W.J.; Monismith, Stephen G.; Armor, C.; Cloern, James E.; Powell, T.M.; Vedlinski, Timothy J.

    1995-01-01

    The striped bass survival data were also used to illustrate a related important point: incorporating additionalexplanatory variables may decrease the prediction error for a population or process, but it can increase theuncertainty in parameter estimates and management strategies based on these estimates. Even in cases wherethe uncertainty is currently too large to guide management decisions, an uncertainty analysis can identify themost practical direction for future data acquisition.

  19. 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.

  20. 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.

  1. [Summary of the consensus document: "Clinical practice guide for the management of low cardiac output syndrome in the postoperative period of heart surgery"].

    PubMed

    Pérez Vela, J L; Martín Benitez, J C; Carrasco Gonzalez, M; de la Cal López, M A; Hinojosa Pérez, R; Sagredo Meneses, V; del Nogal Saez, F

    2012-05-01

    Low cardiac output syndrome is a potential complication in cardiac surgery patients and is associated with increased morbidity and mortality. This guide provides recommendations for the management of these patients, immediately after surgery and following admission to the ICU. The recommendations are grouped into different sections, addressing from the most basic concepts such as definition of the disorder to the different sections of basic and advanced monitoring, and culminating with the complex management of this syndrome. We propose an algorithm for initial management, as well as two others for ventricular failure (predominantly left or right). Most of the recommendations are based on expert consensus, due to the lack of randomized trials of adequate design and sample size in patients of this kind. The quality of evidence and strength of the recommendations were based on the GRADE methodology. The guide is presented as a list of recommendations (with the level of evidence for each recommendation) for each question on the selected topic. For each question, justification of the recommendations is then provided. Copyright © 2011 Elsevier España, S.L. y SEMICYUC. All rights reserved.

  2. [Clinical practice guide for the management of low cardiac output syndrome in the postoperative period of heart surgery].

    PubMed

    Pérez Vela, J L; Martín Benítez, J C; Carrasco González, M; de la Cal López, M A; Hinojosa Pérez, R; Sagredo Meneses, V; del Nogal Saez, F

    2012-05-01

    The low cardiac output syndrome is a potential complication in cardiac surgery patients and associated with increased morbidity and mortality. This guide is to provide recommendations for the management of these patients, immediately after surgery, admitted to the ICU. The recommendations are grouped into different sections, trying to answer from the most basic concepts such as the definition to the different sections of basic and advanced monitoring and ending with the complex management of this syndrome. We propose an algorithm for initial management, as well as two other for ventricular failure (predominantly left or right). Most of the recommendations are based on expert consensus because of the lack of randomized trials of adequate design and sample size in this group of patients. The quality of evidence and strength of the recommendations were made following the GRADE methodology. The guide is presented as a list of recommendations (and level of evidence for each recommendation) for each question on the selected topic. Then for each question, we proceed to the justification of the recommendations. Copyright © 2011 Elsevier España, S.L. y SEMICYUC. All rights reserved.

  3. Self-guided management of exome and whole-genome sequencing results: changing the results return model.

    PubMed

    Yu, Joon-Ho; Jamal, Seema M; Tabor, Holly K; Bamshad, Michael J

    2013-09-01

    Researchers and clinicians face the practical and ethical challenge of if and how to offer for return the wide and varied scope of results available from individual exome sequencing and whole-genome sequencing. We argue that rather than viewing individual exome sequencing and whole-genome sequencing as a test for which results need to be "returned," that the technology should instead be framed as a dynamic resource of information from which results should be "managed" over the lifetime of an individual. We further suggest that individual exome sequencing and whole-genome sequencing results management is optimized using a self-guided approach that enables individuals to self-select among results offered for return in a convenient, confidential, personalized context that is responsive to their value system. This approach respects autonomy, allows individuals to maximize potential benefits of genomic information (beneficence) and minimize potential harms (nonmaleficence), and also preserves their right to an open future to the extent they desire or think is appropriate. We describe key challenges and advantages of such a self-guided management system and offer guidance on implementation using an information systems approach.

  4. The Philosophy of Practice for Comprehensive Medication Management: Evaluating Its Meaning and Application by Practitioners.

    PubMed

    Pestka, Deborah L; Sorge, Lindsay A; McClurg, Mary Roth; Sorensen, Todd D

    2018-01-01

    Philosophy of practice is the foundation of any patient care practice because it provides a set of professional values and beliefs that guide actions and decisions in practice. Study objectives were to understand how pharmacists providing comprehensive medication management (CMM) describe their philosophy of practice and compare how participants' philosophies align with predefined tenets of a CMM philosophy of practice. An instrument with closed and open-ended items was developed and administered online to the lead pharmacist at 36 clinics participating in a large CMM study. Participants were asked to describe their philosophy of practice, rate how well their current practice activities align with five predefined CMM philosophy of practice tenets, and provide examples of how they carry out each tenet and how they could improve. Responses were coded, and descriptive analysis was used to calculate participants' practice alignment with the five philosophy of practice tenets. Thirty pharmacists completed the instrument. Twelve codes emerged that participants used to describe their philosophy of practice. These codes were mapped to five predefined tenets of a philosophy of practice. Only 3 (10%) participants included all five tenets in their philosophy of practice, 8 (26.7%) included four, 8 (26.7%) included three, 6 (20%) included two, and 5 (16.7%) included one tenet. Overall, participants rated their alignment with the five tenets highly. "Embracing a patient-centered approach" received the highest mean score of 9.17/10; "Meeting a societal need" had the lowest mean score of 8.37/10. Participants described their philosophy of practice with significant variability. CMM requires a single and consistently applied philosophy of practice to guide practice and the role of the practitioner. We propose five core tenets that resulted from this assessment to be embraced by pharmacists providing CMM and included in their philosophy of practice. © 2017 Pharmacotherapy Publications, Inc.

  5. Money's (not) on my mind: a qualitative study of how staff and managers understand health care's triple Aim.

    PubMed

    Storkholm, Marie Höjriis; Mazzocato, Pamela; Savage, Mairi; Savage, Carl

    2017-01-31

    The "Triple Aim" - provision of a better care experience and improved population health at a lower cost - may be theoretically sound, but paradoxical in practice as it forces together the logics of management and medicine. The aim of this study was to explore how staff and managers understand the change imperative inherent to the Triple Aim and the mental models underlying their understanding. This qualitative study builds on thirty semi-structured interviews conducted with managers, nurses, midwives, medical secretaries, and physicians at a department of Gynecology and Obstetrics in Denmark who successfully cut costs through staff and bed reductions and, from what we can ascertain, maintained care quality. Mental models were articulated from a content analysis of the interviews. Staff and managers identified with the different dimensions of the Triple Aim along classic professional divides, i.e. nurses and midwives focused on patient experience, physicians on health outcomes, and manager on all three. Underlying these, we found four mental models. The understanding of change was guided by a Professional ethos (inner drive to improve care) and a Socio-political discourse (external requirement to become more efficient) mental model. The understanding of economics was guided by a You-get-what-you-pay-for and by a More-bang-for-the-buck mental model. A complex interplay could be discerned between all four, which led staff to see the Triple Aim as a dilemma between quality and economics and a threat to clinical care and quality, whereas managers saw it as a paradox that invited improvement efforts. Despite these differences, managers chose a change strategy in line with staff mental models. The practical challenges inherent to the Triple Aim may be symptomatic of the interactions between the different mental models that guide staff and managers' understanding and choice of change strategies. Pursuit of quality improvement in the face of financial constraints (the essence of the Triple Aim) may be facilitated through conscious exploration of these empirically identified mental models. Managers might do well to translate the socio-political discourse into a change process that resonates with the mental models held by staff.

  6. Gender, symptom experience, and use of complementary and alternative medicine practices among cancer survivors in the U.S. cancer population.

    PubMed

    Fouladbakhsh, Judith M; Stommel, Manfred

    2010-01-01

    To identify relationships among gender, physical and psychological symptoms (pain, insomnia, fatigue, and depression), and use of specific complementary and alternative medicine (CAM) practices among survivors in the U.S. cancer population. Secondary analysis of the 2002 National Health Interview Survey (NHIS). The CAM Healthcare Model, an extension of the Behavioral Model for Health Services Use, guided the study. United States. 2,262 adults (aged 18 years and older) diagnosed with cancer representing more than 14.3 million cancer survivors in the United States . NHIS interview data on use of CAM practices (diet, yoga, tai chi, qigong, meditation, guided imagery, relaxation, and deep breathing) were examined in relationship to gender and symptoms. Analysis was conducted using Stata 9.2 software for population estimation. Binary logistic regression, the primary statistical model employed in the analysis, focused on between-subject differences in practice use. Dichotomous outcome variables included use of at least one CAM practice and use of specific individual CAM practices. Independent variables included gender, age, education, race, provider contact, cancer diagnosis, pain, insomnia, fatigue, depression, and health status. CAM practice use was more prevalent among female, middle-aged, Caucasian, and well-educated subjects. Pain, depression, and insomnia were strong predictors of practice use, with differences noted by gender and practice type. CAM practices are widely used in the U.S. cancer population, especially among women. Symptom experience influences likelihood of use, with increased odds when men report symptoms. Study findings inform oncology nurses on the benefits of integrating self-care CAM practices in relationship to gender into the symptom management care plan for cancer survivors. Findings reported in this study will help guide future CAM practice intervention studies.

  7. Consensus best practice pathway of the UK Scleroderma Study Group: digital vasculopathy in systemic sclerosis.

    PubMed

    Hughes, Michael; Ong, Voon H; Anderson, Marina E; Hall, Frances; Moinzadeh, Pia; Griffiths, Bridget; Baildam, Eileen; Denton, Christopher P; Herrick, Ariane L

    2015-11-01

    Digital vasculopathy (comprising RP, digital ulceration and critical digital ischaemia) is responsible for much of the pain and disability experienced by patients with SSc. However, there is a limited evidence base to guide clinicians in the management of SSc-related digital vasculopathy. Our aim was to produce recommendations that would be helpful for clinicians, especially for those managing patients outside specialist centres. The UK Scleroderma Study Group set up several working groups to develop a number of consensus best practice pathways for the management of SSc-specific complications, including digital vasculopathy. This overview presents the background and best practice consensus pathways for SSc-related RP, digital ulceration and critical ischaemia. Examples of drug therapies, including doses, are suggested in order to inform prescribing practice. A number of treatment algorithms are provided that are intended to provide the clinician with accessible reference tools for use in daily management. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Implementing Technological Solutions within K-12 Contexts: A Comprehensive Route Guide

    ERIC Educational Resources Information Center

    Subramony, Deepak Prem

    2012-01-01

    This article seeks to reflect, summarize, and present preexisting understandings from multiple interrelated realms of theory and practice--including diffusion of innovations, needs assessment, change management, systemic change, performance improvement, and what might be described as "socio-culturally cognizant" educational technology--in order to…

  9. Practical Guide to HVAC for Schools.

    ERIC Educational Resources Information Center

    ASHRAE Journal, 1998

    1998-01-01

    Features six articles on heating, ventilation, and air-conditioning systems for schools. Examines how to avoid air temperature complaints when choosing a system; special system features; engineers, indoor air quality, and schools; mechanical systems noise in classrooms; operation and management issues related to design; and details on bids and…

  10. Systematic review: predicting and optimising response to anti-TNF therapy in Crohn's disease - algorithm for practical management.

    PubMed

    Ding, N S; Hart, A; De Cruz, P

    2016-01-01

    Nonresponse and loss of response to anti-TNF therapies in Crohn's disease represent significant clinical problems for which clear management guidelines are lacking. To review the incidence, mechanisms and predictors of primary nonresponse and secondary loss of response to formulate practical clinical algorithms to guide management. Through a systematic literature review, 503 articles were identified which fit the inclusion criteria. Primary nonresponse to anti-TNF treatment affects 13-40% of patients. Secondary loss of response to anti-TNF occurs in 23-46% of patients when determined according to dose intensification, and 5-13% of patients when gauged by drug discontinuation rates. Recent evidence suggests that the mechanisms underlying primary nonresponse and secondary loss of response are multifactorial and include disease characteristics (phenotype, location, severity); drug (pharmacokinetic, pharmacodynamic or immunogenicity) and treatment strategy (dosing regimen) related factors. Clinical algorithms that employ therapeutic drug monitoring (using anti-TNF tough levels and anti-drug antibody levels) may be used to determine the underlying cause of primary nonresponse and secondary loss of response respectively and guide clinicians as to which patients are most likely to respond to anti-TNF therapy and help optimise drug therapy for those who are losing response to anti-TNF therapy. Nonresponse or loss of response to anti-TNF occurs commonly in Crohn's disease. Clinical algorithms utilising therapeutic drug monitoring may establish the mechanisms for treatment failure and help guide the subsequent therapeutic approach. © 2015 John Wiley & Sons Ltd.

  11. Risk stratification of prostate cancer: integrating multiparametric MRI, nomograms and biomarkers

    PubMed Central

    Watson, Matthew J; George, Arvin K; Maruf, Mahir; Frye, Thomas P; Muthigi, Akhil; Kongnyuy, Michael; Valayil, Subin G; Pinto, Peter A

    2016-01-01

    Accurate risk stratification of prostate cancer is achieved with a number of existing tools to ensure the identification of at-risk patients, characterization of disease aggressiveness, prediction of cancer burden and extrapolation of treatment outcomes for appropriate management of the disease. Statistical tables and nomograms using classic clinicopathological variables have long been the standard of care. However, the introduction of multiparametric MRI, along with fusion-guided targeted prostate biopsy and novel biomarkers, are being assimilated into clinical practice. The majority of studies to date present the outcomes of each in isolation. The current review offers a critical and objective assessment regarding the integration of multiparametric MRI and fusion-guided prostate biopsy with novel biomarkers and predictive nomograms in contemporary clinical practice. PMID:27400645

  12. Support to LANL: Cost estimation. Final report

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

    Not Available

    This report summarizes the activities and progress by ICF Kaiser Engineers conducted on behalf of Los Alamos National Laboratories (LANL) for the US Department of Energy, Office of Waste Management (EM-33) in the area of improving methods for Cost Estimation. This work was conducted between October 1, 1992 and September 30, 1993. ICF Kaiser Engineers supported LANL in providing the Office of Waste Management with planning and document preparation services for a Cost and Schedule Estimating Guide (Guide). The intent of the Guide was to use Activity-Based Cost (ABC) estimation as a basic method in preparing cost estimates for DOEmore » planning and budgeting documents, including Activity Data Sheets (ADSs), which form the basis for the Five Year Plan document. Prior to the initiation of the present contract with LANL, ICF Kaiser Engineers was tasked to initiate planning efforts directed toward a Guide. This work, accomplished from June to September, 1992, included visits to eight DOE field offices and consultation with DOE Headquarters staff to determine the need for a Guide, the desired contents of a Guide, and the types of ABC estimation methods and documentation requirements that would be compatible with current or potential practices and expertise in existence at DOE field offices and their contractors.« less

  13. Patient-centered blood management.

    PubMed

    Hohmuth, Benjamin; Ozawa, Sherri; Ashton, Maria; Melseth, Richard L

    2014-01-01

    Transfusions are common in hospitalized patients but carry significant risk, with associated morbidity and mortality that increases with each unit of blood received. Clinical trials consistently support a conservative over a liberal approach to transfusion. Yet there remains wide variation in practice, and more than half of red cell transfusions may be inappropriate. Adopting a more comprehensive approach to the bleeding, coagulopathic, or anemic patient has the potential to improve patient care. We present a patient-centered blood management (PBM) paradigm. The 4 guiding principles of effective PBM that we present include anemia management, coagulation optimization, blood conservation, and patient-centered decision making. PBM has the potential to decrease transfusion rates, decrease practice variation, and improve patient outcomes. PBM's value proposition is highly aligned with that of hospital medicine. Hospitalists' dual role as front-line care providers and quality improvement leaders make them the ideal candidates to develop, implement, and practice PBM. © 2013 Society of Hospital Medicine.

  14. An introduction to adaptive management for threatened and endangered species

    USGS Publications Warehouse

    Runge, Michael C.

    2011-01-01

    Management of threatened and endangered species would seem to be a perfect context for adaptive management. Many of the decisions are recurrent and plagued by uncertainty, exactly the conditions that warrant an adaptive approach. But although the potential of adaptive management in these settings has been extolled, there are limited applications in practice. The impediments to practical implementation are manifold and include semantic confusion, institutional inertia, misperceptions about the suitability and utility, and a lack of guiding examples. In this special section of the Journal of Fish and Wildlife Management, we hope to reinvigorate the appropriate application of adaptive management for threatened and endangered species by framing such management in a decision-analytical context, clarifying misperceptions, classifying the types of decisions that might be amenable to an adaptive approach, and providing three fully developed case studies. In this overview paper, I define terms, review the past application of adaptive management, challenge perceived hurdles, and set the stage for the case studies which follow.

  15. Variations in incubator temperature and humidity management: a survey of current practice.

    PubMed

    Deguines, C; Décima, P; Pelletier, A; Dégrugilliers, L; Ghyselen, L; Tourneux, P

    2012-03-01

    To describe and assess routine procedures and practices for incubator temperature and humidity management in France in 2009. A questionnaire was sent to all the 186 neonatal care units in France. The questionnaire return rate was 86%. Seventy-five per cent of the units preferred skin servo-control to air temperature control in routine practice. Air temperature control was mainly used for infants with a gestational age of more than 28 weeks and aged over 7 days of life. In general, thermal management decisions did not depend on the infant's age but were based on a protocol applied specifically by each unit. All units humidified the incubator air, but there was a large difference between the lowest and highest reported humidity values (45% and 100% assumed to be a maximal value, respectively). More than 65% of the units used a fixed humidity value, rather than a variable, protocol-derived value. We observed large variations in incubator temperature and humidity management approaches from one neonatal care unit to another. There is a need for more evidence to better inform practice. A task force should be formed to guide clinical practice. © 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

  16. Risk mitigation measures for diffuse pesticide entry into aquatic ecosystems: proposal of a guide to identify appropriate measures on a catchment scale.

    PubMed

    Bereswill, Renja; Streloke, Martin; Schulz, Ralf

    2014-04-01

    Measures to mitigate the risk of pesticide entry into aquatic ecosystems are becoming increasingly more important in the management of hot spots of pesticide transfer; such management, for example, is required by the European Union's directive for the sustainable use of pesticides (2009/128/EC). Measures beyond those currently stipulated for pesticide product authorization may be needed. A concise compilation of the appropriate measures for users (that are primarily farmers but also, e.g., regulators and farm extension services) and a guide for practically identifying these measures at the catchment scale is currently not available. Therefore, a proposal was developed for a guide focusing on the most important diffuse entry pathways (spray drift and runoff). Based on a survey of exposure-relevant landscape parameters (i.e., the riparian buffer strip width, riparian vegetation type, density of ground vegetation cover, coverage of the water body with aquatic macrophytes, field slope, and existence of concentrated flow paths), a set of risk mitigation measures focusing on the specific situation of pollution of a water body catchment can be identified. The user can then choose risk mitigation measures to implement, assisted by evaluations of their efficiency in reducing pesticide entry, feasibility, and expected acceptability to farmers. Currently, 12 landscape-related measures and 6 application-related measures are included. The present guide presents a step toward the practical implementation of risk mitigation measures for reducing pesticide entry in aquatic ecosystems. © 2013 SETAC.

  17. Evidence-based management of ambulatory electronic health record system implementation: an assessment of conceptual support and qualitative evidence.

    PubMed

    McAlearney, Ann Scheck; Hefner, Jennifer L; Sieck, Cynthia; Rizer, Milisa; Huerta, Timothy R

    2014-07-01

    While electronic health record (EHR) systems have potential to drive improvements in healthcare, a majority of EHR implementations fall short of expectations. Shortcomings in implementations are often due to organizational issues around the implementation process rather than technological problems. Evidence from both the information technology and healthcare management literature can be applied to improve the likelihood of implementation success, but the translation of this evidence into practice has not been widespread. Our objective was to comprehensively study and synthesize best practices for managing ambulatory EHR system implementation in healthcare organizations, highlighting applicable management theories and successful strategies. We held 45 interviews with key informants in six U.S. healthcare organizations purposively selected based on reported success with ambulatory EHR implementation. We also conducted six focus groups comprised of 37 physicians. Interview and focus group transcripts were analyzed using both deductive and inductive methods to answer research questions and explore emergent themes. We suggest that successful management of ambulatory EHR implementation can be guided by the Plan-Do-Study-Act (PDSA) quality improvement (QI) model. While participants did not acknowledge nor emphasize use of this model, we found evidence that successful implementation practices could be framed using the PDSA model. Additionally, successful sites had three strategies in common: 1) use of evidence from published health information technology (HIT) literature emphasizing implementation facilitators; 2) focusing on workflow; and 3) incorporating critical management factors that facilitate implementation. Organizations seeking to improve ambulatory EHR implementation processes can use frameworks such as the PDSA QI model to guide efforts and provide a means to formally accommodate new evidence over time. Implementing formal management strategies and incorporating new evidence through the PDSA model is a key element of evidence-based management and a crucial way for organizations to position themselves to proactively address implementation and use challenges before they are exacerbated. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Knowledge management strategies: Enhancing knowledge transfer to clinicians and patients.

