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Sample records for nephroscopic management strategy

  1. Percutaneous Nephroscopic Surgery

    PubMed Central

    2010-01-01

    With the development of techniques for percutaneous access and equipment to disintegrate calculi, percutaneous nephroscopic surgery is currently used by many urologists and is the procedure of choice for the removal of large renal calculi and the management of diverticula, intrarenal strictures, and urothelial cancer. Although it is more invasive than shock wave lithotripsy and retrograde ureteroscopic surgery, percutaneous nephroscopic surgery has been successfully performed with high efficiency and low morbidity in difficult renal anatomies and patient conditions. These advantages of minimal invasiveness were rapidly perceived and applied to the management of ureteropelvic junction obstruction, calyceal diverticulum, infundibular stenosis, and urothelial cancer. The basic principle of endopyelotomy is a full-thickness incision of the narrow segment followed by prolonged stenting and drainage to allow regeneration of an adequate caliber ureter. The preferred technique for a calyceal diverticulum continues to be debated. Excellent long-term success has been reported with percutaneous, ureteroscopic, and laparoscopic techniques. Each approach is based on the location and size of the diverticulum. So far, percutaneous ablation of the calyceal diverticulum is the most established minimally invasive technique. Infundibular stenosis is an acquired condition usually associated with inflammation or stones. Reported series of percutaneously treated infundibular stenosis are few. In contrast with a calyceal diverticulum, infundibular stenosis is a more difficult entity to treat with only a 50-76% success rate by percutaneous techniques. Currently, percutaneous nephroscopic resection of transitional cell carcinoma in the renal calyx can be applied in indicated cases. PMID:20495691

  2. Percutaneous nephroscopic management of an isolated giant renal hydatid cyst guided by single-incision laparoscopy using conventional instruments: the Santosh-PGI technique.

    PubMed

    Kumar, Santosh; Choudhary, Gautam R; Pushkarna, Arawat; Najjapa, Bhuvnesh; Ht, Vatasla

    2013-11-01

    Isolated renal hydatid rarely presents, but when it does occur, it requires surgical treatment. We report our experience with a novel technique involving percutaneous management of a giant renal hydatid cyst with single-incision laparoscopic assistance. First we performed retrograde ureteropyelogram, which did not show any communication between the cyst and the calyceal. A Veress needle was used for pneumoperitoneum. Three conventional laparoscopic trocars used. Under laparoscopic guidance, we punctured the cyst. The scolicidal solution used was 10% povidone-iodine. The endocyst was removed under vision with grasping forceps through the nephroscope. A Portex drain was placed into the cyst cavity. Percutaneous aspiration and instillation of scolicidal agents followed by re-aspiration have been previously reported. This is an attractive procedure because of its acceptable success rates and reduced morbidity. In our case, simple aspiration of the cyst would not have been successful because the cyst was full of daughter cysts. Also, a blind percutaneous puncture of the cyst and dilatation could have perforated the colon or the mesocolon, which is often wrapped over the surface of such giant cysts thereby making laparoscopic guidance and mobilization of the colon imperative. We devised this unique treatment method for this patient involving three conventional ports at a single umbilical site. We believe this is the first reported case of its kind in the world. Not only this technique is minimally invasive, it is also cost-effective, as only conventional laparoscopic ports and instruments are used during the procedure. © 2013 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

  3. Management strategies for fibromyalgia.

    PubMed

    Le Marshall, Kim Francis; Littlejohn, Geoffrey Owen

    2011-01-01

    What are the effective, evidence-based strategies available for the management of fibromyalgia? There are a number of management strategies available with robust evidence to support their use in clinical practice. 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. Systematic reviews, meta-analyses, randomized controlled trials (RCTs). PubMed, Cochrane Library, manual search. 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.

  4. Use of a Novel Flexible Mini-nephroscope in Minimally Invasive Percutaneous Nephrolithotomy.

    PubMed

    Mishra, Dilip Kumar; Agrawal, Madhu Sudan

    2017-05-01

    To assess the feasibility and safety of a novel flexible mini-nephroscope in minimally invasive percutaneous nephrolithotomy (PCNL). Presumably, limiting the size and number of tracts during PCNL has the potential of decreasing the morbidity of the procedure. We present our experience with this new technique. A retrospective analysis of patients with multiple kidney stones treated with mini-PCNL combined with a novel flexible mini-nephroscope was performed. Minimally invasive PCNL was done with rigid 12 F MIP-M nephroscope, followed by flexible mini-nephroscopy for smaller stones in other inaccessible calyces. Record was made of the operating time, stone-free rates, postoperative pain, morbidity, hospital stay, time to recovery, complication rates, and ancillary procedures. Matched-pair analysis was done with cases operated by flexible ureteroscopy performed with Flex X-2 or Flex X-c scope. Twenty-five patients in the study group were matched with 25 cases from the flexible ureteroscopy group. Both groups were comparable in terms of age, laterality, and mean composite stone burden. The mean operating time was 40.1 ± 10.6 minutes in the mini-PCNL group and 51.2 ± 8.8 minutes in the flexible ureteroscopy group. Mean hospital stay was similar in both groups. The primary stone clearance rate of 92% (23 of 25) in the mini-PCNL group was better than the clearance rate of 80% (20 of 25) in the flexible ureteroscopy group. Eight percent in the mini-PCNL group required ancillary procedures as compared with 20% of cases in the flexible ureteroscopy group. Postoperative pain and analgesia requirement in these patients was minimal. There were no significant complications. Flexible mini-nephroscope is an effective adjuvant to minimally invasive PCNL in achieving high clearance rate with minimum morbidity. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Fault Management Design Strategies

    NASA Technical Reports Server (NTRS)

    Day, John C.; Johnson, Stephen B.

    2014-01-01

    Development of dependable systems relies on the ability of the system to determine and respond to off-nominal system behavior. Specification and development of these fault management capabilities must be done in a structured and principled manner to improve our understanding of these systems, and to make significant gains in dependability (safety, reliability and availability). Prior work has described a fundamental taxonomy and theory of System Health Management (SHM), and of its operational subset, Fault Management (FM). This conceptual foundation provides a basis to develop framework to design and implement FM design strategies that protect mission objectives and account for system design limitations. Selection of an SHM strategy has implications for the functions required to perform the strategy, and it places constraints on the set of possible design solutions. The framework developed in this paper provides a rigorous and principled approach to classifying SHM strategies, as well as methods for determination and implementation of SHM strategies. An illustrative example is used to describe the application of the framework and the resulting benefits to system and FM design and dependability.

