Effect of bariatric surgery on future general surgical procedures.

PubMed

Kini, Subhash; Kannan, Umashankkar

2011-04-01

Bariatric surgery is now accepted as a safe and effective procedure for morbid obesity. The frequency of bariatric procedures is increasing with the adoption of the laparoscopic approach. The general surgeons will be facing many more of such patients presenting with common general surgical problems. Many of the general surgeons, faced with such situations, may not be aware of the changes in the gastrointestinal anatomy following bariatric procedures and management of these clinical situations will therefore present diagnostic and therapeutic challenges. We hereby present a review of management of few common general surgical problems in patients with a history of bariatric surgery.

Managing Digital Learning Environments: Student Teachers' Perception on the Social Networking Services Use in Writing Courses in Teacher Education

ERIC Educational Resources Information Center

Prasojo, Lantip Diat; Habibi, Akhmad; Mukminin, Amirul; Muhaimin; Taridi, Muhammad; Ikhsan; Saudagar, Ferdiaz

2017-01-01

Limited studies have been conducted to examine how effective and what impacts dealing with students' learning experiences as well as the problems faced by the students. This study focused on English student teachers' experiences on the advantages and problems faced in using Social Networking Services (SNS) in English as Foreign Language (EFL)…

Optimal infrastructure maintenance scheduling problem under budget uncertainty.

DOT National Transportation Integrated Search

2010-05-01

This research addresses a general class of infrastructure asset management problems. Infrastructure : agencies usually face budget uncertainties that will eventually lead to suboptimal planning if : maintenance decisions are made without taking the u...

Study on Problems and Countermeasures of Textbook Management in China Universities

ERIC Educational Resources Information Center

Geng, Lihua

2011-01-01

Textbook management in universities is an integral component of teaching management. With gradual development of university education teaching, textbook management in China universities can no longer keep pace with the steps of the teaching management, and the work of textbook management is faced up with new challenges. This article makes an…

Problems in Office Management: Cases in Practice

ERIC Educational Resources Information Center

Hemby, K. Virginia; Smith, Vincent W.

2006-01-01

Office managers face an increasing array of job responsibilities in today's business environment. To prepare new office administration employees and managers, educational institutions must maintain a progressive curriculum to meet position demands. Using a population of members of the Association of Professional Office Managers, this study was…

Knowledge Requirements and Management in Expert Decision Support Systems for (Military) Situation Assessment

DTIC Science & Technology

1983-08-01

constitutes a fundamental problem in many decision making processes. In business management we face this problem when determining the status of an...Tehiical Report 576 ( 1 ) 4 KNOWLEDGE REQUIREMENTS AND MANAGEMENT IN EXPERT DECISION SUPPORT SYSTEMS FOR (MILITARY) SITUATION ASSESSMENT MOOM sen...accomplished under contract for the Department of the Army The Israel Institute of Business Research Technical review by Robert H. Sasmor Joseph M

[Problems in implementing a pain management program for rheumatoid patients and studies of its effectiveness].

PubMed

Cziske, R; Jäckel, W; Jacobi, E

1987-01-01

A pain management program is presented which enables patients to reduce pain by means of relaxation and attention-diversion, etc. The problems arising from applying a psychological training to organic diseases, and the most favourable therapist's behaviour in facing these difficulties are elucidated. Finally, controlled studies are cited showing that pain can be reduced and the emotional state improved by pain management techniques.

MANUAL: REAL TIME CONTROL OF COMBINED SEWERS

EPA Science Inventory

Managers, engineers, and operators of combined urban sewer systems are faced with difficult problems related to the operation and maintenance of their facilities. In addition to the issues related to the operation and upkeep of the system, many sewerage agencies are facing increa...

Addressing Bullying Problems in Irish Schools and in Cyberspace: A Challenge for School Management

ERIC Educational Resources Information Center

Corcoran, Lucie; Mc Guckin, Conor

2014-01-01

Background: School management, in Ireland and also internationally, are currently faced with the problem of peer aggression among students both in a traditional school context and in a cyber context. Although Irish school principals are obliged to implement policy and procedures to counter bullying among students, there is a need for guidance that…

Teaching about the Global Environment.

ERIC Educational Resources Information Center

Blackburn, Anne M.

1985-01-01

Social studies educators hold an important key to our future success in the management of "spaceship earth." Students must be made aware of the global environment and the many problems facing it. These problems are discussed. (RM)

Managing fatigue in operational settings 2: An integrated approach

NASA Technical Reports Server (NTRS)

Rosekind, M. R.; Gander, P. H.; Gregory, K. B.; Smith, R. M.; Miller, D. L.; Oyung, R.; Webbon, L. L.; Johnson, J. M.

1996-01-01

The six domains that must be addressed in managing fatigue in operational settings are identified, and examples of how the aviation industry is dealing with the problems in each domain are given. Challenges facing healthcare providers in managing fatigue are also discussed.

Wilderness management principles: science, logical thinking or personal opinion?

Treesearch

David N. Cole

1995-01-01

Recreational use adversely affects the ecological integrity of wilderness. Wilderness managers face the challenge of keeping this loss of ecological integrity to minimal levels, a task that must be accomplished primarily through management of wilderness visitors. For the past 30 years, researchers have assisted managers by assessing problems associated with...

Assessment of Integrated Environmental Management in Public and Private Schools in the Copperbelt Province of Zambia

ERIC Educational Resources Information Center

Makisa, Kaponda

2016-01-01

Copperbelt Province is one of the ten provinces of Zambia. It has public and private schools which have been faced with escalating levels of environmental problems due to growth in human population and economic growth. The environmental problems which are matters of concern in the schools include, unsound waste management, loss of vegetation…

Time management in health care social work.

PubMed

Sheridan, M S

1988-01-01

Health care social workers face significant problems in controlling and managing time. Among the causes are increased demands for service, economy measures in health care, and the concurrent responsibility which social workers often have for both ongoing case management and crisis coverage. Individuals and social work departments can increase productivity through streamlining case management, increasing use of available resources, and generating new resources. With planning and preparation, many emergencies can be moved into the expected work flow. The social work profession needs to address time management problems and expectations in a more realistic and systematic way.

Pupil Transportation and the Law. Second Edition. NOLPE Monograph Series, No. 55.

ERIC Educational Resources Information Center

Mawdsley, Ralph D.

School officials face a daunting array of legal responsibilities in managing student transportation. This monograph identifies and discusses the most important transportation problems facing school officials, despite the considerable variances among state requirements. Following the introductory section, section 2 describes school districts' and…

Telephone triage by GPs in out-of-hours primary care in Denmark: a prospective observational study of efficiency and relevance

PubMed Central

Huibers, Linda; Moth, Grete; Carlsen, Anders H; Christensen, Morten B; Vedsted, Peter

2016-01-01

Background In the UK, telephone triage in out-of-hours primary care is mostly managed by nurses, whereas GPs perform triage in Denmark. Aim To describe telephone contacts triaged to face-to-face contacts, GP-assessed relevance, and factors associated with triage to face-to-face contact. Design and setting A prospective observational study in Danish out-of-hours primary care, conducted from June 2010 to May 2011. Method Information on patients was collected from the electronic patient administration system and GPs completed electronic questionnaires about the contacts. The GPs conducting the face-to-face contacts assessed relevance of the triage to face-to-face contacts. The authors performed binomial regression analyses, calculating relative risk (RR) and 95% confidence intervals. Results In total, 59.2% of calls ended with a telephone consultation. Factors associated with triage to a face-to-face contact were: patient age >40 years (40–64: RR = 1.13; >64: RR = 1.34), persisting problem for 12–24 hours (RR = 1.15), severe problem (RR = 2.60), potentially severe problem (RR = 5.81), and non-severe problem (RR = 2.23). Face-to-face contacts were assessed as irrelevant for 12.7% of clinic consultations and 11.7% of home visits. A statistically significantly higher risk of irrelevant face-to-face contact was found for a persisting problem of >24 hours (RR = 1.25), contact on weekday nights (RR = 1.25), and contact <2 hours before the patient’s own GP’s opening time (RR = 1.80). Conclusion Around 12% of all face-to-face consultations in the study are assessed as irrelevant by GP colleagues, suggesting that GP triage is efficient. Knowledge of the factors influencing triage can provide better education for GPs, but future studies are needed to investigate other quality aspects of GP telephone triage. PMID:27432608

Department of Education: Long-Standing Management Problems Hamper Reforms. Report to the Secretary of Education.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Div. of Human Resources.

This general management review (one in a series of management reviews of federal departments and agencies) identifies key management issues facing the U.S. Department of Education. This review assesses the management of the department and identifies actions that can be taken to improve organizational performance. Data were derived from 151…

Managing Difficult Behaviour in Young Children.

ERIC Educational Resources Information Center

Slee, June

2003-01-01

Managing antisocial behavior is a critical issue facing those who work with young children, as the presence of early socialization problems is the single greatest predictor of adolescent and adult antisocial behavior. This booklet highlights the effectiveness of behavior management strategies that introduce and reinforce positive behaviors, rather…

International waste management fact book

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

Amaya, J P; LaMarche, M N; Upton, J F

1997-10-01

Many countries around the world are faced with nuclear and environmental management problems similar to those being addressed by the US Department of Energy. The purpose of this Fact Book is to provide the latest information on US and international organizations, programs, activities and key personnel to promote mutual cooperation to solve these problems. Areas addressed include all aspects of closing the commercial and nuclear fuel cycle and managing the wastes and sites from defense-related, nuclear materials production programs.

Improving consistency and quality of service delivery: implications for the addiction treatment field.

PubMed

Knott, Anne Marie; Corredoira, Rafael; Kimberly, John

2008-09-01

Addiction treatment providers face serious problems in delivering consistent, high-quality services over time. Among those providers with multiple treatment sites, there is also intersite variability. This is a serious problem in the addiction field, likely to be made worse as new technologies are introduced and/or as there is industry consolidation (Corredoira, R., Kimberly, J. (2006) Industry evolution through consolidation: Implications for addiction treatment. Journal of Substance Abuse Treatment 31, 255-265.). Although serious, these problems in managing and monitoring to assure consistent service quality have been faced by many other industries. Here, we review evidence from research in other industries regarding three different forms of management (vertical integration, franchising, and licensing) across a chain of individual service providers. We show how each management form affects the level, consistency, and improvement of service delivery over time. In addition, we discuss how such performance advantages affect customer demand as well as regulatory endorsement of the consolidated firm and its approach.

Flux-Based Site Management

EPA Science Inventory

Managing DNAPL contaminated sites continues to be among the most pressing environmental problems currently faced. In particular, the benefits of partial DNAPL mass depletion due to remedial activity are unclear. Recent work conducted by an inter-agency research team has been in...

Responsibility Center Management: Lessons from 25 Years of Decentralized Management.

ERIC Educational Resources Information Center

Strauss, Jon C.; Curry, John R.

Decentralization of authority is a natural act in universities, but decentralization of responsibility is not. A problem faced by universities is the decoupling of academic authority from financial responsibility. The solution proposed in this book for the coupling is Responsibility Center Management (RCM), also called Revenue Responsibility…

An Analysis of Enterprise Risk Management and IT Effectiveness Constructs

ERIC Educational Resources Information Center

Waithe, Errol

2016-01-01

One major problem many organizations are facing is balancing the risk-management practices of the organization with overall information technology (IT) effectiveness. The purpose of this non-experimental quantitative correlational study was to assess the constructs and correlations associated with enterprise risk management and IT effectiveness.…

The most common problem facing by the maintenance department: A case Study between Universiti Tun Hussein Onn Malaysia (UTHM) and Universiti Teknologi Malaysia (UTM)

NASA Astrophysics Data System (ADS)

Norazam Yasin, Mohd; Mohamad Zin, Rosli; Halid Abdullah, Abd; Shafiq Mahmad, Muhammad; Fikri Hasmori, Muhammad

2017-11-01

From time to time, the maintenance works become more challenging due to construction of new building and also aging of the existing buildings. University buildings without any exception require proper maintenance services to support their function requirements and this can be considered as major responsibilities to be fulfilled by the maintenance department in the universities. Maintenance department specifically will face various kinds of problems in their operation works and thus this might influence the maintenance work operations itself. This study purposely to identify the common problem facing by the maintenance department and also to examine the current status of the maintenance department. In addition, this study would also propose any suitable approach that could be implemented to overcome the problem facing by the maintenance department. To achieve the objectives of this study, a combination of deep literature study and carrying out a survey is necessary. Literature study aimed to obtain deeper information about this study, meanwhile a survey aimed at identifying the common problem facing by the maintenance department and also to provide the information of the maintenance department’s organization. Several methods will be used in analyzing the data obtained through the survey, including Microsoft Office Excel and also using mean index formula. This study has identified three categories of problem in the maintenance department, which are management problems, human resource problem, and technical problems. Following the findings, several solutions being proposed which can be implemented as the solution to the problem facing. These suggestions have the potential to improve the maintenance department work efficiency, thus could help to increase the department productivity.

FaceIt: face recognition from static and live video for law enforcement

NASA Astrophysics Data System (ADS)

Atick, Joseph J.; Griffin, Paul M.; Redlich, A. N.

1997-01-01

Recent advances in image and pattern recognition technology- -especially face recognition--are leading to the development of a new generation of information systems of great value to the law enforcement community. With these systems it is now possible to pool and manage vast amounts of biometric intelligence such as face and finger print records and conduct computerized searches on them. We review one of the enabling technologies underlying these systems: the FaceIt face recognition engine; and discuss three applications that illustrate its benefits as a problem-solving technology and an efficient and cost effective investigative tool.

E-waste: a problem or an opportunity? Review of issues, challenges and solutions in Asian countries.

PubMed

Herat, Sunil; Agamuthu, P

2012-11-01

Safe management of electronic and electrical waste (e-waste/WEEE) is becoming a major problem for many countries around the world. In particular, developing countries face a number of issues with the generation, transboundary movement and management of e-waste. It is estimated that the world generates around 20-50 million tonnes of e-waste annually, most of it from Asian countries. Improper handling of e-waste can cause harm to the environment and human health because of its toxic components. Several countries around the world are now struggling to deal with this emerging threat. Although the current emphasis is on end-of-life management of e-waste activities, such as reuse, servicing, remanufacturing, recycling and disposal, upstream reduction of e-waste generation through green design and cleaner production is gaining much attention. Environmentally sound management (ESM) of e-waste in developing countries is absent or very limited. Transboundary movement of e-waste is a major issue throughout the region. Dealing with the informal recycling sector is a complex social and environmental issue. There are significant numbers of such challenges faced by these countries in achieving ESM of e-waste. This article aims to present a review of challenges and issues faced by Asian countries in managing their e-waste in a sustainable way.

Managing fatigue in operational settings II : an integrated approach

DOT National Transportation Integrated Search

1996-01-01

In this article, the six domains that must be addressed in managing fatigue in operational settings are identified, and examples of how the aviation industry is dealing with the problems in each domain are given. Challenges facing healthcare provider...

Simulation modeling for the health care manager.

PubMed

Kennedy, Michael H

2009-01-01

This article addresses the use of simulation software to solve administrative problems faced by health care managers. Spreadsheet add-ins, process simulation software, and discrete event simulation software are available at a range of costs and complexity. All use the Monte Carlo method to realistically integrate probability distributions into models of the health care environment. Problems typically addressed by health care simulation modeling are facility planning, resource allocation, staffing, patient flow and wait time, routing and transportation, supply chain management, and process improvement.

Software management tools: Lessons learned from use

NASA Technical Reports Server (NTRS)

Reifer, D. J.; Valett, J.; Knight, J.; Wenneson, G.

1985-01-01

Experience in inserting software project planning tools into more than 100 projects producing mission critical software are discussed. The problems the software project manager faces are listed along with methods and tools available to handle them. Experience is reported with the Project Manager's Workstation (PMW) and the SoftCost-R cost estimating package. Finally, the results of a survey, which looked at what could be done in the future to overcome the problems experienced and build a set of truly useful tools, are presented.

So What Do Managers Say about Classroom Management? Qualitative Practitioner Research Exploring Managers' Views on Classroom Management

ERIC Educational Resources Information Center

Lebor, Mervyn

2016-01-01

The context of this article was that, after researching issues of classroom management for a number of years, I was asked by managers at different institutions to speak to their staff about strategies for helping to counteract the problems tutors faced in many classes on a day-to-day basis. The question that emerged was how might managers in the…

What is the problem with medically unexplained symptoms for GPs? A meta-synthesis of qualitative studies.

PubMed

Johansen, May-Lill; Risor, Mette Bech

2017-04-01

To gain a deeper understanding of challenges faced by GPs when managing patients with MUS. We used meta-ethnography to synthesize qualitative studies on GPs' perception and management of MUS. The problem with MUS for GPs is the epistemological incongruence between dominant disease models and the reality of meeting patients suffering from persistent illness. GPs have used flexible approaches to manage the situation, yet patients and doctors have had parallel negative experiences of being stuck, untrustworthy and helpless. In the face of cognitive incongruence, GPs have strived to achieve relational congruence with their patients. This has led to parallel positive experiences of mutual trust and validation. With more experience, some GPs seem to overcome the incongruences, and later studies point towards a reframing of the MUS problem. For GPs, the challenge with MUS is most importantly at an epistemological level. Hence, a full reframing of the problem of MUS for GPs (and for patients) implies broad changes in basic medical knowledge and education. Short-term: Improve management of patients with MUS by transferring experience-based, reality-adjusted knowledge from senior GPs to juniors. Long-term: Work towards new models of disease that integrate knowledge from all relevant disciplines. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Patient accounts managers must broaden their horizons beyond their specialty.

PubMed

Herkimer, A G

1990-04-01

Healthcare professionals interested in advancing their careers and helping their institutions to survive need to develop an understanding of industry trends. Managers need to learn about the issues facing other departments if they are to play a role in solving problems.

Water management, purification, and conservation in arid climates. Volume 3: Water conservation

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

Goosen, M.F.A.; Shayya, W.H.

1999-07-01

Arid regions are already feeling the severe restraining effects of potable water shortages. In coming years, humid and sub-humid regions of the world will also have to face many of these same problems. In the future, serious conflicts may arise not because of a lack of oil, but due to water shortages. Are there solutions to these problems? Aside from increasing public awareness about the importance of water, society needs to take a three pronged approach: water needs to be effectively managed, it needs to be economically purified, and it needs to be conserved. Only by doing these three thingsmore » in unison can they hope to alleviate the water problems faced by arid regions of the world. This book presents information valuable to seeking, finding and using current technologies to help solve these problems now. Volume 3 addresses aspects of water conservation and includes rainwater harvesting and wastewater reuse and reclamation.« less

Water management, purification, and conservation in arid climates. Volume 2: Water purification

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

Goosen, M.F.A.; Shayya, W.H.

1999-10-01

Arid regions are already feeling the severe restraining effects of potable water shortages. In coming years, humid and sub-humid regions of the world will also have to face many of these same problems. In the future, serious conflicts may arise not because of a lack of oil, but due to water shortages. Are there solutions to these problems? Aside from increasing public awareness about the importance of water, society needs to take a three pronged approach: water needs to be effectively managed, it needs to be economically purified, and it needs to be conserved. Only by doing these three thingsmore » in unison can they hope to alleviate the water problems faced by arid regions of the world. This book presents information valuable to seeking, finding and using current technologies to help solve these problems now. Volume 2 presents various methods of purifying water, and includes membrane processes and alternative techniques such as solar desalination.« less

A taboo within a stigma? a qualitative study of managing incontinence with people with dementia living at home.

PubMed

Drennan, Vari M; Cole, Laura; Iliffe, Steve

2011-11-14

Incontinence in people with dementia is one of the factors associated with the decision to move to a care home. Managing incontinence adds to carer burden and has been reported by family carers as more difficult to manage than behavioural symptoms. Active management strategies have been reported to be associated with less carer depression. The purpose of this study was to investigate carers' perceptions of the range of incontinence problems they helped their relative with and the strategies they employed to manage these. Family carers of people with dementia living in their own homes were recruited through primary care, specialist community mental health services and voluntary organisations. Qualitative semi structured interviews were conducted either face to face or by telephone and thematically analysed. Thirty two carers were interviewed. They described a range of problems from supporting the person to remain independent in toileting, through to dealing with inappropriate behaviours, to containing and managing incontinence. All carers actively used problem solving strategies but sometimes these were not acceptable or understood by the person with dementia, particularly as the dementia progressed. Most carers reported protecting the person's dignity by not seeking health professionals help often until the point of a crisis. Once the carer has decided to seek help the responses from health professionals can be less than helpful, and carers report local health service policies on access to continence products to be inconsistent and often inappropriate to their circumstances. A few carers reported strategies for managing toileting and incontinence that have the potential for distress and harm to the person with dementia. Primary care professionals could be more proactive in enquiry, repeated over time, about toileting and incontinence problems and in giving advice and information to reduce crisis and problems.

Critical care and the urologic patient.

PubMed

Leung, Anne K H; Tan, Ian K S

2003-01-01

Changing concepts of disease management, expanding indications for invasive therapy to elderly patients, together with technologic advances have changed the management of various urologic diseases. Although minimally invasive surgery may have reduced the need for ICU care, we are faced with new and unique treatment problems.

[Tenure--a Management Problem.

ERIC Educational Resources Information Center

Brassie, Stan

Tenure saturation coupled with declining enrollments, abolishment of general university requirements, program diversity, and affirmative action programs make tenure an issue. These factors are representative of many facing university management today. Serious examination of the concept of tenure reveals that 85 percent of all colleges have tenure,…

Experimental instruction in photonics for high school students: approaches to managing problems faced

NASA Astrophysics Data System (ADS)

Choong, Zhengyang

2017-08-01

Student research projects are increasingly common at the K-12 level. However, students often face difficulties in the course of their school research projects such as setting realistic timelines and expectations, handling problems stemming from a lack of self-confidence, as well as being sufficiently disciplined for sustained communication and experimentation. In this work, we explore manifestations of these problems in the context of a photonics project, characterising the spectrum of the breakdown flash from Silicon Avalanche Photodiodes. We report on the process of planning and building the setup, data collection, analysis and troubleshooting, as well as the technical and human problems at each step. Approaches that were found to be helpful in managing the aforementioned problems are discussed, including an attention to detail during experimental work, as well as communicating in a forthcoming manner. Œe former allowed for clearer planning and the setting of quantifiable proximal goals; the latter helped in motivating discipline, and also helped in the understanding of research as an iterative learning process without a clear definition of success or failure.

Cibecue watershed projects: Then, now, and in the future

Treesearch

Jonathan W. Long

2000-01-01

The White Mountain Apache Tribe has undertaken a watershed analysis and various demonstration projects in the Cibecue watershed in east-central Arizona. The results support an adaptive management strategy to promote ecological health, enhance economic opportunities, and protect cultural values. Some of the problems faced by today’s program are similar to those faced by...

An analysis of whether a working-age ward-based liaison psychiatry service requires the input of a liaison psychiatrist.

PubMed

Guthrie, Elspeth A; McMeekin, Aaron T; Khan, Sylvia; Makin, Sally; Shaw, Ben; Longson, Damien

2017-06-01

Aims and method This article presents a 12-month case series to determine the fraction of ward referrals of adults of working age who needed a liaison psychiatrist in a busy tertiary referral teaching hospital. Results The service received 344 referrals resulting in 1259 face-to-face contacts. Depression accounted for the most face-to-face contacts. We deemed the involvement of a liaison psychiatrist necessary in 241 (70.1%) referrals, with medication management as the most common reason. Clinical implications A substantial amount of liaison ward work involves the treatment and management of severe and complex mental health problems. Our analysis suggests that in the majority of cases the input of a liaison psychiatrist is required.

Managing strategic change--strategy, culture and action.

PubMed

Johnson, G

1992-02-01

One of the major problems facing senior executives is that of effecting significant strategic change in their organizations. This paper develops a number of explanatory frameworks which address the links between the development of strategy in organizations, dimensions of corporate culture and managerial action. In considering such linkages, and by illustrating them with examples from work undertaken in companies, the paper also seeks to advance our understanding of the problems and means of managing strategic change.

Managing Leadership Stress

ERIC Educational Resources Information Center

Bal, Vidula; Campbell, Michael; McDowell-Larsen, Sharon

2008-01-01

Everyone experiences stress, and leaders face the additional stress brought about by the unique demands of leadership: having to make decisions with limited information, to manage conflict, to do more with less ...and faster! The consequences of stress can include health problems and deteriorating relationships. Knowing what signs of stress to…

Managing epilepsy well: self-management needs assessment.

PubMed

Fraser, Robert T; Johnson, Erica K; Miller, John W; Temkin, Nancy; Barber, Jason; Caylor, Lisa; Ciechanowski, Paul; Chaytor, Naomi

2011-02-01

Epilepsy self-management interventions have been investigated with respect to health care needs, medical adherence, depression, anxiety, employment, and sleep problems. Studies have been limited in terms of representative samples and inconsistent or restricted findings. The direct needs assessment of patients with epilepsy as a basis for program design has not been well used as an approach to improving program participation and outcomes. This study investigated the perceived medical and psychosocial problems of adults with epilepsy, as well as their preferences for self-management program design and delivery format. Results indicated a more psychosocially challenged subgroup of individuals with significant depressive and cognitive complaints. A self-management program that involves face-to-face individual or group meetings led by an epilepsy professional and trained peer leader for 60 minutes weekly was preferred. Six to eight sessions focused on diverse education sessions (e.g., managing disability and medical care, socializing on a budget, and leading a healthy lifestyle) and emotional coping strategies delivered on weeknights or Saturday afternoons were most highly endorsed. Emotional self-management and cognitive compensatory strategies require special emphasis given the challenges of a large subgroup. Copyright © 2010 Elsevier Inc. All rights reserved.

Current issues and challenges in the management of bariatric patients.

PubMed

Bell, Sue Ellen

2005-01-01

Morbid obesity is an increasingly common healthcare problem, and providers and patients currently face numerous challenges in dealing with this problem effectively. Issues addressed in this article include the effect of stigma, the need for more evidence regarding effective management options, and the declining insurance coverage for bariatric surgery. The role of bariatric surgery in effective management of morbid obesity is discussed, along with the effect on and possible reasons for declining coverage. A comparison between benefits and coverage for bariatric surgery and angioplasty/stent placement is included.

Learning to See the (W)holes

ERIC Educational Resources Information Center

Burns, Barbara A.; Jordan, Thomas M.

2006-01-01

Business managers are faced with complex decisions involving a wide range of issues--technical, social, environmental, and financial--and their interaction. Our education system focuses heavily on presenting structured problems and teaching students to apply a set of tools or methods to solve these problems. Yet the most difficult thing to teach…

Effective chronic disease management: patients' perspectives on medication-related problems.

PubMed

Gordon, Karen; Smith, Felicity; Dhillon, Soraya

2007-03-01

To examine medication-related problems from the perspective of patients with a chronic condition and to identify how they may be supported in managing their medication. Patients prescribed medication for cardiovascular disease were recruited through five general medical surgeries and four community pharmacies in south London. Data were collected in 98 face-to-face interviews in participants' own homes. Interviews were designed to enable a detailed and holistic exploration of medication-related problems from participants' perspectives. Data were audio-recorded and transcribed verbatim to allow qualitative analysis. Five broad categories of medication-related problem emerged which were examined in the context of patients' perspectives on, and experiences of, the use of medicines and health services. These were concerns about and management of side effects; differing views regarding the use of medicines; cognitive, practical and sensory problems; lack of information or understanding; and problems with access to, and organisation of, services. All categories of problem had potential implications for the success of therapy in that they created barriers to adherence, access to medication or informed decision-making. The study demonstrated how patients actively engage in decision-making about their medicines in the home, if not in the consultation. The five categories of problem provide a focus for interventions by health professionals to support patients in achieving optimal theory outcomes. They demonstrate the need for a comprehensive approach, spanning patient education to the systems of delivery of care. Within the NHS in Britain, policy and practice initiatives are being designed to achieve this end. Further research should focus on the evaluation of professional practices and service developments in supporting patients in the self-management of their medicines.

Big hat, no cattle: managing human resources.

PubMed

Skinner, W

1981-01-01

When faced with business problems, managers naturally make identifying the trouble their priority. Once that is done, at least half the job is over; finding solutions is just a matter of time. This hasn't been so, however, with the human resources problem: how to motivate employees. Sixty years ago, the Hawthorne experiments revealed the issue, and ever since, managers, researchers, and consultants have been searching for the answer to the human resources problem. Why aren't employees as productive, loyal, and dedicated to their companies as their managers know they can be? The author of this article proposes four reasons why actuality has fallen so far below expectation in personnel management, namely, that managers' expectations have been too high in the first place, that the concepts staff professionals offer managers are frequently contradictory, that the corporate role of personnel has always been problematic, and finally, that managers hold assumptions concerning their employees that undermine efforts to motivate them.

Using Classroom Layout to Help Reduce Students' Apprehension and Increase Communication

ERIC Educational Resources Information Center

Rae, Kirsten; Sands, John

2013-01-01

When teaching introductory management accounting courses at undergraduate level, the authors noticed that some students experience difficulty in integrating theoretical and technical knowledge of management accounting and applying it to specific scenarios. However, based on the authors' experience, the problems faced by students when learning…

Enrollment Management: A Key to Student Success.

ERIC Educational Resources Information Center

Spence, Charles C.; And Others

This four-part presentation examines the theory and practice of enrollment management at Florida Community College at Jacksonville (FCCJ). First, Charles C. Spence offers a brief description of FCCJ and reviews some of the problems facing the college when he assumed the presidency in 1985, including a significant enrollment decline and serious…

Proven Techniques: The Use and Impact of Major Management Concepts in Community Colleges.

ERIC Educational Resources Information Center

Deegan, William L.

1992-01-01

Describes a survey of community college presidents' use of and perception of the effectiveness of major management concepts related to planning, organization, budgeting/finance, staffing, and evaluation. Also summarizes presidents' perceptions of the problems facing them and their perspectives on the future. (DMM)

76 FR 21781 - Agency Information Collection Activities; Submission for OMB Emergency Review: Comment Request...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-18

... plant re-purposing from professionals in the communities that have already faced the problems associated...) titled, ``Repurposed Auto Manufacturing Facilities Study,'' to the Office of Management and Budget (OMB... Department of Labor, Office of the Secretary, Office of Management and Budget, Room 10235, Washington, DC...

Cancer survivors' self-efficacy to self-manage in the year following primary treatment.

PubMed

Foster, C; Breckons, M; Cotterell, P; Barbosa, D; Calman, L; Corner, J; Fenlon, D; Foster, R; Grimmett, C; Richardson, A; Smith, P W

2015-03-01

Cancer survivors are increasingly expected to manage the consequences of cancer and its treatment for themselves. There is evidence that self-efficacy is important for successful self-management and that this can be enhanced with support. The purpose of this study was to assess self-efficacy to manage problems in the year following primary treatment. This cross-sectional online survey included cancer survivors who had completed their treatment within the past 12 months. Self-efficacy was assessed and variables expected to be associated with self-efficacy were measured using validated scales including quality of life, well-being, illness perceptions, depression and social support. One hundred eighty-two respondents (mean age 50; 81% female) completed the survey. They had been treated for a range of cancers; most commonly breast (45%). Self-efficacy scores varied between individuals and according to the illness-related task to be managed. Respondents were least confident in managing fatigue and most confident in accessing information about their cancer. Individuals most likely to report low self-efficacy were women, those experiencing higher levels of pain and/or depression, lower well-being scores, lower socio-economic status, low levels of social support, or a more negative perception of cancer. Self-efficacy to self-manage problems faced as a consequence of cancer and its treatment can vary widely in the year following treatment. Fatigue may be particularly difficult to manage. Variations in self-efficacy highlight the importance of assessing specific problems faced and people's confidence to manage them in order to tailor appropriate self-management support.

Initiatives (Part 1): Keystone; Cycle Time Puzzle, A Full-Scale Challenge; Foot to Foot, Face to Face; Change Management; Multi-Element Team Challenge.

ERIC Educational Resources Information Center

Schoel, Jim; Butler, Steve; Murray, Mark; Gass, Mike; Carrick, Moe

2001-01-01

Presents five group problem-solving initiatives for use in adventure and experiential settings, focusing on conflict resolution, corporate workplace issues, or adjustment to change. Includes target group, group size, time and space needs, activity level, overview, goals, props, instructions, and suggestions for framing and debriefing the…

Content Validity of Game-Based Assessment: Case Study of a Serious Game for ICT Managers in Training

ERIC Educational Resources Information Center

Hummel, Hans G. K.; Joosten-ten Brinke, Desirée; Nadolski, Rob J.; Baartman, Liesbeth K. J.

2017-01-01

Serious games foster the acquisition of complex problem-solving skills. Assessment of such skills should be in line with instruction, and within a serious game environment its content validity should equal face-to-face assessment. Research on assessment in serious gaming has remained rather scarce. This article shows how assessment can be…

Anesthetic Management by Laryngeal Mask Airway in a Patient With a History of Difficult Intubation Resulting in Dental Injuries

PubMed Central

Asahi, Yoshinao; Fujii, Ryosuke; Usui, Naoko; Kagamiuchi, Hajime; Omichi, Shiro; Kotani, Junichiro

2015-01-01

Disabled patients may face respiratory problems during general anesthesia because of head and neck anomalies. We describe a case of dental treatment under general anesthesia using a laryngeal mask airway in a disabled patient who faced difficulty in endotracheal intubation on several occasions, 5 of which resulted in dental injuries. PMID:25849470

The Management of Student Affairs Programs in Community Colleges: Revamping Processes and Structures. Horizons Issues Monograph Series.

ERIC Educational Resources Information Center

Deegan, William L.

Based on a review of the management literature in the fields of business and education and on case studies, interviews, and discussions, this monograph identifies the prerequisites for the successful management of student affairs programs. Chapter 1 presents perspectives on the student affairs profession, summarizes the problems facing the field,…

Preparing future fisheries professionals to make good decisions

USGS Publications Warehouse

Colvin, Michael E.; Peterson, James T.

2017-01-01

Future fisheries professionals will face decision-making challenges in an increasingly complex field of fisheries management. Though fisheries students are well trained in the use of the scientific method to understand the natural world, they are rarely exposed to structured decision making (SDM) as part of an undergraduate or graduate education. Specifically, SDM encourages users (e.g., students, managers) to think critically and communicate the problem and then identify specific, measurable objectives as they relate to the problem. Next, users must think critically and creatively about management alternatives that can be used to meet the objectives—there must be more than one alternative or there is no decision to be made. Lastly, the management alternatives are evaluated with regard to how likely they are to succeed in terms of multiple, possibly completing, objectives, such as how stakeholder groups value outcomes of management actions versus monetary cost. We believe that exposure to SDM and its elements is an important part of preparing future fisheries professional to meet the challenges they may face. These challenges include reduced budgets, the growth of potentially competing natural resource interest groups, and stakeholder desire to be involved in management decisions affecting public trust resources, just to name a few.

Reflections on the Difficulties of Educational Development in Minority Areas of Western China

ERIC Educational Resources Information Center

Jian, Wang

2017-01-01

At present, the development of education in western China's rural and ethnic minority areas faces problems including the management of boarding schools, the education of left-behind children, and changing the functions of schools. Resolving these problems requires not only changing traditional ways of thinking, but also placing minority education…

A test planting of 2-0 and 3-0 Douglas-fir trees on a steep south slope.

Treesearch

Carl M. Bernsten

1958-01-01

Regeneration of clear-cut areas is a high-priority problem facing forest managers in the Douglas-fir region. One of the most critical phases of this problem is the establishment of new stands on south-slope sites, where conditions are unfavorable for regeneration.

Coordinating the Cognitive Processes of Writing: The Role of the Monitor

ERIC Educational Resources Information Center

Quinlan, Thomas; Loncke, Maaike; Leijten, Marielle; Van Waes, Luuk

2012-01-01

Moment to moment, a writer faces a host of potential problems. How does the writer's mind coordinate this problem solving? In the original Hayes and Flower model, the authors posited a distinct process to manage this coordinating--that is, the "monitor." The monitor became responsible for executive function in writing. In two…

Factors Influencing the Effectiveness of Inventory Management in Manufacturing SMEs

NASA Astrophysics Data System (ADS)

Chan, Shiau Wei; Tasmin, R.; Nor Aziati, A. H.; Zuraidah Rasi, Raja; Ismail, Fadillah Binti; Yaw, Li Ping

2017-08-01

Effectiveness of inventory management is a vital part in the manufacturing organization to be more competitive. The previous studies have indicated that there are several factors influencing the effectiveness of inventory management in the organization but there is lack of researchers who carried out the research in the manufacturing small medium enterprise in Johor. Therefore, the purpose of this research is to identify the problem of inventory management faced by the manufacturing small medium enterprise and also to determine the factors that will influence the effectiveness of inventory management. In completing this research, 80 employees were selected randomly from the manufacturing small medium enterprise in Batu Pahat, Johor and they were requested to complete questionnaires. The result have shown that the problems of inventory management faced by manufacturing organization were underproduction, overproduction, stock out situation, delays in the delivery of raw materials and discrepancy of records. The factors, documentation/store records, planning, knowledge of employees/staff skill have shown to significantly influence the effectiveness of inventory management while the funds have shown slightly significant influence on the inventory management in manufacturing small medium enterprises. This quantitative study is important to the manufacturing organization in Malaysia because it provides the guidelines to the employers of manufacturing small medium enterprises in Batu Pahat, Johor.

Teacher Efficacy and Disciplinary Expectations in Charter Schools: Understanding the Link to Teachers' Career Decisions

ERIC Educational Resources Information Center

Torres, A. Chris

2016-01-01

Much scholarly work describes a culture of low expectations in low-income, urban schools, the challenges these teachers face managing student behavior, and why these problems so strongly influence teacher turnover. By contrast, some urban charter schools, particularly those associated with high achieving Charter Management Organizations (CMOs),…

Integrating Six Sigma Concepts in an MBA Quality Management Class

ERIC Educational Resources Information Center

Weinstein, Larry B.; Petrick, Joseph; Castellano, Joseph; Vokurka, Robert J.

2008-01-01

Instructors face enormous challenges in presenting effective instruction on concepts and tools of quality management. Most textbooks focus on presenting individual concepts or tools and fail to address complex issues confronted in real-world problem-solving situations. The supplementary use of cases does not help students to understand the dynamic…

Integration of Flux-Based Methods and Triad Principles for DNAPL Site Management, Part II: Review of Flux Measurement Methods

EPA Science Inventory

Managing dense nonaqueous phase liquid (DNAPL) contaminated sites continues to be among the most pressing environmental problems currently faced. One approach that has recently been investigated for use in DNAPL site characterization and remediation is mass flux (mass per unit ar...

Lean management-the journey from toyota to healthcare.

PubMed

Teich, Sorin T; Faddoul, Fady F

2013-04-01

The evolution of production systems is tightly linked to the story of Toyota Motor Company (TMC) that has its roots around 1918. The term "lean" was coined in 1990 following the exploration of the Toyota model that led to the "transference" thesis sustaining the concept that manufacturing problems and technologies are universal problems faced by management and that these concepts can be emulated in non-Japanese enterprises. Lean is a multi-faceted concept and requires organizations to exert effort along several dimensions simultaneously; some consider a successful implementation either achieving major strategic components of lean, implementing practices to support operational aspects, or providing evidence that the improvements are sustainable in the long term. The article explores challenges and opportunities faced by organizations that intend incorporating lean management principles and presents the specific context of the healthcare industry. Finally, the concepts of "essential few" and customer value are illustrated through a simple example of process change following lean principles, which was implemented in a dental school in the United States.

Participatory research towards co-management: lessons from artisanal fisheries in coastal Uruguay.

PubMed

Trimble, Micaela; Berkes, Fikret

2013-10-15

Participatory research has become increasingly common in natural resources management. Even though participatory research is considered a strategy to facilitate co-management, there is little empirical evidence supporting this. The objective of the present paper is to analyze the contributions of participatory research to help encourage the emergence of co-management, based on a case study in Piriápolis artisanal fishery in coastal Uruguay (where management has been top-down). We argue that participatory research involving artisanal fishers, government, and other stakeholders (university scientists and NGOs) can be a key stimulus towards co-management. We build this argument by considering "seven faces" by which co-management can be analyzed: (1) as power sharing; (2) as institution building; (3) as trust building; (4) as process; (5) as learning and knowledge co-production; (6) as problem solving; and (7) as governance. Our findings show that participatory research had an impact on these various faces: (1) power was shared when making research decisions; (2) a multi-stakeholder group (POPA), with a common vision and goals, was created; (3) trust among participants increased; (4) the process of group formation was valued by participants; (5) stakeholders learned skills for participation; (6) two problem-solving exercises were conducted; and (7) a diversity of stakeholders of the initial problem identified by fishers (sea lions' impact on long-line fishery) participated in the process. The case shows that participatory research functions as a platform which enhances learning and knowledge co-production among stakeholders, paving the way towards future co-management. Copyright © 2013 Elsevier Ltd. All rights reserved.

Endourologic management of malignant ureteral obstruction: indications, results, and quality-of-life issues.

PubMed

Sountoulides, Petros; Pardalidis, Nikolaos; Sofikitis, Nikolaos

2010-01-01

Obstruction of the upper urinary tract is a problem commonly faced by practicing urologists. The constant evolution in endourology has effectively facilitated minimally invasive management of upper-tract obstruction. In a case in which malignancy is the cause of obstruction, however, the situation significantly changes. Questions arise regarding the need for relieving the obstruction, the means to accomplish this, and the benefits and drawbacks of each technique regarding both their efficacy and their impact on the patients well-being and the crucial issue of quality of life in the face of malignancy.

A taboo within a stigma? a qualitative study of managing incontinence with people with dementia living at home

PubMed Central

2011-01-01

Background Incontinence in people with dementia is one of the factors associated with the decision to move to a care home. Managing incontinence adds to carer burden and has been reported by family carers as more difficult to manage than behavioural symptoms. Active management strategies have been reported to be associated with less carer depression. The purpose of this study was to investigate carers' perceptions of the range of incontinence problems they helped their relative with and the strategies they employed to manage these. Methods Family carers of people with dementia living in their own homes were recruited through primary care, specialist community mental health services and voluntary organisations. Qualitative semi structured interviews were conducted either face to face or by telephone and thematically analysed. Results Thirty two carers were interviewed. They described a range of problems from supporting the person to remain independent in toileting, through to dealing with inappropriate behaviours, to containing and managing incontinence. All carers actively used problem solving strategies but sometimes these were not acceptable or understood by the person with dementia, particularly as the dementia progressed. Most carers reported protecting the person's dignity by not seeking health professionals help often until the point of a crisis. Once the carer has decided to seek help the responses from health professionals can be less than helpful, and carers report local health service policies on access to continence products to be inconsistent and often inappropriate to their circumstances. A few carers reported strategies for managing toileting and incontinence that have the potential for distress and harm to the person with dementia. Conclusions Primary care professionals could be more proactive in enquiry, repeated over time, about toileting and incontinence problems and in giving advice and information to reduce crisis and problems. PMID:22081876

Still a difficult business? Negotiating alcohol-related problems in general practice consultations.

PubMed

Rapley, Tim; May, Carl; Frances Kaner, Eileen

2006-11-01

This paper describes general practitioners' (GPs) experiences of detecting and managing alcohol and alcohol-related problems in consultations. We undertook qualitative research in two phases in the North-East of England. Initially, qualitative interviews with 29 GPs explored their everyday work with patients with alcohol-related issues. We then undertook group interviews--two with GPs and one with a primary care team--where they discussed and challenged findings of the interviews. The GPs reported routinely discussing alcohol with patients with a range of alcohol-related problems. GPs believed that this work is important, but felt that until patients were willing to accept that their alcohol consumption was problematic they could achieve very little. They tentatively introduced alcohol as a potential problem, re-introduced the topic periodically, and then waited until the patient decided to change their behaviour. They were aware that they could identify and manage more patients. A lack of time and having to work with the multiple problems that patients brought to consultations were the main factors that stopped GPs managing more risky drinkers. Centrally, we compared the results of our study with [Thom, B., & Tellez, C. (1986). A difficult business-Detecting and managing alcohol-problems in general-practice. British Journal of Addiction, 81, 405-418] seminal study that was undertaken 20 years ago. We show how the intellectual, moral, emotional and practical difficulties that GPs currently face are quite similar to those faced by GPs from 20 years ago. As the definition of what could constitute abnormal alcohol consumption has expanded, so the range of consultations that they may have to negotiate these difficulties in has also expanded.

A Study on the State of Development of Higher Education Confucius Institutes from Mainland China

ERIC Educational Resources Information Center

Jeng-Yi, Lin

2016-01-01

Confucius Institutes are the target of this study, and the study uses document analysis method to analyze the origins of their establishment, purpose, organizational structure, administration model, and state of development. This study finds that Confucius Institutes are facing the following problems: problems in the development and management of…

Administrative Problem-Solving for Writing Programs and Writing Centers: Scenarios in Effective Program Management.

ERIC Educational Resources Information Center

Myers-Breslin, Linda

Addressing the issues and problems faced by writing program administrators (WPAs) and writing center directors (WCDs), and how they can most effectively resolve the political, pedagogical, and financial questions that arise, this book presents essays from experienced WPAs and WCDs at a wide variety of institutions that offer scenarios and case…

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…

Workshop Report On Sustainable Urban Development

NASA Technical Reports Server (NTRS)

Langhoff, Stephanie; Martin, Gary; Barone, Larry; Wagener, Wolfgang

2010-01-01

The key workshop goal was to explore and document how NASA technologies, such as remote sensing, climate modeling, and high-end computing and visualization along with NASA assets such as Earth Observing Satellites (EOS) and Unmanned Aerial Vehicles (UAVs) can contribute to creating and managing a sustainable urban environment. The focus was on the greater Bay Area, but many aspects of the workshop were applicable to urban management at the local, regional and global scales. A secondary goal was to help NASA better understand the problems facing urban managers and to make city leaders in the Bay Area more aware of NASA's capabilities. By bringing members of these two groups together we hope to see the beginnings of new collaborations between NASA and those faced with instituting sustainable urban management in Bay Area cities.

Increasing the relevance of research to health care managers: hospital CEO imperatives for improving quality and lowering costs.

PubMed

Alexander, Jeffrey A; Hearld, Larry R; Jiang, H Joanna; Fraser, Irene

2007-01-01

Evidence-based management assumes that available research evidence is consistent with the problems and decision-making conditions faced by those who will utilize this evidence in practice. This article attempts to identify how hospital leaders view key determinants of hospital quality and costs, as well as the fundamental ways these leaders "think" about solutions to quality and cost issues in their organizations. The objective of this analysis is to better inform the research agenda and approaches pursued by health services research so that this research reflects the "realities" of practice in hospitals. We conducted a series of semistructured interviews with a convenience sample of eight hospital and three health system leaders. Questions focused on current and future challenges facing hospitals as they relate to hospital quality, costs, and efficiency, and potential solutions to those challenges. Nine major organizational and managerial factors emerged from the interviews, including staffing, evidence-based practice, information technology, data availability and benchmarking, and leadership. Hospital leaders tend to think about these factors systemically and consider process-related factors as the important drivers of cost and quality. The results suggest a need to expand the methods utilized by health services researchers to make their research more relevant to health care managers. Expanding research methods to reflect the systemic way that managers view the challenges and solutions facing their organizations may enhance the application of research findings into management practice. Finally, better communication is needed between the research and practice communities. Researchers must learn to think more like managers if their research is to be relevant, and managers must learn to more effectively communicate their issues with the research community and frame their problems in researchable terms.

District of Columbia: D.C. Public Schools' Modernization Program Faces Major Challenges. Testimony before the Subcommittee on the District of Columbia, Committee on Appropriations, House of Representatives.

ERIC Educational Resources Information Center

Cooper, David E.

This Congressional testimony focuses on the challenges faced by the District of Columbia in modernizing its public schools. Specifically, it addresses: (1) increases in the cost of modernizing the schools; (2) delays in completing the schools; (3) quality inspection problems; and (4) concerns about managing asbestos hazards. The testimony…

Reconsidering Social Science Theories in Natural Resource Management Continuing Professional Education

ERIC Educational Resources Information Center

Stummann, C. B.; Gamborg, C.

2014-01-01

Over 25 years ago, the "wicked problems" concept was introduced into forestry to describe the increasingly complex work situations faced by many natural resource management (NRM) professionals and at the same time the demand and frequency of public involvement in NRM issues also grew. Research on the impact of these changes for NRM…

Integrating Academic Management with Business Planning Activities: The Case of University of Education, Winneba (UEW), Ghana

ERIC Educational Resources Information Center

Owusu-Ansah, Collins; Afful, Deborah

2015-01-01

Currently, public universities are facing chronic problem of underfunding. In a bid to explore more alternative and innovative ways of addressing such underfunding challenges, authorities of universities have sought to inject business activities into the management of the universities. They are now forced to search for additional sources of income…

Management of Primary Dysmenorrhea by School Adolescents in ILE-IFE, Nigeria

ERIC Educational Resources Information Center

Ogunfowokan, Adesola A.; Babatunde, Oluwayemisi A.

2010-01-01

Dysmenorrhea is a problem that girls and women face and often manage themselves with or without support from health professionals. A cross-sectional, descriptive study was conducted among adolescents with dysmenorrhea (N = 150) in Ile-Ife, Nigeria. The aims of the study were to determine their knowledge of menstruation and primary dysmenorrhea,…

Effect of Leadership Experience on Agricultural Education Student Teacher Self-Efficacy in Classroom Management

ERIC Educational Resources Information Center

Wolf, Kattlyn J.; Foster, Daniel D.; Birkenholz, Robert J.

2009-01-01

Beginning agriculture teachers often cite classroom management as the most important problem they face in their careers. The purpose of this study was to assess the effect of leadership experience on self-perceived teacher efficacy among agricultural education student teachers. The three dimensions of teacher efficacy addressed in this study…

The Entrepreneurial Experience: Confronting Career Dilemmas of the Start-up Executive. The Jossey-Bass Management Series.

ERIC Educational Resources Information Center

Dyer, W. Gibb, Jr.

This book presents the personal, professional, and family dilemmas that entrepreneurs face at each stage of their careers and discusses strategies to manage such problems successfully. The material was gathered in the following ways: (1) interviews with 14 entrepreneurs; (2) 70 case studies of entrepreneurial firms; (3) analysis of biographies of…

Achieving Coherence in District Improvement: Managing the Relationship between the Central Office and Schools

ERIC Educational Resources Information Center

Johnson, Susan Moore; Marietta, Geoff; Higgins, Monica C.; Mapp, Karen L.; Grossman, Allen

2015-01-01

"Achieving Coherence in District Improvement" focuses on a problem of practice faced by educational leaders across the nation: how to effectively manage the relationship between the central office and schools. The book is based on a study of five large urban districts that have demonstrated improvement in student achievement. The…

Draft position paper on knowledge management in space activities

NASA Technical Reports Server (NTRS)

Holm, Jeanne; Moura, Denis

2003-01-01

As other fields of industry, space activities are facing the challenge of Knowledge Management and the International Academy of Astronautics decided to settle in 2002 a Study Group to analyse the problem and issue general guidelines. This communication presents the draft position paper of this group in view to be discussed during the 2003 IAF Congress.

Income Generation and Money Management: Training Women as Entrepreneurs.

ERIC Educational Resources Information Center

Reed, Sheila

Based on a workshop in Gambia in 1989, this manual was developed to help Peace Corps workers to develop training techniques for teaching women to run businesses producing and selling local products and to manage money. Topics covered include the following: (1) the role of the facilitator in adult learning; (2) problems women face in controlling…

Linking wilderness research and management-volume 4. Understanding and managing invasive plants in wilderness and other natural areas: an annotated reading list

Treesearch

Sophie Osborn; Vita Wright; Brett Walker; Amy Cilimburg; Alison Perkins

2002-01-01

Nonnative invasive plants are altering ecosystems around the world with alarming speed. They outcompete native plants and ultimately change the composition and function of the ecosystems they invade. This poses a particular problem in wilderness and other natural areas that are set aside to maintain natural conditions. Wilderness managers are not only faced with the...

Opportunities to utilize traditional phenological knowledge to support adaptive management of social-ecological systems vulnerable to changes in climate and fire regimes

Treesearch

Christopher A. Armatas; Tyron J. Venn; Brooke B. McBride; Alan E. Watson; Steve J. Carver

2016-01-01

The field of adaptive management has been embraced by researchers and managers in the United States as an approach to improve natural resource stewardship in the face of uncertainty and complex environmental problems. Integrating multiple knowledge sources and feedback mechanisms is an important step in this approach. Our objective is to contribute to the...