    PubMed

    Roemer, Lorrie K; Rocha, Roberto A; Del Fiol, Guilherme; Bradshaw, Richard L; Hanna, Timothy P; Hulse, Nathan C

    2006-01-01

    At Intermountain Healthcare (Intermountain), executive clinical content experts are responsible for disseminating consistent evidence-based clinical content throughout the enterprise at the point-of-care. With a paper-based system it was difficult to ensure that current information was received and was being used in practice. With electronic information systems multiple applications were supplying similar, but different, vendor-licensed and locally-developed content. These issues influenced the consistency of clinical practice within the enterprise, jeopardized patient and clinician safety, and exposed the enterprise and its employees to potential financial penalties. In response to these issues Intermountain is developing a knowledge management infrastructure providing tools and services to support clinical content development, deployment, maintenance, and communication. The Intermountain knowledge management philosophy includes strategies guiding clinicians and consumers of health information to relevant best practice information with the intention of changing behaviors. This paper presents three case studies describing different information management problems identified within Intermountain, methods used to solve the problems, implementation challenges, and the current status of each project.

  19. How frontline staff manage paperwork in group homes for people with intellectual disability: Implications for practice.

    PubMed

    Quilliam, Claire; Bigby, Christine; Douglas, Jacinta

    2018-05-08

    Paperwork is a key tool that transforms organizational intentions into actions in group homes, although prescriptive procedures may limit how frontline staff use it in practice. The aim of this study was to explore how frontline staff use paperwork in group homes for people with intellectual disability and identify practice implications. Constructivist grounded theory methodology guided the research. Data collection included semi-structured interviews and participant observations. Coding, comparison and sorting methods were adopted to analyse how staff used paperwork. Staff followed organizational paperwork rules when they aligned with their resident-focused approach to work. When they perceived rules to misalign with this approach, they managed paperwork by adjusting the time and place of completion, managing content, creating alternative tools and refusing completion. Staff purposefully managed paperwork rather than simply following procedures. Disability service organizations could develop flexible paperwork procedures and include frontline perspectives in paperwork development. © 2018 John Wiley & Sons Ltd.

  20. Strategies for Achieving Whole-Practice Engagement and Buy-in to the Patient-Centered Medical Home

    PubMed Central

    Bleser, William K.; Miller-Day, Michelle; Naughton, Dana; Bricker, Patricia L.; Cronholm, Peter F.; Gabbay, Robert A.

    2014-01-01

    PURPOSE The current model of primary care in the United States limits physicians’ ability to offer high-quality care. The patient-centered medical home (PCMH) shows promise in addressing provision of high-quality care, but achieving a PCMH practice model often requires comprehensive organizational change. Guided by Solberg’s conceptual framework for practice improvement, which argues for shared prioritization of improvement and change, we describe strategies for obtaining organizational buy-in to and whole-staff engagement of PCMH transformation and practice improvement. METHODS Semistructured interviews with 136 individuals and 7 focus groups involving 48 individuals were conducted in 20 small- to mid-sized medical practices in Pennsylvania during the first regional rollout of a statewide PCMH initiative. For this study, we analyzed interview transcripts, monthly narrative reports, and observer notes from site visits to identify discourse pertaining to organizational buy-in and strategies for securing buy-in from personnel. Using a consensual qualitative research approach, data were reduced, synthesized, and managed using qualitative data management and analysis software. RESULTS We identified 13 distinct strategies used to obtain practice buy-in, reflecting 3 overarching lessons that facilitate practice buy-in: (1) effective communication and internal PCMH campaigns, (2) effective resource utilization, and (3) creation of a team environment. CONCLUSION Our study provides a list of strategies useful for facilitating PCMH transformation in primary care. These strategies can be investigated empirically in future research, used to guide medical practices undergoing or considering PCMH transformation, and used to inform health care policy makers. Our study findings also extend Solberg’s conceptual framework for practice improvement to include buy-in as a necessary condition across all elements of the change process. PMID:24445102

  1. Guidance: The practical management of the gastrointestinal symptoms of pelvic radiation disease

    PubMed Central

    Andreyev, H Jervoise N; Muls, Ann C; Norton, Christine; Ralph, Charlotte; Watson, Lorraine; Shaw, Clare; Lindsay, James O

    2015-01-01

    Background A recent randomised trial suggested that an algorithmic approach to investigating and managing gastrointestinal symptoms of pelvic radiation disease (PRD) is beneficial and that specially trained nurses can manage patients as effectively as a gastroenterologist. Aims The aim of the development and peer review of the guide was to make the algorithm used in the trial accessible to all levels of clinician. Methods Experts who manage patients with PRD were asked to review the guide, rating each section for agreement with the recommended measures and suggesting amendments if necessary. Specific comments were discussed and incorporated as appropriate, and this process was repeated for a second round of review. Results 34 gastroenterologists, 10 nurses, 9 dietitians, 7 surgeons and 5 clinical oncologists participated in round one. Consensus (defined prospectively as 60% or more panellists selecting ‘strongly agree’ or ‘agree’) was reached for 27 of the original 28 sections in the guide, with a median of 75% of panellists agreeing with each section. 86% of panellists agreed that the guide was acceptable for publication or acceptable with minor revisions. 55 of the original 65 panellists participated in round two. 89% agreed it was acceptable for publication after the first revision. Further minor amendments were made in response to round two. Conclusions Development of the guide in response to feedback included ▸ improvement of occasional algorithmic steps ▸ a more user-friendly layout ▸ clearer timeframes for referral to other teams ▸ expansion of reference list ▸ addition of procedures to the appendix. PMID:25580207

  2. Tried and True: Self-Regulation Theory as a Guiding Framework for Teaching Parents Diabetes Education Using Human Patient Simulation

    PubMed Central

    Sullivan-Bolyai, Susan; Johnson, Kimberly; Cullen, Karen; Hamm, Terry; Bisordi, Jean; Blaney, Kathleen; Maguire, Laura; Melkus, Gail

    2014-01-01

    Parents become emotionally upset when learning their child has Type 1 Diabetes, yet they are expected to quickly learn functional diabetes management. The purpose of this article is to describe the application of Self-Regulation theory to guide a family-focused education intervention using human patient simulation to enhance the initial education of parents in diabetes management. A brief description is provided of the intervention framed by Self-Regulation theory. Based on the literature, we describe the educational vignettes used based on Self-Regulation in the randomized controlled trial entitled Parent Education Through Simulation-Diabetes. Examples of theory-in-practice will be illustrated by parental learning responses to this alternative educational innovation. PMID:25365286

  3. Assessment of a web-based Guided Self-Determination intervention for adults with type 2 diabetes in general practice: a study protocol

    PubMed Central

    Karlsen, Bjørg; Oftedal, Bjørg; Stangeland Lie, Silje; Rokne, Berit; Peyrot, Mark; Zoffmann, Vibeke; Graue, Marit

    2016-01-01

    Introduction Self-management is deemed the cornerstone in overall diabetes management. Web-based self-management interventions have potential to support adults with type 2 diabetes (T2DM) in managing their disease. Owing to somewhat ambiguous results of such interventions, interventions should be theory-based and incorporate well-defined counselling methods and techniques for behavioural change. This study is designed to assess the effectiveness of a theory-driven web-based Guided Self-Determination (GSD) intervention among adults with T2DM in general practice to improve diabetes self-management behaviours and glycosylated haemoglobin (HbA1c). Methods and analysis A complex intervention design based on the framework of the UK Medical Research Council is employed as a guide for developing the intervention, assessing its feasibility and evaluating its effectiveness. The study consists of three phases: (1) the modelling phase adapting the original GSD programme for adults with T2DM, using a qualitative design, (2) feasibility assessment of the adapted intervention on the web, employing qualitative and quantitative methods and (3) evaluating the effectiveness of the intervention on diabetes self-management behaviours and HbA1c, using a quasi-experimental design. The first phase, which is completed, and the second phase, which is underway, will provide important information about the development of the intervention and its acceptability, whereas the third phase will assess the effectiveness of this systematically developed intervention. Ethics and dissemination The Norwegian Regional Committee for Medical and Health Research Ethics (REK west number 2015/60) has approved the study design. Patients recruited in the different phases will fill out an informed consent form prior to inclusion and will be guaranteed anonymity and the right to withdraw from the study at any time. The results of the study will be published in peer-reviewed journals, electronically and in print, and presented at research conferences. Trial registration number: NCT02575599. PMID:27965253

  4. Social Work in a Digital Age: Ethical and Risk Management Challenges

    ERIC Educational Resources Information Center

    Reamer, Frederic G.

    2013-01-01

    Digital, online, and other electronic technology has transformed the nature of social work practice. Contemporary social workers can provide services to clients by using online counseling, telephone counseling, video counseling, cybertherapy (avatar therapy), self-guided Web-based interventions, electronic social networks, e-mail, and text…

  5. Planting native oak in the Pacific Northwest

    Treesearch

    Warren D. Devine; Constance A. Harrington

    2010-01-01

    The extent of oak woodland and savanna habitat in the Pacific Northwest has been dramatically reduced since settlement in the mid-1800s. This report presents a practical guide for landowners and managers who are interested in reestablishing native oak by planting seedlings. Keys to successful establishment are (1) planting quality...

  6. Emergency Response Information for School Facilities

    ERIC Educational Resources Information Center

    National Clearinghouse for Educational Facilities, 2008

    2008-01-01

    Crisis planning includes making preparations for managing school buildings, grounds, occupants, and rescue and recovery personnel during and after a crisis. In "Practical Information on Crisis Planning: A Guide for Schools and Communities, the U.S. Department of Education's Office of Safe and Drug-Free Schools" states: When a crisis…

  7. Marketing the Arts: A Selected and Annotated Bibliography.

    ERIC Educational Resources Information Center

    Nakamoto, Kent, Comp.; Levin, Kathi, Comp.

    Compiled from the marketing, arts, and arts management literature, this selected list includes materials ranging from theoretical articles and reports of studies to practical guides for marketing techniques. It consists of three sections: Primary Sources, Secondary Sources, and Surveys. Of particular interest to the arts administrator, the first…

  8. Economic Development Strategies. Upjohn Institute Staff Working Paper 95-33.

    ERIC Educational Resources Information Center

    Bartik, Timothy J.

    This paper, which is intended as a guide for local government managers responsible for economic development policies, begins with a discussion of typical goals and practices of local economic development programs. Examined next are examples of local government involvement in economic development efforts through policies/activities such as the…

  9. Harnessing and Guiding the Power of Policy: Examples from One State's Experiences

    ERIC Educational Resources Information Center

    Swanson, Julie Dingle; Lord, E. Wayne

    2013-01-01

    This article links research and practice through discussion of policy's conceptual aspects illustrated through real-world examples. Gifted education policy essentials, identification, curriculum and services, personnel preparation, and program management, assessment, and evaluation are described. Examples from studies of one state help the reader…

  10. Acting Locally: A Guide to Model, Community and Demonstration Forests.

    ERIC Educational Resources Information Center

    Keen, Debbie Pella

    1993-01-01

    Describes Canada's efforts in sustainable forestry, which refers to management practices that ensure long-term health of forest ecosystems so that they can continue to provide environmental, social, and economic benefits. Describes model forests, community forests, and demonstration forests and lists contacts for each of the projects. (KS)

  11. Growing Eucalypts in Florida for Industrial Wood Production

    Treesearch

    T.F. Geary; G.F. Meskimen; E.C. Franklin

    1983-01-01

    Eucalypt planting is practical on many sites in southern Florida, and strains resistant to freezes farther north are being bred. Methods have been developed for tree improvement, seed collection and handling, nursery management, plantation establishment and protection,and coppice regeneration.Guides to yields and utilization have been produced.

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

    DTIC Science & Technology

    1988-03-01

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

  13. Teaching Students with Disabilities: A Practical Guide.

    ERIC Educational Resources Information Center

    Illinois Univ., Urbana. Div. of Rehabilitation Education Services.

    This brochure for faculty at the University of Illinois discusses accommodations for students with disabilities. Problems such students have in the areas of time management, accessibility, and coping with sudden changes are considered first. Teachers are urged to address the question of disabilities directly during the first class by inviting any…

  14. Becoming a Master Student. Fifth edition.

    ERIC Educational Resources Information Center

    Ellis, David B.

    A guide to support student success in extended orientation courses, freshman seminars, and study skills classes is presented, using exercises such as journal-keeping, stories of 12 people who have mastered specific skills, practical suggestions, and forms and charts. The major topics are: time management, memory, reading, note-taking, test-taking,…

  15. Employee Privacy Rights: A Management Guide.

    ERIC Educational Resources Information Center

    Shepard, Ira Michael; Olsen, Harry

    Employee privacy rights are considered, along with practical problems and permissible parameters of employer activity. Included is a state-by-state analysis of the status of workplace privacy. Definitions are offered of "invasion of privacy," with attention to four types of privacy invasions: (1) placing someone in a "false light," (2) the public…

  16. Leverage Leadership: A Practical Guide to Building Exceptional Schools

    ERIC Educational Resources Information Center

    Bambrick-Santoyo, Paul

    2012-01-01

    Paul Bambrick-Santoyo (Managing Director of Uncommon Schools) shows leaders how they can raise their schools to greatness by following a core set of principles. These seven principles, or "levers," allow for consistent, transformational, and replicable growth. With intentional focus on these areas, leaders will leverage much more…

  17. A Practical Guide for Building a Digital Library: User-Focused Collection

    ERIC Educational Resources Information Center

    Zhu, Qin; Guevara, Sophia

    2009-01-01

    With changing user expectations, many libraries are moving toward digital content. Accessible from anywhere at any time, digital content provides users with efficient, on-demand information experiences. Accordingly, librarians are presented with challenges and opportunities to build, manage, and implement outreach strategies that promote their…

  18. The Values Guiding the Operational Practices of a Suburban Superintendent.

    ERIC Educational Resources Information Center

    Aplin, Norita D.

    Although the role of a superintendent has commonly involved a conflict between instructional leadership and business management, this dichotomy is apparently false; superintendents can effectively fill both roles. To explore this possible harmony of roles, one superintendent was studied who by reputation filled both roles very well. The…

  19. A comprehensive guide to fuel management practices for dry mixed conifer forests in the northwestern United States: Monitoring

    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

    Short- and medium-term evaluation of how fuel treatments are working is the only way to know if the hundreds of activities on the ground are adding up to the goals of more resilient landscapes and increased safety of people and property. Monitoring is a critical resource for decision makers who design fuels management programs, however it is an often neglected part of...

  20. A Practical Guide for Managing Customer Service in Base Civil Engineering.

    DTIC Science & Technology

    1988-04-01

    IMPROVING CUSTOMER SERVICE IN BASE CIVIL ENGINEERING Step One: Evaluate Present Service Quality .. ......... .11 Step Two: Develop and Clarify a...cross sectional viewpoint. In chapter three, specific steps will be presented for managers to evaluate and improve the present level of service quality in...customer service in base civil engineering or any other organization for that matter is to evaluate the present level of service quality (1:170). Data

  1. Assessing Contract Management Maturity: U.S. Army Joint Munitions and Lethality Contracting Center, Army Contracting Command, Picatinny Arsenal

    DTIC Science & Technology

    2009-09-01

    demonstrate competence” ( Jones , 2006). Most organizations conduct performance management for their employees with actions such as, setting goals...take the 14 form of comprehensive questionnaires, SWOT analyses or diagnostic models and include a comparison of results to various best practices...procnet.pica.army.mil/ Jones , R. (2006). CIDA Organizational Assessment Guide. Retrieved on March 1, 2009 from: http://www.acdi-cida.gc.ca/CIDAWEB

  2. An Ounce of Application Is Worth a Ton of Abstraction. A Practical Guide to Implementing Total Quality Management.

    ERIC Educational Resources Information Center

    Crouch, J. Michael

    This book explains how to implement a Total Quality Management (TQM) program within an organization focusing in particular on ways to sustain the effort. Part 1 of five offers an overview of the TQM approach and the rationale for adopting it. Topics of discussion include signs of the need for change, what TQM is and what it is not, the basics of…

  3. White Paper AGA: POWER - Practice Guide on Obesity and Weight Management, Education, and Resources.

    PubMed

    Acosta, Andres; Streett, Sarah; Kroh, Mathew D; Cheskin, Lawrence J; Saunders, Katherine H; Kurian, Marina; Schofield, Marsha; Barlow, Sarah E; Aronne, Louis

    2017-05-01

    The epidemic of obesity continues at alarming rates, with a high burden to our economy and society. The American Gastroenterological Association understands the importance of embracing obesity as a chronic, relapsing disease and supports a multidisciplinary approach to the management of obesity. Because gastrointestinal disorders resulting from obesity are more frequent and often present sooner than type 2 diabetes mellitus and cardiovascular disease, gastroenterologists have an opportunity to address obesity and provide an effective therapy early. Patients who are overweight or obese already fill gastroenterology clinics with gastroesophageal reflux disease and its associated risks of Barrett's esophagus and esophageal cancer, gallstone disease, nonalcoholic fatty liver disease/nonalcoholic steatohepatitis, and colon cancer. Obesity is a major modifiable cause of diseases of the digestive tract that frequently goes unaddressed. As internists, specialists in digestive disorders, and endoscopists, gastroenterologists are in a unique position to play an important role in the multidisciplinary treatment of obesity. This American Gastroenterological Association paper was developed with content contribution from Society of American Gastrointestinal and Endoscopic Surgeons, The Obesity Society, Academy of Nutrition and Dietetics, and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, endorsed with input by American Society for Gastrointestinal Endoscopy, American Society for Metabolic and Bariatric Surgery, American Association for the Study of Liver Diseases, and Obesity Medicine Association, and describes POWER: Practice Guide on Obesity and Weight Management, Education and Resources. Its objective is to provide physicians with a comprehensive, multidisciplinary process to guide and personalize innovative obesity care for safe and effective weight management. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  4. A practical guide for nurses in diluent selection for subcutaneous infusion using a syringe driver.

    PubMed

    McLeod, Fiona; Flowers, Charne

    2006-12-01

    Appropriate diluent selection in continuous subcutaneous infusion optimises symptom management and client well-being. The responsibility of diluent selection is commonly one of the attending nurse. This paper was developed with the intention of providing nurses with practical instruction for diluent selection when preparing medications for administration subcutaneously using a syringe driver. A literature review was undertaken of published journal databases and published guidelines sites. Recommendations regarding diluent choice were reviewed in two iterations by an expert panel of palliative care nurse clinicians. The principles for diluent selection are presented. They are based primarily on expert opinion level of evidence given a lack of primary research evidence in the area of diluent selection. There is a pressing need for manufacturers' guidance on diluent selection and independent research to establish the impact of diluents on drug and drug combinations when using syringe drivers. Until such time that this evidence is available to guide practice, clinicians need to be trained to inspect solutions and assess the effectiveness of the medication in controlling symptoms. The capacity of this paper to provide practical instruction has been limited by the lack of rigorous evidence available, and indeed, the process of developing this guide identified perhaps more questions than answers available at the present time.

  5. Models meet data: Challenges and opportunities in implementing land management in Earth system models.

    PubMed

    Pongratz, Julia; Dolman, Han; Don, Axel; Erb, Karl-Heinz; Fuchs, Richard; Herold, Martin; Jones, Chris; Kuemmerle, Tobias; Luyssaert, Sebastiaan; Meyfroidt, Patrick; Naudts, Kim

    2018-04-01

    As the applications of Earth system models (ESMs) move from general climate projections toward questions of mitigation and adaptation, the inclusion of land management practices in these models becomes crucial. We carried out a survey among modeling groups to show an evolution from models able only to deal with land-cover change to more sophisticated approaches that allow also for the partial integration of land management changes. For the longer term a comprehensive land management representation can be anticipated for all major models. To guide the prioritization of implementation, we evaluate ten land management practices-forestry harvest, tree species selection, grazing and mowing harvest, crop harvest, crop species selection, irrigation, wetland drainage, fertilization, tillage, and fire-for (1) their importance on the Earth system, (2) the possibility of implementing them in state-of-the-art ESMs, and (3) availability of required input data. Matching these criteria, we identify "low-hanging fruits" for the inclusion in ESMs, such as basic implementations of crop and forestry harvest and fertilization. We also identify research requirements for specific communities to address the remaining land management practices. Data availability severely hampers modeling the most extensive land management practice, grazing and mowing harvest, and is a limiting factor for a comprehensive implementation of most other practices. Inadequate process understanding hampers even a basic assessment of crop species selection and tillage effects. The need for multiple advanced model structures will be the challenge for a comprehensive implementation of most practices but considerable synergy can be gained using the same structures for different practices. A continuous and closer collaboration of the modeling, Earth observation, and land system science communities is thus required to achieve the inclusion of land management in ESMs. © 2017 John Wiley & Sons Ltd.

  6. Using data to improve medical practice by measuring processes and outcomes of care.

    PubMed

    Nelson, E C; Splaine, M E; Godfrey, M M; Kahn, V; Hess, A; Batalden, P; Plume, S K

    2000-12-01

    The purpose of this article is to help clinicians expand their use of data to improve medical practice performance and to do improvement research. Clinical practices can be viewed as small, complex organizations (microsystems) that produce services for specific patient populations. These services can be greatly improved by embedding measurement into the flow of daily work in the practice. WHY DO IT?: Four good reasons to build measures into daily medical practice are to (1) diagnose strengths and weaknesses in practice performance; (2) improve and innovate in providing care and services using improvement research; (3) manage patients and the practice; and (4) evaluate changes in results over time. It is helpful to have a "physiological" model of a medical practice to analyze the practice, to manage it, and to improve it. One model views clinical practices as microsystems that are designed to generate desired health outcomes for specific subsets of patients and to use resources efficiently. This article provides case study examples to show what an office-based practice might look like if it were using front-line measurement to improve care and services most of the time and to conduct clinical improvement research some of the time. WHAT ARE THE PRINCIPLES FOR USING DATA TO IMPROVE PROCESSES AND OUTCOMES OF CARE?: Principles reflected in the case study examples--such as "Keep Measurement Simple. Think Big and Start Small" and "More Data Is Not Necessarily Better Data. Seek Usefulness, Not Perfection, in Your Measures"--may help guide the development of data to study and improve practice. HOW CAN A PRACTICE START TO USE DATA TO IMPROVE CARE AND CONDUCT IMPROVEMENT RESEARCH?: Practical challenges are involved in starting to use data for enhancing care and improvement research. To increase the odds for success, it would be wise to use a change management strategy to launch the startup plan. Other recommendations include "Establish a Sense of Urgency. (Survival Is Not Mandatory)" and "Create the Guiding Coalition. (A Small, Devoted Group of People Can Change the World)." Over the long term, we must transform thousands of local practice cultures so that useful data are used every day in countless ways to assist clinicians, support staff, patients, families, and communities.

