Expanding the Parameters for Excellence in Patient Assignments: Is Leveraging an Evidence-Data-Based Acuity Methodology Realistic?

PubMed

Gray, Joel; Kerfoot, Karlene

2016-01-01

Finding the balance of equitable assignments continues to be a challenge for health care organizations seeking to leverage evidence-based leadership practices. Ratios and subjective acuity strategies for nurse-patient staffing continue to be the dominant approach in health care organizations. In addition to ratio-based assignments and acuity-based assignment models driven by financial targets, more emphasis on using evidence-based leadership strategies to manage and create science for effective staffing is needed. In particular, nurse leaders are challenged to increase the sophistication of management of patient turnover (admissions, discharges, and transfers) and integrate tools from Lean methodologies and quality management strategies to determine the effectiveness of nurse-patient staffing.

Artificial Intelligence-Based Models for the Optimal and Sustainable Use of Groundwater in Coastal Aquifers

NASA Astrophysics Data System (ADS)

Sreekanth, J.; Datta, Bithin

2011-07-01

Overexploitation of the coastal aquifers results in saltwater intrusion. Once saltwater intrusion occurs, it involves huge cost and long-term remediation measures to remediate these contaminated aquifers. Hence, it is important to have strategies for the sustainable use of coastal aquifers. This study develops a methodology for the optimal management of saltwater intrusion prone aquifers. A linked simulation-optimization-based management strategy is developed. The methodology uses genetic-programming-based models for simulating the aquifer processes, which is then linked to a multi-objective genetic algorithm to obtain optimal management strategies in terms of groundwater extraction from potential well locations in the aquifer.

[Global brain metastases management strategy: a multidisciplinary-based approach].

PubMed

Métellus, P; Tallet, A; Dhermain, F; Reyns, N; Carpentier, A; Spano, J-P; Azria, D; Noël, G; Barlési, F; Taillibert, S; Le Rhun, É

2015-02-01

Brain metastases management has evolved over the last fifteen years and may use varying strategies, including more or less aggressive treatments, sometimes combined, leading to an improvement in patient's survival and quality of life. The therapeutic decision is subject to a multidisciplinary analysis, taking into account established prognostic factors including patient's general condition, extracerebral disease status and clinical and radiological presentation of lesions. In this article, we propose a management strategy based on the state of current knowledge and available therapeutic resources. Copyright © 2015. Published by Elsevier SAS.

Acceptance- versus Change-Based Pain Management: The Role of Psychological Acceptance

ERIC Educational Resources Information Center

Blacker, Kara J.; Herbert, James D.; Forman, Evan M.; Kounios, John

2012-01-01

This study compared two theoretically opposed strategies for acute pain management: an acceptance-based and a change-based approach. These two strategies were compared in a within-subjects design using the cold pressor test as an acute pain induction method. Participants completed a baseline pain tolerance assessment followed by one of the two…

Achieving competitive advantage through strategic human resource management.

PubMed

Fottler, M D; Phillips, R L; Blair, J D; Duran, C A

1990-01-01

The framework presented here challenges health care executives to manage human resources strategically as an integral part of the strategic planning process. Health care executives should consciously formulate human resource strategies and practices that are linked to and reinforce the broader strategic posture of the organization. This article provides a framework for (1) determining and focusing on desired strategic outcomes, (2) identifying and implementing essential human resource management actions, and (3) maintaining or enhancing competitive advantage. The strategic approach to human resource management includes assessing the organization's environment and mission; formulating the organization's business strategy; assessing the human resources requirements based on the intended strategy; comparing the current inventory of human resources in terms of numbers, characteristics, and human resource management practices with respect to the strategic requirements of the organization and its services or product lines; formulating the human resource strategy based on the differences between the assessed requirements and the current inventory; and implementing the appropriate human resource practices to reinforce the strategy and attain competitive advantage.

Development of Learning Management Model Based on Constructivist Theory and Reasoning Strategies for Enhancing the Critical Thinking of Secondary Students

ERIC Educational Resources Information Center

Chaipichit, Dudduan; Jantharajit, Nirat; Chookhampaeng, Sumalee

2015-01-01

The objectives of this research were to study issues around the management of science learning, problems that are encountered, and to develop a learning management model to address those problems. The development of that model and the findings of its study were based on Constructivist Theory and literature on reasoning strategies for enhancing…

The impact of the great recession on community-based mental health organizations: an analysis of top managers' perceptions of the economic downturn's effects and adaptive strategies used to manage the consequences in Ohio.

PubMed

Sweeney, Helen Anne; Knudsen, Kraig

2014-04-01

The Great Recession of 2007-2009 adversely affected the financial stability of the community-based mental health infrastructure in Ohio. This paper presents survey results of the type of adaptive strategies used by Ohio community-based mental health organizations to manage the consequences of the economic downturn. Results were aggregated into geographical classifications of rural, mid-sized urban, and urban. Across all groups, respondents perceived, to varying degrees, that the Great Recession posed a threat to their organization's survival. Urban organizations were more likely to implement adaptive strategies to expand operations while rural and midsized urban organizations implemented strategies to enhance internal efficiencies.

Incorporating hydrologic data and ecohydrologic relationships into ecological site descriptions

Treesearch

C. Jason Williams; Frederick B. Pierson; Kenneth E. Spaeth; Joel R. Brown; Osama Z. Al-Hamdan; Mark A. Weltz; Mark A. Nearing; Jeffrey E. Herrick; Jan Boll; Pete Robichaud; David C. Goodrich; Phillip Heilman; D. Phillip Guertin; Mariano Hernandez; Haiyan Wei; Stuart P. Hardegree; Eva K. Strand; Jonathan D. Bates; Loretta J. Metz; Mary H. Nichols

2016-01-01

The purpose of this paper is to recommend a framework and methodology for incorporating hydrologic data and ecohydrologic relationships in Ecological Site Descriptions (ESDs) and thereby enhance the utility of ESDs for assessing rangelands and guiding resilience-based management strategies. Resilience-based strategies assess and manage ecological state...

Complexity Science Applications to Dynamic Trajectory Management: Research Strategies

NASA Technical Reports Server (NTRS)

Sawhill, Bruce; Herriot, James; Holmes, Bruce J.; Alexandrov, Natalia

2009-01-01

The promise of the Next Generation Air Transportation System (NextGen) is strongly tied to the concept of trajectory-based operations in the national airspace system. Existing efforts to develop trajectory management concepts are largely focused on individual trajectories, optimized independently, then de-conflicted among each other, and individually re-optimized, as possible. The benefits in capacity, fuel, and time are valuable, though perhaps could be greater through alternative strategies. The concept of agent-based trajectories offers a strategy for automation of simultaneous multiple trajectory management. The anticipated result of the strategy would be dynamic management of multiple trajectories with interacting and interdependent outcomes that satisfy multiple, conflicting constraints. These constraints would include the business case for operators, the capacity case for the Air Navigation Service Provider (ANSP), and the environmental case for noise and emissions. The benefits in capacity, fuel, and time might be improved over those possible under individual trajectory management approaches. The proposed approach relies on computational agent-based modeling (ABM), combinatorial mathematics, as well as application of "traffic physics" concepts to the challenge, and modeling and simulation capabilities. The proposed strategy could support transforming air traffic control from managing individual aircraft behaviors to managing systemic behavior of air traffic in the NAS. A system built on the approach could provide the ability to know when regions of airspace approach being "full," that is, having non-viable local solution space for optimizing trajectories in advance.

How negotiators get to yes: predicting the constellation of strategies used across cultures to negotiate conflict.

PubMed

Tinsley, C H

2001-08-01

Individualism, hierarchy, polychronicity, and explicit-contracting values explain why managers from Germany, Japan, and the United States use a different mix of strategies to negotiate workplace conflict. Hypotheses extend prior research in showing that conflict behavior is multiply determined and that each culture uses a variety of interests, regulations, and power-based conflict management strategies. Results of actual (rather than survey-based) conflict resolution behavior suggest several fruitful avenues for future research, including examining the inferred meaning of negotiation arguments, analyzing interaction effects of cultural value dimensions, studying the effectiveness of different strategies across cultures, and examining whether strategic adjustments are made during intercultural conflict management.

Active Traffic Management: Comprehension, Legibility, Distance, and Motorist Behavior In Response to Selected Variable Speed Limit and Lane Control Signing

DOT National Transportation Integrated Search

2016-06-01

Active traffic management (ATM) incorporates a collection of strategies allowing the dynamic management of recurrent and nonrecurrent congestion based on prevailing traffic conditions. These strategies help to increase peak capacity, smooth traffic f...

Executive Order 13514: Federal Leadership in Environmental, Energy, and Economic Performance; Comprehensive Federal Fleet Management Handbook (Book)

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

Daley, R.; Ahdieh, N.; Bentley, J.

2014-01-01

A comprehensive Federal Fleet Management Handbook that builds upon the "Guidance for Federal Agencies on E.O. 13514 Section 12-Federal Fleet Management" and provides information to help fleet managers select optimal greenhouse gas and petroleum reduction strategies for each location, meeting or exceeding related fleet requirements, acquiring vehicles to support these strategies while minimizing fleet size and vehicle miles traveled, and refining strategies based on agency performance.

Monte Carlo-based interval transformation analysis for multi-criteria decision analysis of groundwater management strategies under uncertain naphthalene concentrations and health risks

NASA Astrophysics Data System (ADS)

Ren, Lixia; He, Li; Lu, Hongwei; Chen, Yizhong

2016-08-01

A new Monte Carlo-based interval transformation analysis (MCITA) is used in this study for multi-criteria decision analysis (MCDA) of naphthalene-contaminated groundwater management strategies. The analysis can be conducted when input data such as total cost, contaminant concentration and health risk are represented as intervals. Compared to traditional MCDA methods, MCITA-MCDA has the advantages of (1) dealing with inexactness of input data represented as intervals, (2) mitigating computational time due to the introduction of Monte Carlo sampling method, (3) identifying the most desirable management strategies under data uncertainty. A real-world case study is employed to demonstrate the performance of this method. A set of inexact management alternatives are considered in each duration on the basis of four criteria. Results indicated that the most desirable management strategy lied in action 15 for the 5-year, action 8 for the 10-year, action 12 for the 15-year, and action 2 for the 20-year management.

Fuels planning: science synthesis and integration; social issues fact sheet 13: Strategies for managing fuels and visual quality

Treesearch

Christine Esposito

2006-01-01

The public's acceptance of forest management practices, including fuels reduction, is heavily based on how forests look. Fuels managers can improve their chances of success by considering aesthetics when making management decisions. This fact sheet reviews a three-part general strategy for managing fuels and visual quality: planning, implementation, and monitoring...

Science framework for conservation and restoration of the sagebrush biome: Linking the Department of the Interior’s Integrated Rangeland Fire Management Strategy to long-term strategic conservation actions, Part 1. Science basis and applications

USGS Publications Warehouse

Chambers, Jeanne C.; Beck, Jeffrey L.; Bradford, John B.; Bybee, Jared; Campbell, Steve; Carlson, John; Christiansen, Thomas J; Clause, Karen J.; Collins, Gail; Crist, Michele R.; Dinkins, Jonathan B.; Doherty, Kevin E.; Edwards, Fred; Espinosa, Shawn; Griffin, Kathleen A.; Griffin, Paul; Haas, Jessica R.; Hanser, Steven E.; Havlina, Douglas W.; Henke, Kenneth F.; Hennig, Jacob D.; Joyce, Linda A; Kilkenny, Francis F.; Kulpa, Sarah M; Kurth, Laurie L; Maestas, Jeremy D; Manning, Mary E.; Mayer, Kenneth E.; Mealor, Brian A.; McCarthy, Clinton; Pellant, Mike; Perea, Marco A.; Prentice, Karen L.; Pyke, David A.; Wiechman , Lief A.; Wuenschel, Amarina

2017-01-01

The Science Framework is intended to link the Department of the Interior’s Integrated Rangeland Fire Management Strategy with long-term strategic conservation actions in the sagebrush biome. The Science Framework provides a multiscale approach for prioritizing areas for management and determining effective management strategies within the sagebrush biome. The emphasis is on sagebrush (Artemisia spp.) ecosystems and Greater sage-grouse (Centrocercus urophasianus). The approach provided in the Science Framework links sagebrush ecosystem resilience to disturbance and resistance to nonnative, invasive plant species to species habitat information based on the distribution and abundance of focal species. A geospatial process is presented that overlays information on ecosystem resilience and resistance, species habitats, and predominant threats and that can be used at the mid-scale to prioritize areas for management. A resilience and resistance habitat matrix is provided that can help decisionmakers evaluate risks and determine appropriate management strategies. Prioritized areas and management strategies can be refined by managers and stakeholders at the local scale based on higher resolution data and local knowledge. Decision tools are discussed for determining appropriate management actions for areas that are prioritized for management. Geospatial data, maps, and models are provided through the U.S. Geological Survey (USGS) ScienceBase and Bureau of Land Management (BLM) Landscape Approach Data Portal. The Science Framework is intended to be adaptive and will be updated as additional data become available on other values and species at risk. It is anticipated that the Science Framework will be widely used to: (1) inform emerging strategies to conserve sagebrush ecosystems, sagebrush dependent species, and human uses of the sagebrush system, and (2) assist managers in prioritizing and planning on-the-ground restoration and mitigation actions across the sagebrush biome.

A Simulation-Based Approach for Teaching the Systems Perspective of Strategic Performance Management

ERIC Educational Resources Information Center

Capelo, Carlos; Lopes, Ana; Mata, Ana

2015-01-01

Kaplan and Norton introduced the balanced scorecard (BSC), which is based on a systems perspective of the business strategy and performance measurement. Many organisations around the world use the BSC to define, implement and manage strategy. Nevertheless, there are studies that identify problems and limitations associated with the implementation…

Financial Decentralization in Malaysian Schools: Strategies for Effective Implementation

ERIC Educational Resources Information Center

Radzi, Norfariza Mohd; Ghani, Muhammad Faizal A.; Siraj, Saedah; Afshari, Mojgan

2013-01-01

This article presents findings on the essential strategies required at the school site and the relevant people responsible for the effective implementation of school-based financial management in Malaysia. Many lessons have been learned since more than a decade of the school-based financial management reform in Malaysia through the establishment…

Strategies for Teaching Evidence-Based Management: What Management Educators Can Learn from Medicine

ERIC Educational Resources Information Center

Wright, April L.; Middleton, Stuart; Greenfield, Geoffrey; Williams, Julian; Brazil, Victoria

2016-01-01

Evidence-based management (EBMgt) is a growing literature stream in management education which contends that management decision making should be informed by the best available scientific evidence (Rousseau, 2006). Encouraged by the success of evidence-based practice in the field of medicine, advocates of EBMgt have increasingly called for…

Lessons about Cash and Manager Priorities

ERIC Educational Resources Information Center

Mong, Donald

2013-01-01

Experienced managers know that cash affects virtually every aspect of a company's strategy and operations. Business students and new managers, however, sometimes lose sight of the importance of cash amidst the details of accrual-based accounting courses, formula-based finance courses, and production-based management courses. We therefore use…

Site-Based Management in a Collective Bargaining Environment: Can We Mix Oil and Water?

ERIC Educational Resources Information Center

Fossey, Richard

Site-based management has become a popular school reform strategy. However, conflicts can arise when school districts with collective bargaining try to implement site-based management. Site-based management depends on collaboration and cooperation among educators, both of which conflict with collective bargaining's adversarial nature. There is…

Impacts of adaptive flood management strategies on the Socio-Hydrological system in Ganges - Brahmaputra river basin, Bangladesh

NASA Astrophysics Data System (ADS)

Sung, K.; Jeong, H.; Sangwan, N.; Yu, D. J.

2017-12-01

Human societies have tried to prevent floods by building robust infrastructure such as levees or dams. However, some scholars raise a doubt to this approach because of a lack of adaptiveness to environmental and societal changes in a long-term. Thus, a growing number of studies now suggest adopting new strategies in flood management to reinforce an adapt capacity to the long-term flood risk. This study addresses this issue by developing a conceptual mathematical model exploring how flood management strategies effect to the dynamics human-flood interaction, ultimately the flood resilience in a long-term. Especially, our model is motivated by the community-based flood protection system in southwest coastal area in Bangladesh. We developed several conceptual flood management strategies and investigated the interplay between those strategies and community's capacity to cope with floods. We additionally analyzed how external disturbances (sea level rise, water tide level change, and outside economic development) alter the adaptive capacity to flood risks. The results of this study reveal that the conventional flood management has potential vulnerabilities as external disturbances increase. Our results also highlight the needs of the adaptive strategy as a new paradigm in flood management which is able to feedback to the social and hydrological conditions. These findings provide insights on the resilience-based, adaptive strategies which can build flood resilience under global change.

Rangeland Riparian Systems

Treesearch

Wayne Elmore

1989-01-01

The management and recovery of degraded riparian systems is a major conservation issue. Presently there are many grazing management strategies being applied based on the name of the technique with little incorporation of basic stream processes. Managers must understand the exact workings of grazing strategies and the individual processes of each stream before...

Implementation Planning and Progress on Physical Activity Goals: The Mediating Role of Life-Management Strategies

ERIC Educational Resources Information Center

Dugas, Michelle; Gaudreau, Patrick; Carraro, Natasha

2012-01-01

This 4-week prospective study examined whether the use of life-management strategies mediates the relationship between implementation planning and short-term progress on physical activity goals. In particular, the strategies of elective selection, compensation, and loss-based selection were disentangled to assess their specific mediating effects.…

Knowledge Management and the Competitive Strategy of the Firm

ERIC Educational Resources Information Center

Halawi, Leila A.; McCarthy, Richard V.; Aronson, Jay E.

2006-01-01

Purpose: Knowledge management (KM) has emerged as a strategy to improve organizational competitiveness. Our purpose is to identify the relationship between KM and the firm's competitive advantage. Design/methodology/approach: We review the existing literature on KM and strategy formulation. We utilize the resource-based view approach as a lens for…

One Year On: First-Year Primary Teachers' Perceptions of Preparedness to Manage Misbehaviour and Their Confidence in the Strategies They Use

ERIC Educational Resources Information Center

O'Neill, Sue; Stephenson, Jennifer

2013-01-01

This article reports the findings of a one-year follow-up study of Australian beginning primary teachers' perceived preparedness to manage a variety of problematic student behaviours, and their confidence and use of behaviour management strategies based on their preservice coursework in classroom behaviour management. A total of 216 primary…

The Campus Environmental Management System Cycle in Practice: 15 Years of Environmental Management, Education and Research at Dalhousie University

ERIC Educational Resources Information Center

Clarke, Amelia

2006-01-01

Purpose: To challenge the deliberate strategy approach of the environmental management system (EMS) cycle, and offer a model based on both the practical reality experienced at Dalhousie University and emergent strategy theory. Also, to share some of the lessons learned in the 15 years of environmental management at Dalhousie University.…

Air traffic control resource management strategies and the small aircraft transportation system: A system dynamics perspective

NASA Astrophysics Data System (ADS)

Galvin, James J., Jr.

The National Aeronautics and Space Administration (NASA) is leading a research effort to develop a Small Aircraft Transportation System (SATS) that will expand air transportation capabilities to hundreds of underutilized airports in the United States. Most of the research effort addresses the technological development of the small aircraft as well as the systems to manage airspace usage and surface activities at airports. The Federal Aviation Administration (FAA) will also play a major role in the successful implementation of SATS, however, the administration is reluctant to embrace the unproven concept. The purpose of the research presented in this dissertation is to determine if the FAA can pursue a resource management strategy that will support the current radar-based Air Traffic Control (ATC) system as well as a Global Positioning Satellite (GPS)-based ATC system required by the SATS. The research centered around the use of the System Dynamics modeling methodology to determine the future behavior of the principle components of the ATC system over time. The research included a model of the ATC system consisting of people, facilities, equipment, airports, aircraft, the FAA budget, and the Airport and Airways Trust Fund. The model generated system performance behavior used to evaluate three scenarios. The first scenario depicted the base case behavior of the system if the FAA continued its current resource management practices. The second scenario depicted the behavior of the system if the FAA emphasized development of GPS-based ATC systems. The third scenario depicted a combined resource management strategy that supplemented radar systems with GPS systems. The findings of the research were that the FAA must pursue a resource management strategy that primarily funds a radar-based ATC system and directs lesser funding toward a GPS-based supplemental ATC system. The most significant contribution of this research was the insight and understanding gained of how several resource management strategies and the presence of SATS aircraft may impact the future US Air Traffic Control system.

Self-management programs based on the social cognitive theory for Koreans with chronic disease: a systematic review.

PubMed

Jang, Yeonsoo; Yoo, Hyera

2012-02-01

Self-management programs based on social cognitive theory are useful to improve health care outcomes for patients with chronic diseases in Western culture. The purpose of this review is to identify and synthesize published research on the theory to enhance self-efficacy in disease management and examine its applicability to Korean culture regarding the learning strategies used. Ultimately, it was to identify the optimal use of these learning strategies to improve the self-efficacy of Korean patients in self-management of their hypertension and diabetic mellitus. The authors searched the Korean and international research databases from January 2000 to September 2009. Twenty studies were selected and reviewed. The most frequently used learning strategies of social cognitive theory was skill mastery by practice and feedback (N = 13), followed by social or verbal persuasion by group members (N = 7) and, however, observation learning and reinterpretation of symptoms by debriefing or discussion were not used any of the studies. Eight studies used only one strategy to enhance self-efficacy and six used two. A lack of consistency regarding the content and clinical efficacy of the self-efficacy theory-based self-management programs is found among the reviewed studies on enhancing self-efficacy in Koreans with hypertension and diabetes mellitus. Further research on the effectiveness of these theory-based self-management programs for patients with chronic diseases in Korea and other countries is recommended.

Sleep Management Strategy and Performance in an Extreme Mountain Ultra-marathon.

PubMed

Poussel, Mathias; Laroppe, Julien; Hurdiel, Rémy; Girard, Julien; Poletti, Laurence; Thil, Catherine; Didelot, Antoine; Chenuel, Bruno

2015-01-01

We intended to assess the relationship between sleep strategies and performance during the North-Face Ultra-Trail du Mont-Blanc 2013, to test the hypothesis that sleep management can influence athletic performance. Almost all runners specifically adopted sleep management strategies before the race. Among the finishers 72% didn't sleep at all during the race and 28% took a least one break for sleep. Non-sleepers completed the race faster than the sleepers (P = 0.0008). Race time was positively correlated with drowsiness (P < 0.0001) and negatively correlated with the number participations in this race (P = 0.0039). Runners who adopted a sleep management strategy based on increased sleep time before the race completed the race faster (P = 0.0258). Most finishers seemed to be aware of the importance of developing sleep management strategies and increasing sleep time some nights before the race appeared to be the most relevant strategy to improve performance.

Prolonging fuel cell stack lifetime based on Pontryagin's Minimum Principle in fuel cell hybrid vehicles and its economic influence evaluation

NASA Astrophysics Data System (ADS)

Zheng, C. H.; Xu, G. Q.; Park, Y. I.; Lim, W. S.; Cha, S. W.

2014-02-01

The lifetime of fuel cell stacks is a major issue currently, especially for automotive applications. In order to take into account the lifetime of fuel cell stacks while considering the fuel consumption minimization in fuel cell hybrid vehicles (FCHVs), a Pontryagin's Minimum Principle (PMP)-based power management strategy is proposed in this research. This strategy has the effect of prolonging the lifetime of fuel cell stacks. However, there is a tradeoff between the fuel cell stack lifetime and the fuel consumption when this strategy is applied to an FCHV. Verifying the positive economic influence of this strategy is necessary in order to demonstrate its superiority. In this research, the economic influence of the proposed strategy is assessed according to an evaluating cost which is dependent on the fuel cell stack cost, the hydrogen cost, the fuel cell stack lifetime, and the lifetime prolonging impact on the fuel cell stack. Simulation results derived from the proposed power management strategy are also used to evaluate the economic influence. As a result, the positive economic influence of the proposed PMP-based power management strategy is proved for both current and future FCHVs.

Disease management as a performance improvement strategy.

PubMed

McClatchey, S

2001-11-01

Disease management is a strategy of organizing care and services for a patient population across the continuum. It is characterized by a population database, interdisciplinary and interagency collaboration, and evidence-based clinical information. The effectiveness of a disease management program has been measured by a combination of clinical, financial, and quality of life outcomes. In early 1997, driven by a strategic planning process that established three Centers of Excellence (COE), we implemented disease management as the foundation for a new approach to performance improvement utilizing five key strategies. The five implementation strategies are outlined, in addition to a review of the key elements in outcome achievement.

Constructing Proxy Variables to Measure Adult Learners' Time Management Strategies in LMS

ERIC Educational Resources Information Center

Jo, Il-Hyun; Kim, Dongho; Yoon, Meehyun

2015-01-01

This study describes the process of constructing proxy variables from recorded log data within a Learning Management System (LMS), which represents adult learners' time management strategies in an online course. Based on previous research, three variables of total login time, login frequency, and regularity of login interval were selected as…

Flight Crew Task Management in Non-Normal Situations

NASA Technical Reports Server (NTRS)

Schutte, Paul C.; Trujillo, Anna C.

1996-01-01

Task management (TM) is always performed on the flight deck, although not always explicitly, consistently, or rigorously. Nowhere is TM as important as it is in dealing with non-normal situations. The objective of this study was to analyze pilot TM behavior for non-normal situations. Specifically, the study observed pilots performance in a full workload environment in order to discern their TM strategies. This study identified four different TM prioritization and allocation strategies: Aviate-Navigate-Communicate-Manage Systems; Perceived Severity; Procedure Based; and Event/Interrupt Driven. Subjects used these strategies to manage their personal workload and to schedule monitoring and assessment of the situation. The Perceived Severity strategy for personal workload management combined with the Aviate-Navigate-Communicate-Manage Systems strategy for monitoring and assessing appeared to be the most effective (fewest errors and fastest response times) in responding to the novel system failure used in this study.

Heart failure patients' attitudes, beliefs, expectations and experiences of self-management strategies: a qualitative synthesis.

PubMed

Wingham, Jennifer; Harding, Geoff; Britten, Nicky; Dalal, Hayes

2014-06-01

To develop a model of heart failure patients' attitudes, beliefs, expectations, and experiences based on published qualitative research that could influence the development of self-management strategies. A synthesis of 19 qualitative research studies using the method of meta-ethnography. This synthesis offers a conceptual model of the attitudes, beliefs, and expectations of patients with heart failure. Patients experienced a sense of disruption before developing a mental model of heart failure. Patients' reactions included becoming a strategic avoider, a selective denier, a well-intentioned manager, or an advanced self-manager. Patients responded by forming self-management strategies and finally assimilated the strategies into everyday life seeking to feel safe. This conceptual model suggests that there are a range of interplaying factors that facilitate the process of developing self-management strategies. Interventions should take into account patients' concepts of heart failure and their subsequent reactions.

Site-Based Management: Implications for Risk Management?

ERIC Educational Resources Information Center

Dunklee, Dennis R.

1990-01-01

Site-based school management opens the possibility of problems in districtwide risk management and liability prevention programs. Describes a program to transfer prevention law and risk management strategies to individual school sites. Cautions that only duly authorized agents of local school boards can commit boards to contractual obligations.…

System characteristics of healthcare organizations conducting successful improvements.

PubMed

Olsson, Jesper; Elg, Mattias; Lindblad, Staffan

2007-01-01

In a previous study, based on a survey to all clinical department and primary care center managers in Sweden, it was concluded that the prevailing general improvement strategy is characterized by: drivers for improvement are staff needs; patients and data are not as important; improvements mainly focus on administrative routines and stress management; improvements are mainly reached, by writing guidelines, and conducting meetings; the majority of managers perceive outcomes from this strategy as successful. The purpose of current research in this paper is to investigate whether there is any other improvement strategy at play in Swedish health care. Data from the study of all Swedish managers were stratified into two populations based on an instrument predicting successful improvement. One population represented organizations with exceptionally high probability of successful imrpovement and remaining organizations represented the general improvement strategy. The paper finds that organizations with high probability for successful change differed from the comparison population at the p = 0.05 level in many of the surveyed characteristics. They put emphasis on patient focus, measuring outcomes, feedback of data, interorganizational collaboration, learning and knowledge, communication/information, culture, and development of administration and management. Thus these organizations center their attention towards behavioral changes supported by data. Organizations predicted to conduct successful improvement apply comprehensive improvement strategies as suggested in the literature. Such actions are part of the Patient Centered Task Alignment strategy and it is suggested that this concept has managerial implications as well, as it might be useful in further studies on improvement work in health care. This paper provides empirically based findings on a successful improvement strategy that can aid research-informed policy decisions on organizational improvement strategies.

Power Electronics Thermal Management R&D (Presentation)

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

Waye, S.

2014-11-01

This project will investigate and develop thermal-management strategies for wide bandgap (WBG)-based power electronics systems. Research will be carried out to deal with thermal aspects at the module- and system-level. Module-level research will focus on die- and substrate-integrated cooling strategies and heat-transfer enhancement technologies. System-level research will focus on thermal-management strategies for the entire power electronics system to enable smart packaging solutions. One challenge with WBG device-based power electronics is that although losses in the form of heat may be lower, the footprint of the components is also likely to be reduced to reduce cost, weight, and volume. Combined withmore » higher operational temperatures, this creates higher heat fluxes which much be removed from a smaller footprint, requiring advanced cooling strategies.« less

Silvicultural decisionmaking in an uncertain climate future: a workshop-based exploration of considerations, strategies, and approaches

Treesearch

Maria K. Janowiak; Christopher W. Swanston; Linda M. Nagel; Christopher R. Webster; Brian J. Palik; Mark J. Twery; John B. Bradford; Linda R. Parker; Andrea T. Hille; Sheela M. Johnson

2011-01-01

Land managers across the country face the immense challenge of developing and applying appropriate management strategies as forests respond to climate change. We hosted a workshop to explore silvicultural strategies for addressing the uncertainties surrounding climate change and forest response in the northeastern and north-central United States. Outcomes of this...

Integrating personal medicine into service delivery: empowering people in recovery.

PubMed

MacDonald-Wilson, Kim L; Deegan, Patricia E; Hutchison, Shari L; Parrotta, Nancy; Schuster, James M

2013-12-01

Illness management and recovery strategies are considered evidence-based practices. The article describes how a web-based application, CommonGround, has been used to support implementation of such strategies in outpatient mental health services and assess its impact. The specific focus of this article is Personal Medicine, self-management strategies that are a salient component of the CommonGround intervention. With support from counties and a not-for-profit managed care organization, CommonGround has been introduced in 10 medication clinics, one Assertive Community Treatment (ACT) team, and one peer support center across Pennsylvania. Methods include analysis of data from the application's database and evaluation of health functioning, symptoms, and progress toward recovery. Health functioning improved over time and use of self-management strategies was associated with fewer concerns about medication side effects, fewer concerns about the impact of mental health medicine on physical health, more reports that mental health medicines were helping, and greater progress in individuals' recovery. Using Personal Medicine empowers individuals to work with their prescribers to find a "right balance" between what they do to be well and what they take to be well. This program helps individuals and their service team focus on individual strengths and resilient self-care strategies. More research is needed to assess factors that may predict changes in outcomes and how a web-based tool focused on self-management strategies may moderate those factors. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Management of chronic recurrent osteitis pubis/pubic bone stress in a Premier League footballer: Evaluating the evidence base and application of a nine-point management strategy.

PubMed

McAleer, Stephen S; Gille, Justus; Bark, Stefan; Riepenhof, Helge

2015-08-01

The aim of this paper was to use a clinical example to describe a treatment strategy for the management of recurrent chronic groin pain and evaluate the evidence of the interventions. A professional footballer presented with chronic recurrent OP/PBS. The injury was managed successfully with a nine-point programme - 1. Acute pharmacological management. 2. Tone reduction of over-active structures. 3. Improved ROM at hips, pelvis and thorax. 4. Adductor strength. 5. Functional movement assessment. 6. Core stability. 7. Lumbo-pelvic control. 8. Gym-based strengthening. 9. Field-based conditioning/rehabilitation. The evidence for these interventions is reviewed. The player returned to full training and match play within 41 and 50 days, respectively, and experienced no recurrence of his symptoms in follow up at 13 months. This case report displays a nine-point conservative management strategy for OP/PBS, with non-time dependent clinical objective markers as the progression criteria in a Premier League football player. Copyright © 2015 Elsevier Ltd. All rights reserved.

Asthma management simulation for children: translating theory, methods, and strategies to effect behavior change.

PubMed

Shegog, Ross; Bartholomew, L Kay; Gold, Robert S; Pierrel, Elaine; Parcel, Guy S; Sockrider, Marianna M; Czyzewski, Danita I; Fernandez, Maria E; Berlin, Nina J; Abramson, Stuart

2006-01-01

Translating behavioral theories, models, and strategies to guide the development and structure of computer-based health applications is well recognized, although a continued challenge for program developers. A stepped approach to translate behavioral theory in the design of simulations to teach chronic disease management to children is described. This includes the translation steps to: 1) define target behaviors and their determinants, 2) identify theoretical methods to optimize behavioral change, and 3) choose educational strategies to effectively apply these methods and combine these into a cohesive computer-based simulation for health education. Asthma is used to exemplify a chronic health management problem and a computer-based asthma management simulation (Watch, Discover, Think and Act) that has been evaluated and shown to effect asthma self-management in children is used to exemplify the application of theory to practice. Impact and outcome evaluation studies have indicated the effectiveness of these steps in providing increased rigor and accountability, suggesting their utility for educators and developers seeking to apply simulations to enhance self-management behaviors in patients.

Blood management issues using blood management strategies.

PubMed

Stulberg, Bernard N; Zadzilka, Jayson D

2007-06-01

Blood management strategies is a term used to address a coordinated approach to the management of blood loss in the perioperative period for total joint arthroplasty. The premise of any blood management strategy is that each patient, surgeon, and operative intervention experiences different risks of requiring transfusion, that those risks can be identified, and that a plan can be implemented to address them. A surgeon's decision to transfuse should be based on physiologic assessment of the patient's response to anemia and not on an arbitrary number ("transfusion trigger"). Intervention strategies can be applied preoperatively, intraoperatively, and postoperatively. Patient-specific planning allows for the appropriate use of patient, hospital, and system resources, ensuring that the consequences of anemia are minimized and that the patient's recovery process is optimized.

Management of the ocular surface and tear film before, during, and after laser in situ keratomileusis.

PubMed

Albietz, Julie M; Lenton, Lee M

2004-01-01

To identify evidence-based, best practice strategies for managing the ocular surface and tear film before, during, and after laser in situ keratomileusis (LASIK). After a comprehensive review of relevant published literature, evidence-based recommendations for best practice management strategies are presented. Symptoms of ocular irritation and signs of dysfunction of the integrated lacrimal gland/ocular surface functional gland unit are common before and after LASIK. The status of the ocular surface and tear film before LASIK can impact surgical outcomes in terms of potential complications during and after surgery, refractive outcome, optical quality, patient satisfaction, and the severity and duration of dry eye after LASIK. Before LASIK, the health of the ocular surface should be optimized and patients selected appropriately. Dry eye before surgery and female gender are risk factors for developing chronic dry eye after LASIK. Management of the ocular surface during LASIK can minimize ocular surface damage and the risk of adverse outcomes. Long-term management of the tear film and ocular surface after LASIK can reduce the severity and duration of dry eye symptoms and signs. Strategies to manage the integrated ocular surface/lacrimal gland functional unit before, during, and after LASIK can optimize outcomes. As problems with the ocular surface and tear film are relatively common, attention should focus on the use and improvement of evidence-based management strategies.

Strategies to Improve Management of Acute Watery Diarrhea during a Military Deployment: A Cost Effectiveness Analysis.

PubMed

Schrader, Andrew J; Tribble, David R; Riddle, Mark S

2017-12-01

To inform policy and decision makers, a cost-effectiveness model was developed to predict the cost-effectiveness of implementing two hypothetical management strategies separately and concurrently on the mitigation of deployment-associated travelers' diarrhea (TD) burden. The first management strategy aimed to increase the likelihood that a deployed service member with TD will seek medical care earlier in the disease course compared with current patterns; the second strategy aimed to optimize provider treatment practices through the implementation of a Department of Defense Clinical Practice Guideline. Outcome measures selected to compare management strategies were duty days lost averted (DDL-averted) and a cost effectiveness ratio (CER) of cost per DDL-averted (USD/DDL-averted). Increasing health care and by seeking it more often and earlier in the disease course as a stand-alone management strategy produced more DDL (worse) than the base case (up to 8,898 DDL-gained per year) at an increased cost to the Department of Defense (CER $193). Increasing provider use of an optimal evidence-based treatment algorithm through Clinical Practice Guidelines prevented 5,299 DDL per year with overall cost savings (CER -$74). A combination of both strategies produced the greatest gain in DDL-averted (6,887) with a modest cost increase (CER $118). The application of this model demonstrates that changes in TD management during deployment can be implemented to reduce DDL with likely favorable impacts on mission capability and individual health readiness. The hypothetical combination strategy evaluated prevents the most DDL compared with current practice and is associated with a modest cost increase.

Treatment Seeking and Self-Constructed Explanations of Pain and Pain Management Strategies Among Adolescents with Temporomandibular Disorder Pain.

PubMed

Nilsson, Ing-Marie; Willman, Ania

2016-01-01

To explore adolescents' explanations of their temporomandibular disorder (TMD) pain, their pain management strategies for TMD pain, and their treatment-seeking behavior. One-on-one interviews were conducted with 21 adolescents aged 15 to 19 years who had TMD pain and followed a semistructured interview guide. Subjects were strategically selected from patients referred to an orofacial pain clinic. All participants had been examined and received a pain diagnosis based on the Research Diagnostic Criteria for TMD. The interviews focused on the adolescents' experiences of TMD pain, their strategies for handling pain, and how they seek care. The interviews were recorded, transcribed verbatim, and analyzed using qualitative manifest content analysis. Qualitative manifest content analysis revealed two categories: (1) self-constructed explanations, with three subcategories (situation-based explanatory model, physical/biologic model, and psychological explanatory model); and (2) pain management strategies, with four subcategories (social support, treatment, relaxation/rest, and psychological strategies). Adolescents used physical activities and psychological and pharmacologic treatment to manage pain. Reasons for seeking treatment were to be cured, to obtain an explanation for their pain, and because their symptoms bother others. Adolescents living with TMD pain develop self-constructed explanations and pain management strategies. With access to these descriptions, dentists can be better prepared to have a dialogue with their adolescent patients about their own explanations of pain, the nature of pain, and in which situations the pain appears. Dentists can also explore adolescent patients' pain management strategies and perhaps also suggest new treatment strategies at an earlier stage.

A Different Approach to the Generation of Patient Management Problems from a Knowledge-Based System

PubMed Central

Barriga, Rosa Maria

1988-01-01

Several strategies are proposed to approach the generation of Patient Management Problems from a Knowledge Base and avoid inconsistencies in the results. These strategies are based on a different Knowledge Base structure and in the use of case introductions that describe the patient attributes which are not disease-dependent. This methodology has proven effective in a recent pilot test and it is on its way to implementation as part of an educational program at CWRU, School of Medicine.

Using multi-criteria decision making for selection of the optimal strategy for municipal solid waste management.

PubMed

Jovanovic, Sasa; Savic, Slobodan; Jovicic, Nebojsa; Boskovic, Goran; Djordjevic, Zorica

2016-09-01

Multi-criteria decision making (MCDM) is a relatively new tool for decision makers who deal with numerous and often contradictory factors during their decision making process. This paper presents a procedure to choose the optimal municipal solid waste (MSW) management system for the area of the city of Kragujevac (Republic of Serbia) based on the MCDM method. Two methods of multiple attribute decision making, i.e. SAW (simple additive weighting method) and TOPSIS (technique for order preference by similarity to ideal solution), respectively, were used to compare the proposed waste management strategies (WMS). Each of the created strategies was simulated using the software package IWM2. Total values for eight chosen parameters were calculated for all the strategies. Contribution of each of the six waste treatment options was valorized. The SAW analysis was used to obtain the sum characteristics for all the waste management treatment strategies and they were ranked accordingly. The TOPSIS method was used to calculate the relative closeness factors to the ideal solution for all the alternatives. Then, the proposed strategies were ranked in form of tables and diagrams obtained based on both MCDM methods. As shown in this paper, the results were in good agreement, which additionally confirmed and facilitated the choice of the optimal MSW management strategy. © The Author(s) 2016.

Paper and Process: How Youth Programs Manage Program Intake, Individual Service Strategy Development, and Case Files.

ERIC Educational Resources Information Center

Callahan, Jim; McLaughlin, Brenda

This guide presents information and materials to help youth programs manage program intake, design an individual service strategy (ISS) as mandated in the Workforce Investment Act, and manage case files. The materials are based on information obtained from staff working in seven successful youth workforce investment programs in Maryland,…

Principles for ecologically based invasive plant management

Treesearch

Jeremy J. James; Brenda S. Smith; Edward A. Vasquez; Roger L. Sheley

2010-01-01

Land managers have long identified a critical need for a practical and effective framework for designing restoration strategies, especially where invasive plants dominate. A holistic, ecologically based, invasive plant management (EBIPM) framework that integrates ecosystem health assessment, knowledge of ecological processes, and adaptive management into a successional...

Exploring strategies used following a group-based fatigue management programme for people with multiple sclerosis (FACETS) via the Fatigue Management Strategies Questionnaire (FMSQ).

PubMed

Thomas, S; Kersten, P; Thomas, P W; Slingsby, V; Nock, A; Jones, R; Davies Smith, A; Galvin, K T; Baker, R; Hillier, C

2015-10-20

To explore cross-sectional patterns of use of fatigue management strategies in people with multiple sclerosis (MS) who had attended a group-based fatigue management programme, Fatigue: Applying Cognitive behavioural and Energy effectiveness Techniques to lifeStyle ('FACETS'). In a multicentre randomised controlled trial (RCT) the FACETS programme was shown to reduce fatigue severity and improve self-efficacy and quality of life. A questionnaire substudy within a RCT involving the self-completed Fatigue Management Strategies Questionnaire (FMSQ). The FMSQ includes: (1) closed questions about the use and helpfulness of fatigue management strategies taught in FACETS and (2) open items about changes to lifestyle, attitudes or expectations, barriers or difficulties encountered and helpful strategies not covered in FACETS. All had a clinical diagnosis of MS, significant fatigue, were ambulatory and had attended at least 4 of 6 scheduled FACETS sessions. Participants (n=72) were posted the FMSQ with a prepaid return envelope 4 months after the end of the FACETS programme. 82% (59/72) of participants returned the FMSQ. The fatigue management strategies most frequently used since attending FACETS were prioritisation (80%), pacing (78%), saying no to others (78%), grading tasks (75%) and challenging unhelpful thoughts (71%). Adding in those participants who were already using the respective strategies prior to FACETS, the three most used strategies at 4 months were prioritisation (55/59), grading (54/59) and pacing (53/58). Free-text comments illustrated the complex interplay between attitudes/expectations, behaviours, emotions and the environment. Issues related to expectations featured strongly in participants' comments. Expectations (from self and others) were both facilitators and barriers to effective fatigue management. Individuals' comments highlighted the complex, multifaceted nature of fatigue management. Revising expectations and a greater acceptance of fatigue were important shifts following the programme. Findings support the relevance of a cognitive behavioural approach for fatigue management. Booster sessions might be a useful addition to the FACETS programme. Current controlled trials ISRCTN76517470; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Pain Assessment and Management in Nursing Education Using Computer-based Simulations.

PubMed

Romero-Hall, Enilda

2015-08-01

It is very important for nurses to have a clear understanding of the patient's pain experience and of management strategies. However, a review of the nursing literature shows that one of the main barriers to proper pain management practice is lack of knowledge. Nursing schools are in a unique position to address the gap in pain management knowledge by facilitating the acquisition and use of knowledge by the next generation of nurses. The purpose of this article is to discuss the role of computer-based simulations as a reliable educational technology strategy that can enhance the learning experience of nursing students acquiring pain management knowledge and practice. Computer-based simulations provide a significant number of learning affordances that can help change nursing students' attitudes and behaviors toward and practice of pain assessment and management. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

The Effectiveness of the Instructional Programs Based on Self-Management Strategies in Acquisition of Social Skills by the Children with Intellectual Disabilities

ERIC Educational Resources Information Center

Avcioglu, Hasan

2012-01-01

The purpose of this study is to evaluate the effectiveness of self-management skills training program, based on self-control strategies, on students with intellectual disabilities. A multiple-probe design across subjects single-subject research methodology was used in this study. Nine students with intellectual disabilities, whose ages are between…

Values and strategies: management of radical organizational change in a university hospital.

PubMed

Orvik, Arne

2017-04-01

Managers' experiences of radical change were studied in a Norwegian university hospital, which was relocated from a traditional building to a new, high-tech building. The university hospital was also accredited as a health promoting hospital. Thirteen managers at different levels in the organization and a personnel safety representative were interviewed as part of a trailing research project. The aim of the study was to elucidate the managers' value orientation and strategies for dealing with value tensions. A combination of a hermeneutical, reflective method and a template for quality, efficiency and integrity guided the analysis. The template was based not only on the main findings but also on the core values of a model of organizational health. The results show that clinical managers focus on quality and top managers, not unexpectedly, focus on efficiency. Managers at both levels were concerned about their own integrity, and also about the integrity of their clinician colleagues, as well as showing concern for the hospital's mission, in terms of organizational effectiveness. The discussion was conducted in terms of dominance, cycling and balancing strategies, of which the last was the most prevalent. However, sustainable strategies for dealing with value tensions also call for value-based management and value-conscious leadership. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Assessing the spatial implications of interactions among strategic forest management options using a Windows-based harvest simulator.

Treesearch

Eric J. Gustafson; Luke V. Rasmussen

2002-01-01

Forest management planners must develop strategies to produce timber in ways that do not compromise ecological integrity or sustainability. These strategies often involve modifications to the spatial and temporal scheduling of harvest activities, and these strategies may interact in unexpected ways. We used a timber harvest simulator (HARVEST 6.0) to determine the...

Strategies for managing impressions of racial identity in the workplace.

PubMed

Roberts, Laura Morgan; Cha, Sandra E; Kim, Sung Soo

2014-10-01

This article deepens understanding of the workplace experiences of racial minorities by investigating racial identity-based impression management (RIM) by Asian American journalists. Racial centrality, directly or indirectly, predicted the use of 4 RIM strategies (avoidance, enhancement, affiliation, and racial humor). Professional centrality also predicted strategy use, which was related to life satisfaction and perceived career success. By shedding light on proactive strategies that individuals use to influence colleagues' impressions of their racial identity, we contribute to research on diversity in organizations, impression management, and racial identity. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Site closure management strategies and the responsiveness of conservation outcomes in recreational fishing.

PubMed

Gao, Lei; Hailu, Atakelty

2018-02-01

We develop and use an empirically based model, which integrates fishing behaviour and a coral reef system, to evaluate outcomes from site closure strategies to manage the effects of recreational fishing. The model is designed to estimate management effects in complex settings with two-way feedback effects (between fishing and ecosystem dynamics) as well as spillover effects where the closure of a site (or sites) leads to the redistribution of fishing effort. An iconic coral reef system is used as a case study. The results demonstrate that some site closure strategies provide little incremental benefits over less stringent approaches. They also show that some strategies targeting more sites are actually inferior to more limited strategies, demonstrating that, in the analysis of complex problems involving feedback effects and substitutions, there is little substitute for the use of empirically based and sound modelling as the basis for informed conservation decision making and stakeholder consultation. These findings have direct relevance not only for policies aimed at improving recreational fishing management but also for securing the supply of marine ecosystem services. Copyright © 2017 Elsevier Ltd. All rights reserved.

Long-Term Management Strategy for Dredged Material Disposal for Naval Weapons Station, Yorktown, Yorktown, Virginia; Naval Supply Center, Cheatham Annex, Williamsburg, Virginia; and Naval Amphibious Base, Little Creek, Norfolk, Virginia. Phase 2: Formulation of Alternatives

DTIC Science & Technology

1993-03-01

Regulatory Framework and Management Strategy ... .......... 11 Need for Criteria ............... ........................ .. 12 Criteria for Open-Water... Framework and Managetent Strategy 19. Because the Phase I results indicated that there is insufficient confined disposal capacity, the assessment of open...regulatory framework established for Sections 103 and 404. 11 20. All disposal options considered for this LTMS were examined using the Corps Management

Medication management strategies used by older adults with heart failure: A systems-based analysis.

PubMed

Mickelson, Robin S; Holden, Richard J

2017-09-01

Older adults with heart failure use strategies to cope with the constraining barriers impeding medication management. Strategies are behavioral adaptations that allow goal achievement despite these constraining conditions. When strategies do not exist, are ineffective or maladaptive, medication performance and health outcomes are at risk. While constraints to medication adherence are described in literature, strategies used by patients to manage medications are less well-described or understood. Guided by cognitive engineering concepts, the aim of this study was to describe and analyze the strategies used by older adults with heart failure to achieve their medication management goals. This mixed methods study employed an empirical strategies analysis method to elicit medication management strategies used by older adults with heart failure. Observation and interview data collected from 61 older adults with heart failure and 31 caregivers were analyzed using qualitative content analysis to derive categories, patterns and themes within and across cases. Data derived thematic sub-categories described planned and ad hoc methods of strategic adaptations. Stable strategies proactively adjusted the medication management process, environment, or the patients themselves. Patients applied situational strategies (planned or ad hoc) to irregular or unexpected situations. Medication non-adherence was a strategy employed when life goals conflicted with medication adherence. The health system was a source of constraints without providing commensurate strategies. Patients strived to control their medication system and achieve goals using adaptive strategies. Future patient self-mangement research can benefit from methods and theories used to study professional work, such as strategies analysis.

Management strategies for fibromyalgia

PubMed Central

Le Marshall, Kim Francis; Littlejohn, Geoffrey Owen

2011-01-01

Clinical question What are the effective, evidence-based strategies available for the management of fibromyalgia? Conclusion There are a number of management strategies available with robust evidence to support their use in clinical practice. Definition Fibromyalgia is a complex pain syndrome characterized by widespread, chronic muscular pain and tenderness, disordered sleep, emotional distress, cognitive disturbance, and fatigue. Its prevalence is estimated to be 3%–5% in the population and higher yet in patients with comorbid rheumatic diseases. Level of evidence Systematic reviews, meta-analyses, randomized controlled trials (RCTs). Search sources PubMed, Cochrane Library, manual search Consumer summary Key messages for patients and clinicians are: There are many effective pharmacological management strategies available for fibromyalgia.A nonpharmacological, multicomponent approach utilizing education, aerobic exercise, psychological therapy, and other strategies is also effective for fibromyalgia.Despite the significant and, at times, disabling physical and psychological symptoms, fibromyalgia can be a manageable condition with a potentially good outcome. PMID:27790003

Implementation of real-time energy management strategy based on reinforcement learning for hybrid electric vehicles and simulation validation

PubMed Central

Kong, Zehui; Liu, Teng

2017-01-01

To further improve the fuel economy of series hybrid electric tracked vehicles, a reinforcement learning (RL)-based real-time energy management strategy is developed in this paper. In order to utilize the statistical characteristics of online driving schedule effectively, a recursive algorithm for the transition probability matrix (TPM) of power-request is derived. The reinforcement learning (RL) is applied to calculate and update the control policy at regular time, adapting to the varying driving conditions. A facing-forward powertrain model is built in detail, including the engine-generator model, battery model and vehicle dynamical model. The robustness and adaptability of real-time energy management strategy are validated through the comparison with the stationary control strategy based on initial transition probability matrix (TPM) generated from a long naturalistic driving cycle in the simulation. Results indicate that proposed method has better fuel economy than stationary one and is more effective in real-time control. PMID:28671967

Implementation of real-time energy management strategy based on reinforcement learning for hybrid electric vehicles and simulation validation.

PubMed

Kong, Zehui; Zou, Yuan; Liu, Teng

2017-01-01

To further improve the fuel economy of series hybrid electric tracked vehicles, a reinforcement learning (RL)-based real-time energy management strategy is developed in this paper. In order to utilize the statistical characteristics of online driving schedule effectively, a recursive algorithm for the transition probability matrix (TPM) of power-request is derived. The reinforcement learning (RL) is applied to calculate and update the control policy at regular time, adapting to the varying driving conditions. A facing-forward powertrain model is built in detail, including the engine-generator model, battery model and vehicle dynamical model. The robustness and adaptability of real-time energy management strategy are validated through the comparison with the stationary control strategy based on initial transition probability matrix (TPM) generated from a long naturalistic driving cycle in the simulation. Results indicate that proposed method has better fuel economy than stationary one and is more effective in real-time control.

Gradual weaning and oral care management of prolonged breast-feeding based on family preferences.

PubMed

Hernandez, Purnima; Kisamore, April N

2017-06-01

There are no guidelines about when breast-feeding (BF) should be discontinued. In addition, investigators have not examined patient-provider communication regarding weaning strategies based on function and oral care management during prolonged BF. Suggestions to wean do not include strategies about how to achieve discontinuance. The authors conducted this case study to assist care providers in facilitation of such discussions with parents to minimize the risk of developing dental caries in older children who are breast-fed. The authors conducted a functional behavior assessment of BF and used the results to inform strategy development. The parent successfully implemented the suggested strategies to wean the child from BF with minimal problem behavior by the child. From the outcome of this case report, the authors developed an algorithm based on family preferences and behavioral functions to assist parents with gradual weaning and oral care management during prolonged BF. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

APPROACH TO "FURTHER-REASONABLE-PROGRESS" TO ATTAIN WATER QUALITY STANDARDS

EPA Science Inventory

Watershed managers in urban areas in the US are pursuing optimum strategies or plans for managing wastewater treatment plants, stormwater systems, sanitary sewer overflows (SSO) and combined sewer overflows (CSO). Often these strategies are based on an iterative process or a "fur...

APPROACH TO "FURTHER-REASONABLE-PROGRESS" TO ATTAIN WATER QUALITY STANDARDS

EPA Science Inventory

Watershed managers in urban areas in the US are pursuing optimum strategies or plans for managing wastewater treatment plants, stormwater systems, sanitary sewer overflows (SSO) and combined sewer overflows (CSO). Often thes strategies are based on an iterative process or a "furt...

Increasing On-Task Behavior in Students in a Regular Classroom: Effectiveness of a Self-Management Procedure Using a Tactile Prompt

ERIC Educational Resources Information Center

Moore, Dennis W.; Anderson, Angelika; Glassenbury, Michele; Lang, Russell; Didden, Robert

2013-01-01

Self-management strategies have been shown to be widely effective. However, limited classroom-based research exists involving low performing but developmentally normal high school-aged participants. This study examined the effectiveness of a self-management strategy aimed at increasing on-task behavior in general education classrooms with students…

Evidence-Based Classroom Behaviour Management Strategies

ERIC Educational Resources Information Center

Parsonson, Barry S.

2012-01-01

This paper reviews a range of evidence-based strategies for application by teachers to reduce disruptive and challenging behaviours in their classrooms. These include a number of antecedent strategies intended to help minimise the emergence of problematic behaviours and a range of those which provide positive consequences for appropriate student…

Fuzzy Energy Management for a Catenary-Battery-Ultracapacitor based Hybrid Tramway

NASA Astrophysics Data System (ADS)

Jibin, Yang; Jiye, Zhang; Pengyun, Song

2017-05-01

In this paper, an energy management strategy (EMS) based on fuzzy logic control for a catenary-battery-ultracapacitor powered hybrid modern tramway was presented. The fuzzy logic controller for the catenary zone and catenary-less zone was respectively designed by analyzing the structure and working mode of the hybrid system, then an energy management strategy based on double fuzzy logic control was proposed to enhance the fuel economy. The hybrid modern tramway simulation model was developed based on MATLAB/Simulink environment. The simulation results show that the proposed EMS can satisfy the demand of dynamic performance of the tramway and achieve the power distribution reasonably between the each power source.

Practice Patterns Compared with Evidence-based Strategies for the Management of Androgen Deprivation Therapy-Induced Side Effects in Prostate Cancer Patients: Results of a European Web-based Survey.

PubMed

Bultijnck, Renée; Surcel, Cristian; Ploussard, Guillaume; Briganti, Alberto; De Visschere, Pieter; Fütterer, Jurgen; Ghadjar, Pirus; Giannarini, Gianluca; Isbarn, Hendrik; Massard, Christophe; Sooriakumaran, Prasanna; Valerio, Massimo; van den Bergh, Roderick; Ost, Piet

2016-12-01

Evidence-based recommendations are available for the management of androgen deprivation therapy (ADT)-induced side effects; however, there are no data on the implementation of the recommendations into daily practice patterns. To compare practice patterns in the management of ADT-induced side effects with evidence-based strategies. A European Web-based survey was conducted from January 16, 2015, to June 24, 2015. The 25-item questionnaire was designed with the aid of expert opinion and covered general respondent information, ADT preference per disease stage, patient communication on ADT-induced side effects, and strategies to mitigate side effects. All questions referred to patients with long-term ADT use. Reported practice patterns were compared with available evidence-based strategies. Following data collection, descriptive statistics were used for analysis. Frequency distributions were compiled and compared using a generalised chi-square test. In total, 489 eligible respondents completed the survey. Luteinising hormone-releasing hormone-agonist with or without an antiandrogen was the preferred method of ADT in different settings. Patients were well informed about loss of libido (90%), hot flushes (85%), fatigue (67%), and osteoporosis (63%). An osteoporotic and metabolic risk assessment prior to commencing ADT was done by one-quarter of physicians. The majority (85%) took preventive measures and applied at least one evidence-based strategy. Exercise was recommended by three-quarters of physicians who advocate its positive effects; however, only 25% of physicians had access to exercise programmes. Although the minimum sample size was set at 400 participants, the current survey remains susceptible to volunteer and nonresponder bias. Patients were well informed about several ADT-induced complications but uncommonly underwent an osteoporotic and metabolic risk assessment. Nevertheless, physicians partially provided evidence-based strategies for the management of the complications. Physicians often advised exercise to reduce ADT-induced side effects, but programmes were not widely available. Implementation of evidence-based strategies for androgen deprivation therapy-induced side effects in real-life practice patterns should be improved. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Developing an explicit strategy towards social responsibility in the NHS: a case for including NHS managers in this strategy.

PubMed

Merali, Faruk

2006-01-01

To explore the concept of corporate social responsibility (CSR) within the UK National Health Service (NHS) and to examine how it may be developed to positively influence the psyche, behaviour and performance of NHS managers. Primary research based upon semi-structured individual face to face interviews with 20 NHS managers. Theoretical frameworks and concepts relating to organisational culture and CSR are drawn upon to discuss the findings. The NHS managers see themselves as being driven by altruistic core values. However, they feel that the public does not believe that they share the altruistic NHS value system. The study is based on a relatively small sample of NHS managers working exclusively in London and may not necessarily represent the views of managers either London-wide or nation-wide. It is suggested that an explicit recognition by the NHS of the socially responsible commitment of its managers within its CSR strategy would help challenge the existing negative public image of NHS managers and in turn improve the managers' self esteem and morale. This paper addresses the relative lacunae in research relating to public sector organisations (such as the NHS) explicitly including the role and commitment of its staff within the way it publicises its CSR strategy. This paper would be of interest to a wide readership including public sector and NHS policy formulators, NHS practitioners, academics and students.

