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Sample records for management reduces injection-related

  1. Poultry litter moisture management to reduce ammonia

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Ammonia generation in poultry houses results from the natural breakdown of litter (bedding material mixed with deposits of feces, feathers, spilled feed and water). Good management practices can reduce ammonia concentrations in poultry houses. This factsheet relates findings from a recent publicat...

  2. Fisheries management to reduce contaminant consumption

    SciTech Connect

    Stow, C.A.; Jackson, L.J.; Eby, L.A.

    1995-12-01

    Lake Michigan is a microcosm of global environmental issues. A history of problems has plagued the lake, arising from the wide range of human activities the basin supports. Much of Lake Michigan`s watershed is agriculturally developed, and the shoreline is dotted with major urban, industrial centers. The lake has supported important commercial shipping and fishing industries for more than a century. In the 1960s and 1970s eutrophication was a concern. More recently toxic contaminants, particularly PCBs, and invasions by exotic species, such as the zebra mussel (Dreissena polymorpha), have captured headlines. More than 200 years of development and exploitation have taken Lake Michigan far from a pristine state. The Lake Michigan fishery in intensively managed, and food web manipulation may more effectively reduce PCB exposure than cleanup activities do. Four management options are discussed in this article: trophic cascade; growth maximization; size of stocked fish; and selective species stocking. The most promising option, well supported by data is in many ways the simplist: selective stocking of species that accumulate contaminants at the lowest levels. 51 refs., 6 figs., 1 tab.

  3. Fisheries management to reduce contaminant consumption

    USGS Publications Warehouse

    Stow, Craig A.; Carpenter, Stephen R.; Madenjian, Charles P.; Eby, Lisa A.; Jackson, Leland J.

    1995-01-01

    This paper concludes that contaminants in Lake Michigan fishes are likely to remain above detectable levels for some time. Some interest groups have called for measures ranging from additional effluent controls to a ban on the industrial use of chlorine. Such measures, however well intended, are likely to have little impact on many of the contaminants of primary concern. PCBs, in particular, are largely the legacy of past activities and are not likely to be substantially affected by additional regulation. The authors review several options for reducing human exposure to PCBs, using relatively simple fisheries manipulations, although they do not propose that these measures are the ultimate solution to the contaminant problem. Of the options presented, the most promising is the replacement of lake trout with less-contaminated species, such as rainbow trout.

  4. The staying safe intervention: training people who inject drugs in strategies to avoid injection-related HCV and HIV infection.

    PubMed

    Mateu-Gelabert, Pedro; Gwadz, Marya Viorst; Guarino, Honoria; Sandoval, Milagros; Cleland, Charles M; Jordan, Ashly; Hagan, Holly; Lune, Howard; Friedman, Samuel R

    2014-04-01

    This pilot study explores the feasibility and preliminary efficacy of the Staying Safe Intervention, an innovative, strengths-based program to facilitate prevention of infection with the human immunodeficiency virus and with the hepatitis C virus among people who inject drugs (PWID). The authors explored changes in the intervention's two primary endpoints: (a) frequency and amount of drug intake, and (b) frequency of risky injection practices. We also explored changes in hypothesized mediators of intervention efficacy: planning skills, motivation/self-efficacy to inject safely, skills to avoid PWID-associated stigma, social support, drug-related withdrawal symptoms, and injection network size and risk norms. A 1-week, five-session intervention (10 hours total) was evaluated using a pre- versus 3-month posttest design. Fifty-one participants completed pre- and posttest assessments. Participants reported significant reductions in drug intake and injection-related risk behavior. Participants also reported significant increases in planning skills, motivation/self-efficacy, and stigma management strategies, while reducing their exposure to drug withdrawal episodes and risky injection networks.

  5. THE STAYING SAFE INTERVENTION: TRAINING PEOPLE WHO INJECT DRUGS IN STRATEGIES TO AVOID INJECTION-RELATED HCV AND HIV INFECTION

    PubMed Central

    Mateu-Gelabert, Pedro; Gwadz, Marya Viorst; Guarino, Honoria; Sandoval, Milagros; Cleland, Charles M.; Jordan, Ashly; Hagan, Holly; Lune, Howard; Friedman, Samuel R.

    2014-01-01

    This pilot study explores the feasibility and preliminary efficacy of the Staying Safe Intervention, an innovative, strengths-based program to facilitate prevention of infection with the human immunodeficiency virus and with the hepatitis C virus among people who inject drugs (PWID). The authors explored changes in the intervention's two primary endpoints: (a) frequency and amount of drug intake, and (b) frequency of risky injection practices. We also explored changes in hypothesized mediators of intervention efficacy: planning skills, motivation/self-efficacy to inject safely, skills to avoid PWID-associated stigma, social support, drug-related withdrawal symptoms, and injection network size and risk norms. A 1-week, five-session intervention (10 hours total) was evaluated using a pre- versus 3-month posttest design. Fifty-one participants completed pre- and posttest assessments. Participants reported significant reductions in drug intake and injection-related risk behavior. Participants also reported significant increases in planning skills, motivation/self-efficacy, and stigma management strategies, while reducing their exposure to drug withdrawal episodes and risky injection networks. PMID:24694328

  6. Reducing uncertainty about objective functions in adaptive management

    USGS Publications Warehouse

    Williams, B.K.

    2012-01-01

    This paper extends the uncertainty framework of adaptive management to include uncertainty about the objectives to be used in guiding decisions. Adaptive decision making typically assumes explicit and agreed-upon objectives for management, but allows for uncertainty as to the structure of the decision process that generates change through time. Yet it is not unusual for there to be uncertainty (or disagreement) about objectives, with different stakeholders expressing different views not only about resource responses to management but also about the appropriate management objectives. In this paper I extend the treatment of uncertainty in adaptive management, and describe a stochastic structure for the joint occurrence of uncertainty about objectives as well as models, and show how adaptive decision making and the assessment of post-decision monitoring data can be used to reduce uncertainties of both kinds. Different degrees of association between model and objective uncertainty lead to different patterns of learning about objectives. ?? 2011.

  7. Prospects for managing turfgrass pests with reduced chemical inputs.

    PubMed

    Held, David W; Potter, Daniel A

    2012-01-01

    Turfgrass culture, a multibillion dollar industry in the United States, poses unique challenges for integrated pest management. Why insect control on lawns, golf courses, and sport fields remains insecticide-driven, and how entomological research and extension can best support nascent initiatives in environmental golf and sustainable lawn care are explored. High standards for aesthetics and playability, prevailing business models, risk management-driven control decisions, and difficulty in predicting pest outbreaks fuel present reliance on preventive insecticides. New insights into pest biology, sampling methodology, microbial insecticides, plant resistance, and conservation biological control are reviewed. Those gains, and innovations in reduced-risk insecticides, should make it possible to begin constructing holistic management plans for key turfgrass pests. Nurturing the public's interest in wildlife habitat preservation, including beneficial insects, may be one means to change aesthetic perceptions and gain leeway for implementing integrated pest management practices that lend stability to turfgrass settings.

  8. Transitional care management reimbursement to reduce COPD readmission.

    PubMed

    Kangovi, Shreya; Grande, David

    2014-01-01

    Reducing preventable readmissions for COPD is an important national health policy goal. Thus far, Centers for Medicare & Medicaid Services (CMS) policies focused on incentivizing improvements in inpatient quality have had variable success. In its 2013 physician-payment rule, CMS announced new payments that reimburse ambulatory care providers for timely posthospital visits and transitional care management services. CMS hopes that posthospital transitional care and services will substitute for readmission, but the evidence supporting this hypothesis is mixed. In this article, we discuss ways for ambulatory pulmonologists to leverage transitional care management payments to enhance access for their patients with COPD while minimizing the risk of a paradoxic increase in readmission rates.

  9. Can managed care reduce employers' retiree medical liability?

    PubMed

    Taylor, R S; Newton, B

    1991-01-01

    The Financial Accounting Standards Board (FASB) has forced U.S. companies to look squarely at their current retiree health obligations and their future commitments. Accounting Statement No. 106 (FAS 106) requires employers to accrue liabilities for retiree health benefits during employees' active service, rather than record the costs as benefits are paid. Employers are scrambling to find ways to reduce the statement's effect on corporate balance sheets. While managed health care has been increasingly employed to control benefit costs in active employee health plans, it has not been as popular in retiree plans. This article reviews important demographic and health trends in the retiree population and summarizes employers' early responses to FAS 106. It explores why managed health care has thus far played a limited role in reducing employers' postretirement medical liability, and offers insight into how that role could be increased in the future.

  10. Enhancing outpatient clinics management software by reducing patients' waiting time.

    PubMed

    Almomani, Iman; AlSarheed, Ahlam

    The Kingdom of Saudi Arabia (KSA) gives great attention to improving the quality of services provided by health care sectors including outpatient clinics. One of the main drawbacks in outpatient clinics is long waiting time for patients-which affects the level of patient satisfaction and the quality of services. This article addresses this problem by studying the Outpatient Management Software (OMS) and proposing solutions to reduce waiting times. Many hospitals around the world apply solutions to overcome the problem of long waiting times in outpatient clinics such as hospitals in the USA, China, Sri Lanka, and Taiwan. These clinics have succeeded in reducing wait times by 15%, 78%, 60% and 50%, respectively. Such solutions depend mainly on adding more human resources or changing some business or management policies. The solutions presented in this article reduce waiting times by enhancing the software used to manage outpatient clinics services. Both quantitative and qualitative methods have been used to understand current OMS and examine level of patient's satisfaction. Five main problems that may cause high or unmeasured waiting time have been identified: appointment type, ticket numbering, doctor late arrival, early arriving patient and patients' distribution list. These problems have been mapped to the corresponding OMS components. Solutions to the above problems have been introduced and evaluated analytically or by simulation experiments. Evaluation of the results shows a reduction in patient waiting time. When late doctor arrival issues are solved, this can reduce the clinic service time by up to 20%. However, solutions for early arriving patients reduces 53.3% of vital time, 20% of the clinic time and overall 30.3% of the total waiting time. Finally, well patient-distribution lists make improvements by 54.2%. Improvements introduced to the patients' waiting time will consequently affect patients' satisfaction and improve the quality of health care services.

  11. Forest management strategies for reducing carbon emissions, the French case

    NASA Astrophysics Data System (ADS)

    Valade, Aude; Luyssaert, Sebastiaan; Bellassen, Valentin; Vallet, Patrick; Martin, Manuel

    2015-04-01

    International agreements now recognize the role of forest in the mitigation of climate change through the levers of in-situ sequestration, storage in products and energy and product substitution. These three strategies of carbon management are often antagonistic and it is still not clear which strategy would have the most significant impact on atmospheric carbon concentrations. With a focus on France, this study compares several scenarios of forest management in terms of their effect on the overall carbon budget from trees to wood-products. We elaborated four scenarios of forest management that target different wood production objectives. One scenario is 'Business as usual' and reproduces the current forest management and wood production levels. Two scenarios target an increase in bioenergy wood production, with either long-term or short-term goals. One scenario aims at increasing the production of timber for construction. For this, an empirical regression model was developed building on the rich French inventory database. The model can project the current forest resource at a time horizon of 20 years for characteristic variables diameter, standing volume, above-ground biomass, stand age. A simplified life-cycle analysis provides a full carbon budget for each scenario from forest management to wood use and allows the identification of the scenario that most reduces carbon emissions.

  12. Do continence management strategies reduce falls? a systematic review.

    PubMed

    Batchelor, Frances A; Dow, Briony; Low, May-Ann

    2013-12-01

    Urinary incontinence is associated with increased fall risk, and fall prevention programs include recommendations to manage continence as one component of fall reduction. However, the evidence to support this recommendation is unclear. The aim of this study was to identify continence management interventions that are effective in decreasing falls. A systematic review of the literature was conducted. Studies were included if they evaluated the effect of any type of continence management strategy on falls in older adults. The included studies were assessed for quality, and data relating to participants, interventions and outcomes were extracted by two independent reviewers. Four articles met the inclusion criteria. Two studies were randomised controlled trials, one a retrospective cohort study and one an uncontrolled intervention study. Interventions included pharmacological agents, a toileting regime combined with physical activity and an individualised continence program. Only the study evaluating the combination of physical activity and prompted voiding found an effect on falls. It is surprising that there has been so little research into continence management interventions that include fall outcomes. A toileting regime combined with physical activity may reduce falls in residential care. There is a need for further studies investigating the impact of continence management on falls.

  13. Reputation management: evidence for ability but reduced propensity in autism.

    PubMed

    Cage, Eilidh; Pellicano, Elizabeth; Shah, Punit; Bird, Geoffrey

    2013-10-01

    Previous research has reported that autistic adults do not manage their reputation, purportedly due to problems with theory of mind [Izuma, Matsumoto, Camerer, & Adolphs]. The current study aimed to test alternative explanations for this apparent lack of reputation management. Twenty typical and 19 autistic adults donated to charity and to a person, both when alone and when observed. In an additional manipulation, for half of the participants, the observer was also the recipient of their donations, and participants were told that this observer would subsequently have the opportunity to donate to them (motivation condition). This manipulation was designed to encourage an expectation of a reciprocal "tit-for-tat" strategy in the participant, which may motivate participants to change their behavior to receive more donations. The remaining participants were told that the person watching was just observing the procedure (no motivation condition). Our results replicated Izuma et al.'s finding that autistic adults did not donate more to charity when observed. Yet, in the motivation condition, both typical and autistic adults donated significantly more to the observer when watched, although this effect was significantly attenuated in autistic individuals. Results indicate that, while individuals with autism may have the ability to think about reputation, a reduced expectation of reciprocal behavior from others may reduce the degree to which they engage in reputation management.

  14. Reducing Wildlife Damage with Cost-Effective Management Programmes.

    PubMed

    Krull, Cheryl R; Stanley, Margaret C; Burns, Bruce R; Choquenot, David; Etherington, Thomas R

    2016-01-01

    Limiting the impact of wildlife damage in a cost effective manner requires an understanding of how control inputs change the occurrence of damage through their effect on animal density. Despite this, there are few studies linking wildlife management (control), with changes in animal abundance and prevailing levels of wildlife damage. We use the impact and management of wild pigs as a case study to demonstrate this linkage. Ground disturbance by wild pigs has become a conservation issue of global concern because of its potential effects on successional changes in vegetation structure and composition, habitat for other species, and functional soil properties. In this study, we used a 3-year pig control programme (ground hunting) undertaken in a temperate rainforest area of northern New Zealand to evaluate effects on pig abundance, and patterns and rates of ground disturbance and ground disturbance recovery and the cost effectiveness of differing control strategies. Control reduced pig densities by over a third of the estimated carrying capacity, but more than halved average prevailing ground disturbance. Rates of new ground disturbance accelerated with increasing pig density, while rates of ground disturbance recovery were not related to prevailing pig density. Stochastic simulation models based on the measured relationships between control, pig density and rate of ground disturbance and recovery indicated that control could reduce ground disturbance substantially. However, the rate at which prevailing ground disturbance was reduced diminished rapidly as more intense, and hence expensive, pig control regimes were simulated. The model produced in this study provides a framework that links conservation of indigenous ecological communities to control inputs through the reduction of wildlife damage and suggests that managers should consider carefully the marginal cost of higher investment in wildlife damage control, relative to its marginal conservation return.

  15. Reducing Wildlife Damage with Cost-Effective Management Programmes

    PubMed Central

    Krull, Cheryl R.; Stanley, Margaret C.; Burns, Bruce R.; Choquenot, David; Etherington, Thomas R.

    2016-01-01

    Limiting the impact of wildlife damage in a cost effective manner requires an understanding of how control inputs change the occurrence of damage through their effect on animal density. Despite this, there are few studies linking wildlife management (control), with changes in animal abundance and prevailing levels of wildlife damage. We use the impact and management of wild pigs as a case study to demonstrate this linkage. Ground disturbance by wild pigs has become a conservation issue of global concern because of its potential effects on successional changes in vegetation structure and composition, habitat for other species, and functional soil properties. In this study, we used a 3-year pig control programme (ground hunting) undertaken in a temperate rainforest area of northern New Zealand to evaluate effects on pig abundance, and patterns and rates of ground disturbance and ground disturbance recovery and the cost effectiveness of differing control strategies. Control reduced pig densities by over a third of the estimated carrying capacity, but more than halved average prevailing ground disturbance. Rates of new ground disturbance accelerated with increasing pig density, while rates of ground disturbance recovery were not related to prevailing pig density. Stochastic simulation models based on the measured relationships between control, pig density and rate of ground disturbance and recovery indicated that control could reduce ground disturbance substantially. However, the rate at which prevailing ground disturbance was reduced diminished rapidly as more intense, and hence expensive, pig control regimes were simulated. The model produced in this study provides a framework that links conservation of indigenous ecological communities to control inputs through the reduction of wildlife damage and suggests that managers should consider carefully the marginal cost of higher investment in wildlife damage control, relative to its marginal conservation return. PMID

  16. Can disease management reduce health care costs by improving quality?

    PubMed

    Fireman, Bruce; Bartlett, Joan; Selby, Joe

    2004-01-01

    Disease management (DM) promises to achieve cost savings by improving the quality of care for chronic diseases. During the past decade the Permanente Medical Group in Northern California has implemented extensive DM programs. Examining quality indicators, utilization, and costs for 1996-2002 for adults with four conditions, we find evidence of substantial quality improvement but not cost savings. The causal pathway--from improved care to reduced morbidity to cost savings--has not produced sufficient savings to offset the rising costs of improved care. We conclude that the rationale for DM programs, like the rationale for any medical treatments, should rest on their effectiveness and value.

  17. Can climate-effective land management reduce regional warming?

    NASA Astrophysics Data System (ADS)

    Hirsch, A. L.; Wilhelm, M.; Davin, E. L.; Thiery, W.; Seneviratne, S. I.

    2017-02-01

    Limiting global warming to well below 2°C is an imminent challenge for humanity. However, even if this global target can be met, some regions are still likely to experience substantial warming relative to others. Using idealized global climate simulations, we examine the potential of land management options in affecting regional climate, with a focus on crop albedo enhancement and irrigation (climate-effective land management). The implementation is performed over all crop regions globally to provide an upper bound. We find that the implementation of both crop albedo enhancement and irrigation can reduce hot temperature extremes by more than 2°C in North America, Eurasia, and India over the 21st century relative to a scenario without management application. The efficacy of crop albedo enhancement scales with the magnitude, where a cooling response exceeding 0.5°C for hot temperature extremes was achieved with a large (i.e., ≥0.08) change in crop albedo. Regional differences were attributed to the surface energy balance response with temperature changes mostly explained by latent heat flux changes for irrigation and net shortwave radiation changes for crop albedo enhancement. However, limitations do exist, where we identify warming over the winter months when climate-effective land management is temporarily suspended. This was associated with persistent cloud cover that enhances longwave warming. It cannot be confirmed if the magnitude of this feedback is reproducible in other climate models. Our results overall demonstrate that regional warming of hot extremes in our climate model can be partially mitigated when using an idealized treatment of climate-effective land management.

  18. Do managed care plans reduce racial disparities in preventive care?

    PubMed

    Lin, Chyongchiou Jeng; Musa, Donald; Silverman, Myrna; Degenholtz, Howard B

    2005-02-01

    This study was designed to determine whether managed care plans reduce racial disparities in use of influenza vaccination, mammography, and prostate-specific antigen screening. The study analyzed the use of three types of preventive care in a population-based sample of adults who were 65 years or older and were enrolled in a Medicare managed care (MMC) or fee-for-service (FFS) plan in Allegheny County, Pennsylvania. The study sample included 463 African Americans and 592 whites. Fewer African Americans than whites reported having had an influenza vaccination (64.4% versus 76.5%; p < 0.01) or a prostate-specific antigen test (64% versus 71.2%; p = 0.09) during the previous year. Slightly more African Americans than white women reported having had a mammogram (66.1% versus 63.8%). Logistic regression showed that, regardless of health plan type, African Americans were significantly less likely than whites to have an influenza vaccination (p < 0.05). A MMC plan did not narrow racial differences in preventive care. Reducing disparities may require interventions developed for specific racial/ethnic groups.

  19. Management of tropospheric ozone by reducing methane emissions.

    PubMed

    West, J Jason; Fiore, Arlene M

    2005-07-01

    Background concentrations of tropospheric ozone are increasing and are sensitive to methane emissions, yet methane mitigation is currently considered only for climate change. Methane control is shown here to be viable for ozone management. Identified global abatement measures can reduce approximately 10% of anthropogenic methane emissions at a cost-savings, decreasing surface ozone by 0.4-0.7 ppb. Methane controls produce ozone reductions that are widespread globally and are realized gradually (approximately 12 yr). In contrast, controls on nitrogen oxides (NOx) and nonmethane volatile organic compounds (NMVOCs) target high-ozone episodes in polluted regions and affect ozone rapidly but have a smaller climate benefit. A coarse estimate of the monetized global benefits of ozone reductions for agriculture, forestry, and human health (neglecting ozone mortality) justifies reducing approximately 17% of global anthropogenic methane emissions. If implemented, these controls would decrease ozone by -1 ppb and radiative forcing by approximately 0.12 W m(-2). We also find that climate-motivated methane reductions have air quality-related ancillary benefits comparable to those for CO2. Air quality planning should consider reducing methane emissions alongside NOx and NMVOCs, and because the benefits of methane controls are shared internationally, industrialized nations should consider emphasizing methane in the further development of climate change or ozone policies.

  20. Case Management Reduces Drinking During Pregnancy among High Risk Women

    PubMed Central

    May, Philip A.; Marais, Anna-Susan; Gossage, J. Phillip; Barnard, Ronel; Joubert, Belinda; Cloete, Marise; Hendricks, Natalie; Roux, Sumien; Blom, Annalien; Steenekamp, Jeanetta; Alexander, Theresa; Andreas, Romena; Human, Suzanne; Snell, Cudore; Seedat, Soraya; Parry, Charles C.; Kalberg, Wendy O.; Buckley, David; Blankenship, Jason

    2014-01-01

    Aim Estimate the efficacy of Case Management (CM) for women at high risk for bearing a child with Fetal Alcohol Spectrum Disorders (FASD). Design Women were recruited from antenatal clinics and engaged in 18 months of CM. Setting A South African community with a subculture of heavy, regular, weekend, recreational drinking and high documented rates of FASD. Participants Forty-one women who were high risk for bearing a child with FASD. Measures Statistical analysis of trends in drinking and other risk factors. Findings At intake 87.8% were pregnant, most had previous alcohol-exposed pregnancies, most/all of their friends drink alcohol (67.5%), and 50.0% had stressful lives. CM was particularly valuable for pregnant women, as statistically significant reductions in alcohol risk were obtained for them in multiple variables: total drinks on weekends after six months of CM (p = .026) and estimated peak blood alcohol concentration (BAC) at six (p < .001) and 18 months (p < .001). For participants completing 18 months of CM, AUDIT scores improved significantly by 6-month follow-up (from 19.8 to 9.7, p = .000), and even though rising at 12 and 18 months, AUDIT scores indicate that problematic drinking remained statistically significantly lower than baseline throughout CM. Happiness scale scores correlated significantly with reduced drinking in most time periods. Conclusions An enduring change in drinking behavior is difficult in this social setting. Yet, CM provided by skilled and empathic case managers reduced maternal drinking at critical times, and therefore, alcohol exposure levels to the fetus. PMID:24729823

  1. Reducing maladaptive weight management practices: developing a psychoeducational intervention program.

    PubMed

    O'Brien, Karina M; LeBow, Michael D

    2007-04-01

    Previous research has addressed the issues of behavior change and eating disorder prevention among adolescents and young women. The current study was designed to evaluate: (a) whether an 8-week psychoeducational intervention can reduce maladaptive weight-management practices in women (University females, N=24) with sub-clinical levels of eating pathology; and (b) whether its implementation reduces the risk of developing more severe eating pathology across time. Participants were randomly assigned to an experimental (EX) group or a self-monitoring control (SMC) group. Statistically significant changes on measures of eating pathology, including the Eating Attitudes Test-26 [Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. (1982). The Eating Attitudes Test: psychometric features and clinical correlates. Psychological Medicine, 12, 871-878]; Forbidden Food Survey [Ruggerio, L., Williamson, D. A., Davis, C. J., Schlundt, D. G., & Carey, M. P. (1988). Forbidden Food Survey: Measure of bulimic's anticipated emotional reactions to specific foods. Addictive Behaviors, 13, 267-274]; and Bulimia Test-Revised [Thelen, M. H., Farmer, J., Wonderlich, S., & Smith, M. (1991). A revision of the bulimia test: The BULIT-R. Journal of Consulting and Clinical Psychology, 3(1), 119-124] were observed, as were changes in body image, as measured by the Body Shape Questionnaire [Cooper, P. J., Taylor, M. J., Cooper, Z., & Fairburn, C. G. (1987). The development and validation of the body shape questionnaire. International Journal of Eating Disorders, 6(4), 485-494]. Additional significant between-group differences in eating behavior, as measured by daily meal records, were also seen. Participants in the EX group evidenced improvements in scores which were significantly different from those observed in the SMC group. Unfortunately, attrition limited the utility of follow up data.

  2. Accident Precursor Analysis and Management: Reducing Technological Risk Through Diligence

    NASA Technical Reports Server (NTRS)

    Phimister, James R. (Editor); Bier, Vicki M. (Editor); Kunreuther, Howard C. (Editor)

    2004-01-01

    Almost every year there is at least one technological disaster that highlights the challenge of managing technological risk. On February 1, 2003, the space shuttle Columbia and her crew were lost during reentry into the atmosphere. In the summer of 2003, there was a blackout that left millions of people in the northeast United States without electricity. Forensic analyses, congressional hearings, investigations by scientific boards and panels, and journalistic and academic research have yielded a wealth of information about the events that led up to each disaster, and questions have arisen. Why were the events that led to the accident not recognized as harbingers? Why were risk-reducing steps not taken? This line of questioning is based on the assumption that signals before an accident can and should be recognized. To examine the validity of this assumption, the National Academy of Engineering (NAE) undertook the Accident Precursors Project in February 2003. The project was overseen by a committee of experts from the safety and risk-sciences communities. Rather than examining a single accident or incident, the committee decided to investigate how different organizations anticipate and assess the likelihood of accidents from accident precursors. The project culminated in a workshop held in Washington, D.C., in July 2003. This report includes the papers presented at the workshop, as well as findings and recommendations based on the workshop results and committee discussions. The papers describe precursor strategies in aviation, the chemical industry, health care, nuclear power and security operations. In addition to current practices, they also address some areas for future research.

  3. Reducing watershed scale phosphorus export through integrated management practices

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Phosphorus losses from golf course have been documented and are comparable to losses from agriculture and urban areas. Integrated management practices are required to address the problem. An integrated management approach using filter socks and limiting the amount of phosphorus applied to the golf c...

  4. Feed management for beef feedlots to reduce air emissions

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This power point presentation gives an overview of air emissions from beef cattle feedyards as well as nutritional and management techniques that might decrease these emissions. Topics include greenhouse gases (methane, nitrous oxide), ammonia, particulate matter and odors. This was presented as on...

  5. Improving Benefits and Reducing Costs: Managing Educational Secondments.

    ERIC Educational Resources Information Center

    McMichael, Paquita; And Others

    1995-01-01

    A (British) educational "secondment" involves resource allocation from one institution to another and new forms of employee accountability and commitment. This article examines management implications of educational secondments, exploring costs and benefits accruing to 50 secondees, their seconding organizations, and those to which they…

  6. Can weight management programs in worksites reduce the obesity epidemic?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Worksites can potentially be important locations for weight management programs that contribute to curbing the national obesity epidemic. In published studies, weight loss programs targeting overweight and obese employees have been relatively more effective for weight loss than programs for preventi...

  7. Management Can Reduce Contamination Potential of Beef Backgrounding

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Producers who want to “background” beef cattle on karst landscapes face great challenges. This is because without proper management, manure-borne contaminants from backgrounding sites can quickly degrade water quality in karst regions. Western Kentucky University and USDA-ARS reported on three-year ...

  8. Reducing the variability of compound management delivery using visual management systems.

    PubMed

    Spencer, Philip; Ratcliffe, Stuart; Cole, Shaun

    2014-04-01

    The globalization and externalization of a pharmaceutical company's research and development (R&D) places considerable demands on its underpinning compound management (CM) capability. More robust CM workflows are needed to support higher demands and cross-continent supply chains. The tracking and visibility of compound orders progressing through CM processes has become crucial to ensure prompt and reliable delivery to customers and project timelines worldwide. AstraZeneca at Alderley Park UK has successfully introduced and integrated a visual management system into its CM processes to support the company's global R&D strategy. A simple, low-cost approach has been employed to track solid processing and solubilization orders. This reduced variability and end-to-end cycle times by decreasing waiting time between processing steps. The visual tracking system has been quick to implement, adaptable to change, and able to be owned and run by delivery teams. Introduction of the visual tracking system has resulted in significant improvements in order processing, both in terms of variability and speed. The percentage of orders processed within 24 h rose from 81.5% to 92.5%, and reductions of 50% and 17.5% in the average processing time were seen for solid dispense and solubilization orders, respectively.

  9. Water engineering. Reducing sewer corrosion through integrated urban water management.

    PubMed

    Pikaar, Ilje; Sharma, Keshab R; Hu, Shihu; Gernjak, Wolfgang; Keller, Jürg; Yuan, Zhiguo

    2014-08-15

    Sewer systems are among the most critical infrastructure assets for modern urban societies and provide essential human health protection. Sulfide-induced concrete sewer corrosion costs billions of dollars annually and has been identified as a main cause of global sewer deterioration. We performed a 2-year sampling campaign in South East Queensland (Australia), an extensive industry survey across Australia, and a comprehensive model-based scenario analysis of the various sources of sulfide. Aluminum sulfate addition during drinking water production contributes substantially to the sulfate load in sewage and indirectly serves as the primary source of sulfide. This unintended consequence of urban water management structures could be avoided by switching to sulfate-free coagulants, with no or only marginal additional expenses compared with the large potential savings in sewer corrosion costs.

  10. Waste management: how reducing partiality can promote efficient resource allocation.

    PubMed

    Choshen-Hillel, Shoham; Shaw, Alex; Caruso, Eugene M

    2015-08-01

    Two central principles that guide resource-allocation decisions are equity (providing equal pay for equal work) and efficiency (not wasting resources). When these two principles conflict with one another, people will often waste resources to avoid inequity. We suggest that people wish to avoid inequity not because they find it inherently unfair, but because they want to avoid the appearance of partiality associated with it. We explore one way to reduce waste by reducing the perceived partiality of inequitable allocations. Specifically, we hypothesize that people will be more likely to favor an efficient (albeit inequitable) allocation if it puts them in a disadvantaged position than if it puts others in a disadvantaged position. To test this hypothesis, we asked participants to choose between giving some extra resource to one person (thereby creating inequity between this person and equally deserving others) and not giving the resource to anyone (thereby wasting the resource). Six studies, using realistic scenarios and behavioral paradigms, provide robust evidence for a self-disadvantaging effect: Allocators were consistently more likely to create inequity to avoid wasting resources when the resulting inequity would put them at a relative disadvantage than when it would put others at a relative disadvantage. We further find that this self-disadvantaging effect is a direct result of people's concern about appearing partial. Our findings suggest the importance of impartiality even in distributive justice, thereby bridging a gap between the distributive and procedural justice literatures.

  11. Reducing the cognitive workload: Trouble managing power systems

    NASA Technical Reports Server (NTRS)

    Manner, David B.; Liberman, Eugene M.; Dolce, James L.; Mellor, Pamela A.

    1993-01-01

    The complexity of space-based systems makes monitoring them and diagnosing their faults taxing for human beings. Mission control operators are well-trained experts but they can not afford to have their attention diverted by extraneous information. During normal operating conditions monitoring the status of the components of a complex system alone is a big task. When a problem arises, immediate attention and quick resolution is mandatory. To aid humans in these endeavors we have developed an automated advisory system. Our advisory expert system, Trouble, incorporates the knowledge of the power system designers for Space Station Freedom. Trouble is designed to be a ground-based advisor for the mission controllers in the Control Center Complex at Johnson Space Center (JSC). It has been developed at NASA Lewis Research Center (LeRC) and tested in conjunction with prototype flight hardware contained in the Power Management and Distribution testbed and the Engineering Support Center, ESC, at LeRC. Our work will culminate with the adoption of these techniques by the mission controllers at JSC. This paper elucidates how we have captured power system failure knowledge, how we have built and tested our expert system, and what we believe are its potential uses.

  12. Reducing the cognitive workload - Trouble managing power systems

    NASA Technical Reports Server (NTRS)

    Manner, David B.; Liberman, Eugene M.; Dolce, James L.; Mellor, Pamela A.

    1993-01-01

    The complexity of space-based systems makes monitoring them and diagnosing their faults taxing for human beings. When a problem arises, immediate attention and quick resolution is mandatory. To aid humans in these endeavors we have developed an automated advisory system. Our advisory expert system, Trouble, incorporates the knowledge of the power system designers for Space Station Freedom. Trouble is designed to be a ground-based advisor for the mission controllers in the Control Center Complex at Johnson Space Center (JSC). It has been developed at NASA Lewis Research Center (LeRC) and tested in conjunction with prototype flight hardware contained in the Power Management and Distribution testbed and the Engineering Support Center, ESC, at LeRC. Our work will culminate with the adoption of these techniques by the mission controllers at JSC. This paper elucidates how we have captured power system failure knowledge, how we have built and tested our expert system, and what we believe its potential uses are.

  13. Reducing the cognitive workload: Trouble managing power systems

    NASA Astrophysics Data System (ADS)

    Manner, David B.; Liberman, Eugene M.; Dolce, James L.; Mellor, Pamela A.

    1993-12-01

    The complexity of space-based systems makes monitoring them and diagnosing their faults taxing for human beings. Mission control operators are well-trained experts but they can not afford to have their attention diverted by extraneous information. During normal operating conditions monitoring the status of the components of a complex system alone is a big task. When a problem arises, immediate attention and quick resolution is mandatory. To aid humans in these endeavors we have developed an automated advisory system. Our advisory expert system, Trouble, incorporates the knowledge of the power system designers for Space Station Freedom. Trouble is designed to be a ground-based advisor for the mission controllers in the Control Center Complex at Johnson Space Center (JSC). It has been developed at NASA Lewis Research Center (LeRC) and tested in conjunction with prototype flight hardware contained in the Power Management and Distribution testbed and the Engineering Support Center, ESC, at LeRC. Our work will culminate with the adoption of these techniques by the mission controllers at JSC. This paper elucidates how we have captured power system failure knowledge, how we have built and tested our expert system, and what we believe are its potential uses.

  14. Management Options For Reducing The Release Of Antibiotics And Antibiotic Resistance Genes To The Environment

    EPA Science Inventory

    Background: There is growing concern worldwide about the role of polluted soil and water - 77 environments in the development and dissemination of antibiotic resistance. 78 Objective: To identify management options for reducing the spread of antibiotics and 79 antibiotic resist...

  15. Creating Access to Invisible Special Collections: Using Participatory Management to Reduce a Backlog

    ERIC Educational Resources Information Center

    Lundy, M. Winslow; Hollis, Deborah R.

    2004-01-01

    The University of Colorado at Boulder Libraries used participatory management to reduce a special collections backlog. Without an increase in budget or staffing, technical and public services departments designed a pilot project to redeploy internal human resources in a collaborative manner. The process of backlog management is discussed.

  16. Restructuring materiel management functions: a method for prioritizing changes and reducing costs.

    PubMed

    Craig, K W

    1992-02-01

    The success of any manager depends highly on the ability to seize on opportunities that will achieve the organization's goals. Hospitals are currently searching for ways to reduce costs while maintaining or enhancing the quality of services. Quality services are increasingly being defined as those that are most responsive to customer needs. It is important, as hospital management restructures materiel systems or methods of operation for reduced costs, to focus on the user departments as the customers. The consolidation of materiel management activity should not be seen as a loss of control at the user department level. Instead it can be seen as a new way of providing service with higher quality. User departments should see concrete benefits on a weekly basis, including reduced time spent on materiel management functions; increased planning of purchasing, inventory, and distribution functions; and assistance in meeting restricted supply budgets.

  17. Managing a subsidized predator population: Reducing common raven predation on desert tortoises

    USGS Publications Warehouse

    Boarman, W.I.

    2003-01-01

    Human communities often are an inadvertent source of food, water, and other resources to native species of wildlife. Because these resources are more stable and predictable than those in a natural environment, animals that subsist on them are able to increase in numbers and expand their range, much to the detriment of their competitors and species they prey upon. In the Mojave Desert, common ravens (Corvus corax) have benefited from human-provided resources to increase in population size precipitously in recent years. This trend has caused concern because ravens prey on juvenile desert tortoises (Gopherus agassizii), a federally threatened species. In this paper, I discuss management strategies to reduce raven predation on desert tortoises. The recommendations fall into three categories: (1) managing raven populations by reducing access to anthropogenic resources; (2) removing offending ravens or other birds in specially targeted tortoise management zones; and (3) continuing research on raven ecology, raven behavior, and methods of reducing raven predation on tortoises. I also recommend approaching the problem within an adaptive management framework: management efforts should first be employed as scientific experiments - with replicates and controls - to yield an unbiased assessment of their effectiveness. Furthermore, these strategies should be implemented in concert with actions that reduce other causes of desert tortoise mortality to aid the long-term recovery of their populations. Overall, the approaches outlined in this paper are widely applicable to the management of subsidized predators, particularly where they present a threat to a declining species of prey.

  18. Commentary: Exploiting the overlap: using utilization management to reduce medical malpractice.

    PubMed

    Dulworth, Sherrie

    2003-01-01

    This report presents a practical way in which hospitals can reduce medical malpractice exposure that is related to omissions and delays in care. We illustrate our approach using the results of a risk/medical management study performed at an acute-care hospital. Traditional risk management (RM) often focuses retrospectively on adverse events and may miss opportunities to prevent errors related to omissions and delays in care. Close-to-real-time utilization management (UM) activity offers ready potential to improve quality and reduce medical malpractice--but only if UM can work synergistically with RM. It is our conclusion that hospitals can implement systematic processes to identify and intervene in patterns of omissions and delays and improve the communication and synergy among stakeholders and thereby improve patient safety and reduce their medical malpractice risks.

  19. Does Water Management Reduce uncertainty of Projected Climate Change Impacts on River Discharge?

    NASA Astrophysics Data System (ADS)

    Pohle, I.; Koch, H.; Gaedeke, A.; Hinz, C.; Grünewald, U.

    2015-12-01

    Climate change impact studies are associated with error propagation and amplification of uncertainties through model chains. Water management, especially reservoir management, reduces discharge variability. In this study we investigated how water management influences uncertainty propagation of climate change scenarios. We applied a model ensemble of (i) the regional climate model STAR (STAR 0K: no further climate change, STAR 2K and 3K: increase of mean annual temperature by 2 K and 3 K resp.; each scenario is represented by 100 realizations), (ii) the hydrological models SWIM and EGMO, and (iii) the water management model WBalMo. The study was performed in the two neighbouring catchments of the Schwarze Elster River (Germany) and the Spree River (Germany and Czech Republic). These catchments have similar climate, topography and land use, but differ in their water management. The Spree River has a higher reservoir capacity, more withdrawals and discharges from water users and more water transfers. The projected natural runoff in both catchments is similar. Compared to STAR 0K, the natural runoff decreases remarkably in the other climate scenarios. The uncertainties related to the climate projection are propagated through the hydrological model. In the Schwarze Elster River catchment, these uncertainties are slightly increased by the water management model, whereas in the Spree River catchment, due to a higher reservoir capacity and more water transfers, interannual variability and uncertainty of managed discharge are strongly moderated by water management. The results of this study imply that generally, effective water management can reduce uncertainty related to climate change impacts on river discharge. Catchments with a high storage ratio are less vulnerable to changing climate conditions. This underlines the role of water management in coping with climate change impacts. Yet, due to decreasing reservoir volumes in drought periods, reservoir management alone

  20. Utilizing an Energy Management System with Distributed Resources to Manage Critical Loads and Reduce Energy Costs

    DTIC Science & Technology

    2014-09-01

    Systems with Electric Power Systems,” IEEE std 1547.4–2011, IEEE , 2011. [3] Department of the Navy, “Department of the Navy’s Energy Program for...Providing Improved Power Quality in Microgrids,” IEEE Industry Applications Magazine , pp. 34–43, September– October 2014. [27] A. Julian, N. Peck...and G. Oriti, “ Power electronics enabled energy management systems,” in Proceedings of IEEE Applied Power Electronics Conference, Long Beach, CA

  1. Retaining Educational Fundraisers: Reducing Turnover by Investing in Human Capital Management

    ERIC Educational Resources Information Center

    Thomas, Christy

    2010-01-01

    This article outlines an approach to reducing gift officer turnover during comprehensive campaigns by investing in the human capital management (HCM) program. While many universities have begun to create HCM programs, I suggest creating a position specifically focused on the retention of gift offices to ensure that universities and non-profits can…

  2. Security Officer's Role in Reducing Inmate Problem Behaviors: A Program Based on Contingency Management.

    ERIC Educational Resources Information Center

    Ellis, Janet

    1993-01-01

    Describes guard-designed and implemented contingency-management work squad training program for administratively segregated prison inmates with histories of violent and assaultive behavior. Notes that participation in the work squad program sharply reduced frequency of violent and assaultive behavior for 8 of 10 offender-participants whose…

  3. Best management practices for reducing nutrient loads in a sub-watershed of Chesapeake Bay

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Water quality improvement in the Chesapeake Bay is a grave concern. An initiative to reduce the nutrient loads to stream has been undertaken to attain a target total maximum daily load (TMDL) at Chesapeake Bay. A general guideline with a set of best management practices (BMPs) has been in place for ...

  4. Best management practices for reducing nutrient loads in a sub-watershed of Chesapeake Bay area

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Water quality improvement in the Chesapeake Bay is a grave concern. An initiative to reduce the nutrient loads to stream has been undertaken to attain a target total maximum daily load (TMDL) at Chesapeake Bay. A general guideline with a set of best management practices (BMPs) has been in place for ...

  5. A "Mental-Health-at-the-Workplace" Educational Workshop Reduces Managers' Stigma Toward Depression.

    PubMed

    Hamann, Johannes; Mendel, Rosmarie; Reichhart, Tatjana; Rummel-Kluge, Christine; Kissling, Werner

    2016-01-01

    Stigma and discrimination are important factors hindering people with mental health conditions to stay employed or successfully make their careers. We surveyed 580 German managers before and after visiting a "mental-health-at-the-workplace" educational workshop using the Depression Stigma Scale. The workshop significantly reduced stigma toward depression. Managers at baseline already exhibited lower stigma toward depression compared with the general population. In addition, female gender and higher education predicted lower stigma, which is in line with findings from other studies. We conclude that an educational workshop giving practical guidance regarding "mental-health-at-the-workplace" reduces managers' stigma toward depression and improves knowledge regarding depression, its course, and its treatment.

  6. Source reduction in Florida's salt marshes: management to reduce pesticide use and enhance the resource.

    PubMed

    Carlson, Douglas B

    2006-09-01

    Source reduction as part of an integrated pest management program is a cornerstone of the American Mosquito Control Association's Pesticide Environmental Stewardship Program Strategy Document to reduce pesticide risk. Since the early 1980s, Florida has made important strides in implementing environmentally sound source reduction strategies in salt marshes while managing them for both mosquito control and natural resource enhancement. The political mechanism for this progress has been interagency cooperation through the Florida Coordinating Council on Mosquito Control and its Subcommittee on Managed Marshes. Challenges in accomplishing source reduction continue because both public and private lands are involved. Public lands include those owned by federal (e.g., U.S. Fish and Wildlife Service, National Park Service), state (Florida Department of Environmental Protection), and local governments, and they have a diversity of management objectives. This diversity adds to the challenge facing mosquito control agencies in providing mosquito control services while protecting and enhancing the environment.

  7. Do referral-management schemes reduce hospital outpatient attendances? Time-series evaluation of primary care referral management

    PubMed Central

    Cox, Jonathan MS; Steel, Nicholas; Clark, Allan B; Kumaravel, Bharathy; Bachmann, Max O

    2013-01-01

    Background Ninety-one per cent of primary care trusts were using some form of referral management in 2009, although evidence for its effectiveness is limited. Aim To assess the impact of three referral-management centres (RMCs) and two internal peer-review approaches to referral management on hospital outpatient attendance rates. Design and setting A retrospective time-series analysis of 376 000 outpatient attendances over 3 years from 85 practices divided into five groups, with 714 000 registered patients in one English primary care trust. Method The age-standardised GP-referred first outpatient monthly attendance rate was calculated for each group from April 2009 to March 2012. This was divided by the equivalent monthly England rate, to derive a rate ratio. Linear regression tested for association between the introduction of referral management and change in the outpatient attendance rate and rate ratio. Annual group budgets for referral management were obtained. Results Referral management was not associated with a reduction in the outpatient attendance rate in any group. There was a statistically significant increase in attendance rate in one group (a RMC), which had an increase of 1.05 attendances per 1000 persons per month (95% confidence interval = 0.46 to 1.64; attendance rate ratio increase of 0.07) after adjustment for autocorrelation. Mean annual budgets ranged from £0.55 to £6.23 per registered patient in 2011/2012. RMCs were more expensive (mean annual budget £5.18 per registered patient) than internal peer-review approaches (mean annual budget £0.97 per registered patient). Conclusion Referral-management schemes did not reduce outpatient attendance rates. RMCs were more expensive than internal peer review. PMID:23735409

  8. Management Options for Reducing the Release of Antibiotics and Antibiotic Resistance Genes to the Environment

    PubMed Central

    Pruden, Amy; Amézquita, Alejandro; Collignon, Peter; Brandt, Kristian K.; Graham, David W.; Lazorchak, James M.; Suzuki, Satoru; Silley, Peter; Snape, Jason R.; Topp, Edward; Zhang, Tong; Zhu, Yong-Guan

    2013-01-01

    Background: There is growing concern worldwide about the role of polluted soil and water environments in the development and dissemination of antibiotic resistance. Objective: Our aim in this study was to identify management options for reducing the spread of antibiotics and antibiotic-resistance determinants via environmental pathways, with the ultimate goal of extending the useful life span of antibiotics. We also examined incentives and disincentives for action. Methods: We focused on management options with respect to limiting agricultural sources; treatment of domestic, hospital, and industrial wastewater; and aquaculture. Discussion: We identified several options, such as nutrient management, runoff control, and infrastructure upgrades. Where appropriate, a cross-section of examples from various regions of the world is provided. The importance of monitoring and validating effectiveness of management strategies is also highlighted. Finally, we describe a case study in Sweden that illustrates the critical role of communication to engage stakeholders and promote action. Conclusions: Environmental releases of antibiotics and antibiotic-resistant bacteria can in many cases be reduced at little or no cost. Some management options are synergistic with existing policies and goals. The anticipated benefit is an extended useful life span for current and future antibiotics. Although risk reductions are often difficult to quantify, the severity of accelerating worldwide morbidity and mortality rates associated with antibiotic resistance strongly indicate the need for action. PMID:23735422

  9. Evaluation of vegetable production management practices to reduce the ecological risk of pesticides.

    PubMed

    Rice, Pamela J; Hapeman, Cathleen J; McConnell, Laura L; Sadeghi, Ali M; Teasdale, John R; Coffman, C Benjamin; McCarty, Gregory W; Abdul-Baki, Aref A; Starr, James L

    2007-11-01

    The ability of agricultural management practices to reduce the ecological risks of pesticides was evaluated. Risk quotients, a mathematical description of the relationship between exposure and toxicity, and hazard ratings, a rank of the potential risk of pesticides to aquatic environments, were calculated for conventional and alternative cultivation practices for tomatoes: Poly-Bare, raised beds covered with polyethylene mulch with bare-soil furrows; Poly-Rye, raised beds covered with polyethylene mulch with cereal rye (Secale cereale) grown in the furrows; and Vetch, raised beds and furrows planted with hairy vetch seed (Vicia villosa). Evaluations were conducted using measured pesticide concentrations in runoff at the edge-of-field and estimated environmental concentrations in an adjacent creek and a theoretical pond receiving the runoff. Runoff from Poly-Bare presented the greatest risk to ecosystem health and to sensitive organisms, whereas the use of Vetch minimized these risks. Previous studies have shown that harvest yields were maintained and that runoff volume, soil loss, and off-site transport of pesticides measured in runoff were reduced using the alternative management practices (Poly-Rye and Vetch). Together, these results indicate that the alternative management practices (Poly-Rye and Vetch) have a less adverse impact on the environment than the conventional management practice (Poly-Bare) while providing growers with an acceptable economic return. In addition, the present study demonstrates the need to consider the management practice when assessing the potential risks and hazards for certain pesticides.

  10. Does recyclable separation reduce the cost of municipal waste management in Japan?

    PubMed

    Chifari, Rosaria; Lo Piano, Samuele; Matsumoto, Shigeru; Tasaki, Tomohiro

    2017-02-01

    Municipal solid waste (MSW) management is a system involving multiple sub-systems that typically require demanding inputs, materials and resources to properly process generated waste throughput. For this reason, MSW management is generally one of the most expensive services provided by municipalities. In this paper, we analyze the Japanese MSW management system and estimate the cost elasticity with respect to the waste volumes at three treatment stages: collection, processing, and disposal. Although we observe economies of scale at all three stages, the collection cost is less elastic than the disposal cost. We also examine whether source separation at home affects the cost of MSW management. The empirical results show that the separate collection of the recyclable fraction leads to reduced processing costs at intermediate treatment facilities, but does not change the overall waste management cost. Our analysis also reveals that the cost of waste management systems decreases when the service is provided by private companies through a public tender. The cost decreases even more when the service is performed under the coordination of adjacent municipalities.

  11. Reducing Health Cost: Health Informatics and Knowledge Management as a Business and Communication Tool

    NASA Astrophysics Data System (ADS)

    Gyampoh-Vidogah, Regina; Moreton, Robert; Sallah, David

    Health informatics has the potential to improve the quality and provision of care while reducing the cost of health care delivery. However, health informatics is often falsely regarded as synonymous with information management (IM). This chapter (i) provides a clear definition and characteristic benefits of health informatics and information management in the context of health care delivery, (ii) identifies and explains the difference between health informatics (HI) and managing knowledge (KM) in relation to informatics business strategy and (iii) elaborates the role of information communication technology (ICT) KM environment. This Chapter further examines how KM can be used to improve health service informatics costs, and identifies the factors that could affect its implementation and explains some of the reasons driving the development of electronic health record systems. This will assist in avoiding higher costs and errors, while promoting the continued industrialisation of KM delivery across health care communities.

  12. Working to reduce the effects of discrimination: Identity management strategies in organizations.

    PubMed

    Shih, Margaret; Young, Maia J; Bucher, Amy

    2013-04-01

    Despite efforts to dispel discrimination, workplace discrimination still occurs. We introduce two classes of identity management strategies individuals use to mitigate the negative consequences of discrimination: identity switching (i.e., deemphasizing target identities and recategorizing to a more positively valued identity) and identity redefinition (i.e., stereotype reassociation and regeneration). Organizations adopting a color-blind approach may make it more difficult for individuals to use identity switching because the policies deemphasize differences in social identities. In contrast, organizations adopting a multicultural approach may make it more difficult for individuals to use identity redefinition. Multicultural approaches, applied superficially, may celebrate group differences that might actually reinforce culturally dominant stereotypes. We explore the likelihood that individuals will adopt each strategy given these organizational approaches to diversity. We outline steps organizations can take to reduce the need for identity management strategies and to facilitate identity management when necessary.

  13. Management Strategies Aiming to Improve Horse Welfare Reduce Embryonic Death Rates in Mares.

    PubMed

    Malschitzky, E; Pimentel, A M; Garbade, P; Jobim, Mim; Gregory, R M; Mattos, R C

    2015-08-01

    The objective of this retrospective study was to evaluate the effect of management strategies aiming to improve animal well-being on pregnancy and embryonic death (ED) rates. Breeding records of a cohort of 1206 Thoroughbred mares brought to a stallion station facility, to be bred with the stallions housed there, were evaluated during ten breeding seasons. Mares were blocked according to management strategies in two groups: Stress and Relax. Strategies used to improve animal well-being (Relax group) were as follows: stopping the teasing routine, reducing or eliminating stall confinement, reducing the number of mares per group and maintaining herd stability during the breeding season. In barren mares, the pregnancy rate was higher in the Relax group (91.8%) when compared to the observed in Stress group (84.7%). However, no difference in pregnancy rates were observed (Stress = 85.2% vs. Relax = 86.2) in foaling mares. ED rate was higher in barren and foaling mares of the Stress group mares (25.5% and 26.8%, respectively) compared with the Relax group (16.1% and 14.7%, respectively). No significant differences were observed on foal heat pregnancy rate between groups; yet, the embryo loss on foal heat was significant reduced in Relax mares (Relax = 8.7% vs Stress = 24.5%). In conclusion, management strategies aimed to reduce social stress can reduce early pregnancy losses and the average cycles per pregnancy, improving reproductive performance in mares.

  14. Integrating modeling, monitoring, and management to reduce critical uncertainties in water resource decision making.

    PubMed

    Peterson, James T; Freeman, Mary C

    2016-12-01

    Stream ecosystems provide multiple, valued services to society, including water supply, waste assimilation, recreation, and habitat for diverse and productive biological communities. Managers striving to sustain these services in the face of changing climate, land uses, and water demands need tools to assess the potential effectiveness of alternative management actions, and often, the resulting tradeoffs between competing objectives. Integrating predictive modeling with monitoring data in an adaptive management framework provides a process by which managers can reduce model uncertainties and thus improve the scientific bases for subsequent decisions. We demonstrate an integration of monitoring data with a dynamic, metapopulation model developed to assess effects of streamflow alteration on fish occupancy in a southeastern US stream system. Although not extensive (collected over three years at nine sites), the monitoring data allowed us to assess and update support for alternative population dynamic models using model probabilities and Bayes rule. We then use the updated model weights to estimate the effects of water withdrawal on stream fish communities and demonstrate how feedback in the form of monitoring data can be used to improve water resource decision making. We conclude that investment in more strategic monitoring, guided by a priori model predictions under alternative hypotheses and an adaptive sampling design, could substantially improve the information available to guide decision-making and management for ecosystem services from lotic systems.

  15. The medical management of intestinal failure: methods to reduce the severity.

    PubMed

    Nightingale, Jeremy M D

    2003-08-01

    A new definition of intestinal failure is of reduced intestinal absorption so that macronutrient and/or water and electrolyte supplements are needed to maintain health or growth. Severe intestinal failure is when parenteral nutrition and/or fluid are needed and mild intestinal failure is when oral supplements or dietary modification suffice. Treatment aims to reduce the severity of intestinal failure. In the peri-operative period avoiding the administration of excessive amounts of intravenous saline (9 g NaCl/l) may prevent a prolonged ileus. Patients with intermittent bowel obstruction may be managed with a liquid or low-residue diet. Patients with a distal bowel enterocutaneous fistula may be managed with an enteral feed absorbed by the proximal small bowel while no oral intake may be needed for a proximal bowel enterocutaneous fistula. Patients undergoing high-dose chemotherapy can usually tolerate jejunal feeding. Rotating antibiotic courses may reduce small bowel bacterial overgrowth in patients with chronic intestinal pseudoobstruction. Restricting oral hypotonic fluids, sipping a glucose-saline solution (Na concentration of 90-120 mmol/l) and taking anti-diarrhoeal or anti-secretory drugs, reduces the high output from a jejunostomy. This treatment allows most patients with a jejunostomy and > 1 m functioning jejunum remaining to manage without parenteral support. Patients with a short bowel and a colon should consume a diet high in polysaccharides, as these compounds are fermented in the colon, and low in oxalate, as 25% of the oxalate will develop as calcium oxalate renal stones. Growth factors normally produced by the colon (e.g. glucagon-like peptide-2) to induce structural jejunal adaptation have been given in high doses to patients with a jejunostomy and do marginally increase the daily energy absorption.

  16. Increasing value and reducing waste in biomedical research regulation and management.

    PubMed

    Al-Shahi Salman, Rustam; Beller, Elaine; Kagan, Jonathan; Hemminki, Elina; Phillips, Robert S; Savulescu, Julian; Macleod, Malcolm; Wisely, Janet; Chalmers, Iain

    2014-01-11

    After identification of an important research question and selection of an appropriate study design, waste can arise from the regulation, governance, and management of biomedical research. Obtaining regulatory and governance approval has become increasingly burdensome and disproportionate to the conceivable risks to research participants. Regulation and governance involve interventions that are assumed to be justified in the interests of patients and the public, but they can actually compromise these interests. Inefficient management of the procedural conduct of research is wasteful, especially if it results in poor recruitment and retention of participants in well designed studies addressing important questions. These sources of waste can be minimised if the following four recommendations are addressed. First, regulators should use their influence to reduce other causes of waste and inefficiency in research. Second, regulators and policy makers should work with researchers, patients, and health professionals to streamline and harmonise the laws, regulations, guidelines, and processes that govern whether and how research can be done, and ensure that they are proportionate to the plausible risks associated with the research. Third, researchers and research managers should increase the efficiency of recruitment, retention, data monitoring, and data sharing in research through use of research designs known to reduce inefficiencies, and further research should be done to learn how efficiency can be increased. Finally, everyone, particularly those responsible for health-care systems, should promote integration of research into everyday clinical practice. Regulators and researchers should monitor adherence to each of these recommendations and publish metrics.

  17. Increasing value and reducing waste in biomedical research regulation and management

    PubMed Central

    Salman, Rustam Al-Shahi; Beller, Elaine; Kagan, Jonathan; Hemminki, Elina; Phillips, Robert S; Savulescu, Julian; Macleod, Malcolm; Wisely, Janet; Chalmers, Iain

    2014-01-01

    After identification of an important research question and selection of an appropriate study design, waste can arise from the regulation, governance, and management of biomedical research. Obtaining regulatory and governance approval has become increasingly burdensome and disproportionate to the conceivable risks to research participants. Regulation and governance involve interventions that are assumed to be justified in the interests of patients and the public, but they can actually compromise these interests. Inefficient management of the procedural conduct of research is wasteful, especially if it results in poor recruitment and retention of participants in well designed studies addressing important questions. These sources of waste can be minimised if the following four recommendations are addressed. First, regulators should use their influence to reduce other causes of waste and inefficiency in research. Second, regulators and policy makers should work with researchers, patients, and health professionals to streamline and harmonise the laws, regulations, guidelines, and processes that govern whether and how research can be done, and ensure that they are proportionate to the plausible risks associated with the research. Third, researchers and research managers should increase the efficiency of recruitment, retention, data monitoring, and data sharing in research through use of research designs known to reduce inefficiencies, and further research should be done to learn how efficiency can be increased. Finally, everyone, particularly those responsible for health-care systems, should promote integration of research into everyday clinical practice. Regulators and researchers should monitor adherence to each of these recommendations and publish metrics. PMID:24411646

  18. A multidisciplinary team case management approach reduces the burden of frequent asthma admissions.

    PubMed

    Burke, Hannah; Davis, Jenny; Evans, Sian; Flower, Laura; Tan, Andrew; Kurukulaaratchy, Ramesh J

    2016-07-01

    Up to 10% of asthmatics have "difficult asthma"; however, they account for 80% of asthma-related expenditure and run the highest risk of acute severe exacerbations. An estimated 75% of admissions for asthma are avoidable. Guidelines advise that these patients be managed by an experienced specialist multidisciplinary team (MDT). We aimed to assess the impact of a case management strategy delivered via specialist MDTs on acute healthcare utilisation of patients with frequent asthma admissions. An MDT (consultant, specialist nurse, physiotherapist and psychologist) case management strategy was introduced in 2010 at University Hospital Southampton Foundation Trust (Southampton, UK) to support patients with frequent asthma admissions during admission and then in clinic. To assess efficacy, we systematically searched the hospital database for patients acutely admitted for asthma on two or more occasions in 2010, 2011 and 2012. Data were collected retrospectively covering patient demographics, admission details, asthma severity and comorbidity. From 2010 to 2012, 84 patients were admitted on two or more occasions per year (80% female, mean body mass index 31 kg·m(-2) and 55% psychological comorbidity). After introducing an MDT approach repeat asthma admissions fell by 33% from 127 in 2010 to 84 in 2012 (p=0.0004). In addition, bed days fell by 52% from 895 in 2010 to 430 in 2010 (p=0.015). An MDT case management approach significantly reduces hospitalisation in difficult asthma patients with prior frequent admission.

  19. A multidisciplinary team case management approach reduces the burden of frequent asthma admissions

    PubMed Central

    Burke, Hannah; Davis, Jenny; Evans, Sian; Flower, Laura; Tan, Andrew

    2016-01-01

    Up to 10% of asthmatics have “difficult asthma”; however, they account for 80% of asthma-related expenditure and run the highest risk of acute severe exacerbations. An estimated 75% of admissions for asthma are avoidable. Guidelines advise that these patients be managed by an experienced specialist multidisciplinary team (MDT). We aimed to assess the impact of a case management strategy delivered via specialist MDTs on acute healthcare utilisation of patients with frequent asthma admissions. An MDT (consultant, specialist nurse, physiotherapist and psychologist) case management strategy was introduced in 2010 at University Hospital Southampton Foundation Trust (Southampton, UK) to support patients with frequent asthma admissions during admission and then in clinic. To assess efficacy, we systematically searched the hospital database for patients acutely admitted for asthma on two or more occasions in 2010, 2011 and 2012. Data were collected retrospectively covering patient demographics, admission details, asthma severity and comorbidity. From 2010 to 2012, 84 patients were admitted on two or more occasions per year (80% female, mean body mass index 31 kg·m−2 and 55% psychological comorbidity). After introducing an MDT approach repeat asthma admissions fell by 33% from 127 in 2010 to 84 in 2012 (p=0.0004). In addition, bed days fell by 52% from 895 in 2010 to 430 in 2010 (p=0.015). An MDT case management approach significantly reduces hospitalisation in difficult asthma patients with prior frequent admission. PMID:27730207

  20. Tension between reducing sea-level rise and global warming through solar-radiation management

    NASA Astrophysics Data System (ADS)

    Irvine, P. J.; Sriver, R. L.; Keller, K.

    2012-02-01

    Geoengineering using solar-radiation management (SRM) is gaining interest as a potential strategy to reduce future climate change impacts. Basic physics and past observations suggest that reducing insolation will, on average, cool the Earth. It is uncertain, however, whether SRM can reduce climate change stressors such as sea-level rise or rates of surface air temperature change. Here we use an Earth system model of intermediate complexity to quantify the possible response of sea levels and surface air temperatures to projected climate forcings and SRM strategies. We find that SRM strategies introduce a potentially strong tension between the objectives to reduce (1) the rate of temperature change and (2) sea-level rise. This tension arises primarily because surface air temperatures respond faster to radiative forcings than sea levels. Our results show that the forcing required to stop sea-level rise could cause a rapid cooling with a rate similar to the peak business-as-usual warming rate. Furthermore, termination of SRM was found to produce warming rates up to five times greater than the maximum rates under the business-as-usual CO2 scenario, whereas sea-level rise rates were only 30% higher. Reducing these risks requires a slow phase-out of many decades and thus commits future generations.

  1. Nursing students' time management, reducing stress and gaining satisfaction: a grounded theory study.

    PubMed

    Mirzaei, Tayebeh; Oskouie, Fatemeh; Rafii, Forough

    2012-03-01

    In the course of their studies, nursing students must learn many skills and acquire the knowledge required for their future profession. This study investigates how Iranian nursing students manage their time according to the circumstances and obstacles of their academic field. Research was conducted using the grounded theory method. Twenty-one nursing students were purposefully chosen as participants. Data was collected through semi-structured interviews and analyzed using the method suggested by Corbin and Strauss. One of the three processes that the nursing students used was "unidirectional time management." This pattern consists of accepting the nursing field, overcoming uncertainty, assessing conditions, feeling stress, and trying to reduce stress and create satisfaction. It was found that students allotted most of their time to academic tasks in an attempt to overcome their stress. The findings of this study indicate the need for these students to have time for the extra-curricular activities and responsibilities that are appropriate to their age.

  2. Effectiveness of Print Education at Reducing Urban Mosquito Infestation through Improved Resident-Based Management

    PubMed Central

    Bodner, Danielle; LaDeau, Shannon L.; Biehler, Dawn; Kirchoff, Nicole; Leisnham, Paul T.