Multilevel water governance and problems of scale: setting the stage for a broader debate.

PubMed

Moss, Timothy; Newig, Jens

2010-07-01

Environmental governance and management are facing a multiplicity of challenges related to spatial scales and multiple levels of governance. Water management is a field particularly sensitive to issues of scale because the hydrological system with its different scalar levels from small catchments to large river basins plays such a prominent role. It thus exemplifies fundamental issues and dilemmas of scale in modern environmental management and governance. In this introductory article to an Environmental Management special feature on "Multilevel Water Governance: Coping with Problems of Scale," we delineate our understanding of problems of scale and the dimensions of scalar politics that are central to water resource management. We provide an overview of the contributions to this special feature, concluding with a discussion of how scalar research can usefully challenge conventional wisdom on water resource management. We hope that this discussion of water governance stimulates a broader debate and inquiry relating to the scalar dimensions of environmental governance and management in general.

Coaching Family Caregivers to Become Better Problem Solvers When Caring for Persons with Advanced Cancer.

PubMed

Dionne-Odom, J Nicholas; Lyons, Kathleen D; Akyar, Imatullah; Bakitas, Marie A

2016-01-01

Family caregivers of persons with advanced cancer often take on responsibilities that present daunting and complex problems. Serious problems that go unresolved may be burdensome and result in negative outcomes for caregivers' psychological and physical health and affect the quality of care delivered to the care recipients with cancer, especially at the end of life. Formal problem-solving training approaches have been developed over the past several decades to assist individuals with managing problems faced in daily life. Several of these problem-solving principles and techniques were incorporated into ENABLE (Educate, Nurture, Advise, Before Life End), an "early" palliative care telehealth intervention for individuals diagnosed with advanced cancer and their family caregivers. A hypothetical case resembling the situations of actual caregiver participants in ENABLE that exemplifies the complex problems that caregivers face is presented, followed by presentation of an overview of ENABLE's problem-solving key principles, techniques, and steps in problem-solving support. Though more research is needed to formally test the use of problem-solving support in social work practice, social workers can easily incorporate these techniques into everyday practice.

So This is Knowledge Sharing

NASA Technical Reports Server (NTRS)

Motil, Susan

2003-01-01

People within large organizations have probably already dealt with problems similar to the problems that you face; you can save time and money by taking advantage of that experience and knowledge. Knowledge sharing by mentors can empower less experienced managers who would otherwise not challenge the status quo. Reviews should encourage joint problem solving rather than just reporting. To accomplish this, ensure that the review process is viewed as feedback from independent and supportive experts.

Strategic Directions Within Health Care Institutions: The Role of the Physician

PubMed Central

McDaniel, Reuben R.; Ashmos, Donde P.

1986-01-01

The nature of the strategic problem faced by health care institutions is identified. Physicians are urged to be involved in the strategic decision-making process and are offered several alternative roles that they might play in strategy development. A set of conceptual frameworks from the generic management decision-making literature is used to organize the analysis in addition to the literature of health care management. This combination affords a different perspective into the nature of the problems and new insights into these critical issues. PMID:3746932

Systemic Engagement: Universities as Partners in Systemic Approaches to Community Change

ERIC Educational Resources Information Center

McNall, Miles A.; Barnes-Najor, Jessica V.; Brown, Robert E.; Doberneck, Diane M.; Fitzgerald, Hiram E.

2015-01-01

The most pressing social problems facing humanity in the 21st century are what systems theorist Russell Ackoff referred to as "messes"--complex dynamic systems of problems that interact and reinforce each other over time. In this article, the authors argue that the lack of progress in managing messes is in part due to the predominance of…

The Troublesome Triplets: Issues in Teaching Reliability, Validity and Generalisation to Business Students

ERIC Educational Resources Information Center

Quinton, Sarah; Smallbone, Teresa

2005-01-01

This discussion paper focuses on the problem of how to approach teaching abstract concepts to business and management students at both undergraduate and postgraduate level. Students are faced with the problem of how to identify and assess the rigour of what they read, how to generalise from the results of their research and how to judge the extent…

Blending online therapy into regular face-to-face therapy for depression: content, ratio and preconditions according to patients and therapists using a Delphi study.

PubMed

van der Vaart, Rosalie; Witting, Marjon; Riper, Heleen; Kooistra, Lisa; Bohlmeijer, Ernst T; van Gemert-Pijnen, Lisette J E W C

2014-12-14

Blending online modules into face-to-face therapy offers perspectives to enhance patient self-management and to increase the (cost-)effectiveness of therapy, while still providing the support patients need. The aim of this study was to outline optimal usage of blended care for depression, according to patients and therapists. A Delphi method was used to find consensus on suitable blended protocols (content, sequence and ratio). Phase 1 was an explorative phase, conducted in two rounds of online questionnaires, in which patients' and therapists' preferences and opinions about online psychotherapy were surveyed. In phase 2, data from phase 1 was used in face-to-face interviews with therapists to investigate how blended therapy protocols could be set up and what essential preconditions would be. Twelve therapists and nine patients completed the surveys. Blended therapy was positively perceived among all respondents, especially to enhance the self-management of patients. According to most respondents, practical therapy components (assignments, diaries and psycho-education) may be provided via online modules, while process-related components (introduction, evaluation and discussing thoughts and feelings), should be supported face-to-face. The preferred blend of online and face-to-face sessions differs between therapists and patients; most therapists prefer 75% face-to-face sessions, most patients 50 to 60%. The interviews showed that tailoring treatment to individual patients is essential in secondary mental health care, due to the complexity of their problems. The amount and ratio of online modules needs to be adjusted according to the patient's problems, skills and characteristics. Therapists themselves should also develop skills to integrate online and face-to-face sessions. Blending online and face-to-face sessions in an integrated depression therapy is viewed as a positive innovation by patients and therapists. Following a standard blended protocol, however, would be difficult in secondary mental health care. A database of online modules could provide flexibility to tailor treatment to individual patients, which asks motivation and skills of both patients and therapists. Further research is necessary to determine the (cost-)effectiveness of blended care, but this study provides starting points and preconditions to blend online and face-to-face sessions and create a treatment combining the best of both worlds.

Establishing a Conceptual Foundation for Addressing Challenges Facing Food-Energy-Water Management

NASA Astrophysics Data System (ADS)

Goldsby, M.; Padowski, J.; Katz, S.; Brady, M.; Hampton, S. E.

2017-12-01

Ensuring the security of food, energy and water in the face of a changing environment is a top societal priority. In order to make sound policy decisions aimed at meeting those needs, policy-makers need decision-relevant information. As such, considerable effort and resources have recently been devoted to investigating the Food-Energy-Water (FEW) Nexus in order to better provide that information. However, despite the increased research activity into FEW systems and FEW problems, little attention has been devoted to the fundamental conceptual issues underlying contemporary FEW systems. Consequently, this inattention has led to conceptual confusion about what is and what is not a FEW system. This project aims to fill that lacuna in order to better facilitate the FEW research agenda. Toward that end, we identify three features that distinguish FEW problems from other resource management problems: (1) the production and management of the resources in each sector of a FEW system is specialized to its own sector; (2) interdependencies exist between sectors such that overproduction in one sector, for example, may have impacts on other sectors; and (3) there are real limits to FEW resource availability as well as limits on the ability to transact across sector boundaries. We contend that once armed with this distinction, one can model the stocks and flows of FEW capital in a conceptually rigorous way that may lead to operational innovations of FEW management.

Towards a Model of School Leadership.

ERIC Educational Resources Information Center

Busher, Hugh; Saran, Rene

1994-01-01

Explores the various leadership models (structural-functional, open-systems, cultural-pluralism, interpersonal, and political) used to illuminate headteachers' work and considers the problems faced by leaders in professionally staffed organizations. School leadership activities center on managing organizational cultures and the external…

Solid Waste Management in North Carolina: A Curriculum Resource Guide for Teachers.

ERIC Educational Resources Information Center

Watauga County Board of Education, Boone, NC.

Renewal is the focus of this curriculum designed for students in kindergarten through Grade 8. The purpose of this guide is to educate students and teachers about the problems faced in managing the amount of solid waste generated by society. Each grade level curriculum is organized into activities that support exploration of the nature of solid…

A Study of Career Ladders and Manpower Development for Non-Management Personnel in the Food Service Industry.

ERIC Educational Resources Information Center

State Univ. of New York, Ithaca. School of Hotel Administration at Cornell Univ.

Because of its failure to provide career ladders for non-management employees, the food service industry is facing increasingly severe manpower shortages and labor turnover. Unnecessary requirements bar entry workers from many jobs, and training opportunities leave much to be desired. This report identifies the problem areas and develops a model…

Capitated Medicaid Managed Care in a Rural Area: The Impact of Minnesota's PMAP Program

ERIC Educational Resources Information Center

Long, Sharon K.; Coughlin, Teresa A.; King, Jennifer

2005-01-01

Although states have had difficulty extending Medicaid managed care (MMC) to rural areas, rural models of capitated MMC are expected to grow in response to new federal regulations and the serious budget problems facing nearly all states. As such, understanding the effects of capitated MMC in rural settings is important for policy considerations.…

DCAA Audits: Widespread Problems with Audit Quality Require Significant Reform

DTIC Science & Technology

2009-09-01

is included in appendix III. DOD contract management continues to be a high- risk area for the government.17 With hundreds of billions of taxpayer...Defense Contract Management : DOD’s Lack of Adherence to Key Contracting Principles on Iraq Oil Contract Put Government Interests at Risk , GAO-07-839...in the Federal Government68 require federal agency managers to identify and assess relevant risks the agency faces from external and internal

A proposed simulation optimization model framework for emergency department problems in public hospital

NASA Astrophysics Data System (ADS)

Ibrahim, Ireen Munira; Liong, Choong-Yeun; Bakar, Sakhinah Abu; Ahmad, Norazura; Najmuddin, Ahmad Farid

2015-12-01

The Emergency Department (ED) is a very complex system with limited resources to support increase in demand. ED services are considered as good quality if they can meet the patient's expectation. Long waiting times and length of stay is always the main problem faced by the management. The management of ED should give greater emphasis on their capacity of resources in order to increase the quality of services, which conforms to patient satisfaction. This paper is a review of work in progress of a study being conducted in a government hospital in Selangor, Malaysia. This paper proposed a simulation optimization model framework which is used to study ED operations and problems as well as to find an optimal solution to the problems. The integration of simulation and optimization is hoped can assist management in decision making process regarding their resource capacity planning in order to improve current and future ED operations.

Analysis of constraints and potentials for wastewater management in the coastal city of Manado, North Sulawesi, Indonesia.

PubMed

Lasut, Markus T; Jensen, Kathe R; Shivakoti, Ganesh

2008-09-01

Manado is the largest and most densely populated coastal city in North Sulawesi Province, Indonesia. The city is facing problems of wastewater discharged from various sources. These problems are driven by high population pressure, increasing economic activity, and low household income, in combination with inadequate organizational structure of government institutions for addressing the wastewater problems as well as for law enforcement. There have been no community initiatives to prevent or mitigate wastewater problems. Therefore, a wastewater management plan is urgently needed to prevent and mitigate pollution caused by discharged wastewater. In this paper we analyze the current situation with respect to environmental state, sources and treatment of wastewater, socio-economic and institutional capacities as well as community awareness. Constraints and potentials are discussed to give recommendations for an integrated wastewater management plan for the city of Manado.

Ranking the Project Management Success Factors for Construction Project in South India

NASA Astrophysics Data System (ADS)

Aneesha, K.; Haridharan, M. K.

2017-07-01

In Today’s construction industry, to achieve a greater advantage over the firms, success of each project and efficiency is required. Effective Project Management overcomes these types of challenges. This study identifies the success factors which are important for project management in construction project success. From the literature review, 26 factors were found to be critical. Project managers, construction managers, civil engineers, contractors and site engineers were the respondents. After analyzing the data in SPSS software, the dominant factors from the regression analysis are top management support, competent project team, abilities to solve problems, realistic cost and time estimates, information/communication, competency of the project manager are the 6 factors out of 12 in 26 factors. Effective communication between stakeholders got highest priority and client involvement, good leadership, clarity of project goals got second priority. Informal communication gives better results compared to formal communications like written formats. To remove communication barrier with the stakeholders, informal communication like speaking face-to-face with the language this fits for the stakeholders.

Simultaneous personnel and vehicle shift scheduling in the waste management sector.

PubMed

Ghiani, Gianpaolo; Guerriero, Emanuela; Manni, Andrea; Manni, Emanuele; Potenza, Agostino

2013-07-01

Urban waste management is becoming an increasingly complex task, absorbing a huge amount of resources, and having a major environmental impact. The design of a waste management system consists in various activities, and one of these is related to the definition of shift schedules for both personnel and vehicles. This activity has a great incidence on the tactical and operational cost for companies. In this paper, we propose an integer programming model to find an optimal solution to the integrated problem. The aim is to determine optimal schedules at minimum cost. Moreover, we design a fast and effective heuristic to face large-size problems. Both approaches are tested on data from a real-world case in Southern Italy and compared to the current practice utilized by the company managing the service, showing that simultaneously solving these problems can lead to significant monetary savings. Copyright © 2013 Elsevier Ltd. All rights reserved.

Anaesthesia and intensive care management of face transplantation.

PubMed

Sedaghati-nia, A; Gilton, A; Liger, C; Binhas, M; Cook, F; Ait-Mammar, B; Scherrer, E; Hivelin, M; Lantieri, L; Marty, J; Plaud, B

2013-10-01

The face-grafting techniques are innovative and highly complex, requiring well-defined organization of all the teams involved. Subsequent to the first report in France in 2005, there have been 17 facial allograft transplantations performed worldwide. We describe anaesthesia and postoperative management, and the problems encountered, during the course of seven facial composite tissue grafts performed between 2007 and 2011 in our hospital. The reasons for transplantation were ballistic trauma in four patients, extensive neurofibromatosis in two patients, and severe burns in one patient. Anaesthesia for this long procedure involves advanced planning for airway management, vascular access, technique of anaesthesia, and fluid management. Preparation and grafting phases were highly haemorrhagic (>one blood volume), requiring massive transfusion. Median (range) volumes given for packed red cell (PRC) and fresh-frozen plasma (FFP) were 64.2 ml kg(-1) (35.5-227.5) and 46.2 ml kg(-1) (6.3-173.7), respectively. Blood loss quantification was difficult because of diffuse bleeding to the drapes. The management of patients with neurofibromatosis or burns involving the whole face was more difficult and haemorrhagic than the patients with lower face transplantation. Average surgical duration was 19.1 h (15-28 h). Postoperative severe graft oedema was present in most patients. Most patients encountered complications in ICU, such as renal insufficiency, acute respiratory distress syndrome, and jugular thrombosis. Opportunistic bacterial infections were a feature during the postoperative period in these highly immunosuppressed patients.

Adaptive Management for a Turbulent Future

EPA Science Inventory

The challenges that face humanity today differ from the past because as the scale of human influence has increased, our biggest challenges have become global in nature, and formerly local problems that could be addressed by shifting populations or switching resources, now aggrega...

Gender and Environmental Sustainability: Issues and Problems Involved for Persons with Special Needs in Nigeria

ERIC Educational Resources Information Center

Egaga, Patrick I.; Aderibigbe, S. Akinwumi

2015-01-01

Sustainability of the environment is one of the major problems facing African people, most especially Nigerians. It is unfortunate that women, by the nature of their daily activities of managing the homes and families are in touch with nature and environment and are at greater risk of health hazards and foetal damage. This paper focuses on the…

Toward interactive scheduling systems for managing medical resources.

PubMed

Oddi, A; Cesta, A

2000-10-01

Managers of medico-hospital facilities are facing two general problems when allocating resources to activities: (1) to find an agreement between several and contrasting requirements; (2) to manage dynamic and uncertain situations when constraints suddenly change over time due to medical needs. This paper describes the results of a research aimed at applying constraint-based scheduling techniques to the management of medical resources. A mixed-initiative problem solving approach is adopted in which a user and a decision support system interact to incrementally achieve a satisfactory solution to the problem. A running prototype is described called Interactive Scheduler which offers a set of functionalities for a mixed-initiative interaction to cope with the medical resource management. Interactive Scheduler is endowed with a representation schema used for describing the medical environment, a set of algorithms that address the specific problems of the domain, and an innovative interaction module that offers functionalities for the dialogue between the support system and its user. A particular contribution of this work is the explicit representation of constraint violations, and the definition of scheduling algorithms that aim at minimizing the amount of constraint violations in a solution.

Understanding and Facing Discipline-Related Challenges in the English as a Foreign Language Classroom at Public Schools (Comprensión y tratamiento de los retos asociados a la disciplina en el aula de lengua extranjera en escuelas públicas)

ERIC Educational Resources Information Center

Quintero Corzo, Josefina; Ramírez Contreras, Odilia

2011-01-01

Complying with school regulations and teachers' instructions is a basic principle of an excellent class; both novice and experienced teachers face challenging situations when getting into real classrooms, especially those related to classroom management. There are various reasons that explain discipline problems in public schools, as well as…

Computer-mediated mobile messaging as collaboration support for nurses.

PubMed

Karpati, Peter; Toussaint, Pieter Jelle; Nytrø, Oystein

2009-01-01

Collaboration in hospitals is coordinated mainly by communication, which currently happens by face-to-face meetings, phone calls, pagers, notes and the electronic patient record. These habits raise problems e.g., delayed notifications and unnecessary interruptions. Dealing with these problems could save time and improve the care. Therefore we designed and prototyped a mobile messaging solution based on two specific scenarios coming from observations at a cardiology department of a Norwegian hospital. The main focus was on supporting the work of nurses. One prototype supported patient management while another one dealt with messages related to medication planning. The evaluation of the prototypes suggested that messaging-based collaboration support is worth to explore and also gave ideas for improvement.

Craniostenosis: a neurosurgeon's perspective.

PubMed

Balasubramaniam, Chidambaram; Rao, Santosh Mohan; Subramaniam, Kalyanaraman

2014-09-01

In pediatric neurosurgery departments in India, craniosynostosis is being increasingly identified and dealt with during the past several years. The management of this problem is well established in units that have a strong pediatric bias, whereas it is still in infancy in certain departments. Some misconceptions exist regarding this condition with reference to clinical, genetic aspects and management-in particular, the surgical indications. The experience gained for more than 2 decades of treating this condition as well as the problems faced in the management of this condition will be discussed. Although the terms craniostenosis and craniosynostosis do not mean quite the same thing, the terms are used interchangeably and will be done so in this communication.

Adaptive Management: From More Talk to Real Action

NASA Astrophysics Data System (ADS)

Williams, Byron K.; Brown, Eleanor D.

2014-02-01

The challenges currently facing resource managers are large-scale and complex, and demand new approaches to balance development and conservation goals. One approach that shows considerable promise for addressing these challenges is adaptive management, which by now is broadly seen as a natural, intuitive, and potentially effective way to address decision-making in the face of uncertainties. Yet the concept of adaptive management continues to evolve, and its record of success remains limited. In this article, we present an operational framework for adaptive decision-making, and describe the challenges and opportunities in applying it to real-world problems. We discuss the key elements required for adaptive decision-making, and their integration into an iterative process that highlights and distinguishes technical and social learning. We illustrate the elements and processes of the framework with some successful on-the-ground examples of natural resource management. Finally, we address some of the difficulties in applying learning-based management, and finish with a discussion of future directions and strategic challenges.

Information Communication and Technology for Water Resource Management and Food Security in Kenya: A Case Study of Kericho and Uasin Gishu Districts

ERIC Educational Resources Information Center

Omboto, P. I.; Macharia, J.; Mbagaya, Grace; Standa, F. N.

2011-01-01

Recent reports on Kenya have indicated food insecurity and destruction of water catchments as serious problems facing the country. Despite the tremendous strides in Information and Communication Technology (ICT), the country has not taken advantage of the technology to improve food security by effectively managing her water resources. A survey on…

Impact of parking supply and demand management on central business district (CBD) traffic congestion, transit performance measures and sustainable land use : a study of the impact of parking supply and demand management.

DOT National Transportation Integrated Search

2012-07-01

Parking is one of the thorniest problems facing local officials who wish to maintain the vitality of central business districts (CBD). Viewed in isolation, the solution often is seen as more parking, at least, and more free parking, if possible. But ...

Coaching Family Caregivers to become Better Problem Solvers when Caring for Persons with Advanced Cancer

PubMed Central

Dionne-Odom, J. Nicholas; Lyons, Kathleen D.; Akyar, Imatullah; Bakitas, Marie

2016-01-01

Family caregivers of persons with advanced cancer often take on responsibilities that present daunting and complex problems. Serious problems that go unresolved may be burdensome and result in negative outcomes for caregivers’ psychological and physical health and affect the quality of care delivered to the care recipients with cancer, especially at the end of life. Formal problem-solving training approaches have been developed over the past several decades to assist individuals with managing problems faced in daily life. Several of these problem-solving principles and techniques were incorporated into ENABLE (Educate, Nurture, Advise, Before Life End), an ‘early’ palliative care telehealth intervention for individuals diagnosed with advanced cancer and their family caregivers. A hypothetical case resembling the situations of actual caregiver participants in ENABLE that exemplifies the complex problems that caregivers face is presented followed by presentation of an overview of ENABLE’s problem-solving key principles, techniques and steps in problem-solving support. Though more research is needed to formally test the use of problem-solving support in social work practice, social workers can easily incorporate these techniques into everyday practice. PMID:27143574

Building the Superconducting Super Collider, 1989-1993: The Problem of Project Management

NASA Astrophysics Data System (ADS)

Riordan, Michael

2011-04-01

In attempting to construct the Superconducting Super Collider, US particle physicists faced a challenge unprecedented in the history of science. The SSC was the biggest and costliest pure scientific project ever, comparable in overall scale to the Manhattan Project or the Panama Canal - an order of magnitude larger than any previous particle accelerator or collider project. Managing such an enormous endeavor involved coordinating conventional-construction, magnet-manufacturing, and detector-building efforts costing over a billion dollars apiece. Because project-management experience at this scale did not exist within the physics community, the Universities Research Association and the US Department of Energy turned to companies and individuals from the military-industrial complex, with mixed results. The absence of a strong, qualified individual to serve as Project Manager throughout the duration of the project was a major problem. I contend that these problems in its project management contributed importantly to the SSC's 1993 demise. Research supported by NSF Award No. 823296.

VARIABILITY OF PARAMETERS MEASURED DURING THE RESUSPENSION OF SEDIMENTS WITH A PARTICULATE ENTRAINMENT SIMULATOR

EPA Science Inventory

Contaminated sediments are a problem facing many environmental managers concerned with issues such as maintenance dredging, habitat restoration and dredged material placement. Currently, there are few methods which can be used to assess contaminant remobilization potential from ...

Positive deviance: an elegant solution to a complex problem.

PubMed

Lindberg, Curt; Clancy, Thomas R

2010-04-01

As systems evolve over time, their natural tendency is to become increasingly more complex. Studies in the field of complex systems have generated new perspectives on management in social organizations such as hospitals. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. This is the 13th in a series of articles applying complex systems science to the traditional management concepts of planning, organizing, directing, coordinating, and controlling. This article provides one example of how concepts taken from complex systems theory can be applied to real-world problems facing nurses today.

Collaborative Help in Chronic Disease Management: Supporting Individualized Problems

PubMed Central

Huh, Jina; Ackerman, Mark S.

2013-01-01

Coping with chronic illness disease is a long and lonely journey, because the burden of managing the illness on a daily basis is placed upon the patients themselves. In this paper, we present our findings for how diabetes patient support groups help one another find individualized strategies for managing diabetes. Through field observations of face-to-face diabetes support groups, content analysis of an online diabetes community, and interviews, we found several help interactions that are critical in helping patients in finding individualized solutions. Those are: (1) patients operationalize their experiences to easily contextualize and share executable strategies; (2) operationalization has to be done within the larger context of sharing illness trajectories; and (3) the support groups develop common understanding towards diabetes management. We further discuss how our findings translate into design implications for supporting chronic illness patients in online community settings. PMID:25360442

Ineffective Healthcare Technology Management in Benin’s Public Health Sector: The Perceptions of Key Actors and Their Ability to Address the Main Problems

PubMed Central

Houngbo, P. Thierry; De Cock Buning, Tjard; Bunders, Joske; Coleman, Harry L. S.; Medenou, Daton; Dakpanon, Laurent; Zweekhorst, Marjolein

2017-01-01

Background: Low-income countries face many contextual challenges to manage healthcare technologies effectively, as the majority are imported and resources are constrained to a greater extent. Previous healthcare technology management (HTM) policies in Benin have failed to produce better quality of care for the population and costeffectiveness for the government. This study aims to identify and assess the main problems facing HTM in Benin’s public health sector, as well as the ability of key actors within the sector to address these problems. Methods: We conducted 2 surveys in 117 selected health facilities. The first survey was based on 377 questionnaires and 259 interviews, and the second involved observation and group interviews at health facilities. The Temple-Bird Healthcare Technology Package System (TBHTPS), tailored to the context of Benin’s health system, was used as a conceptual framework. Results: The findings of the first survey show that 85% of key actors in Benin’s HTM sector characterized the system as failing in components of the TBHTPS framework. Biomedical, clinical, healthcare technology engineers and technicians perceived problems most severely, followed by users of equipment, managers and hospital directors, international organization officers, local and foreign suppliers, and finally policy-makers, planners and administrators at the Ministry of Health (MoH). The 5 most important challenges to be addressed are policy, strategic management and planning, and technology needs assessment and selection – categorized as major enabling inputs (MEI) in HTM by the TBHTPS framework – and installation and commissioning, training and skill development and procurement, which are import and use activities (IUA). The ability of each key actor to address these problems (the degree of political or administrative power they possess) was inversely proportional to their perception of the severity of the problems. Observational data gathered during site visits described a different set of challenges including maintenance and repair, distribution, installation and commissioning, use and training and personnel skill development. Conclusion: The lack of experiential and technical knowledge in policy development processes could underpin many of the continuing problems in Benin’s HTM system. Before solutions can be devised to these problems, it is necessary to investigate their root causes, and which problems are most amenable to policy development. PMID:28949474

Measurement and Diagnosis of Student Attitudes Toward a Career in Advertising. Working Paper Series, Center for Marketing Studies Paper No. 19.

ERIC Educational Resources Information Center

Lutz, Richard J.

A problem currently facing many advertising agencies is the recruitment of top quality business school graduates as potential account managers. Viewing the problem from a marketing perspective, a career in advertising is seen as a product competing with other careers for the market of new graduates. Then it is possible to use one of the…

Ecology, life history and management of tropilaelaps mites

USDA-ARS?s Scientific Manuscript database

Parasitic mites are the major threat of the Western honey bee, Apis mellifera. For much of the world, Varroa destructor single-handedly inflicts unsurmountable problems to A. mellifera beekeeping. However, A. mellifera in Asia is also faced with another genus of destructive parasitic mite, Tropilae...

18 CFR 801.2 - Coordination, cooperation, and intergovernmental relations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... water resources problems within a local and regional context, but when faced with obviously needed... rendered. (3) Should it become necessary for the Commission to undertake development, management and operation of projects, arrangements for repayment of all project costs and eventual operation and...

Lean Management—The Journey from Toyota to Healthcare

PubMed Central

Teich, Sorin T.; Faddoul, Fady F.

2013-01-01

The evolution of production systems is tightly linked to the story of Toyota Motor Company (TMC) that has its roots around 1918. The term “lean” was coined in 1990 following the exploration of the Toyota model that led to the “transference” thesis sustaining the concept that manufacturing problems and technologies are universal problems faced by management and that these concepts can be emulated in non-Japanese enterprises. Lean is a multi-faceted concept and requires organizations to exert effort along several dimensions simultaneously; some consider a successful implementation either achieving major strategic components of lean, implementing practices to support operational aspects, or providing evidence that the improvements are sustainable in the long term. The article explores challenges and opportunities faced by organizations that intend incorporating lean management principles and presents the specific context of the healthcare industry. Finally, the concepts of “essential few” and customer value are illustrated through a simple example of process change following lean principles, which was implemented in a dental school in the United States. PMID:23908857

Spatial and Temporal Flood Risk Assessment for Decision Making Approach

NASA Astrophysics Data System (ADS)

Azizat, Nazirah; Omar, Wan-Mohd-Sabki Wan

2018-03-01

Heavy rainfall, adversely impacting inundation areas, depends on the magnitude of the flood. Significantly, location of settlements, infrastructure and facilities in floodplains result in many regions facing flooding risks. A problem faced by the decision maker in an assessment of flood vulnerability and evaluation of adaptation measures is recurrent flooding in the same areas. Identification of recurrent flooding areas and frequency of floods should be priorities for flood risk management. However, spatial and temporal variability become major factors of uncertainty in flood risk management. Therefore, dynamic and spatial characteristics of these changes in flood impact assessment are important in making decisions about the future of infrastructure development and community life. System dynamics (SD) simulation and hydrodynamic modelling are presented as tools for modelling the dynamic characteristics of flood risk and spatial variability. This paper discusses the integration between spatial and temporal information that is required by the decision maker for the identification of multi-criteria decision problems involving multiple stakeholders.

Developing a holistic strategy for integrated waste management within municipal planning: challenges, policies, solutions and perspectives for Hellenic municipalities in the zero-waste, low-cost direction.

PubMed

Zotos, G; Karagiannidis, A; Zampetoglou, S; Malamakis, A; Antonopoulos, I-S; Kontogianni, S; Tchobanoglous, G

2009-05-01

The present position paper addresses contemporary waste management options, weaknesses and opportunities faced by Hellenic local authorities. It focuses on state-of-the-art, tested as well as innovative, environmental management tools on a municipal scale and identifies a range of different collaboration schemes between local authorities and related service providers. Currently, a policy implementation gap is still experienced among Hellenic local authorities; it appears that administration at the local level is inadequate to manage and implement many of the general policies proposed; identify, collect, monitor and assess relevant data; and safeguard efficient and effective implementation of MSWM practices in the framework of integrated environmental management as well. This shortfall is partly due to the decentralisation of waste management issues to local authorities without a parallel substantial budgetary and capacity support, thus resulting in local activity remaining often disoriented and isolated from national strategies, therefore yielding significant planning and implementation problems and delays against pressing issues at hand as well as loss or poor use of available funds. This paper develops a systemic approach for MSWM at both the household and the non-household level, summarizes state-of-the-art available tools and compiles a set of guidelines for developing waste management master plans at the municipal level. It aims to provide a framework in the MSWM field for municipalities in Greece as well as other countries facing similar problems under often comparable socioeconomic settings.

Managing Vocational Education and Training in Central and Eastern European Countries. Report of a Programme on the Training of Researchers in the Management of Vocational Education and Training. IIEP Research and Studies Programme. The Development of Human Resources: New Trends in Technical and Vocational Education.

ERIC Educational Resources Information Center

Caillods, Francoise; And Others

This document provides materials prepared for and discussed at a workshop to analyze the problems facing Central and Eastern European countries in the management of the vocational education and training (VET) system. Part I gives an outline of the major research findings and reflects the discussions of the workshop. "Management of Vocational…

A Mobile IPv6 based Distributed Mobility Management Mechanism of Mobile Internet

NASA Astrophysics Data System (ADS)

Yan, Shi; Jiayin, Cheng; Shanzhi, Chen

A flatter architecture is one of the trends of mobile Internet. Traditional centralized mobility management mechanism faces the challenges such as scalability and UE reachability. A MIPv6 based distributed mobility management mechanism is proposed in this paper. Some important network entities and signaling procedures are defined. UE reachability is also considered in this paper through extension to DNS servers. Simulation results show that the proposed approach can overcome the scalability problem of the centralized scheme.

A Blended Learning Approach to Teaching Basic Pharmacokinetics and the Significance of Face-to-Face Interaction

PubMed Central

Holbrook, Jane

2010-01-01

Objective To assess pharmacy students' attitudes towards a blended-learning pharmacokinetics course. Design Narrated visual presentations and animations that illustrated kinetic processes and guided students through the use of software programs used for calculations were created. Other learning techniques used included online self-assessment quizzes, practice problem sets, and weekly face-to-face problem-solving tutorials. Assessment A precourse questionnaire to assess students' level of enthusiasm towards the blended-learning course and to solicit any concerns they had was administered at the beginning of the course. A postcourse questionnaire that included the same 4 Likert-scale items from the precourse questionnaire and follow-up open-ended questions was administered. Individual changes in level of enthusiasm were compared for individuals who completed both the precourse and postcourse questionnaire. Students' concerns about the blended method of learning had decreased postcourse while their enthusiasm for the benefits of blended learning had increased. Conclusion Students' initial concerns about the blended learning experience were focused on their ability to communicate with the instructor about the online components, but shifted to their own time management skills at the end of the course. Face-to-face interactions with each other and with the instructor were more highly rated than online interactions in this course. PMID:20798797

A blended learning approach to teaching basic pharmacokinetics and the significance of face-to-face interaction.

PubMed

Edginton, Andrea; Holbrook, Jane

2010-06-15

To assess pharmacy students' attitudes towards a blended-learning pharmacokinetics course. Narrated visual presentations and animations that illustrated kinetic processes and guided students through the use of software programs used for calculations were created. Other learning techniques used included online self-assessment quizzes, practice problem sets, and weekly face-to-face problem-solving tutorials. A precourse questionnaire to assess students' level of enthusiasm towards the blended-learning course and to solicit any concerns they had was administered at the beginning of the course. A postcourse questionnaire that included the same 4 Likert-scale items from the precourse questionnaire and follow-up open-ended questions was administered. Individual changes in level of enthusiasm were compared for individuals who completed both the precourse and postcourse questionnaire. Students' concerns about the blended method of learning had decreased postcourse while their enthusiasm for the benefits of blended learning had increased. Students' initial concerns about the blended learning experience were focused on their ability to communicate with the instructor about the online components, but shifted to their own time management skills at the end of the course. Face-to-face interactions with each other and with the instructor were more highly rated than online interactions in this course.

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

PubMed

Nyambok, Edward O; Kastner, Justin J

2012-01-01

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

Challenges to Native American health care.

PubMed

Noren, J; Kindig, D; Sprenger, A

1998-01-01

Native American health care programs face complex and unprecedented challenges resulting from the increased assumption of clinical operations by tribal authorities, shortfalls in Federal funding, modifications in state and Federal health and welfare programs, and intensifying involvement with managed care organizations. These challenges are further complicated by service populations that are increasing at a faster rate than the growth in funding. The authors conducted onsite surveys of 39 Native American health programs in 10 states in order to assess the organizational and management problems they faced. The trend toward transfer of health programs from the Indian Health Service to tribal operation seems likely to continue and accelerate. The survey results indicate that in order for programs to be effective in the long run, they will need to be guided by skilled managers able to adapt to these powerful changes in the health care environment.

Adopting Extensible Business Reporting Language (XBRL): A Grounded Theory

ERIC Educational Resources Information Center

Cruz, Marivic

2010-01-01

In 2007 and 2008, government challenges consisted of error prone, manually intensive, and inefficient environments for financial reporting. Banking regulators worldwide faced issues with respect to transparency, timeliness, quality, and managing risks associated with accounting opacity. The general problem was the existing reporting standards and…

Public Libraries: Responding to Demand.

ERIC Educational Resources Information Center

Annichiarico, Mark; And Others

1993-01-01

Discussion of problems library wholesalers/distributors face trying to fulfill public libraries' needs while adjusting to a changing industry is based on responses by librarians to a survey on library jobbers. Increased services to libraries, electronic ordering, timeliness, stock management, and quality control are addressed; and a chart of…

Interpreting the New Sexual Harassment Guidelines.

ERIC Educational Resources Information Center

Hoyman, Michele; Robinson, Ronda

1980-01-01

Discusses sexual harrassment guidelines which legally define the term as sex discrimination. While this is good for those facing harassment, it unrealistically places a socially-based problem on the shoulders of personnel managers. Points out the long-term benefits of a workplace free from harassment and intimidation. (JOW)

Encopresis in Children on the Autistic Spectrum.

ERIC Educational Resources Information Center

Radford, Jo; Anderson, Maggie

2003-01-01

Outlines problems faced by parents and caregivers of a child with encopresis. Differentiates between knowledge, skill, and volition issues when dealing with the encoprectic child; and suggests possible causal frameworks for the behavior. Concludes with suggestions for managing the teaching/learning situation arising from this behavior. (Author/KB)

Educational Infrastructure Using Virtualization Technologies: Experience at Kaunas University of Technology

ERIC Educational Resources Information Center

Miseviciene, Regina; Ambraziene, Danute; Tuminauskas, Raimundas; Pažereckas, Nerijus

2012-01-01

Many factors influence education nowadays. Educational institutions are faced with budget cuttings, outdated IT, data security management and the willingness to integrate remote learning at home. Virtualization technologies provide innovative solutions to the problems. The paper presents an original educational infrastructure using virtualization…

A new approach to design and use of management information.

PubMed

Daft, R L; MacIntosh, N B

1978-01-01

Information, that is both accurate and timely, is probably the most important resource needed by managers to make sound decisions regarding the problems and issues facing their organizations. Unfortunately, sophisticated information systems often fail to meet this need. Managers complain that the data produced by information systems arrive too late, are too general and lack accuracy. Daft and MacIntosh studied the system problems of a number of organizations, discovering that understanding their work activities is critical to the design of successful information systems. The authors also considered the volume of information, preciseness of information and the way in which it is handled by users to develop a model describing information systems. The article illustrates how the model was applied successfully to four case situations.

Transsexualism: a medical perspective.

PubMed Central

Armstrong, C N

1980-01-01

Transsexualism, a condition in which from earliest recollection the individual is unshakeably convinced he or she has been endowed with the wrong physical sexual body presents one of the most difficult problems as regards management and treatment in clinical medicine. The aetiology and treatment is discussed and the problems with which the medical practitioner may be faced in advising his transsexual patient which include change in social role and marriage and the difference between sex and gender. PMID:7420376

Social, political, and institutional setting: Water management problems of the Rio Grande

USGS Publications Warehouse

Douglas, A.J.

2009-01-01

This paper discusses various water management issues facing federal, state, and local agencies charged with managing the water resources of the Rio Grande River Basin and its major tributaries. The Rio Grande - 3,058 km (=1,900 mi) long - is the fourth longest river in the United States. The river's basin is 870,236 km2 (=336,000 mi2) and for roughly two-thirds of its length it forms the United States-Mexican border. It is a major recreational resource providing world class trout fishing near its headwaters in Colorado's San Juan Mountains and shoreline, angling, and boating opportunities near the Colorado-New Mexico border. The Rio Grande is the principal tourist attraction of Big Bend National Park and flows through downtown Albuquerque and El Paso. Many reaches are wide and broad, but almost all are relatively shallow and not navigable by commercial ships. Nevertheless, it is one of the most important renewable water resources of the southwestern United States and North America. The issue of the "manageability" of the river in the face of social forces and disparate administrative jurisdictions that adversely impact Rio Grande flows is a thread linking various sections of the paper together. The length of the river; the fact that major reaches lie in Colorado, New Mexico, and Texas; and its unique role as an international boundary pose complex management problems. The allocation status quo formed by the complex nexus of existing river laws make it difficult to reshape Rio Grande management. ?? 2009 ASCE.

Serving the Homeless through Recreation Programs. Research Update.

ERIC Educational Resources Information Center

Kunstler, Robin

1993-01-01

Literature review examines problems faced by homeless adults and children and discusses how recreation programs can serve them. The recreation and leisure profession can offer to the healthy child development through play and recreation, physical fitness, stress management, socialization, opportunities to learn goal-setting, self-esteem building,…

Improving Bilingual Program Management. A Handbook for Title VII Directors.

ERIC Educational Resources Information Center

DeGeorge, George P., Ed.

Filled with practical advice and workable techniques and strategies to help bilingual program directors deal with the problems they face, this handbook brings together ideas and suggestions from Title VII program directors, state coordinators, and superintendents with experience in bilingual programs. The handbook, written in question and answer…

Assessment of tort liability risk management in the Virginia Department of Transportation : final report.

DOT National Transportation Integrated Search

1988-01-01

The Virginia Department of Transportation (VDOT) faces a growing tort liability problem. Under the Virginia Tort Claims Act, VOOT is liable for up to $75,000 for negligent or wrongful acts or omissions committed by its employees within the scope of t...

Facing and Managing Dilemmas as a Clinical Educator

ERIC Educational Resources Information Center

McAllister, Lindy; Higgs, Joy; Smith, David

2008-01-01

Although clinical educators make an important and irreplaceable contribution to the education of students undertaking qualifications that will enable them to practise as health professionals, little is known about the day-to-day experiences of clinical educators and the complexities of clinical education that may contribute to the problems or to…

Early Career Teacher Professional Development: Bridging Simulation Technology with Evidence-Based Behavior Management

ERIC Educational Resources Information Center

Shernoff, Elisa; Frazier, Stacy; Lisetti, Christine; Buche, Cedric; Lunn, Stephanie; Brown, Claire; Delmarre, Alban; Chou, Tommy; Gabbard, Joseph; Morgan, Emily

2018-01-01

Early career teachers working in high poverty schools face of overwhelming challenges navigating disruptive behaviors with studies highlighting behavior problems as one of the strongest predictors of turnover (Ingersoll & Smith, 2003). Simulation-based technology leverages important pedagogical strengths (e.g., realistic training context,…

Advanced Interactive Web Technologies in Industry Training.

ERIC Educational Resources Information Center

Vassileva, Tania; Astinov, Ilario; Bojkov, Dimitar; Tchoumatchenko, Vassiliy; Scholten, Ulrich; Furnadziev, Ivan

Today, faced with the problems of global competition, increasing costs, and complex production engineering, a company can only be successfully managed if the employees are motivated and highly qualified. To cope with this demand the new educational scheme for cost-effective retraining, lifelong learning and distance education at the workplace…

A Decision Support Tool to Evaluate Sources and Sinks of Nitrogen within a Watershed Framework

EPA Science Inventory

Human transformation of the nitrogen (N) cycle is causing a number of environmental and human health problems. Federal, state and local authorities focusing on management of N loadings face both technical and non-technical challenges. One technical issue is that we need a bette...

People and Forests.

ERIC Educational Resources Information Center

NatureScope, 1986

1986-01-01

Provides: (1) background information on how forests are managed and some of the problems facing forests around the world; (2) three activities dealing with these topics; and (3) three ready-to-copy pages for student use. Activities include an objective, recommended age level(s), recommended subject area(s), list of materials needed, and…

Emerging Models of the New Paradigm.

ERIC Educational Resources Information Center

Howser, Lee; Schwinn, Carole

Working with the Philadelphia-based Institute of Interactive Management, several teams at Jackson Community College (JCC), in Michigan, set out in 1994 to learn and apply an interactive design methodology to selected college subsystems. Interactive design begins with understanding problems faced by the system as a whole, which in the case of JCC…

Internetworking Services and the Electronic Library.

ERIC Educational Resources Information Center

Brunell, David H.

1991-01-01

Discusses management issues that librarians face in offering public access to library resources through internetworking services, e.g., local area networks, campus networks, or the INTERNET. It is concluded that interface problems and lack of an effective technical support structure make access to library information on INTERNET more of an…

The New Corporate Stake in Higher Education.

ERIC Educational Resources Information Center

Council for Financial Aid to Education, New York, NY.

The ways that selected companies are managing and structuring their responses to the needs of higher education for financial support and cooperative programs are described. According to General Foods Corporation Chairman James L. Ferguson, the academic world faces the problem of maintaining its standards in light of the decrease of federal…

Bridges to Business. Fund for the Improvement of Postsecondary Education Final Report.

ERIC Educational Resources Information Center

Ironfield, Elaine

Bridges to Business is a dual admissions program between Holyoke Community College (HCC) (Massachusetts) and the School of Management at the University of Massachusetts-Amherst (UMass). Established to attract, educate, and graduate linguistic minority students, the FIPSE-funded program addressed the major problems faced by limited English…

Development of the renewal on the Standing Rock Sioux Reservation Project

USDA-ARS?s Scientific Manuscript database

The Standing Rock Sioux Reservation is comprised of 2.3 million acres of primarily rangeland that straddle the North Dakota – South Dakota border. Many of its inhabitants face issues with unemployment and dietary problems. In addition, there are concerns about the management of its natural resourc...

Consultancy on Strategic Information Planning.

ERIC Educational Resources Information Center

Pejova, Zdravka, Ed.; Horton, Forest W., Ed.

At the workshop, better management through strategic planning of information and consultancy was discussed as one way in which developing and Eastern European countries could tackle the complex information problems they are facing during the transition to a market economy. The sixteen papers in this volume are grouped into three basic categories:…

Resolving Complex Research Data Management Issues in Biomedical Laboratories: Qualitative Study of an Industry-Academia Collaboration

PubMed Central

Myneni, Sahiti; Patel, Vimla L.; Bova, G. Steven; Wang, Jian; Ackerman, Christopher F.; Berlinicke, Cynthia A.; Chen, Steve H.; Lindvall, Mikael; Zack, Donald J.

2016-01-01

This paper describes a distributed collaborative effort between industry and academia to systematize data management in an academic biomedical laboratory. Heterogeneous and voluminous nature of research data created in biomedical laboratories make information management difficult and research unproductive. One such collaborative effort was evaluated over a period of four years using data collection methods including ethnographic observations, semi-structured interviews, web-based surveys, progress reports, conference call summaries, and face-to-face group discussions. Data were analyzed using qualitative methods of data analysis to 1) characterize specific problems faced by biomedical researchers with traditional information management practices, 2) identify intervention areas to introduce a new research information management system called Labmatrix, and finally to 3) evaluate and delineate important general collaboration (intervention) characteristics that can optimize outcomes of an implementation process in biomedical laboratories. Results emphasize the importance of end user perseverance, human-centric interoperability evaluation, and demonstration of return on investment of effort and time of laboratory members and industry personnel for success of implementation process. In addition, there is an intrinsic learning component associated with the implementation process of an information management system. Technology transfer experience in a complex environment such as the biomedical laboratory can be eased with use of information systems that support human and cognitive interoperability. Such informatics features can also contribute to successful collaboration and hopefully to scientific productivity. PMID:26652980

Financial Management: Education Faces Challenges in Achieving Financial Management Reform. Testimony before the Subcommittee on Oversight and Investigations, Committee on Education and the Workforce, House of Representatives.

ERIC Educational Resources Information Center

Jarmon, Gloria L.

This report provides a fiscal analysis of the Department of Education's 1999 financial audit results. It focuses on the relationship between the audit findings and the potential for waste, fraud, and abuse, and examines the status of an ongoing study of the Department's grantback account. It describes the ongoing accounting problems that have…

Building co-management as a process: problem solving through partnerships in Aboriginal country, Australia.

PubMed

Zurba, Melanie; Ross, Helen; Izurieta, Arturo; Rist, Philip; Bock, Ellie; Berkes, Fikret

2012-06-01

Collaborative problem solving has increasingly become important in the face of the complexities in the management of resources, including protected areas. The strategy undertaken by Girringun Aboriginal Corporation in north tropical Queensland, Australia, for developing co-management demonstrates the potential for a problem solving approach involving sequential initiatives, as an alternative to the more familiar negotiated agreements for co-management. Our longitudinal case study focuses on the development of indigenous ranger units as a strategic mechanism for the involvement of traditional owners in managing their country in collaboration with government and other interested parties. This was followed by Australia's first traditional use of marine resources agreement, and development of a multi-jurisdictional, land to sea, indigenous protected area. In using a relationship building approach to develop regional scale co-management, Girringun has been strengthening its capabilities as collaborator and regional service provider, thus, bringing customary decision-making structures into play to 'care for country'. From this evolving process we have identified the key components of a relationship building strategy, 'the pillars of co-management'. This approach includes learning-by-doing, the building of respect and rapport, sorting out responsibilities, practical engagement, and capacity-building.

Building Co-Management as a Process: Problem Solving Through Partnerships in Aboriginal Country, Australia

NASA Astrophysics Data System (ADS)

Zurba, Melanie; Ross, Helen; Izurieta, Arturo; Rist, Philip; Bock, Ellie; Berkes, Fikret

2012-06-01

Collaborative problem solving has increasingly become important in the face of the complexities in the management of resources, including protected areas. The strategy undertaken by Girringun Aboriginal Corporation in north tropical Queensland, Australia, for developing co-management demonstrates the potential for a problem solving approach involving sequential initiatives, as an alternative to the more familiar negotiated agreements for co-management. Our longitudinal case study focuses on the development of indigenous ranger units as a strategic mechanism for the involvement of traditional owners in managing their country in collaboration with government and other interested parties. This was followed by Australia's first traditional use of marine resources agreement, and development of a multi-jurisdictional, land to sea, indigenous protected area. In using a relationship building approach to develop regional scale co-management, Girringun has been strengthening its capabilities as collaborator and regional service provider, thus, bringing customary decision-making structures into play to `care for country'. From this evolving process we have identified the key components of a relationship building strategy, `the pillars of co-management'. This approach includes learning-by-doing, the building of respect and rapport, sorting out responsibilities, practical engagement, and capacity-building.

Better management of Irish hospitals.

PubMed

Brugha, C M

1991-08-01

The establishment of the Dublin Hospitals Initiative and the Efficiency Review Group as first steps in an "action" plan was based on the report in 1989 of the Commission of Health Funding which suggested that "the solution to the problem facing the Irish health services...(lies) primarily...in the way that services are planned, organised and delivered". Our health service is in transition from the phase of facility management into that of functional management. This will involve facing the fact of the limit on resources, introducing information systems and getting the co-operation of hospital doctors. The most senior executive in a hospital must firstly be a good general manager with sufficient power to manage. Hospitals should be divided into centres of responsibility made up of one or more centres of activity. Formal education for hospital administrators should be extended. There is a need for training at all levels, particularly of those administrative and medical staff who have direct interaction with the computer-based system. There should be a commitment to management development particularly by means of teamwork and action learning.

Towards Sustainable Ambon Bay: Evaluation of Solid Waste Management in Ambon City

NASA Astrophysics Data System (ADS)

Maryati, S.; Miharja, M.; Iscahyono, A. F.; Arsallia, S.; Humaira, AN S.

2017-07-01

Ambon Bay is a strategic area in the context of regional economic development, however it also faced environmental problems due to economic development and the growth of population. One of the environmental problems in the Ambon Bay is the growing solid waste which in turn lowers the quality of the water. The purpose of this study is to evaluate solid waste management in the Ambon City and propose recommendation in order to reduce solid waste in the Ambon Bay. The analytical method used is descriptive analysis by comparing a number of criteria based on the concept of solid waste management in coastal region with the current conditions of solid waste management in Ambon City. Criteria for waste management are divided into generation, storage, collection, transport, transfer and disposal. From the results of analysis, it can be concluded that the components of solid waste management at transport, transfer, and disposal level are generally still adequate, but solid waste management at source, storage and collection level have to be improved.

Microelectrical Mechanical Systems Flow Control Used to Manage Engine Face Distortion in Compact Inlet Systems

NASA Technical Reports Server (NTRS)

Anderson, Bernhard H.; Miller, Daniel N.

1999-01-01

Turbofan engine-face flow distortion is one of the most troublesome and least understood problems for designers of modern engine inlet systems. One concern is that there are numerous sources of flow-field distortion that are ingested by the inlet or generated within the inlet duct itself. Among these are: (1) flow separation at the cowl lip during in-flight maneuvering, (2) flow separation on the compression surfaces due to shock-wave/boundary layer interactions, (3) spillage of the fuselage boundary layer into the inlet duct, (4) ingestion of aircraft vortices and wakes emanating from upstream disturbances, and (5) strong secondary flow gradients and flow separation induced by wall curvature within the inlet duct itself. Most developing aircraft (including the B70, F-111, F-14, Mig-25, Tornado, and Airbus A300) have experienced one or more of these types of problems, particularly at high Mach numbers and/or extreme maneuver conditions when flow distortion at the engine face exceeded the allowable limits of the engine.

Electric load management and energy conservation

NASA Technical Reports Server (NTRS)

Kheir, N. A.

1976-01-01

Electric load management and energy conservation relate heavily to the major problems facing power industry at present. The three basic modes of energy conservation are identified as demand reduction, increased efficiency and substitution for scarce fuels. Direct and indirect load management objectives are to reduce peak loads and have future growth in electricity requirements in such a manner to cause more of it to fall off the system's peak. In this paper, an overview of proposed and implemented load management options is presented. Research opportunities exist for the evaluation of socio-economic impacts of energy conservation and load management schemes specially on the electric power industry itself.