  7. My46: a web-based tool for self-guided management of genomic test results in research and clinical settings

    PubMed Central

    Tabor, Holly K.; Jamal, Seema M.; Yu, Joon-Ho; Crouch, Julia M.; Shankar, Aditi G.; Dent, Karin M.; Anderson, Nick; Miller, Damon A.; Futral, Brett T.; Bamshad, Michael J.

    2016-01-01

    A major challenge to implementing precision medicine is the need for an efficient and cost-effective strategy for returning individual genomic test results that is easily scalable and can be incorporated into multiple models of clinical practice. My46 is a web-based tool for managing the return of genetic results that was designed and developed to support a wide range of approaches to results disclosure, ranging from traditional face-to-face disclosure to self-guided models. My46 has five key functions: set and modify results return preferences, return results, educate, manage return of results, and assess return of results. These key functions are supported by six distinct modules and a suite of features that enhance the user experience, ease site navigation, facilitate knowledge sharing, and enable results return tracking. My46 is a potentially effective solution for returning results and supports current trends toward shared decision-making between patient and provider and patient-driven health management. PMID:27632689

  8. Management of metastatic retroperitoneal sarcoma: a consensus approach from the Trans-Atlantic Retroperitoneal Sarcoma Working Group (TARPSWG).

    PubMed

    2018-04-01

    Retroperitoneal sarcoma (RPS) is a rare disease accounting for 0.1%-0.2% of all malignancies. Management of RPS is complex and requires multidisciplinary, tailored treatment strategies at all stages, but especially in the context of metastatic or multifocal recurrent disease. Due to the rarity and heterogeneity of this family of diseases, the literature to guide management is limited. The Trans-Atlantic Retroperitoneal Sarcoma Working Group (TARPSWG) is an international collaboration of sarcoma experts from all disciplines convened in an effort to overcome these limitations. The TARPSWG has compiled the available evidence surrounding metastatic and multifocally recurrent RPS along with expert opinion in an iterative process to generate a consensus document regarding the complex management of this disease. The objective of this document is to guide sarcoma specialists from all disciplines in the diagnosis and treatment of multifocal recurrent or metastatic RPS. All aspects of patient assessment, diagnostic processes, local and systemic treatments, and palliation are reviewed in this document, and consensus recommendations provided accordingly. Recommendations were guided by available evidence, in conjunction with expert opinion where evidence was lacking. This consensus document combines the available literature regarding the management of multifocally recurrent or metastastic RPS with the practical expertise of high-volume sarcoma centers from multiple countries. It is designed as a tool for decision making in the complex multidisciplinary management of this condition and is expected to standardize management across centers, thereby ensuring that patients receive the highest quality care.

  9. Self-managing teams: a strategy for quality improvement.

    PubMed

    Feifer, Chris; Nocella, Kiki; DeArtola, Ignacio; Rowden, Suzanne; Morrison, Stephen

    2003-01-01

    Organizations are impacted by their environments, and health care settings are no different. Individuals charged with improving a practice are often impeded by environmental barriers, including incomplete information for decision making. One strategy to empower an organization for change is to form a self-managing team. This paper discusses the self-managing team concept and uses a case study to illustrate its application in primary care. Factors contributing to team success are presented as a guide, and a reminder--there is more to an effective team than gathering people in a room.

  10. Managing corporate capabilities:theory and industry approaches.

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

    Slavin, Adam M.

    2007-02-01

    This study characterizes theoretical and industry approaches to organizational capabilities management and ascertains whether there is a distinct ''best practice'' in this regard. We consider both physical capabilities, such as technical disciplines and infrastructure, and non-physical capabilities such as corporate culture and organizational procedures. We examine Resource-Based Theory (RBT), which is the predominant organizational management theory focused on capabilities. RBT seeks to explain the effect of capabilities on competitiveness, and thus provide a basis for investment/divestment decisions. We then analyze industry approaches described to us in interviews with representatives from Goodyear, 3M, Intel, Ford, NASA, Lockheed Martin, and Boeing. Wemore » found diversity amongst the industry capability management approaches. Although all organizations manage capabilities and consider them to some degree in their strategies, no two approaches that we observed were identical. Furthermore, we observed that theory is not a strong driver in this regard. No organization used the term ''Resource-Based Theory'', nor did any organization mention any other guiding theory or practice from the organizational management literature when explaining their capabilities management approaches. As such, we concluded that there is no single best practice for capabilities management. Nevertheless, we believe that RBT and the diverse industry experiences described herein can provide useful insights to support development of capabilities management approaches.« less

  11. GPs' considerations in multimorbidity management: a qualitative study.

    PubMed

    Luijks, Hilde D; Loeffen, Maartje J W; Lagro-Janssen, Antoine L; van Weel, Chris; Lucassen, Peter L; Schermer, Tjard R

    2012-07-01

    Scientific evidence on how to manage multimorbidity is limited, but GPs have extensive practical experience with multimorbidity management. To explore GPs' considerations and main objectives in the management of multimorbidity and to explore factors influencing their management of multimorbidity. Focus group study of Dutch GPs; with heterogeneity in characteristics such as sex, age and urbanisation. The moderator used an interview guide in conducting the interviews. Two researchers performed the analysis as an iterative process, based on verbatim transcripts and by applying the technique of constant comparative analysis. Data collection proceeded until saturation was reached. Five focus groups were conducted with 25 participating GPs. The main themes concerning multimorbidity management were individualisation, applying an integrated approach, medical considerations placed in perspective, and sharing decision making and responsibility. A personal patient-doctor relationship was considered a major factor positively influencing the management of multimorbidity. Mental-health problems and interacting conditions were regarded as major barriers in this respect and participants experienced several practical problems. The concept of patient-centredness overarches the participants' main objectives. GPs' main objective in multimorbidity management is applying a patient-centred approach. This approach is welcomed since it counteracts some potential pitfalls of multimorbidity. Further research should include a similar design in a different setting and should aim at developing best practice in multimorbidity management.

  12. (Un)organizing equal collaboration between users and professionals: on management of patient education in Norway.

    PubMed

    Stokken, Roar

    2013-03-01

    This is an article about how patient education is managed in Norway, but it also addresses a matter of broader relevance that of how an organization imbued with a request for rational choices is able to take on board a contradictory ideology. In Norway, patient education under the auspice of hospitals is to be conducted as an equal collaboration between users and professionals, posing challenges to the ethos of rationally justified choices within the hospital sector. This calls for an exploration of how the organization copes with the contradictory demands. A theoretical approach on the basis of theories from Scandinavian institutional theory and science and technology studies, informed by documents, interviews and experiences from national, regional and local levels in Norway. The field of patient education is divided into three decoupled domains: one at management level, one at the practical level, and in the middle a domain that acts as an interface between management and practice. This interface mediates the relationship between ideas and practice, without making overt the fact that ideas might not be possible to put into practice and that practice might not reflect ideas. The decoupling of practice and management allows patient education as equal collaboration between users and professionals to thrive as an idea, not subjugated by practical challenges. Thus, it can exist as a guiding star that both management and practitioners can attune to, but this situation might now be threatened by the demand for quality assurance in the field. © 2011 Blackwell Publishing Ltd.

  13. (Un)organizing equal collaboration between users and professionals: on management of patient education in Norway

    PubMed Central

    Stokken, Roar

    2011-01-01

    Abstract Background  This is an article about how patient education is managed in Norway, but it also addresses a matter of broader relevance that of how an organization imbued with a request for rational choices is able to take on board a contradictory ideology. In Norway, patient education under the auspice of hospitals is to be conducted as an equal collaboration between users and professionals, posing challenges to the ethos of rationally justified choices within the hospital sector. This calls for an exploration of how the organization copes with the contradictory demands. Methods  A theoretical approach on the basis of theories from Scandinavian institutional theory and science and technology studies, informed by documents, interviews and experiences from national, regional and local levels in Norway. Discussion  The field of patient education is divided into three decoupled domains: one at management level, one at the practical level, and in the middle a domain that acts as an interface between management and practice. This interface mediates the relationship between ideas and practice, without making overt the fact that ideas might not be possible to put into practice and that practice might not reflect ideas. Conclusions  The decoupling of practice and management allows patient education as equal collaboration between users and professionals to thrive as an idea, not subjugated by practical challenges. Thus, it can exist as a guiding star that both management and practitioners can attune to, but this situation might now be threatened by the demand for quality assurance in the field. PMID:21624027

  14. Developing an interdisciplinary community-based sports concussion management program.

    PubMed

    LoGalbo, Anthony; Salinas, Christine M; Dougherty, Michael; Field, Mel

    2014-01-01

    The increasing incidence and associated consequences of sport-related concussion have been at the forefront of public health concerns in recent years, prompting the need for safe and effective management guidelines and availability of appropriately trained healthcare providers. In this report we provide practical and user-friendly information regarding several important factors to consider when developing a sports concussion program, including how to select relevant team members, assess community needs and available resources, provide concussion education, secure and nurture partnerships with athletic programs, implement management strategies that align with current practice standards, and cater to athletes' unique needs in terms of program accessibility. It is hoped that the knowledge shared and proposed recommendations will be beneficial for guiding both newly developing and established concussion programs alike. © 2014 S. Karger AG, Basel.

  15. 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.

  16. 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...

  17. An online tool for tracking soil nitrogen

    NASA Astrophysics Data System (ADS)

    Wang, J.; Umar, M.; Banger, K.; Pittelkow, C. M.; Nafziger, E. D.

    2016-12-01

    Near real-time crop models can be useful tools for optimizing agricultural management practices. For example, model simulations can potentially provide current estimates of nitrogen availability in soil, helping growers decide whether more nitrogen needs to be applied in a given season. Traditionally, crop models have been used at point locations (i.e. single fields) with homogenous soil, climate and initial conditions. However, nitrogen availability across fields with varied weather and soil conditions at a regional or national level is necessary to guide better management decisions. This study presents the development of a publicly available, online tool that automates the integration of high-spatial-resolution forecast and past weather and soil data in DSSAT to estimate nitrogen availability for individual fields in Illinois. The model has been calibrated with field experiments from past year at six research corn fields across Illinois. These sites were treated with applications of different N fertilizer timings and amounts. The tool requires minimal management information from growers and yet has the capability to simulate nitrogen-water-crop interactions with calibrated parameters that are more appropriate for Illinois. The results from the tool will be combined with incoming field experiment data from 2016 for model validation and further improvement of model's predictive accuracy. The tool has the potential to help guide better nitrogen management practices to maximize economic and environmental benefits.

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

    PubMed

    Simons, M; King, S; Edgar, D

    2003-01-01

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

  19. Using trauma informed care as a nursing model of care in an acute inpatient mental health unit: A practice development process.

    PubMed

    Isobel, Sophie; Edwards, Clair

    2017-02-01

    Without agreeing on an explicit approach to care, mental health nurses may resort to problem focused, task oriented practice. Defining a model of care is important but there is also a need to consider the philosophical basis of any model. The use of Trauma Informed Care as a guiding philosophy provides a robust framework from which to review nursing practice. This paper describes a nursing workforce practice development process to implement Trauma Informed Care as an inpatient model of mental health nursing care. Trauma Informed Care is an evidence-based approach to care delivery that is applicable to mental health inpatient units; while there are differing strategies for implementation, there is scope for mental health nurses to take on Trauma Informed Care as a guiding philosophy, a model of care or a practice development project within all of their roles and settings in order to ensure that it has considered, relevant and meaningful implementation. The principles of Trauma Informed Care may also offer guidance for managing workforce stress and distress associated with practice change. © 2016 Australian College of Mental Health Nurses Inc.

  20. Recommended practices for computerized clinical decision support and knowledge management in community settings: a qualitative study

    PubMed Central

    2012-01-01

    Background The purpose of this study was to identify recommended practices for computerized clinical decision support (CDS) development and implementation and for knowledge management (KM) processes in ambulatory clinics and community hospitals using commercial or locally developed systems in the U.S. Methods Guided by the Multiple Perspectives Framework, the authors conducted ethnographic field studies at two community hospitals and five ambulatory clinic organizations across the U.S. Using a Rapid Assessment Process, a multidisciplinary research team: gathered preliminary assessment data; conducted on-site interviews, observations, and field surveys; analyzed data using both template and grounded methods; and developed universal themes. A panel of experts produced recommended practices. Results The team identified ten themes related to CDS and KM. These include: 1) workflow; 2) knowledge management; 3) data as a foundation for CDS; 4) user computer interaction; 5) measurement and metrics; 6) governance; 7) translation for collaboration; 8) the meaning of CDS; 9) roles of special, essential people; and 10) communication, training, and support. Experts developed recommendations about each theme. The original Multiple Perspectives framework was modified to make explicit a new theoretical construct, that of Translational Interaction. Conclusions These ten themes represent areas that need attention if a clinic or community hospital plans to implement and successfully utilize CDS. In addition, they have implications for workforce education, research, and national-level policy development. The Translational Interaction construct could guide future applied informatics research endeavors. PMID:22333210

  1. Preparing disabled students for professional practice: managing risk through a principles-based approach.

    PubMed

    Hargreaves, Janet; Walker, Lizzie

    2014-08-01

    A discussion exploring the ways disabled students are managed in practice settings. It proposes and argues for morally and legally viable principles to guide risk assessment and inclusive decision-making in practice. Equality law means that universities are bound not to discriminate against students on the basis, amongst other things, of disability. As a consequence in the UK, there is a perceived increase in numbers of disabled people applying for and succeeding as health professionals. Whilst placement providers are equally obliged by the law to have inclusive policies, competing needs including patient safety, public confidence and professional regulations mean that adjustments that can be made in an educational environment to appropriately support student learning may prove to be more difficult in placements that provide direct care to the public. This discussion is an outcome of recommendations from published research by the authors and their research partners. It is supported by related literature, critical debate amongst academics, disabled students and disabled and non-disabled practitioners. Ensuring a nursing workforce that mirrors the diversity of the population it serves is of universal importance. Effective management of disabled students can contribute to achieving this goal and to promoting a positive view of disabled practitioners. Legislation is necessary to protect disabled people from discrimination. To respect this legislation, when preparing nurses and other health professions, a clear understanding of the law and a principles-based approach to guiding risk is important. © 2014 John Wiley & Sons Ltd.

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

    ERIC Educational Resources Information Center

    Hudson, David

    2009-01-01

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

  3. The School Store...Making It Work. Sales, Operations, Merchandising, Management, Accounting, Advertising & Display.

    ERIC Educational Resources Information Center

    Michigan Univ., Ann Arbor. School of Education.

    This guide was developed to provide specific, practical advice to teachers who are involved in operating a school store as an adjunct to the marketing/distributive education curriculum. The handbook format integrates school store operations with classroom learning activities and the Michigan Marketing and Distributive Education Core Curriculum.…

  4. The Management of Training; A Handbook for Training and Development Personnel.

    ERIC Educational Resources Information Center

    Otto, Calvin P.; Glaser, Rollin O.

    Intended as a practical, comprehensive guide to conducting training within an organization, this manual shows how training personnel can create and administer effective programs within the constraints of time, staff, and budget. The first part covers preparation of training forecasts, selection and training of instructors and other basic program…

  5. Charter School Replication. Policy Guide

    ERIC Educational Resources Information Center

    Rhim, Lauren Morando

    2009-01-01

    "Replication" is the practice of a single charter school board or management organization opening several more schools that are each based on the same school model. The most rapid strategy to increase the number of new high-quality charter schools available to children is to encourage the replication of existing quality schools. This policy guide…

  6. A Guide to Using State Longitudinal Data for Applied Research. NCEE 2015-4013

    ERIC Educational Resources Information Center

    Levesque, Karen; Fitzgerald, Robert; Pfeiffer, Jay

    2015-01-01

    State longitudinal data systems (SLDSs) promise a rich source of data for education research. SLDSs contain statewide student data that can be linked over time and to additional data sources for education management, reporting, improvement, and research, and ultimately for informing education policy and practice. Authored by Karen Levesque, Robert…

  7. Department of Defense Motor Carrier Qualification Program Analysis

    DTIC Science & Technology

    1994-03-01

    BOND ............................. 19 1. BASIC AGREEMENT ............................... 20 1. Background ................................. 21 2...institutional practices of carriers and their ratemaking organizations that confined traffic management to a tightly regulated set of rate and service options...matters pertaining to freight movements in DOD Foreign Military Sales (FMS). 5. Maintain and improve the Freight Classification Guide System. 6

  8. Library Facility Siting and Location Handbook. The Greenwood Library Management Collection.

    ERIC Educational Resources Information Center

    Koontz, Christine M.

    This handbook is a guide to the complex process of library facility siting and location. It includes relevant research and professionals' siting experiences, as well as actual case studies of closures, openings, mergers, and relocations of library facilities. While the bulk of the volume provides practical information, the work also presents an…

  9. Portfolio Assessment: A Handbook for Educators. Assessment Bookshelf Series.

    ERIC Educational Resources Information Center

    Barton, James, Ed.; Collins, Angelo, Ed.

    This guide contains practical steps for integrating portfolios into any K-12 classroom and tips for effective classroom management of portfolios. It also contains actual examples of portfolios in action in a variety of subject areas. The chapters are: (1) "Starting Out: Designing Your Portfolio" (James Barton and Angelo Collins); (2) "Preparing…

  10. Leave no trace in the outdoors

    USGS Publications Warehouse

    Marion, Jeffrey L.

    2014-01-01

    The essential guide for enjoying the outdoors without harming the environment. - Details the seven core principles of Leave No Trace ethics and practices - Covers hiking, campfires, food storage, and personal hygiene - Endorsed by the USDI National Park Service, Bureau of Land Management, Fish & Wildlife Service, U.S. Geological Survey, and the USDA Forest Service

  11. Guidelines and Minimum Standards for Operation of Texas Proprietary Schools. (Revised.)

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin. Div. of Proprietary Schools and Veterans Education.

    This guide, prepared to assist owners and managers of proprietary schools in Texas in applying for and obtaining approval by the Texas Education Agency, provides guidelines and minimum standards of practice for proprietary school operation. First, the guidelines are discussed in terms of definitions, exemptions, general provisions, certificates of…

  12. 29 CFR 451.1 - Introductory statement.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... provisions of the Act with “a practical guide * * * as to how the office representing the public interest in....1 Introductory statement. (a) This part discusses the meaning and scope of sections 3(i) and 3(j) of..., nor to section 505 of title V, which amends section 302 (a), (b), and (c) of the Labor Management...

  13. Counseling for the Training of Leaders and Leadership Development: A Commentary

    ERIC Educational Resources Information Center

    Barreto, Alfonso

    2012-01-01

    Counseling is the instrument that empowers training and forges the development of leaders in their essential drive to inspire and guide others. As much a discipline and praxis as a professional practice, counseling increases consciousness and optimizes the management and synergy of human energy. This article addresses methods for sustaining…

  14. A Student Guide to Tropical Forest Conservation

    Treesearch

    J. Louise Mastrantonio; John K. Francis

    1997-01-01

    Tropical forests, which circle the globe, are surprisingly diverse, ranging from rain forests to savannas. Tropical forests are disappearing at an alarming rate as they are converted to farmland and other uses. Modern forest management practices can help stem the tide by providing income and valuable products while maintaining forest cover. Puerto Rico has already gone...

  15. Understanding Challenges, Strategies, and the Role of Support Networks in Medication Self-management Among Patients With Type 2 Diabetes.

    PubMed

    Bernhard, Gerda; Ose, Dominik; Baudendistel, Ines; Seidling, Hanna M; Stützle, Marion; Szecsenyi, Joachim; Wensing, Michel; Mahler, Cornelia

    2017-04-01

    Purpose The purpose of this qualitative study was to investigate the challenges and strategies of patients with type 2 diabetes mellitus (T2DM) regarding daily management of their medication regimen focusing on the role of their support networks. Methods A purposeful sample of 25 patients with T2DM was recruited from local self-help groups, general practitioner practices, and a university hospital in southwestern Germany. Four semi-structured focus groups were conducted to identify the challenges patients experienced, the strategies they used, and their collaboration with support networks to assist them in self-managing their medication regimen. Sessions were audio- and video-recorded, fully transcribed, and subjected to computer-aided qualitative content analysis, guided by the Self- and Family Management Framework (SFMF). Results Patients with T2DM experienced numerous challenges affecting medication self-management arising from their personal situation, health status and resources, characteristics of their regimen, and how health care is currently organized. Patients' self-initiated strategies included activating health care, community, social, and online resources; taking ownership of medication-related needs; and integrating medication-taking into daily life. Patients drew on self-help groups, family, and friends to discuss concerns regarding medication safety and receive experience-based information and advice for navigating within the health care system as well as practical hands-on support with daily medication self-management. Conclusions Understanding the challenges and building on strategies patients with T2DM devised help diabetes educators to better address patients' needs and priorities and guide patient-centered interventions to support patients' self-management activities. Community and social support networks operating in patients' lives need to be engaged in the self-management support.