  6. Fault Management Design Strategies

    NASA Technical Reports Server (NTRS)

    Day, John C.; Johnson, Stephen B.

    2014-01-01

    Development of dependable systems relies on the ability of the system to determine and respond to off-nominal system behavior. Specification and development of these fault management capabilities must be done in a structured and principled manner to improve our understanding of these systems, and to make significant gains in dependability (safety, reliability and availability). Prior work has described a fundamental taxonomy and theory of System Health Management (SHM), and of its operational subset, Fault Management (FM). This conceptual foundation provides a basis to develop framework to design and implement FM design strategies that protect mission objectives and account for system design limitations. Selection of an SHM strategy has implications for the functions required to perform the strategy, and it places constraints on the set of possible design solutions. The framework developed in this paper provides a rigorous and principled approach to classifying SHM strategies, as well as methods for determination and implementation of SHM strategies. An illustrative example is used to describe the application of the framework and the resulting benefits to system and FM design and dependability.

  7. Medical equipment management strategies.

    PubMed

    Wang, Binseng; Furst, Emanuel; Cohen, Ted; Keil, Ode R; Ridgway, Malcolm; Stiefel, Robert

    2006-01-01

    Clinical engineering professionals need to continually review and improve their management strategies in order to keep up with improvements in equipment technology, as well as with increasing expectations of health care organizations. In the last 20 years, management strategies have evolved from the initial obsession with electrical safety to flexible criteria that fit the individual institution's needs. Few hospitals, however, are taking full advantage of the paradigm shift offered by the evolution of joint Commission standards. The focus should be on risks caused by equipment failure, rather than on equipment with highest maintenance demands. Furthermore, it is not enough to consider risks posed by individual pieces of equipment to individual patients. It is critical to anticipate the impact of an equipment failure on larger groups of patients, especially when dealing with one of a kind, sophisticated pieces of equipment that are required to provide timely and accurate diagnoses for immediate therapeutic decisions or surgical interventions. A strategy for incorporating multiple criteria to formulate appropriate management strategies is provided in this article.

  8. Strategies in managing asthma.

    PubMed Central

    Barker, A F

    1989-01-01

    The management of adult asthma involves a concerted effort to identify and remove or mollify inciting or triggering stimuli such as respiratory tract infections, gastric reflux, aspirin, beta-antagonists, and environmental agents; educate patients, using written treatment plans and pulmonary function monitoring; and properly use the antiasthmatic medications including beta-agonists, theophylline, anticholinergics, and corticosteroids, with an emphasis on aerosol delivery and the use of corticosteroids during exacerbations. This strategy is summarized with suggestions on therapy in emergency departments, during the transition from hospital to ambulatory care, before exercise, and during pregnancy. PMID:2660411

  9. Human capital strategy: talent management.

    PubMed

    Nagra, Michael

    2011-01-01

    Large organizations, including the US Army Medical Department and the Army Nurse Corps, are people-based organizations. Consequently, effective and efficient management of the human capital within these organizations is a strategic goal for the leadership. Over time, the Department of Defense has used many different systems and strategies to manage people throughout their service life-cycle. The current system in use is called Human Capital Management. In the near future, the Army's human capital will be managed based on skills, knowledge, and behaviors through various measurement tools. This article elaborates the human capital management strategy within the Army Nurse Corps, which identifies, develops, and implements key talent management strategies under the umbrella of the Corps' human capital goals. The talent management strategy solutions are aligned under the Nurse Corps business strategy captured by the 2008 Army Nurse Corps Campaign Plan, and are implemented within the context of the culture and core values of the organization.

  10. Knowledge management: an innovative risk management strategy.

    PubMed

    Zipperer, Lorri; Amori, Geri

    2011-01-01

    Knowledge management effectively lends itself to the enterprise risk process. The authors introduce the concept of knowledge management as a strategy to drive innovation and support risk management. They align this work with organizational efforts to improve patient safety and quality through the effective sharing of experience and lessons learned. The article closes with suggestions on how to develop a knowledge management initiative at an organization, who should be on the team, and how to sustain this effort and build the culture it requires to drive success.

  11. The office of strategy management.

    PubMed

    Kaplan, Robert S; Norton, David P

    2005-10-01

    There is a disconnect in most companies between strategy formulation and strategy execution. On average, 95% of a company's employees are unaware of, or do not understand, its strategy. If employees are unaware of the strategy, they surely cannot help the organization implement it effectively. It doesn't have to be like this. For the past 15 years, the authors have studied companies that achieved performance breakthroughs by adopting the Balanced Scorecard and its associated tools to help them better communicate strategy to their employees and to guide and monitor the execution of that strategy. Some companies, of course, have achieved better, longer-lasting improvements than others. The organizations that have managed to sustain their strategic focus have typically established a new corporate-level unit to oversee all activities related to strategy: an office of strategy management (OS M). The OSM, in effect, acts as the CEO's chief of staff. It coordinates an array of tasks: communicating corporate strategy; ensuring that enterprise-level plans are translated into the plans of the various units and departments; executing strategic initiatives to deliver on the grand design; aligning employees' plans for competency development with strategic objectives; and testing and adapting the strategy to stay abreast of the competition. The OSM does not do all the work, but it facilitates the processes so that strategy is executed in an integrated fashion across the enterprise. Although the companies that Kaplan and Norton studied use the Balanced Scorecard as the framework for their strategy management systems, the authors say the lessons of the OSM are applicable even to companies that do not use it.