Social/Electronic Media Use of Children and Adolescents Who Attend the Pediatric Weight Management Programs of the COMPASS Network.

PubMed

Siegel, Robert; Fals, Angela; Mirza, Nazrat; Datto, George; Stratbucker, William; Ievers-Landis, Carolyn E; Christison, Amy; Wang, Yu; Woolford, Susan J

2015-10-01

Obesity is a major healthcare problem in youth and their social/electronic media (SEM) use has been described as a risk factor. Though much is known about the newer technologies youth use to communicate, little is known about what is used by those in weight management programs. The aim of this study was to determine what types of SEM, including sedentary and active video games, youth in weight management programs use and which they prefer for communicating with healthcare providers. This was a multisite study using a 24-question online SurveyMonkey® questionnaire. Youth, 12-17 years old, attending pediatric weight management programs at seven participating centers in the Childhood Obesity Multi Program Analysis and Study System network were eligible. There were 292 responders with a mean age of 14.2 years. Fifty-four percent were female, 36% Caucasian, 35% African American, and 33% were Hispanic. Ninety-four percent had access to a computer, 71% had Internet access, and 63% had smartphones. Whereas 87% had at least one gaming system at home, 50% reported they never played sedentary video games (71% of females vs. 25% males; p < 0.0001) and 63% never played exercise video games during the week. The preferred method of communication with a healthcare provider was face to face (60%), with few indicating a preference for communication by texting (13%), phone (12%), or social media (6%). Face-to-face communication with healthcare providers is the preferred method for youth in pediatric weight management programs. They self-reported video game use less than previously described.

Hospital Management Between The Modern Image And Aging

NASA Astrophysics Data System (ADS)

Dadulescu, Ana-Maria

2015-09-01

Hospital management has experienced significant progress with the evolution of the Romanian health system reform, it has made strides in terms of resource allocation and cost control, new systems for classification, evaluation and monitoring (DRGs, SIUI, CaPeSaRo) were implemented, some taken from other countries and adapted to local conditions, but not always integrated with the other components and sometimes incompletely implemented and developed. This material does not offer definite solutions to current problems. It only briefly addresses the main aspects of hospital activity, and points out some failures with whom hospital managers are presently faced. Once the problems are identified it creates prerequisites for solving them, it opens channels of research and development of new methodologies or correlation of the existing deficient workflows that can be corrected.

Comfortably, Safely, and Without Shame: Defining Menstrual Hygiene Management as a Public Health Issue

PubMed Central

Hirsch, Jennifer S.; Nathanson, Constance; Parker, Richard G.

2015-01-01

In recent years, the menstrual hygiene management challenges facing schoolgirls in low-income-country contexts have gained global attention. We applied Gusfield’s sociological analysis of the culture of public problems to better understand how this relatively newly recognized public health challenge rose to the level of global public health awareness and action. We similarly applied the conceptualization by Dorfman et al. of the role of public health messaging in changing corporate practice to explore the conceptual frames and the news frames that are being used to shape the perceptions of menstrual hygiene management as an issue of social justice within the context of public health. Important lessons were revealed for getting other public health problems onto the global-, national-, and local-level agendas. PMID:25973831

Comfortably, Safely, and Without Shame: Defining Menstrual Hygiene Management as a Public Health Issue.

PubMed

Sommer, Marni; Hirsch, Jennifer S; Nathanson, Constance; Parker, Richard G

2015-07-01

In recent years, the menstrual hygiene management challenges facing schoolgirls in low-income-country contexts have gained global attention. We applied Gusfield's sociological analysis of the culture of public problems to better understand how this relatively newly recognized public health challenge rose to the level of global public health awareness and action. We similarly applied the conceptualization by Dorfman et al. of the role of public health messaging in changing corporate practice to explore the conceptual frames and the news frames that are being used to shape the perceptions of menstrual hygiene management as an issue of social justice within the context of public health. Important lessons were revealed for getting other public health problems onto the global-, national-, and local-level agendas.

Global change and conservation triage on National Wildlife Refuges

USGS Publications Warehouse

Johnson, Fred A.; Eaton, Mitchell; McMahon, Gerard; Raye Nilius,; Mike Bryant,; Dave Case,; Martin, Julien; Wood, Nathan J.; Laura Taylor,

2015-01-01

National Wildlife Refuges (NWRs) in the United States play an important role in the adaptation of social-ecological systems to climate change, land-use change, and other global-change processes. Coastal refuges are already experiencing threats from sea-level rise and other change processes that are largely beyond their ability to influence, while at the same time facing tighter budgets and reduced staff. We engaged in workshops with NWR managers along the U.S. Atlantic coast to understand the problems they face from global-change processes and began a multidisciplinary collaboration to use decision science to help address them. We are applying a values-focused approach to base management decisions on the resource objectives of land managers, as well as those of stakeholders who may benefit from the goods and services produced by a refuge. Two insights that emerged from our workshops were a conspicuous mismatch between the scale at which management can influence outcomes and the scale of environmental processes, and the need to consider objectives related to ecosystem goods and services that traditionally have not been explicitly considered by refuges (e.g., protection from storm surge). The broadening of objectives complicates the decision-making process, but also provides opportunities for collaboration with stakeholders who may have agendas different from those of the refuge, as well as an opportunity for addressing problems across scales. From a practical perspective, we recognized the need to (1) efficiently allocate limited staff time and budgets for short-term management of existing programs and resources under the current refuge design and (2) develop long-term priorities for acquiring or protecting new land/habitat to supplement or replace the existing refuge footprint and thus sustain refuge values as the system evolves over time. Structuring the decision-making problem in this manner facilitated a better understanding of the issues of scale and suggested that a long-term solution will require a significant reassessment of objectives to better reflect the comprehensive values of refuges to society. We discuss some future considerations to integrate these two problems into a single framework by developing novel optimization approaches for dynamic problems that account for uncertainty in future conditions.

Teachers' beliefs about mental health needs in inner city elementary schools.

PubMed

Walter, Heather J; Gouze, Karen; Lim, Karen G

2006-01-01

To survey teachers' beliefs about mental health service needs in inner city elementary schools. A total of 119 teachers from six elementary schools in a major city in the midwestern United States were surveyed to assess their beliefs about the major mental health problems facing their schools, the major barriers to surmounting those problems, their preferences for mental health topics for in-service education, and their education, experience, knowledge, attitudes, and self-efficacy pertaining to mental health issues. Disruptive behavior was endorsed by approximately 50% of teachers as the largest mental health problem facing their schools, and lack of information/training was endorsed as the greatest barrier to surmounting mental health problems. The highest-rated topics for in-service education were disruptive behavior disorders and implementing behavior plans. Although most teachers had taught students with mental health problems, most had had little education in mental health and little consultation with mental health professionals. Correspondingly, teachers' knowledge about mental health issues was limited, and they did not feel confident about their ability to manage mental health problems in their classrooms. Teachers would benefit from education, training, and consultation from mental health professionals if they serve as effective gatekeepers to mental health services.

Clinical-outcome-based demand management in health services.

PubMed

Brogan, C; Lawrence, D; Mayhew, L

2008-01-01

THE PROBLEM OF MANAGING DEMAND: Most healthcare systems have 'third-party payers' who face the problem of keeping within budgets despite pressures to increase resources due to the ageing population, new technologies and patient demands to lower thresholds for care. This paper uses the UK National Health Service as a case study to suggest techniques for system-based demand management, which aims to control demand and costs whilst maintaining the cost-effectiveness of the system. The technique for managing demand in primary, elective and urgent care consists of managing treatment thresholds for appropriate care, using a whole-systems approach and costing the care elements in the system. It is important to analyse activity in relation to capacity and demand. Examples of using these techniques in practice are given. The practical effects of using such techniques need evaluation. If these techniques are not used, managing demand and limiting healthcare expenditure will be at the expense of clinical outcomes and unmet need, which will perpetuate financial crises.

Reasoning by analogy as an aid to heuristic theorem proving.

NASA Technical Reports Server (NTRS)

Kling, R. E.

1972-01-01

When heuristic problem-solving programs are faced with large data bases that contain numbers of facts far in excess of those needed to solve any particular problem, their performance rapidly deteriorates. In this paper, the correspondence between a new unsolved problem and a previously solved analogous problem is computed and invoked to tailor large data bases to manageable sizes. This paper outlines the design of an algorithm for generating and exploiting analogies between theorems posed to a resolution-logic system. These algorithms are believed to be the first computationally feasible development of reasoning by analogy to be applied to heuristic theorem proving.

Introducing the Small Business Management Course.

ERIC Educational Resources Information Center

Saskatchewan NewStart, Inc., Prince Albert.

Canadian Indians face the threat of a loss of their once rich resources of fish, fur, and game as undeveloped lands are filling with tourists and new populations. Public awareness of this social problem has produced governmental loans and grants for business undertaking which require some training of recipients to make productive use of the…

Don't Get Lost in the Translation.

ERIC Educational Resources Information Center

Wederspahn, Gary M.

In this era of rapid globalization of business opportunities, many managers face the need to communicate with foreign counterparts who do not speak English. The solution, in many cases, is to use an interpreter. Interpreters, however, may make mistakes, and irritation, embarrassment and even major problems may arise from errors in translation.…

Peripheral nerve injuries secondary to missiles.

PubMed

Katzman, B M; Bozentka, D J

1999-05-01

Peripheral nerve injuries secondary to missiles can present some of the most challenging problems faced by hand surgeons. This article reviews the pertinent neural anatomy, injury classifications, and repair techniques. Options in the management of nerve gaps are presented including the use of vascularized nerve grafts. The results are discussed and a treatment algorithm is presented.

Situated Leadership: A New Community Leadership Model. CRLRA Discussion Paper Series.

ERIC Educational Resources Information Center

Falk, Ian

Rural areas around the world face problems stemming from the globalization of agricultural and other markets, the resulting competitiveness for existing and shifting markets, loss of population, and consequent decline of economic and social infrastructure. Rural communities need to develop the ability to manage change, and this requires engaging…

From the Fear of Death to the Fear of "Dissimilar Other": A Research in Elementary School Classrooms

ERIC Educational Resources Information Center

Leondari, A.; Magos, K.; Oikonomou, A.

2014-01-01

Social stereotyping and prejudice constitute pressing societal problems and have many causes. Terror Management Theory offers a compelling and heavily researched account of individuals' reactions towards "dissimilar others" when faced with thoughts of mortality. Building from previous research with adult samples, the present study aimed…

Interfutures: Facing the Future, Mastering the Probable and Managing the Unpredictable.

ERIC Educational Resources Information Center

Organisation for Economic Cooperation and Development, Paris (France).

This report discusses the findings of the three year Interfutures Project which studied the future development of advanced industrial societies and the relations between these countries and the developing countries. The major emphasis of the project was to analyze economic problems. However, political and social elements were also studied. The…

NEWS Ltd.: Simulations for Trust Development.

ERIC Educational Resources Information Center

Ruhe, John A.; Allen, William R.

2001-01-01

Examines some of the unique problems faced by global teams and describes two simulations that have been successfully used to assist students in understanding key elements in effective global and cross-cultural team management. The first simulation focuses on a virtual global team situation; the second, using the same teams at a later date, expands…

Impact of parking supply and demand management on central business district traffic congestion, transit performance measures and sustainable land use [summary].

DOT National Transportation Integrated Search

2012-01-01

Parking is one of the thorniest problems facing local officials who wish to maintain the vitality of central business districts (CBD). Viewed in isolation, the solution often is seen as more parking, at least, and more free parking, if possible. But ...

The Relationship Factor: Making or Breaking Successful Transitions for Youth at Risk

ERIC Educational Resources Information Center

Powell, Norman W.; Marshall, Amy

2011-01-01

Whenever educators are asked to identify the major problems they face, behavior management is near the top of the list. Research shows that effective teachers are able to build relationships with students and implement well-developed classroom procedures (Holt, Hargrove, & Harris, 2011, p. 18). Yet schools give scant attention to developing…

University and E-Learning Classes in Italy

ERIC Educational Resources Information Center

Capogna, Stefania

2012-01-01

The article explores the use of e-learning in Italian universities. The aim is to understand how the university system has faced this problem or opportunity to date and what weaknesses or developing perspectives may result from multimedia technologies applied to academic teaching management. After a brief review of the current position of Italian…

The Wicked Problem of Information Sharing in Homeland Security - A Leadership Perspective

DTIC Science & Technology

2014-06-01

filled environment. One such coping strategy termed emotion work, describes how analysts manage their feelings to display a public face or bodily ...in many aspects of Western culture but 56 Jeff Conklin, Dialogue Mapping : Building Shared...effective, whether modifications should be 60 Conklin, Dialogue Mapping : Building Shared Understanding

Exploring and reducing stress in young restaurant workers: results of a randomized field trial.

PubMed

Petree, Robyn D; Broome, Kirk M; Bennett, Joel B

2012-01-01

Young adult restaurant workers face the dual stressors of work adjustment and managing personal responsibilities. We assessed a new psychosocial/health promotion training designed to reduce these stressors in the context of restaurant work. DESIGN . A cluster-randomized trial of a training program, with surveys administered approximately 2 weeks before training and both 6 and 12 months after training. A national restaurant chain. A total of 947 restaurant workers in 28 restaurants. Personal stress, exposure to problem coworkers, and personal and job characteristics. Team Resilience (TR) is an interactive program for stress management, teamwork, and work-life balance. TR focuses on "five Cs" of resilience: compassion, commitment, centering, community, and confidence. ANALYSIS . Mixed-model (multilevel) analysis of covariances. Compared with workers in control stores, workers in TR-trained stores showed significant reductions over time in exposure to problem coworkers (F[2, 80.60]  =  4.48; p  =  .01) and in personal stress (F[2, 75.28]  =  6.12; p  =  .003). The TR program may help young workers who face the challenges of emerging adulthood and work-life balance.

The dilemma of diabetic patients living with hypoglycaemia.

PubMed

Wu, Fei-Ling; Juang, Jyuhn-Huarng; Yeh, Mei Chang

2011-08-01

To examine the impact of the threat of hypoglycaemic episodes on people with diabetes in Taiwan. Intensive diabetes treatment in people with diabetes helps them to achieve better glycaemic control. However, it also causes more frequent hypoglycaemic episodes and has an impact on their overall quality of life. Hypoglycaemia is accompanied by various distressing symptoms which may cause excessive fear, affecting decision making in hypoglycaemic management. Purposive sampling and in-depth, face-to-face interviews were used to collect data. Semi-structured interviews were conducted from July 2008-January 2009 with 17 individuals treated with insulin who had previous hypoglycaemic episodes. Data were analysed using qualitative content analysis. Four themes were generated from the analysis, 'inability to control fluctuations in health', 'challenges to interpersonal relationships', 'facing the disease alone' and 'finding a balance between competing symptoms'. Hypoglycaemia is a major health issue for many people with diabetes. Understanding individuals' experiences with hypoglycaemic episodes should help practitioners become more fully involved in promoting self-management. We identified key areas that health care providers should address, including concerns about patient education and professional support for people with diabetes experiencing hypoglycaemia, to enhance problem solving skills for them and their families. We recommend that health care providers make proper use of support groups for family caregivers or other important individuals in the lives of people with diabetes to provide education, clarification, support and guidance. In addition, health care providers also need to provide clients with hypoglycaemia-related emotional support, while enhancing diabetes self-management and problem-solving skills. © 2011 Blackwell Publishing Ltd.

Marine reserves solve an important bycatch problem in fisheries

PubMed Central

Hastings, Alan; Gaines, Steven D.; Costello, Christopher

2017-01-01

Management of the diverse fisheries of the world has had mixed success. While managing single species in data-rich environments has been largely effective, perhaps the greatest challenge facing fishery managers is how to deal with mixed stocks of fish with a range of life histories that reside in the same location. Because many fishing gears are nonselective, and the costs of making gear selective can be high, a particular problem is bycatch of weak stocks. This problem is most severe when the weak stock is long-lived and has low fecundity and thus requires a very long recovery time once overfished. We investigate the role that marine reserves might play in solving this challenging and ubiquitous problem in ecosystem-based management. Evidence for marine reserves’ potential to manage fisheries in an ecosystem context has been mixed, so we develop a heuristic strategic mathematical model to obtain general conclusions about the merits of managing multispecies fisheries by using reserves relative to managing them with nonspatial approaches. We show that for many fisheries, yields of strong stocks can be increased, and persistence of weak stocks can be ensured, by using marine reserves rather than by using traditional nonspatial approaches alone. Thus, reserves have a distinct advantage as a management tool in many of the most critical multispecies settings. We also show how the West Coast groundfish fishery of the United States meets these conditions, suggesting that management by reserves may be a superior option in that case. PMID:28794280

[How do universities confront and manage environmental problems?].

PubMed

Inadera, H

2001-06-01

Occupational medicine is concerned with the recognition and prevention of diseases related to the work environment. The special tools, namely, epidemiology, toxicology, and public health and clinical expertise, are joined by another specialty, environmental medicine. The Environmental Science Center (ESC) of the University of Tokyo was established in April 1975 for the purpose of treating chemically-hazardous wastes deriving from the university. The ESC houses various sections including research, education, operations, management, and also a waste-collection and-treatment division. In this review, the author intends to summarize the activity of the ESC, and then review the approaches we have applied in order to deal with the environmental problems we have faced.

Re-thinking pain educational strategies: Pain a new model using e-learning and PBL.

PubMed

Keyte, Donna; Richardson, Cliff

2011-02-01

Despite some high profile reorganisation including the introduction of acute pain teams, many patients still experience unnecessary pain. Traditional teaching and learning strategies seem to have made little impact in clinical practice. This paper explores the possible reasons for this and identifies the need to help postregistration students transfer (re-contextualise) what they are learning to practice. A new, more flexible pain management module utilising a blended face to face/e-learning approach within a problem-based learning philosophy was introduced to increase knowledge in pain management whilst also attempting to overcome the barriers to knowledge transfer into practice. This is done by challenging attitudes and encouraging students to explore their clinical practice alongside theoretical concepts. Copyright © 2010 Elsevier Ltd. All rights reserved.

Physics and the car business

NASA Astrophysics Data System (ADS)

Compton, W. Dale; Reitz, John R.

1981-01-01

Physicists have made important contributions to many areas of Ford Motor Company activity, particularly in areas of basic and applied research and product development. A number have assumed positions with management responsibility. Many of the technical problems facing the automotive industry today require a fundamental understanding, and the ability of physicists to contribute to the solution of these problems is greater now than it has been in the past. The present paper discusses some of these problems, and also traces a few case histories of physicists at Ford Motor Company; these illustrate the wide diversity of career paths for persons entering industry with a physics background.

Giant fibrosarcoma prostuberans of abodominal wall: management problems in resources-constrained country.

PubMed

Chukwuanukwu, T O G; Anyanwu, S N C

2009-09-01

Abdominal wall sarcomas represent less than 1% of adult malignancies. Dermatofibrosarcoma protuberans can grow to very large sizes and the recommended resection 2-3 cm from the macroscopic tumour margin can produce very large full thickness defects of the abdominal wall. Reconstruction of such defects can be quite challenging in resource constrained areas where patients present late with giant lesions. To highlight the presentation and management challenges faced by the surgical oncologist and reconstructive surgeon in a resource constrained country when faced with giant Dermatofibrosarcoma protuberans of the abdominal wall. Prospective study of patients with abdominal wall soft tissue sarcoma presenting to the authors. Cases of giant dermatofibrosarcoma protuberns who underwent surgery were analysed. Seven cases managed over an eight year period (January 2000 to December 2007). Age ranged from 27-70 yrs with slight female preponderance 1.5:1 F:M. Three presented with recurrent fungating masses. Only one could be reconstructed with prolene mesh. One recurrence was noted during the period under study. Poverty, ignorance and lack of necessary working tools are major challenges faced by the surgical oncologist and reconstructive surgeon in resource constrained areas and pose a major obstacle to the control of cancer in these areas.

Resolving complex research data management issues in biomedical laboratories: Qualitative study of an industry-academia collaboration.

PubMed

Myneni, Sahiti; Patel, Vimla L; Bova, G Steven; Wang, Jian; Ackerman, Christopher F; Berlinicke, Cynthia A; Chen, Steve H; Lindvall, Mikael; Zack, Donald J

2016-04-01

This paper describes a distributed collaborative effort between industry and academia to systematize data management in an academic biomedical laboratory. Heterogeneous and voluminous nature of research data created in biomedical laboratories make information management difficult and research unproductive. One such collaborative effort was evaluated over a period of four years using data collection methods including ethnographic observations, semi-structured interviews, web-based surveys, progress reports, conference call summaries, and face-to-face group discussions. Data were analyzed using qualitative methods of data analysis to (1) characterize specific problems faced by biomedical researchers with traditional information management practices, (2) identify intervention areas to introduce a new research information management system called Labmatrix, and finally to (3) evaluate and delineate important general collaboration (intervention) characteristics that can optimize outcomes of an implementation process in biomedical laboratories. Results emphasize the importance of end user perseverance, human-centric interoperability evaluation, and demonstration of return on investment of effort and time of laboratory members and industry personnel for success of implementation process. In addition, there is an intrinsic learning component associated with the implementation process of an information management system. Technology transfer experience in a complex environment such as the biomedical laboratory can be eased with use of information systems that support human and cognitive interoperability. Such informatics features can also contribute to successful collaboration and hopefully to scientific productivity. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Living With Diabetes in Appalachia: A Focus Group Study.

PubMed

Carpenter, Roger; Smith, Mary Jane

This article presents an innovative holistic practice application based on evidence from a focus group study on managing diabetes. The purpose of this study addressed the research question: How do persons with type 2 diabetes describe ways of managing the challenge of living with diabetes? A second purpose was to link the findings on ways to manage diabetes to holistic nursing practice through story theory. Nine adults with type 2 diabetes living in rural West Virginia participated in 3 focus groups. Using content analysis, the study findings integrated themes with core qualities, and are as follows: living life as an evolving process is awakening to the present and doing it your way, being on guard is a vigilant ongoing responsibility, attending to bodily experience is awareness of body and facing life stress, and knowing the consequences is awareness of potential problems and taking charge. Merging the study findings with the concepts of story theory led to the development of an innovative practice application for managing diabetes. Managing diabetes in this practice application goes beyond problem-centeredness to a patient-centered approach, offering attention to individual preferences. Since managing diabetes is a major problem in Appalachia, there a need for innovative approaches. This study adds to the body of knowledge on how persons from Appalachia manage diabetes. In addition, it offers a story practice approach for managing diabetes-replacing a problem focus to a more holistic approach to practice leading to more meaningful and fulfilling outcomes.

Construction and Application of a Refined Hospital Management Chain.

PubMed

Lihua, Yi

2016-01-01

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

Current Welfare Problems Facing Horses in Great Britain as Identified by Equine Stakeholders.

PubMed

Horseman, Susan V; Buller, Henry; Mullan, Siobhan; Whay, Helen R

2016-01-01

Despite growing concerns about the welfare of horses in Great Britain (GB) there has been little surveillance of the welfare status of the horse population. Consequently we have limited knowledge of the range of welfare problems experienced by horses in GB and the situations in which poor welfare occurs. Thirty-one in-depth interviews were conducted with a cross -section of equine stakeholders, in order to explore their perceptions of the welfare problems faced by horses in GB. Welfare problems relating to health, management and riding and training were identified, including horses being under or over weight, stabling 24 hours a day and the inappropriate use of training aids. The interviewees also discussed broader contexts in which they perceived that welfare was compromised. The most commonly discussed context was where horses are kept in unsuitable environments, for example environments with poor grazing. The racing industry and travellers horses were identified as areas of the industry where horse welfare was particularly vulnerable to compromise. Lack of knowledge and financial constraints were perceived to be the root cause of poor welfare by many interviewees. The findings give insight into the range of welfare problems that may be faced by horses in GB, the contexts in which these may occur and their possible causes. Many of the problems identified by the interviewees have undergone limited scientific investigation pointing to areas where further research is likely to be necessary for welfare improvement. The large number of issues identified suggests that some form of prioritisation may be necessary to target research and resources effectively.

Current Welfare Problems Facing Horses in Great Britain as Identified by Equine Stakeholders

PubMed Central

Horseman, Susan V.; Buller, Henry

2016-01-01

Despite growing concerns about the welfare of horses in Great Britain (GB) there has been little surveillance of the welfare status of the horse population. Consequently we have limited knowledge of the range of welfare problems experienced by horses in GB and the situations in which poor welfare occurs. Thirty-one in-depth interviews were conducted with a cross -section of equine stakeholders, in order to explore their perceptions of the welfare problems faced by horses in GB. Welfare problems relating to health, management and riding and training were identified, including horses being under or over weight, stabling 24 hours a day and the inappropriate use of training aids. The interviewees also discussed broader contexts in which they perceived that welfare was compromised. The most commonly discussed context was where horses are kept in unsuitable environments, for example environments with poor grazing. The racing industry and travellers horses were identified as areas of the industry where horse welfare was particularly vulnerable to compromise. Lack of knowledge and financial constraints were perceived to be the root cause of poor welfare by many interviewees. The findings give insight into the range of welfare problems that may be faced by horses in GB, the contexts in which these may occur and their possible causes. Many of the problems identified by the interviewees have undergone limited scientific investigation pointing to areas where further research is likely to be necessary for welfare improvement. The large number of issues identified suggests that some form of prioritisation may be necessary to target research and resources effectively. PMID:27501387

Assessment of Collaboration and Interoperability in an Information Management System to Support Bioscience Research

PubMed Central

Myneni, Sahiti; Patel, Vimla L.

2009-01-01

Biomedical researchers often have to work on massive, detailed, and heterogeneous datasets that raise new challenges of information management. This study reports an investigation into the nature of the problems faced by the researchers in two bioscience test laboratories when dealing with their data management applications. Data were collected using ethnographic observations, questionnaires, and semi-structured interviews. The major problems identified in working with these systems were related to data organization, publications, and collaboration. The interoperability standards were analyzed using a C4I framework at the level of connection, communication, consolidation, and collaboration. Such an analysis was found to be useful in judging the capabilities of data management systems at different levels of technological competency. While collaboration and system interoperability are the “must have” attributes of these biomedical scientific laboratory information management applications, usability and human interoperability are the other design concerns that must also be addressed for easy use and implementation. PMID:20351900

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

PubMed

Sultana, Parvin; Abeyasekera, Savitri

2008-01-01

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

Quality of life in stoma patients.

PubMed

Nugent, K P; Daniels, P; Stewart, B; Patankar, R; Johnson, C D

1999-12-01

Patients with stomas face many difficulties both physical and psychological. Little is known about the long-term problems and the impact on patient lifestyle of a permanent stoma. This study was designed to address the problems faced by patients with stomas. Patients were identified from the Stoma Care Department records for the years 1985 to 1992 and were contacted by mail. A questionnaire was designed to assess postoperative care, quality of life issues, and equipment problems. Responses were recorded on either a visual analog scale, a choice of yes-or-no alternatives, or by selection from a list of responses. A total of 542 eligible patients were contacted, and 391 replies were received. Major stomal problems included rashes (51 percent), leakage (36 percent), and ballooning (90 percent of patients with ileostomy). The majority of patients experienced some change in lifestyle (80 percent), and more than 40 percent of patients had problems with their sex lives. Many patients cope extremely well with a stoma; however, some patients experience considerable difficulty and distress. Improved preoperative assessment and counseling with longer follow-up by the stoma department would be helpful in the management of these patients and probably would contribute to improvement in the quality of their lives.

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

Jacobson, L.N.

Traffic congestion and personal mobility preservation are the most challenging issues facing transportation professionals. From Phoenix to San Francisco to Washington, D.C., citizens are identifying transportation as their number one concern, outweighing issues such as pollution, overpopulation, unemployment, and crime. In the state of Washington, particularly in the greater Seattle area, congestion is likewise a major concern. In order to address the mobility problems facing the urban areas of Washington, the state initiated a new transportation research and implementation program in October 1987. The program is called Freeway and Arterial Management Effort (FAME). The focus of the program is discussedmore » by the author.« less

Big game habitat use in southeastern Montana

Treesearch

James G. MacCracken; Daniel W. Uresk

1984-01-01

The loss of suitable, high quality habitat is a major problem facing big game managers in the western United States. Agricultural, water, road and highway, housing, and recreational development have contributed to loss of natural big game habitat (Wallmo et al. 1976, Reed 1981). In the western United States, surface mining of minerals has great potential to adversely...

The Efficiency of Higher Education Institutions as a Basis for Forming Competent Personnel for Region Economy

ERIC Educational Resources Information Center

Sezonova, Olga N.; Galchenko, Svetlana A.; Khodirevskaya, Valentina N.

2016-01-01

The modern market relations open provide new opportunities of development for higher educational institutions, however the majority of universities aren't ready for effective and independent business management yet. At the turn of the 21st century many educational institutions faced such problems as scarcity of federal financing, fundamental…

Restructuring, Reallocation and Retrenchment at the Same Time: The Dutch Universities. AIR 1983 Annual Forum Paper.

ERIC Educational Resources Information Center

Dijkman, Frank G.; Savenije, Bas S.

Conditions and management procedures used in Dutch universities are discussed. Attention is directed to: (1) the structure of higher education in the Netherlands -- especially the University of Utrecht, its administrative procedures, and decision-making process; (2) the nature of the problems the university faced and the ineffective way in which…

Self-Management in Epilepsy Care: Putting Teen and Families in the Center--Part One

ERIC Educational Resources Information Center

Shafer, Patricia Osborne; Dilorio, Colleen

2006-01-01

Epilepsy is one of the most common chronic neurological problems in childhood and adolescence. Unfortunately, it is also one of the most misunderstood conditions. Epilepsy can interfere with the physical, emotional and social functioning of youth of all ages, particularly if seizures are uncontrolled. Teenagers living with epilepsy face unique…

A New Technique of Site Selection for Hardwoods

Treesearch

James B. Baker; W. M. Broadfoot

1978-01-01

A problem foresters often face in establishing hardwood plantations is selecting proper sites for various species. Before planting, a forest manager should have confidence that a site is suitable for a particular species, and for investment planning he would like to have some idea of the site's potential productivity. This paper describes how to use a new...

Self-Recruited Feedback: A Cost-Effective Procedure for Maintaining Behavior.

ERIC Educational Resources Information Center

Mank, David M.; Horner, Robert H.

The maintenance of learned behavior is a problem frequently faced by teachers of persons with severe disabilities. The study examined the use of a self-management procedure to improve and maintain the work performance of 6 young adults (ages 18-20) with severe retardation in integrated job settings. Students were taught to self-monitor their work…

Hazardous Waste Management: A View to the New Century, 2001.

ERIC Educational Resources Information Center

Burton, Gwen

Like many parts of the United States, Colorado is facing a significant hazardous waste problem. Radioactive and chemical wastes generated by the Rocky Flats Nuclear Plant, the toxic Lowry Land Fill Site, industrial dumps, and heavy land and air traffic contribute to water, land, and air pollution in the state. As part of a statewide response…

From "connecting the dots" to "threading the needle:" The challenges ahead in managing agricultural landscapes for environmental quality

USDA-ARS?s Scientific Manuscript database

Non point source pollution from agriculture is one of the most challenging problems facing society. In this book chapter, we briefly review the development of “landscape thinking” in agriculture and how this has been incorporated into the USDA Conservation Effects Assessment Program (CEAP). We pre...

Radar Resource Management in a Dense Target Environment

DTIC Science & Technology

2014-03-01

problem faced by networked MFRs . While relaxing our assumptions concerning information gain presents numerous challenges worth exploring, future research...linear programming MFR multifunction phased array radar MILP mixed integer linear programming NATO North Atlantic Treaty Organization PDF probability...1: INTRODUCTION Multifunction phased array radars ( MFRs ) are capable of performing various tasks in rapid succession. The performance of target search

Ocular surgery in a child with Coffin Lowry syndrome: Anesthetic concerns.

PubMed

Singh, P M; Baidya, Dalim K; Govindarajan, Srinivasa; Trikha, Anjan

2013-01-01

Coffin Lowry syndrome is a rare disease involving multiple organ systems. From the anesthesiologists point of view it involves mental retardation, seizures, difficult airway, cardiac abnormalities (pediatric dilated cardiomyopathy) and skeletal deformities. We share our experience of management of a child with Coffin Lowry syndrome and also discuss the problems faced during perioperative period.

The Hazardous-Drums Project: A Multiweek Laboratory Exercise for General Chemistry Involving Environmental, Quality Control, and Cost Evaluation

ERIC Educational Resources Information Center

Hayes, David; Widanski, Bozena

2013-01-01

A laboratory experiment is described that introduces students to "real-world" hazardous waste management issues chemists face. The students are required to define an analytical problem, choose a laboratory analysis method, investigate cost factors, consider quality-control issues, interpret the meaning of results, and provide management…

A Planning and Assessment Model for Developing Effective CMS Support

ERIC Educational Resources Information Center

Johnson, Douglas F.

2004-01-01

At the University of Florida, in Spring 2003, more than 32,000 individuals enrolled in courses using the centrally-supported Course Management System (CMS). Because less than 1 full time equivalent (FTE) was allocated to support the CMS, this created problems for both users and support providers. In the face of rapid growth, support resources for…

Managing the professional nurse. Part I. The organizational theories.

PubMed

McClure, M L

1984-02-01

How do employment organizations outside the hospital field deal with issues such as staff productivity, motivation, burnout, and high turnover? In Part I of this two-part article, the author presents an overview of modern management theory and practice, drawn from the literature on organizational behavior. She shows how nursing administrators can use this scholarly foundation to better understand the organizing principles and problems of their departments. In Part II (to be published in March 1984), the author applies these classic and relevant theories to the specific challenges that face the manager of professional nurses.

Teaching organization theory for healthcare management: three applied learning methods.

PubMed

Olden, Peter C

2006-01-01

Organization theory (OT) provides a way of seeing, describing, analyzing, understanding, and improving organizations based on patterns of organizational design and behavior (Daft 2004). It gives managers models, principles, and methods with which to diagnose and fix organization structure, design, and process problems. Health care organizations (HCOs) face serious problems such as fatal medical errors, harmful treatment delays, misuse of scarce nurses, costly inefficiency, and service failures. Some of health care managers' most critical work involves designing and structuring their organizations so their missions, visions, and goals can be achieved-and in some cases so their organizations can survive. Thus, it is imperative that graduate healthcare management programs develop effective approaches for teaching OT to students who will manage HCOs. Guided by principles of education, three applied teaching/learning activities/assignments were created to teach OT in a graduate healthcare management program. These educationalmethods develop students' competency with OT applied to HCOs. The teaching techniques in this article may be useful to faculty teaching graduate courses in organization theory and related subjects such as leadership, quality, and operation management.

How immigrant workers experience workplace problems: a qualitative study.

PubMed

de Castro, Arnold B; Fujishiro, Kaori; Sweitzer, Erica; Oliva, Jose

2006-01-01

In this qualitative study, the authors describe work organization factors, problems workers encounter on the job, consequences of these problems, and actions taken to deal with them. Study participants were immigrant workers seeking assistance at the Chicago Interfaith Workers' Rights Center. Using a grounded theory approach, the investigators coded narratives from 455 records describing workers' problems. Emerged sequences of events were then integrated into a model. Data show that workers' rights are systematically violated and problems are rooted in how jobs are designed and managed. Work organization factors are associated with occupational injury/illness, job loss, and worker actions. Employer responses included indifference and various forms of retaliation. This model provides insight into the work-related troubles immigrants face and informs hypothesis generation and action initiatives.

Difficulties facing healthcare workers in the era of AIDS treatment in Lesotho.

PubMed

Koto, Masebeo Veronica; Maharaj, Pranitha

2016-01-01

Sub-Saharan Africa is most affected by the AIDS pandemic and Lesotho is no exception. In many countries, healthcare workers are at the forefront of the fight against AIDS. This study explores the difficulties facing healthcare workers in Lesotho using a combination of qualitative methods--focus group discussions and in-depth interviews. The findings suggest that healthcare workers are afraid of contracting HIV from their patients and this affects their delivery of services. In addition, the results revealed that poor infrastructure and shortage of supplies at the facilities hinder healthcare workers from performing their duties effectively. The other concern was the heavy workload and severe time constraints which puts enormous stress on healthcare workers. Stigma and discrimination emerged as major problems for healthcare workers. Addressing the challenges facing healthcare workers is essential in effectively managing the AIDS pandemic facing the continent.

Age synthesis and estimation via faces: a survey.

PubMed

Fu, Yun; Guo, Guodong; Huang, Thomas S

2010-11-01

Human age, as an important personal trait, can be directly inferred by distinct patterns emerging from the facial appearance. Derived from rapid advances in computer graphics and machine vision, computer-based age synthesis and estimation via faces have become particularly prevalent topics recently because of their explosively emerging real-world applications, such as forensic art, electronic customer relationship management, security control and surveillance monitoring, biometrics, entertainment, and cosmetology. Age synthesis is defined to rerender a face image aesthetically with natural aging and rejuvenating effects on the individual face. Age estimation is defined to label a face image automatically with the exact age (year) or the age group (year range) of the individual face. Because of their particularity and complexity, both problems are attractive yet challenging to computer-based application system designers. Large efforts from both academia and industry have been devoted in the last a few decades. In this paper, we survey the complete state-of-the-art techniques in the face image-based age synthesis and estimation topics. Existing models, popular algorithms, system performances, technical difficulties, popular face aging databases, evaluation protocols, and promising future directions are also provided with systematic discussions.

Social Consequences of Nomadic Working: A Case Study in an Organization

NASA Astrophysics Data System (ADS)

Singh, Ramanjit; Wood-Harper, Trevor

This research study identified social challenges that knowledge workers in the Swedish organization TeliaSonera (Telia) face when utilizing wireless technologies to conduct work on the move. Upon collecting the relevant research data, five problem areas were identified: work and life balance, addiction, organizational involvement, nomadic work and control, and individual productivity. Each problem area was examined with the philosophical underpinning of socio-technical design principles. The results confirm that better role boundary management, self-discipline, work negotiation, and e-mail communication skills may be required for the knowledge workers to manage the demands of nomadic working. Similarly, rewarding nomadic work performance, building employee supervisor trust relations, and designing jobs that enhance work and life balance can be imperative.

Sustainable water future with global implications: everyone's responsibility.

PubMed

Kuylenstierna, J L; Bjorklund, G; Najlis, P

1997-01-01

The current use and management of freshwater is not sustainable in many countries and regions of the world. If current trends are maintained, about two-thirds of the world's population will face moderate to severe water stress by 2025 compared to one-third at present. This water stress will hamper economic and social development unless action is taken to deal with the emerging problems. The Comprehensive Assessment of the Freshwater Resources of the World, prepared by the UN and the Stockholm Environment Institute, calls for immediate action to prevent further deterioration of freshwater resources. Although most problems related to water quantity and quality require national and regional solutions, only a global commitment can achieve the necessary agreement on principles, as well as financial means to attain sustainability. Due to the central and integrated role played by water in human activities, any measures taken need to incorporate a wide range of social, ecological and economic factors and needs. The Assessment thus addresses the many issues related to freshwater use, such as integrated land and water management at the watershed level, global food security, water supply and sanitation, ecosystem requirements, pollution, strengthening of major groups, and national water resource assessment capabilities and monitoring networks. Governments are urged to work towards a consensus regarding global principles and guidelines for integrated water management, and towards their implementation in local and regional water management situations. The alternative development options available to countries facing water stress, or the risk thereof, needs to be considered in all aspects of development planning.

Review of multiple-choice-questions and group performance - A comparison of face-to-face and virtual groups with and without facilitation

PubMed Central

Kazubke, Edda; Schüttpelz-Brauns, Katrin

2010-01-01

Background: Multiple choice questions (MCQs) are often used in exams of medical education and need careful quality management for example by the application of review committees. This study investigates whether groups communicating virtually by email are similar to face-to-face groups concerning their review process performance and whether a facilitator has positive effects. Methods: 16 small groups of students were examined, which had to evaluate and correct MCQs under four different conditions. In the second part of the investigation the changed questions were given to a new random sample for the judgement of the item quality. Results: There was no significant influence of the variables “form of review committee” and “facilitation”. However, face-to-face and virtual groups clearly differed in the required treatment times. The test condition “face to face without facilitation” was generally valued most positively concerning taking over responsibility, approach to work, sense of well-being, motivation and concentration on the task. Discussion: Face-to-face and virtual groups are equally effective in the review of MCQs but differ concerning their efficiency. The application of electronic review seems to be possible but is hardly recommendable because of the long process time and technical problems. PMID:21818213

Specific problems in visual cognition of dyslexic readers: Face discrimination deficits predict dyslexia over and above discrimination of scrambled faces and novel objects.

PubMed

Sigurdardottir, Heida Maria; Fridriksdottir, Liv Elisabet; Gudjonsdottir, Sigridur; Kristjánsson, Árni

2018-06-01

Evidence of interdependencies of face and word processing mechanisms suggest possible links between reading problems and abnormal face processing. In two experiments we assessed such high-level visual deficits in people with a history of reading problems. Experiment 1 showed that people who were worse at face matching had greater reading problems. In experiment 2, matched dyslexic and typical readers were tested, and difficulties with face matching were consistently found to predict dyslexia over and above both novel-object matching as well as matching noise patterns that shared low-level visual properties with faces. Furthermore, ADHD measures could not account for face matching problems. We speculate that reading difficulties in dyslexia are partially caused by specific deficits in high-level visual processing, in particular for visual object categories such as faces and words with which people have extensive experience. Copyright © 2018 Elsevier B.V. All rights reserved.

Childhood fever management program for Korean pediatric nurses: A comparison between blended and face-to-face learning method.

PubMed

Jeong, Yong Sun; Kim, Jin Sun

2014-01-01

A blended learning can be a useful learning strategy to improve the quality of fever and fever management education for pediatric nurses. This study compared the effects of a blended and face-to-face learning program on pediatric nurses' childhood fever management, using theory of planned behavior. A nonequivalent control group pretest-posttest design was used. A fever management education program using blended learning (combining face-to-face and online learning components) was offered to 30 pediatric nurses, and 29 pediatric nurses received face-to-face education. Learning outcomes did not significantly differ between the two groups. However, learners' satisfaction was higher for the blended learning program than the face-to-face learning program. A blended learning pediatric fever management program was as effective as a traditional face-to-face learning program. Therefore, a blended learning pediatric fever management-learning program could be a useful and flexible learning method for pediatric nurses.

Control of Future Air Traffic Systems via Complexity Bound Management

NASA Technical Reports Server (NTRS)

Alexandrov, Natalia

2013-01-01

The complexity of the present system for managing air traffic has led to "discreteness" in approaches to creating new concepts: new concepts are created as point designs, based on experience, expertise, and creativity of the proposer. Discrete point designs may be highly successful but they are difficult to substantiate in the face of equally strong substantiation of competing concepts, as well as the state of the art in concept evaluation via simulations. Hybrid concepts may present a compromise - the golden middle. Yet a hybrid of sometimes in principle incompatible concepts forms another point design that faces the challenge of substantiation and validation. We are faced with the need to re-design the air transportation system ab initio. This is a daunting task, especially considering the problem of transitioning from the present system to any fundamentally new system. However, design from scratch is also an opportunity to reconsider approaches to new concept development. In this position paper we propose an approach, Optimized Parametric Functional Design, for systematic development of concepts for management and control of airspace systems, based on optimization formulations in terms of required system functions and states. This reasoning framework, realizable in the context of ab initio system design, offers an approach to deriving substantiated airspace management and control concepts. With growing computational power, we hope that the approach will also yield a methodology for actual dynamic control of airspace

Reducing environmental noise impacts: A USAREUR noise management program handbook

NASA Astrophysics Data System (ADS)

Feather, Timothy D.; Shekell, Ted K.

1991-06-01

Noise pollution is a major environmental problem faced by the U.S. Army in Europe. Noise-related complaints from German citizens can escalate into intense political issues in German communities. This in turn hampers efficient operation of military training and often times threatens the Army's mission. In order to remedy these problems, USAREUR has developed a noise management program. A successful noise management program will limit the impact of unavoidable noise on the populace. This report, a component of the noise management program, is a reference document for noise management planning. It contains guidelines and rules-of-thumb for noise management. This document contains procedures which operation and training level personnel can understand and apply in their day to day noise management planning. Noise mitigation tips are given. Basic technical information that will aid in understanding noise mitigation is provided along with noise management through land use planning. Noise management for specific components of the military community, (airfields, base operations, training areas, and housing and recreation areas) are addressed. The nature of noise generated, means of noise abatement at the source, path, and receiver (both physical and organizational/public relations methods), and a case study example are described.

Designing an IMAC system using TeraNet

NASA Astrophysics Data System (ADS)

Mun, In K.; Hilal, S. K.; Andrews, M. C.; Gidron, Rafael

1992-07-01

Even though considerable progresses have been made with communication technology, one of the more difficult problems facing in installing a comprehensive clinically effective Image Management and Communication (IMAC) system for a hospital is the communication problem. Most existing systems are based on Ethernet or Token-ring net. Some of the newer systems are being installed using FDDL. All these systems have inherent problems like communication speed, control of bandwidth usage, or/and poor performance under heavy traffic. In order to overcome these difficulties, we are designing a complete IMAC system based on a novel network known as TeraNet, being developed at Center for Telecommunication Research, Columbia University.

Predictive analysis and data mining among the employment of fresh graduate students in HEI

NASA Astrophysics Data System (ADS)

Rahman, Nor Azziaty Abdul; Tan, Kian Lam; Lim, Chen Kim

2017-10-01

Management of higher education have a problem in producing 100% of graduates who can meet the needs of industry while industry is also facing the problem of finding skilled graduates who suit their needs partly due to the lack of an effective method in assessing problem solving skills as well as weaknesses in the assessment of problem-solving skills. The purpose of this paper is to propose a suitable classification model that can be used in making prediction and assessment of the attributes of the student's dataset to meet the selection criteria of work demanded by the industry of the graduates in the academic field. Supervised and unsupervised Machine Learning Algorithms were used in this research where; K-Nearest Neighbor, Naïve Bayes, Decision Tree, Neural Network, Logistic Regression and Support Vector Machine. The proposed model will help the university management to make a better long-term plans for producing graduates who are skilled, knowledgeable and fulfill the industry needs as well.

Energy Consumption Management of Virtual Cloud Computing Platform

NASA Astrophysics Data System (ADS)

Li, Lin

2017-11-01

For energy consumption management research on virtual cloud computing platforms, energy consumption management of virtual computers and cloud computing platform should be understood deeper. Only in this way can problems faced by energy consumption management be solved. In solving problems, the key to solutions points to data centers with high energy consumption, so people are in great need to use a new scientific technique. Virtualization technology and cloud computing have become powerful tools in people’s real life, work and production because they have strong strength and many advantages. Virtualization technology and cloud computing now is in a rapid developing trend. It has very high resource utilization rate. In this way, the presence of virtualization and cloud computing technologies is very necessary in the constantly developing information age. This paper has summarized, explained and further analyzed energy consumption management questions of the virtual cloud computing platform. It eventually gives people a clearer understanding of energy consumption management of virtual cloud computing platform and brings more help to various aspects of people’s live, work and son on.

Organization of Biomedical Data for Collaborative Scientific Research: A Research Information Management System

PubMed Central

Myneni, Sahiti; Patel, Vimla L.

2010-01-01

Biomedical researchers often work with massive, detailed and heterogeneous datasets. These datasets raise new challenges of information organization and management for scientific interpretation, as they demand much of the researchers’ time and attention. The current study investigated the nature of the problems that researchers face when dealing with such data. Four major problems identified with existing biomedical scientific information management methods were related to data organization, data sharing, collaboration, and publications. Therefore, there is a compelling need to develop an efficient and user-friendly information management system to handle the biomedical research data. This study evaluated the implementation of an information management system, which was introduced as part of the collaborative research to increase scientific productivity in a research laboratory. Laboratory members seemed to exhibit frustration during the implementation process. However, empirical findings revealed that they gained new knowledge and completed specified tasks while working together with the new system. Hence, researchers are urged to persist and persevere when dealing with any new technology, including an information management system in a research laboratory environment. PMID:20543892

Organization of Biomedical Data for Collaborative Scientific Research: A Research Information Management System.

PubMed

Myneni, Sahiti; Patel, Vimla L

2010-06-01

Biomedical researchers often work with massive, detailed and heterogeneous datasets. These datasets raise new challenges of information organization and management for scientific interpretation, as they demand much of the researchers' time and attention. The current study investigated the nature of the problems that researchers face when dealing with such data. Four major problems identified with existing biomedical scientific information management methods were related to data organization, data sharing, collaboration, and publications. Therefore, there is a compelling need to develop an efficient and user-friendly information management system to handle the biomedical research data. This study evaluated the implementation of an information management system, which was introduced as part of the collaborative research to increase scientific productivity in a research laboratory. Laboratory members seemed to exhibit frustration during the implementation process. However, empirical findings revealed that they gained new knowledge and completed specified tasks while working together with the new system. Hence, researchers are urged to persist and persevere when dealing with any new technology, including an information management system in a research laboratory environment.

Efficacy of Seren@ctif, a Computer-Based Stress Management Program for Patients With Adjustment Disorder With Anxiety: Protocol for a Controlled Trial

PubMed Central

Leterme, Anne-Claire; Rougegrez, Laure; Duhamel, Alain; Vaiva, Guillaume

2017-01-01

Background Adjustment disorder with anxiety (ADA) is the most frequent and best characterized stress-related psychiatric disorder. The rationale for prescription of benzodiazepine monotherapy is a public health issue. Cognitive behavioral stress management programs have been studied in many countries. Several reports have shown beyond reasonable doubt their efficiency at reducing perceived stress and anxiety symptoms and improving patient quality of life. Considering the number of people who could benefit from such programs but are unable to access them, self-help programs have been offered. First presented as books, these programs became enriched with computer-based and digital supports. Regrettably, programs for stress management based on cognitive behavioral therapy (CBT), both face-to-face and digital support, have been only minimally evaluated in France. To our knowledge, the Seren@ctif program is the first French language self-help program for stress management using digital supports. Objective The aim of this study is to assess the effectiveness of a 5-week standardized stress management program for reducing anxiety conducted via eLearning (iCBT) or through face-to-face interviews (CBT) with patients suffering from ADA compared with a wait list control group (WLC). These patients seek treatment in a psychiatric unit for anxiety disorders at a university hospital. The primary outcome is change in the State Trait Anxiety Inventory scale trait subscale (STAI-T) between baseline and 2-month visit. Methods This is a multicenter, prospective, open label, randomized controlled study in 3 parallel groups with balanced randomization (1:1:1): computer-based stress management with minimal contact (not fully automated) (group 1), stress management with face-to-face interviews (group 2), and a WLC group that receives usual health care from a general practitioner (group 3). Programs are based on standard CBT principles and include 5 modules in 5 weekly sessions that include the following topics: stress and stress reaction and assessment; deep respiration and relaxation techniques; cognitive restructuring, mindfulness, and acceptance; behavioral skills as problem solving; and time management, healthy behaviors, and emotion regulation. In the Internet-based group, patients have minimal contact with a medical professional before and after every session. In the first session, a flash memory drive is supplied containing videos, audio files, a self-help book portfolio in the form of an eGuide, and log books providing the exercises to be completed between 2 sessions. The patient is encouraged to practice a 20-minute daily exercise 5 or 6 times per week. In the face-to-face group, patients receive the same program from a therapist with 5 weekly sessions without digital support. Interviews and self-assessments were collected face-to-face with the investigator. Results The feasibility of this program is being tested, and results show good accessibility in terms of acceptance, understanding, and treatment credibility. Results are expected in 2018. Conclusions To our knowledge, this is the first French study to examine the effectiveness of a computer-based stress management program for patients with ADA. The Seren@ctif program may be useful within the framework of a psychoeducative approach. It could also be advised for people suffering from other diseases related to stress and for people with a clinical level of perceived stress. Trial Registration Clinicaltrials.gov NCT02621775; https://clinicaltrials.gov/ct2/show/NCT02621775 (Archived by WebCite at http://www.webcitation.org/6tQrkPs1u) PMID:28970192

Critical social theory as a model for the informatics curriculum for nursing.

PubMed

Wainwright, P; Jones, P G

2000-01-01

It is widely acknowledged that the education and training of nurses in information management and technology is problematic. Drawing from recent research this paper presents a theoretical framework within which the nature of the problems faced by nurses in the use of information may be analyzed. This framework, based on the critical social theory of Habermas, also provides a model for the informatics curriculum. The advantages of problem based learning and multi-media web-based technologies for the delivery of learning materials within this area are also discussed.