    2016-01-01

    Improving resident-based management and knowledge of mosquitoes is often an integral component of integrated mosquito management, especially in urban landscapes with considerable mosquito habitat on privately owned lands. This study tested the effectiveness of print education materials at reducing urban mosquito exposure through improving resident knowledge of, and attitudes towards, mosquitoes and mosquito management in Washington DC, USA. There was a specific focus on the removal of water-filled containers that are utilized by the developmental stages of the two most common vector species in the region, Aedes albopictus and Culex pipiens. Households in six neighborhoods that varied in socio-economic status were administered knowledge, attitude, and practice (KAP) surveys in 2010 and 2012, and had their yards surveyed for container habitats and immature mosquitoes (larvae and pupae) in 2010, 2011, and 2012. Half the households (intervention, n = 120) received education materials in 2011 and 2012 to yield a before-after control-intervention (BACI) design. Unexpectedly, residents in intervention households were more likely to show decreased concern for mosquito-borne illnesses than residents in control households, which did not receive materials. Moreover, there was a greater probability that control households reduced containers in 2012 than intervention households, particularly when they had low numbers of baseline (2010) containers. Irrespective of control, reductions in containers were associated with decreased abundances of immature mosquitoes. Overall, our findings suggest that print education materials may have unintended negative effects on resident attitudes and household management of mosquito production. We recommend that mosquito control agencies need to carefully consider their content of print messages and the effectiveness of strategies that passively convey information with little or no engagement with control professionals. PMID:27171195

  3. Vegetation management for reducing mortality of ponderosa pine seedlings from Thomomys spp

    USGS Publications Warehouse

    Barnes, V.G.; Anthony, M.; ,

    1995-01-01

    The effects of vegetation management on Mazama pocket gopher activity and damage to ponderosa pine seedlings were studied using atrazine herbicide to alter the habitat. Atrazine treatments were applied to a large treatment unit and observed effects were compared to an untreated control unit. The greatly reduced forb and grass cover on the treated unit was associated with a corresponding decrease in pocket gopher activity. Times until seedlings first incurred gopher damage and overall survival of two cohorts of seedlings were greatly increased on the treated unit.

  4. Damage-reducing measures to manage flood risks in a changing climate

    NASA Astrophysics Data System (ADS)

    Kreibich, Heidi; Bubeck, Philip; Van Vliet, Mathijs; De Moel, Hans

    2014-05-01

    Damage due to floods has increased during the last few decades, and further increases are expected in several regions due to climate change and a growing vulnerability. To address the projected increase in flood risk, a combination of structural and non-structural flood risk mitigation measures is considered as a promising adaptation strategy. Such a combination takes into account that flood defence systems may fail, and prepare for unexpected crisis situations via land-use planning, building construction, evacuation and disaster response. Non-structural flood risk mitigation measures like shielding with water shutters or sand bags, building fortification or safeguarding of hazardous substances are often voluntary: they demand self-dependent action by the population at risk (Bubeck et al. 2012; 2013). It is believed that these measures are especially effective in areas with frequent flood events and low flood water levels, but some types of measures showed a significant damage-reducing effect also during extreme flood events, such as the Elbe River flood in August 2002 in Germany (Kreibich et al. 2005; 2011). Despite the growing importance of damage-reducing measures, information is still scarce about factors that motivate people to undertake such measures, the state of implementation of various non-structural measures in different countries and their damage reducing effects. Thus, we collected information and undertook an international review about this topic in the framework of the Dutch KfC project "Climate proof flood risk management". The contribution will present an overview about the available information on damage-reducing measures and draw conclusions for practical flood risk management in a changing climate. References: Bubeck, P., Botzen, W. J. W., Suu, L. T. T., Aerts, J. C. J. H. (2012): Do flood risk perceptions provide useful insights for flood risk management? Findings from central Vietnam. Journal of Flood Risk Management, 5, 4, 295-302 Bubeck, P

  5. Wind erosion reduces soil organic carbon sequestration falsely indicating ineffective management practices

    NASA Astrophysics Data System (ADS)

    Chappell, Adrian; Baldock, Jeffrey A.

    2016-09-01

    Improved management of agricultural land has the potential to reduce greenhouse gas emissions and to reduce atmospheric CO2 via soil carbon sequestration. However, SOC stocks are reduced by soil erosion which is commonly omitted from calculations of crop production, C cycling, C sequestration and C accounting. We used fields from the wind eroded dryland cropping region of Western Australia to demonstrate the global implications for C sequestration and C accounting of omitting soil erosion. For the fields we previously estimated mean net (1950s-1990) soil erosion of 1.2 ± 1.0 t ha-1 y-1. The mean net (1990-2013) soil erosion increased by nearly four times to 4.4 ± 2.1 t ha-1 y-1. Conservation agriculture has evidently not reduced wind erosion in this region. The mean net (1990-2013) SOC erosion was up to 0.2 t C ha-1 y-1 across all sampled fields and similar to measured sequestration rates in the region (up to 0.5 t C ha-1 y-1; 10 years) for many management practices recommended for building SOC stocks. The minimum detectable change (MDC; 10 years) of SOC without erosion was up to 0.2 t C ha-1 y-1 whilst the MDC of SOC with erosion was up to 0.4 t C ha-1 y-1. These results illustrate the generally applicable outcome: (i) if SOC erosion is equal to (or greater than) the increase in SOC due to management practices, the change will not be detectable (or a loss will be evident); (ii) without including soil erosion in SOC sequestration calculations, the monitoring of SOC stocks will lead to, at best the inability to detect change and, at worst the false impression that management practices have failed to store SOC. Furthermore, continued omission of soil erosion in crop production, C accounting and C sequestration will most likely undermine confidence in policy designed to encourage adoption of C farming and the attendant benefits for soil stewardship and food security.

  6. Reduced gravity and ground testing of a two-phase thermal management system for large spacecraft

    NASA Technical Reports Server (NTRS)

    Hill, D. G.; Hsu, K.; Parish, R.; Dominick, J.

    1988-01-01

    Experiments were performed aboard the NASA-JSC KC-135 aircraft to study the effect of reduced gravity on two-phase (liquid/vapor) flow and condensation. A prototype two-phase thermal management system for a large spacecraft was tested. Both visual observation and photography of the flow regimes were made. Ground test simulations of the KC-135 flight tests were conducted for comparison purposes. Two-phase pressure drops were predictable by the Heat Transfer Research Institute (HTRI) method, or the Friedel correlation.

  7. Managing delegation in the FDA: reducing delay in new-drug review.

    PubMed

    Olson, Mary K

    2004-06-01

    This article examines the effects of the user fee reform on the speed of drug review in the U.S. Food and Drug Administration. The results show that even after controlling for increased agency resources, the reform reduced review times among new-drug approvals by 34 percent (95 percent confidence interval, 11 to 51 percent, p = .01). The results suggest that increased agency resources alone cannot explain the reductions in drug-review times. Evidence suggests that other reform-specific factors facilitated the change. Such factors may include the agency's desire to obtain program renewal and secure future fee revenues as well as heightened industry monitoring. Additional results show that there were significant increases in the speed of review for novel drugs in the reform era and for drugs in certain classes that have historically experienced longer delays. The results suggest that the user fee reform has helped politicians manage delegation and reduce delay in new-drug review.

  8. Incentivizing the public to support invasive species management: eurasian milfoil reduces lakefront property values.

    PubMed

    Olden, Julian D; Tamayo, Mariana

    2014-01-01

    Economic evaluations of invasive species are essential for providing comprehensive assessments of the benefits and costs of publicly-funded management activities, yet many previous investigations have focused narrowly on expenditures to control spread and infestation. We use hedonic modeling to evaluate the economic effects of Eurasian milfoil (Myriophyllum spicatum) invasions on lakefront property values of single-family homes in an urban-suburban landscape. Milfoil often forms dense canopies at the water surface, diminishing the value of ecosystem services (e.g., recreation, fishing) and necessitating expensive control and management efforts. We compare 1,258 lakeshore property sale transactions (1995-2006) in 17 lakes with milfoil and 24 un-invaded lakes in King County, Washington (USA). After accounting for structural (e.g., house size), locational (e.g., boat launch), and environmental characteristics (e.g., water clarity) of lakes, we found that milfoil has a significant negative effect on property sales price ($94,385 USD lower price), corresponding to a 19% decline in mean property values. The aggregate cost of milfoil invading one additional lake in the study area is, on average, $377,542 USD per year. Our study illustrates that invasive aquatic plants can significantly impact property values (and associated losses in property taxes that reduce local government revenue), justifying the need for management strategies that prevent and control invasions. We recommend coordinated efforts across Lake Management Districts to focus institutional support, funding, and outreach to prevent the introduction and spread of milfoil. This effort will limit opportunities for re-introduction from neighboring lakes and incentivize private landowners and natural resource agencies to commit time and funding to invasive species management.

  9. Urinary Incontinence Management Costs are Reduced Following Burch or Sling Surgery for Stress Incontinence

    PubMed Central

    Subak, Leslee L.; Goode, Patricia S.; Brubaker, Linda; Kusek, John W.; Schembri, Mr. Michael; Lukacz, Emily S.; Kraus, Stephen R.; Chai, Toby C.; Norton, Peggy; Tennstedt, Sharon L.

    2014-01-01

    Objective To estimate the effect of Burch and fascial sling surgery on out-of-pocket urinary incontinence (UI) management costs at 24 months post-operatively and identify predictors of change in cost among women enrolled in a randomized trial comparing these procedures. Methods Resources used for UI management (supplies, laundry, dry cleaning) were self-reported by 491 women at baseline and 24 months post-surgery and total out-of-pocket costs for UI management (in 2012 US dollars) were estimated. Data from the two surgical groups were combined to examine change in cost for UI management over 24 months. Univariate and bivariate changes in cost were analyzed using Wilcoxon signed rank test. Predictors of change in cost were examined using multivariate mixed models. Results At baseline mean (±SD) age of participants was 53±10 years, and frequency of weekly UI episodes was 23±21. Weekly UI episodes decreased by 86% at 24 months (P<0.001). Mean weekly cost was $16.60±$27 (median $9.39) at baseline and $4.57±$15 (median $0.10) at 24 months (P<0.001), a decrease of 72%. In multivariate analyses, cost decreased by $3.38±$0.77 per week for each decrease of 1 UI episode per day (P<0.001) and was strongly associated with greater improvement in UDI and IIQ scores (P<0.001) and decreased 24-hour pad weight (P<0.02). Conclusion Following Burch or fascial sling surgery, UI management cost at 24 months decreased by 72% ($625 per woman per year) and was strongly associated with decreasing UI frequency. Reduced out-of-pocket expenses may be a benefit of these established urinary incontinence procedures. PMID:24631433

  10. Incentivizing the Public to Support Invasive Species Management: Eurasian Milfoil Reduces Lakefront Property Values

    PubMed Central

    Olden, Julian D.; Tamayo, Mariana

    2014-01-01

    Economic evaluations of invasive species are essential for providing comprehensive assessments of the benefits and costs of publicly-funded management activities, yet many previous investigations have focused narrowly on expenditures to control spread and infestation. We use hedonic modeling to evaluate the economic effects of Eurasian milfoil (Myriophyllum spicatum) invasions on lakefront property values of single-family homes in an urban-suburban landscape. Milfoil often forms dense canopies at the water surface, diminishing the value of ecosystem services (e.g., recreation, fishing) and necessitating expensive control and management efforts. We compare 1,258 lakeshore property sale transactions (1995–2006) in 17 lakes with milfoil and 24 un-invaded lakes in King County, Washington (USA). After accounting for structural (e.g., house size), locational (e.g., boat launch), and environmental characteristics (e.g., water clarity) of lakes, we found that milfoil has a significant negative effect on property sales price ($94,385 USD lower price), corresponding to a 19% decline in mean property values. The aggregate cost of milfoil invading one additional lake in the study area is, on average, $377,542 USD per year. Our study illustrates that invasive aquatic plants can significantly impact property values (and associated losses in property taxes that reduce local government revenue), justifying the need for management strategies that prevent and control invasions. We recommend coordinated efforts across Lake Management Districts to focus institutional support, funding, and outreach to prevent the introduction and spread of milfoil. This effort will limit opportunities for re-introduction from neighboring lakes and incentivize private landowners and natural resource agencies to commit time and funding to invasive species management. PMID:25333619

  11. DEVELOPMENT OF A BRIEF SUBSTANCE USE SENSATION SEEKING SCALE: VALIDATION AND PREDICTION OF INJECTION-RELATED BEHAVIORS

    PubMed Central

    Werb, Dan; Richardson, Chris; Buxton, Jane; Shoveller, Jeannie; Wood, Evan; Kerr, Thomas

    2015-01-01

    Sensation seeking, a personality trait, has been shown to predict engagement in high-risk behaviors. However, little is known regarding the impact of sensation seeking on substance use among street youth. We therefore sought to modify a sensation seeking scale (SSS) for use among this population. Street youth from the Vancouver-based At-Risk Youth Study (n = 226) completed the modified SSS. Exploratory and confirmatory factor analysis (EFA/CFA) were undertaken to establish the scale’s dimensionality and internal validity. The association between SSS score and injection-related behaviors was tested using generalized estimating equation (GEE) analysis. EFA results indicated scale unidimensionality. The comparative fit index (CFI) suggested acceptable fit (CFI = 0.914). In multivariate analysis, sensation seeking was independently associated with injection drug use, crystal methamphetamine use, polysubstance use, and binge drug use (all p < 0.05). Our findings provide preliminary support for the use of the modified SSS among street youth. PMID:25119056

  12. The efficiency of asset management strategies to reduce urban flood risk.

    PubMed

    ten Veldhuis, J A E; Clemens, F H L R

    2011-01-01

    In this study, three asset management strategies were compared with respect to their efficiency to reduce flood risk. Data from call centres at two municipalities were used to quantify urban flood risks associated with three causes of urban flooding: gully pot blockage, sewer pipe blockage and sewer overloading. The efficiency of three flood reduction strategies was assessed based on their effect on the causes contributing to flood risk. The sensitivity of the results to uncertainty in the data source, citizens' calls, was analysed through incorporation of uncertainty ranges taken from customer complaint literature. Based on the available data it could be shown that increasing gully pot blockage is the most efficient action to reduce flood risk, given data uncertainty. If differences between cause incidences are large, as in the presented case study, call data are sufficient to decide how flood risk can be most efficiently reduced. According to the results of this analysis, enlargement of sewer pipes is not an efficient strategy to reduce flood risk, because flood risk associated with sewer overloading is small compared to other failure mechanisms.

  13. Reducing nitrogen loss with managed drainage and polymer-coated urea.

    PubMed

    Nash, Patrick; Nelson, Kelly; Motavalli, Peter

    2015-01-01

    Continuous corn ( L.) production during dry years combined with high N fertilizer rates can have a high potential for NO-N loss through tile drainage water. Claypan soils can further increase the potential for NO-N loss through tile drainage water due to the claypan layer that restricts N leaching below the tile drains. The objective of this 4-yr study was to determine whether use of managed subsurface drainage (MD) in combination with a controlled-release N fertilizer could reduce the annual amount of NO-N loss through tile drainage water compared with free subsurface tile drainage (FD) with a noncoated urea application. Due to dry conditions over the summer and fall months, MD reduced the annual amount of water drained by at least 73% compared with FD in two of the four crop years. Low N loss and reduced corn N uptake possibly resulted in carry-over N and high soil N concentrations throughout the study, which may have limited the effect of N fertilizer source on annual NO-N loss in the tile drainage water. Use of MD reduced annual NO-N loss in the tile drainage water by 78 to 85% in two of the four years. High NO-N loss reduction with MD compared with FD was largely due to dry growing season conditions in combination with wet conditions over the noncropping period.

  14. Reducing Heart Failure Hospital Readmissions: A Systematic Review of Disease Management Programs

    PubMed Central

    Gorthi, Janardhana; Hunter, Claire B.; Mooss, Ayran N.; Alla, Venkata M.; Hilleman, Daniel E.

    2014-01-01

    The recent enactment of the Patient Protection and Affordable Care Act which established the federal Hospital Readmissions Reduction Program (HRRP) has accelerated efforts to develop heart failure (HF) disease management programs (DMPs) that reduce readmissions in patients hospitalized for HF. This systematic review identified randomized controlled trials of HF DMPs which included home care, outpatient clinic interventions, structured telephone support, and non-invasive and invasive telemonitoring. These different types of DMPs have been associated with conflicting results. No specific type of DMP has produced consistent benefit in reducing HF hospitalizations. Although probably effective at reducing readmissions, home visits and outpatient clinic interventions have substantial limitations including cost and accessibility. Telemanagement has the potential to reach a large number of patients at a reasonable cost. Structured telephone support follow-up has been shown to significantly reduce HF readmissions, but does not significantly reduce all-cause mortality or all-cause hospitalization. A meta-analysis of 11 non-invasive telemonitoring studies demonstrated significant reductions in all-cause mortality and HF hospitalizations. Invasive telemonitoring is a potentially effective means of reducing HF hospitalizations, but only one study using pulmonary artery pressure monitoring was able to demonstrate a reduction in HF hospitalizations. Other studies using invasive hemodynamic monitoring have failed to demonstrate changes in rates of readmission or mortality. The efficacy of HF DMPs is associated with inconsistent results. Our review should not be interpreted to indicate that HF DMPs are universally ineffective. Rather, our data suggest that one approach applied to a broad spectrum of different patient types may produce an erratic impact on readmissions and clinical outcomes. HF DMPs should include the flexibility to meet the individualized needs of specific patients

  15. Waste Management Strategy for Dismantling Waste to Reduce Costs for Power Plant Decommissioning - 13543

    SciTech Connect

    Larsson, Arne; Lidar, Per; Bergh, Niklas; Hedin, Gunnar

    2013-07-01

    -necks in the process causes increased space requirements and will have negative impact on the project schedule, which increases not only the cost but also the dose exposure to personnel. For these reasons it is critical to create a process that transfers material into conditioned waste ready for disposal as quickly as possible. To a certain extent the decommissioning program should be led by the waste management process. With the objective to reduce time for handling of dismantled material at site and to efficiently and environmental-friendly use waste management methods (clearance for re-use followed by clearance for recycling), the costs for the plant decommissioning could be reduced as well as time needed for performing the decommissioning project. Also, risks for delays would be reduced with a well-defined handling scheme which limits surprises. Delays are a major cost driver for decommissioning projects. (authors)

  16. Effectiveness of managed gene flow in reducing genetic divergence associated with captive breeding

    PubMed Central

    Waters, Charles D; Hard, Jeffrey J; Brieuc, Marine S O; Fast, David E; Warheit, Kenneth I; Waples, Robin S; Knudsen, Curtis M; Bosch, William J; Naish, Kerry A

    2015-01-01

    Captive breeding has the potential to rebuild depressed populations. However, associated genetic changes may decrease restoration success and negatively affect the adaptive potential of the entire population. Thus, approaches that minimize genetic risks should be tested in a comparative framework over multiple generations. Genetic diversity in two captive-reared lines of a species of conservation interest, Chinook salmon (Oncorhynchus tshawytscha), was surveyed across three generations using genome-wide approaches. Genetic divergence from the source population was minimal in an integrated line, which implemented managed gene flow by using only naturally-born adults as captive broodstock, but significant in a segregated line, which bred only captive-origin individuals. Estimates of effective number of breeders revealed that the rapid divergence observed in the latter was largely attributable to genetic drift. Three independent tests for signatures of adaptive divergence also identified temporal change within the segregated line, possibly indicating domestication selection. The results empirically demonstrate that using managed gene flow for propagating a captive-reared population reduces genetic divergence over the short term compared to one that relies solely on captive-origin parents. These findings complement existing studies of captive breeding, which typically focus on a single management strategy and examine the fitness of one or two generations. PMID:26640521

  17. Identification and Prioritization of Management Practices to Reduce Methylmercury Exports from Wetlands and Irrigated Agricultural Lands

    NASA Astrophysics Data System (ADS)

    McCord, Stephen A.; Heim, Wesley A.

    2015-03-01

    The Sacramento-San Joaquin Delta's (Delta) beneficial uses for humans and wildlife are impaired by elevated methylmercury (MeHg) concentrations in fish. MeHg is a neurotoxin that bioaccumulates in aquatic food webs. The total maximum daily load (TMDL) implementation plan aimed at reducing MeHg in Delta fish obligates dischargers to conduct MeHg control studies. Over 150 stakeholders collaborated to identify 24 management practices (MPs) addressing MeHg nonpoint sources (NPS) in three categories: biogeochemistry (6), hydrology (14), and soil/vegetation (4). Land uses were divided into six categories: permanently and seasonally flooded wetlands, flooded and irrigated agricultural lands, floodplains, and brackish-fresh tidal marshes. Stakeholders scored MPs based on seven criteria: scientific certainty, costs, MeHg reduction potential, spatial applicability, technical capacity to implement, negative impacts to beneficial uses, and conflicting requirements. Semi-quantitative scoring for MPs applicable to each land use (totaling >400 individual scores) led to consensus-based prioritization. This process relied on practical experience from diverse and accomplished NPS stakeholders and synthesis of 17 previous studies. Results provide a comprehensive, stakeholder-driven prioritization of MPs for wetland and irrigated agricultural land managers. Final prioritization highlights the most promising MPs for practical application and control study, and a secondary set of MPs warranting further evaluation. MPs that address hydrology and soil/vegetation were prioritized because experiences were positive and implementation appeared more feasible. MeHg control studies will need to address the TMDL conundrum that MPs effective at reducing MeHg exports could both exacerbate MeHg exposure and contend with other management objectives on site.

  18. Identification and prioritization of management practices to reduce methylmercury exports from wetlands and irrigated agricultural lands.

    PubMed

    McCord, Stephen A; Heim, Wesley A

    2015-03-01

    The Sacramento-San Joaquin Delta's (Delta) beneficial uses for humans and wildlife are impaired by elevated methylmercury (MeHg) concentrations in fish. MeHg is a neurotoxin that bioaccumulates in aquatic food webs. The total maximum daily load (TMDL) implementation plan aimed at reducing MeHg in Delta fish obligates dischargers to conduct MeHg control studies. Over 150 stakeholders collaborated to identify 24 management practices (MPs) addressing MeHg nonpoint sources (NPS) in three categories: biogeochemistry (6), hydrology (14), and soil/vegetation (4). Land uses were divided into six categories: permanently and seasonally flooded wetlands, flooded and irrigated agricultural lands, floodplains, and brackish-fresh tidal marshes. Stakeholders scored MPs based on seven criteria: scientific certainty, costs, MeHg reduction potential, spatial applicability, technical capacity to implement, negative impacts to beneficial uses, and conflicting requirements. Semi-quantitative scoring for MPs applicable to each land use (totaling >400 individual scores) led to consensus-based prioritization. This process relied on practical experience from diverse and accomplished NPS stakeholders and synthesis of 17 previous studies. Results provide a comprehensive, stakeholder-driven prioritization of MPs for wetland and irrigated agricultural land managers. Final prioritization highlights the most promising MPs for practical application and control study, and a secondary set of MPs warranting further evaluation. MPs that address hydrology and soil/vegetation were prioritized because experiences were positive and implementation appeared more feasible. MeHg control studies will need to address the TMDL conundrum that MPs effective at reducing MeHg exports could both exacerbate MeHg exposure and contend with other management objectives on site.

  19. Nurse-led risk assessment/management clinics reduce predicted cardiac morbidity and mortality in claudicants.

    PubMed

    Hatfield, Josephine; Gulati, Sumit; Abdul Rahman, Morhisham N A; Coughlin, Patrick A; Chetter, Ian C

    2008-12-01

    Nurse-led assessment/management of risk factors is effective in many chronic medical conditions. We aimed to evaluate whether this finding was true for patients with intermittent claudication and to analyze its impact on patient-reported quality of life and predicted mortality due to coronary heart disease. We prospectively studied a series of 78 patients (51 men; median age, 65 years [IQR: 56-74 years]), diagnosed with intermittent claudication and referred to a nurse-led risk assessment/management clinic (NLC) from a consultant-led vascular surgical clinic. The NLC used clinical care pathways to manage antiplatelet medication, smoking cessation, hyperlipidemia, hypertension, and diabetes and to provide exercise advice. All patients were reassessed at a 3 months. Medication compliance, smoking status, fasting lipid profiles, blood pressure, and HbA1c were recorded. Disease-specific quality of life was assessed using King's College VascuQoL and predicted cardiac morbidity and mortality were calculated using the PROCAM and Framingham risk scores. We found that NLC enrollment produced an antiplatelet and a statin compliance of 100%, a smoking cessation rate of 17% (9 patients) and significant improvements in total cholesterol (median, 5.2-4.5 mmol/l), LDL (median, 3.1-2.5 mmol/l) and triglyceride (median, 1.7-1.4 mmol/l) levels. Significant disease-specific quality of life improvements and significant reduction in both the PROCAM (14% to 10%) and Framingham (14% to 11%) coronary risk scores were observed. Providing care at NLCs for claudicants is effective in assessing and managing risk factors, improves disease-specific quality of life and reduces predicted morbidity and mortality due to coronary heart disease.

  20. Evaluation of individual and combined management practices to reduce the off-site transport of pesticides from golf course turf.

    PubMed

    Rice, Pamela J; Horgan, Brian P; Hamlin, Jennifer L

    2017-04-01

    The detection of pesticides, associated with turfgrass management, in storm runoff and surface waters of urban watersheds has raised concerns regarding their source, potential environmental effects and a need for strategies to reduce their inputs. In previous research we discovered that hollow tine core cultivation (HTCC) was more effective than other management practices for reducing the off-site transport of pesticides with runoff from creeping bentgrass turf managed as a golf course fairway. This was primarily the result of enhanced infiltration and reduced runoff volumes associated with turf managed with hollow tines. In this study we evaluated the addition of verticutting (VC) to HTCC (HTCC+VC) in an attempt to further enhance infiltration and mitigate the off-site transport of pesticides with runoff from managed turf. Overall, greater or equal quantities of pesticides were transported with runoff from plots managed with HTCC+VC compared to HTCC or VC alone. For the pesticides evaluated HTCCreduced availability of recently exposed soil sorptive sites produced from the HTCC. Results of this research provides guidance to golf course managers on selection of management practices that assure quality turf while minimizing off-site transport of pesticides, improving pesticide efficacy and the environmental stewardship of managed biological systems.

  1. Improving Learning Results and Reducing Cognitive Load through 3D Courseware on Color Management and Inspection Instruction

    ERIC Educational Resources Information Center

    Hsiung, Liang-Yuan; Lai, Mu-Hui

    2013-01-01

    This study intends to solve the problem that schools in Taiwan lack of the equipment for color management and inspection instruction and seek ways to improve learning results and reduce cognitive load. The researchers developed 3D courseware for color management and inspection through a research and development process. To further scrutinize the…

  2. Reducing Overheating-Induced Failures Via Performance-Aware CPU Power Management.

    SciTech Connect

    Hsu, C.-H.; Feng, W. C.

    2005-01-01

    Cluster end-users and administrators have become more cognizant of the fact that large-scale commodity clusters fail quite frequently, and the main source of these failures is hardware (e.g., processors) with the primary cause being heat. This situation is expected to worsen with even larger-scale clusters powered by faster (and/or multicore) processors. In this paper, we propose a power-management algorithm that addresses heat-related reliability for processors by controlling their clock speeds in a performance-aware manner. This approach is complementary to existing approaches such as exotic cooling and fault-tolerant technologies in that it proactively deals with power and cooling issues before they become a problem. Our preliminary experimental work demonstrates that our approach can easily be applied commodity processors and can reduce heat generation by 30% on average with minimal effect on performance when running the SPEC benchmarks.

  3. Can Artificial Reef Wrecks Reduce Diver Impacts on Shipwrecks? The Management Dimension

    NASA Astrophysics Data System (ADS)

    Edney, Joanne; Spennemann, Dirk H. R.

    2015-08-01

    Managers have been advocating the use of artificial reef wrecks to diversify the experiences of recreational divers and thereby reduce the well-known impact on reefs. To examine whether artificial reef wrecks can serve as substitutes for historic shipwrecks this paper discusses the attitude of Australian divers to wreck diving in general and to artificial reef wrecks in particular. While the overwhelming majority of divers surveyed accepted the need for control, the experienced divers were less interested in artificial reef wrecks and less prepared to tolerate controls over their perceived freedom to dive wrecks. We present projections that show that this legacy issue will have largely resolved itself by 2025 due to attrition and natural ageing.

  4. Managing sedentary behavior to reduce the risk of diabetes and cardiovascular disease.

    PubMed

    Dempsey, Paddy C; Owen, Neville; Biddle, Stuart J H; Dunstan, David W

    2014-01-01

    Modern human environments are vastly different from those of our forebears. Rapidly advancing technology in transportation, communications, workplaces, and home entertainment confer a wealth of benefits, but increasingly come with costs to human health. Sedentary behavior-too much sitting as distinct from too little physical activity-contributes adversely to cardiometabolic health outcomes and premature mortality. Findings from observational epidemiology have been synthesized in meta-analyses, and evidence is now shifting into the realm of experimental trials with the aim of identifying novel mechanisms and potential causal relationships. We discuss recent observational and experimental evidence that makes a compelling case for reducing and breaking up prolonged sitting time in both the primary prevention and disease management contexts. We also highlight future research needs, the opportunities for developing targeted interventions, and the potential of population-wide initiatives designed to address too much sitting as a health risk.

  5. Pharmacist-physician co-management of hypertension reduces 24-hour ambulatory blood pressures

    PubMed Central

    Weber, Cynthia A.; Ernst, Michael E.; Sezate, Genesis S.; Zheng, Shimin; Carter, Barry L.

    2010-01-01

    Background Pharmacist-physician co-management of hypertension has been shown to improve office blood pressures (BP). We sought to describe the effect of such a model on 24-hour ambulatory BPs. Methods We performed a prospective, cluster-randomised controlled clinical trial in 179 patients with uncontrolled hypertension from five primary care clinics in Iowa City, Iowa. Patients were randomized by clinic to receive pharmacist-physician collaborative management of hypertension (intervention) or usual care (control) for a 9-month period. In the intervention group, pharmacists helped patients identify barriers to BP control, counselled on lifestyle and dietary modifications, and adjusted antihypertensive therapy in collaboration with the patient’s primary care provider. Patients were seen by pharmacists a minimum every 2 months. Ambulatory BP was obtained at baseline and study end. Results Baseline and end of study ambulatory BP profiles were evaluated for 175 patients. Ambulatory BPs were reduced to a greater extent in the intervention compared to control group (daytime ΔSBP [SD] 15.2[11.5] vs 5.5[13.5], p<0.001; nighttime ΔSBP [SD] 12.2[14.8] vs 3.4[13.3], p<0.001; 24-hour ΔSBP [SD] 14.1[11.3] vs 5.5[12.5], p<0.001). More patients in the intervention group had BP controlled at the end of the study (75% vs 50.7%, p<0.001) as defined by overall 24-hour ambulatory BP monitoring. Conclusions Pharmacist-physician collaborative management of hypertension achieved consistent and significantly greater reduction in 24-hour BP and a high rate of BP control. PMID:20937921

  6. Surveillance Recommendations in Reducing Risk of and Optimally Managing Breast Cancer-Related Lymphedema

    PubMed Central

    Ostby, Pamela L.; Armer, Jane M.; Dale, Paul S.; Van Loo, Margaret J.; Wilbanks, Cassie L.; Stewart, Bob R.

    2014-01-01

    Breast cancer survivors are at increased risk for the development of breast cancer-related lymphedema (BCRL), a chronic, debilitating, and disfiguring condition that is progressive and requires lifelong self-management of symptoms. It has been reported that over 40% of the 2.5 million breast cancer survivors in the United States may meet the criteria for BCRL during their lifetimes. Ongoing surveillance, beginning with pre-operative assessment, has been effective in identifying subclinical lymphedema (LE). A prospective model for surveillance is necessary in order to detect BCRL at an early stage when there is the best chance to reduce risk or slow progression. Physical methods for monitoring and assessment, such as circumferential arm measures, perometry, bioimpedance; exercise programs; prophylactic and early-intervention compression garments; and referral for complete decongestive therapy are all interventions to consider in the development of a BCRL surveillance program. In addition, supportive-educative programs and interactive engagement for symptom self-management should also be implemented. The importance of interdisciplinary collaboration is integral to the success of an effective personalized medicine program in breast cancer-related lymphedema surveillance. PMID:25563360

  7. Can arbuscular mycorrhiza and fertilizer management reduce phosphorus runoff from paddy fields?

    PubMed

    Zhang, Shujuan; Wang, Li; Ma, Fang; Zhang, Xue; Li, Zhe; Li, Shiyang; Jiang, Xiaofeng

    2015-07-01

    Our study sought to assess how much phosphorus (P) runoff from paddy fields could be cut down by fertilizer management and inoculation with arbuscular mycorrhizal fungi. A field experiment was conducted in Lalin River basin, in the northeast China: six nitrogen-phosphorus-potassium fertilizer levels were provided (0, 20%, 40%, 60%, 80%, and 100% of the recommended fertilizer supply), with or without inoculation with Glomus mosseae. The volume and concentrations of particle P (PP) and dissolved P (DP) were measured for each runoff during the rice growing season. It was found that the seasonal P runoff, including DP and PP, under the local fertilization was 3.7 kg/ha, with PP, rather than DP, being the main form of P in runoff water. Additionally, the seasonal P runoff dropped only by 8.9% when fertilization decreased by 20%; rice yields decreased with declining fertilization. We also found that inoculation increased rice yields and decreased P runoff at each fertilizer level and these effects were lower under higher fertilization. Conclusively, while rice yields were guaranteed arbuscular mycorrhizal inoculation and fertilizer management would play a key role in reducing P runoff from paddy fields.

  8. Kraft mill effluent survey: progress toward best management practices for reducing effects on fish reproduction.

    PubMed

    Kovacs, Tibor G; Martel, Pierre H; O'Connor, Brian I; Parrott, Joanne L; McMaster, Mark E; Van Der Kraak, Glen J; MacLatchy, Deborah L; van den Heuvel, Michael R; Hewitt, L Mark

    2011-06-01

    Pulp and paper mill effluents have been linked to effects on fish reproduction for more than 25 years. To date, the causes of these effects and remedial strategies have eluded investigators. Recent work has shown that the degree of reproductive effect caused by a mill effluent is related to the overall organic content. If verified, this could lead to breakthroughs for best management practices (BMPs). For this study, the effluents from seven kraft mills were assessed for their ability to reduce egg production in fathead minnow (Pimephales promelas) in the laboratory. At the same time, the effluents were analyzed for three parameters thought to be good indicators of organic losses: biochemical oxygen demand (BOD), methyl-substituted 2-cyclopentenones (cellulose degradation products), and a gas chromatographic (GC) profile index, which integrates the total area of the chromatographic peaks of solvent-extracted effluents using low-resolution mass spectrometry. The results showed that the degree to which the effluents reduced egg production increased with increased organic losses as characterized by BOD and the GC profile index. Therefore, these parameters could be used to guide BMPs at kraft mills according to specific targets: BOD < 20 mg/L and GC profile index equivalent to effluent with BOD of 20 mg/L. Such targets should be achievable by good in-plant control of organic losses and optimized effluent biotreatment systems.

  9. Reduced biological control and enhanced chemical pest management in the evolution of fungus farming in ants

    PubMed Central

    Fernández-Marín, Hermógenes; Zimmerman, Jess K.; Nash, David R.; Boomsma, Jacobus J.; Wcislo, William T.

    2009-01-01

    To combat disease, most fungus-growing ants (Attini) use antibiotics from mutualistic bacteria (Pseudonocardia) that are cultured on the ants' exoskeletons and chemical cocktails from exocrine glands, especially the metapleural glands (MG). Previous work has hypothesized that (i) Pseudonocardia antibiotics are narrow-spectrum and control a fungus (Escovopsis) that parasitizes the ants' fungal symbiont, and (ii) MG secretions have broad-spectrum activity and protect ants and brood. We assessed the relative importance of these lines of defence, and their activity spectra, by scoring abundance of visible Pseudonocardia for nine species from five genera and measuring rates of MG grooming after challenging ants with disease agents of differing virulence. Atta and Sericomyrmex have lost or greatly reduced the abundance of visible bacteria. When challenged with diverse disease agents, including Escovopsis, they significantly increased MG grooming rates and expanded the range of targets. By contrast, species of Acromyrmex and Trachymyrmex maintain abundant Pseudonocardia. When challenged, these species had lower MG grooming rates, targeted primarily to brood. More elaborate MG defences and reduced reliance on mutualistic Pseudonocardia are correlated with larger colony size among attine genera, raising questions about the efficacy of managing disease in large societies with chemical cocktails versus bacterial antimicrobial metabolites. PMID:19324734

  10. Water cycle and its management for plant habitats at reduced pressures

    NASA Technical Reports Server (NTRS)

    Rygalov, Vadim Y.; Fowler, Philip A.; Wheeler, Raymond M.; Bucklin, Ray A.

    2004-01-01

    Experimental and mathematical models were developed for describing and testing temperature and humidity parameters for plant production in bioregenerative life support systems. A factor was included for analyzing systems operating at low (10-101.3 kPa) pressure to reduce gas leakage and structural mass (e.g., inflatable greenhouses for space application). The expected close relationship between temperature and relative humidity was observed, along with the importance of heat exchanger coil temperature and air circulation rate. The presence of plants in closed habitats results in increased water flux through the system. Changes in pressure affect gas diffusion rates and surface boundary layers, and change convective transfer capabilities and water evaporation rates. A consistent observation from studies with plants at reduced pressures is increased evapotranspiration rates, even at constant vapor pressure deficits. This suggests that plant water status is a critical factor for managing low-pressure production systems. The approach suggested should help space mission planners design artificial environments in closed habitats.

  11. Development of a brief substance use sensation seeking scale: validation and prediction of injection-related behaviors.

    PubMed

    Werb, Dan; Richardson, Chris; Buxton, Jane; Shoveller, Jeannie; Wood, Evan; Kerr, Thomas

    2015-02-01

    Sensation seeking, a personality trait, has been shown to predict engagement in high-risk behaviors. However, little is known regarding the impact of sensation seeking on substance use among street youth. We therefore sought to modify a sensation seeking scale (SSS) for use among this population. Street youth from the Vancouver-based At-Risk Youth Study (n = 226) completed the modified SSS. Exploratory and confirmatory factor analysis (EFA/CFA) were undertaken to establish the scale's dimensionality and internal validity. The association between SSS score and injection-related behaviors was tested using generalized estimating equation analysis. EFA results indicated scale unidimensionality. The comparative fit index (CFI) suggested acceptable fit (CFI = 0.914). In multivariate analysis, sensation seeking was independently associated with injection drug use, crystal methamphetamine use, polysubstance use, and binge drug use (all p < 0.05). Our findings provide preliminary support for the use of the modified SSS among street youth.

  12. Reducing soil erosion and nutrient loss on sloping land under crop-mulberry management system.

    PubMed

    Fan, Fangling; Xie, Deti; Wei, Chaofu; Ni, Jiupai; Yang, John; Tang, Zhenya; Zhou, Chuan

    2015-09-01

    Sloping croplands could result in soil erosion, which leads to non-point source pollution of the aquatic system in the Three Gorges Reservoir Region. Mulberry, a commonly grown cash plant in the region, is traditionally planted in contour hedgerows as an effective management practice to control soil erosion and non-point source pollution. In this field study, surface runoff and soil N and P loss on sloping land under crop-mulberry management were investigated. The experiments consisted of six crop-mulberry treatments: Control (no mulberry hedgerow with mustard-corn rotation); T1 (two-row contour mulberry with mustard-corn rotation); T2 (three-row contour mulberry with mustard-corn rotation); T3 (border mulberry and one-row contour mulberry with mustard-corn rotation); T4 (border mulberry with mustard-corn rotation); T5 (two-row longitudinal mulberry with mustard). The results indicated that crop-mulberry systems could effectively reduce surface runoff and soil and nutrient loss from arable slope land. Surface runoff from T1 (342.13 m(3) hm(-2)), T2 (260.6 m(3) hm(-2)), T3 (113.13 m(3) hm(-2)), T4 (114 m(3) hm(-2)), and T5 (129 m(3) hm(-2)) was reduced by 15.4, 35.6, 72.0, 71.8, and 68.1%, respectively, while soil loss from T1 (0.21 t hm(-2)), T2 (0.13 t hm(-2)), T3 (0.08 t hm(-2)), T4 (0.11 t hm(-2)), and T5 (0.12 t hm(-2)) was reduced by 52.3, 70.5, 81.8, 75.0, and 72.7%, respectively, as compared with the control. Crop-mulberry ecosystem would also elevate soil N by 22.3% and soil P by 57.4%, and soil nutrient status was contour-line dependent.

  13. Implications of chronic wasting disease, cougar predation, and reduced recruitment for elk management

    USGS Publications Warehouse

    Sargeant, G.A.; Weber, D.C.; Roddy, D.E.

    2011-01-01

    Emerging diseases and expanding carnivore populations may have profound implications for ungulate harvest management and population regulation. To better understand effects of chronic wasting disease (CWD) and cougar (Puma concolor) predation, we studied mortality and recruitment of elk (Cervus elaphus) at Wind Cave National Park (WICA) during 2005-2009. We marked 202 elk (83 subadult M and 119 subadult and ad F) with Global Positioning System (GPS) collars, observed 28 deaths during 74,220 days of monitoring, and investigated 42 additional deaths of unmarked elk found dead. Survival rates were similar for males and females and averaged 0.863 (SE = 0.025) annually. Leading causes of mortality included hunting (0.065, SE = 0.019), CWD (0.034, SE = 0.012), and cougar predation (0.029, SE = 0.012). Marked elk killed by hunters and cougars typically were in good physical condition and not infected with CWD. Effects of mortality on population growth were exacerbated by low rates of pregnancy (subadults = 9.5%, SE = 6.6%; ad = 76.9%, SE = 4.2%) and perinatal survival (0.49, SE = 0.085 from 1 Feb to 1 Sep). Chronic wasting disease, increased predation, and reduced recruitment reduced the rate of increase for elk at WICA to approximately ?? = 1.00 (SE = 0.027) during the past decade. Lower rates of increase are mitigating effects of elk on park vegetation, other wildlife, and neighboring lands and will facilitate population control, but may reduce opportunities for elk hunting outside the park. ?? 2011 The Wildlife Society.

  14. Modeling of Solar Radiation Management: A comparison of simulations using reduced solar constant and stratospheric aerosols

    NASA Astrophysics Data System (ADS)

    Kalidindi, Sirisha; Bala, Govindasamy; Modak, Angshuman; Caldeira, Ken

    2014-05-01

    The climatic effects of Solar Radiation Management (SRM) geoengineering have been often modeled by simply reducing the solar constant. This is most likely valid only for space sunshades and not for atmosphere and surface based SRM methods. In this study, a global climate model is used to test if the climate response to SRM by stratospheric aerosols and uniform solar constant reduction are equivalent. Our analysis shows that when global mean warming from a doubling of CO2 is nearly cancelled by both these methods, they are equivalent when important surface and tropospheric climate variables are considered. However, a difference of 1 K in the global mean stratospheric (61-9.8 hPa) temperature is simulated between the two SRM methods. Further, while the global mean surface diffuse radiation increases by about 15-20% and direct radiation decreases by about 8% in the case of sulphate aerosol SRM method, both direct and diffuse radiation decrease by similar fractional amounts (~ -1.5%) when solar constant is reduced. Though the contribution from shaded leaves to gross primary productivity (GPP) increases by 6% in aerosol SRM because of increased diffuse light this increase is almost offset by a 7% decline in sunlit contribution due to reduced direct light. Hence, in the aerosol SRM there is a slight net reduction (~ 1%) in total GPP which is close to the decrease due to solar constant reduction. Based on our results we conclude that the climate states produced by a reduction in solar constant and addition of aerosols into the stratosphere can be considered almost equivalent except for two important aspects: stratospheric temperature change and the partitioning of direct versus diffuse radiation reaching the surface.

  15. Reduced-Order Models for Load Management in the Power Grid

    NASA Astrophysics Data System (ADS)

    Alizadeh, Mahnoosh

    In recent years, considerable research efforts have been directed towards designing control schemes that can leverage the inherent flexibility of electricity demand that is not tapped into in today's electricity markets. It is expected that these control schemes will be carried out by for-profit entities referred to as aggregators that operate at the edge of the power grid network. While the aggregator control problem is receiving much attention, more high-level questions of how these aggregators should plan their market participation, interact with the main grid and with each other, remain rather understudied. Answering these questions requires a large-scale model for the aggregate flexibility that can be harnessed from the a population of customers, particularly for residences and small businesses. The contribution of this thesis towards this goal is divided into three parts: In Chapter 3, a reduced-order model for a large population of heterogeneous appliances is provided by clustering load profiles that share similar degrees of freedom together. The use of such reduced-order model for system planning and optimal market decision making requires a foresighted approximation of the number of appliances that will join each cluster. Thus, Chapter 4 provides a systematic framework to generate such forecasts for the case of Electric Vehicles, based on real-world battery charging data. While these two chapters set aside the economic side that is naturally involved with participation in demand response programs and mainly focus on the control problem, Chapter 5 is dedicated to the study of optimal pricing mechanisms in order to recruit heterogeneous customers in a demand response program in which an aggregator can directly manage their appliances' load under their specified preferences. Prices are proportional to the wholesale market savings that can result from each recruitment event.

  16. Health management with reduced antibiotic use - the U.S. experience.

    PubMed

    Baker, Rodney

    2006-01-01

    Since World War II the use of antimicrobial products associated with food animal production has increased. Antimicrobials along with evolving production practices have significantly increased throughput, animal welfare, and improved health. Concerns surrounding the growing significance of emerging and in some cases rapidly disseminating antibiotic (antimicrobial) resistant bacterial pathogens among human and livestock populations has stimulated a reassessment of this application. The negative publicity has led many consumers and activist groups to believe that protein derived from food animals grown in the absence of those drugs is safer than products derived from the conventionally reared. There is a general fear that antimicrobial usage in agriculture threatens the sustainability of human therapeutic agents and the public wellbeing. The issue has gradually emerged from "fringe group paranoia" to mainstream - finally impacting consumer choices. Antimicrobial resistance concerns have stimulated a significant reaction by the US animal agriculture industry. Numerous pig production entities, large and small, have attempted to create additional pork product value by developing niche marketing opportunities. Thus far most of the subtherapeutic in-feed antimicrobial reduction has been voluntary in the US. Two production areas have developed where reduced usage occurs. First is the growth of antibiotic free production (ABF) and second is an increased use of treatment levels which avoids subtherapeutic criticism. The bulk of this article is directed at new production practices, pig health management, disease elimination, and biosecurity efforts that result from early industry attempts at reduced or excluded antimicrobial pig production. Raising antimicrobial (antibiotic) free (ABF) pork from birth is challenging for a variety of reasons. Some of these challenges can be cost effectively dealt with while others are difficult if not impossible to control in modern production

  17. Longitudinal annoyance responses to a road traffic noise management strategy that reduced heavy vehicles at night.

    PubMed

    Brown, A L

    2015-01-01

    A traffic management strategy was designed to reduce trucks using an urban corridor. The intervention had potential to affect night-time truck flows, but did not target truck traffic in the day, or vehicles other than trucks at any hour. A two-year long panel study measured the community's response to this intervention, using five repeated measurements of response. There were significant reductions in the panel's response to noise, both for night-time annoyance and for interference with activities. This was remarkable given that noise monitoring showed that the intervention produced no change in conventional traffic noise indicators. However, there were measureable changes in the number of articulated truck movements at night, and the benefit can be attributed to reduction in the number of noise events from heavy vehicles. The parallel tracking of changes in reported noise effects and the numbers of heavy vehicles in the night hours in this longitudinal study provides strong support to the notion that noise effects at night depend on the number of noise events experienced, not only on the overall level of traffic noise. The latter appear to be unresponsive indicators by which to assess the noise-effect benefit of heavy vehicle reduction strategies.

  18. Integrated nutrient management (INM) for sustaining crop productivity and reducing environmental impact: a review.

    PubMed

    Wu, Wei; Ma, Baoluo

    2015-04-15

    The increasing food demands of a growing human population and the need for an environmentally friendly strategy for sustainable agricultural development require significant attention when addressing the issue of enhancing crop productivity. Here we discuss the role of integrated nutrient management (INM) in resolving these concerns, which has been proposed as a promising strategy for addressing such challenges. INM has multifaceted potential for the improvement of plant performance and resource efficiency while also enabling the protection of the environment and resource quality. This review examines the concepts, objectives, procedures and principles of INM. A comprehensive literature search revealed that INM enhances crop yields by 8-150% compared with conventional practices, increases water-use efficiency, and the economic returns to farmers, while improving grain quality and soil health and sustainability. Model simulation and fate assessment further reveal that reactive nitrogen (N) losses and GHG (greenhouse gas) emissions are reduced substantially under advanced INM practices. Lower inputs of chemical fertilizer and therefore lower human and environmental costs (such as intensity of land use, N use, reactive N losses and GHG emissions) were achieved under advanced INM practices without compromising crop yields. Various approaches and perspectives for further development of INM in the near future are also proposed and discussed. Strong and convincing evidence indicates that INM practice could be an innovative and environmentally friendly strategy for sustainable agriculture worldwide.

  19. A bespoke management package can reduce levels of injurious pecking in loose-housed laying hen flocks.

    PubMed

    Lambton, S L; Nicol, C J; Friel, M; Main, D C J; McKinstry, J L; Sherwin, C M; Walton, J; Weeks, C A

    2013-04-20

    This study investigated the protective effects of an on-farm management package designed to reduce injurious pecking (IP) in loose-housed laying hens. A systematic review of scientific literature generated 46 potentially protective management strategies. Bespoke management packages were designed for treatment flocks (TF) using these management strategies. IP in 53 TFs was compared with IP in 47 control flocks (CF) where the management package was not employed. Scoring of plumage damage (PD) and observations of gentle and severe feather pecking (GFP; SFP), and vent and cannibalistic pecking (VP) were completed, and management strategy use was recorded, at 20, 30 and 40 weeks of age. Differences between treatment and CF were examined using multilevel modelling. Compared with CF, TF employed more management strategies (P<0.001), had lower PD (P=0.003) and SFP (P=0.019). Regardless of treatment or control flock status, the more of the 46 management strategies that were employed the lower was the PD (P=0.004), GFP (P=0.021), SFP (P=0.043), mortality at 40 weeks (P=0.025), and the likelihood of VP (P=0.021). Therefore, the provision of a bespoke management package was protective against the majority of forms of IP in commercial laying hen flocks.

  20. Reducing stillbirths: prevention and management of medical disorders and infections during pregnancy

    PubMed Central

    Menezes, Esme V; Yakoob, Mohammad Yawar; Soomro, Tanya; Haws, Rachel A; Darmstadt, Gary L; Bhutta, Zulfiqar A

    2009-01-01

    Background An estimated two-thirds of the world's 3.2 million stillbirths occur antenatally, prior to labour, and are often overlooked in policy and programs. Poorly recognised, untreated or inadequately treated maternal infections such as syphilis and malaria, and maternal conditions including hypertensive disorders, are known risk factors for stillbirth. Methods We undertook a systematic review of the evidence for 16 antenatal interventions with the potential to prevent stillbirths. We searched a range of sources including PubMed and the Cochrane Library. For interventions with prior Cochrane reviews, we conducted additional meta-analyses including eligible newer randomised controlled trials following the Cochrane protocol. We focused on interventions deliverable at the community level in low-/middle-income countries, where the burden of stillbirths is greatest. Results Few of the studies we included reported stillbirth as an outcome; most that did were underpowered to assess this outcome. While Cochrane reviews or meta-analyses were available for many interventions, few focused on stillbirth or perinatal mortality as outcomes, and evidence was frequently conflicting. Several interventions showed clear evidence of impact on stillbirths, including heparin therapy for certain maternal indications; syphilis screening and treatment; and insecticide-treated bed nets for prevention of malaria. Other interventions, such as management of obstetric intrahepatic cholestasis, maternal anti-helminthic treatment, and intermittent preventive treatment of malaria, showed promising impact on stillbirth rates but require confirmatory studies. Several interventions reduced known risk factors for stillbirth (e.g., anti-hypertensive drugs for chronic hypertension), yet failed to show statistically significant impact on stillbirth or perinatal mortality rates. Periodontal disease emerged as a clear risk factor for stillbirth but no interventions have reduced stillbirth rates

  1. Practical Pest Management Strategies to Reduce Pesticide Runoff for Argentine Ant (Hymenoptera: Formicidae) Control.

    PubMed

    Greenberg, Les; Rust, Michael K; Richards, Jaben; Wu, Xiaoqin; Kabashima, John; Wilen, Cheryl; Gan, Jay; Choe, Dong-Hwan

    2014-12-01

    The purpose of this study was to involve pest management professionals in the design of application techniques and strategies that would be efficacious and also reduce insecticide runoff. Our study involved measuring both the efficacy of treatments for the Argentine ant, Linepithema humile (Mayr), and the concurrent runoff of fipronil and pyrethroids. Two collaborating companies used low-impact protocols for controlling ants while minimizing runoff. Protocol 1 involved bimonthly treatments, while Protocol 2 was monthly. Both protocols involved an initial treatment with a fipronil spray around the foundation. At the garage door-driveway interface, the fipronil application was done as a pin stream for Protocol 1, and as a crack and crevice application in the expansion joint near the garage for Protocol 2. Protocol 1 replaced most pyrethroid sprays with bifenthrin granules placed around bushes and away from the driveway. For the next treatment on day 63, Protocol 1 also included cyfluthrin spray treatments around the house foundation and crack and crevice applications around the edge of the driveway. For the first treatment in Protocol 2, the fipronil spray was supplemented with spot treatments of cyfluthrin. For subsequent Protocol 2 treatments, botanical insecticides were applied. For weeks 1 and 2 posttreatment combined, Protocol 1 had significantly higher reductions in ant numbers compared with Protocol 2. Thereafter there were no significant differences between the protocols. Runoff of bifenthrin from the granules used with Protocol 1 was much lower than in previous trials involving bifenthrin sprays. Day 1 fipronil runoff for Protocol 2 was significantly lower than that for Protocol 1. This difference may be because of the crack and crevice application applied in Protocol 2. Cyfluthrin runoff was minimal for Protocol 2, which involved spot treatments to supplement the fipronil on day 1, or the botanical insecticides for subsequent treatments. Protocol 1 had a

  2. Reducing six-month inpatient psychiatric recidivism and costs through case management.

    PubMed

    Kolbasovsky, Andrew; Reich, Leonard; Meyerkopf, Neil

    2010-01-01

    The objective of this study is to determine the reduction in inpatient psychiatric recidivism and costs associated with an intensive case management (ICM) program among high-risk adults with chronic mental health conditions. An intent-to-treat, historical control design was used to examine utilization differences between 306 intervention group (IG) members eligible to receive ICM services and a cohort of 290 baseline group (BG) members over a six-month outcome period. Members were identified retrospectively using identical criteria during one year prior to implementation of the program. The six-month recidivism rate for BG members was 49.67% compared to 22.07% among IG members. Forward stepwise regression results indicated a significant main effect for the ICM intervention on inpatient psychiatric costs. Inpatient psychiatric costs for the six-month outcome period were $4,982.90 lower per member in the IG group. Additional models demonstrated that the ICM intervention was associated with significantly lower inpatient substance abuse costs and psychiatric emergency department costs. There were no statistically significant increases in utilization associated with the ICM intervention. After factoring in program costs, it is estimated that the ICM services contributed to almost $1,500,000 in cost savings over the six-month outcome period. The ICM intervention was associated with significant reductions in inpatient, psychiatric six-month readmission rates and associated costs among adult members who are at elevated risk of inpatient, psychiatric recidivism. The intervention, enrollment process, and measurement strategies can be adapted for use by health plans looking to reduce psychiatric costs.

  3. Reduced Population Control of an Insect Pest in Managed Willow Monocultures

    PubMed Central

    Dalin, Peter; Kindvall, Oskar; Björkman, Christer

    2009-01-01

    Background There is a general belief that insect outbreak risk is higher in plant monocultures than in natural and more diverse habitats, although empirical studies investigating this relationship are lacking. In this study, using density data collected over seven years at 40 study sites, we compare the temporal population variability of the leaf beetle Phratora vulgatissima between willow plantations and natural willow habitats. Methodology/Principal Findings The study was conducted in 1999–2005. The density of adult P. vulgatissima was estimated in the spring every year by a knock-down sampling technique. We used two measures of population variability, CV and PV, to compare temporal variations in leaf beetle density between plantation and natural habitat. Relationships between density and variability were also analyzed to discern potential underlying processes behind stability in the two systems. The results showed that the leaf beetle P. vulgatissima had a greater temporal population variability and outbreak risk in willow plantations than in natural willow habitats. We hypothesize that the greater population stability observed in the natural habitat was due to two separate processes operating at different levels of beetle density. First, stable low population equilibrium can be achieved by the relatively high density of generalist predators observed in natural stands. Second, stable equilibrium can also be imposed at higher beetle density due to competition, which occurs through depletion of resources (plant foliage) in the natural habitat. In willow plantations, competition is reduced mainly because plants grow close enough for beetle larvae to move to another plant when foliage is consumed. Conclusion/Significance To our knowledge, this is the first empirical study confirming that insect pest outbreak risk is higher in monocultures. The study suggests that comparative studies of insect population dynamics in different habitats may improve our ability to

  4. Integrating land cover modeling and adaptive management to conserve endangered species and reduce catastrophic fire risk

    USGS Publications Warehouse

    Breininger, David; Duncan, Brean; Eaton, Mitchell J.; Johnson, Fred; Nichols, James

    2014-01-01

    Land cover modeling is used to inform land management, but most often via a two-step process, where science informs how management alternatives can influence resources, and then, decision makers can use this information to make decisions. A more efficient process is to directly integrate science and decision-making, where science allows us to learn in order to better accomplish management objectives and is developed to address specific decisions. Co-development of management and science is especially productive when decisions are complicated by multiple objectives and impeded by uncertainty. Multiple objectives can be met by the specification of tradeoffs, and relevant uncertainty can be addressed through targeted science (i.e., models and monitoring). We describe how to integrate habitat and fuel monitoring with decision-making focused on the dual objectives of managing for endangered species and minimizing catastrophic fire risk. Under certain conditions, both objectives might be achieved by a similar management policy; other conditions require tradeoffs between objectives. Knowledge about system responses to actions can be informed by developing hypotheses based on ideas about fire behavior and then applying competing management actions to different land units in the same system state. Monitoring and management integration is important to optimize state-specific management decisions and to increase knowledge about system responses. We believe this approach has broad utility and identifies a clear role for land cover modeling programs intended to inform decision-making.

  5. The Slope of Change: An Environmental Management Approach to Reduce Drinking on a Day of Celebration at a US College

    ERIC Educational Resources Information Center

    Marchell, Timothy C.; Lewis, Deborah D.; Croom, Katherine; Lesser, Martin L.; Murphy, Susan H.; Reyna, Valerie F.; Frank, Jeremy; Staiano-Coico, Lisa

    2013-01-01

    Objective: This research extends the literature on event-specific environmental management with a case study evaluation of an intervention designed to reduce student drinking at a university's year-end celebration. Participants: Cornell University undergraduates were surveyed each May from 2001 through 2009. Sample sizes ranged from 322 to 1,973.…

  6. Evaluation of individual and combined management practices to reduce the off-site transport of pesticides from golf course turf

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The detection of pesticides, associated with turfgrass management, in storm runoff and surface waters of urban watersheds has raised concerns regarding their source, potential environmental effects and a need for strategies to reduce their inputs. In previous research we discovered that hollow tine ...

  7. Environmental Management: A Comprehensive Strategy for Reducing Alcohol and Other Drug Use on College Campuses.

    ERIC Educational Resources Information Center

    DeJong, William; Vince-Whitman, Cheryl; Colthurst, Tom; Cretella, Maggie; Gilbreath, Michael; Rosati, Michael; Zweig, Karen

    This guide presents a comprehensive strategy, called "environmental management," for alcohol and other drug (AOD) prevention in institutions of higher education. The environmental management approach utilizes, in addition to educational programs, changes in the physical, social, economic, and legal environment accomplished through a…

  8. Reducing environmental noise impacts: A USAREUR noise-management program handbook. Final report

    SciTech Connect

    Feather, T.D.; Shekell, T.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.

  9. Medication Management in Schools: A Systems Approach to Reducing Risk and Strengthening Quality in School Medication Management

    ERIC Educational Resources Information Center

    Center for Health and Health Care in Schools, 2004

    2004-01-01

    This paper and the invitational meeting for which it has been prepared make certain assumptions about the challenge of strengthening the quality of medication management in school. The participants believe that recent research on improving the safety and quality of patient care has relevance for health services in school, particularly the safety…

  10. Coping Card Usage can Further Reduce Suicide Reattempt in Suicide Attempter Case Management Within 3-Month Intervention.

    PubMed

    Wang, Ying-Chuan; Hsieh, Ling-Yu; Wang, Ming-Yu; Chou, Cheng-Hsiang; Huang, Min-Wei; Ko, Huei-Chen

    2016-02-01

    This randomized controlled trial was designed to evaluate the effectiveness of using crisis coping cards (n = 32) in the case management of suicide prevention compared with case management without the use of coping cards (n = 32) over a 3-month intervention period. The generalized estimating equation was used to examine the interaction effect between treatments and time on suicide risk, depression, anxiety, and hopelessness. Results indicated that subsequent suicidal behaviors, severity of suicide risk, depression, anxiety, and hopelessness were reduced more in the coping card intervention group compared to the case management only group. Moreover, for the survival curves of time to suicide reattempt, the coping card group showed a significantly longer time to reattempt than the case management only group at 2-month and 3-month intervention periods.

  11. The Office of Land and Emergency Management is Seeking Feedback on Reducing Regulatory Burden

    EPA Pesticide Factsheets

    This page contains information about the comments the Office of Land and Emergency Management is collecting and the public meeting they are holding in response to Executive Order 13777 Regulatory Reform Review

  12. Regional growth management policies: Toward reducing global warming at state and local levels

    SciTech Connect

    Purdie, J.

    1995-09-01

    State and local governments in the United States are accepting mandates to coordinate legislated land use and growth management planning with vigorous environmental protection and resource conservation. These mandates, implemented or planned in states with populations totaling over 100 million, will directly impact growth patterns and ultimately affect the level of atmospheric gases and particulates generated within their borders. This paper addresses the issues of growth management and land use planning at the local, state and regional levels and identifies areas impacting global warming. A review of existing systems will be presented, and recommendations will be made to improve monitoring of growth management mechanisms and organizational structures with the goal of global atmospheric improvement. The issues discussed include urban sprawl, transportation, and growth patterns as managed by policies also designed to protect environments and provide for sustainable growth. Areas for improved coordination between jurisdictions to ease global warming will also be examined.

  13. Sustainable Materials Management (SMM) Web Academy Webinar: Reducing Wasted Food: How Packaging Can Help

    EPA Pesticide Factsheets

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

  14. Case management of chronic ventilator patients. Reduce average length of stay and cost by half.

    PubMed

    Yaksic, J R; DeWoody, S; Campbell, S

    1996-01-01

    The implementation of the case management model and the use of critical pathways has become a major strategy to improve quality of care and cope with measuring and managing costs. Grant Medical Center, a 640-bed Level I Trauma Center, began case managing its chronic ventilator patients in July, 1993. A 30-day critical pathway was developed using a multidisciplinary team approach. In case managing these patients, many problematic issues were identified, such as lack of adequate involvement by staff experienced in specific disciplines and multiple physician decision makers for each case. By increasing multidisciplinary collaboration, care of these patients was systematically changed and streamlined. Over a 2-year period, the average length of stay for chronic ventilator patients decreased from 74.5 days to 41.9 days, and the average cost per case decreased from $189,080 to $107,019.

  15. Efficacy of home-based lymphoedema management in reducing acute attacks in subjects with lymphatic filariasis in Burkina Faso.