Integral control for population management.

PubMed

Guiver, Chris; Logemann, Hartmut; Rebarber, Richard; Bill, Adam; Tenhumberg, Brigitte; Hodgson, Dave; Townley, Stuart

2015-04-01

We present a novel management methodology for restocking a declining population. The strategy uses integral control, a concept ubiquitous in control theory which has not been applied to population dynamics. Integral control is based on dynamic feedback-using measurements of the population to inform management strategies and is robust to model uncertainty, an important consideration for ecological models. We demonstrate from first principles why such an approach to population management is suitable via theory and examples.

20 strategies for marketing your managed care plan.

PubMed

Firshein, J

1996-01-01

In today's fiercely competitive managed care marketplace, healthcare executives must find a way to set their plans apart from the competition and build a sufficient customer base. At the same time, they must confront a growing anti-managed care backlash among a wary and confused public. Healthcare executive magazine talked with managed care experts to gather their views on key strategies to help executives meet both of these challenges. Here's what they suggest.

Does Training Matter? Comparing the Behaviour Management Strategies of Pre-Service Teachers in a Four-Year Program and Those in a One-Year Program

ERIC Educational Resources Information Center

Woodcock, Stuart; Reupert, Andrea

2013-01-01

Survey-based research was conducted with Australian pre-service teachers to identify the classroom management strategies that they would employ, their confidence in employing them, and the effectiveness of the strategies. Furthermore, the study aimed to identify significant differences in these variables between pre-service teachers in the final…

Choosing the Right Words: The Development of Guidelines for the Selection of the "Appropriate" Crisis-Response Strategies.

ERIC Educational Resources Information Center

Coombs, W. Timothy

1995-01-01

States that although crisis management has evolved rapidly in the past decade, the symbolic aspect of crisis management has been ignored. Indicates little research has been done to examine the effects of crisis-response strategies to see how they shape public opinion. Presents a list of guidelines for appropriate use of a given strategy (based on…

Self-Regulated Assignment Attack Strategy: Evaluating the Effects of a Classroom-Level Intervention on Student Management of Curricular Activities in a Resource Context

ERIC Educational Resources Information Center

Ness, Bryan M.; Sohlberg, McKay Moore

2013-01-01

The purpose of this study was to evaluate the impact of a classroom-based strategy instruction package grounded in self-regulated learning. The Self-Regulated Assignment Attack Strategy (SAAS) targeted self-regulation of assignment management and related academic-behavioral variables for 6th grade students in resource support classrooms. SAAS was…

Micro practices of coordination based on complex adaptive systems: user needs and strategies for coordinating public health in Denmark.

PubMed

Terkildsen, Morten Deleuran; Wittrup, Inge; Burau, Viola

2015-01-01

Many highly formalised approaches to coordination poorly fit public health and recent studies call for coordination based on complex adaptive systems. Our contribution is two-fold. Empirically, we focus on public health, and theoretically we build on the patient perspective and treat coordination as a process of contingent, two-level negotiations of user needs. The paper draws on the concept of user needs-based coordination and sees coordination as a process, whereby needs emerging from the life world of the user are made amenable to the health system through negotiations. The analysis is based on an explorative case study of a health promotion initiative in Denmark. It adopts an anthropological qualitative approach and uses a range of qualitative data. The analysis identifies four strategies of coordination: the coordinator focusing on the individual user or on relations with other professionals; and the manager coaching the coordinator or providing structural support. Crucially, the coordination strategies by management remain weak as they do not directly relate to specific user needs. In process of bottom-up negotiations user needs become blurred and this is especially a challenge for management. The study therefore calls for an increased focus on the level nature of negotiations to bridge the gap that currently weakens coordination strategies by management.

University Students' Views of Obesity and Weight Management Strategies

ERIC Educational Resources Information Center

Okonkwo, Ononuju; While, Alison

2010-01-01

Objective: To investigate the knowledge and views of university students regarding obesity and weight management strategies. Design: Online questionnaire-based survey of undergraduate and postgraduate university students in a large London university with a diverse student population. Method: The survey was administered online and circulated…

Team Culture and Business Strategy Simulation Performance

ERIC Educational Resources Information Center

Ritchie, William J.; Fornaciari, Charles J.; Drew, Stephen A. W.; Marlin, Dan

2013-01-01

Many capstone strategic management courses use computer-based simulations as core pedagogical tools. Simulations are touted as assisting students in developing much-valued skills in strategy formation, implementation, and team management in the pursuit of superior strategic performance. However, despite their rich nature, little is known regarding…

Setting the stage for a sustainable Pacific salmon fisheries strategy

USGS Publications Warehouse

MacDonald, Donald D.; Steward, Cleveland R.; Knudsen, E. Eric; Knudsen, E. Eric; Steward, Cleveland R.; MacDonald, Donald D.; Williams, Jack E.; Reiser, Dudley W.

1999-01-01

Salmon and steelhead Oncorhynchus spp., have been keystone species for ecosystems and human cultures of the North American Pacific coast for cons. Yet, in the past century, many populations have been greatly diminished and some are now extinct-the result of a combination of factors, including habitat loss and degradation, overfishing, natural variability in salmon production, negative effects of artificial propagation, and weaknesses in institutional and regulatory structures. We argue that a major shift is required, from the egocentric environmental approach (wherein each part of the ecosystem is managed as a unit) to the ecocentric ecosystem approach (wherein all parts are integrated for management). A management framework is proposed that contains-for each management unit such as a watershed-four elements: management goals; management objectives, ecosystem indicators; and a coordinated action plan. We also describe the Sustainable Fisheries Strategy, a consultative process for developing an ecosystem-based approach toward achieving sustainable Pacific salmon and steelhead populations and fisheries. This book is one of three important underpinnings of the Strategy; the other two are the Strategy itself and a manual being developed to guide community-based programs embracing the principles of sustainable fisheries. This book contains important historical perspectives as well as numerous innovative ideas for moving toward ecosystem-oriented, sustainable management of Pacific salmon and steelhead.

Energy management strategy based on fuzzy logic for a fuel cell hybrid bus

NASA Astrophysics Data System (ADS)

Gao, Dawei; Jin, Zhenhua; Lu, Qingchun

Fuel cell vehicles, as a substitute for internal-combustion-engine vehicles, have become a research hotspot for most automobile manufacturers all over the world. Fuel cell systems have disadvantages, such as high cost, slow response and no regenerative energy recovery during braking; hybridization can be a solution to these drawbacks. This paper presents a fuel cell hybrid bus which is equipped with a fuel cell system and two energy storage devices, i.e., a battery and an ultracapacitor. An energy management strategy based on fuzzy logic, which is employed to control the power flow of the vehicular power train, is described. This strategy is capable of determining the desired output power of the fuel cell system, battery and ultracapacitor according to the propulsion power and recuperated braking power. Some tests to verify the strategy were developed, and the results of the tests show the effectiveness of the proposed energy management strategy and the good performance of the fuel cell hybrid bus.

Review of Ecologically-Based Pest Management in California Vineyards

PubMed Central

Wilson, Houston

2017-01-01

Grape growers in California utilize a variety of biological, cultural, and chemical approaches for the management of insect and mite pests in vineyards. This combination of strategies falls within the integrated pest management (IPM) framework, which is considered to be the dominant pest management paradigm in vineyards. While the adoption of IPM has led to notable and significant reductions in the environmental impacts of grape production, some growers are becoming interested in the use of an explicitly non-pesticide approach to pest management that is broadly referred to as ecologically-based pest management (EBPM). Essentially a subset of IPM strategies, EBPM places strong emphasis on practices such as habitat management, natural enemy augmentation and conservation, and animal integration. Here, we summarize the range and known efficacy of EBPM practices utilized in California vineyards, followed by a discussion of research needs and future policy directions. EBPM should in no way be seen in opposition, or as an alternative to the IPM framework. Rather, the further development of more reliable EBPM practices could contribute to the robustness of IPM strategies available to grape growers. PMID:29019946

Review of Ecologically-Based Pest Management in California Vineyards.

PubMed

Wilson, Houston; Daane, Kent M

2017-10-11

Grape growers in California utilize a variety of biological, cultural, and chemical approaches for the management of insect and mite pests in vineyards. This combination of strategies falls within the integrated pest management (IPM) framework, which is considered to be the dominant pest management paradigm in vineyards. While the adoption of IPM has led to notable and significant reductions in the environmental impacts of grape production, some growers are becoming interested in the use of an explicitly non-pesticide approach to pest management that is broadly referred to as ecologically-based pest management (EBPM). Essentially a subset of IPM strategies, EBPM places strong emphasis on practices such as habitat management, natural enemy augmentation and conservation, and animal integration. Here, we summarize the range and known efficacy of EBPM practices utilized in California vineyards, followed by a discussion of research needs and future policy directions. EBPM should in no way be seen in opposition, or as an alternative to the IPM framework. Rather, the further development of more reliable EBPM practices could contribute to the robustness of IPM strategies available to grape growers.

Clinicians in management: a qualitative study of managers' use of influence strategies in hospitals.

PubMed

Spehar, Ivan; Frich, Jan C; Kjekshus, Lars Erik

2014-06-13

Combining a professional and managerial role can be challenging for doctors and nurses. We aimed to explore influence strategies used by doctors and nurses who are managers in hospitals with a model of unitary and profession neutral management at all levels. We did a study based on data from interviews and observations of 30 managers with a clinical background in Norwegian hospitals. Managers with a nursing background argued that medical doctors could more easily gain support for their views. Nurses reported deliberately not disclosing their professional background, and could use a doctor as their agent to achieve a strategic advantage. Doctors believed that they had to use their power as experts to influence peers. Doctors attempted to be medical role models, while nurses spoke of being a role model in more general terms. Managers who were not able to influence the system directly found informal workarounds. We did not identify horizontal strategies in the observations and accounts given by the managers in our study. Managers' professional background may be both a resource and constraint, and also determine the influence strategies they use. Professional roles and influence strategies should be a theme in leadership development programs for health professionals.

Stand quality management in a late-rotation, red oak-sweetgum stand in east Mississippi: preliminary results following thinning

Treesearch

James S. Meadows; Daniel A. Skojac

2012-01-01

Stand quality management is a new management strategy in which thinning prescriptions are based solely on tree quality rather than a quantitative level of residual stand density. As long as residual density falls within fairly broad limits, prescriptions are based on tree quality alone. We applied four thinning prescriptions based on stand quality management, along...

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

PubMed

Damastuti, Ekaningrum; de Groot, Rudolf

2017-12-01

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

Variable speed limit strategies analysis with link transmission model on urban expressway

NASA Astrophysics Data System (ADS)

Li, Shubin; Cao, Danni

2018-02-01

The variable speed limit (VSL) is a kind of active traffic management method. Most of the strategies are used in the expressway traffic flow control in order to ensure traffic safety. However, the urban expressway system is the main artery, carrying most traffic pressure. It has similar traffic characteristics with the expressways between cities. In this paper, the improved link transmission model (LTM) combined with VSL strategies is proposed, based on the urban expressway network. The model can simulate the movement of the vehicles and the shock wave, and well balance the relationship between the amount of calculation and accuracy. Furthermore, the optimal VSL strategy can be proposed based on the simulation method. It can provide management strategies for managers. Finally, a simple example is given to illustrate the model and method. The selected indexes are the average density, the average speed and the average flow on the traffic network in the simulation. The simulation results show that the proposed model and method are feasible. The VSL strategy can effectively alleviate traffic congestion in some cases, and greatly promote the efficiency of the transportation system.

Employing Knowledge Transfer to Support IS Implementation in SMEs

ERIC Educational Resources Information Center

Wynn, Martin; Turner, Phillip; Abas, Hanida; Shen, Rui

2009-01-01

Information systems strategy is an increasingly important component of overall business strategy in small and medium-sized enterprises (SMEs). The need for readily available and consistent management information, drawn from integrated systems based on sound and upgradeable technologies, has led many senior company managers to review the business…

Managing Tensions in Educational Organizations: Trying for a Win-Win Approach.

ERIC Educational Resources Information Center

Grab, Rudi

1996-01-01

Constructive tension can be healthy for an organization. Although win-lose solutions based on adversarial strategies are common, the management of conflicts in schools should focus on win-win problem solving, which requires creativity. Identifies collaboration as the most desirable conflict resolution strategy, and discusses conflict management…

Replication of urban innovations - prioritization of strategies for the replication of Dhaka's community-based decentralized composting model.

PubMed

Yedla, Sudhakar

2012-01-01

Dhaka's community-based decentralized composting (DCDC) is a successful demonstration of solid waste management by adopting low-cost technology, local resources community participation and partnerships among the various actors involved. This paper attempts to understand the model, necessary conditions, strategies and their priorities to replicate DCDC in the other developing cities of Asia. Thirteen strategies required for its replication are identified and assessed based on various criteria, namely transferability, longevity, economic viability, adaptation and also overall replication. Priority setting by multi-criteria analysis by applying analytic hierarchy process revealed that immediate transferability without long-term and economic viability consideration is not advisable as this would result in unsustainable replication of DCDC. Based on the analysis, measures to ensure the product quality control; partnership among stakeholders (public-private-community); strategies to achieve better involvement of the private sector in solid waste management (entrepreneurship in approach); simple and low-cost technology; and strategies to provide an effective interface among the complementing sectors are identified as important strategies for its replication.

A test-based strategy is more cost effective than empiric dose escalation for patients with Crohn's disease who lose responsiveness to infliximab.

PubMed

Velayos, Fernando S; Kahn, James G; Sandborn, William J; Feagan, Brian G

2013-06-01

Patients with Crohn's disease who become unresponsive to therapy with tumor necrosis factor antagonists are managed initially with either empiric dose escalation or testing-based strategies. The comparative cost effectiveness of these 2 strategies is unknown. We investigated whether a testing-based strategy is more cost effective than an empiric dose-escalation strategy. A decision analytic model that simulated 2 cohorts of patients with Crohn's disease compared outcomes for the 2 strategies over a 1-year time period. The incremental cost-effectiveness ratio of the empiric strategy was expressed as cost per quality-adjusted life-year (QALY) gained, compared with the testing-based strategy. We performed 1-way, probabilistic, and prespecified secondary analyses. The testing strategy yielded similar QALYs compared with the empiric strategy (0.801 vs 0.800, respectively) but was less expensive ($31,870 vs $37,266, respectively). In sensitivity analyses, the incremental cost-effectiveness ratio of the empiric strategy ranged from $500,000 to more than $5 million per QALY gained. Similar rates of remission (63% vs 66%) and response (28% vs 26%) were achieved through differential use of available interventions. The testing-based strategy resulted in a higher percentage of surgeries (48% vs 34%) and lower percentage use of high-dose biological therapy (41% vs 54%). A testing-based strategy is a cost-effective alternative to the current strategy of empiric dose escalation for managing patients with Crohn's disease who have lost responsiveness to infliximab. The basis for this difference is lower cost at similar outcomes. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

RFID Application Strategy in Agri-Food Supply Chain Based on Safety and Benefit Analysis

NASA Astrophysics Data System (ADS)

Zhang, Min; Li, Peichong

Agri-food supply chain management (SCM), a management method to optimize internal costs and productivities, has evolved as an application of e-business technologies. These days, RFID has been widely used in many fields. In this paper, we analyze the characteristics of agri-food supply chain. Then the disadvantages of RFID are discussed. After that, we study the application strategies of RFID based on benefit and safety degree.

D-WISE: Diabetes Web-Centric Information and Support Environment: conceptual specification and proposed evaluation.

PubMed

Abidi, Samina; Vallis, Michael; Raza Abidi, Syed Sibte; Piccinini-Vallis, Helena; Imran, Syed Ali

2014-06-01

To develop and evaluate Diabetes Web-Centric Information and Support Environment (D-WISE) that offers 1) a computerized decision-support system to assist physicians to A) use the Canadian Diabetes Association clinical practice guidelines (CDA CPGs) to recommend evidence-informed interventions; B) offer a computerized readiness assessment strategy to help physicians administer behaviour-change strategies to help patients adhere to disease self-management programs; and 2) a patient-specific diabetes self-management application, accessible through smart mobile devices, that offers behaviour-change interventions to engage patients in self-management. The above-mentioned objectives were pursued through a knowledge management approach that involved 1) Translation of paper-based CDA CPGs and behaviour-change models as computerized decision-support tools that will assist physicians to offer evidence-informed and personalized diabetes management and behaviour-change strategies; 2) Engagement of patients in their diabetes care by generating a diabetes self-management program that takes into account their preferences, challenges and needs; 3) Empowering patients to self-manage their condition by providing them with personalized educational and motivational messages through a mobile self-management application. The theoretical foundation of our research is grounded in behaviour-change models and healthcare knowledge management. We used 1) knowledge modelling to computerize the paper-based CDA CPGs and behaviour-change models, in particular, the behaviour-change strategy elements of A) readiness-to-change assessments; B) motivation-enhancement interventions categorized along the lines of patients' being ready, ambivalent or not ready; and C) self-efficacy enhancement. The CDA CPGs and the behaviour-change models are modelled and computerized in terms of A) a diabetes management ontology that serves as the knowledge resource for all the services offered by D-WISE; B) decision support services that use logic-based reasoning algorithms to utilize the knowledge encoded within the diabetes management ontology to assist physicians by recommending patient-specific diabetes-management interventions and behaviour-change strategies; C) a mobile diabetes self-management application to engage and educate diabetes patients to self-manage their condition in a home-based setting while working in concert with their family physicians. We have been successful in creating and conducting a usability assessment of the physician decision support tool. These results will be published once the patient self- management application has been evaluated. D-WISE will be evaluated through pilot studies measuring 1) the usability of the e-Health interventions; and 2) the impact of the interventions on patients' behaviour changes and diabetes control. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Choice-Based Segmentation as an Enrollment Management Tool

ERIC Educational Resources Information Center

Young, Mark R.

2002-01-01

This article presents an approach to enrollment management based on target marketing strategies developed from a choice-based segmentation methodology. Students are classified into "switchable" or "non-switchable" segments based on their probability of selecting specific majors. A modified multinomial logit choice model is used to identify…

Model-Based Battery Management Systems: From Theory to Practice

NASA Astrophysics Data System (ADS)

Pathak, Manan

Lithium-ion batteries are now extensively being used as the primary storage source. Capacity and power fade, and slow recharging times are key issues that restrict its use in many applications. Battery management systems are critical to address these issues, along with ensuring its safety. This dissertation focuses on exploring various control strategies using detailed physics-based electrochemical models developed previously for lithium-ion batteries, which could be used in advanced battery management systems. Optimal charging profiles for minimizing capacity fade based on SEI-layer formation are derived and the benefits of using such control strategies are shown by experimentally testing them on a 16 Ah NMC-based pouch cell. This dissertation also explores different time-discretization strategies for non-linear models, which gives an improved order of convergence for optimal control problems. Lastly, this dissertation also explores a physics-based model for predicting the linear impedance of a battery, and develops a freeware that is extremely robust and computationally fast. Such a code could be used for estimating transport, kinetic and material properties of the battery based on the linear impedance spectra.

An empirical model of water quality for use in rapid management strategy evaluation in Southeast Queensland, Australia.

PubMed

de la Mare, William; Ellis, Nick; Pascual, Ricardo; Tickell, Sharon

2012-04-01

Simulation models have been widely adopted in fisheries for management strategy evaluation (MSE). However, in catchment management of water quality, MSE is hampered by the complexity of both decision space and the hydrological process models. Empirical models based on monitoring data provide a feasible alternative to process models; they run much faster and, by conditioning on data, they can simulate realistic responses to management actions. Using 10 years of water quality indicators from Queensland, Australia, we built an empirical model suitable for rapid MSE that reproduces the water quality variables' mean and covariance structure, adjusts the expected indicators through local management effects, and propagates effects downstream by capturing inter-site regression relationships. Empirical models enable managers to search the space of possible strategies using rapid assessment. They provide not only realistic responses in water quality indicators but also variability in those indicators, allowing managers to assess strategies in an uncertain world. Copyright © 2012 Elsevier Ltd. All rights reserved.

iCanCope with Pain™: User-centred design of a web- and mobile-based self-management program for youth with chronic pain based on identified health care needs

PubMed Central

Stinson, Jennifer N; Lalloo, Chitra; Harris, Lauren; Isaac, Lisa; Campbell, Fiona; Brown, Stephen; Ruskin, Danielle; Gordon, Allan; Galonski, Marilyn; Pink, Leah R; Buckley, Norman; Henry, James L; White, Meghan; Karim, Allia

2014-01-01

BACKGROUND: While there are emerging web-based self-management programs for children and adolescents with chronic pain, there is currently not an integrated web- and smartphone-based app that specifically addresses the needs of adolescents with chronic pain. OBJECTIVES: To conduct a needs assessment to inform the development of an online chronic pain self-management program for adolescents, called iCanCope with Pain™. METHODS: A purposive sample of adolescents (n=23; 14 to 18 years of age) was recruited from two pediatric chronic pain clinics in Ontario. Interdisciplinary health care providers were also recruited from these sites. Three focus groups were conducted with adolescents (n=16) and one with pediatric health care providers (n=7). Individual adolescent interviews were also conducted (n=7). RESULTS: Qualitative analysis uncovered four major themes: pain impact; barriers to care; pain management strategies; and transition to adult care. Pain impacted social, emotional, physical and role functioning, as well as future goals. Barriers to care were revealed at the health care system, patient and societal levels. Pain management strategies included support systems, and pharmacological, physical and psychological approaches. Transition subthemes were: disconnect between pediatric and adult systems; skills development; parental role; and fear/anxiety. Based on these identified needs, the iCanCope with Pain™ architecture will include the core theory-based functionalities of: symptom self-monitoring; personalized goal setting; pain coping skills training; peer-based social support; and chronic pain education. CONCLUSIONS: The proposed iCanCope with Pain™ program aims to address the self-management needs of adolescents with chronic pain by improving access to disease information, strategies to manage symptoms and social support. PMID:25000507

Strategies for positioning in the managed health care marketplace.

PubMed

Cohn, R

1994-01-01

Managed health care is becoming increasingly common as the demands of cost containment are placed on providers of care. This article defines managed health care, illustrates its continued growth, demonstrates its effect on clinical decision making and reimbursement issues, and suggests strategies for optimal positioning in the managed care marketplace. The hand therapy specialist, whether based in a hospital, an institution-based ambulatory care setting, or a private practice, must be aware of a managed plan's contractual limitations. Parameters discussed are patient length of stay, documentation, reimbursement, patient responsibility, alternatives to conventional treatment protocols, and the potential effects of utilization review on patient treatment. A heightened awareness of managed health care is critical for the manager and practitioner, especially because national health care reform is on the horizon. A provider must be well prepared to ensure delivery of quality care within the myriad restrictions imposed by managed care regulations.

Development of practice and consensus-based strategies including a treat-to-target approach for the management of moderate and severe juvenile dermatomyositis in Germany and Austria.

PubMed

Hinze, Claas H; Oommen, Prasad T; Dressler, Frank; Urban, Andreas; Weller-Heinemann, Frank; Speth, Fabian; Lainka, Elke; Brunner, Jürgen; Fesq, Heike; Foell, Dirk; Müller-Felber, Wolfgang; Neudorf, Ulrich; Rietschel, Christoph; Schwarz, Tobias; Schara, Ulrike; Haas, Johannes-Peter

2018-06-25

Juvenile dermatomyositis (JDM) is the most common inflammatory myopathy in childhood and a major cause of morbidity among children with pediatric rheumatic diseases. The management of JDM is very heterogeneous. The JDM working group of the Society for Pediatric Rheumatology (GKJR) aims to define consensus- and practice-based strategies in order to harmonize diagnosis, treatment and monitoring of JDM. The JDM working group was established in 2015 consisting of 23 pediatric rheumatologists, pediatric neurologists and dermatologists with expertise in the management of JDM. Current practice patterns of management in JDM had previously been identified via an online survey among pediatric rheumatologists and neurologists. Using a consensus process consisting of online surveys and a face-to-face consensus conference statements were defined regarding the diagnosis, treatment and monitoring of JDM. During the conference consensus was achieved via nominal group technique. Voting took place using an electronic audience response system, and at least 80% consensus was required for individual statements. Overall 10 individual statements were developed, finally reaching a consensus of 92 to 100% regarding (1) establishing a diagnosis, (2) case definitions for the application of the strategies (moderate and severe JDM), (3) initial diagnostic testing, (4) monitoring and documentation, (5) treatment targets within the context of a treat-to-target strategy, (6) supportive therapies, (7) explicit definition of a treat-to-target strategy, (8) various glucocorticoid regimens, including intermittent intravenous methylprednisolone pulse and high-dose oral glucocorticoid therapies with tapering, (9) initial glucocorticoid-sparing therapy and (10) management of refractory disease. Using a consensus process among JDM experts, statements regarding the management of JDM were defined. These statements and the strategies aid in the management of patients with moderate and severe JDM.

A comparative risk assessment framework for wildland fire management: the 2010 cohesive strategy science report

Treesearch

David E. Calkin; Alan A. Ager; Matthew P. Thompson; Mark A. Finney; Danny C. Lee; Thomas M. Quigley; Charles W. McHugh; Karin L. Riley; Julie M. Gilbertson-Day

2011-01-01

The FLAME Act of 2009 requires the U.S. Department of Agriculture Forest Service and the U.S. Department of Interior to submit to Congress a Cohesive Wildfire Management Strategy. In this report, we explore the general science available for a risk-based approach to fire and fuels management and suggest analyses that may be applied at multiple scales to inform...

Enhancing industry-based dissemination of an occupational sun protection program with theory-based strategies employing personal contact.

PubMed

Buller, David B; Andersen, Peter A; Walkosz, Barbara J; Scott, Michael D; Cutter, Gary R; Dignan, Mark B; Kane, Ilima L; Zhang, Xiao

2012-01-01

Industry-based strategies for dissemination of an evidence-based occupational sun protection program, Go Sun Smart (GSS), were tested. Two dissemination strategies were compared in a randomized trial in 2004-2007. The North American ski industry. Ski areas in the United States and Canada (n  =  69) and their senior managers (n  =  469). Employers received GSS through a basic dissemination strategy (BDS) from the industry's professional association that included conference presentations and free starter kits. Half of the areas also received the enhanced dissemination strategy (EDS), in which project staff met face-to-face with managers and made ongoing contacts to support program use. Observation of program materials in use and managers' reports on communication about sun protection. The effects of two alternative dissemination strategies were compared on program use using PROC MIXED in SAS, adjusted for covariates using one-tailed p values. Ski areas receiving the EDS used more GSS materials (x¯  =  7.36) than those receiving the BDS (x¯  =  5.17; F  =  7.82, p < .01). Managers from more areas receiving the EDS reported communicating about sun protection in employee newsletters/flyers (x¯  =  .97, p  =  .04), in guest e-mail messages (x¯  =  .75, p  =  .02), and on ski area Web sites (x¯  =  .38, p  =  .02) than those receiving the BDS (x¯  =  .84, .50, .15, respectively). Industry professional associations play an important role in disseminating prevention programs; however, active personal communication may be essential to ensure increased implementation fidelity.

Compromise-based Robust Prioritization of Climate Change Adaptation Strategies for Watershed Management

NASA Astrophysics Data System (ADS)

Kim, Y.; Chung, E. S.

2014-12-01

This study suggests a robust prioritization framework for climate change adaptation strategies under multiple climate change scenarios with a case study of selecting sites for reusing treated wastewater (TWW) in a Korean urban watershed. The framework utilizes various multi-criteria decision making techniques, including the VIKOR method and the Shannon entropy-based weights. In this case study, the sustainability of TWW use is quantified with indicator-based approaches with the DPSIR framework, which considers both hydro-environmental and socio-economic aspects of the watershed management. Under the various climate change scenarios, the hydro-environmental responses to reusing TWW in potential alternative sub-watersheds are determined using the Hydrologic Simulation Program in Fortran (HSPF). The socio-economic indicators are obtained from the statistical databases. Sustainability scores for multiple scenarios are estimated individually and then integrated with the proposed approach. At last, the suggested framework allows us to prioritize adaptation strategies in a robust manner with varying levels of compromise between utility-based and regret-based strategies.

Daily Use of Energy Management Strategies and Occupational Well-being: The Moderating Role of Job Demands.

PubMed

Parker, Stacey L; Zacher, Hannes; de Bloom, Jessica; Verton, Thomas M; Lentink, Corine R

2017-01-01

We examine the relationships among employees' use of energy management strategies and two occupational well-being outcomes: job satisfaction and emotional exhaustion. Based on conservation of resources theory, it was hypothesized that employees with high job demands would benefit more from using energy management strategies (i.e., including prosocial, organizing, and meaning-related strategies), compared to employees with low job demands. We tested this proposition using a quantitative diary study. Fifty-four employees provided data twice daily across one work week (on average, 7 daily entries). Supporting the hypotheses, prosocial energy management was positively related to job satisfaction. Moreover, employees with high job demands were less emotionally exhausted when using prosocial strategies. Contrary to predictions, when using organizing strategies, employees with low job demands had higher job satisfaction and lower emotional exhaustion. Under high job demands, greater use of organizing strategies was associated with lower job satisfaction and higher emotional exhaustion. Finally, use of meaning-related strategies was associated with higher emotional exhaustion when job demands were low. With this research, we position energy management as part of a resource investment process aimed at maintaining and improving occupational well-being. Our findings show that this resource investment will be more or less effective depending on the type of strategy used and the existing drain on resources (i.e., job demands). This is the first study to examine momentary effects of distinct types of work-related energy management strategies on occupational well-being.

Daily Use of Energy Management Strategies and Occupational Well-being: The Moderating Role of Job Demands

PubMed Central

Parker, Stacey L.; Zacher, Hannes; de Bloom, Jessica; Verton, Thomas M.; Lentink, Corine R.

2017-01-01

We examine the relationships among employees’ use of energy management strategies and two occupational well-being outcomes: job satisfaction and emotional exhaustion. Based on conservation of resources theory, it was hypothesized that employees with high job demands would benefit more from using energy management strategies (i.e., including prosocial, organizing, and meaning-related strategies), compared to employees with low job demands. We tested this proposition using a quantitative diary study. Fifty-four employees provided data twice daily across one work week (on average, 7 daily entries). Supporting the hypotheses, prosocial energy management was positively related to job satisfaction. Moreover, employees with high job demands were less emotionally exhausted when using prosocial strategies. Contrary to predictions, when using organizing strategies, employees with low job demands had higher job satisfaction and lower emotional exhaustion. Under high job demands, greater use of organizing strategies was associated with lower job satisfaction and higher emotional exhaustion. Finally, use of meaning-related strategies was associated with higher emotional exhaustion when job demands were low. With this research, we position energy management as part of a resource investment process aimed at maintaining and improving occupational well-being. Our findings show that this resource investment will be more or less effective depending on the type of strategy used and the existing drain on resources (i.e., job demands). This is the first study to examine momentary effects of distinct types of work-related energy management strategies on occupational well-being. PMID:28912741

Cover-Copy-Compare: A Method for Enhancing Evidence-Based Instruction

ERIC Educational Resources Information Center

Konrad, Moira; Joseph, Laurice M.

2014-01-01

Cover-copy-compare is a practical, low-cost, effective strategy for teachers to add to their repertoires of evidence-based practices. This article describes the cover-copy-compare strategy and how it can be applied to teach both self-management and basic academic skills. A variety of ways this strategy can be used across content areas are…

A generalized strategy for building resident database interfaces

NASA Technical Reports Server (NTRS)

Moroh, Marsha; Wanderman, Ken

1990-01-01

A strategy for building resident interfaces to host heterogeneous distributed data base management systems is developed. The strategy is used to construct several interfaces. A set of guidelines is developed for users to construct their own interfaces.

Facilitating Elementary Science Teachers' Implementation of Inquiry-Based Science Teaching

ERIC Educational Resources Information Center

Qablan, Ahmad M.; DeBaz, Theodora

2015-01-01

Preservice science teachers generally feel that the implementation of inquiry-based science teaching is very difficult to manage. This research project aimed at facilitating the implementation of inquiry-based science teaching through the use of several classroom strategies. The evaluation of 15 classroom strategies from 80 preservice elementary…

Social Utility versus Social Desirability of Students' Attributional Self-Presentation Strategies

ERIC Educational Resources Information Center

Matteucci, Maria Cristina

2014-01-01

Research on impression management has shown that students can manage their social images by providing attributional self-presentation strategies (ASPSs). Based on the distinction between social desirability judgments and social utility judgments, two studies were conducted to examine the students' understanding of the impact of ASPSs both on…

Increasing In-Service Teacher Implementation of Classroom Management Practices through Consultation, Implementation Planning, and Participant Modeling

ERIC Educational Resources Information Center

Hagermoser Sanetti, Lisa M.; Williamson, Kathleen M.; Long, Anna C. J.; Kratochwill, Thomas R.

2018-01-01

Numerous evidence-based classroom management strategies to prevent and respond to problem behavior have been identified, but research consistently indicates teachers rarely implement them with sufficient implementation fidelity. The purpose of this study was to evaluate the effectiveness of implementation planning, a strategy involving logistical…

Coping Strategies for Managing Acculturative Stress among Asian International Students

ERIC Educational Resources Information Center

Ra, Young-An; Trusty, Jerry

2015-01-01

This article examines the effects of specific coping strategies on managing acculturative stress and acculturation of Asian international students, based on a sample of 220 Asian international students in the U.S. The data were analyzed with hierarchical multiple regression using Baron and Kenny's (1986) mediation procedure. The results supported…

Board and Senior Management Alignment on School Strategy

ERIC Educational Resources Information Center

Sarros, James C.; Sarros, Anne M.; Cooper, Brian K.; Santora, Joseph C.; Baker, Robin

2016-01-01

This study examines the degree to which senior executive members of a school's decision-making team (senior management team and board of directors) are aligned on fundamental principles of school strategy. Our study is based on a conceptual framework of strategic leadership as it applies in an Australian independent school context. We also examine…

Behavior Management Strategies for Teachers. A Student Workbook. 2nd Edition.

ERIC Educational Resources Information Center

Harlan, Joan C.; Rowland, Sidney T.

This student workbook is designed to accompany the textbook, "Behavior Management Strategies for Teachers," helping to reinforce understanding of the basic principles described in the companion textbook. It presents a summary of the key concepts in each of the workbook's 15 chapters. Questions in this student workbook are based on each…

Risk management for food and beverage industry using Australia/New Zealand 4360 Standard

NASA Astrophysics Data System (ADS)

Kristina, S.; Wijaya, B. M.

2017-12-01

This research aims to identifying, measuring and establishing risk in food and beverage industry. The risk management is implemented by referring to Australia/New Zealand 4360 Standard which has four phases such as problem formulation, risk analysis, risk characterization, and risk management. The implementation of risk management is done by case study at Back Alley Café. Based on the risk identification result, there are 59 risks were found in Back Alley Café. The risk identification is conducted based on observation and interview with the café manager who understand the condition of Back Alley Café properly. Based on the assessment of impact and probability, the risk mapping produced four risks at extreme level, 16 risks at high level, 24 risks at medium level, and 18 risks at low level. The strategy was designed as the risk mitigation after the risk mapping for the extreme and high level. The strategy which is given as the prevention or treatment of risk in Back Alley Café is divided into three. There are reducing the risk, sharing the risk and accepting the risk. The strategy is then implemented for each relevant activities.

Power Management Based Current Control Technique for Photovoltaic-Battery Assisted Wind-Hydro Hybrid System

NASA Astrophysics Data System (ADS)

Ram Prabhakar, J.; Ragavan, K.

2013-07-01

This article proposes new power management based current control strategy for integrated wind-solar-hydro system equipped with battery storage mechanism. In this control technique, an indirect estimation of load current is done, through energy balance model, DC-link voltage control and droop control. This system features simpler energy management strategy and necessitates few power electronic converters, thereby minimizing the cost of the system. The generation-demand (G-D) management diagram is formulated based on the stochastic weather conditions and demand, which would likely moderate the gap between both. The features of management strategy deploying energy balance model include (1) regulating DC-link voltage within specified tolerances, (2) isolated operation without relying on external electric power transmission network, (3) indirect current control of hydro turbine driven induction generator and (4) seamless transition between grid-connected and off-grid operation modes. Furthermore, structuring of the hybrid system with appropriate selection of control variables enables power sharing among each energy conversion systems and battery storage mechanism. By addressing these intricacies, it is viable to regulate the frequency and voltage of the remote network at load end. The performance of the proposed composite scheme is demonstrated through time-domain simulation in MATLAB/Simulink environment.

Updates in the management of stable chronic obstructive pulmonary disease.

PubMed

Narsingam, Saiprasad; Bozarth, Andrew L; Abdeljalil, Asem

2015-01-01

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease state characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory process. It is increasingly recognized as a major public health problem, affecting more than 20 million adults in the US. It is also recognized as a leading cause of hospitalizations and is the fourth leading cause of death in the US. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) operates to promote evidence-based management of COPD, increase awareness and encourage research. In 2011, GOLD published a consensus report detailing evidence-based management strategies for COPD, which were last updated in 2015. In recent years, newer strategies and a growing number of new pharmacologic agents to treat symptoms of COPD have also been introduced and show promise in improving the management of COPD. We aim to provide an evidence-based review of the available and upcoming pharmacologic and non-pharmacologic treatment options for stable COPD, with continued emphasis on evidence-based management.

An Analytics-Based Approach to Managing Cognitive Load by Using Log Data of Learning Management Systems and Footprints of Social Media

ERIC Educational Resources Information Center

Yen, Cheng-Huang; Chen, I-Chuan; Lai, Su-Chun; Chuang, Yea-Ru

2015-01-01

Traces of learning behaviors generally provide insights into learners and the learning processes that they employ. In this article, a learning-analytics-based approach is proposed for managing cognitive load by adjusting the instructional strategies used in online courses. The technology-based learning environment examined in this study involved a…

Remembering the Important Things: Semantic Importance in Stream Reasoning

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

Yan, Rui; Greaves, Mark T.; Smith, William P.

Reasoning and querying over data streams rely on the abil- ity to deliver a sequence of stream snapshots to the processing algo- rithms. These snapshots are typically provided using windows as views into streams and associated window management strategies. Generally, the goal of any window management strategy is to preserve the most im- portant data in the current window and preferentially evict the rest, so that the retained data can continue to be exploited. A simple timestamp- based strategy is rst-in-rst-out (FIFO), in which items are replaced in strict order of arrival. All timestamp-based strategies implicitly assume that a temporalmore » ordering reliably re ects importance to the processing task at hand, and thus that window management using timestamps will maximize the ability of the processing algorithms to deliver accurate interpretations of the stream. In this work, we explore a general no- tion of semantic importance that can be used for window management for streams of RDF data using semantically-aware processing algorithms like deduction or semantic query. Semantic importance exploits the infor- mation carried in RDF and surrounding ontologies for ranking window data in terms of its likely contribution to the processing algorithms. We explore the general semantic categories of query contribution, prove- nance, and trustworthiness, as well as the contribution of domain-specic ontologies. We describe how these categories behave using several con- crete examples. Finally, we consider how a stream window management strategy based on semantic importance could improve overall processing performance, especially as available window sizes decrease.« less

A Decentralized Compositional Framework for Dependable Decision Process in Self-Managed Cyber Physical Systems

PubMed Central

Hou, Kun-Mean; Zhang, Zhan

2017-01-01

Cyber Physical Systems (CPSs) need to interact with the changeable environment under various interferences. To provide continuous and high quality services, a self-managed CPS should automatically reconstruct itself to adapt to these changes and recover from failures. Such dynamic adaptation behavior introduces systemic challenges for CPS design, advice evaluation and decision process arrangement. In this paper, a formal compositional framework is proposed to systematically improve the dependability of the decision process. To guarantee the consistent observation of event orders for causal reasoning, this work first proposes a relative time-based method to improve the composability and compositionality of the timing property of events. Based on the relative time solution, a formal reference framework is introduced for self-managed CPSs, which includes a compositional FSM-based actor model (subsystems of CPS), actor-based advice and runtime decomposable decisions. To simplify self-management, a self-similar recursive actor interface is proposed for decision (actor) composition. We provide constraints and seven patterns for the composition of reliability and process time requirements. Further, two decentralized decision process strategies are proposed based on our framework, and we compare the reliability with the static strategy and the centralized processing strategy. The simulation results show that the one-order feedback strategy has high reliability, scalability and stability against the complexity of decision and random failure. This paper also shows a way to simplify the evaluation for dynamic system by improving the composability and compositionality of the subsystem. PMID:29120357

A Decentralized Compositional Framework for Dependable Decision Process in Self-Managed Cyber Physical Systems.

PubMed

Zhou, Peng; Zuo, Decheng; Hou, Kun-Mean; Zhang, Zhan

2017-11-09

Cyber Physical Systems (CPSs) need to interact with the changeable environment under various interferences. To provide continuous and high quality services, a self-managed CPS should automatically reconstruct itself to adapt to these changes and recover from failures. Such dynamic adaptation behavior introduces systemic challenges for CPS design, advice evaluation and decision process arrangement. In this paper, a formal compositional framework is proposed to systematically improve the dependability of the decision process. To guarantee the consistent observation of event orders for causal reasoning, this work first proposes a relative time-based method to improve the composability and compositionality of the timing property of events. Based on the relative time solution, a formal reference framework is introduced for self-managed CPSs, which includes a compositional FSM-based actor model (subsystems of CPS), actor-based advice and runtime decomposable decisions. To simplify self-management, a self-similar recursive actor interface is proposed for decision (actor) composition. We provide constraints and seven patterns for the composition of reliability and process time requirements. Further, two decentralized decision process strategies are proposed based on our framework, and we compare the reliability with the static strategy and the centralized processing strategy. The simulation results show that the one-order feedback strategy has high reliability, scalability and stability against the complexity of decision and random failure. This paper also shows a way to simplify the evaluation for dynamic system by improving the composability and compositionality of the subsystem.

A Task-Based Language Teaching Approach to Developing Metacognitive Strategies for Listening Comprehension

ERIC Educational Resources Information Center

Chou, Mu-Hsuan

2017-01-01

In second (L2) or foreign language (FL) learning, learning strategies help learners perform tasks, solve specific problems, and compensate for learning deficits. Of the strategy types, metacognitive strategies manage and regulate the construction of L2 or FL knowledge. Although learning strategies are frequently taught via teacher demonstration,…

Estimation of crop water requirements using remote sensing for operational water resources management

NASA Astrophysics Data System (ADS)

Vasiliades, Lampros; Spiliotopoulos, Marios; Tzabiras, John; Loukas, Athanasios; Mylopoulos, Nikitas

2015-06-01

An integrated modeling system, developed in the framework of "Hydromentor" research project, is applied to evaluate crop water requirements for operational water resources management at Lake Karla watershed, Greece. The framework includes coupled components for operation of hydrotechnical projects (reservoir operation and irrigation works) and estimation of agricultural water demands at several spatial scales using remote sensing. The study area was sub-divided into irrigation zones based on land use maps derived from Landsat 5 TM images for the year 2007. Satellite-based energy balance for mapping evapotranspiration with internalized calibration (METRIC) was used to derive actual evapotranspiration (ET) and crop coefficient (ETrF) values from Landsat TM imagery. Agricultural water needs were estimated using the FAO method for each zone and each control node of the system for a number of water resources management strategies. Two operational strategies of hydro-technical project development (present situation without operation of the reservoir and future situation with the operation of the reservoir) are coupled with three water demand strategies. In total, eight (8) water management strategies are evaluated and compared. The results show that, under the existing operational water resources management strategies, the crop water requirements are quite large. However, the operation of the proposed hydro-technical projects in Lake Karla watershed coupled with water demand management measures, like improvement of existing water distribution systems, change of irrigation methods, and changes of crop cultivation could alleviate the problem and lead to sustainable and ecological use of water resources in the study area.

Cost Minimization Analysis of Different Strategies of Management of Clinically Significant Scorpion Envenomation Among Pediatric Patients.

PubMed

Sinha, Madhumita; Quan, Dan; McDonald, Fred W; Valdez, André

2016-12-01

Scorpion antivenom was recently approved for use in patients with clinically significant scorpion envenomation in the United States; no formal economic analysis on its impact on cost of management has been performed. Three different strategies of management of scorpion envenomation with systemic neurotoxic symptoms in children were compared for cost minimization from a societal perspective. In strategy I, patients were managed with supportive care only without antivenom. In strategy II, an aggressive strategy of full-dose antivenom (initial dose of 3 vials with the use of additional vials administered 1 vial at a time) was considered. In strategy III, a single-vial serial antivenom dosing strategy titrated to clinical response was considered. Clinical probabilities for the different strategies were obtained from retrospective review of medical records of patients with scorpion envenomation over a 10-year period at our institution. Baseline cost values were obtained from patient reimbursement data from our institution. In baseline analysis, strategy I of supportive care only with no antivenom was least costly at US $3466.50/patient. Strategy III of single-vial serial dosing was intermediate but less expensive than strategy II of full-dose antivenom, with an incremental cost of US $3171.08 per patient. In a 1-way sensitivity analysis, at a threshold antivenom cost of US $1577.87, strategy III of single-vial serial dosing became the least costly strategy. For children with scorpion envenomation, use of a management strategy based on serial dosing of antivenom titrated to clinical response is less costly than a strategy of initial use of full-dose antivenom.

Integrated ocean management as a strategy to meet rapid climate change: the Norwegian case.

PubMed

Hoel, Alf Håkon; Olsen, Erik

2012-02-01

The prospects of rapid climate change and the potential existence of tipping points in marine ecosystems where nonlinear change may result from them being overstepped, raises the question of strategies for coping with ecosystem change. There is broad agreement that the combined forces of climate change, pollution and increasing economic activities necessitates more comprehensive approaches to oceans management, centering on the concept of ecosystem-based oceans management. This article addresses the Norwegian experience in introducing integrated, ecosystem-based oceans management, emphasizing how climate change, seen as a major long-term driver of change in ecosystems, is addressed in management plans. Understanding the direct effects of climate variability and change on ecosystems and indirect effects on human activities is essential for adaptive planning to be useful in the long-term management of the marine environment.

Is there an optimal preoperative management strategy for phaeochromocytoma/paraganglioma?

PubMed

Challis, B G; Casey, R T; Simpson, H L; Gurnell, M

2017-02-01

Phaeochromocytomas and paragangliomas (PPGLs) are catecholamine secreting neuroendocrine tumours that predispose to haemodynamic instability. Currently, surgery is the only available curative treatment, but carries potential risks including hypertensive and hypotensive crises, cardiac arrhythmias, myocardial infarction and stroke, due to tumoral release of catecholamines during anaesthetic induction and tumour manipulation. The mortality associated with surgical resection of PPGL has significantly improved from 20-45% in the early 20th century (Apgar & Papper, AMA Archives of Surgery, 1951, 62, 634) to 0-2·9% in the early 21st century (Kinney et al. Journal of Cardiothoracic and Vascular Anesthesia, 2002, 16, 359), largely due to availability of effective pharmacological agents and advances in surgical and anaesthetic practice. However, surgical resection of PPGL still poses significant clinical management challenges. Preoperatively, alpha-adrenoceptor blockade is the mainstay of management, although various pharmacological strategies have been proposed, based largely on reports derived from retrospective data sets. To date, no consensus has been reached regarding the 'ideal' preoperative strategy due, in part, to a paucity of data from high-quality evidence-based studies comparing different treatment regimens. Here, based on the available literature, we address the Clinical Question: Is there an optimal preoperative management strategy for PPGL? © 2016 John Wiley & Sons Ltd.

Fever management in the emergency department of the Children's Hospital of Fudan University: a best practice implementation project.

PubMed

Hu, Fei; Zhang, Jiayan; Shi, Shupeng; Zhou, Zhang

2016-09-01

Febrile illness in young children usually indicates an underlying infection and is a cause of concern for parents and carers. It is very important that healthcare professionals know how to recognize fever, assess children with fever, treat children with fever and role of nurses and parents. This paper outlines a best practice implementation project on the management of fever in children in an emergency department. To audit current practice of fever management for children in an emergency department and to implement strategies to standardize pediatric fever management based on evidence-based practice guidelines. We used the Joanna Briggs Institute's Practical Application of Clinical Evidence System and Getting Research into Practice to examine compliance with fever management criteria based on the best available evidence before and after the implementation of strategies to spread the use of evidence-based practice protocols. We found significant improvements in pediatric fever management as measured by the knowledge scores of parents (54.5-83.7) and nurses (67.6-90.3). This suggested a need for continuous education. We found a noticeable improvement in compliance across all the five criteria; using correct methods to measure temperature (86-98%), staff education (0-100%), parents education (0-100%), using assessment tools (0-100%) and observed management (0-98%). This best practice implementation project demonstrated the use of effective strategies to standardize the protocol for fever management, implement assessment tool, develop multimedia materials, deliver continuous staff education and update nursing documentation and patient education pamphlets to ensure best practice is delivered by nurses to improve patient outcomes.

Value Creation in the Knowledge-Based Economy

ERIC Educational Resources Information Center

Liu, Fang-Chun

2013-01-01

Effective investment strategies help companies form dynamic core organizational capabilities allowing them to adapt and survive in today's rapidly changing knowledge-based economy. This dissertation investigates three valuation issues that challenge managers with respect to developing business-critical investment strategies that can have…

The Ineffectiveness of "Effective" Management Strategies: First-Year Teachers, Behavior Management, and Identity

ERIC Educational Resources Information Center

Dugas, Daryl

2016-01-01

This article presents a research project that challenges the skills-based approach to classroom management in teacher education, particularly in the domain of responding to student misbehaviors. In 90-minute narrative-based interviews, 16 first-year Chicago Public School (CPS) teachers were prompted for narratives of their experiences responding…

Fads, fashions, and bandwagons in health care strategy.

PubMed

Kaissi, Amer A; Begun, James W

2008-01-01

Many observers have alleged that "fads," "fashions," and "bandwagons" (imitation strategies) are prominent feature of the health care organizational strategy landscape. "Imitation behavior" may fulfill symbolic functions such as signaling innovativeness but results in the adoption of strategies that are effective for some organizations but not for many organizations that adopt them. We seek to identify and recognize the extent of fads, fashions, and bandwagons in health care strategy, understand the rationale for such imitation behavior, and draw implications for practice, education, and research. We examine theoretical arguments for imitation and evidence on imitation strategies in health care organizations, based on literature review, interviews with health care managers in two different metropolitan areas, and a case example of the purchase of medical group practices by hospitals. Fads, fashions, and bandwagons can be distinguished from strategic responses to regulatory requirements and efficient strategic choices that are the result of systematic analysis. There are substantial theoretical reasons to expect imitation behavior. Imitation strategies can derive from copying the behavior of "exemplar" organizations or from "keeping up" with competitive rivals. Anecdotal and empirical evidence points to a significant amount of imitation behavior in health care strategy. The performance effects of imitation behavior have not been investigated in past research. The widespread existence of fads and fashions is an argument for evidence-based management. Although it is essential to learn about strategies that have worked for other organizations, managers should carefully take account of the quality of evidence for the strategy and their organizations' distinctive local conditions. Managers should beware of the tendency of individuals and groups to move too readily to the solution stage of problem solving.

Public perceptions about climate change mitigation in British Columbia's forest sector

PubMed Central

Hagerman, Shannon; Kozak, Robert; Hoberg, George

2018-01-01

The role of forest management in mitigating climate change is a central concern for the Canadian province of British Columbia. The successful implementation of forest management activities to achieve climate change mitigation in British Columbia will be strongly influenced by public support or opposition. While we now have increasingly clear ideas of the management opportunities associated with forest mitigation and some insight into public support for climate change mitigation in the context of sustainable forest management, very little is known with respect to the levels and basis of public support for potential forest management strategies to mitigate climate change. This paper, by describing the results of a web-based survey, documents levels of public support for the implementation of eight forest carbon mitigation strategies in British Columbia’s forest sector, and examines and quantifies the influence of the factors that shape this support. Overall, respondents ascribed a high level of importance to forest carbon mitigation and supported all of the eight proposed strategies, indicating that the British Columbia public is inclined to consider alternative practices in managing forests and wood products to mitigate climate change. That said, we found differences in levels of support for the mitigation strategies. In general, we found greater levels of support for a rehabilitation strategy (e.g. reforestation of unproductive forest land), and to a lesser extent for conservation strategies (e.g. old growth conservation, reduced harvest) over enhanced forest management strategies (e.g. improved harvesting and silvicultural techniques). We also highlighted multiple variables within the British Columbia population that appear to play a role in predicting levels of support for conservation and/or enhanced forest management strategies, including environmental values, risk perception, trust in groups of actors, prioritized objectives of forest management and socio-demographic factors. PMID:29684041

Public perceptions about climate change mitigation in British Columbia's forest sector.

PubMed

Peterson St-Laurent, Guillaume; Hagerman, Shannon; Kozak, Robert; Hoberg, George

2018-01-01

The role of forest management in mitigating climate change is a central concern for the Canadian province of British Columbia. The successful implementation of forest management activities to achieve climate change mitigation in British Columbia will be strongly influenced by public support or opposition. While we now have increasingly clear ideas of the management opportunities associated with forest mitigation and some insight into public support for climate change mitigation in the context of sustainable forest management, very little is known with respect to the levels and basis of public support for potential forest management strategies to mitigate climate change. This paper, by describing the results of a web-based survey, documents levels of public support for the implementation of eight forest carbon mitigation strategies in British Columbia's forest sector, and examines and quantifies the influence of the factors that shape this support. Overall, respondents ascribed a high level of importance to forest carbon mitigation and supported all of the eight proposed strategies, indicating that the British Columbia public is inclined to consider alternative practices in managing forests and wood products to mitigate climate change. That said, we found differences in levels of support for the mitigation strategies. In general, we found greater levels of support for a rehabilitation strategy (e.g. reforestation of unproductive forest land), and to a lesser extent for conservation strategies (e.g. old growth conservation, reduced harvest) over enhanced forest management strategies (e.g. improved harvesting and silvicultural techniques). We also highlighted multiple variables within the British Columbia population that appear to play a role in predicting levels of support for conservation and/or enhanced forest management strategies, including environmental values, risk perception, trust in groups of actors, prioritized objectives of forest management and socio-demographic factors.

Fundraising Strategies Developed by MBA Students in Project-Based Learning Courses

ERIC Educational Resources Information Center

Arantes do Amaral, Joao Alberto; Petroni, Liége Mariel; Hess, Aurélio

2016-01-01

The ability to raise funds is a skill that most modern project managers need. While a good deal of literature exists on the strategies NGOs employ to raise funds for their operations, less attention has been paid to the strategies used by students involved in Project-Based Learning courses that often partner with NGOs. Fundraising is an important…

Skills and Strategies of African American Parents in the Management of ADHD: A Qualitative Study.

PubMed

Saulsberry, Alexandria; Bansa, Melishia; DeFrino, Daniela; Dallas, Constance M

2017-08-01

The purpose of this study is to use a strengths-based approach to determine African American parents' skills and strategies for management of children with ADHD. Four focus groups were conducted to identify African American parent beliefs about appropriate ADHD management. Sixteen parents participated and reported having a total of 21 children diagnosed with ADHD. Participants discussed several parenting challenges but advocated for the child by working closely with the child's school and physician. They also managed relationships with family members to protect the child from possible physical or emotional harm. However, parents desired more social support for management of ADHD. African American parents possess key skills and strategies in their management of children with ADHD. Further research is needed to determine the roles and responsibilities of extended family members for children with this disorder, and to identify the social supports parents access to aid with ADHD management.

'Fish out of water': a cross-sectional study on the interaction between social and neighbourhood effects on weight management behaviours.

PubMed

Green, M A; Subramanian, S V; Strong, M; Cooper, C L; Loban, A; Bissell, P

2015-03-01

To analyse whether an individual's neighbourhood influences the uptake of weight management strategies and whether there is an interaction between individual socio-economic status and neighbourhood deprivation. Data were collected from the Yorkshire Health Study (2010-2012) for 27 806 individuals on the use of the following weight management strategies: 'slimming clubs', 'healthy eating', 'increasing exercise' and 'controlling portion size'. A multi-level logistic regression was fit to analyse the use of these strategies, controlling for age, sex, body mass index, education, neighbourhood deprivation and neighbourhood population turnover (a proxy for neighbourhood social capital). A cross-level interaction term was included for education and neighbourhood deprivation. Lower Super Output Area was used as the geographical scale for the areal unit of analysis. Significant neighbourhood effects were observed for use of 'slimming clubs', 'healthy eating' and 'increasing exercise' as weight management strategies, independent of individual- and area-level covariates. A significant interaction between education and neighbourhood deprivation was observed across all strategies, suggesting that as an area becomes more deprived, individuals of the lowest education are more likely not to use any strategy compared with those of the highest education. Neighbourhoods modify/amplify individual disadvantage and social inequalities, with individuals of low education disproportionally affected by deprivation. It is important to include neighbourhood-based explanations in the development of community-based policy interventions to help tackle obesity.

The Correlation between Interpersonal Communication Skills of Inspection Groups and Their Conflict Management Strategies

ERIC Educational Resources Information Center

Sabanci, Ali; Sahin, Ahmet; Özdemir, Izzet

2018-01-01

The purpose of this study was to explore the correlation between interpersonal communication skills and conflict management strategies in the case of inspection groups constituted by a number of inspectors based on the geographical and demographic dispersion of the school population in Turkey. This research was conducted as a survey. The…

2005 AG20/20 Annual Review

NASA Technical Reports Server (NTRS)

Ross, Kenton W.; McKellip, Rodney D.

2005-01-01

Topics covered include: Implementation and Validation of Sensor-Based Site-Specific Crop Management; Enhanced Management of Agricultural Perennial Systems (EMAPS) Using GIS and Remote Sensing; Validation and Application of Geospatial Information for Early Identification of Stress in Wheat; Adapting and Validating Precision Technologies for Cotton Production in the Mid-Southern United States - 2004 Progress Report; Development of a System to Automatically Geo-Rectify Images; Economics of Precision Agriculture Technologies in Cotton Production-AG 2020 Prescription Farming Automation Algorithms; Field Testing a Sensor-Based Applicator for Nitrogen and Phosphorus Application; Early Detection of Citrus Diseases Using Machine Vision and DGPS; Remote Sensing of Citrus Tree Stress Levels and Factors; Spectral-based Nitrogen Sensing for Citrus; Characterization of Tree Canopies; In-field Sensing of Shallow Water Tables and Hydromorphic Soils with an Electromagnetic Induction Profiler; Maintaining the Competitiveness of Tree Fruit Production Through Precision Agriculture; Modeling and Visualizing Terrain and Remote Sensing Data for Research and Education in Precision Agriculture; Thematic Soil Mapping and Crop-Based Strategies for Site-Specific Management; and Crop-Based Strategies for Site-Specific Management.