  12. Management Strategies for Clopidogrel Hypersensitivity.

    PubMed

    Beavers, Craig J; Carris, Nicolas W; Ruf, Kathryn M

    2015-06-01

    Clopidogrel is a cornerstone of dual antiplatelet therapy. Hypersensitivity reactions potentially limit the use of this treatment and present a significant clinical challenge. The authors have developed recommendations for the management of clopidogrel hypersensitivity with consideration for the etiology, pathophysiology, and critical evaluation of potential management strategies. The clopidogrel hypersensitivity reaction is complex in mechanism and presents generally around day 5 of treatment. Generalized reactions are most common, but the reaction may also be localized or systemic. Screening patients for hypersensitivity is not always possible because the type IV delayed reaction is not detected reliably by conventional skin prick, intradermal challenge, or patch testing. Proposed strategies for management of clopidogrel hypersensitivity include treatment of the reaction with corticosteroids, clopidogrel desensitization, substituting an alternative P2Y12 inhibitor, or clopidogrel avoidance. The safety, efficacy, and cost of each potential strategy must be considered when managing a patient with clopidogrel hypersensitivity.

  13. Crisis management strategies.

    PubMed

    Koster, Maria C; Politis-Norton, Helen

    2004-01-01

    This paper discusses the different facets of crisis as experienced within the pharmaceutical industry but which are also prevalent throughout other industries. It highlights the importance of early identification and management of crises and issues, which in return are strongly intertwined with a fundamental positive internal corporate climate. A corporate philosophy should always embrace crisis management with the attitude of 'when' and not 'if'; therefore, a company should act today and not tomorrow once a crisis is on its doorstep. Preparation is of utmost importance and there are several items that can be addressed even before a crisis has arisen. Further, this paper also provides guidance on how to deal with the media, what to do and what not to do, and how to appoint the appropriate spokesperson. In this era of fast exchange of information, crisis, which previously may have stayed behind corporate doors, may not do so any longer. Image is very important and should therefore not be risked. Crisis and issue management should therefore be integrated in every company's philosophy and standard operating procedures.

  14. Managing incontinence: women's normalizing strategies.

    PubMed

    Skoner, M M; Haylor, M J

    1993-01-01

    Women's strategies for managing urinary incontinence were examined in a grounded-theory study. The women's basic social concern was dealing with incontinence in a manner that enabled them to feel normal. Feeling normal meant being able to do what they wanted to do and needed to do to have a normal life-style as they perceived it. This goal was accomplished by normalizing incontinence and its management. Normalization was achieved by directing its course through self-management, accounting for it in terms of personal history and life experiences, and delaying medical counsel. These strategies are described. The findings provide fresh insights about women's response to incontinence and their practice of self-managing its consequences.

  15. Funding strategies for wilderness management

    Treesearch

    Carolyn Alkire

    2000-01-01

    Funding wilderness protection will continue to be a challenge for public land managers. With continuing competition for federal funds and balanced budget goals, other sources of funds may be necessary to supplement annual federal appropriations. This paper identifies and evaluates five potential funding strategies and provides examples of each that are currently in use...

  16. Management strategies for encouraging creativity.

    PubMed

    Preston, P

    1998-01-01

    Change, chaos, and uncertainty touch every part of every institution. The laboratory is not immune. Managers content to continue on their familiar path soon will find themselves bypassed. To meet today's challenges, directors of technical operations, laboratory directors, team leaders, and coordinators need plenty of creativity--from everyone on their staff. It is no longer just "nice" to improve group output and problem-solving skills while staying within a "shoestring" budget. It is absolutely necessary. In this article, we explore strategies laboratory managers can use to tap the creative potential and commitment of their people. These strategies work. Whether it involves using humor, creating "idea centers," or "deconstructing the bureaucracy," the goal is the same: to encourage clinical managers to think beyond their technical and managerial experience. The examples in this article may not suit the needs, situations, or tastes of all laboratory managers. They are "food for thought." The concepts and strategies these examples illustrate are every laboratory manager's keys to adapting successfully to future challenges.

  17. Percutaneous nephroscopic with holmium laser and ultrasound lithotripsy for complicated renal calculi.

    PubMed

    Gu, Zhengqin; Qi, Jun; Shen, Haibo; Liu, Jianhe; Chen, Jianhua

    2010-07-01

    The aim of this work is to validate the clinical efficacy of the high-power holmium:YAG laser with percutaneous nephrolithotripsy (PCNL) in combination with ultrasound lithotripsy for complicated renal calculi. From November 2006 to December 2007, 60 patients with complicated renal calculi were treated with PCNL, where an F24 standard renal access tract was established by percutaneous renal puncture under the guidance of B-mode ultrasound, and stones were fragmented and cleared by high-power holmium laser in combination with ultrasound under an F20.8 nephroscope. Of the 60 patients with complicated renal calculi, 20 were complete staghorn calculi and 30 were partial staghorn calculi, of which six patients were accompanied with renal insufficiency; two were solitary calculi, and eight were caliceal diverticular calculi. Calculi were removed by one attempt in 49 patients and by two attempts in 11 patients; through one tract in 50 patients and through two and three tracts in ten patients. The stone-free rate was 81.7%. No injury to the pleura and abdominal organs occurred during the intraoperative puncture. No postoperative blood transfusion was needed in any patient, nor did fever and secondary hemorrhage occur. The mean operation duration was 98 min (range, 60-150 min), and the mean lithotripsy time was 45 min (range, 30-85 min). Additional postoperative extracorporeal shock wave lithotripsy (ESWL) was performed on six patients. High-power holmium laser PCNL in combination with ultrasound lithotripsy is safe, effective, and minimally invasive, with a high stone-free rate, especially for complicated renal calculi.

  18. Managing human resources for successful strategy execution.

    PubMed

    Arnold, Edwin

    2010-01-01

    Managers face difficult challenges when they implement organizational strategies to achieve important goals. Execution of strategy has become more dependent upon the effective management of human resources. This article suggests how people can be managed more effectively to facilitate the execution of strategies and improve organizational performance.

  19. Disease management strategies for wildlife.

    PubMed

    Wobeser, G

    2002-04-01

    Three basic forms of management strategies exist for wildlife disease, as follows: prevention of introduction of disease, control of existing disease or eradication. Management may be directed at the disease agent, host population, habitat or be focused on human activities. Disease agents may be dealt with in the environment through disinfection or in the host through treatment. Disinfection and pesticides used to destroy agents or vectors are limited to local situations, may have serious environmental effects and may result in acquired resistance. Difficulty in delivering treatment limits chemotherapy to local situations. Host populations may be managed by immunisation, by altering their distribution or density, or by extirpation. Immunisation is best suited for microparasitic exogenous infections with a low reproductive rate and in populations which have a low turnover. Mass immunisation with oral baits has been effective, but this strategy is limited to a few serious diseases. It is difficult to move wild animals and techniques to discourage animals from entering an area become ineffective rapidly. The setting up of fences is feasible only in local situations. Selective culling is limited to situations in which affected individuals are readily identifiable. General population reduction has had little success in disease control but reducing populations surrounding a focus or creating a barrier to disease movement have been successful. Population reduction is a temporary measure. Eradication of a wildlife population has not been attempted for disease management. Habitat modification may be used to reduce exposure to disease agents, or to alter host distribution or density. Management of diseases of wild animals usually requires a change in human activities. The most important method is by restricting translocation of wild animals to prevent movement of disease.