    PubMed

    Jullien, Patrick; Somé, Jeanne d'Arc; Brantus, Pierre; Bougma, Roland W; Bamba, Issouf; Kyelem, Dominique

    2011-09-01

    One of the two main goals of the Global Programme to Eliminate Lymphatic Filariasis (LF) is to provide care for those suffering from the devastating clinical manifestations of this filarial infection. Among the 120 million infected people worldwide, up to 16 million have lymphoedema. The WHO strategy for managing lymphoedema is based on rigorous skin hygiene, exercise, antibiotics and antifungals when indicated. The aim is to reduce acute attacks of adenolymphangitis and cellulitis responsible for lymphoedema progression and disability. The objective of our study was to assess the effectiveness of home-based lymphoedema management implemented by the national health system of Burkina Faso. Any patient was eligible to participate in the study if suffering from LF-related lymphoedema of a lower limb at any stage, and receiving care as part of the health education and washing project between April 2005 and December 2007. The primary readout was the occurrence of an acute attack in the month preceding the consultation reported by the patient or observed by the care-giver. In all, 1089 patients were enrolled in the study. Before lymphoedema management intervention, 78.1% (95%CI: 75.5-80.5) of the patients had an acute attack in the month preceding the consultation; after four and half months of lymphoedema management, this was reduced to 39.1% (95%CI: 36.2-42.1). A reduction of acute attacks related to the number of consultations or related to the patients' age and gender was not observed. Our results suggest that the home-based lymphoedema management programme in the primary health care system of Burkina Faso is effective in reducing morbidity due to LF in the short-term (4.5 months). The lymphoedema management requires no additional human resources, but whether its effect can be sustained remains to be seen.

  16. Evaluation and management of patients with recurrent peptic ulcer disease after acid-reducing operations: a systematic review.

    PubMed

    Turnage, Richard H; Sarosi, George; Cryer, Byron; Spechler, Stuart; Peterson, Walter; Feldman, Mark

    2003-01-01

    This systematic review examines the evidence for commonly employed strategies of managing patients with recurrent ulcer disease after acid-reducing operations. Particular attention is given to recent evidence relating Helicobacter pylori (H. pylori ) and nonsteroidal anti-inflammatory drugs (NSAIDs) to ulcer recurrence after operative therapy. MEDLINE word searches of the literature from 1966 to 2001 identified 895 articles that cross-reference the terms "peptic ulcer disease (PUD)," "surgery," and "recurrence." Articles were selected for systematic review of evidence relating incomplete vagotomy, NSAIDs, and H. pylori to postoperative ulcer recurrence and evidence supporting common medical and surgical strategies. The relationship between incomplete vagotomy and recurrent ulcer disease is suggested by randomized controlled trials and well-designed prospective case series. The evidence that NSAID use is an important pathogenic factor in recurrent ulcer disease includes the relationship between NSAIDs and primary PUD, the occurrence of NSAID-induced ulcers in patients taking proton pump inhibitors, and case series demonstrating virulent ulcer disease in patients taking aspirin despite prior acid-reducing operations. The relationship between H. pylori infection and postoperative ulcer recurrence remains uncertain despite multiple controlled trials and well-designed case series that have documented high rates of H. pylori infection in postoperative patients. The initial management of patients with recurrent ulcer disease after acid-reducing operations consists of a protein pump inhibitor or a histamine-2 receptor antagonist and antibiotics directed at H. pylori, if present. Evidence for this regimen includes prospective randomized trials demonstrating the efficacy of cimetidine in healing ulcers after acid-reducing operations and prospective, randomized studies documenting the efficacy of histamine-2 receptor antagonists and protein pump inhibitors in the management

  17. Reducing energy costs at state agencies and institutions in Texas through the Governor's energy management center

    SciTech Connect

    White, J.A.

    1989-01-01

    The one year internship required for partial fulfillment of the Doctor of Engineering Degree was completed at the Governor's Energy Management Center in Austin, Texas. The intern worked for the State Agencies Department of the Energy Management Center. The intern was involved in a variety of projects, but the primary projects requiring the greatest time were the involvement with the design reviews for energy efficiency of new prisons being constructed in Texas, conducting energy management audits at 18 major state universities, and the technical and administrative assistance to the State Cogeneration Council. Other project involvement included managing the preliminary engineering design of the cogeneration facility at Austin State Hospital, responsibility for applying for a $1.4 million dollar crude oil refund on the behalf of all state agencies in Texas, and assisting in the planning and coordination of the $48 million Revolving Loan Program for the state of Texas. The internship taught many things about management and communications. The experience also provided a better understanding of how the state and federal government operate. The greatest contribution of the internship experience was the improvement of the intern's written and oral communication skills.

  18. Toward efficient medication error reduction: error-reducing information management systems.

    PubMed

    Chung, Kyusuk; Choi, Young B; Moon, Sangho

    2003-12-01

    Hospitals and other health-care providers today are being pressed more than ever to use technologies for reducing medical errors. Particularly, medication errors are likely to increase fast as Americans age. This paper intends to provide a starting point for understanding information technologies and database systems supporting such technologies as Computerized Physician Order Entry (CPOE), Automated Dispensing System (ADS), and Bar Coding System designed to reduce medication errors in hospitals. Although vendors provide the necessary communication software and applications, actions involving governments, technology vendors, pharmaceutical companies, and clinical researchers are needed to put to actual use the applications with a massive potential to significantly reduce medication-related errors.

  19. Farm-economic analysis of reducing antimicrobial use whilst adopting improved management strategies on farrow-to-finish pig farms.

    PubMed

    Rojo-Gimeno, Cristina; Postma, Merel; Dewulf, Jeroen; Hogeveen, Henk; Lauwers, Ludwig; Wauters, Erwin

    2016-07-01

    Due to increasing public health concerns that food animals could be reservoirs for antibiotic resistant organisms, calls for reduced current antibiotic use on farms are growing. Nevertheless, it is challenging for farmers to perform this reduction without negatively affecting technical and economic performance. As an alternative, improved management practices based on biosecurity and vaccinations have been proven useful to reduce antimicrobial use without lowering productivity, but issues with insufficient experimental design possibilities have hindered economic analysis. In the present study a quasi-experimental approach was used for assessing the economic impact of reduction of antimicrobial use coupled with improved management strategies, particularly biosecurity strategies. The research was performed on farrow-to-finish pig farms in Flanders (northern region of Belgium). First, to account for technological progress and to avoid selection bias, propensity score analysis was used to compare data on technical parameters. The treatment group (n=48) participated in an intervention study whose aim was to improve management practices to reduce the need for use of antimicrobials. Before and after the change in management, data were collected on the technical parameters, biosecurity status, antimicrobial use, and vaccinations. Treated farms were matched without replacement with control farms (n=69), obtained from the Farm Accountancy Data Network, to estimate the difference in differences (DID) of the technical parameters. Second, the technical parameters' DID, together with the estimated costs of the management intervention and the price volatility of the feed, meat of the finisher pigs, and piglets served as a basis for modelling the profit of 11 virtual farrow-to-finish pig farms representative of the Flemish sector. Costs incurred by new biosecurity measures (median +€3.96/sow/year), and new vaccinations (median €0.00/sow/year) did not exceed the cost reduction

  20. Debriefing Can Reduce Misperceptions of Feedback: The Case of Renewable Resource Management

    ERIC Educational Resources Information Center

    Qudrat-Ullah, Hassan

    2007-01-01

    According to the hypothesis of misperception of feedback, people's poor performance in renewable resource management tasks can be attributed to their general tendency to systematically misperceive the dynamics of bioeconomic systems. The thesis of this article is that dynamic decision performance can be improved by helping individuals develop more…

  1. Prefire (preemptive) management to decrease fire-induced bunchgrass mortality and reduce reliance on postfire seeding

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Western rangelands are currently under severe threat from exotic annual grasses. To successfully manage rangelands that are either infested with or susceptible to exotic annual grasses, we must focus on increasing resilience to disturbance and resistance to exotic annual grass invasion. Here, we p...

  2. Working to Reduce the Effects of Discrimination: Identity Management Strategies in Organizations

    ERIC Educational Resources Information Center

    Shih, Margaret; Young, Maia J.; Bucher, Amy

    2013-01-01

    Despite efforts to dispel discrimination, workplace discrimination still occurs. We introduce two classes of identity management strategies individuals use to mitigate the negative consequences of discrimination: identity switching (i.e., deemphasizing target identities and recategorizing to a more positively valued identity) and identity…

  3. Topographic placement of management practices to reduce water quality impacts from pastures

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Best management practices (BMPs) such as streambank fencing and vegetative buffers lessen environmental impacts on streams from pasture-based agriculture by limiting livestock time in streams and intercepting sediment and nutrients in overland flow. Placing streamside BMPs at the closest point to th...

  4. Strategic Management of ELT in Public Educational Systems: Trying to Reduce Failure, Increase Success

    ERIC Educational Resources Information Center

    Davies, Paul

    2009-01-01

    English as a foreign/second language teaching (ELT) is notably successful in some national public educational systems and unsuccessful in others. Holland, Singapore and Sweden are outstanding examples of great success in the strategic management of ELT in their public educational systems. General failures abound, particularly in countries that…

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

    ERIC Educational Resources Information Center

    Holmer, Leanna L.

    2014-01-01

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

  6. This New Management Demeanor Reduces Post-Strike Rancor in Schools.

    ERIC Educational Resources Information Center

    Schwerdtfeger, Robert D.

    1984-01-01

    Following examples of strike management in Tacoma and West Valley, Washington, advice is offered to school boards for minimizing damage during teachers' strikes. Topics discussed are substitute teachers, teacher contact, public relations, telephone strategies, consultants, picket lines, and maintaining patience and communication with school and…

  7. Lack of Cross-Scale Linkages Reduces Robustness of Community-Based Fisheries Management

    PubMed Central

    Cudney-Bueno, Richard; Basurto, Xavier

    2009-01-01

    Community-based management and the establishment of marine reserves have been advocated worldwide as means to overcome overexploitation of fisheries. Yet, researchers and managers are divided regarding the effectiveness of these measures. The “tragedy of the commons” model is often accepted as a universal paradigm, which assumes that unless managed by the State or privatized, common-pool resources are inevitably overexploited due to conflicts between the self-interest of individuals and the goals of a group as a whole. Under this paradigm, the emergence and maintenance of effective community-based efforts that include cooperative risky decisions as the establishment of marine reserves could not occur. In this paper, we question these assumptions and show that outcomes of commons dilemmas can be complex and scale-dependent. We studied the evolution and effectiveness of a community-based management effort to establish, monitor, and enforce a marine reserve network in the Gulf of California, Mexico. Our findings build on social and ecological research before (1997–2001), during (2002) and after (2003–2004) the establishment of marine reserves, which included participant observation in >100 fishing trips and meetings, interviews, as well as fishery dependent and independent monitoring. We found that locally crafted and enforced harvesting rules led to a rapid increase in resource abundance. Nevertheless, news about this increase spread quickly at a regional scale, resulting in poaching from outsiders and a subsequent rapid cascading effect on fishing resources and locally-designed rule compliance. We show that cooperation for management of common-pool fisheries, in which marine reserves form a core component of the system, can emerge, evolve rapidly, and be effective at a local scale even in recently organized fisheries. Stakeholder participation in monitoring, where there is a rapid feedback of the systems response, can play a key role in reinforcing

  8. Sodium chlorate reduces presence of Escherichia coli in feces of lambs and ewes managed in shed-lambing systems

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Our objective was to establish doses of orally-administered NaClO3 that reduced presence of generic Escherichia coli in intestines of ewes and neonatal lambs managed in a shed-lambing system. Neonatal lambs (n = 32; age = 7.1 ± 1.2 d; BW = 6.8 ± 1.0 kg) and yearling ewes (n = 44; BW = 74.8 ± 5.6 kg)...

  9. Integrated Pest Management Practices Reduce Insecticide Applications, Preserve Beneficial Insects, and Decrease Pesticide Residues in Flue-Cured Tobacco Production.

    PubMed

    Slone, Jeremy D; Burrack, Hannah J

    2016-09-22

    Integrated pest management (IPM) recommendations, including scouting and economic thresholds (ETs), are available for North Carolina flue-cured tobacco growers, although ETs for key pests have not been updated in several decades. Moreover, reported IPM adoption rates by flue-cured tobacco growers remain low, at < 40%, according to NC cooperative extension surveys conducted during the last four years. Previous research has suggested that timing insecticide treatments using currently available ETs can reduce the average number of applications to two or fewer per season. We conducted field-scale trials at nine commercial tobacco farms, three in 2104 and six in 2015, to quantify inputs associated with current scouting recommendations, to determine if current ETs were able to reduce insecticide applications as compared to grower standard practices, and to assess the impacts of reduced insecticide applications on end of season yield and pesticide residues. Two fields were identified at each farm and were scouted weekly for insects. One field was only treated with insecticides if pests reached ET (IPM), while the other field was managed per grower discretion (Grower Standard). IPM fields received an average of two fewer insecticide applications without compromising yield. More insecticide applications resulted in higher pesticide residues in cured leaf samples from Grower Standard fields than those from IPM fields. Reductions in insecticides and management intensity also resulted in larger beneficial insect populations in IPM fields.

  10. Damage Characterization Method for Structural Health Management Using Reduced Number of Sensor Inputs

    NASA Technical Reports Server (NTRS)

    Krishnamurthy, T.; Hochhalter, Jacob D.; Gallegos, Adam M.

    2012-01-01

    The development of validated multidisciplinary Integrated Vehicle Health Management (IVHM) tools, technologies, and techniques to enable detection, diagnosis, prognosis, and mitigation in the presence of adverse conditions during flight will provide effective solutions to deal with safety related challenges facing next generation aircraft. The adverse conditions include loss of control caused by environmental factors, actuator and sensor faults or failures, and damage conditions. A major concern in these structures is the growth of undetected damage (cracks) due to fatigue and low velocity foreign impacts that can reach a critical size during flight, resulting in loss of control of the aircraft. Hence, development of efficient methodologies to determine the presence, location, and severity of damage in critical structural components is highly important in developing efficient structural health management systems.

  11. Scaling Task Management in Space and Time: Reducing User Overhead in Ubiquitous-Computing Environments

    DTIC Science & Technology

    2005-03-28

    limitation of this approach is that it does not easily scale to large numbers of tasks over extended periods. Busy users may intermittently touch on...dozens of different tasks over the course of a workweek, and this strategy keeps all the applications consuming resources and cluttering the workspace...RETSINA framework, with applications in domains such as financial portfolio management, ecommerce and military logistics [88]; and more recently Carnegie

  12. Telehealth interventions to reduce management complications in type 1 diabetes: A review.

    PubMed

    Balkhi, Amanda M; Reid, Adam M; Westen, Sarah C; Olsen, Brian; Janicke, David M; Geffken, Gary R

    2015-04-15

    Type 1 diabetes is a chronic illness with a high burden of care. While effective interventions and recommendations for diabetes care exist, the intensive nature of diabetes management makes compliance difficult. This is especially true in children and adolescents as they have unique psychosocial and diabetes needs. Despite the development of effective in-person interventions targeting improving self-management and ameliorating psychosocial difficulties there are still a number of barriers to implementing these interventions, namely time, cost, and access. Telehealth interventions allow for the dissemination of these interventions to a broader audience. Self-management and psychosocial telehealth interventions are reviewed with a special emphasis on mobile phone and internet based technology use. While efficacy has been demonstrated in a number of telehealth interventions with improved cost effectiveness over in-person interventions, many challenges remain including high participant attrition and difficulties with receiving reimbursement for services rendered. These and other challenges are discussed with recommendations for researchers and telehealth providers provided.

  13. Telehealth interventions to reduce management complications in type 1 diabetes: A review

    PubMed Central

    Balkhi, Amanda M; Reid, Adam M; Westen, Sarah C; Olsen, Brian; Janicke, David M; Geffken, Gary R

    2015-01-01

    Type 1 diabetes is a chronic illness with a high burden of care. While effective interventions and recommendations for diabetes care exist, the intensive nature of diabetes management makes compliance difficult. This is especially true in children and adolescents as they have unique psychosocial and diabetes needs. Despite the development of effective in-person interventions targeting improving self-management and ameliorating psychosocial difficulties there are still a number of barriers to implementing these interventions, namely time, cost, and access. Telehealth interventions allow for the dissemination of these interventions to a broader audience. Self-management and psychosocial telehealth interventions are reviewed with a special emphasis on mobile phone and internet based technology use. While efficacy has been demonstrated in a number of telehealth interventions with improved cost effectiveness over in-person interventions, many challenges remain including high participant attrition and difficulties with receiving reimbursement for services rendered. These and other challenges are discussed with recommendations for researchers and telehealth providers provided. PMID:25897348

  14. Reducing Fear in the Schools: Managing Conflict through Student Problem Solving.

    ERIC Educational Resources Information Center

    Kenney, Dennis Jay; Watson, T. Steuart

    1996-01-01

    Describes a component of one North Carolina school district's plan for improving the high school environment by integrating community-policing strategies and problem-solving techniques for reducing school crime, delinquency, and disorder. By using teacher/student working groups, the school reports declines in the incidence of school crime and…

  15. Managing Medical Costs by Reducing Demand for Services: The Missing Element in Health Care Reform.

    ERIC Educational Resources Information Center

    Kelly, Edward K.; And Others

    1994-01-01

    It is argued that higher education institutions can play a major role in health care reform by providing campus cultures that foster healthy lifestyle choices and in turn reduce medical costs. Specific issues discussed include elimination of unnecessary tests, focus on special high-risk populations, and use of advance directives. (MSE)

  16. Corn and soybean rotation under reduced tillage management: impacts on soil properties, yield, and net return

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A 4-yr field study was conducted from 2007 to 2010 at Stoneville, MS to examine the effects of rotating corn and soybean under reduced tillage conditions on soil properties, yields, and net return. The six rotation systems were continuous corn (CCCC), continuous soybean (SSSS), corn-soybean (CSCS),...

  17. Improvements in Care and Reduced Self-Management Barriers Among Rural Patients With Diabetes

    ERIC Educational Resources Information Center

    Dettori, Nancy; Flook, Benjamin N.; Pessl, Erich; Quesenberry, Kim; Loh, Johnson; Harris, Colleen; McDowall, Janet M.; Butcher, Marcene K.; Helgerson, Steven D.; Gohdes, Dorothy; Harwell, Todd S.

    2005-01-01

    Improved preventive care and clinical outcomes among patients with diabetes can reduce complications and costs; however, diabetes care continues to be suboptimal. Few studies have described effective strategies for improving care among rural populations with diabetes. In 2000, the Park County Diabetes Project and the Montana Diabetes Control…

  18. Best Nitrogen Management Practices Can Reduce the Potential Flux of Nitrogen Out of the Arkansas Delta

    Technology Transfer Automated Retrieval System (TEKTRAN)

    It has been reported that nitrogen losses in the Arkansas Delta can contribute to the flux of nitrogen into the Mississippi River Basin, which can in turn contribute to the nitrate load that the hypoxia problem in the Gulf of Mexico has been attributed to. Developing effective methods of reducing th...

  19. Cover crop use for weed management in Southern reduced-tillage vegetable cropping systems

    Technology Transfer Automated Retrieval System (TEKTRAN)

    With growing agricultural demands from both conventional and organic systems comes the need for sustainable practices to ensure long-term productivity. Implementation of reduced- or no-till practices offers a number of environmental benefits for agricultural land and maintains adequate yield for cu...

  20. Reducing pump power consumption by 40% (1000 kw) through improved pump management in a central plant

    SciTech Connect

    Deng, S.; Liu, M.; Turner, D.

    1998-07-01

    Chilled water system data collection and field measurements performed at the Central Utility Plant of Texas A and M University (TAMU) in College Station, Texas revealed that 30--50 % of the primary pump head is consumed by manual and automatic valves being operated in a partially-opened condition. A comprehensive analysis was performed to develop an improved pump management schedule. The results show potential savings of up to 40% of the pump power consumption without any capital investment. The optimized schedule is being implemented. This paper describes the method and presents results of the analysis and implementation.

  1. Reducing errors through a web-based self-management support system.

    PubMed

    Ekstedt, Mirjam; Børøsund, Elin; Svenningsen, Ina K; Ruland, Cornelia M

    2014-01-01

    Web-based self-management support systems SMSS, can successfully assist a wide range of patients with information and self-management support. O or as a stand-alone service, are e-messages. This study describes how one component of a multi component SMSS, an e-message service, in which patients with breast cancer could direct questions to nurses, physicians or social workers at the hospital where they were being treated, had an influence on safety and continuity of care. Ninety-one dialogues consisting of 284 messages were analysed. The communications between patients and the healthcare team revealed that the e-messages service served as a means for quality assurance of information, for double-checking and for coordination of care. We give examples of how an e-mail service may improve patients' knowledge in a process of taking control over their own care - increasingly important in a time of growing complexity and specialization in healthcare. It remains to be tested whether an e-message service can improve continuity of care and prevent or mitigate medical mishaps.

  2. Soil pH management without lime, a strategy to reduce greenhouse gas emissions from cultivated soils

    NASA Astrophysics Data System (ADS)

    Nadeem, Shahid; Bakken, Lars; Reent Köster, Jan; Tore Mørkved, Pål; Simon, Nina; Dörsch, Peter

    2015-04-01

    For decades, agricultural scientists have searched for methods to reduce the climate forcing of food production by increasing carbon sequestration in the soil and reducing the emissions of nitrous oxide (N2O). The outcome of this research is depressingly meagre and the two targets appear incompatible: efforts to increase carbon sequestration appear to enhance the emissions of N2O. Currently there is a need to find alternative management strategies which may effectively reduce both the CO2 and N2O footprints of food production. Soil pH is a master variable in soil productivity and plays an important role in controlling the chemical and biological activity in soil. Recent investigations of the physiology of denitrification have provided compelling evidence that the emission of N2O declines with increasing pH within the range 5-7. Thus, by managing the soil pH at a near neutral level appears to be a feasible way to reduce N2O emissions. Such pH management has been a target in conventional agriculture for a long time, since a near-neutral pH is optimal for a majority of cultivated plants. The traditional way to counteract acidification of agricultural soils is to apply lime, which inevitably leads to emission of CO2. An alternative way to increase the soil pH is the use of mafic rock powders, which have been shown to counteract soil acidification, albeit with a slower reaction than lime. Here we report a newly established field trail in Norway, in which we compare the effects of lime and different mafic mineral and rock powders (olivine, different types of plagioclase) on CO2 and N2O emissions under natural agricultural conditions. Soil pH is measured on a monthly basis from all treatment plots. Greenhouse gas (GHG) emission measurements are carried out on a weekly basis using static chambers and an autonomous robot using fast box technique. Field results from the first winter (fallow) show immediate effect of lime on soil pH, and slower effects of the mafic rocks. The

  3. Through Life Management of Naval Gas Turbines for Extended Service Lives and Reduced Lifetime Costs

    DTIC Science & Technology

    2003-02-01

    Symposium Partie A - Developpements dans le domaine de l’aeroacoustique et I’hydroacoustique numeriques ] [Symposium Partie B ... To order the complete...and Belgian Reduction Strategies developed by the UK Ministry of Defence in Navies, the Olympus operates in combination with direct acting support of... STRATEGIES IN REDUCING THROUGH LIFE COSTSTuRn! TIE DELIVERY PRI GRAMME SIMULATION INCLUDES Current strate2v: TAKE 91 ATES AND RANDOM FAILURES SERVICEABLE

  4. Burnout/stress management: how to reduce burnout and stress in the workplace.

    PubMed

    Matula, Brian

    2013-01-01

    We all encounter various forms of stress every single day. Stress can be caused by family issues, relationships, children and especially work. With the ever-growing demands that are placed on Healthcare Security professionals today, career burnout associated with stress is becoming more and more common. In this article, the author discusses some signs and symptoms, as well as giving some stress reduction exercises that may be able to help your officers reduce their stress.

  5. A management strategy to reduce bacterial pollution in shellfish areas: A case study

    NASA Astrophysics Data System (ADS)

    Crane, Stuart R.; Moore, James A.

    1986-01-01

    The problem of bacterial pollution in shellfishing areas is not uncommon in the coastal regions of the United States. Bacterial contamination from man's activities can effectively reduce our natural shellfish resource areas by forcing their closure because of high potential risk of diseases being spread by shellfish harvested in these areas. Tillamook Bay, a relatively small, enclosed drainage basin of nonurban character, presents an excellent study area for observing this problem. The high population density of animals, raised on a relatively small floodplain area, represents one of the major sources of pollution in the bay. This paper summarizes the history of the agencies involved with the problem and presents the current approach to alleviate bacterial pollution in the bay without unduly penalizing other industries in the Tillamook basin. The paper also presents some of the legal aspects of reducing water pollution in shellfish harvesting areas and the jurisdiction of federal agencies in these matters. Finally, recommendations are given to reduce bacterial output by the major source categories in the basin, and criteria for bay closure to shellfish harvest are developed to protect the public from bacterially contaminated shellfish.

  6. Designing management options to reduce surface runoff and sediment yield with farmers: an experiment in south-western France.

    PubMed

    Furlan, Adriana; Poussin, Jean-Christophe; Mailhol, Jean-Claude; Le Bissonnais, Yves; Gumiere, Silvio J

    2012-04-15

    To preserve the quality of surface water, official French regulations require farmers to keep a minimum acreage of grassland, especially bordering rivers. These agro-environmental measures do not account for the circulation of water within the catchment. This paper examines whether it is possible to design with the farmers agri-environmental measures at field and catchment scale to prevent soil erosion and surface water pollution. To support this participatory approach, the hydrology and erosion model STREAM was used for assessing the impact of a spring stormy event on surface runoff and sediment yield with various management scenarios. The study was carried out in collaboration with an agricultural committee in an area of south-western France where erosive runoff has a major impact on the quality of surface water. Two sites (A and B) were chosen with farmers to discuss ways of reducing total surface runoff and sediment yield at each site. The STREAM model was used to assess surface runoff and sediment yield under current cropping pattern at each site and to evaluate management scenarios including grass strips implementation or changes in cropping patterns within the catchment. The results of STREAM simulations were analysed jointly by farmers and researchers. Moreover, the farmers discussed each scenario in terms of its technical and economical feasibility. STREAM simulations showed that a 40 mm spring rainfall with current cropping patterns led to 3116 m3 total water runoff and 335 metric tons of sediment yield at site A, and 3249 m3 and 241 metric tons at site B. Grass strips implementation could reduce runoff for about 40% and sediment yield for about 50% at site A. At site B, grass strips could reduce runoff and sediment yield for more than 50%, but changes in cropping pattern could reduce it almost totally. The simulations led to three main results: (i) grass strips along rivers and ditches prevented soil sediments from entering the surface water but did not

  7. Many-Objective Reservoir Policy Identification and Refinement to Reduce Institutional Myopia in Water Management

    NASA Astrophysics Data System (ADS)

    Giuliani, M.; Herman, J. D.; Castelletti, A.; Reed, P. M.

    2013-12-01

    Institutional inertia strongly limits our ability to adapt water reservoir operations to better manage growing water demands as well as their associated uncertainties in a changing climate. Although it has long been recognized that these systems are generally framed in heterogeneous socio-economic contexts involving a myriad of conflicting, non-commensurable operating objectives, our broader understanding of the multiobjective consequences of current operating rules as well as their vulnerability to hydroclimatic uncertainties is severely limited. This study proposes a decision analytic framework to overcome policy inertia and myopia in complex river basin management contexts. The framework combines reservoir policy identification and many-objective optimization under uncertainty to characterize current operations and discover key tradeoffs between alternative policies for balancing evolving demands and system uncertainties. The approach is demonstrated on the Conowingo Dam, located within the Lower Susquehanna River, USA. The Lower Susquehanna River is an interstate water body that has been subject to intensive water management efforts due to the system's competing demands from urban water supply, atomic power plant cooling, hydropower production, and federally regulated environmental flows. Initially our proposed framework uses available streamflow observations to implicitly identify the Conowingo Dam's current but unknown operating policy. This baseline policy is identified by fitting radial basis functions to existing system dynamics. Our assumption in the baseline policy is that the dam operator is represented as a rational agent seeking to maximize primary operational objectives (i.e., guaranteeing the public water supply and maximizing the hydropower revenue). The quality of the identified baseline policy is evaluated by its ability to replicate historical release dynamics. Once identified, the historical baseline policy then provides a means of representing

  8. Managing lifestyle change to reduce coronary risk: a synthesis of qualitative research on peoples’ experiences

    PubMed Central

    2014-01-01

    Background Coronary heart disease is an incurable condition. The only approach known to slow its progression is healthy lifestyle change and concordance with cardio-protective medicines. Few people fully succeed in these daily activities so potential health improvements are not fully realised. Little is known about peoples’ experiences of managing lifestyle change. The aim of this study was to synthesise qualitative research to explain how participants make lifestyle change after a cardiac event and explore this within the wider illness experience. Methods A qualitative synthesis was conducted drawing upon the principles of meta-ethnography. Qualitative studies were identified through a systematic search of 7 databases using explicit criteria. Key concepts were identified and translated across studies. Findings were discussed and diagrammed during a series of audiotaped meetings. Results The final synthesis is grounded in findings from 27 studies, with over 500 participants (56% male) across 8 countries. All participants experienced a change in their self-identity from what was ‘familiar’ to ‘unfamiliar’. The transition process involved ‘finding new limits and a life worth living’ , ‘finding support for self’ and ‘finding a new normal’. Analyses of these concepts led to the generation of a third order construct, namely an ongoing process of ‘reassessing past, present and future lives’ as participants considered their changed identity. Participants experienced a strong urge to get back to ‘normal’. Support from family and friends could enable or constrain life change and lifestyle changes. Lifestyle change was but one small part of a wider ‘life’ change that occurred. Conclusions The final synthesis presents an interpretation, not evident in the primary studies, of a person-centred model to explain how lifestyle change is situated within ‘wider’ life changes. The magnitude of individual responses to a changed health status

  9. Integrated mosquito larval source management reduces larval numbers in two highland villages in western Kenya

    PubMed Central

    2012-01-01

    Background In western Kenya, malaria remains one of the major health problems and its control remains an important public health measure. Malaria control is by either use of drugs to treat patients infected with malaria parasites or by controlling the vectors. Vector control may target the free living adult or aquatic (larval) stages of mosquito. The most commonly applied control strategies target indoor resting mosquitoes. However, because mosquitoes spend a considerable time in water, targeting the aquatic stages can complement well with existing adult control measures. Methods Larval source management (LSM) of malaria vectors was examined in two villages i.e. Fort Ternan and Lunyerere, with the aim of testing strategies that can easily be accessed by the affected communities. Intervention strategies applied include environmental management through source reduction (drainage of canals, land levelling or by filling ditches with soil), habitat manipulation (by provision of shading from arrow root plant), application of Bacillus thuringiensis var israelensis (Bti) and the use of predatory fish, Gambusia affinis. The abundance of immature stages of Anopheles and Culex within intervention habitats was compared to that within non-intervention habitats. Results The findings show that in Fort Ternan no significant differences were observed in the abundance of Anopheles early and late instars between intervention and non-intervention habitats. In Lunyerere, the abundance of Anopheles early instars was fifty five times more likely to be present within non-intervention habitats than in habitats under drainage. No differences in early instars abundance were observed between non-intervention and habitats applied with Bti. However, late instars had 89 % and 91 % chance of being sampled from non-intervention rather than habitats under drainage and those applied with Bti respectively. Conclusion Most of these interventions were applied in habitats that arose due to human

  10. Many-objective reservoir policy identification and refinement to reduce institutional myopia in water management

    NASA Astrophysics Data System (ADS)

    Giuliani, Matteo; Herman, Jonathan D.; Castelletti, Andrea; Reed, Patrick M.

    2014-05-01

    Current water reservoir operating policies are facing growing water demands as well as increasing uncertainties associated with a changing climate. However, policy inertia and myopia strongly limit the possibility of adapting current water reservoir operations to the undergoing change. Historical agreements and regulatory constraints limit the rate that reservoir operations are innovated and creates policy inertia, where water institutions are unlikely to change their current practices in absence of dramatic failures. Yet, no guarantee exists that historical management policies will not fail in coming years. In reference to policy myopia, although it has long been recognized that water reservoir systems are generally framed in heterogeneous socio-economic contexts involving a myriad of conflicting, non-commensurable operating objectives, the broader understanding of the multi-objective consequences of current operating rules as well as their vulnerability to hydroclimatic uncertainties is severely limited. This study proposes a decision analytic framework to overcome both policy inertia and myopia in complex river basin management contexts. The framework combines reservoir policy identification, many-objective optimization under uncertainty, and visual analytics to characterize current operations and discover key tradeoffs between alternative policies for balancing evolving demands and system uncertainties. The approach is demonstrated on the Conowingo Dam, located within the Lower Susquehanna River, USA. The Lower Susquehanna River is an interstate water body that has been subject to intensive water management efforts due to the system's competing demands from urban water supply, atomic power plant cooling, hydropower production, and federally regulated environmental flows. The proposed framework initially uses available streamflow observations to implicitly identify the current but unknown operating policy of Conowingo Dam. The quality of the identified baseline

  11. Reducing Gridlock on the Grid: Utility Trends in Managing Peak Electric Load through Residential Demand Response

    NASA Astrophysics Data System (ADS)

    McDonald, Betsy

    Utilities across the United States are piloting residential demand response programs to help manage peak electric demand. Using publicly available program evaluations, this thesis analyzes nine such programs to uncover and synthesize the range of program offerings, goals, enrollment strategies, and customer experiences. This review reveals that program participation, components, and results differ based on a variety of factors, including geographic characteristics, program goals, and implementation strategies. The diversity of program designs and evaluation findings suggests an underlying tension between the need to generate cost-effective program impacts and the desire to increase accessibility so that program benefits are not exclusive to certain segments of the population. For more significant and impactful engagement, program goals may need to shift. State level policy support could help shift program goals toward increasing program accessibility. Future research should explore creative strategies that target existing barriers and allow for more inclusive deployment.

  12. [Modern coagulation management reduces the transfusion rate of allogenic blood products].

    PubMed

    Weber, Christian Friedrich

    2012-06-01

    Evaluating the patient's individual bleeding history with a standardized questionnaire, using "point-of-care" - methods for coagulation analyses and providing autologous transfusion techniques are preconditions of a modern coagulation management. Therapy of coagulopathic patients should be based on structured hemotherapy algorithms. Surgical haemostasis and the maintenance of the basic conditions for haemostasis are elementary requirements for an effective therapy. In cases of diffuse bleeding, early antifibrinolytic therapy should be considered. Coagulation factor deficiencies should be corrected "goal-directed" using coagulation factor concentrates. Transfusion of fresh frozen plasma is only indicated in the clinical setting of massive transfusions. DDAVP and transfusion of platelet concentrates are options to optimize primary haemostasis. In cases of on-going bleeding, recombinant activated coagulation factor VII represents an option for "ultima-ratio" therapy.

  13. Reducing input data via image categorization to improve the speed of copyright content management systems

    NASA Astrophysics Data System (ADS)

    Ikeda, Kanami; Watanabe, Eriko

    2015-02-01

    An optical correlator has the advantage of high data transfer speed and parallel operation. However, in copyright content management systems (CCMSs), the numerous video files that need to be downloaded from the Internet and input to the optical correlator constitute a bottleneck. This paper proposes an image categorization method for CCMSs that uses the difference in the color features between animation and live-action images to remove this bottleneck and increase the speed of CCMSs. The results of experiments conducted indicate that the proposed method achieves a live-action video true rejection rate of 86.7 % and an animation video false rejection rate of 13.3 %. This indicates that the proposed method can improve the overall speed of a CCMS more than twice the original speed.

  14. Failures of foreseeability: Risk management considerations in reducing allegations of sexual violence in psychiatric units.

    PubMed

    Banja, John D

    2017-01-01

    This article begins with a brief discussion of findings on causal factors leading to allegations of sexual violence in health care facilities and then offers the author's account of 4 such cases that he reviewed, 3 of which occurred in psychiatric units. These cases show remarkably similar variables, especially involving decisions to allow male and female patients to commingle, the inadequate physical layout of the units, poor or absent video surveillance, and staff unacquainted with institutional policies on patient safety or refusing to enforce relevant rules. These variables arguably amount to "failures of foreseeability" that reasonably cautious health care personnel should recognize as facilitating or enabling sexual violence. As such, the proactive message of this article for health care risk management urges critical and robust attention paid to a unit's environmental/physical design as well as to performance factors among personnel so as to prevent sexual attacks and diminish the probability of malpractice actions.

  15. Managing tile drainage, subirrigation, and nitrogen fertilization to enhance crop yields and reduce nitrate loss.

    PubMed

    Drury, C F; Tan, C S; Reynolds, W D; Welacky, T W; Oloya, T O; Gaynor, J D

    2009-01-01

    Improving field-crop use of fertilizer nitrogen is essential for protecting water quality and increasing crop yields. The objective of this study was to determine the effectiveness of controlled tile drainage (CD) and controlled tile drainage with subsurface irrigation (CDS) for mitigating off-field nitrate losses and enhancing crop yields. The CD and CDS systems were compared on a clay loam soil to traditional unrestricted tile drainage (UTD) under a corn (Zea Mays L.)-soybean (Glycine Max. (L.) Merr.) rotation at two nitrogen (N) fertilization rates (N1: 150 kg N ha(-1) applied to corn, no N applied to soybean; N2: 200 kg N ha(-1) applied to corn, 50 kg N ha(-1) applied to soybean). The N concentrations in tile flow events with the UTD treatment exceeded the provisional long-term aquatic life limit (LT-ALL) for freshwater (4.7 mg N L(-1)) 72% of the time at the N1 rate and 78% at the N2 rate, whereas only 24% of tile flow events at N1 and 40% at N2 exceeded the LT-ALL for the CDS treatment. Exceedances in N concentration for surface runoff and tile drainage were greater during the growing season than the non-growing season. At the N1 rate, CD and CDS reduced average annual N losses via tile drainage by 44 and 66%, respectively, relative to UTD. At the N2 rate, the average annual decreases in N loss were 31 and 68%, respectively. Crop yields from CDS were increased by an average of 2.8% relative to UTD at the N2 rate but were reduced by an average of 6.5% at the N1 rate. Hence, CD and CDS were effective for reducing average nitrate losses in tile drainage, but CDS increased average crop yields only when additional N fertilizer was applied.

  16. Tail biting in pigs--causes and management intervention strategies to reduce the behavioural disorder. A review.

    PubMed

    Sonoda, Lilia Thays; Fels, Michaela; Oczak, Maciej; Vranken, Erik; Ismayilova, Gunel; Guarino, Marcella; Viazzi, Stefano; Bahr, Claudia; Berckmans, Daniel; Hartung, Jörg

    2013-01-01

    One of the largest animal welfare problems in modern pig production is tail biting. This abnormal behaviour compromises the well-being of the animals, can seriously impair animal health and can cause considerable economic losses. Tail biting has a multifactorial origin and occurs mainly in fattening pigs. High stocking densities, poor environment and bad air quality are seen as important factors. However, it is presumed that a plurality of internal and external motivators in intensive pig production can trigger this behaviour which is not reported in sounders of wild boars. The aim of this review is to summarize the causes and the effects of tail biting in pigs and present management strategies that are likely to reduce its incidence. In particular, management strategies by applying Precision Livestock Farming (PLF) technologies to monitor and control the behaviour of the pigs may be suitable to detect the outbreaks of tail biting at an early stage so that counter measures can be taken in time.

  17. Modelling the benefits of flood emergency management measures in reducing damages: a case study on Sondrio, Italy

    NASA Astrophysics Data System (ADS)

    Molinari, D.; Ballio, F.; Menoni, S.

    2013-08-01

    The European "Floods Directive" 2007/60/EU has produced an important shift from a traditional approach to flood risk management centred only on hazard analysis and forecast to a newer one which encompasses other aspects relevant to decision-making and which reflect recent research advances in both hydraulic engineering and social studies on disaster risk. This paper accordingly proposes a way of modelling the benefits of flood emergency management interventions calculating the possible damages by taking into account exposure, vulnerability, and expected damage reduction. The results of this model can be used to inform decisions and choices for the implementation of flood emergency management measures. A central role is played by expected damages, which are the direct and indirect consequence of the occurrence of floods in exposed and vulnerable urban systems. How damages should be defined and measured is a key question that this paper tries to address. The Floods Directive suggests that mitigation measures taken to reduce flood impact need to be evaluated also by means of a cost-benefit analysis. The paper presents a methodology for assessing the effectiveness of early warning for flash floods, considering its potential impact in reducing direct physical damage, and it assesses the general benefit in regard to other types of damages and losses compared with the emergency management costs. The methodology is applied to the case study area of the city of Sondrio in the northern Alpine region of Italy. A critical discussion follows the application. Its purpose is to highlight the strengths and weaknesses of available models for quantifying direct physical damage and of the general model proposed, given the current state of the art in damage and loss assessment.

  18. Reducing the economic burden in management of Guillain–Barre syndrome using modified plasmapheresis

    PubMed Central

    Iyer, Rekha Ramaswamy; Shah, Pragnesh Hasmukhlal; Roy, Sher Sankar K.; Suri, Sushil Kumar Kundanlal

    2016-01-01

    Background: Guillain–Barre syndrome (GBS) is an autoimmune acute inflammatory demyelinating polyneuropathy affecting the peripheral nervous system treated with high-dose immunoglobulin, physical therapy, or plasmapheresis. Immunoglobulins are expensive and even plasmapheresis might not be affordable to patients visiting government set-ups. Aims: This study was undertaken to emphasize the efficacy of plasmapheresis in treatment of adult GBS patients and to narrate methods of reducing the economic burden in the treatment of these patients using modified plasmapheresis. Methods: A study was conducted on 12 adult GBS patients at Sir Takhtasinhji General Hospital, Bhavnagar from July 2012 to July 2014. Patients were assessed on a 6-point disability scale. They were treated with plasmapheresis over 10 days with REF627 kit from Haemonetics Corporation Limited on MCS+ machine. Improvement was noted by the change in the disability scale score and expenses of various modes of treatment were also considered. Results: Seventy-five percent showed improvement at the end of the treatment. The cost of modified plasmapheresis was Rs. 8000/cycle, i.e., Rs. 40,000/patient. Conclusion: Plasmapheresis along with proper supportive measures is a more cost-effective efficacious mode of therapy in adult patients of GBS. Further, modified plasmapheresis using REF627 kit and 6% hexastarch as replacement fluid on MCS+ apheresis machine reduces the cost of therapy for poor patients visiting government set-ups. PMID:27605847

  19. Simulating land management options to reduce nitrate pollution in an agricultural watershed dominated by an alluvial aquifer.

    PubMed

    Cerro, Itsasne; Antigüedad, Iñaki; Srinavasan, Raghavan; Sauvage, Sabine; Volk, Martin; Sanchez-Perez, José Miguel

    2014-01-01

    The study area (Alegria watershed, Basque Country, Northern Spain) considered here is influenced by an important alluvial aquifer that plays a significant role in nitrate pollution from agricultural land use and management practices. Nitrates are transported primarily from the soil to the river through the alluvial aquifer. The agricultural activity covers 75% of the watershed and is located in a nitrate-vulnerable zone. The main objective of the study was to find land management options for water pollution abatement by using model systems. In a first step, the SWAT model was applied to simulate discharge and nitrate load in stream flow at the outlet of the catchment for the period between October 2009 and June 2011. The LOADEST program was used to estimate the daily nitrate load from measured nitrate concentration. We achieved satisfactory simulation results for discharge and nitrate loads at monthly and daily time steps. The results revealed clear variations in the seasons: higher nitrate loads were achieved for winter (20,000 kg mo NO-N), and lower nitrate loads were simulated for the summer (<1000 kg mo NO-N) period. In a second step, the calibrated model was used to evaluate the long-term effects of best management practices (BMPs) for a 50-yr period by maintaining actual agricultural practices, reducing fertilizer application by 20%, splitting applications (same total N but applied over the growing period), and reducing 20% of the applied fertilizer amount and splitting the fertilizer doses. The BMPs were evaluated on the basis of local experience and farmer interaction. Results showed that reducing fertilizer amounts by 20% could lead to a reduction of 50% of the number of days exceeding the nitrate concentration limit value (50 mg L) set by the European Water Framework Directive.

  20. Forest management under climatic and social uncertainty: trade-offs between reducing climate change impacts and fostering adaptive capacity.

    PubMed

    Seidl, Rupert; Lexer, Manfred J

    2013-01-15

    The unabated continuation of anthropogenic greenhouse gas emissions and the lack of an international consensus on a stringent climate change mitigation policy underscore the importance of adaptation for coping with the all but inevitable changes in the climate system. Adaptation measures in forestry have particularly long lead times. A timely implementation is thus crucial for reducing the considerable climate vulnerability of forest ecosystems. However, since future environmental conditions as well as future societal demands on forests are inherently uncertain, a core requirement for adaptation is robustness to a wide variety of possible futures. Here we explicitly address the roles of climatic and social uncertainty in forest management, and tackle the question of robustness of adaptation measures in the context of multi-objective sustainable forest management (SFM). We used the Austrian Federal Forests (AFF) as a case study, and employed a comprehensive vulnerability assessment framework based on ecosystem modeling, multi-criteria decision analysis, and practitioner participation. We explicitly considered climate uncertainty by means of three climate change scenarios, and accounted for uncertainty in future social demands by means of three societal preference scenarios regarding SFM indicators. We found that the effects of climatic and social uncertainty on the projected performance of management were in the same order of magnitude, underlining the notion that climate change adaptation requires an integrated social-ecological perspective. Furthermore, our analysis of adaptation measures revealed considerable trade-offs between reducing adverse impacts of climate change and facilitating adaptive capacity. This finding implies that prioritization between these two general aims of adaptation is necessary in management planning, which we suggest can draw on uncertainty analysis: Where the variation induced by social-ecological uncertainty renders measures aiming to

  1. Exploiting Co-Benefits of Increased Rice Production and Reduced Greenhouse Gas Emission through Optimized Crop and Soil Management.

    PubMed

    An, Ning; Fan, Mingsheng; Zhang, Fusuo; Christie, Peter; Yang, Jianchang; Huang, Jianliang; Guo, Shiwei; Shi, Xiaojun; Tang, Qiyuan; Peng, Jianwei; Zhong, Xuhua; Sun, Yixiang; Lv, Shihua; Jiang, Rongfeng; Dobermann, Achim

    2015-01-01

    Meeting the future food security challenge without further sacrificing environmental integrity requires transformative changes in managing the key biophysical determinants of increasing agronomic productivity and reducing the environmental footprint. Here, we focus on Chinese rice production and quantitatively address this concern by conducting 403 on-farm trials across diverse rice farming systems. Inherent soil productivity, management practices and rice farming type resulted in confounded and interactive effects on yield, yield gaps and greenhouse gas (GHG) emissions (N2O, CH4 and CO2-equivalent) with both trade-offs and compensating effects. Advances in nitrogen, water and crop management (Best Management Practices-BMPs) helped closing existing yield gaps and resulted in a substantial reduction in CO2-equivalent emission of rice farming despite a tradeoff of increase N2O emission. However, inherent soil properties limited rice yields to a larger extent than previously known. Cultivating inherently better soil also led to lower GHG intensity (GHG emissions per unit yield). Neither adopting BMPs only nor improving soils with low or moderate productivity alone can adequately address the challenge of substantially increasing rice production while reducing the environmental footprint. A combination of both represents the most efficient strategy to harness the combined-benefits of enhanced production and mitigating climate change. Extrapolating from our farm data, this strategy could increase rice production in China by 18%, which would meet the demand for direct human consumption of rice by 2030. It would also reduce fertilizer nitrogen consumption by 22% and decrease CO2-equivalent emissions during the rice growing period by 7% compared with current farming practice continues. Benefits vary by rice-based cropping systems. Single rice systems have the largest food provision benefits due to its wider yield gap and total cultivated area, whereas double-rice system

  2. Exploiting Co-Benefits of Increased Rice Production and Reduced Greenhouse Gas Emission through Optimized Crop and Soil Management

    PubMed Central

    An, Ning; Fan, Mingsheng; Zhang, Fusuo; Christie, Peter; Yang, Jianchang; Huang, Jianliang; Guo, Shiwei; Shi, Xiaojun; Tang, Qiyuan; Peng, Jianwei; Zhong, Xuhua; Sun, Yixiang; Lv, Shihua; Jiang, Rongfeng; Dobermann, Achim

    2015-01-01

    Meeting the future food security challenge without further sacrificing environmental integrity requires transformative changes in managing the key biophysical determinants of increasing agronomic productivity and reducing the environmental footprint. Here, we focus on Chinese rice production and quantitatively address this concern by conducting 403 on-farm trials across diverse rice farming systems. Inherent soil productivity, management practices and rice farming type resulted in confounded and interactive effects on yield, yield gaps and greenhouse gas (GHG) emissions (N2O, CH4 and CO2-equivalent) with both trade-offs and compensating effects. Advances in nitrogen, water and crop management (Best Management Practices—BMPs) helped closing existing yield gaps and resulted in a substantial reduction in CO2-equivalent emission of rice farming despite a tradeoff of increase N2O emission. However, inherent soil properties limited rice yields to a larger extent than previously known. Cultivating inherently better soil also led to lower GHG intensity (GHG emissions per unit yield). Neither adopting BMPs only nor improving soils with low or moderate productivity alone can adequately address the challenge of substantially increasing rice production while reducing the environmental footprint. A combination of both represents the most efficient strategy to harness the combined-benefits of enhanced production and mitigating climate change. Extrapolating from our farm data, this strategy could increase rice production in China by 18%, which would meet the demand for direct human consumption of rice by 2030. It would also reduce fertilizer nitrogen consumption by 22% and decrease CO2-equivalent emissions during the rice growing period by 7% compared with current farming practice continues. Benefits vary by rice-based cropping systems. Single rice systems have the largest food provision benefits due to its wider yield gap and total cultivated area, whereas double-rice system

  3. Potential for reduced methane and carbon dioxide emissions from livestock and pasture management in the tropics

    PubMed Central

    Thornton, Philip K.; Herrero, Mario

    2010-01-01

    We estimate the potential reductions in methane and carbon dioxide emissions from several livestock and pasture management options in the mixed and rangeland-based production systems in the tropics. The impacts of adoption of improved pastures, intensifying ruminant diets, changes in land-use practices, and changing breeds of large ruminants on the production of methane and carbon dioxide are calculated for two levels of adoption: complete adoption, to estimate the upper limit to reductions in these greenhouse gases (GHGs), and optimistic but plausible adoption rates taken from the literature, where these exist. Results are expressed both in GHG per ton of livestock product and in Gt CO2-eq. We estimate that the maximum mitigation potential of these options in the land-based livestock systems in the tropics amounts to approximately 7% of the global agricultural mitigation potential to 2030. Using historical adoption rates from the literature, the plausible mitigation potential of these options could contribute approximately 4% of global agricultural GHG mitigation. This could be worth on the order of $1.3 billion per year at a price of $20 per t CO2-eq. The household-level and sociocultural impacts of some of these options warrant further study, however, because livestock have multiple roles in tropical systems that often go far beyond their productive utility. PMID:20823225

  4. Managing Errors to Reduce Accidents in High Consequence Networked Information Systems

    SciTech Connect

    Ganter, J.H.

    1999-02-01

    Computers have always helped to amplify and propagate errors made by people. The emergence of Networked Information Systems (NISs), which allow people and systems to quickly interact worldwide, has made understanding and minimizing human error more critical. This paper applies concepts from system safety to analyze how hazards (from hackers to power disruptions) penetrate NIS defenses (e.g., firewalls and operating systems) to cause accidents. Such events usually result from both active, easily identified failures and more subtle latent conditions that have resided in the system for long periods. Both active failures and latent conditions result from human errors. We classify these into several types (slips, lapses, mistakes, etc.) and provide NIS examples of how they occur. Next we examine error minimization throughout the NIS lifecycle, from design through operation to reengineering. At each stage, steps can be taken to minimize the occurrence and effects of human errors. These include defensive design philosophies, architectural patterns to guide developers, and collaborative design that incorporates operational experiences and surprises into design efforts. We conclude by looking at three aspects of NISs that will cause continuing challenges in error and accident management: immaturity of the industry, limited risk perception, and resource tradeoffs.

  5. Potential for reduced methane and carbon dioxide emissions from livestock and pasture management in the tropics.

    PubMed

    Thornton, Philip K; Herrero, Mario

    2010-11-16

    We estimate the potential reductions in methane and carbon dioxide emissions from several livestock and pasture management options in the mixed and rangeland-based production systems in the tropics. The impacts of adoption of improved pastures, intensifying ruminant diets, changes in land-use practices, and changing breeds of large ruminants on the production of methane and carbon dioxide are calculated for two levels of adoption: complete adoption, to estimate the upper limit to reductions in these greenhouse gases (GHGs), and optimistic but plausible adoption rates taken from the literature, where these exist. Results are expressed both in GHG per ton of livestock product and in Gt CO(2)-eq. We estimate that the maximum mitigation potential of these options in the land-based livestock systems in the tropics amounts to approximately 7% of the global agricultural mitigation potential to 2030. Using historical adoption rates from the literature, the plausible mitigation potential of these options could contribute approximately 4% of global agricultural GHG mitigation. This could be worth on the order of $1.3 billion per year at a price of $20 per t CO(2)-eq. The household-level and sociocultural impacts of some of these options warrant further study, however, because livestock have multiple roles in tropical systems that often go far beyond their productive utility.

  6. Weight Management to Reduce Prostate Cancer Risk: A Survey of Men’s Needs and Interests

    PubMed Central

    Schleper, Amy; Sullivan, Debra K.; Thrasher, J. Brantley; Holzbeierlein, Jeffrey M.; Klemp, Jennifer; Befort, Christie; Hamilton-Reeves, Jill M.

    2016-01-01

    Obese men have a higher rate of prostate cancer-related death than non-obese men, and obesity increases the risk of prostate cancer progression and biochemical recurrence. The purpose of this study was to assess needs and interests of men for a technology-driven weight loss intervention to reduce prostate cancer risk. We distributed a survey collecting demographic characteristics, health history, exercise and eating habits (and perception of those habits), current and prior attempts of health behavior change, and technology use. Survey answers were summarized by count and percent of total respondents. Completed surveys (N = 109) described men with a family history of prostate cancer (25%), a history of elevated prostate specific antigen (26%), and prostate cancer survivors (22%). We compared body mass index (BMI) to perception of weight; overweight and obese men perceived their weight as more normal than their BMI category suggests. Most men reported their diet needed minor improvement (74%), and 65% of men reported they are either currently trying to lose weight or interested in weight loss. Most respondents access the internet (92%), while text messaging (60%) and smartphone application use (40%) are less frequent, especially in men over 60. Our results revealed a need and willingness for lifestyle modification and suggest a need for evidence-based weight loss strategies and for addressing the misperception of weight status. A male-tailored intervention that implements technology could improve energy balance, hold men accountable to healthy behavior change, and promote dietary patterns in order to reduce prostate cancer risk. PMID:27547287

  7. As low as reasonably achievable: Methods for reducing radiation exposure during the management of renal and ureteral stones

    PubMed Central

    Cabrera, Fernando; Preminger, Glenn M.; Lipkin, Michael E.

    2014-01-01

    Imaging for urolithiasis has evolved over the past 30 years. Currently, non-contrast computed tomography (NCCT) remains the first line imaging modality for the evaluation of patients with suspected urolithiasis. NCCT is a dominant source of ionizing radiation for patients and one of its major limitation. However, new low dose NCCT protocols may help to reduce the risk. Fluoroscopy use during operating room (OR) surgical procedures can be a substantial source of radiation for patients, OR staff and surgeons. It is important to consider the amount of radiation patients are exposed to from fluoroscopy during operative interventions for stones. Radiation reduction can be accomplished by appropriate selection of imaging studies and multiple techniques, which minimize the use of fluoroscopy whenever possible. The purpose of this manuscript is to review common imaging modalities used for diagnosing and management of renal and ureteral stones associated with radiation exposure. We also review alternatives and techniques to reduce radiation exposure. PMID:24497684

  8. Managing population immunity to reduce or eliminate the risks of circulation following the importation of polioviruses.

    PubMed

    Thompson, Kimberly M; Kalkowska, Dominika A; Duintjer Tebbens, Radboud J

    2015-03-24

    Poliovirus importations into polio-free countries represent a major concern during the final phases of global eradication of wild polioviruses (WPVs). We extend dynamic transmission models to demonstrate the dynamics of population immunity out through 2020 for three countries that only used inactivated poliovirus vaccine (IPV) for routine immunization: the US, Israel, and The Netherlands. For each country, we explore the vulnerability to re-established transmission following an importation for each poliovirus serotype, including the impact of immunization choices following the serotype 1 WPV importation that occurred in 2013 in Israel. As population immunity declines below the threshold required to prevent transmission, countries become at risk for re-established transmission. Although importations represent stochastic events that countries cannot fully control because people cross borders and polioviruses mainly cause asymptomatic infections, countries can ensure that any importations die out. Our results suggest that the general US population will remain above the threshold for transmission through 2020. In contrast, Israel became vulnerable to re-established transmission of importations of live polioviruses by the late 2000s. In Israel, the recent WPV importation and outbreak response use of bivalent oral poliovirus vaccine (bOPV) eliminated the vulnerability to an importation of poliovirus serotypes 1 and 3 for several years, but not serotype 2. The Netherlands experienced a serotype 1 WPV outbreak in 1992-1993 and became vulnerable to re-established transmission in religious communities with low vaccine acceptance around the year 2000, although the general population remains well-protected from widespread transmission. All countries should invest in active management of population immunity to avoid the potential circulation of imported live polioviruses. IPV-using countries may wish to consider prevention opportunities and/or ensure preparedness for response

  9. Spatial and temporal changes in sulphate-reducing groundwater bacterial community structure in response to Managed Aquifer Recharge.

    PubMed

    Reed, D A; Toze, S; Chang, B

    2008-01-01

    The population dynamics of bacterial able to be cultured under sulphate reducing condition was studied in conjunction with changes in aquifer geochemistry using multivariate statistics for two contrasting Managed Aquifer Recharge (MAR) techniques at two different geographical locations (Perth, Western Australia and Adelaide, South Australia). Principal component analysis (PCA) was used to investigate spatial and temporal changes in the overall chemical signature of the aquifers using an array of chemical analytes which demonstrated a migrating geochemical plume. Denaturing Gradient Gel Electrophoresis (DGGE) using DNA from sulphate-reducing bacteria cultures was used to detect spatial and temporal changes in population dynamics. Bacterial and geochemical evidence suggested that groundwater at greatest distance from the nutrient source was least affected by treated effluent recharge. The results suggested that bacterial populations that were able to be cultured in sulphate reducing media responded to the migrating chemical gradient and to the changes in aquifer geochemistry. Most noticeably, sulphate-reducing bacterial populations associated with the infiltration galleries were stable in community structure over time. Additionally, the biodiversity of these culturable bacteria was restored when aquifer geochemistry returned to ambient conditions during the recovery phase at the Adelaide Aquifer Storage and Recovery site.

  10. Alternate Wetting and Drying as an Effective Management Practice to Reduce Methane in Arkansas Rice Production

    NASA Astrophysics Data System (ADS)

    Runkle, B.; Smith, S. F.; Suvocarev, K.; Reba, M. L.

    2015-12-01

    Approximately 15% of the global 308 Tg CH4 emitted by anthropogenic sources is currently attributed to rice cultivation. Arkansas, the leading state in rice cultivation, produces over 42% of the total rice and represents over 43% of total land planted to rice in the US. Although rice production is generally water-intensive, some rice producers have adopted a conservation practice, 'Alternate Wetting and Drying' (AWD), in which the flood is released periodically during the growing season. In addition, implementing AWD can reduce CH4 emissions though the introduction of aerobic conditions. To assess the magnitude of this reduction, conventionally flooded (CONV) and AWD fields were identically instrumented for the 2015 season and fluxes of CH4 were measured with an open path IRGA. Other biophysical variables were monitored to determine the relative dominance of potential drivers. Half-hourly CH4 fluxes from the AWD and CONV fields during their similar initial flood (DOY 138-161) were well correlated (R2 = 0.762), indicating similar mechanisms controlling CH4 emissions in both fields. After the initial drydown event in the AWD field (162 DOY), daily median CH4 fluxes continued to rise to 7.80 mg CH4 m-2 h-1 on 163 DOY before subsiding to a local minimum of 0.162 mg CH4 m-2 h-1 on 171 DOY. Daily median CH4 fluxes between 9.24 and 16.0 mg CH4 m-2 h-1 were observed in the CONV field during this same period. Cumulative emissions from both fields following the drydown event and prior to rewetting demonstrated a reduction in CH4 emissions by the AWD treatment by 82%. The substantial decrease in CH4 emissions by AWD in the early growing season supports and expands upon previous chamber-based research and offers strong evidence for the efficacy of AWD in reducing CH4 emissions in AR rice production. The presentation will also assess the latter portion of the growing season, currently underway, and will provide process-based relationships between biophysical parameters and CH

  11. Improving patient care over weekends by reducing on-call work load and better time management.

    PubMed

    Gardezi, Syed Anjum Ali

    2014-01-01

    The Royal College of Physicians states that "handover, particularly of temporary 'on-call' responsibility, has been identified as a point at which errors are likely to occur."[1] Working a weekend on-call covering medical wards is often busy and stressful for all junior doctors. The high volume of routine and unplanned tasks make the situation even worse. In Nevill Hall hospital Abergavenny, we measured the workload on a junior doctor for medical ward cover on weekends by counting the number of times he/she was bleeped for routine tasks. Initial study demonstrated that on average 30-40% of time on a long day shift was spent on jobs which could have been done on the preceding Friday. The "FRIDAYS" checklist was introduced for clinical staff (particularly junior doctors) to identify these jobs. According to this model, all the junior doctors were encouraged to review: F: Phlebotomy R: Rewriting drug charts I: IV fluids D: discharge summaries A: Antibiotic review Y: Yellow book/Warfarin dose S: Status of resuscitation and escalation plans before leaving the wards on Friday afternoon. This implementation successfully showed reduction in weekend workload, allowing the ward cover to be focused on care and safety of comparatively sick patients while at the same time reducing the stress for the on-call team.

  12. Improving patient care over weekends by reducing on-call work load and better time management

    PubMed Central

    Gardezi, Syed Anjum Ali

    2014-01-01

    The Royal College of Physicians states that “handover, particularly of temporary ‘on-call’ responsibility, has been identified as a point at which errors are likely to occur.”[1] Working a weekend on-call covering medical wards is often busy and stressful for all junior doctors. The high volume of routine and unplanned tasks make the situation even worse. In Nevill Hall hospital Abergavenny, we measured the workload on a junior doctor for medical ward cover on weekends by counting the number of times he/she was bleeped for routine tasks. Initial study demonstrated that on average 30–40% of time on a long day shift was spent on jobs which could have been done on the preceding Friday. The “FRIDAYS” checklist was introduced for clinical staff (particularly junior doctors) to identify these jobs. According to this model, all the junior doctors were encouraged to review: F: Phlebotomy R: Rewriting drug charts I: IV fluids D: discharge summaries A: Antibiotic review Y: Yellow book/Warfarin dose S: Status of resuscitation and escalation plans before leaving the wards on Friday afternoon. This implementation successfully showed reduction in weekend workload, allowing the ward cover to be focused on care and safety of comparatively sick patients while at the same time reducing the stress for the on-call team. PMID:26734257

  13. Integrated soil-crop system management: reducing environmental risk while increasing crop productivity and improving nutrient use efficiency in China.

    PubMed

    Zhang, Fusuo; Cui, Zhenling; Fan, Mingsheng; Zhang, Weifeng; Chen, Xinping; Jiang, Rongfeng

    2011-01-01

    During the past 47 yr (1961-2007), Chinese cereal production has increased by 3.2-fold, successfully feeding 22% of the global human population with only 9% of the world's arable land, but at high environmental cost and resource consumption. Worse, crop production has been stagnant since 1996 while the population and demand for food continue to rise. New advances for sustainability of agriculture and ecosystem services will be needed during the coming 50 yr to reduce environmental risk while increasing crop productivity and improving nutrient use efficiency. Here, we advocate and develop integrated soil-crop system management (ISSM). In this approach, the key points are (i) to take all possible soil quality improvement measures into consideration, (ii) to integrate the utilization of various nutrient resources and match nutrient supply to crop requirements, and (iii) to integrate soil and nutrient management with high-yielding cultivation systems. Recent field experiments have shed light on how ISSM can lead to significant increases in crop yields while increasing nutrient use efficiency and reducing environmental risk.