The weight management strategies inventory (WMSI). Development of a new measurement instrument, construct validation, and association with dieting success.

PubMed

Keller, Carmen; Siegrist, Michael

2015-09-01

In an obesogenic environment, people have to adopt effective weight management strategies to successfully gain or maintain normal body weight. Little is known about the strategies used by the general population in daily life. Due to the lack of a comprehensive measurement instrument to assess conceptually different strategies with various scales, we developed the weight management strategies inventory (WMSI). In study 1, we collected 19 weight management strategies from research on self-regulation of food intake and successful weight loss and maintenance, as well as from expert interviews. We classified them under the five main categories of health self-regulation strategies - goal setting and monitoring, prospection and planning, automating behavior, construal, and inhibition. We formulated 93 items. In study 2, we developed the WMSI in a random sample from the general population (N = 658), using reliability and exploratory factor analysis. This resulted in 19 factors with 63 items, representing the 19 strategies. In study 3, we tested the 19-factor structure in a quota (age, gender) sample from the general population (N = 616), using confirmatory factor analysis. A good model fit (CFI = .918; RMSEA = .043) was revealed. Reliabilities and construct validity were high. Positive correlations of most strategies with dieting success and negative correlations of some strategies with body mass index were found among dieters (N = 292). Study 4 (N = 162) revealed a good test-retest reliability. The WMSI assesses theoretically derived, evidence-based, and conceptually different weight management strategies with different scales that have good psychometric characteristics. The scales can also be used for pre- and post measures in intervention studies. The scales provide insights into the general population's weight management strategies and facilitate tailoring and evaluating health communication. Copyright © 2015 Elsevier Ltd. All rights reserved.

Integrating School-Based Health Centers into Managed Care in Massachusetts.

ERIC Educational Resources Information Center

Hacker, Karen

1996-01-01

This paper examines key steps in the integration of school-based health centers in Massachusetts into managed care and describes the administrative and clinical impact of these relationships. Strategies include enhancing communication between SBHCs and health maintenance organizations, standardizing school-based care, and mandating integration of…

Behavior-Based Safety and Occupational Risk Management

ERIC Educational Resources Information Center

Geller, E. Scott

2005-01-01

The behavior-based approach to managing occupational risk and preventing workplace injuries is reviewed. Unlike the typical top-down control approach to industrial safety, behavior-based safety (BBS) provides tools and procedures workers can use to take personal control of occupational risks. Strategies the author and his colleagues have been…

The diffusion of evidence-based decision making among local health department practitioners in the United States.

PubMed

Harris, Jenine K; Erwin, Paul C; Smith, Carson; Brownson, Ross C

2015-01-01

Evidence-based decision making (EBDM) is the process, in local health departments (LHDs) and other settings, of translating the best available scientific evidence into practice. Local health departments are more likely to be successful if they use evidence-based strategies. However, EBDM and use of evidence-based strategies by LHDs are not widespread. Drawing on diffusion of innovations theory, we sought to understand how LHD directors and program managers perceive the relative advantage, compatibility, simplicity, and testability of EBDM. Directors and managers of programs in chronic disease, environmental health, and infectious disease from LHDs nationwide completed a survey including demographic information and questions about diffusion attributes (advantage, compatibility, simplicity, and testability) related to EBDM. Bivariate inferential tests were used to compare responses between directors and managers and to examine associations between participant characteristics and diffusion attributes. Relative advantage and compatibility scores were high for directors and managers, whereas simplicity and testability scores were lower. Although health department directors and managers of programs in chronic disease generally had higher scores than other groups, there were few significant or large differences between directors and managers across the diffusion attributes. Larger jurisdiction population size was associated with higher relative advantage and compatibility scores for both directors and managers. Overall, directors and managers were in strong agreement on the relative advantage of an LHD using EBDM, with directors in stronger agreement than managers. Perceived relative advantage has been demonstrated to be the most important factor in the rate of innovation adoption, suggesting an opportunity for directors to speed EBDM adoption. However, lower average scores across all groups for simplicity and testability may be hindering EBDM adoption. Recommended strategies for increasing perceived EBDM simplicity and testability are provided.

VOP memory management in MPEG-4

NASA Astrophysics Data System (ADS)

Vaithianathan, Karthikeyan; Panchanathan, Sethuraman

2001-03-01

MPEG-4 is a multimedia standard that requires Video Object Planes (VOPs). Generation of VOPs for any kind of video sequence is still a challenging problem that largely remains unsolved. Nevertheless, if this problem is treated by imposing certain constraints, solutions for specific application domains can be found. MPEG-4 applications in mobile devices is one such domain where the opposite goals namely low power and high throughput are required to be met. Efficient memory management plays a major role in reducing the power consumption. Specifically, efficient memory management for VOPs is difficult because the lifetimes of these objects vary and these life times may be overlapping. Varying life times of the objects requires dynamic memory management where memory fragmentation is a key problem that needs to be addressed. In general, memory management systems address this problem by following a combination of strategy, policy and mechanism. For MPEG4 based mobile devices that lack instruction processors, a hardware based memory management solution is necessary. In MPEG4 based mobile devices that have a RISC processor, using a Real time operating system (RTOS) for this memory management task is not expected to be efficient because the strategies and policies used by the ROTS is often tuned for handling memory segments of smaller sizes compared to object sizes. Hence, a memory management scheme specifically tuned for VOPs is important. In this paper, different strategies, policies and mechanisms for memory management are considered and an efficient combination is proposed for the case of VOP memory management along with a hardware architecture, which can handle the proposed combination.

Science framework for the conservation and restoration strategy of DOI secretarial order 3336: Utilizing resilience and resistance concepts to assess threats to sagebrush ecosystems and greater sage-grouse, prioritize conservation and restoration actions, and inform management strategies

USGS Publications Warehouse

Chambers, Jeanne C.; Campbell, Steve; Carlson, John; Beck, Jeffrey L.; Clause, Karen J.; Dinkins, Jonathan B.; Doherty, Kevin E.; Espinosa, Shawn; Griffin, Kathleen A.; Christiansen, Thomas J.; Crist, Michele R.; Hanser, Steven E.; Havlina, Douglas W.; Henke, Kenneth F.; Hennig, Jacob D.; Kurth, Laurie L.; Maestas, Jeremy D.; Mayer, Kenneth E.; Manning, Mary E.; Mealor, Brian A.; McCarthy, Clinton; Pellant, Mike; Prentice, Karen L.; Perea, Marco A.; Pyke, David A.; Wiechman , Lief A.; Wuenschel, Amarina

2016-01-01

The Science Framework for the Conservation and Restoration Strategy of the Department of the Interior, Secretarial Order 3336 (SO 3336), Rangeland Fire Prevention, Management and Restoration, provides a strategic, multiscale approach for prioritizing areas for management and determining effective management strategies across the sagebrush biome. The emphasis of this version is on sagebrush ecosystems and greater sage-grouse. The Science Framework uses a six step process in which sagebrush ecosystem resilience to disturbance and resistance to nonnative, invasive annual grasses is linked to species habitat information based on the distribution and abundance of focal species. The predominant ecosystem and anthropogenic threats are assessed, and a habitat matrix is developed that helps decision makers evaluate risks and determine appropriate management strategies at regional and local scales. Areas are prioritized for management action using a geospatial approach that overlays resilience and resistance, species habitat information, and predominant threats. Decision tools are discussed for determining the suitability of priority areas for management and the most appropriate management actions at regional to local scales. The Science Framework and geospatial crosscut are intended to complement the mitigation strategies associated with the Greater Sage-Grouse Land Use Plan amendments for the Department of the Interior Bureaus, such as the Bureau of Land Management, and the U.S. Forest Service.

Prevention and management of cochlear implant infections.

PubMed

Gluth, Michael B; Singh, Rajesh; Atlas, Marcus D

2011-11-01

Understanding the issues of infection related to an implantable medical device is crucial to all cochlear implant teams. Furthermore, given the risk of central nervous system complications and the relatively high quantity of underlying resource investment associated with cochlear implantation, the stakes of infection are high. The optimal strategies to prevent and manage such infections are still evolving as good-quality prospective data to guide such management decisions are not yet abundant within the medical literature and many recommendations are based on retrospective reviews or anecdotal evidence. We will outline a general strategy to deal with cochlear implant-related infection based on both the authors' experience and the published literature.

Preeclampsia: A review of the pathogenesis and possible management strategies based on its pathophysiological derangements.

PubMed

El-Sayed, Amel A F

2017-10-01

This review is divided into three parts. The first part briefly describes the pathogenesis of preeclampsia. This is followed by reviewing previously reported management strategies of the disease based on its pathophysiological derangements. Finally, the author defines the safe and acceptable methods/medications that may be used to 'prevent' preeclampsia (in high risk patients) and those that may be used to 'treat' preeclampsia (meant to prolong the pregnancy in patients with established preeclampsia). The review concludes that multi-center trials are required to include multiple drugs in the same management protocol. Copyright © 2017. Published by Elsevier B.V.

Refueling Strategies for a Team of Cooperating AUVs

DTIC Science & Technology

2011-01-01

manager, and thus the constraint a centrally managed underwater network imposes on the mission. Task management utilizing Robust Decentralized Task ...the computational complexity. A bid based approach to task management has also been studied as a possible means of decentralization of group task ...currently performing another task . In [18], ground robots perform distributed task allocation using the ASyMTRy-D algorithm, which is based on CNP

A goal management intervention for polyarthritis patients: rationale and design of a randomized controlled trial.

PubMed

Arends, Roos Y; Bode, Christina; Taal, Erik; Van de Laar, Mart A F J

2013-08-13

A health promotion intervention was developed for inflammatory arthritis patients, based on goal management. Elevated levels of depression and anxiety symptoms, which indicate maladjustment, are found in such patients. Other indicators of adaptation to chronic disease are positive affect, purpose in life and social participation. The new intervention focuses on to improving adaptation by increasing psychological and social well-being and decreasing symptoms of affective disorders. Content includes how patients can cope with activities and life goals that are threatened or have become impossible to attain due to arthritis. The four goal management strategies used are: goal maintenance, goal adjustment, goal disengagement and reengagement. Ability to use various goal management strategies, coping versatility and self-efficacy are hypothesized to mediate the intervention's effect on primary and secondary outcomes. The primary outcome is depressive symptoms. Secondary outcomes are anxiety symptoms, positive affect, purpose in life, social participation, pain, fatigue and physical functioning. A cost-effectiveness analysis and stakeholders' analysis are planned. The protocol-based psycho-educational program consists of six group-based meetings and homework assignments, led by a trained nurse. Participants are introduced to goal management strategies and learn to use these strategies to cope with threatened personal goals. Four general hospitals participate in a randomized controlled trial with one intervention group and a waiting list control condition. The purpose of this study is to evaluate the effectiveness of a goal management intervention. The study has a holistic focus as both the absence of psychological distress and presence of well-being are assessed. In the intervention, applicable goal management competencies are learned that assist people in their choice of behaviors to sustain and enhance their quality of life. Nederlands Trial Register = NTR3606, registration date 11-09-2012.

Computer simulation of wolf-removal strategies for animal-damage control

USGS Publications Warehouse

Haight, R.G.; Travis, L.E.; Nimerfro, K.; Mech, L.D.

2002-01-01

Because of the sustained growth of the gray wolf (Canis lupus) population in the western Great Lakes region of the United States, management agencies are anticipating gray wolf removal from the federal endangered species list and are proposing strategies for wolf management. Strategies are needed that would balance public demand for wolf conservation with demand for protection against wolf depredation on livestock, poultry, and pets. We used a stochastic, spatially structured, individually based simulation model of a hypothetical wolf population, representing a small subset of the western Great Lakes wolves, to predict the relative performance of 3 wolf-removal strategies. Those strategies included reactive management (wolf removal occurred in summer after depredation), preventive management (wolves removed in winter from territories with occasional depredation), and population-size management (wolves removed annually in winter from all territories near farms). Performance measures included number of depredating packs and wolves removed, cost, and population size after 20 years. We evaluated various scenarios about immigration, trapping success, and likelihood of packs engaging in depredation. Four robust results emerged from the simulations: 1) each strategy reduced depredation by at least 40% compared with no action, 2) preventive and population-size management removed fewer wolves than reactive management because wolves were removed in winter before pups were born, 3)population-size management was least expensive because repeated annual removal kept most territories near farms free of wolves, and 4) none of the strategies threatened wolf populations unless they were isolated because wolf removal took place near farms and not in wild areas. For isolated populations, reactive management alone ensured conservation and reduced depredation. Such results can assist decision makers in managing gray wolves in the western Great Lakes states.

Biologically Based Methods for Pest Management in Agriculture under Changing Climates: Challenges and Future Directions.

PubMed

Chidawanyika, Frank; Mudavanhu, Pride; Nyamukondiwa, Casper

2012-11-09

The current changes in global climatic regimes present a significant societal challenge, affecting in all likelihood insect physiology, biochemistry, biogeography and population dynamics. With the increasing resistance of many insect pest species to chemical insecticides and an increasing organic food market, pest control strategies are slowly shifting towards more sustainable, ecologically sound and economically viable options. Biologically based pest management strategies present such opportunities through predation or parasitism of pests and plant direct or indirect defense mechanisms that can all be important components of sustainable integrated pest management programs. Inevitably, the efficacy of biological control systems is highly dependent on natural enemy-prey interactions, which will likely be modified by changing climates. Therefore, knowledge of how insect pests and their natural enemies respond to climate variation is of fundamental importance in understanding biological insect pest management under global climate change. Here, we discuss biological control, its challenges under climate change scenarios and how increased global temperatures will require adaptive management strategies to cope with changing status of insects and their natural enemies.

[Traditional Chinese Medicine data management policy in big data environment].

PubMed

Liang, Yang; Ding, Chang-Song; Huang, Xin-di; Deng, Le

2018-02-01

As traditional data management model cannot effectively manage the massive data in traditional Chinese medicine(TCM) due to the uncertainty of data object attributes as well as the diversity and abstraction of data representation, a management strategy for TCM data based on big data technology is proposed. Based on true characteristics of TCM data, this strategy could solve the problems of the uncertainty of data object attributes in TCM information and the non-uniformity of the data representation by using modeless properties of stored objects in big data technology. Hybrid indexing mode was also used to solve the conflicts brought by different storage modes in indexing process, with powerful capabilities in query processing of massive data through efficient parallel MapReduce process. The theoretical analysis provided the management framework and its key technology, while its performance was tested on Hadoop by using several common traditional Chinese medicines and prescriptions from practical TCM data source. Result showed that this strategy can effectively solve the storage problem of TCM information, with good performance in query efficiency, completeness and robustness. Copyright© by the Chinese Pharmaceutical Association.

Total Quality Management in Higher Education: Clearing the Hurdles. A Survey on Strategies for Implementing Quality Management Practices in Higher Education. A GOAL/QPC Application Report.

ERIC Educational Resources Information Center

Seymour, Daniel

Based on a survey of Quality Management (QM) practitioners at 21 colleges, this study presents the 10 most difficult implementation hurdles to QM in higher education and a set of hurdle-clearing strategies. The hurdles are: (1) lack of time to implement QM; (2) perception that QM is something for janitorial and housing staffs but not applicable to…

Bicycle Commuting and Exposure to Air Pollution: A Questionnaire-Based Investigation of Perceptions, Symptoms, and Risk Management Strategies.

PubMed

Cole-Hunter, Tom; Morawska, Lidia; Solomon, Colin

2015-04-01

An increase in bicycle commuting participation may improve public health and traffic congestion in cities. Information on air pollution exposure (such as perception, symptoms, and risk management) contributes to the responsible promotion of bicycle commuting participation. To determine perceptions, symptoms, and willingness for specific exposure risk management strategies of exposure to air pollution, a questionnaire-based cross-sectional investigation was conducted with adult bicycle commuters (n = 153; age = 41 ± 11 years; 28% female). Frequency of acute respiratory signs and symptoms were positively associated with in-commute and postcommute compared with precommute time periods (P < .05); there was greater positive association with respiratory disorder compared with healthy, and female compared with male, participants. The perception (but not signs or symptoms) of in-commute exposure to air pollution was positively associated with the estimated level of in-commute proximity to motorized traffic. The majority of participants indicated a willingness (which varied with health status and gender) to adopt risk management strategies (with desired features) if shown to be appropriate and effective. While acute signs and symptoms of air pollution exposure are indicated with bicycle commuting, and more so in susceptible individuals, there is willingness to manage exposure risk by adopting effective strategies with desired features.

Fundamentals of management of acute postoperative pulmonary hypertension.

PubMed

Taylor, Mary B; Laussen, Peter C

2010-03-01

In the last several years, there have been numerous advancements in the field of pulmonary hypertension as a whole, but there have been few changes in the management of children with pulmonary hypertension after cardiac surgery. Patients at particular risk for postoperative pulmonary hypertension can be identified preoperatively based on their cardiac disease and can be grouped into four broad categories based on the mechanisms responsible for pulmonary hypertension: 1) increased pulmonary vascular resistance; 2) increased pulmonary blood flow with normal pulmonary vascular resistance; 3) a combination of increased pulmonary vascular resistance and increased blood flow; and 4) increased pulmonary venous pressure. In this review of the immediate postoperative management of pulmonary hypertension, various strategies are discussed including medical therapies, monitoring, ventilatory strategies, and weaning from these supports. With early recognition of patients at particular risk for severe pulmonary hypertension, management strategies can be directed at preventing or minimizing hemodynamic instability and thereby prevent the development of ventricular dysfunction and a low output state.

Managing geometric information with a data base management system

NASA Technical Reports Server (NTRS)

Dube, R. P.

1984-01-01

The strategies for managing computer based geometry are described. The computer model of geometry is the basis for communication, manipulation, and analysis of shape information. The research on integrated programs for aerospace-vehicle design (IPAD) focuses on the use of data base management system (DBMS) technology to manage engineering/manufacturing data. The objectives of IPAD is to develop a computer based engineering complex which automates the storage, management, protection, and retrieval of engineering data. In particular, this facility must manage geometry information as well as associated data. The approach taken on the IPAD project to achieve this objective is discussed. Geometry management in current systems and the approach taken in the early IPAD prototypes are examined.

Managing the harmful effects of unsupportive organizations during pregnancy.

PubMed

Little, Laura M; Hinojosa, Amanda S; Paustian-Underdahl, Samantha; Zipay, Kate P

2018-06-01

Unfortunately, not all organizations are supportive of employees' family lives. Family unsupportive workplaces can be stressful for all employees and particularly for pregnant women, who carry a physical reminder of their family life. In the present study, we draw on conservation of resources (COR) theory (Hobfoll, 1989, 2001) to investigate how women manage family unsupportive organizational perceptions during pregnancy via social identity-based impression management behaviors as well as how these strategies relate to changes in stress and changes in conflict between work and family. Specifically, we find that image maintenance strategies-impression management strategies aimed at maintaining one's prepregnancy image-are associated with decreases in work stress and work-family conflict over the course of pregnancy, while decategorization-impression management strategies aimed at avoiding negative outcomes by hiding the pregnancy or dodging the issue-are related to increases in work-family conflict. These results suggest strategies for both organizations and pregnant workers to decrease stress during a time when health is vital for both mother and baby. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Implementation Strategies for Educational Intranet Resources.

ERIC Educational Resources Information Center

Herson, Katie; Sosabowski, Michael; Lloyd, Andrew; Flowers, Stephen; Paine, Cameron; Newton, Becci

2000-01-01

Describes two alternative strategies for intranet implementation based on experiences at the University of Brighton (United Kingdom). Highlights include differing degrees of staff and student utilization; barriers to success; a unified strategy for effective intranet implementation; and how to manage organizational resistance to change.…

Summary of the consultation on a strategy for services for chronic obstructive pulmonary disease (COPD) in England.

PubMed

Jones, Rupert; Gruffydd-Jones, Kevin; Pinnock, Hilary; Peffers, Sarah-Jane; Lawrence, Judith; Scullion, Jane; White, Patrick; Holmes, Steve

2010-12-01

The Consultation on a Strategy for Services for COPD in England is the culmination of five years' work by respiratory specialists from all disciplines, as well as representatives from the voluntary sector, patients, carers and planners. It has been led by the Department of Health in England and the joint National Directors for the programme, Professor Sue Hill and Dr Robert Winter. The Strategy outlines service standards for providers of COPD care and is complementary to the UK National Institute for Health and Clinical Excellence (NICE) guidelines on the management of COPD. Its key elements are: • preventing the development and progression of COPD • diagnosing COPD accurately and at an early stage • developing structured care based on national guidance • promoting self-management education • reducing the number of people admitted to hospital • improving access to end-of-life care • promoting good asthma services. In essence this is an aspirational strategy which aims to change the way that the NHS in England delivers care for people with COPD by identifying them earlier and managing them optimally in order to reduce the likelihood of progression to the more severe stages of the disease. An economic impact assessment shows that implementing the Strategy will save approximately £1billion over 10 years as well as sparing many people from a debilitating illness. This supplement is based on the Strategy Consultation document as well as the NICE guidelines for COPD management. It aims to elucidate practical implementation of the COPD Strategy, and includes verbatim the Strategy recommendations as well as highly relevant clinical information from the NICE guidelines. Implementation of the Strategy recommendations should lead to optimum care for patients with COPD.

Effectiveness of an interprofessional workshop on pain management for medical and nursing students.

PubMed

Erickson, Jeanne M; Brashers, Valentina; Owen, John; Marks, Jennifer R; Thomas, Shannon M

2016-07-01

Interprofessional (IP) care is critical for effective pain management, but evidence is lacking about the best way to teach pain management skills to medical and nursing students using IP strategies. In 2013 and 2014, 307 medical and 169 nursing students participated in an IP case-based pain management workshop. The aims of this study were to determine (1) if students who participate in IP case-based learning groups will have improved pain management skills compared to students who participate in uniprofessional case-based learning groups, and (2) if students mentored by faculty with IP training will have improved pain management skills compared to students who are not mentored by IP-trained faculty. Student learning was assessed and compared using scored checklists for each group's pain management plans. Findings show that IP mentorship and IP group participation improved medical students' pain management skills but did not have the same effect on nursing student performance. Continued work is needed to develop, refine, and integrate innovative and tailored IP strategies into the curricula of medical and nursing schools to advance the pain management competencies of students before they enter clinical practice.

Coping strategies used by poorly adherent patients for self-managing bipolar disorder.

PubMed

Blixen, Carol; Levin, Jennifer B; Cassidy, Kristin A; Perzynski, Adam T; Sajatovic, Martha

2016-01-01

Bipolar disorder (BD) is a chronic mental illness associated with reduced quality of life, high rates of suicide, and high financial costs. Evidence indicates that psychosocial stress might play an important role in the onset and course of BD. The objective of this study was to address the gap between coping theory and the clinical use of coping strategies used to self-manage BD. In-depth interviews were conducted with a sample of 21 poorly adherent patients with BD. All interviews were audiotaped, transcribed verbatim, and analyzed using content analysis with an emphasis on dominant themes. Transcript-based analysis generated two major domains of coping strategies used to self-manage BD: 1) problem focused (altering eating habits, managing mood-stabilizing medications, keeping psychiatric appointments, seeking knowledge, self-monitoring, and socializing) and 2) emotion focused (distracting activities, denial, isolation, modifying/avoiding, helping others, and seeking social support). Participants used both types of coping strategies to deal with stressful situations brought about by the internal and external demands associated with self-management of BD. This qualitative study provided a first step in evaluating coping strategies as a possible mediator in the self-management of BD and has implications for health care providers. Being able to characterize an individual's coping behaviors can help patients modify or replace more maladaptive coping with better coping strategies in the self-management of this chronic mental illness.

A cognitive task analysis of information management strategies in a computerized provider order entry environment.

PubMed

Weir, Charlene R; Nebeker, Jonathan J R; Hicken, Bret L; Campo, Rebecca; Drews, Frank; Lebar, Beth

2007-01-01

Computerized Provider Order Entry (CPOE) with electronic documentation, and computerized decision support dramatically changes the information environment of the practicing clinician. Prior work patterns based on paper, verbal exchange, and manual methods are replaced with automated, computerized, and potentially less flexible systems. The objective of this study is to explore the information management strategies that clinicians use in the process of adapting to a CPOE system using cognitive task analysis techniques. Observation and semi-structured interviews were conducted with 88 primary-care clinicians at 10 Veterans Administration Medical Centers. Interviews were taped, transcribed, and extensively analyzed to identify key information management goals, strategies, and tasks. Tasks were aggregated into groups, common components across tasks were clarified, and underlying goals and strategies identified. Nearly half of the identified tasks were not fully supported by the available technology. Six core components of tasks were identified. Four meta-cognitive information management goals emerged: 1) Relevance Screening; 2) Ensuring Accuracy; 3) Minimizing memory load; and 4) Negotiating Responsibility. Strategies used to support these goals are presented. Users develop a wide array of information management strategies that allow them to successfully adapt to new technology. Supporting the ability of users to develop adaptive strategies to support meta-cognitive goals is a key component of a successful system.

The management of aldosterone-producing adrenal adenomas--does adrenalectomy increase costs?

PubMed

Reimel, Bethann; Zanocco, Kyle; Russo, Mark J; Zarnegar, Rasa; Clark, Orlo H; Allendorf, John D; Chabot, John A; Duh, Quan-Yang; Lee, James A; Sturgeon, Cord

2010-12-01

Most experts agree that primary hyperaldosteronism (PHA) caused by an aldosterone-producing adenoma (APA) is best treated by adrenalectomy. From a public health standpoint, the cost of treatment must be considered. We sought to compare the current guideline-based (surgical) strategy with universal pharmacologic management to determine the optimal strategy from a cost perspective. A decision analysis was performed using a Markov state transition model comparing the strategies for PHA treatment. Pharmacologic management for all patients with PHA was compared with a strategy of screening for and resecting an aldosterone-producing adenoma. Success rates were determined for treatment outcomes based on a literature review. Medicare reimbursement rates were calculated to estimate costs from a third-party payer perspective. Screening for and resecting APAs was the least costly strategy in this model. For a reference patient with 41 remaining years of life, the discounted expected cost of the surgical strategy was $27,821. The discounted expected cost of the medical strategy was $34,691. The cost of adrenalectomy would have to increase by 156% to $22,525 from $8,784 for universal pharmacologic therapy to be less costly. Screening for APA is more costly if fewer than 9.6% of PHA patients have resectable APA. Resection of APAs was the least costly treatment strategy in this decision analysis model. Copyright © 2010 Mosby, Inc. All rights reserved.

Risk management assessment of Health Maintenance Organisations participating in the National Health Insurance Scheme

PubMed Central

Campbell, Princess Christina; Korie, Patrick Chukwuemeka; Nnaji, Feziechukwu Collins

2014-01-01

Background: The National Health Insurance Scheme (NHIS), operated majorly in Nigeria by health maintenance organisations (HMOs), took off formally in June 2005. In view of the inherent risks in the operation of any social health insurance, it is necessary to efficiently manage these risks for sustainability of the scheme. Consequently the risk-management strategies deployed by HMOs need regular assessment. This study assessed the risk management in the Nigeria social health insurance scheme among HMOs. Materials and Methods: Cross-sectional survey of 33 HMOs participating in the NHIS. Results: Utilisation of standard risk-management strategies by the HMOs was 11 (52.6%). The other risk-management strategies not utilised in the NHIS 10 (47.4%) were risk equalisation and reinsurance. As high as 11 (52.4%) of participating HMOs had a weak enrollee base (less than 30,000 and poor monthly premium and these impacted negatively on the HMOs such that a large percentage 12 (54.1%) were unable to meet up with their financial obligations. Most of the HMOs 15 (71.4%) participated in the Millennium development goal (MDG) maternal and child health insurance programme. Conclusions: Weak enrollee base and poor monthly premium predisposed the HMOs to financial risk which impacted negatively on the overall performance in service delivery in the NHIS, further worsened by the non-utilisation of risk equalisation and reinsurance as risk-management strategies in the NHIS. There is need to make the scheme compulsory and introduce risk equalisation and reinsurance. PMID:25298605

Managing challenging interactions with family caregivers in the cancer setting: Guidelines for clinicians (TRIO Guidelines-2).

PubMed

Laidsaar-Powell, Rebekah; Butow, Phyllis; Boyle, Frances; Juraskova, Ilona

2018-06-01

Family caregivers can, at times, add complexity to clinical encounters. Difficult family caregivers and dynamics may: derail consultation communication, reduce patient autonomy, and compromise effective clinical care. A paucity of practical strategies guiding effective clinician-family communication exists. This study aimed to develop and evaluate the first comprehensive, evidence-based guidelines (the TRIO guidelines) for oncology physicians and nurses to better manage several complex/challenging situations involving family members. TRIO Guidelines were based on a comprehensive review of literature, relevant guidelines, and feedback from an expert advisory group (n = 10). Draft guidelines underwent two rounds of evaluation via an online Delphi consensus process involving international experts (n = 35). Guidelines incorporate topic areas, strategies, and sub-strategies on managing challenging family involvement (7 topics). Example wording, behaviours and level of evidence are provided. Challenging triadic interactions require skillful navigation, and the TRIO Guidelines provide clear, specific, and evidence-based strategies for clinicians to utilise in these potentially stressful encounters. Training based on these guidelines may improve both patient care and clinician confidence. Implementation of these guidelines into medical/nursing curricula and as a component of continuing professional development programs will likely be highly beneficial. Copyright © 2018 Elsevier B.V. All rights reserved.

Managing caries: the need to close the gap between the evidence base and current practice.

PubMed

Schwendicke, F; Doméjean, S; Ricketts, D; Peters, M

2015-11-13

Underpinned by a changing knowledge of the aetiology of caries and its sequelae, and assisted by established and advancing dental materials, there is growing evidence supporting less invasive management of dental caries based on the principles of minimal intervention dentistry. This narrative review assesses both the evidence and the adoption of less invasive caries management strategies and describes ways in which the gap between evidence and practice might be overcome. While there is increasing data supporting less invasive management of carious lesions, these are not standard in most dental practices worldwide. Usually, clinical studies focused on efficacy as outcome, and did not take into consideration the views and priorities of other stakeholders, such as primary care dentists, educators, patients and those financing services. Involving these stakeholders into study design and demonstrating the broader advantages of new management strategies might improve translation of research into practice. In theory, clinical dentists can rely on a growing evidence in cariology regarding less invasive management options. In practice, further factors seem to impede adoption of these strategies. Future research should address these factors by involving major stakeholders and investigating their prioritised outcomes to narrow or close the evidence gap.

Applying the cell-based coagulation model in the management of critical bleeding.

PubMed

Ho, K M; Pavey, W

2017-03-01

The cell-based coagulation model was proposed 15 years ago, yet has not been applied commonly in the management of critical bleeding. Nevertheless, this alternative model may better explain the physiological basis of current coagulation management during critical bleeding. In this article we describe the limitations of the traditional coagulation protein cascade and standard coagulation tests, and explain the potential advantages of applying the cell-based model in current coagulation management strategies. The cell-based coagulation model builds on the traditional coagulation model and explains many recent clinical observations and research findings related to critical bleeding unexplained by the traditional model, including the encouraging results of using empirical 1:1:1 fresh frozen plasma:platelets:red blood cells transfusion strategy, and the use of viscoelastic and platelet function tests in patients with critical bleeding. From a practical perspective, applying the cell-based coagulation model also explains why new direct oral anticoagulants are effective systemic anticoagulants even without affecting activated partial thromboplastin time or the International Normalized Ratio in a dose-related fashion. The cell-based coagulation model represents the most cohesive scientific framework on which we can understand and manage coagulation during critical bleeding.

Identifying conservation priorities and management strategies based on ecosystem services to improve urban sustainability in Harbin, China

PubMed Central

2018-01-01

Rapid urbanization and agricultural development has resulted in the degradation of ecosystems, while also negatively impacting ecosystem services (ES) and urban sustainability. Identifying conservation priorities for ES and applying reasonable management strategies have been found to be effective methods for mitigating this phenomenon. The purpose of this study is to propose a comprehensive framework for identifying ES conservation priorities and associated management strategies for these planning areas. First, we incorporated 10 ES indicators within a systematic conservation planning (SCP) methodology in order to identify ES conservation priorities with high irreplaceability values based on conservation target goals associated with the potential distribution of ES indicators. Next, we assessed the efficiency of the ES conservation priorities for meeting the designated conservation target goals. Finally, ES conservation priorities were clustered into groups using a K-means clustering analysis in an effort to identify the dominant ES per location before formulating management strategies. We effectively identified 12 ES priorities to best represent conservation target goals for the ES indicators. These 12 priorities had a total areal coverage of 13,364 km2 representing 25.16% of the study area. The 12 priorities were further clustered into five significantly different groups (p-values between groups < 0.05), which helped to refine management strategies formulated to best enhance ES across the study area. The proposed method allows conservation and management plans to easily adapt to a wide variety of quantitative ES target goals within urban and agricultural areas, thereby preventing urban and agriculture sprawl and guiding sustainable urban development. PMID:29682412

Identifying conservation priorities and management strategies based on ecosystem services to improve urban sustainability in Harbin, China.

PubMed

Qu, Yi; Lu, Ming

2018-01-01

Rapid urbanization and agricultural development has resulted in the degradation of ecosystems, while also negatively impacting ecosystem services (ES) and urban sustainability. Identifying conservation priorities for ES and applying reasonable management strategies have been found to be effective methods for mitigating this phenomenon. The purpose of this study is to propose a comprehensive framework for identifying ES conservation priorities and associated management strategies for these planning areas. First, we incorporated 10 ES indicators within a systematic conservation planning (SCP) methodology in order to identify ES conservation priorities with high irreplaceability values based on conservation target goals associated with the potential distribution of ES indicators. Next, we assessed the efficiency of the ES conservation priorities for meeting the designated conservation target goals. Finally, ES conservation priorities were clustered into groups using a K-means clustering analysis in an effort to identify the dominant ES per location before formulating management strategies. We effectively identified 12 ES priorities to best represent conservation target goals for the ES indicators. These 12 priorities had a total areal coverage of 13,364 km 2 representing 25.16% of the study area. The 12 priorities were further clustered into five significantly different groups ( p -values between groups < 0.05), which helped to refine management strategies formulated to best enhance ES across the study area. The proposed method allows conservation and management plans to easily adapt to a wide variety of quantitative ES target goals within urban and agricultural areas, thereby preventing urban and agriculture sprawl and guiding sustainable urban development.

Strategies for waste management in small and medium towns of developing countries: a case study of India.

PubMed

Sundaravadivel, M; Vigneswaran, S

2003-01-01

This paper evaluates the issues of waste management in small and medium towns (SMTs) (with population in the range of 10,000-100,000) of India, and identifies the need for a multi-disciplinary approach encompassing technological, economic and financial aspects of the issues to effect improvements. A comprehensive set of cross-disciplinary strategies is suggested to improve the prevailing conditions with environmentally appropriate, economically efficient and financially self-sustaining waste management services. Based on a case study of four SMTs in the State of Tamil Nadu in India, this paper evaluates the application of the suggested strategies and offers policy recommendations.

Supplier behaviour and public contracting in the English agency nursing market.

PubMed

Lonsdale, Chris; Kirkpatrick, Ian; Hoque, Kim; de Ruyter, Alex

2010-01-01

The worldwide expansion in the use of private firms to deliver public services and infrastructure has promoted a substantial literature on public sector contract and relationship management. This literature is currently dominated by the notion that supplier relationships should be based upon trust. Less prominent are more sceptical approaches that emphasize the need to assiduously manage potential supplier exploitation and opportunism. This article addresses this imbalance by focusing upon the recent experience of the English National Health Service (NHS) in its dealings with its nursing agencies. Between 1997 and 2001, the NHS was subjected to considerable exploitation and opportunism. This forced managers to adopt a supply strategy based upon an assiduous use of e-auctions, framework agreements and quality audits. The article assesses the effectiveness of this strategy and reflects upon whether a more defensive approach to contract and relationship management offers a viable alternative to one based upon trust.

Going International: What We Can Learn about International Strategy, Market Entry, and Resource Allocation from the Game of Go

ERIC Educational Resources Information Center

Watson, Andrew; Chatterjee, Sangit

2006-01-01

We identify three aspects of management particularly crucial in the environment of globalization: the formulation of international strategy; entry into foreign markets; and resource allocation. We advocate the board game Go as an aid to learning management amidst globalization. Our advocacy is based on drawing links between Go and each of the…

Service-Learning by Doing: How a Student-Run Consulting Company Finds Relevance and Purpose in a Business Strategy Capstone Course

ERIC Educational Resources Information Center

Robinson, David F.; Sherwood, Arthur Lloyd; DePaolo, Concetta A.

2010-01-01

A challenge for undergraduate learning in strategy is that the students lack professional work experiences. Without a rich background of experience, many strategic management topics are difficult to grasp. Our solution has been to develop a strategic management capstone course that combines service-learning and problem-based learning. The…

Integrating Ecosystem-Based Management Principles of Adaptive Management and Stakeholder Engagement in California Fisheries

NASA Astrophysics Data System (ADS)

Erickson, A.; Martone, R. G.; Hazen, L.; Mease, L.; Gourlie, D.; Le Cornu, E.; Ourens, R.; Micheli, F.

2016-12-01

California's fisheries management law, the Marine Life Management Act (MLMA) of 1998, signaled a transformative shift from traditional single-species management to an ecosystem-based approach. In response, the fisheries management community in California is striving to integrate new science and management innovations while maximizing its limited capacity. However, data gaps, high compliance costs, capacity constraints, and limited access to the best available data and technologies persist. Here we present two decision support tools being developed to aid California fisheries managers as they continue to implement ecosystem-based management (EBM). First, to practice adaptive management, a key principle of EBM, managers must know whether and how their decisions are meeting their management objectives over time. Based on a cross-walk of MLMA goals with metrics and indicators from sustainable fishery certification programs, we present a flexible and practical tool for tracking fishery management performance in California. We showcase a draft series of decision trees and questionnaires managers can use to quantitatively or qualitatively measure both ecological and social outcomes, helping them to prioritize management options and limited resources. Second, state fisheries managers acknowledge the need for more effective stakeholder engagement to facilitate and inform decision-making and long-term outcomes, another key principle of EBM. Here, we present a pilot version of a decision-support tool to aid managers in choosing the most appropriate stakeholder engagement strategies in various types of decision contexts. This online tool will help staff identify their engagement goals, when they can strategically engage stakeholders based on their needs, and the fishery characteristics that will inform how engagement strategies are tailored to specific contexts. We also share opportunities to expand these EBM tools to other resource management contexts and scales.

Integrating Ecosystem-Based Management Principles of Adaptive Management and Stakeholder Engagement in California Fisheries

NASA Astrophysics Data System (ADS)

Erickson, A.; Martone, R. G.; Hazen, L.; Mease, L.; Gourlie, D.; Le Cornu, E.; Ourens, R.; Micheli, F.

2016-02-01

California's fisheries management law, the Marine Life Management Act (MLMA) of 1998, signaled a transformative shift from traditional single-species management to an ecosystem-based approach. In response, the fisheries management community in California is striving to integrate new science and management innovations while maximizing its limited capacity. However, data gaps, high compliance costs, capacity constraints, and limited access to the best available data and technologies persist. Here we present two decision support tools being developed to aid California fisheries managers as they continue to implement ecosystem-based management (EBM). First, to practice adaptive management, a key principle of EBM, managers must know whether and how their decisions are meeting their management objectives over time. Based on a cross-walk of MLMA goals with metrics and indicators from sustainable fishery certification programs, we present a flexible and practical tool for tracking fishery management performance in California. We showcase a draft series of decision trees and questionnaires managers can use to quantitatively or qualitatively measure both ecological and social outcomes, helping them to prioritize management options and limited resources. Second, state fisheries managers acknowledge the need for more effective stakeholder engagement to facilitate and inform decision-making and long-term outcomes, another key principle of EBM. Here, we present a pilot version of a decision-support tool to aid managers in choosing the most appropriate stakeholder engagement strategies in various types of decision contexts. This online tool will help staff identify their engagement goals, when they can strategically engage stakeholders based on their needs, and the fishery characteristics that will inform how engagement strategies are tailored to specific contexts. We also share opportunities to expand these EBM tools to other resource management contexts and scales.

Air quality management in Portugal: example of needs and available tools.

PubMed

Borrego, C; Miranda, A I; Coutinho, M; Ferreira, J; Carvalho, A C

2002-01-01

The Framework Directive (FWD) and the proposed Daughter Directives are the newest legislative instruments concerning a new political strategy and air quality management approach for Europe. Additionally, the member countries of the United Nations Economic Commission for Europe have included the concepts of critical load and level for planning air pollution abatement strategies and as a base of international agreements concerning limitation of the emissions of air pollutants. These concepts imply an accurate knowledge about pollutants deposition fluxes. The paper describes the main needs and the tools available to define a strategy of air quality management in Portugal. Two study cases are presented: (1) extensive monitoring plan to assess the impact of an urban incinerator plant; and (2) contribution to a methodology to estimate critical levels for a coastal region in Portugal. These different approaches allowed illustrating the complexity of the implementation of an air pollution management strategy.

Enhancing Industry-based Dissemination of an Occupational Sun Protection Program with Theory-based Strategies Employing Personal Contact

PubMed Central

Buller, David B.; Andersen, Peter A.; Walkosz, Barbara J.; Scott, Michael D.; Cutter, Gary R.; Dignan, Mark B.; Kane, Ilima L.; Zhang, Xiao

2012-01-01

Purpose Industry-based strategies for dissemination of an evidence-based occupational sun protection program, Go Sun Smart (GSS), were tested. Design Two dissemination strategies were compared in a randomized trial in 2004 – 2007. Setting The North American ski industry. Subjects Ski areas in the United States and Canada (n=69) and their senior managers (n=469). Intervention Employers received GSS through a Basic Dissemination Strategy (BDS) from the industry’s professional association which included conference presentations and free starter kits. Half of the areas also received the Enhanced Dissemination Strategy (EDS), in which project staff met face-to-face with managers and made ongoing contacts to support program use. Measures Observation of program materials in use and managers’ reports on communication about sun protection. Analysis The effects of two alternative dissemination strategies were compared on program use using PROC MIXED in SAS, adjusted for covariates using 1-tailed p-values. Results Ski areas receiving the EDS used more GSS materials (M=7.36) than those receiving the BDS (M=5.17; F=7.82, p<.01). Managers from more areas receiving the EDS reported communicating about sun protection in employee newsletters/flyers (M=0.97, p=.04), in guest email messages (M=0.75, p=.02), and on ski area websites (M=0.38, p=.02) than those receiving the BDS (M=0.84, 0.50, 0.15, respectively). Conclusion Industry professional associations play an important role in disseminating prevention programs; however, active personal communication may be essential to ensure increased implementation fidelity. PMID:22747318

Clinicians in management: a qualitative study of managers’ use of influence strategies in hospitals

PubMed Central

2014-01-01

Background Combining a professional and managerial role can be challenging for doctors and nurses. We aimed to explore influence strategies used by doctors and nurses who are managers in hospitals with a model of unitary and profession neutral management at all levels. Methods We did a study based on data from interviews and observations of 30 managers with a clinical background in Norwegian hospitals. Results Managers with a nursing background argued that medical doctors could more easily gain support for their views. Nurses reported deliberately not disclosing their professional background, and could use a doctor as their agent to achieve a strategic advantage. Doctors believed that they had to use their power as experts to influence peers. Doctors attempted to be medical role models, while nurses spoke of being a role model in more general terms. Managers who were not able to influence the system directly found informal workarounds. We did not identify horizontal strategies in the observations and accounts given by the managers in our study. Conclusions Managers’ professional background may be both a resource and constraint, and also determine the influence strategies they use. Professional roles and influence strategies should be a theme in leadership development programs for health professionals. PMID:24927743

Top Training Strategies: New Twists on Familiar Ideas.

ERIC Educational Resources Information Center

Ellis, Kristine

2003-01-01

Provides examples of how companies are using the following strategies in innovative ways: knowledge sharing using knowledge-management portals, informal learning, real-time learning, competency-based learning linked to business strategies, calculation of the return on investment in learning, and academic-corporate partnerships. (SK)

Managing temptation in obesity treatment: a neurobehavioral model of intervention strategies

PubMed Central

Appelhans, Bradley M; French, Simone A; Pagoto, Sherry L; Sherwood, Nancy E

2015-01-01

Weight loss outcomes in lifestyle interventions for obesity are primarily a function of sustained adherence to a reduced-energy diet, and most lapses in diet adherence are precipitated by temptation from palatable food. The high nonresponse and relapse rates of lifestyle interventions suggest that current temptation management approaches may be insufficient for most participants. In this conceptual review, we discuss three neurobehavioral processes (attentional bias, temporal discounting, and the cold-hot empathy gap) that emerge during temptation and contribute to lapses in diet adherence. Characterizing the neurobehavioral profile of temptation highlights an important distinction between temptation resistance strategies aimed at overcoming temptation while it is experienced, and temptation prevention strategies that seek to avoid or minimize exposure to tempting stimuli. Many temptation resistance and temptation prevention strategies heavily rely on executive functions mediated by prefrontal systems that are prone to disruption by common occurrences such as stress, insufficient sleep, and even exposure to tempting stimuli. In contrast, commitment strategies are a set of devices that enable individuals to manage temptation by constraining their future choices, without placing heavy demands on executive functions. These concepts are synthesized in a conceptual model that categorizes temptation management approaches based on their intended effects on reward processing and degree of reliance on executive functions. We conclude by discussing the implications of our model for strengthening temptation management approaches in future lifestyle interventions, tailoring these approaches based on key individual difference variables, and suggesting high-priority topics for future research. PMID:26431681

Using Positive Behavior Support to Design Effective Classrooms

ERIC Educational Resources Information Center

Anderson, Cynthia M.; Spaulding, Scott A.

2007-01-01

A number of evidence-based classroom management approaches, procedures, and programs have been developed and presented over the years. In this article the authors synthesize recommendations from various sources, focusing on evidence-based strategies that can be implemented in a systematic manner. They focus specifically on universal strategies,…

[Strategy Development for International Cooperation in the Clinical Laboratory Field].

PubMed

Kudo, Yoshiko; Osawa, Susumu

2015-10-01

The strategy of international cooperation in the clinical laboratory field was analyzed to improve the quality of intervention by reviewing documents from international organizations and the Japanese government. Based on the world development agenda, the target of action for health has shifted from communicable diseases to non-communicable diseases (NCD). This emphasizes the importance of comprehensive clinical laboratories instead of disease-specific examinations in developing countries. To achieve this goal, the World Health Organization (WHO) has disseminated to the African and Asian regions the Laboratory Quality Management System (LQMS), which is based on the same principles of the International Organization of Standardization (ISO) 15189. To execute this strategy, international experts must have competence in project management, analyze information regarding the target country, and develop a strategy for management of the LQMS with an understanding of the technical aspects of laboratory work. However, there is no appropriate pre- and post-educational system of international health for Japanese international workers. Universities and academic organizations should cooperate with the government to establish a system of education for international workers. Objectives of this education system must include: (1) training for the organization and understanding of global health issues, (2) education of the principles regarding comprehensive management of clinical laboratories, and (3) understanding the LQMS which was employed based on WHO's initiative. Achievement of these objectives will help improve the quality of international cooperation in the clinical laboratory field.

Development of a mobile probe-based traffic data fusion and flow management platform for innovative public-private information-based partnerships.

DOT National Transportation Integrated Search

2011-10-17

"Under the aegis of Intelligent Transportation Systems (ITS), real-time traffic information provision strategies are being proposed to manage traffic congestion, alleviate the effects of incidents, enhance response efficiency after disasters, and imp...

Nurse-Managed Clinics: A Blueprint for Success Using the Covey Framework.

ERIC Educational Resources Information Center

Starck, Patricia L.; And Others

1995-01-01

Describes the process from inception to successful operation of a university-based, nurse-managed clinic, based on Covey's seven habits of highly effective people. Includes information on the planning process, financing, political strategies for gaining approval, and ongoing development of services. (JOW)

Influence of the management strategy model on estimating water system performance under climate change

NASA Astrophysics Data System (ADS)

Francois, Baptiste; Hingray, Benoit; Creutin, Jean-Dominique; Hendrickx, Frederic

2015-04-01

The performance of water systems used worldwide for the management of water resources is expected to be influenced by future changes in regional climates and water uses. Anticipating possible performance changes of a given system requires a modeling chain simulating its management. Operational management is usually not trivial especially when several conflicting objectives have to be accounted for. Management models are therefore often a crude representation of the real system and they only approximate its performance. Estimated performance changes are expected to depend on the management model used, but this is often not assessed. This communication analyzes the influence of the management strategy representation on the performance of an Alpine reservoir (Serre-Ponçon, South-East of France) for which irrigation supply, hydropower generation and recreational activities are the main objectives. We consider three ways to construct the strategy named as clear-, short- and far-sighted management. They are based on different forecastability degrees of seasonal inflows into the reservoir. The strategies are optimized using a Dynamic Programming algorithm (deterministic for clear-sighted and implicit stochastic for short- and far-sighted). System performance is estimated for an ensemble of future hydro-meteorological projections obtained in the RIWER2030 research project (http://www.lthe.fr/RIWER2030/) from a suite of climate experiments from the EU - ENSEMBLES research project. Our results show that changes in system performance is much more influenced by changes in hydro-meteorological variables than by the choice of strategy modeling. They also show that a simple strategy representation (i.e. clear-sighted management) leads to similar estimates of performance modifications than those obtained with a representation supposedly closer to real world (i.e. the far-sighted management). The Short-Sighted management approach lead to significantly different results, especially when inter-annual inflow variability is high. Key words: Climate change, water resource, impact, management strategy modelling

Strategies of Production Control as Tools of Efficient Management of Production Enterprises

NASA Astrophysics Data System (ADS)

Budynek, Mateusz; Celińska, Elżbieta; Dybikowska, Adrianna; Kozak, Monika; Ratajczak, Joanna; Urban, Jagoda; Materne, Karolina

2016-03-01

The paper discusses the problem of principle methods of production control as a strategy supporting the production system and stimulating efficient solutions in respect management in production enterprises. The article describes MRP, ERP, JIT, KANBAN and TOC methods and focuses on their main goals, principles of functioning as well as benefits resulting from their application. The methods represent two diverse strategies of production control, i.e. pull and push strategies. Push strategies are used when the plans apply to the first and principle part of production and are based on the demand forecasts. Pull strategies are used when all planning decisions apply to the final stage and depend on the actual demand or orders from customers.

12 years of intensive management increases soil carbon stocks in Loblolly pine and Sweetgum stands

NASA Astrophysics Data System (ADS)

Sanchez, F. G.; Samuelson, L.; Johnsen, K.

2009-12-01

To achieve and maintain productivity goals, forest managers rely on intensive management strategies. These strategies have resulted in considerable gains in forest productivity. However, the impacts of these strategies on belowground carbon dynamics is less clear. Carbon dynamics are influenced by a multitude of factors including soil moisture, nutrient status, net primary productivity and carbon allocation patterns. In this study, we describe the impact of four management strategies on soil carbon and nitrogen stocks in 12-year-old loblolly pine and sweetgum plantations. The management strategies are: (1) complete understory control, (2) complete understory control + drip irrigation, (3) complete understory control + drip irrigation and fertilization and (4) complete understory control + drip irrigation and fertilization and pest control. These management strategies were replicated on 3 blocks in a randomized complete block design. After 12 years, soil carbon stocks increased with increasing management intensity for both tree species. This effect was consistent throughout the depth increments measured (0-10, 10-20, 20-30 cm). Alternatively, no significant effect was detected for soil nitrogen at any depth increment. Sweetgum had higher soil carbon and nitrogen stocks at each depth increment than loblolly pine. There was a greater difference in nitrogen stocks than carbon stocks between the two species resulting in lower soil C:N ratios in the sweetgum stands. These observations may be due to differences in net primary productivity, rooting structure and carbon allocation patterns of sweetgum compared with loblolly pine. To determine the relative stability of the carbon and nitrogen stocks for the different treatments and tree species, we sequentially fractionated the soil samples into six fractions of differing stability. Although soil carbon stocks for both species increased with management intensity, there was no detectable difference in the soil carbon fractions based on management intensity. Additionally, there was no difference between soil carbon fractions based on tree species. These observations suggest that although external inputs (i.e., moisture, carbon and nutrients) increase soil carbon stocks, they do not alter soil carbon stabilization mechanisms at these sites.

Fostering Self-Efficacy through Time Management in an Online Learning Environment

ERIC Educational Resources Information Center

Terry, Krista P.; Doolittle, Peter E.

2008-01-01

In this study, we investigated the use of a web-based tool designed to influence levels of student self-efficacy by engaging participants in a time management strategy. On a daily basis for 16 days, a total of 64 undergraduate and graduate students engaged in the web-based time management tool in which students set goals regarding how they planned…

Veterinary teaching hospitals: current challenges and pathways for the future.

PubMed

Hubbell, John A E

2008-01-01

University-based veterinary teaching hospitals must change to maintain their viability. A number of factors both internal and external to universities and the veterinary profession have contributed to the need for change. A task force formed by the Association of American Veterinary Medical Colleges and the American Association of Veterinary Clinicians was convened to identify the issues and propose individual and collective strategies for the future. Primary issues include a shortage of faculty and staff, the nature of the case load, the need for fiscal management strategies, and the need to manage stakeholder expectations. The majority of the proposed strategies for the future will be managed individually by the colleges. Proposed collective strategies center on increasing the number of specialists and improving recruitment and retention of faculty and staff.

Strategies for Maintaining Positive Behavior Change Stemming from Functional Behavioral Assessment in Schools.

ERIC Educational Resources Information Center

Gable, Robert A.; Hendrickson, Jo M.

2000-01-01

This article discusses strategies and procedures for promoting maintenance and generalization of student behavior changes resulting from interventions based on functional behavioral assessment. Strategies include self-management techniques, cognitive mediation, self-advocacy training, use of peers, booster training, environmental modifications,…

Strategies for converting to a DBMS environment

NASA Technical Reports Server (NTRS)

Durban, D. M.

1984-01-01

The conversion to data base management systems processing techniques consists of three different strategies - one for each of the major stages in the development process. Each strategy was chosen for its approach in bringing about a smooth evolutionary type transition from one mode of operation to the next. The initial strategy of the indoctrination stage consisted of: (1) providing maximum access to current administrative data as soon as possible; (2) select and developing small prototype systems; (3) establishing a user information center as a central focal point for user training and assistance; and (4) developing a training program for programmers, management and ad hoc users in DBMS application and utilization. Security, the rate of the data dictionary, and data base tuning and capacity planning, and the development of a change of attitude in an automated office are issues meriting consideration.

Urethritis in men: benefits, risks, and costs of alternative strategies of management.

PubMed

Braun, P; Sherman, H; Komaroff, A L

1982-01-01

Four alternative strategies for the management of men with acute urethritis were analyzed: treating patients with tetracycline, with or without a urethral culture, without basing the initial treatment decision on the results of a gram-stained smear; treating patients with penicillin, without basing initial treatment on the results of a gram-stained smear; basing initial treatment with tetracycline or penicillin on the results of a gram-stained smear; and basing treatment on the results of both a gram-stained smear and a culture. The tetracycline strategy resulted in fewer days of morbidity, a lower probability of premature death, lower dollar costs, and a much lower rate of uncured nongonococcal urethritis, but in slightly higher rates of uncured gonorrhea and syphilis than more traditional strategies. Use of culture with the tetracycline strategy (1A) permitted tracing of gonorrhea contacts, achieved the same low morbidity, and added little cost. The conclusions were true regardless of the probability of gonorrhea and for reasonable estimates of probable compliance with oral medication regimens. Test-of-cure cultures for patients who were asymptomatic after treatment for gonorrhea required the expenditure of from $4,900 to $109,800 for each case of asymptomatic persistent gonorrhea discovered and cured, depending on the strategy used.

Engaging Watershed Stakeholders for Cost-Effective Environmental Management Planning with "Watershed Manager"

ERIC Educational Resources Information Center

Williams, Jeffery R.; Smith, Craig M.; Roe, Josh D.; Leatherman, John C.; Wilson, Robert M.

2012-01-01

"Watershed Manager" is a spreadsheet-based model that is used in extension education programs for learning about and selecting cost-effective watershed management practices to reduce soil, nitrogen, and phosphorus losses from cropland. It can facilitate Watershed Restoration and Protection Strategy (WRAPS) stakeholder groups' development…

Social-Emotional Learning Is Essential to Classroom Management

ERIC Educational Resources Information Center

Jones, Stephanie M.; Bailey, Rebecca; Jacob, Robin

2014-01-01

Research tells us that children's social-emotional development can propel learning. A new program, SECURe, embeds that research into classroom management strategies that improve teaching and learning. Across all classrooms and grade levels, four principles of effective management are constant: Effective classroom management is based in…

Green campus management based on conservation program in Universitas Negeri Semarang

NASA Astrophysics Data System (ADS)

Prihanto, Teguh

2018-03-01

Universitas Negeri Semarang (UNNES) has a great commitment in the development of higher education programs in line with its vision as a conservation - minded and internationally reputable university. Implementation of conservation programs with respect to the rules or conservation aspects of sustainable use, preservation, provisioning, protection, restoration and conservation of nature. In order to support the implementation of UNNES conservation program more focused, development strategies and development programs for each conservation scope are covered: (1) Biodiversity management; (2) Internal transportation management; (3) energy management; (4) Green building management; (5) Waste and water management; (6) Cultural conservation management. All related to conservation development strategies and programs are managed in the form of green campus management aimed at realizing UNNES as a green campus, characterized and reputable at the regional and global level.

Ameliioration and Conversion of Excessive Se to New Resources from a Plant-based System

USDA-ARS?s Scientific Manuscript database

The green technology of phytoremediation has being developed for the management of metal(loid)-contaminated soils and waters via the processes of phytoextraction, phytovolatilization, and phytostabilization. Based upon these processes a plant management remediation strategy for selenium (Se) has be...

Predicting Conflict Management Based on Organizational Commitment and Selected Demographic Variables

ERIC Educational Resources Information Center

Balay, Refik

2007-01-01

The purpose of this study is to investigate the relationship between different levels of organizational commitment (compliance, identification, internalization) of teachers and their different conflict management strategies (compromising, problem solving, forcing, yielding, avoiding). Based on a questionnaire survey of 418 teachers, this study…

Mobile Apps for Weight Management: A Scoping Review.