  16. How guiding coalitions promote positive culture change in hospitals: a longitudinal mixed methods interventional study

    PubMed Central

    Bradley, Elizabeth H; Brewster, Amanda L; McNatt, Zahirah; Linnander, Erika L; Cherlin, Emily; Fosburgh, Heather; Ting, Henry H; Curry, Leslie A

    2018-01-01

    Background Quality collaboratives are widely endorsed as a potentially effective method for translating and spreading best practices for acute myocardial infarction (AMI) care. Nevertheless, hospital success in improving performance through participation in collaboratives varies markedly. We sought to understand what distinguished hospitals that succeeded in shifting culture and reducing 30-day risk-standardised mortality rate (RSMR) after AMI through their participation in the Leadership Saves Lives (LSL) collaborative. Procedures We conducted a longitudinal, mixed methods intervention study of 10 hospitals over a 2-year period; data included surveys of 223 individuals (response rates 83%–94% depending on wave) and 393 in-depth interviews with clinical and management staff most engaged with the LSL intervention in the 10 hospitals. We measured change in culture and RSMR, and key aspects of working related to team membership, turnover, level of participation and approaches to conflict management. Main findings The six hospitals that experienced substantial culture change and greater reductions in RSMR demonstrated distinctions in: (1) effective inclusion of staff from different disciplines and levels in the organisational hierarchy in the team guiding improvement efforts (referred to as the ‘guiding coalition’ in each hospital); (2) authentic participation in the work of the guiding coalition; and (3) distinct patterns of managing conflict. Guiding coalition size and turnover were not associated with success (p values>0.05). In the six hospitals that experienced substantial positive culture change, staff indicated that the LSL learnings were already being applied to other improvement efforts. Principal conclusions Hospitals that were most successful in a national quality collaborative to shift hospital culture and reduce RSMR showed distinct patterns in membership diversity, authentic participation and capacity for conflict management. PMID:29101290

  17. State of education regarding ultrasound-guided interventions during pain fellowships in Korea: a survey of recent fellows

    PubMed Central

    Kim, Hyung Tae; Kim, Sae Young; Byun, Gyung Jo; Shin, Byung Chul; Lee, Jin Young; Choi, Eun Joo; Choi, Jong Bum; Hong, Ji Hee; Choi, Seung Won

    2017-01-01

    Background Recently, the use of ultrasound (US) techniques in regional anesthesia and pain medicine has increased significantly. However, the current extent of training in the use of US-guided pain management procedures in Korea remains unknown. The purpose of the present study was to assess the current state of US training provided during Korean Pain Society (KPS) pain fellowship programs through the comparative analysis between training hospitals. Methods We conducted an anonymous survey of 51 pain physicians who had completed KPS fellowships in 2017. Items pertained to current US practices and education, as well as the types of techniques and amount of experience with US-guided pain management procedures. Responses were compared based on the tier of the training hospital. Results Among the 51 respondents, 14 received training at first- and second-tier hospitals (Group A), while 37 received training at third-tier hospitals (Group B). The mean total duration of pain training during the 1-year fellowship was 7.4 months in Group A and 8.4 months in Group B. Our analysis revealed that 36% and 40% of respondents in Groups A and B received dedicated US training, respectively. Most respondents underwent US training in patient-care settings under the supervision of attending physicians. Cervical root, stellate ganglion, piriformis, and lumbar plexus blocks were more commonly performed by Group B than by Group A (P < 0.05). Conclusions Instruction regarding US-guided pain management interventions varied among fellowship training hospitals, highlighting the need for the development of educational standards that mandate a minimum number of US-guided nerve blocks or injections during fellowships in interventional pain management. PMID:29123624

  18. Chemotherapy extravasations: prevention, identification, management, and documentation.

    PubMed

    Gonzalez, Tulia

    2013-02-01

    The nurses' role in safe and effective practice of chemotherapy administration is paramount. The purpose of this article is to present nurses administering chemotherapy with evidence-based information useful in eliminating or reducing the severity of an injury from a chemotherapy extravasation. Nurse education is essential to prevent, recognize, manage, and document chemotherapy extravasations. The classification of the cytotoxic drug and its mechanism of action is useful when selecting the IV access device and also will direct the nurse's intervention to manage the injury. The Oncology Nursing Society's Chemotherapy and Biotherapy Guidelines and Recommendations for Practice and the drug manufacturer are the best sources offering pharmacologic and nonpharmacologic recommendations. The nurse's best ally in the prevention, prompt recognition, and management of an extravasation is the educated patient. Documenting chemotherapy extravasation is another important step to guide the treatment plan; therefore, the document must provide complete details and the extent of the event.

  19. Profiling Patients' Healthcare Needs to Support Integrated, Person-Centered Models for Long-Term Disease Management (Profile): Research Design.

    PubMed

    Elissen, Arianne Mj; Hertroijs, Dorijn Fl; Schaper, Nicolaas C; Vrijhoef, Hubertus Jm; Ruwaard, Dirk

    2016-04-29

    This article presents the design of PROFILe, a study investigating which (bio)medical and non-(bio)medical patient characteristics should guide more tailored chronic care. Based on this insight, the project aims to develop and validate 'patient profiles' that can be used in practice to determine optimal treatment strategies for subgroups of chronically ill with similar healthcare needs and preferences. PROFILe is a practice-based research comprising four phases. The project focuses on patients with type 2 diabetes. During the first study phase, patient profiles are drafted based on a systematic literature research, latent class growth modeling, and expert collaboration. In phase 2, the profiles are validated from a clinical, patient-related and statistical perspective. Phase 3 involves a discrete choice experiment to gain insight into the patient preferences that exist per profile. In phase 4, the results from all analyses are integrated and recommendations formulated on which patient characteristics should guide tailored chronic care. PROFILe is an innovative study which uses a uniquely holistic approach to assess the healthcare needs and preferences of chronically ill. The patient profiles resulting from this project must be tested in practice to investigate the effects of tailored management on patient experience, population health and costs.

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

    Peck, T; Sparkman, D; Storch, N

    ''The LLNL Site-Specific Advanced Simulation and Computing (ASCI) Software Quality Engineering Recommended Practices VI.I'' document describes a set of recommended software quality engineering (SQE) practices for ASCI code projects at Lawrence Livermore National Laboratory (LLNL). In this context, SQE is defined as the process of building quality into software products by applying the appropriate guiding principles and management practices. Continual code improvement and ongoing process improvement are expected benefits. Certain practices are recommended, although projects may select the specific activities they wish to improve, and the appropriate time lines for such actions. Additionally, projects can rely on the guidance ofmore » this document when generating ASCI Verification and Validation (VSrV) deliverables. ASCI program managers will gather information about their software engineering practices and improvement. This information can be shared to leverage the best SQE practices among development organizations. It will further be used to ensure the currency and vitality of the recommended practices. This Overview is intended to provide basic information to the LLNL ASCI software management and development staff from the ''LLNL Site-Specific ASCI Software Quality Engineering Recommended Practices VI.I'' document. Additionally the Overview provides steps to using the ''LLNL Site-Specific ASCI Software Quality Engineering Recommended Practices VI.I'' document. For definitions of terminology and acronyms, refer to the Glossary and Acronyms sections in the ''LLNL Site-Specific ASCI Software Quality Engineering Recommended Practices VI.I''.« less

  1. Percutaneous aspiration of fluid for management of peritonitis in space

    NASA Technical Reports Server (NTRS)

    Kirkpatrick, A. W.; Nicolaou, S.; Campbell, M. R.; Sargsyan, A. E.; Dulchavsky, S. A.; Melton, S.; Beck, G.; Dawson, D. L.; Billica, R. D.; Johnston, S. L.; hide

    2002-01-01

    BACKGROUND: As a medical emergency that can affect even well-screened, healthy individuals, peritonitis developing during a long-duration space exploration mission may dictate deviation from traditional clinical practice due to the absence of otherwise indicated surgical capabilities. Medical management can treat many intra-abdominal processes, but treatment failures are inevitable. In these circumstances, percutaneous aspiration under sonographic guidance could provide a "rescue" strategy. Hypothesis: Sonographically guided percutaneous aspiration of intra-peritoneal fluid can be performed in microgravity. METHODS: Investigations were conducted in the microgravity environment of NASA's KC-135 research aircraft (0 G). The subjects were anesthetized female Yorkshire pigs weighing 50 kg. The procedures were rehearsed in a terrestrial animal lab (1 G). Colored saline (500 mL) was introduced through an intra-peritoneal catheter during flight. A high-definition ultrasound system (HDI-5000, ATL, Bothell, WA) was used to guide a 16-gauge needle into the peritoneal cavity to aspirate fluid. RESULTS: Intra-peritoneal fluid collections were easily identified, distinct from surrounding viscera, and on occasion became more obvious during weightless conditions. Subjectively, with adequate restraint of the subject and operators, the procedure was no more demanding than during the 1-G rehearsals. CONCLUSIONS: Sonographically guided percutaneous aspiration of intra-peritoneal fluid collections is feasible in weightlessness. Treatment of intra-abdominal inflammatory conditions in spaceflight might rely on pharmacological options, backed by sonographically guided percutaneous aspiration for the "rescue" of treatment failures. While this risk mitigation strategy cannot guarantee success, it may be the most practical option given severe resource limitations.

  2. Using nurse managers' perceptions to guide new graduates toward positive nurse relationships.

    PubMed

    Moore, Linda Weaver; Sublett, Cynthia; Leahy, Cathy; Bradley, Jennifer M

    One of the greatest challenges new graduates confront when transitioning to practice is establishing positive relationships with experienced nurses. Nursing faculty must prepare graduates for this challenge. However, nursing faculty are often removed from everyday practice and must rely on the perceptions of those entrenched in practice in order to ground teaching endeavors in authenticity. Nurse managers are well positioned to provide knowledgeable insights to nursing faculty regarding nurse relationships. The purpose of this qualitative, descriptive study was to explore nurse managers' perceptions regarding new graduates' relationships with more experienced nurses. Researcher-participant audiotaped interviews were conducted with 13 nurse managers. A content analysis revealed that all participants believed nurse relationships were significant, that factors such as perceived inequities and stressful occurrences triggered poor relationships, that new graduates were often targeted for negative relationships, and that reasons for targeting of new graduates included prolonged dependence on experienced nurses and either over or under confidence of the new graduate. Providing a supportive, protective environment and hiring practices that promote team unity were posed as strategies that could help to prevent targeting of new graduates. Findings provide real-life, practice based information that can underpin nurse educators' teaching regarding nurse relationships and relationship building. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    PubMed

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

    2016-10-01

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

  4. Development of Animal Physiology Practical Guidance Oriented Guided Inquiry for Student of Biology Department

    NASA Astrophysics Data System (ADS)

    Putra, Z. A. Z.; Sumarmin, R.; Violita, V.

    2018-04-01

    The guides used for practicing animal physiology need to be revised and adapted to the lecture material. This is because in the subject of Animal Physiology. The guidance of animal physiology practitioners is still conventional with prescription model instructions and is so simple that it is necessary to develop a practical guide that can lead to the development of scientific work. One of which is through practice guided inquiry guided practicum guide. This study aims to describe the process development of the practical guidance and reveal the validity, practicality, and effectiveness Guidance Physiology Animals guided inquiry inferior to the subject of Animal Physiology for students Biology Department State University of Padang. This type of research is development research. This development research uses the Plomp model. Stages performed are problem identification and analysis stage, prototype development and prototyping stage, and assessment phase. Data analysis using descriptive analysis. The instrument of data collection using validation and practical questionnaires, competence and affective field of competence observation and psychomotor and cognitive domain competence test. The result of this research shows that guidance of Inquiry Guided Initiative Guided Physiology with 3.23 valid category, practicality by lecturer with value 3.30 practical category, student with value 3.37 practical criterion. Affective effectiveness test with 93,00% criterion is very effective, psychomotor aspect 89,50% with very effective criteria and cognitive domain with value of 67, pass criterion. The conclusion of this research is Guided Inquiry Student Guided Protoxial Guidance For Students stated valid, practical and effective.

  5. An interactive quality of work life model applied to organizational transition.

    PubMed

    Knox, S; Irving, J A

    1997-01-01

    Most healthcare organizations in the United States are in the process of some type of organizational change or transition. Professional nurses and other healthcare providers practicing in U.S. healthcare delivery organizations are very aware of the dramatic effects of restructuring processes. A phenomenal amount of change and concern is occurring with organizational redesign, generating many questions and uncertainties. These transitions challenge the basic assumptions and principles guiding the practice of clinical and management roles in healthcare.

  6. An Early Survey of Best Practices for the Use of Small Unmanned Aerial Systems by the Electric Utility Industry

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

    Lusk, Rick M.; Monday, William

    This technical manual is about doing things safely. It isn’t so much a how-to guide as it is a collection of best practices from unmanned aerial system (UAS) operators from all over the world. The desired end state is to provide a touchstone for utility businesses, directors, managers, and operators that will inform them as they begin to strategize, plan, and incorporate this technology into day-to-day operations.

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

    PubMed

    Holley, Jessica; Chambers, Mary; Gillard, Steven

    2016-08-01

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

  8. Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Revision 2018: Using the Evidence to Guide Physical Therapist Practice.

    PubMed

    2018-02-01

    Meniscus and articular cartilage lesions are common knee injuries. The resulting knee pain and mobility impairments can be improved by physical therapists during nonoperative and operative management. Recommendations from clinical practice guidelines (CPGs) such as this revision, titled "Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions," published in the February 2018 issue of JOSPT, can help physical therapists engage in evidence-informed practice and reduce unnecessary clinical variation. J Orthop Sports Phys Ther 2018;48(2):123-124. doi:10.2519/jospt.2018.0503.

  9. Academy of Osseointegration's Summit on Clinical Practice Guidelines for the Edentulous Maxilla: Overview, Process, and Outcomes-Changing the Face of Implant Dentistry.

    PubMed

    Stanford, Clark M

    2016-01-01

    Starting in 2012, the Academy of Osseointegration initiated the planning process for an AO Summit to develop clinical practice guidelines (CPGs) for management of the edentulous maxilla. A planning committee led by Professor Clark Stanford and Dr Ole Jensen created a work plan based on five domain areas to be addressed by the summit. The five domain areas were defined as: (1) role of grafting for ridge development for implant placement, (2) role of implant design and systems in management of the edentulous maxilla, (3) role of imaging to guide implant placement, (4) role of biologics to assist in ridge development, and (5) role of prosthetic management. The summit was held in August 2014, and the results are presented in this overview. All of the supporting systematic reviews and the detailed CPGs are presented in this special edition of JOMI. While the evidence was observed to be weak in regard to the literature for most of the systematic reviews, the summit strived to establish the current best evidence and practical CPGs that will assist clinicians in practice.

  10. Factors that influence effective perioperative temperature management by anesthesiologists: a qualitative study using the Theoretical Domains Framework.

    PubMed

    Boet, Sylvain; Patey, Andrea M; Baron, Justine S; Mohamed, Karim; Pigford, Ashlee-Ann E; Bryson, Gregory L; Brehaut, Jamie C; Grimshaw, Jeremy M

    2017-06-01

    Inadvertent perioperative hypothermia (IPH) is associated with a range of adverse outcomes. Safe and effective warming techniques exist to prevent IPH; however, IPH remains common. This study aimed to identify factors that anesthesiologists perceive may influence temperature management during the perioperative period. After Research Ethics Board approval, semi-structured interviews were conducted with staff anesthesiologists at a Canadian academic hospital. An interview guide based on the Theoretical Domains Framework (TDF) was used to capture 14 theoretical domains that may influence temperature management. The interview transcripts were coded using direct content analysis to generate specific beliefs and to identify relevant TDF domains perceived to influence temperature management behaviour. Data saturation was achieved after 15 interviews. The following nine theoretical domains were identified as relevant to designing an intervention for practices in perioperative temperature management: knowledge, beliefs about capabilities, beliefs about consequences, reinforcement, memory/attention/decision-making, environmental context and resources, social/professional role/identity, social influences, and behavioural regulation. Potential target areas to improve temperature management practices include interventions that address information needs about individual temperature management behaviour as well as patient outcome (feedback), increasing awareness of possible temperature management strategies and guidelines, and a range of equipment and surgical team dynamics that influence temperature management. This study identified several potential target areas for future interventions from nine of the TDF behavioural domains that anesthesiologists perceive to drive their temperature management practices. Future interventions that aim to close the evidence-practice gap in perioperative temperature management may include these targets.

  11. A new framing approach in guideline development to manage different sources of knowledge.

    PubMed

    Lukersmith, Sue; Hopman, Katherine; Vine, Kristina; Krahe, Lee; McColl, Alexander

    2017-02-01

    Contemporary guideline methodology struggles to consider context and information from different sources of knowledge besides quantitative research. Return to work programmes involve multiple components and stakeholders. If the guideline is to be relevant and practical for a complex intervention such as return to work, it is essential to use broad sources of knowledge. This paper reports on a new method in guideline development to manage different sources of knowledge. The method used framing for the return-to-work guidance within the Clinical Practice Guidelines for the Management of Rotator Cuff Syndrome in the Workplace. The development involved was a multi-disciplinary working party of experts including consumers. The researchers considered a broad range of research, expert (practice and experience) knowledge, the individual's and workplace contexts, and used framing with the International Classification of Functioning, Disability and Health. Following a systematic database search on four clinical questions, there were seven stages of knowledge management to extract, unpack, map and pack information to the ICF domains framework. Companion graded recommendations were developed. The results include practical examples, user and consumer guides, flow charts and six graded or consensus recommendations on best practice for return to work intervention. Our findings suggest using framing in guideline methodology with internationally accepted frames such as the ICF is a reliable and transparent framework to manage different sources of knowledge. Future research might examine other examples and methods for managing complexity and using different sources of knowledge in guideline development. © 2016 John Wiley & Sons, Ltd.

  12. Population health management guiding principles to stimulate collaboration and improve pharmaceutical care.

    PubMed

    Steenkamer, Betty; Baan, Caroline; Putters, Kim; van Oers, Hans; Drewes, Hanneke

    2018-04-09

    Purpose A range of strategies to improve pharmaceutical care has been implemented by population health management (PHM) initiatives. However, which strategies generate the desired outcomes is largely unknown. The purpose of this paper is to identify guiding principles underlying collaborative strategies to improve pharmaceutical care and the contextual factors and mechanisms through which these principles operate. Design/methodology/approach The evaluation was informed by a realist methodology examining the links between PHM strategies, their outcomes and the contexts and mechanisms by which these strategies operate. Guiding principles were identified by grouping context-specific strategies with specific outcomes. Findings In total, ten guiding principles were identified: create agreement and commitment based on a long-term vision; foster cooperation and representation at the board level; use layered governance structures; create awareness at all levels; enable interpersonal links at all levels; create learning environments; organize shared responsibility; adjust financial strategies to market contexts; organize mutual gains; and align regional agreements with national policies and regulations. Contextual factors such as shared savings influenced the effectiveness of the guiding principles. Mechanisms by which these guiding principles operate were, for instance, fostering trust and creating a shared sense of the problem. Practical implications The guiding principles highlight how collaboration can be stimulated to improve pharmaceutical care while taking into account local constraints and possibilities. The interdependency of these principles necessitates effectuating them together in order to realize the best possible improvements and outcomes. Originality/value This is the first study using a realist approach to understand the guiding principles underlying collaboration to improve pharmaceutical care.

  13. Nitrates as a Treatment of Acute Heart Failure

    PubMed Central

    Alzahri, Mohammad S; Rohra, Anita

    2016-01-01

    The purpose of this article is to review the clinical efficacy and safety of nitrates in acute heart failure (AHF) by examining various trials on nitrates in AHF. Management of AHF can be challenging due to the lack of objective clinical evidence guiding optimal management. There have been many articles suggesting that, despite a benefit, nitrates are underused in clinical practice. Nitrates, when appropriately dosed, have a favourable effect on symptoms, blood pressure, intubation rates, mortality and other parameters. PMID:28785453

  14. Pearls and pitfalls: Autoimmune lymphoproliferative syndrome and autoimmune lymphoproliferative syndrome-like disease.

    PubMed

    Bartels, Anne K; Banks, Taylor A; Bay, Jeannie L

    2017-07-01

    A case of autoimmune lymphoproliferative syndrome (ALPS) was presented, followed by a discussion of the clinical characteristics, pathophysiology, diagnosis, and management of this disease. Clinical pearls and pitfalls are emphasized for the use of the practicing allergist and the fellow in-training. The diagnosis of ALPS was guided by published criteria. A careful history and workup were needed to exclude other possible etiologies for the patient's symptoms and physical findings. ALPS often carries significant morbidity and is best managed through a multidisciplinary approach.

  15. Management of lymphatic malformations in children.

    PubMed

    Bagrodia, Naina; Defnet, Ann M; Kandel, Jessica J

    2015-06-01

    To review the literature on lymphatic malformations and to provide current opinion about the management of these lesions. Current treatment options include nonoperative management, surgery, sclerotherapy, radiofrequency ablation, and laser therapy. New therapies are emerging, including sildenafil, propranolol, sirolimus, and vascularized lymph node transfer. The primary focus of management centers on the patient's quality of life. Multimodal treatment of lymphatic malformations continues to expand as new information about the biology and genetics of these lesions is discovered, in addition to knowledge gained from clinical practice. A patient-centered approach should guide timing and modality of treatment. Continued study of lymphatic malformations will increase and solidify a treatment algorithm for these complicated lesions.