  14. Complication Reducing Effect of the Information Technology-Based Diabetes Management System on Subjects with Type 2 Diabetes

    PubMed Central

    Cho, Jae-Hyoung; Lee, Jin-Hee; Oh, Jeong-Ah; Kang, Mi-Ja; Choi, Yoon-Hee; Kwon, Hyuk-Sang; Chang, Sang-Ah; Cha, Bong-Yun; Son, Ho-Young; Yoon, Kun-Ho

    2008-01-01

    Objective We introduced a new information technology-based diabetes management system, called the Internet-based glucose monitoring system (IBGMS), and demonstrated its short-term and long-term favorable effects. However, there has been no report on clinical effects of such a new diabetes management system on the development of diabetic complications so far. This study was used to simulate the complication reducing effect of the IBGMS, given in addition to existing treatments in patients with type 2 diabetes. Research Design and Methods The CORE Diabetes Model, a peer-reviewed, published, validated computer simulation model, was used to project long-term clinical outcomes in type 2 diabetes patients receiving the IBGMS in addition to their existing treatment. The model combined standard Markov submodels to simulate the incidence and progression of diabetes-related complications. Results The addition of IBGMS was associated with improvements in reducing diabetic complications, mainly microangiopathic complications, including diabetic retinopathy, diabetic neuropathy, diabetic nephropathy, and diabetic foot ulcer. The IBGMS also delayed the development of all diabetic complications for more than 1 year. Conclusions This study demonstrated that the simulated IBGMS, compared to existing treatment, was associated with a reduction of diabetic complications. As a result, it provides valuable evidence for practical application to the public in the world. PMID:19885180

  15. Water management reduces greenhouse gas emissions in a Mediterranean rice paddy field

    NASA Astrophysics Data System (ADS)

    Gruening, Carsten; Meijide, Ana; Manca, Giovanni; Goded, Ignacio; Seufert, Guenther; Cescatti, Alessandro

    2016-04-01

    Rice paddy fields are one of the biggest anthropogenic sources of methane (CH4), the second most important greenhouse gas (GHG) after carbon dioxide (CO2). Therefore most studies on greenhouse gases (GHG) in these agricultural systems focus on the evaluation of CH4 production. However, there are other GHGs such as CO2 and nitrous oxide (N2O) also exchanged within the atmosphere. Since each of the GHGs has its own radiative forcing effect, the total GHG budget of rice cultivation and its global warming potential (GWP) must be assessed. For this purpose a field experiment was carried out in a Mediterranean rice paddy field in the Po Valley (Italy), the largest rice producing region in Europe. Ecosystem CO2 and CH4 fluxes were assessed using the eddy covariance technique, while soil respiration and soil CH4 and N2O fluxes were measured with closed chambers for two complete years. Combining all GHGs measured, the rice paddy field acted as a sink of -368 and -828 g CO2 eq m-2 year-1 in the first and second years respectively. Both years, it was a CO2 sink and a CH4 source, while the N2O contribution to the GWP was relatively small. Differences in the GHG budget between the two years of measurements were mainly caused by the greater CH4 emissions in the first year (37.4 g CH4 m-2 compared to 21.03 g CH4 m-2 in the second year), probably as a consequence of the drainage of the water table in the middle of the growing season during the second year, which resulted in lower CH4 emissions without significant increases of N2O and CO2 fluxes. However, midseason drainage also resulted in small decreases of yield, indicating that GHG budget studies from agricultural systems should consider carbon exports through the harvest. The balance between net GWP and carbon yield indicated a loss of carbon equivalents from the system, which was more than 30-fold higher in the first year. Our results therefore suggest that an adequate management of the water table has the potential to be an

  16. Reducing environmental risk by improving N management in intensive Chinese agricultural systems.

    PubMed

    Ju, Xiao-Tang; Xing, Guang-Xi; Chen, Xin-Ping; Zhang, Shao-Lin; Zhang, Li-Juan; Liu, Xue-Jun; Cui, Zhen-Ling; Yin, Bin; Christie, Peter; Zhu, Zhao-Liang; Zhang, Fu-Suo

    2009-03-03

    Excessive N fertilization in intensive agricultural areas of China has resulted in serious environmental problems because of atmospheric, soil, and water enrichment with reactive N of agricultural origin. This study examines grain yields and N loss pathways using a synthetic approach in 2 of the most intensive double-cropping systems in China: waterlogged rice/upland wheat in the Taihu region of east China versus irrigated wheat/rainfed maize on the North China Plain. When compared with knowledge-based optimum N fertilization with 30-60% N savings, we found that current agricultural N practices with 550-600 kg of N per hectare fertilizer annually do not significantly increase crop yields but do lead to about 2 times larger N losses to the environment. The higher N loss rates and lower N retention rates indicate little utilization of residual N by the succeeding crop in rice/wheat systems in comparison with wheat/maize systems. Periodic waterlogging of upland systems caused large N losses by denitrification in the Taihu region. Calcareous soils and concentrated summer rainfall resulted in ammonia volatilization (19% for wheat and 24% for maize) and nitrate leaching being the main N loss pathways in wheat/maize systems. More than 2-fold increases in atmospheric deposition and irrigation water N reflect heavy air and water pollution and these have become important N sources to agricultural ecosystems. A better N balance can be achieved without sacrificing crop yields but significantly reducing environmental risk by adopting optimum N fertilization techniques, controlling the primary N loss pathways, and improving the performance of the agricultural Extension Service.

  17. Maintaining yields and reducing nitrogen loss in rice-wheat rotation system in Taihu Lake region with proper fertilizer management

    NASA Astrophysics Data System (ADS)

    Xue, Lihong; Yu, Yingliang; Yang, Linzhang

    2014-11-01

    In the Tailake region of China, heavy nitrogen (N) loss of rice-wheat rotation systems, due to high fertilizer-N input with low N use efficiency (NUE), was widely reported. To alleviate the detrimental impacts caused by N loss, it is necessary to improve the fertilizer management practices. Therefore, a 3 yr field experiments with different N managements including organic combined chemical N treatment (OCN, 390 kg N ha-1 yr-1, 20% organic fertilizer), control-released urea treatment (CRU, 390 kg N ha-1 yr-1, 70% resin-coated urea), reduced chemical N treatment (RCN, 390 kg N ha-1 yr-1, all common chemical fertilizer), and site-specific N management (SSNM, 333 kg N ha-1 yr-1, all common chemical fertilizer) were conducted in the Taihu Lake region with the ‘farmer’s N’ treatment (FN, 510 kg N ha-1 yr-1, all common chemical fertilizer) as a control. Grain yield, plant N uptake (PNU), NUE, and N losses via runoff, leaching, and ammonia volatilization were assessed. In the rice season, the FN treatment had the highest N loss and lowest NUE, which can be attributed to an excessive rate of N application. Treatments of OCN and RCN with a 22% reduced N rate from FN had no significant effect on PNU nor the yield of rice in the 3 yr; however, the NUE was improved and N loss was reduced 20-32%. OCN treatment achieved the highest yield, while SSNM has the lowest N loss and highest NUE due to the lowest N rate. In wheat season, N loss decreased about 28-48% with the continuous reduction of N input, but the yield also declined, with the exception of OCN treatment. N loss through runoff, leaching and ammonia volatilization was positively correlated with the N input rate. When compared with the pure chemical fertilizer treatment of RCN under the same N input, OCN treatment has better NUE, better yield, and lower N loss. 70% of the urea replaced with resin-coated urea had no significant effect on yield and NUE improvement, but decreased the ammonia volatilization loss. Soil

  18. Innovative Water Management Technology to Reduce Environment Impacts of Produced Water

    SciTech Connect

    Castle, James W.; Rodgers, John H.; Alley, Bethany; Beebe, Alex; Coffey, Ruthanne; Jurinko, Kristen; Pardue, Michael; Ritter, Tina; Spacil, Michael M.

    2013-08-08

    -reverse osmosis produced water was designed to promote oxidizing conditions within the first wetland cell for nitrification of ammonia, and the subsequent three cells were designed to promote reducing conditions for denitrification of nitrate. By incorporating multiple wetland cells in a CWTS, the conditions within each cell can be modified for removal of specific COCs. In addition, a CWTS designed with multiple cells allows for convenient sample collection points so that biogeochemical conditions of individual cells can be monitored and performance evaluated. Removal rate coefficients determined from the pilot-scale CWTS experiments and confirmed by the demonstration system can be used to calculate HRTs required to treat COCs in full-scale CWTSs. The calculated HRTs can then be used to determine the surface area or footprint of a full-size CWTS for a given inflow rate of produced water.

  19. Innovative Water Management Technology to Reduce Environmental Impacts of Produced Water

    SciTech Connect

    Castle, James; Rodgers, John; Alley, Bethany; Beebe, Alex; Coffey, Ruthanne; Jurinko, Kristen; Pardue, Michael; Ritter, Tina; Spacil, Michael

    2013-05-15

    -reverse osmosis produced water was designed to promote oxidizing conditions within the first wetland cell for nitrification of ammonia, and the subsequent three cells were designed to promote reducing conditions for denitrification of nitrate. By incorporating multiple wetland cells in a CWTS, the conditions within each cell can be modified for removal of specific COCs. In addition, a CWTS designed with multiple cells allows for convenient sample collection points so that biogeochemical conditions of individual cells can be monitored and performance evaluated. Removal rate coefficients determined from the pilot-scale CWTS experiments and confirmed by the demonstration system can be used to calculate HRTs required to treat COCs in full-scale CWTSs. The calculated HRTs can then be used to determine the surface area or ?footprint? of a full-size CWTS for a given inflow rate of produced water.

  20. Innovative Water Management Technology to Reduce Environment Impacts of Produced Water

    SciTech Connect

    Castle, James; Rodgers, John; Alley, Bethany; Coffey, Ruthanne; Jurinko, Kristen; Pardue, Michael; Ritter, Tina; Spacil, Michael

    2013-05-15

    -reverse osmosis produced water was designed to promote oxidizing conditions within the first wetland cell for nitrification of ammonia, and the subsequent three cells were designed to promote reducing conditions for denitrification of nitrate. By incorporating multiple wetland cells in a CWTS, the conditions within each cell can be modified for removal of specific COCs. In addition, a CWTS designed with multiple cells allows for convenient sample collection points so that biogeochemical conditions of individual cells can be monitored and performance evaluated. Removal rate coefficients determined from the pilot-scale CWTS experiments and confirmed by the demonstration system can be used to calculate HRTs required to treat COCs in full-scale CWTSs. The calculated HRTs can then be used to determine the surface area or footprint of a full-size CWTS for a given inflow rate of produced water.

  1. Reducing psychosocial risks through supervisors' development: a contribution for a brief version of the "Stress Management Competency Indicator Tool".

    PubMed

    Toderi, Stefano; Gaggia, Andrea; Balducci, Cristian; Sarchielli, Guido

    2015-06-15

    With the recent changes in the world of work psychosocial risks are increasingly prevalent, causing work stress and physical and mental illnesses, which have a tremendous impact on public health and social participation. Supervisors' behaviour development was proposed as an innovative intervention that can reduce psychosocial risks. The "Stress Management Competency Indicator Tool" is one of the most important questionnaires that assess managers' preventive behaviour. However, its psychometric properties have never been evaluated and the length of the questionnaire (66 items) limits its practical applicability. The aim of this study was to contribute to the development of the questionnaire by providing psychometric evidence on a brief version of the tool focusing on the "Managing and Communicating existing and future Work" cluster of behaviours, which has been found to be the crucial one in terms of stress prevention. A questionnaire was administered to 178 employees of two Italian public organizations (a municipality and a hospital), measuring the supervisors' "Managing and Communicating existing and future Work" competency, and the affective well-being and work team effectiveness. The results showed excellent psychometric properties of the supervisors' behaviour scale and confirmed the expected relationships with criterion outcomes (affective well-being and team effectiveness). Overall, the factorial structure and dimensionality, the construct validity and reliability, and the concurrent validity of the tool were strongly supported by this study. We concluded that the brief version of the scale is a valid and reliable measure that can be easily used in practice and that can contribute to the development of research and practice on this topic.

  2. Lost opportunities for effective management of obstetric conditions to reduce maternal mortality and severe maternal morbidity in Argentina and Uruguay

    PubMed Central

    Karolinski, Ariel; Mazzoni, Agustina; Belizán, José M; Althabe, Fernando; Bergel, Eduardo; Buekens, Pierre

    2010-01-01

    Objective To review the use of evidence-based practices in the care of mothers who died or had severe morbidity attending public hospitals in two Latin American countries. Methods This study is part of a multicenter intervention to increase the use of evidence-based obstetric practice. Data on maternal deaths and women admitted to intensive care units whose deliveries occurred in 24 hospitals in Argentina and Uruguay were analyzed. Primary outcomes were use rates of effective interventions to reduce maternal mortality (MM) and severe maternal morbidity (SMM). Results A total of 106 women were included: 26 maternal deaths and 80 women with SMM. Some effective interventions for severe acute hemorrhage had a high use rate, such as blood transfusion (91%) and timely cesarean delivery (75%), while active management of the third stage of labor (25%) showed a lower rate. The overall use rate of effective interventions was 58% (95% CI, 49%–67%). This implies that 42% of the women did not receive one of the effective interventions to reduce MM and SMM. Conclusion This study shows a low use of effective interventions to reduce MM and SMM in public hospitals in Argentina and Uruguay. Dissemination and implementation of evidence-based practices must be guaranteed to effectively achieve progress on maternal health. PMID:20605151

  3. Use of drinking water treatment residuals as a potential best management practice to reduce phosphorus risk index scores.

    PubMed

    Dayton, E A; Basta, N T

    2005-01-01

    The P risk index system has been developed to identify agricultural fields vulnerable to P loss as a step toward protecting surface water. Because of their high Langmuir phosphorus adsorption maxima (P(max)), use of drinking water treatment residuals (WTRs) should be considered as a best management practice (BMP) to lower P risk index scores. This work discusses three WTR application methods that can be used to reduce P risk scores: (i) enhanced buffer strip, (ii) incorporation into a high soil test phosphorus (STP) soil, and (iii) co-blending with manure or biosolids. The relationship between WTR P(max) and reduction in P extractability and runoff P was investigated. In a simulated rainfall experiment, using a buffer strip enhanced with 20 Mg WTR ha(-1), runoff P was reduced by from 66.8 to 86.2% and reductions were related to the WTR P(max). When 25 g kg(-1) WTR was incorporated into a high STP soil of 315 mg kg(-1) determined using Mehlich-3 extraction, 0.01 M calcium chloride-extractable phosphorus (CaCl(2)-P) reductions ranged from 60.9 to 96.0% and were strongly (P < 0.01) related to WTR P(max). At a 100 g kg(-1) WTR addition, Mehlich 3-extractable P reductions ranged from 41.1 to 86.7% and were strongly (P < 0.01) related to WTR P(max). Co-blending WTR at 250 g kg(-1) to manure or biosolids reduced CaCl(2)-P by >75%. The WTR P(max) normalized across WTR application rates (P(max) x WTR application) was significantly related to reductions in CaCl(2)-P or STP. Using WTR as a P risk index modifying factor will promote effective use of WTR as a BMP to reduce P loss from agricultural land.

  4. ICONS: Managing Care and Costs: The Sustained Cost Impact of Reduced Hospitalizations in a Partnership-Measurement Model of Disease Management.

    PubMed

    Paradis, Pierre Emmanuel; Nemis-White, Joanna; Meilleur, Marie-Claude; Ginn, Marissa; Cox, Jafna; Montague, Terrence

    2010-01-01

    Improving Cardiovascular Outcomes in Nova Scotia (ICONS) was a multidisciplinary-partnership, measurement-driven disease management project designed to improve the care and outcomes of patients with acute and chronic heart diseases in Nova Scotia. Previous analyses demonstrated beneficial clinical and macroeconomic end points at the population and system levels, including heightened awareness of the value of team care, increased use of proven therapies, decreased re-hospitalizations and a positive dollar return on investment for the economies of Nova Scotia and Canada. This article analyzes the additional cost-reduction benefits resulting from the reduced re-hospitalizations that occurred among patient populations with heart attacks and heart failure. Over the five-year course of ICONS, one-year readmissions and readmission rates fell continuously for both index disease states. Despite a general inflationary rise in real hospital costs, the per-event cost of readmissions expressed in constant 2002 dollars also decreased: from $10,377 in 1997 to $9,022 in 2002 for the heart attack patient population; and from $9,020 to $8,697 for patients with heart failure. Total real yearly costs for heart attack readmissions fell from $7.4 million in 1997 to $6.4 million in 2002, a 14% decrease; for heart failure, yearly costs decreased by 26%, from $9.2 million to $6.8 million. These microeconomic data supplement the previously reported improvements in patient care and the positive macroeconomic impact of ICONS. Overall, ICONS demonstrated that quality and cost of healthcare could be simultaneously and successfully managed over a sustained period of time for whole patient populations in a real-world setting. ICONS offers strong evidence of the value of the partnership-measurement model of disease management and prevention as a reproducible and desirable template for next-generation healthcare in Canada.

  5. Effectiveness of a Reduced-Risk Insecticide Based Bed Bug Management Program in Low-Income Housing

    PubMed Central

    Singh, Narinderpal; Wang, Changlu; Cooper, Richard

    2013-01-01

    Bed bug (Cimex lectularius L.) infestations are becoming increasingly common in low-income communities. Once they are introduced, elimination is very difficult. As part of the efforts to develop effective and safe bed bug management programs, we conducted a laboratory study evaluating the efficacy of a reduced-risk insecticide—Alpine aerosol (0.5% dinotefuran). We then conducted a field evaluation of a reduced-risk insecticide based integrated pest management (IPM) program in low-income family apartments with young children. In laboratory evaluations, direct spray and 5 min exposure to dry Alpine aerosol residue caused 100.0 ± 0.0 and 91.7 ± 8.3% mortality to bed bug nymphs, respectively. Direct Alpine aerosol spray killed 91.3 ± 4.3% of the eggs. The IPM program included education, steam, bagging infested linens, placing intercepting devices under furniture legs and corners of rooms, applying Alpine aerosol and Alpine dust (0.25% dinotefuran, 95% diatomaceous earth dust), and regularly scheduled monitoring and re-treatment. Nine apartments ranging from 1–1,428 (median: 29) bed bugs based on visual inspection and Climbup interceptor counts were included. Over a 6-month period, an average 172 g insecticide (Alpine aerosol + Alpine dust) was used in each apartment, a 96% reduction in pesticide usage compared to chemical only treatment reported in a similar environment. The IPM program resulted in an average of 96.8 ± 2.2% reduction in the number of bed bugs. However, elimination of bed bugs was only achieved in three lightly infested apartments (<30 bed bugs at the beginning). Elimination success was closely correlated with the level of bed bug populations. PMID:26462533

  6. Effectiveness of a Reduced-Risk Insecticide Based Bed Bug Management Program in Low-Income Housing.

    PubMed

    Singh, Narinderpal; Wang, Changlu; Cooper, Richard

    2013-11-28

    Bed bug (Cimex lectularius L.) infestations are becoming increasingly common in low-income communities. Once they are introduced, elimination is very difficult. As part of the efforts to develop effective and safe bed bug management programs, we conducted a laboratory study evaluating the efficacy of a reduced-risk insecticide-Alpine aerosol (0.5% dinotefuran). We then conducted a field evaluation of a reduced-risk insecticide based integrated pest management (IPM) program in low-income family apartments with young children. In laboratory evaluations, direct spray and 5 min exposure to dry Alpine aerosol residue caused 100.0 ± 0.0 and 91.7 ± 8.3% mortality to bed bug nymphs, respectively. Direct Alpine aerosol spray killed 91.3 ± 4.3% of the eggs. The IPM program included education, steam, bagging infested linens, placing intercepting devices under furniture legs and corners of rooms, applying Alpine aerosol and Alpine dust (0.25% dinotefuran, 95% diatomaceous earth dust), and regularly scheduled monitoring and re-treatment. Nine apartments ranging from 1-1,428 (median: 29) bed bugs based on visual inspection and Climbup interceptor counts were included. Over a 6-month period, an average 172 g insecticide (Alpine aerosol + Alpine dust) was used in each apartment, a 96% reduction in pesticide usage compared to chemical only treatment reported in a similar environment. The IPM program resulted in an average of 96.8 ± 2.2% reduction in the number of bed bugs. However, elimination of bed bugs was only achieved in three lightly infested apartments (<30 bed bugs at the beginning). Elimination success was closely correlated with the level of bed bug populations.

  7. Application of strategies for sanitation management in wastewater treatment plants in order to control/reduce greenhouse gas emissions.

    PubMed

    Préndez, Margarita; Lara-González, Scarlette

    2008-09-01

    Greenhouse gases (GHG), basically methane (CH(4)), carbon dioxide (CO(2)) and nitrous oxide (N(2)O), occur at atmospheric concentrations of ppbv to ppmv under natural conditions. GHG have long mean lifetimes and are an important factor for the mean temperature of the Earth. However, increasing anthropogenic emissions could produce a scenario of progressive and cumulative effects over time, causing a potential "global climate change". Biological degradation of the organic matter present in wastewater is considered one of the anthropogenic sources of GHG. In this study, GHG emissions for the period 1990-2027 were estimated considering the sanitation process and the official domestic wastewater treatment startup schedule approved for the Metropolitan Region (MR) of Santiago, Chile. The methodology considers selected models proposed by the Intergovernmental Panel on Climate Change (IPCC) and some others published by different authors; these were modified according to national conditions and different sanitation and temporal scenarios. For the end of the modeled period (2027), results show emissions of about 65 Tg CO(2) equiv./year (as global warming potential), which represent around 50% of national emissions. These values could be reduced if certain sanitation management strategies were introduced in the environmental management by the sanitation company in charge of wastewater treatment.

  8. The efficacy of asthma case management in an urban school district in reducing school absences and hospitalizations for asthma.

    PubMed

    Levy, Marian; Heffner, Brenda; Stewart, Tara; Beeman, Gail

    2006-08-01

    Pediatric asthma rates are reaching epidemic proportions, adversely affecting children's quality of life, educational potential, and health care costs, especially those in the inner city. This study evaluated the effectiveness of a school-based asthma case management (CM) approach with medically underserved inner-city children attending Memphis City schools. Fourteen elementary schools with high rates of asthma-related hospital utilization were grouped according to school size, percentage of children with asthma enrolled, and percentage of children eligible for free or reduced-price lunch. Schools were randomized to either a nurse CM intervention or a usual care (UC) condition. The CM group included 115 students; 128 students were in the UC group. A longitudinal design was used to follow students' progress. Students were primarily African-American children diagnosed with asthma. In CM schools, nurse case managers conducted weekly group sessions incorporating the Open Airways curriculum, followed up on students' school absences, and coordinated students' asthma care with families, school personnel, and medical providers. In UC schools, students received routine school nursing services. CM students had fewer school absences than their counterparts in UC schools (mean 4.38 vs 8.18 days, respectively) and experienced significantly fewer emergency department visits (p < .0001) and fewer hospital days (p < .05) than UC students. No such differences existed before program initiation. Replication and follow-up in year 2 showed continued significant improvements. School-based nurse CM can achieve significant improvements in school attendance and medical utilization.

  9. Shift work: health, performance and safety problems, traditional countermeasures, and innovative management strategies to reduce circadian misalignment

    PubMed Central

    Smith, Mark R; Eastman, Charmane I

    2012-01-01

    There are three mechanisms that may contribute to the health, performance, and safety problems associated with night-shift work: (1) circadian misalignment between the internal circadian clock and activities such as work, sleep, and eating, (2) chronic, partial sleep deprivation, and (3) melatonin suppression by light at night. The typical countermeasures, such as caffeine, naps, and melatonin (for its sleep-promoting effect), along with education about sleep and circadian rhythms, are the components of most fatigue risk-management plans. We contend that these, while better than nothing, are not enough because they do not address the underlying cause of the problems, which is circadian misalignment. We explain how to reset (phase-shift) the circadian clock to partially align with the night-work, day-sleep schedule, and thus reduce circadian misalignment while preserving sleep and functioning on days off. This involves controlling light and dark using outdoor light exposure, sunglasses, sleep in the dark, and a little bright light during night work. We present a diagram of a sleep-and-light schedule to reduce circadian misalignment in permanent night work, or a rotation between evenings and nights, and give practical advice on how to implement this type of plan. PMID:23620685

  10. Cool temperatures reduce antifungal activity of symbiotic bacteria of threatened amphibians--implications for disease management and patterns of decline.

    PubMed

    Daskin, Joshua H; Bell, Sara C; Schwarzkopf, Lin; Alford, Ross A

    2014-01-01

    Chytridiomycosis, caused by the fungus Batrachochytrium dendrobatidis (Bd), is a widespread disease of amphibians responsible for population declines and extinctions. Some bacteria from amphibians' skins produce antimicrobial substances active against Bd. Supplementing populations of these cutaneous antifungal bacteria might help manage chytridiomycosis in wild amphibians. However, the activity of protective bacteria may depend upon environmental conditions. Biocontrol of Bd in nature thus requires knowledge of how environmental conditions affect their anti-Bd activity. For example, Bd-driven amphibian declines have often occurred at temperatures below Bd's optimum range. It is possible these declines occurred due to reduced anti-Bd activity of bacterial symbionts at cool temperatures. Better understanding of the effects of temperature on chytridiomycosis development could also improve risk evaluation for amphibian populations yet to encounter Bd. We characterized, at a range of temperatures approximating natural seasonal variation, the anti-Bd activity of bacterial symbionts from the skins of three species of rainforest tree frogs (Litoria nannotis, Litoria rheocola, and Litoria serrata). All three species declined during chytridiomycosis outbreaks in the late 1980s and early 1990s and have subsequently recovered to differing extents. We collected anti-Bd bacterial symbionts from frogs and cultured the bacteria at constant temperatures from 8 °C to 33 °C. Using a spectrophotometric assay, we monitored Bd growth in cell-free supernatants (CFSs) from each temperature treatment. CFSs from 11 of 24 bacteria showed reduced anti-Bd activity in vitro when they were produced at cool temperatures similar to those encountered by the host species during population declines. Reduced anti-Bd activity of metabolites produced at low temperatures may, therefore, partially explain the association between Bd-driven declines and cool temperatures. We show that to avoid

  11. Modeling of solar radiation management: a comparison of simulations using reduced solar constant and stratospheric sulphate aerosols

    NASA Astrophysics Data System (ADS)

    Kalidindi, Sirisha; Bala, Govindasamy; Modak, Angshuman; Caldeira, Ken

    2015-05-01

    The climatic effects of Solar Radiation Management (SRM) geoengineering have been often modeled by simply reducing the solar constant. This is most likely valid only for space sunshades and not for atmosphere and surface based SRM methods. In this study, a global climate model is used to evaluate the differences in the climate response to SRM by uniform solar constant reduction and stratospheric aerosols. Our analysis shows that when global mean warming from a doubling of CO2 is nearly cancelled by both these methods, they are similar when important surface and tropospheric climate variables are considered. However, a difference of 1 K in the global mean stratospheric (61-9.8 hPa) temperature is simulated between the two SRM methods. Further, while the global mean surface diffuse radiation increases by ~23 % and direct radiation decreases by about 9 % in the case of sulphate aerosol SRM method, both direct and diffuse radiation decrease by similar fractional amounts (~1.0 %) when solar constant is reduced. When CO2 fertilization effects from elevated CO2 concentration levels are removed, the contribution from shaded leaves to gross primary productivity (GPP) increases by 1.8 % in aerosol SRM because of increased diffuse light. However, this increase is almost offset by a 15.2 % decline in sunlit contribution due to reduced direct light. Overall both the SRM simulations show similar decrease in GPP (~8 %) and net primary productivity (~3 %). Based on our results we conclude that the climate states produced by a reduction in solar constant and addition of aerosols into the stratosphere can be considered almost similar except for two important aspects: stratospheric temperature change and the consequent implications for the dynamics and the chemistry of the stratosphere and the partitioning of direct versus diffuse radiation reaching the surface. Further, the likely dependence of global hydrological cycle response on aerosol particle size and the latitudinal and

  12. Group Training of Stress Management vs. Group Cognitive-Behavioral Therapy in Reducing Depression, Anxiety and Perceived Stress Among HIV-Positive Men

    PubMed Central

    Hemmati Sabet, Akbar; Khalatbari, Javad; Abbas Ghorbani, Maryam; Haghighi, Mohammad; Ahmadpanah, Mohammad

    2013-01-01

    Objective: To compare the effectiveness of group training of stress management with cognitive-behavioral therapy (CBT) in reducing depression, anxiety and stress perceived among HIV-positive men. Methods:Inthis semi-experimental study, three groups of HIV-positive men (CBT group, stress management group, and control group) including 15 patients in each group were compared regarding depression, anxiety, and stress using pre-test and post-test tools. Results: Both interventions (CBT and stress management) were effective in reducing depression, anxiety and perceived stress. Evaluating adjustedmean showed the more effectivenessofthe group stressmanagementtraining than CBT. Conclusion: Group stress management training is more effective than group CBT in HIV-positive mentodecreasedepression, anxiety and stress management. Declaration of interest: None. Clinical Trial Registration: URL: http://.irct.ir. Unique identifier: 2012121711782N1 PMID:24644493

  13. Determining which land management practices reduce catchment scale flood risk and where to implement them for optimum effect

    NASA Astrophysics Data System (ADS)

    Pattison, Ian; Lane, Stuart; Hardy, Richard; Reaney, Sim

    2010-05-01

    The theoretical basis for why changes in land management might increase flood risk are well known, but proving them through numerical modelling still remains a challenge. In large catchments, like the River Eden in Cumbria, NW England, one of the reasons for this is that it is unfeasible to test multiple scenarios in all their possible locations. We have developed two linked approaches to refine the number of scenarios and locations using 1) spatial downscaling and 2) participatory decision making, which potentially should increase the likelihood of finding a link between land use and downstream flooding. Firstly, land management practices can have both flood reducing and flood increasing effects, depending on their location. As a result some areas of the catchment are more important in determining downstream flood risk than others, depending on the land use and hydrological connectivity. We apply a downscaling approach to identify which sub-catchments are most important in explaining downstream flooding. This is important because it is in these areas that management options are most likely to have a positive and detectable effect. Secondly, once the dominant sub-catchment has been identified, the land management scenarios that are both feasible and likely to impact flood risk need to be determined. This was done through active stakeholder engagement. The stakeholder group undertook a brainstorming exercise, which suggested about 30 different rural land management scenarios, which were mapped on to a literature-based conceptual framework of hydrological processes. Then these options were evaluated based on five criteria: relevance to catchment, scientific effectiveness, testability, robustness/uncertainty and feasibility of implementation. The suitability of each scenario was discussed and prioritised by the stakeholder group based on scientific needs and expectations and local suitability and feasibility. The next stage of the participatory approach was a mapping

  14. Reducing the predictive uncertainty associated with groundwater management decision-making in the Perth regional aquifer system of Western Australia

    NASA Astrophysics Data System (ADS)

    Siade, A. J.

    2015-12-01

    The Perth Regional Aquifer Model (PRAMS) framework has been used for about a decade now to evaluate the potential anthropogenic impacts associated with management decisions that affect Perth's groundwater resources. A great wealth of data, expertise and numerical analysis have gone into the development of PRAMS over the years. However, there has been little quantitative work conducted on systemically addressing the uncertainty in the model's structure and predictions. PRAMS is designed to make a variety of regional and local-scale predictions and, both the nature and magnitude of the uncertainty associated with these predictions can vary significantly. A primary prediction to be addressed using the PRAMS framework, will be the effects of various deep-aquifer groundwater management scenarios on both the environmental and social concerns surrounding the superficial aquifer, which supports sensitive wetlands, and the negative impacts of seawater intrusion into the deep aquifers. A particular model-structure component that greatly affects the predictions associated with deep-aquifer groundwater extraction is the characterization of the local fault structure, i.e., whether or not faults are acting as barriers to groundwater flow. Therefore, uncertainty in fault characterization can subsequently lead to significant predictive uncertainty. However, new observation data can be obtained to reduce this uncertainty. In this study, an experimental design methodology is employed to optimally acquire new observations of state in such a way as to maximize the information obtained about the hydraulic properties of faults. Various information criteria are employed to develop optimal locations of new observation wells. The A-optimality criterion was found to be the most effective for comparing sampling strategies given the design assumptions, which include the parameter sets employed, hydraulic forcing, temporal considerations, and the use of the existing observation network. A

  15. Estimation and evaluation of management options to control and/or reduce the risk of not complying with commercial sterility.

    PubMed

    Pujol, Laure; Albert, Isabelle; Magras, Catherine; Johnson, Nicholas Brian; Membré, Jeanne-Marie

    2015-11-20

    In a previous study, a modular process risk model, from the raw material reception to the final product storage, was built to estimate the risk of a UHT-aseptic line of not complying with commercial sterility (Pujol et al., 2015). This present study was focused on demonstrating how the model (updated version with uncertainty and variability separated and 2(nd) order Monte Carlo procedure run) could be used to assess quantitatively the influence of management options. This assessment was done in three steps: pinpoint which process step had the highest influence on the risk, identify which management option(s) could be the most effective to control and/or reduce the risk, and finally evaluate quantitatively the influence of changing process setting(s) on the risk. For Bacillus cereus, it was identified that during post-process storage in an aseptic tank, there was potentially an air re-contamination due to filter efficiency loss (efficiency loss due to successive in-place sterilizations after cleaning operations), followed by B. cereus growth. Two options were then evaluated: i) reducing by one fifth of the number of filter sterilizations before renewing the filters, ii) designing new UHT-aseptic lines without an aseptic tank, i.e. without a storage period after the thermal process and before filling. Considering the uncertainty in the model, it was not possible to confirm whether these options had a significant influence on the risk associated with B. cereus. On the other hand, for Geobacillus stearothermophilus, combinations of heat-treatment time and temperature enabling the control or reduction in risk by a factor of ca. 100 were determined; for ease of operational implementation, they were presented graphically in the form of iso-risk curves. For instance, it was established that a heat treatment of 138°C for 31s (instead of 138°C for 25s) enabled a reduction in risk to 18×10(-8) (95% CI=[10; 34]×10(-8)), instead of 578×10(-8) (95% CI=[429; 754]×10

  16. A managed protocol for treatment of deceased potential donors reduces the incidence of cardiac arrest before organ explant

    PubMed Central

    Westphal, Glauco Adrieno; Zaclikevis, Viviane Renata; Vieira, Kalinca Daberkow; Cordeiro, Rodrigo de Brito; Horner, Marina Borges W.; de Oliveira, Thamy Pellizzaro; Duarte, Robson; Sperotto, Geonice; da Silveira, Georgiana; Caldeira, Milton; Coll, Elisabeth; Yus-Teruel, Santiago

    2012-01-01

    Objective To assess the effect of the application of a managed protocol for the maintenance care of deceased potential multiple organ donors at two hospitals. Methods A before (Phase 1)/after (Phase 2) study conducted at two general hospitals, which included consecutively potential donors admitted to two intensive care units. In Phase 1 (16 months), the data were collected retrospectively, and the maintenance care measures of the potential donors were instituted by the intensivists. In Phase 2 (12 months), the data collection was prospective, and a managed protocol was used for maintenance care. The two phases were compared in terms of their demographic variables, physiological variables at diagnosis of brain death and the end of the process, time to performance of brain death confirmatory test and end of the process, adherence to bundles of maintenance care essential measures, losses due to cardiac arrest, family refusal, contraindications, and the conversion rate of potential into actual donors. Student's t- and chi-square tests were used, and p-value < 0.05 was considered to be significant. Results A total of 42 potential donors were identified (18 in Phase 1 and 24 in Phase 2). The time interval between the first clinical assessment and the recovery decreased in Phase 2 (Phase 1: 35.0±15.5 hours versus Phase 2: 24.6±6.2 hours; p = 0.023). Adherence increased to 10 out of the 19 essential items of maintenance care, and losses due to cardiac arrest also decreased in Phase 2 (Phase 1: 27.8 versus 0% in Phase 2; p = 0.006), while the convertion rate increased (Phase 1: 44.4 versus 75% in Phase 2; p = 0.044). The losses due to family refusal and medical contraindication did not vary. Conclusion The adoption of a managed protocol focused on the application of essential measures for the care of potential deceased donors might reduce the loss of potential donors due to cardiac arrest. PMID:23917929

  17. Reduced fine sediment flux and channel change in response to the managed diversion of an upland river channel

    NASA Astrophysics Data System (ADS)

    Perks, Matthew Thomas; Warburton, Jeff

    2016-09-01

    This paper describes the implementation of a novel mitigation approach and subsequent adaptive management, designed to reduce the transfer of fine sediment (< 2 mm) in Glaisdale Beck, a small, predominantly upland catchment in the UK. Hydro-meteorological and suspended sediment data sets are collected over a 2-year period spanning pre- and post-diversion periods in order to assess the impact of the channel reconfiguration scheme on the fluvial suspended sediment dynamics. Analysis of the river response demonstrates that the fluvial sediment system has become more restrictive with reduced fine sediment transfer. This is characterized by reductions in flow-weighted mean suspended sediment concentrations from 77.93 mg L-1 prior to mitigation, to 74.36 mg L-1 following the diversion. A Mann-Whitney U test found statistically significant differences (p < 0.001) between the pre- and post-monitoring median suspended sediment concentrations (SSCs). Whilst application of one-way analysis of covariance (ANCOVA) on the coefficients of sediment rating curves developed before and after the diversion found statistically significant differences (p < 0.001), with both Loga and b coefficients becoming smaller following the diversion. Non-parametric analysis indicates a reduction in residuals through time (p < 0.001), with the developed LOWESS model over-predicting sediment concentrations as the channel stabilizes. However, the channel is continuing to adjust to the reconfigured morphology, with evidence of a headward propagating knickpoint which has migrated 120 m at an exponentially decreasing rate over the last 7 years since diversion. The study demonstrates that channel reconfiguration can be effective in mitigating fine sediment flux in headwater streams but the full value of this may take many years to achieve whilst the fluvial system slowly readjusts.

  18. Niacin-a critical component to the management of atherosclerosis: contemporary management of dyslipidemia to prevent, reduce, or reverse atherosclerotic cardiovascular disease.

    PubMed

    Mason, Carol M; Doneen, Amy L

    2012-01-01

    Niacin (nicotinic acid) is the most effective agent for raising high-density lipoprotein cholesterol levels and can improve the entire lipid panel in patients with dyslipidemia. Niacin-containing regimens are among the few treatments studied for dyslipidemia that have both elicited significant reductions in atherosclerotic progression (by angiography or imaging) and also significantly reduced (by approximately 90% vs control) the incidence of cardiovascular events in a single clinical trial. However, cutaneous flushing-an uncomfortable but typically transient adverse effect of niacin-often results in patient nonadherence with this potentially life-saving therapy. Effective counseling regarding the highly favorable benefit-risk ratio for niacin and management strategies such as careful dose escalation, follow-up monitoring, regimen adjustments, and the use of treatment adjuncts (eg, aspirin) can improve patient adherence with niacin therapy. Clinicians are uniquely positioned to provide such counseling to appropriate patients for niacin treatment and hence encourage wider use of this important and necessary cardioprotective medication.

  19. Application of Sleeper Cab Thermal Management Technologies to Reduce Idle Climate Control Loads in Long-Haul Trucks

    SciTech Connect

    Lustbader, J. A.; Venson, T.; Adelman, S.; Dehart, C.; Yeakel, S.; Castillo, M. S.

    2012-10-01

    Each intercity long-haul truck in the U.S. idles approximately 1,800 hrs per year, primarily for sleeper cab hotel loads. Including workday idling, over 2 billion gallons of fuel are used annually for truck idling. NREL's CoolCab project works closely with industry to design efficient thermal management systems for long-haul trucks that keep the cab comfortable with minimized engine idling and fuel use. The impact of thermal load reduction technologies on idle reduction systems were characterized by conducting thermal soak tests, overall heat transfer tests, and 10-hour rest period A/C tests. Technologies evaluated include advanced insulation packages, a solar reflective film applied to the vehicle's opaque exterior surfaces, a truck featuring both film and insulation, and a battery-powered A/C system. Opportunities were identified to reduce heating and cooling loads for long-haul truck idling by 36% and 34%, respectively, which yielded a 23% reduction in battery pack capacity of the idle-reduction system. Data were also collected for development and validation of a CoolCalc HVAC truck cab model. CoolCalc is an easy-to-use, simplified, physics-based HVAC load estimation tool that requires no meshing, has flexible geometry, excludes unnecessary detail, and is less time-intensive than more detailed computer-aided engineering modeling approaches.

  20. Design of experiments with multiple independent variables: a resource management perspective on complete and reduced factorial designs.

    PubMed

    Collins, Linda M; Dziak, John J; Li, Runze

    2009-09-01

    An investigator who plans to conduct an experiment with multiple independent variables must decide whether to use a complete or reduced factorial design. This article advocates a resource management perspective on making this decision, in which the investigator seeks a strategic balance between service to scientific objectives and economy. Considerations in making design decisions include whether research questions are framed as main effects or simple effects; whether and which effects are aliased (confounded) in a particular design; the number of experimental conditions that must be implemented in a particular design and the number of experimental subjects the design requires to maintain the desired level of statistical power; and the costs associated with implementing experimental conditions and obtaining experimental subjects. In this article 4 design options are compared: complete factorial, individual experiments, single factor, and fractional factorial. Complete and fractional factorial designs and single-factor designs are generally more economical than conducting individual experiments on each factor. Although relatively unfamiliar to behavioral scientists, fractional factorial designs merit serious consideration because of their economy and versatility.

  1. Combined effects of constant versus variable intensity simulated rainfall and reduced tillage management on cotton preemergence herbicide runoff.

    PubMed

    Potter, Thomas L; Truman, Clint C; Strickland, Timothy C; Bosch, David D; Webster, Theodore M; Franklin, Dorcas H; Bednarz, Craig W

    2006-01-01

    Pesticide runoff research relies heavily on rainfall simulation experiments. Most are conducted at a constant intensity, i.e., at a fixed rainfall rate; however, large differences in natural rainfall intensity is common. To assess implications we quantified runoff of two herbicides, fluometuron and pendimethalin, and applied preemergence after planting cotton on Tifton loamy sand. Rainfall at constant and variable intensity patterns representative of late spring thunderstorms in the Atlantic Coastal Plain region of Georgia (USA) were simulated on 6-m2 plots under strip- (ST) and conventional-tillage (CT) management. The variable pattern produced significantly higher runoff rates of both compounds from CT but not ST plots. However, on an event-basis, runoff totals (% applied) were not significantly different, with one exception: fluometuron runoff from CT plots. There was about 25% more fluometuron runoff with the variable versus the constant intensity pattern (P = 0.10). Study results suggest that conduct of simulations using variable intensity storm patterns may provide more representative rainfall simulation-based estimates of pesticide runoff and that the greatest impacts will be observed with CT. The study also found significantly more fluometuron in runoff from ST than CT plots. Further work is needed to determine whether this behavior may be generalized to other active ingredients with similar properties [low K(oc) (organic carbon partition coefficient) approximately 100 mL g(-1); high water solubility approximately 100 mg L(-1)]. If so, it should be considered when making tillage-specific herbicide recommendations to reduce runoff potential.

  2. Introduction to Special Edition (of the Journal of Nuclear Materials Management) on Reducing the Threat from Radioactive Materials

    SciTech Connect

    Mladineo, Stephen V.

    2007-03-01

    Introductory article for special edition of the JOURNAL OF NUCLEAR MATERIALS MANAGEMENT outlining the Institute of Nuclear Materials Management Nonproliferation and Arms Control Technical Division. In particular the International Nuclear and Radiological Security Standing Committee and its initial focus covering four topical areas--Radiological Threat Reduction, Nuclear Smuggling and Illicit Trafficking, Countering Nuclear Terrorism, and Radioligical Terrorism Consequence Management.

  3. Modeling of Solar Radiation Management: A Comparison of Simulations Using Reduced Solar Constant and Stratospheric Sulphate Aerosols

    NASA Astrophysics Data System (ADS)

    Bala, G.; Kalidindi, S.; Modak, A.; Caldeira, K.

    2014-12-01

    Several climate modelling studies in the past have used reduction in solar constant to simulate the climatic effects of Solar Radiation Management (SRM) geoengineering. This is most likely valid only for space-based mirrors/reflectors but not for SRM methods that rely on stratospheric aerosols. In this study, we use a climate model to evaluate the differences in climate response to SRM by uniform solar constant reduction and stratospheric aerosols. The experiments are designed such that global mean warming from a doubling of atmospheric CO2 concentration (2xCO2) is nearly cancelled in each case. In such a scenario, the residual climate effects are similar when important surface and tropospheric climate variables such as temperature and precipitation are considered. However, there are significant differences in stratospheric temperature response and diffuse and direct radiation reaching the surface. A difference of 1K in the global mean stratospheric (61-9.8 hPa) temperature is simulated between the two SRM methods, with warming in the aerosol scheme and a slight cooling for sunshades. While the global mean surface diffuse radiation increases by ~23% and direct radiation decreases by about 9% in the case of aerosol SRM method, both direct and diffuse radiation decrease by similar fractional amounts (~1.0%) when solar constant is reduced. When CO2 fertilization effects from elevated CO2 concentration levels are removed, the contribution from shaded leaves to gross primary productivity (GPP) increases by 1.8 % in aerosol SRM because of increased diffuse light. However, this increase is almost offset by a 15.2% decline in sunlit contribution due to reduced direct light. Overall both the SRM simulations show similar decrease in GPP (~ 8%) and NPP (~3%) relative to 2xCO2, indicating the negligible effect of the fractional changes in direct/diffuse radiation on the overall plant productivity. Based on our modelling study, we conclude that the climate states produced by a

  4. A Vehicle Management End-to-End Testing and Analysis Platform for Validation of Mission and Fault Management Algorithms to Reduce Risk for NASA's Space Launch System

    NASA Technical Reports Server (NTRS)

    Trevino, Luis; Johnson, Stephen B.; Patterson, Jonathan; Teare, David

    2015-01-01

    The development of the Space Launch System (SLS) launch vehicle requires cross discipline teams with extensive knowledge of launch vehicle subsystems, information theory, and autonomous algorithms dealing with all operations from pre-launch through on orbit operations. The characteristics of these systems must be matched with the autonomous algorithm monitoring and mitigation capabilities for accurate control and response to abnormal conditions throughout all vehicle mission flight phases, including precipitating safing actions and crew aborts. This presents a large complex systems engineering challenge being addressed in part by focusing on the specific subsystems handling of off-nominal mission and fault tolerance. Using traditional model based system and software engineering design principles from the Unified Modeling Language (UML), the Mission and Fault Management (M&FM) algorithms are crafted and vetted in specialized Integrated Development Teams composed of multiple development disciplines. NASA also has formed an M&FM team for addressing fault management early in the development lifecycle. This team has developed a dedicated Vehicle Management End-to-End Testbed (VMET) that integrates specific M&FM algorithms, specialized nominal and off-nominal test cases, and vendor-supplied physics-based launch vehicle subsystem models. The flexibility of VMET enables thorough testing of the M&FM algorithms by providing configurable suites of both nominal and off-nominal test cases to validate the algorithms utilizing actual subsystem models. The intent is to validate the algorithms and substantiate them with performance baselines for each of the vehicle subsystems in an independent platform exterior to flight software test processes. In any software development process there is inherent risk in the interpretation and implementation of concepts into software through requirements and test processes. Risk reduction is addressed by working with other organizations such as S

  5. Managing runoff and flow pathways in a small rural catchment to reduce flood risk with other multi-purpose benefits

    NASA Astrophysics Data System (ADS)

    Wilkinson, Mark; Welton, Phil; Kerr, Peter; Quinn, Paul; Jonczyk, Jennine

    2010-05-01

    From 2000 to 2009 there have been a high number of flood events throughout Northern Europe. Meanwhile, there is a demand for land in which to construct homes and businesses on, which is encroaching on land which is prone to flooding. Nevertheless, flood defences usually protect us from this hazard. However, the severity of floods and this demand for land has increased the number of homes which have been flooded in the past ten years. Public spending on flood defences can only go so far which targets the large populations first. Small villages and communities, where in many cases normal flood defences are not cost effective, tend to wait longer for flood mitigation strategies. The Belford Burn (Northumberland, UK) catchment is a small rural catchment that drains an area of 6 km2. It flows through the village of Belford. There is a history of flooding in Belford, with records of flood events dating back to 1877. Normal flood defences are not suitable for this catchment as it failed the Environment Agency (EA) cost benefit criteria for support. There was a desire by the local EA Flood Levy Team and the Northumbria Regional Flood Defence Committee at the Environment Agency to deliver an alternative catchment-based solution to the problem. The EA North East Flood Levy team and Newcastle University have created a partnership to address the flood problem using soft engineered runoff management features. Farm Integrated Runoff Management (FIRM) plans manage flow paths directly by storing slowing and filtering runoff at source on farms. The features are multipurpose addressing water quality, trapping sediment, creating new habitats and storing and attenuating flood flow. Background rainfall and stream stage data have been collected since November 2007. Work on the first mitigation features commenced in July 2008. Since that date five flood events have occurred in the catchment. Two of these flood events caused widespread damage in other areas of the county. However, in

  6. Evaluation of Impaired Driving Assessments and Special Management Reviews in Reducing Impaired Driving Fatal Crashes in the United States

    PubMed Central

    Fell, James; Auld-Owens, Amy; Snowden, Cecelia

    2013-01-01

    Since 1991, State Impaired-Driving Assessments (IDAs) and Special Management Reviews (SMRs) have been conducted by the National Highway Traffic Safety Administration (NHTSA) to serve as a mechanism to assess the impaired-driving problem in the State, document the existing system, recommend improvements, and garner both political and public support to fund and implement improvements. Did these assessments and reviews serve the States as intended and provide a catalyst to reduce impaired driving? Almost half of the priority recommendations from IDAs in seven States and 60% of the priority recommendations in SMR States were implemented. Barriers to the implementation of some recommendations are discussed. IDAs and SMRs implemented at varying times were examined using logistic regression analyses of the Fatality Analysis Reporting System (FARS) for the years 1990 to 2008 to determine the effect they may have triggered on impaired driving rates in fatal crashes. States receiving IDAs and SMRs were compared to similar States not receiving them. Paired comparisons of similar States (e.g. IDA-State vs. non-IDA State) did not reveal any significant differences in impaired driving rates, but IDA and SMR States as a group showed significantly greater impaired driving declines in fatal crashes compared to non-IDA and non-SMR States as a group. IDAs and SMRs appear to provide a mechanism to examine the State’s impaired-driving program by an external team of experts and reveal areas where improvement is needed and confirm strategies that appear to be effective. PMID:24406944

  7. The use of LeptiCore® in reducing fat gain and managing weight loss in patients with metabolic syndrome

    PubMed Central

    2010-01-01

    Background LeptiCore® is a proprietary combination of various ingredients which have been shown to have properties which could be beneficial to weight loss in obese and overweight human subjects. This study evaluates the effect of Lepticore® on bodyweight as well as parameters associated with obesity and metabolic syndrome. Methods The study was an 8 week randomized, double-blind, placebo-controlled design involving 92 obese (mean BMI > 30 kg/m2) participants (37 males; 55 females; ages 19-52; mean age = 30.7). The participants were randomly divided into three groups: placebo (n = 30), LeptiCore® formula A (low dose) (n = 31) and LeptiCore® formula B (high dose) (n = 31). Capsules containing the placebo or active formulations were administered twice daily before meals with 300 ml of water. None of the participants followed any specific diet nor took any weight-reducing medications for the duration of the study. A total of 12 anthropomorphic and serological measurements were taken at the beginning of the study and after 2, 4, 6, and 8 weeks of treatment. Results Compared to the placebo group, the two active groups showed statistically significant differences on all 12 variables by week 8. These included four anthropomorphic variables (body weight, body fat, waist and hip size) and eight measures of serological levels (plasma total cholesterol, LDL, HDL, triglycerides, blood glucose, serotonin, leptin, C-reactive protein). The two active groups also showed significant intra-group differences on all 12 variables between study onset and week 8. Conclusion The LeptiCore® formulation at both the low and high dosages appears to be helpful in the management of fat gain and its related complications. The higher dosage resulted in significantly greater reductions in body weight and triglyceride, blood glucose, and C-reactive protein levels, as well as increased serotonin levels. PMID:20170522

  8. A Vehicle Management End-to-End Testing and Analysis Platform for Validation of Mission and Fault Management Algorithms to Reduce Risk for NASAs Space Launch System

    NASA Technical Reports Server (NTRS)

    Trevino, Luis; Johnson, Stephen B.; Patterson, Jonathan; Teare, David

    2015-01-01

    ) early in the development lifecycle for the SLS program, NASA formed the M&FM team as part of the Integrated Systems Health Management and Automation Branch under the Spacecraft Vehicle Systems Department at the Marshall Space Flight Center (MSFC). To support the development of the FM algorithms, the VMET developed by the M&FM team provides the ability to integrate the algorithms, perform test cases, and integrate vendor-supplied physics-based launch vehicle (LV) subsystem models. Additionally, the team has developed processes for implementing and validating the M&FM algorithms for concept validation and risk reduction. The flexibility of the VMET capabilities enables thorough testing of the M&FM algorithms by providing configurable suites of both nominal and off-nominal test cases to validate the developed algorithms utilizing actual subsystem models such as MPS, GNC, and others. One of the principal functions of VMET is to validate the M&FM algorithms and substantiate them with performance baselines for each of the target vehicle subsystems in an independent platform exterior to the flight software test and validation processes. In any software development process there is inherent risk in the interpretation and implementation of concepts from requirements and test cases into flight software compounded with potential human errors throughout the development and regression testing lifecycle. Risk reduction is addressed by the M&FM group but in particular by the Analysis Team working with other organizations such as S&MA, Structures and Environments, GNC, Orion, Crew Office, Flight Operations, and Ground Operations by assessing performance of the M&FM algorithms in terms of their ability to reduce Loss of Mission (LOM) and Loss of Crew (LOC) probabilities. In addition, through state machine and diagnostic modeling, analysis efforts investigate a broader suite of failure effects and associated detection and responses to be tested in VMET to ensure reliable failure

  9. Modelling coral reef futures to inform management: can reducing local-scale stressors conserve reefs under climate change?

    PubMed

    Gurney, Georgina G; Melbourne-Thomas, Jessica; Geronimo, Rollan C; Aliño, Perry M; Johnson, Craig R

    2013-01-01

    Climate change has emerged as a principal threat to coral reefs, and is expected to exacerbate coral reef degradation caused by more localised stressors. Management of local stressors is widely advocated to bolster coral reef resilience, but the extent to which management of local stressors might affect future trajectories of reef state remains unclear. This is in part because of limited understanding of the cumulative impact of multiple stressors. Models are ideal tools to aid understanding of future reef state under alternative management and climatic scenarios, but to date few have been sufficiently developed to be useful as decision support tools for local management of coral reefs subject to multiple stressors. We used a simulation model of coral reefs to investigate the extent to which the management of local stressors (namely poor water quality and fishing) might influence future reef state under varying climatic scenarios relating to coral bleaching. We parameterised the model for Bolinao, the Philippines, and explored how simulation modelling can be used to provide decision support for local management. We found that management of water quality, and to a lesser extent fishing, can have a significant impact on future reef state, including coral recovery following bleaching-induced mortality. The stressors we examined interacted antagonistically to affect reef state, highlighting the importance of considering the combined impact of multiple stressors rather than considering them individually. Further, by providing explicit guidance for management of Bolinao's reef system, such as which course of management action will most likely to be effective over what time scales and at which sites, we demonstrated the utility of simulation models for supporting management. Aside from providing explicit guidance for management of Bolinao's reef system, our study offers insights which could inform reef management more broadly, as well as general understanding of reef

  10. Improved Battery Pack Thermal Management to Reduce Cost and Increase Energy Density: Cooperative Research and Development Final Report, CRADA Number CRD-12-499

    SciTech Connect

    Smith, K.

    2013-10-01

    Under this CRADA NREL will support Creare's project for the Department of Energy entitled 'Improved Battery Pack Thermal Management to Reduce Cost and Increase Energy Density' which involves the development of an air-flow based cooling product that increases energy density, safety, and reliability of hybrid electric vehicle battery packs.

  11. A Vehicle Management End-to-End Testing and Analysis Platform for Validation of Mission and Fault Management Algorithms to Reduce Risk for NASA's Space Launch System

    NASA Technical Reports Server (NTRS)

    Trevino, Luis; Patterson, Jonathan; Teare, David; Johnson, Stephen

    2015-01-01

    integrates specific M&FM algorithms, specialized nominal and off-nominal test cases, and vendor-supplied physics-based launch vehicle subsystem models. Additionally, the team has developed processes for implementing and validating these algorithms for concept validation and risk reduction for the SLS program. The flexibility of the Vehicle Management End-to-end Testbed (VMET) enables thorough testing of the M&FM algorithms by providing configurable suites of both nominal and off-nominal test cases to validate the developed algorithms utilizing actual subsystem models such as MPS. The intent of VMET is to validate the M&FM algorithms and substantiate them with performance baselines for each of the target vehicle subsystems in an independent platform exterior to the flight software development infrastructure and its related testing entities. In any software development process there is inherent risk in the interpretation and implementation of concepts into software through requirements and test cases into flight software compounded with potential human errors throughout the development lifecycle. Risk reduction is addressed by the M&FM analysis group working with other organizations such as S&MA, Structures and Environments, GNC, Orion, the Crew Office, Flight Operations, and Ground Operations by assessing performance of the M&FM algorithms in terms of their ability to reduce Loss of Mission and Loss of Crew probabilities. In addition, through state machine and diagnostic modeling, analysis efforts investigate a broader suite of failure effects and associated detection and responses that can be tested in VMET to ensure that failures can be detected, and confirm that responses do not create additional risks or cause undesired states through interactive dynamic effects with other algorithms and systems. VMET further contributes to risk reduction by prototyping and exercising the M&FM algorithms early in their implementation and without any inherent hindrances such as meeting FSW

  12. Reducing Students' Carbon Footprints Using Personal Carbon Footprint Management System Based on Environmental Behavioural Theory and Persuasive Technology

    ERIC Educational Resources Information Center

    Lin, Shyh-ming

    2016-01-01

    This study applied environmental behavioural theories to develop a personal carbon footprint management system and used persuasive technology to implement it. The system serves as an educational system to improve the determinants of students' low-carbon behaviours, to promote low-carbon concepts and to facilitate their carbon management. To assess…

  13. Managing phosphorus fertilizer to reduce algae, maintain water quality, and sustain yields in water-seeded rice

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In water-seeded rice systems blue-green algae (cyanobacteria) hinder early-season crop growth by dislodging rice seedlings and reducing light. Since algae are often phosphorus (P) limited, we investigated whether changing the timing of P fertilizer application could reduce algae without reducing cro...

  14. Reducing the dimensionality of soil microinvertebrate community datasets using Indicator Species Analysis: Implications for ecosystem monitoring and soil management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Soil microinvertebrates are closely associated with soil decomposition and nutrient cycles and may be particularly responsive indicators for soil management practices. However, identification of appropriate bioindicator species for many systems has been severely limited by a lack of information on ...

  15. Ship Maintenance Processes with Collaborative Product Lifecycle Management and 3D Terrestrial Laser Scanning Tools: Reducing Costs and Increasing Productivity

    DTIC Science & Technology

    2012-04-30

    approach that incorporates the 3D terrestrial laser scanning (3D TLS) and collaborative product lifecycle management (collab- PLM ) tool suite. Results...incorporated into final implementation of the 3D TLS and collab- PLM tools. 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF...terrestrial laser scanning (3D TLS) and collaborative product lifecycle management (collab- PLM ) tool suite. Results suggest that when the SHIPMAIN process

  16. Comparative Effectiveness of Risk-Stratified Care Management in Reducing Readmissions in Medicaid Adults With Chronic Disease.

    PubMed

    Hewner, Sharon; Wu, Yow-Wu Bill; Castner, Jessica

    2015-03-06

    Hospitalized adult Medicaid recipients with chronic disease are at risk for rehospitalization within 90 days of discharge, but most research has focused on the Medicare population. The purpose of this study is to examine the impact of population-based care management intensity on inpatient readmissions in Medicaid adults with pre-existing chronic disease. Retrospective analyses of 2,868 index hospital admissions from 2012 New York State Medicaid Data Warehouse claims compared 90-day post-discharge utilization in populations with and without transitional care management interventions. High intensity managed care organization interventions were associated with higher outpatient and lower emergency department post-discharge utilization than low intensity fee-for-service management. However, readmission rates were higher for the managed care cases. Shorter time to readmission was associated with managed care, diagnoses that include heart and kidney failure, shorter length of stay for index hospitalization, and male sex; with no relationship to age. This unexpected result flags the need to re-evaluate readmission as a quality indicator in the complex Medicaid population. Quality improvement efforts should focus on care continuity during transitions and consider population-specific factors that influence readmission. Optimum post-discharge utilization in the Medicaid population requires a balance between outpatient, emergency and inpatient services to improve access and continuity.

  17. Comparative Effectiveness of Risk-Stratified Care Management in Reducing Readmissions in Medicaid Adults With Chronic Disease.

    PubMed

    Hewner, Sharon; Wu, Yow-Wu Bill; Castner, Jessica

    2016-01-01

    Hospitalized adult Medicaid recipients with chronic disease are at risk for rehospitalization within 90 days of discharge, but most research has focused on the Medicare population. The purpose of this study is to examine the impact of population-based care management intensity on inpatient readmissions in Medicaid adults with pre-existing chronic disease. Retrospective analyses of 2,868 index hospital admissions from 2012 New York State Medicaid Data Warehouse claims compared 90-day post-discharge utilization in populations with and without transitional care management interventions. High intensity managed care organization interventions were associated with higher outpatient and lower emergency department post-discharge utilization than low intensity fee-for-service management. However, readmission rates were higher for the managed care cases. Shorter time to readmission was associated with managed care, diagnoses that include heart and kidney failure, shorter length of stay for index hospitalization, and male sex; with no relationship to age. This unexpected result flags the need to re-evaluate readmission as a quality indicator in the complex Medicaid population. Quality improvement efforts should focus on care continuity during transitions and consider population-specific factors that influence readmission. Optimum post-discharge utilization in the Medicaid population requires a balance between outpatient, emergency and inpatient services to improve access and continuity.

  18. Risk assessment and management of brucellosis in the southern greater Yellowstone area (II): Cost-benefit analysis of reducing elk brucellosis prevalence.

    PubMed

    Boroff, Kari; Kauffman, Mandy; Peck, Dannele; Maichak, Eric; Scurlock, Brandon; Schumaker, Brant

    2016-11-01

    Recent cases of bovine brucellosis (Brucella abortus) in cattle (Bos taurus) and domestic bison (Bison bison) of the southern Greater Yellowstone Area (SGYA) have been traced back to free-ranging elk (Cervus elaphus). Several management activities have been implemented to reduce brucellosis seroprevalence in elk, including test-and-slaughter, low-density feeding at elk winter feedgrounds, and elk vaccination. It is unclear which of these activities are most cost-effective at reducing the risk of elk transmitting brucellosis to cattle. In a companion paper, a stochastic risk model was used to translate a reduction in elk seroprevalence to a reduction in the risk of transmission to cattle. Here, we use those results to estimate the expected economic benefits and costs of reducing seroprevalence in elk using three different management activities: vaccination of elk with Brucella strain 19 (S19), low-density feeding of elk, and elk test-and-slaughter. Results indicate that the three elk management activities yield negative expected net benefits, ranging from -$2983 per year for low-density feeding to -$595,471 per year for test-and-slaughter. Society's risk preferences will determine whether strategies that generate small negative net benefit, such as low-density feeding, are worth implementing. However, activities with large negative net benefits, such as test-and-slaughter and S19 vaccination, are unlikely to be economically worthwhile. Given uncertainty about various model parameters, we identify some circumstances in which individual management activities might generate positive expected net benefit.