  20. Relapsed Hodgkin Lymphoma: Management Strategies

    PubMed Central

    Montanari, Francesca; Diefenbach, Catherine

    2016-01-01

    Although Hodgkin lymphoma (HL) is largely curable with first-line therapy, approximately one-third of patients will not have a complete response to frontline treatment or will subsequently relapse. Only 50 % of these patients will be effectively salvaged with conventional therapies. The prognosis is particularly poor for those patients with chemotherapy refractory disease, who are unable to obtain even transient disease control, and for patients who relapse following high dose chemotherapy and autologous stem cell transplant. In this review, we summarize the most recent updates on the management of patients with relapsed HL, the role of novel therapies such as brentuximab vedotin, and an overview of promising new agents currently under investigation. We also discuss the role of consolidation strategies such as high-dose chemotherapy and autologous stem cell transplant, and reduced-intensity allogeneic hematopoietic stem cell transplant, and the need for new strategies in the elderly patient population. PMID:24942298

  1. Population communication management training strategy.

    PubMed

    Bayan Salas, E

    1985-01-01

    The discussion presents some thoughts on a general training strategy in information/education/communication (IEC) management which might meet the needs of 3rd world countries. Management by objectives (MBO) has emerged as the central doctrine in management theory and practice since its initial formulation in 1954. Yet, little evidence exists to date of its successful application in IEC activities. Population IEC activities, being staff activities in a nonprofit, public sector program, are in the "twilight zone" of MBO where hasty efforts to comply with the form if not the substance of this management technique can lead to lower levels of performance and achievement than before the goal setting system was implemented. Yet, clearly, IEC managers need the benefits that management by objectives can bring if done properly. It is essential that IEC managers and workers stop looking at IEC materials as end products in themselves but rather as inputs to be combined with other inputs in realizing the desired output of voluntary behavioral change on a mass level. To overcome tendencies toward provincialism, all IEC managers should initially spend time working in other areas of the population program. The experience of using IEC materials and approaches in face-to-face transactions with potential acceptors is a prerequisite to the successful formulation of such materials and approaches. Training programs for IEC managers and supervisors should emphasize development of consensual decision making skills. The success or failure of the program depends on the ability of its workers to resolve potential conflicts between an individual's priorities and national priorities in a noncoercive manner. The social dynamics approach that seeks a conscious, voluntary, nonmanipulated shift of shared attitudes, opinions, feelings, and actions is the approach underlying the most successful population programs. All IEC managers and supervisors should be systematically trained in norm shifting

  2. Combination strategies for pain management.

    PubMed

    Raffa, Robert B; Clark-Vetri, Rachel; Tallarida, Ronald J; Wertheimer, Albert I

    2003-10-01

    At least two factors relating to pain management using oral analgesics suggest that combination strategies merit consideration: many pains arise from more than one physiological cause and current analgesics have adverse effect profiles that might be reduced by combination with another agent in smaller doses or with less frequent dosing. In addition to increased convenience, combinations sometimes also result in the unexpected benefit of synergy. But not all pains, clinical settings or combinations merit the extra expense or other potential negative features of fixed-ratio products. This review examines the multiple basic science, clinical and pharmacoeconomic issues relating to analgesic combinations and the methodologies available for assessing these issues.

  3. Management strategies of Barrett's esophagus.

    PubMed

    De Palma, Giovanni D

    2012-11-21

    Barrett's esophagus is a condition resulting from chronic gastro-esophageal reflux disease with a documented risk of esophageal adenocarcinoma. Current strategies for improved survival in patients with Barrett's adenocarcinoma focus on detection of dysplasia. This can be obtained by screening programs in high-risk cohorts of patients and/or endoscopic biopsy surveillance of patients with known Barrett's esophagus (BE). Several therapies have been developed in attempts to reverse BE and reduce cancer risk. Aggressive medical management of acid reflux, lifestyle modifications, antireflux surgery, and endoscopic treatments have been recommended for many patients with BE. Whether these interventions are cost-effective or reduce mortality from esophageal cancer remains controversial. Current treatment requires combinations of endoscopic mucosal resection techniques to eliminate visible lesions followed by ablation of residual metaplastic tissue. Esophagectomy is currently indicated in multifocal high-grade neoplasia or mucosal Barrett's carcinoma which cannot be managed by endoscopic approach.

  4. Configuration Management Process Assessment Strategy

    NASA Technical Reports Server (NTRS)

    Henry, Thad

    2014-01-01

    Purpose: To propose a strategy for assessing the development and effectiveness of configuration management systems within Programs, Projects, and Design Activities performed by technical organizations and their supporting development contractors. Scope: Various entities CM Systems will be assessed dependent on Project Scope (DDT&E), Support Services and Acquisition Agreements. Approach: Model based structured against assessing organizations CM requirements including best practices maturity criteria. The model is tailored to the entity being assessed dependent on their CM system. The assessment approach provides objective feedback to Engineering and Project Management of the observed CM system maturity state versus the ideal state of the configuration management processes and outcomes(system). center dot Identifies strengths and risks versus audit gotcha's (findings/observations). center dot Used "recursively and iteratively" throughout program lifecycle at select points of need. (Typical assessments timing is Post PDR/Post CDR) center dot Ideal state criteria and maturity targets are reviewed with the assessed entity prior to an assessment (Tailoring) and is dependent on the assessed phase of the CM system. center dot Supports exit success criteria for Preliminary and Critical Design Reviews. center dot Gives a comprehensive CM system assessment which ultimately supports configuration verification activities.*