PubMed

Rivera, Jordan; McPherson, Amy; Hamilton, Jill; Birken, Catherine; Coons, Michael; Iyer, Sindoora; Agarwal, Arnav; Lalloo, Chitra; Stinson, Jennifer

2016-07-26

Obesity remains a major public health concern. Mobile apps for weight loss/management are found to be effective for improving health outcomes in adults and adolescents, and are pursued as a cost-effective and scalable intervention for combating overweight and obesity. In recent years, the commercial market for 'weight loss apps' has expanded at rapid pace, yet little is known regarding the evidence-based quality of these tools for weight control. To characterize the inclusion of evidence-based strategies, health care expert involvement, and scientific evaluation of commercial mobile apps for weight loss/management. An electronic search was conducted between July 2014 and July 2015 of the official app stores for four major mobile operating systems. Three raters independently identified apps with a stated goal of weight loss/management, as well as weight loss/management apps targeted to pediatric users. All discrepancies regarding selection were resolved through discussion with a fourth rater. Metadata from all included apps were abstracted into a standard assessment criteria form and the evidence-based strategies, health care expert involvement, and scientific evaluation of included apps was assessed. Evidence-based strategies included: self-monitoring, goal-setting, physical activity support, healthy eating support, weight and/or health assessment, personalized feedback, motivational strategies, and social support. A total of 393 apps were included in this review. Self-monitoring was most common (139/393, 35.3%), followed by physical activity support (108/393, 27.5%), weight assessment (100/393, 25.4%), healthy eating support (91/393, 23.2%), goal-setting (84/393, 21.4%), motivational strategies (28/393, 7.1%), social support (21/393, 5.3%), and personalized feedback (7/393, 1.8%). Of apps, 0.8% (3/393) underwent scientific evaluation and 0.3% (1/393) reported health care expert involvement. No apps were comprehensive in the assessment criteria, with the majority of apps meeting less than two criteria. Commercial mobile apps for weight loss/management lack important evidence-based features, do not involve health care experts in their development process, and have not undergone rigorous scientific testing. This calls into question the validity of apps' claims regarding their effectiveness and safety, at a time when the availability and growth in adoption of these tools is rapidly increasing. Collaborative efforts between developers, researchers, clinicians, and patients are needed to develop and test high-quality, evidence-based mobile apps for weight loss/management before they are widely disseminated in commercial markets.

Surveying perceptions of landslide risk management in Norway

NASA Astrophysics Data System (ADS)

Chiu, Jessica Ka Yi; Eidsvig, Unni

2016-04-01

Enhanced precipitation due to climate change leads to increase in both frequency and intensity of landslides in Norway. A proactive approach to risk management is therefore required to significantly reduce the losses associated with landslides. Opinions and perceptions from practitioners on the performance of landslide risk management can provide insights on areas for improvement in the landslide risk management strategies in Norway. The Risk Management Index (RMI), proposed by Cardona et al. (2004), is a well-established method to measure perceptions of disaster management of selected actors holistically. The RMI is measured based on opinion questionnaires to technical staff, decision-makers, and stakeholders involved in all stages of risk reduction strategies. It is a composite index that considers a wide variety of strategies to manage risks, including structural and non-structural measures, acceptance strategies, disaster management, and risk transfer. The RMI method was modified to be implemented in landslide hazards and to fit with Norwegian conditions. An opinion survey was conducted in autumn 2015 to measure perceptions of landslide risk management in Norway. Perceptions were surveyed for two time periods: 2015 and 2050, and are based on national, county, and municipality levels. Based on the survey results, performance of landslide risk management at any administrative levels in Norway is perceived to improve from `significant' in 2015 to `significant' to `outstanding' in 2050. Knowledge and technology, climate, risk perceptions, and anthropogenic activities are mostly considered by respondents for their 2050 perceptions. Several aspects of landslide risk management in Norway can be improved. For example, landslide hazard evaluation and mapping should be prioritised in Norway. Upgrading, retrofitting, and reconstruction of assets may also be included in the landslide risk reduction strategies. In addition, there should be more focus on inter-institutional organisation as well as allocation and use of financial resources for dealing with landslides at local levels. Although the survey was considered too difficult by some of the respondents, it can be regarded as a starting point to develop a common terminology/language in landslide risk management in Norway that allows mutual understandings among people with different backgrounds. The approach of surveying perceptions of landslide risk management can also be expanded to the public to enable comparisons of perceptions between experts and the public. Furthermore, the methodology can be applied to other types of natural hazards in Norway, such as floods. This project is supported by Klima2050 (http://www.klima2050.no/).

Spatial strategies for managing visitor impacts in National Parks

USGS Publications Warehouse

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

1999-01-01

Resource and social impacts caused by recreationists and tourists have become a management concern in national parks and equivalent protected areas. The need to contain visitor impacts within acceptable limits has prompted park and protected area managers to implement a wide variety of strategies and actions, many of which are spatial in nature. This paper classifies and illustrates the basic spatial strategies for managing visitor impacts in parks and protected areas. A typology of four spatial strategies was proposed based on the recreation and park management literature. Spatial segregation is a common strategy for shielding sensitive resources from visitor impacts or for separating potentially conflicting types of use. Two forms of spatial segregation are zoning and closure. A spatial containment strategy is intended to minimize the aggregate extent of visitor impacts by confining use to limited designated or established Iocations. In contrast, a spatial dispersal strategy seeks to spread visitor use, reducing the frequency of use to levels that avoid or minimize permanent resource impacts or visitor crowding and conflict. Finally, a spatial configuration strategy minimizes impacting visitor behavior though the judicious spatial arrangement of facilities. These four spatial strategics can be implemented separately or in combination at varying spatial scales within a single park. A survey of national park managers provides an empirical example of the diversity of implemented spatial strategies in managing visitor impacts. Spatial segregation is frequently applied in the form of camping restrictions or closures to protect sensitive natural or cultural resources and to separate incompatible visitor activities. Spatial containment is the most widely applied strategy for minimizing the areal extent of resource impacts. Spatial dispersal is commonly applied to reduce visitor crowding or conflicts in popular destination areas but is less frequently applied or effective in minimizing resource impacts. Spatial configuration was only minimally evaluated, as it was not included in the survey. The proposed typology of spatial strategies offers a useful means of organizing and understanding the wide variety of management strategies and actions applied in managing visitor impacts in parks and protected areas. Examples from U.S. national parks demonstrate the diversity of these basic strategies and their flexibility in implementation at various spatial scales. Documentation of these examples helps illustrate their application and inform managers of the multitude of options. Further analysis from the spatial perspective is needed Io extend the applicability of this typology to other recreational activities and management issues.

Pilot Evaluation of the Feasibility and Acceptability of StressOFF Strategies: A Single-Session School-Based Stress Management Program for Adolescents

ERIC Educational Resources Information Center

Shapiro, Amy J.; Heath, Nancy L.; Carsley, Dana

2016-01-01

The present study reports the pilot evaluation of the feasibility and acceptability of StressOFF Strategies, a "single-session" (45 min) adolescent-targeted, school-based psychoeducational program, which introduces cognitive behavioral techniques and mindfulness-based techniques. Five hundred and sixty-five Grade 9 students (57% female;…

Unmanned Aircraft Systems Traffic Management (UTM) Safely Enabling UAS Operations in Low-Altitude Airspace

NASA Technical Reports Server (NTRS)

Kopardekar, Parimal H.

2017-01-01

Conduct research, development and testing to identify airspace operations requirements to enable large-scale visual and beyond visual line of sight UAS operations in the low-altitude airspace. Use build-a-little-test-a-little strategy remote areas to urban areas Low density: No traffic management required but understanding of airspace constraints. Cooperative traffic management: Understanding of airspace constraints and other operations. Manned and unmanned traffic management: Scalable and heterogeneous operations. UTM construct consistent with FAAs risk-based strategy. UTM research platform is used for simulations and tests. UTM offers path towards scalability

Care management and nursing governance in a maternity ward: grounded theory.

PubMed

Copelli, Fernanda Hannah da Silva; Oliveira, Roberta Juliane Tono de; Santos, José Luís Guedes Dos; Magalhães, Aline Lima Pestana; Gregório, Vitória Regina Petters; Erdmann, Alacoque Lorenzini

2017-01-01

To understand the care management strategies used by nurses in the governance of nursing practice in a maternity ward. Qualitative study based on grounded theory conducted with 27 participants, partitioned into four sample groups. The data were collected through semi-structured interviews and analyzed through open, axial, and selective coding. The care management strategies used by the nurses were: planning professional practice, leading the nursing team, search for scientific knowledge, and training inthe best practices in obstetric care. Associating care management with nursing governance can foster better care outcomes and strengthen nursing autonomy when coordinating nursing work in maternity wards.

Incentive-compatible demand-side management for smart grids based on review strategies

NASA Astrophysics Data System (ADS)

Xu, Jie; van der Schaar, Mihaela

2015-12-01

Demand-side load management is able to significantly improve the energy efficiency of smart grids. Since the electricity production cost depends on the aggregate energy usage of multiple consumers, an important incentive problem emerges: self-interested consumers want to increase their own utilities by consuming more than the socially optimal amount of energy during peak hours since the increased cost is shared among the entire set of consumers. To incentivize self-interested consumers to take the socially optimal scheduling actions, we design a new class of protocols based on review strategies. These strategies work as follows: first, a review stage takes place in which a statistical test is performed based on the daily prices of the previous billing cycle to determine whether or not the other consumers schedule their electricity loads in a socially optimal way. If the test fails, the consumers trigger a punishment phase in which, for a certain time, they adjust their energy scheduling in such a way that everybody in the consumer set is punished due to an increased price. Using a carefully designed protocol based on such review strategies, consumers then have incentives to take the socially optimal load scheduling to avoid entering this punishment phase. We rigorously characterize the impact of deploying protocols based on review strategies on the system's as well as the users' performance and determine the optimal design (optimal billing cycle, punishment length, etc.) for various smart grid deployment scenarios. Even though this paper considers a simplified smart grid model, our analysis provides important and useful insights for designing incentive-compatible demand-side management schemes based on aggregate energy usage information in a variety of practical scenarios.

Development of UK recommendations on treatment for post-surgical erectile dysfunction

PubMed Central

Kirby, M G; White, I D; Butcher, J; Challacombe, B; Coe, J; Grover, L; Hegarty, P; Jackson, G; Lowndes, A; Payne, H; Rees, J; Sangar, V; Thompson, A

2014-01-01

Aim To develop a management strategy (rehabilitation programme) for postsurgical erectile dysfunction (ED) among men experiencing ED associated with treatment of prostate, bladder or rectal cancer that is suitable for use in a UK NHS healthcare context. Methods PubMed literature searches of ED management together with a survey of 13 experts in the management of ED from across the UK were conducted. Results Data from 37 articles and completed questionnaires were collated. The results discussed in this study demonstrate improved objective and subjective clinical outcomes for physical parameters, sexual satisfaction, and rates of both spontaneous erections and those associated with ED treatment strategies. Conclusion Based on the literature and survey analysis, recommendations are proposed for the standardisation of management strategies employed for postsurgical ED. PMID:24188207

Ten clinician-driven strategies for maximising value of Australian health care.

PubMed

Scott, Ian

2014-05-01

To articulate the concept of high-value care (i.e. clinically relevant, patient-important benefit at lowest possible cost) and suggest strategies by which clinicians can promote such care in rendering the Australian healthcare system more affordable and sustainable. Strategies were developed by the author based on personal experience in clinical practice, evidence-based medicine and quality improvement. Relevant literature was reviewed in retrieving studies supporting each strategy. Ten strategies were developed: (1) minimise errors in diagnosis; (2) discontinue low- or no-value practices that provide little benefit or cause harm; (3) defer the use of unproven interventions; (4) select care options according to comparative cost-effectiveness; (5) target clinical interventions to those who derive greatest benefit; (6) adopt a more conservative approach nearing the end of life; (7) actively involve patients in shared decision making and self-management; (8) minimise day-to-day operational waste; (9) convert healthcare institutions into rapidly learning organisations; and (10) advocate for integrated patient care across all clinical settings. Clinicians and their professional organisations, in partnership with managers, can implement strategies capable of maximising value and sustainability of health care in Australia. What is known about this topic? Value-based care has emerged as a unitary concept that integrates quality and cost, and is being increasingly used to inform healthcare policy making and reform. What does this paper add? There is scant literature that translates the concept of high value care into actionable enhancement strategies for clinicians in everyday practice settings. This article provides 10 strategies with supporting studies in an attempt to fill this gap. What are the implications for practitioners? If all practitioners, in partnership with healthcare managers, attempted to enact all 10 strategies in their workplaces, a significant quantum of healthcare resources could be redirected from low- to high-value care, culminating in much greater health benefit from the healthcare dollars currently being spent. However, such reforms will require a shift in clinician thinking and practice away from volume-based care to value-based care.

Responsibility, Authority, and Accountability in School-Based and Non-School-Based Management: Principals' Coping Strategies

ERIC Educational Resources Information Center

Grinshtain, Yael; Gibton, Dan

2018-01-01

Purpose: The purpose of this paper is to understand how primary school principals in Israel cope with the gaps between authority and responsibility in their work, deriving from partially implemented decentralization processes, and how this relates to school-based management (SBM) and accountability principles. Design/methodology/approach: Using…

Nonstationary decision model for flood risk decision scaling

NASA Astrophysics Data System (ADS)

Spence, Caitlin M.; Brown, Casey M.

2016-11-01

Hydroclimatic stationarity is increasingly questioned as a default assumption in flood risk management (FRM), but successor methods are not yet established. Some potential successors depend on estimates of future flood quantiles, but methods for estimating future design storms are subject to high levels of uncertainty. Here we apply a Nonstationary Decision Model (NDM) to flood risk planning within the decision scaling framework. The NDM combines a nonstationary probability distribution of annual peak flow with optimal selection of flood management alternatives using robustness measures. The NDM incorporates structural and nonstructural FRM interventions and valuation of flows supporting ecosystem services to calculate expected cost of a given FRM strategy. A search for the minimum-cost strategy under incrementally varied representative scenarios extending across the plausible range of flood trend and value of the natural flow regime discovers candidate FRM strategies that are evaluated and compared through a decision scaling analysis (DSA). The DSA selects a management strategy that is optimal or close to optimal across the broadest range of scenarios or across the set of scenarios deemed most likely to occur according to estimates of future flood hazard. We illustrate the decision framework using a stylized example flood management decision based on the Iowa City flood management system, which has experienced recent unprecedented high flow episodes. The DSA indicates a preference for combining infrastructural and nonstructural adaptation measures to manage flood risk and makes clear that options-based approaches cannot be assumed to be "no" or "low regret."

Coping strategies used by poorly adherent patients for self-managing bipolar disorder

PubMed Central

Blixen, Carol; Levin, Jennifer B; Cassidy, Kristin A; Perzynski, Adam T; Sajatovic, Martha

2016-01-01

Background Bipolar disorder (BD) is a chronic mental illness associated with reduced quality of life, high rates of suicide, and high financial costs. Evidence indicates that psychosocial stress might play an important role in the onset and course of BD. Objective The objective of this study was to address the gap between coping theory and the clinical use of coping strategies used to self-manage BD. Methods In-depth interviews were conducted with a sample of 21 poorly adherent patients with BD. All interviews were audiotaped, transcribed verbatim, and analyzed using content analysis with an emphasis on dominant themes. Results Transcript-based analysis generated two major domains of coping strategies used to self-manage BD: 1) problem focused (altering eating habits, managing mood-stabilizing medications, keeping psychiatric appointments, seeking knowledge, self-monitoring, and socializing) and 2) emotion focused (distracting activities, denial, isolation, modifying/avoiding, helping others, and seeking social support). Participants used both types of coping strategies to deal with stressful situations brought about by the internal and external demands associated with self-management of BD. Conclusion This qualitative study provided a first step in evaluating coping strategies as a possible mediator in the self-management of BD and has implications for health care providers. Being able to characterize an individual’s coping behaviors can help patients modify or replace more maladaptive coping with better coping strategies in the self-management of this chronic mental illness. PMID:27524888

Optimal management of fatigue in patients with systemic lupus erythematosus: a systematic review

PubMed Central

Yuen, Hon K; Cunningham, Melissa A

2014-01-01

Among the host of distressing pathophysiological and psychosocial symptoms, fatigue is the most prevalent complaint in patients with systemic lupus erythematosus (SLE). This review is to update the current findings on non-pharmacological, pharmacological, and modality strategies to manage fatigue in patients with SLE and to provide some recommendations on optimal management of fatigue based on the best available evidence. We performed a systematic literature search of the PubMed and Scopus databases to identify publications on fatigue management in patients with SLE. Based on the studies reported in the literature, we identified nine intervention strategies that have the potential to alleviate fatigue in patients with SLE. Of the nine strategies, aerobic exercise and belimumab seem to have the strongest evidence of treatment efficacy. N-acetylcysteine and ultraviolet-A1 phototherapy demonstrated low-to-moderate levels of evidence. Psychosocial interventions, dietary manipulation (low calorie or glycemic index diet) aiming for weight loss, vitamin D supplementation, and acupuncture all had weak evidence. Dehydroepiandrosterone is not recommended due to a lack of evidence for its efficacy. In addition to taking treatment efficacy and side effects into consideration, clinicians should consider factors such as cost of treatment, commitments, and burden to the patient when selecting fatigue management strategies for patients with SLE. Any comorbidities, such as psychological distress, chronic pain, sleep disturbance, obesity, or hypovitaminosis D, associated with fatigue should be addressed. PMID:25328393

Contemporary management and surveillance strategy after shunt or endoscopic third ventriculostomy procedures for hydrocephalus.

PubMed

Janjua, M Burhan; Hoffman, Caitlin E; Souweidane, Mark M

2017-11-01

The management of hydrocephalus can be challenging even in expert hands. Due to acute presentation, recurrence, accompanying complications, the need for urgent diagnosis; a robust management plan is an absolute necessity. We devised a novel time efficient surveillance strategy during emergency, and clinic follow up settings which has never been described in the literature. We searched all articles embracing management/surveillance protocol on pediatric hydrocephalus utilizing the terms "hydrocephalus follow up" or "surveillance protocol after hydrocephalus treatment". The authors present their own strategy based on vast experience in the hydrocephalus management at a single institution. The need for the diagnostic laboratory testing, age and presentation based radiological imaging, significance of neuro-opthalmological exam, and when to consider the emergent exploration have been discussed in detail. Moreover, a definitive triaging strategy has been described with the help of flow chart diagrams for clinicians, and the neurosurgeons in practice. The triage starts from detail history, physical exam, necessary labs, radiological imaging depending on the presentation, and the age of the child. A quick head CT scan helps after shunt surgery while, a FAST sequence MRI scan (fsMRI) is important in post ETV patients. The need for neuro-opthalmological exam, and the shunt series stays vital in asymptomatic patients during regular follow up. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Cognitive Task Analysis of Information Management Strategies in a Computerized Provider Order Entry Environment

PubMed Central

Weir, Charlene R.; Nebeker, Jonathan J.R.; Hicken, Bret L.; Campo, Rebecca; Drews, Frank; LeBar, Beth

2007-01-01

Objective Computerized Provider Order Entry (CPOE) with electronic documentation, and computerized decision support dramatically changes the information environment of the practicing clinician. Prior work patterns based on paper, verbal exchange, and manual methods are replaced with automated, computerized, and potentially less flexible systems. The objective of this study is to explore the information management strategies that clinicians use in the process of adapting to a CPOE system using cognitive task analysis techniques. Design Observation and semi-structured interviews were conducted with 88 primary-care clinicians at 10 Veterans Administration Medical Centers. Measurements Interviews were taped, transcribed, and extensively analyzed to identify key information management goals, strategies, and tasks. Tasks were aggregated into groups, common components across tasks were clarified, and underlying goals and strategies identified. Results Nearly half of the identified tasks were not fully supported by the available technology. Six core components of tasks were identified. Four meta-cognitive information management goals emerged: 1) Relevance Screening; 2) Ensuring Accuracy; 3) Minimizing memory load; and 4) Negotiating Responsibility. Strategies used to support these goals are presented. Conclusion Users develop a wide array of information management strategies that allow them to successfully adapt to new technology. Supporting the ability of users to develop adaptive strategies to support meta-cognitive goals is a key component of a successful system. PMID:17068345

Automatic Processes in Self-Regulation: Implications for Alcohol Interventions

ERIC Educational Resources Information Center

Palfai, Tibor

2004-01-01

A number of learning-based interventions for problem drinking have emphasized the importance of behavioral self-control skills to help manage responses to high-risk cues. Self-management interventions typically have been based on the premise that effective self-regulation involves the use of conscious, controlled strategies to override habitual…

Managing Diversity-Based Conflicts among Children. Fastback 414.

ERIC Educational Resources Information Center

Scott, Charles C.; And Others

This guide is designed to provide assistance in handling complex situational conflicts involving diversity through appropriate conflict management strategies for diverse classrooms at the elementary and middle school levels. Diversity-based conflict is not new in the United States. The classroom is, as it has been historically, one of the major…

Obstetric simulation as a risk control strategy: course design and evaluation.

PubMed

Gardner, Roxane; Walzer, Toni B; Simon, Robert; Raemer, Daniel B

2008-01-01

Patient safety initiatives aimed at reducing medical errors and adverse events are being implemented in Obstetrics. The Controlled Risk Insurance Company (CRICO), Risk Management Foundation (RMF) of the Harvard Medical Institutions pursued simulation as an anesthesia risk control strategy. Encouraged by their success, CRICO/RMF promoted simulation-based team training as a risk control strategy for obstetrical providers. We describe the development, implementation, and evaluation of an obstetric simulation-based team training course grounded in crisis resource management (CRM) principles. We pursued systematic design of course development, implementation, and evaluation in 3 phases, including a 1-year or more posttraining follow-up with self-assessment questionnaires. The course was highly rated overall by participants immediately after the course and 1-year or more after the course. Most survey responders reported having experienced a critical clinical event since the course and that various aspects of their teamwork had significantly or somewhat improved as a result of the course. Most (86%) reported CRM principles as useful for obstetric faculty and most (59%) recommended repeating the simulation course every 2 years. A simulation-based team-training course for obstetric clinicians was developed and is a central component of CRICO/RMF's obstetric risk management incentive program that provides a 10% reduction in annual obstetrical malpractice premiums. The course was highly regarded immediately and 1 year or more after completing the course. Most survey responders reported improved teamwork and communication in managing a critical obstetric event in the interval since taking the course. Simulation-based CRM training can serve as a strategy for mitigating adverse perinatal events.

Comparative Analysis of Cervical Spine Management in a Subset of Severe Traumatic Brain Injury Cases Using Computer Simulation

PubMed Central

Carter, Kimbroe J.; Dunham, C. Michael; Castro, Frank; Erickson, Barbara

2011-01-01

Background No randomized control trial to date has studied the use of cervical spine management strategies in cases of severe traumatic brain injury (TBI) at risk for cervical spine instability solely due to damaged ligaments. A computer algorithm is used to decide between four cervical spine management strategies. A model assumption is that the emergency room evaluation shows no spinal deficit and a computerized tomogram of the cervical spine excludes the possibility of fracture of cervical vertebrae. The study's goal is to determine cervical spine management strategies that maximize brain injury functional survival while minimizing quadriplegia. Methods/Findings The severity of TBI is categorized as unstable, high risk and stable based on intracranial hypertension, hypoxemia, hypotension, early ventilator associated pneumonia, admission Glasgow Coma Scale (GCS) and age. Complications resulting from cervical spine management are simulated using three decision trees. Each case starts with an amount of primary and secondary brain injury and ends as a functional survivor, severely brain injured, quadriplegic or dead. Cervical spine instability is studied with one-way and two-way sensitivity analyses providing rankings of cervical spine management strategies for probabilities of management complications based on QALYs. Early collar removal received more QALYs than the alternative strategies in most arrangements of these comparisons. A limitation of the model is the absence of testing against an independent data set. Conclusions When clinical logic and components of cervical spine management are systematically altered, changes that improve health outcomes are identified. In the absence of controlled clinical studies, the results of this comparative computer assessment show that early collar removal is preferred over a wide range of realistic inputs for this subset of traumatic brain injury. Future research is needed on identifying factors in projecting awakening from coma and the role of delirium in these cases. PMID:21544239

A comparison of integrated river basin management strategies: A global perspective

NASA Astrophysics Data System (ADS)

Zhao, Chunhong; Wang, Pei; Zhang, Guanghong

In order to achieve the integrated river basin management in the arid and rapid developing region, the Heihe River Basin (HRB) in Northwestern China, one of critical river basins were selected as a representative example, while the Murray-Darling Basin (MDB) in Australia and the Colorado River Basin (CRB) in the USA were selected for comparative analysis in this paper. Firstly, the comparable characters and hydrological contexts of these three watersheds were introduced in this paper. Then, based on comparative studies on the river basin challenges in terms of the drought, intensive irrigation, and rapid industrialization, the hydrological background of the MDB, the CRB and the HRB was presented. Subsequently, the river management strategies were compared in three aspects: water allocation, water organizations, and water act and scientific projects. Finally, we proposed recommendations for integrated river basin management for the HRB: (1) Water allocation strategies should be based on laws and markets on the whole basin; (2) Public participation should be stressed by the channels between governance organizations and local communities; (3) Scientific research should be integrated into river management to understand the interactions between the human and nature.

Rule Driven Multi-Objective Management (RDMOM) - An Alternative Form for Describing and Developing Effective Water Resources Management Strategies

NASA Astrophysics Data System (ADS)

Sheer, D. P.

2011-12-01

Economics provides a model for describing human behavior applied to the management of water resources, but that model assumes, among other things, that managers have a way of directly relating immediate actions to long-term economic outcomes. This is rarely the case in water resources problems where uncertainty has significant impacts on the effectiveness of management strategies and where the management objectives are very difficult to commensurate. The difficulty in using economics is even greater in multiparty disputes, where each party has a different relative value for each of the management objectives, and many of the management objectives are shared. A three step approach to collaborative decision making can overcome these difficulties. The first step involves creating science based performance measures and evaluation tools to estimate the effect of alternative management strategies on each of the non-commensurate objectives. The second step involves developing short-term surrogate operating objectives that implicitly deal with all of the aspects of the long term uncertainty. Management that continually "optimizes" the short-term objectives subject to physical and other constraints that change through time can be characterized as Rule Driven Multi-Objective Management (RDMOM). RDMOM strategies are then tested in simulation models to provide the basis for evaluating performance measures. Participants in the collaborative process then engage in multiparty discussions that create new alternatives, and "barter" a deal. RDMOM does not assume that managers fully understand the link between current actions and long term goals. Rather, it assumes that managers operate to achieve short-term surrogate objectives which they believe will achieve an appropriate balance of both short and long-term incommensurable benefits. A reservoir rule curve is a simple, but often not particularly effective, example of the real-world implementation of RDMOM. Water managers find they can easily describe and explain their written and unwritten protocols using the RDMOM, and that the use of short-term surrogates is both intellectually appealing and pragmatic. The identification of operating targets as short-term surrogates leads naturally to a critical discussion of long-term objectives, and to the development of performance measures for the long-term objectives. The transparency and practical feasibility RDMOM based strategies is often crucial to the success of collaborative efforts. Complex disputes in the Delaware and Susquehanna Basins, the Everglades and Lower East Coast South Florida, Southern Nevada, Washington DC and many others have been resolved using RDMOM strategies.

[Research on the Clinical Alarm Management Mechanism Based on Closed-loop Control Theory].

PubMed

Lin, Zhongkuan; Zheng, Kun; Shen, Yunming; Wu, Yunyun

2018-05-30

This paper proposes a clinical alarm management system based on the theory of the closed loop control. The alarm management mechanism can be divided into the expected standard, improving execution rule, rule execution, medical devices with alarm functions, results analysis strategy and the output link. And, we make relevant application and discussion. Results showed that the mechanism can be operable and effective.

Engineering youth service system infrastructure: Hawaii's continued efforts at large-scale implementation through knowledge management strategies.

PubMed

Nakamura, Brad J; Mueller, Charles W; Higa-McMillan, Charmaine; Okamura, Kelsie H; Chang, Jaime P; Slavin, Lesley; Shimabukuro, Scott

2014-01-01

Hawaii's Child and Adolescent Mental Health Division provides a unique illustration of a youth public mental health system with a long and successful history of large-scale quality improvement initiatives. Many advances are linked to flexibly organizing and applying knowledge gained from the scientific literature and move beyond installing a limited number of brand-named treatment approaches that might be directly relevant only to a small handful of system youth. This article takes a knowledge-to-action perspective and outlines five knowledge management strategies currently under way in Hawaii. Each strategy represents one component of a larger coordinated effort at engineering a service system focused on delivering both brand-named treatment approaches and complimentary strategies informed by the evidence base. The five knowledge management examples are (a) a set of modular-based professional training activities for currently practicing therapists, (b) an outreach initiative for supporting youth evidence-based practices training at Hawaii's mental health-related professional programs, (c) an effort to increase consumer knowledge of and demand for youth evidence-based practices, (d) a practice and progress agency performance feedback system, and (e) a sampling of system-level research studies focused on understanding treatment as usual. We end by outlining a small set of lessons learned and a longer term vision for embedding these efforts into the system's infrastructure.

The management of cytotoxic chemotherapy extravasation: a systematic review of the literature to evaluate the evidence underpinning contemporary practice.

PubMed

Harrold, K; Gould, D; Drey, N

2015-11-01

Management of cytotoxic drug extravasation remains contentious, with differing views on the most effective management strategy. With the increasing drive to provide effective, evidence-based healthcare, while ensuring the patient experience of the treatment provided plays a significant part in the development of clinical practice guidelines, the purpose of this literature review was to both critically analyse the quality of evidence that underpins contemporary practice and to determine if the patient experience is taken into account. A literature search was undertaken sourcing publications from the 1960s to July 2014 identifying all studies detailing strategies aimed at preventing the need for surgical debridement and all studies evaluating extravasation management from the patient's perspective. No conclusive evidence was found to suggest one clinical strategy as more effective than the other. No studies were identified that evaluated outcome from the patient's perspective. It is therefore suggested that outcomes-based research should underpin contemporary extravasation management guidelines to determine what the final outcome or 'end result' is and how this impacts on the patient and that the current lack of research into the patient experience of extravasation management is an area that needs to be addressed. © 2015 John Wiley & Sons Ltd.

[Evaluation of the family focus and community orientation in the Family Health Strategy].

PubMed

Alencar, Monyk Neves de; Coimbra, Liberata Campos; Morais, Ana Patrícia Pereira; Silva, Antônio Augusto Moura da; Pinheiro, Siane Rocha de Almeida; Queiroz, Rejane Christine de Sousa

2014-02-01

The Family Health Strategy should be focused on the family unit and constructed operationally within the community sphere. The research assessed the family focus and community orientation as attributes of Primary Health Care, comparing if the responses differed among users, professionals and managers. It is an evaluative study of a population-based quantitative approach conducted between January 2010 and March 2011 in São Luís in the state of Maranhão. The study involved a population of 32 managers and 80 professionals with more than six months experience in the Family Health Strategy, and 883 users were selected by means of cluster sampling. Questionnaires validated in Brazil were used based on the components of the Primary Care Assessment Tool (PCATool). The composite index of the family focus was 2.7 for users, 4.9 for professionals and 5.3 for managers. In the posttest phase, differences were detected between users and professionals, and users and managers. The composite index of community orientation was 2.9 for users, 3.9 for professionals and 4.8 for managers (p < 0.001). Managers attributed higher percentages in all indicators, followed by professionals and lastly users. Both attributes were rated as being unsatisfactory in the perception of the users.

77 FR 65364 - Mid-Atlantic Fishery Management Council (MAFMC); Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-26

... Economic Impact, Governance and Regulatory Process goals, objectives and strategies initially drafted on... and threats on science and data and ecosystem based fishery management. No formal actions will be...

Integrated Watershed Management using the Watershed Management Optimization Support Tool (WMOST)

EPA Science Inventory

Integrated watershed management is an effective planning strategy to balance tradeoffs between competing water uses within a watershed. WMOST is an Excel-based decision tool to aid planners in making cost effective decisions that meet water quantity and quality regulations. WMOST...

A novel multimode hybrid energy storage system and its energy management strategy for electric vehicles

NASA Astrophysics Data System (ADS)

Wang, Bin; Xu, Jun; Cao, Binggang; Zhou, Xuan

2015-05-01

This paper proposes a novel topology of multimode hybrid energy storage system (HESS) and its energy management strategy for electric vehicles (EVs). Compared to the conventional HESS, the proposed multimode HESS has more operating modes and thus it could in further enhance the efficiency of the system. The rule-based control strategy and the power-balancing strategy are developed for the energy management strategy to realize mode selection and power distribution. Generally, the DC-DC converter will operate at peak efficiency to convey the energy from the batteries to the UCs. Otherwise, the pure battery mode or the pure ultracapacitors (UCs) mode will be utilized without the DC-DC converter. To extend the battery life, the UCs have the highest priority to recycle the energy and the batteries are isolated from being recharged directly during regenerative braking. Simulations and experiments are established to validate the proposed multimode HESS and its energy management strategy. The results reveal that the energy losses in the DC-DC converter, the total energy consumption and the overall system efficiency of the proposed multimode HESS are improved compared to the conventional HESS.

Evidence-Based Nonpharmacologic Strategies for Comprehensive Pain Care: the Consortium Pain Task Force White Paper.

PubMed

Tick, Heather; Nielsen, Arya; Pelletier, Kenneth R; Bonakdar, Robert; Simmons, Samantha; Glick, Ronald; Ratner, Emily; Lemmon, Russell L; Wayne, Peter; Zador, Veronica

2018-03-01

Consortium Pain Taskforce White Paper Summary Evidence-based Nonpharmacologic Strategies for Comprehensive Pain Care Supplementary information can be found in the online version at https://doi.org/10.1016/j.explore.2018.02.001. Medical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care have prompted action from state and federal agencies including the DOD, VHA, NIH, FDA and CDC. There is pressure for pain medicine to shift away from reliance on opioids, ineffective procedures and surgeries toward comprehensive pain management that includes evidence-based nonpharmacologic options. This White Paper details the historical context and magnitude of the current pain problem including individual, social and economic impacts as well as the challenges of pain management for patients and a healthcare workforce engaging prevalent strategies not entirely based in current evidence. Detailed here is the evidence-base for nonpharmacologic therapies effective in postsurgical pain with opioid sparing, acute non-surgical pain, cancer pain and chronic pain. Therapies reviewed include acupuncture therapy, massage therapy, osteopathic and chiropractic manipulation, meditative movement therapies Tai chi and yoga, mind body behavioral interventions, dietary components and self-care/self-efficacy strategies. Transforming the system of pain care to a responsive comprehensive model necessitates that options for treatment and collaborative care must be evidence-based and include effective nonpharmacologic strategies that have the advantage of reduced risks of adverse events and addiction liability. The evidence demands a call to action to increase awareness of effective nonpharmacologic treatments for pain, to train healthcare practitioners and administrators in the evidence base of effective nonpharmacologic practice, to advocate for policy initiatives that remedy system and reimbursement barriers to evidence-informed comprehensive pain care, and to promote ongoing research and dissemination of the role of effective nonpharmacologic treatments in pain, focused on the short- and long-term therapeutic and economic impact of comprehensive care practices. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

The design and implementation of hydrographical information management system (HIMS)

NASA Astrophysics Data System (ADS)

Sui, Haigang; Hua, Li; Wang, Qi; Zhang, Anming

2005-10-01

With the development of hydrographical work and information techniques, the large variety of hydrographical information including electronic charts, documents and other materials are widely used, and the traditional management mode and techniques are unsuitable for the development of the Chinese Marine Safety Administration Bureau (CMSAB). How to manage all kinds of hydrographical information has become an important and urgent problem. A lot of advanced techniques including GIS, RS, spatial database management and VR techniques are introduced for solving these problems. Some design principles and key techniques of the HIMS including the mixed mode base on B/S, C/S and stand-alone computer mode, multi-source & multi-scale data organization and management, multi-source data integration and diverse visualization of digital chart, efficient security control strategies are illustrated in detail. Based on the above ideas and strategies, an integrated system named Hydrographical Information Management System (HIMS) was developed. And the HIMS has been applied in the Shanghai Marine Safety Administration Bureau and obtained good evaluation.

Developing management strategies for riparian areas.

Treesearch

D.E. Hibbs; S. Chan

2001-01-01

This talk outlines four principles that are critical to successful management of a riparian area. First, given problems both with defining historic conditions and with returning to them, attaining management goals based on restoration of ecological processes and functions will be far more successful. Second, the management goals for any stream reach must be placed in a...

Risk preferences, probability weighting, and strategy tradeoffs in wildfire management

Treesearch

Michael S. Hand; Matthew J. Wibbenmeyer; Dave Calkin; Matthew P. Thompson

2015-01-01

Wildfires present a complex applied risk management environment, but relatively little attention has been paid to behavioral and cognitive responses to risk among public agency wildfire managers. This study investigates responses to risk, including probability weighting and risk aversion, in a wildfire management context using a survey-based experiment administered to...

Health Care Leadership: Managing Knowledge Bases as Stakeholders.

PubMed

Rotarius, Timothy

Communities are composed of many organizations. These organizations naturally form clusters based on common patterns of knowledge, skills, and abilities of the individual organizations. Each of these spontaneous clusters represents a distinct knowledge base. The health care knowledge base is shown to be the natural leader of any community. Using the Central Florida region's 5 knowledge bases as an example, each knowledge base is categorized as a distinct type of stakeholder, and then a specific stakeholder management strategy is discussed to facilitate managing both the cooperative potential and the threatening potential of each "knowledge base" stakeholder.

Will the right Robin patient rise, please? Definitions and criteria during management of Robin sequence patients in the Netherlands and Belgium.

PubMed

Basart, Hanneke; Kruisinga, Frea H; Breugem, Corstiaan C; Don Griot, J Peter W; Hennekam, Raoul C; Van der Horst, Chantal M A M

2015-01-01

Robin Sequence (RS) is characterized by micrognathia and upper airway obstruction (UAO), with or without cleft palate, causing respiratory and feeding problems. Management options are: positioning; nasopharyngeal airway (NPA); tongue-lip adhesion (TLA); mandibular distraction (MDO); and tracheostomy. Controversy exists in literature regarding RS definition and management. Here we describe definitions, management strategies and criteria in opting for management strategies, used by Dutch and Belgian cleft teams. A specifically designed questionnaire was sent to members of all 16 Dutch and Belgian cleft teams. 14 cleft teams returned 35 questionnaires. All used micrognathia as definition criterion, 93.4% cleft palate, 51.5%glossoptosis and 45.7% UAO. Six different RS definitions were used; even within a single team >1 definition was used. All teams used different management strategies: all used positioning, 10 NPA, 6 TLA, 7 MDO, 8 tracheostomy, 5 refer patients with invasive treatment indication. Criteria in opting management modalities were: O2-saturation (89.3%), clinical presentation (86.2%), growth and feeding problems (69.0%), polysomnography (62.1%), and differed within teams. The Dutch and Belgian cleft teams use variable RS definitions, different management modalities and criteria in choosing management strategies. A single, strict definition and evidence-based management guidelines should be formulated for optimal patient care. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Integrative review on the non-invasive management of lower urinary tract symptoms in men following treatments for pelvic malignancies.

PubMed

Faithfull, S; Lemanska, A; Aslet, P; Bhatt, N; Coe, J; Drudge-Coates, L; Feneley, M; Glynn-Jones, R; Kirby, M; Langley, S; McNicholas, T; Newman, J; Smith, C C; Sahai, A; Trueman, E; Payne, H

2015-10-01

To develop a non-invasive management strategy for men with lower urinary tract symptoms (LUTS) after treatment for pelvic cancer, that is suitable for use in a primary healthcare context. PubMed literature searches of LUTS management in this patient group were carried out, together with obtaining a consensus of management strategies from a panel of authors for the management of LUTS from across the UK. Data from 41 articles were investigated and collated. Clinical experience was sought from authors where there was no clinical evidence. The findings discussed in this paper confirm that LUTS after the cancer treatment can significantly impair men's quality of life. While many men recover from LUTS spontaneously over time, a significant proportion require long-term management. Despite the prevalence of LUTS, there is a lack of consensus on best management. This article offers a comprehensive treatment algorithm to manage patients with LUTS following pelvic cancer treatment. Based on published research literature and clinical experience, recommendations are proposed for the standardisation of management strategies employed for men with LUTS after the pelvic cancer treatment. In addition to implementing the algorithm, understanding the rationale for the type and timing of LUTS management strategies is crucial for clinicians and patients. © 2015 The Authors. International Journal of Clinical Practice Published by John Wiley & Sons Ltd.

Learning to manage complexity through simulation: students' challenges and possible strategies.

PubMed

Gormley, Gerard J; Fenwick, Tara

2016-06-01

Many have called for medical students to learn how to manage complexity in healthcare. This study examines the nuances of students' challenges in coping with a complex simulation learning activity, using concepts from complexity theory, and suggests strategies to help them better understand and manage complexity.Wearing video glasses, participants took part in a simulation ward-based exercise that incorporated characteristics of complexity. Video footage was used to elicit interviews, which were transcribed. Using complexity theory as a theoretical lens, an iterative approach was taken to identify the challenges that participants faced and possible coping strategies using both interview transcripts and video footage.Students' challenges in coping with clinical complexity included being: a) unprepared for 'diving in', b) caught in an escalating system, c) captured by the patient, and d) unable to assert boundaries of acceptable practice.Many characteristics of complexity can be recreated in a ward-based simulation learning activity, affording learners an embodied and immersive experience of these complexity challenges. Possible strategies for managing complexity themes include: a) taking time to size up the system, b) attuning to what emerges, c) reducing complexity, d) boundary practices, and e) working with uncertainty. This study signals pedagogical opportunities for recognizing and dealing with complexity.

A dynamic replication management strategy in distributed GIS

NASA Astrophysics Data System (ADS)

Pan, Shaoming; Xiong, Lian; Xu, Zhengquan; Chong, Yanwen; Meng, Qingxiang

2018-03-01

Replication strategy is one of effective solutions to meet the requirement of service response time by preparing data in advance to avoid the delay of reading data from disks. This paper presents a brand-new method to create copies considering the selection of replicas set, the number of copies for each replica and the placement strategy of all copies. First, the popularities of all data are computed considering both the historical access records and the timeliness of the records. Then, replica set can be selected based on their recent popularities. Also, an enhanced Q-value scheme is proposed to assign the number of copies for each replica. Finally, a reasonable copies placement strategy is designed to meet the requirement of load balance. In addition, we present several experiments that compare the proposed method with techniques that use other replication management strategies. The results show that the proposed model has better performance than other algorithms in all respects. Moreover, the experiments based on different parameters also demonstrated the effectiveness and adaptability of the proposed algorithm.

Environmental strategy and performance in small firms: a resource-based perspective.

PubMed

Aragón-Correa, J Alberto; Hurtado-Torres, Nuria; Sharma, Sanjay; García-Morales, Víctor J

2008-01-01

In spite of the widespread recognition of the important roles that small and medium sized enterprises (SMEs) play in most economies, limited research has focused on their impacts on the natural environment and the strategies such enterprises adopt to reduce these impacts. It is usually assumed that SMEs lack the resources to implement proactive environmental strategies that go beyond minimum regulatory compliance. In this study of 108 SMEs in the automotive repair sector in Southern Spain, we found that SMEs undertake a range of environmental strategies from reactive regulatory compliance to proactive pollution prevention and environmental leadership. These strategies are associated with three organizational capabilities: shared vision, stakeholder management, and strategic proactivity, hypothesized based on the unique strategic characteristics of SMEs--shorter lines of communication and closer interaction within the SMEs, the presence of a founder's vision, flexibility in managing external relationships, and an entrepreneurial orientation. We also found that firms with the most proactive practices exhibited a significantly positive financial performance.

UTM Safely Enabling UAS Operations in Low-Altitude Airspace

NASA Technical Reports Server (NTRS)

Kopardekar, Parimal

2017-01-01

Conduct research, development and testing to identify airspace operations requirements to enable large-scale visual and beyond visual line of sight UAS operations in the low-altitude airspace. Use build-a-little-test-a-little strategy remote areas to urban areas Low density: No traffic management required but understanding of airspace constraints. Cooperative traffic management: Understanding of airspace constraints and other operations. Manned and unmanned traffic management: Scalable and heterogeneous operations. UTM construct consistent with FAAs risk-based strategy. UTM research platform is used for simulations and tests. UTM offers path towards scalability.

UTM Safely Enabling UAS Operations in Low-Altitude Airspace

NASA Technical Reports Server (NTRS)

Kopardekar, Parimal H.

2016-01-01

Conduct research, development and testing to identify airspace operations requirements to enable large-scale visual and beyond visual line of sight UAS operations in the low-altitude airspace. Use build-a-little-test-a-little strategy remote areas to urban areas Low density: No traffic management required but understanding of airspace constraints. Cooperative traffic management: Understanding of airspace constraints and other operations. Manned and unmanned traffic management: Scalable and heterogeneous operations. UTM construct consistent with FAAs risk-based strategy. UTM research platform is used for simulations and tests. UTM offers path towards scalability.

Applying risk management strategies to strengthen an IDS's investment policy.

PubMed

Fine, R P

1998-11-01

The increased financial risk that not-for-profit integrated delivery systems have assumed to function under managed care has required them to become increasingly reliant on income and gains from their investment portfolios. This reliance underscores the need for these organizations to take steps to effectively manage their investment risk. Not-for-profit IDSs should establish a systematic approach to investment risk management that is based on maintaining a sound fiduciary infrastructure and having a clear understanding of risk exposures, the most important of which are policy and market risk. Applying reasonable and common-sense risk management strategies to investment policy will enhance an IDS's overall financial and competitive strength.

Hypercompetitive Environments: An Agent-based model approach

NASA Astrophysics Data System (ADS)

Dias, Manuel; Araújo, Tanya

Information technology (IT) environments are characterized by complex changes and rapid evolution. Globalization and the spread of technological innovation have increased the need for new strategic information resources, both from individual firms and management environments. Improvements in multidisciplinary methods and, particularly, the availability of powerful computational tools, are giving researchers an increasing opportunity to investigate management environments in their true complex nature. The adoption of a complex systems approach allows for modeling business strategies from a bottom-up perspective — understood as resulting from repeated and local interaction of economic agents — without disregarding the consequences of the business strategies themselves to individual behavior of enterprises, emergence of interaction patterns between firms and management environments. Agent-based models are at the leading approach of this attempt.

Making it local: Beacon Communities use health information technology to optimize care management.

PubMed

Allen, Amy; Des Jardins, Terrisca R; Heider, Arvela; Kanger, Chatrian R; Lobach, David F; McWilliams, Lee; Polello, Jennifer M; Rein, Alison L; Schachter, Abigail A; Singh, Ranjit; Sorondo, Barbara; Tulikangas, Megan C; Turske, Scott A

2014-06-01

Care management aims to provide cost-effective, coordinated, non-duplicative care to improve care quality, population health, and reduce costs. The 17 communities receiving funding from the Office of the National Coordinator for Health Information Technology through the Beacon Community Cooperative Agreement Program are leaders in building and strengthening their health information technology (health IT) infrastructure to provide more effective and efficient care management. This article profiles 6 Beacon Communities' health IT-enabled care management programs, highlighting the influence of local context on program strategy and design, and describing challenges, lessons learned, and policy implications for care delivery and payment reform. The unique needs (eg, disease burden, demographics), community partnerships, and existing resources and infrastructure all exerted significant influence on the overall priorities and design of each community's care management program. Though each Beacon Community needed to engage in a similar set of care management tasks--including patient identification, stratification, and prioritization; intervention; patient engagement; and evaluation--the contextual factors helped shape the specific strategies and tools used to carry out these tasks and achieve their objectives. Although providers across the country are striving to deliver standardized, high-quality care, the diverse contexts in which this care is delivered significantly influence the priorities, strategies, and design of community-based care management interventions. Gaps and challenges in implementing effective community-based care management programs include: optimizing allocation of care management services; lack of available technology tailored to care management needs; lack of standards and interoperability; integrating care management into care settings; evaluating impact; and funding and sustainability.

Operation management of daily economic dispatch using novel hybrid particle swarm optimization and gravitational search algorithm with hybrid mutation strategy

NASA Astrophysics Data System (ADS)

Wang, Yan; Huang, Song; Ji, Zhicheng

2017-07-01

This paper presents a hybrid particle swarm optimization and gravitational search algorithm based on hybrid mutation strategy (HGSAPSO-M) to optimize economic dispatch (ED) including distributed generations (DGs) considering market-based energy pricing. A daily ED model was formulated and a hybrid mutation strategy was adopted in HGSAPSO-M. The hybrid mutation strategy includes two mutation operators, chaotic mutation, Gaussian mutation. The proposed algorithm was tested on IEEE-33 bus and results show that the approach is effective for this problem.

Non-Native Speaker Interaction Management Strategies in a Network-Based Virtual Environment

ERIC Educational Resources Information Center

Peterson, Mark

2008-01-01

This article investigates the dyad-based communication of two groups of non-native speakers (NNSs) of English involved in real time interaction in a type of text-based computer-mediated communication (CMC) tool known as a MOO. The object of this semester long study was to examine the ways in which the subjects managed their L2 interaction during…

A goal management intervention for polyarthritis patients: rationale and design of a randomized controlled trial

PubMed Central

2013-01-01

Background A health promotion intervention was developed for inflammatory arthritis patients, based on goal management. Elevated levels of depression and anxiety symptoms, which indicate maladjustment, are found in such patients. Other indicators of adaptation to chronic disease are positive affect, purpose in life and social participation. The new intervention focuses on to improving adaptation by increasing psychological and social well-being and decreasing symptoms of affective disorders. Content includes how patients can cope with activities and life goals that are threatened or have become impossible to attain due to arthritis. The four goal management strategies used are: goal maintenance, goal adjustment, goal disengagement and reengagement. Ability to use various goal management strategies, coping versatility and self-efficacy are hypothesized to mediate the intervention’s effect on primary and secondary outcomes. The primary outcome is depressive symptoms. Secondary outcomes are anxiety symptoms, positive affect, purpose in life, social participation, pain, fatigue and physical functioning. A cost-effectiveness analysis and stakeholders’ analysis are planned. Methods/design The protocol-based psycho-educational program consists of six group-based meetings and homework assignments, led by a trained nurse. Participants are introduced to goal management strategies and learn to use these strategies to cope with threatened personal goals. Four general hospitals participate in a randomized controlled trial with one intervention group and a waiting list control condition. Discussion The purpose of this study is to evaluate the effectiveness of a goal management intervention. The study has a holistic focus as both the absence of psychological distress and presence of well-being are assessed. In the intervention, applicable goal management competencies are learned that assist people in their choice of behaviors to sustain and enhance their quality of life. Trial registration Nederlands Trial Register = NTR3606, registration date 11-09-2012. PMID:23941633

Proactive and Early Aggressive Wound Management: A Shift in Strategy Developed by a Consensus Panel Examining the Current Science, Prevention, and Management of Acute and Chronic Wounds.

PubMed

Bohn, Gregory A; Schultz, Gregory S; Liden, Brock A; Desvigne, Michael N; Lullove, Eric J; Zilberman, Igor; Regan, Mary B; Ostler, Marta; Edwards, Karen; Arvanitis, Georgia M; Hartman, Jodi F

2017-11-01

Normal wound healing is accomplished through a series of well-coordinated, progressive events with overlapping phases. Chronic wounds are described as not progressing to healing or not being responsive to management in a timely manner. A consensus panel of multidisciplinary wound care professionals was assembled to (1) educate wound care practitioners by identifying key principles of the basic science of chronic wound pathophysiology, highlighting the impact of metalloproteinases and biofilms, as well as the role of the extracellular matrix; and (2) equip practitioners with a systematic strategy for the prevention and healing of acute injuries and chronic wounds based upon scientific evidence and the panel members' expertise. An algorithm is presented that represents a shift in strategy to proactive and early aggressive wound management. With proactive management, adjunct therapies are applied preemptively to acute injuries to reduce wound duration and risk of chronicity. For existing chronic wounds, early aggressive wound management is employed to break the pathophysiology cycle and drive wounds toward healing. Reducing bioburden through debridement and bioburden management and using collagen dressings to balance protease activity prior to the use of advanced modalities may enhance their effectiveness. This early aggressive wound management strategy is recommended for patients at high risk for chronic wound development at a minimum. In their own practices, the panel members apply this systematic strategy for all patients presenting with acute injuries or chronic wounds.

Parent Attitudes Toward Pain Management for Childhood Immunizations.

PubMed

Connelly, Mark; Wallace, Dustin P; Williams, Kristi; Parker, JoLynn; Schurman, Jennifer V

2016-08-01

Evidence-based pain-limiting strategies for pediatric immunizations remain underutilized, with barriers identified to date mostly pertaining to health care providers and systems of care. The present study sought to quantify and investigate parent attitudes toward pain management as another potential barrier to the routine use of pain-mitigating strategies during immunizations. Questionnaires measuring parent attitudes, willingness to pay, and perceived barriers for using pain management for immunizations were completed by 259 parent/guardians of children ages 0 to 5 years attending appointments at an urban primary care clinic in the Midwestern United States. Parent attitudes toward pain management for immunization were relatively normally distributed and varied from strongly positive to negative, with 33% of parents disagreeing that they were concerned about the pain their child may experience and 50% agreeing that there are no lasting negative effects from immunization pain. Negative parent attitudes were associated with willingness to spend less in money or time for pain management and with greater perceived significance of cost, time, and other barriers for using pain-mitigating strategies. Some parents perceive limited value in trying to reduce pain during immunizations such that they may be hesitant to invest much time or effort in interventions. Greater success of translating evidence-based pain management into practice therefore may require accounting for differences in parent attitudes by tailoring educational efforts and pain management options accordingly.

Power-balancing instantaneous optimization energy management for a novel series-parallel hybrid electric bus

NASA Astrophysics Data System (ADS)

Sun, Dongye; Lin, Xinyou; Qin, Datong; Deng, Tao

2012-11-01

Energy management(EM) is a core technique of hybrid electric bus(HEB) in order to advance fuel economy performance optimization and is unique for the corresponding configuration. There are existing algorithms of control strategy seldom take battery power management into account with international combustion engine power management. In this paper, a type of power-balancing instantaneous optimization(PBIO) energy management control strategy is proposed for a novel series-parallel hybrid electric bus. According to the characteristic of the novel series-parallel architecture, the switching boundary condition between series and parallel mode as well as the control rules of the power-balancing strategy are developed. The equivalent fuel model of battery is implemented and combined with the fuel of engine to constitute the objective function which is to minimize the fuel consumption at each sampled time and to coordinate the power distribution in real-time between the engine and battery. To validate the proposed strategy effective and reasonable, a forward model is built based on Matlab/Simulink for the simulation and the dSPACE autobox is applied to act as a controller for hardware in-the-loop integrated with bench test. Both the results of simulation and hardware-in-the-loop demonstrate that the proposed strategy not only enable to sustain the battery SOC within its operational range and keep the engine operation point locating the peak efficiency region, but also the fuel economy of series-parallel hybrid electric bus(SPHEB) dramatically advanced up to 30.73% via comparing with the prototype bus and a similar improvement for PBIO strategy relative to rule-based strategy, the reduction of fuel consumption is up to 12.38%. The proposed research ensures the algorithm of PBIO is real-time applicability, improves the efficiency of SPHEB system, as well as suite to complicated configuration perfectly.

Development, implementation, and evaluation of a mental rehearsal strategy to improve clinical performance and reduce stress: A mixed methods study.

PubMed

Ignacio, Jeanette; Dolmans, Diana; Scherpbier, Albert; Rethans, Jan-Joost; Lopez, Violeta; Liaw, Sok Ying

2016-02-01

Mental rehearsal is a form of mental training that has been used by physicians and nurses to improve performance of clinical skills, and as a vital component of stress management training. To help novice nurses deal with often stressful clinical events that require the processing of information essential to patient management, a mental rehearsal strategy was developed and implemented in a Year 3 nursing simulation program. Inherent to mental rehearsal is imagery, which facilitates cognitive and affective modification, and reduction of extraneous cognitive load. As such, it was expected that the mental rehearsal strategy would improve students' performance and reduce stress in managing deteriorating patients. The study used a mixed methods design. Eighteen Year 3 nursing students participated in the pre- and post-design study, which consisted of the development and implementation of a mental rehearsal strategy. The Rescuing A Patient In Deteriorating Situations (RAPIDS) tool was used to assess performance. Heart rates and systolic blood pressures were used to measure stress. The State-Trait Anxiety Inventory (STAI) was used as a psychological measure of stress/anxiety. Five participants were involved in a focus group discussion that evaluated the usefulness of the mental rehearsal strategy. There was a significant improvement in performance (P<0.05). However, post-test heart rate and systolic blood pressure were not significantly different from pre-test measures. A comparison of STAI results did not show significant differences between pre- and post-test state anxiety and pre- and post-test trait anxiety. Three themes emerged from the focus group interview: managing stress, using a mental framework, and integrating realistic simulations with the mental rehearsal strategy. The mental rehearsal strategy for deteriorating patient management can be valuable based on the findings on performance and based on the participants' feedback. Its role in reducing stress, however, needs further evaluation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Global Education and Local School Change.

ERIC Educational Resources Information Center

Otero, George

1983-01-01

Change strategies that focus on improving local schools' abilities to manage change are described, and examples of how the strategies can be applied to help the schools prepare students for life in a global society are furnished. Specific strategies are based on the work of Las Palomas de Taos, an agency promoting change in the Southwest. (PP)

Software reliability through fault-avoidance and fault-tolerance

NASA Technical Reports Server (NTRS)

Vouk, Mladen A.; Mcallister, David F.

1993-01-01

Strategies and tools for the testing, risk assessment and risk control of dependable software-based systems were developed. Part of this project consists of studies to enable the transfer of technology to industry, for example the risk management techniques for safety-concious systems. Theoretical investigations of Boolean and Relational Operator (BRO) testing strategy were conducted for condition-based testing. The Basic Graph Generation and Analysis tool (BGG) was extended to fully incorporate several variants of the BRO metric. Single- and multi-phase risk, coverage and time-based models are being developed to provide additional theoretical and empirical basis for estimation of the reliability and availability of large, highly dependable software. A model for software process and risk management was developed. The use of cause-effect graphing for software specification and validation was investigated. Lastly, advanced software fault-tolerance models were studied to provide alternatives and improvements in situations where simple software fault-tolerance strategies break down.

Risk-based management of invading plant disease.