  19. Sodium chlorate reduces the presence of Escherichia coli in feces of lambs and ewes managed in shed-lambing systems.

    PubMed

    Taylor, J B; Dungan, R S; Lewis, G S

    2012-01-01

    Our objective was to establish doses of orally administered NaClO(3) that reduced the presence of generic Escherichia coli in intestines of ewes and neonatal lambs managed in a shed-lambing system. Neonatal lambs (n = 32; age = 7.1 ± 1.2 d; BW = 6.8 ± 1.0 kg) and yearling ewes (n = 44; BW = 74.8 ± 5.6 kg) were used in 2 experiments. In both experiments, lambs and ewes were randomly assigned to 1 of 4 groups, and groups were randomly assigned to 1 of 4 treatments. In Exp. 1, neonatal lambs were given single, aqueous, oral doses of saline (control; NaCl, 30 mg·kg of BW(-1)) or 30, 60, or 90 mg of NaClO(3)·kg(-1) of BW. At 25.9 ± 1.3 h after treatment, lambs were euthanized, and intestinal contents were collected aseptically. In Exp. 2, ewes were given single, aqueous, oral doses of saline (NaCl, 150 mg·kg of BW(-1)) or 150, 300, or 450 mg of NaClO(3)·kg(-1) of BW. At 24.0 ± 0.8 h after treatment, fecal samples were collected aseptically from the rectum of each ewe. For both experiments, generic E. coli were enumerated from intestinal contents and feces within 4 to 12 h after collection. In Exp. 1, the effect (P = 0.08) of NaClO(3) on the presence of generic E. coli in colon contents was dose-dependent. This effect was linear (P < 0.01) and negative, which indicated that as NaClO(3) dose increased, generic E. coli that could be isolated from colon contents decreased. Specifically, lambs dosed with 60 and 90 mg of NaClO(3)·kg(-1) of BW had fewer E. coli cfu·g(-1) of content than control lambs (P < 0.06). Lambs dosed with 90 mg of NaClO(3)·kg(-1) of BW had fewer E. coli cfu·g(-1) of content than lambs dosed with 30 mg of NaClO(3)·kg(-1) of BW (P = 0.09). Sodium chlorate dose did not influence (P = 0.58) the presence of generic E. coli in contents collected from the cecum. In Exp. 2, the effect (P < 0.0001) of NaClO(3) on the presence of E. coli in fecal contents from ewes was dose-dependent. This effect was quadratic (P < 0.0001) and negative; ewes dosed

  20. Reduced-risk pest management programs for eastern U.S. peach orchards: effects on arthropod predators, parasitoids, and select pests.

    PubMed

    Biddinger, David J; Leslie, Timothy W; Joshi, Neelendra K

    2014-06-01

    We developed new integrated pest management programs for eastern U.S. peaches with minimal use of organophosphates. From 2002-2005, we assessed the ecological impacts of these reduced-risk programs versus grower standard conventional programs that still relied primarily on the use of organophosphorous and carbamate insecticides. Using a split-plot design replicated at four commercial Pennsylvania peach orchards, we quantified pesticide rates, environmental impact, and arthropod community response. We used Environmental Impact Quotient (EIQ) analysis based on the growers' pesticide records from each orchard to calculate seasonal cumulative EIQ field ratings for all years. Ecological effects of the reduced-risk and conventional program were also measured as the abundance and diversity of nontarget arthropod predators, parasitoids, and selected pest taxa. Pesticide inputs and EIQ values were substantially lower in reduced-risk programs compared with conventional spray programs. Arthropod arrays differed significantly between pest management programs: most beneficial predator and parasitoid taxa were positively associated with the reduced-risk program and negatively associated with the standard grower program. Regardless of the pest management program, we observed significant differences in species arrays in the peach tree canopy compared with the ground cover of the orchards, but the arthropod community did not differ among the field sites or based on distance from the edge of the orchard. We conclude that reduced-risk programs not only provide control comparable with that of conventional programs, but they also reduce negative environmental effects while conserving key arthropod biological control agents within eastern U.S. peach orchards.

  1. Bumps on the managed care road: the search for an alternative model to reduce collisions between HMOs, physicians, and patients.

    PubMed

    Reece, R L

    2000-01-01

    Managed care is experiencing political, litigious, and financial bumps on the road. There are various reasons for this bumpy ride: out-of-control costs, prescription drug expense, negative media reports, public revolt at denials of care or limited access to specialists, bad physician relations, patients' rights legislation, dropping health maintenance organization (HMO) stock prices, the ripple effect of the Harvard Pilgrim bankruptcy, and threat of massive litigation against HMOs. Two reasons not often mentioned, but explored in this article, are the orthodox managed care's flawed market model and lack of enough understanding of physician culture and emerging consumer trends to effectively address these two key constituencies.

  2. Defense Management: DOD Needs Better Information and Guidance to More Effectively Manage and Reduce Operating and Support Costs of Major Weapon Systems

    DTIC Science & Technology

    2010-07-01

    contractor logistics support arrangements since before 2005, the estimates included the costs for government -provided logistics support of the aircraft . For...GAO United States Government Accountability Office Report to Congressional Committees DEFENSE MANAGEMENT DOD Needs Better... Government Accountability Office,441 G Street NW,Washington,DC,20548 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S

  3. The Slope of Change: An Environmental Management Approach to Reduce Drinking on a Day of Celebration at a U.S. College

    PubMed Central

    Marchell, Timothy C.; Lewis, Deborah D.; Croom, Katherine; Lesser, Martin L.; Murphy, Susan H.; Reyna, Valerie F.; Frank, Jeremy; Staiano-Coico, Lisa

    2013-01-01

    OBJECTIVE This research extends the literature on event-specific environmental management with a case study evaluation of an intervention designed to reduce student drinking at a university's year-end celebration. PARTICIPANTS Cornell University undergraduates were surveyed each May from 2001 through 2009. Sample sizes ranged from 322 to 1,973. METHODS Randomly sampled surveys were conducted after a large, annual spring campus celebration. An environmental management plan was initiated in 2003 that included increased enforcement of the minimum age drinking law (MADL). RESULTS In the short-term, drinking at the campus celebration decreased while drinking before the event increased. Over time, the intervention significantly reduced high-risk drinking on the day of the event, especially among those under the age of 21. CONCLUSION These findings are contrary to the argument that enforcement of MADLs simply lead to increased high-risk drinking, and therefore have implications for how colleges approach the challenge of student alcohol misuse. PMID:23930747

  4. The Efficacy of Asthma Case Management in an Urban School District in Reducing School Absences and Hospitalizations for Asthma

    ERIC Educational Resources Information Center

    Levy, Marian; Heffner, Brenda; Stewart, Tara; Beeman, Gail

    2006-01-01

    Pediatric asthma rates are reaching epidemic proportions, adversely affecting children's quality of life, educational potential, and health care costs, especially those in the inner city. This study evaluated the effectiveness of a school-based asthma case management (CM) approach with medically undeserved inner-city children attending Memphis…

  5. Ship Maintenance Processes with Collaborative Product Lifecycle Management and 3D Terrestrial Laser Scanning Tools: Reducing Costs and Increasing Productivity

    DTIC Science & Technology

    2011-04-30

    Brookings Institution Press. Lev, B. (2003, September). Remarks on the measurement , valuation , and reporting of intangible assets . Economic Policy...http://www.sixsigmainstitute.com/leansigma/index leansigma.shtml Lev, B. (2001). Intangibles : Management, measurement , and reporting . Washington, DC... measure of risk), and the correlation matrix between these assets , sets of portfolios with expected returns greater than any other with the same or

  6. The Effectiveness of Stress Management and Test-Taking Workshops in Reducing Test Anxiety of Community College Students.

    ERIC Educational Resources Information Center

    Price, Elsa C.

    A study was conducted to determine the effectiveness of a Stress Management Seminar and a Test-Taking Skills Workshop in improving the scores of pre-nursing and guidance examinees at Wallace Community College in Dothan, Alabama. The 73 subjects took the Pre-Nursing and Guidance Examination (PNGE) in June 1984, September 1984, or January 1985.…

  7. Has the Shift to Managed Care Reduced Medicaid Expenditures? Evidence from State and Local-Level Mandates

    ERIC Educational Resources Information Center

    Duggan, Mark; Hayford, Tamara

    2013-01-01

    From 1991 to 2009, the fraction of Medicaid recipients enrolled in HMOs and other forms of Medicaid managed care (MMC) increased from 11 percent to 71 percent. This increase was largely driven by state and local mandates that required most Medicaid recipients to enroll in an MMC plan. Theoretically, it is ambiguous whether the shift from…

  8. Management of Sodium-reduced Meals at Worksite Cafeterias: Perceptions, Practices, Barriers, and Needs among Food Service Personnel

    PubMed Central

    Lee, Jounghee; Park, Sohyun

    2015-01-01

    Objectives The sodium content of meals provided at worksite cafeterias is greater than the sodium content of restaurant meals and home meals. The objective of this study was to assess the relationships between sodium-reduction practices, barriers, and perceptions among food service personnel. Methods We implemented a cross-sectional study by collecting data on perceptions, practices, barriers, and needs regarding sodium-reduced meals at 17 worksite cafeterias in South Korea. We implemented Chi-square tests and analysis of variance for statistical analysis. For post hoc testing, we used Bonferroni tests; when variances were unequal, we used Dunnett T3 tests. Results This study involved 104 individuals employed at the worksite cafeterias, comprised of 35 men and 69 women. Most of the participants had relatively high levels of perception regarding the importance of sodium reduction (very important, 51.0%; moderately important, 27.9%). Sodium reduction practices were higher, but perceived barriers appeared to be lower in participants with high-level perception of sodium-reduced meal provision. The results of the needs assessment revealed that the participants wanted to have more active education programs targeting the general population. The biggest barriers to providing sodium-reduced meals were use of processed foods and limited methods of sodium-reduced cooking in worksite cafeterias. Conclusion To make the provision of sodium-reduced meals at worksite cafeterias more successful and sustainable, we suggest implementing more active education programs targeting the general population, developing sodium-reduced cooking methods, and developing sodium-reduced processed foods. PMID:27169011

  9. Dynamic Cost-Contingency Management: A Method for Reducing Project Costs While Increasing the Probability of Success

    DTIC Science & Technology

    2007-04-30

    simple Monte Carlo simulation tools such as @Risk® and Crystal Ball®. The premise of this paper is that a credible Probabilistic Cost Analysis...readily performed using commercially available Monte Carlo simulation Excel add-ins. The implementation of a project-wide cost contingency to ensure...deterministic to probabilistic approach is NOT silver bullet • Monte Carlo simulation is only a mathematical tool: GIGO Poor management practices Lack of

  10. Energy-Smart Building Choices: How School Facilities Managers and Business Officials Are Reducing Operating Costs and Saving Money

    SciTech Connect

    Energy Smart Schools Team

    2001-08-06

    Most K-12 schools could save 25% of their energy costs by being smart about energy. Nationwide, the savings potential is $6 billion. While improving energy use in buildings and busses, schools are likely to create better places for teaching and learning, with better lighting, temperature control, acoustics, and air quality. This brochure, targeted to school facilities managers and business officials, describes how schools can become more energy efficient.

  11. Double-crested Cormorant Management Plan to Reduce Predation of Juvenile Salmonids in the Columbia River Estuary

    DTIC Science & Technology

    2015-01-01

    techniques (setting up decoys and broadcasting audio playback of bird calls to encourage nesting) were tested within and outside the Columbia River...Supplemental Federal Columbia River Power System Biological Opinion called for the Corps to “…develop a cormorant management plan (including...Double-crested Cormorants Satellite-tagged on East Sand Island within the Affected Environment. #of Birds Act ive+ t hat %of Birds #of %of Active

  12. How School Facilities Managers and Business Officials Are Reducing Operating Costs and Saving Money. Energy-Smart Building Choices.

    ERIC Educational Resources Information Center

    Department of Energy, Washington, DC.

    This guide addresses contributions that school facility administrators and business officials can make in an effort to reduce operating costs and free up money for capital improvements. The guide explores opportunities available to utilize energy-saving strategies at any stage in a building's life, from its initial design phase through renovation.…

  13. Managing potential drug-drug interactions between gastric acid-reducing agents and antiretroviral therapy: experience from a large HIV-positive cohort.

    PubMed

    Lewis, J M; Stott, K E; Monnery, D; Seden, K; Beeching, N J; Chaponda, M; Khoo, S; Beadsworth, M B J

    2016-02-01

    Drug-drug interactions between antiretroviral therapy and other drugs are well described. Gastric acid-reducing agents are one such class. However, few data exist regarding the frequency of and indications for prescription, nor risk assessment in the setting of an HIV cohort receiving antiretroviral therapy. To assess prevalence of prescription of gastric acid-reducing agents and drug-drug interaction within a UK HIV cohort, we reviewed patient records for the whole cohort, assessing demographic data, frequency and reason for prescription of gastric acid-reducing therapy. Furthermore, we noted potential drug-drug interaction and whether risk had been documented and mitigated. Of 701 patients on antiretroviral therapy, 67 (9.6%) were prescribed gastric acid-reducing therapy. Of these, the majority (59/67 [88.1%]) were prescribed proton pump inhibitors. We identified four potential drug-drug interactions, which were appropriately managed by temporally separating the administration of gastric acid-reducing agent and antiretroviral therapy, and all four of these patients remained virally suppressed. Gastric acid-reducing therapy, in particular proton pump inhibitor therapy, appears common in patients prescribed antiretroviral therapy. Whilst there remains a paucity of published data, our findings are comparable to those in other European cohorts. Pharmacovigilance of drug-drug interactions in HIV-positive patients is vital. Education of patients and staff, and accurate data-gathering tools, will enhance patient safety.

  14. Can telemonitoring reduce hospitalization and cost of care? A health plan's experience in managing patients with heart failure.

    PubMed

    Maeng, Daniel D; Starr, Alison E; Tomcavage, Janet F; Sciandra, Joann; Salek, Doreen; Griffith, David

    2014-12-01

    Telemonitoring provides a potentially useful tool for disease and case management of those patients who are likely to benefit from frequent and regular monitoring by health care providers. Since 2008, Geisinger Health Plan (GHP) has implemented a telemonitoring program that specifically targets those members with heart failure. This study assesses the impact of this telemonitoring program by examining claims data of those GHP Medicare Advantage plan members who were enrolled in the program, measuring its impact in terms of all-cause hospital admission rates, readmission rates, and total cost of care. The results indicate significant reductions in probability of all-cause admission (odds ratio [OR] 0.77; P<0.01), 30-day and 90-day readmission (OR 0.56, 0.62; P<0.05), and cost of care (11.3%; P<0.05). The estimated return on investment was 3.3. These findings imply that telemonitoring can be an effective add-on tool for managing elderly patients with heart failure.

  15. Many-objective reservoir policy identification and refinement to reduce policy inertia and myopia in water management

    NASA Astrophysics Data System (ADS)

    Giuliani, M.; Herman, J. D.; Castelletti, A.; Reed, P.

    2014-04-01

    This study contributes a decision analytic framework to overcome policy inertia and myopia in complex river basin management contexts. The framework combines reservoir policy identification, many-objective optimization under uncertainty, and visual analytics to characterize current operations and discover key trade-offs between alternative policies for balancing competing demands and system uncertainties. The approach is demonstrated on the Conowingo Dam, located within the Lower Susquehanna River, USA. The Lower Susquehanna River is an interstate water body that has been subject to intensive water management efforts due to competing demands from urban water supply, atomic power plant cooling, hydropower production, and federally regulated environmental flows. We have identified a baseline operating policy for the Conowingo Dam that closely reproduces the dynamics of current releases and flows for the Lower Susquehanna and thus can be used to represent the preferences structure guiding current operations. Starting from this baseline policy, our proposed decision analytic framework then combines evolutionary many-objective optimization with visual analytics to discover new operating policies that better balance the trade-offs within the Lower Susquehanna. Our results confirm that the baseline operating policy, which only considers deterministic historical inflows, significantly overestimates the system's reliability in meeting the reservoir's competing demands. Our proposed framework removes this bias by successfully identifying alternative reservoir policies that are more robust to hydroclimatic uncertainties while also better addressing the trade-offs across the Conowingo Dam's multisector services.

  16. Synthetic fertilizer management for China's cereal crops has reduced N2O emissions since the early 2000s.

    PubMed

    Sun, Wenjuan; Huang, Yao

    2012-01-01

    China has implemented a soil testing and fertilizer recommendation (STFR) program to reduce the over-usage of synthetic nitrogen (N) fertilizer on cereal crops since the late 1990 s. Using province scale datasets, we estimated an annual reduction rate of 2.5-5.1 kg N ha(-1) from 1998 to 2008 and improving grain yields, which were attributed to the balanced application of phosphate and potassium fertilization. Relative to the means for 1998-2000, the synthetic N fertilizer input and the corresponding N-induced N(2)O production in cereal crops were reduced by 22 ± 0.7 Tg N and 241 ± 4 Gg N(2)O-N in 2001-2008. Further investigation suggested that the N(2)O emission related to wheat and maize cultivation could be reduced by 32-43 Gg N(2)O-N per year in China (26%-41% of the emissions in 2008) if the STFR practice is implemented universally in the future.

  17. Reducing greenhouse gas emissions and adapting agricultural management for climate change in developing countries: providing the basis for action.

    PubMed

    Ogle, Stephen M; Olander, Lydia; Wollenberg, Lini; Rosenstock, Todd; Tubiello, Francesco; Paustian, Keith; Buendia, Leandro; Nihart, Alison; Smith, Pete

    2014-01-01

    Agriculture in developing countries has attracted increasing attention in international negotiations within the United Nations Framework Convention on Climate Change for both adaptation to climate change and greenhouse gas mitigation. However, there is limited understanding about potential complementarity between management practices that promote adaptation and mitigation, and limited basis to account for greenhouse gas emission reductions in this sector. The good news is that the global research community could provide the support needed to address these issues through further research linking adaptation and mitigation. In addition, a small shift in strategy by the Intergovernmental Panel on Climate Change (IPCC) and ongoing assistance from agricultural organizations could produce a framework to move the research and development from concept to reality. In turn, significant progress is possible in the near term providing the basis for UNFCCC negotiations to move beyond discussion to action for the agricultural sector in developing countries.

  18. Scheduling fertilizer applications as a simple mitigation option for reducing N2O emission in intensively managed mown grassland systems

    NASA Astrophysics Data System (ADS)

    Neftel, Albrecht; Calanca, Pierluigi; Felber, Raphael; Grant, Robert; Conen, Franz

    2014-05-01

    A general principle in all proposed N2O mitigation options is the fertilization according to plants' requirements. Meanwhile the amount of N fertilization allowed is regulated in many countries. Due to the high pressure from food security and the need for economic efficiency the given limits are generally used up. In mown grassland systems a simple mitigation option is to optimize the timing of the fertilizer applications. Application of fertilizer, both organic manure and mineral fertilizer, is generally scheduled after each cut in a narrow time window. In practice, the delay between cut and fertilizer application is determined by weather conditions, management conditions and most important by the planning and experience of the individual farmer. Many field experiments have shown that enhanced N2O emissions tend to occur after cuts but before the application of fertilizer, especially when soils are characterized by a high WFPS. These findings suggest that the time of fertilizer application has an important implications for the N2O emission rate and that scheduling fertilization according to soil conditions might be a simple, cheap and efficient measure to mitigate N2O emissions. In this paper we report on results from a sensitivity analysis aiming at quantifying the effects of the timing of the fertilizer applications on N2O emissions from intensively managed, mown grasslands. Simulations for different time schedules were carried out with the comprehensive ecosystem model "ECOSYS" . To our knowledge this aspect has not been systematically investigated from a scientific point of view, but might have been always there within the experiences of attentive environmentally concerned farmers.

  19. Modelling the potential of slurry management technologies to reduce the constraints of environmental legislation on pig production.

    PubMed

    Hutchings, Nicholas J; ten Hoeve, Marieke; Jensen, Rikke; Bruun, Sander; Søtoft, Lene F

    2013-11-30

    Limits on land applications of slurry nitrogen (N) and phosphorus (P) are used to restrict losses of nutrients caused by livestock production. Here, we used a model to assess technologies that enable a more even geographic distribution of slurry nutrients to land. Technologies included were screw press slurry separation, with or without solid fraction composting, centrifuge separation with or without liquid fraction ammonia (NH3) stripping, and anaerobic digestion. Regulatory constraints were placed first on the application in slurry of N, then P, then N and P both on the producing (donor) and receiving (recipient) farms. Finally, a constraint preventing an increase in donor farm NH3 emissions was imposed. Separation had little effect on N losses per unit mass of slurry, but NH3 stripping led to a reduction. Centrifuge separation allowed a greater increase in pig production than a screw press, especially with P regulation. NH3 stripping was only advantageous with N regulation or when combined with NH3 scrubbing of pig housing ventilation air, when donor farm NH3 emissions were a constraint. There was a production penalty for using composting or anaerobic digestion. The choice of appropriate slurry management option therefore depends on the focus of the regulation. Nuanced and therefore complex regulations are necessary to take advantage of synergies and avoid cross-policy conflicts and incongruencies.

  20. Efforts to Reduce International Space Station Crew Maintenance for the Management of the Extravehicular Mobility Unit Transport Loop Water Quality

    NASA Technical Reports Server (NTRS)

    Steele, John W.; Etter, David; Rector, Tony; Boyle, Robert; Vandezande, Christopher

    2013-01-01

    The EMU (Extravehicular Mobility Unit) contains a semi-closed-loop re-circulating water circuit (Transport Loop) to absorb heat into a LCVG (Liquid Coolant and Ventilation Garment) worn by the astronaut. A second, single-pass water circuit (Feed-water Loop) provides water to a cooling device (Sublimator) containing porous plates, and that water sublimates through the porous plates to space vacuum. The cooling effect from the sublimation of this water translates to a cooling of the LCVG water that circulates through the Sublimator. The quality of the EMU Transport Loop water is maintained through the use of a water processing kit (ALCLR Airlock Cooling Loop Remediation) that is used to periodically clean and disinfect the water circuit. Opportunities to reduce crew time associated with on-orbit ALCLR operations include a detailed review of the historical water quality data for evidence to support an extension to the implementation cycle. Furthermore, an EMU returned after 2-years of use on the ISS (International Space Station) is being used as a test bed to evaluate the results of extended and repeated ALCLR implementation cycles. Finally, design, use and on-orbit location enhancements to the ALCLR kit components are being considered to allow the implementation cycle to occur in parallel with other EMU maintenance and check-out activities, and to extend the life of the ALCLR kit components. These efforts are undertaken to reduce the crew-time and logistics burdens for the EMU, while ensuring the long-term health of the EMU water circuits for a post-Shuttle 6-year service life.

  1. Managed European-Derived Honey Bee, Apis mellifera sspp, Colonies Reduce African-Matriline Honey Bee, A. m. scutellata, Drones at Regional Mating Congregations

    PubMed Central

    Mortensen, Ashley N.; Ellis, James D.

    2016-01-01

    African honey bees (Apis mellifera scutellata) dramatically changed the South American beekeeping industry as they rapidly spread through the Americas following their introduction into Brazil. In the present study, we aimed to determine if the management of European-derived honey bees (A. mellifera sspp.) could reduce the relative abundance of African-matriline drones at regional mating sites known as drone congregation areas (DCAs). We collected 2,400 drones at six DCAs either 0.25 km or >2.8 km from managed European-derived honey bee apiaries. The maternal ancestry of each drone was determined by Bgl II enzyme digestion of an amplified portion of the mitochondrial Cytochrome b gene. Furthermore, sibship reconstruction via nuclear microsatellites was conducted for a subset of 1,200 drones to estimate the number of colonies contributing drones to each DCA. Results indicate that DCAs distant to managed European apiaries (>2.8 km) had significantly more African−matriline drones (34.33% of the collected drones had African mitochondrial DNA) than did DCAs close (0.25 km) to managed European apiaries (1.83% of the collected drones had African mitochondrial DNA). Furthermore, nuclear sibship reconstruction demonstrated that the reduction in the proportion of African matriline drones at DCAs near apiaries was not simply an increase in the number of European matriline drones at the DCAs but also the result of fewer African matriline colonies contributing drones to the DCAs. Our data demonstrate that the management of European honey bee colonies can dramatically influence the proportion of drones with African matrilines at nearby drone congregation areas, and would likely decreasing the probability that virgin European queens will mate with African drones at those drone congregation areas. PMID:27518068

  2. Managed European-Derived Honey Bee, Apis mellifera sspp, Colonies Reduce African-Matriline Honey Bee, A. m. scutellata, Drones at Regional Mating Congregations.

    PubMed

    Mortensen, Ashley N; Ellis, James D

    2016-01-01

    African honey bees (Apis mellifera scutellata) dramatically changed the South American beekeeping industry as they rapidly spread through the Americas following their introduction into Brazil. In the present study, we aimed to determine if the management of European-derived honey bees (A. mellifera sspp.) could reduce the relative abundance of African-matriline drones at regional mating sites known as drone congregation areas (DCAs). We collected 2,400 drones at six DCAs either 0.25 km or >2.8 km from managed European-derived honey bee apiaries. The maternal ancestry of each drone was determined by Bgl II enzyme digestion of an amplified portion of the mitochondrial Cytochrome b gene. Furthermore, sibship reconstruction via nuclear microsatellites was conducted for a subset of 1,200 drones to estimate the number of colonies contributing drones to each DCA. Results indicate that DCAs distant to managed European apiaries (>2.8 km) had significantly more African-matriline drones (34.33% of the collected drones had African mitochondrial DNA) than did DCAs close (0.25 km) to managed European apiaries (1.83% of the collected drones had African mitochondrial DNA). Furthermore, nuclear sibship reconstruction demonstrated that the reduction in the proportion of African matriline drones at DCAs near apiaries was not simply an increase in the number of European matriline drones at the DCAs but also the result of fewer African matriline colonies contributing drones to the DCAs. Our data demonstrate that the management of European honey bee colonies can dramatically influence the proportion of drones with African matrilines at nearby drone congregation areas, and would likely decreasing the probability that virgin European queens will mate with African drones at those drone congregation areas.

  3. Investigating the potential to reduce flood risk through catchment-based land management techniques and interventions in the River Roe catchment, Cumbria,UK

    NASA Astrophysics Data System (ADS)

    Pearson, Callum; Reaney, Sim; Bracken, Louise; Butler, Lucy

    2015-04-01

    Throughout the United Kingdom flood risk is a growing problem and a significant proportion of the population are at risk from flooding throughout the country. Across England and Wales over 5 million people are believed to be at risk from fluvial, pluvial or coastal flooding (DEFRA, 2013). Increasingly communities that have not dealt with flooding before have recently experienced significant flood events. The communities of Stockdalewath and Highbridge in the Roe catchment, a tributary of the River Eden in Cumbria, UK, are an excellent example. The River Roe has a normal flow of less than 5m3 sec-1 occurring 97 percent of the time however there have been two flash floods of 98.8m3 sec-1 in January 2005 and 86.9m3 sec-1 in May 2013. These two flash flood events resulted in the inundation of numerous properties within the catchment with the 2013 event prompting the creation of the Roe Catchment Community Water Management Group which aims are to deliver a sustainable approach to managing the flood risk. Due to the distributed rural population the community fails the cost-benefit analysis for a centrally funded flood risk mitigation scheme. Therefore the at-risk community within the Roe catchment have to look for cost-effective, sustainable techniques and interventions to reduce the potential negative impacts of future events; this has resulted in a focus on natural flood risk management. This research investigates the potential to reduce flood risk through natural catchment-based land management techniques and interventions within the Roe catchment; providing a scientific base from with further action can be enacted. These interventions include changes to land management and land use, such as soil aeration and targeted afforestation, the creation of runoff attenuation features and the construction of in channel features, such as debris dams. Natural flood management (NFM) application has been proven to be effective when reducing flood risk in smaller catchments and the

  4. Delayed uterine fluid clearance and reduced uterine perfusion in bitches with endometrial hyperplasia and clinical management with postmating antibiotic.

    PubMed

    England, G C W; Moxon, R; Freeman, S L

    2012-10-15

    In many species a transient uterine inflammatory response follows mating and is proposed to remove excess spermatozoa, bacteria, and other contaminants from the uterus. Similar events have been documented in the bitch involving increased uterine contractions, polymorphonuclear neutrophil influx and uterine artery vasodilation. Some healthy bitches with endometrial hyperplasia have increased numbers of uterine luminal polymorphonuclear neutrophils after mating and reduced fertility; it is purported that this represents a presumed postmating endometritis. This study used B-mode and Doppler ultrasonography at the time of mating to measure uterine contractions, clearance of ejaculated fluid, and uterine artery velocity in normal bitches and those with endometrial hyperplasia. Mating resulted in an increase in the number of uterine contractions, although fewer mating-induced contractions were noted in bitches with endometrial hyperplasia. Interestingly, uterine fluid cleared significantly more slowly after mating from the bitches with endometrial hyperplasia than the normal bitches (P = 0.01). In a further study, Doppler ultrasonography showed that in normal bitches there was a significant increase in uterine artery blood velocity (P = 0.04) and a decrease in the resistance index after mating (P = 0.04), indicating vasodilation. In bitches with endometrial hyperplasia the baseline resistance index was significantly higher than normal bitches (P = 0.05), and furthermore, although there was a significant decrease in resistance index after mating, in the bitches with endometrial hyperplasia this was of a smaller magnitude that in normal bitches. These findings indicate lower baseline uterine perfusion, and a blunted vasodilation response to mating in bitches with endometrial hyperplasia. Short-duration postmating administration of systemic antibiotic increased pregnancy rates in bitches with endometrial hyperplasia (P < 0.01). Litter sizes in bitches with endometrial

  5. Potential of forest management to reduce French carbon emissions - regional modelling of the French forest carbon balance from the forest to the wood.

    NASA Astrophysics Data System (ADS)

    Valade, A.; Luyssaert, S.; Bellassen, V.; Vallet, P.

    2015-12-01

    In France the low levels of forest harvest (40 Mm3 per year over a volume increment of 89Mm3) is frequently cited to push for a more intensive management of the forest that would help reducing CO2 emissions. This reasoning overlooks the medium-to-long-term effects on the carbon uptake at the national scale that result from changes in the forest's structure and delayed emissions from products decay and bioenergy burning, both determinant for the overall C fluxes between the biosphere and the atmosphere. To address the impacts of an increase in harvest removal on biosphere-atmosphere carbon fluxes at national scale, we build a consistent regional modeling framework to integrate the forest-carbon system from photosynthesis to wood uses. We aim at bridging the gap between regional ecosystem modeling and land managers' considerations, to assess the synergistic and antagonistic effects of management strategies over C-based forest services: C-sequestration, energy and material provision, fossil fuel substitution. For this, we built on inventory data to develop a spatial forest growth simulator and design a novel method for diagnosing the current level of management based on stand characteristics (density, quadratic mean diameter or exploitability). The growth and harvest simulated are then processed with a life cycle analysis to account for wood transformation and uses. Three scenarii describe increases in biomass removals either driven by energy production target (set based on national prospective with a lock on minimum harvest diameters) or by changes in management practices (shorter or longer rotations, management of currently unmanaged forests) to be compared with business as usual simulations. Our management levels' diagnostics quantifies undermanagement at national scale and evidences the large weight of ownership-based undermanagement with an average of 26% of the national forest (between 10% and 40% per species) and thus represents a huge potential wood resource

  6. Forest carbon response to management scenarios intended to mitigate GHG emissions and reduce fire impacts in the US West Coast region

    NASA Astrophysics Data System (ADS)

    Hudiburg, T. W.; Law, B. E.; Thornton, P. E.; Luyssaert, S.

    2012-12-01

    US West coast forests are among the most carbon dense biomes in the world and the potential for biomass accumulation in mesic coastal forests is the highest recorded (Waring and Franklin 1979, Hudiburg et al. 2009). Greenhouse gas (GHG) mitigation strategies have recently expanded to include forest woody biomass as bioenergy, with the expectation that this will also reduce forest mortality. We examined forest carbon response and life cycle assessment (LCA) of net carbon emissions following varying combinations of bioenergy management scenarios in Pacific Northwest forests for the period from 2010-2100. We use the NCAR CLM4 model combined with a regional atmospheric forcing dataset and account for future environmental change using the IPCC RCP4.5 and RCP 8.5 scenarios. Bioenergy management strategies include a repeated thinning harvest, a repeated clearcut harvest, and a single salvage harvest in areas with projected insect-related mortality. None of the bioenergy management scenarios reduce net emissions to the atmosphere compared to continued business-as-usual harvest (BAU) by the end of the 21st century. Forest regrowth and reduced fire emissions are not large enough to balance the wood removals from harvest. Moreover, the substitution of wood for fossil fuel energy and products is not large enough to offset the wood losses through decomposition and combustion. However, in some ecoregions (Blue Mountains and East Cascades), emissions from the thinning harvests begin to improve over BAU at the end of the century and could lead to net reductions in those ecoregions over a longer time period (> 100 years). For salvage logging, there is no change compared to BAU emissions by the end of the 21st century because the treatment area is minimal compared to the other treatments and only performed once. These results suggest that managing forests for carbon sequestration will need to include a variety of approaches accounting for forest baseline conditions and in some

  7. Organic matter and water management strategies to reduce methane and nitrous oxide emissions from rice fields in Vietnam

    NASA Astrophysics Data System (ADS)

    Pandey, A.

    2014-12-01

    The reduction of CH4 and N2O emissions from rice paddies is of utmost importance in minimizing the impact of rice production on global warming. A field experiment was therefore conducted in farmers' field in Hanoi, Vietnam to examine whether the use of straw compost or straw biochar, in combination with the safe alternate wetting and drying (AWD) has the potential to suppress both CH4 and N2O emissions from rice paddies while maintaining the rice yield. The study compared the proposed strategies with local farmers' practice of permanent flooding (PF) and farmyard manure (FYM) incorporation, respectively. A control treatment without organic matter incorporation in both AWD and PF water regimes was also included in the study; all treatments received equal amounts of mineral fertilizer. Gas emissions were monitored using the closed chamber method at seven-day intervals during the first 50 days and at 15-day intervals thereafter. Addition of FYM, straw compost and biochar increased CH4 emissions by 230 %, 150 % and 38 %, respectively, when compared with the control treatments in both the AWD and PF water regimes. Within AWD, FYM increased N2O emissions by 30 %, straw compost and biochar displayed similar amount of N2O emissions as the control treatment. Within PF, N2O emissions under FYM and straw compost were 40 % and 35 % higher than the control treatment, respectively, and biochar once again displayed similar amount of N2O emissions as the control treatment. Yield difference was not significant (P > 0.05) between any of the treatments. These results indicated that the straw compost incorporation might not reduce the global warming potential (GWP) and yield-scaled GWP of rice production, whereas biochar in combination with AWD has the potential to maintain the GWP and yield-scaled GWP of rice production at lower level than the farmers' practice.

  8. Impact of early-season thrips management on reducing the risks of spotted wilt virus and suppressing aphid populations in Flue-cured tobacco.

    PubMed

    McPherson, R M; Stephenson, M G; Lahue, S S; Mullis, S W

    2005-02-01

    The influence of tray drench (TD) treatments, with and without foliar applications of the plant activator acibenzolar-S-methyl (Actigard), was examined in replicated field plots in 2000--2002. TD treatments of Actigard, imidacloprid (Admire), and these two products combined had little effect on seasonal mean thrips populations; however, thrips densities were lower in the Admire-treated plots at 4 and 5 wk after transplanting. Actigard and Admire TD treatments significantly reduced the seasonal incidence of tomato spotted wilt virus (TSWV) symptomatic plants in 2 yr in the study. The combination of both products was better in reducing TSWV than Actigard alone. Three early-season foliar sprays of Actigard had no effect on thrips population densities, but they did reduce TSWV incidence. The tobacco thrips, Frankliniella fusca (Hinds), comprised 92-95% of the thrips complex each year. Other thrips collected on tobacco foliage at very low densities included Haplothrips spp., Chirothrips spp., Limothrips cerealium (Haliday), other Frankliniella spp. and other unidentified species. Using nonstructural TSWV protein enzyme-linked immunosorbent assay, 1.5-2.3% of the F. fusca tested positive for nonstructural TSWV protein. Cured yields were higher in the TD treatments and the Actigard foliar treatments in the years with high TSWV in the untreated plots. The TD treatments and foliar Actigard had little impact on plant height or grade index; however, TD treatments with Admire had low tobacco aphid, Myzus nicotianae Blackman, populations through 10 wk after transplanting. The early-season Actigard and Admire treatment options are management decisions that can effectively reduce the risks of TSWV incidence in flue-cured tobacco.

  9. Does case management for patients with heart failure based in the community reduce unplanned hospital admissions? A systematic review and meta-analysis

    PubMed Central

    Huntley, A L; Johnson, R; King, A; Morris, R W; Purdy, S

    2016-01-01

    Objectives The aim of this systematic review of randomised controlled trials (RCTs) and controlled trials (non-RCTs, NRCTs) is to investigate the effectiveness and related costs of case management (CM) for patients with heart failure (HF) predominantly based in the community in reducing unplanned readmissions and length of stay (LOS). Setting CM initiated either while as an inpatient, or on discharge from acute care hospitals, or in the community and then continuing on in the community. Participants Adults with a diagnosis of HF and resident in Organisation for Economic Co-operation and Development countries. Intervention CM based on nurse coordinated multicomponent care which is applicable to the primary care-based health systems. Primary and secondary outcomes Primary outcomes of interest were unplanned (re)admissions, LOS and any related cost data. Secondary outcomes were primary healthcare resources. Results 22 studies were included: 17 RCTs and 5 NRCTs. 17 studies described hospital-initiated CM (n=4794) and 5 described community-initiated CM of HF (n=3832). Hospital-initiated CM reduced readmissions (rate ratio 0.74 (95% CI 0.60 to 0.92), p=0.008) and LOS (mean difference −1.28 days (95% CI −2.04 to −0.52), p=0.001) in favour of CM compared with usual care. 9 trials described cost data of which 6 reported no difference between CM and usual care. There were 4 studies of community-initiated CM versus usual care (2 RCTs and 2 NRCTs) with only the 2 NRCTs showing a reduction in admissions. Conclusions Hospital-initiated CM can be successful in reducing unplanned hospital readmissions for HF and length of hospital stay for people with HF. 9 trials described cost data; no clear difference emerged between CM and usual care. There was limited evidence for community-initiated CM which suggested it does not reduce admission. PMID:27165648

  10. A job safety program for construction workers designed to reduce the potential for occupational injury using tool box training sessions and computer-assisted biofeedback stress management techniques.

    PubMed

    Johnson, Kenneth A; Ruppe, Joan

    2002-01-01

    This project was conducted with a multicultural construction company in Hawaii, USA. The job duties performed included drywall and carpentry work. The following objectives were selected for this project: (a) fire prevention training and inspection of first aid equipment; (b) blood-borne pathogen training and risk evaluation; (c) ergonomic and risk evaluation intervention program; (d) electrical safety training and inspection program; (e) slips, trips, and falls safety training; (f) stress assessment and Personal Profile System; (g) safety and health program survey; (h) improving employee relations and morale by emphasizing spirituality; and (i) computer-assisted biofeedback stress management training. Results of the project indicated that observed safety hazards, reported injuries, and levels of perceived stress. were reduced for the majority of the population.

  11. The role of sustainable agriculture and renewable-resource management in reducing greenhouse-gas emissions and increasing sinks in China and India.

    PubMed

    Pretty, J N; Ball, A S; Xiaoyun, Li; Ravindranath, N H

    2002-08-15

    This paper contains an analysis of the technical options in agriculture for reducing greenhouse-gas emissions and increasing sinks, arising from three distinct mechanisms: (i) increasing carbon sinks in soil organic matter and above-ground biomass; (ii) avoiding carbon emissions from farms by reducing direct and indirect energy use; and (iii) increasing renewable-energy production from biomass that either substitutes for consumption of fossil fuels or replaces inefficient burning of fuelwood or crop residues, and so avoids carbon emissions, together with use of biogas digesters and improved cookstoves. We then review best-practice sustainable agriculture and renewable-resource-management projects and initiatives in China and India, and analyse the annual net sinks being created by these projects, and the potential market value of the carbon sequestered. We conclude with a summary of the policy and institutional conditions and reforms required for adoption of best sustainability practice in the agricultural sector to achieve the desired reductions in emissions and increases in sinks. A review of 40 sustainable agriculture and renewable-resource-management projects in China and India under the three mechanisms estimated a carbon mitigation potential of 64.8 MtC yr(-1) from 5.5 Mha. The potential income for carbon mitigation is $324 million at $5 per tonne of carbon. The potential exists to increase this by orders of magnitude, and so contribute significantly to greenhouse-gas abatement. Most agricultural mitigation options also provide several ancillary benefits. However, there are many technical, financial, policy, legal and institutional barriers to overcome.

  12. Improving efficiency and reducing costs: Design of an adaptive, seamless, and enriched pragmatic efficacy trial of an online asthma management program.

    PubMed

    Lu, Mei; Ownby, Dennis R; Zoratti, Edward; Roblin, Douglas; Johnson, Dayna; Johnson, Christine Cole; Joseph, Christine L M

    2014-05-01

    Clinical trials are critical for medical decision-making, however, under the current paradigm, clinical trials are fraught with problems including low enrollment and high cost. Promising alternatives to increase trial efficiency and reduce costs include the use of (1) electronic initiatives that permit electronic remote data capture (EDC) for direct data collection at a site (2), electronic medical records (EMR) for patient identification and data collection, and (3) adaptive, enrichment designs with pragmatic approaches. We describe the design of a seamless, multi-site randomized Phase II/III trial to evaluate an asthma management intervention in urban adolescents with asthma. Patients are randomized, asked to access four online sessions of the intervention or control asthma management program, and are then followed for one year. The primary efficacy endpoint is self-reported asthma control as measured by the Asthma Control Test (ACT). Comparative effectiveness parametric approaches are utilized to conduct the trial in a real world setting with reduced costs. Escalated electronic initiatives are implemented for patient identification, assent, enrollment and tracking. Patient enrollment takes place during primary care visits. A centralized database with EDC is used for CRF data collection with integration of EMR data. This Phase II/III trial plans to have a total sample size of 500 patients with an interim look at the completion of Phase II (n=250), The interim analyses include an assessment of the intervention effect, marker(s) identification and the feasibility study of EMR data as the trial CRF data collection. Patient enrollment has begun and is ongoing.

  13. Self-Management Strategies to Reduce Pain and Improve Function among Older Adults in Community Settings: A Review of the Evidence

    PubMed Central

    Reid, M. Carrington; Papaleontiou, Maria; Ong, Anthony; Breckman, Risa; Wethington, Elaine; Pillemer, Karl

    2012-01-01

    Context Self-management strategies for pain hold substantial promise as a means of reducing pain and improving function among older adults with chronic pain, but their use in this age group has not been well defined. Objective To review the evidence regarding self-management interventions for pain due to musculoskeletal disorders among older adults. Design We searched the Medline and Cumulative Index to Nursing and Allied Health Literature databases to identify relevant articles for review and analyzed English-language articles that presented outcome data on pain, function, and/or other relevant endpoints and evaluated programs/strategies that could be feasibly implemented in the community. Abstracted information included study sample characteristics, estimates of treatment effect, and other relevant outcomes when present. Results Retained articles (N = 27) included those that evaluated programs sponsored by the Arthritis Foundation and other programs/strategies including yoga, massage therapy, Tai Chi, and music therapy. Positive outcomes were found in 96% of the studies. Proportionate change in pain scores ranged from an increase of 18% to a reduction of 85% (median = 23% reduction), whereas change in disability scores ranged from an increase of 2% to a reduction of 70% (median = 19% reduction). Generalizability issues identified included limited enrollment of ethnic minority elders, as well as non-ethnic elders aged 80 and above. Conclusions Our results suggest that a broad range of self-management programs may provide benefits for older adults with chronic pain. Research is needed to establish the efficacy of the programs in diverse age and ethnic groups of older adults and identify strategies that maximize program reach, retention, and methods to ensure continued use of the strategies over time. PMID:18346056

  14. Sexual and injection-related risks in Puerto Rican-born injection drug users living in New York City: A mixed-methods analysis

    PubMed Central

    2011-01-01

    perpetuated in their new setting following an almost natural flow. These norms may have a particular stronghold over risky drug injection practices. These results indicate that culturally appropriate HIV and HCV prevention and education services are needed. In addition, homelessness should be addressed to reduce risky sexual practices. PMID:22004801

  15. Evaluation of Land Use, Land Management and Soil Conservation Strategies to Reduce Non-Point Source Pollution Loads in the Three Gorges Region, China.

    PubMed

    Strehmel, Alexander; Schmalz, Britta; Fohrer, Nicola

    2016-11-01

    The construction of the Three Gorges Dam in China and the subsequent impoundment of the Yangtze River have induced a major land use change in the Three Gorges Reservoir Region, which fosters increased inputs of sediment and nutrients from diffuse sources into the water bodies. Several government programs have been implemented to mitigate high sediment and nutrient loads to the reservoir. However, institutional weaknesses and a focus on economic development have so far widely counteracted the effectiveness of these programs. In this study, the eco-hydrological model soil and water assessment tool is used to assess the effects of changes in fertilizer amounts and the conditions of bench terraces in the Xiangxi catchment in the Three Gorges Reservoir Region on diffuse matter releases. With this, the study aims at identifying efficient management measures, which should have priority. The results show that a reduction of fertilizer amounts cannot reduce phosphorus loads considerably without inhibiting crop productivity. The condition of terraces in the catchment has a strong impact on soil erosion and phosphorus releases from agricultural areas. Hence, if economically feasible, programmes focusing on the construction and maintenance of terraces in the region should be implemented. Additionally, intercropping on corn fields as well as more efficient fertilization schemes for agricultural land were identified as potential instruments to reduce diffuse matter loads further. While the study was carried out in the Three Gorges Region, its findings may also beneficial for the reduction of water pollution in other mountainous areas with strong agricultural use.

  16. Evaluation of Land Use, Land Management and Soil Conservation Strategies to Reduce Non-Point Source Pollution Loads in the Three Gorges Region, China

    NASA Astrophysics Data System (ADS)

    Strehmel, Alexander; Schmalz, Britta; Fohrer, Nicola

    2016-11-01

    The construction of the Three Gorges Dam in China and the subsequent impoundment of the Yangtze River have induced a major land use change in the Three Gorges Reservoir Region, which fosters increased inputs of sediment and nutrients from diffuse sources into the water bodies. Several government programs have been implemented to mitigate high sediment and nutrient loads to the reservoir. However, institutional weaknesses and a focus on economic development have so far widely counteracted the effectiveness of these programs. In this study, the eco-hydrological model soil and water assessment tool is used to assess the effects of changes in fertilizer amounts and the conditions of bench terraces in the Xiangxi catchment in the Three Gorges Reservoir Region on diffuse matter releases. With this, the study aims at identifying efficient management measures, which should have priority. The results show that a reduction of fertilizer amounts cannot reduce phosphorus loads considerably without inhibiting crop productivity. The condition of terraces in the catchment has a strong impact on soil erosion and phosphorus releases from agricultural areas. Hence, if economically feasible, programmes focusing on the construction and maintenance of terraces in the region should be implemented. Additionally, intercropping on corn fields as well as more efficient fertilization schemes for agricultural land were identified as potential instruments to reduce diffuse matter loads further. While the study was carried out in the Three Gorges Region, its findings may also beneficial for the reduction of water pollution in other mountainous areas with strong agricultural use.

  17. Managing the interactions between sulfate- and perchlorate-reducing bacteria when using hydrogen-fed biofilms to treat a groundwater with a high perchlorate concentration.

    PubMed

    Ontiveros-Valencia, Aura; Tang, Youneng; Krajmalnik-Brown, Rosa; Rittmann, Bruce E

    2014-05-15

    A groundwater containing an unusually high concentration (∼4000 μg/L) of perchlorate (ClO4(-)) and significant (∼60 mg/L) sulfate (SO4(2-)) was treated with hydrogen (H2)-fed biofilms. The objective was to manage the interactions between sulfate-reducing bacteria (SRB) and perchlorate-reducing bacteria (PRB) by controlling the H2-delivery capacity to achieve ClO4(-) reduction to below the detection limit (4 μg/L). Complete ClO4(-) reduction with minimized SO4(2-) reduction was achieved by using two membrane biofilm reactors (MBfRs) in series. The lead MBfR removed >96% ClO4(-), and the lag MBfR further reduced ClO4(-) to below the detection limit. SO4(2-) reduction ranged from 10 to 60%, and lower SO4(2-) reduction corresponded to lower H2 availability (i.e., lower H2 pressure or membranes with lower H2-delivery capacity). Minimizing SO4(2-) reduction improved ClO4(-) removal by increasing the fraction of PRB in the biofilm. High SO4(2-) flux correlated with enrichment of Desulfovibrionales, autotrophic SRB that can compete strongly with denitrifying bacteria (DB) and PRB. Increased SO4(2-) reduction also led to enrichment of: 1) Ignavibacteriales and Thiobacteriales, sulfide-oxidizing bacteria that allow sulfur cycling in the biofilm; 2) Bacteroidales, heterotrophic microorganisms likely using organic sources of carbon (e.g., acetate); and 3) Spirochaetales, which potentially utilize soluble microbial products (SMPs) from autotrophic SRB to produce acetate.

  18. Bayesian evaluation of budgets for endemic disease control: An example using management changes to reduce milk somatic cell count early in the first lactation of Irish dairy cows.

    PubMed

    Archer, S C; Mc Coy, F; Wapenaar, W; Green, M J

    2014-01-01

    The aim of this research was to determine budgets for specific management interventions to control heifer mastitis in Irish dairy herds as an example of evidence synthesis and 1-step Bayesian micro-simulation in a veterinary context. Budgets were determined for different decision makers based on their willingness to pay. Reducing the prevalence of heifers with a high milk somatic cell count (SCC) early in the first lactation could be achieved through herd level management interventions for pre- and peri-partum heifers, however the cost effectiveness of these interventions is unknown. A synthesis of multiple sources of evidence, accounting for variability and uncertainty in the available data is invaluable to inform decision makers around likely economic outcomes of investing in disease control measures. One analytical approach to this is Bayesian micro-simulation, where the trajectory of different individuals undergoing specific interventions is simulated. The classic micro-simulation framework was extended to encompass synthesis of evidence from 2 separate statistical models and previous research, with the outcome for an individual cow or herd assessed in terms of changes in lifetime milk yield, disposal risk, and likely financial returns conditional on the interventions being simultaneously applied. The 3 interventions tested were storage of bedding inside, decreasing transition yard stocking density, and spreading of bedding evenly in the calving area. Budgets for the interventions were determined based on the minimum expected return on investment, and the probability of the desired outcome. Budgets for interventions to control heifer mastitis were highly dependent on the decision maker's willingness to pay, and hence minimum expected return on investment. Understanding the requirements of decision makers and their rational spending limits would be useful for the development of specific interventions for particular farms to control heifer mastitis, and other

  19. Implementation of ‘matrix support’ (collaborative care) to reduce asthma and COPD referrals and improve primary care management in Brazil: a pilot observational study

    PubMed Central

    Martins, Sonia Maria; Salibe-Filho, William; Tonioli, Luís Paulo; Pfingesten, Luís Eduardo; Braz, Patrícia Dias; McDonnell, Juliet; Williams, Siân; do Carmo, Débora; de Sousa, Jaime Correia; Pinnock, Hilary; Stelmach, Rafael

    2016-01-01

    Asthma and chronic obstructive pulmonary disease (COPD) are leading causes of hospitalisation and death in the city of Sao Bernardo do Campo. The municipality had difficulties in sustaining a pulmonology specialist team. Local policy has strengthened the knowledge of the primary care teams to improve the management of these diseases. Our aim is to pilot the implementation of an educational intervention based on collaborative care focused on reducing respiratory-related referrals. We implemented ‘matrix support’: a Brazilian collaborative educational intervention promoting specialist training and support for primary care physicians in three health territories with the highest number of referrals. Clinicians and nurses from primary care attended an 8-h workshop. The backlog of respiratory referrals was prioritised, where Asthma and COPD represented 70% of referral reasons. Initially, pulmonologists held joint consultations with physicians and nurses; as confidence grew, these were replaced by round-table note-based case discussions. The primary outcome was the number of asthma and COPD referrals. Almost all primary healthcare professionals in the three areas (132 of 157–87%) were trained; 360 patients were discussed, including 220 joint consultations. The number of respiratory referrals dropped from 290 (the year before matrix support) to 134 (the year after) (P<0.05). Referrals for asthma/COPD decreased from 13.4 to 5.4 cases per month (P=0.09) and for other lung diseases from 10.8 to 5.3 cases per month (P<0.05). Knowledge scores showed a significant improvement (P<0.001). Matrix-support collaborative care was well-accepted by primary care professionals associated with improved knowledge and reduced respiratory referrals. The initiative attracted specialists to the region overcoming historical recruitment problems. PMID:27536853

  20. Exploring the Effectiveness of an Internet-Based Program for Reducing Caregiver Distress Using the iCare Stress Management e-Training Program

    PubMed Central

    Kajiyama, Bruno; Thompson, Larry W.; Eto-Iwase, Tamiko; Yamashita, Mio; Di Mario, John; Tzuang, Yuan Marian; Gallagher-Thompson, Dolores

    2013-01-01

    OBJECTIVE Determine if the online iCare Stress Management e-Training Program reduces stress, bother depression and poor life quality for dementia family caregivers (CGs). METHOD CGs (N=150) were randomly assigned to the iCare Condition (ICC) or to the Education/Information-Only Condition (EOC) for a 3-month periodChange in self-report measures of stress (PSS) (primary outcome), caregiver bother(RMBPC), depression (CES-D) and quality of life (PQOL) (secondary outcomes) was determined, along with usage of new information in one’s own caregiving. RESULTS A mixed ANOVA revealed that change in perceived stress was significant for the ICC but not the EOC (p = .017). Changes in the other measures were not significant. More caregivers in the ICC used the materials in their own caregiving situation than those in the EOC. Roughly one-third of the caregivers enrolled in the study dropped prior to completion. CONCLUSION Results are promising, but the high dropout is a concern. Future efforts to improve dropout rate and increase participant engagement are warranted. To our knowledge this is the first attempt to present an evidence-based intervention for CGs via the Internet. PMID:23461355

  1. Implementation of Home based management of malaria in children reduces the work load for peripheral health facilities in a rural district of Burkina Faso

    PubMed Central

    Tiono, Alfred B; Kaboré, Youssouf; Traoré, Abdoulaye; Convelbo, Nathalie; Pagnoni, Franco; Sirima, Sodiomon B

    2008-01-01

    Background Home Management of Malaria (HMM) is one of the key strategies to reduce the burden of malaria for vulnerable population in endemic countries. It is based on the evidence that well-trained communities health workers can provide prompt and adequate care to patients close to their homes. The strategy has been shown to reduce malaria mortality and severe morbidity and has been adopted by the World Health Organization as a cornerstone of malaria control in Africa. However, the potential fall-out of this community-based strategy on the work burden at the peripheral health facilities level has never been investigated. Methods A two-arm interventional study was conducted in a rural health district of Burkina Faso. The HMM strategy has been implemented in seven community clinics catchment's area (intervention arm). For the other seven community clinics in the control arm, no HMM intervention was implemented. In each of the study arms, presumptive treatment was provided for episodes of fevers/malaria (defined operationally as malaria). The study drug was artemether-lumefantrine, which was sold at a subsidized price by community health workers/Key opinion leaders at the community level and by the pharmacists at the health facility level. The outcome measured was the proportion of malaria cases among all health facility attendance (all causes diseases) in both arms throughout the high transmission season. Results A total of 7,621 children were enrolled in the intervention arm and 7,605 in the control arm. During the study period, the proportions of malaria cases among all health facility attendance (all causes diseases) were 21.0%, (445/2,111, 95% CI [19.3%–22.7%]) and 70.7% (2,595/3,671, 95% CI 68.5%–71.5%), respectively in the intervention and control arms (p << 0.0001). The relative risk ratio for a fever/malaria episode to be treated at the HF level was 30% (0.30 < RR < 0.32). The number of malaria episodes treated in the intervention arm was much higher

  2. Feasibility of Adapting Multisystemic Therapy to Improve Illness Management Behaviors and Reduce Asthma Morbidity in High Risk African American Youth: A Case Series

    ERIC Educational Resources Information Center

    Naar-King, Sylvie; Ellis, Deborah; Kolmodin, Karen; Cunningham, Phillippe; Secord, Elizabeth

    2009-01-01

    African-American adolescents have the highest rates of asthma morbidity and mortality, yet there are few successful behavioral interventions to improve illness management for this group. Mental health providers have an opportunity to expand their services and impact by targeting adolescents with poor asthma management. We describe the adaptation…

  3. Towards a no-till no-spray future? Introduction to a symposium on nonchemical weed management for reduced-tillage cropping systems

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Reduced-tillage systems including no-tillage and strip tillage have well-known benefits for conserving and improving soils, protecting vulnerable crops from extreme weather events, and reducing labor and fuel costs associated with full-width inversion tillage. Despite these benefits, reduced-tillage...

  4. Sustainable Materials Management (SMM) Web Academy Webinar: How to Reduce Wasted Food: EPA’s Food Waste Reduction Tools for Food Services & Restaurants

    EPA Pesticide Factsheets

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

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

    EPA Pesticide Factsheets

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

  6. Can Chronic Disease Management Programs for Patients with Type 2 Diabetes Reduce Productivity-Related Indirect Costs of the Disease? Evidence from a Randomized Controlled Trial

    PubMed Central

    Bolin, Jane N.; Ohsfeldt, Robert L.; Phillips, Charles D.; Zhao, Hongwei; Ory, Marcia G.; Forjuoh, Samuel N.

    2014-01-01

    Abstract The objective was to assess the impacts of diabetes self-management programs on productivity-related indirect costs of the disease. Using an employer's perspective, this study estimated the productivity losses associated with: (1) employee absence on the job, (2) diabetes-related disability, (3) employee presence on the job, and (4) early mortality. Data were obtained from electronic medical records and survey responses of 376 adults aged ≥18 years who were enrolled in a randomized controlled trial of type 2 diabetes self-management programs. All study participants had uncontrolled diabetes and were randomized into one of 4 study arms: personal digital assistant (PDA), chronic disease self-management program (CDSMP), combined PDA and CDSMP, and usual care (UC). The human-capital approach was used to estimate lost productivity resulting from 1, 2, 3, and 4 above, which are summed to obtain total productivity loss. Using robust regression, total productivity loss was modeled as a function of the diabetes self-management programs and other identified demographic and clinical characteristics. Compared to subjects in the UC arm, there were no statistically significant differences in productivity losses among persons undergoing any of the 3 diabetes management interventions. Males were associated with higher productivity losses (+$708/year; P<0.001) and persons with greater than high school education were associated with additional productivity losses (+$758/year; P<0.001). Persons with more than 1 comorbid condition were marginally associated with lower productivity losses (-$326/year; P=0.055). No evidence was found that the chronic disease management programs examined in this trial affect indirect productivity losses. (Population Health Management 2014;17:112–120) PMID:24152055

  7. Can chronic disease management programs for patients with type 2 diabetes reduce productivity-related indirect costs of the disease? Evidence from a randomized controlled trial.

    PubMed

    Adepoju, Omolola E; Bolin, Jane N; Ohsfeldt, Robert L; Phillips, Charles D; Zhao, Hongwei; Ory, Marcia G; Forjuoh, Samuel N

    2014-04-01

    The objective was to assess the impacts of diabetes self-management programs on productivity-related indirect costs of the disease. Using an employer's perspective, this study estimated the productivity losses associated with: (1) employee absence on the job, (2) diabetes-related disability, (3) employee presence on the job, and (4) early mortality. Data were obtained from electronic medical records and survey responses of 376 adults aged ≥18 years who were enrolled in a randomized controlled trial of type 2 diabetes self-management programs. All study participants had uncontrolled diabetes and were randomized into one of 4 study arms: personal digital assistant (PDA), chronic disease self-management program (CDSMP), combined PDA and CDSMP, and usual care (UC). The human-capital approach was used to estimate lost productivity resulting from 1, 2, 3, and 4 above, which are summed to obtain total productivity loss. Using robust regression, total productivity loss was modeled as a function of the diabetes self-management programs and other identified demographic and clinical characteristics. Compared to subjects in the UC arm, there were no statistically significant differences in productivity losses among persons undergoing any of the 3 diabetes management interventions. Males were associated with higher productivity losses (+$708/year; P<0.001) and persons with greater than high school education were associated with additional productivity losses (+$758/year; P<0.001). Persons with more than 1 comorbid condition were marginally associated with lower productivity losses (-$326/year; P=0.055). No evidence was found that the chronic disease management programs examined in this trial affect indirect productivity losses.

  8. Managing for resilience

    EPA Science Inventory

    Early efforts in wildlife management focused on reducing population variability and maximizing yields of select species. Aldo Leopold proposed the concept of habitat management as superior to population management. More recently, ecosystem management, whereby ecological processes...

  9. EPA Proposes Rules to Improve Hazardous Waste Management and Better Protect our Waterways / New Rules Also Reduce Regulatory Burden on Businesses

    EPA Pesticide Factsheets

    WASHINGTON -- The U.S. Environmental Protection Agency (EPA) is proposing two new hazardous waste rules to strengthen environmental protection while reducing regulatory burden on businesses. One of the proposed rules will protect waterways, includin

  10. Evaluating the "Healthy Diabetes" Caribbean Food Plate and Website Portal for Diabetes Prevention and Management: Results of an Online Study and Implications for Reducing Health Disparities

    ERIC Educational Resources Information Center

    Thomas, Nigel M.

    2013-01-01

    Given the challenge of cooking traditional Caribbean meals so they are consistent with the goals of diabetes prevention and management, the researcher created and evaluated a new website portal as e-health tailored to be culturally appropriate and teach the following: how to cook and prepare "Healthy Diabetes" Caribbean Plates. A social…

  11. Sensitivity of disease management decision aids to temperature input errors associated with out-of-canopy and reduced time-resolution measurements

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Plant disease management decision aids typically require inputs of weather elements such as air temperature. Whereas many disease models are created based on weather elements at the crop canopy, and with relatively fine time resolution, the decision aids commonly are implemented with hourly weather...

  12. Experience with an extended-release opioid formulation designed to reduce abuse liability in a community-based pain management clinic

    PubMed Central

    Rubino, Daniel

    2011-01-01

    Context With the growing public health concern over rising rates of opioid abuse, physicians have a responsibility to incorporate safeguards into their practice to minimize the potential for opioid misuse, abuse, and diversion. Patient-specific treatment regimens should include steps to monitor treatment success with regard to optimal pain management as well as inappropriate use of opioids and other substances. Opioid formulations designed to be less attractive for abuse are also being developed. While future studies are needed to determine the impact of such formulations in addressing the issue of opioid misuse in the community as a whole, the experience of practitioners who have utilized these formulations can highlight the practical steps to incorporate such formulations into the everyday patient-care setting. Purpose The purpose of this report is to describe experience in managing patients with chronic, moderate-to-severe pain using morphine sulfate and naltrexone hydrochloride extended release capsules (MS-sNT) (EMBEDA®, King Pharmaceuticals® Inc, Bristol, TN, which was acquired by Pfizer Inc, New York, NY, in March 2011), a formulation designed with features to deter abuse/misuse, in a community-based pain management clinic. Case presentations Case reports demonstrating a clinical management plan for assessment, initial interview procedures, explanation/discussion of proposed therapies, patients’ treatment goals, conversion to MS-sNT, and titration and treatment outcomes are provided. Results The management approach yielded successful outcomes including pain relief, improved quality of life, treatment satisfaction, and patient acceptance of a formulation designed to deter abuse/misuse. Discussion The cases presented demonstrate that the communication accompanying complete pretreatment assessment, goal-setting and expectations, and attention to individual patient needs can enable optimization of pain-related outcomes, resulting in improved quality of life

  13. Changes in Soil Moisture, Microbial Biomass, Mineralization and Nitrification Explain Increases in N2O Emissions from a Spring Barley Crop Under Combined Reduced Tillage and Cover Crop Management

    NASA Astrophysics Data System (ADS)

    Rueangritsarakul, K.; Jones, M.; Roth, B.; Abdalla, M.; Williams, M.