Challenges in comprehensive management of spinal cord injury in India and in the Asian Spinal Cord network region: findings of a survey of experts, patients and consumers.

PubMed

Chhabra, H S; Sharma, S; Arora, M

2018-01-01

Online survey. To understand the prevailing scenario of the comprehensive management of spinal cord injuries (SCI) in India and in the Asian Spinal Cord Network (ASCoN) region, especially with a view to document the challenges faced and its impact. Indian Spinal Injuries Centre. A questionnaire was designed which covered various aspects of SCI management. Patients, consumers (spinal injured patients discharged since at least 1 year) and experts in SCI management from different parts of India and the ASCoN region were approached to complete the survey. Sixty patients, 66 consumers and 34 experts completed the survey. Difference of opinion was noticed among the three groups. Disposable Nelaton catheters were used by 57% consumers and 47% patients. For reusable catheter, 31% experts recommended processing with soap and running water and 45% recommended clean cotton cloth bag for storage. Pre-hospital care and community inclusion pose the biggest challenges in management of SCI. More than 75% of SCI faced problems of access and mobility in the community. Awareness about SCI, illiteracy and inadequate patient education are the most important factors hindering pre- and in-hospital care. Inadequate physical as well as vocational rehabilitation and financial barriers are thought to be the major factors hindering integration of spinal injured into mainstream society. Strong family support helped in rehabilitation. Our study brought out that SCI in India and ASCoN region face numerous challenges that affect access to almost all aspects of comprehensive management of SCI.

Functional Coherence in the State Education Agency: A Structure for Performance Management. Solutions. Issue No. 4

ERIC Educational Resources Information Center

Redding, Sam; Nafziger, Dean

2013-01-01

The purpose of the state education agency (SEA) is to focus the entire education system on helping students become capable in college and career in an increasingly complex world. One of the most vexing problems facing SEAs today is how to meet increasing demands for performance while adjusting to significant resource reductions. Meeting that…

An Analysis of Facebook Intensity and Privacy Management Practices of Public School Educators in the United States

ERIC Educational Resources Information Center

Neely, Laura Sue Perry

2011-01-01

Social networking sites like Facebook continue to gain popularity among all segments of the population (boyd & Ellison, 2007; Madden & Smith, 2010). Public school employees all over the country are finding themselves facing disciplinary action due to participation in this fast growing fad. The problem is that there is a lack of clarity in the…

Performance Indicators: Sickness and Absence Rates as Indicators of Staff Morale.

ERIC Educational Resources Information Center

Parker, Sandra

Employee absenteeism is a problem faced by all library and information service managers as it erodes both salary budgets and productivity. It can have an undermining effect on staff morale, and may be an indicator of low staff motivation levels. There are two types of absence, unavoidable and avoidable, which can be measured using lost time and…

Identifying the Criteria for Planning the Selection and Succession of a CIO: A Phenomenological Study

ERIC Educational Resources Information Center

Williamson, Charles E.

2010-01-01

Many challenges face CIOs in their management of IT systems; yet, very little research is available regarding the issues and constraints associated with their role. CIO leadership is still a subject of inquiry for those with aspirations to pursue such a position. The specific problem of the current qualitative phenomenological study concerned the…

Pearls and pitfalls of deformity correction and limb lengthening via monolateral external fixation.

PubMed Central

Noonan, K. J.; Price, C. T.

1996-01-01

In conclusion, monolateral external fixation can be effectively utilized in the management of limb length discrepancy and angular deformity. This manuscript outlines the pertinent theory, application and problems important in these cases. When faced with specific congenital conditions the surgeon is encouraged to reference relevant literature that is more focused than the current paper. PMID:9129275

Mobile Computing: 5 Solutions for Your Tablet Management Woes

ERIC Educational Resources Information Center

Raths, David

2013-01-01

At the end of the 2010-2011 school year, San Diego Unified School District, had 10,000 iPads in use and was set to add 18,000 more the next semester. Teachers and students were enthusiastic about using the devices yet the district faced a serious problem: Teachers were reporting to the instructional tech team that using Apple Configurator and…

The Primary Headteacher's Handbook: The Essential Guide for Primary Heads. Primary Essentials Series.

ERIC Educational Resources Information Center

Smith, Roger

Although the setting is British, the primary head's problems are similar to those faced by U.S. elementary principals. This is a guidebook for managing primary schools. It shows the day-to-day running of a primary school and the organizational structures in which staff and pupils can be inspired. Chapter 1 considers the creation of a positive…

Implementing Education Reforms in New Zealand, 1987-97: A Case Study. The Education Reform and Management Series, Vol. 1, No. 1.

ERIC Educational Resources Information Center

Perris, Lyall

In 1987 New Zealand faced multiple economic problems and high unemployment. A flexible and responsive education system was needed to produce the skills, attitudes, and learning required for New Zealand's future. The primary objective was decentralizing authority to school level. This book emphasizes the process of successful reform, rather than…

Restoring fire-adapted ecosystems: proceedings of the 2005 national silviculture workshop

Treesearch

Robert F. Powers

2007-01-01

Many federal forests are at risk to catastrophic wild fire owing to past management practices and policies. Mangers of these forests face the immense challenge of making their forests resilient to wild fire, and the problem is complicated by the specter of climate change that may affect wild fire frequency and intensity. Some of the Nation’s leading...

Depression is More Than Just Sadness: A Case of Excessive Anger and Its Management in Depression

PubMed Central

Sahu, Anamika; Gupta, Preeti; Chatterjee, Biswadip

2014-01-01

People with depressive illness often have symptoms of overt or suppressed anger. Those with anger traits face exaggerated problem during symptomatic period of depression. Pharmacological management helps in control of depressive and anxiety symptoms, but rarely address anger symptoms. Non-pharmacological management like cognitive-behavioral therapy (CBT) is effective in depression as well as in anger management, but is not used frequently in anger associated or exacerbated by depression. We present the case of a 27-year-old male suffering from moderate depressive episode with associated anger outburst. He underwent CBT, which resulted in a significant decrease in anger symptoms as well as in severity of depression. PMID:24701016

Depression is More Than Just Sadness: A Case of Excessive Anger and Its Management in Depression.

PubMed

Sahu, Anamika; Gupta, Preeti; Chatterjee, Biswadip

2014-01-01

People with depressive illness often have symptoms of overt or suppressed anger. Those with anger traits face exaggerated problem during symptomatic period of depression. Pharmacological management helps in control of depressive and anxiety symptoms, but rarely address anger symptoms. Non-pharmacological management like cognitive-behavioral therapy (CBT) is effective in depression as well as in anger management, but is not used frequently in anger associated or exacerbated by depression. We present the case of a 27-year-old male suffering from moderate depressive episode with associated anger outburst. He underwent CBT, which resulted in a significant decrease in anger symptoms as well as in severity of depression.

Dealing with sub-trochanteric fracture in a child with osteopetrosis : A case report.

PubMed

Behera, P; Khurana, A; Saibaba, B; Aggarwal, S

2016-12-01

Osteopetrosis is a rare hereditary condition which may have autosomal recessive or autosomal dominant inheritance. Patients tend to present most commonly with fractures but involvement of cranial nerves and hematopoetic system is not uncommon. Patients with infantile and intermediate type tend to present more often with problems other than orthopaedic problems. While diagnosis can be made on the basis of radiographs, management needs to be customized for every patient. Non operative and operative management both have their advantages and disadvantages. We are here reporting a case of sub-trochanteric fracture in an eight-year-old child which was managed successfully with a dynamic hip screw (DHS). Surgery could be performed successfully by taking precautions during reduction, drilling and screw placement. At the latest follow up, which was after one and half years of surgery, the fracture had united well and the child faced no limitations of activities. Thus, open reduction and fixation with DHS can be considered as an effective management modality for pediatric sub-trochanteric fractures in osteopetrosis.

Problems, acceptance and social inequality: a study of the deformed leprosy patients and their families.

PubMed

Kopparty, S N

1995-09-01

Though the impact of social inequality on health conditions is widely known, its impact on the chronic and stigmatized disease, leprosy, has received little attention. Deformity sometimes leads to disabilities and to handicaps causing problems to the patient and his family. In this paper an attempt has been made to understand the impact of social inequality, prevalent in the form of the caste system in India on the deformed leprosy patients and on their families. This impact was examined in terms of the problems faced by the patients. A sample of 150 deformed patients and their families, drawn from two districts in Tamil Nadu, was selected for the study. About 57% of the deformed patients experienced their deformity as a handicap which caused social and economic problems while the rest did not. Of the three caste groups, the Lower Caste group experienced more severe economic problems while the Upper Caste group faced more social problems. The extent of acceptance of deformed patients in their family varied significantly among those facing and not facing problems due to their deformity. The deformed patients without any handicap were accepted in a large majority of their families (82%) regardless of their caste status. In contrast the deformed but handicapped patients were accepted differentially among the three caste groups with the Upper group accepting them in most of their families (80%) while in the Lower group much less number of families (54%) did. All the families of the deformed but not handicapped patients desired to keep their patients till their death irrespective of their caste status. On the contrary, while all the families in the Upper Caste group expressed their willingness to keep their handicapped patients in the family till their death, 10% in the Middle and 22% in the Lower Caste groups did not want to do so. This suggests the gradual marginalization, rejection and dehabilitation of the affected. Thus, one's caste status can be a broad indicator of the nature and the extent of handicaps and acceptance in the family. This factor needs to be appropriately taken care of for rehabilitation and disability management in leprosy control programmes.

Better Medicare Cost Report data are needed to help hospitals benchmark costs and performance.

PubMed

Magnus, S A; Smith, D G

2000-01-01

To evaluate costs and achieve cost control in the face of new technology and demands for efficiency from both managed care and governmental payers, hospitals need to benchmark their costs against those of other comparable hospitals. Since they typically use Medicare Cost Report (MCR) data for this purpose, a variety of cost accounting problems with the MCR may hamper hospitals' understanding of their relative costs and performance. Managers and researchers alike need to investigate the validity, accuracy, and timeliness of the MCR's cost accounting data.

Acute poisoning: understanding 90% of cases in a nutshell

PubMed Central

Greene, S; Dargan, P; Jones, A

2005-01-01

The acutely poisoned patient remains a common problem facing doctors working in acute medicine in the United Kingdom and worldwide. This review examines the initial management of the acutely poisoned patient. Aspects of general management are reviewed including immediate interventions, investigations, gastrointestinal decontamination techniques, use of antidotes, methods to increase poison elimination, and psychological assessment. More common and serious poisonings caused by paracetamol, salicylates, opioids, tricyclic antidepressants, selective serotonin reuptake inhibitors, benzodiazepines, non-steroidal anti-inflammatory drugs, and cocaine are discussed in detail. Specific aspects of common paediatric poisonings are reviewed. PMID:15811881

Acute poisoning: understanding 90% of cases in a nutshell.

PubMed

Greene, S L; Dargan, P I; Jones, A L

2005-04-01

The acutely poisoned patient remains a common problem facing doctors working in acute medicine in the United Kingdom and worldwide. This review examines the initial management of the acutely poisoned patient. Aspects of general management are reviewed including immediate interventions, investigations, gastrointestinal decontamination techniques, use of antidotes, methods to increase poison elimination, and psychological assessment. More common and serious poisonings caused by paracetamol, salicylates, opioids, tricyclic antidepressants, selective serotonin reuptake inhibitors, benzodiazepines, non-steroidal anti-inflammatory drugs, and cocaine are discussed in detail. Specific aspects of common paediatric poisonings are reviewed.

Guidelines for Implementing Change: A Case Study

NASA Astrophysics Data System (ADS)

Masekela, Belinda; Nienaber, Rita

To attain and sustain a competitive advantage organizations are continually faced with the need to change their structures, processes and technologies. Converting to new technology and implementing a new information management system in an organization results in inevitable changes in organizational procedures impacting on the people involved. A major problem encountered during this process is resistance to change, which may contribute to total failure of this system. Change management is the process that can be used to negate this impact and assist employees in transitioning to a new way of doing things.

[Ethical problems experienced by nurses in primary health care: integrative literature review].

PubMed

Nora, Carlise Rigon Dalla; Zoboli, Elma Lourdes Campos Pavone; Vieira, Margarida

2015-03-01

The aim of this study is to identify ethical problems experienced by nurses in primary health care and resources for coping based on publications on the subject. An integrative literature review was performed between the months of October and November 2013, using the databases: BDTD, CINAHL, LILACS, MEDLINE, Biblioteca Cochrane, PubMed, RCAAP and SciELO. Articles, dissertations and theses published in Portuguese, English and Spanish were included, totalling 31 studies published from 1992 to 2013. This analysis resulted in four categories: ethical problems in the relationship between team members, ethical problems in the relationship with the user, ethical problems in health services management and resources for coping with ethical problems. Results showed that nurses need to be prepared to face ethical problems, emphasizing the importance of ethics education during the education process before and during professional practice to enhance the development of ethical sensitivity and competence for problem resolution.

Managing in the interprofessional environment: a theory of action perspective.

PubMed

Rogers, Tim

2004-08-01

Managers of multidisciplinary teams face difficult dilemmas in managing competing interests, diverse perspectives and interpersonal conflicts. This paper illustrates the potential of the theory of action methodology of Argyris and Schön (1974, 1996) to illuminate these problems and contribute to their resolution. An empirical example of a depth-investigation with one multidisciplinary community health care team leader in Australia demonstrates that the theory of action offers a more accurate account of the causal dimensions of her dilemmas and provides more scope for effective intervention than her lay explanation will allow. It also provides a more satisfactory analysis of her difficulties with two common problems identified in the literature: defining the appropriate level of autonomy for team members and developing constructive dialogue across perceived discipline-based differences of opinion. Consequently the theory of action appears to offer enormous promise to managers of multidisciplinary teams wanting to understand and resolve their problems and develop a rigorous reflective practice. Further research on the viability of the theory to facilitate a self-correcting system that can promote learning even under conditions of stress and conflict is suggested and implications for learning and teaching for the multidisciplinary environment are briefly discussed.

Health Management Technology as a General Solution Framework

NASA Astrophysics Data System (ADS)

Nakajima, Hiroshi; Hasegawa, Yoshifumi; Tasaki, Hiroshi; Iwami, Taro; Tsuchiya, Naoki

Health maintenance and improvement of humans, artifacts, and nature are pressing requirements considering the problems human beings have faced. In this article, the health management technology is proposed by centering cause-effect structure. The important aspect of the technology is evolvement through human-machine collaboration in response to changes of target systems. One of the reasons why the cause-effect structure is centered in the technology is its feature of transparency to humans by instinct point of view. The notion has been spreaded over wide application areas such as quality control, energy management, and healthcare. Some experiments were conducted to prove effectiveness of the technology in the article.

A Comprehensive Rehabilitation Approach in a Patient With Serious Neuropsychiatric Systemic Lupus Erythematosus.

PubMed

Ko, Yong Jae; Lee, Yang Gyun; Park, Ji Woong; Ahn, Sung Ho; Kwak, Jin Myoung; Choi, Yoon-Hee

2016-08-01

Neuropsychiatric systemic lupus erythematosus (NPSLE) involves the central and peripheral nervous system in patients with systemic lupus erythematosus (SLE). It is essential to specify the problems faced by patients with NPSLE because it causes diverse disabilities and impairs quality of life. After performing a comprehensive evaluation, tailored management should be provided for the patient's specific problems. We report here the case of a 30-year-old female with SLE who experienced serious neuropsychiatric symptoms cerebral infarction followed by posterior reversible encephalopathy syndrome and peripheral polyneuropathy. We systemically assessed the patient using the International Classification of Functioning, Disability and Health model as a clinical problem-solving tool and provided comprehensive rehabilitation by focusing on her problems.

Context Oriented Information Integration

NASA Astrophysics Data System (ADS)

Mohania, Mukesh; Bhide, Manish; Roy, Prasan; Chakaravarthy, Venkatesan T.; Gupta, Himanshu

Faced with growing knowledge management needs, enterprises are increasingly realizing the importance of seamlessly integrating critical business information distributed across both structured and unstructured data sources. Academicians have focused on this problem but there still remain a lot of obstacles for its widespread use in practice. One of the key problems is the absence of schema in unstructured text. In this paper we present a new paradigm for integrating information which overcomes this problem - that of Context Oriented Information Integration. The goal is to integrate unstructured data with the structured data present in the enterprise and use the extracted information to generate actionable insights for the enterprise. We present two techniques which enable context oriented information integration and show how they can be used for solving real world problems.

Bringing managed care home to the long-term care population.

PubMed

Nadash, Pamela; Ahrens, Joann

2004-01-01

Managed care has been proposed as a solution to the problems facing long-term care: its high costs, bias towards nursing homes, lack of coordination with acute and primary care, and inflexible service delivery. Kodner and Kyriacou (2003) argue that home care agencies may have considerable advantages in creating managed care systems for this population over traditional managed care organizations because of the experience home care organizations have in caring for older adults as well as people with disabilities. Although home care agencies are likely to better understand the needs of the long-term care population, they may lack the expertise and organizational resources to develop successful managed care organizations. Addressing these deficiencies will be key in order for home care organizations to successfully operate as managed care providers.

Use of the Internet and Mobile Phones for Self-Management of Severe Mental Health Problems: Qualitative Study of Staff Views

PubMed Central

Bucci, Sandra; Lobban, Fiona

2017-01-01

Background Researchers are currently investigating the feasibility, acceptability, and efficacy of digital health interventions for people who experience severe mental health problems such as psychosis and bipolar disorder. Although the acceptability of digital health interventions for severe mental health problems appears to be relatively high and some people report successfully using the Internet and mobile phones to manage their mental health, the attitudes of mental health care staff toward such approaches have yet to be considered. Objective The aim of this study was to explore mental health care staff experiences of clients with severe mental health problems engaging with the Internet and mobile phones to self-manage their mental health and their views toward these behaviors. The study also sought to examine the opinions expressed by mental health care staff toward digital health interventions for severe mental health problems to identify potential facilitators and barriers to implementation. Methods Four focus groups were conducted with 20 staff working in mental health care services in the North West of the England using a topic guide. Focus groups involved 12 staff working in secondary care psychological services (7 participants in focus group 1 and 5 participants in focus group 4), 4 staff working in a rehabilitation unit (focus group 2), and 4 staff working in a community mental health team (focus group 3). Focus groups were transcribed verbatim, and transcripts were analyzed thematically to identify key themes that emerged from the data. Results Four overarching themes, two with associated subthemes, were identified: (1) staff have conflicting views about the pros and cons of using Web-based resources and digital health interventions to manage mental health; (2) digital health interventions could increase access to mental health support options for severe mental health problems but may perpetuate the digital divide; (3) digital health interventions’ impact on staff roles and responsibilities; and (4) digital health interventions should be used to enhance, not replace, face-to-face support. Conclusions This study is the first, to our knowledge, to qualitatively explore the experiences and attitudes of mental health care staff toward individuals with severe mental health problems using the Internet, mobile phones, and digital health interventions to self-manage their mental health. Understanding the positive and negative experiences and views shared by staff toward both current and potential digital health intervention use has enabled the identification of several considerations for implementation. Additionally, the findings suggest mental health care staff need clear guidance and training in relation to their responsibilities in recommending reputable and secure websites, forums, and digital health interventions and in how to manage professional boundaries on the Internet. Overall, the study highlights that digital health interventions could be well received by staff working in mental health services but importantly, such management options must be presented to frontline staff as an avenue to enhance care and extend choice, rather than as a method to reduce costs. PMID:29092809

The airport gate assignment problem: a survey.

PubMed

Bouras, Abdelghani; Ghaleb, Mageed A; Suryahatmaja, Umar S; Salem, Ahmed M

2014-01-01

The airport gate assignment problem (AGAP) is one of the most important problems operations managers face daily. Many researches have been done to solve this problem and tackle its complexity. The objective of the task is assigning each flight (aircraft) to an available gate while maximizing both conveniences to passengers and the operational efficiency of airport. This objective requires a solution that provides the ability to change and update the gate assignment data on a real time basis. In this paper, we survey the state of the art of these problems and the various methods to obtain the solution. Our survey covers both theoretical and real AGAP with the description of mathematical formulations and resolution methods such as exact algorithms, heuristic algorithms, and metaheuristic algorithms. We also provide a research trend that can inspire researchers about new problems in this area.

The Airport Gate Assignment Problem: A Survey

PubMed Central

Ghaleb, Mageed A.; Salem, Ahmed M.

2014-01-01

The airport gate assignment problem (AGAP) is one of the most important problems operations managers face daily. Many researches have been done to solve this problem and tackle its complexity. The objective of the task is assigning each flight (aircraft) to an available gate while maximizing both conveniences to passengers and the operational efficiency of airport. This objective requires a solution that provides the ability to change and update the gate assignment data on a real time basis. In this paper, we survey the state of the art of these problems and the various methods to obtain the solution. Our survey covers both theoretical and real AGAP with the description of mathematical formulations and resolution methods such as exact algorithms, heuristic algorithms, and metaheuristic algorithms. We also provide a research trend that can inspire researchers about new problems in this area. PMID:25506074

The Scatter Search Based Algorithm to Revenue Management Problem in Broadcasting Companies

NASA Astrophysics Data System (ADS)

Pishdad, Arezoo; Sharifyazdi, Mehdi; Karimpour, Reza

2009-09-01

The problem under question in this paper which is faced by broadcasting companies is how to benefit from a limited advertising space. This problem is due to the stochastic behavior of customers (advertiser) in different fare classes. To address this issue we propose a mathematical constrained nonlinear multi period model which incorporates cancellation and overbooking. The objective function is to maximize the total expected revenue and our numerical method performs it by determining the sales limits for each class of customer to present the revenue management control policy. Scheduling the advertising spots in breaks is another area of concern and we consider it as a constraint in our model. In this paper an algorithm based on Scatter search is developed to acquire a good feasible solution. This method uses simulation over customer arrival and in a continuous finite time horizon [0, T]. Several sensitivity analyses are conducted in computational result for depicting the effectiveness of proposed method. It also provides insight into better results of considering revenue management (control policy) compared to "no sales limit" policy in which sooner demand will served first.

Municipal Solid Waste Management and its Energy Potential in Roorkee City, Uttarakhand, India

NASA Astrophysics Data System (ADS)

Alam, Tabish; Kulkarni, Kishore

2016-03-01

Energy plays a vital role in the development of any country. With rapid economic growth and multifold urbanization, India faces the problem of municipal solid waste management and disposal. This problem can be mitigate through adoption of environment friendly technologies for treatment and processing of waste before it is disposed off. Currently, urban and industrial wastes throughout India receive partial treatment before its final disposal, except in few exceptional cases. This practice leads to severe environmental pollution problems including major threat to human health. There is an absolute need to provide adequate waste collection and treatment before its disposal. Municipal Solid Waste (MSW) is getting importance in recent years. The MSW management involves collection, transportation, handling and conversion to energy by biological and thermal routes. Based on the energy potential available, the energy conversion through biogas production using available waste is being carried out. Waste-to-energy is now a clean, renewable, sustainable source of energy. The estimation of energy content of MSW in Roorkee city is discussed in this paper. Furthermore this paper also takes into account the benefits of carbon credits.

Understanding enabling capacities for managing the 'wicked problem' of nonpoint source water pollution in catchments: a conceptual framework.

PubMed

Patterson, James J; Smith, Carl; Bellamy, Jennifer

2013-10-15

Nonpoint source (NPS) water pollution in catchments is a 'wicked' problem that threatens water quality, water security, ecosystem health and biodiversity, and thus the provision of ecosystem services that support human livelihoods and wellbeing from local to global scales. However, it is a difficult problem to manage because water catchments are linked human and natural systems that are complex, dynamic, multi-actor, and multi-scalar in nature. This in turn raises questions about understanding and influencing change across multiple levels of planning, decision-making and action. A key challenge in practice is enabling implementation of local management action, which can be influenced by a range of factors across multiple levels. This paper reviews and synthesises important 'enabling' capacities that can influence implementation of local management action, and develops a conceptual framework for understanding and analysing these in practice. Important enabling capacities identified include: history and contingency; institutional arrangements; collaboration; engagement; vision and strategy; knowledge building and brokerage; resourcing; entrepreneurship and leadership; and reflection and adaptation. Furthermore, local action is embedded within multi-scalar contexts and therefore, is highly contextual. The findings highlight the need for: (1) a systemic and integrative perspective for understanding and influencing change for managing the wicked problem of NPS water pollution; and (2) 'enabling' social and institutional arenas that support emergent and adaptive management structures, processes and innovations for addressing NPS water pollution in practice. These findings also have wider relevance to other 'wicked' natural resource management issues facing similar implementation challenges. Copyright © 2013 Elsevier Ltd. All rights reserved.

Adaptive management for a turbulent future

USGS Publications Warehouse

Allen, Craig R.; Fontaine, J.J.; Pope, K.L.; Garmestani, A.S.

2011-01-01

The challenges that face humanity today differ from the past because as the scale of human influence has increased, our biggest challenges have become global in nature, and formerly local problems that could be addressed by shifting populations or switching resources, now aggregate (i.e., "scale up") limiting potential management options. Adaptive management is an approach to natural resource management that emphasizes learning through management based on the philosophy that knowledge is incomplete and much of what we think we know is actually wrong. Adaptive management has explicit structure, including careful elucidation of goals, identification of alternative management objectives and hypotheses of causation, and procedures for the collection of data followed by evaluation and reiteration. It is evident that adaptive management has matured, but it has also reached a crossroads. Practitioners and scientists have developed adaptive management and structured decision making techniques, and mathematicians have developed methods to reduce the uncertainties encountered in resource management, yet there continues to be misapplication of the method and misunderstanding of its purpose. Ironically, the confusion over the term "adaptive management" may stem from the flexibility inherent in the approach, which has resulted in multiple interpretations of "adaptive management" that fall along a continuum of complexity and a priori design. Adaptive management is not a panacea for the navigation of 'wicked problems' as it does not produce easy answers, and is only appropriate in a subset of natural resource management problems where both uncertainty and controllability are high. Nonetheless, the conceptual underpinnings of adaptive management are simple; there will always be inherent uncertainty and unpredictability in the dynamics and behavior of complex social-ecological systems, but management decisions must still be made, and whenever possible, we should incorporate learning into management. ?? 2010 .

Adaptive Management for a Turbulent Future

USGS Publications Warehouse

Allen, Craig R.; Fontaine, Joseph J.; Pope, Kevin L.; Garmestani, Ahjond S.

2011-01-01

The challenges that face humanity today differ from the past because as the scale of human influence has increased, our biggest challenges have become global in nature, and formerly local problems that could be addressed by shifting populations or switching resources, now aggregate (i.e., "scale up") limiting potential management options. Adaptive management is an approach to natural resource management that emphasizes learning through management based on the philosophy that knowledge is incomplete and much of what we think we know is actually wrong. Adaptive management has explicit structure, including careful elucidation of goals, identification of alternative management objectives and hypotheses of causation, and procedures for the collection of data followed by evaluation and reiteration. It is evident that adaptive management has matured, but it has also reached a crossroads. Practitioners and scientists have developed adaptive management and structured decision making techniques, and mathematicians have developed methods to reduce the uncertainties encountered in resource management, yet there continues to be misapplication of the method and misunderstanding of its purpose. Ironically, the confusion over the term "adaptive management" may stem from the flexibility inherent in the approach, which has resulted in multiple interpretations of "adaptive management" that fall along a continuum of complexity and a priori design. Adaptive management is not a panacea for the navigation of 'wicked problems' as it does not produce easy answers, and is only appropriate in a subset of natural resource management problems where both uncertainty and controllability are high. Nonetheless, the conceptual underpinnings of adaptive management are simple; there will always be inherent uncertainty and unpredictability in the dynamics and behavior of complex social-ecological systems, but management decisions must still be made, and whenever possible, we should incorporate learning into management. Published by Elsevier Ltd.

Technology Confidence, Competence and Problem Solving Strategies: Differences within Online and Face-to-Face Formats

ERIC Educational Resources Information Center

Peterson, Sharon L.; Palmer, Louann Bierlein

2011-01-01

This study identified the problem solving strategies used by students within a university course designed to teach pre-service teachers educational technology, and whether those strategies were influenced by the format of the course (i.e., face-to-face computer lab vs. online). It also examined to what extent the type of problem solving strategies…

Composite multilobe descriptors for cross-spectral recognition of full and partial face

NASA Astrophysics Data System (ADS)

Cao, Zhicheng; Schmid, Natalia A.; Bourlai, Thirimachos

2016-08-01

Cross-spectral image matching is a challenging research problem motivated by various applications, including surveillance, security, and identity management in general. An example of this problem includes cross-spectral matching of active infrared (IR) or thermal IR face images against a dataset of visible light images. A summary of recent developments in the field of cross-spectral face recognition by the authors is presented. In particular, it describes the original form and two variants of a local operator named composite multilobe descriptor (CMLD) for facial feature extraction with the purpose of cross-spectral matching of near-IR, short-wave IR, mid-wave IR, and long-wave IR to a gallery of visible light images. The experiments demonstrate that the variants of CMLD outperform the original CMLD and other recently developed composite operators used for comparison. In addition to different IR spectra, various standoff distances from close-up (1.5 m) to intermediate (50 m) and long (106 m) are also investigated. Performance of CMLD I to III is evaluated for each of the three cases of distances. The newly developed operators, CMLD I to III, are further utilized to conduct a study on cross-spectral partial face recognition where different facial regions are compared in terms of the amount of useful information they contain for the purpose of conducting cross-spectral face recognition. The experimental results show that among three facial regions considered in the experiments the eye region is the most informative for all IR spectra at all standoff distances.

ECS Resignations Raise Questions of Fiscal Health: Leader of State Policy Group Says Problems Can Be Fixed

ERIC Educational Resources Information Center

Hoff, David J.

2006-01-01

Kathy Christie, senior vice president at the Education Commission of the States (ECS), resigned on May 1, 2006, saying that the Denver-based group faces a financial crisis, and that she doubts the current ECS president can fix it. By the end of the week, the accounting manager had also resigned, expressing similar concerns, and two policy analysts…

Major Management Challenges and Program Risks. Department of Agriculture

DTIC Science & Technology

2001-01-01

environment, ensure food safety , improve the well-being of rural America, promote domestic marketing and the export of food and farm products, conduct...meat and poultry. USDA must also determine if foreign countries have implemented equivalent food safety and inspection systems before those countries...continuing fundamental problem facing USDA, namely, that the current food safety system is highly fragmented with as many as 12 different federal

Looking at Leadership: Some Neglected Issues

DTIC Science & Technology

1977-10-01

problems. (3) Use of power Using social skills, rewards and punishments to control organizational events. A way to study leaders is to simulate the...conditions managers face. Simulation paradigms allow detailed ex- amination of the complex forces impacting on organizations from without and within...modifying the impacts of other variables. Given this horrendous complexity, it is no surprise that Vaill (in press) has questioned whether it makes much

Optimum use of air tankers in initial attack: selection, basing, and transfer rules

Treesearch

Francis E. Greulich; William G. O' Regan

1982-01-01

Fire managers face two interrelated problems in deciding the most efficient use of air tankers: where best to base them, and how best to reallocate them each day in anticipation of fire occurrence. A computerized model based on a mixed integer linear program can help in assigning air tankers throughout the fire season. The model was tested using information from...

Economic considerations in Douglas-fir stand establishment.

Treesearch

T.A. McClay

1955-01-01

One of the most important problem facing a forest manager is how to successfully bridge the gap between the cutting of the old stand and establishment of the new one. Perhaps its importance is due to the fact that it requires prompt action based upon definite planning. At most other points in a forest stand's history, failure to take action is not quite so obvious...

Approaches to Standard School Education Balanced with Psychological Care for Children during Disaster Recovery: From the Point of View of Class Management

ERIC Educational Resources Information Center

Kawamura, Shigeo

2013-01-01

Schools in the areas afflicted by an earthquake disaster of unprecedented scale, already faced with the challenge of simply carrying out regular school education, also struggled with the problem of how to ensure the necessary psychological care for the damaged children. With regard to this, I undertook school support based on the following…

Developing and sustaining human resources in the health supply chain in Ethiopia: barriers and enablers.

PubMed

Kälvemark Sporrong, Sofia; Traulsen, Janine M; Damene Kabtimer, Woynabeba; Mekasha Habtegiorgis, Bitsatab; Teshome Gebregeorgise, Dawit; Essah, Nana Am; Khan, Sara A; Brown, Andrew N

2016-01-01

The health supply chain is often the weakest link in achieving the health-related Millennium Development Goals and universal health coverage, requiring trained professionals who are often unavailable. In Ethiopia there have been recent developments in the area of health supply chain management. The aim of this study was to explore the current status of the development of human resources in health supply chain management in Ethiopia and to identify important factors affecting this development. A series of face-to-face interviews with key stakeholders was carried out in 2014. The interviews were conducted using a semi-structured interview guide. The interview guide comprised 51 questions. A qualitative analysis of transcripts was made. A total of 25 interviews were conducted. Three themes were identified: General changes: recognition, commitment and resources, Education and training, and Barriers and enablers. Results confirm the development of human resources in health supply chain management in many areas. However, several problems were identified including lack of coordination, partly due to the large number of stakeholders; reported high staff mobility; and a lack of overall strategy regarding the job/career structures necessary for maintaining human resources. Rural areas have a particular set of problems, including in transportation of goods and personnel, attracting and keeping personnel, and in communication and access to information. Ethiopia is on the way to developing a nationwide viable system for health supply chain management. However, there are still challenges. Short-term challenges include the importance of highlighting strategies and programs for human resources in health supply chain management. In the long term, commitments to financial support must be obtained. A strategy is needed for the further development and sustainability of human resources in the health supply chain in Ethiopia.

Barriers to managing child and adolescent mental health problems: a systematic review of primary care practitioners' perceptions.

PubMed

O'Brien, Doireann; Harvey, Kate; Howse, Jessica; Reardon, Tessa; Creswell, Cathy

2016-10-01

Mental health problems are common and typically have an early onset. Effective treatments for mental health problems in childhood and adolescence are available, yet only a minority of children who are affected access them. This is of serious concern, considering the far-reaching and long-term negative consequences of such problems. Primary care is usually the first port of call for concerned parents so it is important to understand how primary care practitioners manage child and adolescent mental health problems and the barriers they face. To ascertain primary care practitioners' perceptions of the barriers that prevent effective management of child and adolescent mental health problems. A systematic review of qualitative and quantitative literature in a primary care setting. A database search of peer-reviewed articles using PsycINFO, MEDLINE(®), Embase, and Web of Science, from inception (earliest 1806) until October 2014, was conducted. Additional studies were identified through hand searches and forward-citation searches. Studies needed to have at least one search term in four categories: primary care, childhood/adolescence, mental health, and barriers. A total of 4151 articles were identified, of which 43 were included (30 quantitative studies and 13 qualitative studies). The majority of the barriers related to identification, management, and/or referral. Considerable barriers included a lack of providers and resources, extensive waiting lists, and financial restrictions. The identification of a broad range of significant barriers highlights the need to strengthen the ability to deal with these common difficulties in primary care. There is a particular need for tools and training to aid accurate identification and management, and for more efficient access to specialist services. © British Journal of General Practice 2016.

Barriers to managing child and adolescent mental health problems: a systematic review of primary care practitioners’ perceptions

PubMed Central

O’Brien, Doireann; Harvey, Kate; Howse, Jessica; Reardon, Tessa; Creswell, Cathy

2016-01-01

Background Mental health problems are common and typically have an early onset. Effective treatments for mental health problems in childhood and adolescence are available, yet only a minority of children who are affected access them. This is of serious concern, considering the far-reaching and long-term negative consequences of such problems. Primary care is usually the first port of call for concerned parents so it is important to understand how primary care practitioners manage child and adolescent mental health problems and the barriers they face. Aim To ascertain primary care practitioners’ perceptions of the barriers that prevent effective management of child and adolescent mental health problems. Design and setting A systematic review of qualitative and quantitative literature in a primary care setting. Method A database search of peer-reviewed articles using PsycINFO, MEDLINE®, Embase, and Web of Science, from inception (earliest 1806) until October 2014, was conducted. Additional studies were identified through hand searches and forward-citation searches. Studies needed to have at least one search term in four categories: primary care, childhood/adolescence, mental health, and barriers. Results A total of 4151 articles were identified, of which 43 were included (30 quantitative studies and 13 qualitative studies). The majority of the barriers related to identification, management, and/or referral. Considerable barriers included a lack of providers and resources, extensive waiting lists, and financial restrictions. Conclusion The identification of a broad range of significant barriers highlights the need to strengthen the ability to deal with these common difficulties in primary care. There is a particular need for tools and training to aid accurate identification and management, and for more efficient access to specialist services. PMID:27621291

Animal bite injuries to the face : A Case Report.

PubMed

Simao, Niverso Rodrigues; Borba, Alexandre Meireles; da Silva, Andre Luis Fernandes; Vieira, Evanice Menezes Marcal; Carvalhosa, Artur Aburad; Bandeca, Matheus Coelho; Borges, Alvaro Henrique

2013-08-01

Traumatic lacerations to the skin are problems frequently seen and treated by emergency centers around the world. Among all wounds, dog and cat bites are commonly seen. As in many mammals, different species of microorganisms are found in dog and cat mouths with a potential pathological effect to humans, as represented by rabies. The injuries have disfiguration effect with possible psychological repercussion to the patient. This article aimed presenting up to date considerations regarding the management of animal bite injuries to the face, exemplified by a case report that should be the interest of all professions that deal with facial tissues, as dentists do. How to cite this article: Simao NR, Borba AM, da Silva ALF, Vieira EMM, Carvalhosa AA, Bandeca MC, Borges AH. Animal bite injuries to the face: A Case Report. J Int Oral Health 2013; 5(4):68-72.

Health of adolescent refugees resettling in high-income countries.

PubMed

Hirani, Kajal; Payne, Donald; Mutch, Raewyn; Cherian, Sarah

2016-07-01

Adolescent refugees are a vulnerable population with complex healthcare needs that are distinct from younger and older age groups. Physical health problems are common in this cohort with communicable diseases being the focus of attention followed by an emphasis on nutritional deficiencies and other chronic disorders. Adolescent refugees have also often experienced multiple traumatic stressors and are at a heightened risk of developing mental health problems. Navigating these problems at the time of pubertal development adds further challenges and can exacerbate or lead to the emergence of health risk behaviours. Educational difficulties and acculturation issues further compound these issues. Adolescents who have had experiences in detention or are unaccompanied by parents are particularly at risk. Despite a constantly growing number of adolescent refugees resettling in high-income countries, knowledge regarding their specific healthcare needs is limited. Research data are largely extrapolated from studies conducted within paediatric and adult cohorts. Holistic management of the medical and psychological issues faced by this group is challenging and requires an awareness of the socioeconomic factors that can have an impact on effective healthcare delivery. Legal and ethical issues can further complicate their management and addressing these in a culturally appropriate manner is essential. Early identification and management of the healthcare issues faced by adolescent refugees resettling in high-income countries are key to improving long-term health outcomes and future healthcare burden. This review article aims to increase knowledge and awareness of these issues among paediatricians and other health professionals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

China's quest for management of academic medicine.

PubMed

Butler, W T; Ruma, S J

1990-08-01

The China Medical Board organized a management conference for the presidents of China's national medical universities. A three-person consulting team arranged by the Association of American Medical Colleges led the conference. Designed as a preliminary examination of the management problems faced by the national medical universities, the conference covered content similar to that of the AAMC Executive Development Seminars, including governance, financial management, faculty practice plans, technology transfer, information management, and organizational diagnosis. China's national medical universities are strategically managed by the Ministry of Public Health in Beijing, and for several years the ministry has increasingly decentralized the management and operational planning and control of these universities. The universities do not have enough properly trained personnel to absorb the additional management responsibilities, and the university presidents feel that they and their senior staffs need extensive training in adapting western-style management principles and practice to the Chinese setting.

Nothing prepared me to manage AIDS.

PubMed

Banas, G E

1992-01-01

Articles and seminars about AIDS in the workplace are not adequate preparation for the genuine problems faced by actual managers in real organizations. There are no easy, win-win solutions to the impossible dilemmas AIDS presents, only various forms of damage control and, at best, more or less humane compromises. Gary Banas knows. Over a period of four years, two of his direct reports developed AIDS, and he watched them suffer through debility, slowly deteriorating performance, and eventual death. He also watched the gradual decline of their subordinates' productivity and morale. He found that, to different degrees, both men refused to acknowledge their illness and their decreasing organizational effectiveness. One of them resisted the author's efforts to give him an easier job at no loss in salary. Both insisted on confidentiality long after the rumor mill had identified their problem. In the course of these two consecutive ordeals, Banas discovered that AIDS patients fall into no single, neat category. AIDS is not an issue but a disease, and the people who get it are human beings first and victims second. He also learned that AIDS affects everyone around the sick individual and that almost every choice a manager makes will injure someone. Finally, he came to understand that while managers have an unequivocal obligation to treat AIDS-afflicted employees with compassion and respect, they have an equally unequivocal obligation to keep their organizations functioning. "Don't let anyone kid you," Banas warns. "When you confront AIDS in the workplace, you will face untenable choices that seem to pit your obligation to humanity against your obligation to your organization.(ABSTRACT TRUNCATED AT 250 WORDS)

Definition and use of Solution-focused Sustainability Assessment: A novel approach to generate, explore and decide on sustainable solutions for wicked problems.

PubMed

Zijp, Michiel C; Posthuma, Leo; Wintersen, Arjen; Devilee, Jeroen; Swartjes, Frank A

2016-05-01

This paper introduces Solution-focused Sustainability Assessment (SfSA), provides practical guidance formatted as a versatile process framework, and illustrates its utility for solving a wicked environmental management problem. Society faces complex and increasingly wicked environmental problems for which sustainable solutions are sought. Wicked problems are multi-faceted, and deriving of a management solution requires an approach that is participative, iterative, innovative, and transparent in its definition of sustainability and translation to sustainability metrics. We suggest to add the use of a solution-focused approach. The SfSA framework is collated from elements from risk assessment, risk governance, adaptive management and sustainability assessment frameworks, expanded with the 'solution-focused' paradigm as recently proposed in the context of risk assessment. The main innovation of this approach is the broad exploration of solutions upfront in assessment projects. The case study concerns the sustainable management of slightly contaminated sediments continuously formed in ditches in rural, agricultural areas. This problem is wicked, as disposal of contaminated sediment on adjacent land is potentially hazardous to humans, ecosystems and agricultural products. Non-removal would however reduce drainage capacity followed by increased risks of flooding, while contaminated sediment removal followed by offsite treatment implies high budget costs and soil subsidence. Application of the steps in the SfSA-framework served in solving this problem. Important elements were early exploration of a wide 'solution-space', stakeholder involvement from the onset of the assessment, clear agreements on the risk and sustainability metrics of the problem and on the interpretation and decision procedures, and adaptive management. Application of the key elements of the SfSA approach eventually resulted in adoption of a novel sediment management policy. The stakeholder participation and the intensive communication throughout the project resulted in broad support for both the scientific approaches and results, as well as for policy implementation. Copyright © 2016 Elsevier Ltd. All rights reserved.

A case study of the knowledge transfer practices from the perspectives of highly experienced engineers in the aerospace industry

NASA Astrophysics Data System (ADS)

Martin, Deloris

Purpose. The purpose of this study was to describe the existing knowledge transfer practices in selected aerospace companies as perceived by highly experienced engineers retiring from the company. Specifically it was designed to investigate and describe (a) the processes and procedures used to transfer knowledge, (b) the systems that encourage knowledge transfer, (c) the impact of management actions on knowledge transfer, and (d) constraining factors that might impede knowledge transfer. Methodology. A descriptive case study was the methodology applied in this study. Qualitative data were gathered from highly experienced engineers from 3 large aerospace companies in Southern California. A semistructured interview was conducted face-to-face with each participant in a private or semiprivate, non-workplace setting to obtain each engineer's perspectives on his or her company's current knowledge transfer practices. Findings. The participants in this study preferred to transfer knowledge using face-to-face methods, one-on-one, through actual troubleshooting and problem-solving scenarios. Managers in these aerospace companies were observed as having knowledge transfer as a low priority; they tend not to promote knowledge transfer among their employees. While mentoring is the most common knowledge transfer system these companies offer, it is not the preferred method of knowledge transfer among the highly experienced engineers. Job security and schedule pressures are the top constraints that impede knowledge transfer between the highly experienced engineers and their coworkers. Conclusions. The study data support the conclusion that the highly experienced engineers in the study's aerospace companies would more likely transfer their knowledge to those remaining in the industry if the transfer could occur face-to-face with management support and acknowledgement of their expertise and if their job security is not threatened. The study also supports the conclusion that managers should be responsible for the leadership in developing a knowledge-sharing culture and rewarding those who do share. Recommendations. It is recommended that a quantitative study of highly experienced engineers in aerospace be conducted to determine the degree to which knowledge-sharing methods, processes, and procedures may be effective in capturing their knowledge. It is also recommended that a replication of this study be undertaken to include the perspectives of first-line managers on developing a knowledge-sharing culture for the aerospace industry.

Analyzing the social factors that influence willingness to pay for invasive alien species management under two different strategies: eradication and prevention.

PubMed

García-Llorente, Marina; Martín-López, Berta; Nunes, Paulo A L D; González, José A; Alcorlo, Paloma; Montes, Carlos

2011-09-01

Biological invasions occur worldwide, and have been the object of ecological and socio-economic research for decades. However, the manner in which different stakeholder groups identify the problems associated with invasive species and confront invasive species management under different policies remains poorly understood. In this study, we conducted an econometric analysis of the social factors influencing willingness to pay for invasive alien species management under two different regimes: eradication and prevention in the Doñana Natural Protected Area (SW Spain). Controlling for the participation of local residents, tourists and conservationists, email and face-to-face questionnaires were conducted. Results indicated that respondents were more willing to pay for eradication than prevention; and public support for invasive alien species management was influenced by an individual's knowledge and perception of invasive alien species, active interest in nature, and socio-demographic attributes. We concluded that invasive alien species management research should confront the challenges to engage stakeholders and accept any tradeoffs necessary to modify different conservation policies to ensure effective management is implemented. Finally, our willingness to pay estimates suggest the Department of Environment of Andalusian Government has suitable social support to meet the budgetary expenditures required for invasive alien species plans and adequate resources to justify an increase in the invasive alien species management budget.

Analyzing the Social Factors That Influence Willingness to Pay for Invasive Alien Species Management Under Two Different Strategies: Eradication and Prevention

NASA Astrophysics Data System (ADS)

García-Llorente, Marina; Martín-López, Berta; Nunes, Paulo A. L. D.; González, José A.; Alcorlo, Paloma; Montes, Carlos

2011-09-01

Biological invasions occur worldwide, and have been the object of ecological and socio-economic research for decades. However, the manner in which different stakeholder groups identify the problems associated with invasive species and confront invasive species management under different policies remains poorly understood. In this study, we conducted an econometric analysis of the social factors influencing willingness to pay for invasive alien species management under two different regimes: eradication and prevention in the Doñana Natural Protected Area (SW Spain). Controlling for the participation of local residents, tourists and conservationists, email and face-to-face questionnaires were conducted. Results indicated that respondents were more willing to pay for eradication than prevention; and public support for invasive alien species management was influenced by an individual's knowledge and perception of invasive alien species, active interest in nature, and socio-demographic attributes. We concluded that invasive alien species management research should confront the challenges to engage stakeholders and accept any tradeoffs necessary to modify different conservation policies to ensure effective management is implemented. Finally, our willingness to pay estimates suggest the Department of Environment of Andalusian Government has suitable social support to meet the budgetary expenditures required for invasive alien species plans and adequate resources to justify an increase in the invasive alien species management budget.

The Greening Role of Tour Operators

NASA Astrophysics Data System (ADS)

Lozano, Javier; Arbulú, Italo; Rey-Maquieira, Javier

2016-01-01

This paper shows that the tour operators (TOs) can play a coordinating role in the adoption of environmental management upstream the tourism supply chain. This is done using a dynamic model to analyze the environmental management adoption by hotels in a tourism destination induced by a TO. The TO can create incentives to greening hotels' management through the sharing of an environmental price premium. We show that the extent of green management adoption depends on interest rate, the willingness to pay for environmental quality, and hotels' organizational inertia. We also show how the financial yields from green management are shared between TOs and hotels. Finally, we consider a destination manager that subsidizes hotels' green management. If the destination manager does not take the greening role of TOs into account, she could mistake the true trade-off that she faces between the destination's economic and environmental outcomes for the win-win setting that characterizes the general problem.

Critical thinking in nurse managers.

PubMed

Zori, Susan; Morrison, Barbara

2009-01-01

Formal education and support is needed for nurse managers to effectively function in their role in the current health care environment. Many nurse managers assume their positions based on expertise in a clinical role with little expertise in managerial and leadership skills. Operating as a manager and leader requires ongoing development of critical thinking skills and the inclination to use those skills. Critical thinking can have a powerful influence on the decision making and problem solving that nurse managers are faced with on a daily basis. The skills that typify critical thinking include analysis, evaluation, inference, and deductive and inductive reasoning. It is intuitive that nurse managers require both the skills and the dispositions of critical thinking to be successful in this pivotal role at a time of transformation in health care. Incorporating critical thinking into education and support programs for the nurse manager is necessary to position the nurse manager for success.

The Greening Role of Tour Operators.

PubMed

Lozano, Javier; Arbulú, Italo; Rey-Maquieira, Javier

2016-01-01

This paper shows that the tour operators (TOs) can play a coordinating role in the adoption of environmental management upstream the tourism supply chain. This is done using a dynamic model to analyze the environmental management adoption by hotels in a tourism destination induced by a TO. The TO can create incentives to greening hotels' management through the sharing of an environmental price premium. We show that the extent of green management adoption depends on interest rate, the willingness to pay for environmental quality, and hotels' organizational inertia. We also show how the financial yields from green management are shared between TOs and hotels. Finally, we consider a destination manager that subsidizes hotels' green management. If the destination manager does not take the greening role of TOs into account, she could mistake the true trade-off that she faces between the destination's economic and environmental outcomes for the win-win setting that characterizes the general problem.

Progress and challenges to the global waste management system.

PubMed

Singh, Jagdeep; Laurenti, Rafael; Sinha, Rajib; Frostell, Björn

2014-09-01

Rapid economic growth, urbanization and increasing population have caused (materially intensive) resource consumption to increase, and consequently the release of large amounts of waste to the environment. From a global perspective, current waste and resource management lacks a holistic approach covering the whole chain of product design, raw material extraction, production, consumption, recycling and waste management. In this article, progress and different sustainability challenges facing the global waste management system are presented and discussed. The study leads to the conclusion that the current, rather isolated efforts, in different systems for waste management, waste reduction and resource management are indeed not sufficient in a long term sustainability perspective. In the future, to manage resources and wastes sustainably, waste management requires a more systems-oriented approach that addresses the root causes for the problems. A specific issue to address is the development of improved feedback information (statistics) on how waste generation is linked to consumption. © The Author(s) 2014.

Networking: an overview for leaders of academic medical centers.

PubMed

Panko, W B; Erhardt-Domino, K; Pletcher, T; Wilson, W

1993-07-01

Organizations face a unique challenge over the next decade. When technology was expensive, it was arguably necessary to use an undifferentiated, or monolithic, model for computer-based solutions to problems. This has fundamentally changed. Technology is now so inexpensive that solutions are not limited by costs, but rather by how well the implementors understand the many different problem domains. Thus, academic medical centers are faced with successive waves in information technology use. First, there will be a wave of innovation, driven by the need for specialization in problem solving. This will be followed by consolidation of the best of the approaches into the core systems of the institution. The average level of heterogeneity (cost) will be higher, but the overall quality of the solutions (benefit) will also be higher. If one can develop a strategy for managing and creatively limiting the heterogeneity, the cost-benefit ratio will be much more favorable. While there may be other strategies that will do this, we support the use of a strategy centered on enterprise networking. This strategy emphasizes not simply technology but also the cultural and organizational changes that empower innovation--within a framework that makes it possible to simply implement interoperability and data sharing within nearly all solutions. The organizations that survive the coming period of change and external pressure will be those that do the best job of managing their resources. Information will continue to be one of the most important resources.(ABSTRACT TRUNCATED AT 250 WORDS)

Decision Making Under Uncertainty and Complexity: A Model-Based Scenario Approach to Supporting Integrated Water Resources Management

NASA Astrophysics Data System (ADS)

Liu, Y.; Gupta, H.; Wagener, T.; Stewart, S.; Mahmoud, M.; Hartmann, H.; Springer, E.