PubMed

Hyatt-Twynam, Samuel R; Parnell, Stephen; Stutt, Richard O J H; Gottwald, Tim R; Gilligan, Christopher A; Cunniffe, Nik J

2017-05-01

Effective control of plant disease remains a key challenge. Eradication attempts often involve removal of host plants within a certain radius of detection, targeting asymptomatic infection. Here we develop and test potentially more effective, epidemiologically motivated, control strategies, using a mathematical model previously fitted to the spread of citrus canker in Florida. We test risk-based control, which preferentially removes hosts expected to cause a high number of infections in the remaining host population. Removals then depend on past patterns of pathogen spread and host removal, which might be nontransparent to affected stakeholders. This motivates a variable radius strategy, which approximates risk-based control via removal radii that vary by location, but which are fixed in advance of any epidemic. Risk-based control outperforms variable radius control, which in turn outperforms constant radius removal. This result is robust to changes in disease spread parameters and initial patterns of susceptible host plants. However, efficiency degrades if epidemiological parameters are incorrectly characterised. Risk-based control including additional epidemiology can be used to improve disease management, but it requires good prior knowledge for optimal performance. This focuses attention on gaining maximal information from past epidemics, on understanding model transferability between locations and on adaptive management strategies that change over time. © 2017 The Authors. New Phytologist © 2017 New Phytologist Trust.

Improving cost-effectiveness of and outcomes from drug therapy in patients with atrial fibrillation in managed care: role of the pharmacist.

PubMed

Johnson, Samuel G

2009-08-01

The medical care costs for procedures, medications, and testing associated with atrial fibrillation (AF) in the United States are high and projected to increase markedly in the future as the number of Americans affected grows. The burden on patient quality of life, the health care system, and society are pharmacoeconomic considerations in managing AF. To identify key pharmacoeconomic considerations in managing AF and describe ways in which managed care pharmacists can improve the cost-effectiveness of and outcomes from drug therapy for AF. The high medical care costs of AF are largely the result of the high cost of hospitalization and inpatient procedures. Recurrence of AF dramatically increases costs, especially for hospital care. Managed care pharmacists have many opportunities to provide cost-effective care to and improve outcomes in patients with AF. Policy and process review, population management, and case management are key strategies for improving outcomes in patients with AF. Pharmacist input into policy and process review, including pharmacy benefits design, formulary management, and the use of information technology, can help ensure that the use of drug therapy for AF is cost-effective. Population management strategies, such as development of clinical pathways and patient registries, seek to improve the quality, consistency, and cost-effectiveness of care and the likelihood that desired therapeutic outcomes are achieved through targeted interventions. Case management strategies focus on longitudinal care for individuals in order to improve quality. Pharmacist-managed anticoagulation services and antiarrhythmic drug monitoring are the 2 most widely known case management strategies for patients with AF. Managed care pharmacists can screen patients with AF for the use of anticoagulation, which is needed to prevent embolic stroke but is under-used, even though recommended by evidence-based guidelines. The clinical efficacy and cost-effectiveness of pharmacist-managed anticoagulation services for patients with AF are well documented. Pharmacist-managed antiarrhythmic drug monitoring is a less well-known case management strategy that facilitates early detection and intervention to minimize toxicity. Managed care pharmacists can play an instrumental role in implementing strategies to improve the cost-effectiveness of and outcomes from drug therapy for AF.

Managing Liability. Employment Discrimination: A Risk Management Strategy.

ERIC Educational Resources Information Center

McMullan, Sandra H.

This booklet discusses the risks that educational institutions face in regard to employment discrimination litigation and outlines a program to effectively manage such risks. Institutions need to address three main types of employment discrimination issues: sexual harassment, disability-based discrimination, and age discrimination. To deal with…

Managing for forage and grazingland resilience to maintain enterprise resilience in the Northern Great Plains of the US

USDA-ARS?s Scientific Manuscript database

Maintaining grazingland and enterprise resilience under changing climatic and economic conditions requires novel, resilience based, management strategies. State and Transition models provide a solid foundation and framework for management of grazinglands using non-equilibrium dynamics. These models ...

Knowledge management: an application to wildfire prevention planning

Treesearch

Daniel L Schmoldt

1989-01-01

Residential encroachment into wildland areas places an additional burden on fire management activities. Prevention programs, fuel management efforts, and suppression strategies, previously employed in wildland areas, require modification for protection of increased values at risk in this interface area. Knowledge-based computer systems are being investigated as...

Proactive pavement asset management with climate change aspects

NASA Astrophysics Data System (ADS)

Zofka, Adam

2018-05-01

Pavement Asset Management System is a systematic and objective tool to manage pavement network based on the rational, engineering and economic principles. Once implemented and mature Pavement Asset Management System serves the entire range of users starting with the maintenance engineers and ending with the decision-makers. Such a system is necessary to coordinate agency management strategy including proactive maintenance. Basic inputs in the majority of existing Pavement Asset Management System approaches comprise the actual pavement inventory with associated construction history and condition, traffic information as well as various economical parameters. Some Pavement Management System approaches include also weather aspects which is of particular importance considering ongoing climate changes. This paper presents challenges in implementing the Pavement Asset Management System for those National Road Administrations that manage their pavement assets using more traditional strategies, e.g. worse-first approach. Special considerations are given to weather-related inputs and associated analysis to demonstrate the effects of climate change in a short- and long-term range. Based on the presented examples this paper concludes that National Road Administrations should account for the weather-related factors in their Pavement Management Systems as this has a significant impact on the system outcomes from the safety and economical perspective.

Harmonizing human-hydrological system under climate change: A scenario-based approach for the case of the headwaters of the Tagus River

NASA Astrophysics Data System (ADS)

Lobanova, Anastasia; Liersch, Stefan; Tàbara, J. David; Koch, Hagen; Hattermann, Fred F.; Krysanova, Valentina

2017-05-01

Conventional water management strategies, that serve solely socio-economic demands and neglect changing natural conditions of the river basins, face significant challenges in governing complex human-hydrological systems, especially in the areas with constrained water availability. In this study we assess the possibility to harmonize the inter-sectoral water allocation scheme within a highly altered human-hydrological system under reduction in water availability, triggered by projected climate change applying scenario-based approach. The Tagus River Basin headwaters, with significant disproportion in the water resources allocation between the environmental and socio-economic targets were taken as a perfect example of such system out of balance. We propose three different water allocation strategies for this region, including two conventional schemes and one imposing shift to sustainable water management and environmental restoration of the river. We combine in one integrated modelling framework the eco-hydrological process-based Soil and Water Integrated Model (SWIM), coupled with the conceptual reservoir and water allocation modules driven by the latest bias-corrected climate projections for the region and investigate possible water allocation scenarios in the region under constrained water availability in the future. Our results show that the socio-economic demands have to be re-considered and lowered under any water allocation strategy, as the climate impacts may significantly reduce water availability in the future. Further, we show that a shift to sustainable water management strategy and river restoration is possible even under reduced water availability. Finally, our results suggest that the adaptation of complex human-hydrological systems to climate change and a shift to a more sustainable water management are likely to be parts of one joint strategy to cope with climate change impacts.

Development of a stand-scale forest biodiversity index based on the state forest inventory

Treesearch

Diego Van Den Meersschaut; Kris Vandekerkhove

2000-01-01

Ecological aspects are increasingly influencing silvicultural management. Estimating forest biodiversity has become one often major tools for evaluating management strategies. A stand-scale forest biodiversity index is developed, based on available data from the state forest inventory. The index combines aspects of forest structure, woody and herbal layer composition,...

75 FR 78725 - Recreational Boating Safety Projects, Programs and Activities Funded Under Provisions of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-16

... defect. ($17,335). Web-based Document Management System: Funding was provided to continue to provide a web-based document management system to better enable the handling of thousands of recreational... program strategy support to the nation-wide RBS effort. The goal is to coordinate the RBS outreach...

Results-Based Monitoring and Evaluation at the Commonwealth of Learning: A Handbook

ERIC Educational Resources Information Center

Farrell, Glen M.

2009-01-01

Results-based management (RBM) is an approach to programme planning and management that integrates strategy, people, resources, processes and measurements to improve decision-making, transparency and accountability. The Commonwealth of Learning (COL) began the adoption of a RBM model with its 2003-2006 Three-Year Plan. This led to a significantly…

NASA Administrative Data Base Management Systems, 1984

NASA Technical Reports Server (NTRS)

Radosevich, J. D. (Editor)

1984-01-01

Strategies for converting to a data base management system (DBMS) and the implementation of the software packages necessary are discussed. Experiences with DBMS at various NASA centers are related including Langley's ADABAS/NATURAL and the NEMS subsystem of the NASA metrology informaton system. The value of the integrated workstation with a personal computer is explored.

A Regional Strategy for the Assessment and Management of Transboundary Aquifer Systems in the Americas

NASA Astrophysics Data System (ADS)

Hanson, R. T.; Rivera, A.; Tujchneider, O.; Guillén, C.; Campos, M.; Da Franca, N.; May, Z.; Aureli, A.

2015-12-01

The UNESCO-IHP ISARM-Americas technical committee has developed a regional strategy for the assessment and management of transboundary aquifer systems in the Americas as part of their ongoing cooperative assistance to help neighboring countries sustain water resources and reduce potential conflict. The fourth book in the series of publications sponsored by UNESCO and OAS documents this strategy. The goal of this strategy is the collective understanding, developing, managing, and protecting of the transboundary aquifers in the Americas This strategy includes technical, social, and governance recommendations for an integrated resource management of groundwater based on flexible arrangements that not only manage but also demand social participation in solving problems, consider changes in land use and water use and promote the increase of water sustainability for all transboundary neighbors. The successful implementation of this strategy starts with sharing information of the status and use of land and water as well as intergovernmental partnerships to link science and policy with existing instruments for managing the water resources. International organizations such as UNESCO and OAS also can help facilitate the development of transboundary agreements and establish cooperation on transboundary aquifers between neighbors. The UNESCO-IHP ISARM-Americas technical committee has been successful in creating a network of partners from 24 countries and in translating existing aquifer knowledge into a meaningful strategy for the American hemisphere. The strategy aims to explain and develop the role of science and the informed-decision approach. Examples from North and South America show how the process has begun to develop for selected transboundary aquifers. These include the Milk River basin between the US and Canada, the Rio Grande and Colorado River basins between the US and Mexico, and the Guarani River basin in South America.

On the role of budget sufficiency, cost efficiency, and uncertainty in species management

USGS Publications Warehouse

van der Burg, Max Post; Bly, Bartholomew B.; Vercauteren, Tammy; Grand, James B.; Tyre, Andrew J.

2014-01-01

Many conservation planning frameworks rely on the assumption that one should prioritize locations for management actions based on the highest predicted conservation value (i.e., abundance, occupancy). This strategy may underperform relative to the expected outcome if one is working with a limited budget or the predicted responses are uncertain. Yet, cost and tolerance to uncertainty rarely become part of species management plans. We used field data and predictive models to simulate a decision problem involving western burrowing owls (Athene cunicularia hypugaea) using prairie dog colonies (Cynomys ludovicianus) in western Nebraska. We considered 2 species management strategies: one maximized abundance and the other maximized abundance in a cost-efficient way. We then used heuristic decision algorithms to compare the 2 strategies in terms of how well they met a hypothetical conservation objective. Finally, we performed an info-gap decision analysis to determine how these strategies performed under different budget constraints and uncertainty about owl response. Our results suggested that when budgets were sufficient to manage all sites, the maximizing strategy was optimal and suggested investing more in expensive actions. This pattern persisted for restricted budgets up to approximately 50% of the sufficient budget. Below this budget, the cost-efficient strategy was optimal and suggested investing in cheaper actions. When uncertainty in the expected responses was introduced, the strategy that maximized abundance remained robust under a sufficient budget. Reducing the budget induced a slight trade-off between expected performance and robustness, which suggested that the most robust strategy depended both on one's budget and tolerance to uncertainty. Our results suggest that wildlife managers should explicitly account for budget limitations and be realistic about their expected levels of performance.

Data quality and processing for decision making: divergence between corporate strategy and manufacturing processes

NASA Astrophysics Data System (ADS)

McNeil, Ronald D.; Miele, Renato; Shaul, Dennis

2000-10-01

Information technology is driving improvements in manufacturing systems. Results are higher productivity and quality. However, corporate strategy is driven by a number of factors and includes data and pressure from multiple stakeholders, which includes employees, managers, executives, stockholders, boards, suppliers and customers. It is also driven by information about competitors and emerging technology. Much information is based on processing of data and the resulting biases of the processors. Thus, stakeholders can base inputs on faulty perceptions, which are not reality based. Prior to processing, data used may be inaccurate. Sources of data and information may include demographic reports, statistical analyses, intelligence reports (e.g., marketing data), technology and primary data collection. The reliability and validity of data as well as the management of sources and information is critical element to strategy formulation. The paper explores data collection, processing and analyses from secondary and primary sources, information generation and report presentation for strategy formulation and contrast this with data and information utilized to drive internal process such as manufacturing. The hypothesis is that internal process, such as manufacturing, are subordinate to corporate strategies. The impact of possible divergence in quality of decisions at the corporate level on IT driven, quality-manufacturing processes based on measurable outcomes is significant. Recommendations for IT improvements at the corporate strategy level are given.

The Admissions Office Goes Scientific.

ERIC Educational Resources Information Center

Bryant, Peter; Crockett, Kevin

1993-01-01

Data-based planning and management is revolutionizing college student recruitment. Data analysis focuses on historical trends, marketing and recruiting strategies, cost-effectiveness strategy, and markets. Data sources include primary market demographics, geo-demographics, secondary sources, student price response information, and institutional…

77 FR 45379 - Advisory Board Hearing

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-31

.... Place: U.S. Department of Justice, Main Conference Center, 7th Floor, 950 Pennsylvania Avenue NW...- based Budgeting and Public Safety; reengineering population management; cost-effective strategies for meeting policy requirements and legislative mandates; innovative cost-saving strategies; identifying and...

Integrating human resources and program-planning strategies.

PubMed

Smith, J E

1989-06-01

The integration of human resources management (HRM) strategies with long-term program-planning strategies in hospital pharmacy departments is described. HRM is a behaviorally based, comprehensive strategy for the effective management and use of people that seeks to achieve coordination and integration with overall planning strategies and other managerial functions. It encompasses forecasting of staffing requirements; determining work-related factors that are strong "motivators" and thus contribute to employee productivity and job satisfaction; conducting a departmental personnel and skills inventory; employee career planning and development, including training and education programs; strategies for promotion and succession, including routes of advancement that provide alternatives to the managerial route; and recruitment and selection of new personnel to meet changing departmental needs. Increased competitiveness among hospitals and a shortage of pharmacists make it imperative that hospital pharmacy managers create strategies to attract, develop, and retain the right individuals to enable the department--and the hospital as a whole--to grow and change in response to the changing health-care environment in the United States. Pharmacy managers would be greatly aided in this mission by the establishment of a well-defined, national strategic plan for pharmacy programs and services that includes an analysis of what education and training are necessary for their successful accomplishment. Creation of links between overall program objectives and people-planning strategies will aid hospital pharmacy departments in maximizing the long-term effectiveness of their practice.

Sustainable water management in the southwestern United States: reality or rhetoric?

PubMed

Marshall, Robert M; Robles, Marcos D; Majka, Daniel R; Haney, Jeanmarie A

2010-07-21

While freshwater sustainability is generally defined as the provisioning of water for both people and the environment, in practice it is largely focused only on supplying water to furnish human population growth. Symptomatic of this is the state of Arizona, where rapid growth outside of the metropolitan Phoenix-Tucson corridor relies on the same groundwater that supplies year-round flow in rivers. Using Arizona as a case study, we present the first study in the southwestern United States that evaluates the potential impact of future population growth and water demand on streamflow depletion across multiple watersheds. We modeled population growth and water demand through 2050 and used four scenarios to explore the potential effects of alternative growth and water management strategies on river flows. Under the base population projection, we found that rivers in seven of the 18 study watersheds could be dewatered due to municipal demand. Implementing alternative growth and water management strategies, however, could prevent four of these rivers from being dewatered. The window of opportunity to implement water management strategies is narrowing. Because impacts from groundwater extraction are cumulative and cannot be immediately reversed, proactive water management strategies should be implemented where groundwater will be used to support new municipal demand. Our approach provides a low-cost method to identify where alternative water and growth management strategies may have the most impact, and demonstrates that such strategies can maintain a continued water supply for both people and the environment.

IS THERE A DOWNSIDE TO CUSTOMIZING CARE? IMPLICATIONS OF GENERAL AND PATIENT-SPECIFIC TREATMENT STRATEGIES

PubMed Central

Johnson, Paul E.; O’Connor, Patrick J.

2009-01-01

The use of general clinical guidelines versus customization of patient care presents a dilemma for clinicians managing chronic illness. We propose that the performance of customized strategies for the management of chronic illness depends on accurate patient categorization, and inaccurate categorization can lead to worse performance than that achievable using a general clinical guideline. This paper is based on an analysis of a basic utility model differentiating outcomes between the use of general management strategies and customized strategies. Results of the analysis have four implications regarding the design and use of clinical guidelines and customization of care: (1) the balance between the applications of more general strategies versus customization depends on the specificity and accuracy of the strategies; (2) adoption of clinical guidelines may be stifled as the complexity of guidelines increases to account for growing evidence; (3) clinical inertia (i.e. the failure to intensify an indicated treatment) can be a rational response to strategy specificity and the probability of misapplication; and, (4) current clinical guidelines and other decision-support tools may be improved if they accommodate the need for customization of strategies for some patients while providing support for proper categorization of patients. PMID:20367722

Assessing Fishers' Support of Striped Bass Management Strategies.

PubMed

Murphy, Robert D; Scyphers, Steven B; Grabowski, Jonathan H

2015-01-01

Incorporating the perspectives and insights of stakeholders is an essential component of ecosystem-based fisheries management, such that policy strategies should account for the diverse interests of various groups of anglers to enhance their efficacy. Here we assessed fishing stakeholders' perceptions on the management of Atlantic striped bass (Morone saxatilis) and receptiveness to potential future regulations using an online survey of recreational and commercial fishers in Massachusetts and Connecticut (USA). Our results indicate that most fishers harbored adequate to positive perceptions of current striped bass management policies when asked to grade their state's management regime. Yet, subtle differences in perceptions existed between recreational and commercial fishers, as well as across individuals with differing levels of fishing experience, resource dependency, and tournament participation. Recreational fishers in both states were generally supportive or neutral towards potential management actions including slot limits (71%) and mandated circle hooks to reduce mortality of released fish (74%), but less supportive of reduced recreational bag limits (51%). Although commercial anglers were typically less supportive of management changes than their recreational counterparts, the majority were still supportive of slot limits (54%) and mandated use of circle hooks (56%). Our study suggests that both recreational and commercial fishers are generally supportive of additional management strategies aimed at sustaining healthy striped bass populations and agree on a variety of strategies. However, both stakeholder groups were less supportive of harvest reductions, which is the most direct measure of reducing mortality available to fisheries managers. By revealing factors that influence stakeholders' support or willingness to comply with management strategies, studies such as ours can help managers identify potential stakeholder support for or conflicts that may result from regulation changes.

Assessing Fishers' Support of Striped Bass Management Strategies

PubMed Central

Murphy, Robert D.; Scyphers, Steven B.; Grabowski, Jonathan H.

2015-01-01

Incorporating the perspectives and insights of stakeholders is an essential component of ecosystem-based fisheries management, such that policy strategies should account for the diverse interests of various groups of anglers to enhance their efficacy. Here we assessed fishing stakeholders’ perceptions on the management of Atlantic striped bass (Morone saxatilis) and receptiveness to potential future regulations using an online survey of recreational and commercial fishers in Massachusetts and Connecticut (USA). Our results indicate that most fishers harbored adequate to positive perceptions of current striped bass management policies when asked to grade their state’s management regime. Yet, subtle differences in perceptions existed between recreational and commercial fishers, as well as across individuals with differing levels of fishing experience, resource dependency, and tournament participation. Recreational fishers in both states were generally supportive or neutral towards potential management actions including slot limits (71%) and mandated circle hooks to reduce mortality of released fish (74%), but less supportive of reduced recreational bag limits (51%). Although commercial anglers were typically less supportive of management changes than their recreational counterparts, the majority were still supportive of slot limits (54%) and mandated use of circle hooks (56%). Our study suggests that both recreational and commercial fishers are generally supportive of additional management strategies aimed at sustaining healthy striped bass populations and agree on a variety of strategies. However, both stakeholder groups were less supportive of harvest reductions, which is the most direct measure of reducing mortality available to fisheries managers. By revealing factors that influence stakeholders’ support or willingness to comply with management strategies, studies such as ours can help managers identify potential stakeholder support for or conflicts that may result from regulation changes. PMID:26305324

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

Kastenberg, W.E.; Apostolakis, G.; Dhir, V.K.

Severe accident management can be defined as the use of existing and/or altemative resources, systems and actors to prevent or mitigate a core-melt accident. For each accident sequence and each combination of severe accident management strategies, there may be several options available to the operator, and each involves phenomenological and operational considerations regarding uncertainty. Operational uncertainties include operator, system and instrumentation behavior during an accident. A framework based on decision trees and influence diagrams has been developed which incorporates such criteria as feasibility, effectiveness, and adverse effects, for evaluating potential severe accident management strategies. The framework is also capable ofmore » propagating both data and model uncertainty. It is applied to several potential strategies including PWR cavity flooding, BWR drywell flooding, PWR depressurization and PWR feed and bleed.« less

What is heartburn worth? A cost-utility analysis of management strategies.

PubMed

Heudebert, G R; Centor, R M; Klapow, J C; Marks, R; Johnson, L; Wilcox, C M

2000-03-01

To determine the best treatment strategy for the management of patients presenting with symptoms consistent with uncomplicated heartburn. We performed a cost-utility analysis of 4 alternatives: empirical proton pump inhibitor, empirical histamine2-receptor antagonist, and diagnostic strategies consisting of either esophagogastroduodenoscopy (EGD) or an upper gastrointestinal series before treatment. The time horizon of the model was 1 year. The base case analysis assumed a cohort of otherwise healthy 45-year-old individuals in a primary care practice. Empirical treatment with a proton pump inhibitor was projected to provide the greatest quality-adjusted survival for the cohort. Empirical treatment with a histamine2 receptor antagonist was projected to be the least costly of the alternatives. The marginal cost-effectiveness of using a proton pump inhibitor over a histamine2-receptor antagonist was approximately $10,400 per quality-adjusted life year (QALY) gained in the base case analysis and was less than $50,000 per QALY as long as the utility for heartburn was less than 0.95. Both diagnostic strategies were dominated by proton pump inhibitor alternative. Empirical treatment seems to be the optimal initial management strategy for patients with heartburn, but the choice between a proton pump inhibitor or histamine2-receptor antagonist depends on the impact of heartburn on quality of life.

Managing Loss and Change: Grief Interventions for Dementia Caregivers in a CBT-Based Trial.

PubMed

Meichsner, Franziska; Schinköthe, Denise; Wilz, Gabriele

2016-05-01

Dementia caregivers often experience loss and grief related to general caregiver burden, physical, and mental health problems. Through qualitative content analysis, this study analyzed intervention strategies applied by therapists in a randomized-controlled trial in Germany to assist caregivers in managing losses and associated emotions. Sequences from 61 therapy sessions that included interventions targeting grief, loss, and change were transcribed and analyzed. A category system was developed deductively, and the intercoder reliability was satisfactory. The identified grief intervention strategies were recognition and acceptance of loss and change,addressing future losses,normalization of grief, and redefinition of the relationship Therapists focused on identifying experienced losses, managing associated feelings, and fostering acceptance of these losses. A variety of cognitive-behavioral therapy-based techniques was applied with each strategy. The findings contribute to understanding how dementia caregivers can be supported in their experience of grief and facilitate the development of a manualized grief intervention. © The Author(s) 2015.

Development of the Champlain primary care cardiovascular disease prevention and management guideline

PubMed Central

Montoya, Lorraine; Liddy, Clare; Hogg, William; Papadakis, Sophia; Dojeiji, Laurie; Russell, Grant; Akbari, Ayub; Pipe, Andrew; Higginson, Lyall

2011-01-01

Abstract Problem addressed A well documented gap remains between evidence and practice for clinical practice guidelines in cardiovascular disease (CVD) care. Objective of program As part of the Champlain CVD Prevention Strategy, practitioners in the Champlain District of Ontario launched a large quality-improvement initiative that focused on increasing the uptake in primary care practice settings of clinical guidelines for heart disease, stroke, diabetes, and CVD risk factors. Program description The Champlain Primary Care CVD Prevention and Management Guideline is a desktop resource for primary care clinicians working in the Champlain District. The guideline was developed by more than 45 local experts to summarize the latest evidence-based strategies for CVD prevention and management, as well as to increase awareness of local community-based programs and services. Conclusion Evidence suggests that tailored strategies are important when implementing specific practice guidelines. This article describes the process of creating an integrated clinical guideline for improvement in the delivery of cardiovascular care. PMID:21673196

Brownfields to green fields: Realising wider benefits from practical contaminant phytomanagement strategies.

PubMed

Cundy, A B; Bardos, R P; Puschenreiter, M; Mench, M; Bert, V; Friesl-Hanl, W; Müller, I; Li, X N; Weyens, N; Witters, N; Vangronsveld, J

2016-12-15

Gentle remediation options (GROs) are risk management strategies or technologies involving plant (phyto-), fungi (myco-), and/or bacteria-based methods that result in a net gain (or at least no gross reduction) in soil function as well as effective risk management. GRO strategies can be customised along contaminant linkages, and can generate a range of wider economic, environmental and societal benefits in contaminated land management (and in brownfields management more widely). The application of GROs as practical on-site remedial solutions is still limited however, particularly in Europe and at trace element (typically metal and metalloid) contaminated sites. This paper discusses challenges to the practical adoption of GROs in contaminated land management, and outlines the decision support tools and best practice guidance developed in the European Commission FP7-funded GREENLAND project aimed at overcoming these challenges. The GREENLAND guidance promotes a refocus from phytoremediation to wider GROs- or phyto-management based approaches which place realisation of wider benefits at the core of site design, and where gentle remediation technologies can be applied as part of integrated, mixed, site risk management solutions or as part of "holding strategies" for vacant sites. The combination of GROs with renewables, both in terms of biomass generation but also with green technologies such as wind and solar power, can provide a range of economic and other benefits and can potentially support the return of low-level contaminated sites to productive usage, while combining GROs with urban design and landscape architecture, and integrating GRO strategies with sustainable urban drainage systems and community gardens/parkland (particularly for health and leisure benefits), has large potential for triggering GRO application and in realising wider benefits in urban and suburban systems. Quantifying these wider benefits and value (above standard economic returns) will be important in leveraging funding for GRO application and soft site end-use more widely at vacant or underutilized sites. Copyright © 2016 Elsevier Ltd. All rights reserved.

An index-based robust decision making framework for watershed management in a changing climate.

PubMed

Kim, Yeonjoo; Chung, Eun-Sung

2014-03-01

This study developed an index-based robust decision making framework for watershed management dealing with water quantity and quality issues in a changing climate. It consists of two parts of management alternative development and analysis. The first part for alternative development consists of six steps: 1) to understand the watershed components and process using HSPF model, 2) to identify the spatial vulnerability ranking using two indices: potential streamflow depletion (PSD) and potential water quality deterioration (PWQD), 3) to quantify the residents' preferences on water management demands and calculate the watershed evaluation index which is the weighted combinations of PSD and PWQD, 4) to set the quantitative targets for water quantity and quality, 5) to develop a list of feasible alternatives and 6) to eliminate the unacceptable alternatives. The second part for alternative analysis has three steps: 7) to analyze all selected alternatives with a hydrologic simulation model considering various climate change scenarios, 8) to quantify the alternative evaluation index including social and hydrologic criteria with utilizing multi-criteria decision analysis methods and 9) to prioritize all options based on a minimax regret strategy for robust decision. This framework considers the uncertainty inherent in climate models and climate change scenarios with utilizing the minimax regret strategy, a decision making strategy under deep uncertainty and thus this procedure derives the robust prioritization based on the multiple utilities of alternatives from various scenarios. In this study, the proposed procedure was applied to the Korean urban watershed, which has suffered from streamflow depletion and water quality deterioration. Our application shows that the framework provides a useful watershed management tool for incorporating quantitative and qualitative information into the evaluation of various policies with regard to water resource planning and management. Copyright © 2013 Elsevier B.V. All rights reserved.

Adapting natural resource management to climate change: The South Central Oregon and Northern Rockies Adaptation Partnerships

NASA Astrophysics Data System (ADS)

Halofsky, J.; Peterson, D. L.

2015-12-01

Concrete ways to adapt to climate change are needed to help natural resource managers take the first steps to incorporate climate change into management and take advantage of opportunities to balance the negative effects of climate change. We recently initiated two science-management climate change adaptation partnerships, one with three national forests and one national park in south central Oregon, and the other with 16 national forests, three national parks and other stakeholders in the northern Rockies region. Goals of both partnerships were to: (1) synthesize published information and data to assess the exposure, sensitivity, and adaptive capacity of key resource areas, including water use, infrastructure, fisheries, and vegetation and disturbance; (2) develop science-based adaptation strategies and tactics that will help to mitigate the negative effects of climate change and assist the transition of biological systems and management to a warmer climate; (3) ensure adaptation strategies and tactics are incorporated into relevant planning documents; and (4) foster an enduring partnership to facilitate ongoing dialogue and activities related to climate change in the partnerships regions. After an initial vulnerability assessment by agency and university scientists and local resource specialists, adaptation strategies and tactics were developed in a series of scientist-manager workshops. The final vulnerability assessments and adaptation actions are incorporated in technical reports. The partnerships produced concrete adaptation options for national forest and other natural resource managers and illustrated the utility of place-based vulnerability assessments and scientist-manager workshops in adapting to climate change.

The need to implement the landscape of fear within rodent pest management strategies

PubMed Central

Belmain, Steven R; Singleton, Grant R; Groot Koerkamp, Peter WG; Meerburg, Bastiaan G

2017-01-01

Abstract Current reactive pest management methods have serious drawbacks such as the heavy reliance on chemicals, emerging genetic rodenticide resistance and high secondary exposure risks. Rodent control needs to be based on pest species ecology and ethology to facilitate the development of ecologically based rodent management (EBRM). An important aspect of EBRM is a strong understanding of rodent pest species ecology, behaviour and spatiotemporal factors. Gaining insight into the behaviour of pest species is a key aspect of EBRM. The landscape of fear (LOF) is a mapping of the spatial variation in the foraging cost arising from the risk of predation, and reflects the levels of fear a prey species perceives at different locations within its home range. In practice, the LOF maps habitat use as a result of perceived fear, which shows where bait or traps are most likely to be encountered and used by rodents. Several studies have linked perceived predation risk of foraging animals with quitting‐harvest rates or giving‐up densities (GUDs). GUDs have been used to reflect foraging behaviour strategies of predator avoidance, but to our knowledge very few papers have directly used GUDs in relation to pest management strategies. An opportunity for rodent control strategies lies in the integration of the LOF of rodents in EBRM methodologies. Rodent management could be more efficient and effective by concentrating on those areas where rodents perceive the least levels of predation risk. © 2017 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry. PMID:28556521

Using resilience and resistance concepts to manage persistent threats to sagebrush ecosystems and greater sage-grouse

USGS Publications Warehouse

Chambers, Jeanne C.; Maestas, Jeremy D.; Pyke, David A.; Boyd, Chad S.; Pellant, Mike; Wuenschel, Amarina

2017-01-01

Conservation of imperiled species often demands addressing a complex suite of threats that undermine species viability. Regulatory approaches, such as the US Endangered Species Act (1973), tend to focus on anthropogenic threats through adoption of policies and regulatory mechanisms. However, persistent ecosystem-based threats, such as invasive species and altered disturbance regimes, remain critical issues for most at-risk species considered to be conservation-reliant. We describe an approach for addressing persistent ecosystem threats to at-risk species based on ecological resilience and resistance concepts that is currently being used to conserve greater sage-grouse (Centrocercus urophasianus)and sagebrush ecosystems. The approach links biophysical indicators of ecosystem resilience and resistance with species-specific population and habitat requisites in a risk-based framework to identify priority areas for management and guide allocation of resources to manage persistent ecosystem-based threats. US federal land management and natural resource agencies have adopted this framework as a foundation for prioritizing sage-grouse conservation resources and determining effective restoration and management strategies. Because threats and strategies to address them cross-cut program areas, an integrated approach that includes wildland fire operations, postfire rehabilitation, fuels management, and habitat restoration is being used. We believe this approach is applicable to species conservation in other largely intact ecosystems with persistent, ecosystem-based threats.

[Clinical Management: Basics and organization].

PubMed

Torres, Juan; Mingo, Carlos

2015-01-01

Many strategies have been proposed over the last years to ensure the Health Care System sustainability, mainly after the recent global economic crisis. One of the most attractive approaches is clinical management, which is a way of organizing health care units based on active participation of professionals who receive the transference of responsibilities dispoto achieve the objectives with the mission of ensuring a proper patient centered care, taking into consideration the rational use of resources (Efficiency) For the start up of Health Care structures based on clinical management, it is necessary a previous management culture within the departments involved and the center's executive board. Furthermore, to achieve the objectives proposed various tools must be used, such as evidence based medicine, clinical practice variability analysis, process management, in addition of quality and safety strategies. The units involved have to propose a management plan that will result in a management contract with the center's executive board. This agreement will establish some activity, expense and quality objectives that will be quantifiable through various indicators. Risk transference to the unit must include certain budget allocation and incentive decision capacity. Clinical management must not be employed as a savings tool from the part of macro and meso management. There is not a health care structure based on clinical management that have a general character for all health care organizations, existing a great variability in the adoption of various organizational formulas, so that every center must perform its own analysis and decide the most adequate model. In our country there are many clinical management experiences, although there is a long way to go.

Public views on a wait time management initiative: a matter of communication

PubMed Central

2010-01-01

Background Many countries have tried to reduce waiting times for health care through formal wait time reduction strategies. Our paper describes views of members of the public about a wait time management initiative - the Ontario Wait Time Strategy (OWTS) (Canada). Scholars and governmental reports have advocated for increased public involvement in wait time management. We provide empirically derived recommendations for public engagement in a wait time management initiative. Methods Two qualitative studies: 1) an analysis of all emails sent by the public to the (OWTS) email address; and 2) in-depth interviews with members of the Ontario public. Results Email correspondents and interview participants supported the intent of the OWTS. However they wanted more information about the Strategy and its actions. Interview participants did not feel they were sufficiently made aware of the Strategy and email correspondents requested additional information beyond what was offered on the Strategy's website. Moreover, the email correspondents believed that some of the information that was provided on the Strategy's website and through the media was inaccurate, misleading, and even dishonest. Interview participants strongly supported public involvement in the OWTS priority setting. Conclusions Findings suggest the public wanted increased communication from and with the OWTS. Effective communication can facilitate successful public engagement, and in turn fair and legitimate priority setting. Based on the study's findings we developed concrete recommendations for improving public involvement in wait time management. PMID:20687952

Public views on a wait time management initiative: a matter of communication.

PubMed

Bruni, Rebecca A; Laupacis, Andreas; Levinson, Wendy; Martin, Douglas K

2010-08-05

Many countries have tried to reduce waiting times for health care through formal wait time reduction strategies. Our paper describes views of members of the public about a wait time management initiative--the Ontario Wait Time Strategy (OWTS) (Canada). Scholars and governmental reports have advocated for increased public involvement in wait time management. We provide empirically derived recommendations for public engagement in a wait time management initiative. Two qualitative studies: 1) an analysis of all emails sent by the public to the (OWTS) email address; and 2) in-depth interviews with members of the Ontario public. Email correspondents and interview participants supported the intent of the OWTS. However they wanted more information about the Strategy and its actions. Interview participants did not feel they were sufficiently made aware of the Strategy and email correspondents requested additional information beyond what was offered on the Strategy's website. Moreover, the email correspondents believed that some of the information that was provided on the Strategy's website and through the media was inaccurate, misleading, and even dishonest. Interview participants strongly supported public involvement in the OWTS priority setting. Findings suggest the public wanted increased communication from and with the OWTS. Effective communication can facilitate successful public engagement, and in turn fair and legitimate priority setting. Based on the study's findings we developed concrete recommendations for improving public involvement in wait time management.

Development of a Faith-Based Stress Management Intervention in a Rural African American Community.

PubMed

Bryant, Keneshia; Moore, Todd; Willis, Nathaniel; Hadden, Kristie

2015-01-01

Faith-based mental health interventions developed and implemented using a community-based participatory research (CBPR) approach hold promise for reaching rural African Americans and addressing health disparities. To describe the development, challenges, and lessons learned from the Trinity Life Management, a faith-based stress management intervention in a rural African American faith community. The researchers used a CBPR approach by partnering with the African American faith community to develop a stress management intervention. Development strategies include working with key informants, focus groups, and a community advisory board (CAB). The community identified the key concepts that should be included in a stress management intervention. The faith-based "Trinity Life Management" stress management intervention was developed collaboratively by a CAB and an academic research team. The intervention includes stress management techniques that incorporate Biblical principles and information about the stress-distress-depression continuum.

The need to implement the landscape of fear within rodent pest management strategies.

PubMed

Krijger, Inge M; Belmain, Steven R; Singleton, Grant R; Groot Koerkamp, Peter Wg; Meerburg, Bastiaan G

2017-12-01

Current reactive pest management methods have serious drawbacks such as the heavy reliance on chemicals, emerging genetic rodenticide resistance and high secondary exposure risks. Rodent control needs to be based on pest species ecology and ethology to facilitate the development of ecologically based rodent management (EBRM). An important aspect of EBRM is a strong understanding of rodent pest species ecology, behaviour and spatiotemporal factors. Gaining insight into the behaviour of pest species is a key aspect of EBRM. The landscape of fear (LOF) is a mapping of the spatial variation in the foraging cost arising from the risk of predation, and reflects the levels of fear a prey species perceives at different locations within its home range. In practice, the LOF maps habitat use as a result of perceived fear, which shows where bait or traps are most likely to be encountered and used by rodents. Several studies have linked perceived predation risk of foraging animals with quitting-harvest rates or giving-up densities (GUDs). GUDs have been used to reflect foraging behaviour strategies of predator avoidance, but to our knowledge very few papers have directly used GUDs in relation to pest management strategies. An opportunity for rodent control strategies lies in the integration of the LOF of rodents in EBRM methodologies. Rodent management could be more efficient and effective by concentrating on those areas where rodents perceive the least levels of predation risk. © 2017 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry. © 2017 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Is reconstruction the best management strategy for anterior cruciate ligament rupture? A systematic review and meta-analysis comparing anterior cruciate ligament reconstruction versus non-operative treatment.

PubMed

Smith, T O; Postle, K; Penny, F; McNamara, I; Mann, C J V

2014-03-01

The purpose of this study was to determine the optimal clinical and cost-effective strategy for managing people following ACL rupture. A systematic review of the published (AMED, CINAHL, MEDLINE, EMBASE, PubMed, psycINFO and the Cochrane Library) and unpublished literature (OpenGrey, the WHO International Clinical Trials Registry Platform, Current Controlled Trials and the UK National Research Register Archive) was conducted on April 2013. All randomised and non-randomised controlled trials evaluating clinical or health economic outcomes of isolated ligament reconstruction versus non-surgical management following ACL rupture were included. Methodological quality was assessed using the PEDro appraisal tool. When appropriate, meta-analysis was conducted to pool data. From a total of 943 citations, sixteen studies met the eligibility criteria. These included 1397 participants, 825 who received ACL reconstruction versus 592 who were managed non-surgically. The methodological quality of the literature was poor. The findings indicated that whilst reconstructed ACL offers significantly greater objective tibiofemoral stability (p<0.001), there appears limited evidence to suggest a superiority between reconstruction versus non-surgical management in functional outcomes. There was a small difference between the management strategies in respect to the development of osteoarthritis during the initial 20 years following index management strategy (Odds Ratio 1.56; p=0.05). The current literature is insufficient to base clinical decision-making with respect to treatment opinions for people following ACL rupture. Whilst based on a poor evidence, the current evidence would indicate that people following ACL rupture should receive non-operative interventions before surgical intervention is considered. © 2013.

The Dance of Elementary School Classroom Management

ERIC Educational Resources Information Center

Powell, Pamela

2014-01-01

At times, classroom management and guidance elude even the most seasoned teachers. Yet, students need guidance and practice in self-regulatory skills to assist in the learning that occurs in classrooms. Teachers need both practical and research-based classroom management strategies that benefit the environment and help create a space conducive to…

Teacher Classroom Management Practices: Effects on Disruptive or Aggressive Student Behavior

ERIC Educational Resources Information Center

Oliver, Regina M.; Wehby, Joseph H.; Reschly, Daniel J.

2011-01-01

Despite the large research base grounded in behavioral theory for strategies to increase appropriate behavior and prevent or decrease inappropriate behavior in the classroom, a systematic review of multi-component universal classroom management research is necessary to establish the effects of teachers' universal classroom management approaches.…

The Industrial Base and National Security: A New Strategy

DTIC Science & Technology

1993-04-01

addresses this issue in her article entitled, " Managing Innovation on the Factory Floor": Manufacturing managers often buy the most advanced...Incentives Program." Government Contract Number MDA903-85-C-0139 Final Report, 1986. 31 11. Tyre, Marcie J. " Managing Innovation On The Factory Floor

Observing and Understanding Children's Social Interactions. An Impression Management Perspective.

ERIC Educational Resources Information Center

Hatch, J. Amos

1994-01-01

Describes ways of observing and interpreting children's peer social behavior based on the impression management perspective, which focuses on the social construction of a child's individual self-concept. Suggests that teachers and caregivers can use impression management strategies to observe and promote prosocial development in young children.…

How do Air Traffic Controllers Use Automation and Tools Differently During High Demand Situations?

NASA Technical Reports Server (NTRS)

Kraut, Joshua M.; Mercer, Joey; Morey, Susan; Homola, Jeffrey; Gomez, Ashley; Prevot, Thomas

2013-01-01

In a human-in-the-loop simulation, two air traffic controllers managed identical airspace while burdened with higher than average workload, and while using advanced tools and automation designed to assist with scheduling aircraft on multiple arrival flows to a single meter fix. This paper compares the strategies employed by each controller, and investigates how the controllers' strategies change while managing their airspace under more normal workload conditions and a higher workload condition. Each controller engaged in different methods of maneuvering aircraft to arrive on schedule, and adapted their strategies to cope with the increased workload in different ways. Based on the conclusions three suggestions are made: that quickly providing air traffic controllers with recommendations and information to assist with maneuvering and scheduling aircraft when burdened with increased workload will improve the air traffic controller's effectiveness, that the tools should adapt to the strategy currently employed by a controller, and that training should emphasize which traffic management strategies are most effective given specific airspace demands.

Water and wastewater in developing countries: present reality and strategy for the future.

PubMed

Ujang, Z; Buckley, C

2002-01-01

This paper summarises the paper presentation sessions at the Conference, as well giving insights on the issues related to developing countries. It also discusses the present status of practice and research on water and wastewater management, and projected future scenario based not only on the papers presented in the Conference, but also on other sources. The strategy is presented to overcome many problems in developing countries such as rapid urbanization, industrialization, population growth, financial and institutional problems and, depleting water resources. The strategy consists of Integrated Urban Water Management (IUWM), cleaner industrial production, waste minimisation and financial arrangements.

Participation of Racial and Ethnic Minorities in Technology-Based Interventions to Self-Manage Type 2 Diabetes: A Scoping Review.

PubMed

Jang, Myoungock; Johnson, Constance M; D'Eramo-Melkus, Gail; Vorderstrasse, Allison A

2018-05-01

Strategies to decrease societal and cultural barriers for ethnic minorities to participate in health research are well established. However, limited data are available regarding participation of ethnic minorities in mobile and Internet technology-based interventions to self-manage type 2 diabetes where health disparities are predominant. Thus, the purpose was to understand the participation of ethnic minorities in technology-based intervention programs to manage type 2 diabetes. A scoping review was used to review a total of 21 intervention studies containing participant information about ethnic minorities and one qualitative study discussing participation of ethnic minorities. There was limited enrollment and participation of ethnic minorities. Technological barriers in addition to existing societal and cultural barriers were identified. Strategies to decrease the barriers were recommended. Technological barriers were identified on top of the societal and cultural barriers in traditional interventions. Further research to reduce the barriers is warranted.

Gender sensitive education in watershed management to support environmental friendly city

NASA Astrophysics Data System (ADS)

Asteria, D.; Budidarmono; Herdiansyah, H.; Ni’mah, N. L.

2018-03-01

This study is about gender-sensitive perspective in watershed management education program as one of capacity building for citizens in watershed management with community-based strategy to support environmental friendly cities and security for women from flood disasters. Involving women and increasing women’s active participation in sustainable watershed management is essential in urban area. In global warming and climate change situations, city management should be integrated between social aspect and environmental planning. This study used mix method (concurrent embedded type, with quantitative as primary method) with research type is descriptive-explanatory. The result of this study is education strategies with gender approaches and affirmative action through emancipation approach and local knowledge from women’s experiences can increase women’s participation. Women’s empowerment efforts need integrated intervention and collaboration from government, NGO, and other stakeholders to optimize women’s role in watershed management for support environmental friendly city. The implication of this study is an educational strategy on watershed conservation with gender perspective to offer social engineering alternatives for decision makers to policy of sustainable watershed management in urban area related to flood mitigation efforts.

Making It Local: Beacon Communities Use Health Information Technology to Optimize Care Management

PubMed Central

Allen, Amy; Des Jardins, Terrisca R.; Heider, Arvela; Kanger, Chatrian R.; Lobach, David F.; McWilliams, Lee; Polello, Jennifer M.; Schachter, Abigail A.; Singh, Ranjit; Sorondo, Barbara; Tulikangas, Megan C.; Turske, Scott A.

2014-01-01

Abstract Care management aims to provide cost-effective, coordinated, non-duplicative care to improve care quality, population health, and reduce costs. The 17 communities receiving funding from the Office of the National Coordinator for Health Information Technology through the Beacon Community Cooperative Agreement Program are leaders in building and strengthening their health information technology (health IT) infrastructure to provide more effective and efficient care management. This article profiles 6 Beacon Communities' health IT-enabled care management programs, highlighting the influence of local context on program strategy and design, and describing challenges, lessons learned, and policy implications for care delivery and payment reform. The unique needs (eg, disease burden, demographics), community partnerships, and existing resources and infrastructure all exerted significant influence on the overall priorities and design of each community's care management program. Though each Beacon Community needed to engage in a similar set of care management tasks—including patient identification, stratification, and prioritization; intervention; patient engagement; and evaluation—the contextual factors helped shape the specific strategies and tools used to carry out these tasks and achieve their objectives. Although providers across the country are striving to deliver standardized, high-quality care, the diverse contexts in which this care is delivered significantly influence the priorities, strategies, and design of community-based care management interventions. Gaps and challenges in implementing effective community-based care management programs include: optimizing allocation of care management services; lack of available technology tailored to care management needs; lack of standards and interoperability; integrating care management into care settings; evaluating impact; and funding and sustainability. (Population Health Management 2014;17:149–158) PMID:24476558

Systolic blood pressure control among individuals with Type 2 Diabetes: A comparative effectiveness analysis of three interventions

USDA-ARS?s Scientific Manuscript database

Intensive lifestyle management or frequent goal-based monitoring with pharmacological management can be successful strategies for blood pressure control in overweight and obese adults with type 2 diabetes....

A research-based strategy for managing housing adaptations: study protocol for a quasi-experimental trial.

PubMed

Ekstam, Lisa; Carlsson, Gunilla; Chiatti, Carlos; Nilsson, Maria H; Malmgren Fänge, Agneta

2014-11-29

The primary aim of this paper is to describe the design of a project evaluating the effects of using a research-based strategy for managing housing adaptations (HAs). The evaluation targets clients' perspectives in terms of activity, participation, usability, fear of falling, fall incidence, use of mobility devices, and health-related quality of life, and determines the societal effects of HAs in terms of costs. Additional aims of the project are to explore and describe this strategy in relation to experiences and expectations (a) among clients and cohabitants and (b) occupational therapists in ordinary practice. This study is a quasi-experimental trial applying a multiphase design, combining quantitative and qualitative data. At the experimental sites, the occupational therapists (OTs) apply the intervention, i.e. a standardized research-based strategy for HA case management. At the control site, the occupational therapists are following their regular routine in relation to HA. Three municipalities in south Sweden will be included based on their population, their geographical dispersion, and their similar organizational structures for HA administration. Identical data on outcomes is being collected at all the sites at the same four time points: before the HA and then 3, 6, and 12 months after the HA. The data-collection methods are semi-structured qualitative interviews, observations, clinical assessments, and certificates related to each client's HA. The intervention in this study has been developed and tested through many years of research and in collaboration with practitioners. This process includes methodological development and testing research aimed at identifying the most important outcomes and research targeting current HA case-management procedures in Swedish municipalities. When the study is completed, the results will be used for further optimization of the practice strategy for HA, in close collaboration with the data-collecting OTs. No: NCT01960582.

Effective self-management strategies for bipolar disorder: A community-engaged Delphi Consensus Consultation study.

PubMed

Michalak, Erin E; Suto, Melinda J; Barnes, Steven J; Hou, Sharon; Lapsley, Sara; Scott, Mike W; Murray, Greg; Austin, Jehannine; Elliott, Nusha Balram; Berk, Lesley; Crest Bd

2016-12-01

Self-management represents an important complement to psychosocial treatments for bipolar disorder (BD), but research is limited. Specifically, little is known about self-management approaches for elevated mood states; this study investigated self-management strategies for: (1) maintaining balance in mood, and (2) stopping progression into hypomania/mania. To identify the common components of BD self-management, Delphi Consensus Consultation methods were combined with a Community-Based Participatory Research (CBPR) approach across five study phases: (1) Qualitative dataset content analysis; (2) Academic/grey literature reviews; (3) Content analysis; (4) Two Delphi rounds (rating strategies on a 5-point Likert scale, Very Unhelpful-Very Helpful), and; (5) Quantitative analysis and interpretation. Participants were people with BD and healthcare providers. Phases 1 and 2 identified 262 and 3940 candidate strategies, respectively; 3709 were discarded as duplicates/unintelligible. The remaining 493 were assessed via Delphi methods in Phase 4: 101 people with BD and 52 healthcare providers participated in Round 1; 83 of the BD panel (82%) and 43 of the healthcare provider panel (83%) participated in Round 2-exploratory factor analysis (EFA) was conducted on Round 2 results. EFA was underpowered and sample was not ethnically diverse, limiting generalizability. High concordance was observed in ratings of strategy effectiveness between the two panels. Future research could usefully investigate the provisional discovery here of underlying factors which link individual strategies. For example, 'maintaining hope' underpinned strategies for maintaining balance, and 'decreasing use of stimulants' underpinned strategies to interrupt hypo/manic ascent. There is merit in combining CBPR and Delphi methods. Copyright © 2016 Elsevier B.V. All rights reserved.

LEACHATE CLOGGING ASSESSMENT OF GEOTEXTILE AND SOIL LANDFILL FILTERS

EPA Science Inventory

The liquids management strategy for any municipal or hazardous waste landfill requires a knowledgeable design strategy for the leachate collection system located at the base of the waste mass. Such leachate collection systems generally consist of sumps, perforated pipes, drainag...

Research of information classification and strategy intelligence extract algorithm based on military strategy hall

NASA Astrophysics Data System (ADS)

Chen, Lei; Li, Dehua; Yang, Jie

2007-12-01

Constructing virtual international strategy environment needs many kinds of information, such as economy, politic, military, diploma, culture, science, etc. So it is very important to build an information auto-extract, classification, recombination and analysis management system with high efficiency as the foundation and component of military strategy hall. This paper firstly use improved Boost algorithm to classify obtained initial information, then use a strategy intelligence extract algorithm to extract strategy intelligence from initial information to help strategist to analysis information.

A qualitative investigation of the impact of asthma and self-management strategies among older adults.

PubMed

O'Conor, Rachel; Martynenko, Melissa; Gagnon, Monica; Hauser, Diane; Young, Edwin; Lurio, Joseph; Wisnivesky, Juan P; Wolf, Michael S; Federman, Alex D

2017-01-02

 We sought feedback from elderly patients living with asthma to understand their experience with assuming self-management roles for their asthma in order to inform the design and implementation of a primary care-based strategy that could best support their asthma control. We held six focus groups with a total of 31 English- and Spanish-speaking older adults with a current diagnosis of asthma. Focus groups addressed the effect of asthma on patients' lives and self-management strategies. Transcripts were analyzed using constant comparative techniques. Asthma exerted a consistent effect on patients' physical and psychological well-being. Common barriers to self-care included misuse of controller medications and uncertainty whether shortness of breath, fatigue, and cough were due to their asthma or some other chronic illness. Patients developed coping strategies to continue with daily activities even when experiencing symptoms, but did not recognize attainable asthma quality of life. Asthma had a distinct impact on elderly adults' quality of life; due to their longstanding history with this condition, many patients had accepted these symptoms as a "new normal." Developing strategies to reorient patients' perceptions of the possibilities for managing their illness will be critical to the success of asthma self-management support programs specific to older adults.

Putting Residents First: Strategies Developed by CNAs to Prevent and Manage Resident-to-Resident Violence in Nursing Homes

PubMed Central

Snellgrove, Susan; Beck, Cornelia; Green, Angela; McSweeney, Jean C.

2015-01-01

Purpose of the Study: Resident-to-resident violence (RRV) in nursing homes (NHs) is common and threatens the safety and quality of life of both residents and caregivers. The purpose of this portion of a larger qualitative study was to explore strategies developed by certified nurses’ assistants (CNAs) to prevent and manage RRV in NHs. Design and Methods: Semistructured interviews were used to collect data. Data were analyzed utilizing content analysis and constant comparison. Results: Analysis revealed one overriding theme, “Putting Residents First” which the CNAs described as a conscious effort to put themselves or a beloved family member in the place of the resident while administering care. Within this theme, there were three related subthemes: (a) Knowing the Residents, (b) Keeping Residents Safe, and (c) Spending Quality Time. Implications: Together, these themes suggest that the formulation of strategies for decreasing and managing RRV was influenced significantly by the ability of the CNAs to empathize with the residents for whom they were caring. The results indicate that in the absence of evidence-based interventions, CNAs have developed their own strategies for the management and prevention of RRV. These strategies may provide a foundation for the development and testing of interventions aimed at preventing and managing RRV in NHs. PMID:26055786

Managing Bias in Palliative Care: Professional Hazards in Goals of Care Discussions at the End of Life.

PubMed

Callaghan, Katharine A; Fanning, Joseph B

2018-02-01

In the setting of end-of-life care, biases can interfere with patient articulation of goals and hinder provision of patient-centered care. No studies have addressed clinician bias or bias management specific to goals of care discussions at the end of life. To identify and determine the prevalence of palliative care clinician biases and bias management strategies in end-of-life goals of care discussions. A semistructured interview guide with relevant domains was developed to facilitate data collection. Participants were asked directly to identify biases and bias management strategies applicable to this setting. Two researchers developed a codebook to identify themes using a 25% transcript sample through an iterative process based on grounded theory. Inter-rater reliability was evaluated using Cohen κ. It was 0.83, indicating near perfect agreement between coders. The data approach saturation. A purposive sampling of 20 palliative care clinicians in Middle Tennessee participated in interviews. The 20 clinicians interviewed identified 16 biases and 11 bias management strategies. The most frequently mentioned bias was a bias against aggressive treatment (n = 9), described as a clinician's assumption that most interventions at the end of life are not beneficial. The most frequently mentioned bias management strategy was self-recognition of bias (n = 17), described as acknowledging that bias is present. This is the first study identifying palliative care clinicians' biases and bias management strategies in end-of-life goals of care discussions.

Electric vehicle energy management system

NASA Astrophysics Data System (ADS)

Alaoui, Chakib

This thesis investigates and analyzes novel strategies for the optimum energy management of electric vehicles (EVs). These are aimed to maximize the useful life of the EV batteries and make the EV more practical in order to increase its acceptability to market. The first strategy concerns the right choice of the batteries for the EV according to the user's driving habits, which may vary. Tests conducted at the University of Massachusetts Lowell battery lab show that the batteries perform differently from one manufacturer to the other. The second strategy was to investigate the fast chargeability of different batteries, which leads to reduce the time needed to recharge the EV battery pack. Tests were conducted again to prove that only few battery types could be fast charged. Test data were used to design a fast battery charger that could be installed in an EV charging station. The third strategy was the design, fabrication and application of an Electric Vehicle Diagnostic and Rejuvenation System (EVDRS). This system is based on Mosfet Controlled Thyristors (MCTs). It is capable of quickly identifying any failing battery(s) within the EV pack and rejuvenating the whole battery pack without dismantling them and unloading them. A novel algorithm to rejuvenate Electric Vehicle Sealed Lead Acid Batteries is described. This rejuvenation extends the useful life of the batteries and makes the EV more competitive. The fourth strategy was to design a thermal management system for EV, which is crucial to the safe operation, and the achievement of normal/optimal performance of, electric vehicle (EV) batteries. A novel approach for EV thermal management, based on Pettier-Effect heat pumps, was designed, fabricated and tested in EV. It shows the application of this type of technology for thermal management of EVs.

Coupling Agent-Based and Groundwater Modeling to Explore Demand Management Strategies for Shared Resources

NASA Astrophysics Data System (ADS)

Al-Amin, S.

2015-12-01

Municipal water demands in growing population centers in the arid southwest US are typically met through increased groundwater withdrawals. Hydro-climatic uncertainties attributed to climate change and land use conversions may also alter demands and impact the replenishment of groundwater supply. Groundwater aquifers are not necessarily confined within municipal and management boundaries, and multiple diverse agencies may manage a shared resource in a decentralized approach, based on individual concerns and resources. The interactions among water managers, consumers, and the environment influence the performance of local management strategies and regional groundwater resources. This research couples an agent-based modeling (ABM) framework and a groundwater model to analyze the effects of different management approaches on shared groundwater resources. The ABM captures the dynamic interactions between household-level consumers and policy makers to simulate water demands under climate change and population growth uncertainties. The groundwater model is used to analyze the relative effects of management approaches on reducing demands and replenishing groundwater resources. The framework is applied for municipalities located in the Verde River Basin, Arizona that withdraw groundwater from the Verde Formation-Basin Fill-Carbonate aquifer system. Insights gained through this simulation study can be used to guide groundwater policy-making under changing hydro-climatic scenarios for a long-term planning horizon.

Classification, prevention and management of entero-atmospheric fistula: a state-of-the-art review.