  16. Unwitnessed lithium ion disc battery ingestion: case report and review of best practice management of an increasing clinical concern.

    PubMed

    Dawe, N; Puvanendran, M; Flood, L

    2013-01-01

    To describe a case of unwitnessed lithium ion disc battery ingestion, with a review of radiology findings and current best practice management. A three-year-old girl presented following ingestion of a foreign body, which her four-year-old brother claimed was a one pound coin. The patient was managed non-urgently and transferred for specialist ENT assessment 6 hours following the initial ingestion, with no evidence of airway compromise. A corroded battery was removed from the level of the cricopharyngeus after 8 hours, with an associated circumferential mucosal burn. There is increasing concern regarding the acknowledged rising incidence of lithium ion disc battery ingestion. The lack of a high index of suspicion and the inability to recognise subtleties on imaging may lead to suboptimal management with a higher degree of unnecessary immediate and delayed morbidity. The recently published American Academy of Pediatrics Guidelines may guide the approach to managing battery ingestions.

  17. 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

  18. Managing corneal foreign bodies in office-based general practice.

    PubMed

    Fraenkel, Alison; Lee, Lawrence R; Lee, Graham A

    2017-03-01

    Patients with a corneal foreign body may first present to their general practitioner (GP). Safe and efficacious management of these presentations avoids sight-threatening and eye-threatening complications. Removal of a simple, superficial foreign body without a slit lamp is within The Royal Australian College of General Practitioners' (RACGP's) curriculum and scope of practice. Knowing the rele-vant procedural skills and indications for referral is equally important. The objective of this article is to provide an evidence-based and expert-based guide to the management of corneal foreign bodies in the GP's office. History is key to identifying patient characteristics and mechanisms of ocular injury that are red flags for referral. Examination tech-niques and methods of superficial foreign body removal without a slit lamp are outlined, as well as the procedural threshold for referral to an ophthalmologist.

  19. Expanding Role of Data Science and Bioinformatics in Drug Discovery and Development.

    PubMed

    Fingert, Howard J

    2018-01-01

    Numerous barriers have been identified which detract from successful applications of clinical trial data and platforms. Despite the challenges, opportunities are growing to advance compliance, quality, and practical applications through top-down establishment of guiding principles, coupled with bottom-up approaches to promote data science competencies among data producers. Recent examples of successful applications include modern treatments for hematologic malignancies, developed with support from public-private partnerships, guiding principles for data-sharing, standards for protocol designs and data management, digital technologies, and quality analytics. © 2017 American Society for Clinical Pharmacology and Therapeutics.

  20. [Ethnography for nursing research, a sensible way to understand human behaviors in their context].

    PubMed

    Bourbonnais, Anne

    2015-03-01

    Understanding human behaviours is at the heart of the nursing discipline. Knowledge development about behaviours is essential to guide nursing practice in the clinical field, for nursing education or in nursing management. In this context, ethnography is often overlooked as a research method to understand better behaviours in their sociocultural environment This article aims to present the principles guiding this qualitative method and its application to nursing research. First, the ethnographic method and some of its variants will be described. The conduct of an ethnographic study will then be exposed. Finally, examples of ethnographic studies in nursing will be presented. This article provides a foundation for the development of research protocols using ethnography for the advancement of nursing knowledge, as well as better use of ethnographic findings to improve care practices.

  1. Building Resiliency: How To Thrive in Times of Change. An Ideas into Action Guidebook.

    ERIC Educational Resources Information Center

    Pulley, Mary Lynn; Wakefield, Michael

    This is a practicing managers' guide for gaining the ability to thrive during change, for leaders of any kind of organization. Resiliency is defined, its components described, and its importance explained. Concrete examples of resiliency and questions that can determine degree of resiliency are provided. Resiliency is not described as being…

  2. Moving from Bureaucracy to Empowerment: Shifting Paradigms To Practice What We Preach in Class.

    ERIC Educational Resources Information Center

    Luechauer, David L.; Shulman, Gary M.

    The empowerment paradigm with roots in the literature of education and management (both applied and theoretical) can guide faculty to help prepare students to make the transition from the classroom to the boardroom. While numerous faculty leaders have joined corporate leaders in espousing the virtues of empowerment, most classes in business…

  3. Open for Business: Learning Economics through Social Interaction in a Student-Operated Store

    ERIC Educational Resources Information Center

    Broome, John P.; Preston-Grimes, Patrice

    2011-01-01

    This study examines teaching and learning economics and entrepreneurship through a student-run Montessori middle school store. By designing and managing a school store, students created a "community of practice" to learn economics concepts in their daily environment. Questions guiding this study were: (a) How do students' social-interactions in a…

  4. Chesapeake Bay Riparian Handbook: A Guide for Establishing and Maintaining Riparian Forest Buffers

    Treesearch

    Roxane Palone; Albert Todd

    1998-01-01

    The Purpose of This Handbook Riparian forest buffers have been identified as avaluable nutrient reduction tool when used inconjunction with other conservation practices. For this reason, the Chesapeake Bay Programhas targeted riparian forests as a key habitat for restoration. The purpose of this handbook is toprovide professional land managers and plan-ners with the...

  5. Southern Research Station Global Change Research Strategy 2011-2019

    Treesearch

    Kier Klepzig; Zoe Hoyle; Stevin Westcott; Emrys Treasure

    2012-01-01

    In keeping with the goals of the Research and Development agenda of the Forest Service, U.S. Department of Agriculture (USDA), the Southern Research Station (SRS) provides the information and technology needed to develop best management practices for the forest lands of the Southern United States, where science-guided actions are needed to sustain ecosystem health,...

  6. Variety and evolution of American endoscopic image management and recording systems.

    PubMed

    Korman, L Y

    1996-03-01

    The rapid evolution of computing technology has and will continue to alter the practice of gastroenterology and gastrointestinal endoscopy. Development of communication standards for text, images, and security systems will be necessary for medicine to take advantage of high-speed computing and communications. Professional societies can have an important role in guiding the development process.

  7. U.S. Department of Education Indirect Cost Determination Guidance for State and Local Government Agencies.

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC. Office of the Chief Financial and Chief Information Officer.

    This guide provides new direction in financial management and oversight practices for accounting and charging administrative costs as they relate to programs administered by the U.S. Department of Education. The document is divided into six sections. Section 1, which presents general information, offers details on definitions; indirect-cost rates;…

  8. The Promises and Challenges of Implementing Humanistic Pedagogy in the Curriculum of Hong Kong Kindergartens

    ERIC Educational Resources Information Center

    Lau, Grace

    2009-01-01

    To his article reports on two case studies of teachers' managing the challenges associated with gaining acceptance for child-centeredness curriculum practices in the Hong Kong Special Administrative Region. These teachers intended to respond to the newly published "Guide to the Preprimary Curriculum" (Education and Manpower Branch, 2006)…

  9. Silviculture guide for the mahogany forests of Quintana Roo, Mexico – Criteria and recommendations

    Treesearch

    P. Negreros-Castillo; L. Cámara-Cabrales; Margaret Devall; M.A. Fajvan; M.A. Mendoza Briseño; C.W. Mize

    2014-01-01

    Silviculture is the art, science and practice of controlling the establishment, composition, health, quality and growth of forests to accomplish a set of management objectives. This publication offers an approach to silviculture of the forests of Quintana Roo in which mahogany (Swietenia macrophylla King), the commercially most important tree species in Latin America,...

  10. Improving Academic Management: A Handbook of Planning and Institutional Research.

    ERIC Educational Resources Information Center

    Jedamus, Paul, Ed.; Peterson, Marvin W., Ed.

    A guide to the practice of institutional research and planning in American higher education in the 1980s is presented. Attention is directed to the impact of current changes in the external environment on higher education and implications of these changes for institutional research and planning. Topics include national issues crucial to the future…

  11. Beginning the Principalship. A Practical Guide for New School Leaders. Third Edition

    ERIC Educational Resources Information Center

    Daresh, John C.

    2006-01-01

    This new edition of John C. Daresh's bestseller provides the resources needed to become a strong and effective leader. The reader will find out have they can: (1) Manage others' expectations as principal; (2) Master the technical skills necessary to run a school; (3) Create and clarify a personal professional growth plan; (4) Work effectively…

  12. Forest Services: World of Work Project: Fifth Grade: Science.

    ERIC Educational Resources Information Center

    Utah State Board for Vocational Education, Salt Lake City.

    The document is one of the teaching units developed by the Utah World of Work Project, designed to integrate career awareness into the regular curriculum at the elementary level. The fifth grade guide is tied to the science area and focuses on conservation as practiced by Forest Service workers; the growth cycle of forests and the management of…

  13. Nurse Aide Empowerment Strategies and Staff Stability: Effects on Nursing Home Resident Outcomes

    ERIC Educational Resources Information Center

    Barry, Theresa; Brannon, Diane; Mor, Vincent

    2005-01-01

    Purpose: This study examines the moderating effect of staff stability on the relationship between management practices used to empower nurse aides and resident outcomes in a multistate sample of nursing homes. An adaptation of Kanter's theory of structural power in organizations guided the framework for the model used in this study. Design and…

  14. 77 FR 21795 - Notice of Submission of Proposed Information Collection to OMB Public Housing Agency Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-11

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

  15. Human Performance in Continuous Operations: Volume 2. Management Guide

    DTIC Science & Technology

    1979-12-01

    the tank would have to approach nearly 60m from the starting distance of 284m before the naked eye could detect it. If only one eye were used, the...the likely state of morale at the expected time of attack? • How much training practice h^as *hei ■* teen with this sort of situation? For what

  16. University of Missouri-St. Louis: Data-Driven Online Course Design and Effective Practices

    ERIC Educational Resources Information Center

    Grant, Mary Rose

    2012-01-01

    Analytics has a significant place in the future of higher education by guiding reform and system change. As this case study has shown, analytics can do more than evaluate what students have done and predict what they will do. Learning analytics can be transformative, altering existing pedagogical processes, research, data management, and…

  17. Elementary Principals: A Checklist to Succeed. ACSA Operations Notebook 23.

    ERIC Educational Resources Information Center

    Amato, Ted, Ed.

    This operations notebook is constructed so that it can serve as a practical guide and quick reference for elementary school principals. It has a checklist-type format, and the entire document can be inserted into a three-ring binder. The eight topics covered include preparation for the opening of school, contract management, handling emergencies,…

  18. Application of Sludges and Wastewaters on Agricultural Land: A Planning and Educational Guide, MCD-35. Research Bulletin 1090.

    ERIC Educational Resources Information Center

    Knezek, Bernard D., Ed.; Miller, Robert H., Ed.

    This report addresses the application of agricultural processing wastes, industrial and municipal wastes on agricultural land as both a waste management and resource recovery and reuse practice. The document emphasizes the treatment and beneficial utilization of sludge and wastewater as opposed to waste disposal. These objectives are achieved…

  19. A community hospital acute pain service.

    PubMed

    Musclow, Shirley L

    2005-11-01

    This article provides readers with a guide to developing and implementing an acute pain service in a community hospital. Kanter's theory of innovative diffusion is used to frame the author's experiences as a lead nurse in two community hospital acute pain services. Health-care providers recognize the importance of quality pain assessment and management. One initiative for improving pain management has been the implementation of an acute pain service (APS). In Canada, most university-affiliated teaching hospitals have now developed an APS to improve pain management. Community hospitals, however, have only recently begun to adopt the concept. Improving pain management through an APS provides an excellent opportunity for nursing leadership at all levels. Nursing administration may take the lead in proposing the idea and benefits of acquiring an APS. An advanced practice nurse can provide leadership through the coordination and provision of enhanced pain management as a lead nurse in an APS. Staff nurses can provide leadership in improving pain management on a daily basis and ensuring that quality pain care reaches the bedside, Nursing practice is at the core of making a difference in pain management.

  20. Augmentation of Conventional Medical Management of Moderately Severe or Severe Asthma with Acupuncture and Guided Imagery/Meditation

    PubMed Central

    Mehl-Madrona, Lewis

    2008-01-01

    Objective: I sought to determine if a combination of acupuncture and guided imagery could augment the conventional medical management of moderately severe or severe asthma. Design: This was an early-phase study with a convenience sample of self-selecting patients compared with self—year before, during treatment, and one year after treatment. Setting: Patients were recruited from an outpatient practice. Patients: All participants were adults with moderately severe or severe asthma (class 3 or 4). Interventions: The study employed acupuncture and guided imagery/meditation for a 24-week period. Main Outcome Measures: The main outcome measures were number of days of hospitalization, number of Emergency Department (ED) visits, number of physician visits, days per year taking steroids, puffs per week of inhaled β-agonists, FVC (forced vital capacity), FEV1 (forced expiratory volume in the first second), and FEF25-75 (forced expiratory flow between 25% and 75% of the FVC). Results: With the addition of acupuncture and guided imagery to conventional medical management, members of the study group experienced improvement. The number of hospitalized days and the number of ED visits not leading to hospitalizations decreased, as did number of medical visits and total days taking oral corticosteroids. Parameters of respiratory function improved despite reduced use of inhaled β-agonists. Conclusion: With acupuncture and guided imagery and meditation together, a self-selecting group of patients with moderately severe or severe asthma experienced improvement in respiratory function, taking less medication than before and having fewer emergencies and hospitalizations at a lower cost of care. PMID:21339915

  1. Care guides: an examination of occupational conflict and role relationships in primary care.

    PubMed

    Wholey, Douglas R; White, Katie M; Adair, Richard; Christianson, Jon B; Lee, Suhna; Elumba, Deborah

    2013-01-01

    Improving the efficiency and effectiveness of primary care treatment of patients with chronic illness is an important goal in reforming the U.S. health care system. Reducing occupational conflicts and creating interdependent primary care teams is crucial for the effective functioning of new models being developed to reorganize chronic care. Occupational conflict, role interdependence, and resistance to change in a proof-of-concept pilot test of one such model that uses a new kind of employee in the primary care office, a "care guide," were analyzed. Care guides are lay individuals who help chronic disease patients and their providers achieve standard health goals. The aim of this study was to examine the development of occupational boundaries, interdependence of care guides and primary care team members, and acceptance by clinic employees of this new kind of health worker. A mixed methods, pilot study was conducted using qualitative analysis; clinic, provider, and patient surveys; administrative data; and multivariate analysis. Qualitative analysis examined the emergence of the care guide role. Administrative data and surveys were used to examine patterns of interdependence between care guides, physicians, team members, and clinic staff; obtain physician evaluations of the care guide role; and evaluate the effect of care guides on patient perceptions of care coordination and follow-up. Evaluation of implementation of the care guide model showed that (a) the care guide scope of practice was clearly defined; (b) interdependent relationships between care guides and providers were formed; (c) relational triads consisting of patient, care guide, and physician were created; (d) patients and providers were supported in managing chronic disease; and (e) resistance to this model among traditional employees was minimized. The feasibility of implementing a new care model for chronic disease management in the primary care setting, identifying factors associated with a positive organizational experience, was shown in this study.

  2. Hepcidin in chronic kidney disease: not an anaemia management tool, but promising as a cardiovascular biomarker.

    PubMed

    van der Weerd, N C; Grooteman, M P C; Nubé, M J; ter Wee, P M; Swinkels, D W; Gaillard, C A J M

    2015-03-01

    Hepcidin is a key regulator of iron homeostasis and plays a role in the pathogenesis of anaemia of chronic disease. Its levels are increased in patients with chronic kidney disease (CKD) due to diminished renal clearance and an inflammatory state. Increased hepcidin levels in CKD patients are supposed to be responsible for functional iron deficiency in these patients and contribute to renal anaemia and resistance to erythropoiesis-stimulating agents. Therefore, hepcidin was purported to be useful as a management tool guiding treatment of renal anaemia. Furthermore, since hepcidin is associated with iron accumulation in macrophages in the vessel wall inducing oxidative stress and atherosclerosis, it has been speculated that hepcidin might function as a biomarker of cardiovascular disease. In this descriptive review, the merits of hepcidin with respect to its role in the pathophysiology of renal anaemia in CKD patients, its presumptive role as a practical diagnostic tool guiding management of renal anaemia, and its possible usefulness as a prognostic biomarker will be discussed.

  3. Treatment outcomes of a Numeric Rating Scale (NRS)-guided pharmacological pain management strategy in symptomatic knee and hip osteoarthritis in daily clinical practice.

    PubMed

    Snijders, Gijs F; van den Ende, Cornelia H M; van den Bemt, Bart J F; van Riel, Piet L C M; van den Hoogen, Frank H J; den Broeder, Alfons A

    2012-01-01

    To describe the results of a Numeric Rating Scale (NRS)-guided pharmacological pain management strategy in symptomatic knee and hip osteoarthritis (OA) in daily clinical practice. In this observational cohort study, standardised conservative treatment was offered to patients with symptomatic knee and/or hip OA referred to secondary care. Pain management was guided by a NRS for pain, aiming for NRS ≤4. The first step in pharmacological treatment was paracetamol (acetaminophen) in case of no recent use in adequate dose. In case of treatment failure, patients switched to a non-steroidal anti-inflammatory drug (NSAID) and eventually to a second NSAID, each after a 4-week trial period. Predictors for response to treatment were identified. Moreover, reasons for protocol violations were collected. Three-hundred and forty-seven patients were included. The proportion of patients that reached a response after paracetamol, first and second NSAID was 25% (59/234), 16% (31/190) and 11% (10/87), respectively. Non-adherence to protocol occurred in 46% of cases when switch of analgesic was advised, mainly due to unwillingness of patients to change the analgesic. Identified predictors for response to analgesics included higher age, lower patient global assessment, less stiffness and more radiographic severity. Adequate use of paracetamol and switching to a NSAID after failing paracetamol resulted in moderate treatment response percentages, whereas the result of a second NSAID was disappointing in patients with advanced knee and hip OA. Predictors for response included patient and disease related factors. A substantial part of patients with NRS >4 were unwilling to change their analgesics.

  4. Predictors of Adolescents’ Health- promoting Behaviors Guided by Primary Socialization Theory

    PubMed Central

    Rew, Lynn; Arheart, Kristopher L.; Thompson, Sanna; Johnson, Karen

    2013-01-01

    Purpose The purpose of this study was to determine the influence of parents and peers on adolescents’ health-promoting behaviors, framed by Primary Socialization Theory. Design and Method Longitudinal data collected annually from 1,081 rural youth (mean age = 17 ±.7; 43.5% males; 44% Hispanic) and once from their parents were analyzed using generalized linear models. Results Parental monitoring and adolescent’s religious commitment significantly predicted all health-promoting behaviors (nutrition, physical activity, safety, health practices awareness, stress management). Other statistically significant predictors were parent’s responsiveness and health-promoting behaviors. Peer influence predicted safety and stress management. Practice Implications Nurses may facilitate adolescents’ development of health-promoting behaviors through family-focused interventions. PMID:24094123

  5. A pan-Canadian practice guideline and algorithm: screening, assessment, and supportive care of adults with cancer-related fatigue

    PubMed Central

    Howell, D.; Keller–Olaman, S.; Oliver, T.K.; Hack, T.F.; Broadfield, L.; Biggs, K.; Chung, J.; Gravelle, D.; Green, E.; Hamel, M.; Harth, T.; Johnston, P.; McLeod, D.; Swinton, N.; Syme, A.; Olson, K.

    2013-01-01

    Purpose The purpose of the present systematic review was to develop a practice guideline to inform health care providers about screening, assessment, and effective management of cancer-related fatigue (crf) in adults. Methods The internationally endorsed adapte methodology was used to develop a practice guideline for pan-Canadian use. A systematic search of the literature identified a broad range of evidence: clinical practice guidelines, systematic reviews, and other guidance documents on the screening, assessment, and management of crf. The search included medline, embase, cinahl, the Cochrane Library, and other guideline and data sources to December 2009. Results Two clinical practice guidelines were identified for adaptation. Seven guidance documents and four systematic reviews also provided supplementary evidence to inform guideline recommendations. Health professionals across Canada provided expert feedback on the adapted recommendations in the practice guideline and algorithm through a participatory external review process. Conclusions Practice guidelines can facilitate the adoption of evidence-based assessment and interventions for adult cancer patients experiencing fatigue. Development of an algorithm to guide decision-making in practice may also foster the uptake of a guideline into routine care. PMID:23737693

  6. Factors influencing performance of health workers in the management of seriously sick children at a Kenyan tertiary hospital--participatory action research.

    PubMed

    Irimu, Grace W; Greene, Alexandra; Gathara, David; Kihara, Harrison; Maina, Christopher; Mbori-Ngacha, Dorothy; Zurovac, Dejan; Migiro, Santau; English, Mike

    2014-02-07

    Implementation of World Health Organization case management guidelines for serious childhood illnesses remains a challenge in hospitals in low-income countries. Facilitators of and barriers to implementation of locally adapted clinical practice guidelines (CPGs) have not been explored. This ethnographic study based on the theory of participatory action research (PAR) was conducted in Kenyatta National Hospital, Kenya's largest teaching hospital. The primary intervention consisted of dissemination of locally adapted CPGs. The PRECEDE-PROCEED health education model was used as the conceptual framework to guide and examine further reinforcement activities to improve the uptake of the CPGs. Activities focussed on introduction of routine clinical audits and tailored educational sessions. Data were collected by a participant observer who also facilitated the PAR over an eighteen-month period. Naturalistic inquiry was utilized to obtain information from all hospital staff encountered while theoretical sampling allowed in-depth exploration of emerging issues. Data were analysed using interpretive description. Relevance of the CPGs to routine work and emergence of a champion of change facilitated uptake of best-practices. Mobilization of basic resources was relatively easily undertaken while activities that required real intellectual and professional engagement of the senior staff were a challenge. Accomplishments of the PAR were largely with the passive rather than active involvement of the hospital management. Barriers to implementation of best-practices included i) mismatch between the hospital's vision and reality, ii) poor communication, iii) lack of objective mechanisms for monitoring and evaluating quality of clinical care, iv) limited capacity for planning strategic change, v) limited management skills to introduce and manage change, vi) hierarchical relationships, and vii) inadequate adaptation of the interventions to the local context. Educational interventions, often regarded as 'quick-fixes' to improve care in low-income countries, may be necessary but are unlikely to be sufficient to deliver improved services. We propose that an understanding of organizational issues that influence the behaviour of individual health professionals should guide and inform the implementation of best-practices.