  5. Management strategies for idiopathic urethritis.

    PubMed

    Henderson, L; Farrelly, P; Dickson, A P; Goyal, A

    2016-02-01

    Williams and Mikhael (1971) described idiopathic urethritis (IU) as a self-limiting condition that affects boys aged 5-15 years, with symptoms of urethrorrhagia, dysuria and haematuria. However, a proportion of boys will remain symptomatic for several years, and may develop urethral stricture (Poch et al., 2007; Palagiri et al., 2003). There is no universally effective treatment for IU, although various strategies have been employed. To review the presentation and long-term outcomes of boys with IU, and present the efficacy of management strategies that have been utilised. A retrospective review was performed of all boys with IU. It was based on clinical and cystoscopic findings for presentation, medical history, management and clinical progress. Fifty-four boys were included, with a median age of 11 years (range 5-15 years) at presentation. The median duration of symptoms was 18 months (range 2-132 months). The median follow-up was 18.5 months (range 1-120 months). Seven (13.0%) boys had early urethral stricture at initial cystourethroscopy, and one (1.9%) developed stricture during follow-up. Thirty-six boys (66.7%) had previous circumcision and four (7.4%) had meatal stenosis. Eight (14.8%) had previous hypospadias repair. Whilst 50% of boys with IU do not require any specific treatment, those with severe/unremitting symptoms may benefit from a trial of urethral steroids or short-term urethral catheterisation. The mechanisms of benefit from these modalities are unclear and they require further evaluation. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  6. Homosexuality in Turkey: strategies for managing heterosexism.

    PubMed

    Bakacak, Ayça Gelgeç; Oktem, Pinar

    2014-01-01

    The goal of this study was to identify the strategies used by young homosexuals to manage their sexual minority status in Turkey. In-depth interviews were conducted with 15 self-identified homosexual university students. The data on the strategies employed by homosexuals suggested a categorization of these strategies into four interrelated areas: strategies employed in the process of self-acceptance; strategies to manage sexual stigma and prejudice; strategies specific to the coming-out process; and the strategies used while openly expressing their sexual identities.

  7. Disease management strategies: managing care giving in managed care.

    PubMed

    Nesse, R E; Hagedorn, S D; Scheitel, S M; Nyman, M A; Broers, J K

    2000-01-01

    The rapid rate of change in health care delivery systems has challenged and troubled health care providers. Some new health care delivery systems primarily emphasize the economics of medical care and leave providers with a sense that their profession has strayed from its mission. In addition, there is an increasing demand by payers and the public for public accountability for the quality and expense of clinical services. One response to these changes in health care is the use of disease management strategies. There is a growing body of knowledge regarding disease management strategies and practice guidelines in the literature. This article discusses how a provider group can implement improvement in the clinical process successfully by applying techniques of disease management.

  8. Galveston Island, Texas, Sand Management Strategies

    DTIC Science & Technology

    2016-07-01

    conducted a study to support a sand management strategy for the Galveston Park Board of Trustees of Galveston, TX. The long-term management strategy ...ER D C/ CH L TR -1 6- 13 Galveston Island, Texas, Sand Management Strategies Co as ta l a nd H yd ra ul ic s La bo ra to ry...online library at http://acwc.sdp.sirsi.net/client/default. ERDC/CHL TR-16-13 July 2016 Galveston Island, Texas, Sand Management Strategies

  9. State Strategies To Manage Budget Shortfalls.

    ERIC Educational Resources Information Center

    National Conference of State Legislatures, Denver, CO.

    Some of the strategies that states have used to manage budget shortfalls are presented in this report. It provides information, evaluations, and case studies that policymakers can refer to when considering their options, and it emphasizes strategies to manage budget shortfalls, which tend to need a quick resolution. The report also examines some…

  10. Leadership Strategies for Managing Conflict.

    ERIC Educational Resources Information Center

    Kormanski, Chuck

    1982-01-01

    Discusses the impact of conflict in small group development theory. Views conflict as a positive, normally occurring behavior and presents leadership strategies involving withdrawal, suppression, integration, compromise, and power. Examines situational contingencies and presents a rationale for strategy selection and intervention. (Author)

  11. 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.

  12. Demand management and case management: a conservation strategy.

    PubMed

    Bryant, C D R Anna K

    2007-01-01

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

  13. Contemporary management strategies for fibromyalgia.

    PubMed

    Navarro, Robert P

    2009-06-01

    A roundtable meeting that comprised clinical, patient advocacy, and managed care experts discussed issues regarding the diagnosis and management of fibromyalgia. The panel agreed that earlier diagnosis and treatment, additional education for the medical community, and appropriate management by health plans, including patient access to US Food and Drug Administration-approved fibromyalgia medications, are needed. In addition, physicians, payers, and patient advocates must work to improve clinical, economic, and quality-of-life outcomes for fibromyalgia patients. Finally, treatment and diagnostic guidelines must be updated as advances in disease management are made (including approvals of 3 new pharmacologic agents), and development of a therapeutic category for "fibromyalgia" on payer formularies is needed.

  14. Time management strategies for research productivity.

    PubMed

    Chase, Jo-Ana D; Topp, Robert; Smith, Carol E; Cohen, Marlene Z; Fahrenwald, Nancy; Zerwic, Julie J; Benefield, Lazelle E; Anderson, Cindy M; Conn, Vicki S

    2013-02-01

    Researchers function in a complex environment and carry multiple role responsibilities. This environment is prone to various distractions that can derail productivity and decrease efficiency. Effective time management allows researchers to maintain focus on their work, contributing to research productivity. Thus, improving time management skills is essential to developing and sustaining a successful program of research. This article presents time management strategies addressing behaviors surrounding time assessment, planning, and monitoring. Herein, the Western Journal of Nursing Research editorial board recommends strategies to enhance time management, including setting realistic goals, prioritizing, and optimizing planning. Involving a team, problem-solving barriers, and early management of potential distractions can facilitate maintaining focus on a research program. Continually evaluating the effectiveness of time management strategies allows researchers to identify areas of improvement and recognize progress.