    2012-04-01

    This study investigated the effect of conventional tillage (CT), combined reduced tillage-cover crop (RT-CC), and reduced N application on crop yield and N2O emissions from spring barley. Reduced tillage plots were established for seven years, the final four incorporating a mustard cover crop. Higher N2O fluxes were from fertilized, RT-CC plots due to higher WFPS, soil nitrate, and soil carbon. Fluxes during the non-growing season were variable and the main source of cumulative emissions. Emission factors were in the range of IPCC default values. Low N fertilization reduced cumulative emissions, however during the wetter growing season this reduction was smaller than the reduction in barley production particular in the conventional tillage plots. Adopting RT-CC management for cereal crops may be problematic in reducing GHG emissions due to high N2O fluxes. Reducing N fertilizer in order to reduce N2O emissions is not feasible due to high inter-annual variation in crop yield. N2O flux in all plots was positively correlated with microbial biomass carbon, net nitrification and mineralization determined in the field. Increased emissions of N2O in the RT-CC plots are accounted for by increases in organic carbon in the soil and increases in mineralization.

  14. Adaptive management

    USGS Publications Warehouse

    Allen, Craig R.; Garmestani, Ahjond S.

    2015-01-01

    Adaptive management is an approach to natural resource management that emphasizes learning through management where knowledge is incomplete, and when, despite inherent uncertainty, managers and policymakers must act. Unlike a traditional trial and error approach, adaptive management has explicit structure, including a 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. The process is iterative, and serves to reduce uncertainty, build knowledge and improve management over time in a goal-oriented and structured process.

  15. Please Reduce Cycle Time

    DTIC Science & Technology

    2014-12-01

    Defense AT&L: November–December 2014 4 Please Reduce Cycle Time Brian Schultz “Time is what we want most but what we use worst.” — William Penn ...Schultz is a professor of program management at the Defense Acquisition University’s Mid-Atlantic Region in California, Md. As William Penn noted

  16. Managing Multiple Mandates: A System of Systems Model to Analyze Strategies for Producing Cellulosic Ethanol and Reducing Riverine Nitrate Loads in the Upper Mississippi River Basin.

    PubMed

    Housh, Mashor; Yaeger, Mary A; Cai, Ximing; McIsaac, Gregory F; Khanna, Madhu; Sivapalan, Murugesu; Ouyang, Yanfeng; Al-Qadi, Imad; Jain, Atul K

    2015-10-06

    Implementing public policies often involves navigating an array of choices that have economic and environmental consequences that are difficult to quantify due to the complexity of multiple system interactions. Implementing the mandate for cellulosic biofuel production in the Renewable Fuel Standard (RFS) and reducing hypoxia in the northern Gulf of Mexico by reducing riverine nitrate-N loads represent two such cases that overlap in the Mississippi River Basin. To quantify the consequences of these interactions, a system of systems (SoS) model was developed that incorporates interdependencies among the various subsystems, including biofuel refineries, transportation, agriculture, water resources and crop/ethanol markets. The model allows examination of the impact of imposing riverine nitrate-N load limits on the biofuel production system as a whole, including land use change and infrastructure needs. The synergies of crop choice (first versus second generation biofuel crops), infrastructure development, and environmental impacts (streamflow and nitrate-N load) were analyzed to determine the complementarities and trade-offs between environmental protection and biofuel development objectives. For example, the results show that meeting the cellulosic biofuel target in the RFS using Miscanthus x giganteus reduces system profits by 8% and reduces nitrate-N loads by 12% compared to the scenario without a mandate. However, greater water consumption by Miscanthus is likely to reduce streamflow with potentially adverse environmental consequences that need to be considered in future decision making.

  17. Double-crested cormorant studies at Little Galloo Island, Lake Ontario in 2008: Diet composition, fish consumption and the efficacy of management activities in reducing fish predation

    USGS Publications Warehouse

    Johnson, James H.; McCullough, Russell D.; Farquhar, James F.

    2008-01-01

    The year 2008 marked the seventeenth consecutive year of study of the food habits and fish consumption of LGI cormorants, and represented the tenth consecutive year evaluating the efficacy of management activities to control the reproductive success of cormorants nesting at LGI. The program consists mainly of spraying cormorant eggs with oil as well as the culling of adult and immature birds.This paper reports the findings of work carried outin 2008 at LGI.

  18. Risk Management.

    ERIC Educational Resources Information Center

    Randal, L. Nathan

    This chapter of "Principles of School Business Management" presents an overview of risk management for school districts. The chapter first discusses four fundamental elements of risk management: (1) identifying and measuring risks; (2) reducing or eliminating risks; (3) transferring unassumable risks; and (4) assuming remaining risks.…

  19. A Comparison of Computer-Assisted and Self-Management Programs for Reducing Alcohol Use among Students in First Year Experience Courses

    ERIC Educational Resources Information Center

    Lane, David J.; Lindemann, Dana F.; Schmidt, James A.

    2012-01-01

    The National Institute of Alcohol Abuse and Alcoholism has called for the use of evidence-based approaches to address high-risk drinking prevalent on many college campuses. In line with this recommendation, the present study evaluated the efficacy of two evidence-based approaches to reducing alcohol use. One hundred and three college students in…

  20. The Project Manager’s Lieutenant for Logistics: A Study of the Chief Logistician’s Key Roles in Reducing Operations & Support Costs During Developmental Programs

    DTIC Science & Technology

    2002-03-01

    failure of an item which would result in a system failure, and is not compensated for by redundancy or alternative operational procedures. • Design...CPT David A. Searle USAF, Dr. Caisse Vickery, “ The Impact of the Packard Commission’s Recommendations on Reducing Cost Overruns on Defense

  1. 4 Rs are not enough: We need 7 Rs for nutrient management and conservation to increase nutrient use efficiency and reduce off-site transport of nutrients

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Cox (2010) reported that under business as usual, the environmental impacts of nutrient losses from agriculture will not be resolved and that precision conservation and precision regulation are two mechanisms to reduce the environmental impacts of nutrient losses. This is in agreement with the rece...

  2. Feasible Management of Southern Corn Leaf Blight via Induction of Systemic Resistance by Bacillus cereus C1L in Combination with Reduced Use of Dithiocarbamate Fungicides

    PubMed Central

    Lai, Yi-Ru; Lin, Pei-Yu; Chen, Chao-Ying; Huang, Chien-Jui

    2016-01-01

    Dithiocarbamate fungicides such as maneb and mancozeb are widely used nonsystemic protectant fungicides to control various plant fungal diseases. Dithiocarbamate fungicides should be frequently applied to achieve optimal efficacy of disease control and avoid either decline in effectiveness or wash-off from leaf surface. Dithiocarbamates are of low resistance risk but have the potential to cause human neurological diseases. The objective of this study was to develop a strategy to effectively control plant disease with reduced use of dithiocarbamtes. Southern corn leaf blight was the model pathosystem for the investigation. When corn plants were drench-treated with Bacillus cereus C1L, a rhizobacterium able to induce systemic resistance in corn plants against southern leaf blight, frequency of spraying dithiocarbamate fungicides could be decreased. The treatment of B. cereus C1L was able to protect maize from southern leaf blight while residues of dithiocarbamates on leaf surface were too low to provide sufficient protection. On the other hand, frequent sprays of mancozeb slightly but significantly reduced growth of corn plants under natural conditions. In contrast, application of B. cereus C1L can significantly promote growth of corn plants whether sprayed with mancozeb or not. Our results provide the information that plant disease can be well controlled by rhizobacteria-mediated induced systemic resistance in combination with reduced but appropriate application of dithiocarbamate fungicides just before a heavy infection period. An appropriate use of rhizobacteria can enhance plant growth and help plants overcome negative effects caused by dithiocarbamates. PMID:27721698

  3. Feasible Management of Southern Corn Leaf Blight via Induction of Systemic Resistance by Bacillus cereus C1L in Combination with Reduced Use of Dithiocarbamate Fungicides.

    PubMed

    Lai, Yi-Ru; Lin, Pei-Yu; Chen, Chao-Ying; Huang, Chien-Jui

    2016-10-01

    Dithiocarbamate fungicides such as maneb and mancozeb are widely used nonsystemic protectant fungicides to control various plant fungal diseases. Dithiocarbamate fungicides should be frequently applied to achieve optimal efficacy of disease control and avoid either decline in effectiveness or wash-off from leaf surface. Dithiocarbamates are of low resistance risk but have the potential to cause human neurological diseases. The objective of this study was to develop a strategy to effectively control plant disease with reduced use of dithiocarbamtes. Southern corn leaf blight was the model pathosystem for the investigation. When corn plants were drench-treated with Bacillus cereus C1L, a rhizobacterium able to induce systemic resistance in corn plants against southern leaf blight, frequency of spraying dithiocarbamate fungicides could be decreased. The treatment of B. cereus C1L was able to protect maize from southern leaf blight while residues of dithiocarbamates on leaf surface were too low to provide sufficient protection. On the other hand, frequent sprays of mancozeb slightly but significantly reduced growth of corn plants under natural conditions. In contrast, application of B. cereus C1L can significantly promote growth of corn plants whether sprayed with mancozeb or not. Our results provide the information that plant disease can be well controlled by rhizobacteria-mediated induced systemic resistance in combination with reduced but appropriate application of dithiocarbamate fungicides just before a heavy infection period. An appropriate use of rhizobacteria can enhance plant growth and help plants overcome negative effects caused by dithiocarbamates.

  4. New procedure to reduce the time and cost of broncho-pulmonary specimen management using the Previ Isola® automated inoculation system.

    PubMed

    Nebbad-Lechani, Biba; Emirian, Aurélie; Maillebuau, Fabienne; Mahjoub, Nadia; Fihman, Vincent; Legrand, Patrick; Decousser, Jean-Winoc

    2013-12-01

    The microbiological diagnosis of respiratory tract infections requires serial manual dilutions of the clinical specimen before agar plate inoculation, disrupting the workflow in bacteriology clinical laboratories. Automated plating instrument systems have been designed to increase the speed, reproducibility and safety of this inoculating step; nevertheless, data concerning respiratory specimens are lacking. We tested a specific procedure that uses the Previ Isola® (bioMérieux, Craponne, France) to inoculate with broncho-pulmonary specimens (BPS). A total of 350 BPS from a university-affiliated hospital were managed in parallel using the manual reference and the automated methods (expectoration: 75; broncho-alveolar lavage: 68; tracheal aspiration: 17; protected distal sample: 190). A specific enumeration reading grid, a pre-liquefaction step and a fluidity test, performed before the inoculation, were designed for the automated method. The qualitative (i.e., the number of specimens yielding a bacterial count greater than the clinical threshold) and quantitative (i.e., the discrepancy within a 0.5 log value) concordances were 100% and 98.2%, respectively. The slimmest subgroup of expectorations could not be managed by the automated method (8%, 6/75). The technical time and cost savings (i.e., number of consumed plates) reached 50%. Additional studies are required for specific populations, such as cystic fibrosis specimens and associated bacterial variants. An automated decapper should be implemented to increase the biosafety of the process. The PREVI Isola® adapted procedure is a time- and cost-saving method for broncho-pulmonary specimen processing.

  5. Process benchmarking appraisal of surgical decompression of spinal cord following traumatic cervical spinal cord injury: opportunities to reduce delays in surgical management.

    PubMed

    Furlan, Julio C; Tung, Kayee; Fehlings, Michael G

    2013-03-15

    Prior pre-clinical and clinical studies indicate that early decompression of the spinal cord (≤ 24 h post-trauma) may have benefits regarding clinical outcomes and neurological recovery after spinal cord injury (SCI). This study examines the benchmarking of management of patients with acute traumatic cervical SCI in order to determine the potential barriers and ideal timelines for each step to early surgical decompression. We reviewed patient charts and the Surgical Trial in Acute Spinal Cord Injury Study (STASCIS) forms regarding the time and reasons for delay of each step in the management of patients with SCI. The reasons for delays were classified into: 1) health care-related ("extrinsic") factors and 2) patient-related ("intrinsic") factors. The cases were grouped into patients who underwent early surgical decompression of spinal cord (early-surgery group) and individuals who underwent later decompression (later-surgery group). Whereas both groups showed comparable time periods related to intrinsic factors, patients in the early surgery group had a significantly shorter time period associated with extrinsic factors when compared with the later surgery group. Both groups were comparable regarding pre-hospital time, time in a second general hospital prior to transfer to a spine center, and time in the trauma emergency department. Patients in the early surgery group had a significantly shorter waiting time, shorter waiting time for assessment by a spine surgeon, and a shorter waiting time for a surgical decision than did the later surgery group. Our benchmarking analysis suggests that health-related factors are key determinants of the timing from SCI to spinal cord decompression. Time in the general hospital and time of waiting for a surgical decision were the most important causes of delay of surgical spinal cord decompression. Early surgery is possible in the vast majority of the cases.

  6. IMPROVING ENERGY EFFICIENCY AND REDUCING COSTS IN THE DRINKING WATER SUPPLY INDUSTRY: An ENERGY STAR Resource Guide for Energy and Plant Managers

    SciTech Connect

    Melody, Moya; Dunham Whitehead, Camilla; Brown, Richard

    2010-09-30

    As American drinking water agencies face higher production costs, demand, and energy prices, they seek opportunities to reduce costs without negatively affecting the quality of the water they deliver. This guide describes resources for cost-effectively improving the energy efficiency of U.S. public drinking water facilities. The guide (1) describes areas of opportunity for improving energy efficiency in drinking water facilities; (2) provides detailed descriptions of resources to consult for each area of opportunity; (3) offers supplementary suggestions and information for the area; and (4) presents illustrative case studies, including analysis of cost-effectiveness.

  7. Relation of people-centered public health and person-centered healthcare management: a case study to reduce burn-out

    PubMed Central

    Stoyanov, Drozdstoj S.; Cloninger, C. Robert

    2013-01-01

    Healthcare management is one practical tool for mediation and implementation of public health into clinical healthcare outcomes and is taken in our case study as an exemplar arena to demonstrate the vital importance of the person-centered approach. Healthcare personnel are frequently at risk for the ‘burn-out’ syndrome. However, modern measures of burn-out recognize burn-out only at a late stage when it is fully developed. There are no available methods to assess the risk for vulnerability to burnout in healthcare systems. Our aim was therefore to design a complex person-centered model for detection of high risk for burn-out at an early stage, that has been termed ‘flame-out’. We accept the observation that decreased personal performance is one crucial expression of burn-out. Low personal performance and negative emotions are strongly related to low self-directedness as measured by the Temperament and Character Inventory (TCI). At the same time, burn-out is characterized by decreased interest and positive emotions from work. Decreased positive emotion is directly related to low self-transcendence as measured by the TCI. Burn-out is also frequently associated with feelings of social alienation or inadequacy of support, which is in turn related to low TCI Cooperativeness. However, high Persistence and Harm Avoidance are predisposing traits for burn-out in healthcare professionals who are often overly perfectionistic and compulsive, predisposing them to anxiety, depression, suicide and burn-out. Hence, people at risk for future burn-out are often highly conscientious over-achievers with intense mixtures of positive and negative emotions. The high demand for perfection comes from both intrinsic characteristics and from features of the social milieu in their psychological climate. Letting go of the unfulfillable desire to be perfect by increasing self-transcendence allows acceptance of the imperfection of the human condition, thereby preventing burn-out and

  8. ISS Update: Reduced Gravity Education

    NASA Video Gallery

    NASA Public Affairs Officer Dan Huot interviews Veronica Seyl, Acting Manager for Reduced Gravity Education. NASA works with students and educators to design experiments for flight testing aboard t...

  9. Efforts to Reduce International Space Station Crew Maintenance Time in the Management of the Extravehicular Mobility Unit Transport Loop Water Quality

    NASA Technical Reports Server (NTRS)

    Etter,David; Rector, Tony; Boyle, robert; Zande, Chris Vande

    2012-01-01

    The EMU (Extravehicular Mobility Unit) contains a semi-closed-loop re-circulating water circuit (Transport Loop) to absorb heat into a LCVG (Liquid Coolant and Ventilation Garment) worn by the astronaut. A second, single-pass water circuit (Feed-water Loop) provides water to a cooling device (Sublimator) containing porous plates, and that water sublimates through the porous plates to space vacuum. The cooling effect from the sublimation of this water translates to a cooling of the LCVG water that circulates through the Sublimator. The quality of the EMU Transport Loop water is maintained through the use of a water processing kit (ALCLR - Airlock Cooling Loop Remediation) that is used to periodically clean and disinfect the water circuit. Opportunities to reduce crew time associated with ALCLR operations include a detailed review of the historical water quality data for evidence to support an extension to the implementation cycle. Furthermore, an EMU returned after 2-years of use on the ISS (International Space Station) is being used as a test bed to evaluate the results of extended and repeated ALCLR implementation cycles. Finally, design, use and on-orbit location enhancements to the ALCLR kit components are being considered to allow the implementation cycle to occur in parallel with other EMU maintenance and check-out activities, and to extend the life of the ALCLR kit components. These efforts are undertaken to reduce the crew-time and logistics burdens for the EMU, while ensuring the long-term health of the EMU water circuits for a post- Shuttle 6-year service life.

  10. Can mercury in fish be reduced by water level management? Evaluating the effects of water level fluctuation on mercury accumulation in yellow perch (Perca flavescens).

    PubMed

    Larson, James H; Maki, Ryan P; Knights, Brent C; Gray, Brian R

    2014-10-01

    Mercury (Hg) contamination of fisheries is a major concern for resource managers of many temperate lakes. Anthropogenic Hg contamination is largely derived from atmospheric deposition within a lake's watershed, but its incorporation into the food web is facilitated by bacterial activity in sediments. Temporal variation in Hg content of fish (young-of-year yellow perch) in the regulated lakes of the Rainy-Namakan complex (on the border of the United States and Canada) has been linked to water level (WL) fluctuations, presumably through variation in sediment inundation. As a result, Hg contamination of fish has been linked to international regulations of WL fluctuation. Here we assess the relationship between WL fluctuations and fish Hg content using a 10-year dataset covering six lakes. Within-year WL rise did not appear in strongly supported models of fish Hg, but year-to-year variation in maximum water levels (∆maxWL) was positively associated with fish Hg content. This WL effect varied in magnitude among lakes: In Crane Lake, a 1 m increase in ∆maxWL from the previous year was associated with a 108 ng increase in fish Hg content (per gram wet weight), while the same WL change in Kabetogama was associated with only a 5 ng increase in fish Hg content. In half the lakes sampled here, effect sizes could not be distinguished from zero. Given the persistent and wide-ranging extent of Hg contamination and the large number of regulated waterways, future research is needed to identify the conditions in which WL fluctuations influence fish Hg content.

  11. Can mercury in fish be reduced by water level management? Evaluating the effects of water level fluctuation on mercury accumulation in yellow perch (Perca flavescens)

    USGS Publications Warehouse

    Larson, James H.; Maki, Ryan P.; Knights, Brent C.; Gray, Brian R.

    2014-01-01

    Mercury (Hg) contamination of fisheries is a major concern for resource managers of many temperate lakes. Anthropogenic Hg contamination is largely derived from atmospheric deposition within a lake’s watershed, but its incorporation into the food web is facilitated by bacterial activity in sediments. Temporal variation in Hg content of fish (young-of-year yellow perch) in the regulated lakes of the Rainy–Namakan complex (on the border of the United States and Canada) has been linked to water level (WL) fluctuations, presumably through variation in sediment inundation. As a result, Hg contamination of fish has been linked to international regulations of WL fluctuation. Here we assess the relationship between WL fluctuations and fish Hg content using a 10-year dataset covering six lakes. Within-year WL rise did not appear in strongly supported models of fish Hg, but year-to-year variation in maximum water levels (∆maxWL) was positively associated with fish Hg content. This WL effect varied in magnitude among lakes: In Crane Lake, a 1 m increase in ∆maxWL from the previous year was associated with a 108 ng increase in fish Hg content (per gram wet weight), while the same WL change in Kabetogama was associated with only a 5 ng increase in fish Hg content. In half the lakes sampled here, effect sizes could not be distinguished from zero. Given the persistent and wide-ranging extent of Hg contamination and the large number of regulated waterways, future research is needed to identify the conditions in which WL fluctuations influence fish Hg content.

  12. Usefulness of statin-ezetimibe combination to reduce the care gap in dyslipidemia management in patients with a high risk of atherosclerotic disease.

    PubMed

    Teoh, Hwee; Mendelsohn, Aurora A; Goodman, Shaun G; Jaffer, Shahin; Chen, Richard Y Y; Tjia, Sabine; Theriault, Lyne; Langer, Anatoly; Leiter, Lawrence A

    2009-09-15

    Lowering of low-density lipoprotein (LDL) cholesterol is a fundamental step in the comprehensive management of patients at high risk for cardiovascular events. The combination of a statin with ezetimibe usually provides additional LDL cholesterol lowering compared to statin monotherapy. This open-label observational study evaluated the impact of a 26-week treatment program with uptitration of statin dosages and incorporation of ezetimibe 10 mg therapy in 2,577 men and women (median age 64 years) with hypercholesterolemia and an LDL cholesterol level >2.5 mmol/L (97 mg/dl). Attainment of an LDL cholesterol target of 2.5 mmol/L (97 mg/dl) increased with consecutive visits (63%, 67%, and 71% at the second, third, and final visits, respectively). Current guideline-recommended LDL cholesterol value <2.0 mmol/L (77 mg/dl) was achieved by 36%, 40%, and 41% of the group at the same consecutive follow-up sessions. Median LDL cholesterol decreased from 3.0 mmol/L (116 mg/dl) at baseline to 2.1 mmol/L (81 mg/dl) at the end of the 26-week monitoring period. Favorable changes were concomitantly observed for median total cholesterol (5.1 to 4.1 mmol/L [197 to 159 mg/dl]), total cholesterol/high-density lipoprotein cholesterol ratio (4.2 to 3.3), and triglyceride (1.6 to 1.4 mmol/L [142 to 124 mg/dl]). Of those who attended visit 4, 48% exhibited LDL cholesterol lowering of > or =1 mmol/L (39 mg/dl) compared to baseline levels. In conclusion, an algorithm-based statin uptitration/ezetimibe combination regimen is useful to increase LDL cholesterol lowering where statin monotherapy has not achieved target lipid values.

  13. Double-crested Cormorant studies at Little Galloo Island, Lake Ontario in 2013: diet composition, fish consumption and the efficacy of management activities in reducing fish predation

    USGS Publications Warehouse

    Johnson, James H.; McCullough, Russell D.; Mazzocchi, Irene

    2014-01-01

    For almost two decades Little Galloo Island (LGI) has supported a large colony of Double-crested Cormorants (Phalacrocorax auritus) in the eastern basin of Lake Ontario. Cormorant nest counts on the island since the early 1990's have averaged 4,297 per year. However, less than 2,000 pairs have nested on the island in three of the past five years. The highest count was reached in 1996 with 8,410 nesting pairs on the island. Johnson et al. (2013) estimated that cormorants from LGI alone have consumed 504 million fish since 1992. The proliferation of cormorants in the eastern basin of Lake Ontario coincided with declines in two important recreational fish species, smallmouth bass (Micropterus dolemieu) and yellow perch (Perca falvescens). Lantry et al. (2002) and Burnett et al. (2002) provide convincing evidence linking cormorant population increases to declining eastern basin smallmouth bass and yellow perch stocks. Decline of these fish stocks was evident only in the eastern basin, suggesting a localized problem, which is consistent with the halo effect where large piscivorous waterbird colonies may deplete local fish stocks (Birt et al. 1987). The year 2013 marked the twenty second consecutive year of study of the food habits and fish consumption of LGI cormorants and the fifteenth consecutive year evaluating the efficacy of management activities to control the reproductive success of cormorants nesting at LGI. The program consists mainly of spraying cormorant eggs with food grade vegetable oil as well as the culling of adult and immature birds. This paper reports the findings of work carried out in 2013 at LGI.

  14. Construct a Management Architecture

    DTIC Science & Technology

    2008-10-23

    Task: Consider management architecture options that better align functional and budget responsibility consistent with comprehensive strategic ... planning . Scope the leadership hierarchy to the appropriate management responsibilities, reduce layers of management and move decision making closer to issue identification.

  15. Reducing the Use of Pesticides with Site-Specific Application: The Chemical Control of Rhizoctonia solani as a Case of Study for the Management of Soil-Borne Diseases

    PubMed Central

    Le Cointe, Ronan; Simon, Thomas E.; Delarue, Patrick; Hervé, Maxime; Leclerc, Melen; Poggi, Sylvain

    2016-01-01

    Reducing our reliance on pesticides is an essential step towards the sustainability of agricultural production. One approach involves the rational use of pesticides combined with innovative crop management. Most control strategies currently focus on the temporal aspect of epidemics, e.g. determining the optimal date for spraying, regardless of the spatial mechanics and ecology of disease spread. Designing innovative pest management strategies incorporating the spatial aspect of epidemics involves thorough knowledge on how disease control affects the life-history traits of the pathogen. In this study, using Rhizoctonia solani/Raphanus sativus as an example of a soil-borne pathosystem, we investigated the effects of a chemical control currently used by growers, Monceren® L, on key epidemiological components (saprotrophic spread and infectivity). We tested the potential “shield effect” of Monceren® L on pathogenic spread in a site-specific application context, i.e. the efficiency of this chemical to contain the spread of the fungus from an infected host when application is spatially localized, in our case, a strip placed between the infected host and a recipient bait. Our results showed that Monceren® L mainly inhibits the saprotrophic spread of the fungus in soil and may prevent the fungus from reaching its host plant. However, perhaps surprisingly we did not detect any significant effect of the fungicide on the pathogen infectivity. Finally, highly localized application of the fungicide—a narrow strip of soil (12.5 mm wide) sprayed with Monceren® L—significantly decreased local transmission of the pathogen, suggesting lowered risk of occurrence of invasive epidemics. Our results highlight that detailed knowledge on epidemiological processes could contribute to the design of innovative management strategies based on precision agriculture tools to improve the efficacy of disease control and reduce pesticide use. PMID:27668731

  16. Managing Restored Wetlands in the Sacramento-San Joaquin Delta to Reduce Methane Emissions and Increase Carbon Uptake Laurie Koteen, Sara Knox, Cove Sturtevant, Joseph Verfaillie, Jaclyn Hatala, Dennis Baldocchi

    NASA Astrophysics Data System (ADS)

    Koteen, L. E.; Knox, S. H.; Sturtevant, C. S.; Verfaillie, J. G.; Matthes, J. H.; Baldocchi, D. D.

    2013-12-01

    The Sacramento-San Joaquin Delta of California is a region transformed by more than a century of agricultural practices. Beginning in the 19th century, substantial regions were first drained of water and then converted to cropland in order to take advantage of the area's rich peatland soils. In the intervening time period, soil oxidation and subsidence have led to huge peat losses of up to 10 m in some places, and river water now threatens to topple the levees that were erected to keep fields from flooding. Within this region, we have been monitoring greenhouse gas exchange of several agricultural sites, a degraded pasture, and two restored wetlands. Of these land use types, restoration of wetlands is of particular interest to Delta managers as these sites attain many of the region's most pressing ecological goals, including improved water quality, increased wildlife habitat, and soil accretion. In our current investigation, we hope to assess if wetland management activities can be implemented to achieve greenhouse gas management goals as well. While we find that the restored wetlands are able to take up and store a substantial amount of carbon via rapid growth rates, they also emit methane; a greenhouse gas 25 times more potent than CO¬2. We are currently in the process of implementing two management activities with the goals of reducing methane emissions and increasing carbon uptake. Evidence from the wetland literature indicates that periodic lowering of the water table below the soil surface can reduce wetland methane emissions by: 1. Reintroducing oxygen into the soil column. This both supports growth of the methanotrophic bacteria that consume methane produced in the anaerobic zones of the soil column, and suppresses the methanogens that produce it. 2. Re-oxidization of formerly reduced compounds in the soil, (i.e. NO3-, SO42-) which can serve as alternative terminal electron acceptors of the decomposition byproducts (i.e. H2 and acetate) that lead to

  17. The current state of knowledge on the interaction of Escherichia coli within vegetative filter strips as a sustainable best management practice to reduce fecal pathogen loading into surface waters

    PubMed Central

    Olilo, Casianes Owino; Muia, Anastasia Wairimu; Moturi, Wilkister Nyaora; Onyando, Japhet Ogalo; Amber, Ford Roegner

    2016-01-01

    Agro-pastoral operations have the potential to threaten public health with loading of diverse pathogens into surface waters through overland flow; increasing awareness of the limitations of fecal indicators has led to development of a number of advancements in detection, source tracking and predictive modeling of public health risk. These tools and techniques are beginning to be integrated into management strategies. The objective of this review was to determine the status of current knowledge and challenges of the fate and transport of Escherichia coli in overland flow and their interaction within vegetative filter strip (VFS) as one of these implemented best management practices and to critically evaluate its use in that setting as an indicator organism. With few studies directly focusing on VFS removal of E. coli from overland flow, we critically evaluated the available data on movement of E. coil from fecal source loading to retention and decay or re-release for potential contamination of water ways and pointed out potential limitations in both pathogen-specific removal and its use as an indicator organisms within overland flow and VFS. Critical areas of focus for future studies to reduce gaps in knowledge were identified, and the integration of newer approaches in source tracking, alternative indicators and the use of non-pathogenic surrogates for field testing of existing VFS models was encouraged. With VFS as a growing field of interest as an economical conservation practice and as an avenue for conservation of resources for small-scale agro-pastoral operations, management strategies to reduce initial fecal load from either applied manure constituents or shedding from free-range animals will continue to test the limits in the applications of models to overland flow and VFS management strategies. Further studies at the microscale in understanding discrepancies between low and high pathogenicity strains of E. coil and between E. coil and other fecal pathogens

  18. Stepped-wedge cluster randomised controlled trial to assess the effectiveness of an electronic medication management system to reduce medication errors, adverse drug events and average length of stay at two paediatric hospitals: a study protocol

    PubMed Central

    Westbrook, J I; Li, L; Raban, M Z; Baysari, M T; Prgomet, M; Georgiou, A; Kim, T; Lake, R; McCullagh, C; Dalla-Pozza, L; Karnon, J; O'Brien, T A; Ambler, G; Day, R; Cowell, C T; Gazarian, M; Worthington, R; Lehmann, C U; White, L; Barbaric, D; Gardo, A; Kelly, M; Kennedy, P

    2016-01-01

    Introduction Medication errors are the most frequent cause of preventable harm in hospitals. Medication management in paediatric patients is particularly complex and consequently potential for harms are greater than in adults. Electronic medication management (eMM) systems are heralded as a highly effective intervention to reduce adverse drug events (ADEs), yet internationally evidence of their effectiveness in paediatric populations is limited. This study will assess the effectiveness of an eMM system to reduce medication errors, ADEs and length of stay (LOS). The study will also investigate system impact on clinical work processes. Methods and analysis A stepped-wedge cluster randomised controlled trial (SWCRCT) will measure changes pre-eMM and post-eMM system implementation in prescribing and medication administration error (MAE) rates, potential and actual ADEs, and average LOS. In stage 1, 8 wards within the first paediatric hospital will be randomised to receive the eMM system 1 week apart. In stage 2, the second paediatric hospital will randomise implementation of a modified eMM and outcomes will be assessed. Prescribing errors will be identified through record reviews, and MAEs through direct observation of nurses and record reviews. Actual and potential severity will be assigned. Outcomes will be assessed at the patient-level using mixed models, taking into account correlation of admissions within wards and multiple admissions for the same patient, with adjustment for potential confounders. Interviews and direct observation of clinicians will investigate the effects of the system on workflow. Data from site 1 will be used to develop improvements in the eMM and implemented at site 2, where the SWCRCT design will be repeated (stage 2). Ethics and dissemination The research has been approved by the Human Research Ethics Committee of the Sydney Children's Hospitals Network and Macquarie University. Results will be reported through academic journals and

  19. Nitrogen management to reduce nitrous oxide emissions

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Nitrous oxide (N2O) emissions from agricultural soils represent a complex interaction between the inputs of nitrogen into the soil and the soil environment. Mitigating these emissions will have a positive impact on greenhouse gases. Agriculture is the primary source of N2O emissions and must develop...

  20. Managing biogeochemical cycles to reduce greenhouse gases

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This special issue focuses on terrestrial biogeochemical cycles and their roles in determining current continental-scale budgets and future trends in biogenic greenhouse gases (GHGs) for North America. Understanding the current magnitude and forecasting future trajectories of atmospheric GHG concent...

  1. Risk management: Reducing brownfield cleanup costs

    SciTech Connect

    Graves, N.

    1997-08-01

    Balancing environmental protection with economic vitality is crucial to maintaining competitiveness in world markets. One key initiative that has been identified as important to both environmental protection and the economy is the redevelopment of brownfields. Brownfield redevelopment can stimulate local economies that have been devastated by lost jobs and can recycle industrial land use, thereby preserving undeveloped lands. Many existing brownfield sites appear on the US Environmental Protection Agency`s (EPA) National Priority List (NPL), which designates over 1200 sites and is expected to grow to more than 2000 by the end of the decade. EPA estimates the cost of remediating the sites on the current list will approach $30 billion, with the average cost of remediating a site close to $25 million. Thousands of additional brownfield sites that do not appear on the NPL are listed under state cleanup programs.

  2. Reducing the Teacher Workforce: A Management Perspective.

    ERIC Educational Resources Information Center

    Collins, Philip; Nelson, Dorothy Q.

    1983-01-01

    Discusses substantive and procedural restraints, including legal pitfalls, due process, and no-layoff clauses, within which public employers must decide questions of reduction in workforce (RIF). Describes elements of a sound RIF policy and considers ways of using the collective bargaining process to facilitate the RIF process. (JBM)

  3. Hydrology and the hypothetical effects of reducing nutrient applications of water quality in the Bald Eagle Creek Headwaters, southeastern Pennsylvania prior to implementation of agricultural best-management practices

    USGS Publications Warehouse

    Fishel, D.K.; Langland, M.J.; Truhlar, M.V.

    1991-01-01

    The report characterizes a 0.43-square-mile agricultural watershed in York County, underlain by albite-chlorite and oligoclase-mica schist in the Lower Susquehanna River basin, that is being studied as part of the U.S. Environmental Protection Agency's Chesapeake Bay Program. The water quality of Bald Eagle Creek was studied from October 1985 through September 1987 prior to the implementation of Best-Management Practices to reduce nutrient and sediment discharge into Muddy Creek, a tributary to the Chesapeake Bay. About 88 percent of the watershed is cropland and pasture, and nearly 33 percent of the cropland is used for corn. The animal population is entirely dairy cattle. About 85,640 pounds of nitrogen (460 pounds per acre) and 21,800 pounds of phosphorus (117 pounds per acre) were applied to fields; 52 percent of the nitrogen and 69 percent of the phosphorus was from commercial fertilizer. Prior to fertilization, nitrate nitrogen in the soil ranged from 36 to 136 pounds per acre and phosphorus ranged from 0.89 to 5.7 pounds per acre in the top 4 feet of soil. Precipitation was about 18 percent below normal and streamflow about 35 percent below normal during the 2-year study. Eighty-four percent of the 20.44 inches of runoff was base flow. Median concentrations of total nitrogen and dissolved phosphorous in base flow were 0.05 and 0.04 milligrams per liter as phosphorus, respectively. Concentrations of dissolved nitrate in base flow increased following wet periods after crops were harvested and manure was applied. During the growing season, concentrations decreased similarly to those observed in carbonate-rock areas as nutrient uptake and evapotranspiration by corn increased. About 4,550 pounds of suspended sediment, 5,250 pounds of nitrogen, and 66.6 pounds of phosphorus discharged in base flow during the 2-year period. The suspended sediment load was about 232,000 pounds in stormflow from 26 storms that contributed 51 percent of the total stormflow. The

  4. Pravastatin reduces the risk for cardiovascular disease in Japanese hypercholesterolemic patients with impaired fasting glucose or diabetes: diabetes subanalysis of the Management of Elevated Cholesterol in the Primary Prevention Group of Adult Japanese (MEGA) Study.

    PubMed

    Tajima, Naoko; Kurata, Hideaki; Nakaya, Noriaki; Mizuno, Kyoichi; Ohashi, Yasuo; Kushiro, Toshio; Teramoto, Tamio; Uchiyama, Shinichiro; Nakamura, Haruo

    2008-08-01

    Diabetes mellitus (DM) is a major risk factor for cardiovascular disease (CVD) in patients with no history of CVD. Evidence for the effect of statins on CVD in the diabetic population in low-risk populations (e.g., Japanese) is limited. We evaluated the effect of pravastatin on risk reduction of CVD related to baseline glucose status in a primary prevention setting. The Management of Elevated Cholesterol in the Primary Prevention Group of Adult Japanese (MEGA) Study, in patients with mild-to-moderate hypercholesterolemia (220-270 mg/dL), showed that low-dose pravastatin significantly reduced the risk for CVD by 26%. This exploratory subanalyses examined the efficacy of diet plus pravastatin on CVD in 2210 patients with abnormal fasting glucose (AFG, including 1746 patients with DM and 464 patients with impaired fasting glucose (IFG) at 5 years in the MEGA Study. CVD was threefold higher in AFG patients (threefold higher in DM, and twofold higher in IFG) compared with normal fasting glucose (NFG) patients in the diet group. Diet plus pravastatin treatment significantly reduced the risk of CVD by 32% (hazard ratio 0.68, 95% CI 0.48-0.96, number needed to treat, 42) in the AFG group compared with the diet alone group, and no significant interaction between AFG and NFG (interaction P=0.85) was found. Safety problems were not observed during long-term treatment with pravastatin. In conclusion, pravastatin reduces the risk of CVD in subjects with hypercholesterolemia and abnormal fasting glucose in the primary prevention setting in Japan.

  5. Global Aesthetics Consensus: Avoidance and Management of Complications from Hyaluronic Acid Fillers—Evidence- and Opinion-Based Review and Consensus Recommendations

    PubMed Central

    Liew, Steven; Sundaram, Hema; De Boulle, Koenraad L.; Goodman, Greg J.; Monheit, Gary; Wu, Yan; Trindade de Almeida, Ada R.; Swift, Arthur; Vieira Braz, André

    2016-01-01

    Background: Although the safety profile of hyaluronic acid fillers is favorable, adverse reactions can occur. Clinicians and patients can benefit from ongoing guidance on adverse reactions to hyaluronic acid fillers and their management. Methods: A multinational, multidisciplinary group of experts in cosmetic medicine convened the Global Aesthetics Consensus Group to review the properties and clinical uses of Hylacross and Vycross hyaluronic acid products and develop updated consensus recommendations for early and late complications associated with hyaluronic acid fillers. Results: The consensus panel provided specific recommendations focusing on early and late complications of hyaluronic acid fillers and their management. The impact of patient-, product-, and technique-related factors on such reactions was described. Most of these were noted to be mild and transient. Serious adverse events are rare. Early adverse reactions to hyaluronic acid fillers include vascular infarction and compromise; inflammatory reactions; injection-related events; and inappropriate placement of filler material. Among late reactions are nodules, granulomas, and skin discoloration. Most adverse events can be avoided with proper planning and technique. Detailed understanding of facial anatomy, proper patient and product selection, and appropriate technique can further reduce the risks. Should adverse reactions occur, the clinician must be prepared and have tools available for effective treatment. Conclusions: Adverse reactions with hyaluronic acid fillers are uncommon. Clinicians should take steps to further reduce the risk and be prepared to treat any complications that arise. PMID:27219265

  6. Reducing Iatrogenic Risks

    PubMed Central

    Ely, E. Wesley; Speroff, Theodore; Pun, Brenda T.; Boehm, Leanne; Dittus, Robert S.

    2010-01-01

    ICUs are experiencing an epidemic of patients with acute brain dysfunction (delirium) and weakness, both associated with increased mortality and long-term disability. These conditions are commonly acquired in the ICU and are often initiated or exacerbated by sedation and ventilation decisions and management. Despite > 10 years of evidence revealing the hazards of delirium, the quality chasm between current and ideal processes of care continues to exist. Monitoring of delirium and sedation levels remains inconsistent. In addition, sedation, ventilation, and physical therapy practices proven successful at reducing the frequency and severity of adverse outcomes are not routinely practiced. In this article, we advocate for the adoption and implementation of a standard bundle of ICU measures with great potential to reduce the burden of ICU-acquired delirium and weakness. Individual components of this bundle are evidence based and can help standardize communication, improve interdisciplinary care, reduce mortality, and improve cognitive and functional outcomes. We refer to this as the “ABCDE bundle,” for awakening and breathing coordination, delirium monitoring, and exercise/early mobility. This evidence-based bundle of practices will build a bridge across the current quality chasm from the “front end” to the “back end” of critical care and toward improved cognitive and functional outcomes for ICU survivors. PMID:21051398

  7. Reducing GWAS Complexity

    PubMed Central

    Hazelett, Dennis J.; Conti, David V.; Han, Ying; Al Olama, Ali Amin; Easton, Doug; Eeles, Rosalind A.; Kote-Jarai, Zsofia; Haiman, Christopher A.; Coetzee, Gerhard A.

    2016-01-01

    ABSTRACT Genome-wide association studies (GWAS) have revealed numerous genomic 'hits' associated with complex phenotypes. In most cases these hits, along with surrogate genetic variation as measure by numerous single nucleotide polymorphisms (SNPs) that are in linkage disequilibrium, are not in coding genes making assignment of functionality or causality intractable. Here we propose that fine-mapping along with the matching of risk SNPs at chromatin biofeatures lessen this complexity by reducing the number of candidate functional/causal SNPs. For example, we show here that only on average 2 SNPs per prostate cancer risk locus are likely candidates for functionality/causality; we further propose that this manageable number should be taken forward in mechanistic studies. The candidate SNPs can be looked up for each prostate cancer risk region in 2 recent publications in 20151,2 from our groups. PMID:26771711

  8. Machines that Manage.

    ERIC Educational Resources Information Center

    Kennedy, Mike

    2003-01-01

    Describes how facilities-management systems use technology to help schools and universities operate their buildings more efficiently, reduce energy consumption, manage inventory more accurately, keep track of supplies and maintenance schedules, and save money. (EV)

  9. 41 CFR 101-27.303 - Reducing long supply.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Reducing long supply. 101-27.303 Section 101-27.303 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 27-INVENTORY MANAGEMENT...

  10. Public health impacts of the severe haze in Equatorial Asia in September-October 2015: demonstration of a new framework for informing fire management strategies to reduce downwind smoke exposure

    NASA Astrophysics Data System (ADS)

    Koplitz, Shannon N.; Mickley, Loretta J.; Marlier, Miriam E.; Buonocore, Jonathan J.; Kim, Patrick S.; Liu, Tianjia; Sulprizio, Melissa P.; DeFries, Ruth S.; Jacob, Daniel J.; Schwartz, Joel; Pongsiri, Montira; Myers, Samuel S.

    2016-09-01

    In September-October 2015, El Niño and positive Indian Ocean Dipole conditions set the stage for massive fires in Sumatra and Kalimantan (Indonesian Borneo), leading to persistently hazardous levels of smoke pollution across much of Equatorial Asia. Here we quantify the emission sources and health impacts of this haze episode and compare the sources and impacts to an event of similar magnitude occurring under similar meteorological conditions in September-October 2006. Using the adjoint of the GEOS-Chem chemical transport model, we first calculate the influence of potential fire emissions across the domain on smoke concentrations in three receptor areas downwind—Indonesia, Malaysia, and Singapore—during the 2006 event. This step maps the sensitivity of each receptor to fire emissions in each grid cell upwind. We then combine these sensitivities with 2006 and 2015 fire emission inventories from the Global Fire Assimilation System (GFAS) to estimate the resulting population-weighted smoke exposure. This method, which assumes similar smoke transport pathways in 2006 and 2015, allows near real-time assessment of smoke pollution exposure, and therefore the consequent morbidity and premature mortality, due to severe haze. Our approach also provides rapid assessment of the relative contribution of fire emissions generated in a specific province to smoke-related health impacts in the receptor areas. We estimate that haze in 2015 resulted in 100 300 excess deaths across Indonesia, Malaysia and Singapore, more than double those of the 2006 event, with much of the increase due to fires in Indonesia’s South Sumatra Province. The model framework we introduce in this study can rapidly identify those areas where land use management to reduce and/or avoid fires would yield the greatest benefit to human health, both nationally and regionally.

  11. Risk management.

    PubMed

    Chambers, David W

    2010-01-01

    Every plan contains risk. To proceed without planning some means of managing that risk is to court failure. The basic logic of risk is explained. It consists in identifying a threshold where some corrective action is necessary, the probability of exceeding that threshold, and the attendant cost should the undesired outcome occur. This is the probable cost of failure. Various risk categories in dentistry are identified, including lack of liquidity; poor quality; equipment or procedure failures; employee slips; competitive environments; new regulations; unreliable suppliers, partners, and patients; and threats to one's reputation. It is prudent to make investments in risk management to the extent that the cost of managing the risk is less than the probable loss due to risk failure and when risk management strategies can be matched to type of risk. Four risk management strategies are discussed: insurance, reducing the probability of failure, reducing the costs of failure, and learning. A risk management accounting of the financial meltdown of October 2008 is provided.

  12. The ACC/AHA 2013 guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: the good the bad and the uncertain: a comparison with ESC/EAS guidelines for the management of dyslipidaemias 2011.

    PubMed

    Ray, Kausik K; Kastelein, John J P; Boekholdt, S Matthijs; Nicholls, Stephen J; Khaw, Kay-Tee; Ballantyne, Christie M; Catapano, Alberico L; Reiner, Željko; Lüscher, Thomas F

    2014-04-01

    Atherosclerotic cardiovascular disease is the most important public health problem of our time in both Europe and the rest of the world, accounting for the greatest expenditure in most healthcare budgets. Achieving consistency of clinical care, incorporating new evidence and their synthesis into practical recommendations for clinicians is the task of various guideline committees throughout the world. Any change in a set of guidelines therefore can have far reaching consequences, particularly if they appear to be at variance with the existing guidelines. The present article discusses the recent American College of Cardiology (ACC)/American Heart Association (AHA) guidelines 2013 on the control of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults. When compared with the ESC/EAS guidelines on lipid modification in 2011, the ACC/AHA guidelines of 2013 differ markedly. Specifically, (i) the scope is limited to randomized trials only, which excludes a significant body of data and promotes essentially a statin centric approach only; (ii) the abolition of low-density lipoprotein cholesterol (LDL-C) targets in favour of specific statin regimens that produce a 30-50% reduction in LDL-C we believe will confuse many physicians and miss the opportunity for medication adherence and patient engagement in self-management; (iii) the absence of target LDL-C levels in very high-risk patients with high absolute risk or residual risk factors will discourage clinicians to consider the addition of lipid modification treatments and individualize patient care; (iv) a reduction in the threshold for treatment in primary prevention will result in a greater number of patients being prescribed statin therapy, which is potentially good in young patients with high life time risk, but will result in a very large number of older patients offered therapy; and (v) the mixed pool risk calculator used to asses CVD risk in the guidelines for primary prevention has not

  13. Adaptive management: Chapter 1

    USGS Publications Warehouse

    Allen, Craig R.; Garmestani, Ahjond S.; Allen, Craig R.; Garmestani, Ahjond S.

    2015-01-01

    Adaptive management is an approach to natural resource management that emphasizes learning through management where knowledge is incomplete, and when, despite inherent uncertainty, managers and policymakers must act. Unlike a traditional trial and error approach, adaptive management has explicit structure, including a 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. The process is iterative, and serves to reduce uncertainty, build knowledge and improve management over time in a goal-oriented and structured process.

  14. Cotton insect pest management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Cotton production is challenged worldwide by a diversity of arthropod pests that require management to prevent or reduce crop damage. Advances in arthropod control technologies and improved insect and crop management systems have dramatically reduced levels of arthropod damage and the need for inse...

  15. Finding Ways to Lift Barriers to Care for Chronic Pain Patients: Outcomes of Using Internet-Based Self-Management Activities to Reduce Pain and Improve Quality of Life

    PubMed Central

    Rod, Kevin

    2016-01-01

    Background. Chronic pain is prevalent, disabling, costly, and undertreated. There is clearly a need to improve patient understanding of ways to manage their pain. Internet-based programs are continually being developed to facilitate mental health improvement, providing tailored content for patients to manage their pain, anxiety, and depression. Objective. To evaluate the impact of Internet-based patient self-management education and activities on patients' pain, anxiety, and quality of life in patients who could not access multidisciplinary pain management. Design. Observational study. Subjects. Two hundred (200) patients (61% females, 39% males, between 18 and 75 years old) from one community pain clinic in Toronto, Canada (Toronto Poly Clinic), participated. Patients had moderate to severe pain, depression, and anxiety. These patients committed to study from a group of 515 patients with chronic noncancer pain of different origins who were stable on their levels of pain, anxiety, and depression for 12 consecutive months before start of study and could not afford noninsured treatment modalities like physiotherapy, psychology, nutrition, or exercise therapy consultation. Methods. Patients were encouraged to visit two Internet sites (a blog and Twitter postings) for educational postings written by the author about exercise, nutrition, mindfulness meditation, disease management methods, evidence-based supplements, daily relaxation exercises, and overall self-management methods 15 minutes per day for six months. Patients were also encouraged to share their ideas and comments on a blog. Activity logs were kept by patients and reviewed by physician at follow-up visits. Compliance was encouraged via weekly email reminders and phone calls during the observation period. Results. Modest improvements were noted in pain, anxiety, depression, and quality of life. Of the patients with moderate or severe pain before treatment, 45% reported mild levels of pain after treatment

  16. Management Academy LANL Business Systems: Property Management, Course #31036

    SciTech Connect

    Shepherd, Michael J.; Rinke, Helen Mae; Hanson, Todd; Wolfe, Randy P.

    2016-07-08

    Los Alamos National Laboratory (LANL) is responsible for the efficient economical management of all government property in its stewardship. This training explains the role LANL managers have in managing, controlling, and disposing of government property. The Laboratory's goal is good asset management. By properly managing property across the facility, Laboratory managers can help ASM improve government property utilization and extend asset life, while reducing asset-related operating costs and expenditures.

  17. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology/American Heart Association task force on practice guidelines

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The goals of the American College of Cardiology (ACC) and the American Heart Association (AHA) are to prevent cardiovascular (CV) diseases, improve the management of people who have these diseases through professional education and research, and develop guidelines, standards and policies that promot...

  18. Reduce HIV Risk

    MedlinePlus

    ... incidence could be reduced if people changed their sexual behaviors. Our research has demonstrated remarkable success in reducing HIV risk-associated sexual behaviors among African American adolescents and adults." Spring 2008 ...

  19. Health Management Guide. Disease management.

    PubMed

    Harrison, S; Hunter, D; Fairfield, G; Cole, A

    1996-01-01

    Disease management has been described as a comprehensive, integrated approach to care and reimbursement based on the natural course of a disease. It requires a management approach which brings together research evidence, best practice and inter-professional and inter-agency working. Starting with the ideal of continuity of care for individual patients, it implies structured co-ordination of care over time and across primary, secondary and tertiary settings. The appeal of disease management is that it promises reduced costs, combined with increased quality of care and patient satisfaction. But the concept is open to different definitions and interpretations and its effectiveness in improving UK healthcare is still largely untested. This Health Management Guide removes the mystique behind disease management and puts it in the context of existing knowledge and practice. Treating it as a concept, rather than a specific technique, it distinguishes between its different potential applications, offers practical guidance on implementation, and reports on how NHS organisations are taking it forward.

  20. Reducing Rock Climbing Risks.

    ERIC Educational Resources Information Center

    Attarian, Aram

    1998-01-01

    Provides checklists that can be used as risk-management tools to evaluate rock-climbing programs: developing goals, policies, and procedures; inspecting the climbing environment; maintaining and inspecting equipment; protecting participants; and managing staff (hiring, training, retraining, and evaluating) and campers (experience level, needs, and…

  1. Reducing rattlesnake-human conflicts

    USGS Publications Warehouse

    Nowak, Erika M.

    2006-01-01

    Arizona is home to 11 species of rattlesnakes. As rapidly growing Arizona communities move into formerly undeveloped landscapes, encounters between people and rattlesnakes increase. As a result, the management of nuisance snakes, or snakes found in areas where people do not want them, is increasingly important. Since 1994, the U.S. Geological Survey (USGS) has conducted research on the behavior and ecology of nuisance rattlesnake in Arizona national park units. A decade of research provides important insights into rattlesnake behavior that can be used by national parks and communities to reduce rattlesnake-human conflicts.

  2. Rosacea Management

    PubMed Central

    Abokwidir, Manal; Feldman, Steven R.

    2016-01-01

    Background Rosacea is a chronic inflammatory skin condition associated with four distinct subtypes: erythematotelangiectatic, papulopustular, phymatous, and ocular. Purpose To review the different kinds of management for all subtypes. Methods We divided rosacea management into three main categories: patient education, skin care, and pharmacological/procedural interventions. Results Flushing is better prevented rather than treated, by avoiding specific triggers, decreasing transepidermal water loss by moisturizers, and blocking ultraviolet light. Nonselective β-blockers and α2-adrenergic agonists decrease erythema and flushing. The topical α-adrenergic receptor agonist brimonidine tartrate 0.5% reduces persistent facial erythema. Intradermal botulinum toxin injection is almost safe and effective for the erythema and flushing. Flashlamp-pumped dye, potassium-titanyl-phosphate and pulsed-dye laser, and intense pulsed light are used for telangiectasias. Metronidazole 1% and azelaic acid 15% cream reduce the severity of erythema. Both systemic and topical remedies treat papulopustules. Systemic remedies include metronidazole, doxycycline, minocycline, clarithromycin and isotretinoin, while topical remedies are based on metronidazole 0.75%, azelaic acid 15 or 20%, sodium sulfacetamide, ivermectin 1%, permethrin 5%, and retinoid. Ocular involvement can be treated with oral or topical antibacterial. Rhinophyma can be corrected by dermatosurgical procedures, decortication, and various types of lasers. Conclusion There are many options for rosacea management. Patients may have multiple subtypes, and each phase has its own treatment. PMID:27843919

  3. Weed Management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Adaptive management can complement integrated programs to manage weeds in forage production systems. This approach requires establishing management goals, developing and implementing management programs based on the goals, monitoring and assessing impacts of management efforts, and modifying goals a...

  4. Reducing Unnecessary and Duplicate Ordering for Ovum and Parasite Examinations and Clostridium difficile PCR in Immunocompromised Patients by Using an Alert at the Time of Request in the Order Management System.

    PubMed

    Otto, Caitlin C; Shuptar, Susan L; Milord, Philippe; Essick, Connor J; Nevrekar, Reshma; Granovsky, Svetlana L; Seo, Susan K; Babady, N Esther; Martin, Steven C; Tang, Yi-Wei; Pessin, Melissa S

    2015-08-01

    We implemented hospital information system (HIS) alerts to deter unnecessary test orders for ovum and parasite (O&P) exams and Clostridium difficile PCR. The HIS alerts decreased noncompliant O&P orders (orders after >72 h of hospitalization) from 49.8% to 30.9%, an overall decrease of 19%, and reduced noncompliant C. difficile PCR orders (orders <7 days after a previous positive result) from 30.6% to 19.2%, an overall decrease of 31.9%.

  5. A rotational framework to reduce weed density in organic systems

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Weeds are a major obstacle to successful crop production in organic farming. Producers may be able to reduce inputs for weed management by designing rotations to disrupt population dynamics of weeds. Population-based management in conventional farming has reduced herbicide use 50% because weed den...

  6. Managing Radon in Schools

    EPA Pesticide Factsheets

    EPA recommends testing all schools for radon. As part of an effective IAQ management program, schools can take simple steps to test for radon and reduce risks to occupants if high radon levels are found.

  7. Managing Conflict during Divorce

    MedlinePlus

    ... MFT Network Find Members Benefits Managing Conflict During Divorce Ending a marriage or a long-term relationship ... best interests. Fortunately, there are approaches by which divorce professionals can help parents reduce conflict. Options include ...

  8. Boiler burden reduced at Bedford site.

    PubMed

    Horsley, Chris

    2011-10-01

    With the NHS aiming to reduce its 2007 carbon footprint by 10% by 2015, Chris Horsley, managing director of Babcock Wanson UK, a provider of industrial boilers and burners, thermal oxidisers, air treatment, water treatment, and associated services, looks at how one NHS Trust has approached the challenge, and considerably reduced its carbon emissions, by refurbishing its boiler house and moving from oil to gas-fired steam generation.

  9. Resource Management for Distributed Parallel Systems

    NASA Technical Reports Server (NTRS)

    Neuman, B. Clifford; Rao, Santosh

    1993-01-01

    Multiprocessor systems should exist in the the larger context of distributed systems, allowing multiprocessor resources to be shared by those that need them. Unfortunately, typical multiprocessor resource management techniques do not scale to large networks. The Prospero Resource Manager (PRM) is a scalable resource allocation system that supports the allocation of processing resources in large networks and multiprocessor systems. To manage resources in such distributed parallel systems, PRM employs three types of managers: system managers, job managers, and node managers. There exist multiple independent instances of each type of manager, reducing bottlenecks. The complexity of each manager is further reduced because each is designed to utilize information at an appropriate level of abstraction.

  10. Reducing Teacher Incompetence.

    ERIC Educational Resources Information Center

    Rich, John Martin

    1988-01-01

    Suggests how administrators may reduce teacher incompetence. Teacher incompetence can be reduced if administrators fully understand and undertake appropriate preventive and remedial measures. Two sections comprise this article. First, a taxonomy of teacher incompetence reveals the magnitude of the problem. Second, preventive and remedial measures…

  11. Reducible oxide based catalysts

    DOEpatents

    Thompson, Levi T.; Kim, Chang Hwan; Bej, Shyamal K.

    2010-04-06

    A catalyst is disclosed herein. The catalyst includes a reducible oxide support and at least one noble metal fixed on the reducible oxide support. The noble metal(s) is loaded on the support at a substantially constant temperature and pH.

  12. Reducing Unnecessary and Duplicate Ordering for Ovum and Parasite Examinations and Clostridium difficile PCR in Immunocompromised Patients by Using an Alert at the Time of Request in the Order Management System

    PubMed Central

    Shuptar, Susan L.; Milord, Philippe; Essick, Connor J.; Nevrekar, Reshma; Granovsky, Svetlana L.; Seo, Susan K.; Martin, Steven C.; Pessin, Melissa S.

    2015-01-01

    We implemented hospital information system (HIS) alerts to deter unnecessary test orders for ovum and parasite (O&P) exams and Clostridium difficile PCR. The HIS alerts decreased noncompliant O&P orders (orders after >72 h of hospitalization) from 49.8% to 30.9%, an overall decrease of 19%, and reduced noncompliant C. difficile PCR orders (orders <7 days after a previous positive result) from 30.6% to 19.2%, an overall decrease of 31.9%. PMID:26063860

  13. Managing Fault Management Development

    NASA Technical Reports Server (NTRS)

    McDougal, John M.

    2010-01-01

    As the complexity of space missions grows, development of Fault Management (FM) capabilities is an increasingly common driver for significant cost overruns late in the development cycle. FM issues and the resulting cost overruns are rarely caused by a lack of technology, but rather by a lack of planning and emphasis by project management. A recent NASA FM Workshop brought together FM practitioners from a broad spectrum of institutions, mission types, and functional roles to identify the drivers underlying FM overruns and recommend solutions. They identified a number of areas in which increased program and project management focus can be used to control FM development cost growth. These include up-front planning for FM as a distinct engineering discipline; managing different, conflicting, and changing institutional goals and risk postures; ensuring the necessary resources for a disciplined, coordinated approach to end-to-end fault management engineering; and monitoring FM coordination across all mission systems.

  14. Sodium Valproate Withdrawal Correlates with Reduced Aggression

    ERIC Educational Resources Information Center

    Pritchard, Duncan; Hoerger, Marguerite; Dyer, Tim; Graham, Nicola; Penney, Heather; Mace, F. Charles

    2014-01-01

    People with learning disabilities are sometimes prescribed psychotropic medication to help manage their challenging behaviour. This case study describes how a multicomponent behavioural intervention in conjunction with the systematic withdrawal of sodium valproate was strongly correlated with reduced aggression. No symptoms of bipolar disorder or…

  15. How to reduce your fire insurance rates

    NASA Technical Reports Server (NTRS)

    Dubain, M.

    1971-01-01

    Construction procedures and utilization of materials to reduce the cost of insuring large buildings against losses from fire are discussed. Examples of good and bad techniques in building construction and fire safety management are provided. The inadequacies of building codes and the hazards resulting from improper construction are examined.

  16. The Three Rs: Reduce, Reuse, Recycle.

    ERIC Educational Resources Information Center

    Science Activities, 1991

    1991-01-01

    A student hand-out for a recycling unit defines the terms reduce, recycle, and reuse as they relate to solid waste management. Presents the characteristics of recyclable items such as yard wastes, metals, glass, and paper. Lists organizations through which more information about recycling can be obtained. (MCO)

  17. Reducing Childhood Obesity

    MedlinePlus

    ... Navigation Bar Home Current Issue Past Issues Reducing Childhood Obesity Past Issues / Summer 2007 Table of Contents For ... page please turn Javascript on. The We Can! childhood obesity-prevention program involves parents, caregivers, and community leaders ...

  18. Reduced shear power spectrum

    SciTech Connect

    Dodelson, Scott; Shapiro, Charles; White, Martin J.; /UC, Berkeley, Astron. Dept. /UC, Berkeley

    2005-08-01

    Measurements of ellipticities of background galaxies are sensitive to the reduced shear, the cosmic shear divided by (1-{kappa}) where {kappa} is the projected density field. They compute the difference between shear and reduced shear both analytically and with simulations. The difference becomes more important an smaller scales, and will impact cosmological parameter estimation from upcoming experiments. A simple recipe is presented to carry out the required correction.

  19. Adaptive Management

    EPA Science Inventory

    Adaptive management is an approach to natural resource management that emphasizes learning through management where knowledge is incomplete, and when, despite inherent uncertainty, managers and policymakers must act. Unlike a traditional trial and error approach, adaptive managem...

  20. Orthopaedic Management of Spasticity.

    PubMed

    Pidgeon, Tyler S; Ramirez, Jose M; Schiller, Jonathan R

    2015-12-01

    Spasticity is a common manifestation of many neurological conditions including multiple sclerosis, stroke, cerebral palsy, traumatic brain injury, and spinal cord injuries. Management of spasticity seeks to reduce its burden on patients and to limit secondary complications. Non-operative interventions including stretching/splinting, postural management, physical therapy/strengthening, anti-spasticity medications, and botulinum toxin injections may help patients with spasticity. Surgical management of these conditions, however, is often necessary to improve quality of life and prevent complications. Orthopaedic surgeons manage numerous sequelae of spasticity, including joint contractures, hip dislocations, scoliosis, and deformed extremities. When combined with the efforts of rehabilitation specialists, neurologists, and physical/occupational therapists, the orthopaedic management of spasticity can help patients maintain and regain function and independence as well as reduce the risk of long-tem complications.

  1. Information management

    NASA Technical Reports Server (NTRS)

    Ricks, Wendell; Corker, Kevin

    1990-01-01

    Primary Flight Display (PFD) information management and cockpit display of information management research is presented in viewgraph form. The information management problem in the cockpit, information management burdens, the key characteristics of an information manager, the interface management system handling the flow of information and the dialogs between the system and the pilot, and overall system architecture are covered.

  2. Reduced Magmatic Volatiles

    NASA Astrophysics Data System (ADS)

    Hirschmann, M. M.; Withers, A. C.; Ardia, P.; Stanley, B. D.; Foley, N.

    2012-12-01

    Volatiles in Earth's upper mantle are dominated by H2O and CO2, but under more reduced conditions likely deeper in the mantle, other volatile species may be important or dominant. However, the speciation, solubilities, and effect on physical properties of reduced magmatic volatiles are poorly constrained. Here we summarize results from an experimental campaign to better understand reduced volatiles in magmas. Experiments emphasize spectroscopic and SIMS characterization of dissolved species in experiments for which fluid fugacities are known, thereby facilitating thermodynamic parameterization. Experimental determinations of molecular H2 solubility in basaltic and andesitic liquids show concentrations that are proportional to H2 fugacity. Because H2 increases with fH2 whereas dissolved H2O increases with fH2O1/2, the relative importance of H2 increases with pressure and for more hydrous magmas. At 1 GPa and IW-1, solubility in basalt reaches 0.3 wt.% (equivalent to 2.7 wt.% H2O). Solubilities at pressures of the deep upper mantle have not been explored experimentally (as is also true for H2O and CO2), but H2 could become the dominant hydrous species at 400 km and deeper, and so deep hydrous melts may have chiefly H2 rather than H2O or OH. Experiments suggest an extremely low partial specific density (0.18 kg/m3) for dissolved H2 at low pressure, and so appreciable dissolved H2 in melt atop the 410 km discontinuity or in the lower mantle may promote positive buoyancy. Solubilities of reduced C-species remain poorly known. In contrast to results in Na2O-SiO2 liquids (Mysen et al., 2009), experiments with a haplobasaltic liquid at controlled CH4 fugacities indicated very small (<0.05 wt.%) CH4 solubilities even at very reduced conditions (reduced conditions and in

  3. Energy Management in Municipal Buildings.

    ERIC Educational Resources Information Center

    Massachusetts State Dept. of Community Affairs, Boston. Energy Conservation Project.