  7. Opinions of general practitioners about psychotherapy and their relationships with mental health professionals in the management of major depression: A qualitative survey

    PubMed Central

    Dumesnil, Hélène; Apostolidis, Thémis; Verger, Pierre

    2018-01-01

    Background French general practitioners (GPs) refer their patients with major depression to psychiatrists or for psychotherapy at particularly low rates. Objectives This qualitative study aims to explore general practitioners' (GP) opinions about psychotherapy, their relationships with mental health professionals, their perceptions of their role and that of psychiatrists in treating depression, and the relations between these factors and the GPs' strategies for managing depression. Methods In 2011, in-depth interviews based on a semi-structured interview guide were conducted with 32 GPs practicing in southeastern France. Verbatim transcripts were examined by analyzing their thematic content. Results We identified three profiles of physicians according to their opinions and practices about treatment strategies for depression: pro-pharmacological treatment, pro-psychotherapy and those with mixed practices. Most participants considered their relationships with psychiatrists unsatisfactory, would like more and better collaboration with them and shared the same concept of management in general practice. This concept was based both on the values and principles of practice shared by GPs and on their strong differentiation of their management practices from those of psychiatrists, Conclusion Several attitudes and values common to GPs might contribute to their low rate of referrals for psychotherapy in France: strong occupational identity, substantial variations in GPs' attitudes and practices regarding depression treatment strategies, representations sometimes unfavorable toward psychiatrists. Actions to develop a common culture and improve cooperation between GPs and psychiatrists are essential. They include systems of collaborative care and the development of interdisciplinary training common to GPs and psychiatrists practicing in the same area. PMID:29385155

  8. Management of common gastrointestinal disorders: quality criteria based on patients' views and practice guidelines

    PubMed Central

    Jones, Roger; Hunt, Claire; Stevens, Richard; Dalrymple, Jamie; Driscoll, Richard; Sleet, Sarah; Smith, Jonathan Blanchard

    2009-01-01

    Background Although gastrointestinal disorders are common in general practice, clinical guidelines are not always implemented, and few patient-generated quality criteria are available to guide management. Aim To develop quality criteria for the management of four common gastrointestinal disorders: coeliac disease, gastro-oesophageal reflux disease (GORD), inflammatory bowel disease, and irritable bowel syndrome. Design of study Qualitative study including thematic analysis of transcripts from patient focus groups and content analysis of published clinical practice guidelines. Emergent themes were synthesised by a consensus panel, into quality criteria for each condition. Setting Community-based practice in England, UK. Methods Fourteen focus groups were conducted (four for coeliac disease, irritable bowel syndrome, and inflammatory bowel disease, and two for GORD) involving a total of 93 patients (64 females, 29 males; mean age 55.4 years). Quality criteria were based on patients' views and expectations, synthesised with an analysis of clinical practice guidelines. Results A chronic disease management model was developed for each condition. Key themes included improving the timeliness and accuracy of diagnosis, appropriate use of investigations, better provision of information for patients, including access to patient organisations, better communication with, and access to, secondary care providers, and structured follow-up and regular review, particularly for coeliac disease and inflammatory bowel disease. Conclusion This study provides a model for the development of quality markers for chronic disease management in gastroenterology, which is likely to be applicable to other chronic conditions. PMID:19520018

  9. The drainage information and control system of smart city

    NASA Astrophysics Data System (ADS)

    Mao, Tonglei; Li, Lei; Liu, JiChang; Cheng, Liang; Zhang, Jing; Song, Zengzhong; Liu, Lianhai; Hu, Zichen

    2018-03-01

    At present, due to the continuous expansion of city and the increase of the municipal drainage facilities, which leads to a serious lack of management and operation personnel, the existing production management pattern already can't adapt to the new requirements. In this paper, according to river drainage management, flood control, water management, auditing, administrative license, etc. different business management requirement, an information management system for water planning and design of smart city based on WebGIS in Linyi was introduced, which can collect the various information of gate dam, water pump, bridge sensor and traffic guide terminal nodes etc. together. The practical application show that the system can not only implement the sharing, resources integration and collaborative application for the regional water information, but also improve the level of the integrated water management.

  10. 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.

  11. Ideology and wildlands management: The case of Rondeau Provincial Park, Ontario

    NASA Astrophysics Data System (ADS)

    Mann, D. L.; Nelson, J. G.

    1980-03-01

    This is a critical examination of some of the basic concepts that have guided management of parks and related reserves, often termed wildlands. Study is focussed on Rondeau Provincial Park, Ontario, and on concepts such as wilderness, primeval forest, and the Carolinian forest. Deer culling and other management policies and practices have been based upon the idea that the highly valued sassafras, tulip, and other species of the Carolinian forest are decreasing due to browsing. Field mapping and analysis of historic vegetation records indicate that this trend is not in fact occurring. Historic research also reveals difficulties in defining the Carolinian or other perceived types of forest for management purposes. A major reassessment of ideology and management policy and practice seem to be required in Rondeau and other wildlands. Vague or general concepts such as wilderness or preservation should be strongly complemented and supported by more precise statements of objectives, a learning attitude, and experimentation and research. As a result of the technical uncertainties and value judgments frequently involved, management should also be based upon the expressed preferences and continuing involvement of citizens.

  12. Implementing chronic care for COPD: planned visits, care coordination, and patient empowerment for improved outcomes.

    PubMed

    Fromer, Len

    2011-01-01

    Current primary care patterns for chronic obstructive pulmonary disease (COPD) focus on reactive care for acute exacerbations, often neglecting ongoing COPD management to the detriment of patient experience and outcomes. Proactive diagnosis and ongoing multifactorial COPD management, comprising smoking cessation, influenza and pneumonia vaccinations, pulmonary rehabilitation, and symptomatic and maintenance pharmacotherapy according to severity, can significantly improve a patient's health-related quality of life, reduce exacerbations and their consequences, and alleviate the functional, utilization, and financial burden of COPD. Redesign of primary care according to principles of the chronic care model, which is implemented in the patient-centered medical home, can shift COPD management from acute rescue to proactive maintenance. The chronic care model and patient-centered medical home combine delivery system redesign, clinical information systems, decision support, and self-management support within a practice, linked with health care organization and community resources beyond the practice. COPD care programs implementing two or more chronic care model components effectively reduce emergency room and inpatient utilization. This review guides primary care practices in improving COPD care workflows, highlighting the contributions of multidisciplinary collaborative team care, care coordination, and patient engagement. Each primary care practice can devise a COPD care workflow addressing risk awareness, spirometric diagnosis, guideline-based treatment and rehabilitation, and self-management support, to improve patient outcomes in COPD.

  13. Research and organizational issues for the implementation of family work in community psychiatric services.

    PubMed

    Jones, Adrian; Scannell, Tony

    2002-04-01

    The need for evidence-based practice (EBP) to guide and develop mental health services remains fundamental for modern services. Aim. To discuss issues that impact upon implementation of EBP and practice development using family work (FW) as an example. A selection of the FW literature was reviewed drawing on sources including the Cochrane Library, Cinahl and Medline. Keywords used were FW, community mental health team and research design. Centralized policy initiatives and guidelines that are themselves guided by evidence of randomized controlled trials predominantly risk alienating practitioners and clients/carers. Family work has some demonstrable clinical benefits although models differ and the active therapeutic agent remains unclear. Its adoption into routine care is also hindered by a productivity management outlook that seeks to maximize stretched resources and whose values are likely to be internalized by practitioners. The dichotomous position of previous research and practice development make implementation of EBP difficult and highlights the need for strategic planning that embraces both factors. The current drive to increase EBP requires a bi-directional process of influence that allows individual practitioners and clients/carers to become producers of evidence and not simply recipients. The authors support wider adoption of case study research designs to reflect the unpredictable nature of mental health care. Adoption of assertive community treatment models within community services is most likely to promote the excellence management model and accommodate EBP such as FW.

  14. Too Safe for Their Own Good? Helping Children Learn about Risk and Lifeskills.

    ERIC Educational Resources Information Center

    Lindon, Jennie

    Because young children have a limited understanding of risks that surround them, many adults try to create a risk-free environment for them. Suggesting that this strategy may leave children without the skills to manage risk and may make it difficult for them to judge situations for themselves, this book provides a practical guide showing adults…

  15. Perinatal Depression Algorithm: A Home Visitor Step-by-Step Guide for Advanced Management of Perinatal Depressive Symptoms

    ERIC Educational Resources Information Center

    Laszewski, Audrey; Wichman, Christina L.; Doering, Jennifer J.; Maletta, Kristyn; Hammel, Jennifer

    2016-01-01

    Early childhood professionals do many things to support young families. This is true now more than ever, as researchers continue to discover the long-term benefits of early, healthy, nurturing relationships. This article provides an overview of the development of an advanced practice perinatal depression algorithm created as a step-by-step guide…

  16. Strategic Planning in Higher Education: An Examination of Variation in Strategic Planning Practices and Their Effect on Success in NCAA Division I Athletic Departments

    ERIC Educational Resources Information Center

    Starsia, Gerald

    2010-01-01

    Higher education and intercollegiate athletics are operating in an era of heightened competition and diminishing resources. As these organizations increase in complexity, the need for highly professional staff and management strategies becomes critical. The theoretical framework guiding this research was generated from the literature in…

  17. Endoscopic ampullectomy: a practical guide

    PubMed Central

    Bassan, Milan

    2012-01-01

    Endoscopic ampullectomy is a minimally invasive method of treating superficial lesions of the ampulla of Vater. With careful patient selection and lesion assessment it is a safe and efficacious therapeutic procedure that can obviate the need for potentially major surgical intervention. Strategies for safe and successful endoscopic ampullectomy with a focus on resection technique and recognition and management of complications are presented. PMID:22586547

  18. Examining Data Driven Decision Making via Formative Assessment: A Confluence of Technology, Data Interpretation Heuristics and Curricular Policy

    ERIC Educational Resources Information Center

    Swan, Gerry; Mazur, Joan

    2011-01-01

    Although the term data-driven decision making (DDDM) is relatively new (Moss, 2007), the underlying concept of DDDM is not. For example, the practices of formative assessment and computer-managed instruction have historically involved the use of student performance data to guide what happens next in the instructional sequence (Morrison, Kemp, &…

  19. Gangs: Straight Talk, Straight Up. A Practical Guide for Teachers, Parents, and the Community.

    ERIC Educational Resources Information Center

    Jensen, Mary M.; Yerington, Philip C.

    This book is written about youth gangs with the aim of educating teachers and administrators, parents, and others who work with youth. The main emphasis is on gang identifiers and positive behavior management strategies and crisis intervention techniques that can be used in schools and the home. Section 1, "Youth Gangs Past and Present," provides…

  20. Managing Your Mathematics Program: A Total System. A Guide to the U-SAIL Basic Mathematics System.

    ERIC Educational Resources Information Center

    Hales, Carma M.; Jones, Maurine E.

    The Utah System Approach to Individual Learning (U-SAIL) Mathematics System was developed to make it possible for teachers to provide excellence in arithmetic instruction. It is based on the premise that in order to teach arithmetic well, teachers must accurately assess, teach directly, provide students with focused practice, corrective feedback,…

  1. Principals' Perspectives on How Transformational, Instructional, and Managerial Leadership Practices Influence Teacher Effectiveness and Student Achievement

    ERIC Educational Resources Information Center

    Fernandez, Julie A.

    2012-01-01

    In the context of a global school reform movement, defining the extent of a principal's influence on teacher effectiveness and student achievement is essential. A principal must be more than a manager, but also a transformational and an instructional leader. This concurrent mix methods study incorporated guided interviews and an online survey…

  2. A Clinical Practice Guideline to Guide a System Approach to Diabetes Care in Hong Kong

    PubMed Central

    2017-01-01

    The Hospital Authority of Hong Kong is a statutory body that manages all the public medical care institutions in Hong Kong. There are currently around 400,000 diabetic patients under its care at 17 hospitals (providing secondary care for 40%) and 73 General Outpatient Clinics (providing primary care for 60%). The patient population has been growing at 6% to 8% per year over the past 5 years, estimated to include over 95% of all diagnosed patients in Hong Kong. In order to provide equitable and a minimal level of care within resources and local system factors constraints, a Clinical Practice Guideline on the management of type 2 diabetes mellitus was drawn in 2013 to guide a system approach to providing diabetes care. There is an algorithm for the use of various hypoglycemic agents. An organizational drug formulary governs that less expansive options have to be used first. A number of clinical care and patient empowerment programs have been set up to support structured and systematic diabetes care. With such a system approach, there have been overall improvements in diabetes care with the percentage of patients with glycosylated hemoglobin <7% rising from 40% in 2010 to 52% in 2015. PMID:28447435

  3. Collaborating to embrace evidence-informed management practices within Canada's health system.

    PubMed

    Strelioff, Wayne; Lavoie-Tremblay, Mélanie; Barton, Melissa

    2007-01-01

    In late 2005, 11 major national health organizations decided to work together to build healthier workplaces for healthcare providers. To do so, they created a pan-Canadian collaborative of 45 experts and asked them to develop an action strategy to improve healthcare workplaces. One of the first steps taken by members of the collaborative was to adopt the following shared belief statements to guide their thinking: "We believe it is unacceptable to fund, govern, manage, work in or receive care in an unhealthy health workplace," and, "A fundamental way to better healthcare is through healthier healthcare workplaces. This commentary provides an overview of the Quality Worklife-Quality Healthcare Collaborative action strategy. This strategy embraces the thinking set out by the lead papers in a recent Special Issue of Healthcare Papers (www.Longwoods.com/special_issues.php) focused on developing healthy workplaces for healthcare workers, and brings to Life evidence-informed management practices.

  4. Collaborating to embrace evidence-informed management practices within Canada's health system.

    PubMed

    Strelioff, Wayne; Lavoie-Tremblay, Mélanie; Barton, Melissa

    2007-01-01

    In late 2005, 11 major national health organizations decided to work together to build healthier workplaces for healthcare providers. To do so, they created a pan-Canadian collaborative of 45 experts and asked them to develop an action strategy to improve healthcare workplaces. One of the first steps taken by members of the collaborative was to adopt the following shared belief statements to guide their thinking: "We believe it is unacceptable to fund, govern, manage, work in or receive care in an unhealthy health workplace," and, "A fundamental way to better healthcare is through healthier healthcare workplaces." This commentary provides an overview of the Quality Worklife-Quality Healthcare Collaborative action strategy. This strategy embraces the thinking set out by the lead papers (by Shamian and El-Jardali and by Clements, Dault and Priest) and brings to life evidence-informed management practices.

  5. What is the role of procedural justice in civil commitment?

    PubMed

    McKenna, B G; Simpson, A I; Coverdale, J H

    2000-08-01

    To determine best practice management strategies in the clinical application of civil commitment. All relevant literature on the topics of 'civil commitment', 'coercion' and 'procedural justice' were located on MEDLINE and PsychLIT databases and reviewed. Literature on the use of Ulysses contracts and advance directives in mental health treatment was integrated into the findings. Best practice evidence that guides management strategies is limited to the time of enactment of civil commitment. Management strategies involve enhancing the principles of procedural justice as a means of limiting negative patient perception of commitment. In the absence of evidence-based research beyond this point of enactment, grounds for the application of the principles of procedural justice are supported by reference to ethical considerations. Ulysses contracts provide an additional method for strengthening procedural justice. Procedural justice principles should be routinely applied throughout the processes of civil commitment in order to enhance longer term therapeutic outcomes and to blunt paternalism.

  6. Monoclonal gammopathy of undetermined significance (MGUS) and smoldering myeloma (SMM): a practical guide to management.

    PubMed

    Maciocia, Nicola; Wechalekar, Ashutosh; Yong, Kwee

    2017-12-01

    Monoclonal gammopathy of undetermined significance and smoldering multiple myeloma are precursor conditions of symptomatic multiple myeloma (MM). Diagnostic principles are aimed at excluding MM requiring therapy, other conditions associated with paraproteins that may require different management, and risk stratifying patients for the purposes of tailored follow-up and investigation. The International Myeloma Working Group have recently published a revised definition of MM, which singles out a small group of patients with smoldering multiple myeloma who are at very high risk of progression and organ damage; such patients are now included under the definition of MM and recommended to start anti-myeloma treatment. Furthermore, the recently published National Institute of Health and Care Excellence guideline recommends cross-sectional imaging techniques in place of skeletal survey. These recent recommendations are discussed, and practical guidance for investigation and management are presented. Copyright © 2016 John Wiley & Sons, Ltd.

  7. Portfolio management in early stage drug discovery - a traveler's guide through uncharted territory.

    PubMed

    Betz, Ulrich A K

    2011-07-01

    Portfolio management in drug development has become a best practice in the pharmaceutical industry. By contrast, early on in the value chain - the discovery phase - portfolio management is still in its infancy. Nevertheless, owing to the attrition of R&D projects from phase to phase and the cost of capital involved, these early phases of drug discovery play a significant part for the overall cost of bringing new, innovative drugs to the market. This paper describes various approaches to manage a portfolio of projects in early-stage drug discovery and provides crucial factors that determine the success of such an approach. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Can formal collaborative methodologies improve quality in primary health care in New Zealand? Insights from the EQUIPPED Auckland Collaborative.

    PubMed

    Palmer, Celia; Bycroft, Janine; Healey, Kate; Field, Adrian; Ghafel, Mazin

    2012-12-01

    Auckland District Health Board was one of four District Health Boards to trial the Breakthrough Series (BTS) methodology to improve the management of long-term conditions in New Zealand, with support from the Ministry of Health. To improve clinical outcomes, facilitate planned care and promote quality improvement within participating practices in Auckland. Implementation of the Collaborative followed the improvement model / Institute for Healthcare Improvement methodology. Three topic areas were selected: system redesign, cardio-vascular disease/diabetes, and self-management support. An expert advisory group and the Improvement Foundation Australia helped guide project development and implementation. Primary Health Organisation facilitators were trained in the methodology and 15 practice teams participated in the three learning workshops and action periods over 12 months. An independent evaluation study using both quantitative and qualitative methods was conducted. Improvements were recorded in cardiovascular disease risk assessment, practice-level systems of care, self-management systems and follow-up and coordination for patients. Qualitative research found improvements in coordination and teamwork, knowledge of practice populations and understanding of managing long-term conditions. The Collaborative process delivered some real improvements in the systems of care for people with long-term conditions and a change in culture among participating practices. The findings suggest that by strengthening facilitation processes, improving access to comprehensive population audit tools and lengthening the time frame, the process has the potential to make significant improvements in practice. Other organisations should consider this approach when investigating quality improvement programmes.

  9. Structured data quality reports to improve EHR data quality.

    PubMed

    Taggart, Jane; Liaw, Siaw-Teng; Yu, Hairong

    2015-12-01

    To examine whether a structured data quality report (SDQR) and feedback sessions with practice principals and managers improve the quality of routinely collected data in EHRs. The intervention was conducted in four general practices participating in the Fairfield neighborhood electronic Practice Based Research Network (ePBRN). Data were extracted from their clinical information systems and summarised as a SDQR to guide feedback to practice principals and managers at 0, 4, 8 and 12 months. Data quality (DQ) metrics included completeness, correctness, consistency and duplication of patient records. Information on data recording practices, data quality improvement, and utility of SDQRs was collected at the feedback sessions at the practices. The main outcome measure was change in the recording of clinical information and level of meeting Royal Australian College of General Practice (RACGP) targets. Birth date was 100% and gender 99% complete at baseline and maintained. DQ of all variables measured improved significantly (p<0.01) over 12 months, but was not sufficient to comply with RACGP standards. Improvement was greatest with allergies. There was no significant change in duplicate records. SDQRs and feedback sessions support general practitioners and practice managers to focus on improving the recording of patient information. However, improved practice DQ, was not sufficient to meet RACGP targets. Randomised controlled studies are required to evaluate strategies to improve data quality and any associated improved safety and quality of care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Putting Safety in the Frame: Nurses' Sensemaking at Work.

    PubMed

    O'Keeffe, Valerie Jean; Thompson, Kirrilly Rebecca; Tuckey, Michelle Rae; Blewett, Verna Lesley

    2015-01-01

    Current patient safety policy focuses nursing on patient care goals, often overriding nurses' safety. Without understanding how nurses construct work health and safety (WHS), patient and nurse safety cannot be reconciled. Using ethnography, we examine social contexts of safety, studying 72 nurses across five Australian hospitals making decisions during patient encounters. In enacting safe practice, nurses used "frames" built from their contextual experiences to guide their behavior. Frames are produced by nurses, and they structure how nurses make sense of their work. Using thematic analysis, we identify four frames that inform nurses' decisions about WHS: (a) communicating builds knowledge, (b) experiencing situations guides decisions, (c) adapting procedures streamlines work, and (d) team working promotes safe working. Nurses' frames question current policy and practice by challenging how nurses' safety is positioned relative to patient safety. Recognizing these frames can assist the design and implementation of effective WHS management.