  15. Gingival overgrowth: Part 2: management strategies.

    PubMed

    Chesterman, J; Beaumont, J; Kellett, M; Durey, K

    2017-02-10

    The effective and predictable management of gingival overgrowth requires correct diagnosis and consideration of aetiological factors, as discussed in Part 1 (BDJ 2017; 222: 85-91). Initial management should involve cause-related therapy, which may resolve or reduce the lesion. If functional, aesthetic and maintenance complications persist following this phase; further treatment may be required in the form of surgery. This paper discusses management strategies, including management of aetiological factors and surgical techniques.

  16. What's your strategy for managing knowledge?

    PubMed

    Hansen, M T; Nohria, N; Tierney, T

    1999-01-01

    The rise of the computer and the increasing importance of intellectual assets have compelled executives to examine the knowledge underlying their businesses and how it is used. Because knowledge management as a conscious practice is so young, however, executives have lacked models to use as guides. To help fill that gap, the authors recently studied knowledge management practices at management consulting firms, health care providers, and computer manufacturers. They found two very different knowledge management strategies in place. In companies that sell relatively standardized products that fill common needs, knowledge is carefully codified and stored in databases, where it can be accessed and used--over and over again--by anyone in the organization. The authors call this the codification strategy. In companies that provide highly customized solutions to unique problems, knowledge is shared mainly through person-to-person contacts; the chief purpose of computers is to help people communicate. They call this the personalization strategy. A company's choice of knowledge management strategy is not arbitrary--it must be driven by the company's competitive strategy. Emphasizing the wrong approach or trying to pursue both can quickly undermine a business. The authors warn that knowledge management should not be isolated in a functional department like HR or IT. They emphasize that the benefits are greatest--to both the company and its customers--when a CEO and other general managers actively choose one of the approaches as a primary strategy.

  17. Speed Management Strategies; A Systematic Review

    PubMed Central

    Sadeghi-Bazargani, Homayoun; Saadati, Mohammad

    2016-01-01

    Objective: To systematically identify the various methods of speed management and their effects. Methods: A systematic search was performed in Science Direct, Ovid Medline, Scopus, PubMed and ProQuest databases from April to June 2015. Hand searching and reference of selected articles were used to improve article identification. Articles published after 1990 which had reported on efficacy/effectiveness of speed management strategies were included. Data were extracted using pre-defined extraction table. Results: Of the 803 retrieved articles, 22 articles were included in this review. Most of the included articles (63%) had before-after design and were done in European countries. Speed cameras, engineering schemes, intelligent speed adaption (ISA), speed limits and zones, vehicle activated sign and integrated strategies were the most common strategies reported in the literature. Various strategies had different effects on mean speed of the vehicles ranging from 1.6 to 10 km/h. Moreover, 8-65% and 11-71% reduction was reported in person injured accidents and fatal accidents, respectively as a result of employing various strategies. Conclusion: Literature revealed positive effects of various speed management strategies. Using various strategies was mostly dependent on road characteristics, driver’s attitude about the strategy as well as economic and technological capabilities of the country. Political support is considered as a main determinant in selecting speed management strategies. PMID:27540546

  18. Strategies for data management engagement.

    PubMed

    Charbonneau, Deborah H

    2013-01-01

    The research landscape is growing dramatically, and librarians are examining new roles, services, and types of collaborations to support data-intensive research. This column describes curricular enhancements at one School of Library and Information Science in the United States. Several key areas of data management in which health sciences librarians may wish to build or enhance their skills are outlined. Possible roles and opportunities for health sciences librarians to strategically engage in data management initiatives are also presented.

  19. Optimizing diabetes management: managed care strategies.

    PubMed

    Tzeel, E Albert

    2013-06-01

    Both the prevalence of type 2 diabetes mellitus (DM) and its associated costs have been rising over time and are projected to continue to escalate. Therefore, type 2 DM (T2DM) management costs represent a potentially untenable strain on the healthcare system unless substantial, systemic changes are made. Managed care organizations (MCOs) are uniquely positioned to attempt to make the changes necessary to reduce the burdens associated with T2DM by developing policies that align with evidence-based DM management guidelines and other resources. For example, MCOs can encourage members to implement healthy lifestyle choices, which have been shown to reduce DM-associated mortality and delay comorbidities. In addition, MCOs are exploring the strengths and weaknesses of several different benefit plan designs. Value-based insurance designs, sometimes referred to as value-based benefit designs, use both direct and indirect data to invest in incentives that change behaviors through health information technologies, communications, and services to improve health, productivity, quality, and financial trends. Provider incentive programs, sometimes referred to as "pay for performance," represent a payment/delivery paradigm that places emphasis on rewarding value instead of volume to align financial incentives and quality of care. Accountable care organizations emphasize an alignment between reimbursement and implementation of best practices through the use of disease management and/ or clinical pathways and health information technologies. Consumer-directed health plans, or high-deductible health plans, combine lower premiums with high annual deductibles to encourage members to seek better value for health expenditures. Studies conducted to date on these different designs have produced mixed results.

  20. 15 Strategies for Managing Attention Problems

    ERIC Educational Resources Information Center

    Thorne, Glenda; Thomas, Alice; Lawson, Candy

    2005-01-01

    In this document, 15 strategies are offered for enhancing attention and managing attention problems. This listing is by no means exhaustive, but rather is meant as a place to begin. The best resources for strategies are the creative, inventive minds of enlightened assessment professionals, teachers and parents, in partnership with the students…

  1. Winning Strategies for Classroom Management.

    ERIC Educational Resources Information Center

    Cummings, Carol

    This book offers advice on arranging classrooms, diagnosing student behavior, and responding to students' emotional needs, examining intellectual, emotional, and physical challenges students face and providing strategies which help teachers create communities of learners, design classrooms, diagnose student behavior, and respond to student needs.…

  2. Internationalisation Strategies for Management Education.

    ERIC Educational Resources Information Center

    Howe, W. Stewart; Martin, Graeme

    1998-01-01

    A literature review and case study of a British business school examined these areas: (1) competing rationales for internationalizing management education; (2) transfer of best practice from the west; and (3) problems that parent and host countries face in joint ventures. (SK)

  3. Selecting habitat management strategies on refuges

    USGS Publications Warehouse

    Schroeder, Richard L.; King, Wayne J.; Cornely, John E.