PubMed

Di Saverio, Salomone; Tarasconi, Antonio; Walczak, Dominik A; Cirocchi, Roberto; Mandrioli, Matteo; Birindelli, Arianna; Tugnoli, Gregorio

2016-02-01

Entero-atmospheric fistula (EAF) is an enteric fistula occurring in the setting of an open abdomen, thus creating a communication between the GI tract and the external atmosphere. Management and nursing of patients suffering EAF carries several challenges, and prevention of EAF should be the first and best treatment option. Here, we present a novel modified classification of EAF and review the current state of the art in its prevention and management including nutritional issues and feeding strategies. We also provide an overview on surgical management principles, highlighting several surgical techniques for dealing with EAF that have been reported in the literature throughout the years. The treatment strategy for EAF should be multidisciplinary and multifaceted. Surgical treatment is most often multistep and should be tailored to the single patient, based on the type and characteristics of the EAF, following its correct identification and classification. The specific experience of surgeons and nursing staff in the management of EAF could be enhanced, applying distinct simulation-based ex vivo training models.

Disease management and medication compliance.

PubMed

Cohen, Joshua; Christensen, Kathyrn; Feldman, Lanna

2012-02-01

Lack of medication compliance is harmful to health care systems from both a clinical and economic perspective. This study examines the methods that disease management organizations employ to identify nonadherent patients and to measure effectiveness of compliance programs for patients with diabetes, hyperlipidemia, and cystic fibrosis. In addition, this study investigates the degree to which disease managers assume risk in their contracts, and whether compliance strategies are being coordinated with payers' use of value-based insurance design, in which patient cost sharing is a function of the relative value of pharmaceuticals. This study's findings suggest that disease management may be falling short in terms of: (a) comprehensive commitment to expert-recommended at-home devices used to self-diagnose and measure health indicators; (b) early adoption of expert-recommended new technologies to measure and improve compliance; (c) intensity of use of standard tests in outpatient clinics; (d) coordination of compliance strategies with payers' use of value-based insurance design; and (e) the proportion of risk assumed in disease management contracts.

Management of forest fires to maximize carbon sequestration in temperate and boreal forests

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

Guggenheim, D.E.

1996-12-31

This study examines opportunities for applying prescribed burning strategies to forest stands to enhance net carbon sequestration and compared prescribed burning strategies with more conventional forestry-based climate change mitigation alternatives, including fire suppression and afforestation. Biomass burning is a major contributor to greenhouse gas accumulation in the atmosphere. Biomass burning has increased by 50% since 1850. Since 1977, the annual extent of burning in the northern temperate and boreal forests has increased dramatically, from six- to nine-fold. Long-term suppression of fires in North America, Russia, and other parts of the world has led to accumulated fuel load and an increasemore » in the destructive power of wildfires. Prescribed burning has been used successfully to reduce the destructiveness of wildfires. However, across vast areas of Russia and other regions, prescribed burning is not a component of forest management practices. Given these factors and the sheer size of the temperate-boreal carbon sink, increasing attention is being focused on the role of these forests in mitigating climate change, and the role of fire management strategies, such as prescribed burning, which could work alongside more conventional forestry-based greenhouse gas offset strategies, such as afforestation.« less

Compiler-directed cache management in multiprocessors

NASA Technical Reports Server (NTRS)

Cheong, Hoichi; Veidenbaum, Alexander V.

1990-01-01

The necessity of finding alternatives to hardware-based cache coherence strategies for large-scale multiprocessor systems is discussed. Three different software-based strategies sharing the same goals and general approach are presented. They consist of a simple invalidation approach, a fast selective invalidation scheme, and a version control scheme. The strategies are suitable for shared-memory multiprocessor systems with interconnection networks and a large number of processors. Results of trace-driven simulations conducted on numerical benchmark routines to compare the performance of the three schemes are presented.

Partnerships in Health Systems: Social Organization as limits and possibilities in the Family Health Strategy Management.

PubMed

Silva, Vanessa Costa E; Barbosa, Pedro Ribeiro; Hortale, Virgínia Alonso

2016-05-01

This is a case study in the municipality of Rio de Janeiro about management in the Family Health Strategy based on the Social Organizations model. The aims were to characterize and analyze aspects of the governance system adopted by the Rio de Janeiro Municipal Health Department and identify limits and possibilities of this model as a management option in Brazil's Unified Health System. A qualitative study was performed based on a literature review, document analysisand interviews with key informants. This management model facilitated the expansion of access to primary healthcare through the Family Health Strategy in Rio - where the population covered increased from 7.2% of the population in 2008 to 45.5% in 2015. The results showthat some practices in the contractual logic need to be improved, including negotiation and accountability with autonomywith the service suppliers. Evaluation and control has focus on processes, not results, and there has not been an increase in transparency and social control. The system of performance incentives has been reported as inducing improvements in the work process of the health teams. It is concluded that the regulatory capacity of the municipal management would need to be improved. On the other hand, there is an important and significant process of learning in progress.

Ecosystem-Based Management and the Sustainable Delivery of Marine Ecosystem Services

NASA Astrophysics Data System (ADS)

Fogarty, M.; Schwing, F. B.

2016-12-01

Ecosystem-Based Management can provide an essential framework for the sustainable delivery of a broad spectrum of marine Ecosystem Services (ES) essential to human well being. Key elements of the approach involve the specification of clearly articulated goals for EBM; the development of an accompanying Marine Ecosystem Services Assessment (MESA) designed to evaluate the status of delivery of these services; and strategies for the implementation of management options designed to achieve the stated goals of the program. The specification of goals is the purview of managers. In the United States under the provisions of the National Ocean Policy, Regional Planning Bodies are charged with the responsibility of articulating goals and developing strategies to meet these goals. Government agencies, in concert with the broader scientific community, hold the responsibility for assessing the status of the delivery of ecosystem services in relation to designated objectives and advising on appropriate management strategies. In this presentation, I will illustrate the specification of a MESA for the Northwest U.S Continental Shelf Large Marine Ecosystem (NES LME). The approach focuses on the evaluation of ES indicators and additional metrics related to threats and impacts to the sustainable delivery of these services. Results are combined into an overall index of status of the NES LME.

Peer-based behavioural strategies to improve chronic disease self-management and clinical outcomes: evidence, logistics, evaluation considerations and needs for future research

PubMed Central

2010-01-01

The diagnosis of a chronic disease such as diabetes generally evokes strong emotions and often brings with it the need to make changes in lifestyle behaviours, such as diet, exercise, medication management and monitoring clinical and metabolic parameters. The diagnosis thus affects not only the person diagnosed but also the family members. Chronic illnesses are largely self-managed with ∼99% of the care becoming the responsibility of patients and their families or others involved in the daily management of their illnesses. While the responsibility for outcomes, such as metabolic control and chronic complications, are shared with the health care team, the daily decisions and behaviours adopted by patients clearly have a strong influence on their future health and well-being. While diabetes self-management education is essential, it is generally not sufficient for patients to sustain behaviours and cope with a lifetime of diabetes. Peers have been proposed as one method for assisting patients to deal with the behavioural and affective components of diabetes and to provide ongoing self-management support. This paper first describes effective behavioural strategies in diabetes, based on multiple studies and/or meta-analyses, and then provides examples of their use by peers or in peer-based programmes in diabetes. A comprehensive search using the MEDLINE® and Cinahl databases was conducted. Key search terms included peer mentors, peer leaders, peer educators, lay health workers and community health workers. Studies that clearly identified behavioural strategies used by peers were included. PMID:19509083

Peer-based behavioural strategies to improve chronic disease self-management and clinical outcomes: evidence, logistics, evaluation considerations and needs for future research.

PubMed

Funnell, Martha Mitchell

2010-06-01

The diagnosis of a chronic disease such as diabetes generally evokes strong emotions and often brings with it the need to make changes in lifestyle behaviours, such as diet, exercise, medication management and monitoring clinical and metabolic parameters. The diagnosis thus affects not only the person diagnosed but also the family members. Chronic illnesses are largely self-managed with approximately 99% of the care becoming the responsibility of patients and their families or others involved in the daily management of their illnesses. While the responsibility for outcomes, such as metabolic control and chronic complications, are shared with the health care team, the daily decisions and behaviours adopted by patients clearly have a strong influence on their future health and well-being. While diabetes self-management education is essential, it is generally not sufficient for patients to sustain behaviours and cope with a lifetime of diabetes. Peers have been proposed as one method for assisting patients to deal with the behavioural and affective components of diabetes and to provide ongoing self-management support. This paper first describes effective behavioural strategies in diabetes, based on multiple studies and/or meta-analyses, and then provides examples of their use by peers or in peer-based programmes in diabetes. A comprehensive search using the MEDLINE and Cinahl databases was conducted. Key search terms included peer mentors, peer leaders, peer educators, lay health workers and community health workers. Studies that clearly identified behavioural strategies used by peers were included.

Urban gray vs. urban green vs. soil protection — Development of a systemic solution to soil sealing management on the example of Germany

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

Artmann, Martina, E-mail: m.artmann@ioer.de

Managing urban soil sealing is a difficult venture due to its spatial heterogeneity and embedding in a socio-ecological system. A systemic solution is needed to tackle its spatial, ecological and social sub-systems. This study develops a guideline for urban actors to find a systemic solution to soil sealing management based on two case studies in Germany: Munich and Leipzig. Legal-planning, informal-planning, economic-fiscal, co-operative and informational responses were evaluated by indicators to proof which strategy considers the spatial complexity of urban soil sealing (systemic spatial efficiency) and, while considering spatial complexity, to assess what the key management areas for action aremore » to reduce the ecological impacts by urban soil sealing (ecological impact efficiency) and to support an efficient implementation by urban actors (social implementation efficiency). Results suggest framing the systemic solution to soil sealing management through a cross-scale, legal-planning development strategy embedded in higher European policies. Within the socio-ecological system, the key management area for action should focus on the protection of green infrastructure being of high value for actors from the European to local scales. Further efforts are necessary to establish a systemic monitoring concept to optimize socio-ecological benefits and avoid trade-offs such as between urban infill development and urban green protection. This place-based study can be regarded as a stepping stone on how to develop systemic strategies by considering different spatial sub-targets and socio-ecological systems. - Highlights: • Urban soil sealing management is spatially complex. • The legal-planning strategy supports a systemic sealing management. • Urban green infrastructure protection should be in the management focus. • Soil protection requires policies from higher levels of government. • A systemic urban soil sealing monitoring concept is needed.« less

Development of a Consumable Inventory Management Strategy for the Supply Management Unit

DTIC Science & Technology

2007-12-01

should be either returned to the supplier for partial credit or sent to disposal. This means that based 52 upon current and projected consumption ...economical to maintain based upon current and projected consumption rates. The magnitude of the feasible excess is driven by the base stock level prescribed...Days of Supply model to establish Requisitioning Objectives (RO) and Reorder Points (ROP), which are based upon historical usage, lead time, and supply

Evaluating environmental impacts of alternative construction waste management approaches using supply-chain-linked life-cycle analysis.

PubMed

Kucukvar, Murat; Egilmez, Gokhan; Tatari, Omer

2014-06-01

Waste management in construction is critical for the sustainable treatment of building-related construction and demolition (C&D) waste materials, and recycling of these wastes has been considered as one of the best strategies in minimization of C&D debris. However, recycling of C&D materials may not always be a feasible strategy for every waste type and therefore recycling and other waste treatment strategies should be supported by robust decision-making models. With the aim of assessing the net carbon, energy, and water footprints of C&D recycling and other waste management alternatives, a comprehensive economic input-output-based hybrid life-cycle assessment model is developed by tracing all of the economy-wide supply-chain impacts of three waste management strategies: recycling, landfilling, and incineration. Analysis results showed that only the recycling of construction materials provided positive environmental footprint savings in terms of carbon, energy, and water footprints. Incineration is a better option as a secondary strategy after recycling for water and energy footprint categories, whereas landfilling is found to be as slightly better strategy when carbon footprint is considered as the main focus of comparison. In terms of construction materials' environmental footprint, nonferrous metals are found to have a significant environmental footprint reduction potential if recycled. © The Author(s) 2014.

Operational concepts and implementation strategies for the design configuration management process.

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

Trauth, Sharon Lee

2007-05-01

This report describes operational concepts and implementation strategies for the Design Configuration Management Process (DCMP). It presents a process-based systems engineering model for the successful configuration management of the products generated during the operation of the design organization as a business entity. The DCMP model focuses on Pro/E and associated activities and information. It can serve as the framework for interconnecting all essential aspects of the product design business. A design operation scenario offers a sense of how to do business at a time when DCMP is second nature within the design organization.

Dietary Management of Obesity: Cornerstones of Healthy Eating Patterns.

PubMed

Smethers, Alissa D; Rolls, Barbara J

2018-01-01

Several dietary patterns, both macronutrient and food based, can lead to weight loss. A key strategy for weight management that can be applied across dietary patterns is to reduce energy density. Clinical trials show that reducing energy density is effective for weight loss and weight loss maintenance. A variety of practical strategies and tools can help facilitate successful weight management by reducing energy density, providing portion control, and improving diet quality. The flexibility of energy density gives patients options to tailor and personalize their dietary pattern to reduce energy intake for sustainable weight loss. Copyright © 2017 Elsevier Inc. All rights reserved.

Crew workload-management strategies - A critical factor in system performance

NASA Technical Reports Server (NTRS)

Hart, Sandra G.

1989-01-01

This paper reviews the philosophy and goals of the NASA/USAF Strategic Behavior/Workload Management Program. The philosophical foundation of the program is based on the assumption that an improved understanding of pilot strategies will clarify the complex and inconsistent relationships observed among objective task demands and measures of system performance and pilot workload. The goals are to: (1) develop operationally relevant figures of merit for performance, (2) quantify the effects of strategic behaviors on system performance and pilot workload, (3) identify evaluation criteria for workload measures, and (4) develop methods of improving pilots' abilities to manage workload extremes.

A Landscape Approach to Invasive Species Management.

PubMed

Lurgi, Miguel; Wells, Konstans; Kennedy, Malcolm; Campbell, Susan; Fordham, Damien A

2016-01-01

Biological invasions are not only a major threat to biodiversity, they also have major impacts on local economies and agricultural production systems. Once established, the connection of local populations into metapopulation networks facilitates dispersal at landscape scales, generating spatial dynamics that can impact the outcome of pest-management actions. Much planning goes into landscape-scale invasive species management. However, effective management requires knowledge on the interplay between metapopulation network topology and management actions. We address this knowledge gap using simulation models to explore the effectiveness of two common management strategies, applied across different extents and according to different rules for selecting target localities in metapopulations with different network topologies. These management actions are: (i) general population reduction, and (ii) reduction of an obligate resource. The reduction of an obligate resource was generally more efficient than population reduction for depleting populations at landscape scales. However, the way in which local populations are selected for management is important when the topology of the metapopulation is heterogeneous in terms of the distribution of connections among local populations. We tested these broad findings using real-world scenarios of European rabbits (Oryctolagus cuniculus) infesting agricultural landscapes in Western Australia. Although management strategies targeting central populations were more effective in simulated heterogeneous metapopulation structures, no difference was observed in real-world metapopulation structures that are highly homogeneous. In large metapopulations with high proximity and connectivity of neighbouring populations, different spatial management strategies yield similar outcomes. Directly considering spatial attributes in pest-management actions will be most important for metapopulation networks with heterogeneously distributed links. Our modelling framework provides a simple approach for identifying the best possible management strategy for invasive species based on metapopulation structure and control capacity. This information can be used by managers trying to devise efficient landscape-oriented management strategies for invasive species and can also generate insights for conservation purposes.

Current management of advanced and castration resistant prostate cancer.

PubMed

Gomella, Leonard G; Petrylak, Daniel P; Shayegan, Bobby

2014-04-01

Newer approaches to the management of advanced prostate cancer have rapidly evolved. While basic androgen deprivation remains as the first line in newly diagnosed hormone naïve metastatic prostate cancer, the agents used and strategies followed have undergone significant changes. Numerous new agents such as sipuleucel-T, abiraterone, enzalutamide, cabazitaxel and radium 223 have all been approved since 2010 to treat metastatic castration resistant prostate cancer (CRPC). New imaging techniques to detect advanced disease such as F-18 PET, 11 C-choline PET and other modalities are becoming available. The concepts of "bone health" and the management of side effects related to androgen deprivation therapy are also gaining attention as men are being treated with longer courses of androgen deprivation. Understanding the theory behind these new agents and management approaches while focusing on the practical clinical considerations are essential to improve outcomes in advanced prostate cancer. A review of the current state of the art in the management of advanced and castration resistant prostate cancer presented in this Canadian Journal of Urology International supplement was performed. Key findings are summarized and presented along with critical updates based on recent publications and meeting presentations. Key concepts identified in the management of advanced prostate cancer included the new understanding of prostate cancer based on translational discoveries, applications of various hormonally based strategies in advanced disease including traditional and recently approved agents. The use of new imaging modalities to identify metastatic disease, immunotherapy approaches and discussions of sequencing and which new agents are likely to be available in the future in the management of CRPC were identified. Bone targeted strategies are also addressed in the setting of androgen deprivation and metastatic disease. The management of men with advanced prostate cancer has become more multidisciplinary as treatment options have expanded. As the use of these agents and new strategies expand, urologists, medical oncologists and radiation oncologists must all become familiar with this rapidly changing field in order to maximize the outcome of patients with advanced and castration resistant prostate cancer.

Value-based leadership. Is your hospital management team prepared for the future?

PubMed

Stempniak, Marty

2013-05-01

This foldout section looks at the seven steps to a value-structured hospital, 10 must-do strategies for thriving in the new health care era, and what new skills management, physicians and trustees should have.

Application of dynamic traffic assignment to advanced managed lane modeling.

DOT National Transportation Integrated Search

2013-11-01

In this study, a demand estimation framework is developed for assessing the managed lane (ML) : strategies by utilizing dynamic traffic assignment (DTA) modeling, instead of the traditional : approaches that are based on the static traffic assignment...

Ethical Challenges in Evaluation with Communities: A Manager's Perspective.

ERIC Educational Resources Information Center

Nee, David; Mojica, Maria I.

1999-01-01

Senior staff members at a family foundation share their perspectives, as managers and practitioners, on the ethical challenges and opportunities facing professionals engaged in the evaluation of comprehensive, community-based initiatives and other nontraditional program strategies. (Author/SLD)

A plant-based diet for type 2 diabetes: scientific support and practical strategies.

PubMed

Trapp, Caroline; Barnard, Neal; Katcher, Heather

2010-01-01

The purpose of this review is to provide educators with the knowledge and tools to utilize plant-based nutrition education as an intervention for type 2 diabetes. Scientific support for the efficacy, acceptability, and nutritional adequacy of a plant-based diet for people with type 2 diabetes is presented, and practical considerations such as medication adjustment and risk of hypoglycemia are reviewed. Plant-based meal planning is an acceptable and effective strategy that educators can use to improve diabetes management and reduce risk of complications. Studies show that dietary changes that are effective for reducing cardiac risk may also be helpful for management of type 2 diabetes. A low-fat, plant-based diet reduces body weight and improves glycemic control, and has been shown to be remarkably well accepted by patients.

Regional approaches to the management of patients with advanced, radioactive iodine-refractory differentiated thyroid carcinoma.

PubMed

Brose, Marcia S; Smit, Johannes; Capdevila, Jaume; Elisei, Rossella; Nutting, Christopher; Pitoia, Fabian; Robinson, Bruce; Schlumberger, Martin; Shong, Young Kee; Takami, Hiroshi

2012-09-01

For patients with advanced, radioactive iodine-refractory differentiated thyroid cancer, current treatment guidelines recommend clinical trial enrollment or small-molecule kinase inhibitor therapy. However, details of patient management vary between countries depending on trial availability and national regulatory policies. Insufficient clinical trial data and variable disease characteristics challenge the creation of universal guidelines, and treatment plans often reflect regional influences. A multidisciplinary, multiregional panel of experts met to discuss regional approaches to managing patients with advanced, radioactive iodine-refractory differentiated thyroid cancer and the potential impact of emerging therapies on current treatment strategies. Despite process-oriented regional differences, the decision-making strategies were similar. Multidisciplinary teams used to manage high-risk patients varied in composition across regions, particularly regarding the responsible physician's specialty. Cytotoxic chemotherapy was viewed as limited in clinical benefit, and targeted agents as attractive, based on promising data. Panel members support clinical trial enrollment as the preferred treatment strategy for managing these patients.

Tools for Analyzing Computing Resource Management Strategies and Algorithms for SDR Clouds

NASA Astrophysics Data System (ADS)

Marojevic, Vuk; Gomez-Miguelez, Ismael; Gelonch, Antoni

2012-09-01

Software defined radio (SDR) clouds centralize the computing resources of base stations. The computing resource pool is shared between radio operators and dynamically loads and unloads digital signal processing chains for providing wireless communications services on demand. Each new user session request particularly requires the allocation of computing resources for executing the corresponding SDR transceivers. The huge amount of computing resources of SDR cloud data centers and the numerous session requests at certain hours of a day require an efficient computing resource management. We propose a hierarchical approach, where the data center is divided in clusters that are managed in a distributed way. This paper presents a set of computing resource management tools for analyzing computing resource management strategies and algorithms for SDR clouds. We use the tools for evaluating a different strategies and algorithms. The results show that more sophisticated algorithms can achieve higher resource occupations and that a tradeoff exists between cluster size and algorithm complexity.

How CEOs use management information systems for strategy implementation in hospitals.

PubMed

Naranjo-Gil, David; Hartmann, Frank

2007-04-01

Institutional and market changes seem to force hospitals across the Western world to revitalize their corporate strategies towards more cost efficiency on the one hand, and more flexibility towards customer demands on the other hand. Hospitals, however, apparently differ in the extent to which they are able to implement such strategies effectively. This paper explores whether these different levels of effectiveness depend on how hospitals' top managers' use of the available management information systems (MIS). Based on data obtained from the 218 CEOs of public hospitals in Spain, we analyze how CEOs' professional and educational backgrounds affect their use of MIS, and how the use of the MIS subsequently supports or inhibits the implementation of these strategic goals. The results indicate that CEOs with a predominant clinical background focus more on non-financial information for decision-making and prefer an interactive style of using MIS, which together support flexibility strategies. CEOs with a predominant administrative background seem more effective in establishing cost-reduction strategies, through their larger inclination to emphasize financial information in combination with a diagnostic use of the MIS. Implications for the strategic management of hospitals are outlined.

Fostering Learning Through Interprofessional Virtual Reality Simulation Development.

PubMed

Nicely, Stephanie; Farra, Sharon

2015-01-01

This article presents a unique strategy for improving didactic learning and clinical skill while simultaneously fostering interprofessional collaboration and communication. Senior-level nursing students collaborated with students enrolled in the Department of Interactive Media Studies to design a virtual reality simulation based upon disaster management and triage techniques. Collaborative creation of the simulation proved to be a strategy for enhancing students' knowledge of and skill in disaster management and triage while impacting attitudes about interprofessional communication and teamwork.

Consumer-oriented health care reform strategies: a review of the evidence on managed competition and consumer-directed health insurance.

PubMed

Buchmueller, Thomas C

2009-12-01

For many years, leading health care reform proposals have been based on market-oriented strategies. In the 1990s, a number of reform proposals were built around the concept of "managed competition," but more recently, "consumer-directed health care" models have received attention. Although price-conscious consumer demand plays a critical role in both the managed competition and consumer-directed health care models, the two strategies are based on different visions of the health care marketplace and the best way to use market forces to achieve greater systemwide efficiencies. This article reviews the research literature that tests the main hypotheses concerning the two policy strategies. Numerous studies provide consistent evidence that consumers' health plan choices are sensitive to out-of-pocket premiums. The elasticity of demand appears to vary with consumers' health risk, with younger, healthier individuals being more price sensitive. This heterogeneity increases the potential for adverse selection. Biased risk selection also is a concern when the menu of health plan options includes consumer-directed health plans. Several studies confirm that such plans tend to attract healthier enrollees. A smaller number of studies test the main hypothesis regarding consumer-directed health plans, which is that they result in lower medical spending than do more generous plans. These studies find little support for this claim. The experiences of employers that have adopted key elements of managed competition are generally consistent with the key hypotheses underlying that strategy. Research in this area, however, has focused on only a narrow range of questions. Because consumer-directed health care is such a recent phenomenon, research on this strategy is even more limited. Additional studies on both topics would be valuable.

Consumer-Oriented Health Care Reform Strategies: A Review of the Evidence on Managed Competition and Consumer-Directed Health Insurance

PubMed Central

Buchmueller, Thomas C

2009-01-01

Context: For many years, leading health care reform proposals have been based on market-oriented strategies. In the 1990s, a number of reform proposals were built around the concept of “managed competition,” but more recently, “consumer-directed health care” models have received attention. Although price-conscious consumer demand plays a critical role in both the managed competition and consumer-directed health care models, the two strategies are based on different visions of the health care marketplace and the best way to use market forces to achieve greater systemwide efficiencies. Methods: This article reviews the research literature that tests the main hypotheses concerning the two policy strategies. Findings: Numerous studies provide consistent evidence that consumers’ health plan choices are sensitive to out-of-pocket premiums. The elasticity of demand appears to vary with consumers’ health risk, with younger, healthier individuals being more price sensitive. This heterogeneity increases the potential for adverse selection. Biased risk selection also is a concern when the menu of health plan options includes consumer-directed health plans. Several studies confirm that such plans tend to attract healthier enrollees. A smaller number of studies test the main hypothesis regarding consumer-directed health plans, which is that they result in lower medical spending than do more generous plans. These studies find little support for this claim. Conclusions: The experiences of employers that have adopted key elements of managed competition are generally consistent with the key hypotheses underlying that strategy. Research in this area, however, has focused on only a narrow range of questions. Because consumer-directed health care is such a recent phenomenon, research on this strategy is even more limited. Additional studies on both topics would be valuable. PMID:20021587

Characterization of Model-Based Reasoning Strategies for Use in IVHM Architectures

NASA Technical Reports Server (NTRS)

Poll, Scott; Iverson, David; Patterson-Hine, Ann

2003-01-01

Open architectures are gaining popularity for Integrated Vehicle Health Management (IVHM) applications due to the diversity of subsystem health monitoring strategies in use and the need to integrate a variety of techniques at the system health management level. The basic concept of an open architecture suggests that whatever monitoring or reasoning strategy a subsystem wishes to deploy, the system architecture will support the needs of that subsystem and will be capable of transmitting subsystem health status across subsystem boundaries and up to the system level for system-wide fault identification and diagnosis. There is a need to understand the capabilities of various reasoning engines and how they, coupled with intelligent monitoring techniques, can support fault detection and system level fault management. Researchers in IVHM at NASA Ames Research Center are supporting the development of an IVHM system for liquefying-fuel hybrid rockets. In the initial stage of this project, a few readily available reasoning engines were studied to assess candidate technologies for application in next generation launch systems. Three tools representing the spectrum of model-based reasoning approaches, from a quantitative simulation based approach to a graph-based fault propagation technique, were applied to model the behavior of the Hybrid Combustion Facility testbed at Ames. This paper summarizes the characterization of the modeling process for each of the techniques.

An integrated approach to preventing cardiovascular disease: community-based approaches, health system initiatives, and public health policy.

PubMed

Karwalajtys, Tina; Kaczorowski, Janusz

2010-01-01

Cardiovascular disease (CVD) is largely the product of interactions among modifiable risk factors that are common in developed nations and increasingly of concern in developing countries. Hypertension is an important precursor to the development of CVD, and although detection and treatment rates have improved in recent years in some jurisdictions, effective strategies and policies supporting a shift in distribution of risk factors at the population level remain paramount. Challenges in managing cardiovascular health more effectively include factors at the patient, provider, and system level. Strategies to reduce hypertension and CVD should be population based, incorporate multilevel, multicomponent, and socioenvironmental approaches, and integrate community resources with public health and clinical care. There is an urgent need to improve monitoring and management of risk factors through community-wide, primary care-linked initiatives, increase the evidence base for community-based prevention strategies, further develop and evaluate promising program components, and develop new approaches to support healthy lifestyle behaviors in diverse age, socioeconomic, and ethnocultural groups. Policy and system changes are critical to reduce risk in populations, including legislation and public education to reduce dietary sodium and trans-fatty acids, food pricing policies, and changes to health care delivery systems to explicitly support prevention and management of CVD.

Online energy management strategy of fuel cell hybrid electric vehicles based on data fusion approach

NASA Astrophysics Data System (ADS)

Zhou, Daming; Al-Durra, Ahmed; Gao, Fei; Ravey, Alexandre; Matraji, Imad; Godoy Simões, Marcelo

2017-10-01

Energy management strategy plays a key role for Fuel Cell Hybrid Electric Vehicles (FCHEVs), it directly affects the efficiency and performance of energy storages in FCHEVs. For example, by using a suitable energy distribution controller, the fuel cell system can be maintained in a high efficiency region and thus saving hydrogen consumption. In this paper, an energy management strategy for online driving cycles is proposed based on a combination of the parameters from three offline optimized fuzzy logic controllers using data fusion approach. The fuzzy logic controllers are respectively optimized for three typical driving scenarios: highway, suburban and city in offline. To classify patterns of online driving cycles, a Probabilistic Support Vector Machine (PSVM) is used to provide probabilistic classification results. Based on the classification results of the online driving cycle, the parameters of each offline optimized fuzzy logic controllers are then fused using Dempster-Shafer (DS) evidence theory, in order to calculate the final parameters for the online fuzzy logic controller. Three experimental validations using Hardware-In-the-Loop (HIL) platform with different-sized FCHEVs have been performed. Experimental comparison results show that, the proposed PSVM-DS based online controller can achieve a relatively stable operation and a higher efficiency of fuel cell system in real driving cycles.

Lakes and ponds recreation management: a state-wide application of the visitor impact management process

Treesearch

Jerry J. Vaske; Rodney R. Zwick; Maureen P. Donnelly

1992-01-01

The Visitor Impact Management (VIM) process is designed to identify unacceptable changes occurring as a result of visitor use and to develop management strategies to keep visitor impacts within acceptable levels. All previous attempts to apply the VIM planning framework have concentrated on specific resources. This paper expands this focus to an entire state. Based on...

Leadership and Management in Vocational Education and Training: Staying Focused on Strategy. Volume 1 [and] Volume 2.

ERIC Educational Resources Information Center

Mulcahy, Dianne

Roles and functions of senior and front line managers in VET organizations and their approaches to developing management and leadership expertise were examined in order to identify best practices. Based upon mail surveys sent to managers in 1551 registered training organizations (365 responded, for a response rate of 23.5%), 147 telephone…

Dream project: Applications of earth observations to disaster risk management

NASA Astrophysics Data System (ADS)

Dyke, G.; Gill, S.; Davies, R.; Betorz, F.; Andalsvik, Y.; Cackler, J.; Dos Santos, W.; Dunlop, K.; Ferreira, I.; Kebe, F.; Lamboglia, E.; Matsubara, Y.; Nikolaidis, V.; Ostoja-Starzewski, S.; Sakita, M.; Verstappen, N.

2011-01-01

The field of disaster risk management is relatively new and takes a structured approach to managing uncertainty related to the threat of natural and man-made disasters. Disaster risk management consists primarily of risk assessment and the development of strategies to mitigate disaster risk. This paper will discuss how increasing both Earth observation data and information technology capabilities can contribute to disaster risk management, particularly in Belize. The paper presents the results and recommendations of a project conducted by an international and interdisciplinary team of experts at the 2009 session of the International Space University in NASA Ames Research Center (California, USA). The aim is to explore the combination of current, planned and potential space-aided, airborne, and ground-based Earth observation tools, the emergence of powerful new web-based and mobile data management tools, and how this combination can support and improve the emerging field of disaster risk management. The starting point of the project was the World Bank's Comprehensive Approach to Probabilistic Risk Assessment (CAPRA) program, focused in Central America. This program was used as a test bed to analyze current space technologies used in risk management and develop new strategies and tools to be applied in other regions around the world.

Dimensions of osteoarthritis self-management.

PubMed

Prior, Kirsty N; Bond, Malcolm J

2004-06-01

Our aims were to determine whether a taxonomy of self-management strategies for osteoarthritis could be identified, and whether the resultant dimensions of such a taxonomy demonstrate predictable relationships with health status indices. Participants (n = 117) from community-based self-help groups and a general rheumatology outpatient clinic completed a self-management inventory consisting of 11 items, answered for both the past 7 days and a day on which symptoms were worse than usual. Duration of symptoms, level of pain, perceived functional ability and self-rated health were recorded as indicators of health status. Three essentially identical factors were obtained for both past 7 days and worse day items. Resultant scales were labeled passive, complementary and active, respectively. Correlations with health status measures provided modest evidence for the construct validity of these self-management scales. Compared with a simple aggregate score based on the total number of strategies used, the scales provided a clearer understanding of the relationship between self-management and health. The study provided a useful extension to existing research, addressing a number of shortcomings identified by previous researchers. The identified self-management dimensions offered a greater insight into the self-management choices of patients. Suggestions for further improvements to the measurement of self-management are outlined.

Systematic review of prevention and management strategies for the consequences of gender-based violence in refugee settings.

PubMed

Asgary, Ramin; Emery, Eleanor; Wong, Marcia

2013-06-01

Uncertainties continue regarding effective strategies to prevent and address the consequences of gender-based violence (GBV) among refugees. The databases of PubMed, Cochrane Library, Scopus, PsycINFO, Web of Science, Anthropology Plus, EMBASE, DARE, Google Scholar, MSF Field Research, UNHCR and the regional and global indices of the WHO Global Health Library were searched twice within a 6-month period (April and September 2011) for English-language clinical, public health, basic and social science studies evaluating strategies to prevent and manage health sequelae of GBV among refugees before September 2011. Studies not primarily about prevention and treatment, and not describing population, health outcome and interventions, were excluded. The literature search for the prevention and management arms produced 1212 and 1106 results, respectively. After reviewing the titles and abstracts, 29 and 27 articles were selected for review in their entirety, none of which met the inclusion criteria. Multiple panels of expert recommendations and guidelines were not supported by primary data on actual displaced populations. There is a dire need for research that evaluates the efficacy and effectiveness of various responses to GBV to ultimately allow a transition from largely theoretical and expertise driven to a more evidence-based field. We recommend strategies to improve data collection and to overcome barriers in primary data driven research.

Mechanism-based strategies for the management of autoimmunity and immune dysregulation in primary immunodeficiencies

PubMed Central

Walter, Jolan E; Farmer, Jocelyn R; Foldvari, Zsofia; Torgerson, Troy R; Cooper, Megan A

2016-01-01

A broad spectrum of autoimmunity is now well described in patients with primary immunodeficiencies (PIDs). Management of autoimmune disease in the background of PID is particularly challenging given the seemingly discordant goals of immune support and immune suppression. Our growing ability to define the molecular underpinnings of immune dysregulation has facilitated novel targeted therapeutics. This review focuses on mechanism-based treatment strategies for the most common autoimmune and inflammatory complications of PID including autoimmune cytopenias, rheumatologic disease, and gastrointestinal disease. We aim to provide guidance regarding the rational use of these agents in the complex PID patient population. PMID:27836058

NEW MOLECULAR MEDICINE-BASED SCAR MANAGEMENT STRATEGIES

PubMed Central

Arno, Anna I; Gauglitz, Gerd G; Barret, Juan P; Jeschke, Marc G

2014-01-01

Keloids and hypertrophic scars are prevalent disabling conditions with still suboptimal treatments. Basic science and molecular-based medicine research has contributed to unravel new bench-to-bedside scar therapies, and to dissect the complex signaling pathways involved. Peptides such as transforming growth factor beta (TGF-β) superfamily, with SMADs, Ski, SnoN, Fussels, endoglin, DS-Sily, Cav-1p, AZX100, thymosin-β4 and other related molecules may emerge as targets to prevent and treat keloids and hypertrophic scars. The aim of this review is to describe the basic complexity of these new molecular scar management strategies, and point out new fibrosis research lines. PMID:24438742

Advancing the science of microbial symbiosis to support invasive species management: a case study on Phragmites in the Great Lakes

PubMed Central

Kowalski, Kurt P.; Bacon, Charles; Bickford, Wesley; Braun, Heather; Clay, Keith; Leduc-Lapierre, Michèle; Lillard, Elizabeth; McCormick, Melissa K.; Nelson, Eric; Torres, Monica; White, James; Wilcox, Douglas A.

2015-01-01

A growing body of literature supports microbial symbiosis as a foundational principle for the competitive success of invasive plant species. Further exploration of the relationships between invasive species and their associated microbiomes, as well as the interactions with the microbiomes of native species, can lead to key new insights into invasive success and potentially new and effective control approaches. In this manuscript, we review microbial relationships with plants, outline steps necessary to develop invasive species control strategies that are based on those relationships, and use the invasive plant species Phragmites australis (common reed) as an example of how development of microbial-based control strategies can be enhanced using a collective impact approach. The proposed science agenda, developed by the Collaborative for Microbial Symbiosis and Phragmites Management, contains a foundation of sequential steps and mutually-reinforcing tasks to guide the development of microbial-based control strategies for Phragmites and other invasive species. Just as the science of plant-microbial symbiosis can be transferred for use in other invasive species, so too can the model of collective impact be applied to other avenues of research and management. PMID:25745417

Advancing the science of microbial symbiosis to support invasive species management: a case study on Phragmites in the Great Lakes.

PubMed

Kowalski, Kurt P; Bacon, Charles; Bickford, Wesley; Braun, Heather; Clay, Keith; Leduc-Lapierre, Michèle; Lillard, Elizabeth; McCormick, Melissa K; Nelson, Eric; Torres, Monica; White, James; Wilcox, Douglas A

2015-01-01

A growing body of literature supports microbial symbiosis as a foundational principle for the competitive success of invasive plant species. Further exploration of the relationships between invasive species and their associated microbiomes, as well as the interactions with the microbiomes of native species, can lead to key new insights into invasive success and potentially new and effective control approaches. In this manuscript, we review microbial relationships with plants, outline steps necessary to develop invasive species control strategies that are based on those relationships, and use the invasive plant species Phragmites australis (common reed) as an example of how development of microbial-based control strategies can be enhanced using a collective impact approach. The proposed science agenda, developed by the Collaborative for Microbial Symbiosis and Phragmites Management, contains a foundation of sequential steps and mutually-reinforcing tasks to guide the development of microbial-based control strategies for Phragmites and other invasive species. Just as the science of plant-microbial symbiosis can be transferred for use in other invasive species, so too can the model of collective impact be applied to other avenues of research and management.

Advancing the science of microbial symbiosis to support invasive species management: a case study on Phragmites in the Great Lakes

USGS Publications Warehouse

Kowalski, Kurt P.; Bacon, Charles R.; Bickford, Wesley A.; Braun, Heather A.; Clay, Keith; Leduc-Lapierre, Michele; Lillard, Elizabeth; McCormick, Melissa K.; Nelson, Eric; Torres, Monica; White, James W. C.; Wilcox, Douglas A.

2015-01-01

A growing body of literature supports microbial symbiosis as a foundational principle for the competitive success of invasive plant species. Further exploration of the relationships between invasive species and their associated microbiomes, as well as the interactions with the microbiomes of native species, can lead to key new insights into invasive success and potentially new and effective control approaches. In this manuscript, we review microbial relationships with plants, outline steps necessary to develop invasive species control strategies that are based on those relationships, and use the invasive plant species Phragmites australis (common reed) as an example of how development of microbial-based control strategies can be enhanced using a collective impact approach. The proposed science agenda, developed by the Collaborative for Microbial Symbiosis andPhragmites Management, contains a foundation of sequential steps and mutually-reinforcing tasks to guide the development of microbial-based control strategies for Phragmites and other invasive species. Just as the science of plant-microbial symbiosis can be transferred for use in other invasive species, so too can the model of collective impact be applied to other avenues of research and management.

Implementation of a Self-Management System for Students with Disabilities in General Education Settings

ERIC Educational Resources Information Center

Schulze, Margaret A.

2016-01-01

Despite the fact that self-management procedures have a robust literature base attesting to their efficacy with students with disabilities, the use of these strategies in general education settings remains limited. This mixed methods study examined the implementation of self-management procedures using both quantitative and qualitative methods.…

Managing Sierra Nevada forests

Treesearch

Malcolm North

2012-01-01

There has been widespread interest in applying new forest practices based on concepts presented in U.S. Forest Service General Technical Report PSW-GTR-220, "An Ecosystem Management Strategy for Sierran Mixed-Conifer Forests." This collection of papers (PSW-GTR-237) summarizes the state of the science in some topics relevant to this forest management approach...

Leadership Strategies for Department Chairs and Program Directors: A Case Study Approach.

ERIC Educational Resources Information Center

Comer, Robert W.; Haden, N. Karl; Taylor, Robert L.; Thomas, D. Denee

2002-01-01

Reviews leadership challenges and management concepts in academic dentistry as they were applied in a case-based faculty development workshop, in order to provide a foundation for three cases that follow in subsequent articles. The workshop was structured to address leadership challenges relating to managing people, mission management, conflict…

Treatment of an Anonymous Recipient: Solid-Waste Management Simulation Game

ERIC Educational Resources Information Center

Wu, Ko-Chiu; Huang, Po-Yuan

2015-01-01

This study developed a game simulation based on problem solving in the management of urban waste. We then investigated the factors affecting the decisions made by players. During gameplay, the players sought to guide the development of a city via management strategies involving a balance of economic growth and environmental protection. Nature…

Public acceptance of disturbance-based forest management: factors influencing support

Treesearch

Christine S. Olsen; Angela L. Mallon; Bruce A. Shindler

2012-01-01

Growing emphasis on ecosystem and landscape-level forest management across North America has spurred an examination of alternative management strategies which focus on emulating dynamic natural disturbance processes, particularly those associated with forest fire regimes. This topic is the cornerstone of research in the Blue River Landscape Study (BRLS) on the...

Middle School Teachers' Perceptions of Barriers of Managing Student Behavior

ERIC Educational Resources Information Center

Whitlock, Winifred Nicole

2012-01-01

Despite training and support, many middle school teachers struggle to create, implement, and enforce research-based strategies to manage students' behaviors. The purpose of this case study was to examine teachers' perceptions about the barriers of managing student behavior. The research questions investigated 9 teachers' perceived…

Meadow management and treatment options [chapter 8

Treesearch

Jeanne C. Chambers; Jerry R. Miller

2011-01-01

Restoration and management objectives and approaches are most effective when based on an understanding of ecosystem processes and the long- and short-term causes of disturbance (Wohl and others 2005). As detailed in previous chapters, several factors are critical in developing effective management strategies for streams and their associated meadow ecosystems in the...

Adaptive capacity and community-based natural resource management.

PubMed

Armitage, Derek

2005-06-01

Why do some community-based natural resource management strategies perform better than others? Commons theorists have approached this question by developing institutional design principles to address collective choice situations, while other analysts have critiqued the underlying assumptions of community-based resource management. However, efforts to enhance community-based natural resource management performance also require an analysis of exogenous and endogenous variables that influence how social actors not only act collectively but do so in ways that respond to changing circumstances, foster learning, and build capacity for management adaptation. Drawing on examples from northern Canada and Southeast Asia, this article examines the relationship among adaptive capacity, community-based resource management performance, and the socio-institutional determinants of collective action, such as technical, financial, and legal constraints, and complex issues of politics, scale, knowledge, community and culture. An emphasis on adaptive capacity responds to a conceptual weakness in community-based natural resource management and highlights an emerging research and policy discourse that builds upon static design principles and the contested concepts in current management practice.

Pain management strategies and lessons from the military: A narrative review

PubMed Central

Vallerand, April Hazard; Cosler, Patricia; Henningfield, Jack E; Galassini, Pam

2015-01-01

BACKGROUND: Wounded soldiers often experience substantial pain, which must be addressed before returning to active duty or civilian life. The United States (US) military has instituted several guidelines and initiatives aimed at improving pain management by providing rapid access to medical care, and developing interdisciplinary multimodal pain management strategies based on outcomes observed both in combat and hospital settings. OBJECTIVE: To provide a narrative review regarding US military pain management guidelines and initiatives, which may guide improvements in pain management, particularly chronic pain management and prevention, for the general population. METHODS: A literature review of US military pain management guidelines and initiatives was conducted, with a particular focus on the potential of these guidelines to address shortcomings in chronic pain management in the general population. DISCUSSION: The application of US military pain management guidelines has been shown to improve pain monitoring, education and relief. In addition, the US military has instituted the development of programs and guidelines to ensure proper use and discourage aberrant behaviours with regard to opioid use, because opioids are regarded as a critical part of acute and chronic pain management schemes. Inadequate pain management, particularly inadequate chronic pain management, remains a major problem for the general population in the US. Application of military strategies for pain management to the general US population may lead to more effective pain management and improved long-term patient outcomes. PMID:26448972

Wait time management strategies for total joint replacement surgery: sustainability and unintended consequences.

PubMed

Pomey, Marie-Pascale; Clavel, Nathalie; Amar, Claudia; Sabogale-Olarte, Juan Carlos; Sanmartin, Claudia; De Coster, Carolyn; Noseworthy, Tom

2017-09-07

In Canada, long waiting times for core specialized services have consistently been identified as a key barrier to access. Governments and organizations have responded with strategies for better access management, notably for total joint replacement (TJR) of the hip and knee. While wait time management strategies (WTMS) are promising, the factors which influence their sustainable implementation at the organizational level are understudied. Consequently, this study examined organizational and systemic factors that made it possible to sustain waiting times for TJR within federally established limits and for at least 18 months or more. The research design is a multiple case study of WTMS implementation. Five cases were selected across five Canadian provinces. Three success levels were pre-defined: 1) the WTMS maintained compliance with requirements for more than 18 months; 2) the WTMS met requirements for 18 months but could not sustain the level thereafter; 3) the WTMS never met requirements. For each case, we collected documents and interviewed key informants. We analyzed systemic and organizational factors, with particular attention to governance and leadership, culture, resources, methods, and tools. We found that successful organizations had specific characteristics: 1) management of the whole care continuum, 2) strong clinical leadership; 3) dedicated committees to coordinate and sustain strategy; 4) a culture based on trust and innovation. All strategies led to relatively similar unintended consequences. The main negative consequence was an initial increase in waiting times for TJR and the main positive consequence was operational enhancement of other areas of specialization based on the TJR model. This study highlights important differences in factors which help to achieve and sustain waiting times. To be sustainable, a WTMS needs to generate greater synergies between contextual-level strategy (provincial or regional) and organizational objectives and constraints. Managers at the organizational level should be vigilant with regard to unintended consequences that a WTMS in one area can have for other areas of care. A more systemic approach to sustainability can help avoid or mitigate undesirable unintended consequences.

Postoperative pain management experiences among school-aged children: a qualitative study.

PubMed

Sng, Qian Wen; Taylor, Beverley; Liam, Joanne Lw; Klainin-Yobas, Piyanee; Wang, Wenru; He, Hong-Gu

2013-04-01

To explore postoperative pain management experiences among school-aged children. Ineffective postoperative pain management among children has been commonly reported. School-aged children are able to evaluate how their pain is managed and what their preferred strategies are. Most studies in pain management have adopted quantitative methods and have overlooked children's pain management experiences. This is a qualitative study using face-to-face interviews. Data were collected from 15 school-aged children admitted to a tertiary hospital in Singapore by in-depth interviews conducted between November 2010 and January 2011. Data were analysed by thematic analysis. Five themes were identified: children's self-directed actions to relieve their postoperative pain (e.g. using cognitive-behavioural methods of distraction and imagery, physical method of positioning, sleeping and drinking, seeking other people's help by informing parents and crying and using pain medications); children's perceptions of actions parents take for their postoperative pain relief (assessing pain, administering pain medications, using various cognitive-behavioural, physical methods and emotional support strategies, assisting in activities and alerting health professionals); children's perception of actions nurses take for their postoperative pain relief (administering medication, using cognitive-behavioural methods, emotional support strategies and helping with activities of daily living) and suggestions for parents (using distraction and presence) and nurses (administering medications, distraction and positioning) for their postoperative pain relief improvement. This study contributed to the existing knowledge about children's postoperative pain management based on their own experiences. Children, their parents and nurses used various strategies, including pain medication and non-pharmacological methods, especially distraction, for children's postoperative pain relief. This study provides evidence for health care professionals to consider using more pain relief strategies when caring for children postoperatively and provide guidance for children to practice these strategies. © 2013 Blackwell Publishing Ltd.

How Does Gender Affect Sustainable Intensification of Cereal Production in the West African Sahel? Evidence from Burkina Faso.

PubMed

Theriault, Veronique; Smale, Melinda; Haider, Hamza

2017-04-01

Better understanding of gender differences in the adoption of agricultural intensification strategies is crucial for designing effective policies to close the gender gap while sustainably enhancing farm productivity. We examine gender differences in adoption rates, likelihood and determinants of adopting strategy sets that enhance yields, protect crops, and restore soils in the West African Sahel, based on analysis of cereal production in Burkina Faso. Applying a multivariate probit model to a nationally representative household panel, we exploit the individual plot as unit of analysis and control for plot manager characteristics along with other covariates. Reflecting the socio-cultural context of farming combined with the economic attributes of inputs, we find that female managers of individual cereal fields are less likely than their male counterparts to adopt yield-enhancing and soil-restoring strategies, although no differential is apparent for yield-protecting strategies. More broadly, gender-disaggregated regressions demonstrate that adoption determinants differ by gender. Plot manager characteristics, including age, marital status, and access to credit or extension services do influence adoption decisions. Furthermore, household resources influence the probability of adopting intensification strategy sets differently by gender of the plot manager. Variables expressing the availability of household labor strongly influence the adoption of soil-restoring strategies by female plot managers. By contrast, household resources such as extent of livestock owned, value of non-farm income, and area planted to cotton affect the adoption choices of male plot managers. Rectifying the male bias in extension services along with improving access to credit, income, and equipment to female plot managers could contribute to sustainable agricultural intensification.

Obesity: Risk factors, complications, and strategies for sustainable long-term weight management.

PubMed

Fruh, Sharon M

2017-10-01

The aims of this article are to review the effects of obesity on health and well-being and the evidence indicating they can be ameliorated by weight loss, and consider weight-management strategies that may help patients achieve and maintain weight loss. Narrative review based on literature searches of PubMed up to May 2016 with no date limits imposed. Search included terms such as "obesity," "overweight," "weight loss," "comorbidity," "diabetes," cardiovascular," "cancer," "depression," "management," and "intervention." Over one third of U.S. adults have obesity. Obesity is associated with a range of comorbidities, including diabetes, cardiovascular disease, obstructive sleep apnea, and cancer; however, modest weight loss in the 5%-10% range, and above, can significantly improve health-related outcomes. Many individuals struggle to maintain weight loss, although strategies such as realistic goal-setting and increased consultation frequency can greatly improve the success of weight-management programs. Nurse practitioners have key roles in establishing weight-loss targets, providing motivation and support, and implementing weight-loss programs. With their in-depth understanding of the research in the field of obesity and weight management, nurse practitioners are well placed to effect meaningful changes in weight-management strategies deployed in clinical practice. ©2017 American Association of Nurse Practitioners.

Water resources management strategies and its implications on hydrodynamic and hydrochemical changes of costal groundwater: Case of Grombalia shallow aquifer, NE Tunisia

NASA Astrophysics Data System (ADS)

Lachaal, Fethi; Chekirbane, Anis; Chargui, Sameh; Sellami, Haykel; Tsujimura, Maki; Hezzi, Hmida; Faycel, Jelassi; Mlayah, Ammar

2016-12-01

Information on groundwater quantity as well as quality is required by water managers and decision-makers for defining a sustainable management strategy. This requires a comprehensive assessment of the surface water and groundwater resources. This paper provides an assessment of water resources management strategy in the Grombalia region (Northeast Tunisia) and its impact on quantity and quality evolution of groundwater resources based on an approach that combines (i) hydro-climatic data, (ii) field monitoring, (iii) historic piezometric records, and (iv) geochemical and stable isotopes (δ18O and δ2H) analyses. We apply this approach to identify the origin of the various water resources and outline how the actual water management impact the quantity and quality of the groundwater in the region. As consequence of poor water resources management, the shallow groundwater levels have been disrupted: a groundwater rise is observed in the centre and a piezometric drawdown is observed in the upstream regions. Groundwater quality degradation was registered especially in the centre and downstream zones.

Laboratory testing under managed care dominance in the USA

PubMed Central

Takemura, Y; Beck, J

2001-01-01

The uncontrolled escalation of total health care expenditure despite the government's endeavours during the past decades in the USA had led to the rapid infiltration of managed care organisations (MCOs). Traditional hospital based laboratories have been placed in a crucial situation with the advent of the managed care era. A massive reduction of in house testing urged them to develop strategies against financial difficulty. Consolidation and networking, participation in the outreach testing market, and emphasis on point of care/satellite laboratory testing in non-traditional, ambulatory settings are major strategies for the survival of hospital laboratories. Several physicians' office laboratories (POLS) have closed their doors in response both to regulatory restrictions imposed by the Clinical Laboratory Improvement Amendments of 1988 and to managed care infiltration. It seems likely that POLs and hospital laboratories will continue to reduce test volumes, whereas commercial reference laboratories will thrive through contracting with MCOs. In the current climate of managed care dominance in the USA, clinical laboratories are changing their basic operation focus and mission in response to the aggressively changing landscape. Key Words: laboratory testing • managed care organisations • survival strategies PMID:11215291

Burning, fire prevention and landscape productions among the Pemon, Gran Sabana, Venezuela: toward an intercultural approach to wildland fire management in Neotropical Savannas.

PubMed

Sletto, Bjørn; Rodriguez, Iokiñe

2013-01-30

Wildland fire management in savanna landscapes increasingly incorporates indigenous knowledge to pursue strategies of controlled, prescriptive burning to control fuel loads. However, such participatory approaches are fraught with challenges because of contrasting views on the role of fire and the practices of prescribed burning between indigenous and state fire managers. Also, indigenous and state systems of knowledge and meanings associated with fire are not monolithic but instead characterized by conflicts and inconsistencies, which require new, communicative strategies in order to develop successful, intercultural approaches to fire management. This paper is based on long-term research on indigenous Pemon social constructs, rules and regulations regarding fire use, and traditional system of prescribed burning in the Gran Sabana, Venezuela. The authors review factors that act as constraints against successful intercultural fire management in the Gran Sabana, including conflicting perspectives on fire use within state agencies and in indigenous communities, and propose strategies for research and communicative planning to guide future efforts for more participatory and effective fire management. Copyright © 2012 Elsevier Ltd. All rights reserved.

Northern Wisconsin snowmobilers: their characteristics and management preferences.

Treesearch

Earl C. Leatherberry

1976-01-01

This paper provides an insight into how snowmobilers feel about various management strategies to regulate snowmobile use on public land. The paper provides the composite opinion of snowmobilers and their opinion based on whether they were members of snowmobile clubs.

REMEDIATION AND PROTECTION OF GROUND WATER FROM CONTAMINATION BY ARSENIC

EPA Science Inventory

Successful prevention of public exposure to arsenic in ground-water resources impacted by natural sources or contaminated sites is dependent on scientifically-based strategies for site remediation and water resource management. Research within the National Risk Management Resear...

Management Information Systems.

ERIC Educational Resources Information Center

Finlayson, Jean, Ed.

1989-01-01

This collection of papers addresses key questions facing college managers and others choosing, introducing, and living with big, complex computer-based systems. "What Use the User Requirement?" (Tony Coles) stresses the importance of an information strategy driven by corporate objectives, not technology. "Process of Selecting a…

The Prevention of Childhood Sexual Abuse

ERIC Educational Resources Information Center

Finkelhor, David

2009-01-01

David Finkelhor examines initiatives to prevent child sexual abuse, which have focused on two primary strategies--offender management and school-based educational programs. Recent major offender management initiatives have included registering sex offenders, notifying communities about their presence, conducting background employment checks,…

Integrated Pest Management of Coffee Berry Borer: Strategies from Latin America that Could Be Useful for Coffee Farmers in Hawaii.

PubMed

Aristizábal, Luis F; Bustillo, Alex E; Arthurs, Steven P

2016-02-03

The coffee berry borer (CBB), Hypothenemus hampei Ferrari (Coleoptera: Curculionidae: Scolytinae) is the primary arthropod pest of coffee plantations worldwide. Since its detection in Hawaii (September 2010), coffee growers are facing financial losses due to reduced quality of coffee yields. Several control strategies that include cultural practices, biological control agents (parasitoids), chemical and microbial insecticides (entomopathogenic fungi), and a range of post-harvest sanitation practices have been conducted to manage CBB around the world. In addition, sampling methods including the use of alcohol based traps for monitoring CBB populations have been implemented in some coffee producing countries in Latin America. It is currently unclear which combination of CBB control strategies is optimal under economical, environmental, and sociocultural conditions of Hawaii. This review discusses components of an integrated pest management program for CBB. We focus on practical approaches to provide guidance to coffee farmers in Hawaii. Experiences of integrated pest management (IPM) of CBB learned from Latin America over the past 25 years may be relevant for establishing strategies of control that may fit under Hawaiian coffee farmers' conditions.

Robust Power Management Control for Stand-Alone Hybrid Power Generation System

NASA Astrophysics Data System (ADS)

Kamal, Elkhatib; Adouane, Lounis; Aitouche, Abdel; Mohammed, Walaa

2017-01-01

This paper presents a new robust fuzzy control of energy management strategy for the stand-alone hybrid power systems. It consists of two levels named centralized fuzzy supervisory control which generates the power references for each decentralized robust fuzzy control. Hybrid power systems comprises: a photovoltaic panel and wind turbine as renewable sources, a micro turbine generator and a battery storage system. The proposed control strategy is able to satisfy the load requirements based on a fuzzy supervisor controller and manage power flows between the different energy sources and the storage unit by respecting the state of charge and the variation of wind speed and irradiance. Centralized controller is designed based on If-Then fuzzy rules to manage and optimize the hybrid power system production by generating the reference power for photovoltaic panel and wind turbine. Decentralized controller is based on the Takagi-Sugeno fuzzy model and permits us to stabilize each photovoltaic panel and wind turbine in presence of disturbances and parametric uncertainties and to optimize the tracking reference which is given by the centralized controller level. The sufficient conditions stability are formulated in the format of linear matrix inequalities using the Lyapunov stability theory. The effectiveness of the proposed Strategy is finally demonstrated through a SAHPS (stand-alone hybrid power systems) to illustrate the effectiveness of the overall proposed method.

Integrated Curriculum Design Reform of Civil Engineering Management Discipline Based on Inter-disciplinary Professional Training

NASA Astrophysics Data System (ADS)

Yidong, Xu; Ping, Wu; Jian, Chen; Jiansheng, Shen

2018-05-01

In view of the shortcomings of the current civil engineering management discipline, this paper investigates the necessity of the course design reform. Based on the analysis of basic occupation requirements of civil engineering management discipline, the basic ideas and implementation strategies of the integrated reform of curriculum design system are proposed, which can not only improve the students’ overall understanding of knowledge and skills, but also enhance the system of student learning.