2007-12-01

Some of the most challenging issues facing contemporary water resources management are those typified by complex coupled human-environmental systems with poorly characterized uncertainties. In other words, major decisions regarding water resources have to be made in the face of substantial uncertainty and complexity. It has been suggested that integrated models can be used to coherently assemble information from a broad set of domains, and can therefore serve as an effective means for tackling the complexity of environmental systems. Further, well-conceived scenarios can effectively inform decision making, particularly when high complexity and poorly characterized uncertainties make the problem intractable via traditional uncertainty analysis methods. This presentation discusses the integrated modeling framework adopted by SAHRA, an NSF Science & Technology Center, to investigate stakeholder-driven water sustainability issues within the semi-arid southwestern US. The multi-disciplinary, multi-resolution modeling framework incorporates a formal scenario approach to analyze the impacts of plausible (albeit uncertain) alternative futures to support adaptive management of water resources systems. Some of the major challenges involved in, and lessons learned from, this effort will be discussed.

Fish stocking in protected areas: Summary of a workshop

USGS Publications Warehouse

Corn, Paul Stephen; Knapp, Roland A.

2000-01-01

Native and nonnative sport fish have been introduced into the majority of historically fishless lakes in wilderness, generating conflicts between managing wilderness as natural ecosystems and providing opportunities for recreation. Managers faced with controversial and difficult decisions about how to manage wilderness lakes may not always have ready access to research relevant to these decisions. To address this problem, and to expose scientists to the concerns and constraints of managers and wilderness users, a workshop was held in October 1998 at the Flathead Lake Biological Station in Polson, Montana. Participants included 43 scientists, state and federal managers, wilderness users and advocates and students. Four subject areas were addressed: federal, state, tribal and user perspectives, community and ecosystem effects, species effects and management recommendations. Papers from the workshop are being developed for an issue of the journal Ecosystems.

Managing chronic orofacial pain: A qualitative study of patients', doctors', and dentists' experiences.

PubMed

Peters, Sarah; Goldthorpe, Joanna; McElroy, Cheryl; King, Elizabeth; Javidi, Hanieh; Tickle, Martin; Aggarwal, Vishal R

2015-11-01

Persistent pain in the face, mouth, and jaws is a common presentation to dental and medical services. The aetiology remains unclear, but a growing evidence base recognizes the effectiveness of psychological rather than biomedical interventions. To understand how this approach might be implemented into clinical practice, knowledge is needed of patients' and clinicians' experience of chronic orofacial pain (COFP). The aim of this study was to explore the experience and understanding of COFP by patients and primary and secondary care medical and dental practitioners. Qualitative interview study. Audio-recorded semi-structured interviews with a purposive sample of 12 dentists, 11 general practitioners, and seven patients were thematically analysed. Clinicians and patients recognized the role that psychological factors could play in the development and maintenance of COFP, yet management and self-management strategies were largely limited to biomedical interventions. Achieving a diagnosis proved problematic but largely functional for both parties. GPs and dentists viewed COFP as a non-dental problem and felt inadequately equipped to manage the condition. GPs, unlike dentists, felt obligated to support patients using techniques for managing patients with other long-term conditions. Frustration at the current inadequacy of COFP management often led to conflict with (or disengagement from) the clinician-patient relationship. Current management of COFP is ineffective and unsatisfactory for patients and practitioners, which impacts on their relationship. Fundamental barriers to accessing and implementing psychological interventions for COFP arise from ineffective communication between physicians and patients, and between medical and dental practitioners. Statement of contribution What is already known on this subject? COFP is characterized by persistent pain in the face, mouth, or jaws that are not the result of organic disease or physical trauma. Patients with COFP present to both medical and dental services and receive sub-optimal care. No studies have examined the experiences of managing this problem from the perspectives of dentists, general practitioners and patients. What does this study add? Patients, dentists, and GPs recognize the role that psychological factors have in maintaining and addressing facial pain symptoms, yet principally manage it through biomedical interventions. Challenges exist over arriving at a diagnosis and managing the problem, and challenges are exacerbated by poor communication between doctors and medical services. Improvements are needed in liaison between medical and dental services and further training to support primary care clinicians to facilitate a stepped care approach to managing COFP. © 2015 The British Psychological Society.

How much is new information worth? Evaluating the financial benefit of resolving management uncertainty

USGS Publications Warehouse

Maxwell, Sean L.; Rhodes, Jonathan R.; Runge, Michael C.; Possingham, Hugh P.; Ng, Chooi Fei; McDonald Madden, Eve

2015-01-01

Conservation decision-makers face a trade-off between spending limited funds on direct management action, or gaining new information in an attempt to improve management performance in the future. Value-of-information analysis can help to resolve this trade-off by evaluating how much management performance could improve if new information was gained. Value-of-information analysis has been used extensively in other disciplines, but there are only a few examples where it has informed conservation planning, none of which have used it to evaluate the financial value of gaining new information. We address this gap by applying value-of-information analysis to the management of a declining koala Phascolarctos cinereuspopulation. Decision-makers responsible for managing this population face uncertainty about survival and fecundity rates, and how habitat cover affects mortality threats. The value of gaining new information about these uncertainties was calculated using a deterministic matrix model of the koala population to find the expected population growth rate if koala mortality threats were optimally managed under alternative model hypotheses, which represented the uncertainties faced by koala managers. Gaining new information about survival and fecundity rates and the effect of habitat cover on mortality threats will do little to improve koala management. Across a range of management budgets, no more than 1·7% of the budget should be spent on resolving these uncertainties. The value of information was low because optimal management decisions were not sensitive to the uncertainties we considered. Decisions were instead driven by a substantial difference in the cost efficiency of management actions. The value of information was up to forty times higher when the cost efficiencies of different koala management actions were similar. Synthesis and applications. This study evaluates the ecological and financial benefits of gaining new information to inform a conservation problem. We also theoretically demonstrate that the value of reducing uncertainty is highest when it is not clear which management action is the most cost efficient. This study will help expand the use of value-of-information analyses in conservation by providing a cost efficiency metric by which to evaluate research or monitoring.

Rebuilding self-confidence after cancer: a feasibility study of life-coaching.

PubMed

Wagland, Richard; Fenlon, Deborah; Tarrant, Ruth; Howard-Jones, Gilly; Richardson, Alison

2015-03-01

Cancer survivors often experience decreased self-confidence which impacts negatively on their ability to self-manage the practical, social and emotional problems frequently faced as they emerge from end of treatment. This was a feasibility study of a life-coaching intervention, designed to rebuild confidence of survivors and support transition to life after cancer treatment. A one group pre-test, post-test design was used, recruiting participants from community organisations. Eligibility criteria are as follows: <1 year of completion of primary cancer treatment, aged >18, no metastases, and no mental health problems. Participants received one individualised face-to-face and five telephone coaching sessions over 3 months. Outcome measures are as follows: New General Self-Efficacy Scale, Hope Scale, Personal Well-being Index, Assessment of Survivorship Concerns, Quality of Life in Adult Cancer Survivors, Hospital Anxiety and Depression Scale, Social Difficulties Index, and a goal attainment score. Interviews explored feasibility, acceptability and impact of life-coaching and research design. Nine women and two men were recruited, representing varying cancer diagnoses. All outcome measures were sensitive to change and indicated positive trends post-intervention. Participant interviews indicated the intervention was well received and had a positive impact. Lessons were learnt about study design, recruitment and intervention delivery. Life-coaching has a potential to enable cancer survivors to manage the transition to life beyond cancer and effect change on a range of outcomes. The intervention was feasible to deliver and acceptable to survivors at a time when many struggle to make sense of life. It merits further evaluation through a randomised controlled trial.

Constraints affecting dairy goats milk production in Kenya.

PubMed

Mbindyo, C M; Gitao, C G; Peter, S G

2018-01-01

In Kenya, the population of dairy goats is about 200,000 and 80% of these are reared in Mount Kenya region. They provide a quick source of milk for consumption or sale, which has an immense value especially to poor households. The small land sizes required for their rearing are especially useful in these highly populated areas. Although much research has been done on problems faced by dairy cattle farmers, limited information is available on problems faced by dairy goat farmers. Therefore, the objective of this study was to determine the constraints affecting dairy goat production in Mount Kenya region. In a cross-sectional survey, 157 farmers were interviewed on major constraints using a semi-structured questionnaire. The results from the questionnaires showed that the main problems experienced by these farmers were as follows: lack of market of milk and goats 45% (71/157), diseases 33% (52/157), high cost of concentrates 25% (38/157), lack of feed 19% (30/157), problems of unreliable buck rotation program 16.5% (26/157), and insecurity 1.8% (3/157). The study revealed that dairy goat farmers in the region faced by a number of challenges and therefore, our recommendation is there is a need for farmers to be trained on innovative ways of value chain addition and other strategies to market their milk. Additionally, the government should put resources to salvage the milk plant and association members should put firm measures to improve management. Creation of farmer awareness, treatment, and disease control measures should be instituted to improve productivity.

Facial laceration at caesarean section: experience with tissue adhesive.

PubMed

Saraf, Sanjay

2009-01-01

The fetal laceration is one of the most commonly identified injuries at the caesarean delivery. The incidence in the literature has been reported to be as high as 3%. The management of such injuries has remained a perplexing problem for both the physician and the parents. We present a case of a newborn who accidentally sustained laceration over the face during a caesarean delivery. A review of the literature and management of lacerations with tissue adhesives has been presented. The laceration was successfully managed with tissue adhesive alone with good aesthetic outcome. Topical 2-octylcyanoacrylate tissue adhesives can be an effective alternative therapy for traditional devices for closing simple low-tension lacerations.

An insight into burns in a developing country: a Sri Lankan experience.

PubMed

Lau, Y S

2006-10-01

Burn injuries represent a diverse and varied challenge to medical and paramedical staff. The management of burns and their sequelae in a well-equipped, modern burns unit remains demanding despite advances in surgical techniques and development of tissue-engineered biomaterials; in a developing country, these difficulties are amplified many times. Sri Lanka has a high incidence of burn-related injuries annually due to a combination of adverse social, economic and cultural factors. The management of burn injuries remains a formidable public health problem. The epidemiology of burns, challenges faced in their management and effective strategies specific to Sri Lanka, such as the Safe Bottle Lamp campaign, are highlighted in this paper.

The paper crisis: from hospitals to medical practices.

PubMed

Park, Gregory; Neaveill, Rodney S

2009-01-01

Hospitals, not unlike physician practices, are faced with an increasing burden of managing piles of hard copy documents including insurance forms, requests for information, and advance directives. Healthcare organizations are moving to transform paper-based forms and documents into digitized files in order to save time and money and to have those documents available at a moment's notice. The cost of these document management/imaging systems can be easily justified with the significant savings of resources realized from the implementation of these systems. This article illustrates the enormity of the "paper problem" in healthcare and outlines just a few of the required processes that could be improved with the use of automated document management/imaging systems.

Aquaculture and food crisis: opportunities and constraints.

PubMed

Liao, I Chiu; Chao, Nai-Hsien

2009-01-01

Fish farming, now well known as aquaculture, has been well recognized since the ancient era. The first written document on fish culture was published in China in 475 BC, and the first koi pond was constructed at the Japanese Imperial Palace grounds during 71-130 AD. In recent years, aquaculture has progressively played an important role in the provision of: animal protein and gourmet cuisines, job opportunities, and foreign currency for developing countries. Asian countries produce around 91 percent of the world's total aquaculture production. Among the top ten aquaculture-producing countries, nine are from Asia. The current global population consist of more than 6.5 billion individuals; over one billion of which face hunger problem. In the highly populated Asia-Pacific region with moderately high-productivity, 642 million people are still facing hunger. Being a proficient and potential source of animal protein, aquaculture will play an increasing and important role in solving the world food problem in the future. This paper discusses both the opportunities and constraints in the aquaculture industry, specifically in the Asia-Pacific region, and its possible role in solving the current global food crisis. Strategies including promotion and adoption of traceability and HACCP systems for food safety, and marketing management for aquaculture products are also suggested. It is hoped that traditional administration of aquaculture management for survival, profit, as well as food safety will successfully match sustainability management to meet the urgent global need for food.

Counting to 20: Online Implementation of a Face-to-Face, Elementary Mathematics Methods Problem-Solving Activity

ERIC Educational Resources Information Center

Schwartz, Catherine Stein

2012-01-01

This study describes implementation of the same problem-solving activity in both online and face-to-face environments. The activity, done in the first class period or first module of a K-2 mathematics methods course, was initially used in a face-to-face class and then adapted later for use in an online class. While the task was originally designed…

Research on Interactive Acquisition and Use of Knowledge.

DTIC Science & Technology

1983-11-01

complex and challenging endeavor. Computer scientists faced with the problem of managing software complexity have de - veloped strict design disciplines...handle most-indeed, probably all-- phenomena in the syntax and semantics of natural language. It has also turned out to be well suited for the classes of...Semantics The previous grammar performs a de facto coordination of syntax and semantics by requiring that the (syntactically) preverbal NP play the

The Influence of Daily Stressors, Severity of Behavior Problems, Uncertainty, and Coping Strategies on Family Adaptation in Families of Adolescents with Autism Spectrum Disorders

ERIC Educational Resources Information Center

O'Brien, Sandra L.

2013-01-01

The prevalence of autism spectrum disorder (ASD) is rising exponentially. U.S. public health authorities report a 78% increase in ASD prevalence rate during the period (2002-2008), effecting 1 child in 50. Families of adolescents with ASD face the complex task of managing their children's transition into adulthood. Complicating this task is…

Balancing conservation management and tourism development with wilderness stewardship in the Kruger National Park, South Africa

Treesearch

F. J. (Freek) Venter

2007-01-01

The Kruger National Park (KNP) faces greatly amplified problems than was the case in the early 1900s when the KNP was established. Areas surrounding the park have experienced a human population explosion with a rapid expansion of farming areas and rural settlements. In the 1970s the KNP was fenced. Ecologically the KNP became an island and previous regional animal...

River history.

PubMed

Vita-Finzi, Claudio

2012-05-13

During the last half century, advances in geomorphology-abetted by conceptual and technical developments in geophysics, geochemistry, remote sensing, geodesy, computing and ecology-have enhanced the potential value of fluvial history for reconstructing erosional and depositional sequences on the Earth and on Mars and for evaluating climatic and tectonic changes, the impact of fluvial processes on human settlement and health, and the problems faced in managing unstable fluvial systems. This journal is © 2012 The Royal Society

Software architecture of the Magdalena Ridge Observatory Interferometer

NASA Astrophysics Data System (ADS)

Farris, Allen; Klinglesmith, Dan; Seamons, John; Torres, Nicolas; Buscher, David; Young, John

2010-07-01

Merging software from 36 independent work packages into a coherent, unified software system with a lifespan of twenty years is the challenge faced by the Magdalena Ridge Observatory Interferometer (MROI). We solve this problem by using standardized interface software automatically generated from simple highlevel descriptions of these systems, relying only on Linux, GNU, and POSIX without complex software such as CORBA. This approach, based on gigabit Ethernet with a TCP/IP protocol, provides the flexibility to integrate and manage diverse, independent systems using a centralized supervisory system that provides a database manager, data collectors, fault handling, and an operator interface.

The Pain Crisis: What It Is and What Can Be Done

PubMed Central

Sessle, Barry J.

2012-01-01

Chronic pain is present in epidemic proportions in most countries, is often unrelieved, and has a huge socioeconomic impact. It is not just a “medical” illness but indeed is a problem that faces all healthcare professional fields. Several steps are identified to address this crisis. These include approaches to enhance pain awareness and access to timely and effective care for pain, and educational and research approaches to improve the knowledge base of healthcare professionals and students and diagnostic and management procedures for pain. Several opportunities to enhance pain understanding, access, and management are also identified. PMID:23050138

Adolescents with type 1 diabetes mellitus and attention-deficit/hyperactivity disorder require specific support from healthcare professionals.

PubMed

Lindblad, Ida; Engström, Ann-Charlotte; Nylander, Charlotte; Fernell, Elisabeth

2017-12-01

Managing type 1 diabetes mellitus requires efficient cognitive and executive skills, and adolescents who have attention-deficit/hyperactivity disorder (ADHD) may face specific challenges. This study explored young people's experiences of diabetes treatment and care. In a population-based study, comprising 175 patients aged 5-16 years with type 1 diabetes mellitus in two Swedish counties, we found that eight also met criteria for ADHD. Six of these, aged 14.5-16 years, participated 2013-2014 in interviews that targeted aspects of their diabetes treatment. Conducted by two psychologists, these used the inductive qualitative, semi-structured interview format. The two boys and four girls all reported difficulties in creating routines for their diabetes treatment and that problems were aggravated during stress. They had been criticised by their parents and the diabetes team when their blood levels indicated inadequate diabetes control. They requested ongoing information, involvement of their friends, group meetings and easy access to the healthcare system during difficult times. Patients with type 1 diabetes mellitus and concomitant ADHD faced problems with their diabetes management, especially during stressful situations. Diabetes care provision should pay particular attention to patients with co-existing neuropsychiatric and neurodevelopmental disorders such as ADHD. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

What do we know about the situation of women living with HIV in Europe?

PubMed

Miralles, Celia; Mardarescu, Mariana; Sherr, Lorraine

2013-01-01

At present, women represent approximately one-third of new diagnoses of HIV in Europe - most are infected by heterosexual transmission. Some specific populations of women, such as migrants, sex workers and those who are intravenous drug users, may be at increased risk of HIV infection. Women living with HIV face a range of intersecting situations and challenges distinct from those faced by men. The most familiar of these is pregnancy and motherhood; however, family and social situations will also be different for women compared with men, and can affect how individuals access care and manage their disease. The stigma of HIV can be a particular problem for women in many communities. Improved surveillance of HIV and increased study of the situations facing women living with HIV will help to identify improved strategies to support the care of this patient population.

Animal bite injuries to the face : A Case Report

PubMed Central

Simao, Niverso Rodrigues; Borba, Alexandre Meireles; da Silva, Andre Luis Fernandes; Vieira, Evanice Menezes Marcal; Carvalhosa, Artur Aburad; Bandeca, Matheus Coelho; Borges, Alvaro Henrique

2013-01-01

Traumatic lacerations to the skin are problems frequently seen and treated by emergency centers around the world. Among all wounds, dog and cat bites are commonly seen. As in many mammals, different species of microorganisms are found in dog and cat mouths with a potential pathological effect to humans, as represented by rabies. The injuries have disfiguration effect with possible psychological repercussion to the patient. This article aimed presenting up to date considerations regarding the management of animal bite injuries to the face, exemplified by a case report that should be the interest of all professions that deal with facial tissues, as dentists do. How to cite this article: Simao NR, Borba AM, da Silva ALF, Vieira EMM, Carvalhosa AA, Bandeca MC, Borges AH. Animal bite injuries to the face: A Case Report. J Int Oral Health 2013; 5(4):68-72. PMID:24155623

Consideration of Environmental Factors in Planning and Development of Urban Areas

NASA Astrophysics Data System (ADS)

Kustysheva, I.

2017-11-01

Environmental factors, in varying degrees, always have a direct influence on the urban environment formation and the provision of favorable and safe conditions for the life of the population. Their role in the planning and development of urban areas remains an integral part of the management of such areas. Management should be aimed at improving the efficiency of use of the territories and ecological environment improvement. Planning must be done with the consideration of identified ecological processes in cities on the basis of the information about their occurrence in the past and present. Currently, cities face a multitude of problems that require urgent and immediate solutions. One of the most important issues is the poor state of the urban environment, so the environmental factors remain one of the most critical problems that should be considered by the authorities while implementing the urban areas’ development plans. The article discusses the role of environmental factors in the management and planning of urban territories by the example of the city of Tobolsk.

Innovative and applied research on big data platforms of smart heritage

NASA Astrophysics Data System (ADS)

Qiu, J.; Li, J.; Sun, H.

2015-08-01

Big data has huge commercial value and potential. Under the background of big data, a heritage site is faced with a number of questions and challenges such as, how to accelerate industrial innovation, benign competition and the creation of new business value. Based on the analysis of service data from the national archaeological site and park, Yuan Ming Yuan, this paper investigates the common problems of site management operations such as, inappropriate cultural interpretation, insufficient consumer demand and so on. In order to solve these operational problems, a new service system called the "one platform - three systems" was put forward. This system includes the smart heritage platform and three management systems: the smart heritage management system, the 3-O (Online-Offline-Onsite) service system and the digital explanation system. Combined with the 3-O marketing operation, the platform can realize bidirectional interaction between heritage site management units and tourists, which can also benefit visitors to the heritage site by explaining the culture and history of the heritage site, bring about more demand for cultural information and expand the social and economic benefits.

The quality movement in higher education in the United States.

PubMed

Buchanan, H S

1995-09-01

Continuous quality improvement (CQI), often implemented as part of an integrated management system called total quality management (TQM), has been institutionalized within many manufacturing, military and service organizations in the USA as a response to declining market share, low productivity and customer complaints about poor quality. Signs and symptoms suggest that higher education has similar problems which are systematic and relate to the quality ot higher education, financing, facilities, curriculum and graduates. In the 1990S, the quality movement has begun to spread to the field of education as a means of diagnosing and treating the problems widely recognized as residing in US educational institutions, especially in colleges and universities. Many business leaders and authors believe that 'quality is the most important strategic issue facing top management in the 1990s'. This belief arises partly due to the fact that managers are beginning to understand the relationship between healthy, high quality organizations and healthy profits. This article traces the recent US quality movement from its roots in manufacturing and the military, its adoption by service institutions, and its more recent application by higher education institutions.

Use of the Internet and Mobile Phones for Self-Management of Severe Mental Health Problems: Qualitative Study of Staff Views.

PubMed

Berry, Natalie; Bucci, Sandra; Lobban, Fiona

2017-11-01

Researchers are currently investigating the feasibility, acceptability, and efficacy of digital health interventions for people who experience severe mental health problems such as psychosis and bipolar disorder. Although the acceptability of digital health interventions for severe mental health problems appears to be relatively high and some people report successfully using the Internet and mobile phones to manage their mental health, the attitudes of mental health care staff toward such approaches have yet to be considered. The aim of this study was to explore mental health care staff experiences of clients with severe mental health problems engaging with the Internet and mobile phones to self-manage their mental health and their views toward these behaviors. The study also sought to examine the opinions expressed by mental health care staff toward digital health interventions for severe mental health problems to identify potential facilitators and barriers to implementation. Four focus groups were conducted with 20 staff working in mental health care services in the North West of the England using a topic guide. Focus groups involved 12 staff working in secondary care psychological services (7 participants in focus group 1 and 5 participants in focus group 4), 4 staff working in a rehabilitation unit (focus group 2), and 4 staff working in a community mental health team (focus group 3). Focus groups were transcribed verbatim, and transcripts were analyzed thematically to identify key themes that emerged from the data. Four overarching themes, two with associated subthemes, were identified: (1) staff have conflicting views about the pros and cons of using Web-based resources and digital health interventions to manage mental health; (2) digital health interventions could increase access to mental health support options for severe mental health problems but may perpetuate the digital divide; (3) digital health interventions' impact on staff roles and responsibilities; and (4) digital health interventions should be used to enhance, not replace, face-to-face support. This study is the first, to our knowledge, to qualitatively explore the experiences and attitudes of mental health care staff toward individuals with severe mental health problems using the Internet, mobile phones, and digital health interventions to self-manage their mental health. Understanding the positive and negative experiences and views shared by staff toward both current and potential digital health intervention use has enabled the identification of several considerations for implementation. Additionally, the findings suggest mental health care staff need clear guidance and training in relation to their responsibilities in recommending reputable and secure websites, forums, and digital health interventions and in how to manage professional boundaries on the Internet. Overall, the study highlights that digital health interventions could be well received by staff working in mental health services but importantly, such management options must be presented to frontline staff as an avenue to enhance care and extend choice, rather than as a method to reduce costs. ©Natalie Berry, Sandra Bucci, Fiona Lobban. Originally published in JMIR Mental Health (http://mental.jmir.org), 01.11.2017.

Gaining hospital administrators' attention: ways to improve physician-hospital management dialogue.

PubMed

Cohn, Kenneth H; Gill, Sandra L; Schwartz, Richard W

2005-02-01

Despite marked differences in training and professional interests, physicians and hospital managers face similar problems stemming from the unprecedented rate of change in the health care delivery system: failure of reimbursement to keep pace with rising costs, new therapeutic modalities, increasing government and managed care regulations, heightened consumerism, and an aging patient population. In the face of these mounting challenges, both physicians and hospital managers could benefit significantly from a climate of collaboration and interdependence. This article presents a "case report" of a community teaching hospital in which practicing physicians and hospital administrators collaborated to develop an operating plan for the next 3 years to improve the practice environment. The physicians recommended new clinical priorities to enhance service to patients and families, to improve physician-physician communication, to develop clinical protocols, and to build coordinated diagnostic treatment centers, which the administration has implemented. Physicians and hospital managers can no longer pass on cost increases at will to patients and third-party payers. Nor can physicians and managers ignore the heightened power of patients and third-party payers. Effective dialogue and collaboration are in all parties' interests to optimize patient care and to develop innovative services. Despite the tensions created by competition and rapid change, transformation from a blaming to a learning environment may be a key strategic advantage in today's health care marketplace.

Efficacy and cost-effectiveness of a web-based and mobile stress-management intervention for employees: design of a randomized controlled trial.

PubMed

Heber, Elena; Ebert, David Daniel; Lehr, Dirk; Nobis, Stephanie; Berking, Matthias; Riper, Heleen

2013-07-15

Work-related stress is associated with a variety of mental and emotional problems and can lead to substantial economic costs due to lost productivity, absenteeism or the inability to work. There is a considerable amount of evidence on the effectiveness of traditional face-to-face stress-management interventions for employees; however, they are often costly, time-consuming, and characterized by a high access threshold. Web-based interventions may overcome some of these problems yet the evidence in this field is scarce. This paper describes the protocol for a study that will examine the efficacy and cost-effectiveness of a web-based guided stress-management training which is based on problem solving and emotion regulation and aimed at reducing stress in adult employees. The study will target stressed employees aged 18 and older. A randomized controlled trial (RCT) design will be applied. Based on a power calculation of d=.35 (1-β of 80%, α = .05), 264 participants will be recruited and randomly assigned to either the intervention group or a six-month waitlist control group. Inclusion criteria include an elevated stress level (Cohen's Perceived Stress Scale-10 ≥ 22) and current employment. Exclusion criteria include risk of suicide or previously diagnosed psychosis or dissociative symptoms. The primary outcome will be perceived stress, and secondary outcomes include depression and anxiety. Data will be collected at baseline and seven weeks and six months after randomization. An extended follow up at 12 months is planned for the intervention group. Moreover, a cost-effectiveness analysis will be conducted from a societal perspective and will include both direct and indirect health care costs. Data will be analyzed on an intention-to-treat basis and per protocol. The substantial negative consequences of work-related stress emphasize the necessity for effective stress-management trainings. If the proposed internet intervention proves to be (cost-) effective, a preventative, economical stress-management tool will be conceivable. The strengths and limitations of the present study are discussed. German Register of Clinical Studies (DRKS): DRKS00004749.

Efficacy of Seren@ctif, a Computer-Based Stress Management Program for Patients With Adjustment Disorder With Anxiety: Protocol for a Controlled Trial.

PubMed

Servant, Dominique; Leterme, Anne-Claire; Barasino, Olivia; Rougegrez, Laure; Duhamel, Alain; Vaiva, Guillaume

2017-10-02

Adjustment disorder with anxiety (ADA) is the most frequent and best characterized stress-related psychiatric disorder. The rationale for prescription of benzodiazepine monotherapy is a public health issue. Cognitive behavioral stress management programs have been studied in many countries. Several reports have shown beyond reasonable doubt their efficiency at reducing perceived stress and anxiety symptoms and improving patient quality of life. Considering the number of people who could benefit from such programs but are unable to access them, self-help programs have been offered. First presented as books, these programs became enriched with computer-based and digital supports. Regrettably, programs for stress management based on cognitive behavioral therapy (CBT), both face-to-face and digital support, have been only minimally evaluated in France. To our knowledge, the Seren@ctif program is the first French language self-help program for stress management using digital supports. The aim of this study is to assess the effectiveness of a 5-week standardized stress management program for reducing anxiety conducted via eLearning (iCBT) or through face-to-face interviews (CBT) with patients suffering from ADA compared with a wait list control group (WLC). These patients seek treatment in a psychiatric unit for anxiety disorders at a university hospital. The primary outcome is change in the State Trait Anxiety Inventory scale trait subscale (STAI-T) between baseline and 2-month visit. This is a multicenter, prospective, open label, randomized controlled study in 3 parallel groups with balanced randomization (1:1:1): computer-based stress management with minimal contact (not fully automated) (group 1), stress management with face-to-face interviews (group 2), and a WLC group that receives usual health care from a general practitioner (group 3). Programs are based on standard CBT principles and include 5 modules in 5 weekly sessions that include the following topics: stress and stress reaction and assessment; deep respiration and relaxation techniques; cognitive restructuring, mindfulness, and acceptance; behavioral skills as problem solving; and time management, healthy behaviors, and emotion regulation. In the Internet-based group, patients have minimal contact with a medical professional before and after every session. In the first session, a flash memory drive is supplied containing videos, audio files, a self-help book portfolio in the form of an eGuide, and log books providing the exercises to be completed between 2 sessions. The patient is encouraged to practice a 20-minute daily exercise 5 or 6 times per week. In the face-to-face group, patients receive the same program from a therapist with 5 weekly sessions without digital support. Interviews and self-assessments were collected face-to-face with the investigator. The feasibility of this program is being tested, and results show good accessibility in terms of acceptance, understanding, and treatment credibility. Results are expected in 2018. To our knowledge, this is the first French study to examine the effectiveness of a computer-based stress management program for patients with ADA. The Seren@ctif program may be useful within the framework of a psychoeducative approach. It could also be advised for people suffering from other diseases related to stress and for people with a clinical level of perceived stress. Clinicaltrials.gov NCT02621775; https://clinicaltrials.gov/ct2/show/NCT02621775 (Archived by WebCite at http://www.webcitation.org/6tQrkPs1u). ©Dominique Servant, Anne-Claire Leterme, Olivia Barasino, Laure Rougegrez, Alain Duhamel, Guillaume Vaiva. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 02.10.2017.

Critical Problems Facing Technology Education: Perceptions of Indiana Teachers

ERIC Educational Resources Information Center

Lazaros, Edward J.; Rogers, George E.

2006-01-01

In 1993 Wicklein conducted a study to determine the present and the future critical issues and problems facing the technology education (TE) profession. The Wicklein study questioned 25 panelists from 15 states and the District of Columbia to ascertain the issues and problems facing TE. However, in the Wicklein study, only seven of the panelists…

Lean Six Sigma Application in Rear Combination Automotive Lighting Process

NASA Astrophysics Data System (ADS)

Sodkomkham, Thanwarhat; Chutima, Parames

2016-05-01

The case study company produces various front and rear lightings for automobiles and motorcycles. Currently, it faces two problems, i.e. high defective rate and high inventory. Lean Six Sigma was applied as a tool to solve the first problem, whereas the other problem was managed by changing the production concept from push to pull. The results showed that after applying all new settings to the process, the defect rate was reduced from 36,361 DPPM to 3,029 DPPM. In addition, after the implementation of the Kanban system, the company achieved substantial improvement in lead time reduction by 44%, in-process inventory reduction by 42%, finished good inventory reduction by 50%, and finished good area increased by 16%.

[Strategies to prevent the transmission of multidrug-resistant pathogens and their practical implementation in oupatient care].

PubMed

Adler, A C; Spegel, H; Wilke, J; Höller, C; Herr, C

2012-10-01

Multidrugresistant pathogens which are highly relevant for infection control in hospitals and other health-care facilities are a serious public health problem and a big challenge for all players in the health sector. In order to prevent the spread of multi-resistant pathogens the Commission for Hospital Hygiene of the Robert Koch-Institute (RKI) has published guidelines. These recommendations refer to the consequent implementation of an infection control management in all health care settings, including outpatient care. In Germany there are only few data available concerning infection control management and the implementation of preventive strategies in outpatient care. To what extent are national guidelines concerning infection control of multidrugresistant pathogens (i.e. methicillin-resistant Staphylococcus aureus, MRSA) feasible and practicable in outpatient care? And what are the reasons not to practice these strategies. In outpatient care the status of the infection control management and the implementation of prevention strategies was surveyed and assessed. Data were collected by structured interviews - a face to face method. Guidelines concerning infection control management are not always sufficiently implemented in outpatient care. There are multiple reasons for this, such as, e.g., lack of compliance with the recommendations as well as structural problems in the health-care system, and special challenges of outpatient care. Implementation of an infection control management concerning multidrug-resistant pathogens in outpatient care is problematic. Prevention strategies are commonly not known or not adequately implemented into daily practice. Actions to improve the situation should focus at the individual level (e.g., trainings in the context of the initiative "clean hands" ), the institutional level (improving networking, bonus schemes) and the social level (financial and legal support for outpatient care centres to bear the expenses of infection control management, "search and destroy"). © Georg Thieme Verlag KG Stuttgart · New York.

Environmental Management Science Program Workshop. Proceedings

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

None

1998-07-01

The Department of Energy Office of Environmental Management (EM), in partnership with the Office of Energy Research (ER), designed, developed, and implemented the Environmental Management Science Program as a basic research effort to fund the scientific and engineering understanding required to solve the most challenging technical problems facing the government's largest, most complex environmental cleanup program. The intent of the Environmental Management Science Program is to: (1) Provide scientific knowledge that will revolutionize technologies and cleanup approaches to significantly reduce future costs, schedules, and risks. (2) Bridge the gap between broad fundamental research that has wide-ranging applications such as thatmore » performed in the Department's Office of Energy Research and needs-driven applied technology development that is conducted in Environmental Management's Office of Science and Technology. (3) Focus the nation's science infrastructure on critical Department of Energy environmental problems. In an effort to share information regarding basic research efforts being funded by the Environmental Management Science Program and the Environmental Management/Energy Research Pilot Collaborative Research Program (Wolf-Broido Program), this CD includes summaries for each project. These project summaries, available in portable document format (PDF), were prepared in the spring of 1998 by the principal investigators and provide information about their most recent project activities and accomplishments.« less

Value measurement in health care: a new perspective.

PubMed

Michelman, J E; Rausch, P E; Barton, T L

1999-08-01

Vital to the success of any healthcare organization is the ability to obtain useful information and feedback about its performance. In particular, healthcare organizations need to begin to understand how non-value-adding work activities detract from their bottom lines. Additionally, financial managers and information systems need to provide data and reports throughout the continuum of care. Overall, healthcare organizations must align the management information and control systems with the planning and decision-making processes. The horizontal information system is a tool to manage three common problems facing today's healthcare managers: (1) the use of existing information to focus on control rather than improve business, (2) failure to focus on satisfying the customer, and (3) failure to combine their efforts with those of the employees by developing trust and a common focus.

Ecological literacy and beyond: Problem-based learning for future professionals.

PubMed

Lewinsohn, Thomas M; Attayde, José Luiz; Fonseca, Carlos Roberto; Ganade, Gislene; Jorge, Leonardo Ré; Kollmann, Johannes; Overbeck, Gerhard E; Prado, Paulo Inácio; Pillar, Valério D; Popp, Daniela; da Rocha, Pedro L B; Silva, Wesley Rodrigues; Spiekermann, Annette; Weisser, Wolfgang W

2015-03-01

Ecological science contributes to solving a broad range of environmental problems. However, lack of ecological literacy in practice often limits application of this knowledge. In this paper, we highlight a critical but often overlooked demand on ecological literacy: to enable professionals of various careers to apply scientific knowledge when faced with environmental problems. Current university courses on ecology often fail to persuade students that ecological science provides important tools for environmental problem solving. We propose problem-based learning to improve the understanding of ecological science and its usefulness for real-world environmental issues that professionals in careers as diverse as engineering, public health, architecture, social sciences, or management will address. Courses should set clear learning objectives for cognitive skills they expect students to acquire. Thus, professionals in different fields will be enabled to improve environmental decision-making processes and to participate effectively in multidisciplinary work groups charged with tackling environmental issues.

Environmental strategies: A case study of systematic evaluation

NASA Astrophysics Data System (ADS)

Sherman, Douglas J.; Garès, Paul A.

1982-09-01

A major problem facing environmental managers is the necessity to effectively evaluate management alternatives. Traditional environmental assessments have emphasized the use of economic analyses. These approaches are often deficient due to difficulty in assigning dollar values to environmental systems and to social amenities. A more flexible decisionmaking model has been developed to analyze management options for coping with beach erosion problems at the Sandy Hook Unit of Gateway National Recreation Area in New Jersey. This model is comprised of decision-making variables which are formulated from a combination of environmental and management criteria, and it has an accept-reject format in which the management options are analyzed in terms of the variables. Through logical ordering of the insertion of the variables into the model, stepwise elimination of alternatives is possible. A hierarchy of variables is determined through estimating work required to complete an assessment of the alternatives for each variable. The assessment requiring the least work is performed first so that the more difficult evaluation will be limited to fewer alternatives. The application of this approach is illustrated with a case study in which beach protection alternatives were evaluated for the United States National Park Service.

A call to insect scientists: Challenges and opportunities of managing insect communities under climate change

USGS Publications Warehouse

Hellmann, Jessica J.; Grundel, Ralph; Hoving, Chris; Schuurman, Gregor W.

2016-01-01

As climate change moves insect systems into uncharted territory, more knowledge about insect dynamics and the factors that drive them could enable us to better manage and conserve insect communities. Climate change may also require us revisit insect management goals and strategies and lead to a new kind of scientific engagement in management decision-making. Here we make five key points about the role of insect science in aiding and crafting management decisions, and we illustrate those points with the monarch butterfly and the Karner blue butterfly, two species undergoing considerable change and facing new management dilemmas. Insect biology has a strong history of engagement in applied problems, and as the impacts of climate change increase, a reimagined ethic of entomology in service of broader society may emerge. We hope to motivate insect biologists to contribute time and effort toward solving the challenges of climate change.

[Effective delegation].

PubMed

Fang, Li; Hung, Chich-Hsiu

2008-12-01

Ninety-seven percent of middle level managers feel they face work overload. The source of this problem may lie in a failure to delegate tasks effectively. If a manager does not effectively delegate, he/she is more likely to report fatigue, stress and depression. Conversely, effectively delegating tasks will improve overall job quality, professional growth in subordinates and cooperation within the team. While it is necessary for managers to delegate tasks effectively, few can be considered to be good natural 'delegators'. Learning and training is necessary for managers to develop the necessary confidence and maturity. This article describes the definitions, purpose and benefits of delegation; factors related to effective delegation; strategies related to successful delegation and skills related to performing cross-cultural delegations. Such issues have seldom been addressed in previous articles. Moreover, nursing implications and suggested applications in nursing practice, education, management and research are mentioned. This article is intended to provide directions to nursing managers and subordinates to promote delegation knowledge and skills.

Causative factors of cost overrun in highway projects of Sindh province of Pakistan

NASA Astrophysics Data System (ADS)

Sohu, S.; Halid, A.; Nagapan, S.; Fattah, A.; Latif, I.; Ullah, K.

2017-11-01

Cost overrun is an increase of cost of project from approved budget which was signed by parties at the time of tender. Cost overrun in construction of highway projects is a common problem worldwide and construction industry of Pakistan is also facing this crucial problem of cost overrun in highway projects of Pakistan. The main objective of this research is to identify the causative factors of cost overrun in highway projects of Sindh province of Pakistan. A well designed questionnaire was developed based on 64 common factors of cost overrun from literature review. Developed questionnaire was distributed among selected 30 experts from owner/client, designer/consultant and contractor who have experience more than 20 years’ experience in highway projects. The collected data was statistical analyzed. After analysis results showed that delay process in payment by client, inadequate planning, client interference, poor contract management, delay of decision making, change of scope of project and financial problems faced by client were most causative factors of cost overrun in highway projects. This research will provide alertness to stakeholders of highway projects of Sindh province to avoid cost overrun in projects.

Heparin-induced thrombocytopenia and heart operation: management with tedelparin.

PubMed

Altés, A; Martino, R; Gari, M; Cámara, M L; Garín, R; Casas, J I; Fontcuberta, J

1995-02-01

Anticoagulation for cardiopulmonary bypass in the infrequent clinical setting of thrombocytopenia associated with the use of unfractionated heparin is a very serious problem. We describe a case in which a low-molecular-weight heparin (tedelparin) was selected for this purpose based on a platelet aggregation test, permitting adequate anticoagulation during cardiopulmonary bypass for valve replacement. This case report might help establish an adequate anticoagulation protocol when faced with a patient suffering from this condition.

Clinical leadership: the elephant in the room.

PubMed

Edmonstone, John

2009-01-01

The article explores the concept of clinical leadership in the National Health Service in the UK by seeking to establish a workable definition and by contrasting it with managerial leadership, focussing on the 'disconnected hierarchy' in professional organizations. It proposes that the problems faced by clinical leadership relate to the current nature of general management in the NHS and concludes by suggesting that clinical leadership is the 'elephant in the room'-often ignored or unaddressed.

High Performance Databases For Scientific Applications

NASA Technical Reports Server (NTRS)

French, James C.; Grimshaw, Andrew S.

1997-01-01

The goal for this task is to develop an Extensible File System (ELFS). ELFS attacks the problem of the following: 1. Providing high bandwidth performance architectures; 2. Reducing the cognitive burden faced by applications programmers when they attempt to optimize; and 3. Seamlessly managing the proliferation of data formats and architectural differences. The approach for ELFS solution consists of language and run-time system support that permits the specification on a hierarchy of file classes.

Big Data Challenges for Large Radio Arrays

NASA Technical Reports Server (NTRS)

Jones, Dayton L.; Wagstaff, Kiri; Thompson, David; D'Addario, Larry; Navarro, Robert; Mattmann, Chris; Majid, Walid; Lazio, Joseph; Preston, Robert; Rebbapragada, Umaa

2012-01-01

Future large radio astronomy arrays, particularly the Square Kilometre Array (SKA), will be able to generate data at rates far higher than can be analyzed or stored affordably with current practices. This is, by definition, a "big data" problem, and requires an end-to-end solution if future radio arrays are to reach their full scientific potential. Similar data processing, transport, storage, and management challenges face next-generation facilities in many other fields.

Application of an Operational Audit Model in a Not For Profit Hospital

DTIC Science & Technology

1993-12-01

Advisor David R. Whipple, Chairman Department of Administrative Sciences ii AIITRCT This thesis has examined various problems facing the not- for...the interviewee and more closely gauge the validity of the comments. ( Fetterman , 1986) As the auditor sifts through bits and pieces of conversations... Fetterman , D.M., "Operational Auditing: A Cultural Approach," The Internal Auditor, April 1986, pp. 48-54. Fisher, J., How to Manage a Nonprofit

Development of an e-supported illness management and recovery programme for consumers with severe mental illness using intervention mapping, and design of an early cluster randomized controlled trial.

PubMed

Beentjes, Titus A A; van Gaal, Betsie G I; Goossens, Peter J J; Schoonhoven, Lisette

2016-01-19

E-mental health is a promising medium to keep mental health affordable and accessible. For consumers with severe mental illness the evidence of the effectiveness of e-health is limited. A number of difficulties and barriers have to be addressed concerning e-health for consumers with severe mental illness. One possible solution might be to blend e-health with face-to-face delivery of a recovery-oriented treatment, like the Illness Management & Recovery (IMR) programme. This paper describes the development of an e-health application for the IMR programme and the design of an early clustered randomized controlled trial. We developed the e-IMR intervention according to the six-step protocol of Intervention Mapping. Consumers joined the development group to address important and relevant issues for the target group. Decisions during the six-step development process were based on qualitative evaluations of the Illness Management & Recovery programme, structured interviews, discussion in the development group, and literature reviews on qualitative papers concerning consumers with severe mental illness, theoretical models, behavioural change techniques, and telemedicine for consumers with severe mental illness. The aim of the e-IMR intervention is to help consumers with severe mental illness to involve others, manage achieving goals, and prevent relapse. The e-IMR intervention consists of face-to-face delivery of the Illness Management & Recovery programme and an e-health application containing peer-testimonials on videos, follow up on goals and coping strategies, monitoring symptoms, solving problems, and communication opportunities. We designed an early cluster randomized controlled trial that will evaluate the e-IMR intervention. In the control condition the Illness Management & Recovery programme is provided. The main effect-study parameters are: illness management, recovery, psychiatric symptoms severity, self-management, quality of life, and general health. The process of the IMR program will be evaluated on fidelity and feasibility in semi-structured interviews with participants and trainers. Intervention Mapping provided a systematic procedure for the development of this e-health intervention for consumers with severe mental illness and the preparation of an early randomized controlled trial. The trial is registered in the Dutch Trial Register: NTR4772 .

Ethical challenges in pain management post-surgery.

PubMed

Rejeh, Nahid; Ahmadi, Fazlollah; Mohamadi, Eesa; Anoosheh, Moniereh; Kazemnejad, Anooshirvan

2009-03-01

This qualitative study describes ethical challenges faced by Iranian nurses in the process of pain management in surgical units. To address this issue, semistructured interviews were conducted with 26 nurses working in surgery units in three large university hospitals in Tehran. An analysis of the transcripts revealed three main categories: institutional limitations; nurses' proximity to and involvement with pain and suffering; and nurses' fallibility. Specific themes identified within the categories were: insufficient resources, medical hierarchy; difficulties with believing patients' complaints regarding pain and suffering; and experiencing the consequences of poor judgments. Our findings lead us to conclude that, as nurses are much closer to patients' pain and suffering than other health professionals, being aware of their ethical problems, and being able to reflect on them and discuss and learn from them, will reduce the burden of the ethical challenges faced. The findings will help nurses in other countries to devise suitable ways to reduce the ethical burdens they bear in their daily practice.

Marshak Lectureship Talk: Women in Physics in the Baltic States Region: Problems and Solutions

NASA Astrophysics Data System (ADS)

Satkovskiene, Dalia

2008-03-01

In this contribution the gender equality problem in physics will be discussed on the basis of the results obtained implementing the project ``Baltic States Network: Women in Sciences and High Technology'' (BASNET) initiated by Lithuanian women physicists and financed by European Commission. The main goal of BASNET project was creation of the regional Strategy how to deal with women in sciences problem in the Baltic States. It has some stages and the contribution follows them. The first one was in depth sociological study aiming to find out disincentives and barriers women scientists face in their career and work at science and higher education institutions. Analysis of results revealed wide range of problems concerned with science organization, management and financing common for both counterparts. However it also proved the existence of women discrimination in sciences. As main factors influencing women under-representation in Physics was found: the stereotypes existing in the society where physics is assigned to the masculine area of activity; failings of the science management system, where highest positions are distributed not using the institutionalized objective criteria but by voting, where the correctness of majority solutions is anticipated implicitly. In physics where male scientists are the majority (they also usually compose executive boards, committees etc.) results of such a procedures often are unfavorable for women. The same reasons also influence women ``visibility'' in physicist's community and as the consequence possibility to receive needed recourses for their research as well as appropriate presentation of results obtained. The study revealed also the conservatism of scientific community- reluctance to face existing in the scientific society problems and to start solving them. On the basis of the results obtained as well practice of other countries the common strategy of solving women in physics (sciences) in the Baltic States region was formulated. As changing the stereotypes is long lasting process it was decided firstly to concentrate strategy implementation plans on changes in science management policy tackling the problem from the top and allowing receive the most quick results. For this we created the regional Baltic States Network among the corresponding international women working groups, professional organizations (Scientific societies) and corresponding departments of the governmental institutions. BASNET also became a full member of European Platform of Women Scientists (EPWS)-prestige women organization signally influencing the European Community science policy.

General Concepts in Adult Congenital Heart Disease.

PubMed

Mutluer, Ferit Onur; Çeliker, Alpay

2018-01-20

Congenital heart disease in adults (adult congenital heart disease) is a growing burden for healthcare systems. While infant mortality due to congenital heart disease in the last four decades decreased by almost 3-fold, adult congenital heart disease prevalence increased by more than 2-fold in United States. Adult congenital heart disease prevalence is expected to increase steadily until 2050 in projections. Adult congenital heart disease is a multifaceted problem with many dimensions. This manuscript aims to provide an overview of the common adult congenital heart diseases and summarize important points in management of these diseases with possible problems and complications that the patients and the physicians face.

Far-field mission planning for nap-of-the-earth flight

NASA Technical Reports Server (NTRS)

Deutsch, Owen L.; Desai, Mukund; Mcgee, Leonard A.

1987-01-01

In the face of numerically superior hostile forces, deployment of individual vehicles to the right place, at the right time, and the ability to plan missions with less conservatism, will become significant force multipliers. Far-field mission planning is one of the enabling technologies that will facilitate force coordination through management of mission timeline, vehicle survivability and fuel constraints. On-board replanning is required to deal responsively with departures from nominal plan execution that result from imperfect knowledge of and temporal variability in the mission environment. The far-field planning problem is posed as a constrained optimization problem and algorithms and structural organization are proposed for the solution.

An early 19th-century Canadian surgical practice: the casebook of John Mackieson of Charlottetown, 1795–1885

PubMed Central

Shephard, David A.E.; Grogono, Basil J.S.

2002-01-01

A casebook written by Dr. John Mackieson (1795–1885), of Charlottetown, contains the records of 49 surgical cases he managed between 1826 and 1857. In view of the rarity of first-hand accounts of surgical practice in Canada in the mid-19th century, Mackieson’s case records are a significant source of information. These cases are discussed in order to delineate Mackieson’s approach to the surgical problems he faced in his general practice. His case records also illustrate some of the general problems that beset surgeons in that era. PMID:11939660

Pragmatic failure, mind style and characterisation in fiction about autism

PubMed Central

2014-01-01

This article presents an analysis of different types of pragmatic failure in the interactional behaviour of the ‘autistic’ protagonists of three recent novels. Three main types of pragmatic failure occur across all three novels: problems with informativeness and relevance in conversational contributions; problems with face management resulting in unintentional impolite behaviours; and problems with the interpretation of figurative language. These problems are salient and frequent enough to contribute to the projection of distinctive mind styles, and more generally to the characterisation of the protagonists as individuals with communication and socialisation difficulties that are likely to both reflect and reinforce general perceptions of autism-spectrum disorders. It is also argued that pragmatic failure contributes to the potential defamiliarisation of ‘normal’ communication, which is presented as being fraught with obscurity, ambiguity and insincerity. PMID:29710882

The longitudinal effects of early behavior problems in the dementia caregiving career.

PubMed

Gaugler, Joseph E; Kane, Robert L; Kane, Rosalie A; Newcomer, Robert

2005-03-01

Using multiregional, 3-year data from early career dementia caregivers, this study determines how behavior problems that occur early in the caregiving career influence time to nursing home placement and change in burden and depression over time. A Cox proportional hazards model indicated that caregivers who managed frequent behavior problems earlier are more likely to institutionalize. After controlling for important time-varying covariates in a series of growth-curve models, caregivers who were faced with severe, early behavior problems reported greater increases in burden and depression over the 3-year study period. The findings suggest the need to consider experiences early in the dementia caregiving career when accounting for key longitudinal outcomes and also emphasize the importance of attrition when attempting to model the health implications of informal long-term care over time.

Pharmacy executives: leadership issues and associated skills, knowledge, and abilities in the U.S. Department of Defense.

PubMed

Meadows, Andrew B; Finstuen, Kenn; Hudak, Ronald P

2003-01-01

To identify the issues or problems that current and aspiring U.S. Department of Defense (DoD) pharmacy executives will face in the future and to define the skills, knowledge, and abilities (SKAs) required to successfully address these issues. Delphi method for executive decision making. DoD. Ninety-three pharmacists serving in the military grades of lieutenant colonel/commander and colonel/captain, as well as pharmacists selected for promotion to those grades. iterations of the Delphi method for executive decision making separated by an expert panel content analysis. Round 1--participants identified five major issues believed to be of greatest importance to pharmacy executives and reported specific SKAs that might be needed to successfully manage those issues. An expert panel sorted these issues into meaningful domains, then provided an appropriate title for each domain. Round 2--on a 7-point scale, respondents rated the SKA items according to their assessment of how much a future DoD pharmacy executive would need each SKA. Response rates were 44.1% and 46.2% for Delphi rounds 1 and 2, respectively. The first round generated 62 unique issues facing pharmacy executives. The expert panel reviewed and sorted the issues into eight domains and selected an appropriate title for each domain. The domains identified by the panel were human resources, pharmacy operations/business practices, information management and technology, financial resources, formulary management, drug therapy management, pharmacy benefit management, and leadership. During round 2, 73.3% of the top 15 rated SKAs came from the drug therapy management, leadership, and formulary management domains. The three highest-rated SKAs were "ability to see the big picture," "ability to build strong relations with medical staffs," and "skills in both writing and verbal communication." The issues facing future DoD pharmacy executives will require them to expand their clinical abilities as well as their ability to collaborate and communicate with other professionals.