  11. Putting Safety in the Frame

    PubMed Central

    O’Keeffe, Valerie Jean; Thompson, Kirrilly Rebecca; Tuckey, Michelle Rae; Blewett, Verna Lesley

    2015-01-01

    Current patient safety policy focuses nursing on patient care goals, often overriding nurses’ safety. Without understanding how nurses construct work health and safety (WHS), patient and nurse safety cannot be reconciled. Using ethnography, we examine social contexts of safety, studying 72 nurses across five Australian hospitals making decisions during patient encounters. In enacting safe practice, nurses used “frames” built from their contextual experiences to guide their behavior. Frames are produced by nurses, and they structure how nurses make sense of their work. Using thematic analysis, we identify four frames that inform nurses’ decisions about WHS: (a) communicating builds knowledge, (b) experiencing situations guides decisions, (c) adapting procedures streamlines work, and (d) team working promotes safe working. Nurses’ frames question current policy and practice by challenging how nurses’ safety is positioned relative to patient safety. Recognizing these frames can assist the design and implementation of effective WHS management. PMID:28462311

  12. Perioperative Pain Management in Total Hip Arthroplasty: Korean Hip Society Guidelines

    PubMed Central

    Kim, Yeesuk; Cho, Hong-Man; Park, Kyung-Soon; Yoon, Pil Whan; Nho, Jae-Hwi; Kim, Sang-Min; Lee, Kyung-Jae; Moon, Kyong-Ho

    2016-01-01

    Effective perioperative pain management techniques and accelerated rehabilitation programs can improve health-related quality of life and functional status of patients after total hip arthroplasty. Traditionally, postoperative analgesia following arthroplasty was provided by intravenous patient-controlled analgesia or epidural analgesia. Recently, peripheral nerve blockade has emerged alternative analgesic approach. Multimodal analgesia strategy combines analgesics with different mechanisms of action to improve pain management. Intraoperative periarticular injection of multimodal drugs is one of the most important procedures in perioperative pain control for total hip arthroplasty. The goal of this review article is to provide a concise overview of the principles of multimodal pain management regimens as a practical guide for the perioperative pain management for total hip arthroplasty. PMID:27536639

  13. Planning Guide to Statewide Implementation, Scale-Up, and Sustainability of Recommended Practices. RP[superscript 2]: Reaching Potentials through Recommended Practices

    ERIC Educational Resources Information Center

    Smith, Barbara J.; Fox, Lise; Dunlap, Glen; Strain, Phil; Trivette, Carol M.; Perez Binder, Denise; Bovey, Ted; McCullough, Katy; Blase, Karen

    2015-01-01

    This document is a guide for implementing widespread use of evidence-based practices for improving the outcomes for young children with or at-risk for delays or disabilities and their families. The evidence-based practices are selected practices from the Division for Early Childhood (DEC) Recommended Practices (RPs). The guide is written for…

  14. [Practical implementation of a quality management system in a radiological department].

    PubMed

    Huber, S; Zech, C J

    2011-10-01

    This article describes the architecture of a project aiming to implement a DIN EN ISO 9001 quality management system in a radiological department. It is intended to be a practical guide to demonstrate each step of the project leading to certification of the system. In a planning phase resources for the implementation of the project have to be identified and a quality management (QM) group as core team has to be formed. In the first project phase all available documents have to be checked and compiled in the QM manual. Moreover all relevant processes of the department have to be described in so-called process descriptions. In a second step responsibilities for the project are identified. Customer and employee surveys have to be carried out and a nonconformity management system has to be implemented. In this phase internal audits are also needed to check the new QM system, which is finally tested in the external certification audit with reference to its conformity with the standards.

  15. Comprehensive Guide for Middle School Programs. Instructor's Guide.

    ERIC Educational Resources Information Center

    Hansen, Joan

    This instructor's guide contains materials for use in teaching a middle school exploratory home economics course. Addressed in the individual units of the guide are the following topics: nutrition education and food management, parenting education, resource management, clothing management, and personal management. Each section contains a unit…

  16. Surgery for ventricular tachycardia in patients undergoing surgical ventricular restoration: the Karolinska approach.

    PubMed

    Sartipy, Ulrik; Albåge, Anders; Insulander, Per; Lindblom, Dan

    2007-09-01

    This article presents a review on the efficacy of surgical ventricular restoration and direct surgery for ventricular tachycardia in patients with left ventricular aneurysm or dilated ischemic cardiomyopathy. The procedure includes a non-electrophysiologically guided subtotal endocardiectomy and cryoablation in addition to endoventricular patch plasty of the left ventricle. Coronary artery bypass surgery and mitral valve repair are performed concomitantly as needed. In our experience, this procedure yielded a 90% success rate in terms of freedom from spontaneous ventricular tachycardia, with an early mortality rate of 3.8%. A practical guide to the pre- and postoperative management of these patients is provided.

  17. Embracing technology? Using change management strategies to improve the use of continuous lateral rotation therapy.

    PubMed

    Cybulski, Pamela; Zantinge, Johanna; Abbott-McNeil, Deanna

    2006-01-01

    The purpose of this quality improvement initiative was to improve the utilization of continuous lateral rotation therapy (CLRT) in a nine-bed community hospital ICU within the context of a nurse-driven protocol. Nursing focus groups, analyzed using a strength, weakness, opportunity, threat (SWOT) approach, resulted in the implementation of four interventions over seven weeks. Change management strategies guided all aspects of the project. Results showed a modest increase in the utilization of CLRT. This initiative demonstrates that change management strategies may assist with the incorporation of technology into nursing practice by increasing empowerment and creating an attachment to and responsibility for outcomes.

  18. Late-life dementia. Review of the APA guidelines for patient management.

    PubMed

    Schindler, R J; Cucio, C P

    2000-10-01

    Management of dementia in older patients requires an individualized and multimodal approach that involves use of psychiatric, psychotherapeutic, psychosocial, and somatic tools and treatments, in addition to patient and family education. The progressive nature of dementia and the invariable presence of comorbidity complicates the management task, although symptoms characteristic of dementia's phases can provide helpful clinical clues to guide evolving care. In 1997, the American Psychiatric Association published the "Practice guideline for the treatment of patients with Alzheimer's disease and other dementias of late life." To date, this is the most comprehensive clinical guideline available to physicians caring for patients with Alzheimer's disease and other related dementias.

  19. 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).

  20. Developing a new hybrid revascularization program: a road map for hospital managers and physician leaders.

    PubMed

    Harjai, Kishore J; Samy, Sanjay; Pennypacker, Barbara; Onofre, Bonnie; Stanfield, Pamela; Yaeger, Lynne; Stapleton, Dwight; Esrig, Barry C

    2012-12-01

    Hybrid coronary revascularization, which involves minimally invasive direct coronary artery bypass surgery using the left internal mammary artery to left anterior descending and percutaneous coronary intervention using drug-eluting stents for the remaining diseased coronary vessels, is an innovative approach to decrease the morbidity of conventional surgery. Little information is available to guide hospital managers and physician leaders in implementing a hybrid revascularization program. In this article, we describe the people-process-technology issues that managers and leaders are likely to encounter as they develop a hybrid revascularization program in their practice. ©2012, Wiley Periodicals, Inc.

  1. Implementation of customized health information technology in diabetes self management programs.

    PubMed

    Alexander, Susan; Frith, Karen H; O'Keefe, Louise; Hennigan, Michael A

    2011-01-01

    The project was a nurse-led implementation of a software application, designed to combine clinical and demographic records for a diabetes education program, which would result in secure, long-term record storage. Clinical information systems may be prohibitively expensive for small practices and require extensive training for implementation. A review of the literature suggests that the use of simple, practice-based registries offer an economical method of monitoring the outcomes of diabetic patients. The database was designed using a common software application, Microsoft Access. The theory used to guide implementation and staff training was Rogers' Diffusion of Innovations theory (1995). Outcomes after a 3-month period included incorporation of 100% of new clinical and demographic patient records into the database and positive changes in staff attitudes regarding software applications used in diabetes self-management training. These objectives were met while keeping project costs under budgeted amounts. As a function of the clinical nurse specialist (CNS) researcher role, there is a need for CNSs to identify innovative and economical methods of data collection. The success of this nurse-led project reinforces suggestions in the literature for less costly methods of data maintenance in small practice settings. Ongoing utilization and enhancement have resulted in the creation of a robust database that could aid in the research of multiple clinical issues. Clinical nurse specialists can use existing evidence to guide and improve both their own practice and outcomes for patients and organizations. Further research regarding specific factors that predict efficient transition of informatics applications, how these factors vary according to practice settings, and the role of the CNS in implementation of such applications is needed.

  2. Comparative-Effectiveness of Simulation-Based Deliberate Practice Versus Self-Guided Practice on Resident Anesthesiologists' Acquisition of Ultrasound-Guided Regional Anesthesia Skills.

    PubMed

    Udani, Ankeet Deepak; Harrison, T Kyle; Mariano, Edward R; Derby, Ryan; Kan, Jack; Ganaway, Toni; Shum, Cynthia; Gaba, David M; Tanaka, Pedro; Kou, Alex; Howard, Steven K

    2016-01-01

    Simulation-based education strategies to teach regional anesthesia have been described, but their efficacy largely has been assumed. We designed this study to determine whether residents trained using the simulation-based strategy of deliberate practice show greater improvement of ultrasound-guided regional anesthesia (UGRA) skills than residents trained using self-guided practice in simulation. Anesthesiology residents new to UGRA were randomized to participate in either simulation-based deliberate practice (intervention) or self-guided practice (control). Participants were recorded and assessed while performing simulated peripheral nerve blocks at baseline, immediately after the experimental condition, and 3 months after enrollment. Subject performance was scored from video by 2 blinded reviewers using a composite tool. The amount of time each participant spent in deliberate or self-guided practice was recorded. Twenty-eight participants completed the study. Both groups showed within-group improvement from baseline scores immediately after the curriculum and 3 months following study enrollment. There was no difference between groups in changed composite scores immediately after the curriculum (P = 0.461) and 3 months following study enrollment (P = 0.927) from baseline. The average time in minutes that subjects spent in simulation practice was 6.8 minutes for the control group compared with 48.5 minutes for the intervention group (P < 0.001). In this comparative effectiveness study, there was no difference in acquisition and retention of skills in UGRA for novice residents taught by either simulation-based deliberate practice or self-guided practice. Both methods increased skill from baseline; however, self-guided practice required less time and faculty resources.

  3. District health manager and mid-level provider perceptions of practice environments in acute obstetric settings in Tanzania: a mixed-method study.

    PubMed

    Ng'ang'a, Njoki; Byrne, Mary Woods; Kruk, Margaret E; Shemdoe, Aloisia; de Pinho, Helen

    2016-08-08

    In sub-Saharan Africa, the capacity of human resources for health (HRH) managers to create positive practice environments that enable motivated, productive, and high-performing HRH is weak. We implemented a unique approach to examining HRH management practices by comparing perspectives offered by mid-level providers (MLPs) of emergency obstetric care (EmOC) in Tanzania to those presented by local health authorities, known as council health management teams (CHMTs). This study was guided by the basic strategic human resources management (SHRM) component model. A convergent mixed-method design was utilized to assess qualitative and quantitative data from the Health Systems Strengthening for Equity: The Power and Potential of Mid-Level Providers project. Survey data was obtained from 837 mid-level providers, 83 of whom participated in a critical incident interview whose aim was to elicit negative events in the practice environment that induced intention to leave their job. HRH management practices were assessed quantitatively in 48 districts with 37 members of CHMTs participating in semi-structured interviews. The eight human resources management practices enumerated in the basic SHRM component model were implemented unevenly. On the one hand, members of CHMTs and mid-level providers agreed that there were severe shortages of health workers, deficient salaries, and an overwhelming workload. On the other hand, members of CHMTs and mid-level providers differed in their perspectives on rewards and allocation of opportunities for in-service training. Although written standards of performance and supervision requirements were available in most districts, they did not reflect actual duties. Members of CHMTs reported high levels of autonomy in key HRH management practices, but mid-level providers disputed the degree to which the real situation on the ground was factored into job-related decision-making by CHMTs. The incongruence in perspectives offered by members of CHMTs and mid-level providers points to deficient HRH management practices, which contribute to poor practice environments in acute obstetric settings in Tanzania. Our findings indicate that members of CHMTs require additional support to adequately fulfill their HRH management role. Further research conducted in low-income countries is necessary to determine the appropriate package of interventions required to strengthen the capacity of members of CHMTs.

  4. FGMReview: design of a knowledge management tool on female genital mutilation.

    PubMed

    Martínez Pérez, Guillermo; Turetsky, Risa

    2015-11-01

    Web-based literature search engines may not be user-friendly for some readers searching for information on female genital mutilation. This is a traditional practice that has no health benefits, and about 140 million girls and women worldwide have undergone it. In 2012, the website FGMReview was created with the aim to offer a user-friendly, accessible, scalable, and innovative knowledge management tool specialized in female genital mutilation. The design of this website was guided by a conceptual model based on the use of benchmarking techniques and requirements engineering, an area of knowledge from the computer informatics field, influenced by the Transcultural Nursing model. The purpose of this article is to describe this conceptual model. Nurses and other health care providers can use this conceptual model to guide their methodological approach to design and launch other eHealth projects. © The Author(s) 2014.

  5. How guiding coalitions promote positive culture change in hospitals: a longitudinal mixed methods interventional study.

    PubMed

    Bradley, Elizabeth H; Brewster, Amanda L; McNatt, Zahirah; Linnander, Erika L; Cherlin, Emily; Fosburgh, Heather; Ting, Henry H; Curry, Leslie A

    2018-03-01

    Quality collaboratives are widely endorsed as a potentially effective method for translating and spreading best practices for acute myocardial infarction (AMI) care. Nevertheless, hospital success in improving performance through participation in collaboratives varies markedly. We sought to understand what distinguished hospitals that succeeded in shifting culture and reducing 30-day risk-standardised mortality rate (RSMR) after AMI through their participation in the Leadership Saves Lives (LSL) collaborative. We conducted a longitudinal, mixed methods intervention study of 10 hospitals over a 2-year period; data included surveys of 223 individuals (response rates 83%-94% depending on wave) and 393 in-depth interviews with clinical and management staff most engaged with the LSL intervention in the 10 hospitals. We measured change in culture and RSMR, and key aspects of working related to team membership, turnover, level of participation and approaches to conflict management. The six hospitals that experienced substantial culture change and greater reductions in RSMR demonstrated distinctions in: (1) effective inclusion of staff from different disciplines and levels in the organisational hierarchy in the team guiding improvement efforts (referred to as the 'guiding coalition' in each hospital); (2) authentic participation in the work of the guiding coalition; and (3) distinct patterns of managing conflict. Guiding coalition size and turnover were not associated with success (p values>0.05). In the six hospitals that experienced substantial positive culture change, staff indicated that the LSL learnings were already being applied to other improvement efforts. Hospitals that were most successful in a national quality collaborative to shift hospital culture and reduce RSMR showed distinct patterns in membership diversity, authentic participation and capacity for conflict management. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. How would case managers' practice change in a consumer-directed care environment in Australia?

    PubMed

    You, Emily Chuanmei; Dunt, David; Doyle, Colleen

    2017-01-01

    The aim of this study was to explore case managers' perceived changes in their practice in the future when consumer-directed care (CDC) is widely implemented in Australia's community aged care system. Purposeful sampling was used and semi-structured individual and group interviews were conducted between September 2012 and March 2013. Participants were drawn from a list of all case managers who administered publicly funded community aged care packages in Victoria, Australia. Empowerment theory was used to guide the analysis and interpretation of the data. The thematic analysis revealed that case managers had mixed views about CDC. They also perceived changes in case managers' practice in the future when CDC is widely implemented. These might specifically include: first, case managers would not directly manage clients' budgets. While some case managers were concerned about losing power for this change, others believed that they would still have important financial roles to perform, such as setting rules, providing financial support and monitoring clients' use of budgets. Second, case managers would focus on performing roles in providing information, and empowering, facilitating and educating clients. These would help to strengthen clients' capacities and assist them to self-manage their care. Third, case managers would work in partnership with clients through frequent or skilful communication, mutual goal setting and goal facilitation. Fourth, case managers would manage more clients. In addition, they would provide less support to each individual client and perform less care co-ordination role. The findings suggest case managers paying attention to power balance regarding budget management in a CDC environment. Furthermore, they might frequently or skilfully communicate with, empower, facilitate and educate clients; work together with them to set up goals; and facilitate them to achieve goals. New research using empowerment theory to examine the actual practice of case managers in a well-established CDC system is warranted. © 2015 John Wiley & Sons Ltd.

  7. 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

  8. 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.

  9. 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

  10. Strategies and methods for aligning current and best medical practices. The role of information technologies.

    PubMed

    Schneider, E C; Eisenberg, J M

    1998-05-01

    Rapid change in American medicine requires that physicians adjust established behaviors and acquire new skills. In this article, we address three questions: What do we know about how to change physicians' practices? How can physicians take advantage of new and evolving information technologies that are likely to have an impact on the future practice of medicine? and What strategic educational interventions will best enable physicians to show competencies in information management and readiness to change practice? We outline four guiding principles for incorporating information systems tools into both medical education and practice, and we make eight recommendations for the development of a new medical school curriculum. This curriculum will produce a future medical practitioner who is capable of using information technologies to systematically measure practice performance, appropriateness, and effectiveness while updating knowledge efficiently.

  11. Development and implementation of clinical algorithms in occupational health practice.

    PubMed

    Ghafur, Imran; Lalloo, Drushca; Macdonald, Ewan B; Menon, Manju

    2013-12-01

    Occupational health (OH) practice is framed by legal, ethical, and regulatory requirements. Integrating this information into daily practice can be a difficult task. We devised evidence-based framework standards of good practice that would aid clinical management, and assessed their impact. The clinical algorithm was the method deemed most appropriate to our needs. Using "the first OH consultation" as an example, the development, implementation, and evaluation of an algorithm is described. The first OH consultation algorithm was developed. Evaluation demonstrated an overall improvement in recording of information, specifically consent, recreational drug history, function, and review arrangements. Clinical algorithms can be a method for assimilating and succinctly presenting the various facets of OH practice, for use by all OH clinicians as a practical guide and as a way of improving quality in clinical record-keeping.

  12. [Teaching management disciplines in nursing education in Brazil: the experience of a group of teachers from the Federal University of Minas Gerais].

    PubMed

    Spagnol, Carla Aparecida; Villa, Eliana Aparecida; Dos Santos Pereira, Márcia; Velloso, Isabela Silva Câncio

    2015-01-20

    Nursing education in Brazil is based on the following principles that guide profession : assistance, management, education and research. These activities can not be developed separately as the intersection between them is an important factor to provide nursing care to the population with safety and quality. Even recognizing the importance of this articulation, in this study it is highlighted the professional managerial training. The aim of this paper is to describe the management disciplines teaching in the training of nurses from a critical and reflective analysis of a group of teachers from the Federal University of Minas Gerais, Brazil. The Brazilian Health Reform Movement and the implementation of the National Curriculum Guidelines have resulted in significant advances in teaching Nursing Management, considering that currently content and practical activities take place at different moments of nursing training. It is concluded that, in this new context, teachers have sought more contemporary theoretical references, which focus on a more participative manage in order to train competent professionals who have a more humane and ethical practice.

  13. Management Strategies for CLN2 Disease.

    PubMed

    Williams, Ruth E; Adams, Heather R; Blohm, Martin; Cohen-Pfeffer, Jessica L; de Los Reyes, Emily; Denecke, Jonas; Drago, Kristen; Fairhurst, Charlie; Frazier, Margie; Guelbert, Norberto; Kiss, Szilárd; Kofler, Annamaria; Lawson, John A; Lehwald, Lenora; Leung, Mary-Anne; Mikhaylova, Svetlana; Mink, Jonathan W; Nickel, Miriam; Shediac, Renée; Sims, Katherine; Specchio, Nicola; Topcu, Meral; von Löbbecke, Ina; West, Andrea; Zernikow, Boris; Schulz, Angela

    2017-04-01

    CLN2 disease (neuronal ceroid lipofuscinosis type 2) is a rare, autosomal recessive, pediatric-onset, rapidly progressive neurodegenerative lysosomal storage disorder caused by tripeptidyl peptidase 1 (TPP1) enzyme deficiency, and is characterized by language delay, seizures, rapid cognitive and motor decline, blindness, and early death. No management guidelines exist and there is a paucity of published disease-specific evidence to inform clinical practice, which currently draws upon experience from the field of childhood neurodisability. Twenty-four disease experts were surveyed on CLN2 disease management and a subset met to discuss current practice. Management goals and strategies are consistent among experts globally and are guided by the principles of pediatric palliative care. Goals and interventions evolve as the disease progresses, with a shift in focus from maintenance of function early in the disease to maintenance of quality of life. A multidisciplinary approach is critical for optimal patient care. This work represents an initial step toward the development of consensus-based management guidelines for CLN2 disease. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Assisting community management of groundwater: Irrigator attitudes in two watersheds in Rajasthan and Gujarat, India

    NASA Astrophysics Data System (ADS)

    Varua, M. E.; Ward, J.; Maheshwari, B.; Oza, S.; Purohit, R.; Hakimuddin; Chinnasamy, P.