Habitat-based conservation strategies cannot compensate for climate-change-induced range loss

NASA Astrophysics Data System (ADS)

Wessely, Johannes; Hülber, Karl; Gattringer, Andreas; Kuttner, Michael; Moser, Dietmar; Rabitsch, Wolfgang; Schindler, Stefan; Dullinger, Stefan; Essl, Franz

2017-11-01

Anthropogenic habitat fragmentation represents a major obstacle to species shifting their range in response to climate change. Conservation measures to increase the (meta-)population capacity and permeability of landscapes may help but the effectiveness of such measures in a warming climate has rarely been evaluated. Here, we simulate range dynamics of 51 species from three taxonomic groups (vascular plants, butterflies and grasshoppers) in Central Europe as driven by twenty-first-century climate scenarios and analyse how three habitat-based conservation strategies (establishing corridors, improving the landscape matrix, and protected area management) modify species' projected range size changes. These simulations suggest that the conservation strategies considered are unable to save species from regional extinction. For those persisting, they reduce the magnitude of range loss in lowland but not in alpine species. Protected area management and corridor establishment are more effective than matrix improvement. However, none of the conservation strategies evaluated could fully compensate the negative impact of climate change for vascular plants, butterflies or grasshoppers in central Europe.

The role of communities in sustainable land and forest management: The case of Nyanga, Zvimba and Guruve districts of Zimbabwe

PubMed Central

Sagonda, Ruvimbo; Kaundikiza, Munyaradzi

2016-01-01

Forest benefit analysis is vital in ensuring sustainable community-based natural resources management. Forest depletion and degradation are key issues in rural Zimbabwe and strategies to enhance sustainable forest management are continually sought. This study was carried out to assess the impact of forests on communities from Nyanga, Guruve and Zvimba districts of Zimbabwe. It is based on a Big Lottery Fund project implemented by Progressio-UK and Environment Africa. It focuses on identifying replicable community forest and land management strategies and the level of benefits accruing to the community. Analysis of change was based on the Income and Food Security and Forest benefits, which also constitutes the tools used during the research. The study confirms the high rate of deforestation and the increased realisation by communities to initiate practical measures aimed at protecting and sustaining forest and land resources from which they derive economic and social benefits. The results highlight the value of community structures (Farmer Field Schools and Environmental Action Groups) as conduits for natural resource management. The interconnectivity among forests, agricultural systems and the integral role of people are recognised as key to climate change adaptation.

Randomized Trial Comparing Two Treatment Strategies Using Prize-Based Reinforcement of Abstinence in Cocaine and Opiate Users

ERIC Educational Resources Information Center

Preston, Kenzie L.; Ghitza, Udi E.; Schmittner, John P.; Schroeder, Jennifer R.; Epstein, David H.

2008-01-01

We compared two strategies of prize-based contingency management (CM) in methadone-maintained outpatients. Urine was tested thrice weekly for 5 weeks pre-CM, 12 weeks CM, and 8 weeks post-CM. Participants were randomly assigned to a cocaine contingency (four prize draws for each cocaine-negative urine, N = 29) or an opiate-cocaine contingency (one…

Community-based shared values as a 'Heart-ware' driver for integrated watershed management: Japan-Malaysia policy learning perspective

NASA Astrophysics Data System (ADS)

Mohamad, Zeeda Fatimah; Nasaruddin, Affan; Abd Kadir, Siti Norasiah; Musa, Mohd Noor; Ong, Benjamin; Sakai, Nobumitsu

2015-11-01

This paper explores the case for using ;community-based shared values; as a potential driver for the ;Heartware; aspects of governance in Integrated Watershed Management (IWM) - from a Japan-Malaysia policy learning perspective. This policy approach was originally inspired by the Japanese experience, and the paper investigates whether a similar strategy can be adapted in the Malaysian context-based on a qualitative exploratory case study of a local downstream watershed community. The community-based shared values are categorized into six functional values that can be placed on a watershed: industry, ecosystem, lifestyle, landscape, water resource and spirituality. The study confirmed the availability of a range of community-based shared values in each category that are promising to drive the heartware for integrated watershed management in the local Malaysian context. However, most of these shared values are either declining in its appreciation or nostalgic in nature. The paper ends with findings on key differences and similarities between the Malaysian and Japanese contexts, and concludes with lessons for international transfer of IWM heartware policy strategies between the two countries.

Adapting Natural Resource Management to Climate Change: The Blue Mountains and Northern Rockies Adaptation Partnerships

NASA Astrophysics Data System (ADS)

Halofsky, J.; Peterson, D. L.

2014-12-01

Concrete ways to adapt to climate change are needed to help natural resource managers take the first steps to incorporate climate change into management and take advantage of opportunities to balance the negative effects of climate change. We recently initiated two science-management climate change adaptation partnerships, one with three national forests and other key stakeholders in the Blue Mountains region of northeastern Oregon, and the other with 16 national forests, three national parks and other stakeholders in the northern Rockies region. Goals of both partnerships were to: (1) synthesize published information and data to assess the exposure, sensitivity, and adaptive capacity of key resource areas, including water use, infrastructure, fisheries, and vegetation and disturbance; (2) develop science-based adaptation strategies and tactics that will help to mitigate the negative effects of climate change and assist the transition of biological systems and management to a warmer climate; (3) ensure adaptation strategies and tactics are incorporated into relevant planning documents; and (4) foster an enduring partnership to facilitate ongoing dialogue and activities related to climate change in the partnerships regions. After an initial vulnerability assessment by agency and university scientists and local resource specialists, adaptation strategies and tactics were developed in a series of scientist-manager workshops. The final vulnerability assessments and adaptation actions are incorporated in technical reports. The partnerships produced concrete adaptation options for national forest and other natural resource managers and illustrated the utility of place-based vulnerability assessments and scientist-manager workshops in adapting to climate change.

Comparison of provider and plan-based targeting strategies for disease management.

PubMed

Annis, Ann M; Holtrop, Jodi Summers; Tao, Min; Chang, Hsiu-Ching; Luo, Zhehui

2015-05-01

We aimed to describe and contrast the targeting methods and engagement outcomes for health plan-delivered disease management with those of a provider-delivered care management program. Health plan epidemiologists partnered with university health services researchers to conduct a quasi-experimental, mixed-methods study of a 2-year pilot. We used semi-structured interviews to assess the characteristics of program-targeting strategies, and calculated target and engagement rates from clinical encounter data. Five physician organizations (POs) with 51 participating practices implemented care management. Health plan member lists were sent monthly to the practices to accept patients, and then the practices sent back data reports regarding targeting and engagement in care management. Among patients accepted by the POs, we compared those who were targeted and engaged by POs with those who met health plan targeting criteria. The health plan's targeting process combined claims algorithms and employer group preferences to identify candidates for disease management; on the other hand, several different factors influenced PO practices' targeting approaches, including clinical and personal knowledge of the patients, health assessment information, and availability of disease-relevant programs. Practices targeted a higher percentage of patients for care management than the health plan (38% vs 16%), where only 7% of these patients met the targeting criteria of both. Practices engaged a higher percentage of their targeted patients than the health plan (50% vs 13%). The health plan's claims-driven targeting approach and the clinically based strategies of practices both provide advantages; an optimal model may be to combine the strengths of each approach to maximize benefits in care management.

A randomized controlled trial of an HIV/AIDS Symptom Management Manual for depressive symptoms.

PubMed

Eller, Lucille S; Kirksey, Kenn M; Nicholas, Patrice K; Corless, Inge B; Holzemer, William L; Wantland, Dean J; Willard, Suzanne S; Robinson, Linda; Hamilton, Mary Jane; Sefcik, Elizabeth F; Moezzi, Shahnaz; Mendez, Marta Rivero; Rosa, Maria; Human, Sarie

2013-01-01

Abstract Depressive symptoms are highly prevalent, underdiagnosed, and undertreated in people living with HIV/AIDS (PLWH), and are associated with poorer health outcomes. This randomized controlled trial examined the effects of the HIV/AIDS Symptom Management Manual self-care symptom management strategies compared with a nutrition manual on depressive symptoms in an international sample of PLWH. The sample consisted of a sub-group (N=222) of participants in a larger study symptom management study who reported depressive symptoms. Depressive symptoms of the intervention (n=124) and control (n=98) groups were compared over three months: baseline, one-month, and two-months. Use and effectiveness of specific strategies were examined. Depressive symptom frequency at baseline varied significantly by country (χ (2) 12.9; p=0.04). Within the intervention group there were significant differences across time in depressive symptom frequency [F(2, 207) = 3.27, p=0.05], intensity [F(2, 91) = 4.6, p=0.01], and impact [F(2, 252) = 2.92, p= 0.05), and these were significantly lower at one month but not at two months, suggesting that self-care strategies are effective in reducing depressive symptoms, however effects may be short term. Most used and most effective self-care strategies were distraction techniques and prayer. This study suggests that people living with HIV can be taught and will employ self-care strategies for management of depressive symptoms and that these strategies are effective in reducing these symptoms. Self-care strategies are noninvasive, have no side-effects, and can be readily taught as an adjunct to other forms of treatment. Studies are needed to identify the most effective self-care strategies and quantify optimum dose and frequency of use as a basis for evidence-based practice.

Smart EV Energy Management System to Support Grid Services

NASA Astrophysics Data System (ADS)

Wang, Bin

Under smart grid scenarios, the advanced sensing and metering technologies have been applied to the legacy power grid to improve the system observability and the real-time situational awareness. Meanwhile, there is increasing amount of distributed energy resources (DERs), such as renewable generations, electric vehicles (EVs) and battery energy storage system (BESS), etc., being integrated into the power system. However, the integration of EVs, which can be modeled as controllable mobile energy devices, brings both challenges and opportunities to the grid planning and energy management, due to the intermittency of renewable generation, uncertainties of EV driver behaviors, etc. This dissertation aims to solve the real-time EV energy management problem in order to improve the overall grid efficiency, reliability and economics, using online and predictive optimization strategies. Most of the previous research on EV energy management strategies and algorithms are based on simplified models with unrealistic assumptions that the EV charging behaviors are perfectly known or following known distributions, such as the arriving time, leaving time and energy consumption values, etc. These approaches fail to obtain the optimal solutions in real-time because of the system uncertainties. Moreover, there is lack of data-driven strategy that performs online and predictive scheduling for EV charging behaviors under microgrid scenarios. Therefore, we develop an online predictive EV scheduling framework, considering uncertainties of renewable generation, building load and EV driver behaviors, etc., based on real-world data. A kernel-based estimator is developed to predict the charging session parameters in real-time with improved estimation accuracy. The efficacy of various optimization strategies that are supported by this framework, including valley-filling, cost reduction, event-based control, etc., has been demonstrated. In addition, the existing simulation-based approaches do not consider a variety of practical concerns of implementing such a smart EV energy management system, including the driver preferences, communication protocols, data models, and customized integration of existing standards to provide grid services. Therefore, this dissertation also solves these issues by designing and implementing a scalable system architecture to capture the user preferences, enable multi-layer communication and control, and finally improve the system reliability and interoperability.

Modifying physician behavior to improve cost-efficiency in safety-net ambulatory settings.

PubMed

Borkowski, Nancy; Gumus, Gulcin; Deckard, Gloria J

2013-01-01

Change interventions in one form or another are viewed as important tools to reduce variation in medical services, reduce costs, and improve quality of care. With the current focus on efficient resource use, the successful design and implementation of change strategies are of utmost importance for health care managers. We present a case study in which macro and micro level change strategies were used to modify primary care physicians' practice patterns of prescribing diagnostic services in a safety-net's ambulatory clinics. The findings suggest that health care managers using evidence-based strategies can create a practice environment that reduces barriers and facilitates change.

A guide to multi-objective optimization for ecological problems with an application to cackling goose management

USGS Publications Warehouse

Williams, Perry J.; Kendall, William L.

2017-01-01

Choices in ecological research and management are the result of balancing multiple, often competing, objectives. Multi-objective optimization (MOO) is a formal decision-theoretic framework for solving multiple objective problems. MOO is used extensively in other fields including engineering, economics, and operations research. However, its application for solving ecological problems has been sparse, perhaps due to a lack of widespread understanding. Thus, our objective was to provide an accessible primer on MOO, including a review of methods common in other fields, a review of their application in ecology, and a demonstration to an applied resource management problem.A large class of methods for solving MOO problems can be separated into two strategies: modelling preferences pre-optimization (the a priori strategy), or modelling preferences post-optimization (the a posteriori strategy). The a priori strategy requires describing preferences among objectives without knowledge of how preferences affect the resulting decision. In the a posteriori strategy, the decision maker simultaneously considers a set of solutions (the Pareto optimal set) and makes a choice based on the trade-offs observed in the set. We describe several methods for modelling preferences pre-optimization, including: the bounded objective function method, the lexicographic method, and the weighted-sum method. We discuss modelling preferences post-optimization through examination of the Pareto optimal set. We applied each MOO strategy to the natural resource management problem of selecting a population target for cackling goose (Branta hutchinsii minima) abundance. Cackling geese provide food security to Native Alaskan subsistence hunters in the goose's nesting area, but depredate crops on private agricultural fields in wintering areas. We developed objective functions to represent the competing objectives related to the cackling goose population target and identified an optimal solution first using the a priori strategy, and then by examining trade-offs in the Pareto set using the a posteriori strategy. We used four approaches for selecting a final solution within the a posteriori strategy; the most common optimal solution, the most robust optimal solution, and two solutions based on maximizing a restricted portion of the Pareto set. We discuss MOO with respect to natural resource management, but MOO is sufficiently general to cover any ecological problem that contains multiple competing objectives that can be quantified using objective functions.

Integrated weed management strategies in cover crop-based, organic rotational no-till corn and soybean in the mid-Atlantic region

USDA-ARS?s Scientific Manuscript database

Cover crop-based, organic rotational no-till (CCORNT) corn and soybean systems have been developed in the mid-Atlantic region to build soil health, increase management flexibility, and reduce labor. In this system, a roll-crimped cover crop mulch provides within-season weed suppression in no-till co...

A Comparative Study of Singapore's School Excellence Model with Hong Kong's School-Based Management

ERIC Educational Resources Information Center

Ng, Pak Tee; Chan, David

2008-01-01

Purpose: This paper aims to examine and compare the school excellence model (SEM) approach adopted by Singapore and the school-based management (SBM) approach adopted by Hong Kong. It discusses the implications of such a strategy and the challenges that both Singapore and Hong Kong schools face in navigating a new paradigm of managerialism while…

Managing Conflict: A Guide for the Pharmacy Manager.

PubMed

Haumschild, Ryan J; Hertig, John B; Weber, Robert J

2015-06-01

Managing conflict among a variety of people and groups is a necessary part of creating a high performance pharmacy department. As new pharmacy managers enter the workforce, much of their success depends on how they manage conflict. The goal of this article is to provide a guide for the pharmacy director on conflict in the workplace. By evaluating each type of conflict, we can learn how to respond when it occurs. Resolving conflict requires a unique and individualized approach, and the strategy used may often be based on the situational context and the personality of the employee or manager. The more that pharmacy leaders can engage in conflict resolution with employees and external leaders, the more proactive they can be in achieving positive results. If pharmacy directors understand the source of conflicts and use management strategies to resolve them, they will ensure that conflicts result in a more effective patient-centered pharmacy service.

Determining the optimum strategy of techniques from the municipal solid waste management hierarchy to maximize social value. Master`s thesis

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

Still, C.M.

1996-12-01

The primary waste management alternatives are source reduction, recycling, composting, incineration, and landfilling. Often waste management policies are based entirely on technical considerations and ignore that actual disposal practices depend on individuals` attitudes and behaviors. This research formulated a decision analysis model that incorporates social value measures to determine the waste management strategy that maximizes the individuals` willingness to participate. The social values that are important and that were considered in the decision support model to assist with making decisions about solid waste management were convenience, feeling good about reducing waste, feeling good about leaving a good environment for futuremore » generations, and the value of recreation programs that can be provided with profit from a recycling program.« less

Mourning dove hunting regulation strategy based on annual harvest statistics and banding data

USGS Publications Warehouse

Otis, D.L.

2006-01-01

Although managers should strive to base game bird harvest management strategies on mechanistic population models, monitoring programs required to build and continuously update these models may not be in place. Alternatively, If estimates of total harvest and harvest rates are available, then population estimates derived from these harvest data can serve as the basis for making hunting regulation decisions based on population growth rates derived from these estimates. I present a statistically rigorous approach for regulation decision-making using a hypothesis-testing framework and an assumed framework of 3 hunting regulation alternatives. I illustrate and evaluate the technique with historical data on the mid-continent mallard (Anas platyrhynchos) population. I evaluate the statistical properties of the hypothesis-testing framework using the best available data on mourning doves (Zenaida macroura). I use these results to discuss practical implementation of the technique as an interim harvest strategy for mourning doves until reliable mechanistic population models and associated monitoring programs are developed.

Clinic-Based Mobile Health Decision Support to Enhance Adult Epilepsy Self-Management: An Intervention Mapping Approach.

PubMed

Shegog, Ross; Begley, Charles E

2017-01-01

Epilepsy is a neurological disorder involving recurrent seizures. It affects approximately 5 million people in the U.S. To optimize their quality of life people with epilepsy are encouraged to engage in self-management (S-M) behaviors. These include managing their treatment (e.g., adhering to anti-seizure medication and clinical visit schedules), managing their seizures (e.g., responding to seizure episodes), managing their safety (e.g., monitoring and avoiding environmental seizure triggers), and managing their co-morbid conditions (e.g., anxiety, depression). The clinic-based Management Information Decision Support Epilepsy Tool (MINDSET) is a decision-support system founded on theory and empirical evidence. It is designed to increase awareness by adult patients (≥18 years) and their health-care provider regarding the patient's epilepsy S-M behaviors, facilitate communication during the clinic visit to prioritize S-M goals and strategies commensurate with the patient's needs, and increase the patient's self-efficacy to achieve those goals. The purpose of this paper is to describe the application of intervention mapping (IM) to develop, implement, and formatively evaluate the clinic-based MINDSET prototype and in developing implementation and evaluation plans. Deliverables comprised a logic model of the problem (IM Step 1); matrices of program objectives (IM Step 2); a program planning document comprising scope, sequence, theory-based methods, and practical strategies (IM Step 3); a functional MINDSET program prototype (IM Step 4); plans for implementation (IM Step 5); and evaluation (IM Step 6). IM provided a logical and systematic approach to developing and evaluating clinic-based decision support toward epilepsy S-M.

Learning to manage a complex ecosystem: adaptive management and the Northwest Forest Plan.

Treesearch

George H. Stankey; Roger N. Clark; Bernard T. Bormann

2006-01-01

The Northwest Forest Plan (the Plan) identifies adaptive management as a central strategy for effective implementation. Despite this, there has been a lack of any systematic evaluation of its performance. This study is based on an extensive literature review, 50 interviews with resource managers and scientists involved with the Plan’s implementation, and a survey of...

Flight crew fatigue management in a more flexible regulatory environment: an overview of the New Zealand aviation industry.

PubMed

Signal, T Leigh; Ratieta, Denise; Gander, Philippa H

2008-04-01

Since 1995, air transport operators in New Zealand have been able to meet the flight and duty time (FDT) regulations by operating according to prescriptive FDT limits or by seeking approval to operate under a potentially more flexible company-specific FDT scheme. There has been no formal assessment of the impact of this increased flexibility on fatigue management processes. The aim of the present study was to determine the strategies and processes that commercial aircraft operators in New Zealand have in place for managing fatigue and whether these differed according to the type of FDT system under which organizations were operating. All air transport operators in New Zealand were sent questionnaires that were to be completed by an individual in a management role, a line pilot, and an individual in a rostering role. Questions were asked about the FDT system under which the organization operated, the strategies and processes in place for managing fatigue, and the consequences of the organization's approach to managing fatigue. One hundred and fifty-three responses were received from 88 organizations (55% of all air operators) and were representative of the structure of the New Zealand industry. Air operators were most likely to report that they monitored flight and duty times and pilot workload to manage fatigue (used by 90-99% and 70-90%, respectively), while educating rostering staff and reviewing the processes for managing fatigue were the least utilized strategies (used by 36-50% and 39-60%, respectively). Within the same organization, managers were more likely than line pilots to report the use of specific fatigue management strategies. There were no differences found between organizations operating under prescriptive regulations and those using a company-specific scheme on ratings of how well fatigue was managed, the number of fatigue management strategies employed, or the frequency of use of selected strategies. Across the industry as a whole, the provision of more flexible regulatory options has not greatly changed fatigue management practices, although some operators have implemented innovative strategies. The findings suggest a need to raise the level of knowledge within the industry regarding the causes and consequences of fatigue and of processes for its management. This is further supported by the discrepancies between the responses of line pilots and managers, which raise doubts about the effectiveness of some strategies nominally being employed. The regulator and other relevant industry groups should consider how to move the industry toward a mature safety culture and solid knowledge base because these are fundamental to more flexible fatigue management regimes, as is adequate regulatory knowledge, support, and oversight.

Optimal environmental management strategy and implementation for groundwater contamination prevention and restoration.

PubMed

Wang, Mingyu

2006-04-01

An innovative management strategy is proposed for optimized and integrated environmental management for regional or national groundwater contamination prevention and restoration allied with consideration of sustainable development. This management strategy accounts for availability of limited resources, human health and ecological risks from groundwater contamination, costs for groundwater protection measures, beneficial uses and values from groundwater protection, and sustainable development. Six different categories of costs are identified with regard to groundwater prevention and restoration. In addition, different environmental impacts from groundwater contamination including human health and ecological risks are individually taken into account. System optimization principles are implemented to accomplish decision-makings on the optimal resources allocations of the available resources or budgets to different existing contaminated sites and projected contamination sites for a maximal risk reduction. Established management constraints such as budget limitations under different categories of costs are satisfied at the optimal solution. A stepwise optimization process is proposed in which the first step is to select optimally a limited number of sites where remediation or prevention measures will be taken, from all the existing contaminated and projected contamination sites, based on a total regionally or nationally available budget in a certain time frame such as 10 years. Then, several optimization steps determined year-by-year optimal distributions of the available yearly budgets for those selected sites. A hypothetical case study is presented to demonstrate a practical implementation of the management strategy. Several issues pertaining to groundwater contamination exposure and risk assessments and remediation cost evaluations are briefly discussed for adequately understanding implementations of the management strategy.

Energy management strategy for fuel cell-supercapacitor hybrid vehicles based on prediction of energy demand

NASA Astrophysics Data System (ADS)

Carignano, Mauro G.; Costa-Castelló, Ramon; Roda, Vicente; Nigro, Norberto M.; Junco, Sergio; Feroldi, Diego

2017-08-01

Offering high efficiency and producing zero emissions Fuel Cells (FCs) represent an excellent alternative to internal combustion engines for powering vehicles to alleviate the growing pollution in urban environments. Due to inherent limitations of FCs which lead to slow transient response, FC-based vehicles incorporate an energy storage system to cover the fast power variations. This paper considers a FC/supercapacitor platform that configures a hard constrained powertrain providing an adverse scenario for the energy management strategy (EMS) in terms of fuel economy and drivability. Focusing on palliating this problem, this paper presents a novel EMS based on the estimation of short-term future energy demand and aiming at maintaining the state of energy of the supercapacitor between two limits, which are computed online. Such limits are designed to prevent active constraint situations of both FC and supercapacitor, avoiding the use of friction brakes and situations of non-power compliance in a short future horizon. Simulation and experimentation in a case study corresponding to a hybrid electric bus show improvements on hydrogen consumption and power compliance compared to the widely reported Equivalent Consumption Minimization Strategy. Also, the comparison with the optimal strategy via Dynamic Programming shows a room for improvement to the real-time strategies.

Preschool Teachers' Views about Classroom Management Models

ERIC Educational Resources Information Center

Sahin-Sak, Ikbal Tuba; Sak, Ramazan; Tezel-Sahin, Fatma

2018-01-01

This survey-based quantitative study investigates 310 Turkish preschool teachers' views about classroom management, using the following six models of disciplinary strategy: behavioral change theory, Dreikurs' social discipline model, Canter's assertive discipline model, the Glasser model of discipline, Kounin's model, and Gordon's teacher…

Evaluation of parking management strategies for urban areas : final report.

DOT National Transportation Integrated Search

1980-01-01

The state of the art of parking management in urban areas in the United States was established using an extensive review of the literature and a nationwide questionnaire survey that was distributed to 458 city officials, 173 of whom responded. Based ...

Uptake, metabolism, and volatilization of selenium by terrestrial plants

USDA-ARS?s Scientific Manuscript database

The green technology of phytoremediation has being developed for the management of metal(loid)-contaminated soils and waters via the processes of phytoextraction, and phytovolatilization. Based upon these processes a plant management remediation strategy for selenium (Se) has been developed for the ...

Individualizing Educational Strategies: An Apple Computer Managed System for the Diagnosis and Evaluation of Reading, Math and Behavior.

ERIC Educational Resources Information Center

Kern, Richard

1985-01-01

A computer-based interactive system for diagnosing academic and school behavior problems is described. Elements include criterion-referenced testing, an instructional management system, and a behavior evaluation tool developed by the author. (JW)

A SCIENTIFIC AND TECHNOLOGICAL FRAMEWORK FOR ENVIRONMENTAL DECISION MAKING

EPA Science Inventory

There are significant scientific and technological challenges to managing natural resources. Data needs are cited as an obvious limitation, but there exist more fundamental scientific issues. What is still needed is a method of comparing management strategies based on projected i...

Catalog and Assessment of the Manpower and Personnel Research Division Data Bases

DTIC Science & Technology

1992-11-01

objectives are: to assess the effectiveness of Army advertising, to assess the advertising strategy in an integrated framework, and to support management...and planning of future advertising strategy . 8POMSOR$ DCSPER, USAREC INSTRUMENT CLEARANCE APPROVAL NUMBERS: N/A TECH ARZ/TBAM RESPONSIBLE: MPPRG

Teaching the Balanced Scorecard through Simulation

ERIC Educational Resources Information Center

Capelo, Carlos; Lopes, Ana Isabel; Mata, Ana

2012-01-01

Kaplan and Norton introduced the Balanced Scorecard (BSC) which is based on a systems perspective of the business strategy and performance measurement. Many organizations around the world are using the BSC to define, implement and manage strategy. Nevertheless there exist studies that identify problems and limitations associated with the…

Same-day transfer for the invasive strategy of patients with non-ST-segment elevation acute coronary syndrome admitted to spoke hospitals: Data from the Emilia-Romagna Regional Network.

PubMed

Campo, Gianluca; Menozzi, Mila; Guastaroba, Paolo; Vignali, Luigi; Belotti, Laura Mb; Casella, Gianni; Berti, Elena; Solinas, Emilia; Guiducci, Vincenzo; Biscaglia, Simone; Pavasini, Rita; De Palma, Rossana; Manari, Antonio

2016-10-01

The service strategy (same-day transfer between spoke hospital and hub centre with catheterisation laboratory (cath-lab) facility to perform invasive procedures) has been suggested to improve the management of patients with non-ST-segment elevation acute coronary syndrome (NSTEACS) admitted to spoke hospitals. We used data from a large prospective Italian registry to describe application, performance and outcome of the service strategy in the daily clinical practice. This study was based on an observational, post-hoc analysis of all consecutive NSTEACS patients admitted to spoke non-invasive hospitals of the Emilia-Romagna regional network and receiving coronary artery angiography (CAA)±percutaneous coronary intervention (PCI). We evaluated: application of service strategy, time to cath-lab access, hospital stay length, 30-days occurrence of adverse events. From January 2011-December 2012, 2952 NSTEACS consecutive patients were admitted to spoke non-invasive hospitals and received CAA. Overall, 1765 (60%) patients were managed with a service strategy. After multivariable analysis, service strategy emerged as independent predictor of faster access to cath-lab (within 72 h: hazard ratio (HR) 2.3, 95% confidence interval (CI) 1.9-2.7, p<0.0001; within 24 h: HR 2.8, 95% CI 2.2-3.3, p<0.0001, respectively). Service strategy significantly reduced hospital stay length (-5.5 days, p<0.0001). We estimated a mean of €1590 saved for each patient managed with service strategy. Thirty-day occurrence of adverse events did not differ between patients managed with or without a service strategy. In our daily clinical practice, a service strategy seems to be an effective approach to optimise the invasive management of NSTEACS patients admitted to spoke hospitals. © The European Society of Cardiology 2015.

Classroom management of situated group learning: A research study of two teaching strategies

NASA Astrophysics Data System (ADS)

Smeh, Kathy; Fawns, Rod

2000-06-01

Although peer-based work is encouraged by theories in developmental psychology and although classroom interventions suggest it is effective, there are grounds for recognising that young pupils find collaborative learning hard to sustain. Discontinuities in collaborative skill during development have been suggested as one interpretation. Theory and research have neglected situational continuities that the teacher may provide in management of formal and informal collaborations. This experimental study, with the collaboration of the science faculty in one urban secondary college, investigated the effect of two role attribution strategies on communication in peer groups of different gender composition in three parallel Year 8 science classes. The group were set a problem that required them to design an experiment to compare the thermal insulating properties of two different materials. This presents the data collected and key findings, and reviews the findings from previous parallel studies that have employed the same research design in different school settings. The results confirm the effectiveness of social role attribution strategies in teacher management of communication in peer-based work.

Lake States natural resource managers' perspectives on forest land parcelization and its implications for public land management

Treesearch

Michael A. Kilgore; Stephanie A. Snyder

2016-01-01

Field-based public natural resource managers in the Lake States (MI, MN, WI) were surveyed for theirperspectives on various aspects of private forest land parcelization. This includes their perceptions ofrecent changes in parcelization activity, drivers and impacts, mitigation strategies, and ability to influenceparcelization. Their perspectives on the implications...

Gender Differences in the Management of Four Different Personnel Disputes with Male and Female Employees.

ERIC Educational Resources Information Center

Rossi, Ana; Todd-Mancillas, Wm. R.

A study compared male and female managers' preferences for using communication-based as opposed to power-centered strategies for resolving employer-employee disputes. Subjects, 40 male and 40 female middle and upper level managers, were interviewed and asked to report their preferred manner of resolving four different personnel problems: (1) an…

Diabetes Prevention and Management among Minority Ethnic Groups in Nicaragua: Findings from Phase 2 of a Community-Based Participatory Research Study

ERIC Educational Resources Information Center

Newlin Lew, Kelley; Mitchell, Emma McKim; Mclean, Yolanda

2016-01-01

Objectives: To (1) describe barriers to diabetes prevention and self-management, (2) explore how religious beliefs inform diabetes prevention and self-management and (3) describe community action strategies to address the problem of diabetes locally. Design: Qualitative, descriptive design. Setting: Three Moravian Churches located, respectively,…

Contingency Management to Increase Grade Point Average among Fraternity Members: A Feasibility Study

ERIC Educational Resources Information Center

Van Patten, Ryan A.; Irons, Jessica G.; Apple, Kevin J.

2015-01-01

Contingency management is an incentive-based intervention strategy that has been demonstrated to be effective for inducing behavior change among a variety of populations and for a variety of behaviors. The current study examined whether contingency management techniques can help students change behaviors in an effort to raise their grade point…

Understanding Challenges, Strategies, and the Role of Support Networks in Medication Self-management Among Patients With Type 2 Diabetes.

PubMed

Bernhard, Gerda; Ose, Dominik; Baudendistel, Ines; Seidling, Hanna M; Stützle, Marion; Szecsenyi, Joachim; Wensing, Michel; Mahler, Cornelia

2017-04-01

Purpose The purpose of this qualitative study was to investigate the challenges and strategies of patients with type 2 diabetes mellitus (T2DM) regarding daily management of their medication regimen focusing on the role of their support networks. Methods A purposeful sample of 25 patients with T2DM was recruited from local self-help groups, general practitioner practices, and a university hospital in southwestern Germany. Four semi-structured focus groups were conducted to identify the challenges patients experienced, the strategies they used, and their collaboration with support networks to assist them in self-managing their medication regimen. Sessions were audio- and video-recorded, fully transcribed, and subjected to computer-aided qualitative content analysis, guided by the Self- and Family Management Framework (SFMF). Results Patients with T2DM experienced numerous challenges affecting medication self-management arising from their personal situation, health status and resources, characteristics of their regimen, and how health care is currently organized. Patients' self-initiated strategies included activating health care, community, social, and online resources; taking ownership of medication-related needs; and integrating medication-taking into daily life. Patients drew on self-help groups, family, and friends to discuss concerns regarding medication safety and receive experience-based information and advice for navigating within the health care system as well as practical hands-on support with daily medication self-management. Conclusions Understanding the challenges and building on strategies patients with T2DM devised help diabetes educators to better address patients' needs and priorities and guide patient-centered interventions to support patients' self-management activities. Community and social support networks operating in patients' lives need to be engaged in the self-management support.

Dysmenorrhoea among Hong Kong university students: prevalence, impact, and management.

PubMed

Chia, C F; Lai, Joyce H Y; Cheung, P K; Kwong, L T; Lau, Fiona P M; Leung, K H; Leung, M T; Wong, Francis C H; Ngu, S F

2013-06-01

OBJECTIVE. To evaluate the prevalence of dysmenorrhoea, its impact, and management approaches in Hong Kong university students, and to compare between medical and non-medical students for any potential differences in coping strategies. DESIGN. Cross-sectional questionnaire survey. SETTING. The University of Hong Kong, Hong Kong. PARTICIPANTS. A total of 240 undergraduate (128 medical and 112 non-medical) students. MAIN OUTCOME MEASURES. Data on the presence and severity of dysmenorrhoea, its impact on daily life, management approaches, specific strategies, and their self-perceived effectiveness were obtained and analysed. RESULTS. In these subjects, the prevalence of dysmenorrhoea was 80% (95% confidence interval, 75-85%) with a mean (standard deviation) pain score of 5.0 (1.7). The most common impacts on daily life included reduced ability to concentrate and/or disturbance with study (75%) and changes in normal physical activity (60%). Only 6% sought medical advice, while 70% practised self-management. Pain scores and pain affecting normal physical activities were important predictive factors for self-management and for management based on pharmacological or non-pharmacological means. The commonest specific strategies used were a warm beverage (62%), paracetamol (57%), and sleeping (45%), while the most effective strategies were non-steroidal anti-inflammatory drugs (100%), traditional Chinese medicine (93%), and dietary/nutritional supplements (92%). Regarding the comparison of medical and non-medical students, the former used fewer pharmacological strategies among the various management approaches investigated. CONCLUSION. With data showing dysmenorrhoea as a very common condition having a significant impact in the Hong Kong community, primary care doctors should reassure young women with dysmenorrhoea that it is a common experience in the same age-group. Health education on the existence of effective treatment from medical practitioners could help women whose dysmenorrhoea was not controlled by self-management.

The impact of demand management strategies on parents’ decision-making for out-of-hours primary care: findings from a survey in The Netherlands

PubMed Central

Giesen, Marie-Jeanne; Keizer, Ellen; van de Pol, Julia; Knoben, Joris; Wensing, Michel; Giesen, Paul

2017-01-01

Objective To explore the potential impact of demand management strategies on patient decision-making in medically non-urgent and urgent scenarios during out-of-hours for children between the ages of 0 and 4 years. Design and methods We conducted a cross-sectional survey with paper-based case scenarios. A survey was sent to all 797 parents of children aged between 0 and 4 years from four Dutch general practitioner (GP) practices. Four demand management strategies (copayment, online advice, overview medical cost and GP appointment next morning) were incorporated in two medically non-urgent and two urgent case scenarios. Combining the case scenarios with the demand management strategies resulted in 16 cases (four scenarios each with four demand management strategies). Each parent randomly received a questionnaire with three different case scenarios with three different demand strategies and a baseline case scenario without a demand management strategy. Results The response rate was 47.4%. The strategy online advice led to more medically appropriate decision-making for both non-urgent case scenarios (OR 0.26; 95% CI 0.11 to 0.58) and urgent case scenarios (OR 0.16; 95% CI 0.08 to 0.32). Overview of medical cost (OR 0.59; 95% CI 0.38 to 0.92) and a GP appointment planned the next morning (OR 0.57; 95% CI 0.34 to 0.97) had some influence on patient decisions for urgent cases, but not for non-urgent cases. Copayment had no influence on patient decisions. Conclusion Online advice has the highest potential to reduce medically unnecessary use. Furthermore it enhanced safety of parents' decisions on seeking help for their young children during out-of-hours primary care. Valid online information on health symptoms for patients should be promoted. PMID:28487458

The impact of demand management strategies on parents' decision-making for out-of-hours primary care: findings from a survey in The Netherlands.

PubMed

Giesen, Marie-Jeanne; Keizer, Ellen; van de Pol, Julia; Knoben, Joris; Wensing, Michel; Giesen, Paul

2017-05-09

To explore the potential impact of demand management strategies on patient decision-making in medically non-urgent and urgent scenarios during out-of-hours for children between the ages of 0 and 4 years. We conducted a cross-sectional survey with paper-based case scenarios. A survey was sent to all 797 parents of children aged between 0 and 4 years from four Dutch general practitioner (GP) practices. Four demand management strategies (copayment, online advice, overview medical cost and GP appointment next morning) were incorporated in two medically non-urgent and two urgent case scenarios. Combining the case scenarios with the demand management strategies resulted in 16 cases (four scenarios each with four demand management strategies). Each parent randomly received a questionnaire with three different case scenarios with three different demand strategies and a baseline case scenario without a demand management strategy. The response rate was 47.4%. The strategy online advice led to more medically appropriate decision-making for both non-urgent case scenarios (OR 0.26; CI 0.11 to 0.58) and urgent case scenarios (OR 0.16; CI 0.08 to 0.32). Overview of medical cost (OR 0.59; CI 0.38 to 0.92) and a GP appointment planned the next morning (OR 0.57; CI 0.34 to 0.97) had some influence on patient decisions for urgent cases, but not for non-urgent cases. Copayment had no influence on patient decisions. Online advice has the highest potential to reduce medically unnecessary use. Furthermore it enhanced safety of parents' decisions on seeking help for their young children during out-of-hours primary care. Valid online information on health symptoms for patients should be promoted. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Evidence-based practice beliefs and behaviors of nurses providing cancer pain management: a mixed-methods approach.

PubMed

Eaton, Linda H; Meins, Alexa R; Mitchell, Pamela H; Voss, Joachim; Doorenbos, Ardith Z

2015-03-01

To describe evidence-based practice (EBP) beliefs and behaviors of nurses who provide cancer pain management. Descriptive, cross-sectional with a mixed-methods approach. Two inpatient oncology units in the Pacific Northwest. 40 RNs.
 Data collected by interviews and web-based surveys. EBP beliefs, EBP implementation, evidence-based pain management. Nurses agreed with the positive aspects of EBP and their implementation ability, although implementation level was low. They were satisfied with their pain management practices. Oncology nursing certification was associated with innovativeness, and innovativeness was associated with EBP beliefs. Themes identified were (a) limited definition of EBP, (b) varied evidence-based pain management decision making, (c) limited identification of evidence-based pain management practices, and (d) integration of nonpharmacologic interventions into patient care. Nurses' low level of EBP implementation in the context of pain management was explained by their trust that standards of care and medical orders were evidence-based. Nurses' EBP beliefs and behaviors should be considered when developing strategies for sustaining evidence-based pain management practices. Implementation of the EBP process by nurses may not be realistic in the inpatient setting; therefore, hospital pain management policies need to be evidence-based and reinforced with nurses.

"I just start crying for no reason": the experience of stress and depression in pregnant, urban, African-American adolescents and their perception of yoga as a management strategy.

PubMed

Kinser, Patricia; Masho, Saba

2015-01-01

Perinatal health disparities are of particular concern with pregnant, urban, African-American (AA) adolescents, who have high rates of stress and depression during pregnancy, higher rates of adverse pregnancy and neonatal outcomes, and many barriers to effective treatment. The purpose of this study was to explore pregnant, urban, AA teenagers' experience of stress and depression and examine their perceptions of adjunctive nonpharmacologic management strategies, such as yoga. This community-based, qualitative study used nontherapeutic focus groups to allow for exploration of attitudes, concerns, beliefs, and values regarding stress and depression in pregnancy and nonpharmacologic management approaches, such as mind-body therapies and other prenatal activities. The sample consisted of pregnant, AA, low-income adolescents (n=17) who resided in a large urban area in the United States. The themes that arose in the focus group discussions were that 1) stress and depression symptoms are pervasive in daily life, 2) participants felt a generalized sense of isolation, 3) stress/depression management techniques should be group based, interactive, and focused on the specific needs of teenagers, and 4) yoga is an appealing stress management technique to this population. Findings from this study suggest that pregnant, urban, adolescents are highly stressed; they interpret depression-like symptoms to be signs of stress; they desire group-based, interactive activities; and they are interested in yoga classes for stress/depression management and relationship building. It is imperative that health care providers and researchers focus on these needs, particularly when designing prevention and intervention strategies. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

“I just start crying for no reason”: The experience of stress and depression in pregnant urban African American adolescents and their perception of yoga as a management strategy

PubMed Central

Kinser, Patricia; Masho, Saba

2015-01-01

Purpose Perinatal health disparities are of particular concern with pregnant urban African American adolescents who have high rates of stress and depression during pregnancy, higher rates of adverse pregnancy and neonatal outcomes, and many barriers to effective treatment. The purpose of this study was to explore pregnant urban African American teenagers’ experience of stress and depression and examine their perceptions of adjunctive non-pharmacologic management strategies, such as yoga. Methods This community-based qualitative study utilized non-therapeutic focus groups to allow for exploration of attitudes, concerns, beliefs and values regarding stress and depression in pregnancy and non-pharmacologic management approaches, such as mind-body therapies and other prenatal activities. Findings The sample consisted of pregnant African-American low-income adolescents (n=17) who resided in a large urban area in the United States. The themes that arose in the focus group discussions were: (1) stress and depression symptoms are pervasive in daily life; (2) participants felt a generalized sense of isolation; (3) stress/depression-management techniques should be group-based, interactive, and focused on the specific needs of teenagers; (4) yoga is an appealing stress-management technique to this population. Conclusions The findings from this study suggest that pregnant urban adolescents are highly stressed, they interpret depression-like symptoms to be signs of stress, they desire group-based, interactive activities, and they are interested in yoga classes for stress/depression management and relationship-building. It is imperative that healthcare providers and researchers focus on these needs, particularly when designing prevention and intervention strategies. PMID:25648492

Cost-effectiveness of competing strategies for management of recurrent Clostridium difficile infection: a decision analysis.

PubMed

Konijeti, Gauree G; Sauk, Jenny; Shrime, Mark G; Gupta, Meera; Ananthakrishnan, Ashwin N

2014-06-01

Clostridium difficile infection (CDI) is an important cause of morbidity and healthcare costs, and is characterized by high rates of disease recurrence. The cost-effectiveness of newer treatments for recurrent CDI has not been examined, yet would be important to inform clinical practice. The aim of this study was to analyze the cost effectiveness of competing strategies for recurrent CDI. We constructed a decision-analytic model comparing 4 treatment strategies for first-line treatment of recurrent CDI in a population with a median age of 65 years: metronidazole, vancomycin, fidaxomicin, and fecal microbiota transplant (FMT). We modeled up to 2 additional recurrences following the initial recurrence. We assumed FMT delivery via colonoscopy as our base case, but conducted sensitivity analyses based on different modes of delivery. Willingness-to-pay threshold was set at $50 000 per quality-adjusted life-year. At our base case estimates, initial treatment of recurrent CDI using FMT colonoscopy was the most cost-effective strategy, with an incremental cost-effectiveness ratio of $17 016 relative to oral vancomycin. Fidaxomicin and metronidazole were both dominated by FMT colonoscopy. On sensitivity analysis, FMT colonoscopy remained the most cost-effective strategy at cure rates >88.4% and CDI recurrence rates <14.9%. Fidaxomicin required a cost <$1359 to meet our cost-effectiveness threshold. In clinical settings where FMT is not available or applicable, the preferred strategy appears to be initial treatment with oral vancomycin. In this decision analysis examining treatment strategies for recurrent CDI, we demonstrate that FMT colonoscopy is the most cost-effective initial strategy for management of recurrent CDI.

The Tobacco Control Network's Policy Readiness and Stage of Change Assessment: What the Results Suggest for Moving Tobacco Control Efforts Forward at the State and Territorial Levels.

PubMed

Roeseler, April; Solomon, Madeleine; Beatty, Carissa; Sipler, Alison M

2016-01-01

The Tobacco Control Network (TCN) is comprised of the tobacco control programs in the health departments of states, territories, and the District of Columbia. During the assessment period, the TCN was managed by the Tobacco Technical Assistance Consortium at Emory University. To assess the readiness of state and territory tobacco control programs to work on evidence-based, promising policy and system change strategies aimed at preventing and reducing tobacco use and secondhand smoke exposure. The Policy Readiness and Stage of Change Assessment was a Web-based survey fielded in September 2013, which was based on the Community Readiness Model. Fifty-nine comprehensive tobacco control programs. State and territory tobacco control program managers and their internal and external partners. The TCN's 2012 Policy Platform recommendations were used as the basis to assess state/territory readiness to adopt and implement evidence-based and promising tobacco control policy/system change strategies. Sixteen tobacco control strategies were rated on: (1) implementation status, (2) readiness, (3) stage of change, and (4) the appropriate level of action for work on the strategy. The 3 strategies with the highest readiness scores were as follows: (1) 100% smoke-free air in workplaces (64%), (2) tobacco-free schools (61%), and (3) $1.50 or less cigarette tax with funds to tobacco control (53%). The 3 strategies with lowest readiness scores were: 1) coupon redemption (17%), 2) tobacco mitigation fee (14%), and 3) disclosure or sunshine laws (8%). Readiness to work on tobacco control strategies varied by region and strategy. Many states/territories are ready to work on strategies for which there is less evidence of a population-level impact for reducing tobacco use, but which contribute to denormalizing tobacco use. Working toward less impactful policies may build support, capacity, and policy success, laying an important foundation to achieve more impactful strategies.

Action plans for COPD: strategies to manage exacerbations and improve outcomes.

PubMed

Jalota, Leena; Jain, Vipul V

2016-01-01

COPD is the third-largest killer in the world, and certainly takes a toll on the health care system. Recurrent COPD exacerbations accelerate lung-function decline, worsen mortality, and consume over US$50 billion in health care spending annually. This has led to a tide of payment reforms eliciting interest in strategies reducing preventable COPD exacerbations. In this review, we analyze and discuss the evidence for COPD action plan-based self-management strategies. Although action plans may provide stabilization of acute symptomatology, there are several limitations. These include patient-centered attributes, such as comprehension and adherence, and nonadherence of health care providers to established guidelines. While no single intervention can be expected independently to translate into improved outcomes, structured together within a comprehensive integrated disease-management program, they may provide a robust paradigm.

Addressing strategy execution challenges to lead sustainable change.

PubMed

Shirey, Maria R

2011-01-01

This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author discusses strategy execution challenges that must be addressed to lead sustainable change.

The US Forest Service Framework for Climate Adaptation (Invited)

NASA Astrophysics Data System (ADS)

Cleaves, D.

2013-12-01

Public lands are changing in response to climate change and related stressors such that resilience-based management plans that integrate climate-smart adaptation are needed. The goal of these plans is to facilitate land managers' consideration of a range of potential futures while simplifying the complex array of choices and assumptions in a rigorous, defensible manner. The foundation for climate response has been built into recent Forest Service policies, guidance, and strategies like the climate change Roadmap and Scorecard; 2012 Planning Rule; Cohesive Wildland Fire Management strategy; and Inventory, Monitoring & Assessment strategy. This has driven the need for information that is relevant, timely, and accessible to support vulnerability assessments and risk management to aid in designing and choosing alternatives and ranking actions. Managers must also consider carbon and greenhouse gas implications as well as understand the nature and level of uncertainties. The major adjustments that need to be made involve: improving risk-based decision making and working with predictive models and information; evaluating underlying assumptions against new realities and possibilities being revealed by climate science; integrating carbon cycle science and a new ethic of carbon stewardship into management practices; and preparing systems for inevitable changes to ameliorate negative effects, capture opportunities, or accept different and perhaps novel ecosystem configurations. We need to avoid waiting for complete science that never arrives and take actions that blend science and experience to boost learning, reduce costs and irreversible losses, and buy lead time.

Population genetic structure in a social landscape: barley in a traditional Ethiopian agricultural system

PubMed Central

Samberg, Leah H; Fishman, Lila; Allendorf, Fred W

2013-01-01

Conservation strategies are increasingly driven by our understanding of the processes and patterns of gene flow across complex landscapes. The expansion of population genetic approaches into traditional agricultural systems requires understanding how social factors contribute to that landscape, and thus to gene flow. This study incorporates extensive farmer interviews and population genetic analysis of barley landraces (Hordeum vulgare) to build a holistic picture of farmer-mediated geneflow in an ancient, traditional agricultural system in the highlands of Ethiopia. We analyze barley samples at 14 microsatellite loci across sites at varying elevations and locations across a contiguous mountain range, and across farmer-identified barley types and management strategies. Genetic structure is analyzed using population-based and individual-based methods, including measures of population differentiation and genetic distance, multivariate Principal Coordinate Analysis, and Bayesian assignment tests. Phenotypic analysis links genetic patterns to traits identified by farmers. We find that differential farmer management strategies lead to markedly different patterns of population structure across elevation classes and barley types. The extent to which farmer seed management appears as a stronger determinant of spatial structure than the physical landscape highlights the need for incorporation of social, landscape, and genetic data for the design of conservation strategies in human-influenced landscapes. PMID:24478796

Improving management of small natural features on private lands by negotiating the science-policy boundary for Maine vernal pools.

PubMed

Calhoun, Aram J K; Jansujwicz, Jessica S; Bell, Kathleen P; Hunter, Malcolm L

2014-07-29

Vernal pools are far more important for providing ecosystem services than one would predict based on their small size. However, prevailing resource-management strategies are not effectively conserving pools and other small natural features on private lands. Solutions are complicated by tensions between private property and societal rights, uncertainties over resource location and function, diverse stakeholders, and fragmented regulatory authority. The development and testing of new conservation approaches that link scientific knowledge, stakeholder decision-making, and conservation outcomes are important responses to this conservation dilemma. Drawing from a 15-y history of vernal pool conservation efforts in Maine, we describe the coevolution of pool conservation and research approaches, focusing on how research-based knowledge was produced and used in support of management decisions. As management shifted from reactive, top-down approaches to proactive and flexible approaches, research shifted from an ecology-focused program to an interdisciplinary program based on social-ecological systems. The most effective strategies for linking scientific knowledge with action changed as the decision-makers, knowledge needs, and context for vernal pool management advanced. Interactions among stakeholders increased the extent to which knowledge was coproduced and shifted the objective of stakeholder engagement from outreach to research collaboration and development of innovative conservation approaches. New conservation strategies were possible because of the flexible, solutions-oriented collaborations and trust between scientists and decision-makers (fostered over 15 y) and interdisciplinary, engaged research. Solutions to the dilemma of conserving small natural features on private lands, and analogous sustainability science challenges, will benefit from repeated negotiations of the science-policy boundary.

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

PubMed

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

2014-07-01

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

Impact of Conflict Management Strategies on the Generation Mechanism of Miners' Unsafe Behavior Tendency

ERIC Educational Resources Information Center

Li, Ji-Zu; Zhang, Ya-Ping; Liu, Xiao-Guang; Liu, Yao-Long; Wang, Tian-Ri

2017-01-01

In this paper, we examine the relationship between the generation mechanism of miners' unsafe behavior tendency and conflict management strategies, including cooperative conflict management strategy, competitive conflict management strategy and avoidant conflict management strategy. Miners from 3 collieries in Shanxi province completed a…

Communication: essential strategies for success.

PubMed

O'Connor, Mary

2013-06-01

This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advance organizational change, content includes evidence-based projects, tool, and resources that mobilize and sustain organizational change initiatives. In this article, the author discusses strategies for communication for change processes, whether large or small. Intentional planning and development of a communication strategy alongside, not as an afterthought, to change initiatives are essential.

Post-game analysis: An initial experiment for heuristic-based resource management in concurrent systems

NASA Technical Reports Server (NTRS)

Yan, Jerry C.

1987-01-01

In concurrent systems, a major responsibility of the resource management system is to decide how the application program is to be mapped onto the multi-processor. Instead of using abstract program and machine models, a generate-and-test framework known as 'post-game analysis' that is based on data gathered during program execution is proposed. Each iteration consists of (1) (a simulation of) an execution of the program; (2) analysis of the data gathered; and (3) the proposal of a new mapping that would have a smaller execution time. These heuristics are applied to predict execution time changes in response to small perturbations applied to the current mapping. An initial experiment was carried out using simple strategies on 'pipeline-like' applications. The results obtained from four simple strategies demonstrated that for this kind of application, even simple strategies can produce acceptable speed-up with a small number of iterations.

Increasing Army Supply Chain Performance: Using an Integrated End to End Metrics System

DTIC Science & Technology

2017-01-01

Sched Deliver Sched Delinquent Contracts Current Metrics PQDR/SDRs Forecasting Accuracy Reliability Demand Management Asset Mgmt Strategies Pipeline...are identified and characterized by statistical analysis. The study proposed a framework and tool for inventory management based on factors such as

Strategies of Successful Technology Integrators. Part I: Streamlining Classroom Management.

ERIC Educational Resources Information Center

McNally, Lynn; Etchison, Cindy

2000-01-01

Discussion of how to develop curriculum that successfully integrates technology into elementary and secondary school classrooms focuses on solutions for school and classroom management tasks. Highlights include Web-based solutions; student activities; word processing; desktop publishing; draw and paint programs; spreadsheets; and database…

Genome-based nutrition: An intervention strategy for the prevention and treatment of obesity and nonalcoholic steatohepatitis

PubMed Central

Roman, Sonia; Ojeda-Granados, Claudia; Ramos-Lopez, Omar; Panduro, Arturo

2015-01-01

Obesity and nonalcoholic steatohepatitis are increasing in westernized countries, regardless of their geographic location. In Latin America, most countries, including Mexico, have a heterogeneous admixture genome with Amerindian, European and African ancestries. However, certain high allelic frequencies of several nutrient-related polymorphisms may have been achieved by past gene-nutrient interactions. Such interactions may have promoted the positive selection of variants adapted to regional food sources. At present, the unbalanced diet composition of the Mexicans has led the country to a 70% prevalence rate of overweightness and obesity due to substantial changes in food habits, among other factors. International guidelines and intervention strategies may not be adequate for all populations worldwide because they do not consider disparities in genetic and environmental factors, and thus there is a need for differential prevention and management strategies. Here, we provide the rationale for an intervention strategy for the prevention and management of obesity-related diseases such as non-alcoholic steatohepatitis based on a regionalized genome-based diet. The components required to design such a diet should focus on the specific ancestry of each population around the world and the convenience of consuming traditional ethnic food. PMID:25834309

Genome-based nutrition: an intervention strategy for the prevention and treatment of obesity and nonalcoholic steatohepatitis.

PubMed

Roman, Sonia; Ojeda-Granados, Claudia; Ramos-Lopez, Omar; Panduro, Arturo

2015-03-28

Obesity and nonalcoholic steatohepatitis are increasing in westernized countries, regardless of their geographic location. In Latin America, most countries, including Mexico, have a heterogeneous admixture genome with Amerindian, European and African ancestries. However, certain high allelic frequencies of several nutrient-related polymorphisms may have been achieved by past gene-nutrient interactions. Such interactions may have promoted the positive selection of variants adapted to regional food sources. At present, the unbalanced diet composition of the Mexicans has led the country to a 70% prevalence rate of overweightness and obesity due to substantial changes in food habits, among other factors. International guidelines and intervention strategies may not be adequate for all populations worldwide because they do not consider disparities in genetic and environmental factors, and thus there is a need for differential prevention and management strategies. Here, we provide the rationale for an intervention strategy for the prevention and management of obesity-related diseases such as non-alcoholic steatohepatitis based on a regionalized genome-based diet. The components required to design such a diet should focus on the specific ancestry of each population around the world and the convenience of consuming traditional ethnic food.

Teacher Stress and Burnout. Organizing Systems To Support Competent Social Behavior in Children and Youth.

ERIC Educational Resources Information Center

Carter, Susanne

This guide presents individual and school-based strategies to help teachers deal with stress and burnout. The following individual strategies are briefly described: biofeedback, buddy system, childhood energy, conflict management, desensitization, dreams, exercise, humor, ideology, imaging, leaving stress behind, looking forward, making lists,…

Tillage and Composting Strategies to Maximize Potentially Mineralizable Nitrogen in Maize-based Cropping Systems

USDA-ARS?s Scientific Manuscript database

Cereal crop yields vary drastically between developed and developing nations. In developing nations, a lack of synthetic nitrogen (N) fertilizer often limits yields. Low-cost soil management strategies that increase biologically available soil organic matter can reduce farmer reliance on synthetic N...

Acquiring data for large aquatic resource surveys: the art of ompromise among science, logistics, and reality

EPA Science Inventory

The US Environmental Protection Agency (EPA) is revising its strategy to obtain the information needed to answer questions pertinent to water-quality management efficiently and rigorously at national scales. One tool of this revised strategy is use of statistically based surveys ...

Using Teacher Praise and Opportunities to Respond to Promote Appropriate Student Behavior

ERIC Educational Resources Information Center

Moore Partin, Tara C.; Robertson, Rachel E.; Maggin, Daniel M.; Oliver, Regina M.; Wehby, Joseph H.

2010-01-01

Teachers' successful provision of levels of support to prevent and reduce problem classroom behaviors requires skillful application of research-based classroom and behavior management strategies. Among others, 2 teacher-centered strategies have been shown to decrease students' inappropriate behaviors and increase their appropriate behaviors: the…

Developing a health care strategy: a results-based approach.

PubMed

Sperling, K L

1995-01-01

In today's corporate environment, health care managers will be evaluated on performance--and forward-thinking companies are already quantifying their health care success. How this performance is defined and measured will differ from company to company, but shaping the definition and aligning it with the overall business strategy ensures success.

45 CFR 1336.64 - Development of goals and strategies: Responsibilities of the Loan Administrator.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE... availability of business capital; (4) Local resources for economic development and their availability; and (5... institutions; (5) Capital Base Management Strategy: to develop and allocate the financial resources of the fund...

45 CFR 1336.64 - Development of goals and strategies: Responsibilities of the Loan Administrator.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE... availability of business capital; (4) Local resources for economic development and their availability; and (5... institutions; (5) Capital Base Management Strategy: to develop and allocate the financial resources of the fund...

45 CFR 1336.64 - Development of goals and strategies: Responsibilities of the Loan Administrator.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE... availability of business capital; (4) Local resources for economic development and their availability; and (5... institutions; (5) Capital Base Management Strategy: to develop and allocate the financial resources of the fund...

45 CFR 1336.64 - Development of goals and strategies: Responsibilities of the Loan Administrator.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE... availability of business capital; (4) Local resources for economic development and their availability; and (5... institutions; (5) Capital Base Management Strategy: to develop and allocate the financial resources of the fund...