The Social Problem-Solving Questionnaire: Evaluation of Psychometric Properties among Turkish Primary School Students

ERIC Educational Resources Information Center

Dereli Iman, Esra

2013-01-01

Problem Statement: Children, like adults, face numerous problems and conflicts in their everyday lives, including issues with peers, siblings, older children, parents, teachers, and other adults. The methods children use to solve such problems are more important than actually facing the problems. The lack of effective social problem-solving skills…

A Survey on Sentiment Classification in Face Recognition

NASA Astrophysics Data System (ADS)

Qian, Jingyu

2018-01-01

Face recognition has been an important topic for both industry and academia for a long time. K-means clustering, autoencoder, and convolutional neural network, each representing a design idea for face recognition method, are three popular algorithms to deal with face recognition problems. It is worthwhile to summarize and compare these three different algorithms. This paper will focus on one specific face recognition problem-sentiment classification from images. Three different algorithms for sentiment classification problems will be summarized, including k-means clustering, autoencoder, and convolutional neural network. An experiment with the application of these algorithms on a specific dataset of human faces will be conducted to illustrate how these algorithms are applied and their accuracy. Finally, the three algorithms are compared based on the accuracy result.

SPA face lift: SMAS plication-anchoring.

PubMed

Mottura, A Aldo

2011-08-01

A variation of the superficial musculoaponeurotic system (SMAS) plication called SPA face lift is here described. An axial line and then two medial and lateral parallel lines are penciled on the skin from the lateral canthus to the earlobe to show the future plication area. The undermining zone is delimited 1 cm beyond the medial line. In face- and neck-lifting, such marks extend vertically to the neck. Once the skin is undermined up to the delimiting marks, the three lines are penciled again on the fat layer, and a running lock suture is used for plication, with big superficial bites between the two distal lines. In fatty faces, a strip of fat is removed along the axial line to avoid bulging that can be seen through the skin. Because the undermining is limited, minor swelling occurs, and the postoperative recovery is shorter and faster. The same three lines can be marked in the contralateral side or can differ in cases of asymmetry. This report describes 244 face-lifts without any facial nerve problems. The author managed five hematoma cases in which surgery to the neck was performed. Three patients had to be touched up for insufficient skin tension. The SPA technique is consistent and easy to learn.

The Difficult Gallbladder: A Safe Approach to a Dangerous Problem.

PubMed

Santos, B Fernando; Brunt, L Michael; Pucci, Michael J

2017-06-01

Laparoscopic cholecystectomy is a common surgical procedure, and remains the gold standard for the management of benign gallbladder and biliary disease. While this procedure can be technically straightforward, it can also represent one of the most challenging operations facing surgeons. This dichotomy of a routine operation performed so commonly that poses such a hidden risk of severe complications, such as bile duct injury, must keep surgeons steadfast in the pursuit of safety. The "difficult gallbladder" requires strict adherence to the Culture of Safety in Cholecystectomy, which promotes safety first and assists surgeons in managing or avoiding difficult operative situations. This review will discuss the management of the difficult gallbladder and propose the use of subtotal fenestrating cholecystectomy as a definitive option during this dangerous situation.

Facial Laceration at Caesarean Section: Experience With Tissue Adhesive

PubMed Central

Saraf, Sanjay

2009-01-01

Background: The fetal laceration is one of the most commonly identified injuries at the caesarean delivery. The incidence in the literature has been reported to be as high as 3%. The management of such injuries has remained a perplexing problem for both the physician and the parents. Materials and Methods: We present a case of a newborn who accidentally sustained laceration over the face during a caesarean delivery. A review of the literature and management of lacerations with tissue adhesives has been presented. Results: The laceration was successfully managed with tissue adhesive alone with good aesthetic outcome. Conclusion: Topical 2-octylcyanoacrylate tissue adhesives can be an effective alternative therapy for traditional devices for closing simple low-tension lacerations. PMID:19198643

Outsourcing to increase service capacity in a New Zealand hospital.

PubMed

Renner, C; Palmer, E

1999-01-01

Service firms manage variability using both demand-side tactics (levelling customer demand), and supply-side tactics (increasing available capacity). One popular way of increasing available capacity is the outsourcing of non-core services. This article uses a case study to examine the impact of an outsourced non-core service on a hospital's overall service system. Findings show that the outsourced service provides access to more sophisticated technology, increases in-house capacity and saves capital expenditure. However, the outsourcing also increases the scheduling problems that the hospital faces. These problems are largely due to communication delays from the involvement of more than one organisation. These delays decrease the response time available to match changes in demand for the outsourced service. Given the obvious benefits of such outsourcing, the article concludes that management should pay close attention to the communication pathways between organisations, in order to minimise the end effects identified in this study.

PM2006: a highly scalable urban planning management information system--Case study: Suzhou Urban Planning Bureau

NASA Astrophysics Data System (ADS)

Jing, Changfeng; Liang, Song; Ruan, Yong; Huang, Jie

2008-10-01

During the urbanization process, when facing complex requirements of city development, ever-growing urban data, rapid development of planning business and increasing planning complexity, a scalable, extensible urban planning management information system is needed urgently. PM2006 is such a system that can deal with these problems. In response to the status and problems in urban planning, the scalability and extensibility of PM2006 are introduced which can be seen as business-oriented workflow extensibility, scalability of DLL-based architecture, flexibility on platforms of GIS and database, scalability of data updating and maintenance and so on. It is verified that PM2006 system has good extensibility and scalability which can meet the requirements of all levels of administrative divisions and can adapt to ever-growing changes in urban planning business. At the end of this paper, the application of PM2006 in Urban Planning Bureau of Suzhou city is described.

A better communcation with the patients improves the management of HIV disease: a nonsystematic review

PubMed Central

TZANEVA, VALENTINA; IACOB, TEODORA

2013-01-01

The human immunodeficiency virus (HIV) is a blood-borne, sexually transmissible virus which belongs to a subset of viruses called retroviruses. Patients with HIV disease face problems like stigma, discrimination, poverty and marginalization. These problems also affect the physician-patient communication in HIV disease. Learning to conduct a consultation is a complex skill which is gradually learned and perfected during training and career. Good physician-patient communication in HIV disease demands medical professional competence, good communication skills, ethical behaviour, respect of patient’s dignity, good teamwork skills and maintaining confidentiality. The most important aspect of patient care is education, which should include empowering patients with basic knowledge about HIV infection, methods of transmission, progression, prognosis, and prevention. A multidisciplinary approach that uses the special skills of nurses, pharmacists, nutritionists, social workers, and case managers is desirable. Effective methods for clinicians to support such development are needed. PMID:26527943

How risk management can prevent future wildfire disasters in the wildland-urban interface

PubMed Central

Calkin, David E.; Cohen, Jack D.; Finney, Mark A.; Thompson, Matthew P.

2014-01-01

Recent fire seasons in the western United States are some of the most damaging and costly on record. Wildfires in the wildland-urban interface on the Colorado Front Range, resulting in thousands of homes burned and civilian fatalities, although devastating, are not without historical reference. These fires are consistent with the characteristics of large, damaging, interface fires that threaten communities across much of the western United States. Wildfires are inevitable, but the destruction of homes, ecosystems, and lives is not. We propose the principles of risk analysis to provide land management agencies, first responders, and affected communities who face the inevitability of wildfires the ability to reduce the potential for loss. Overcoming perceptions of wildland-urban interface fire disasters as a wildfire control problem rather than a home ignition problem, determined by home ignition conditions, will reduce home loss. PMID:24344292

Training for Efficiency: Work, Time and Systems-based Practice in Medical Residency*

PubMed Central

Szymczak, Julia E.; Bosk, Charles L.

2013-01-01

Medical residency is a period of intense socialization with a heavy workload. Previous sociological studies have identified efficiency as a practical skill necessary for success. However, many contextual features of the training environment have undergone dramatic change since these studies were conducted. What are the consequences of these changes for the socialization of residents to time management and the development of a professional identity? Based on observations of and interviews with internal medicine residents at 3 training programs, we find that efficiency is both a social norm and strategy that residents employ to manage a workload for which the demand for work exceeds the supply of time available to accomplish it. We found that residents struggle to be efficient in the face of seemingly intractable “systems” problems. Residents work around these problems, and in doing so develop a tolerance for organizational vulnerabilities. PMID:22863601

Resveratrol and cancer: Challenges for clinical translation

PubMed Central

Singh, Chandra K.; Ndiaye, Mary A.; Ahmad, Nihal

2014-01-01

Significant work has been done towards identifying the health-beneficial effects of the grape antioxidant resveratrol in a variety of bioassay- and disease- models, with much research being focused on its possible application to cancer management. Despite the large number of preclinical studies dealing with different aspects of the biological effects of resveratrol, it’s translation to clinics is far from reality due to a variety of challenges. In this review, we discuss the issues and questions associated with resveratrol becoming an effective in vivo anticancer drug, from basic metabolic issues to the problems faced by incomplete understanding of the mechanism(s) of action in the body. We also explore efforts taken by researchers, both public and private, to contend with some of these issues. By examining the published data and previous clinical trials, we have attempted to identify the problems and issues that hinder the clinical translation of resveratrol for cancer management. PMID:25446990

Assisted suicide by oxygen deprivation with helium at a Swiss right-to-die organisation.

PubMed

Ogden, Russel D; Hamilton, William K; Whitcher, Charles

2010-03-01

In Switzerland, right-to-die organisations assist their members with suicide by lethal drugs, usually barbiturates. One organisation, Dignitas, has experimented with oxygen deprivation as an alternative to sodium pentobarbital. To analyse the process of assisted suicide by oxygen deprivation with helium and a common face mask and reservoir bag. This study examined four cases of assisted suicide by oxygen deprivation using helium delivered via a face mask. Videos of the deaths were provided by the Zurich police. Dignitas provided protocol and consent information. One man and three women were assisted to death by oxygen deprivation. There was wide variation in the time to unconsciousness and the time to death, probably due to the poor mask fit. Swiss law prevented attendants from effectively managing the face mask apparatus. Purposeless movements of the extremities were disconcerting for Dignitas attendants, who are accustomed to assisting suicide with barbiturates. None of the dying individuals attempted self-rescue. The dying process of oxygen deprivation with helium is potentially quick and appears painless. It also bypasses the prescribing role of physicians, effectively demedicalising assisted suicide. Oxygen deprivation with a face mask is not acceptable because leaks are difficult to control and it may not eliminate rebreathing. These factors will extend time to unconsciousness and time to death. A hood method could reduce the problem of mask fit. With a hood, a flow rate of helium sufficient to provide continuous washout of expired gases would remedy problems observed with the mask.

Placing learning needs in context: distance learning for clinical officers in Tanzania.

PubMed

Brigley, Stephen; Hosein, Ian; Myemba, Irnei

2009-04-01

Poor public health indicators in Tanzania have led to the upgrading of nursing and clinical personnel who currently have just core training. Clinical officers (COs) have 3 years training in basic and applied medicine and are responsible for healthcare of large and dispersed rural populations. UNESCO-Wales has funded colleagues in Wales (UK) to assist the upgrade of COs. An inquiry into their learning needs and the Tanzanian context has produced a framework for design of a module for COs on sexually transmissible infections and HIV & AIDS by distance learning. Face-to-face discussions were held with the Ministry of Health, healthcare workers, educators and administrators in Tanzania; a review of training documents was carried out; and a follow-up questionnaire issued to COs. The discussions and review highlighted teacher-centred approaches, and management, infrastructure and resources obstacles to curriculum change. Principal learning needs of COs around STIs were: counselling, syndromic management, drugs management, laboratory diagnosis, health education, resources, staffing and service morale. Placing learning needs in context in dialogue with Tanzanian colleagues was an advance on simple transfer of educational technologies and expertise. The inquiry resulted in a draft study guide and resources pack that were positively reviewed by Tanzanian tutors. Management and resources issues raised problems of sustainability in the module implementation.

Impact of Integrated Watershed Management on Complex Interlinked Factors Influencing Health: Perceptions of Professional Stakeholders in a Hilly Tribal Area of India

PubMed Central

Nerkar, Sandeep S.; Tamhankar, Ashok J.; Johansson, Eva; Lundborg, Cecilia Stålsby

2016-01-01

Lack of access to water has a significant impact on the health of people in tribal areas, where water in households as well as for productive purposes is essential for life. In resource-limited settings such as hilly tribal areas, implementation of an integrated watershed management programme (IWMP) can have a significant impact on public health by providing a solution to water scarcity and related problems. The professional stakeholders in rural healthcare and development administration are important pillars of the system that implements various programmes and policies of government and non-government organizations, and act as facilitators for the improvement of public health in tribal areas. Information about the perceptions of these stakeholders on public health implications of the integrated watershed management programme is important in this context. A qualitative study was conducted using face to face semi-structured interviews and focus group discussions (FGDs) with stakeholders involved in healthcare provision, education and development administration. The transcripts of interviews and FGDs were analyzed using manifest and latent content analysis. The perceptions and experiences shared by healthcare and development administration stakeholders suggest that implementation of IWMP in tribal areas helps efficient water and agriculture management, which results in improved socio-economic conditions that lead to positive health outcomes. PMID:26959039

Impact of Integrated Watershed Management on Complex Interlinked Factors Influencing Health: Perceptions of Professional Stakeholders in a Hilly Tribal Area of India.

PubMed

Nerkar, Sandeep S; Tamhankar, Ashok J; Johansson, Eva; Lundborg, Cecilia Stålsby

2016-03-04

Lack of access to water has a significant impact on the health of people in tribal areas, where water in households as well as for productive purposes is essential for life. In resource-limited settings such as hilly tribal areas, implementation of an integrated watershed management programme (IWMP) can have a significant impact on public health by providing a solution to water scarcity and related problems. The professional stakeholders in rural healthcare and development administration are important pillars of the system that implements various programmes and policies of government and non-government organizations, and act as facilitators for the improvement of public health in tribal areas. Information about the perceptions of these stakeholders on public health implications of the integrated watershed management programme is important in this context. A qualitative study was conducted using face to face semi-structured interviews and focus group discussions (FGDs) with stakeholders involved in healthcare provision, education and development administration. The transcripts of interviews and FGDs were analyzed using manifest and latent content analysis. The perceptions and experiences shared by healthcare and development administration stakeholders suggest that implementation of IWMP in tribal areas helps efficient water and agriculture management, which results in improved socio-economic conditions that lead to positive health outcomes.

A qualitative evaluation of occupational therapy-led work rehabilitation for people with inflammatory arthritis: Perspectives of therapists and their line managers.

PubMed

Prior, Yeliz; Amanna, Evangeline A; Bodell, Sarah J; Hammond, Alison

2015-08-01

Occupational therapy-led work rehabilitation for employed people with inflammatory arthritis and work problems was piloted in five hospitals in the United Kingdom. This qualitative study explored the views of participating occupational therapists and their line managers about the work rehabilitation training received and conducting the intervention, with particular focus on the structured interview used, the Work Experience Survey - Rheumatic Conditions. Face-to-face semi-structured interviews were conducted with occupational therapists ( n  = 9), followed by telephone interviews with their line managers ( n  = 2). Interviews were audio-recorded, transcribed verbatim and thematically analysed by three researchers to maximize validity. The main themes emerging from the occupational therapists' interviews were: varying levels of prior knowledge and experience of work rehabilitation, initial concerns about the feasibility of a lengthy work assessment in practice and increased confidence in delivering work rehabilitation as the study progressed. The line managers' interviews generated themes around the positive impact of the work rehabilitation training the occupational therapists received, and changes in their practice. The Work Experience Survey - Rheumatic Conditions was considered a good choice of work assessment which can be implemented in practice. Once therapists had provided the work intervention several times, their confidence and skills increased.

Homeland Security. Management Challenges Facing Federal Leadership

DTIC Science & Technology

2002-12-01

Security Management Challenges Facing Federal Leadership 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...including attention to management practices and key success factors. HOMELAND SECURITY Management Challenges Facing Federal Leadership www.gao.gov/cgi...significant management and coordination challenges if it is to provide this leadership and be successful in preventing and responding to any future

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.

[Management of lice infestations, recommendations for 2012].

PubMed

Maillard, Alexia; Trellu, Laurence Toutous; Eicher, Nicole; Michaud, Mélanie; Laffitte, Emmanuel

2012-04-04

Pediculosis is the most frequent and contagious ectoparasitic infestation in human, particularly in children from 3 to 8 years of age. Epidemics are observed from time to time, in schools or in adults in prisons. Even though benign, these infections remain unpleasant and can have an important psyco-social impact. Since a few years, caregivers have to face increasing problems while treating lice: appearance of insecticide resistances, lindane's withdrawal from the market and the marketing of new products which are not always well evaluated. This article offers first recalls about pediculoses and then a sum up of the different available treatments with an evidence based management strategy.

Health-adjusted premium subsidies in the Netherlands.

PubMed

van de Ven, Wynand P M M; van Vliet, René C J A; Lamers, Leida M

2004-01-01

The Dutch government has decided to proceed with managed competition in health care. In this paper we report on progress made with health-based risk adjustment, a key issue in managed competition. In 2004 both Diagnostic Cost Groups (DCGs) computed from hospital diagnoses only and Pharmacy-based Cost Groups (PCGs) computed from out-patient prescription drugs are used to set the premium subsidies for competing risk-bearing sickness funds. These health-based risk adjusters appear to be effective and complementary. Risk selection is not a major problem in the Netherlands. Despite the progress made, we are still faced with a full research agenda for risk adjustment in the coming years.

Challenges of Developing New Classes of NASA Self-Managing Mission

NASA Technical Reports Server (NTRS)

Hinchey, M. G.; Rash, J. I.; Truszkowski, W. F.; Rouff, C. A.; Sterritt, R.

2005-01-01

NASA is proposing increasingly complex missions that will require a high degree of autonomy and autonomicity. These missions pose hereto unforeseen problems and raise issues that have not been well-addressed by the community. Assuring success of such missions will require new software development techniques and tools. This paper discusses some of the challenges that NASA and the rest of the software development community are facing in developing these ever-increasingly complex systems. We give an overview of a proposed NASA mission as well as techniques and tools that are being developed to address autonomic management and the complexity issues inherent in these missions.

A Meta-Analytic and Qualitative Review of Online versus Face-to-Face Problem-Based Learning

ERIC Educational Resources Information Center

Jurewitsch, Brian

2012-01-01

Problem-based learning (PBL) is an instructional strategy that is poised for widespread application in the current, growing, on-line digital learning environment. While enjoying a track record as a defensible strategy in face-to-face learning settings, the research evidence is not clear regarding PBL in on-line environments. A review of the…

Comparison of computing capability and information system abilities of state hospitals owned by Ministry of Labor and Social Security and Ministry of Health.

PubMed

Tengilimoğlu, Dilaver; Celik, Yusuf; Ulgü, Mahir

2006-08-01

The main purpose of this study is to give an idea to the readers about how big and important the computing and information problems that hospital managers as well as policy makers will face with after collecting the Ministry of Labor and Social Security (MoLSS) and Ministry of Health (MoH) hospitals under single structure in Turkey by comparing the current level of computing capability of hospitals owned by two ministries. The data used in this study were obtained from 729 hospitals that belong to both ministries by using a data collection tool. The results indicate that there have been considerable differences among the hospitals owned by the two ministries in terms of human resources and information systems. The hospital managers and decision makers making their decisions based on the data produced by current hospital information system (HIS) would more likely face very important difficulties after merging MoH and MoLSS hospitals in Turkey. It is also possible to claim that the level and adequacy of computing abilities and devices do not allow the managers of public hospitals to use computer technology effectively in their information management practices. Lack of technical information, undeveloped information culture, inappropriate management styles, and being inexperienced are the main reasons of why HIS does not run properly and effectively in Turkish hospitals.

Coping Strategies to Hinder Intention to Leave in Iranian Nurses: A Qualitative Content Analysis.

PubMed

Valizadeh, Leila; Zamanzadeh, Vahid; Habibzadeh, Hosein; Alilu, Leyla; Shakibi, Ali

2015-10-01

Due to the high clinical challenges, differences in coping strategies, and high workload in nurses, there is a need to develop strategies to keep them in the profession. The aim of the present study was to explore the Iranian nurses' coping strategies to deal with intention to leave. A qualitative content analysis was used to obtain rich data. We performed 13 in-depth face-to-face semi-structured interviews with nurses working in hospitals affiliated to Tabriz and Urmia Universities of Medical Sciences in Iran, selected through purposive sampling. Constant comparative method was used for data analysis. Three categories and eleven subcategories emerged during data analysis. The extracted categories and sub-categories consisted of (I) Self-empowerment (practical knowledge increase, responsibility, finding identification of the nurse, balancing work and life, seek support and humanitarian interests), (II) Self-controlling (tolerance, avoidance, the routine-based performance), and (III) Pursuing opportunities for advancement and promotion (community development, planning for higher education). Nurses make attempts to individually manage problems and stressors perceived from bedside that have led them to leave the bedside; these efforts have been effective in some cases but sometimes they are ineffective due to discontinuous training and relative competence in terms of how to manage and deal with problems. It is suggested that nurses should learn strategies scientifically to meet the challenges of bedside. Through enabling and supporting behaviors and creating opportunities for growth and professional development, nursery managers can help nurses to stay and achieve improvement of the quality of cares.

Novel and emerging approaches to combat adolescent obesity

PubMed Central

Sharma, Manoj; Branscum, Paul

2010-01-01

Overweight and obesity continue to be health concerns facing today’s adolescent population. Along with metabolic and physical problems associated with obesity, today’s obese adolescents also face many psychological issues such as high rates of depression, anxiety, and social discrimination. Obesity is commonly recognized as having many causes, such as genetic, lifestyle and environmental. There are four major modalities for management of overweight and obesity in adolescents: dietary management, increasing physical activity, pharmacological therapy, and bariatric surgery. The purpose of this study was to conduct a review of novel and emerging approaches for preventing and managing adolescent obesity. It was found that while not always the case, theory driven approaches are being better utilized in newer interventions especially by those directed toward prevention. New theories that are being used are the theories of reasoned action, planned behavior, intervention mapping, and social marketing. Schools are found to be the most common place for such interventions, which is appropriate since virtually all children attend some form of private or public school. Limitations found in many studies include the underuse of process evaluations, the low number of studies attempted, environmental or policy changes, and that not all studies used a similar control group for comparison. PMID:24600257

Novel and emerging approaches to combat adolescent obesity.

PubMed

Sharma, Manoj; Branscum, Paul

2010-01-01

Overweight and obesity continue to be health concerns facing today's adolescent population. Along with metabolic and physical problems associated with obesity, today's obese adolescents also face many psychological issues such as high rates of depression, anxiety, and social discrimination. Obesity is commonly recognized as having many causes, such as genetic, lifestyle and environmental. There are four major modalities for management of overweight and obesity in adolescents: dietary management, increasing physical activity, pharmacological therapy, and bariatric surgery. The purpose of this study was to conduct a review of novel and emerging approaches for preventing and managing adolescent obesity. It was found that while not always the case, theory driven approaches are being better utilized in newer interventions especially by those directed toward prevention. New theories that are being used are the theories of reasoned action, planned behavior, intervention mapping, and social marketing. Schools are found to be the most common place for such interventions, which is appropriate since virtually all children attend some form of private or public school. Limitations found in many studies include the underuse of process evaluations, the low number of studies attempted, environmental or policy changes, and that not all studies used a similar control group for comparison.

Anaesthetic Considerations in the Perioperative Management of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy.

PubMed

Sheshadri, Deepak B; Chakravarthy, Murali R

2016-06-01

Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy has emerged as one of the primary modalities of treatment of diffuse peritoneal malignancies. It is a complex surgical procedure with the patients facing major and potentially life threatening alterations of haemodynamic, respiratory, metabolic and thermal balance with significant fluid losses and the perioperative management is challenging for anaesthesiologists and intensive care physicians. Though the alterations are short lived, these patients require advanced organ function monitoring and support perioperatively. The anaesthesiologist is involved in the management of haemodynamics, respiratory function, coagulation, haematologic parameters, fluid balance, thermal variations, and metabolic and nutritional support perioperatively. The chemotherapy instillate used are known to cause nephrotoxicity, cardiotoxicity, dyselectrolytemia and lactic acidosis. The preoperative polypharmacy for pain control, previous surgery and/or chemotherapy, malnourished status secondary to feeding problems and tumour wasting syndrome make the task all the more challenging. The anaesthesiologist also needs to consider the perioperative care from a quality of life perspective and proper preoperative counselling is important. The present overview summarizes the challenges faced by the anaesthesiologist regarding the pathophysiological alterations during the Cytoreductive surgery and Hyperthermic intraperitoneal chemotherapy in the preoperative, intraoperative and postoperative periods.

JPRS Report, Soviet Union, Kommunist, No. 5, March 1989

DTIC Science & Technology

1989-06-13

instruments. It is obvious today that democracy is developing in width and depth. The appearance of new forms of self -management in a number of...foresaw future troubles which distorted the face of the organization of a new type created by Lenin, or an anticipation of forthcoming trends...as the question of achieving a new quality of socialism. In the state of law which is being created , the entire array of problems related to the

Drought Management, Service Interruption, and Water Pricing: Evidence From Hong Kong

NASA Astrophysics Data System (ADS)

Woo, Chi-Keung

1992-10-01

Supply shortage is a common problem faced by an urban water supply system. Nonmarket programs are often used to reduce consumption. Using monthly water consumption data collected for Hong Kong for the period 1973-1984, we estimate the effect of service interruption on per capita consumption. The findings show that this effect is statistically significant but relatively small in size. A price increase of 16-35% could have produced the same amount of consumption reduction.

Two management systems in a nursing private practice group.

PubMed

Zahourek, R P

1979-09-01

Entry into private practice can be rewarding for nurses who are willing to risk personal, financial, and professional security. Among the problems faced by the nurse in this new role is the administration of the practice, since few, if any, adequate models exist. This article describes the struggle of nurses in one private nursing practice, Creative Health Services, to meet their needs for individual freedom within an organization that is regulated sufficiently to maintain its viability.

Dealing with labor shortages in long-term care: a marketing problem.

PubMed

Moore, S T

1990-01-01

A recent analysis of data from the Bureau of Labor statistics raise serious implications for the long-term care industry. The human resource problems faced by managers in long-term care will escalate into a fullblown crisis by the end of this century. This will result from a decrease in the number of young workers available to work in unskilled and semiskilled occupations. The effect of this shortage will be exaggerated by an expansion of other sectors of the service industry. Long-term care facilities will be forced to compete with the fast food and retail industry as well as other sectors of the health industry for scarce workers. This article briefly examines the causes, consequences of this problem and suggests several strategies to mitigate the effect of the coming labor shortage.

Amygdala hypoactivity to fearful faces in boys with conduct problems and callous-unemotional traits.

PubMed

Jones, Alice P; Laurens, Kristin R; Herba, Catherine M; Barker, Gareth J; Viding, Essi

2009-01-01

Although early-onset conduct problems predict both psychiatric and health problems in adult life, little research has been done to index neural correlates of conduct problems. Emerging research suggests that a subgroup of children with conduct problems and elevated levels of callous-unemotional traits may be genetically vulnerable to manifesting disturbances in neural reactivity to emotional stimuli indexing distress. Using functional MRI, the authors evaluated differences in neural response to emotional stimuli between boys with conduct problems and elevated levels of callous-unemotional traits and comparison boys. Seventeen boys with conduct problems and elevated levels of callous-unemotional traits and 13 comparison boys of equivalent age (mean=11 years) and IQ (mean=100) viewed blocked presentations of fearful and neutral faces. For each face, participants distinguished the sex of the face via manual response. Relative to the comparison group, boys with conduct problems and elevated levels of callous-unemotional traits manifested lesser right amygdala activity to fearful faces. This finding is in line with data from studies of adults with antisocial behavior and callous-unemotional traits (i.e., psychopaths), as well as from a recent study of adolescents with callous-unemotional traits, and suggests that the neural substrates of emotional impairment associated with callous-unemotional antisocial behavior are already present in childhood.

Challenges faced by nurses in managing pain in a critical care setting.

PubMed

Subramanian, Pathmawathi; Allcock, Nick; James, Veronica; Lathlean, Judith

2012-05-01

To explore nurses' challenges in managing pain among ill patients in critical care. Pain can lead to many adverse medical consequences and providing pain relief is central to caring for ill patients. Effective pain management is vital since studies show patients admitted to critical care units still suffer from significant levels of acute pain. The effective delivery of care in clinical areas remains a challenge for nurses involved with care which is dynamic and constantly changing in critically ill. Qualitative prospective exploratory design. This study employed semi structured interviews with nurses, using critical incident technique. Twenty-one nurses were selected from critical care settings from a large acute teaching health care trust in the UK. A critical incident interview guide was constructed from the literature and used to elicit responses. Framework analysis showed that nurses perceived four main challenges in managing pain namely lack of clinical guidelines, lack of structured pain assessment tool, limited autonomy in decision making and the patient's condition itself. Nurses' decision making and pain management can influence the quality of care given to critically ill patients. It is important to overcome the clinical problems that are faced when dealing with pain experience. There is a need for nursing education on pain management. Providing up to date and practical strategies may help to reduce nurses' challenges in managing pain among critically ill patients. Broader autonomy and effective decision making can be seen as beneficial for the nurses besides having a clearer and structured pain management guidelines. © 2011 Blackwell Publishing Ltd.

The private struggle of mothers with asthma: a gender perspective on illness management.

PubMed

van Mens-Verhulst, Janneke; Radtke, H Lorraine; Spence, Cheryl D

2004-07-01

Little attention has been paid to the specific problems of mothers with chronic illness. In this study of mothers with asthma, we asked the question: "how do they manage their illness"? We interviewed a purposive sample of four Dutch and four Canadian mothers living with asthma and varying in age and socio-economic class. Our analysis explored challenges the mothers face, three main strategies of non-medical illness management (prevention, normalization and mobilizing support), and the influence of age and class differences. Unhealthy cycles of living with asthma are identified and suggestions for mother-specific interventions are offered. By drawing attention to the gendered nature of chronic illness management and to patients' own experiences, a more useful frame of reference is created for professionals who do not have first hand knowledge of living with a chronic illness.

Developing cloud-based Business Process Management (BPM): a survey

NASA Astrophysics Data System (ADS)

Mercia; Gunawan, W.; Fajar, A. N.; Alianto, H.; Inayatulloh

2018-03-01

In today’s highly competitive business environment, modern enterprises are dealing difficulties to cut unnecessary costs, eliminate wastes and delivery huge benefits for the organization. Companies are increasingly turning to a more flexible IT environment to help them realize this goal. For this reason, the article applies cloud based Business Process Management (BPM) that enables to focus on modeling, monitoring and process management. Cloud based BPM consists of business processes, business information and IT resources, which help build real-time intelligence systems, based on business management and cloud technology. Cloud computing is a paradigm that involves procuring dynamically measurable resources over the internet as an IT resource service. Cloud based BPM service enables to address common problems faced by traditional BPM, especially in promoting flexibility, event-driven business process to exploit opportunities in the marketplace.

Transdisciplinary synthesis for ecosystem science, policy and management: The Australian experience.

PubMed

Lynch, A J J; Thackway, R; Specht, A; Beggs, P J; Brisbane, S; Burns, E L; Byrne, M; Capon, S J; Casanova, M T; Clarke, P A; Davies, J M; Dovers, S; Dwyer, R G; Ens, E; Fisher, D O; Flanigan, M; Garnier, E; Guru, S M; Kilminster, K; Locke, J; Mac Nally, R; McMahon, K M; Mitchell, P J; Pierson, J C; Rodgers, E M; Russell-Smith, J; Udy, J; Waycott, M

2015-11-15

Mitigating the environmental effects of global population growth, climatic change and increasing socio-ecological complexity is a daunting challenge. To tackle this requires synthesis: the integration of disparate information to generate novel insights from heterogeneous, complex situations where there are diverse perspectives. Since 1995, a structured approach to inter-, multi- and trans-disciplinary(1) collaboration around big science questions has been supported through synthesis centres around the world. These centres are finding an expanding role due to ever-accumulating data and the need for more and better opportunities to develop transdisciplinary and holistic approaches to solve real-world problems. The Australian Centre for Ecological Analysis and Synthesis (ACEAS ) has been the pioneering ecosystem science synthesis centre in the Southern Hemisphere. Such centres provide analysis and synthesis opportunities for time-pressed scientists, policy-makers and managers. They provide the scientific and organisational environs for virtual and face-to-face engagement, impetus for integration, data and methodological support, and innovative ways to deliver synthesis products. We detail the contribution, role and value of synthesis using ACEAS to exemplify the capacity for synthesis centres to facilitate trans-organisational, transdisciplinary synthesis. We compare ACEAS to other international synthesis centres, and describe how it facilitated project teams and its objective of linking natural resource science to policy to management. Scientists and managers were brought together to actively collaborate in multi-institutional, cross-sectoral and transdisciplinary research on contemporary ecological problems. The teams analysed, integrated and synthesised existing data to co-develop solution-oriented publications and management recommendations that might otherwise not have been produced. We identify key outcomes of some ACEAS working groups which used synthesis to tackle important ecosystem challenges. We also examine the barriers and enablers to synthesis, so that risks can be minimised and successful outcomes maximised. We argue that synthesis centres have a crucial role in developing, communicating and using synthetic transdisciplinary research. Copyright © 2015 Elsevier B.V. All rights reserved.

Readership survey. A big welcome for Diagnostics in Africa.

PubMed

Chinnock, P

1994-09-01

Targeted to physicians, Africa Health is circulated free to 5600 readers in 23 African countries. Diagnostics in Africa (DIA) is a young publication included as a supplement of Africa Health aimed at laboratory personnel. Readers of DIA were surveyed in the first two issues to find out what they thought of the supplement, how it could be improved, and which problems they currently faced in their work. 98 questionnaires were returned from twelve African countries. 46% of respondents were qualified in laboratory science and 41% were physicians; the others were unqualified laboratory staff and other medical personnel. 73% responded that DIA was very useful and 27% useful, with 80% finding the articles of appropriate depth and complexity. Respondents would like to read about clinical chemistry, histopathology/histology, immunology, management issues, serology, and education/professional development, and would particularly enjoy material in the form of readers' letters and quizzes. Readers responded variously that they were regularly exposed to either Medicine Digest, Dialogue on Diarrhea, Postgraduate Doctor, Labmedica, Lancet, International Diabetes Digest, New England Journal of Medicine, British Medical Journal, or ARI News. Problems typically faced in their work include lack of resources, problems related to HIV testing/screening, poor access to literature, problems with professional development, and difficulty understanding the theory and practice of Western blot tests. These findings confirm assessments of the situation in Africa's medical labs which led to the launching of DIA.

In Search for Sustainable Coastal Management: A Case Study of Semarang, Indonesia

NASA Astrophysics Data System (ADS)

Hadi, Sudharto P.

2017-02-01

As a coastal town, Semarang is currently facing environmental problems such as flood, tidal flood (locally called rob), coastal abrasion, emerging land, land subsidence and sea water intrusion. These phenomena severely affect to citizen, community and corporate, disrupting day to day activities, threatening people’s health, causing economics’ burden and reducing property value. Government policies in dealing with these problem are focused on its phenomena such as normalizing river for flood and building polder systems for tidal flood. Impacted people have been implementing various initiatives. People in Tanah Mas Estate set up collective efforts to reduce tidal flood by building pumping system project, while people in Kampong Tambaklorok conduct a regular mutual assistance in cleaning of waste and sedimentation, rehabilitating of local drainages and dikes, reconstructing of local streets and also maintaining of pumping system. People in Mangunharjo, the district of Tugu build a coastal belt and cultivate mangrove. Various government and local initiatives have been effective in dealing with flood and tidal flood temporarily. More comprehensive approaches and focused on the sources of problems are required to achieve sustainable coastal management.

Effective monitoring of agriculture: a response.

PubMed

Sachs, Jeffrey D; Remans, Roseline; Smukler, Sean M; Winowiecki, Leigh; Andelman, Sandy J; Cassman, Kenneth G; Castle, David; DeFries, Ruth; Denning, Glenn; Fanzo, Jessica; Jackson, Louise E; Leemans, Rik; Lehmann, Johannes; Milder, Jeffrey C; Naeem, Shahid; Nziguheba, Generose; Palm, Cheryl A; Pingali, Prabhu L; Reganold, John P; Richter, Daniel D; Scherr, Sara J; Sircely, Jason; Sullivan, Clare; Tomich, Thomas P; Sanchez, Pedro A

2012-03-01

The development of effective agricultural monitoring networks is essential to track, anticipate and manage changes in the social, economic and environmental aspects of agriculture. We welcome the perspective of Lindenmayer and Likens (J. Environ. Monit., 2011, 13, 1559) as published in the Journal of Environmental Monitoring on our earlier paper, "Monitoring the World's Agriculture" (Sachs et al., Nature, 2010, 466, 558-560). In this response, we address their three main critiques labeled as 'the passive approach', 'the problem with uniform metrics' and 'the problem with composite metrics'. We expand on specific research questions at the core of the network design, on the distinction between key universal and site-specific metrics to detect change over time and across scales, and on the need for composite metrics in decision-making. We believe that simultaneously measuring indicators of the three pillars of sustainability (environmentally sound, social responsible and economically viable) in an effectively integrated monitoring system will ultimately allow scientists and land managers alike to find solutions to the most pressing problems facing global food security. This journal is © The Royal Society of Chemistry 2012

Making better decisions in groups

PubMed Central

Frith, Chris D.

2017-01-01

We review the literature to identify common problems of decision-making in individuals and groups. We are guided by a Bayesian framework to explain the interplay between past experience and new evidence, and the problem of exploring the space of hypotheses about all the possible states that the world could be in and all the possible actions that one could take. There are strong biases, hidden from awareness, that enter into these psychological processes. While biases increase the efficiency of information processing, they often do not lead to the most appropriate action. We highlight the advantages of group decision-making in overcoming biases and searching the hypothesis space for good models of the world and good solutions to problems. Diversity of group members can facilitate these achievements, but diverse groups also face their own problems. We discuss means of managing these pitfalls and make some recommendations on how to make better group decisions. PMID:28878973

An Architectural Model of Visual Motion Understanding

DTIC Science & Technology

1989-08-01

of the Center for Visual Sciences of the University of Rochester. Their courage in the face of the overwhelming com- plexity of the human visual...analysis should perform better than either approach by itself. Notice that the problems of the two approaches are non-overlapping. Continuous methods face no...success. This is not terribly surprising, as the problem is inherently very difficult. Consider the problems faced by a unit that is trying to compute the

A Comparison of the Effectiveness of a Game Informed Online Learning Activity and Face to Face Teaching in Increasing Knowledge about Managing Aggression in Health Settings

ERIC Educational Resources Information Center

McKenzie, Karen

2013-01-01

The present study compared the impact of face to face teaching with a short online game informed learning activity on health participants' knowledge about, and confidence in, managing aggressive situations. Both forms of teaching resulted in a significant increase in participants' knowledge and confidence. Face to face training led to…

Empirical evidences of owners’ managerial behaviour - the case of small companies

NASA Astrophysics Data System (ADS)

Lobontiu, G.; Banica, M.; Ravai-Nagy, S.

2017-05-01

In a small firm, the founder or the owner-manager often leaves his or her own personal “stamp” on the way things are done, finding solutions for the multitude of problems the firm faces, and maintaining control over the firm’s operations. The paper aims to investigate the degree to which the owner-managers are controlling the operations of their firm on a day-to-day basis or even getting involved into the management of the functional areas. Our empirical research, conducted on a sample of 200 small and medium-sized enterprises (SME) from the North-Western Romania, Maramures (NUTS3 level - RO114), shows that owner-managers tend to be all-powerful, making decisions based on their experience. Furthermore, the survey highlights the focus of owner-managers on two functional areas, namely the production, and sales and marketing. Finally, the correlation analysis states that in the case of small firms, the owner-manager is more involved in managing the functional areas of the firm, as compared to the medium-ones.

Semisupervised kernel marginal Fisher analysis for face recognition.

PubMed

Wang, Ziqiang; Sun, Xia; Sun, Lijun; Huang, Yuchun

2013-01-01

Dimensionality reduction is a key problem in face recognition due to the high-dimensionality of face image. To effectively cope with this problem, a novel dimensionality reduction algorithm called semisupervised kernel marginal Fisher analysis (SKMFA) for face recognition is proposed in this paper. SKMFA can make use of both labelled and unlabeled samples to learn the projection matrix for nonlinear dimensionality reduction. Meanwhile, it can successfully avoid the singularity problem by not calculating the matrix inverse. In addition, in order to make the nonlinear structure captured by the data-dependent kernel consistent with the intrinsic manifold structure, a manifold adaptive nonparameter kernel is incorporated into the learning process of SKMFA. Experimental results on three face image databases demonstrate the effectiveness of our proposed algorithm.

Problems Facing Rural Schools.

ERIC Educational Resources Information Center

Stewart, C. E.; And Others

Problems facing rural Scottish schools range from short term consideration of daily operation to long term consideration of organizational alternatives. Addressed specifically, such problems include consideration of: (1) liaison between a secondary school and its feeder primary schools; (2) preservice teacher training for work in small, isolated…

Livelihood analysis of floating net cages fish farmers at Sendang Village Sub-district of Gajah Mungkur Reservoir of Wonogiri Regency

NASA Astrophysics Data System (ADS)

Nissa, Z. N. A.; Suadi; Sukardi

2018-03-01

Floating net cages farming (KJA) is one of the main livelihood resources in Sendang Village, Gajah Mungkur Reservoir. The purposes of this study were to determine the livelihood asset of fish farmers, the problems of livelihood asset management and the utilization strategy to support aquaculture businesses also farmers livelihood. The study showed that the natural capital, provides easiest way to farmer in fish cultivation. The fish farmers also have good technical capabilities in fish cultivation and the product has high demand and value which is essential for farmers livelihood. The main problems faced by small-scale farmers and all large-scale farmers were transition period, and the rise of cost price which sometime cause the failure in the business. The strategies to deal the problems include technological adjustment, managing the pattern of stocking of tilapia seeds and income source diversification. There were differences in dealing the rise of cost. The small-scale farmers borrow from the bank, while medium-scale farmers use their savings. Another difference of livelihood strategy was the management of financial capital. However, various strategies were still required to increase the livelihood of fish farmers and could address the vulnerabilities in the cultivation of KJA as a common pool resources.

Multi-Dimensional, Non-Pyrolyzing Ablation Test Problems

NASA Technical Reports Server (NTRS)

Risch, Tim; Kostyk, Chris

2016-01-01

Non-pyrolyzingcarbonaceous materials represent a class of candidate material for hypersonic vehicle components providing both structural and thermal protection system capabilities. Two problems relevant to this technology are presented. The first considers the one-dimensional ablation of a carbon material subject to convective heating. The second considers two-dimensional conduction in a rectangular block subject to radiative heating. Surface thermochemistry for both problems includes finite-rate surface kinetics at low temperatures, diffusion limited ablation at intermediate temperatures, and vaporization at high temperatures. The first problem requires the solution of both the steady-state thermal profile with respect to the ablating surface and the transient thermal history for a one-dimensional ablating planar slab with temperature-dependent material properties. The slab front face is convectively heated and also reradiates to a room temperature environment. The back face is adiabatic. The steady-state temperature profile and steady-state mass loss rate should be predicted. Time-dependent front and back face temperature, surface recession and recession rate along with the final temperature profile should be predicted for the time-dependent solution. The second problem requires the solution for the transient temperature history for an ablating, two-dimensional rectangular solid with anisotropic, temperature-dependent thermal properties. The front face is radiatively heated, convectively cooled, and also reradiates to a room temperature environment. The back face and sidewalls are adiabatic. The solution should include the following 9 items: final surface recession profile, time-dependent temperature history of both the front face and back face at both the centerline and sidewall, as well as the time-dependent surface recession and recession rate on the front face at both the centerline and sidewall. The results of the problems from all submitters will be collected, summarized, and presented at a later conference.

Lymphoedema of the lower limbs: management problems in a developing country.

PubMed

Adigun, A I; Ogundipe, O K

2008-01-01

Lymphoedema is a clinical condition involving the extremities that is characterized by accumulation of protein rich fluid within the intercellular space of the skin and the subcutaneous tissue. It most frequently occurs in the extremities. Developing countries are mostly faced with cases of secondary lymphoedema where patients present lately. In addition to swollen limbs, there are lot of skin changes on the affected limb, these create a lot of problems to the managing clinician. We hereby present five cases out of several patients managed to highlight the challenges. We review the case notes of three patients managed by our unit and present the summary of each patient. Majority of our patients present late to the hospital, mainly because of the socio-cultural and spiritual beliefs concerning the aetiology of the condition. Most of them have visited the spiritualist, herbalist and the clergymen for solution. Clinicians in the developing countries are seriously handicapped by lack of modern equipment for both diagnostic and therapeutic management of these clinical conditions. Chronic lymphoedema is a major cause of permanent disability. Excisional surgery such as Charles procedure even though old is still very much relevant in our environment. Patients need to be enlightened on the need for early presentation, adequate post-operative care and prolonged follow-up.

The addition of E (Empowerment and Economics) to the ABCD algorithm in diabetes care.

PubMed

Khazrai, Yeganeh Manon; Buzzetti, Raffaella; Del Prato, Stefano; Cahn, Avivit; Raz, Itamar; Pozzilli, Paolo

2015-01-01

The ABCD (Age, Body weight, Complications, Duration of disease) algorithm was proposed as a simple and practical tool to manage patients with type 2 diabetes. Diabetes treatment, as for all chronic diseases, relies on patients' ability to cope with daily problems concerning the management of their disease in accordance with medical recommendations. Thus, it is important that patients learn to manage and cope with their disease and gain greater control over actions and decisions affecting their health. Healthcare professionals should aim to encourage and increase patients' perception about their ability to take informed decisions about disease management and to improve patient self-esteem and feeling of self-efficacy to become agents of their own health. E for Empowerment is therefore an additional factor to take into account in the management of patients with type 2 diabetes. E stands also for Economics to be considered in diabetes care. Attention should be paid to public health policies as well as to the physician faced with the dilemma of delivering the best possible care within the problem of limited resources. The financial impact of the new treatment modalities for diabetes represents an issue that needs to be addressed at multiple strata both globally and nationally. Copyright © 2015 Elsevier Inc. All rights reserved.

Palo Alto Research Center - Smart Embedded Network of Sensors with an Optical Readout

ScienceCinema

Raghavan, Ajay; Sahu, Saroj; Bringans, Ross; Johnson, Noble; Kiesel, Peter; Saha, Bhaskar

2018-05-18

PARC is developing new fiber optic sensors that would be embedded into batteries to monitor and measure key internal parameters during charge and discharge cycles. Two significant problems with today's best batteries are their lack of internal monitoring capabilities and their design oversizing. The lack of monitoring interferes with the ability to identify and manage performance or safety issues as they arise, which are presently managed by very conservative design oversizing and protection approaches that result in cost inefficiencies. PARC's design combines low-cost, embedded optical battery sensors and smart algorithms to overcome challenges faced by today's best battery management systems. These advanced fiber optic sensing technologies have the potential to dramatically improve the safety, performance, and life-time of energy storage systems.

[Retention management by means of applied human resource development: lessons from cardiovascular anaesthesiology].

PubMed

Padosch, Stephan A; Schmidt, Christian E; Spöhr, Fabian A M

2011-05-01

At present, besides well-known financial problems, German hospitals are facing a serious lack of qualified medical staff. Given these facts, it is of great importance, especially in work load burdened disciplines, such as cardiovascular anaesthesiology, to retain highly qualified medical staff. Here, human resource development measures offer valuable tools for efficient retention management. Moreover, most of these are applicable to almost any clinical specialty. Surprisingly, financial aspects play a minor role in such concepts, in contrast to human resource development tools, such as mentoring, interviews, training and motivational activities. Especially, with regard to "Generation Y", an efficient retention management will play a key role to keep these physicians as hospital employees of long duration in the future. © Georg Thieme Verlag Stuttgart · New York.

Tackling drug and alcohol misuse in Brazil: priorities and challenges for nurses.

PubMed

Rassool, G H; Villar-Luis, M

2004-12-01

To provide an overview of the extent of drug and alcohol misuse in Brazil and the policies and approaches in tackling substance misuse. An examination of the challenges facing the nursing profession in working with substance misusers is presented. Alcohol, cocaine, and cannabis are the most commonly misused psychoactive substances in Brazil. One of the biggest public health problems is the interface between the misuse of psychoactive substances and HIV prevalence and other sexually transmitted diseases. Findings from a recent study suggest that undergraduate nurses in Brazil are not adequately prepared in the care and management of substance misuse problems. The nursing profession in Brazil faces numerous challenges in the development of professional competence of nurses in this field. A strategy proposed is the creation of regional centres in Brazil to study the integration of substance use and misuse in the nursing undergraduate curriculum and the giving of specific support in teaching and research to nurse teachers. Nurses have a key role to play in the early recognition, assessment, prevention, and treatment of substance misuse.

Family-based therapy for dementia caregivers: clinical observations

PubMed Central

MITRANI, V. B.; CZAJA, S. J.

2008-01-01

Family caregiving for dementia patients is a major social and clinical problem. Family caregivers face major stressful emotional, social and economic burdens, and the negative consequences associated with caregiving are well documented. Given the projected increase in the number of people with dementia, there is a need to identify approaches that will help families manage the challenges of caregiving. Social support from friends and family members has consistently been found to mediate caregiver outcomes, yet many caregivers face problems with isolation and estrangement from family members. In this regard, family-based therapy is a promising intervention for increasing social support for caregivers, and enhancing their quality of life and ability to provide care.This paper will discuss how family-based therapy can be applied as an intervention for family caregivers of dementia patients.The clinical implications of specific interactional patterns will be presented via case examples from an ongoing clinical trial with white American and Cuban American caregivers of dementia patients.The intent is to demonstrate how identification of interactional patterns is a valuable tool for implementing family-based interventions. PMID:18548132

Determinants of Early Marriage from Married Girls' Perspectives in Iranian Setting: A Qualitative Study

PubMed Central

Montazeri, Simin; Gharacheh, Maryam; Mohammadi, Nooredin; Alaghband Rad, Javad; Eftekhar Ardabili, Hassan

2016-01-01

Early marriage is a worldwide problem associated with a range of health and social consequences for teenage girls. Designing effective health interventions for managing early marriage needs to apply the community-based approaches. However, it has received less attention from policymakers and health researchers in Iran. Therefore, the current study aimed to explore determinants of early marriage from married girls' perspectives. The study was conducted from May 2013 to January 2015 in Ahvaz, Iran. A purposeful sampling method was used to select fifteen eligible participants. Data were collected through face-to-face, semistructured interviews and were analyzed using the conventional content analysis approach. Three categories emerged from the qualitative data including “family structure,” “Low autonomy in decision-making,” and “response to needs.” According to the results, although the participants were not ready to get married and intended to postpone their marriage, multiple factors such as individual and contextual factors propelled them to early marriage. Given that early marriage is a multifactorial problem, health care providers should consider a multidimensional approach to support and empower these vulnerable girls. PMID:27123012

Determinants of Early Marriage from Married Girls' Perspectives in Iranian Setting: A Qualitative Study.

PubMed

Montazeri, Simin; Gharacheh, Maryam; Mohammadi, Nooredin; Alaghband Rad, Javad; Eftekhar Ardabili, Hassan

2016-01-01

Early marriage is a worldwide problem associated with a range of health and social consequences for teenage girls. Designing effective health interventions for managing early marriage needs to apply the community-based approaches. However, it has received less attention from policymakers and health researchers in Iran. Therefore, the current study aimed to explore determinants of early marriage from married girls' perspectives. The study was conducted from May 2013 to January 2015 in Ahvaz, Iran. A purposeful sampling method was used to select fifteen eligible participants. Data were collected through face-to-face, semistructured interviews and were analyzed using the conventional content analysis approach. Three categories emerged from the qualitative data including "family structure," "Low autonomy in decision-making," and "response to needs." According to the results, although the participants were not ready to get married and intended to postpone their marriage, multiple factors such as individual and contextual factors propelled them to early marriage. Given that early marriage is a multifactorial problem, health care providers should consider a multidimensional approach to support and empower these vulnerable girls.