    2016-06-01

    The absence of either state regulations or markets to coordinate the operation of individual wells has focussed attention on community level institutions as the primary loci for sustainable groundwater management in Rajasthan and Gujarat, India. The reported research relied on theoretical propositions that livelihood strategies, groundwater management and the propensity to cooperate are associated with the attitudinal orientations of well owners in the Meghraj and Dharta watersheds, located in Gujarat and Rajasthan respectively. The research tested the hypothesis that attitudes to groundwater management and farming practices, household income and trust levels of assisting agencies were not consistent across the watersheds, implying that a targeted approach, in contrast to default uniform programs, would assist communities craft rules to manage groundwater across multiple hydro-geological settings. Hierarchical cluster analysis of attitudes held by survey respondents revealed four statistically significant discrete clusters, supporting acceptance of the hypothesis. Further analyses revealed significant differences in farming practices, household wealth and willingness to adapt across the four groundwater management clusters. In conclusion, the need to account for attitudinal diversity is highlighted and a framework to guide the specific design of processes to assist communities craft coordinating instruments to sustainably manage local aquifers described.

  15. Asset management guide : focusing on the management of our transit investments.

    DOT National Transportation Integrated Search

    2012-10-01

    To advance transit asset management, this guide provides a transit-specific asset management framework for managing assets indi-vidually and as a portfolio of assets that comprise an integrated system. The guide provides flexible, yet targeted guidan...

  16. Foundational Skills to Support Reading for Understanding in Kindergarten through 3rd Grade. Educator's Practice Guide. NCEE 2016-4008

    ERIC Educational Resources Information Center

    Foorman, Barbara; Beyler, Nicholas; Borradaile, Kelley; Coyne, Michael; Denton, Carolyn A.; Dimino, Joseph; Furgeson, Joshua; Hayes, Lynda; Henke, Juliette; Justice, Laura; Keating, Betsy; Lewis, Warnick; Sattar, Samina; Streke, Andrei; Wagner, Richard; Wissel, Sarah

    2016-01-01

    The goal of this practice guide is to offer educators specific, evidence-based recommendations for teaching foundational reading skills to students in kindergarten through 3rd grade. This guide is a companion to the existing practice guide, "Improving Reading Comprehension in Kindergarten Through 3rd Grade", and as a set, these guides…

  17. Putting humans in ecology: consistency in science and management.

    PubMed

    Hobbs, Larry; Fowler, Charles W

    2008-03-01

    Normal and abnormal levels of human participation in ecosystems can be revealed through the use of macro-ecological patterns. Such patterns also provide consistent and objective guidance that will lead to achieving and maintaining ecosystem health and sustainability. This paper focuses on the consistency of this type of guidance and management. Such management, in sharp contrast to current management practices, ensures that our actions as individuals, institutions, political groups, societies, and as a species are applied consistently across all temporal, spatial, and organizational scales. This approach supplants management of today, where inconsistency results from debate, politics, and legal and religious polarity. Consistency is achieved when human endeavors are guided by natural patterns. Pattern-based management meets long-standing demands for enlightened management that requires humans to participate in complex systems in consistent and sustainable ways.

  18. Dental Care Every Day: A Caregiver's Guide. Practical Oral Care for People with Developmental Disabilities

    ERIC Educational Resources Information Center

    National Institute of Dental and Craniofacial Research (NIDCR), 2009

    2009-01-01

    Taking care of someone with a developmental disability requires patience and skill. As a caregiver, you know this as well as anyone does. You also know how challenging it is to help that person with dental care. It takes planning, time, and the ability to manage physical, mental, and behavioral problems. Dental care isn't always easy, but you can…

  19. Liability and Safety in Physical Education and Sport: A Practitioner's Guide to the Legal Aspects of Teaching and Coaching in Elementary and Secondary Schools.

    ERIC Educational Resources Information Center

    Hart, James E.; Ritson, Robert J.

    This second edition contains updated information and new case studies, offering guidance for safer programs and management of risk while reinforcing sound educational practices. The book features overviews of legal concepts and presents examples of situations from the trenches. Case studies illustrate a variety of teacher, coach, and administrator…

  20. Teaching with Emotional Intelligence: A Step-By-Step Guide for Higher and Further Education Professionals. 2nd Edition

    ERIC Educational Resources Information Center

    Mortiboys, Alan

    2011-01-01

    The way teachers shape and handle their own feelings and those of their learners is central to the success of learning. Now in its second edition, "Teaching with Emotional Intelligence" shows how to manage this influential yet neglected area of learning and teaching. This practical book looks at how lecturers and teachers can develop and use their…

  1. Soil C and N minimum detectable changes and treatment differences in a multi-treatment forest experiment.

    Treesearch

    P.S. Homann; B.T. Bormann; J.R. Boyle; R.L. Darbyshire; R. Bigley

    2008-01-01

    Detecting changes in forest soil C and N is vital to the study of global budgets and long-term ecosystem productivity. Identifying differences among land-use practices may guide future management. Our objective was to determine the relation of minimum detectable changes (MDCs) and minimum detectable differences between treatments (MDDs) to soil C and N variability at...

  2. A comprehensive guide to fuel management practices for dry mixed conifer forests in the northwestern United States: Prescribed fire

    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

    Fire has had a profound historical role in shaping dry mixed conifer forests in the western United States. However, the uncertainty and complexity of prescribed fires raises the question “Is fire always the best option for treating fuels?” The decision to use prescribed fire is dependent upon several factors.

  3. Best Management Practices (BMP) Monitoring Manual Field Guide: Implementation and Effectiveness for Protection of Water Resources

    Treesearch

    David Welsch; Roger Ryder; Tim Post

    2006-01-01

    The specific purpose of the BMP protocol is to create an economical, standardized, and repeatable BMP monitoring process that is completely automated, from data gathering through report generation, in order to provide measured data, ease of use, and compatibility with State BMP programs.The protocol was developed to meet the following needs:? Document the use and...

  4. Asset management guide : focusing on the management of our transit investments [updated November 2016].

    DOT National Transportation Integrated Search

    2016-11-01

    To advance transit asset management, this guide provides a transit-specific asset management framework for managing assets individually and as a portfolio of assets that comprise an integrated system. The guide provides flexible, yet targeted guidanc...

  5. Are Behavioural Interventions Doomed to Fail? Challenges to Self-Management Support in Chronic Diseases.

    PubMed

    Vallis, Michael

    2015-08-01

    Self-management and self-management support are concepts very familiar to those of us in diabetes care. These concepts require openness to understanding the behaviours of persons with diabetes broadly, not only behaviours restricted to the biomedical perspective. Understanding the importance of health behaviour change and working within the Expanded Chronic Care Model define the context within which self-management support should occur. The purpose of this perspective is to identify a potential limitation in existing self-management support initiatives. This potential limitation reflects provider issues, not patient issues; that is, true self-management support might require changes by healthcare providers. Specifically, although behavioural interventions within the context of academic research studies are evidence based, behaviour change interventions implemented in general practice settings might prove less effective unless healthcare providers are able to shift from a practice based on the biomedical model to a practice based on the self-management support model. The purpose of this article is to facilitate effective self-management support by encouraging providers to switch from a model of care based on the expert clinician encountering the uninformed help seeker (the biomedical model) to one guided by collaboration grounded in the principles of description, prediction and choice. Key to understanding the value of making this shift are patient-centered communication principles and the tenets of complexity theory. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  6. Ecological Engineering Practices for the Reduction of Excess Nitrogen in Human-Influenced Landscapes: A Guide for Watershed Managers

    NASA Astrophysics Data System (ADS)

    Passeport, Elodie; Vidon, Philippe; Forshay, Kenneth J.; Harris, Lora; Kaushal, Sujay S.; Kellogg, Dorothy Q.; Lazar, Julia; Mayer, Paul; Stander, Emilie K.

    2013-02-01

    Excess nitrogen (N) in freshwater systems, estuaries, and coastal areas has well-documented deleterious effects on ecosystems. Ecological engineering practices (EEPs) may be effective at decreasing nonpoint source N leaching to surface and groundwater. However, few studies have synthesized current knowledge about the functioning principles, performance, and cost of common EEPs used to mitigate N pollution at the watershed scale. Our review describes seven EEPs known to decrease N to help watershed managers select the most effective techniques from among the following approaches: advanced-treatment septic systems, low-impact development (LID) structures, permeable reactive barriers, treatment wetlands, riparian buffers, artificial lakes and reservoirs, and stream restoration. Our results show a broad range of N-removal effectiveness but suggest that all techniques could be optimized for N removal by promoting and sustaining conditions conducive to biological transformations (e.g., denitrification). Generally, N-removal efficiency is particularly affected by hydraulic residence time, organic carbon availability, and establishment of anaerobic conditions. There remains a critical need for systematic empirical studies documenting N-removal efficiency among EEPs and potential environmental and economic tradeoffs associated with the widespread use of these techniques. Under current trajectories of N inputs, land use, and climate change, ecological engineering alone may be insufficient to manage N in many watersheds, suggesting that N-pollution source prevention remains a critical need. Improved understanding of N-removal effectiveness and modeling efforts will be critical in building decision support tools to help guide the selection and application of best EEPs for N management.

  7. 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.

  8. The Chromosome 18 Clinical Resource Center.

    PubMed

    Cody, Jannine D; Hasi-Zogaj, Minire; Heard, Patricia; Hill, Annice; Rupert, David; Sebold, Courtney; Soileau, Bridgette; Hale, Daniel E

    2018-05-01

    The Chromosome 18 Clinical Research Center has created a pediatrician-friendly virtual resource center for managing patients with chromosome 18 abnormalities. To date, children with rare chromosome abnormalities have been cared for either symptomatically or palliatively as a reaction to the presenting medical problems. As we enter an era of genomic-informed medicine, we can provide children, even those with individually unique chromosome abnormalities, with proactive medical care and management based on the most contemporary data on their specific genomic change. It is problematic for practicing physicians to obtain and use the emerging data on specific genes because this information is derived from diverse sources (e.g., animal studies, case reports, in vitro explorations) and is often published in sources that are not easily accessible in the clinical setting. The Chromosome 18 Clinical Resource Center remedies this challenging problem by curating and synthesizing the data with clinical implications. The data are collected from our database of over 26 years of natural history and medical data from over 650 individuals with chromosome 18 abnormalities. The resulting management guides and video presentations are a first edition of this collated data specifically oriented to guide clinicians toward the optimization of care for each child. The chromosome 18 data and guides also serve as models for an approach to the management of any individual with a rare chromosome abnormality of which there are over 1,300 born every year in the US alone. © 2018 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals, Inc.

  9. Advanced Energy Retrofit Guide: Practical Ways to Improve Energy Performance, K-12 Schools (Book)

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

    Not Available

    The U.S. Department of Energy developed the Advanced Energy Retrofit Guides (AERGs) to provide specific methodologies, information, and guidance to help energy managers and other stakeholders plan and execute energy efficiency improvements. Detailed technical discussion is fairly limited. Instead, we emphasize actionable information, practical methodologies, diverse case studies, and unbiased evaluations of the most promising retrofit energy efficiency measures for each building type. A series of AERGs is under development, addressing key segments of the commercial building stock. K-12 schools were selected as one of the highest priority building sectors, because schools affect the lives of most Americans. They alsomore » represent approximately 8% of the energy use and 10% of the floor area in commercial buildings nationwide. U.S. K-12 school districts spend more than $8 billion each year on energy - more than they spend on computers and textbooks combined. Most occupy older buildings that often have poor operational performance - more than 30% of schools were built before 1960. The average age of a school is about 42 years - which is nearly the expected serviceable lifespan of the building. K-12 schools offer unique opportunities for deep, cost-effective energy efficiency improvements, and this guide provides convenient and practical guidance for exploiting these opportunities in the context of public, private, and parochial schools.« less

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

    PubMed

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

    2014-04-01

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

  11. Consensus statement on a framework for the management of comorbidity and extra-articular manifestations in rheumatoid arthritis.

    PubMed

    Loza, Estíbaliz; Lajas, Cristina; Andreu, Jose Luis; Balsa, Alejandro; González-Álvaro, Isidoro; Illera, Oscar; Jover, Juan Ángel; Mateo, Isabel; Orte, Javier; Rivera, Javier; Rodríguez Heredia, José Manuel; Romero, Fredeswinda; Martínez-López, Juan Antonio; Ortiz, Ana María; Toledano, Esther; Villaverde, Virginia; Carmona, Loreto; Castañeda, Santos

    2015-03-01

    The objective of the study was to develop evidence-based and practical recommendations for the detection and management of comorbidity in patients with rheumatoid arthritis (RA) in daily practice. We used a modified RAND/UCLA methodology and systematic review (SR). The process map and specific recommendations, based on the SR, were established in discussion groups. A two round Delphi survey permitted (1) to prioritize the recommendations, (2) to refine them, and (3) to evaluate their agreement by a large group of users. The recommendations cover: (1) which comorbidities should be investigated in clinical practice at the first and following visits (including treatments, risk factors and patient's features that might interfere with RA management); (2) how and when should comorbidities and risk factors be investigated; (3) how to manage specific comorbidities, related or non-related to RA, including major adverse events of RA treatment, and to promote health (general and musculoskeletal health); and (4) specific recommendations to assure an integral care approach for RA patients with any comorbidity, such as health care models for chronic inflammatory patients, early arthritis units, relationships with primary care, specialized nursing care, and self-management. These recommendations are intended to guide rheumatologists, patients, and other stakeholders, on the early diagnosis and management of comorbidity in RA, in order to improve disease outcomes.

  12. [Practical advices in choosing local anesthesia tools in dentistry. Management of carpule's quality in local anesthesia in dentistry].

    PubMed

    Kuzin, A V

    2014-01-01

    The equipment for local anesthesia is described in this article. Practical recommendations for the selection of the injection needle length, size, bevel type is given. Using dental needle for local anesthesia should be guided by the "one injection - one needle" rule, as a needle tends to deform by even the slightest contact with jawbone. Some of the shortcomings of carpule quality may be detected before use: signs of cup corrosion, the presence of sediment, air bubbles, rubber plunger disposition. In the case of such defects being identified all the package should not be used. The use of such carpule in clinical practice is unsafe.

  13. Chronic morbidities after traumatic brain injury: an update for the advanced practice nurse.

    PubMed

    Bay, Esther H; Chartier, Kattlynn S

    2014-06-01

    Emerging data suggest that traumatic brain injury (TBI) is a disease process with considerable long-range morbidities requiring lifelong monitoring and treatment. Multiple chronic morbidities develop across the life span after TBI, including mental health disorders, headaches, seizures, and neuroendocrine imbalances as well as chronic diseases. Still, there has been limited focus on effective guides and strategies for helping persons with TBI meet their chronic health needs as they live with the consequences of TBI. The advanced practice nurse is well positioned to participate collaboratively in practices that promote health screening and chronic disease management after TBI to ameliorate distress and enhance quality of life as persons with TBI live with lifelong consequences.

  14. Understanding effective care management implementation in primary care: a macrocognition perspective analysis.

    PubMed

    Holtrop, Jodi Summers; Potworowski, Georges; Fitzpatrick, Laurie; Kowalk, Amy; Green, Lee A

    2015-08-21

    Care management in primary care can be effective in helping patients with chronic disease improve their health status. Primary care practices, however, are often challenged with its implementation. Incorporating care management involves more than a simple physical process redesign to existing clinical care routines. It involves changes to who is working with patients, and consequently such things as who is making decisions, who is sharing patient information, and how. Studying the range of such changes in "knowledge work" during implementation requires a perspective and tools designed to do so. We used the macrocognition perspective, which is designed to understand how individuals think in dynamic, messy real-world environments such as care management implementation. To do so, we used cognitive task analysis to understand implementation in terms of such thinking as decision making, knowledge, and communication. Data collection involved semi-structured interviews and observations at baseline and at approximately 9 months into implementation at five practices in one physician-owned administratively connected group of practices in the state of Michigan, USA. Practices were intervention participants in a larger trial of chronic care model implementation. Data were transcribed, qualitatively coded and analyzed, initially using an editing approach and then a template approach with macrocognition as a guiding framework. Seventy-four interviews and five observations were completed. There were differences in implementation success across the practices, and these differences in implementation success were well explained by macrocognition. Practices that used more macrocognition functions and used them more often were also more successful in care management implementation. Although care management can introduce many new changes into the delivery of primary care clinical practice, implementing it successfully as a new complex intervention is possible. Macrocognition is a useful perspective for illuminating the elements that facilitate new complex interventions with a view to addressing them during implementation planning.

  15. An exploration of how clinician attitudes and beliefs influence the implementation of lifestyle risk factor management in primary healthcare: a grounded theory study

    PubMed Central

    Laws, Rachel A; Kemp, Lynn A; Harris, Mark F; Davies, Gawaine Powell; Williams, Anna M; Eames-Brown, Rosslyn

    2009-01-01

    Background Despite the effectiveness of brief lifestyle intervention delivered in primary healthcare (PHC), implementation in routine practice remains suboptimal. Beliefs and attitudes have been shown to be associated with risk factor management practices, but little is known about the process by which clinicians' perceptions shape implementation. This study aims to describe a theoretical model to understand how clinicians' perceptions shape the implementation of lifestyle risk factor management in routine practice. The implications of the model for enhancing practices will also be discussed. Methods The study analysed data collected as part of a larger feasibility project of risk factor management in three community health teams in New South Wales (NSW), Australia. This included journal notes kept through the implementation of the project, and interviews with 48 participants comprising 23 clinicians (including community nurses, allied health practitioners and an Aboriginal health worker), five managers, and two project officers. Data were analysed using grounded theory principles of open, focused, and theoretical coding and constant comparative techniques to construct a model grounded in the data. Results The model suggests that implementation reflects both clinician beliefs about whether they should (commitment) and can (capacity) address lifestyle issues. Commitment represents the priority placed on risk factor management and reflects beliefs about role responsibility congruence, client receptiveness, and the likely impact of intervening. Clinician beliefs about their capacity for risk factor management reflect their views about self-efficacy, role support, and the fit between risk factor management ways of working. The model suggests that clinicians formulate different expectations and intentions about how they will intervene based on these beliefs about commitment and capacity and their philosophical views about appropriate ways to intervene. These expectations then provide a cognitive framework guiding their risk factor management practices. Finally, clinicians' appraisal of the overall benefits versus costs of addressing lifestyle issues acts to positively or negatively reinforce their commitment to implementing these practices. Conclusion The model extends previous research by outlining a process by which clinicians' perceptions shape implementation of lifestyle risk factor management in routine practice. This provides new insights to inform the development of effective strategies to improve such practices. PMID:19825189

  16. AASHTO transportation asset management guide : a focus on implementation executive summary.

    DOT National Transportation Integrated Search

    2013-06-01

    This AASHTO Transportation Asset Management Executive Summary serves as a companion to the AASHTO Transportation : Asset Management GuideA Focus on Implementation, which takes as a starting point the Transportation : Asset Management Guide publish...

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

    PubMed

    Taubman, Antony

    2010-01-19

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

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

    PubMed Central

    Taubman, Antony

    2010-01-01

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

  19. Evaluating the implementation of confusion assessment method-intensive care unit using a quality improvement approach.

    PubMed

    Stewart, C; Bench, S

    2018-05-15

    Quality improvement (QI) is a way through which health care delivery can be made safer and more effective. Various models of quality improvement methods exist in health care today. These models can help guide and manage the process of introducing changes into clinical practice. The aim of this project was to implement the use of a delirium assessment tool into three adult critical care units within the same hospital using a QI approach. The objective was to improve the identification and management of delirium. Using the Model for Improvement framework, a multidisciplinary working group was established. A delirium assessment tool was introduced via a series of educational initiatives. New local guidelines regarding the use of delirium assessment and management for the multidisciplinary team were also produced. Audit data were collected at 6 weeks and 5 months post-implementation to evaluate compliance with the use of the tool across three critical care units within a single hospital in London. At 6 weeks, in 134 assessment points out of a possible 202, the tool was deemed to be used appropriately, meaning that 60% of patients received timely assessment; 18% of patients were identified as delirious in audit one. Five months later, only 95 assessment points out of a possible 199 were being appropriately assessed (47%); however, a greater number (32%) were identified as delirious. This project emphasizes the complexity of changing practice in a large busy critical care centre. Despite an initial increase in delirium assessment, this was not sustained over time. The use of a QI model highlights the continuous process of embedding changes into clinical practice and the need to use a QI method that can address the challenging nature of modern health care. QI models guide changes in practice. Consideration should be given to the type of QI model used. © 2018 British Association of Critical Care Nurses.

  20. Embedding care management in the medical home: a case study.

    PubMed

    Daaleman, Timothy P; Hay, Sherry; Prentice, Amy; Gwynne, Mark D

    2014-04-01

    Care managers are playing increasingly significant roles in the redesign of primary care and in the evolution of patient-centered medical homes (PCMHs), yet their adoption within day-to-day practice remains uneven and approaches for implementation have been minimally reported. We introduce a strategy for incorporating care management into the operations of a PCMH and assess the preliminary effectiveness of this approach. A case study of the University of North Carolina at Chapel Hill Family Medicine Center used an organizational model of innovation implementation to guide the parameters of implementation and evaluation. Two sources were used to determine the effectiveness of the implementation strategy: data elements from the care management informatics system in the health record and electronic survey data from the Family Medicine Center providers and care staff. A majority of physicians (75%) and support staff (82%) reported interactions with the care manager, primarily via face-to-face, telephone, or electronic means, primarily for facilitating referrals for behavioral health services and assistance with financial and social and community-based resources. Trend line suggests an absolute decrease of 8 emergency department visits per month for recipients of care management services and an absolute decrease of 7.5 inpatient admissions per month during the initial 2-year implementation period. An organizational model of innovation implementation is a potentially effective approach to guide the process of incorporating care management services into the structure and workflows of PCMHs.

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