Strategies for Financing Universal Basic Education for Sustainable National Development in Nigeria

ERIC Educational Resources Information Center

Abdullahi, N. J. K.; Abdulkareem, A. Y.

2017-01-01

This study investigated strategies of financing universal basic education for sustainable national development by school managers in North-Central Zone, Nigeria. Specifically the purpose was to determine the relationship between commercial based income and sustainable national development as well as to examine the relationship between agricultural…

A Contingent Analysis of the Relationship between IS Implementation Strategies and IS Success.

ERIC Educational Resources Information Center

Kim, Sang-Hoon; Lee, Jinjoo

1991-01-01

Considers approaches to dealing with user attitudes toward newly implemented information systems (IS), and suggests that behavioral management strategies relevant to IS fall into three categories: (1) empirical/rational; (2) normative/reeducative; and (3) power/coercive, based on "planned change" theories. An integrative contingent model…

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

Moreno, Gilberto

Thermal modeling was conducted to evaluate and develop thermal management strategies for high-temperature wide-bandgap (WBG)-based power electronics systems. WBG device temperatures of 175 degrees C to 250 degrees C were modeled under various under-hood temperature environments. Modeling result were used to identify the most effective capacitor cooling strategies under high device temperature conditions.

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

PubMed

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

2006-01-01

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

Establishing an Integrated Catchment Management (ICM) program in East Java, Indonesia.

PubMed

Booth, C A; Warianti, A; Wrigley, T

2001-01-01

The Brantas is one of Indonesia's most important catchments. It is the "rice bowl" of Java and nationally important for its industrial activity. Surabaya, Indonesia's second largest city, is located at the mouth of the Brantas River which is pivotal to the city's water supply. The challenges associated with the institutional framework for natural resource management in East Java parallels that of many states and provinces around the globe. It is multi-layered and complex. Integrated Catchment Management (ICM) may be defined as "the co-ordinated and sustainable management of land, water, soil vegetation, fauna and other natural resources on a water catchment basis". Over a period of six months, an ICM Strategy was researched and facilitated for the Brantas River Catchment in East Java via a short term advisor attachment. The aim of the Strategy is to improve coordination, co-operation, communication and consistency of government and community efforts towards sustaining the catchment's environmental, economic and social values. The attachment was part of the Pollution Control Implementation (PCI) Project funded by AusAid and the Indonesian Government. The ICM Strategy developed was broad based and addressed the priority natural resource management issues facing the Brantas Catchment. It was co-ordinated by BAPEDALDA, the Provincial Environmental Protection Agency, and developed by all agencies involved in natural resource management in the catchment. Various Universities and Non Government Organisations (NGOs) were also involved in the ICM process which developed the Strategy. At the conclusion of the attachment, a draft ICM Strategy and a proposed institutional framework had been developed. A working group of key agencies was also established to further enhance local "ownership", finalise timescales and implementation responsibilities within the Strategy and bring the institutional arrangements into being through a Governor's Decree.

A qualitative analysis of the role of emotions in different patterns of long-term weight loss.

PubMed

Ingels, John Spencer; Zizzi, Sam

2018-08-01

To explore participant perspectives of the impact emotions have on weight loss. A qualitative design gathered data through semi-structured interviews with participants in a weight management programme. The interview addresses the following research questions: (1) how do individuals working to lose weight perceive the impact emotions have on their long-term success, and (2) what strategies do more or less successful participants use to regulate their emotions? Researchers conducted and transcribed the interviews then completed content analysis to create and organise themes. Two broad themes emerged through the interviews with 21 participants: emotional impact and emotional regulation. Further subthemes captured emotions blocking action toward goals, strategies for regulating emotions (e.g. exercise, food) and the need for new strategies to regulate emotions. Themes were also split in to three groups based on weight outcomes: regainer, moderate success (3-6% loss) and large success (>7% loss). More successful participants, compared to regainers, shared being aware of the impact of their emotions and made efforts to develop healthy regulation strategies. Emotional awareness and regulation play an important role in participant's weight management experience. Taking time to build emotional awareness and strategies to manage emotions is important to participants in weight management.

A process-based framework for soil ecosystem services study and management.

PubMed

Su, Changhong; Liu, Huifang; Wang, Shuai

2018-06-15

Soil provides various indispensable ecosystem services for human society. Soil's complex structure and property makes the soil ecological processes complicated and brings about tough challenges for soil ecosystem services study. Most of the current frameworks on soil services focus exclusively on services per se, neglecting the links and underlying ecological mechanisms. This article put forward a framework on soil services by stressing the underlying soil mechanisms and processes, which includes: 1) analyzing soil natural capital stock based on soil structure and property, 2) disentangling the underlying complex links and soil processes, 3) soil services valuation based on field investigation and spatial explicit models, and 4) enacting soil management strategy based on soil services and their driving factors. By application of this framework, we assessed the soil services of sediment retention, water yield, and grain production in the Upper-reach Fenhe Watershed. Based on the ecosystem services and human driving factors, the whole watershed was clustered into five groups: 1) municipal area, 2) typical coal mining area, 3) traditional farming area, 4) unsustainable urbanizing area, and 5) ecological conservation area. Management strategies on soils were made according to the clustering based soil services and human activities. Copyright © 2018 Elsevier B.V. All rights reserved.

Examining classroom influences on student perceptions of school climate: the role of classroom management and exclusionary discipline strategies.

PubMed

Mitchell, Mary M; Bradshaw, Catherine P

2013-10-01

There is growing emphasis on the use of positive behavior supports rather than exclusionary discipline strategies to promote a positive classroom environment. Yet, there has been limited research examining the association between these two different approaches to classroom management and students' perceptions of school climate. Data from 1902 students within 93 classrooms that were nested within 37 elementary schools were examined using multilevel structural equation modeling procedures to investigate the association between two different classroom management strategies (i.e., exclusionary discipline strategies and the use of positive behavior supports) and student ratings of school climate (i.e., fairness, order and discipline, student-teacher relationship, and academic motivation). The analyses indicated that greater use of exclusionary discipline strategies was associated with lower order and discipline scores, whereas greater use of classroom-based positive behavior supports was associated with higher scores on order and discipline, fairness, and student-teacher relationship. These findings suggest that pre-service training and professional development activities should promote teachers' use of positive behavior support strategies and encourage reduced reliance on exclusionary discipline strategies in order to enhance the school climate and conditions for learning. Copyright © 2013 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Sustainable agricultural water management across climates

NASA Astrophysics Data System (ADS)

DeVincentis, A.

2016-12-01

Fresh water scarcity is a global problem with local solutions. Agriculture is one of many human systems threatened by water deficits, and faces unique supply, demand, quality, and management challenges as the global climate changes and population grows. Sustainable agricultural water management is paramount to protecting global economies and ecosystems, but requires different approaches based on environmental conditions, social structures, and resource availability. This research compares water used by conservation agriculture in temperate and tropical agroecosystems through data collected from operations growing strawberries, grapes, tomatoes, and pistachios in California and corn and soybeans in Colombia. The highly manipulated hydrologic regime in California has depleted water resources and incited various adaptive management strategies, varying based on crop type and location throughout the state. Operations have to use less water more efficiently, and sometimes that means fallowing land in select groundwater basins. At the opposite end of the spectrum, the largely untouched landscape in the eastern plains of Colombia are rapidly being converted into commercial agricultural operations, with a unique opportunity to manage and plan for agricultural development with sustainability in mind. Although influenced by entirely different climates and economies, there are some similarities in agricultural water management strategies that could be applicable worldwide. Cover crops are a successful management strategy for both agricultural regimes, and moving forward it appears that farmers who work in coordination with their neighbors to plan for optimal production will be most successful in both locations. This research points to the required coordination of agricultural extension services as a critical component to sustainable water use, successful economies, and protected environments.

Water management in the Roman world

NASA Astrophysics Data System (ADS)

Dermody, Brian J.; van Beek, Rens L. P. H.; Meeks, Elijah; Klein Goldewijk, Kees; Bierkens, Marc F. P.; Scheidel, Walter; Wassen, Martin J.; van der Velde, Ype; Dekker, Stefan C.

2014-05-01

Climate variability can have extreme impacts on societies in regions that are water-limited for agriculture. A society's ability to manage its water resources in such environments is critical to its long-term viability. Water management can involve improving agricultural yields through in-situ irrigation or redistributing water resources through trade in food. Here, we explore how such water management strategies affected the resilience of the Roman Empire to climate variability in the water-limited region of the Mediterranean. Using the large-scale hydrological model PCR-GLOBWB and estimates of landcover based on the Historical Database of the Global Environment (HYDE) we generate potential agricultural yield maps under variable climate. HYDE maps of population density in conjunction with potential yield estimates are used to develop maps of agricultural surplus and deficit. The surplus and deficit regions are abstracted to nodes on a water redistribution network based on the Stanford Geospatial Network Model of the Roman World (ORBIS). This demand-driven, water redistribution network allows us to quantitatively explore how water management strategies such as irrigation and food trade improved the resilience of the Roman Empire to climate variability.

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

ERIC Educational Resources Information Center

Poduska, Jeanne M.; Kurki, Anja

2014-01-01

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

Dynamic ambulance reallocation for the reduction of ambulance response times using system status management.

PubMed

Lam, Sean Shao Wei; Zhang, Ji; Zhang, Zhong Cheng; Oh, Hong Choon; Overton, Jerry; Ng, Yih Yng; Ong, Marcus Eng Hock

2015-02-01

Dynamically reassigning ambulance deployment locations throughout a day to balance ambulance availability and demands can be effective in reducing response times. The objectives of this study were to model dynamic ambulance allocation plans in Singapore based on the system status management (SSM) strategy and to evaluate the dynamic deployment plans using a discrete event simulation (DES) model. The geographical information system-based analysis and mathematical programming were used to develop the dynamic ambulance deployment plans for SSM based on ambulance calls data from January 1, 2011, to June 30, 2011. A DES model that incorporated these plans was used to compare the performance of the dynamic SSM strategy against static reallocation policies under various demands and travel time uncertainties. When the deployment plans based on the SSM strategy were followed strictly, the DES model showed that the geographical information system-based plans resulted in approximately 13-second reduction in the median response times compared to the static reallocation policy, whereas the mathematical programming-based plans resulted in approximately a 44-second reduction. The response times and coverage performances were still better than the static policy when reallocations happened for only 60% of all the recommended moves. Dynamically reassigning ambulance deployment locations based on the SSM strategy can result in superior response times and coverage performance compared to static reallocation policies even when the dynamic plans were not followed strictly. Copyright © 2014 Elsevier Inc. All rights reserved.

Demonstrating PQS Effectiveness and Driving Continual Improvement: Evidence-Based Risk Reduction.

PubMed

Ramnarine, Emma; O'Donnell, Kevin

2018-04-18

Product knowledge grows and evolves during the life of a product. In order to maintain a state of control and deliver product with consistent quality throughout its commercial life, continuous improvement and product lifecycle management become essential. The practical link between product and process knowledge, risk-based control strategies, and continual improvement and innovation can be made stronger through evidence-based risk reduction. Regulatory relief and flexibility in post approval change management and overall product lifecycle management will only be possible with effective application of science and risk-based concepts and demonstrated effectiveness of the PQS in assuring a state of control. Copyright © 2018, Parenteral Drug Association.

Physician practice management companies: implications for hospital-based integrated delivery systems.

PubMed

Burns, L R; Robinson, J C

1997-01-01

Physician practice management companies (PPMCs) are one of the most visible entrants into the industry of managing physician practices, and anywhere from 100-150 are already in operation. Although PPMCs and hospital-based integrated delivery systems (IDSs) differ from each other in many ways, they share a number of common features, including the pursuit of capitation contracts from payors. As a result, PPMCs pose a growing, direct threat to hospital systems in competing for managed care contracts that cover physician service. PPMCs also provide an alternative to hospital-based IDSs at the local market level for physician group consolidation. This article looks at the structure, operation, and strategy of PPMCs and examines what implications their growth will have for hospital-based IDSs.

Positive strategies men regularly use to prevent and manage depression: a national survey of Australian men.

PubMed

Proudfoot, Judy; Fogarty, Andrea S; McTigue, Isabel; Nathan, Sally; Whittle, Erin L; Christensen, Helen; Player, Michael J; Hadzi-Pavlovic, Dusan; Wilhelm, Kay

2015-11-16

Men are at greater risk than women of dying by suicide. One in eight will experience depression--a leading contributor to suicide--in their lifetime and men often delay seeking treatment. Previous research has focused on men's use of unhelpful coping strategies, with little emphasis on men's productive responses. The present study examines the positive strategies men use to prevent and manage depression. A national online survey investigated Australian men's use of positive strategies, including 26 strategies specifically nominated by men in a previous qualitative study. Data were collected regarding frequency of use or openness to using untried strategies, depression risk, depression symptoms, demographic factors, and other strategies suggested by men. Multivariate regression analyses explored relationships between regular use of strategies and other variables. In total, 465 men aged between 18 and 74 years participated. The mean number of strategies used was 16.8 (SD 4.1) for preventing depression and 15.1 (SD 5.1) for management. The top five prevention strategies used regularly were eating healthily (54.2 %), keeping busy (50.1 %), exercising (44.9 %), humour (41.1 %) and helping others (35.7 %). The top five strategies used for management were taking time out (35.7 %), rewarding myself (35.1 %), keeping busy (35.1 %), exercising (33.3 %) and spending time with a pet (32.7 %). With untried strategies, a majority (58 %) were open to maintaining a relationship with a mentor, and nearly half were open to using meditation, mindfulness or gratitude exercises, seeing a health professional, or setting goals. In multivariate analyses, lower depression risk as measured by the Male Depression Risk Scale was associated with regular use of self-care, achievement-based and cognitive strategies, while lower scores on the Patient Health Questionnaire-9 was associated with regular use of cognitive strategies. The results demonstrate that the men in the study currently use, and are open to using, a broad range of practical, social, emotional, cognitive and problem-solving strategies to maintain their mental health. This is significant for men in the community who may not be in contact with professional health services and would benefit from health messages promoting positive strategies as effective tools in the prevention and management of depression.

FY 2013 INL SITE SUSTAINABILITY PLAN WITH THE FY 2012 ANNUAL REPORT

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

Ernest L. Fossum; Steve A. Birrer

2012-12-01

It is the policy of the Department of Energy (DOE) that sustainable energy and transportation fuels management will be integrated into DOE operations to meet obligations under Executive Order (EO) 13423 "Strengthening Federal Environmental, Energy, and Transportation Management," the Instructions for Implementation of EO 13423, as well as Guidance Documents issued in accordance thereto and any modifcations or amendments that may be issued from time to time. In furtherance of this obligation, DOE established strategic performance-based energy and transportation fuels goals and strategies through the Transformational Energy Action Management (TEAM) Initiative, which were incorporated into DOE Order 430.2B "Departmental Energy,more » Renewable energy, and Transportation Management" and were also identified in DOE Order 450.1A, "Environmental Protection Program." These goals and accompanying strategies are to be implemented by DOE sites through the integration of energy and transportation fuels management into site Environmental Management Systems (EMS).« less

A Two-Stage Probabilistic Approach to Manage Personal Worklist in Workflow Management Systems

NASA Astrophysics Data System (ADS)

Han, Rui; Liu, Yingbo; Wen, Lijie; Wang, Jianmin

The application of workflow scheduling in managing individual actor's personal worklist is one area that can bring great improvement to business process. However, current deterministic work cannot adapt to the dynamics and uncertainties in the management of personal worklist. For such an issue, this paper proposes a two-stage probabilistic approach which aims at assisting actors to flexibly manage their personal worklists. To be specific, the approach analyzes every activity instance's continuous probability of satisfying deadline at the first stage. Based on this stochastic analysis result, at the second stage, an innovative scheduling strategy is proposed to minimize the overall deadline violation cost for an actor's personal worklist. Simultaneously, the strategy recommends the actor a feasible worklist of activity instances which meet the required bottom line of successful execution. The effectiveness of our approach is evaluated in a real-world workflow management system and with large scale simulation experiments.

Implementation of multidimensional knowledge translation strategies to improve procedural pain in hospitalized children.

PubMed

Stevens, Bonnie J; Yamada, Janet; Promislow, Sara; Stinson, Jennifer; Harrison, Denise; Victor, J Charles

2014-11-25

Despite extensive research, institutional policies, and practice guidelines, procedural pain remains undertreated in hospitalized children. Knowledge translation (KT) strategies have been employed to bridge the research to practice gap with varying success. The most effective single or combination of KT strategies has not been found. A multifaceted KT intervention, Evidence-based Practice for Improving Quality (EPIQ), that included tailored KT strategies was effective in improving pain practices and clinical outcomes at the unit level in a prospective comparative cohort study in 32 hospital units (16 EPIQ intervention and 16 Standard Care), in eight pediatric hospitals in Canada. In a study of the 16 EPIQ units (two at each hospital) only, the objectives were to: determine the effectiveness of evidence-based KT strategies implemented to achieve unit aims; describe the KT strategies implemented and their influence on pain assessment and management across unit types; and identify facilitators and barriers to their implementation. Data were collected from each EPIQ intervention unit on targeted pain practices and KT strategies implemented, through chart review and a process evaluation checklist, following four intervention cycles over a 15-month period. Following the completion of the four cycle intervention, 78% of 23 targeted pain practice aims across units were achieved within 80% of the stated aims. A statistically significant improvement was found in the proportion of children receiving pain assessment and management, regardless of pre-determined aims (p < 0.001). The median number of KT strategies implemented was 35 and included reminders, educational outreach and materials, and audit and feedback. Units successful in achieving their aims implemented more KT strategies than units that did not. No specific type of single or combination of KT strategies was more effective in improving pain assessment and management outcomes. Tailoring KT strategies to unit context, support from unit leadership, staff engagement, and dedicated time and resources were identified as facilitating effective implementation of the strategies. Further research is required to better understand implementation outcomes, such as feasibility and fidelity, how context influences the effectiveness of multifaceted KT strategies, and the sustainability of improved pain practices and outcomes over time.

A Randomized Controlled Trial of an HIV/AIDS Symptom Management Manual for Depressive Symptoms

PubMed Central

Eller, Lucille Sanzero; Kirksey, Kenn M.; Nicholas, Patrice K.; Corless, Inge B.; Holzemer, William L.; Wantland, Dean J.; Willard, Suzanne S.; Robinson, Linda; Hamilton, Mary Jane; Sefcik, Elizabeth F.; Moezzi, Shahnaz; Mendez, Marta Rivero; Rosa, Maria; Human, Sarie

2012-01-01

Depressive symptoms are highly prevalent, underdiagnosed and undertreated in people living with HIV/AIDS (PLWH), and are associated with poorer health outcomes. This randomized controlled trial examined the effects of the HIV/AIDS Symptom Management Manual self-care symptom management strategies compared to a nutrition manual on depressive symptoms in an international sample of PLWH. The sample consisted of a sub-group (N=222) of participants in a larger study symptom management study who reported depressive symptoms. Depressive symptoms of the intervention (n=124) and control (n=98) groups were compared over three months: baseline, one-month and two-months. Use and effectiveness of specific strategies were examined. Depressive symptom frequency at baseline varied significantly by country (χ2 12.9; p=0.04). Within the intervention group there were significant differences across time in depressive symptom frequency [F(2, 207) = 3.27, p=0.05], intensity [F(2, 91) = 4.6, p=0.01] and impact [F(2, 252) = 2.92, p= 0.05), and these were significantly lower at one-month but not at two-months, suggesting that self-care strategies are effective in reducing depressive symptoms, however effects may be short-term. Most used and most effective self-care strategies were distraction techniques and prayer. This study suggests the people living with HIV can be taught and will employ self-care strategies for management of depressive symptoms, and that they are effective in reducing these symptoms. Self-care strategies are non-invasive, have no side-effects and can be readily taught as an adjunct to other forms of treatment. Studies are needed to identify the most effective self-care strategies and quantify optimum dose and frequency of use as a basis for evidence-based practice. PMID:22880943

Designing and evaluating a web-based self-management site for patients with type 2 diabetes--systematic website development and study protocol.

PubMed

Yu, Catherine H; Parsons, Janet; Mamdani, Muhammad; Lebovic, Gerald; Shah, Baiju R; Bhattacharyya, Onil; Laupacis, Andreas; Straus, Sharon E

2012-06-24

Given that patients provide the majority of their own diabetes care, patient self-management training has increasingly become recognized as an important strategy with which to improve quality of care. However, participation in self management programs is low. In addition, the efficacy of current behavioural interventions wanes over time, reducing the impact of self-management interventions on patient health. Web-based interventions have the potential to bridge the gaps in diabetes care and self-management. Our objective is to improve self-efficacy, quality of life, self-care, blood pressure, cholesterol and glycemic control and promote exercise in people with type 2 diabetes through the rigorous development and use of a web-based patient self-management intervention. This study consists of five phases: (1) intervention development; (2) feasibility testing; (3) usability testing; (4) intervention refinement; and (5) intervention evaluation using mixed methods. We will employ evidence-based strategies and tools, using a theoretical framework of self-efficacy, then elicit user feedback through focus groups and individual user testing sessions. Using iterative redesign the intervention will be refined. Once finalized, the impact of the website on patient self-efficacy, quality of life, self-care, HbA1c, LDL-cholesterol, blood pressure and weight will be assessed through a non-randomized observational cohort study using repeated measures modeling and individual interviews. Increasing use of the World Wide Web by consumers for health information and ongoing revolutions in social media are strong indicators that users are primed to welcome a new era of technology in health care. However, their full potential is hindered by limited knowledge regarding their effectiveness, poor usability, and high attrition rates. Our development and research agenda aims to address these limitations by improving usability, identifying characteristics associated with website use and attrition, and developing strategies to sustain patient use in order to maximize clinical outcomes.

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

PubMed

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

2016-02-01

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

A Framework to Assist Health Professionals in Recommending High-Quality Apps for Supporting Chronic Disease Self-Management: Illustrative Assessment of Type 2 Diabetes Apps.

PubMed

Hale, Kelli; Capra, Sandra; Bauer, Judith

2015-09-14

This paper presents an approach to assist health professionals in recommending high quality apps for supporting chronic disease self-management. Most app reviews focus on popularity, aesthetics, functionality, usability, and information quality. There is no doubt these factors are important in selecting trustworthy apps which are appealing to users, but behavioral theory may be also be useful in matching the apps to user needs. The framework developed aims to be methodologically sound, capable of selecting popular apps which include content covered by evidence-based programs, consistent with behavioral theory, as well as a patient-centered approach for matching apps to patients' individual needs. A single disease-type 2 diabetes-was selected to illustrate how the framework can be applied as this was deemed to represent the types of strategies used in many chronic diseases. A systematic approach based on behavioral theory and recommendations from best practice guidelines was developed for matching apps to patients' needs. In March 2014, a series of search strategies was used to identify top-rated iPhone and Android health apps, representing 29 topics from five categories of type 2 diabetes self-management strategies. The topics were chosen from published international guidelines for the management of diabetes. The senior author (KH) assessed the most popular apps found that addressed these topics using the Behavioral Theory Content Survey (BTS), which is based on traditional behavioral theory. A tool to assist decision making when using apps was developed and trialed with health professionals for ease of use and understanding. A total of 14 apps were assessed representing all five topic categories of self-management. Total theoretical scores (BTS scores) were less than 50 on a 100-point scale for all apps. Each app scored less than 50% of the total possible BTS score for all four behavioral theories and for most of the 20 behavioral strategies; however, apps scored higher than 50% of the total possible BTS score for specific strategies related to their primary focus. Our findings suggest that the apps studied would be more effective when used in conjunction with therapy than as stand-alone apps. Apps were categorized according to topic and core intervention strategies. A framework for matching apps to identified patient needs was developed based on app categorization and principles of patient-centered care. The approach was well accepted and understood by a convenience sample of health practitioners. The framework presented can be used by health practitioners to better match apps with client needs. Some apps incorporate highly interactive strategies of behavioral theory, and when used as an adjunct may increase patient participation and the effectiveness of therapy.

Multiple UAV Cooperation for Wildfire Monitoring

NASA Astrophysics Data System (ADS)

Lin, Zhongjie

Wildfires have been a major factor in the development and management of the world's forest. An accurate assessment of wildfire status is imperative for fire management. This thesis is dedicated to the topic of utilizing multiple unmanned aerial vehicles (UAVs) to cooperatively monitor a large-scale wildfire. This is achieved through wildfire spreading situation estimation based on on-line measurements and wise cooperation strategy to ensure efficiency. First, based on the understanding of the physical characteristics of the wildfire propagation behavior, a wildfire model and a Kalman filter-based method are proposed to estimate the wildfire rate of spread and the fire front contour profile. With the enormous on-line measurements from on-board sensors of UAVs, the proposed method allows a wildfire monitoring mission to benefit from on-line information updating, increased flexibility, and accurate estimation. An independent wildfire simulator is utilized to verify the effectiveness of the proposed method. Second, based on the filter analysis, wildfire spreading situation and vehicle dynamics, the influence of different cooperation strategies of UAVs to the overall mission performance is studied. The multi-UAV cooperation problem is formulated in a distributed network. A consensus-based method is proposed to help address the problem. The optimal cooperation strategy of UAVs is obtained through mathematical analysis. The derived optimal cooperation strategy is then verified in an independent fire simulation environment to verify its effectiveness.

The Research on Integrated Strategy of Supply Chain Information Systems in the Automobile Industry Based on Order-To-Delivery Mode

NASA Astrophysics Data System (ADS)

Li, Ming; Gan, Lianzhen; He, Xuefeng

The automotive industry there are different degrees of impairment of many companies supply chain IT strategy. In this paper, in which the automotive industry supply chain management business cooperation between enterprises loose, poor exchange of information leading to the presence or delays in product customization, supply of raw materials, material control, production planning and control, sales and service and a fast response propose a series of typical problems of scientific and rational supply chain information integration strategy. The strategy through the development system integration platform, improve internal ERP system, implementation of supply chain management and other methods. Put some protection principles in the information process, to ensure the correct implementation of supply chain IT strategy, and ultimately achieve collaborative business development concept and enhance the automotive industry as a whole level of information.

A reduced energy supply strategy in active vibration control

NASA Astrophysics Data System (ADS)

Ichchou, M. N.; Loukil, T.; Bareille, O.; Chamberland, G.; Qiu, J.

2011-12-01

In this paper, a control strategy is presented and numerically tested. This strategy aims to achieve the potential performance of fully active systems with a reduced energy supply. These energy needs are expected to be comparable to the power demands of semi-active systems, while system performance is intended to be comparable to that of a fully active configuration. The underlying strategy is called 'global semi-active control'. This control approach results from an energy investigation based on management of the optimal control process. Energy management encompasses storage and convenient restitution. The proposed strategy monitors a given active law without any external energy supply by considering purely dissipative and energy-demanding phases. Such a control law is offered here along with an analysis of its properties. A suboptimal form, well adapted for practical implementation steps, is also given. Moreover, a number of numerical experiments are proposed in order to validate test findings.

Water Resilience by Design: A water infrastructure planning framework for developing sustainable water management strategies

NASA Astrophysics Data System (ADS)

Brown, C.; Ray, P. A.; Freeman, S.

2016-12-01

Societal need for improved water management and concerns for the long-term sustainability of water resources systems are prominent around the world. The continued susceptibility of society to the harmful effects of hydrologic variability, pervasive concerns related to climate change and the emergent awareness of devastating effects of current practice on aquatic ecosystems all illustrate our limited understanding of how water ought to be managed in a dynamic world. To address these challenges, new problem solving approaches are required that acknowledge uncertainties, incorporate best available information, and link engineering design principles, typically based on determinism, with our best geoscience-based understanding of planetary change. In this presentation, we present and demonstrate a framework for developing water planning and management strategies that are resilient in the face of future uncertainties and our limited ability to anticipate the future. The approach begins with stakeholder engagement and decision framing to elicit relevant context, uncertainties, choices and connections that drive planning and serve as an entry point to exploring possible futures. The result is the development of water strategies that are informed by the best available predictive information and designed to perform well over a future of change. Examples from around the world are presented to illustrate the methodology.

Improving The Quality of Education Through School-Based Management: Learning From International Experiences

NASA Astrophysics Data System (ADS)

Grauwe, Anton De

2005-07-01

School-based management is being increasingly advocated as a shortcut to more efficient management and quality improvement in education. Research, however, has been unable to prove conclusively such a linkage. Especially in developing countries, concerns remain about the possible detrimental impact of school-based management on school quality; equity among different schools in the same system; the motivation of and relationships between principals and teachers; and financial as well as administrative transparency. The present study defines school-based management and, in view of its implementation in different world regions, examines some of its advantages and disadvantages. In particular, the author explores the strategies which must accompany school-based management in order to ensure a positive impact on quality. These are found to include (1) guaranteeing that all schools have certain basic resources; (2) developing an effective school-support system; (3) providing schools with regular information on their performance and advice on how they might improve; and (4) emphasizing the motivational element in the management work of the school principal.

Power inequalities in the assessment of nursing competency within the workplace: implications for nursing management.

PubMed

Cusack, Lynette; Smith, Morgan

2010-09-01

This article explores the power implications of implementing competency-based assessments within the nursing work environment from a manager's perspective. It discusses how the implementation of competency-based assessments for continuing education may affect workplace culture, in particular, the use of power, within the nursing team. The term "managers" for the purpose of this article is defined as "nurses in senior administrative and educational positions within a health care facility." This article adds to the discourse on competency-based models by emphasizing the effect of the nursing work environment on the competency-based assessment process. It concludes by identifying strategies that can be used by nursing management when designing and implementing an effective and fair competency-based assessment for the nursing workplace. Copyright 2010, SLACK Incorporated.

Interactive effects of environmental change and management strategies on regional forest carbon emissions.

PubMed

Hudiburg, Tara W; Luyssaert, Sebastiaan; Thornton, Peter E; Law, Beverly E

2013-11-19

Climate mitigation activities in forests need to be quantified in terms of the long-term effects on forest carbon stocks, accumulation, and emissions. The impacts of future environmental change and bioenergy harvests on regional forest carbon storage have not been quantified. We conducted a comprehensive modeling study and life-cycle assessment of the impacts of projected changes in climate, CO2 concentration, and N deposition, and region-wide forest management policies on regional forest carbon fluxes. By 2100, if current management strategies continue, then the warming and CO2 fertilization effect in the given projections result in a 32-68% increase in net carbon uptake, overshadowing increased carbon emissions from projected increases in fire activity and other forest disturbance factors. To test the response to new harvesting strategies, repeated thinnings were applied in areas susceptible to fire to reduce mortality, and two clear-cut rotations were applied in productive forests to provide biomass for wood products and bioenergy. The management strategies examined here lead to long-term increased carbon emissions over current harvesting practices, although semiarid regions contribute little to the increase. The harvest rates were unsustainable. This comprehensive approach could serve as a foundation for regional place-based assessments of management effects on future carbon sequestration by forests in other locations.

Livestock Disease Management for Trading Across Different Regulatory Regimes.

PubMed

Bate, Andrew M; Jones, Glyn; Kleczkowski, Adam; Naylor, Rebecca; Timmis, Jon; White, Piran C L; Touza, Julia

2018-02-12

The maintenance of livestock health depends on the combined actions of many different actors, both within and across different regulatory frameworks. Prior work recognised that private risk management choices have the ability to reduce the spread of infection to trading partners. We evaluate the efficiency of farmers' alternative biosecurity choices in terms of their own-benefits from unilateral strategies and quantify the impact they may have in filtering the disease externality of trade. We use bovine viral diarrhoea (BVD) in England and Scotland as a case study, since this provides an example of a situation where contrasting strategies for BVD management occur between selling and purchasing farms. We use an agent-based bioeconomic model to assess the payoff dependence of farmers connected by trade but using different BVD management strategies. We compare three disease management actions: test-cull, test-cull with vaccination and vaccination alone. For a two-farm trading situation, all actions carried out by the selling farm provide substantial benefits to the purchasing farm in terms of disease avoided, with the greatest benefit resulting from test-culling with vaccination on the selling farm. Likewise, unilateral disease strategies by purchasers can be effective in reducing disease risks created through trade. We conclude that regulation needs to balance the trade-off between private gains from those bearing the disease management costs and the positive spillover effects on others.

Anesthesia and ventilation strategies in children with asthma: part II - intraoperative management.

PubMed

Regli, Adrian; von Ungern-Sternberg, Britta S

2014-06-01

As asthma is a frequent disease especially in children, anesthetists are increasingly providing anesthesia for children requiring elective surgery with well controlled asthma but also for those requiring urgent surgery with poorly controlled or undiagnosed asthma. This second part of this two-part review details the medical and ventilatory management throughout the perioperative period in general but also includes the perioperative management of acute bronchospasm and asthma exacerbations in children with asthma. Multiple observational trials assessing perioperative respiratory adverse events in healthy and asthmatic children provide the basis for identifying risk reduction strategies. Mainly, animal experiments and to a small extent clinical data have advanced our understanding of how anesthetic agents effect bronchial smooth muscle tone and blunt reflex bronchoconstriction. Asthma treatment outside anesthesia is well founded on a large body of evidence.Perioperative prevention strategies have increasingly been studied. However, evidence on the perioperative management, including mechanical ventilation strategies of asthmatic children, is still only fair, and further research is required. To minimize the considerable risk of perioperative respiratory adverse events in asthmatic children, perioperative management should be based on two main pillars: the preoperative optimization of asthma treatment (please refer to the first part of this two-part review) and - the focus of this second part of this review - the optimization of anesthesia management in order to optimize lung function and minimize bronchial hyperreactivity in the perioperative period.

Australian University Students’ Coping Strategies and Use of Pharmaceutical Stimulants as Cognitive Enhancers

PubMed Central

Jensen, Charmaine; Forlini, Cynthia; Partridge, Brad; Hall, Wayne

2016-01-01

Background: There are reports that some university students are using prescription stimulants for non-medical ‘pharmaceutical cognitive enhancement (PCE)’ to improve alertness, focus, memory, and mood in an attempt to manage the demands of study at university. Purported demand for PCEs in academic contexts have been based on incomplete understandings of student motivations, and often based on untested assumptions about the context within which stimulants are used. They may represent attempts to cope with biopsychosocial stressors in university life by offsetting students’ inadequate coping responses, which in turn may affect their cognitive performance. This study aimed to identify (a) what strategies students adopted to cope with the stress of university life and, (b) to assess whether students who have used stimulants for PCE exhibit particular stress or coping patterns. Methods: We interviewed 38 university students (with and without PCE experience) about their experience of managing student life, specifically their: educational values; study habits; achievement; stress management; getting assistance; competing activities and demands; health habits; and cognitive enhancement practices. All interview transcripts were coded into themes and analyzed. Results: Our thematic analysis revealed that, generally, self-rated coping ability decreased as students’ self-rated stress level increased. Students used emotion- and problem-focused coping for the most part and adjustment-focused coping to a lesser extent. Avoidance, an emotion-focused coping strategy, was the most common, followed by problem-focused coping strategies, the use of cognition on enhancing substances, and planning and monitoring of workload. PCE users predominantly used avoidant emotion-focused coping strategies until they no longer mitigated the distress of approaching deadlines resulting in the use of prescription stimulants as a substance-based problem-focused coping strategy. Conclusion: Our study suggests that students who choose coping responses that do not moderate stress where possible, may cause themselves additional distress and avoid learning more effective coping responses. Helping students to understand stress and coping, and develop realistic stress appraisal techniques, may assist students in general to maintain manageable distress levels and functioning. Furthermore, assisting students who may be inclined to use prescription stimulants for cognitive enhancement may reduce possible drug-related harms. PMID:26973573

Australian University Students' Coping Strategies and Use of Pharmaceutical Stimulants as Cognitive Enhancers.

PubMed

Jensen, Charmaine; Forlini, Cynthia; Partridge, Brad; Hall, Wayne

2016-01-01

There are reports that some university students are using prescription stimulants for non-medical 'pharmaceutical cognitive enhancement (PCE)' to improve alertness, focus, memory, and mood in an attempt to manage the demands of study at university. Purported demand for PCEs in academic contexts have been based on incomplete understandings of student motivations, and often based on untested assumptions about the context within which stimulants are used. They may represent attempts to cope with biopsychosocial stressors in university life by offsetting students' inadequate coping responses, which in turn may affect their cognitive performance. This study aimed to identify (a) what strategies students adopted to cope with the stress of university life and, (b) to assess whether students who have used stimulants for PCE exhibit particular stress or coping patterns. We interviewed 38 university students (with and without PCE experience) about their experience of managing student life, specifically their: educational values; study habits; achievement; stress management; getting assistance; competing activities and demands; health habits; and cognitive enhancement practices. All interview transcripts were coded into themes and analyzed. Our thematic analysis revealed that, generally, self-rated coping ability decreased as students' self-rated stress level increased. Students used emotion- and problem-focused coping for the most part and adjustment-focused coping to a lesser extent. Avoidance, an emotion-focused coping strategy, was the most common, followed by problem-focused coping strategies, the use of cognition on enhancing substances, and planning and monitoring of workload. PCE users predominantly used avoidant emotion-focused coping strategies until they no longer mitigated the distress of approaching deadlines resulting in the use of prescription stimulants as a substance-based problem-focused coping strategy. Our study suggests that students who choose coping responses that do not moderate stress where possible, may cause themselves additional distress and avoid learning more effective coping responses. Helping students to understand stress and coping, and develop realistic stress appraisal techniques, may assist students in general to maintain manageable distress levels and functioning. Furthermore, assisting students who may be inclined to use prescription stimulants for cognitive enhancement may reduce possible drug-related harms.

Managing the health effects of temperature in response to climate change: challenges ahead.

PubMed

Huang, Cunrui; Barnett, Adrian G; Xu, Zhiwei; Chu, Cordia; Wang, Xiaoming; Turner, Lyle R; Tong, Shilu

2013-04-01

Although many studies have shown that high temperatures are associated with an increased risk of mortality and morbidity, there has been little research on managing the process of planned adaptation to alleviate the health effects of heat events and climate change. In particular, economic evaluation of public health adaptation strategies has been largely absent from both the scientific literature and public policy discussion. We examined how public health organizations should implement adaptation strategies and, second, how to improve the evidence base required to make an economic case for policies that will protect the public's health from heat events and climate change. Public health adaptation strategies to cope with heat events and climate change fall into two categories: reducing the heat exposure and managing the health risks. Strategies require a range of actions, including timely public health and medical advice, improvements to housing and urban planning, early warning systems, and assurance that health care and social systems are ready to act. Some of these actions are costly, and given scarce financial resources the implementation should be based on the cost-effectiveness analysis. Therefore, research is required not only on the temperature-related health costs, but also on the costs and benefits of adaptation options. The scientific community must ensure that the health co-benefits of climate change policies are recognized, understood, and quantified. The integration of climate change adaptation into current public health practice is needed to ensure the adaptation strategies increase future resilience. The economic evaluation of temperature-related health costs and public health adaptation strategies are particularly important for policy decisions.

Water consumption and allocation strategies along the river oases of Tarim River based on large-scale hydrological modelling

NASA Astrophysics Data System (ADS)

Yu, Yang; Disse, Markus; Yu, Ruide

2016-04-01

With the mainstream of 1,321km and located in an arid area in northwest China, the Tarim River is China's longest inland river. The Tarim basin on the northern edge of the Taklamakan desert is an extremely arid region. In this region, agricultural water consumption and allocation management are crucial to address the conflicts among irrigation water users from upstream to downstream. Since 2011, the German Ministry of Science and Education BMBF established the Sino-German SuMaRiO project, for the sustainable management of river oases along the Tarim River. The project aims to contribute to a sustainable land management which explicitly takes into account ecosystem functions and ecosystem services. SuMaRiO will identify realizable management strategies, considering social, economic and ecological criteria. This will have positive effects for nearly 10 million inhabitants of different ethnic groups. The modelling of water consumption and allocation strategies is a core block in the SuMaRiO cluster. A large-scale hydrological model (MIKE HYDRO Basin) was established for the purpose of sustainable agricultural water management in the main stem Tarim River. MIKE HYDRO Basin is an integrated, multipurpose, map-based decision support tool for river basin analysis, planning and management. It provides detailed simulation results concerning water resources and land use in the catchment areas of the river. Calibration data and future predictions based on large amount of data was acquired. The results of model calibration indicated a close correlation between simulated and observed values. Scenarios with the change on irrigation strategies and land use distributions were investigated. Irrigation scenarios revealed that the available irrigation water has significant and varying effects on the yields of different crops. Irrigation water saving could reach up to 40% in the water-saving irrigation scenario. Land use scenarios illustrated that an increase of farmland area in the lower reach gravely aggravated the water deficit, while a decrease of farmland in the upper reaches resulted in considerable benefits for all sub-catchments. A substitution of crops was also investigated, which demonstrated the potential for saving considerable amounts of irrigation water in upper and middle reaches. Overall, the results of this study provide a scientific basis for decision-making on the water consumption and allocation strategies in this arid region.

What accounting leaves out of hospital financial management.

PubMed

Boles, K E; Glenn, J K

1986-01-01

As PPS and other fixed-price initiatives replace cost-based reimbursement in the hospital industry, the burden of assuming the risk for business success or failure shifts from the payor to the hospital. As a consequence, theories of risk to the business firm which have found application in other industries now deserve attention by hospital management. Incorporating such risk concepts into hospital strategies and actions requires a view of financial management that goes beyond the generally accepted accounting principles of managing and assigning costs for maximum revenue and profitability. This article examines the financial theory of risk in business firms, illustrates the various components of risk as they apply to a hospital business, and discusses how the hospital management strategies of cost-reduction, marketing, diversification, and multiorganizational affiliation can alter the risk characteristics of a hospital business.

Mitigating amphibian disease: strategies to maintain wild populations and control chytridiomycosis

PubMed Central

2011-01-01

Background Rescuing amphibian diversity is an achievable conservation challenge. Disease mitigation is one essential component of population management. Here we assess existing disease mitigation strategies, some in early experimental stages, which focus on the globally emerging chytrid fungus Batrachochytrium dendrobatidis. We discuss the precedent for each strategy in systems ranging from agriculture to human medicine, and the outlook for each strategy in terms of research needs and long-term potential. Results We find that the effects of exposure to Batrachochytrium dendrobatidis occur on a spectrum from transient commensal to lethal pathogen. Management priorities are divided between (1) halting pathogen spread and developing survival assurance colonies, and (2) prophylactic or remedial disease treatment. Epidemiological models of chytridiomycosis suggest that mitigation strategies can control disease without eliminating the pathogen. Ecological ethics guide wildlife disease research, but several ethical questions remain for managing disease in the field. Conclusions Because sustainable conservation of amphibians in nature is dependent on long-term population persistence and co-evolution with potentially lethal pathogens, we suggest that disease mitigation not focus exclusively on the elimination or containment of the pathogen, or on the captive breeding of amphibian hosts. Rather, successful disease mitigation must be context specific with epidemiologically informed strategies to manage already infected populations by decreasing pathogenicity and host susceptibility. We propose population level treatments based on three steps: first, identify mechanisms of disease suppression; second, parameterize epizootiological models of disease and population dynamics for testing under semi-natural conditions; and third, begin a process of adaptive management in field trials with natural populations. PMID:21496358

From buzzword to business strategy: the case for information and decision support systems in e-healthcare.

PubMed

Korukonda, Appa Rao; Korukonda, Saritha

2006-01-01

Although electronic healthcare can boast of a remarkable origin in modern-day e-commerce in the form of Electronic Data Interchange (EDI), its mission-critical nature in information-based strategising is yet to be realised. Restricting the scope of e-healthcare management to product advertisements and website management reflects an unfortunate trend of underutilisation of the scope of electronic decision support systems in pricing and other business strategies. This paper aims to illustrate how this trend can be corrected by transforming e-healthcare into a full-fledged business strategy for strategic positioning and corporate profitability. This argument is illustrated with the aid of a business example related to transfer pricing.

DEVELOPING A TECHNICAL BASIS FOR REDUCING RISK FROM ARSENIC EXPOSURE IN WATER RESOURCES ACROSS THE UNITED STATES

EPA Science Inventory

Successful prevention of public exposure to arsenic in ground-water resources impacted by natural sources or contaminated sites is dependent on scientifically-based strategies for site remediation and water resource management. Research within the National Risk Management Resear...

A SCIENTIFIC AND TECHNOLOGICAL FRAMEWORK FOR EVALUATING COMPARATIVE RISK IN ECOLOGICAL RISK ASSESSMENTS

EPA Science Inventory

There are significant scientific and technological challenges to managing natural resources. Data needs are cited as an obvious limitation, but there exist more fundamental scientific issues. What is still needed is a method of comparing management strategies based on projected i...

Strategic planning features of subsurface management in Kemerovo Oblast

NASA Astrophysics Data System (ADS)

Romanyuk, V.; Grinkevich, A.; Akhmadeev, K.; Pozdeeva, G.

2016-09-01

The article discusses the strategic planning features of regional development based on the production and subsurface management in Kemerovo Oblast. The modern approach - SWOT analysis was applied to assess the regional development strategy. The estimation of regional development plan implementation was given for the foreseeable future.

Evaluation and experimentation with duck management strategies

USGS Publications Warehouse

Nichols, J.D.; Johnson, F.A.

1989-01-01

Our knowledge of the effects of hunting regulations on duck populations has been based largely on retrospective studies of historical data. We have reached the limits of what can be learned in this way. Future knowledge gains will likely come about only through experimentation and adaptive management.

Building Coping Skills on a Firm Foundation: Using a Metaphorical Interface To Deliver Stress Management Instruction.

ERIC Educational Resources Information Center

Berkley, Jeannette; Cates, Ward Mitchell

This paper examines the benefits of a metaphorical graphical user interface (GUI) and discusses how metaphorical interfaces can be used to deliver instruction on stress management. A computer-based instructional (CBI) program for college students was developed on the fundamentals of stress and the role of time management as a coping strategy. The…

Effects of Teacher Consultation on Evidence-Based Classroom Management Strategies: Teacher and Student Behavior

ERIC Educational Resources Information Center

Funk, Kristin M.

2013-01-01

The American Psychological Association (APA) conducted the online 2005-2006 Teacher Needs Survey wherein 52% of first year teachers, 28% of teachers with two to five years of experience, and 26% of teachers with 6 to 10 years experience ranked classroom management as their greatest need. Difficulty managing student behaviors leads to higher stress…

Use and Users of the Cranberry Backcountry in West Virginia: insights for eastern backcountry management

Treesearch

Herbert E. Echelberger; George H. Moeller

1977-01-01

Management of backcountry recreation areas in the eastern United States should be based in part on information about the identity of backcountry users and what they seek in their backcountry experiences. Because little of this kind of information is now available, managers may be adopting some strategies with inadequate knowledge of the consequences of their decisions...

Alternative to Blood Replacement in the Critically Ill.

PubMed

Tolich, Deborah J; McCoy, Kelly

2017-09-01

This article reviews treatments and strategies that can be used to reduce, or as adjuncts to, blood transfusion to manage blood volumes in patients who are critically ill. Areas addressed include iatrogenic anemia, fluid management, pharmaceutical agents, hemostatic agents, hemoglobin-based oxygen carriers, and management of patients for whom blood is not an option. Copyright © 2017 Elsevier Inc. All rights reserved.

Principles and techniques in the design of ADMS+. [advanced data-base management system

NASA Technical Reports Server (NTRS)

Roussopoulos, Nick; Kang, Hyunchul

1986-01-01

'ADMS+/-' is an advanced data base management system whose architecture integrates the ADSM+ mainframe data base system with a large number of work station data base systems, designated ADMS-; no communications exist between these work stations. The use of this system radically decreases the response time of locally processed queries, since the work station runs in a single-user mode, and no dynamic security checking is required for the downloaded portion of the data base. The deferred update strategy used reduces overhead due to update synchronization in message traffic.

Major Environmental Issues of the Baltic Sea and Science Based Decision Support Strategies towards an Improved Environmental Status

NASA Astrophysics Data System (ADS)

Humborg, C.

2017-12-01

The Baltic Sea is especially susceptible to multiple human impacts due to its estuarine mixing patterns and long water residence times. Temporally and spatially, it is one of the best investigated marginal seas worldwide allowing for a deep knowledge of natural and human processes forming this unique brackish ecosystem. In this presentation, we shortly summarize the physical, biogeochemical and ecological settings of the Baltic Sea and address major human drivers and pressures threatening its ecosystem. Further, we summarize the scientific and political efforts that led to the formulation of Baltic Sea Action Plan, a milestone for eutrophication management and European environmental governance. Further, we summarize the efforts and societal pitfalls towards an Ecosystem Based Fisheries Management, strategies to decrease loads of environmental pollutants and management of marine biodiversity/habitat issues in the unique Baltic Sea context.

The superior effect of nature based solutions in land management for enhancing ecosystem services.

PubMed

Keesstra, Saskia; Nunes, Joao; Novara, Agata; Finger, David; Avelar, David; Kalantari, Zahra; Cerdà, Artemi

2018-01-01

The rehabilitation and restoration of land is a key strategy to recover services -goods and resources- ecosystems offer to the humankind. This paper reviews key examples to understand the superior effect of nature based solutions to enhance the sustainability of catchment systems by promoting desirable soil and landscape functions. The use of concepts such as connectivity and the theory of system thinking framework allowed to review coastal and river management as a guide to evaluate other strategies to achieve sustainability. In land management NBSs are not mainstream management. Through a set of case studies: organic farming in Spain; rewilding in Slovenia; land restoration in Iceland, sediment trapping in Ethiopia and wetland construction in Sweden, we show the potential of Nature based solutions (NBSs) as a cost-effective long term solution for hydrological risks and land degradation. NBSs can be divided into two main groups of strategies: soil solutions and landscape solutions. Soil solutions aim to enhance the soil health and soil functions through which local eco-system services will be maintained or restored. Landscape solutions mainly focus on the concept of connectivity. Making the landscape less connected, facilitating less rainfall to be transformed into runoff and therefore reducing flood risk, increasing soil moisture and reducing droughts and soil erosion we can achieve the sustainability. The enhanced eco-system services directly feed into the realization of the Sustainable Development Goals of the United Nations. Copyright © 2017 Elsevier B.V. All rights reserved.

Management of recurrent depression.

PubMed

Howell, Cate; Marshall, Charlotte; Opolski, Melissa; Newbury, Wendy

2008-09-01

Depression is a potentially recurring or chronic disorder. The provision of evidence based treatment and effective practice organisation is central to chronic disease management, and these principles can be applied to managing depression. This article outlines the principles of chronic disease management, including the use of management plans and a team care approach, and their application to the management of depression. Treatment approaches that systematically assist patients in managing their chronic disease are more effective than those based on acute care. Depression treatment guidelines are available, as well as primary care initiatives which facilitate comprehensive and long term mental health care, including relapse prevention strategies. A number of risk factors for depression relapse have been identified, and research has recommended that novel intensive relapse prevention programs need to be developed.

Recruiting seniors with chronic low back pain for a randomized controlled trial of a self-management program.

PubMed

Groupp, Elyse; Haas, Mitchell; Fairweather, Alisa; Ganger, Bonnie; Attwood, Michael

2005-02-01

To identify recruitment challenges and elucidate specific strategies that enabled recruitment of seniors for a randomized trial on low back pain comparing the Chronic Disease Self-management Program of the Stanford University to a 6-month wait-list control group. Recruitment for a randomized controlled trial. Community-based program offered at 12 locations. Community-dwelling seniors 60 years and older with chronic low back pain of mechanical origin. Passive recruitment strategies included advertisement in local and senior newspapers, in senior e-mail newsletters and listservs, in local community centers and businesses. Active strategies included meeting seniors at health fairs, lectures to the public and organizational meetings, and the help of trusted professionals in the community. A total of 100 white and 20 African American seniors were recruited. The program seemed to have the most appeal to white, middle-class older adults, educated through high school level. Advertisement failed to attract any participants to the program. Successful strategies included interaction with seniors at health fairs and lectures on health care, especially when the program was endorsed by a trusted community professional. Generating interest in the self-management program required keen communication skills because the idea of "self-management" was met with a myriad of responses, ranging from disinterest to disbelief. Generating interest also required active participation within the communities. Initial contacts had to be established with trusted professionals, whose endorsement enabled the project managers to present the concept of self-management to the seniors. More complex recruitment strategies were required for this study involving the self-management approach to back pain than for studies involving treatment.

A Computer Clone of Human Expert for Mobility Management Scheme (E-MMS): Step toward Green Transportation

NASA Astrophysics Data System (ADS)

Resdiansyah; O. K Rahmat, R. A.; Ismail, A.

2018-03-01

Green transportation refers to a sustainable transport that gives the least impact in terms of social and environmental but at the same time is able to supply energy sources globally that includes non-motorized transport strategies deployment to promote healthy lifestyles, also known as Mobility Management Scheme (MMS). As construction of road infrastructure cannot help solve the problem of congestion, past research has shown that MMS is an effective measure to mitigate congestion and to achieve green transportation. MMS consists of different strategies and policies that subdivided into categories according to how they are able to influence travel behaviour. Appropriate selection of mobility strategies will ensure its effectiveness in mitigating congestion problems. Nevertheless, determining appropriate strategies requires human expert and depends on a number of success factors. This research has successfully developed a computer clone system based on human expert, called E-MMS. The process of knowledge acquisition for MMS strategies and the next following process to selection of strategy has been encode in a knowledge-based system using a shell expert system. The newly developed computer cloning system was successfully verified, validated and evaluated (VV&E) by comparing the result output with the real transportation expert recommendation in which the findings suggested Introduction

Managing work, family, and school roles: disengagement strategies can help and hinder.

PubMed

Cheng, Bonnie Hayden; McCarthy, Julie M

2013-07-01

The extent to which individuals manage multiple role domains has yet to be fully understood. We advance past research by examining the effect of interrole conflict among three very common and critically important life roles-work, family, and school-on three corresponding types of satisfaction. Further, we examine individual-based techniques that can empower people to manage multiple roles. In doing so, we integrate the disengagement strategies from the work recovery and coping literatures. These strategies focus on taking your mind off the problems at hand and include cognitive disengagement (psychological detachment, cognitive avoidance coping), as well as cognitive distortion (escape avoidance coping). We examine these strategies in a two-wave study of 178 individuals faced with the challenge of managing work, family, and school responsibilities. Findings demonstrated a joint offsetting effect of psychological detachment and cognitive avoidance coping on the relationship between work conflict and work satisfaction. Findings also indicated an exacerbating effect of escape avoidance coping on the relationship between work conflict and work satisfaction, school conflict and school satisfaction, and between family conflict and family satisfaction. Implications for theory and practice are discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Integrated Pest Management of Coffee Berry Borer: Strategies from Latin America that Could Be Useful for Coffee Farmers in Hawaii

PubMed Central

Aristizábal, Luis F.; Bustillo, Alex E.; Arthurs, Steven P.

2016-01-01

The coffee berry borer (CBB), Hypothenemus hampei Ferrari (Coleoptera: Curculionidae: Scolytinae) is the primary arthropod pest of coffee plantations worldwide. Since its detection in Hawaii (September 2010), coffee growers are facing financial losses due to reduced quality of coffee yields. Several control strategies that include cultural practices, biological control agents (parasitoids), chemical and microbial insecticides (entomopathogenic fungi), and a range of post-harvest sanitation practices have been conducted to manage CBB around the world. In addition, sampling methods including the use of alcohol based traps for monitoring CBB populations have been implemented in some coffee producing countries in Latin America. It is currently unclear which combination of CBB control strategies is optimal under economical, environmental, and sociocultural conditions of Hawaii. This review discusses components of an integrated pest management program for CBB. We focus on practical approaches to provide guidance to coffee farmers in Hawaii. Experiences of integrated pest management (IPM) of CBB learned from Latin America over the past 25 years may be relevant for establishing strategies of control that may fit under Hawaiian coffee farmers’ conditions. PMID:26848690

Chlamydia screening strategies and outcomes in educational settings: a systematic review.

PubMed

Jamil, Muhammad Shahid; Bauer, Heidi M; Hocking, Jane S; Ali, Hammad; Wand, Handan; Walker, Jennifer; Douglas, Laura; Donovan, Basil; Kaldor, John M; Guy, Rebecca J

2014-03-01

Chlamydia trachomatis (CT) screening programs have been established in educational settings in many countries during the past 2 decades. However, recent evidence suggests that high uptake of screening and management (treatment, partner notification, and retesting for reinfection) improves program effectiveness. We conducted a systematic review to understand the screening strategies, the extent of screening conducted, and uptake of management strategies in educational settings. Screening studies in educational settings were identified through a systematic search of published literature from 2005 to 2011. We identified 27 studies describing 30 screening programs in the United States/Canada (n = 10), Europe (n = 8), Australia/New Zealand (n = 5), and Asia (n = 4). Most studies targeted both male and female students (74%). Classroom-based strategies resulted in 21,117 testes overall (4 programs), followed by opportunistic screening during routine health examination (n = 13,470; 5 programs) and opportunistic screening at school-based health centers (n = 13,006; 5 programs). The overall median CT positivity was 4.7% (range, 1.3%-18.1%). Only 5 programs reported treatment rates (median, 100%; range, 86%-100%), 1 partner notification rate (71%), 1 retesting rate within a year of an initial CT diagnosis (47%), and 2 reported repeat positivity rates (21.1% and 26.3%). In conclusion, this systematic review shows that a variety of strategies have been used to screen large numbers of students in educational settings; however, only a few studies have reported CT management outcomes.

The gendered realities and talent management imperatives of women physicians.

PubMed

Hoff, Timothy; Scott, Sarah

2016-01-01

U.S. medicine is increasingly a gender-balanced profession with half of all medical school graduates now female. Despite this reality and the potentially transformative nature of a large female physician cohort in U.S. health care, there is less examination of their workplace realities and the key talent management strategies for health care organizations employing women physicians. First, we identify current knowledge about U.S. women physician satisfaction, role challenges, and work tradeoffs. Gender theory is used to help interpret these workplace realities. Second, we use this information to identify talent management strategies health care organizations might consider to mitigate the realities and provide greater support for women physicians. To facilitate our analysis, we conducted a narrative review of published research that includes analysis focused on U.S. women physicians for the time period 2006-2014. Applying ideas from gender theory, we extrapolated key findings from that research related to three issues: satisfaction, role challenges, and tradeoffs. Then we synthesized the findings to identify general talent management strategies that could address these dynamics proactively while enhancing recruitment and retention with respect to women physicians. U.S. women physicians express strong levels of satisfaction, particularly with their careers, at the same time they continue to experience gender-based inequities, role challenges, and lack of work-life balance in their chosen specialty fields. Lack of suitable role models and appropriate mentoring for women physicians, in addition to barriers to career advancement, are also prevalent across different medical specialties. Similar to other occupations and industries, gender-based inequities and role strains are very real issues for women physicians. Health care organizations must acknowledge these issues and employ effective talent management strategies aimed at women doctors if they are to be viewed as an employer of choice by this increasingly important occupational cohort.