Investment portfolio management from cybernetic point of view

NASA Astrophysics Data System (ADS)

Marchev, Angel, Jr.; Marchev, Angel

2013-12-01

The theory of investment portfolios is a well defined component of financial science. While sound in principle, it faces some setbacks in its real-world implementation. In this paper the authors propose a reformulation of the investment portfolio problem as a cybernetic system where the Investor is the controlling system and the portfolio is the controlled system. Also the portfolio controlling process should be dissected in several ordered phases, so that each phase is represented as a subsystem within the structure of the controlling system Investor.

Black swans, wicked problems, and science during crises

USGS Publications Warehouse

Machlis, G.E.; McNutt, M.K.

2011-01-01

Oceanic resources face challenges that are significant and widespread, including (but not limited to) overharvesting, climate change, selected stock collapse, coral reef decline, species extinction, pollution, and more. These challenges are the focus of much ocean science, which is helping to inform policy and guide management actions. The steady growth of research results and the emergence of new research needs have been systematically reviewed through periodic assessments, such as those of the Intergovernmental Oceanographic Commission (Valdés et al., 2010).

Can we match ultraviolet face images against their visible counterparts?

NASA Astrophysics Data System (ADS)

Narang, Neeru; Bourlai, Thirimachos; Hornak, Lawrence A.

2015-05-01

In law enforcement and security applications, the acquisition of face images is critical in producing key trace evidence for the successful identification of potential threats. However, face recognition (FR) for face images captured using different camera sensors, and under variable illumination conditions, and expressions is very challenging. In this paper, we investigate the advantages and limitations of the heterogeneous problem of matching ultra violet (from 100 nm to 400 nm in wavelength) or UV, face images against their visible (VIS) counterparts, when all face images are captured under controlled conditions. The contributions of our work are three-fold; (i) We used a camera sensor designed with the capability to acquire UV images at short-ranges, and generated a dual-band (VIS and UV) database that is composed of multiple, full frontal, face images of 50 subjects. Two sessions were collected that span over the period of 2 months. (ii) For each dataset, we determined which set of face image pre-processing algorithms are more suitable for face matching, and, finally, (iii) we determined which FR algorithm better matches cross-band face images, resulting in high rank-1 identification rates. Experimental results show that our cross spectral matching (the heterogeneous problem, where gallery and probe sets consist of face images acquired in different spectral bands) algorithms achieve sufficient identification performance. However, we also conclude that the problem under study, is very challenging, and it requires further investigation to address real-world law enforcement or military applications. To the best of our knowledge, this is first time in the open literature the problem of cross-spectral matching of UV against VIS band face images is being investigated.

Implementing a new drug record system: a qualitative study of difficulties perceived by physicians and nurses.

PubMed

Andersen, S E

2002-03-01

To identify organisational difficulties faced by physicians and nurses when using drug prescribing sheets for recording both drug prescriptions and drug administration. Qualitative interview study. Two general internal medicine wards. Seven physicians and eight nurses. Difficulties explicitly identified by the participants during the interviews. The implementation of procedures conflicted with existing structure, culture, and routines. Insufficient competence within the system to use the drug prescribing sheets created resistance and made people down the line create their own interpretations and solutions to the problems they faced. A total of nine problems were identified: (1) insufficient knowledge and uncertainty about procedures, (2) ignorance of sources of error, (3) unclear responsibilities, (4) low community spirit, (5) insufficient communication, (6) clinician autonomy and low acceptance of change, (7) strong professional identity, (8) low priority task, and (9) logistical problems. Unawareness of procedures, insufficient dissemination of knowledge, and insufficient cooperation and skepticism among those who put drug handling into practice is likely to have an impact on the quality of health care. The identification of these obstacles may help managers to improve the quality of the drug handling process on internal medicine wards and make it possible to select a framework for changing the clinical behaviour of doctors and nurses.

The Challenge To Tactical Reconnaissance: Timeliness Through Technology

NASA Astrophysics Data System (ADS)

Stromfors, Richard D.

1984-12-01

As you have no doubt gathered from Mr. Henkel's introduction, I have spent over 20 years of my Air Force career involved in the reconnaissance mission either as a tactical reconnaissance pilot, as a tactical reconnaissance inspector, as a writer and speaker on that subject while attending the Air Force Professional Military Education Schools, and currently as the Air Force's operational manager for reconnaissance aircraft. In all of those positions, I've been challenged many times over with what appeared, at first, to be insurmountable problems that upon closer examination weren't irresolvable after all. All of these problems pale, however, when viewed side-by-side with the one challenge that has faced me since I began my military career and, in fact, faces all of us as I talk with you today. That one challenge is the problem of timeliness. Better put: "Getting information to our customers firstest with the mostest." Together we must develop better platforms and sensors to cure this age-old "Achilles heel" in the reconnaissance cycle. Despite all of our best intentions, despite all of the emerging technologies that will be available, and despite all of the dollars that we've thrown at research and development, we in the reconnaissance business still haven't done a good job in this area. We must do better.

Improving Posthospital Discharge Telephone Reach Rates Through Prehospital Discharge Face-to-Face Meetings.

PubMed

Vergara, Franz H; Sheridan, Daniel J; Sullivan, Nancy J; Budhathoki, Chakra

The purpose of this study was to determine whether a face-to-face meeting with patients by a telephonic case manager prehospital discharge would result in increased telephone follow-up (TFU) reach rates posthospital discharge. Acute care adult medicine inpatient units. A quasiexperimental design was utilized. Two adult inpatient medicine units were selected as the intervention and comparison groups. The framework of the study is the transitions theory. A convenience sampling technique was used, whereby 88 eligible patients on the intervention unit received face-to-face meetings prehospital discharge whereas 123 patients on the comparison unit received standard care (no face-to-face meetings). Cross-tabulation and chi-square tests were employed to examine the association of face-to-face meeting intervention and TFU reach rates. Implementing brief (<10 min) face-to-face meetings by a telephonic case manager prehospital discharge resulted in a TFU reach rate of 87% on the intervention unit, whereas the comparison unit only had a 58% TFU reach rate (p < .001). Increasing reach rates by a telephonic case manager facilitates communication with more patients posthospital discharge. A brief prehospital discharge face-to-face meeting with patients assisted them to understand the reasons for a posthospital discharge telephone call, identified the best times to call using accurate telephone numbers, and taught patients how best to prepare for the call. In addition, by meeting patients face-to-face, the telephonic case manager was no longer an unknown person on the telephone asking them questions about their medical condition. These factors combined may have significantly helped to increase TFU reach rates.

Memory for angry faces, impulsivity, and problematic behavior in adolescence.

PubMed

d'Acremont, Mathieu; Van der Linden, Martial

2007-04-01

Research has shown that cognitive processes like the attribution of hostile intention or angry emotion to others contribute to the development and maintenance of conduct problems. However, the role of memory has been understudied in comparison with attribution biases. The aim of this study was thus to test if a memory bias for angry faces was related to conduct problems in youth. Adolescents from a junior secondary school were presented with angry and happy faces and were later asked to recognize the same faces with a neutral expression. They also completed an impulsivity questionnaire. A teacher assessed their behavior. The results showed that a better recognition of angry faces than happy faces predicted conduct problems and hyperactivity/inattention as reported by the teacher. The memory bias effect was more pronounced for impulsive adolescents. It is suggested that a memory bias for angry faces favors disruptive behavior but that a good ability to control impulses may moderate the negative impact of this bias.

Securing water for the cities.

PubMed

Satterthwaite, D

1993-01-01

Many cities in developing countries have grown so much that they can no longer provide adequate, sustainable water. Over pumping in Dakar and Mexico City has forced those cities to obtain water from ever more distant sources. In Dakar, the result has been saltwater intrusion. Overpumping has caused Mexico City to sink, in some areas by as much as 9 m, resulting in serious damage to buildings and sewage and drainage pipes. Other cities facing similar water problems are coastal cities in Peru (e.g., Lima), La Rioja and Catamarca in Argentina, cities in Northern Mexico, and cities in dry areas of Africa. For some cities, the problem is not so much ever more distant water supplies but insufficient funds to expand supplies. Bangkok and Jakarta both face saltwater intrusion into their overdrawn aquifers. Even through agriculture is the dominant user of water in most countries, demand concentrated in a small area exhausts local and regional sources and pollutes rivers, lakes, and coasts with untreated human and industrial waste. Most cities in Africa and Asia do not have a sewerage system. Further, most cities do not have the drains to deal with storm water and external floodwater, causing frequent, seasonal flooding. The resulting stagnant water provides breeding grounds for insect vectors of diseases (e.g., malaria). The problems in most cities are a result of poor management, not lack of water. Reducing leaks in existing piped distribution systems from the usual 60% loss of water to leaks to 12% would increase the available water 2-fold. Another way to address water shortages would be commercial, industrial, and recreational use of minimally treated waste water, such as is the case in Madras and Mexico City. Political solutions are needed to resolve inadequate water supply and waste management.

Integration of Problem-Based Learning and Web-Based Multimedia to Enhance Soil Management Course

NASA Astrophysics Data System (ADS)

Strivelli, R.; Krzic, M.; Crowley, C.; Dyanatkar, S.; Bomke, A.; Simard, S.; Grand, S.

2012-04-01

In an attempt to address declining enrolment in soil science programs and the changing learning needs of 21st century students, several universities in North America and around the world have re-organized their soil science curriculum and adopted innovative educational approaches and web-based teaching resources. At the University of British Columbia, Canada, an interdisciplinary team set out to integrate teaching approaches to address this trend. The objective of this project was to develop an interactive web-based teaching resource, which combined a face-to-face problem-based learning (PBL) case study with multimedia to illustrate the impacts of three land-uses on soil transformation and quality. The Land Use Impacts (LUI) tool (http://soilweb.landfood.ubc.ca/luitool/) was a collaborative and concentrated effort to maximize the advantages of two educational approaches: (1) the web's interactivity, flexibility, adaptability and accessibility, and (2) PBL's ability to foster an authentic learning environment, encourage group work and promote the application of core concepts. The design of the LUI case study was guided by Herrington's development principles for web-based authentic learning. The LUI tool presented students with rich multimedia (streaming videos, text, data, photographs, maps, and weblinks) and real world tasks (site assessment and soil analysis) to encourage students to utilize knowledge of soil science in collaborative problem-solving. Preliminary student feedback indicated that the LUI tool effectively conveyed case study objectives and was appealing to students. The resource is intended primarily for students enrolled in an upper level undergraduate/graduate university course titled Sustainable Soil Management but it is flexible enough to be adapted to other natural resource courses. Project planning and an interactive overview of the tool will be given during the presentation.

An Exploration of Trainer Filtering Approaches

NASA Technical Reports Server (NTRS)

Hester, Patrick; Tolk, Andreas; Gadi, Sandeep; Carver, Quinn; Roland, Philippe

2011-01-01

Simutator operators face a twofold entity management problem during Live-Virtual-Constructive (LVC) training events. They first must filter potentially hundreds of thousands of simulation entities in order 10 determine which elements are necessary for optimal trainee comprehension. Secondarily, they must manage the number of entities entering the simulation from those present in the object model in order to limit the computational burden on the simulation system and prevent unnecessary entities from entering the simulation, This paper focuses on the first filtering stage and describes a novel approach to entity filtering undertaken to maximize trainee awareness and learning. The feasibility of this novel approach is demonstrated on a case study and limitations to the proposed approach and future work are discussed.

A student manual for promoting mental health among high school students.

PubMed

Gigantesco, Antonella; Del Re, Debora; Cascavilla, Isabella

2013-01-01

We describe a school program based on a student manual for promoting mental health and preventing mental illness. A preliminary version of the manual was assessed for face validity by two focus groups. The final version was evaluated for acceptability among 253 students in 10 high schools and 1 middle school in Italy. The manual included 18 chapters (or "units") which address skills for enabling students to cope with their daily lives: communication skills, problem-solving, assertive skills, negotiation, stress management, anger management and conflict resolution. The manual was found to have been acceptable by high school students. The effectiveness of the manual in actually promoting mental health and preventing mental illness is currently being evaluated.

Does the private sector have a role in Canadian healthcare?

PubMed

McGowan, Tom

2004-01-01

The current system of public pay with primarily public management for essential healthcare services has largely been successful. The Romanow and Kirby reports have made compelling arguments for expanding the definition of essential healthcare services to include, among other things, medications. The problem facing Canadians is that expanding services is not feasible under the current structure, as it is not affordable. The rigid adherence to a 45-year-old definition of system structure is hampering our ability to innovate. In an increasingly unresponsive system, the introduction of private management, through the judicious use of private contracts, can improve efficiency and increase accountability, while maintaining the important principle of public funding.

Total quality management in the hospital setting.

PubMed

Ernst, D F

1994-01-01

With the increasing demands on hospitals for improved quality and lower costs, hospitals have been forced to reevaluate their manner of operation and quality assurance (QA) programs. Hospitals have been faced with customer dissatisfaction with services, escalating costs, intense competition, and reduced reimbursement for services. As a result, many hospitals have incorporated total quality management (TQM), also known as continuous quality improvement (CQI) and quality improvement (QI), to improve quality care and decrease costs. This article examines the concept of TQM, its rationale, and how it can be implemented in a hospital. A comparison of TQM and QA is made. Examples of hospital implementation of TQM and problems and issues associated with TQM in the hospital setting are explored.

Emergency neurological care of strokes and bleeds.

PubMed

Birenbaum, Dale

2010-01-01

Ischemic stroke and brain hemorrhage are common and challenging problems faced by emergency physicians. In this article, important details in the diagnosis and clinical management of these neurological emergencies are presented with the following goals: 1) To provide a more comprehensive understanding of the approach to the identification and management of patients who have sustained ischemic and hemorrhagic strokes; 2) to explain the importance and application of commonly used national stroke scoring and outcome scales; 3) to improve the ability to recognize important aspects in the approach and comprehensive treatment of ruptured and unruptured intracranial aneurysms; and 4) to demonstrate the difficulties in the neurological, neurosurgical, and endovascular treatment of these catastrophic diseases.

Principal-agent theory: a framework for improving health care reform in Tennessee.

PubMed

Sekwat, A

2000-01-01

Using a framework based on principal-agent theory, this study examines problems faced by managed care organizations (MCOs) and major health care providers under the state of Tennessee's current capitation-based managed care programs called TennCare. Based on agency theory, the study proposes a framework to show how an effective collaborative relationship can be forged between the state of Tennessee and participating MCOs which takes into account the major concerns of third-party health care providers. The proposed framework further enhances realization of the state's key health care reform goals which are to control the rising costs of health care delivery and to expand health care coverage to uninsured and underinsured Tennesseans.

Grand challenges in the management and conservation of North American inland fishes and fisheries

USGS Publications Warehouse

Lynch, Abigail; Cooke, Steven J.; Beard, Douglas; Kao, Yu-Chun; Lorenzen, Kai; Song, Andrew M.; Allen, Micheal S.; Basher, Zeenatul; Bunnell, David B.; Camp, Edward V.; Cowx, Ian G.; Freedman, Jonathan A.; Nguyen, Vivian M.; Nohner, Joel K.; Rogers, Mark W.; Siders, Zachary A.; Taylor, William W.; Youn, So-Jung

2017-01-01

Even with long-standing management and extensive science support, North American inland fish and fisheries still face many conservation and management challenges. We used a grand challenges approach to identify critical roadblocks that if removed would help solve important problems in the management and long-term conservation of North American inland fish and fisheries. We identified seven grand challenges within three themes (valuation, governance, and externalities) and 34 research needs and management actions. The major themes identified are to (1) raise awareness of diverse values associated with inland fish and fisheries, (2) govern inland fish and fisheries to satisfy multiple use and conservation objectives, and (3) ensure productive inland fisheries given nonfishing sector externalities. Addressing these grand challenges will help the broader community understand the diverse values of inland fish and fisheries, promote open forums for engagement of diverse stakeholders in fisheries management, and better integrate the inland fish sector into the greater water and land use policy process.

Internet-based virtual classroom and educational management software enhance students' didactic and clinical experiences in perfusion education programs.

PubMed

Riley, Jeffrey B; Austin, Jon W; Holt, David W; Searles, Bruce E; Darling, Edward M

2004-09-01

A challenge faced by many university-based perfusion education (PE) programs is the need for student clinical rotations at hospital locations that are geographically disparate from the main educational campus. The problem has been addressed through the employment of distance-learning environments. The purpose of this educational study is to evaluate the effectiveness of this teaching model as it is applied to PE. Web-based virtual classroom (VC) environments and educational management system (EMS) software were implemented independently and as adjuncts to live, interactive Internet-based audio/video transmission from classroom to classroom in multiple university-based PE programs. These Internet environments have been used in a variety of ways including: 1) forum for communication between the university faculty, students, and preceptors at clinical sites, 2) didactic lectures from expert clinicians to students assigned to distant clinical sites, 3) small group problem-based-learning modules designed to enhance students analytical skills, and 4) conversion of traditional face-to-face lectures to asynchronous learning modules. Hypotheses and measures of student and faculty satisfaction, clinical experience, and learning outcomes are proposed, and some early student feedback was collected. For curricula that emphasize both didactic and clinical education, the use of Internet-based VC and EMS software provides significant advancements over traditional models. Recognized advantages include: 1) improved communications between the college faculty and the students and clinical preceptors, 2) enhanced access to a national network of clinical experts in specialized techniques, 3) expanded opportunity for student distant clinical rotations with continued didactic course work, and 4) improved continuity and consistency of clinical experiences between students through implementation of asynchronous learning modules. Students recognize the learning efficiency of on-line information presentation but still prefer the traditional face-to-face classroom environment. Traditional paradigms impose limitations that are rooted in dependence upon the students and instructors being physically located in the same place at the same time. These represents significant impediments for PE programs that use geographically separate clinical sites to provide clinical experience. Historically this has led to a disintegration of the presentation of theory, and a reduction in the quantity or quality of clinical experience opportunities. New PE models help to eliminate limitations and improve the quality of education especially in the face of economic challenges. Perfusion education students and faculty will have to work together to find computer-based offerings that are equivalent to traditional classroom methods.

NASA'S Water Resources Element Within the Applied Sciences Program

NASA Technical Reports Server (NTRS)

Toll, David; Doorn, Bradley; Engman, Edwin

2011-01-01

The NASA Earth Systems Division has the primary responsibility for the Applied Science Program and the objective to accelerate the use of NASA science results in applications to help solve problems important to society and the economy. The primary goal of the NASA Applied Science Program is to improve future and current operational systems by infusing them with scientific knowledge of the Earth system gained through space-based observation, assimilation of new observations, and development and deployment of enabling technologies, systems, and capabilities. This paper discusses major problems facing water resources managers, including having timely and accurate data to drive their decision support tools. It then describes how NASA's science and space based satellites may be used to overcome this problem. Opportunities for the water resources community to participate in NASA's Water Resources Applications Program are described.

A Qualitative Study to Identify Skills and Competency Required for Hospital Managers

PubMed Central

Barati, Omid; Sadeghi, Ahmad; Khammarnia, Mohammad; Siavashi, Elham; Oskrochi, Gholamreza

2016-01-01

Introduction Hospital managers aim to improve the efficiency and effectiveness of their institutions through leadership and guidance of medical personnel. Fulfilling these objectives requires a holistic approach to both the management of people and institutional prioritization. The aim of this study was to identify the skills and competencies that hospital managers must demonstrate in order to achieve their objectives. Methods In 2015, a regional, multi-center qualitative study was undertaken in Shiraz, Iran. Interviews and focus group discussions were conducted with university hospital managers, senior managers, faculty members, and post-graduate students, and the results were analyzed using the content analysis method by MAXQDA software. Results Eight key skill themes (communication, experience, appreciation of institution logistics/infrastructure, management skills, motivation, systematic problem solving, ethics, and financial/legal awareness) were identified among the hospital managers. The common challenges that face hospital institutions include problems with hierarchical and organizational structure, excessive rules and regulations, lack of resources, poor post-graduate education, and overall management. Recurring themes with respect to how these could be addressed included changing the culture and belief structure of the hospital, restructuring the organizational hierarchy, and empowering the people. Conclusion In our cohort, practical skills, such as communication and experience, were considered more important than theoretical skills for the effective management and administration of hospitals. Therefore, we suggest that practical, skill-based training should be emphasized for students of these disciplines so they will be better suited to deal with real world challenges. Further organizational improvements also can be attained by the active and constructive involvement of senior university managers. PMID:27504159

A Qualitative Study to Identify Skills and Competency Required for Hospital Managers.

PubMed

Barati, Omid; Sadeghi, Ahmad; Khammarnia, Mohammad; Siavashi, Elham; Oskrochi, Gholamreza

2016-06-01

Hospital managers aim to improve the efficiency and effectiveness of their institutions through leadership and guidance of medical personnel. Fulfilling these objectives requires a holistic approach to both the management of people and institutional prioritization. The aim of this study was to identify the skills and competencies that hospital managers must demonstrate in order to achieve their objectives. In 2015, a regional, multi-center qualitative study was undertaken in Shiraz, Iran. Interviews and focus group discussions were conducted with university hospital managers, senior managers, faculty members, and post-graduate students, and the results were analyzed using the content analysis method by MAXQDA software. Eight key skill themes (communication, experience, appreciation of institution logistics/infrastructure, management skills, motivation, systematic problem solving, ethics, and financial/legal awareness) were identified among the hospital managers. The common challenges that face hospital institutions include problems with hierarchical and organizational structure, excessive rules and regulations, lack of resources, poor post-graduate education, and overall management. Recurring themes with respect to how these could be addressed included changing the culture and belief structure of the hospital, restructuring the organizational hierarchy, and empowering the people. In our cohort, practical skills, such as communication and experience, were considered more important than theoretical skills for the effective management and administration of hospitals. Therefore, we suggest that practical, skill-based training should be emphasized for students of these disciplines so they will be better suited to deal with real world challenges. Further organizational improvements also can be attained by the active and constructive involvement of senior university managers.

Risk management and precaution: insights on the cautious use of evidence.

PubMed Central

Hrudey, Steve E; Leiss, William

2003-01-01

Risk management, done well, should be inherently precautionary. Adopting an appropriate degree of precaution with respect to feared health and environmental hazards is fundamental to risk management. The real problem is in deciding how precautionary to be in the face of inevitable uncertainties, demanding that we understand the equally inevitable false positives and false negatives from screening evidence. We consider a framework for detection and judgment of evidence of well-characterized hazards, using the concepts of sensitivity, specificity, positive predictive value, and negative predictive value that are well established for medical diagnosis. Our confidence in predicting the likelihood of a true danger inevitably will be poor for rare hazards because of the predominance of false positives; failing to detect a true danger is less likely because false negatives must be rarer than the danger itself. Because most controversial environmental hazards arise infrequently, this truth poses a dilemma for risk management. PMID:14527835

Uncertainty Management for Diagnostics and Prognostics of Batteries using Bayesian Techniques

NASA Technical Reports Server (NTRS)

Saha, Bhaskar; Goebel, kai

2007-01-01

Uncertainty management has always been the key hurdle faced by diagnostics and prognostics algorithms. A Bayesian treatment of this problem provides an elegant and theoretically sound approach to the modern Condition- Based Maintenance (CBM)/Prognostic Health Management (PHM) paradigm. The application of the Bayesian techniques to regression and classification in the form of Relevance Vector Machine (RVM), and to state estimation as in Particle Filters (PF), provides a powerful tool to integrate the diagnosis and prognosis of battery health. The RVM, which is a Bayesian treatment of the Support Vector Machine (SVM), is used for model identification, while the PF framework uses the learnt model, statistical estimates of noise and anticipated operational conditions to provide estimates of remaining useful life (RUL) in the form of a probability density function (PDF). This type of prognostics generates a significant value addition to the management of any operation involving electrical systems.

Fine granular of shredded waste tyre for road kerb application as improvised road furniture

NASA Astrophysics Data System (ADS)

Munikanan, Vikneswaran; Yahya, Muhamad Azani; Yusof, Mohammed Alias; Radzi, Muhammad Haris Fauzan

2018-02-01

Solid waste management in Malaysia was still in a backward stage. Population growth, urbanization and rapid industrialization led to an increase in the solid waste generated by society. Solid waste management is one of the main problems faced by the community, especially in the city. Solid waste management costs of the collection, collecting, transporting waste to the landfill, is very high. The quantity of solid waste should be reduced in order to reduce government spending. Moreover, improper solid waste management caused a negative impact on people and the environment. Method of recycling is one of the best alternatives to reduce the number of solid waste. Therefore, this study was to identify methods of recycling used tires to be used in civil engineering. This study was conducted to determine the effectiveness and properties of rubber from used tires to be add in the road kerb design.

Case Mix Management Systems: An Opportunity to Integrate Medical Records and Financial Management System Data Bases

PubMed Central

Rusnak, James E.

1987-01-01

Due to previous systems selections, many hospitals (health care facilities) are faced with the problem of fragmented data bases containing clinical, demographic and financial information. Projects to select and implement a Case Mix Management System (CMMS) provide an opportunity to reduce the number of separate physical files and to migrate towards systems with an integrated data base. The number of CMMS candidate systems is often restricted due to data base and system interface issues. The hospital must insure the CMMS project provides a means to implement an integrated on-line hospital information data base for use by departments in operating under a DRG-based Prospective Payment System. This paper presents guidelines for use in selecting a Case Mix Mangement System to meet the hospital's financial and operations planning, budgeting, marketing, and other management needs, while considering the data base implications of the implementation.

Groundwater overexploitation: why is the red flag waved? Case study on the Kairouan plain aquifer (central Tunisia)

NASA Astrophysics Data System (ADS)

Massuel, Sylvain; Riaux, Jeanne

2017-09-01

In many parts of the world, groundwater users regularly face serious resource-depletion threat. At the same time, "groundwater overexploitation" is massively cited when discussing groundwater management problems. A kind of standard definition tends to relegate groundwater overexploitation only as a matter of inputs and outputs. However, a thorough state-of-the-art analysis shows that groundwater overexploitation is not only a matter of hydrogeology but also a qualification of exploitation based on political, social, technical, economic or environmental criteria. Thus, an aquifer with no threat to groundwater storage can rightly be considered as overexploited because of many other prejudicial aspects. So, why is groundwater overexploitation so frequently only associated with resource-depletion threat and so rarely related to other prejudicial aspects? In that case, what really lies behind the use of the overexploitation concept? The case of the Kairouan plain aquifer in central Tunisia was used to analyze the way that the overexploitation message emerges in a given context, how groundwater-use stakeholders (farmers, management agencies and scientists) each qualify the problem in their own way, and how they see themselves with regard to the concept of overexploitation. The analysis shows that focusing messages on overexploitation conceals the problems encountered by the various stakeholders: difficulties accessing water, problems for the authorities in controlling the territory and individual practices, and complications for scientists when qualifying hydrological situations. The solutions put forward to manage overexploitation are at odds with the problems that arise locally, triggering tensions and leading to misunderstandings between the parties involved.

Challenges faced by primary care physicians when prescribing for patients with chronic diseases in a teaching hospital in Malaysia: a qualitative study.

PubMed

Sellappans, Renukha; Lai, Pauline Siew Mei; Ng, Chirk Jenn

2015-08-27

The aim of this study was to identify the challenges faced by primary care physicians (PCPs) when prescribing medications for patients with chronic diseases in a teaching hospital in Malaysia. 3 focus group discussions were conducted between July and August 2012 in a teaching primary care clinic in Malaysia. A topic guide was used to facilitate the discussions which were audio-recorded, transcribed verbatim and analysed using a thematic approach. PCPs affiliated to the primary care clinic were purposively sampled to include a range of clinical experience. Sample size was determined by thematic saturation of the data. 14 family medicine trainees and 5 service medical officers participated in this study. PCPs faced difficulties in prescribing for patients with chronic diseases due to a lack of communication among different healthcare providers. Medication changes made by hospital specialists, for example, were often not communicated to the PCPs leading to drug duplications and interactions. The use of paper-based medical records and electronic prescribing created a dual record system for patients' medications and became a problem when the 2 records did not tally. Patients sometimes visited different doctors and pharmacies for their medications and this resulted in the lack of continuity of care. PCPs also faced difficulties in addressing patients' concerns, and dealing with patients' medication requests and adherence issues. Some PCPs lacked time and knowledge to advise patients about their medications and faced difficulties in managing side effects caused by the patients' complex medication regimen. PCPs faced prescribing challenges related to patients, their own practice and the local health system when prescribing for patients with chronic diseases. These challenges must be addressed in order to improve chronic disease management in primary care and, more importantly, patient safety. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Using decision analysis to choose phosphorus targets for Lake Erie.

PubMed

Anderson, R M; Hobbs, B F; Koonce, J F; Locci, A B

2001-02-01

Lake Erie water quality has improved dramatically since the degraded conditions of the 1960s. Additional gains could be made, but at the expense of further investment and reductions in fishery productivity. In facing such cross-jurisdictional issues, natural resource managers in Canada and the United States must grapple with conflicting objectives and important uncertainties, while considering the priorities of the public that live in the basin. The techniques and tools of decision analysis have been used successfully to deal with such decision problems in a range of environmental settings, but infrequently in the Great Lakes. The objective of this paper is to illustrate how such techniques might be brought to bear on an important, real decision currently facing Lake Erie resource managers and stakeholders: the choice of new phosphorus loading targets for the lake. The heart of our approach is a systematic elicitation of stakeholder preferences and an investigation of the degree to which different phosphorus-loading policies might satisfy ecosystem objectives. Results show that there are potential benefits to changing the historical policy of reducing phosphorus loads in Lake Erie. Copyright 2001 Springer-Verlag

The economic case for low carbon waste management in rapidly growing cities in the developing world: The case of Palembang, Indonesia.

PubMed

Papargyropoulou, Effie; Colenbrander, Sarah; Sudmant, Andrew Heshedahl; Gouldson, Andy; Tin, Lee Chew

2015-11-01

The provision of appropriate waste management is not only an indicator of development but also of broader sustainability. This is particularly relevant to expanding cities in developing countries faced with rising waste generation and associated environmental health problems. Despite these urgent issues, city authorities often lack the evidence required to make well-informed decisions. This study evaluates the carbon and economic performance of low-carbon measures in the waste sector at a city level, within the context of a developing country. Palembang in Indonesia is used as a case of a medium-sized city in a newly industrialized country, with relevance to other similar cities in the developing world. Evidence suggests that the waste sector can achieve substantial carbon emission reductions, and become a carbon sink, in a cost effective way. Hence there is an economic case for a low carbon development path for Palembang, and possibly for other cities in developing and developed countries facing similar challenges. Copyright © 2015 Elsevier Ltd. All rights reserved.

Conservation in the face of climate change: The roles of alternative models, monitoring, and adaptation in confronting and reducing uncertainty

USGS Publications Warehouse

Conroy, M.J.; Runge, M.C.; Nichols, J.D.; Stodola, K.W.; Cooper, R.J.

2011-01-01

The broad physical and biological principles behind climate change and its potential large scale ecological impacts on biota are fairly well understood, although likely responses of biotic communities at fine spatio-temporal scales are not, limiting the ability of conservation programs to respond effectively to climate change outside the range of human experience. Much of the climate debate has focused on attempts to resolve key uncertainties in a hypothesis-testing framework. However, conservation decisions cannot await resolution of these scientific issues and instead must proceed in the face of uncertainty. We suggest that conservation should precede in an adaptive management framework, in which decisions are guided by predictions under multiple, plausible hypotheses about climate impacts. Under this plan, monitoring is used to evaluate the response of the system to climate drivers, and management actions (perhaps experimental) are used to confront testable predictions with data, in turn providing feedback for future decision making. We illustrate these principles with the problem of mitigating the effects of climate change on terrestrial bird communities in the southern Appalachian Mountains, USA. ?? 2010 Elsevier Ltd.

Inexact Socio-Dynamic Modeling of Groundwater Contamination Management

NASA Astrophysics Data System (ADS)

Vesselinov, V. V.; Zhang, X.

2015-12-01

Groundwater contamination may alter the behaviors of the public such as adaptation to such a contamination event. On the other hand, social behaviors may affect groundwater contamination and associated risk levels such as through changing ingestion amount of groundwater due to the contamination. Decisions should consider not only the contamination itself, but also social attitudes on such contamination events. Such decisions are inherently associated with uncertainty, such as subjective judgement from decision makers and their implicit knowledge on selection of whether to supply water or reduce the amount of supplied water under the scenario of the contamination. A socio-dynamic model based on the theories of information-gap and fuzzy sets is being developed to address the social behaviors facing the groundwater contamination and applied to a synthetic problem designed based on typical groundwater remediation sites where the effects of social behaviors on decisions are investigated and analyzed. Different uncertainties including deep uncertainty and vague/ambiguous uncertainty are effectively and integrally addressed. The results can provide scientifically-defensible decision supports for groundwater management in face of the contamination.

Panel workload assessment in US primary care: accounting for non-face-to-face panel management activities.

PubMed

Arndt, Brian; Tuan, Wen-Jan; White, Jennifer; Schumacher, Jessica

2014-01-01

An understanding of primary care provider (PCP) workload is an important consideration in establishing optimal PCP panel size. However, no widely acceptable measure of PCP workload exists that incorporates the effort involved with both non-face-to-face patient care activities and face-to-face encounters. Accounting for this gap is critical given the increase in non-face-to-face PCP activities that has accompanied electronic health records (EHRs) (eg, electronic messaging). Our goal was to provide a comprehensive assessment of perceived PCP workload, accounting for aspects of both face-to-face and non-face-to-face encounters. Internal medicine, family medicine, and pediatric PCPs completed a self-administered survey about the perceived workload involved with face-to-face and non-face-to-face panel management activities as well as the perceived challenge associated with caring for patients with particular biomedical, demographic, and psychosocial characteristics (n = 185). Survey results were combined with EHR data at the individual patient and PCP service levels to assess PCP panel workload, accounting for face-to-face and non-face-to-face utilization. Of the multiple face-to-face and non-face-to-face activities associated with routine primary care, PCPs considered hospital admissions, obstetric care, hospital discharges, and new patient preventive health visits to be greater workload than non-face-to-face activities such as telephone calls, electronic communication, generating letters, and medication refills. Total workload within PCP panels at the individual patient level varied by overall health status, and the total workload of non-face-to-face panel management activities associated with routine primary care was greater than the total workload associated with face-to-face encounters regardless of health status. We used PCP survey results coupled with EHR data to assess PCP workload associated with both face-to-face as well as non-face-to-face panel management activities in primary care. The non-face-to-face workload was an important contributor to overall PCP workload for all patients regardless of overall health status. This is an important consideration for PCP workload assessment given the changing nature of primary care that requires more non-face-to-face effort, resulting in an overall increase in PCP workload. © Copyright 2014 by the American Board of Family Medicine.

Overcoming limited information through participatory watershed management: Case study in Amhara, Ethiopia

NASA Astrophysics Data System (ADS)

Liu, Benjamin M.; Abebe, Yitayew; McHugh, Oloro V.; Collick, Amy S.; Gebrekidan, Brhane; Steenhuis, Tammo S.

This study highlights two highly degraded watersheds in the semi-arid Amhara region of Ethiopia where integrated water resource management activities were carried out to decrease dependence on food aid through improved management of ‘green’ water. While top-down approaches require precise and centrally available knowledge to deal with the uncertainty in engineering design of watershed management projects, bottom-up approaches can succeed without such information by making extensive use of stakeholder knowledge. This approach works best in conjunction with the development of leadership confidence within local communities. These communities typically face a number of problems, most notably poverty, that prevent them from fully investing in the protection of their natural resources, so an integrated management system is needed to suitably address the interrelated problems. Many different implementing agencies were brought together in the two study watersheds to address water scarcity, crop production, and soil erosion, but the cornerstone was enabling local potential through the creation and strengthening of community watershed management organizations. Leadership training and the reinforcement of stakeholder feedback as a fundamental activity led to increased ownership and willingness to take on new responsibilities. A series of small short term successes ranging from micro-enterprise cooperatives to gully rehabilitation have resulted in the pilot communities becoming confident of their own capabilities and proud to share their successes and knowledge with other communities struggling with natural resource degradation.

Examining Information Problem-Solving, Knowledge, and Application Gains within Two Instructional Methods: Problem-Based and Computer-Mediated Participatory Simulation

ERIC Educational Resources Information Center

Newell, Terrance S.

2008-01-01

This study compared the effectiveness of two instructional methods--problem-based instruction within a face-to-face context and computer-mediated participatory simulation--in increasing students' content knowledge and application gains in the area of information problem-solving. The instructional methods were implemented over a four-week period. A…

"PHE in Action": Development and Modeling of an Intervention to Improve Patient Engagement among Older Adults.

PubMed

Menichetti, Julia; Graffigna, Guendalina

2016-01-01

The increasing prevalence of chronic conditions among older adults constitutes a major public health problem. Thus, changes in lifestyles are required to prevent secondary conditions and sustain good care practices. While patient engagement received great attention in the last years as key strategy to solve this issue, to date no interventions exist to sustain the engagement of older chronic patients toward their health management. This study describes the design, development, and optimization of PHEinAction , a theoretically-driven intervention program to increase patient engagement in older chronic populations and consequently to foster healthy changes that can help reduce risks of health problems. The development process followed the UK Medical Research Council's (MRC) guidelines and involved selecting the theoretical base for the intervention, identifying the relevant evidence-based literature, and conducting exploratory research to qualitatively evaluate program's feasibility, acceptability, and comprehension. The result was a user-endorsed intervention designed to improve older patients' engagement in health management based on the theoretical framework of the Patient Health Engagement (PHE) model. The intervention program, which emerged from this process, consisted of 2 monthly face-to-face 1-h sessions delivered by a trained facilitator and one brief telephonic consultation, and aimed to facilitate a range of changes for patient engagement (e.g., motivation to change, health information seeking and use, emotional adjustment, health behaviors planning). PHEinAction is the first example of a theoretically-based patient engagement intervention designed for older chronic targets. The intervention program is based on psychological theory and evidence; it facilitates emotional, psychological, and behavioral processes to support patient engagement and lifestyle change and maintenance. It provides estimates of the extent to which it could help high-risk groups engage in effective health management and informs future trials.

“PHE in Action”: Development and Modeling of an Intervention to Improve Patient Engagement among Older Adults

PubMed Central

Menichetti, Julia; Graffigna, Guendalina

2016-01-01

The increasing prevalence of chronic conditions among older adults constitutes a major public health problem. Thus, changes in lifestyles are required to prevent secondary conditions and sustain good care practices. While patient engagement received great attention in the last years as key strategy to solve this issue, to date no interventions exist to sustain the engagement of older chronic patients toward their health management. This study describes the design, development, and optimization of PHEinAction, a theoretically-driven intervention program to increase patient engagement in older chronic populations and consequently to foster healthy changes that can help reduce risks of health problems. The development process followed the UK Medical Research Council's (MRC) guidelines and involved selecting the theoretical base for the intervention, identifying the relevant evidence-based literature, and conducting exploratory research to qualitatively evaluate program's feasibility, acceptability, and comprehension. The result was a user-endorsed intervention designed to improve older patients' engagement in health management based on the theoretical framework of the Patient Health Engagement (PHE) model. The intervention program, which emerged from this process, consisted of 2 monthly face-to-face 1-h sessions delivered by a trained facilitator and one brief telephonic consultation, and aimed to facilitate a range of changes for patient engagement (e.g., motivation to change, health information seeking and use, emotional adjustment, health behaviors planning). PHEinAction is the first example of a theoretically-based patient engagement intervention designed for older chronic targets. The intervention program is based on psychological theory and evidence; it facilitates emotional, psychological, and behavioral processes to support patient engagement and lifestyle change and maintenance. It provides estimates of the extent to which it could help high-risk groups engage in effective health management and informs future trials. PMID:27695435

The role of Confucianism in South Korea's emergency management system.

PubMed

Ha, Kyoo-Man

2018-03-26

Numerous Western researchers have examined the influence of Confucianism on development in Asia, but almost no South Korean researchers have studied the topic in regard to emergency management in their own country. This study begins by considering Confucianism as a social culture. Next, it goes on to evaluate its role in South Korea's emergency management system, contributing, ultimately, to efficiencies in emergency management. Drawing on a literature review and a case study, the paper assesses the double- and single-faced approaches, using four major Confucian components: destiny; family; ritual; and relation. The double-faced approach includes the positive and negative aspects of emergency management, whereas the single-faced approach incorporates only its positive aspects. This paper provides, for the first time, a systematic analysis of the relationship between Confucianism and emergency management in South Korea. Its key finding is that the double-faced approach needs to be transformed into a single-faced approach through active facilitation of behavioural change. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

Hierarchical Spatio-Temporal Probabilistic Graphical Model with Multiple Feature Fusion for Binary Facial Attribute Classification in Real-World Face Videos.

PubMed

Demirkus, Meltem; Precup, Doina; Clark, James J; Arbel, Tal

2016-06-01

Recent literature shows that facial attributes, i.e., contextual facial information, can be beneficial for improving the performance of real-world applications, such as face verification, face recognition, and image search. Examples of face attributes include gender, skin color, facial hair, etc. How to robustly obtain these facial attributes (traits) is still an open problem, especially in the presence of the challenges of real-world environments: non-uniform illumination conditions, arbitrary occlusions, motion blur and background clutter. What makes this problem even more difficult is the enormous variability presented by the same subject, due to arbitrary face scales, head poses, and facial expressions. In this paper, we focus on the problem of facial trait classification in real-world face videos. We have developed a fully automatic hierarchical and probabilistic framework that models the collective set of frame class distributions and feature spatial information over a video sequence. The experiments are conducted on a large real-world face video database that we have collected, labelled and made publicly available. The proposed method is flexible enough to be applied to any facial classification problem. Experiments on a large, real-world video database McGillFaces [1] of 18,000 video frames reveal that the proposed framework outperforms alternative approaches, by up to 16.96 and 10.13%, for the facial attributes of gender and facial hair, respectively.

Effectiveness of online and face-to-face fatigue self-management programmes for adults with neurological conditions.

PubMed

Ghahari, Setareh; Packer, Tanya

2012-01-01

To evaluate effectiveness of a face-to-face and an online fatigue self-management programme and to compare these to two control groups (information-only and no-intervention) in a sample of adults (n = 115) with neurological conditions reporting extreme fatigue. Non-equivalent pre-test post-test control group design using the Fatigue Impact Scale, Personal Wellbeing Index and Activity Card Sort as primary outcome measures. Participants in the two intervention groups and the information-only group showed clinically significant improvements in fatigue over time (p < 0.05). When compared to the no-intervention group, face-to-face participants showed significantly greater improvement in overall and cognitive fatigue, while participants in the online group showed significant improvement in self-efficacy and stress. Participation in either the online or face-to-face programme appears to result in improved self-management, however, with different potency depending on outcomes. The improvement in the online information only group further complicates the understanding of the results. With few other comparisons of online and face-to-face self-management protocols available, further research is needed to understand differential impacts which may be related to the delivery format, the rural versus urban split of participants or other unknown factors.

How are clinical commissioning groups managing conflicts of interest under primary care co-commissioning in England? A qualitative analysis

PubMed Central

Moran, Valerie; Allen, Pauline; Checkland, Kath; Warwick-Giles, Lynsey; Gore, Oz; Bramwell, Donna; Coleman, Anna

2017-01-01

Objectives From April 2015, NHS England (NHSE) started to devolve responsibility for commissioning primary care services to clinical commissioning groups (CCGs). The aim of this paper is to explore how CCGs are managing potential conflicts of interest associated with groups of GPs commissioning themselves or their practices to provide services. Design We carried out two telephone surveys using a sample of CCGs. We also used a qualitative case study approach and collected data using interviews and meeting observations in four sites (CCGs). Setting/participants We conducted 57 telephone interviews and 42 face-to-face interviews with general practitioners (GPs) and CCG staff involved in primary care co-commissioning and observed 74 meetings of CCG committees responsible for primary care co-commissioning. Results Conflicts of interest were seen as an inevitable consequence of CCGs commissioning primary care. Particular problems arose with obtaining unbiased clinical input for new incentive schemes and providing support to GP provider federations. Participants in meetings concerning primary care co-commissioning declared conflicts of interest at the outset of meetings. Different approaches were pursued regarding GPs involvement in subsequent discussions and decisions with inconsistency in the exclusion of GPs from meetings. CCG senior management felt confident that the new governance structures and policies dealt adequately with conflicts of interest, but we found these arrangements face limitations. While the revised NHSE statutory guidance on managing conflicts of interest (2016) was seen as an improvement on the original (2014), there still remained some confusion over various terms and concepts contained therein. Conclusions Devolving responsibility for primary care co-commissioning to CCGs created a structural conflict of interest. The NHSE statutory guidance should be refined and clarified so that CCGs can properly manage conflicts of interest. Non-clinician members of committees involved in commissioning primary care require training in order to make decisions requiring clinical input in the absence of GPs. PMID:29122801

Patients' experiences of breathing retraining for asthma: a qualitative process analysis of participants in the intervention arms of the BREATHE trial.

PubMed

Arden-Close, Emily; Yardley, Lucy; Kirby, Sarah; Thomas, Mike; Bruton, Anne

2017-10-05

Poor symptom control and impaired quality of life are common in adults with asthma, and breathing retraining exercises may be an effective method of self-management. This study aimed to explore the experiences of participants in the intervention arms of the BREATHE trial, which investigated the effectiveness of breathing retraining as a mode of asthma management. Sixteen people with asthma (11 women, 8 per group) who had taken part in the intervention arms of the BREATHE trial (breathing retraining delivered by digital versatile disc (DVD) or face-to-face sessions with a respiratory physiotherapist) took part in semi-structured telephone interviews about their experiences. Interviews were analysed using thematic analysis. Breathing retraining was perceived positively as a method of asthma management. Motivations for taking part included being asked, to enhance progress in research, to feel better/reduce symptoms, and to reduce medication. Participants were positive about the physiotherapist, liked having the materials tailored, found meetings motivational, and liked the DVD and booklet. The impact of breathing retraining following regular practice included increased awareness of breathing and development of new habits. Benefits of breathing retraining included increased control over breathing, reduced need for medication, feeling more relaxed, and improved health and quality of life. Problems included finding time to practice the exercises, and difficulty mastering techniques. Breathing retraining was acceptable and valued by almost all participants, and many reported improved wellbeing. Face to face physiotherapy was well received. However, some participants in the DVD group mentioned being unable to master techniques. PATIENTS RECEPTIVE TO BREATHING RETRAINING: Patients with asthma taught how to change their unconscious breathing patterns generally like non-pharmacological interventions. Researchers in the UK, led by Mike Thomas from the University of Southampton, interviewed 16 people about their experiences in a trial that tested breathing retraining exercises delivered by DVD or face-to-face sessions with a respiratory physiotherapist. Overwhelmingly, trial participants reported that breathing retraining sessions gave them greater control over their symptoms, helped them relax, improved their quality of life and reduced the need for medications. Some participants who received DVD instruction said they had trouble mastering the techniques, and many in both groups found it hard to find time to practice the exercises. Overall, however, patients were positive about the experience. The authors conclude that breathing exercises are likely to be a well-received method of asthma management.

Universal Skills and Competencies for Geoscientists

NASA Astrophysics Data System (ADS)

Mosher, S.

2015-12-01

Geoscience students worldwide face a changing future workforce, but all geoscience work has universal cross-cutting skills and competencies that are critical for success. A recent Geoscience Employers Workshop, and employers' input on the "Future of Undergraduate Geoscience Education" survey, identified three major areas. Geoscience work requires spatial and temporal (3D & 4D) thinking, understanding that the Earth is a system of interacting parts and processes, and geoscience reasoning and synthesis. Thus, students need to be able to solve problems in the context of an open and dynamic system, recognizing that most geoscience problems have no clear, unambiguous answers. Students must learn to manage uncertainty, work by analogy and inference, and make predations with limited data. Being able to visualize and solve problems in 3D, incorporate the element of time, and understand scale is critical. Additionally students must learn how to tackle problems using real data, including understand the problems' context, identify appropriate questions to ask, and determine how to proceed. Geoscience work requires integration of quantitative, technical, and computational skills and the ability to be intellectually flexible in applying skills to new situations. Students need experience using high-level math and computational methods to solve geoscience problems, including probability and statistics to understand risk. Increasingly important is the ability to use "Big Data", GIS, visualization and modeling tools. Employers also agree a strong field component in geoscience education is important. Success as a geoscientist also requires non-technical skills. Because most work environments involve working on projects with a diverse team, students need experience with project management in team settings, including goal setting, conflict resolution, time management and being both leader and follower. Written and verbal scientific communication, as well as public speaking and listening skills, are important. Success also depends on interpersonal skills and professionalism, including business acumen, risk management, ethical conduct, and leadership. A global perspective is increasingly important, including cultural literacy and understanding societal relevance.

The impact of using computer decision-support software in primary care nurse-led telephone triage: interactional dilemmas and conversational consequences.

PubMed

Murdoch, Jamie; Barnes, Rebecca; Pooler, Jillian; Lattimer, Valerie; Fletcher, Emily; Campbell, John L

2015-02-01

Telephone triage represents one strategy to manage demand for face-to-face GP appointments in primary care. Although computer decision-support software (CDSS) is increasingly used by nurses to triage patients, little is understood about how interaction is organized in this setting. Specifically any interactional dilemmas this computer-mediated setting invokes; and how these may be consequential for communication with patients. Using conversation analytic methods we undertook a multi-modal analysis of 22 audio-recorded telephone triage nurse-caller interactions from one GP practice in England, including 10 video-recordings of nurses' use of CDSS during triage. We draw on Goffman's theoretical notion of participation frameworks to make sense of these interactions, presenting 'telling cases' of interactional dilemmas nurses faced in meeting patient's needs and accurately documenting the patient's condition within the CDSS. Our findings highlight troubles in the 'interactional workability' of telephone triage exposing difficulties faced in aligning the proximal and wider distal context that structures CDSS-mediated interactions. Patients present with diverse symptoms, understanding of triage consultations, and communication skills which nurses need to negotiate turn-by-turn with CDSS requirements. Nurses therefore need to have sophisticated communication, technological and clinical skills to ensure patients' presenting problems are accurately captured within the CDSS to determine safe triage outcomes. Dilemmas around how nurses manage and record information, and the issues of professional accountability that may ensue, raise questions about the impact of CDSS and its use in supporting nurses to deliver safe and effective patient care. Copyright © 2014 Elsevier Ltd. All rights reserved.

How Mode of Delivery Affects Comprehension of an Operations Management Simulation: Online vs Face-to-Face Classrooms

ERIC Educational Resources Information Center

Riley, Jason M.; Ellegood, William A.; Solomon, Stanislaus; Baker, Jerrine

2017-01-01

Purpose: This study aims to understand how mode of delivery, online versus face-to-face, affects comprehension when teaching operations management concepts via a simulation. Conceptually, the aim is to identify factors that influence the students' ability to learn and retain new concepts. Design/methodology/approach: Leveraging Littlefield…

Impression Management in Kindergarten Classrooms: An Analysis of Children's Face-Work in Peer Interactions.

ERIC Educational Resources Information Center

Hatch, J. Amos

A systematic analysis was made of the communications of 5- and 6-year-old children in two kindergarten classrooms to discover whether children's face-to-face interactions with peers included "face work" components (rituals through which individuals manage impressions when it becomes difficult to maintain a social situation) and, if so,…

Learning management system and e-learning tools: an experience of medical students' usage and expectations.

PubMed

Back, David A; Behringer, Florian; Haberstroh, Nicole; Ehlers, Jan P; Sostmann, Kai; Peters, Harm

2016-08-20

To investigate medical students´ utilization of and problems with a learning management system and its e-learning tools as well as their expectations on future developments. A single-center online survey has been carried out to investigate medical students´ (n = 505) usage and perception concerning the learning management system Blackboard, and provided e-learning tools. Data were collected with a standardized questionnaire consisting of 70 items and analyzed by quantitative and qualitative methods. The participants valued lecture notes (73.7%) and Wikipedia (74%) as their most important online sources for knowledge acquisition. Missing integration of e-learning into teaching was seen as the major pitfall (58.7%). The learning management system was mostly used for study information (68.3%), preparation of exams (63.3%) and lessons (54.5%). Clarity (98.3%), teaching-related contexts (92.5%) and easy use of e-learning offers (92.5%) were rated highest. Interactivity was most important in free-text comments (n = 123). It is desired that contents of a learning management system support an efficient learning. Interactivity of tools and their conceptual integration into face-to-face teaching are important for students. The learning management system was especially important for organizational purposes and the provision of learning materials. Teachers should be aware that free online sources such as Wikipedia enjoy a high approval as source of knowledge acquisition. This study provides an empirical basis for medical schools and teachers to improve their offerings in the field of digital learning for their students.