    1998-01-01

    This report is a joint effort of the Biological Resources Division, U.S. Geological Survey and the U.S. Fish and Wildlife Service (FWS) to provide National Wildlife Refuge (NWR) managers guidance on the selection and evaluation of habitat management strategies to meet stated objectives. The FWS recently completed a handbook on writing refuge management goals and objectives (U.S. Fish and Wildlife Service 1996a). the National Wildlife Refuge System Improvement Act of 1997 requires that National Wildlife Refuge System (NWRS) lands be managed according to approved Comprehensive Conservation Plans to guide management decisions and devise strategies for achieving refuge unit purposes and meeting the NWRS mission. It is expected that over the next several years most refuges will develop new or revised refuge goals and objectives for directing their habitat management strategies. This paper outlines the steps we recommend in selecting and evaluating habitat management strategies to meet specific refuge habitat objectives. We selected two examples to illustrate the process. Although each refuge is unique and will require specific information and solutions, these two examples can be used as guidance when selecting and evaluating habitat management strategies for other refuge resources: Example 1. Management of floodplain woods habitat for forest interior birds. The biological recourse of concern is the quality and quantity of floodplain woods habitat for eastern forest interior birds in the Cypress Creek NWR (U.S. Fish and Wildlife Service 1996b). Example 2. Management of habitat for biodiversity: Historical landscape proportions. The biological resource of concern is the change in diversity associated with man-induced changes in the distribution and abundance of habitat types at the Minnesota Valley NWR (U.S. Fish and Wildlife Service 1996c).

  4. Heat Management Strategy Trade Study

    SciTech Connect

    Nick Soelberg; Steve Priebe; Dirk Gombert; Ted Bauer

    2009-09-01

    This Heat Management Trade Study was performed in 2008-2009 to expand on prior studies in continued efforts to analyze and evaluate options for cost-effectively managing SNF reprocessing wastes. The primary objective was to develop a simplified cost/benefit evaluation for spent nuclear fuel (SNF) reprocessing that combines the characteristics of the waste generated through reprocessing with the impacts of the waste on heating the repository. Under consideration were age of the SNF prior to reprocessing, plutonium and minor actinide (MA) separation from the spent fuel for recycle, fuel value of the recycled Pu and MA, age of the remaining spent fuel waste prior to emplacement in the repository, length of time that active ventilation is employed in the repository, and elemental concentration and heat limits for acceptable glass waste form durability. A secondary objective was to identify and qualitatively analyze remaining issues such as (a) impacts of aging SNF prior to reprocessing on the fuel value of the recovered fissile materials, and (b) impact of reprocessing on the dose risk as developed in the Yucca Mountain Total System Performance Assessment (TSPA). Results of this study can be used to evaluate different options for managing decay heat in waste streams from spent nuclear fuel.

  5. Planning your UST management strategy

    SciTech Connect

    Reeves, T.S.; Bacon, P.A. )

    1993-09-01

    For the past six years, federal regulations have required underground storage tank (UST) owners to manage their tank facilities more carefully and accountably than ever before. As mandated by the Resource Conservation and Recovery Act (RCRA), all 50 states have implemented programs to monitor existing USTs, regulate new tank installations and levy fines for leaking tanks. The liability stipulation may be most important. This provision makes the investment in monitoring and safety equipment worthwhile for the tank owner. Equally important, it serves as a deterrent for careless practices and provides financial recourse for the cleanup of leaks or spills. While each state has the option of expanding on the federal government's UST management guidelines, all states had to adopt at least those basics. The minimum standards require that owners protect new USTs from corrosion, leaks and overfills, install leak detection devices and acquire liability insurance. The federal regulations also exempt certain tanks from compliance. These include tanks that hold less than 1,100 gallons, flow-through or process tanks and tanks that hold heating oil used for on-premises heating. Some state, however, have set more stringent regulations disallowing some of these exemptions. Either way, gasoline dealerships are by far the largest group of UST owners affected by the regulations. The rules also affect regulated substances such as heating oil, aviation fuels, and chemical solvents.

  6. Nonpharmacologic strategies for managing hypertension.

    PubMed

    Wexler, Randy; Aukerman, Glen

    2006-06-01

    The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends lifestyle modification for all patients with hypertension or prehypertension. Modifications include reducing dietary sodium to less than 2.4 g per day; increasing exercise to at least 30 minutes per day, four days per week; limiting alcohol consumption to two drinks or less per day for men and one drink or less per day for women; following the Dietary Approaches to Stop Hypertension eating plan (high in fruits, vegetables, potassium, calcium, and magnesium; low in fat and salt); and achieving a weight loss goal of 10 lb (4.5 kg) or more. Alternative treatments such as vitamin C, coenzyme Q10, magnesium, and omega-3 fatty acids have been suggested for managing hypertension, but evidence for their effectiveness is lacking.

  7. Management strategies for acne vulgaris

    PubMed Central

    Whitney, Kristen M; Ditre, Chérie M

    2011-01-01

    Clinical question: What are the most effective treatment(s) for mild, moderate, severe, and hormonally driven acne? Results: Mild acne responds favorably to topical treatments such as benzoyl peroxide, salicylic acid, and a low-dose retinoid. Moderate acne responds well to combination therapy comprising-topical benzoyl peroxide, antibiotics, and/or retinoids, as well as oral antibiotics in refractory cases and oral contraceptive pills for female acne patients. Severe nodulocystic acne vulgaris responds best to oral isotretinoin therapy. In female patients with moderate to severe acne, facial hair, loss of scalp hair and irregular periods, polycystic ovarian syndrome should be considered and appropriate treatment with hormonal modulation given. Adjunctive procedures can also be considered for all acne patients. Implementation: Pitfalls to avoid when treating acne: treatment of acne in women of child-bearing age; familiarization of all acne treatments in order to individualize management for patients; indications for specialist referral. PMID:21691566

  8. Momentum management strategy during Space Station buildup

    NASA Technical Reports Server (NTRS)

    Bishop, Lynda; Malchow, Harvey; Hattis, Philip

    1988-01-01

    The use of momentum storage devices to control effectors for Space Station attitude control throughout the buildup sequence is discussed. Particular attention is given to the problem of providing satisfactory management of momentum storage effectors throughout buildup while experiencing variable torque loading. Continuous and discrete control strategies are compared and the effects of alternative control moment gyro strategies on peak momentum storage requirements and on commanded maneuver characteristics are described.