    This manual is written for the manager or supervisor responsible for instituting an energy management program for municipal buildings. An introduction discusses the management issues facing municipal government in dealing with the need to reduce energy consumption. The guide reviews methods for central coordination of activity to ensure that…

  4. Reducing Lifecycle Sustainment Costs

    DTIC Science & Technology

    2015-05-01

    disposal • In FY12, PEOs given total life cycle management responsibility • PSM position mandated for ACAT I/II programs  Shorter acquisition reporting...sustainment SAE – SAF/AQ PEOs GO/SES PMs O-6/GS-15 PSMs GS-14/15 I n t e g r i t y - S e r v i c e - E x c e l l e n c e Assessing Sustainment

  5. Tank closure reducing grout

    SciTech Connect

    Caldwell, T.B.

    1997-04-18

    A reducing grout has been developed for closing high level waste tanks at the Savannah River Site in Aiken, South Carolina. The grout has a low redox potential, which minimizes the mobility of Sr{sup 90}, the radionuclide with the highest dose potential after closure. The grout also has a high pH which reduces the solubility of the plutonium isotopes. The grout has a high compressive strength and low permeability, which enhances its ability to limit the migration of contaminants after closure. The grout was designed and tested by Construction Technology Laboratories, Inc. Placement methods were developed by the Savannah River Site personnel.

  6. Reducing Behavior through Reinforcement.

    ERIC Educational Resources Information Center

    Deitz, Diane E. D.; Repp, Alan C.

    1983-01-01

    The use of reinforcement to reduce inappropriate behaviors of mentally retarded and emotionally disturbed students may involve the following procedures: differential reinforcement of low rates of responding (DRL), the differential reinforcement of response omission (DRO), and the differential reinforcement of incompatible (DRI) or alternative…

  7. Reduced Braginskii equations

    SciTech Connect

    Yagi, M.; Horton, W. )

    1994-07-01

    A set of reduced Braginskii equations is derived without assuming flute ordering and the Boussinesq approximation. These model equations conserve the physical energy. It is crucial at finite [beta] that the perpendicular component of Ohm's law be solved to ensure [del][center dot][bold j]=0 for energy conservation.

  8. Demonstrating Reduced Gravity

    NASA Technical Reports Server (NTRS)

    Pearlman, Howard; Stocker, Dennis; Gotti, Daniel; Urban, David; Ross, Howard; Sours, Thomas

    1996-01-01

    A miniature drop tower, Reduced-Gravity Demonstrator is developed to illustrate the effects of gravity on a variety of phenomena including the way fluids flow, flames burn, and mechanical systems (such as pendulum) behave. A schematic and description of the demonstrator and payloads are given, followed by suggestions for how one can build his (her) own.

  9. Integrated, automated revenue management for managed care contracts.

    PubMed

    Burckhart, Kent

    2002-04-01

    Faced with increasing managed care penetration and declining net revenue in recent years, healthcare providers increasingly are emphasizing revenue management. To streamline processes and reduce costs in this area, many healthcare providers have implemented or are considering automated contract management systems. When selecting such a system, healthcare financial managers should make certain that the system can interface with both patient-accounting and decision-support systems of the organization. This integration enhances a healthcare provider's financial viability by providing integrated revenue-management capabilities to analyze projected performance of proposed managed care contracts and actual performance of existing contracts.

  10. Reducing float coal dust

    PubMed Central

    Patts, J.R.; Colinet, J.F.; Janisko, S.J.; Barone, T.L.; Patts, L.D.

    2016-01-01

    Controlling float coal dust in underground coal mines before dispersal into the general airstream can reduce the risk of mine explosions while potentially achieving a more effective and efficient use of rock dust. A prototype flooded-bed scrubber was evaluated for float coal dust control in the return of a continuous miner section. The scrubber was installed inline between the face ventilation tubing and an exhausting auxiliary fan. Airborne and deposited dust mass measurements were collected over three days at set distances from the fan exhaust to assess changes in float coal dust levels in the return due to operation of the scrubber. Mass-based measurements were collected on a per-cut basis and normalized on the basis of per ton mined by the continuous miner. The results show that average float coal dust levels measured under baseline conditions were reduced by more than 90 percent when operating the scrubber. PMID:28018004

  11. Reducing rotor weight

    SciTech Connect

    Cheney, M.C.

    1997-12-31

    The cost of energy for renewables has gained greater significance in recent years due to the drop in price in some competing energy sources, particularly natural gas. In pursuit of lower manufacturing costs for wind turbine systems, work was conducted to explore an innovative rotor designed to reduce weight and cost over conventional rotor systems. Trade-off studies were conducted to measure the influence of number of blades, stiffness, and manufacturing method on COE. The study showed that increasing number of blades at constant solidity significantly reduced rotor weight and that manufacturing the blades using pultrusion technology produced the lowest cost per pound. Under contracts with the National Renewable Energy Laboratory and the California Energy Commission, a 400 kW (33m diameter) turbine was designed employing this technology. The project included tests of an 80 kW (15.5m diameter) dynamically scaled rotor which demonstrated the viability of the design.

  12. Reducing teenage pregnancy.

    PubMed

    Fallon, Debbie

    2011-03-01

    The Teenage Pregnancy Independent Advisory Group (TPIAG) was established in 2000 to advise the government about reducing teenage pregnancy rates and supporting teenage parents to continue with their education. The group reached the end of its tenure in December 2010. This short article highlights some of the key issues from the final report and provides some insights into past achievements and future directions from an interview with Gill Frances, TPIAG's chair.

  13. Gradual extinction reduces reinstatement

    PubMed Central

    Shiban, Youssef; Wittmann, Jasmin; Weißinger, Mara; Mühlberger, Andreas

    2015-01-01

    The current study investigated whether gradually reducing the frequency of aversive stimuli during extinction can prevent the return of fear. Thirty-one participants of a three-stage procedure (acquisition, extinction and a reinstatement test on day 2) were randomly assigned to a standard extinction (SE) and gradual extinction (GE) procedure. The two groups differed only in the extinction procedure. While the SE group ran through a regular extinction process without any negative events, the frequency of the aversive stimuli during the extinction phase was gradually reduced for the GE group. The unconditioned stimulus (US) was an air blast (5 bar, 10 ms). A spider and a scorpion were used as conditioned stimuli (CS). The outcome variables were contingency ratings and physiological measures (skin conductance response, SCR and startle response). There were no differences found between the two groups for the acquisition and extinction phases concerning contingency ratings, SCR, or startle response. GE compared to SE significantly reduced the return of fear in the reinstatement test for the startle response but not for SCR or contingency ratings. This study was successful in translating the findings in rodent to humans. The results suggest that the GE process is suitable for increasing the efficacy of fear extinction. PMID:26441581

  14. Naval electrochemical corrosion reducer

    DOEpatents

    Clark, Howard L.

    1991-10-01

    A corrosion reducer for use with ships having a hull, a propeller mounted a propeller shaft and extending through the hull, bearings supporting the shaft, at least one thrust bearing and one seal. The improvement includes a current collector and a current reduction assembly for reducing the voltage between the hull and shaft in order to reduce corrosion due to electrolytic action. The current reduction assembly includes an electrical contact, the current collector, and the hull. The current reduction assembly further includes a device for sensing and measuring the voltage between the hull and the shaft and a device for applying a reverse voltage between the hull and the shaft so that the resulting voltage differential is from 0 to 0.05 volts. The current reduction assembly further includes a differential amplifier having a voltage differential between the hull and the shaft. The current reduction assembly further includes an amplifier and a power output circuit receiving signals from the differential amplifier and being supplied by at least one current supply. The current selector includes a brush assembly in contact with a slip ring over the shaft so that its potential may be applied to the differential amplifier.

  15. Reducing Radiation Damage

    SciTech Connect

    Blankenbecler, Richard

    2006-06-05

    This talk describes the use of a modified treatment sequence, i.e., radiation dose, geometry, dwell time, etc., to mitigate some of the deleterious effects of cancer radiotherapy by utilizing natural cell repair processes. If bad side effects can be reduced, a more aggressive therapy can be put into place. Cells contain many mechanisms that repair damage of various types. If the damage can not be repaired, cells will undergo apoptosis (cell death). Data will be reviewed that support the fact that a small dose of radiation will activate damage repair genes within a cell. Once the mechanisms are fully active, they will efficiently repair the severe damage from a much larger radiation dose. The data ranges from experiments on specific cell cultures using microarray (gene chip) techniques to experiments on complete organisms. The suggested effect and treatment is consistent with the assumption that all radiation is harmful, no matter how small the dose. Nevertheless, the harm can be reduced. These mechanisms need to be further studied and characterized. In particular, their time dependence needs to be understood before the proposed treatment can be optimized. Under certain situations it is also possible that the deleterious effects of chemotherapy can be mitigated and the damage to radiation workers can be reduced.

  16. Reducing Adolescent Obesity through a School Health Program.

    ERIC Educational Resources Information Center

    Botvin, G. J.; And Others

    1979-01-01

    A 10-session weight reduction program that included behavior modification, nutrition education, and exercise management was found to be effective in reducing weight. (Author/DLS) Journal Availability: C. V. Mosby Company, 11830 Westline Industrial Dr., St. Louis, MO 63141

  17. Reducing stillbirths: interventions during labour

    PubMed Central

    Darmstadt, Gary L; Yakoob, Mohammad Yawar; Haws, Rachel A; Menezes, Esme V; Soomro, Tanya; Bhutta, Zulfiqar A

    2009-01-01

    Background Approximately one million stillbirths occur annually during labour; most of these stillbirths occur in low and middle-income countries and are associated with absent, inadequate, or delayed obstetric care. The low proportion of intrapartum stillbirths in high-income countries suggests that intrapartum stillbirths are largely preventable with quality intrapartum care, including prompt recognition and management of intrapartum complications. The evidence for impact of intrapartum interventions on stillbirth and perinatal mortality outcomes has not yet been systematically examined. Methods We undertook a systematic review of the published literature, searching PubMed and the Cochrane Library, of trials and reviews (N = 230) that reported stillbirth or perinatal mortality outcomes for eight interventions delivered during labour. Where eligible randomised controlled trials had been published after the most recent Cochrane review on any given intervention, we incorporated these new trial findings into a new meta-analysis with the Cochrane included studies. Results We found a paucity of studies reporting statistically significant evidence of impact on perinatal mortality, especially on stillbirths. Available evidence suggests that operative delivery, especially Caesarean section, contributes to decreased stillbirth rates. Induction of labour rather than expectant management in post-term pregnancies showed strong evidence of impact, though there was not enough evidence to suggest superior safety for the fetus of any given drug or drugs for induction of labour. Planned Caesarean section for term breech presentation has been shown in a large randomised trial to reduce stillbirths, but the feasibility and consequences of implementing this intervention routinely in low-/middle-income countries add caveats to recommending its use. Magnesium sulphate for pre-eclampsia and eclampsia is effective in preventing eclamptic seizures, but studies have not demonstrated impact

  18. Coating Reduces Ice Adhesion

    NASA Technical Reports Server (NTRS)

    Smith, Trent; Prince, Michael; DwWeese, Charles; Curtis, Leslie

    2008-01-01

    The Shuttle Ice Liberation Coating (SILC) has been developed to reduce the adhesion of ice to surfaces on the space shuttle. SILC, when coated on a surface (foam, metal, epoxy primer, polymer surfaces), will reduce the adhesion of ice by as much as 90 percent as compared to the corresponding uncoated surface. This innovation is a durable coating that can withstand several cycles of ice growth and removal without loss of anti-adhesion properties. SILC is made of a binder composed of varying weight percents of siloxane(s), ethyl alcohol, ethyl sulfate, isopropyl alcohol, and of fine-particle polytetrafluoroethylene (PTFE). The combination of these components produces a coating with significantly improved weathering characteristics over the siloxane system alone. In some cases, the coating will delay ice formation and can reduce the amount of ice formed. SILC is not an ice prevention coating, but the very high water contact angle (greater than 140 ) causes water to readily run off the surface. This coating was designed for use at temperatures near -170 F (-112 C). Ice adhesion tests performed at temperatures from -170 to 20 F (-112 to -7 C) show that SILC is a very effective ice release coating. SILC can be left as applied (opaque) or buffed off until the surface appears clear. Energy dispersive spectroscopy (EDS) and x-ray photoelectron spectroscopy (XPS) data show that the coating is still present after buffing to transparency. This means SILC can be used to prevent ice adhesion even when coating windows or other objects, or items that require transmission of optical light. Car windshields are kept cleaner and SILC effectively mitigates rain and snow under driving conditions.

  19. Modelling reduced sparse data

    NASA Astrophysics Data System (ADS)

    Kozera, Ryszard; Noakes, Lyle

    2016-09-01

    In this paper we discuss the problem of fitting to an ordered collection of points in arbitary Euclidean space called reduced data. We are not given here the corresponding interpolation knots. Instead, these are estimated by new knots upon minimizing a relevant highly nonlinear optimization scheme based on natural spline interpolation. The existence of a global minimizer (i.e. the collection of interpolation knots in ascending order) is also addressed in this paper. Finally, Leap-Frog optimization tool is used to compute these knots approximating the unknown interpolation knots. This numerical scheme is subsequently compared with the Secant Method. Two illustrative examples are given.

  20. Nonlinearity-reduced interferometer

    NASA Astrophysics Data System (ADS)

    Wu, Chien-ming

    2007-12-01

    Periodic nonlinearity is a systematic error limiting the accuracy of displacement measurements at the nanometer level. It results from many causes such as the frequency mixing, polarization mixing, polarization-frequency mixing, and the ghost reflections. An interferometer having accuracy in displacement measurement of less than one-nanometer is necessary in nanometrology. To meet the requirement, the periodic nonlinearity should be less than deep sub-nanometer. In this paper, a nonlinearity-reduced interferometry has been proposed. Both the linear- and straightness-interferometer were tested. The developed interferometer demonstrated of a residual nonlinearity less than 25 pm.

  1. Leveraging Technology to Reduce Patient Transaction Costs.

    PubMed

    Edlow, Richard C

    2015-01-01

    Medical practices are under significant pressure to provide superior customer service in an environment of declining or flat reimbursement. The solution for many practices involves the integration of a variety of third-party technologies that conveniently interface with one's electronic practice management and medical records systems. Typically, the applications allow the practice to reduce the cost of each patient interaction. Drilling down to quantify the cost of each individual patient interaction helps to determine the practicality of implementation.

  2. Amending poultry litter to reduce ammonia producing bacteria

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Poultry litter is a valuable nutrient source for crop production that requires proper management to garner environmentally and financially sustainable benefits. Successful management to reduce ammonia (NH3-N) and its harmful side-effects for poultry and the environment can be aided by the use of lit...

  3. Risk Management Programs for Defense Acquisition Systems

    DTIC Science & Technology

    2007-11-02

    The audit objective was to evaluate the effectiveness of risk management programs for Defense acquisition systems. Specifically, we determined whether DoD risk management policies and procedures for Defense acquisition systems were effectively implemented and what impact risk management programs bad on reducing program risks and costs. We also reviewed management controls as they applied to the audit objectives.

  4. Reducing transfusion requirements in liver transplantation

    PubMed Central

    Donohue, Ciara I; Mallett, Susan V

    2015-01-01

    Liver transplantation (LT) was historically associated with massive blood loss and transfusion. Over the past two decades transfusion requirements have reduced dramatically and increasingly transfusion-free transplantation is a reality. Both bleeding and transfusion are associated with adverse outcomes in LT. Minimising bleeding and reducing unnecessary transfusions are therefore key goals in the perioperative period. As the understanding of the causes of bleeding has evolved so too have techniques to minimize or reduce the impact of blood loss. Surgical “piggyback” techniques, anaesthetic low central venous pressure and haemodilution strategies and the use of autologous cell salvage, point of care monitoring and targeted correction of coagulopathy, particularly through use of factor concentrates, have all contributed to declining reliance on allogenic blood products. Pre-emptive management of preoperative anaemia and adoption of more restrictive transfusion thresholds is increasingly common as patient blood management (PBM) gains momentum. Despite progress, increasing use of marginal grafts and transplantation of sicker recipients will continue to present new challenges in bleeding and transfusion management. Variation in practice across different centres and within the literature demonstrates the current lack of clear transfusion guidance. In this article we summarise the causes and predictors of bleeding and present the evidence for a variety of PBM strategies in LT. PMID:26722645

  5. Management Options for Reducing Ammonia Emissions from Poultry Litter

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Ammonia emissions from poultry litter not only result in air pollution; high levels of ammonia in poultry houses cause poor bird performance, increase the susceptibility of birds to viral diseases, and negatively impact human health. Although ammonia emissions are a concern, few cost-effective best ...

  6. Management strategies to reduce environmental impact from soil fumigation

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Soil fumigation is an important agronomic practice for controlling soil-borne plant pests. However, all fumigant chemicals have relatively high vapor pressure values and are prone to emission losses to the ambient atmosphere. This poses significant safety and human health concerns for farmers and ...

  7. Reducing Environmental Noise Impacts: A USAREUR Noise Management Program Handbook

    DTIC Science & Technology

    1991-06-01

    the vibration . Use of acoustical absorbing material and double walls enhance abatement considerably (see Figure 7-2). It should be noted that enclosures... vibration . Use of acoustical absorbingI1i material and double walls enhance abatement considerably (see Figure 8-4). It should be noted that enclosures for...sound is received. Remember these three media (source, path, receiver) - they will come up again. The actual sound created is from vibration in the air

  8. Management’s Role for Reducing Employee Stress.

    DTIC Science & Technology

    1983-03-01

    provide additional energy, the adrenals increase the amount of fat and cholestoral in the blood and the liver is directed to increase the amount of sugar ...one cause of heart disease and has been directly related to such maladies as hypertension, mental depression, migraine headaches, fever, colitis

  9. Managing hybrid marketing systems.

    PubMed

    Moriarty, R T; Moran, U

    1990-01-01

    As competition increases and costs become critical, companies that once went to market only one way are adding new channels and using new methods - creating hybrid marketing systems. These hybrid marketing systems hold the promise of greater coverage and reduced costs. But they are also hard to manage; they inevitably raise questions of conflict and control: conflict because marketing units compete for customers; control because new indirect channels are less subject to management authority. Hard as they are to manage, however, hybrid marketing systems promise to become the dominant design, replacing the "purebred" channel strategy in all kinds of businesses. The trick to managing the hybrid is to analyze tasks and channels within and across a marketing system. A map - the hybrid grid - can help managers make sense of their hybrid system. What the chart reveals is that channels are not the basic building blocks of a marketing system; marketing tasks are. The hybrid grid forces managers to consider various combinations of channels and tasks that will optimize both cost and coverage. Managing conflict is also an important element of a successful hybrid system. Managers should first acknowledge the inevitability of conflict. Then they should move to bound it by creating guidelines that spell out which customers to serve through which methods. Finally, a marketing and sales productivity (MSP) system, consisting of a central marketing database, can act as the central nervous system of a hybrid marketing system, helping managers create customized channels and service for specific customer segments.

  10. Radio frequency spectrum management

    NASA Astrophysics Data System (ADS)

    Sujdak, E. J., Jr.

    1980-03-01

    This thesis is a study of radio frequency spectrum management as practiced by agencies and departments of the Federal Government. After a brief introduction to the international agency involved in radio frequency spectrum management, the author concentrates on Federal agencies engaged in frequency management. These agencies include the National Telecommunications and Information Administration (NTIA), the Interdepartment Radio Advisory Committee (IRAC), and the Department of Defense (DoD). Based on an analysis of Department of Defense frequency assignment procedures, recommendations are given concerning decentralizing military frequency assignment by delegating broader authority to unified commanders. This proposal includes a recommendation to colocate the individual Service frequency management offices at the Washington level. This would result in reduced travel costs, lower manpower requirements, and a common tri-Service frequency management data base.

  11. Embodied intervention reduce depression

    NASA Astrophysics Data System (ADS)

    Song, Dong-Qing; Bi, Xin; Fu, Ying

    2011-10-01

    To investigate the difference of the selected-rate of undergraduates' depression with respect to time, gender and scales and the intervention effect of embodied exercise, 201 Undergraduates were measured with Self-Rating Depression Scale and Beck Depression Inventory (BDI).The result shows there are significant difference of the selected-rates of undergraduates' depression resulted from long-time interval rather than from short-time interval and gender. After the intervention, the selected-rates are decreased and no significant difference has been found between the embodied groups and the controlled group. Only the embodied groups maintain the better effects of the intervention in the tracking. Also the result shows that only the participants of embodied groups obtain more positive emotional experience. We conclude that there is significant difference of selected-rate of undergraduates' depression on scales, and the embodied exercise can effectively reduce undergraduate's depression.

  12. Pressure reducing regulator

    DOEpatents

    Whitehead, J.C.; Dilgard, L.W.

    1995-10-10

    A pressure reducing regulator that controls its downstream or outlet pressure to a fixed fraction of its upstream or inlet pressure is disclosed. The regulator includes a housing which may be of a titanium alloy, within which is located a seal or gasket at the outlet end which may be made of annealed copper, a rod, and piston, each of which may be made of high density graphite. The regulator is insensitive to temperature by virtue of being without a spring or gas sealed behind a diaphragm, and provides a reference for a system in which it is being used. The rod and piston of the regulator are constructed, for example, to have a 1/20 ratio such that when the downstream pressure is less than 1/20 of the upstream pressure the regulator opens and when the downstream pressure exceeds 1/20 of the upstream pressure the regulator closes. 10 figs.

  13. Pressure reducing regulator

    DOEpatents

    Whitehead, John C.; Dilgard, Lemoyne W.

    1995-01-01

    A pressure reducing regulator that controls its downstream or outlet pressure to a fixed fraction of its upstream or inlet pressure. The regulator includes a housing which may be of a titanium alloy, within which is located a seal or gasket at the outlet end which may be made of annealed copper, a rod, and piston, each of which may be made of high density graphite. The regulator is insensitive to temperature by virtue of being without a spring or gas sealed behind a diaphragm, and provides a reference for a system in which it is being used. The rod and piston of the regulator are constructed, for example, to have a 1/20 ratio such that when the downstream pressure is less than 1/20 of the upstream pressure the regulator opens and when the downstream pressure exceeds 1/20 of the upstream pressure the regulator closes.

  14. Reduced Order Podolsky Model

    NASA Astrophysics Data System (ADS)

    Thibes, Ronaldo

    2017-02-01

    We perform the canonical and path integral quantizations of a lower-order derivatives model describing Podolsky's generalized electrodynamics. The physical content of the model shows an auxiliary massive vector field coupled to the usual electromagnetic field. The equivalence with Podolsky's original model is studied at classical and quantum levels. Concerning the dynamical time evolution, we obtain a theory with two first-class and two second-class constraints in phase space. We calculate explicitly the corresponding Dirac brackets involving both vector fields. We use the Senjanovic procedure to implement the second-class constraints and the Batalin-Fradkin-Vilkovisky path integral quantization scheme to deal with the symmetries generated by the first-class constraints. The physical interpretation of the results turns out to be simpler due to the reduced derivatives order permeating the equations of motion, Dirac brackets and effective action.

  15. Reducing medical waste.

    PubMed

    Conrardy, Julie; Hillanbrand, Mary; Myers, Sandra; Nussbaum, George F

    2010-06-01

    Medical waste is a necessary by-product of any hospital environment; however, the majority of regulated medical waste is produced in the OR from the use of disposable surgical supplies (eg, drapes, gowns, basins, gloves, sponges). We conducted a concept comparison project in the ORs of two large medical centers in Bethesda, Maryland, and Washington, DC, to evaluate the effects of using reusable surgical basins, gowns, and table and Mayo stand covers in place of disposable products. Survey results indicated that surgeons and surgical technologists found the reusable products to be preferable to the disposable products currently in use. In addition, using reusable products provided a means to decrease regulated medical waste generated in the OR by an average of 65% as well as reduce the cost of waste disposal. AORN recommends evaluating the environmental effects of using reusable, reposable, and disposable products; our findings provide evidence that may be useful to surgical facilities that seek to adopt a "green" approach.

  16. Developing Tribal Integrated Waste Management Plans

    EPA Pesticide Factsheets

    An IWMP outlines how the tribe will reduce, manage, and dispose of its waste. It identifies existing waste systems, assesses needs, and sets forth the ways to design, implement, and monitor a more effective and sustainable waste management program.

  17. What is an Integrated Waste Management Plan

    EPA Pesticide Factsheets

    This document describes the Integrated Waste Management Plans (IWMPs) as an efficient and cost-effective way to reduce open dumping, effectively manage solid waste, and protect human health and the environment.

  18. Population management takes disease management to the next level.

    PubMed

    Ketner, L

    1999-08-01

    The increased development and implementation of disease management programs reflect attempts by a growing number of health plans to reduce costs while providing patients with high-quality care. Unfortunately, few of these programs are generating optimal cost savings. Instituting initiatives for a select group of plan members afflicted with a disease will not produce the positive results that a comprehensive population management program can. Through the integration, coordination, and management of all of a population's healthcare needs, diabetes population management programs are producing significantly greater cost savings than are other disease management programs, including those for diabetes.

  19. [Does clinical risk management require a structured conflict management?].

    PubMed

    Neumann, Stefan

    2015-01-01

    A key element of clinical risk management is the analysis of errors causing near misses or patient damage. After analyzing the causes and circumstances, measures for process improvement have to be taken. Process management, human resource development and other established methods are used. If an interpersonal conflict is a contributory factor to the error, there is usually no structured conflict management available which includes selection criteria for various methods of conflict processing. The European University Viadrina in Frankfurt (Oder) has created a process model for introducing a structured conflict management system which is suitable for hospitals and could fill the gap in the methodological spectrum of clinical risk management. There is initial evidence that a structured conflict management reduces staff fluctuation and hidden conflict costs. This article should be understood as an impulse for discussion on to what extent the range of methods of clinical risk management should be complemented by conflict management.

  20. Measuring the reduced shear

    NASA Astrophysics Data System (ADS)

    Zhang, Jun

    2011-11-01

    Neglecting the second order corrections in weak lensing measurements can lead to a few percent uncertainties on cosmic shears, and becomes more important for cluster lensing mass reconstructions. Existing methods which claim to measure the reduced shears are not necessarily accurate to the second order when a point spread function (PSF) is present. We show that the method of Zhang (2008) exactly measures the reduced shears at the second order level in the presence of PSF. A simple theorem is provided for further confirming our calculation, and for judging the accuracy of any shear measurement method at the second order based on its properties at the first order. The method of Zhang (2008) is well defined mathematically. It does not require assumptions on the morphologies of galaxies and the PSF. To reach a sub-percent level accuracy, the CCD pixel size is required to be not larger than 1/3 of the Full Width at Half Maximum (FWHM) of the PSF, regardless of whether the PSF has a power-law or exponential profile at large distances. Using a large ensemble (gtrsim107) of mock galaxies of unrestricted morphologies, we study the shear recovery accuracy under different noise conditions. We find that contaminations to the shear signals from the noise of background photons can be removed in a well defined way because they are not correlated with the source shapes. The residual shear measurement errors due to background noise are consistent with zero at the sub-percent level even when the amplitude of such noise reaches about 1/10 of the source flux within the half-light radius of the source. This limit can in principle be extended further with a larger galaxy ensemble in our simulations. On the other hand, the source Poisson noise remains to be a cause of systematic errors. For a sub-percent level accuracy, our method requires the amplitude of the source Poisson noise to be less than 1/80 ~ 1/100 of the source flux within the half-light radius of the source, corresponding to

  1. Measuring the reduced shear

    SciTech Connect

    Zhang, Jun

    2011-11-01

    Neglecting the second order corrections in weak lensing measurements can lead to a few percent uncertainties on cosmic shears, and becomes more important for cluster lensing mass reconstructions. Existing methods which claim to measure the reduced shears are not necessarily accurate to the second order when a point spread function (PSF) is present. We show that the method of Zhang (2008) exactly measures the reduced shears at the second order level in the presence of PSF. A simple theorem is provided for further confirming our calculation, and for judging the accuracy of any shear measurement method at the second order based on its properties at the first order. The method of Zhang (2008) is well defined mathematically. It does not require assumptions on the morphologies of galaxies and the PSF. To reach a sub-percent level accuracy, the CCD pixel size is required to be not larger than 1/3 of the Full Width at Half Maximum (FWHM) of the PSF, regardless of whether the PSF has a power-law or exponential profile at large distances. Using a large ensemble (∼>10{sup 7}) of mock galaxies of unrestricted morphologies, we study the shear recovery accuracy under different noise conditions. We find that contaminations to the shear signals from the noise of background photons can be removed in a well defined way because they are not correlated with the source shapes. The residual shear measurement errors due to background noise are consistent with zero at the sub-percent level even when the amplitude of such noise reaches about 1/10 of the source flux within the half-light radius of the source. This limit can in principle be extended further with a larger galaxy ensemble in our simulations. On the other hand, the source Poisson noise remains to be a cause of systematic errors. For a sub-percent level accuracy, our method requires the amplitude of the source Poisson noise to be less than 1/80 ∼ 1/100 of the source flux within the half-light radius of the source

  2. Local stressors reduce coral resilience to bleaching.

    PubMed

    Carilli, Jessica E; Norris, Richard D; Black, Bryan A; Walsh, Sheila M; McField, Melanie

    2009-07-22

    Coral bleaching, during which corals lose their symbiotic dinoflagellates, typically corresponds with periods of intense heat stress, and appears to be increasing in frequency and geographic extent as the climate warms. A fundamental question in coral reef ecology is whether chronic local stress reduces coral resistance and resilience from episodic stress such as bleaching, or alternatively promotes acclimatization, potentially increasing resistance and resilience. Here we show that following a major bleaching event, Montastraea faveolata coral growth rates at sites with higher local anthropogenic stressors remained suppressed for at least 8 years, while coral growth rates at sites with lower stress recovered in 2-3 years. Instead of promoting acclimatization, our data indicate that background stress reduces coral fitness and resilience to episodic events. We also suggest that reducing chronic stress through local coral reef management efforts may increase coral resilience to global climate change.

  3. Stewarding a Reduced Stockpile

    SciTech Connect

    Goodwin, B T; Mara, G

    2008-04-18

    The future of the US nuclear arsenal continues to be guided by two distinct drivers: the preservation of world peace and the prevention of further proliferation through our extended deterrent umbrella. Timely implementation of US nuclear policy decisions depends, in part, on the current state of stockpile weapons, their delivery systems, and the supporting infrastructure within the Department of Defense (DoD) and the Department of Energy's National Nuclear Security Administration (NNSA). In turn, the present is a product of past choices and world events. Now more than ever, the nuclear weapons program must respond to the changing global security environment and to increasing budget pressures with innovation and sound investments. As the nation transitions to a reduced stockpile, the successes of the Stockpile Stewardship Program (SSP) present options to transition to a sustainable complex better suited to stockpile size, national strategic goals and budgetary realities. Under any stockpile size, we must maintain essential human capital, forefront capabilities, and have a right-sized effective production capacity. We present new concepts for maintaining high confidence at low stockpile numbers and to effectively eliminate the reserve weapons within an optimized complex. We, as a nation, have choices to make on how we will achieve a credible 21st century deterrent.

  4. Reducing miner absenteeism

    SciTech Connect

    Peters, R.H.; Clingan, M.R.; Randolph, R.F.

    1989-01-01

    The U. S. Bureau of Mines has prepared this report on strategies for maintaining high job attendance among underground coal miners because high absenteeism is a threat to miners' safety and seriously hampers productivity. A substantial number of research studies on the effectiveness of various strategies for reducing absenteeism among the employees of nonmining industries have been reported in the literature. These strategies have aimed at improving job attendance through one or more of the following: (1) improving employment procedures, (2) overcoming problems that adversely affect one's ability to attend work, and (3) increasing miners' motivation to attend work. Many of these strategies appear applicable to the mining industry, and are reviewed in the first half of this report. The second half of this report describes how one could develop and implement a program for maintaining high attendance at underground coal mines. The steps include measuring and evaluating attendance levels, formulating attendance goals and an absenteeism policy, developing and implementing an attendance promotion program and periodically going through the preceding steps (known as recycling).

  5. Pollution reducing aircraft propulsion

    SciTech Connect

    Tamura, R.

    1980-07-29

    An aircraft pollution reducing propulsion airfoil system comprising a wing having upper and lower surfaces comprising wing skin plates extending longitudinally on the wing and being spaced one from another in chordwise directions, spars extending into the wing between the surfaces, stringer ducts extending along internal sides of the wing surfaces, the stringers having relatively rigid surface-supporting structure and having outward directed openings extending across the wing surfaces, interrupting the wing surfaces between edges of the wing skin plates, the ducts thereby forming stringer structural elements supporting the wing skin plates, the outward directed openings of the stringer ducts being arranged perpendicularly to the wing surfaces in a leading portion of the wing and tangential to the wing surfaces in a trailing portion of the wing surfaces, suction means connected to the stringer ducts with perpendicular opening for drawing gas into the ducts through those openings and blowing means connected to the ducts with tangential openings for flowing gas out of the tangential openings, combustion means connected to the suction means and to the blowing meanas for accelerating gas through the means.

  6. National Policy Agenda to Reduce the Burden of Student Debt

    ERIC Educational Resources Information Center

    Institute for College Access & Success, 2014

    2014-01-01

    Since 2005, "The Institute for College Access & Success" (TICAS) and its Project on Student Debt have worked to reduce the risks and burdens of student debt. TICAS helped create and improve income-based repayment plans to keep federal loan payments manageable; strengthen Pell Grants, which reduce the need to borrow; and simplify the…

  7. Trained Home Composters Reduce Solid Waste by 18%.

    ERIC Educational Resources Information Center

    Vossen, Paul; Rilla, Ellen

    1996-01-01

    In the University of California Cooperative Extension's Master Gardener Program, a partnership with the Sonoma County Waste Management Agency, volunteers teach approximately 1000 people annually how to compost in their backyards to help reduce landfill waste. Surveys conducted in 1995 and 1996 showed that home composters reduced their input into…

  8. Reduced Gravity Walking Simulator

    NASA Technical Reports Server (NTRS)

    1963-01-01

    A test subject being suited up for studies on the Reduced Gravity Walking Simulator located in the hanger at Langley Research Center. The initial version of this simulator was located inside the hanger. Later a larger version would be located at the Lunar Landing Facility. The purpose of this simulator was to study the subject while walking, jumping or running. Researchers conducted studies of various factors such as fatigue limit, energy expenditure, and speed of locomotion. Francis B. Smith wrote in his paper 'Simulators For Manned Space Research,' 'I would like to conclude this talk with a discussion of a device for simulating lunar gravity which is very effective and yet which is so simple that its cost is in the order of a few thousand dollars at most, rather than hundreds of thousands. With a little ingenuity, one could almost build this type simulator in his backyard for children to play on. The principle is ...if a test subject is suspended in a sling so that his body axis makes an angle of 9 1/2 degrees with the horizontal and if he then 'stands' on a platform perpendicular to his body axis, the component of the earth's gravity forcing him toward the platform is one times the sine of 9 1/2 degrees or approximately 1/6 of the earth's normal gravity field. That is, a 180 pound astronaut 'standing' on the platform would exert a force of only 30 pounds - the same as if he were standing upright on the lunar surface.' Published in James R. Hansen, Spaceflight Revolution: NASA Langley Research Center From Sputnik to Apollo, NASA SP-4308; Francis B. Smith, 'Simulators For Manned Space Research,' Paper for 1966 IEEE International Convention, New York, NY, March 21-25, 1966.

  9. Materials and Waste Management Research

    EPA Pesticide Factsheets

    EPA is developing data and tools to reduce waste, manage risks, reuse and conserve natural materials, and optimize energy recovery. Collaboration with states facilitates assessment and utilization of technologies developed by the private sector.

  10. Drainage water management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This article introduces a series of papers that report results of field studies to determine the effectiveness of drainage water management (DWM) on conserving drainage water and reducing losses of nitrogen (N) to surface waters. The series is focused on the performance of the DWM (also called contr...

  11. Essays on Knowledge Management

    ERIC Educational Resources Information Center

    Xiao, Wenli

    2012-01-01

    For many firms, particularly those operating in high technology and competitive markets, knowledge is cited as the most important strategic asset to the firm, which significantly drives its survival and success (Grant 1996, Webber 1993). Knowledge management (KM) impacts the firm's ability to develop process features that reduce manufacturing…

  12. Managing 'tail liability'.

    PubMed

    Frese, Richard C; Weber, Ryan J

    2013-11-01

    To reduce and control their level of tail liability, hospitals should: Utilize a self-insurance vehicle; Consider combined limits between the hospital and physicians; Communicate any program changes to the actuary, underwriter, and auditor; Continue risk management and safety practices; Ensure credit is given to the organization's own medical malpractice program.

  13. Risk Management Implementation Tool

    NASA Technical Reports Server (NTRS)

    Wright, Shayla L.

    2004-01-01

    Continuous Risk Management (CM) is a software engineering practice with processes, methods, and tools for managing risk in a project. It provides a controlled environment for practical decision making, in order to assess continually what could go wrong, determine which risk are important to deal with, implement strategies to deal with those risk and assure the measure effectiveness of the implemented strategies. Continuous Risk Management provides many training workshops and courses to teach the staff how to implement risk management to their various experiments and projects. The steps of the CRM process are identification, analysis, planning, tracking, and control. These steps and the various methods and tools that go along with them, identification, and dealing with risk is clear-cut. The office that I worked in was the Risk Management Office (RMO). The RMO at NASA works hard to uphold NASA s mission of exploration and advancement of scientific knowledge and technology by defining and reducing program risk. The RMO is one of the divisions that fall under the Safety and Assurance Directorate (SAAD). I worked under Cynthia Calhoun, Flight Software Systems Engineer. My task was to develop a help screen for the Continuous Risk Management Implementation Tool (RMIT). The Risk Management Implementation Tool will be used by many NASA managers to identify, analyze, track, control, and communicate risks in their programs and projects. The RMIT will provide a means for NASA to continuously assess risks. The goals and purposes for this tool is to provide a simple means to manage risks, be used by program and project managers throughout NASA for managing risk, and to take an aggressive approach to advertise and advocate the use of RMIT at each NASA center.

  14. Reservoir management cost-cutting

    SciTech Connect

    Gulati, M.S.

    1996-12-31

    This article by Mohinder S. Gulati, Chief Engineer, Unocal Geothermal Operations, discusses cost cutting in geothermal reservoir management. The reservoir engineer or geoscientist can make a big difference in the economical outcome of a project by improving well performance and thus making geothermal energy more competitive in the energy marketplace. Bringing plants online in less time and proving resources to reduce the cycle time are some of the ways to reduce reservoir management costs discussed in this article.

  15. Anger Management

    MedlinePlus

    ... how to do this. You may learn anger management skills on your own, using books or other resources. ... for weeks or months. Generally, counseling for anger management focuses on learning specific skills and ways of thinking so you can cope ...

  16. Weight Management

    MedlinePlus

    ... Together Understanding Adult Overweight & Obesity About Food Portions Bariatric Surgery for Severe Obesity More Weight Management Topics Healthy ... Sleep Apnea Weight Management Topics About Food Portions Bariatric Surgery for Severe Obesity Being Healthy is a Big ...

  17. Exploiting Data Similarity to Reduce Memory Footprints

    SciTech Connect

    Biswas, S; de Supinski, B R; Schulz, M; Franklin, D; Sherwood, T; Chong, F T

    2011-01-28

    Memory size has long limited large-scale applications on high-performance computing (HPC) systems. Since compute nodes frequently do not have swap space, physical memory often limits problem sizes. Increasing core counts per chip and power density constraints, which limit the number of DIMMs per node, have exacerbated this problem. Further, DRAM constitutes a significant portion of overall HPC system cost. Therefore, instead of adding more DRAM to the nodes, mechanisms to manage memory usage more efficiently - preferably transparently - could increase effective DRAM capacity and thus the benefit of multicore nodes for HPC systems. MPI application processes often exhibit significant data similarity. These data regions occupy multiple physical locations across the individual rank processes within a multicore node and thus offer a potential savings in memory capacity. These regions, primarily residing in heap, are dynamic, which makes them difficult to manage statically. Our novel memory allocation library, SBLLmalloc, automatically identifies identical memory blocks and merges them into a single copy. SBLLmalloc does not require application or OS changes since we implement it as a user-level library. Overall, we demonstrate that SBLLmalloc reduces the memory footprint of a range of MPI applications by 32.03% on average and up to 60.87%. Further, SBLLmalloc supports problem sizes for IRS over 21.36% larger than using standard memory management techniques, thus significantly increasing effective system size. Similarly, SBLLmalloc requires 43.75% fewer nodes than standard memory management techniques to solve an AMG problem.

  18. Managing Conflict.

    ERIC Educational Resources Information Center

    Labovitz, George H.

    1980-01-01

    Examines the causes of conflict and various methods of managing it. Argues that by confronting disputes and providing a process that encourages their productive management, managers may help guarantee that the healthy aspects of conflict flourish in their organization. Available from Business Horizons, School of Business, Indiana University,…

  19. Cash Management.

    ERIC Educational Resources Information Center

    Fischer, Mary L.; Ostrom, John S.

    1982-01-01

    Elements of an effective management program for colleges and universities are examined. Five basic purposes of an effective program of cash management are identified: developing accurate cash projections, managing cash receipts, controlling cash disbursements, establishing sound banking relationships, and investing funds. It is suggested that all…

  20. Time Management

    ERIC Educational Resources Information Center

    Stoilov, Todor, Ed.

    2012-01-01

    The time management is worthy goal of many human activities. It concerns variety problems related to goals definition, assessment of available resources, control of management policies, scheduling of decisions. This book is an attempt to illustrate the decision making process in time management for different success stories, which can be used as…

  1. Team Management.

    ERIC Educational Resources Information Center

    Lindelow, John

    Chapter 5 of a volume on school leadership, this chapter reviews the literature to define and explain management teams and to describe several successful management team arrangements. The author begins by noting that team management has recently enjoyed a resurgence as a response to collective negotiations, but beyond this function can have value…

  2. Managing Success.

    ERIC Educational Resources Information Center

    Gaydon, Tony

    2002-01-01

    Offers guidelines to ensure a smooth school construction project: (1) validate the program and budget; (2) create a management plan; (3) develop a reporting system; (4) qualify designers; (5) manage the design phase; (6) put the schedule in bidding documents; and (6) closely manage the construction phase. (EV)

  3. Interpreting Financial Results. Financial Management Module. Operational Management Programme. Increasing Opportunities for Supervisors and Managers.

    ERIC Educational Resources Information Center

    Adamson, Jan; And Others

    One of a series of three self-instructional units, these materials are aimed at helping British hotel and catering managers improve profits and/or reduce costs in their areas of responsibility. Following an introduction and a paragraph on how to use the unit, section 1 covers how to use management information. The section includes these trainee…

  4. Reducing gas generators and methods for generating a reducing gas

    DOEpatents

    Scotto, Mark Vincent; Perna, Mark Anthony

    2015-11-03

    One embodiment of the present invention is a unique reducing gas generator. Another embodiment is a unique method for generating a reducing gas. Other embodiments include apparatuses, systems, devices, hardware, methods, and combinations for generating reducing gas. Further embodiments, forms, features, aspects, benefits, and advantages of the present application will become apparent from the description and figures provided herewith.

  5. Team Management: Quick Relief from the Minor Aches and Pains of School Business Management.

    ERIC Educational Resources Information Center

    Stevens, Kenneth R.; Pellicer, Leonard O.

    1984-01-01

    The use of the management team approach by school business officials will result in increased operational efficiency, greater accountability, better decisions, less crisis management, reduced stress, and increased job satisfaction. (MLF)

  6. Adaptive Management for Urban Watersheds: The Slavic Village Pilot Project

    EPA Science Inventory

    Adaptive management is an environmental management strategy that uses an iterative process of decision-making to reduce the uncertainty in environmental management via system monitoring. A central tenet of adaptive management is that management involves a learning process that ca...

  7. Gene Variants Reduce Opioid Risks

    MedlinePlus

    ... this reduced potency is due to changes in binding to the receptor or to changes in the ... the body’s natural opioids, β-endorphin. Because this binding reduces the number of receptors required to achieve ...

  8. Input management of production systems.

    PubMed

    Odum, E P

    1989-01-13

    Nonpoint sources of pollution, which are largely responsible for stressing regional and global life-supporting atmosphere, soil, and water, can only be reduced (and ultimately controlled) by input management that involves increasing the efficiency of production systems and reducing the inputs of environmentally damaging materials. Input management requires a major change, an about-face, in the approach to management of agriculture, power plants, and industries because the focus is on waste reduction and recycling rather than on waste disposal. For large-scale ecosystem-level situations a top-down hierarchical approach is suggested and illustrated by recent research in agroecology and landscape ecology.

  9. Management of hemochromatosis. Hemochromatosis Management Working Group.

    PubMed

    Barton, J C; McDonnell, S M; Adams, P C; Brissot, P; Powell, L W; Edwards, C Q; Cook, J D; Kowdley, K V

    1998-12-01

    The complications of iron overload in hemochromatosis can be avoided by early diagnosis and appropriate management. Therapeutic phlebotomy is used to remove excess iron and maintain low normal body iron stores, and it should be initiated in men with serum ferritin levels of 300 microg/L or more and in women with serum ferritin levels of 200 microg/L or more, regardless of the presence or absence of symptoms. Typically, therapeutic phlebotomy consists of 1) removal of 1 unit (450 to 500 mL) of blood weekly until the serum ferritin level is 10 to 20 microg/L and 2) maintenance of the serum ferritin level at 50 microg/L or less thereafter by periodic removal of blood. Hyperferritinemia attributable to iron overload is resolved by therapeutic phlebotomy. When applied before iron overload becomes severe, this treatment also prevents complications of iron overload, including hepatic cirrhosis, primary liver cancer, diabetes mellitus, hypogonadotrophic hypogonadism, joint disease, and cardiomyopathy. In patients with established iron overload disease, weakness, fatigue, increased hepatic enzyme concentrations, right upper quadrant pain, and hyperpigmentation are often substantially alleviated by therapeutic phlebotomy. Patients with liver disease, joint disease, diabetes mellitus and other endocrinopathic abnormalities, and cardiac abnormalities often require additional, specific management. Dietary management of hemochromatosis includes avoidance of medicinal iron, mineral supplements, excess vitamin C, and uncooked seafoods. This can reduce the rate of iron reaccumulation; reduce retention of nonferrous metals; and help reduce complications of liver disease, diabetes mellitus, and Vibrio infection. This comprehensive approach to the management of hemochromatosis can decrease the frequency and severity of iron overload, improve quality of life, and increase longevity.

  10. Communicating Risk to Program Managers

    NASA Technical Reports Server (NTRS)

    Shivers, C. Herbert

    2005-01-01

    Program Managers (PM) can protect program resources and improve chances of success by anticipating, understanding and managing risks. Understanding the range of potential risks helps one to avoid or manage the risks. A PM must choose which risks to accept to reduce fire fighting, must meet the expectations of stakeholders consistently, and avoid falling into costly "black holes" that may open. A good risk management process provides the PM more confidence to seize opportunities save money, meet schedule, even improve relationships with people important to the program. Evidence of managing risk and sound internal controls can mean better support from superiors for the program by building a trust and reputation from being on top of issues. Risk managers have an obligation to provide the PM with the best information possible to allow the benefits to be realized (Small Business Consortium, 2004). The Institute for Chartered Accountants in England and Wales sees very important benefits for companies in providing better information about what they do to assess and manage key business risks. Such information will: a) provide practical forward-looking information; b) reduce the cost of capital; c) encourage better risk management; and d) improve accountability for stewardship, investor protection and the usefulness of financial reporting. We are particularly convinced that enhanced risk reporting will help listed companies obtain capital at the lowest possible cost (The Institute of Chartered Accountants in England &Wales, June 2002). Risk managers can take a significant role in quantifying the success of their department and communicating those figures to executive (program) management levels while pushing for a broader risk management role. Overall, risk managers must show that risk management work matters in the most crucial place-the bottom line- as they prove risk management can be a profit center (Sullivan, 2004).

  11. In situ mobility of uranium in the presence of nitrate following sulfate-reducing conditions.

    PubMed

    Paradis, Charles J; Jagadamma, Sindhu; Watson, David B; McKay, Larry D; Hazen, Terry C; Park, Melora; Istok, Jonathan D

    2016-04-01

    Reoxidation and mobilization of previously reduced and immobilized uranium by dissolved-phase oxidants poses a significant challenge for remediating uranium-contaminated groundwater. Preferential oxidation of reduced sulfur-bearing species, as opposed to reduced uranium-bearing species, has been demonstrated to limit the mobility of uranium at the laboratory scale yet field-scale investigations are lacking. In this study, the mobility of uranium in the presence of nitrate oxidant was investigated in a shallow groundwater system after establishing conditions conducive to uranium reduction and the formation of reduced sulfur-bearing species. A series of three injections of groundwater (200 L) containing U(VI) (5 μM) and amended with ethanol (40 mM) and sulfate (20 mM) were conducted in ten test wells in order to stimulate microbial-mediated reduction of uranium and the formation of reduced sulfur-bearing species. Simultaneous push-pull tests were then conducted in triplicate well clusters to investigate the mobility of U(VI) under three conditions: 1) high nitrate (120 mM), 2) high nitrate (120 mM) with ethanol (30 mM), and 3) low nitrate (2 mM) with ethanol (30 mM). Dilution-adjusted breakthrough curves of ethanol, nitrate, nitrite, sulfate, and U(VI) suggested that nitrate reduction was predominantly coupled to the oxidation of reduced-sulfur bearing species, as opposed to the reoxidation of U(IV), under all three conditions for the duration of the 36-day tests. The amount of sulfate, but not U(VI), recovered during the push-pull tests was substantially more than injected, relative to bromide tracer, under all three conditions and further suggested that reduced sulfur-bearing species were preferentially oxidized under nitrate-reducing conditions. However, some reoxidation of U(IV) was observed under nitrate-reducing conditions and in the absence of detectable nitrate and/or nitrite. This suggested that reduced sulfur-bearing species may not be fully effective at

  12. In situ mobility of uranium in the presence of nitrate following sulfate-reducing conditions

    NASA Astrophysics Data System (ADS)

    Paradis, Charles J.; Jagadamma, Sindhu; Watson, David B.; McKay, Larry D.; Hazen, Terry C.; Park, Melora; Istok, Jonathan D.

    2016-04-01

    Reoxidation and mobilization of previously reduced and immobilized uranium by dissolved-phase oxidants poses a significant challenge for remediating uranium-contaminated groundwater. Preferential oxidation of reduced sulfur-bearing species, as opposed to reduced uranium-bearing species, has been demonstrated to limit the mobility of uranium at the laboratory scale yet field-scale investigations are lacking. In this study, the mobility of uranium in the presence of nitrate oxidant was investigated in a shallow groundwater system after establishing conditions conducive to uranium reduction and the formation of reduced sulfur-bearing species. A series of three injections of groundwater (200 L) containing U(VI) (5 μM) and amended with ethanol (40 mM) and sulfate (20 mM) were conducted in ten test wells in order to stimulate microbial-mediated reduction of uranium and the formation of reduced sulfur-bearing species. Simultaneous push-pull tests were then conducted in triplicate well clusters to investigate the mobility of U(VI) under three conditions: 1) high nitrate (120 mM), 2) high nitrate (120 mM) with ethanol (30 mM), and 3) low nitrate (2 mM) with ethanol (30 mM). Dilution-adjusted breakthrough curves of ethanol, nitrate, nitrite, sulfate, and U(VI) suggested that nitrate reduction was predominantly coupled to the oxidation of reduced-sulfur bearing species, as opposed to the reoxidation of U(IV), under all three conditions for the duration of the 36-day tests. The amount of sulfate, but not U(VI), recovered during the push-pull tests was substantially more than injected, relative to bromide tracer, under all three conditions and further suggested that reduced sulfur-bearing species were preferentially oxidized under nitrate-reducing conditions. However, some reoxidation of U(IV) was observed under nitrate-reducing conditions and in the absence of detectable nitrate and/or nitrite. This suggested that reduced sulfur-bearing species may not be fully effective at

  13. Teaching Managers How to Manage

    SciTech Connect

    Hylko, J.M.

    2006-07-01

    Following graduation from a college or university with a technical degree, or through years of experience, an individual's training and career development activities typically focus on enhancing technical problem-solving skills. However, as these technical professionals, herein referred to as 'Techies', advance throughout their careers, they may be required to accept and adapt to the role of being a manager, and must undergo a transition to learn and rely on new problem-solving skills. However, unless a company has a specific manager-trainee class to address this subject and develop talent from within, an employee's management style is learned and developed 'on the job'. Both positive and negative styles are nurtured by those managers having similar qualities. Unfortunately, a negative style often contributes to the deterioration of employee morale and ultimate closing of a department or company. This paper provides the core elements of an effective management training program for 'Teaching Managers How to Manage' derived from the Department of Energy's Integrated Safety Management System and the Occupational Safety and Health Administration 's Voluntary Protection Program. Discussion topics and real-life examples concentrate on transitioning an employee from a 'Techie' to a manager; common characteristics of being a manager; the history and academic study of management; competition, change and the business of waste management; what to do after taking over a department by applying Hylko's Star of Success; command media; the formal and informal organizational charts; chain of command; hiring and developing high-degree, autonomous employees through effective communication and delegation; periodic status checks; and determining if the program is working successfully. These common characteristics of a strong management/leadership culture and practical career tips discussed herein provide a solid foundation for any company or department that is serious about developing

  14. [Clinical management. Clinical management units. Management agreements].

    PubMed

    Ortega Moreno, A

    2003-12-01

    Clinical management (CM) as a concept includes different innovating experiences in health care services management among developed countries, which were initiated during the late eighties and the first nineties. They were mostly due to the concern that political leaders had about their financial viability. CM, as far as it is understood in Spain, is an organizing model which considers the patient as the centre of the health system. It is guided towards disease, looking for continuous assistance and facilitates an autonomous management together with decentralization at the time of taking decisions. It involves professionals whose clinical practice, based on guides, medical records and care planning, incorporate the knowledge and methodology of "evidence based medicine". Clinical management units (CMU) are organizational types of CM, which implantation is spreading rapidly in the different national health care systems. They include a person who assumes responsibility for them, who act as the hospital directorship interlocutor and are autonomous at the time of managing the allocated resources related to their medical programmes and services. They have an information system adapted to their own needs and an outcome evaluation system which allows them "process" re-engineering. CMU's strengths and weaknesses are highly dependent on the professionals that integrate them. The CMU responsible carries out a management contract with the hospital directorship in which CMU competences, directorship's obligations, essential aspects to meet agreed goals, an outcome evaluation system and an incentives scheme are included.

  15. Managing costs and managing care.

    PubMed

    Rivers, P A; Tsai, K L

    2001-01-01

    With a defined population served, contracted provider panels and the nature of care delivery integration, managed care has provided a solution, though not a panacea, to provide equitable services, standardized and prevention oriented cares to its enrolled members. Combined with the earmarked capitation reimbursement system and a series of cost containment and utilization review techniques, managed care has also demonstrated potently its capacity in cost-saving and quality promotion. Presents steps and measures related to managed care that federal government has taken to manage care and contain cost. It is crucial to identify and promulgate best practices continually, while managing utilization of resources for improving health care, containing cost, and equalizing medical care access to a greater proportion of the population. Concludes that it may take time for a universal adoption of managed care. However, Americans may actually benefit more from having a standard level of health care that managed care could achieve and provide.

  16. Utilization management in anatomic pathology.

    PubMed

    Lewandrowski, Kent; Black-Schaffer, Steven

    2014-01-01

    There is relatively little published literature concerning utilization management in anatomic pathology. Nonetheless there are many utilization management opportunities that currently exist and are well recognized. Some of these impact only the cost structure within the pathology department itself whereas others reduce charges for third party payers. Utilization management may result in medical legal liabilities for breaching the standard of care. For this reason it will be important for pathology professional societies to develop national utilization guidelines to assist individual practices in implementing a medically sound approach to utilization management.

  17. Climate change and disaster management.

    PubMed

    O'Brien, Geoff; O'Keefe, Phil; Rose, Joanne; Wisner, Ben

    2006-03-01

    Climate change, although a natural phenomenon, is accelerated by human activities. Disaster policy response to climate change is dependent on a number of factors, such as readiness to accept the reality of climate change, institutions and capacity, as well as willingness to embed climate change risk assessment and management in development strategies. These conditions do not yet exist universally. A focus that neglects to enhance capacity-building and resilience as a prerequisite for managing climate change risks will, in all likelihood, do little to reduce vulnerability to those risks. Reducing vulnerability is a key aspect of reducing climate change risk. To do so requires a new approach to climate change risk and a change in institutional structures and relationships. A focus on development that neglects to enhance governance and resilience as a prerequisite for managing climate change risks will, in all likelihood, do little to reduce vulnerability to those risks.

  18. Portfolio Management

    NASA Technical Reports Server (NTRS)

    Duncan, Sharon L.

    2011-01-01

    Enterprise Business Information Services Division (EBIS) supports the Laboratory and its functions through the implementation and support of business information systems on behalf of its business community. EBIS Five Strategic Focus Areas: (1) Improve project estimating, planning and delivery capability (2) Improve maintainability and sustainability of EBIS Application Portfolio (3) Leap forward in IT Leadership (4) Comprehensive Talent Management (5) Continuous IT Security Program. Portfolio Management is a strategy in which software applications are managed as assets

  19. Integrated work management system.

    SciTech Connect

    Williams, Edward J., Jr.; Henry, Karen Lynne

    2010-06-01

    Sandia National Laboratories develops technologies to: (1) sustain, modernize, and protect our nuclear arsenal (2) Prevent the spread of weapons of mass destruction; (3) Provide new capabilities to our armed forces; (4) Protect our national infrastructure; (5) Ensure the stability of our nation's energy and water supplies; and (6) Defend our nation against terrorist threats. We identified the need for a single overarching Integrated Workplace Management System (IWMS) that would enable us to focus on customer missions and improve FMOC processes. Our team selected highly configurable commercial-off-the-shelf (COTS) software with out-of-the-box workflow processes that integrate strategic planning, project management, facility assessments, and space management, and can interface with existing systems, such as Oracle, PeopleSoft, Maximo, Bentley, and FileNet. We selected the Integrated Workplace Management System (IWMS) from Tririga, Inc. Facility Management System (FMS) Benefits are: (1) Create a single reliable source for facility data; (2) Improve transparency with oversight organizations; (3) Streamline FMOC business processes with a single, integrated facility-management tool; (4) Give customers simple tools and real-time information; (5) Reduce indirect costs; (6) Replace approximately 30 FMOC systems and 60 homegrown tools (such as Microsoft Access databases); and (7) Integrate with FIMS.

  20. Reducing Risks of Birth Defects

    MedlinePlus

    ... lead. Lead can be found in old paint, construction materials, alternative medicines, and items made in foreign countries, ... Technology Professional Liability Managing Your Practice Patient Safety & Quality Payment Reform (MACRA) Education & Events Annual Meeting CME ...

  1. Reducing societal vulnerability to drought: A methodology

    SciTech Connect

    Wilhite, D.A.

    1995-12-31

    Given worldwide experience with drought during the past several decades and the magnitude of associated impacts, it is apparent that vulnerability to extended periods of water shortage is escalating. Developing a national or provincial drought policy and preparedness plan is a complicated but essential first step toward reducing societal vulnerability. Until recently, nations had devoted little effort to drought preparedness, preferring instead the reactive or crisis management approach. Presently, an increasing number of nations are pursuing a more proactive approach that emphasizes the principles of risk management and sustainable development. Because of the multitude of impacts associated with drought and the numerous governmental agencies that have responsibility for some aspect of monitoring, assessment, mitigation, and planning, developing a policy and plan must be an integrated process within and between levels of government. This paper outlines a generic process that can be adopted by governments that desire to develop a more comprehensive and long-term approach to drought management and planning. Countries and states or provincial authorities that have adopted this approach is presented as case studies. This process is timely, given the declaration of the 1990s as the International Decade for Natural Disaster Reduction and the recent International Convention to Combat Desertification and Drought (June, 1994), an offshoot of deliberations at the United Nations Conference on Environment and Development.

  2. Oxygen-reducing catalyst layer

    DOEpatents

    O'Brien, Dennis P [Maplewood, MN; Schmoeckel, Alison K [Stillwater, MN; Vernstrom, George D [Cottage Grove, MN; Atanasoski, Radoslav [Edina, MN; Wood, Thomas E [Stillwater, MN; Yang, Ruizhi [Halifax, CA; Easton, E Bradley [Halifax, CA; Dahn, Jeffrey R [Hubley, CA; O'Neill, David G [Lake Elmo, MN

    2011-03-22

    An oxygen-reducing catalyst layer, and a method of making the oxygen-reducing catalyst layer, where the oxygen-reducing catalyst layer includes a catalytic material film disposed on a substrate with the use of physical vapor deposition and thermal treatment. The catalytic material film includes a transition metal that is substantially free of platinum. At least one of the physical vapor deposition and the thermal treatment is performed in a processing environment comprising a nitrogen-containing gas.

  3. Reducing Risk for the Next Generation Nuclear Plant

    SciTech Connect

    John M. Beck II; Harold J. Heydt; Emmanuel O. Opare; Kyle B. Oswald

    2010-07-01

    The Next Generation Nuclear Plant (NGNP) Project, managed by the Idaho National Laboratory (INL), is directed by the Energy Policy Act of 2005, to research, develop, design, construct, and operate a prototype forth generation nuclear reactor to meet the needs of the 21st Century. As with all large projects developing and deploying new technologies, the NGNP has numerous risks that need to be identified, tracked, mitigated, and reduced in order for successful project completion. A Risk Management Plan (RMP) was created to outline the process the INL is using to manage the risks and reduction strategies for the NGNP Project. Integral to the RMP is the development and use of a Risk Management System (RMS). The RMS is a tool that supports management and monitoring of the project risks. The RMS does not only contain a risk register, but other functionality that allows decision makers, engineering staff, and technology researchers to review and monitor the risks as the project matures.

  4. Perioperative supply chain management.

    PubMed

    Feistritzer, N R; Keck, B R

    2000-09-01

    Faced with declining revenues and increasing operating expenses, hospitals are evaluating numerous mechanisms designed to reduce costs while simultaneously maintaining quality care. Many facilities have targeted initial cost reduction efforts in the reduction of labor expenses. Once labor expenses have been "right sized," facilities have continued to focus on service delivery improvements by the optimization of the "supply chain" process. This report presents a case study of the efforts of Vanderbilt University Medical Center in the redesign of its supply chain management process in the department of Perioperative Services. Utilizing a multidisciplinary project management structure, 3 work teams were established to complete the redesign process. To date, the project has reduced costs by $2.3 million and enhanced quality patient care by enhancing the delivery of appropriate clinical supplies during the perioperative experience.

  5. Disease management improves ESRD outcomes.

    PubMed

    Sands, J J

    2006-02-01

    Renal disease management organizations have reported achieving significant decreases in mortality and hospitalization in conjunction with cost savings, improved patient satisfaction and quality of life. Disease management organizations strive to fill existing gaps in care delivery through the standardized use of risk assessment, predictive modeling, evidence based guidelines and process and outcomes measurement. Patient self-management education and the provision of individual nurse care managers are also key program components. As we more fully measure clinical outcomes and total health-care costs including payments from all insurance and government entities, pharmacy costs and out-of-pocket expenditures, the full implications of disease management can be better defined. The results of this analysis will have a profound influence on United States healthcare policy. At present, current data suggests that the promise of disease management, improved care at reduced cost, can and is being realized in ESRD.