Learning management system and e-learning tools: an experience of medical students' usage and expectations

PubMed Central

Back, David A.; Behringer, Florian; Haberstroh, Nicole; Ehlers, Jan P.; Sostmann, Kai

2016-01-01

Objectives To investigate medical students´ utilization of and problems with a learning management system and its e-learning tools as well as their expectations on future developments. Methods A single-center online survey has been carried out to investigate medical students´ (n = 505) usage and perception concerning the learning management system Blackboard, and provided e-learning tools. Data were collected with a standardized questionnaire consisting of 70 items and analyzed by quantitative and qualitative methods. Results The participants valued lecture notes (73.7%) and Wikipedia (74%) as their most important online sources for knowledge acquisition. Missing integration of e-learning into teaching was seen as the major pitfall (58.7%). The learning management system was mostly used for study information (68.3%), preparation of exams (63.3%) and lessons (54.5%). Clarity (98.3%), teaching-related contexts (92.5%) and easy use of e-learning offers (92.5%) were rated highest. Interactivity was most important in free-text comments (n = 123). Conclusions It is desired that contents of a learning management system support an efficient learning. Interactivity of tools and their conceptual integration into face-to-face teaching are important for students. The learning management system was especially important for organizational purposes and the provision of learning materials. Teachers should be aware that free online sources such as Wikipedia enjoy a high approval as source of knowledge acquisition. This study provides an empirical basis for medical schools and teachers to improve their offerings in the field of digital learning for their students. PMID:27544782

Facilitating the improved management of waste in South Africa through a national waste information system

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

Godfrey, Linda

2008-07-01

Developing a waste information system (WIS) for a country is more than just about collecting routine data on waste; it is about facilitating the improved management of waste by providing timely, reliable information to the relevant role-players. It is a means of supporting the waste governance challenges facing South Africa - challenges ranging from strategic waste management issues at national government to basic operational challenges at local government. The paper addresses two hypotheses. The first is that the identified needs of government can provide a platform from which to design a national WIS framework for a developing country such asmore » South Africa, and the second is that the needs for waste information reflect greater, currently unfulfilled challenges in the sustainable management of waste. Through a participatory needs analysis process, it is shown that waste information is needed by the three spheres of government, to support amongst others, informed planning and decision-making, compliance monitoring and enforcement, community participation through public access to information, human, infrastructure and financial resource management and policy development. These needs for waste information correspond closely with key waste management challenges currently facing the country. A shift in governments approach to waste, in line with national and international policy, is evident from identified current and future waste information needs. However, the need for information on landfilling remains entrenched within government, possibly due to the poor compliance of landfill sites in South Africa and the problems around the illegal disposal of both general and hazardous waste.« less

Prominent Constraints Faced by Government Managers.

DTIC Science & Technology

1983-06-01

A A t-32 412 PROMINENT CONSTRAINTS FACED BY GOVERNMENT MANAGERS (U) JUN 83NAVAL POSTGRADUATE SCHOOL MONTEREY CA R I NIEDERMULLER7N.LASSI FIED F/G ,5...STANDARS-963A- ’ I It I Uf NAVAL POSTGRADUATE SCHOOL Monterey, California co IA THESIS PROMINENT CONSTRAINTS FACED BY GOVERNMENT MANAGERS by Robert T...Government Managers June 1983 S. PERFORMING ORO. REPORT NUMsER 7. AUTNOR(s) .COtAC R03 GRANT NUNSER(W.) Robert T. Niedermuller I. PERPORMIXG OROANIZATIIOM

Managing and Evaluating Digital Repositories

ERIC Educational Resources Information Center

Zuccala, Alesia; Oppenheim, Charles; Dhiensa, Rajveen

2008-01-01

Introduction: We examine the role of the digital repository manager, discuss the future of repository management and evaluation and suggest that library and information science schools develop new repository management curricula. Method: Face-to-face interviews were carried out with managers of five different types of repositories and a Web-based…

A qualitative evaluation of occupational therapy-led work rehabilitation for people with inflammatory arthritis: Perspectives of therapists and their line managers

PubMed Central

Amanna, Evangeline A; Bodell, Sarah J; Hammond, Alison

2015-01-01

Introduction Occupational therapy-led work rehabilitation for employed people with inflammatory arthritis and work problems was piloted in five hospitals in the United Kingdom. This qualitative study explored the views of participating occupational therapists and their line managers about the work rehabilitation training received and conducting the intervention, with particular focus on the structured interview used, the Work Experience Survey – Rheumatic Conditions. Method Face-to-face semi-structured interviews were conducted with occupational therapists (n = 9), followed by telephone interviews with their line managers (n = 2). Interviews were audio-recorded, transcribed verbatim and thematically analysed by three researchers to maximize validity. Results The main themes emerging from the occupational therapists’ interviews were: varying levels of prior knowledge and experience of work rehabilitation, initial concerns about the feasibility of a lengthy work assessment in practice and increased confidence in delivering work rehabilitation as the study progressed. The line managers’ interviews generated themes around the positive impact of the work rehabilitation training the occupational therapists received, and changes in their practice. Conclusion The Work Experience Survey – Rheumatic Conditions was considered a good choice of work assessment which can be implemented in practice. Once therapists had provided the work intervention several times, their confidence and skills increased. PMID:26321786

A problem-solving routine for improving hospital operations.

PubMed

Ghosh, Manimay; Sobek Ii, Durward K

2015-01-01

The purpose of this paper is to examine empirically why a systematic problem-solving routine can play an important role in the process improvement efforts of hospitals. Data on 18 process improvement cases were collected through semi-structured interviews, reports and other documents, and artifacts associated with the cases. The data were analyzed using a grounded theory approach. Adherence to all the steps of the problem-solving routine correlated to greater degrees of improvement across the sample. Analysis resulted in two models. The first partially explains why hospital workers tended to enact short-term solutions when faced with process-related problems; and tended not seek longer-term solutions that prevent problems from recurring. The second model highlights a set of self-reinforcing behaviors that are more likely to address problem recurrence and result in sustained process improvement. The study was conducted in one hospital setting. Hospital managers can improve patient care and increase operational efficiency by adopting and diffusing problem-solving routines that embody three key characteristics. This paper offers new insights on why caregivers adopt short-term approaches to problem solving. Three characteristics of an effective problem-solving routine in a healthcare setting are proposed.

Systems identification and the adaptive management of waterfowl in the United States

USGS Publications Warehouse

Williams, B.K.; Nichols, J.D.

2001-01-01

Waterfowl management in the United States is one of the more visible conservation success stories in the United States. It is authorized and supported by appropriate legislative authorities, based on large-scale monitoring programs, and widely accepted by the public. The process is one of only a limited number of large-scale examples of effective collaboration between research and management, integrating scientific information with management in a coherent framework for regulatory decision-making. However, harvest management continues to face some serious technical problems, many of which focus on sequential identification of the resource system in a context of optimal decision-making. The objective of this paper is to provide a theoretical foundation of adaptive harvest management, the approach currently in use in the United States for regulatory decision-making. We lay out the legal and institutional framework for adaptive harvest management and provide a formal description of regulatory decision-making in terms of adaptive optimization. We discuss some technical and institutional challenges in applying adaptive harvest management and focus specifically on methods of estimating resource states for linear resource systems.

A review of Integrated Vehicle Health Management tools for legacy platforms: Challenges and opportunities

NASA Astrophysics Data System (ADS)

Esperon-Miguez, Manuel; John, Philip; Jennions, Ian K.

2013-01-01

Integrated Vehicle Health Management (IVHM) comprises a set of tools, technologies and techniques for automated detection, diagnosis and prognosis of faults in order to support platforms more efficiently. Specific challenges are faced when IVHM tools are to be retrofitted into legacy vehicles since major modifications are much more challenging than with platforms whose design can still be modified. The topics covered in this Review Paper include the state of the art of IVHM tools and how their characteristics match the requirements of legacy aircraft, a summary of problems faced in the past trying to retrofit IVHM tools both from a technical and organisational perspective and the current level of implementation of IVHM in industry. Although the technology has not reached the level necessary to implement IVHM to its full potential on every kind of component, significant progress has been achieved on rotating equipment, structures or electronics. Attempts to retrofit some of these tools in the past faced both technical difficulties and opposition by some stakeholders, the later being responsible for the failure of technically sound projects in more than one occasion. Nevertheless, despite these difficulties, products and services based on IVHM technology have started to be offered by the manufacturers and, what is more important, demanded by the operators, providing guidance on what the industry would demand from IVHM on legacy aircraft.

Municipal solid waste management in the Southern Province of Sri Lanka: Problems, issues and challenges

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

Vidanaarachchi, Chandana K.; Yuen, Samuel T.S.; Pilapitiya, Sumith

2006-07-01

This paper describes the problems, issues and challenges faced by Sri Lanka based on the outcome of a recent study conducted in the country's Southern Province. The study consists of a public survey, discussions with local authority staff involved in waste management, discussions with Provincial Council and Government officials, dialogue with local politicians, review of documents and field observations. The study revealed that only 24% of the households have access to waste collection and that in rural areas it was less than 2%. A substantial number of households in areas without waste collection expect local authorities to collect their waste.more » The study also showed that most sites in the province are under capacity to handle any increased demand. Urgent and immediate improvement of the waste disposal sites is necessary to meet the current demand for improved waste collection. The study also revealed that there is a high willingness of people for home composting.« less

Evaluation of Pharmacists' Work in a Physician-Pharmacist Collaborative Model for the Management of Hypertension.

PubMed

Isetts, Brian J; Buffington, Daniel E; Carter, Barry L; Smith, Marie; Polgreen, Linnea A; James, Paul A

2016-04-01

Physician-pharmacist collaborative models have been shown to improve the care of patients with numerous chronic medical conditions. Team-based health care using integrated clinical pharmacists provides one opportunity to improve quality in health care systems that use population-based financing. In November 2015, the Centers for Medicare and Medicaid Services (CMS) requested that the relative value of pharmacists' work in team-based care needs to be established. Thus the objective of this study was to describe the components of pharmacists' work in the management of hypertension with a physician-pharmacist collaborative model. Descriptive analysis of the components of pharmacists' work in the Collaboration Among Pharmacists and Physicians to Improve Outcomes Now (CAPTION) study, a prospective, cluster randomized trial. This analysis was intended to provide policymakers with data and information, using the CAPTION study model, on the time and intensity of pharmacists' work to understand pharmacists' relative value contributions in the context of CMS financing and population management aims. The CAPTION trial was conducted in 32 community-based medical offices in 15 U.S. states and included 390 patients with multiple cardiovascular risk factors. Blood pressure was measured by trained study coordinators in each office, and patients were included in the study if they had uncontrolled blood pressure. Included patients were randomized to a 9-month intervention, a 24-month intervention, or usual care. The goal of the pharmacist intervention was to improve blood pressure control and resolve drug therapy problems impeding progress toward blood pressure goals. This intervention included medical record review, a structured assessment with the patient, collaboration to achieve goals of therapy, and patient follow-up. The two intervention arms (9 and 24 mo) were identical the first 9 months, and that time frame is the focus of this workload evaluation. Pharmacists completed study encounter forms for every patient encounter and estimated time spent in pre-visit, face-to-face care, and post-visit activities. Among the 390 patients, there were 2811 encounters with pharmacists that involved 3.44 hours/patient for face-to-face care visits plus 1.55 hours/patient for pre-visit and post-visit work. Intensity of work was reflected in interventions to resolve drug therapy problems with patients (43% of encounters) and with physicians (1169 recommendations, of which physicians accepted 1153 [98.6%]), resulting in improvement of patients' blood pressure goals achieved (from 0% at baseline to 43% at 9 months based on the primary study end point). Pharmacists provided extensive interventions to patients with hypertension. This analysis provides a framework for health systems, provider groups, and payers to measure pharmacists' work in value-based financing and population management. © 2016 Pharmacotherapy Publications, Inc.

Evaluation of Pharmacists’ Work in a Physician-Pharmacist Collaborative Model for the Management of Hypertension

PubMed Central

Isetts, Brian J.; Buffington, Daniel E.; Carter, Barry L.; Smith, Marie; Polgreen, Linnea A.; James, Paul A.

2016-01-01

Study Objective Physician-pharmacist collaborative models have been shown to improve the care of patients with numerous chronic medical conditions. Team-based health care using integrated clinical pharmacists provides one opportunity to improve quality in health care systems that use population-based financing. In November 2015, the Centers for Medicare and Medicaid Services (CMS) requested that the relative value of pharmacists’ work in team-based care needs to be established. Thus, the objective of this study was to describe the components of pharmacists’ work in the management of hypertension with a physician-pharmacist collaborative model. Design Descriptive analysis of the components of pharmacists’ work in the Collaboration Among Pharmacists and Physicians To Improve Outcomes Now (CAPTION) study, a prospective, cluster randomized trial. Measurements and Main Results This analysis was intended to provide policymakers with data and information, using the CAPTION study model, on the time and intensity of pharmacists’ work to understand pharmacists’ relative value contributions in the context of CMS financing and population management aims. The CAPTION trial was conducted in 32 community-based medical offices in 15 U.S. states and included 390 patients with multiple cardiovascular risk factors. Blood pressure was measured by trained study coordinators in each office, and patients were included in the study if they had uncontrolled blood pressure. Included patients were randomized to a 9-month intervention, a 24-month intervention, or usual care. The goal of the pharmacist intervention was to improve blood pressure control and resolve drug therapy problems impeding progress toward blood pressure goals. This intervention included medical record review, a structured assessment with the patient, collaboration to achieve goals of therapy, and patient follow-up. The two intervention arms (9 months and 24 months) were identical the first 9 months, and that time frame is the focus of this workload evaluation. Pharmacists completed study encounter forms for every patient encounter and estimated time spent in pre-visit, face-to-face care, and post-visit activities. Among the 390 patients, there were 2,811 encounters with pharmacists that involved 3.44 hours/patient for face-to-face care visits plus 1.55 hours/patient for pre-visit and post-visit work. Intensity of work was reflected in interventions to resolve drug therapy problems with patients (43% of encounters) and with physicians (1,169 recommendations, of which physicians accepted 1,153 [98.6%]), resulting in improvement of patients’ blood pressure goals achieved (from 0% at baseline to 43% at 9 months based on the primary study endpoint). Conclusion Pharmacists provided extensive interventions to patients with hypertension. This analysis provides a framework for health systems, provider groups, and payers to measure pharmacists’ work in value-based financing and population management. PMID:26893135

Study protocol: the sleeping sound with attention-deficit/hyperactivity disorder project.

PubMed

Sciberras, Emma; Efron, Daryl; Gerner, Bibi; Davey, Margot; Mensah, Fiona; Oberklaid, Frank; Hiscock, Harriet

2010-12-30

Up to 70% of children with Attention-Deficit/Hyperactivity Disorder (ADHD) experience sleep problems including difficulties initiating and maintaining sleep. Sleep problems in children with ADHD can result in poorer child functioning, impacting on school attendance, daily functioning and behaviour, as well as parental mental health and work attendance. The Sleeping Sound with ADHD trial aims to investigate the efficacy of a behavioural sleep program in treating sleep problems experienced by children with ADHD. We have demonstrated the feasibility and the acceptability of this treatment program in a pilot study. This randomised controlled trial (RCT) is being conducted with 198 children (aged between 5 to 12 years) with ADHD and moderate to severe sleep problems. Children are recruited from public and private paediatric practices across the state of Victoria, Australia. Upon receiving informed written consent, families are randomised to receive either the behavioural sleep intervention or usual care. The intervention consists of two individual, face-to-face consultations and a follow-up phone call with a trained clinician (trainee consultant paediatrician or psychologist), focusing on the assessment and management of child sleep problems. The primary outcome is parent- and teacher-reported ADHD symptoms (ADHD Rating Scale IV). Secondary outcomes are child sleep (actigraphy and parent report), behaviour, daily functioning, school attendance and working memory, as well as parent mental health and work attendance. We are also assessing the impact of children's psychiatric comorbidity (measured using a structured diagnostic interview) on treatment outcome. To our knowledge, this is the first RCT of a behavioural intervention aiming to treat sleep problems in children with ADHD. If effective, this program will provide a feasible non-pharmacological and acceptable intervention improving child sleep and ADHD symptoms in this patient group. Current Controlled Trials ISRCTN68819261. ISRCTN: ISRCTN68819261.

The Management Of Intellectual Property In A Romanian State University Where Research Represents A Strength

NASA Astrophysics Data System (ADS)

Tîţu, Aurel Mihail; Oprean, Constantin; Răulea, Andreea Simina

2015-07-01

The transition to the knowledge-based economy and society requires adaptation to constant change that implies intellectual property as a multidimensional concept that continually leaves its mark on generations contributing to their well-being in obvious and undeniable ways. The main objective of this article was to assess the present level of the management of intellectual property in a state university in Romania displaying their strengths and weaknesses. The overall objective of the work is to analyze the state of the art in a Romanian state university in order to find solutions to the current problems that the Romanian scientific environment is facing. The conclusions drawn in the study converge in directions and proposals for improving the way in which the intellectual property is regarded and its management in the state universities of Romania.

Employee assistance programs.

PubMed

Austin, R L

1987-10-01

The substance abuser brings his problems to the workplace. Ninety-five percent or more of all individuals experiencing alcohol-or drug-related problems are either employed or the spouse or dependent of someone who is working. It is clear we are facing a problem which transcends the boundaries of the workplace. The result in the workplace, of course, is increased costs, lower productivity, more accidents on the job, but most importantly additional suffering for the individuals involved. It is important to remember that neither GM, the UAW, nor the IUE can be expected to accept responsibility for those individuals who have the ability to control their own "wellness" and productivity. Any joint union-management substance abuse program can only be a catalyst to help individuals confront their problems. Along with the other groups and institutions concerned with these problems, GM, in cooperation with the UAW, IUE, and the other unions that represent our employees, is trying to help individuals with addictive diseases confront and obtain treatment for their problems. We believe our programs are moving in the right direction and will continue to make progress.

Modeling of Lunar Dust Contamination Due to Plume Impingement

NASA Technical Reports Server (NTRS)

Woronowicz, Michael

2009-01-01

During the Apollo missions it became apparent that lunar dust was a significant hazard. Problems included: surface obscuration during landing sequence; abrasion damage to gouge faces and helmet visors; mechanism clogging; development of space suit pressurization leaks; loss of radiator heat rejection capabilities to the point where vulnerable equipment exceeded maximum survival temperature ratings; temporary vision and respiratory problems within the Apollo Lunar Module (LM). NASA Constellation Program features many system-level components, including the Altair Lunar Lander. Altair to endure longer periods at lunar surface conditions: Apollo LM, about three days; Altair, over seven months. Program managers interested in plume-generated dust transport onto thermal control surface radiators of the first Altair created by its own landing operations.

Estimating costs in the economic evaluation of medical technologies.

PubMed

Luce, B R; Elixhauser, A

1990-01-01

The complexities and nuances of evaluating the costs associated with providing medical technologies are often underestimated by analysts engaged in economic evaluations. This article describes the theoretical underpinnings of cost estimation, emphasizing the importance of accounting for opportunity costs and marginal costs. The various types of costs that should be considered in an analysis are described; a listing of specific cost elements may provide a helpful guide to analysis. The process of identifying and estimating costs is detailed, and practical recommendations for handling the challenges of cost estimation are provided. The roles of sensitivity analysis and discounting are characterized, as are determinants of the types of costs to include in an analysis. Finally, common problems facing the analyst are enumerated with suggestions for managing these problems.

Goldenhar syndrome: Cardiac anesthesiologist's perspective.

PubMed

Choudhury, Minati; Kapoor, Poonam Malhotra

2017-01-01

Goldenhar syndrome or oculo-auriculo-vertebral dysplasia was defined by Goldenhar in 1952 and redefined by Grolin et al. later. As the name denotes, children with this syndrome present with craniofacial and vertebral anomalies which increase the risk of airway compromise. Neonates and infants with this syndrome often have premature internal organs, low birth weight, and airway disorders. For this reason, safe anesthesia in such infants requires a complete knowledge regarding metabolism and side effects of the drugs. The association of cardiovascular abnormalities is not uncommon and possesses additional challenge for anesthetic management. The aim of this review is to draw attention to the various perioperative problems that can be faced in these infants when they undergo surgery or the correction of the underlying cardiac problem.

Developing a strategic marketing plan for physical and occupational therapy services: a collaborative project between a critical access hospital and a graduate program in health care management.

PubMed

Kash, Bita A; Deshmukh, A A

2013-01-01

The purpose of this study was to develop a marketing plan for the Physical and Occupational Therapy (PT/OT) department at a Critical Access Hospital (CAH). We took the approach of understanding and analyzing the rural community and health care environment, problems faced by the PT/OT department, and developing a strategic marketing plan to resolve those problems. We used hospital admissions data, public and physician surveys, a SWOT analysis, and tools to evaluate alternative strategies. Lack of awareness and negative perception were key issues. Recommended strategies included building relationships with physicians, partnering with the school district, and enhancing the wellness program.

NRC says integrated approach needed to understand, protect environment

NASA Astrophysics Data System (ADS)

Kolb, Charles E.; Loehr, Raymond C.; Gopnik, Morgan

A recent study by the National Research Council (NRC) advocates a more comprehensive and integrated approach to our nation's environmental research and development (R&D) activities. Because we face environmental problems of unprecedented complexity, the study maintains that the traditional practice of studying isolated environmental problems and devising narrowly focused control or remediation strategies to manage them will no longer suffice.In the report, Building a Foundation for Sound Environmental Decisions [National Academy Press, 1997], an NRC committee highlighted the need for developing a deeper scientific understanding of ecosystems, as well as the sociological and economic aspects of human interactions with the environment. To achieve these goals, the committee recommended a core research agenda for the Environmental Protection Agency (EPA) that has three components.

Systems Engineering Awareness

NASA Technical Reports Server (NTRS)

Lucero, John

2016-01-01

The presentation will provide an overview of the fundamentals and principles of Systems Engineering (SE). This includes understanding the processes that are used to assist the engineer in a successful design, build and implementation of solutions. The context of this presentation will be to describe the involvement of SE throughout the life-cycle of a project from cradle to grave. Due to the ever growing number of complex technical problems facing our world, a Systems Engineering approach is desirable for many reasons. The interdisciplinary technical structure of current systems, technical processes representing System Design, Technical Management and Product Realization are instrumental in the development and integration of new technologies into mainstream applications. This tutorial will demonstrate the application of SE tools to these types of problems..

Cyberbullying victimization and mental health in adolescents and the moderating role of family dinners.

PubMed

Elgar, Frank J; Napoletano, Anthony; Saul, Grace; Dirks, Melanie A; Craig, Wendy; Poteat, V Paul; Holt, Melissa; Koenig, Brian W

2014-11-01

This study presents evidence that cyberbullying victimization relates to internalizing, externalizing, and substance use problems in adolescents and that the frequency of family dinners attenuate these associations. To examine the unique association between cyberbullying victimization and adolescent mental health (after controlling differences in involvement in traditional, face-to-face bullying) and to explore the potential moderating role of family contact in this association. This cross-sectional, observational study used survey data on 18,834 students (aged 12-18 years) from 49 schools in a Midwestern US state. Logistic regression analysis tested associations between cyberbullying victimization and the likelihood of mental health and substance use problems. Negative binomial regression analysis tested direct and synergistic contributions of cyberbullying victimization and family dinners on the rates of mental health and substance use problems. Frequency of cyberbullying victimization during the previous 12 months; victimization by traditional (face-to-face) bullying; and perpetration of traditional bullying. Five internalizing mental health problems (anxiety, depression, self-harm, suicide ideation, and suicide attempt), 2 externalizing problems (fighting and vandalism), and 4 substance use problems (frequent alcohol use, frequent binge drinking, prescription drug misuse, and over-the-counter drug misuse). About one-fifth (18.6%) of the sample experienced cyberbullying during the previous 12 months. The frequency of cyberbullying positively related to all 11 internalizing, externalizing, and substance use problems (odds ratios from 2.6 [95% CI, 1.7-3.8] to 4.5 [95% CI, 3.0-6.6]). However, victimization related more closely to rates of problems in adolescents that had fewer family dinners. Cyberbullying relates to mental health and substance use problems in adolescents, even after their involvement in face-to-face bullying is taken into account. Although correlational, these results suggest that family dinners (ie, family contact and communication) are beneficial to adolescent mental health and may help protect adolescents from the harmful consequences of cyberbullying.

Collaborative Accounting Problem Solving via Group Support Systems in a Face-to-Face versus Distant Learning Environment.

ERIC Educational Resources Information Center

Burke, Jacqueline A.

2001-01-01

Accounting students (n=128) used either face-to-face or distant Group support systems to complete collaborative tasks. Participation and social presence perceptions were significantly higher face to face. Task difficulty did not affect participation in either environment. (Contains 54 references.) (JOW)

AANA Journal course: update for nurse anesthetists--ERR WATCH: anesthesia crisis resource management from the nurse anesthetist's perspective.

PubMed

Fletcher, J L

1998-12-01

Anesthesia crisis resource management (ACRM) was developed by David Gaba, MD, and colleagues at Stanford University in the early 1990s. Derived from cockpit resource management of the aviation industry, ACRM addresses the issues of human performance and patient safety in anesthesia. Due to the inherent complexity of our dynamic work environment, we are frequently faced with situations that could escalate into critical incidents. ACRM explains the role of personal and environmental factors that can contribute to the evolution of critical incidents and provides the practitioner with some behavioral and intellectual guidelines to manage the risks more effectively. ERR WATCH is an acronym I developed to interpret the principles of ACRM from the nurse anesthetist's perspective. It provides a quick review of the major principles of ACRM, which are Environment, Resources, Reevaluation, Workload, Attention, Teamwork, Communication, and Help. Used together with good clinical management, these principles may provide an edge in solving complex problems and improving performance.

Managing Network Partitions in Structured P2P Networks

NASA Astrophysics Data System (ADS)

Shafaat, Tallat M.; Ghodsi, Ali; Haridi, Seif

Structured overlay networks form a major class of peer-to-peer systems, which are touted for their abilities to scale, tolerate failures, and self-manage. Any long-lived Internet-scale distributed system is destined to face network partitions. Consequently, the problem of network partitions and mergers is highly related to fault-tolerance and self-management in large-scale systems. This makes it a crucial requirement for building any structured peer-to-peer systems to be resilient to network partitions. Although the problem of network partitions and mergers is highly related to fault-tolerance and self-management in large-scale systems, it has hardly been studied in the context of structured peer-to-peer systems. Structured overlays have mainly been studied under churn (frequent joins/failures), which as a side effect solves the problem of network partitions, as it is similar to massive node failures. Yet, the crucial aspect of network mergers has been ignored. In fact, it has been claimed that ring-based structured overlay networks, which constitute the majority of the structured overlays, are intrinsically ill-suited for merging rings. In this chapter, we motivate the problem of network partitions and mergers in structured overlays. We discuss how a structured overlay can automatically detect a network partition and merger. We present an algorithm for merging multiple similar ring-based overlays when the underlying network merges. We examine the solution in dynamic conditions, showing how our solution is resilient to churn during the merger, something widely believed to be difficult or impossible. We evaluate the algorithm for various scenarios and show that even when falsely detecting a merger, the algorithm quickly terminates and does not clutter the network with many messages. The algorithm is flexible as the tradeoff between message complexity and time complexity can be adjusted by a parameter.

Self-management of multiple chronic conditions among African American women with asthma: A qualitative study

PubMed Central

Janevic, Mary R.; Ellis, Katrina R.; Sanders, Georgiana M.; Nelson, Belinda W.; Clark, Noreen M.

2014-01-01

Objective African American women are disproportionately burdened by asthma morbidity and mortality, and may be more likely than asthma patients in general to have comorbid health conditions. This study sought to identify the self-management challenges faced by African American women with asthma and comorbidities, how they prioritize their conditions, and behaviors perceived as beneficial across conditions. Methods In-depth interviews were conducted with 25 African-American women (mean age 52 years) with persistent asthma and at least one of the following: diabetes, heart disease, or arthritis. Information was elicited on women’s experiences managing asthma and concurrent health conditions. The constant-comparison analytic method was used to develop and apply a coding scheme to interview transcripts. Key themes and subthemes were identified. Results Participants reported an average of 5.7 comorbidities. Fewer than half of the sample considered asthma their main health problem; these perceptions were influenced by beliefs about the relative controllability, predictability, and severity of their health conditions. Participants reported ways in which comorbidities affected asthma management, including that asthma sometimes took a ‘backseat’ to conditions considered more troublesome or worrisome. Mood problems, sometimes attributed to pain or functional limitations resulting from comorbidities, reduced motivation for self-management. Women described how asthma affected comorbidity management; e.g., by impeding recommended exercise. Some self-management recommendations, such as physical activity and weight control, were seen as beneficial across conditions. Conclusions Multiple chronic conditions that include asthma may interact to complicate self-management of each condition. Additional clinical attention and self-management support may help reduce multimorbidity-related challenges. PMID:24161047

Strategies to address management challenges in larger intensive care units.

PubMed

Matlakala, M C; Bezuidenhout, M C; Botha, A D H

2015-10-01

To illustrate the need for and suggest strategies that will enhance sustainable management of a large intensive care unit (ICU). The challenges faced by intensive care nursing in South Africa are well documented. However, there appear to be no strategies available to assist nurses to manage large ICUs or for ICU managers to deal with problems as they arise. Data sources to illustrate the need for strategies were challenges described by ICU managers in the management of large ICUs. A purposive sample of managers was included in individual interviews during compilation of evidence regarding the challenges experienced in the management of large ICUs. The challenges were presented at the Critical Care Society of Southern Africa Congress held on 28 August to 2 September 2012 in Sun City North-West province, South Africa. Five strategies are suggested for the challenges identified: divide the units into sections; develop a highly skilled and effective nursing workforce to ensure delivery of quality nursing care; create a culture to retain an effective ICU nursing team; manage assets; and determine the needs of ICU nurses. ICUs need measures to drive the desired strategies into actions to continuously improve the management of the unit. Future research should be aimed at investigating the effectiveness of the strategies identified. This research highlights issues relating to large ICUs and the strategies will assist ICU managers to deal with problems related to large unit sizes, shortage of trained ICU nurses, use of agency nurses, shortage of equipment and supplies and stressors in the ICU. The article will make a contribution to the body of nursing literature on management of ICUs. © 2014 John Wiley & Sons Ltd.

Final Report: Resolving and Discriminating Overlapping Anomalies from Multiple Objects in Cluttered Environments

DTIC Science & Technology

2015-12-15

UXO community . NAME Total Number: PERCENT_SUPPORTEDNAME FTE Equivalent: Total Number: Irma Shamatava 0.50 0.50 1 Resolving and Discriminating...Distinguishing an object of interest from innocuous items is the main problem that the UXO community is facing currently. This inverse problem...innocuous items is the main problem that the UXO community is facing currently. This inverse problem demands fast and accurate representation of

Tamarisk control on public lands in the desert of southern California: two case studies

USGS Publications Warehouse

1994-01-01

As a land manager, the Federal Government faces enormous challenges from exotic pest invasions and associated changes to the structure and stability of native ecosystems (Bureau of Land Management, 1988). On public lands administered by the Bureau of Land Management (BLM) alone, it is estimated that almost three million hectares are occupied by invasive exotic plant species (weeds). Assuming an annual rate of invasion of 14 percent, 930 hectares of BLM-administered land are infested everyday by weeds (Jerry Asher, personal communication). When one considers the fact that BLM administers only about one-third of the public land in the United States (The Keystone Center, 1991), the magnitude of the problem assumes staggering proportions. The scenario described in the quote above portrays only some of the problems associated with the spread of the exotic plant tamarisk, a species on the California Exotic Pest Plant Council’s list of exotic pest plants of greatest concern (California Exotic Pest Plant Council, 1993). In this paper we review the threats posed by tamarisk invasion and proliferation and examine the traits that make the plant such a successful competitor. In addition, we highlight two tamarisk control efforts conducted by the Bureau of Land Management in the southern California desert.

Associations Between Economic Pressure and Diabetes Efficacy in Couples With Type 2 Diabetes

PubMed Central

Novak, Joshua R.; Anderson, Jared R.; Johnson, Matthew D.; Walker, Ann; Wilcox, Allison; Lewis, Virginia L.; Robbins, David C.

2017-01-01

Objective The purpose of this study was to explore dyadic associations between economic pressure and diabetes self-efficacy via emotional distress in patients with type 2 diabetes and their partners. Background Understanding how economic pressure is associated with successful diabetes management is an important area for research, as couples with type 2 diabetes can incur heavy economic pressures that could likely influence diabetes outcomes. Method Data from 117 married couples were used to test actor–partner associations using moderated mediation analyses in a structural equation modeling framework. Problem-solving communication was tested as a possible moderator of the economic pressure–emotional distress pathway. Results Results revealed that greater patient economic pressure was associated with lower patient and spouse confidence in the patient’s diabetes management ability through higher levels of patient emotional distress. The deleterious association between economic pressure and emotional distress was less pronounced when spouses reported more effective problem-solving communication. Conclusion These results provide evidence that the economic pressure couples with type 2 diabetes face may reduce the patient and spouse’s confidence in the patient’s diabetes management ability. Implications This study demonstrates the importance of couple’s relationship processes in buffering the impact of economic pressure on diabetes management, providing a clear target for intervention and education efforts. PMID:29151662

Pose-Invariant Face Recognition via RGB-D Images.

PubMed

Sang, Gaoli; Li, Jing; Zhao, Qijun

2016-01-01

Three-dimensional (3D) face models can intrinsically handle large pose face recognition problem. In this paper, we propose a novel pose-invariant face recognition method via RGB-D images. By employing depth, our method is able to handle self-occlusion and deformation, both of which are challenging problems in two-dimensional (2D) face recognition. Texture images in the gallery can be rendered to the same view as the probe via depth. Meanwhile, depth is also used for similarity measure via frontalization and symmetric filling. Finally, both texture and depth contribute to the final identity estimation. Experiments on Bosphorus, CurtinFaces, Eurecom, and Kiwi databases demonstrate that the additional depth information has improved the performance of face recognition with large pose variations and under even more challenging conditions.

Reconstructive Management of Devastating Electrical Injuries to the Face.

PubMed

Janis, Jeffrey E; Khansa, Ibrahim; Lehrman, Craig R; Orgill, Dennis P; Pomahac, Bohdan

2015-10-01

Devastating fourth-degree electrical injuries to the face and head pose significant reconstructive challenges. To date, there have been few peer-reviewed articles in the literature that describe those reconstructive challenges. The authors present the largest case series to date that describes the management of these injuries, including the incorporation of face transplantation. A retrospective case series was conducted of patients with devastating electrical injuries to the face who were managed at two level-1 trauma centers between 2007 and 2011. Data describing patient injuries, initial management, and reconstructive procedures were collected. Five patients with devastating electrical injuries to the face were reviewed. After initial stabilization and treatment of life-threatening injuries, all five underwent burn excision and microsurgical reconstruction using distant flaps. Two of the patients eventually underwent face transplantation. The authors describe differences in management between the two trauma centers, one of which had the availability for composite tissue allotransplantation; the other did not. Also described is how initial attempts at traditional reconstruction affected the eventual face transplantation. The care of patients with complex electrical burns must be conducted in a multidisciplinary fashion. As with all other trauma, the initial priority should be management of the airway, breathing, and circulation. Additional considerations include cardiac arrhythmias and renal impairment attributable to myoglobinuria. Before embarking on aggressive reconstruction attempts, it is advisable to determine early whether the patient is a candidate for face transplantation in order to avoid antigen sensitization, loss of a reconstructive "lifeboat," surgical plane disruption, and sacrifice of potential recipient vessels. Therapeutic, V.

Centre-based restricted nearest feature plane with angle classifier for face recognition

NASA Astrophysics Data System (ADS)

Tang, Linlin; Lu, Huifen; Zhao, Liang; Li, Zuohua

2017-10-01

An improved classifier based on the nearest feature plane (NFP), called the centre-based restricted nearest feature plane with the angle (RNFPA) classifier, is proposed for the face recognition problems here. The famous NFP uses the geometrical information of samples to increase the number of training samples, but it increases the computation complexity and it also has an inaccuracy problem coursed by the extended feature plane. To solve the above problems, RNFPA exploits a centre-based feature plane and utilizes a threshold of angle to restrict extended feature space. By choosing the appropriate angle threshold, RNFPA can improve the performance and decrease computation complexity. Experiments in the AT&T face database, AR face database and FERET face database are used to evaluate the proposed classifier. Compared with the original NFP classifier, the nearest feature line (NFL) classifier, the nearest neighbour (NN) classifier and some other improved NFP classifiers, the proposed one achieves competitive performance.

A modified active appearance model based on an adaptive artificial bee colony.

PubMed

Abdulameer, Mohammed Hasan; Sheikh Abdullah, Siti Norul Huda; Othman, Zulaiha Ali

2014-01-01

Active appearance model (AAM) is one of the most popular model-based approaches that have been extensively used to extract features by highly accurate modeling of human faces under various physical and environmental circumstances. However, in such active appearance model, fitting the model with original image is a challenging task. State of the art shows that optimization method is applicable to resolve this problem. However, another common problem is applying optimization. Hence, in this paper we propose an AAM based face recognition technique, which is capable of resolving the fitting problem of AAM by introducing a new adaptive ABC algorithm. The adaptation increases the efficiency of fitting as against the conventional ABC algorithm. We have used three datasets: CASIA dataset, property 2.5D face dataset, and UBIRIS v1 images dataset in our experiments. The results have revealed that the proposed face recognition technique has performed effectively, in terms of accuracy of face recognition.

Assignment of Grades and Student Performance in a Hybrid Operations Management Course: What Works and Ideas for Improvements

ERIC Educational Resources Information Center

Houts, Lisa M.; Taylor, James C.

2008-01-01

The production and operations management class offered at California State University, Fresno underwent a transformation from being a four-unit, face-to-face course to a hybrid course. This hybrid course, which is required for all students in the Craig School of Business, includes two units of face-to-face instruction each week, with some coverage…

Introducing quality management into primary health care services in Uganda.

PubMed Central

Omaswa, F.; Burnham, G.; Baingana, G.; Mwebesa, H.; Morrow, R.

1997-01-01

In 1994, a national quality assurance programme was established in Uganda to strengthen district-level management of primary health care services. Within 18 months both objective and subjective improvements in the quality of services had been observed. In the examples documented here, there was a major reduction in maternal mortality among pregnant women referred to Jinja District Hospital, a reduction in waiting times and increased patient satisfaction at Masaka District Hospital, and a marked reduction in reported cases of measles in Arua District. Beyond these quantitative improvements, increased morale of district health team members, improved satisfaction among patients, and greater involvement of local government in the decisions of district health committees have been observed. At the central level, the increased coordination of activities has led to new guidelines for financial management and the procurement of supplies. District quality management workshops followed up by regular support visits from the Ministry of Health headquarters have led to a greater understanding by central staff of the issues faced at the district level. The quality assurance programme has also fostered improved coordination among national disease-control programmes. Difficulties encountered at the central level have included delays in carrying out district support visits and the failure to provide appropriate support. At the district level, some health teams tackled problems over which they had little control or which were overly complex; others lacked the management capacity for problem solving. PMID:9185368

NASA's Applied Sciences for Water Resources

NASA Technical Reports Server (NTRS)

Doorn, Bradley; Toll, David; Engman, Ted

2011-01-01

The Earth Systems Division within NASA has the primary responsibility for the Earth Science Applied Science Program and the objective to accelerate the use of NASA science results in applications to help solve problems important to society and the economy. The primary goal of the Earth Science Applied Science Program is to improve future and current operational systems by infusing them with scientific knowledge of the Earth system gained through space-based observation, assimilation of new observations, and development and deployment of enabling technologies, systems, and capabilities. This paper discusses one of the major problems facing water resources managers, that of having timely and accurate data to drive their decision support tools. It then describes how NASA?s science and space based satellites may be used to overcome this problem. Opportunities for the water resources community to participate in NASA?s Water Resources Applications Program are described.

Enablers and barriers to implementing collaborative care for anxiety and depression: a systematic qualitative review.

PubMed

Overbeck, Gritt; Davidsen, Annette Sofie; Kousgaard, Marius Brostrøm

2016-12-28

Collaborative care is an increasingly popular approach for improving quality of care for people with mental health problems through an intensified and structured collaboration between primary care providers and health professionals with specialized psychiatric expertise. Trials have shown significant positive effects for patients suffering from depression, but since collaborative care is a complex intervention, it is important to understand the factors which affect its implementation. We present a qualitative systematic review of the enablers and barriers to implementing collaborative care for patients with anxiety and depression. We developed a comprehensive search strategy in cooperation with a research librarian and performed a search in five databases (EMBASE, PubMed, PsycINFO, ProQuest, and CINAHL). All authors independently screened titles and abstracts and reviewed full-text articles. Studies were included if they were published in English and based on the original qualitative data on the implementation of a collaborative care intervention targeted at depression or anxiety in an adult patient population in a high-income country. Our subsequent analysis employed the normalization process theory (NPT). We included 17 studies in our review of which 11 were conducted in the USA, five in the UK, and one in Canada. We identified several barriers and enablers within the four major analytical dimensions of NPT. Securing buy-in among primary care providers was found to be critical but sometimes difficult. Enablers included physician champions, reimbursement for extra work, and feedback on the effectiveness of collaborative care. The social and professional skills of the care managers seemed critical for integrating collaborative care in the primary health care clinic. Day-to-day implementation was also found to be facilitated by the care managers being located in the clinic since this supports regular face-to-face interactions between physicians and care managers. The following areas require special attention when planning collaborative care interventions: effective educational programs, especially for care managers; issues of reimbursement in relation to primary care providers; good systems for communication and monitoring; and promoting face-to-face interaction between care managers and physicians, preferably through co-location. There is a need for well-sampled, in-depth qualitative studies on the implementation of collaborative care in settings outside the USA and the UK.

A data reduction, management, and analysis system for a 10-terabyte data set

NASA Technical Reports Server (NTRS)

DeMajistre, R.; Suther, L.

1995-01-01

Within 12 months a 5-year space-based research investigation with an estimated daily data volume of 10 to 15 gigabytes will be launched. Our instrument/analysis team will analyze 2 to 8 gigabytes per day from this mission. Most of these data will be spatial and multispectral collected from nine sensors covering the UV/Visible/NlR spectrum. The volume and diversity of these data and the nature of its analysis require a very robust reduction and management system. This paper is a summary of the systems requirements and a high-level description of a solution. The paper is intended as a case study of the problems and potential solutions faced by the new generation of Earth observation data support systems.

Data management, archiving, visualization and analysis of space physics data

NASA Technical Reports Server (NTRS)

Russell, C. T.

1995-01-01

A series of programs for the visualization and analysis of space physics data has been developed at UCLA. In the course of those developments, a number of lessons have been learned regarding data management and data archiving, as well as data analysis. The issues now facing those wishing to develop such software, as well as the lessons learned, are reviewed. Modern media have eased many of the earlier problems of the physical volume required to store data, the speed of access, and the permanence of the records. However, the ultimate longevity of these media is still a question of debate. Finally, while software development has become easier, cost is still a limiting factor in developing visualization and analysis software.

The critically ill injured patient.

PubMed

Cereda, Maurizio; Weiss, Yoram G; Deutschman, Clifford S

2007-03-01

Patients admitted to the ICU after severe trauma require frequent procedures in the operating room, particularly in cases where a damage control strategy is used. The ventilatory management of these patients in the operating room can be particularly challenging. These patients often have severely impaired respiratory mechanics because of acute lung injury and abdominal compartment syndrome. Consequently, the pressure and flow generation capabilities of standard anesthesia ventilators may be inadequate to support ventilation and gas exchange. This article presents the problems that may be encountered in patients who have severe abdominal and lung injuries, and the current management concepts used in caring for these patients in the critical care setting, to provide guidelines for the anesthetist faced with these patients in the operating room.

When health systems are barriers to health care: challenges faced by uninsured Mexican kidney patients.

PubMed

Kierans, Ciara; Padilla-Altamira, Cesar; Garcia-Garcia, Guillermo; Ibarra-Hernandez, Margarita; Mercado, Francisco J

2013-01-01

Chronic Kidney Disease disproportionately affects the poor in Low and Middle Income Countries (LMICs). Mexico exemplifies the difficulties faced in supporting Renal Replacement Therapy (RRT) and providing equitable patient care, despite recent attempts at health reform. The objective of this study is to document the challenges faced by uninsured, poor Mexican families when attempting to access RRT. The article takes an ethnographic approach, using interviewing and observation to generate detailed accounts of the problems that accompany attempts to secure care. The study, based in the state of Jalisco, comprised interviews with patients, their caregivers, health and social care professionals, among others. Observations were carried out in both clinical and social settings. In the absence of organised health information and stable pathways to renal care, patients and their families work extraordinarily hard and at great expense to secure care in a mixed public-private healthcare system. As part of this work, they must navigate challenging health and social care environments, negotiate treatments and costs, resource and finance healthcare and manage a wide range of formal and informal health information. Examining commonalities across pathways to adequate healthcare reveals major failings in the Mexican system. These systemic problems serve to reproduce and deepen health inequalities. A system, in which the costs of renal care are disproportionately borne by those who can least afford them, faces major difficulties around the sustainability and resourcing of RRTs. Attempts to increase access to renal therapies, therefore, need to take into account the complex social and economic demands this places on those who need access most. This paper further shows that ethnographic studies of the concrete ways in which healthcare is accessed in practice provide important insights into the plight of CKD patients and so constitute an important source of evidence in that effort.

Management challenges faced by managers of New Zealand long-term care facilities.

PubMed

Madas, E; North, N

2000-01-01

This article reports on a postal survey of 78 long-term care managers in one region of New Zealand, of whom 45 (58%) responded. Most long-term care managers (73.2%) were middle-aged females holding nursing but not management qualifications. Most long-term care facilities (69%) tended to be stand-alone facilities providing a single type of care (rest home or continuing care hospital). The most prominent issues facing managers were considered to be inadequate funding to match the growing costs of providing long-term care and occupancy levels. Managers believed that political/regulatory, economic and social factors influenced these issues. Despite a turbulent health care environment and the challenges facing managers, long-term care managers reported they were coping well and valued networking.

Dynamic Flow Management Problems in Air Transportation

NASA Technical Reports Server (NTRS)

Patterson, Sarah Stock

1997-01-01

In 1995, over six hundred thousand licensed pilots flew nearly thirty-five million flights into over eighteen thousand U.S. airports, logging more than 519 billion passenger miles. Since demand for air travel has increased by more than 50% in the last decade while capacity has stagnated, congestion is a problem of undeniable practical significance. In this thesis, we will develop optimization techniques that reduce the impact of congestion on the national airspace. We start by determining the optimal release times for flights into the airspace and the optimal speed adjustment while airborne taking into account the capacitated airspace. This is called the Air Traffic Flow Management Problem (TFMP). We address the complexity, showing that it is NP-hard. We build an integer programming formulation that is quite strong as some of the proposed inequalities are facet defining for the convex hull of solutions. For practical problems, the solutions of the LP relaxation of the TFMP are very often integral. In essence, we reduce the problem to efficiently solving large scale linear programming problems. Thus, the computation times are reasonably small for large scale, practical problems involving thousands of flights. Next, we address the problem of determining how to reroute aircraft in the airspace system when faced with dynamically changing weather conditions. This is called the Air Traffic Flow Management Rerouting Problem (TFMRP) We present an integrated mathematical programming approach for the TFMRP, which utilizes several methodologies, in order to minimize delay costs. In order to address the high dimensionality, we present an aggregate model, in which we formulate the TFMRP as a multicommodity, integer, dynamic network flow problem with certain side constraints. Using Lagrangian relaxation, we generate aggregate flows that are decomposed into a collection of flight paths using a randomized rounding heuristic. This collection of paths is used in a packing integer programming formulation, the solution of which generates feasible and near-optimal routes for individual flights. The algorithm, termed the Lagrangian Generation Algorithm, is used to solve practical problems in the southwestern portion of United States in which the solutions are within 1% of the corresponding lower bounds.

Policy options for the split incentive: Increasing energy efficiency for low-income renters.

PubMed

Bird, Stephen; Hernández, Diana

2012-09-01

The split incentive problem concerns the lack of appropriate incentives to implement energy efficiency measures. In particular, low income tenants face a phenomenon of energy poverty in which they allocate significantly more of their household income to energy expenditures than other renters. This problem is substantial, affecting 1.89% of all United States' energy use. If effectively addressed, it would create a range of savings between 4 and 11 billion dollars per year for many of the nation's poorest residents. We argue that a carefully designed program of incentives for participants (including landlords) in conjunction with a unique type of utility-managed on-bill financing mechanism has significant potential to solve many of the complications. We focus on three kinds of split incentives, five concerns inherent to addressing split incentive problems (scale, endurance, incentives, savings, political disfavor), and provide a detailed policy proposal designed to surpass those problems, with a particular focus on low-income tenants in a U.S.

Policy options for the split incentive: Increasing energy efficiency for low-income renters

PubMed Central

Bird, Stephen; Hernández, Diana

2016-01-01

The split incentive problem concerns the lack of appropriate incentives to implement energy efficiency measures. In particular, low income tenants face a phenomenon of energy poverty in which they allocate significantly more of their household income to energy expenditures than other renters. This problem is substantial, affecting 1.89% of all United States' energy use. If effectively addressed, it would create a range of savings between 4 and 11 billion dollars per year for many of the nation's poorest residents. We argue that a carefully designed program of incentives for participants (including landlords) in conjunction with a unique type of utility-managed on-bill financing mechanism has significant potential to solve many of the complications. We focus on three kinds of split incentives, five concerns inherent to addressing split incentive problems (scale, endurance, incentives, savings, political disfavor), and provide a detailed policy proposal designed to surpass those problems, with a particular focus on low-income tenants in a U.S. context. PMID:27053828

Minority stress and sexual problems among African-American gay and bisexual men.

PubMed

Zamboni, Brian D; Crawford, Isiaah

2007-08-01

Minority stress, such as racism and gay bashing, may be associated with sexual problems, but this notion has not been examined in the literature. African-American gay/bisexual men face a unique challenge in managing a double minority status, putting them at high risk for stress and sexual problems. This investigation examined ten predictors of sexual problems among 174 African-American gay/bisexual men. Covarying for age, a forward multiple regression analysis showed that the measures of self-esteem, male gender role stress, HIV prevention self-efficacy, and lifetime experiences with racial discrimination significantly added to the prediction of sexual problems. Gay bashing, psychiatric symptoms, low life satisfaction, and low social support were significantly correlated with sexual problems, but did not add to the prediction of sexual problems in the regression analysis. Mediation analyses showed that stress predicted psychiatric symptoms, which then predicted sexual problems. Sexual problems were not significantly related to HIV status, racial/ethnic identity, or gay identity. The findings from this study showed a relationship between experiences with racial and sexual discrimination and sexual problems while also providing support for mediation to illustrate how stress might cause sexual problems. Addressing minority stress in therapy may help minimize and treat sexual difficulties among minority gay/bisexual men.

Applying multi-criteria decision-making to improve the waste reduction policy in Taiwan.

PubMed

Su, Jun-Pin; Hung, Ming-Lung; Chao, Chia-Wei; Ma, Hwong-wen

2010-01-01

Over the past two decades, the waste reduction problem has been a major issue in environmental protection. Both recycling and waste reduction policies have become increasingly important. As the complexity of decision-making has increased, it has become evident that more factors must be considered in the development and implementation of policies aimed at resource recycling and waste reduction. There are many studies focused on waste management excluding waste reduction. This study paid more attention to waste reduction. Social, economic, and management aspects of waste treatment policies were considered in this study. Further, a life-cycle assessment model was applied as an evaluation system for the environmental aspect. Results of both quantitative and qualitative analyses on the social, economic, and management aspects were integrated via the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) method into the comprehensive decision-making support system of multi-criteria decision-making (MCDM). A case study evaluating the waste reduction policy in Taoyuan County is presented to demonstrate the feasibility of this model. In the case study, reinforcement of MSW sorting was shown to be the best practice. The model in this study can be applied to other cities faced with the waste reduction problems.