  6. Management Manual.

    ERIC Educational Resources Information Center

    San Joaquin Delta Community Coll. District, CA.

    This manual articulates the rights, responsibilities, entitlements, and conditions of employment of management personnel at San Joaquin Delta College (SJDC). The manual first presents SJDC's mission statement and then discusses the college's management goals and priorities. An examination of SJDC's administrative organization and a list of…

  7. Sport Management.

    ERIC Educational Resources Information Center

    Parkhouse, Bonnie L., Ed.; And Others

    1984-01-01

    Traditional teaching and coaching positions have become scarce but the expanding field of sport management has created its own job market, demanding new skills and preparation. Three articles are offered that explore different aspects and possibilities for a sport management career. (DF)

  8. Energy Management.

    ERIC Educational Resources Information Center

    Bete, Tim, Ed.

    1998-01-01

    Presents the opinions of three energy experts on the issue of school facility energy management. The experts respond to the following questions: will energy deregulation occur in all 50 states and will it provide real savings; and will the majority of districts hire ESCOs to manage their energy needs? (GR)

  9. Clothing Management.

    ERIC Educational Resources Information Center

    Michigan State Univ., East Lansing. Coll. of Agriculture and Natural Resources Education Inst.

    This task-based curriculum guide for clothing management is intended to help the teacher develop a classroom management system where students learn by doing. Introductory materials include a Dictionary of Occupational Titles job code and title sheet, a career ladder, a matrix relating duty/task numbers to job titles, and a task list. Each task is…

  10. Environmental Management.

    ERIC Educational Resources Information Center

    Bandhu, Desh, Ed.

    The Indian Environmental Society, in association with the International Programme on Environmental Management Education, organized two seminars on World Environment Day and Environmental Impact Assessment during June 1980. A large number of papers on various aspects of environmental management were presented during the seminars. The papers…

  11. Forest Management.

    ERIC Educational Resources Information Center

    Weicherding, Patrick J.; And Others

    This bulletin deals with forest management and provides an overview of forestry for the non-professional. The bulletin is divided into six sections: (1) What Is Forestry Management?; (2) How Is the Forest Measured?; (3) What Is Forest Protection?; (4) How Is the Forest Harvested?; (5) What Is Forest Regeneration?; and (6) What Is Forest…

  12. Management Development.

    ERIC Educational Resources Information Center

    1997

    This document contains three papers from a symposium on management development. "LMX (Leader-Member Exchange) Theory, Personality Type, and Management Development" (Janet Z. Burns) reports the results of a study on the similarities and differences in personality type (as outlined in the theories of Carl Jung and Isabel Myers) and its relationship…

  13. Inventory Management

    NASA Technical Reports Server (NTRS)

    1983-01-01

    Known as MRO for Maintenance, Repair and Operating supplies, Tropicana Products, Inc.'s automated inventory management system is an adaptation of the Shuttle Inventory Management System (SIMS) developed by NASA to assure adequate supply of every item used in support of the Space Shuttle. The Tropicana version monitors inventory control, purchasing receiving and departmental costs for eight major areas of the company's operation.

  14. Knowledge Management.

    ERIC Educational Resources Information Center

    1999

    The first of the four papers in this symposium, "Knowledge Management and Knowledge Dissemination" (Wim J. Nijhof), presents two case studies exploring the strategies companies use in sharing and disseminating knowledge and expertise among employees. "A Theory of Knowledge Management" (Richard J. Torraco), develops a conceptual…

  15. Optimizing diabetes management: managed care strategies.

    PubMed

    Tzeel, E Albert

    2013-06-01

    Both the prevalence of type 2 diabetes mellitus (DM) and its associated costs have been rising over time and are projected to continue to escalate. Therefore, type 2 DM (T2DM) management costs represent a potentially untenable strain on the healthcare system unless substantial, systemic changes are made. Managed care organizations (MCOs) are uniquely positioned to attempt to make the changes necessary to reduce the burdens associated with T2DM by developing policies that align with evidence-based DM management guidelines and other resources. For example, MCOs can encourage members to implement healthy lifestyle choices, which have been shown to reduce DM-associated mortality and delay comorbidities. In addition, MCOs are exploring the strengths and weaknesses of several different benefit plan designs. Value-based insurance designs, sometimes referred to as value-based benefit designs, use both direct and indirect data to invest in incentives that change behaviors through health information technologies, communications, and services to improve health, productivity, quality, and financial trends. Provider incentive programs, sometimes referred to as "pay for performance," represent a payment/delivery paradigm that places emphasis on rewarding value instead of volume to align financial incentives and quality of care. Accountable care organizations emphasize an alignment between reimbursement and implementation of best practices through the use of disease management and/ or clinical pathways and health information technologies. Consumer-directed health plans, or high-deductible health plans, combine lower premiums with high annual deductibles to encourage members to seek better value for health expenditures. Studies conducted to date on these different designs have produced mixed results.

  16. Managing change: an overview.

    PubMed

    Lorenzi, N M; Riley, R T

    2000-01-01

    As increasingly powerful informatics systems are designed, developed, and implemented, they inevitably affect larger, more heterogeneous groups of people and more organizational areas. In turn, the major challenges to system success are often more behavioral than technical. Successfully introducing such systems into complex health care organizations requires an effective blend of good technical and good organizational skills. People who have low psychological ownership in a system and who vigorously resist its implementation can bring a "technically best" system to its knees. However, effective leadership can sharply reduce the behavioral resistance to change-including to new technologies-to achieve a more rapid and productive introduction of informatics technology. This paper looks at four major areas-why information system failures occur, the core theories supporting change management, the practical applications of change management, and the change management efforts in informatics.

  17. Surgical management of hemorrhoids.

    PubMed

    Agbo, S P

    2011-07-01

    Hemorrhoids are common human afflictions known since the dawn of history. Surgical management of this condition has made tremendous progress from complex ligation and excision procedures in the past to simpler techniques that allow the patient to return to normal life within a short period. Newer techniques try to improve on the post-operative complications of older ones. The surgical options for the management of hemorrhoids today are many. Capturing all in a single article may be difficult if not impossible. The aim of this study therefore is to present in a concise form some of the common surgical options in current literature, highlighting some important post operative complications. Current literature is searched using MEDLINE, EMBASE and the Cochrane library. The conclusion is that even though there are many surgical options in the management of hemorrhoids today, most employ the ligature and excision technique with newer ones having reduced post operative pain and bleeding.

  18. Pavement management

    SciTech Connect

    Ross, F.R.; Connor, B.; Lytton, R.L.; Darter, M.I.; Shahin, M.Y.

    1982-01-01

    The 11 papers in this report deal with the following areas: effect of pavement roughness on vehicle fuel consumption; rational seasonal load restrictions and overload permits; state-level pavement monitoring program; data requirements for long-term monitoring of pavements as a basis for development of multiple regression relations; simplified pavement management at the network level; combined priority programming of maintenance and rehabilitation for pavement networks; Arizona pavement management system: Phase 2-verification of performance prediction models and development of data base; overview of paver pavement management system; economic analysis of field implementation of paver pavement management system; development of a statewide pavement maintenance management system; and, prediction of pavement maintenance expenditure by using a statistical cost function.

  19. Paladin Integrated Management (PIM)

    DTIC Science & Technology

    2013-12-01

    DAMIR - Defense Acquisition Management Information Retrieval Dev Est - Development Estimate DoD - Department of Defense DSN - Defense Switched Network...contractor support to Production Qualification Testing, Initial Operational Test and Evaluation ( IOT &E) and the Logistics Demonstration. In the FY 2015 PB...LRIP testing and the planned Logistics Demonstration. This reduced contractor support increases schedule risk for IOT &E and First Unit Equipped

  20. Management of lymphoedema.

    PubMed

    Yüksel, Ahmet; Gürbüz, Orçun; Velioğlu, Yusuf; Kumtepe, Gencehan; Şenol, Sefa

    2016-01-01

    Lymphoedema is a common and progressive disease which causes deterioration of the quality of life of patients. It is divided into two groups: primary and secondary lymphoedema. Nowadays, the majority of patients with lymphoedema are associated with a malignancy or its treatment modalities, such as cancer surgery and radiation therapy. Accurate diagnosis and effective treatment are crucial for alleviating the symptoms, preventing progression and reducing the potential risks of lymphoedema. This report provides an overview of the management of lymphoedema.

  1. Complex medicines management.

    PubMed

    Thomas, Ruth; Kilbey, Carol

    Patients with long-term conditions (LTCs) often take many prescribed drugs. A specialist nurse and pharmacist at a Milton Keynes practice identified the need for a more coordinated medication service for patients with LTCs who take multiple medicines. Adopting a holistic approach, they set up a joint medication management project. This article describes how the one-year project improved quality and safety, reduced out-of-hours presentations and hospital admissions, and cut costs.

  2. [Interventions during labor for reducing instrumental deliveries].

    PubMed

    Schmitz, T; Meunier, E

    2008-12-01

    Several interventions have been demonstrated, with high evidence levels (EL), to be associated with reduced instrumental deliveries and should therefore be undertaken during labor for increasing spontaneous vaginal deliveries. Using a partogram (EL1) and continuous support during labor and childbirth (EL1) lead to fewer operative vaginal deliveries. Systematic early amniotomy increases the frequency of fetal heart rate abnormalities (EL2) without decreasing the incidence of instrumental deliveries (EL1) and should thus be avoided. Early oxytocin in dysfunctional labor (EL2) and manual rotation of posterior and transverse presentations (EL3) may reduce operative vaginal deliveries. Even without epidural analgesia, any upright or lateral positions compared to supine or lithotomy positions do not reduce instrumental deliveries (EL2). Epidural analgesia alters significantly instrumental delivery rates and therefore patient management in the labor ward. Indeed, when used with high concentration of local anesthetic, epidural analgesia is associated with increased operative vaginal deliveries (EL1), at least in part because of increased posterior presentations (EL2). However, the effect of epidural analgesia on instrumental delivery rates closely depends from the type of anesthetic and concentrations used. This effect is reduced when low concentrations of local anesthetic are used in combination with fat-soluble morphinated agent (EL1). Finally, for nulliparous women with continuous epidural analgesia, unless irresistible urge to push or medical indication to shorten second stage of labor, delayed pushing is associated with reduced difficult instrumental deliveries (EL1). Fundal pressure maneuvers should be prohibited because of their inefficiency (EL2) and dangerousness (EL4).

  3. Summary of the Economic Effects of Reduced Defense Spending

    DTIC Science & Technology

    1990-03-01

    CBO STAFF MEMORANDUM I SUMMARY OF THE ECONOMIC EFFECTS OF REDUCED DEFENSE SPENDING March 1990 I I I I I ’ e ogress of the ruted States...2. REPORT TYPE 3. DATES COVERED 00-00-1990 to 00-00-1990 4. TITLE AND SUBTITLE Summary of the Economic Effects of Reduced Defense Spending 5a...management posed by cuts in defense spending . the rate of budgetary reduction is important. Rapid reductions would permit less time for adjustments, such as

  4. Reducing Risk in DoD Software-Intensive Systems Development

    DTIC Science & Technology

    2016-03-01

    appropriate. The purpose of this research is to analyze why DoD risk management processes have not been more effective in reducing software...every software-intensive weapon system development. • Given that the software technical risk cannot be effectively managed , risk reduction is...focused on reducing management risk for both the supplier (contractor) and the acquirer (government PM organization). Acquisition Research

  5. Reduced Gravity Zblan Optical Fiber

    NASA Technical Reports Server (NTRS)

    Tucker, Dennis S.; Workman, Gary L.; Smith, Guy A.

    2000-01-01

    Two optical fiber pullers have been designed for pulling ZBLAN optical fiber in reduced gravity. One fiber puller was designed, built and flown on board NASA's KC135 reduced gravity aircraft. A second fiber puller has been designed for use on board the International Space Station.

  6. Managing environmental mastitis.

    PubMed

    Hogan, Joe; Smith, K Larry

    2012-07-01

    Many of the practices and principals of management for reducing the exposure of dairy cows to environmental mastitis pathogens were introduced a quarter of a century ago22–25 and have been the subject of numerous reviews.1,3,21 The common theme for reducing mastitis pathogens in the cows’ environment is reducing moisture and organic contamination.1 Frequent manure removal, avoiding overstocking of cows, taking precautions to eliminate stagnant water around cows, and providing clean, dry inorganic bedding for cows to lay on are important management considerations. These factors of environmental hygiene transcend stall barns, manure pack barns, open corrals, and pasture systems. The emphasis of control should center on protecting periparturient animals during wet, hot periods of the year when mastitis pathogen growth in the environment is greatest. As the dairy industry in North America changes and progresses to adapt to economic, social, and environmental demands, the old adage of keeping cows cool, dry, and comfortable remains paramount in managing environmental mastitis.

  7. Diabetes disease management in managed care organizations.

    PubMed

    Lynne, Donna

    2004-01-01

    Recent clinical trials and disease management programs sponsored by managed care organizations have demonstrated achievements in limiting complications, improving health measures, reducing costs, and enhancing the quality of life of the person with diabetes. In one managed care organization, Group Health, Inc., persons with diabetes received discounted supplies and educational material as encouragement to participate in a diabetes disease management program [Disease Management Solutions (DMS)]. Health risk appraisals (HRAs) were provided at enrollment, and at 6-month intervals thereafter. Over 8,000 persons with diabetes participated in the DMS program over a 2 and 1/2-year period. Claims data over a 3-year period (pre- and post-enrollment) for 1,368 persons with diabetes demonstrated that participation in DMS resulted in greater utilization of primary care services by enrolled persons than by non-enrolled, but a lower increase in costs for those enrolled. In addition to evaluating the program impact through changes in services and costs, HRAs provided self-reported scores on (1) several compliance measures and (2) general health impressions and productivity. In the DMS population, self-reported compliance with physician-recommended office visits and tests (eg, cholesterol screening) improved for persons with diabetes once they enrolled in the program. Participants also reported greater productivity (eg, fewer missed work days) once enrolled in the program. To validate self-reported results, medical claims were used to verify compliance with general office, ophthalmologic, and emergency room visits and hospital admissions. A high level of validity between self-reported results and claims data recording office and emergency room visits and hospital admissions was found.

  8. Medicines management.

    PubMed

    Pegram, Anne; Bloomfield, Jacqueline

    2015-04-15

    All newly registered graduate nurses are required to have the appropriate knowledge and understanding to perform the skills required for patient care, specifically the competencies identified in the Nursing and Midwifery Council's essential skills clusters. This article focuses on the fifth essential skills cluster – medicines management. Nursing students should work to attain the knowledge and skills required for effective medicines management throughout their pre-registration education. The roles and responsibilities of the newly registered graduate nurse in the area of medicines management are discussed in this the final article of the essential skills cluster series.

  9. Nonlinear Acoustics Used To Reduce Leakage Flow

    NASA Technical Reports Server (NTRS)

    Daniels, Christopher C.; Steinetz, Bruce M.

    2004-01-01

    Leakage and wear are two fundamental problems in all traditional turbine seals that contribute to an engine's inefficiency. The solutions to seal leakage and wear conflict in the conventional design space. Reducing the clearance between the seal and rotating shaft reduces leakage but increases wear because of increased contact incidents. Increasing the clearance to reduce the contact between parts reduces wear but increases parasitic leakage. The goal of this effort is to develop a seal that restricts leakage flow using acoustic pressure while operating in a noncontacting manner, thereby increasing life. In 1996, Dr. Timothy Lucas announced his discovery of a method to produce shock-free high-amplitude pressure waves. For the first time, the formation of large acoustic pressures was possible using dissonant resonators. A pre-prototype acoustic seal developed at the NASA Glenn Research Center exploits this fundamental acoustic discovery: a specially shaped cavity oscillated at the contained fluid's resonant frequency produces high-amplitude acoustic pressure waves of a magnitude approaching those required of today's seals. While the original researchers are continuing their development of acoustic pumps, refrigeration compressors, and electronic thermal management systems using this technology, the goal of researchers at Glenn is to apply these acoustic principles to a revolutionary sealing device. When the acoustic resonator shape is optimized for the sealing device, the flow from a high-pressure cavity to a low-pressure cavity will be restricted by a series of high-amplitude standing pressure waves of higher pressure than the pressure to be sealed. Since the sealing resonator cavity will not touch the adjacent sealing structures, seal wear will be eliminated, improving system life. Under a cooperative agreement between Glenn and the Ohio Aerospace Institute (OAI), an acoustic-based pre-prototype seal was demonstrated for the first time. A pressurized cavity was

  10. Reducing GHG emissions in rice systems: Opportunities and challenges

    NASA Astrophysics Data System (ADS)

    Linquist, B.

    2014-12-01

    Agriculture is faced with the challenge of providing healthy food for a growing population at minimal environmental cost. Rice (Oryza sativa), the staple crop for the largest number of people on earth, is grown under flooded soil conditions has higher greenhouse gas (GHG) emissions than most crops. This is primarily due to high methane emissions. In this talk I will focus on recent work and reviews on efforts to reduce GHG emissions from rice systems while at the same time maintaining or increasing the productivity of these systems. Specifically, the role of water, straw and nutrient management will be discussed. A great deal of research has gone into evaluating alternate-wetting and drying (AWD) irrigation management. AWD has tremendous potential to reduce GHG emissions; however I will examine how it needs to be practiced to achieve these goals, as well as limitations to its use such as where it can be practiced and possible effects on soil C. Straw management is critical as it provides a key carbon source for methanogens. Straw, however, is difficult to manage and has limited alternative uses. Various forms of nutrient management have also been proposed to reduced GHG emissions in rice systems. I will provide an overview of these and discuss their potential.

  11. Does management really work?

    PubMed

    Bloom, Nicholas; Sadun, Raffaella; Van Reenen, John

    2012-11-01

    HBR's 90th anniversary is a sensible time to revisit a basic question: Are organizations more likely to succeed if they adopt good management practices? The answer may seem obvious to most HBR readers, but these three economists cast their net much wider than that. In a decadelong study of thousands of organizations in 20 countries, they and their interview teams assessed how well manufacturers, schools, and hospitals adhere to three management basics: targets, incentives, and monitoring. They found that huge numbers of companies follow none of those fundamentals, that adopting the basics yields big improvements in outcomes such as productivity and longevity, and that good nuts-and-bolts management at individual firms shapes national performance. At 14 textile manufacturers in India, for example, an intervention--involving free, high-quality advice from a consultant who was on-site half-time for five months--cut defects by half, reduced inventory by 20%, and raised output by 10%. A control group saw no such gains. The authors' global data set suggests that implementing good management at schools and hospitals yields change more slowly than at manufacturers--but it does come eventually. And the macroeconomic potential--for incomes, productivity, and delivery of critically needed services--is huge. A call for "better management" may sound prosaic, but given the global payoffs, it's actually quite radical.

  12. Active Supervision: An Intervention to Reduce High School Tardiness

    ERIC Educational Resources Information Center

    Johnson-Gros, Kristin N.; Lyons, Elizabeth A.; Griffin, Jennifer R.

    2008-01-01

    One proactive approach to aid in reducing disciplinary problems in schools is implementing Positive Behavior Support (PBS) strategies. To successfully implement PBS school-wide, Sugai and Horner (2002a) emphasize a multisystems perspective, which focuses on school-wide discipline, classroom management, non-classroom settings, and individual…

  13. STREAM RESTORATION STRATEGIES FOR REDUCING RIVER NITROGEN LOADS

    EPA Science Inventory

    Despite decades of work implementing agricultural and urban best management practices to reduce the movement of excess nitrogen (N) from the land to aquatic ecosystems, the amount of N moving down streams and rivers remains unacceptably high in many watersheds. During this same ...

  14. Reduced Environmental Stimulation Techniques and Control of Psychological Dependencies.

    ERIC Educational Resources Information Center

    Cooper, G. David

    Three areas of research have supported the conceptual relevance of Reduced Environmental Stimulation (RES) techniques in the management of psychological dependencies. First, preliminary studies through the late l960's indicated that relatively short periods of RES had a facilitative effect on the type of subject who might be most vulnerable to…

  15. Saccharomyces cerevisiae expressing bacteriophage endolysins reduce Lactobacillus contamination during fermentation

    Technology Transfer Automated Retrieval System (TEKTRAN)

    One of the challenges facing the fuel ethanol industry is the management of bacterial contamination during fermentation. Lactobacillus species are the predominant contaminants that decrease the profitability of biofuel production by reducing ethanol yields and causing “stuck” fermentations, which i...

  16. Student Assistance Programs: New Approaches for Reducing Adolescent Substance Abuse.

    ERIC Educational Resources Information Center

    Moore, David D.; Forster, Jerald R.

    1993-01-01

    Describes school-based Student Assistance Programs (SAPs), which are designed to reduce adolescents' substance abuse. Notes that SAPs, modeled after Employee Assistance Programs in workplace, are identifying, assessing, referring, and managing cases of substance-abusing students. Sees adoption of SAP model as accelerating in response to growing…

  17. Stress Management

    MedlinePlus

    ... It can help your mind and body adapt (resilience). Without it, your body might always be on ... of a self-guided, multimedia, stress management and resilience training program. Behaviour Research and Therapy. 2013;51: ...

  18. Managed Care

    MedlinePlus

    ... three types of managed care plans: Health Maintenance Organizations (HMO) usually only pay for care within the ... who coordinates most of your care. Preferred Provider Organizations (PPO) usually pay more if you get care ...

  19. Managing Oneself.

    ERIC Educational Resources Information Center

    Drucker, Peter F.

    1999-01-01

    Knowledge workers must take responsibility for managing their own careers. They are challenged to gain a better understanding of themselves so that they will know how and when to change the work they do. (Author/JOW)

  20. Reducing crosstalk between stereoscopic views

    NASA Astrophysics Data System (ADS)

    Lipscomb, James S.; Wooten, Wayne L.

    1994-04-01

    Crosstalk between the left and right eyes consists of the one eye's image seen faintly by the other. Image processing can reduce this. The technique is effective, but there are costs of course, and some surprises.

  1. Reducing Cancer Patients' Painful Treatment

    NASA Video Gallery

    A NASA light technology originally developed to aid plant growth experiments in space has proved to reduce the painful side effects resulting from chemotherapy and radiation treatment in bone marro...

  2. Reduced Gravity Education Flight Program

    NASA Video Gallery

    NASA'€™s Reduced Gravity Education Flight Program gives students and educators the opportunity to design, build and fly an experiment in microgravity and get a look at what it takes to be a NASA en...

  3. How to Reduce Solid Waste.

    ERIC Educational Resources Information Center

    Martins, George; Clapp, Leallyn B.

    1974-01-01

    Discusses the problem of solid waste disposal in the United States, suggests ways in which solid wastes might be reduced, and proposes a number of related topics for student debate in classes or in science clubs. (JR)

  4. Strategies To Reduce Student Misbehavior.

    ERIC Educational Resources Information Center

    Moles, Oliver C., Ed.

    Originally presented at a 1986 conference on student discipline strategies, this collection of papers represents highlights of the conference proceedings. Each paper has since been revised and updated. An introduction by Oliver C. Moles discusses the nature, extent, and academic effects of student misbehavior. In "Classroom Management Techniques,"…

  5. Interventions for reducing extinction risk in chytridiomycosis-threatened amphibians.

    PubMed

    Scheele, Ben C; Hunter, David A; Grogan, Laura F; Berger, Lee; Kolby, Jon E; McFadden, Michael S; Marantelli, Gerry; Skerratt, Lee F; Driscoll, Don A

    2014-10-01

    Wildlife diseases pose an increasing threat to biodiversity and are a major management challenge. A striking example of this threat is the emergence of chytridiomycosis. Despite diagnosis of chytridiomycosis as an important driver of global amphibian declines 15 years ago, researchers have yet to devise effective large-scale management responses other than biosecurity measures to mitigate disease spread and the establishment of disease-free captive assurance colonies prior to or during disease outbreaks. We examined the development of management actions that can be implemented after an epidemic in surviving populations. We developed a conceptual framework with clear interventions to guide experimental management and applied research so that further extinctions of amphibian species threatened by chytridiomycosis might be prevented. Within our framework, there are 2 management approaches: reducing Batrachochytrium dendrobatidis (the fungus that causes chytridiomycosis) in the environment or on amphibians and increasing the capacity of populations to persist despite increased mortality from disease. The latter approach emphasizes that mitigation does not necessarily need to focus on reducing disease-associated mortality. We propose promising management actions that can be implemented and tested based on current knowledge and that include habitat manipulation, antifungal treatments, animal translocation, bioaugmentation, head starting, and selection for resistance. Case studies where these strategies are being implemented will demonstrate their potential to save critically endangered species.

  6. After-school enrichment and the activity theory: How can a management service organization assist schools with reducing the achievement gap among minority and non-minority students in science, technology, engineering, and mathematics (STEM) during the after-school hours?

    NASA Astrophysics Data System (ADS)

    Flowers, Reagan D.

    The primary purpose of this study was to investigate how a management service organization can assist schools with reducing the achievement gap between minority and non-minority students in science, technology, engineering, and mathematics (STEM) during the after-school hours. Developing a strategic plan through creating a program that provides support services for the implementation of hands-on activities in STEM for children during the after-school hours was central to this purpose. This Project Demonstrating Excellence (PDE), a social action project, also presents historical and current after-school program developments in the nation. The study is quantitative and qualitative in nature. Surveys were utilized to quantitatively capture the opinions of participants in the social action project on three specific education related issues: (1) disparity in academic motivation of students to participate in after-school STEM enrichment programs; (2) whether teachers and school administrators saw a need for STEM after-school enrichment; and (3) developing STEM after-school programs that were centered on problem-solving and higher-order thinking skills to develop students' interest in STEM careers. The sample consisted of 50 participants comprised of students, teachers, and administrators. The focus groups and interviews provided the qualitative data for the study. The qualitative sample consisted of 14 participants comprised of students, parents and teachers, administrators, an education consultant, and a corporate sponsor. The empirical data obtained from the study survey, focus groups, and interviews provided a comprehensive profile on the current views and future expectations of STEM after-school enrichment, student and school needs, and community partnerships with STEM companies. Results of the study and review of the implementation of the social action project, C-STEM (communication, science, technology, engineering, and mathematics) Teacher and Student Support

  7. Comprehensive Medical Management of Rosacea

    PubMed Central

    Baum, Eric W.

    2008-01-01

    Rosacea is a common inflammatory facial dermatosis seen in adults that exhibits considerable variety in clinical presentation. Multiple medical therapeutic options are available including topical and oral treatments. Optimal medical management of rosacea includes assessment of subtype and disease severity and use of appropriate skin care to reduce epidermal barrier dysfunction. This article provides an overall discussion of the medical management of rosacea and reviews interim results from a study evaluating the role of designated skin care in rosacea treatment. PMID:21103305

  8. Facility management in German hospitals.

    PubMed

    Gudat, H

    2000-04-01

    Facility management and optimum building management offer for hospitals a chance to reduce costs and to increase quality, process sequences, employee motivation and customer satisfaction. Some years ago simple services such as cleaning, catering or laundry were outsourced. Now, German hospitals progress to more complex fields such as building and medical technology, clinical support processes such as pharmacy, central laboratory and sterilization, goods and logistics services.

  9. The management of complicated glaucoma

    PubMed Central

    Clement, C I; Goldberg, Ivan

    2011-01-01

    Complicated glaucomas present considerable diagnostic and management challenges. Response to treatment can be unpredictable or reduced compared with other glaucomas. However, target intraocular pressure and preservation of vision may be achieved with selected medical, laser and surgical treatment. The evidence for such treatment is expanding and consequently affords clinicians a better understanding of established and novel techniques. Herein we review the mechanisms involved in the development of complicated glaucoma and the current evidence supporting its management. PMID:21150026

  10. Learning to REDUCE: A Reduced Electricity Consumption Prediction Ensemble

    SciTech Connect

    Aman, Saima; Chelmis, Charalampos; Prasanna, Viktor

    2016-02-12

    Utilities use Demand Response (DR) to balance supply and demand in the electric grid by involving customers in efforts to reduce electricity consumption during peak periods. To implement and adapt DR under dynamically changing conditions of the grid, reliable prediction of reduced consumption is critical. However, despite the wealth of research on electricity consumption prediction and DR being long in practice, the problem of reduced consumption prediction remains largely un-addressed. In this paper, we identify unique computational challenges associated with the prediction of reduced consumption and contrast this to that of normal consumption and DR baseline prediction.We propose a novel ensemble model that leverages different sequences of daily electricity consumption on DR event days as well as contextual attributes for reduced consumption prediction. We demonstrate the success of our model on a large, real-world, high resolution dataset from a university microgrid comprising of over 950 DR events across a diverse set of 32 buildings. Our model achieves an average error of 13.5%, an 8.8% improvement over the baseline. Our work is particularly relevant for buildings where electricity consumption is not tied to strict schedules. Our results and insights should prove useful to the researchers and practitioners working in the sustainable energy domain.

  11. Reduced Boil-Off System Sizing

    NASA Technical Reports Server (NTRS)

    Guzik, Monica C.; Plachta, David W.; Feller, Jeffrey R.

    2015-01-01

    NASA is currently developing cryogenic propellant storage and transfer systems for future space exploration and scientific discovery missions by addressing the need to raise the technology readiness level of cryogenic fluid management technologies. Cryogenic propellants are baselined in many propulsion systems due to their inherently high specific impulse; however, their low boiling points can cause substantial boil-off losses over time. Recent efforts such as the Reduced Boil-off Testing and the Active Thermal Control Scaling Study provide important information on the benefit of an active cooling system applied to LH2 propellant storage. Findings show that zero-boil off technologies can reduce overall mass in LH2 storage systems when low Earth orbit loiter periods extend beyond two months. A significant part of this mass reduction is realized by integrating two stages of cooling: a 20 K stage to intercept heat at the tank surface, and a 90 K stage to reduce the heat entering the less efficient 20 K stage. A missing element in previous studies, which is addressed in this paper, is the development of a direct method for sizing the 90 K cooling stage. Such a method requires calculation of the heat entering both the 90 K and 20 K stages as compared to the overall system masses, and is reliant upon the temperature distribution, performance, and unique design characteristics of the system in question. By utilizing the known conductance of a system without active thermal control, the heat being intercepted by a 90 K stage can be calculated to find the resultant lift and mass of each active thermal control stage. Integral to this is the thermal conductance of the cooling straps and the broad area cooling shield, key parts of the 90 K stage. Additionally, a trade study is performed to show the ability of the 90 K cooling stage to reduce the lift on the 20 K cryocooler stage, which is considerably less developed and efficient than 90 K cryocoolers.

  12. Data Management Tools

    SciTech Connect

    Ridley, M; Stoker, C

    2001-02-12

    What is data management (DM) and why is it important? As described in the ''Handbook of Data Management'' (Thuraisingham, 1998), data management is the process of understanding the data needs of an organization and making the data available to support the operations of the organization. The ultimate goal of data management is to provide the seamless access and fusion of massive amounts of data, information, and knowledge in a heterogeneous and real-time environment, and to support the functions and decision making processes of an organization. The important questions that need to be asked for proper data management are: who is going to be using the data, what types of data need to be stored, and how will this data be accessed? With these questions answered, the data management system (DMS) can then be created, or an existing system can be modified to meet the needs of the organization. The real importance of a data management system is to provide the end user with a consistent data set of known quality. The elements of a good data management system should include a system that: is modeled to how the data is collected and processed, is very well documented, has specifically defined data elements, and has supporting data documentation. Supporting documentation includes items like quality control (QC) data that is carried with the analytical data, and meta data (information about the data). Supporting documentation can be anything that is useful to the project and that needs to be accessed with the data. Data sets get better the more they are used. As errors and inconsistencies are identified and corrected, the data set improves. A good DMS will achieve this because its design promotes use, and the ultimate value of data is in its use rather than its storage. The development and use of Internet access tools, and existing environmental data management systems, can help reduce the effort and cost associated with setting up a DMS. This presentation will discuss the

  13. Reducing falls in a care home

    PubMed Central

    Cooper, Rosie

    2017-01-01

    Care home residents are 3 times more likely to fall than their community dwelling peers and 10 times more likely to sustain a significant injury as a result. 2 A project commenced at a care home in Aberdeen with the aim of reducing the number of falls by 20% by 30st April 2016 using the model for improvement. Qualitative data was gathered to establish staff belief about falls and their level of knowledge& understanding about falls risks and how to manage these. This informed the training which was delivered and iterative testing commenced with the introduction of the Lanarkshire Falls Risk/Intervention tool – where the multifactorial nature of a resident's falls risks are explored and specific actions to manage these are identified and implemented. Failure to meet PDSA predictions about sharing risk reducing actions with staff and length of time to complete the tool prompted a focus on communication and the processes whereby the tool is completed. “Teach back” was employed to highlight communication difficulties and ultimately the introduction of Huddles out improved the flow of information about residents and informed the Falls Risk/Intervention tool. 5 PDSAs were completed and within them multiple tests of change. The improvement shift came following a root cause analysis of the nature & cause of one resident's falls and applying the tool & communication processes. The average falls rate fell from 49 per 1000 occupied bed days to 23.6 and was sustained because of the attention to the importance of communication. The aim was achieved with a 36.6% reduction in Falls rate. Care home residents are 3 times more likely to fall than their community dwelling peers and 10 times more likely to sustain a significant injury as a result. 2 A project commenced at a care home in Aberdeen with the aim of reducing the number of falls by 20% by 30th April 2016 using the model for improvement. Qualitative data was gathered to establish staff belief about falls and their level

  14. Reducing falls in a care home.

    PubMed

    Cooper, Rosie

    2017-01-01

    Care home residents are 3 times more likely to fall than their community dwelling peers and 10 times more likely to sustain a significant injury as a result. 2 A project commenced at a care home in Aberdeen with the aim of reducing the number of falls by 20% by 30st April 2016 using the model for improvement. Qualitative data was gathered to establish staff belief about falls and their level of knowledge& understanding about falls risks and how to manage these. This informed the training which was delivered and iterative testing commenced with the introduction of the Lanarkshire Falls Risk/Intervention tool - where the multifactorial nature of a resident's falls risks are explored and specific actions to manage these are identified and implemented. Failure to meet PDSA predictions about sharing risk reducing actions with staff and length of time to complete the tool prompted a focus on communication and the processes whereby the tool is completed. "Teach back" was employed to highlight communication difficulties and ultimately the introduction of Huddles out improved the flow of information about residents and informed the Falls Risk/Intervention tool. 5 PDSAs were completed and within them multiple tests of change. The improvement shift came following a root cause analysis of the nature & cause of one resident's falls and applying the tool & communication processes. The average falls rate fell from 49 per 1000 occupied bed days to 23.6 and was sustained because of the attention to the importance of communication. The aim was achieved with a 36.6% reduction in Falls rate. Care home residents are 3 times more likely to fall than their community dwelling peers and 10 times more likely to sustain a significant injury as a result. 2 A project commenced at a care home in Aberdeen with the aim of reducing the number of falls by 20% by 30th April 2016 using the model for improvement. Qualitative data was gathered to establish staff belief about falls and their level of

  15. [Application of supply chain integration management of medical consumables].

    PubMed

    Zhang, Jian

    2013-07-01

    This paper introduces the background, the content, the information management system of material supply chain integration management and the consumables management process. The system helps to expand the selection of hospital supplies varieties, to reduce consumables management costs, to improve the efficiency of supplies, to ensure supplies safety, reliability and traceability.

  16. Determining Reduced Order Models for Optimal Stochastic Reduced Order Models

    SciTech Connect

    Bonney, Matthew S.; Brake, Matthew R.W.

    2015-08-01

    The use of parameterized reduced order models(PROMs) within the stochastic reduced order model (SROM) framework is a logical progression for both methods. In this report, five different parameterized reduced order models are selected and critiqued against the other models along with truth model for the example of the Brake-Reuss beam. The models are: a Taylor series using finite difference, a proper orthogonal decomposition of the the output, a Craig-Bampton representation of the model, a method that uses Hyper-Dual numbers to determine the sensitivities, and a Meta-Model method that uses the Hyper-Dual results and constructs a polynomial curve to better represent the output data. The methods are compared against a parameter sweep and a distribution propagation where the first four statistical moments are used as a comparison. Each method produces very accurate results with the Craig-Bampton reduction having the least accurate results. The models are also compared based on time requirements for the evaluation of each model where the Meta- Model requires the least amount of time for computation by a significant amount. Each of the five models provided accurate results in a reasonable time frame. The determination of which model to use is dependent on the availability of the high-fidelity model and how many evaluations can be performed. Analysis of the output distribution is examined by using a large Monte-Carlo simulation along with a reduced simulation using Latin Hypercube and the stochastic reduced order model sampling technique. Both techniques produced accurate results. The stochastic reduced order modeling technique produced less error when compared to an exhaustive sampling for the majority of methods.

  17. Pain management in neonates.

    PubMed

    Carbajal, Ricardo; Gall, Olivier; Annequin, Daniel

    2004-05-01

    Multiple lines of evidence suggest an increased sensitivity to pain in neonates. Repeated and prolonged pain exposure may affect the subsequent development of pain systems, as well as potentially contribute to alterations in long-term development and behavior. Despite impressive gains in the knowledge of neonatal pain mechanisms and strategies to treat neonatal pain acquired during the last 15 years, a large gap still exists between routine clinical practice and research results. Accurate assessment of pain is crucial for effective pain management in neonates. Neonatal pain management should rely on current scientific evidence more than the attitudes and beliefs of care-givers. Parents should be informed of pain relief strategies and their participation in the health care plan to alleviate pain should be encouraged. The need for systemic analgesia for both moderate and severe pain, in conjunction with behavioral/environmental approaches to pain management, is emphasized. A main sources of pain in the neonate is procedural pain which should always be prevented and treated. Nonpharmacological approaches constitute important treatment options for managing procedural pain. Nonpharmacological interventions (environmental and preventive measures, non-nutritive sucking, sweet solutions, skin-skin contact, and breastfeeding analgesia) can reduce neonatal pain indirectly by reducing the total amount of noxious stimuli to which infants are exposed, and directly, by blocking nociceptive transduction or transmission or by activation of descending inhibitory pathways or by activating attention and arousal systems that modulate pain. Opioids are the mainstay of pharmacological pain treatment but there are other useful medications and techniques that may be used for pain relief. National guidelines are necessary to improve neonatal pain management at the institutional level, individual neonatal intensive care units need to develop specific practice guidelines regarding pain

  18. The cost management organization: the next step for materiel management.

    PubMed

    Schuweiler, R C

    1997-06-01

    With Materiel Management's transition over the last decade from simple logistics to analysis and cost management, it has gained recognition as a key part of the management team responsible for supplies, equipment, standards, and associated processes to identify, purchase, store, distribute, issue, and dispose of supplies and equipment. The materiel manager's job consists of putting the right product in the right place at the right time and in the right quantity at the best total delivered cost. In this context, Materiel Management has made powerful impacts to lower costs associated with: Distribution--costs have been lowered by actively adopting advanced supply channel management techniques such as primary suppliers, JIT, stockless programs, case cart/custom kit/procedure based delivery systems, modified stockless programs as well as margin management through cost plus, flat fee, or margins paid per activity. Cost of goods--lowered through aggregated purchasing in the forms of regional and national purchasing alliances and local capitation or other gain/risk share programs. Internal process costs--lowered by out-sourcing and/or integrating supplier processes and personnel into operations via partnership approaches. We have also reduced transactional costs through EDI transaction sets and the emerging use of the inter and intranet/electronic commerce, procurement cards, and evaluated receipt settlement processes. De-layering--We have lowered the operating costs of Materiel Management overhead by re-design/re-engineering, resulting in reduced management and greater front line authority. Quality--We have learned to identify and respond to customer and supplier needs by using quality improvement tools and ongoing measurement and monitoring techniques. Through this we have identified the waste of non-beneficial products and services. We have adopted supplier certification measurers to ensure quality is built into processes and outcomes. With so much already accomplished

  19. Does Zoning Winter Recreationists Reduce Recreation Conflict?

    NASA Astrophysics Data System (ADS)

    Miller, Aubrey D.; Vaske, Jerry J.; Squires, John R.; Olson, Lucretia E.; Roberts, Elizabeth K.

    2017-01-01

    Parks and protected area managers use zoning to decrease interpersonal conflict between recreationists. Zoning, or segregation, of recreation—often by non-motorized and motorized activity—is designed to limit physical interaction while providing recreation opportunities to both groups. This article investigated the effectiveness of zoning to reduce recreation conflict in the Vail Pass Winter Recreation Area in Colorado, USA. Despite a zoning management system, established groomed travel routes were used by both non-motorized recreationists (backcountry skiers, snowboarders, snowshoers) and motorized recreationists (snowmobilers). We hypothesized that persistent recreation conflict reported by non-motorized recreationists was the result of recreation occurring in areas of mixed non-motorized and motorized use, mostly along groomed routes. We performed a geospatial analysis of recreation [from Global Positioning System (GPS) points, n = 1,233,449] in the Vail Pass Winter Recreation Area to identify areas of mixed non-motorized and motorized use. We then surveyed non-motorized recreationists ( n = 199) to test whether reported conflict is higher for respondents who traveled in areas of mixed-use, compared with respondents traveling outside areas of mixed-use. Results from the geospatial analysis showed that only 0.7 % of the Vail Pass Winter Recreation Area contained recreation from both groups, however that area contained 14.8 % of all non-motorized recreation and 49.1 % of all motorized recreation. Survey analysis results showed higher interpersonal conflict for all five standard conflict variables among non-motorized respondents who traveled in areas of mixed-use, compared with those traveling outside mixed-use areas. Management implications and recommendations for increasing the effectiveness of zoning are provided.

  20. Does Zoning Winter Recreationists Reduce Recreation Conflict?

    PubMed

    Miller, Aubrey D; Vaske, Jerry J; Squires, John R; Olson, Lucretia E; Roberts, Elizabeth K

    2017-01-01

    Parks and protected area managers use zoning to decrease interpersonal conflict between recreationists. Zoning, or segregation, of recreation-often by non-motorized and motorized activity-is designed to limit physical interaction while providing recreation opportunities to both groups. This article investigated the effectiveness of zoning to reduce recreation conflict in the Vail Pass Winter Recreation Area in Colorado, USA. Despite a zoning management system, established groomed travel routes were used by both non-motorized recreationists (backcountry skiers, snowboarders, snowshoers) and motorized recreationists (snowmobilers). We hypothesized that persistent recreation conflict reported by non-motorized recreationists was the result of recreation occurring in areas of mixed non-motorized and motorized use, mostly along groomed routes. We performed a geospatial analysis of recreation [from Global Positioning System (GPS) points, n = 1,233,449] in the Vail Pass Winter Recreation Area to identify areas of mixed non-motorized and motorized use. We then surveyed non-motorized recreationists (n = 199) to test whether reported conflict is higher for respondents who traveled in areas of mixed-use, compared with respondents traveling outside areas of mixed-use. Results from the geospatial analysis showed that only 0.7 % of the Vail Pass Winter Recreation Area contained recreation from both groups, however that area contained 14.8 % of all non-motorized recreation and 49.1 % of all motorized recreation. Survey analysis results showed higher interpersonal conflict for all five standard conflict variables among non-motorized respondents who traveled in areas of mixed-use, compared with those traveling outside mixed-use areas. Management implications and recommendations for increasing the effectiveness of zoning are provided.

  1. Reducing the Consequences of a Nuclear Detonation.

    SciTech Connect

    Buddemeier, B R

    2007-11-09

    The 2002 National Strategy to Combat Weapons of Mass Destruction states that 'the United States must be prepared to respond to the use of WMD against our citizens, our military forces, and those of friends and allies'. Scenario No.1 of the 15 Department of Homeland Security national planning scenarios is an improvised nuclear detonation in the national capitol region. An effective response involves managing large-scale incident response, mass casualty, mass evacuation, and mass decontamination issues. Preparedness planning activities based on this scenario provided difficult challenges in time critical decision making and managing a large number of casualties within the hazard area. Perhaps even more challenging is the need to coordinate a large scale response across multiple jurisdictions and effectively responding with limited infrastructure and resources. Federal response planning continues to make improvements in coordination and recommending protective actions, but much work remains. The most critical life-saving activity depends on actions taken in the first few minutes and hours of an event. The most effective way to reduce the enormous national and international social and economic disruptions from a domestic nuclear explosion is through planning and rapid action, from the individual to the federal response. Anticipating response resources for survivors based on predicted types and distributions of injuries needs to be addressed.

  2. Reducing Design Cycle Time and Cost Through Process Resequencing

    NASA Technical Reports Server (NTRS)

    Rogers, James L.

    2004-01-01

    In today's competitive environment, companies are under enormous pressure to reduce the time and cost of their design cycle. One method for reducing both time and cost is to develop an understanding of the flow of the design processes and the effects of the iterative subcycles that are found in complex design projects. Once these aspects are understood, the design manager can make decisions that take advantage of decomposition, concurrent engineering, and parallel processing techniques to reduce the total time and the total cost of the design cycle. One software tool that can aid in this decision-making process is the Design Manager's Aid for Intelligent Decomposition (DeMAID). The DeMAID software minimizes the feedback couplings that create iterative subcycles, groups processes into iterative subcycles, and decomposes the subcycles into a hierarchical structure. The real benefits of producing the best design in the least time and at a minimum cost are obtained from sequencing the processes in the subcycles.

  3. Strategies to Reduce Indoor Tanning

    PubMed Central

    Holman, Dawn M.; Fox, Kathleen A.; Glenn, Jeffrey D.; Guy, Gery P.; Watson, Meg; Baker, Katie; Cokkinides, Vilma; Gottlieb, Mark; Lazovich, DeAnn; Perna, Frank M.; Sampson, Blake P.; Seidenberg, Andrew B.; Sinclair, Craig; Geller, Alan C.

    2015-01-01

    Exposure to ultraviolet radiation from indoor tanning device use is associated with an increased risk of skin cancer, including risk of malignant melanoma, and is an urgent public health problem. By reducing indoor tanning, future cases of skin cancer could be prevented, along with the associated morbidity, mortality, and healthcare costs. On August 20, 2012, the CDC hosted a meeting to discuss the current body of evidence on strategies to reduce indoor tanning as well as research gaps. Using the Action Model to Achieve Healthy People 2020 Overarching Goals as a framework, the current paper provides highlights on the topics that were discussed, including (1) the state of the evidence on strategies to reduce indoor tanning; (2) the tools necessary to effectively assess, monitor, and evaluate the short- and long-term impact of interventions designed to reduce indoor tanning; and (3) strategies to align efforts at the national, state, and local levels through transdisciplinary collaboration and coordination across multiple sectors. Although many challenges and barriers exist, a coordinated, multilevel, transdisciplinary approach has the potential to reduce indoor tanning and prevent future cases of skin cancer. PMID:23683986

  4. Sleep can reduce proactive interference.

    PubMed

    Abel, Magdalena; Bäuml, Karl-Heinz T

    2014-01-01

    Sleep has repeatedly been connected to processes of memory consolidation. While extensive research indeed documents beneficial effects of sleep on memory, little is yet known about the role of sleep for interference effects in episodic memory. Although two prior studies reported sleep to reduce retroactive interference, no sleep effect has previously been found for proactive interference. Here we applied a study format differing from that employed by the prior studies to induce a high degree of proactive interference, and asked participants to encode a single list or two interfering lists of paired associates via pure study cycles. Testing occurred after 12 hours of diurnal wakefulness or nocturnal sleep. Consistent with the prior work, we found sleep in comparison to wake did not affect memory for the single list, but reduced retroactive interference. In addition we found sleep reduced proactive interference, and reduced retroactive and proactive interference to the same extent. The finding is consistent with the view that arising benefits of sleep are caused by the reactivation of memory contents during sleep, which has been suggested to strengthen and stabilise memories. Such stabilisation may make memories less susceptible to competition from interfering memories at test and thus reduce interference effects.

  5. Reduce air, reduce compliance cost new patented spray booth technology

    SciTech Connect

    McGinnis, F.

    1997-12-31

    A New Paint Spray Booth System that dramatically reduces air volumes normally required for capturing and controlling paint overspray that contains either Volatile Organic Compounds (VOC) or Hazardous Air Pollutants (HAP), or both. In turn, a substantial reduction in capital equipment expenditures for air abatement systems and air make-up heaters as well as related annual operating expenses is realized.

  6. Delineating Area of Review in a System with Pre-injection Relative Overpressure

    DOE PAGES

    Oldenburg, Curtis M.; Cihan, Abdullah; Zhou, Quanlin; ...

    2014-12-31

    The Class VI permit application for geologic carbon sequestration (GCS) requires delineation of an area of review (AoR), defined as the region surrounding the (GCS) project where underground sources of drinking water (USDWs) may be endangered. The methods for estimating AoR under the Class VI regulation were developed assuming that GCS reservoirs would be in hydrostatic equilibrium with overlying aquifers. Here we develop and apply an approach to estimating AoR for sites with preinjection relative overpressure for which standard AoR estimation methods produces an infinite AoR. The approach we take is to compare brine leakage through a hypothetical open flowmore » path in the base-case scenario (no-injection) to the incrementally larger leakage that would occur in the CO2-injection case. To estimate AoR by this method, we used semi-analytical solutions to single-phase flow equations to model reservoir pressurization and flow up (single) leaky wells located at progressively greater distances from the injection well. We found that the incrementally larger flow rates for hypothetical leaky wells located 6 km and 4 km from the injection well are ~20% and 30% greater, respectively, than hypothetical baseline leakage rates. If total brine leakage is considered, the results depend strongly on how the incremental increase in total leakage is calculated, varying from a few percent to up to 40% greater (at most at early time) than base-case total leakage.« less

  7. Delineating Area of Review in a System with Pre-injection Relative Overpressure

    SciTech Connect

    Oldenburg, Curtis M.; Cihan, Abdullah; Zhou, Quanlin; Fairweather, Stacey; Spangler, Lee H.

    2014-12-31

    The Class VI permit application for geologic carbon sequestration (GCS) requires delineation of an area of review (AoR), defined as the region surrounding the (GCS) project where underground sources of drinking water (USDWs) may be endangered. The methods for estimating AoR under the Class VI regulation were developed assuming that GCS reservoirs would be in hydrostatic equilibrium with overlying aquifers. Here we develop and apply an approach to estimating AoR for sites with preinjection relative overpressure for which standard AoR estimation methods produces an infinite AoR. The approach we take is to compare brine leakage through a hypothetical open flow path in the base-case scenario (no-injection) to the incrementally larger leakage that would occur in the CO2-injection case. To estimate AoR by this method, we used semi-analytical solutions to single-phase flow equations to model reservoir pressurization and flow up (single) leaky wells located at progressively greater distances from the injection well. We found that the incrementally larger flow rates for hypothetical leaky wells located 6 km and 4 km from the injection well are ~20% and 30% greater, respectively, than hypothetical baseline leakage rates. If total brine leakage is considered, the results depend strongly on how the incremental increase in total leakage is calculated, varying from a few percent to up to 40% greater (at most at early time) than base-case total leakage.

  8. Knowledge Management

    NASA Technical Reports Server (NTRS)

    Shariq, Syed Z.; Kutler, Paul (Technical Monitor)

    1997-01-01

    The emergence of rapidly expanding technologies for distribution and dissemination of information and knowledge has brought to focus the opportunities for development of knowledge-based networks, knowledge dissemination and knowledge management technologies and their potential applications for enhancing productivity of knowledge work. The challenging and complex problems of the future can be best addressed by developing the knowledge management as a new discipline based on an integrative synthesis of hard and soft sciences. A knowledge management professional society can provide a framework for catalyzing the development of proposed synthesis as well as serve as a focal point for coordination of professional activities in the strategic areas of education, research and technology development. Preliminary concepts for the development of the knowledge management discipline and the professional society are explored. Within this context of knowledge management discipline and the professional society, potential opportunities for application of information technologies for more effectively delivering or transferring information and knowledge (i.e., resulting from the NASA's Mission to Planet Earth) for the development of policy options in critical areas of national and global importance (i.e., policy decisions in economic and environmental areas) can be explored, particularly for those policy areas where a global collaborative knowledge network is likely to be critical to the acceptance of the policies.

  9. Power and reduced temporal discounting.

    PubMed

    Joshi, Priyanka D; Fast, Nathanael J

    2013-04-01

    Decision makers generally feel disconnected from their future selves, an experience that leads them to prefer smaller immediate gains to larger future gains. This pervasive tendency is known as temporal discounting, and researchers across disciplines are interested in understanding how to overcome it. Following recent advances in the power literature, we suggest that the experience of power enhances one's connection with the future self, which in turn results in reduced temporal discounting. In Study 1, we found that participants assigned to high-power roles were less likely than participants assigned to low-power roles to display temporal discounting. In Studies 2 and 3, priming power reduced temporal discounting in monetary and nonmonetary tasks, and, further, connection with the future self mediated the relation between power and reduced discounting. In Study 4, experiencing a general sense of power in the workplace predicted actual lifetime savings. These results have important implications for future research.

  10. Microbial methods of reducing technetium

    DOEpatents

    Wildung, Raymond E [Richland, WA; Garland, Thomas R [Greybull, WY; Gorby, Yuri A [Richland, WA; Hess, Nancy J [Benton City, WA; Li, Shu-Mei W [Richland, WA; Plymale, Andrew E [Richland, WA

    2001-01-01

    The present invention is directed toward a method for microbial reduction of a technetium compound to form other compounds of value in medical imaging. The technetium compound is combined in a mixture with non-growing microbial cells which contain a technetium-reducing enzyme system, a stabilizing agent and an electron donor in a saline solution under anaerobic conditions. The mixture is substantially free of an inorganic technetium reducing agent and its reduction products. The resulting product is Tc of lower oxidation states, the form of which can be partially controlled by the stabilizing agent. It has been discovered that the microorganisms Shewanella alga, strain Bry and Shewanelia putrifacians, strain CN-32 contain the necessary enzyme systems for technetium reduction and can form both mono nuclear and polynuclear reduced Tc species depending on the stabilizing agent.

  11. Contrasting reduced overshadowing and blocking.

    PubMed

    Wheeler, Daniel S; Miller, Ralph R

    2007-07-01

    Preexposure of a cue without an outcome (X-) prior to compound pairings with the outcome (XZ-->O) can reduce overshadowing of a target cue (Z). Moreover, pairing a cue with an outcome (X-->O) before compound training can enhance its ability to compete with another cue (i.e., blocking). Four experiments were conducted in a conditioned bar-press suppression preparation with rats to determine whether spacing of the X- or X-->O trials would differentially affect reduced overshadowing and blocking. Experiment 1a showed that reduced overshadowing was larger with massed trials than with spaced trials. Experiment 1b found that blocking was larger with spaced trials than with massed trials. Experiments 2a and 2b indicated that these effects of trial spacing were both mediated by the associative status of the context at test. The results are interpreted in the framework of contemporary learning theories.

  12. Pain Management in Newborns

    PubMed Central

    Hall, Richard W.; Anand, Kanwaljeet J. S.

    2014-01-01

    Effective pain management is a desirable standard of care for preterm and term newborns and may potentially improve their clinical and neurodevelopmental outcomes. Neonatal pain should be assessed routinely using context-specific, validated and objective pain methods, despite the limitations of currently available tools. Reducing invasive procedures, and using pharmacological, behavioral or environmental measures can be used to manage neonatal pain. Non-pharmacologic approaches include kangaroo care, facilitated tucking, non-nutritive sucking, sucrose and other sweeteners, massage and acupuncture therapy. They are used for procedures causing acute, transient, or mild pain, or as adjunctive therapy for moderate or severe pain. Local and topical anesthetics can reduce the acute pain caused by skin-breaking or mucosa-injuring procedures. Opioids form the mainstay for treatment of severe pain; morphine and fentanyl are the most commonly used drugs, although other opioids are also available. Non-opioid drugs include various sedatives and anesthetic agents, mostly used as adjunctive therapy in ventilated neonates. Acetaminophen, ibuprofen and other drugs are used for neonates, although their efficacy and safety remains unproven. Approaches for implementing an effective pain management program in the Neonatal ICU are summarized, together with practical protocols for procedural, postoperative, and mechanical ventilation-associated neonatal pain and stress. PMID:25459780

  13. How Project Managers Really Manage: An Indepth Look at Some Managers of Large, Complex NASA Projects

    NASA Technical Reports Server (NTRS)

    Mulenburg, Gerald M.; Impaeilla, Cliff (Technical Monitor)

    2000-01-01

    This paper reports on a research study by the author that examined ten contemporary National Aeronautics and Space Administration (NASA) complex projects. In-depth interviews with the project managers of these projects provided qualitative data about the inner workings of the project and the methodologies used in establishing and managing the projects. The inclusion of a variety of space, aeronautics, and ground based projects from several different NASA research centers helped to reduce potential bias in the findings toward any one type of project, or technical discipline. The findings address the participants and their individual approaches. The discussion includes possible implications for project managers of other large, complex, projects.

  14. Six ways to reduce inventory.

    PubMed

    Lunn, T

    1996-05-01

    The purpose of this presentation is to help you reduce the inventory in your operation. We will accomplish that task by discussing six specific methods that companies have used successfully to reduce their inventory. One common attribute of these successes is that they also build teamwork among the people. Every business operation today is concerned with methods to improve customer service. The real trick is to accomplish that task without increasing inventory. We are all concerned with improving our skills at keeping inventory low.

  15. Flexure Bearing Reduces Startup Friction

    NASA Technical Reports Server (NTRS)

    Clingman, W. Dean

    1991-01-01

    Design concept for ball bearing incorporates small pieces of shim stock, wire spokes like those in bicycle wheels, or other flexing elements to reduce both stiction and friction slope. In flexure bearing, flexing elements placed between outer race of ball bearing and outer ring. Elements flex when ball bearings encounter small frictional-torque "bumps" or even larger ones when bearing balls encounter buildups of grease on inner or outer race. Flexure of elements reduce high friction slopes of "bumps", helping to keep torque between outer ring and inner race low and more nearly constant. Concept intended for bearings in gimbals on laser and/or antenna mirrors.

  16. In praise of middle managers.

    PubMed

    Huy, Q N

    2001-09-01

    Middle managers have often been cast as dinosaurs. Has-beens. Mediocre managers and intermediaries who defend the status quo instead of supporting others' attempts to change organizations for the better. An INSEAD professor has examined this interesting breed of manager--in particular, middle managers' roles during periods of radical organizational change. His findings will surprise many. Middle managers, it turns out, make valuable contributions to the realization of radical change at companies--contributions that go largely unrecognized by most senior executives. Quy Nguyen Huy says these contributions occur in four major areas. First, middle managers often have good entrepreneurial ideas that they are able and willing to realize--if only they can get a hearing. Second, they're far better than most senior executives at leveraging the informal networks at companies that make substantive, lasting change. Because they've worked their way up the corporate ladder, middle managers' networks run deep. Third, they stay attuned to employees' emotional needs during organizational change, thereby maintaining the transformation's momentum. And finally, they manage the tension between continuity and change--they keep the organization from falling into extreme inertia or extreme chaos. The author examines each of these strengths, citing real-world examples culled from his research. Of course, not every middle manager in an organization is a paragon of entrepreneurial vigor and energy, Huy acknowledges. But cavalierly dismissing the roles that middle managers play--and carelessly reducing their ranks--will drastically diminish senior managers' chances of realizing radical change at their companies. Indeed, middle managers may be the most effective allies of corner office executives when it's time to make major changes in businesses.

  17. Reducing human nitrogen use for food production

    PubMed Central

    Liu, Junguo; Ma, Kun; Ciais, Philippe; Polasky, Stephen

    2016-01-01

    Reactive nitrogen (N) is created in order to sustain food production, but only a small fraction of this N ends up being consumed as food, the rest being lost to the environment. We calculated that the total N input (TN) of global food production was 171 Tg N yr−1 in 2000. The production of animal products accounted for over 50% of the TN, against 17% for global calories production. Under current TN per unit of food production and assuming no change in agricultural practices and waste-to-food ratios, we estimate that an additional TN of 100 Tg N yr−1 will be needed by 2030 for a baseline scenario that would meet hunger alleviation targets for over 9 billion people. Increased animal production will have the largest impact on increasing TN, which calls for new food production systems with better N-recycling, such as cooperation between crop and livestock producing farms. Increased N-use efficiency, healthier diet and decreased food waste could mitigate this increase and even reduce TN in 2030 by 8% relative to the 2000 level. Achieving a worldwide reduction of TN is a major challenge that requires sustained actions to improve nitrogen management practices and reduce nitrogen losses into the environment. PMID:27445108

  18. Reducing human nitrogen use for food production.

    PubMed

    Liu, Junguo; Ma, Kun; Ciais, Philippe; Polasky, Stephen

    2016-07-22

    Reactive nitrogen (N) is created in order to sustain food production, but only a small fraction of this N ends up being consumed as food, the rest being lost to the environment. We calculated that the total N input (TN) of global food production was 171 Tg N yr(-1) in 2000. The production of animal products accounted for over 50% of the TN, against 17% for global calories production. Under current TN per unit of food production and assuming no change in agricultural practices and waste-to-food ratios, we estimate that an additional TN of 100 Tg N yr(-1) will be needed by 2030 for a baseline scenario that would meet hunger alleviation targets for over 9 billion people. Increased animal production will have the largest impact on increasing TN, which calls for new food production systems with better N-recycling, such as cooperation between crop and livestock producing farms. Increased N-use efficiency, healthier diet and decreased food waste could mitigate this increase and even reduce TN in 2030 by 8% relative to the 2000 level. Achieving a worldwide reduction of TN is a major challenge that requires sustained actions to improve nitrogen management practices and reduce nitrogen losses into the environment.

  19. Reducing human nitrogen use for food production

    NASA Astrophysics Data System (ADS)

    Liu, Junguo; Ma, Kun; Ciais, Philippe; Polasky, Stephen

    2016-07-01

    Reactive nitrogen (N) is created in order to sustain food production, but only a small fraction of this N ends up being consumed as food, the rest being lost to the environment. We calculated that the total N input (TN) of global food production was 171 Tg N yr‑1 in 2000. The production of animal products accounted for over 50% of the TN, against 17% for global calories production. Under current TN per unit of food production and assuming no change in agricultural practices and waste-to-food ratios, we estimate that an additional TN of 100 Tg N yr‑1 will be needed by 2030 for a baseline scenario that would meet hunger alleviation targets for over 9 billion people. Increased animal production will have the largest impact on increasing TN, which calls for new food production systems with better N-recycling, such as cooperation between crop and livestock producing farms. Increased N-use efficiency, healthier diet and decreased food waste could mitigate this increase and even reduce TN in 2030 by 8% relative to the 2000 level. Achieving a worldwide reduction of TN is a major challenge that requires sustained actions to improve nitrogen management practices and reduce nitrogen losses into the environment.

  20. A Randomized Intervention Trial to Reduce the Lending of Used Injection Equipment Among Injection Drug Users Infected With Hepatitis C

    PubMed Central

    Latka, Mary H.; Hagan, Holly; Kapadia, Farzana; Golub, Elizabeth T.; Bonner, Sebastian; Campbell, Jennifer V.; Coady, Micaela H.; Garfein, Richard S.; Pu, Minya; Thomas, Dave L.; Thiel, Thelma K.; Strathdee, Steffanie A.

    2008-01-01

    Objectives. We evaluated the efficacy of a peer-mentoring behavioral intervention designed to reduce risky distributive injection practices (e.g., syringe lending, unsafe drug preparation) among injection drug users with hepatitis C virus (HCV) infection. Methods. A randomized trial with a time-equivalent attention-control group was conducted among 418 HCV-positive injection drug users aged 18 to 35 years in 3 US cities. Participants reported their injection-related behaviors at baseline and at 3- and 6-month follow-ups. Results. Compared with the control group, intervention-group participants were less likely to report distributive risk behaviors at 3 months (odds ratio [OR]=0.46; 95% confidence interval [CI]=0.27, 0.79) and 6 months (OR=0.51; 95% CI=0.31, 0.83), a 26% relative risk reduction, but were no more likely to cite their HCV-positive status as a reason for refraining from syringe lending. Effects were strongest among intervention-group participants who had known their HCV-positive status for at least 6 months. Peer mentoring and self-efficacy were significantly increased among intervention-group participants, and intervention effects were mediated through improved self-efficacy. Conclusions. This behavioral intervention reduced unsafe injection practices that may propagate HCV among injection drug users. PMID:18382005