  9. Initial management strategies for follicular lymphoma

    PubMed Central

    Chen, Qiushi; Ayer, Turgay; Nastoupil, Loretta J; Seward, Miray; Zhang, Hongzheng; Sinha, Rajni; Flowers, Christopher R

    2013-01-01

    SUMMARY Follicular lymphoma (FL) can vary markedly in its initial presentation, and no single standard approach for its initial management has been adopted. Available options for the initial management of FL include watchful waiting, radiation, single-agent rituximab and combination of rituximab and chemotherapy with strategies segregated for patients who have low and high tumor burden disease based on established criteria. However, marked debate occurs regarding the role of watchful waiting in the modern era for low tumor burden, asymptomatic patients, the optimal timing of rituximab, the selection of chemotherapy regimen to partner with rituximab in high tumor burden patients, and strategies for the management of relapsed disease. We provide an evidence-based discussion on these and other issues regarding the management of FL, and propose a mathematical modeling approach for addressing some of these questions. PMID:23476737

  10. Workforce management strategies in a disaster scenario.

    SciTech Connect

    Kelic, Andjelka; Turk, Adam L.

    2008-08-01

    A model of the repair operations of the voice telecommunications network is used to study labor management strategies under a disaster scenario where the workforce is overwhelmed. The model incorporates overtime and fatigue functions and optimizes the deployment of the workforce based on the cost of the recovery and the time it takes to recover. The analysis shows that the current practices employed in workforce management in a disaster scenario are not optimal and more strategic deployment of that workforce is beneficial.

  11. Strategies for Managing a Multigenerational Workforce

    NASA Astrophysics Data System (ADS)

    Iden, Ronald

    The multigenerational workforce presents a critical challenge for business managers, and each generation has different expectations. A human resource management study of organizations with more than 500 employees reported 58% of the managers experiencing conflict between younger and older workers. The purpose of this single case study was to explore the multigenerational strategies used by 3 managers from a Franklin County, Ohio manufacturing facility with a population size of 6 participants. The conceptual framework for this study was built upon generational theory and cohort group theory. The data were collected through face-to-face semistructured interviews, company documents, and a reflexive journal. Member checking was completed to strengthen the credibility and trustworthiness of the interpretation of participants' responses. A modified van Kaam method enabled separation of themes following the coding of data. Four themes emerged from the data: (a) required multigenerational managerial skills, (b) generational cohort differences, (c) most effective multigenerational management strategies, and (d) least effective multigenerational management strategies. Findings from this study may contribute to social change through better understanding, acceptance, and appreciation of the primary generations in the workforce, and, in turn, improve community relationships.

  12. Group-Oriented Behavior Management Strategies.

    ERIC Educational Resources Information Center

    Salend, Spencer J.

    1987-01-01

    A variety of group oriented behavior management strategies to modify classroom behavior problems is suggested. Advantages, disadvantages, and implementation guidelines for the group response cost system, the good behavior game, the group timeout ribbon, hero method, peer-mediated extinction, and peer confrontation. (DB)

  13. Management Strategies for Promoting Teacher Collective Learning

    ERIC Educational Resources Information Center

    Cheng, Eric C. K.

    2011-01-01

    This paper aims to validate a theoretical model for developing teacher collective learning by using a quasi-experimental design, and explores the management strategies that would provide a school administrator practical steps to effectively promote collective learning in the school organization. Twenty aided secondary schools in Hong Kong were…

  14. Classroom Management Strategies for Students with Autism

    ERIC Educational Resources Information Center

    Valdivia, Joe S.

    2007-01-01

    Classroom management strategies designed to improve problem behavior directly affect student achievement. Researchers have demonstrated positive behavior supports (PBS) can reduce problem behavior. However, researchers have also found evidence that PBS may not always be successful and further studies are needed to improve the use of PBS as a…

  15. Practical management strategies for diaper dermatitis.

    PubMed

    Humphrey, S; Bergman, J N; Au, S

    2006-09-01

    Common diaper dermatitis is an irritant contact diaper dermatitis (IDD) created by the combined influence of moisture, warmth, urine, feces, friction, and secondary infection. It is difficult to completely eradicate these predisposing factors in a diapered child. Thus, IDD presents an ongoing therapeutic challenge for parents, family physicians, pediatricians, and dermatologists. This article will focus on practical management strategies for IDD.

  16. Seeking sustainability: Israel's evolving water management strategy.

    PubMed

    Tal, Alon

    2006-08-25

    The water management policies adopted to address Israel's chronic scarcity have not been without environmental consequences. Yet, through a trial-and-error process, a combined strategy of water transport, rainwater harvesting, and wastewater reuse and desalination, along with a variety of water conservation measures, have put the country on a more sustainable path for the future.

  17. Strategies to manage antifungal drug resistance.

    PubMed

    Tseng, Hsiang-Kuang; Perfect, John R

    2011-02-01

    Invasive fungal infections continue to cause significant morbidity and mortality in immunocompromised hosts. From more than half a million deaths from cryptococcosis in sub-Saharan Africa to an unchanging death rate from invasive candidiasis, despite three antifungal classes of drugs, insights into better strategies to reduce therapeutic failures or resistance are needed. This review examines the issues around antifungal drug resistance from both a basic description of the failures and how they are detected to the variety of issues that need to be addressed to help prevent failures for successful management. The reader will gain an understanding of the clinical complexities in this patient population for management of invasive fungal infections. Throughout the review, principles of management are given along with some specific clinical examples to illustrate the issues and frame the knowledge base. From this discussion it is hoped that the clinician can use the insights provided to manage individual patients and find links to the evidence-based material that support its conclusions. Also, this review specifically identifies the limitations of present management and directs clinicians to gather additional information and provide even better treatment strategies. Invasive fungal infections are life-threatening complications of serious underlying diseases. Their management can be complicated by both direct and clinical drug resistance and by understanding these possibilities and correcting them; most patients can be successfully managed with present antifungal drugs if the underlying diseases can be controlled.

  18. Assessment of two BWR accident management strategies

    SciTech Connect

    Hodge, S.A.; Petek, M.

    1991-01-01

    Candidate mitigative strategies for management of in-vessel events during the late phase (after core degradation has occurred) of postulated BWR severe accidents were considered at Oak Ridge National Laboratory (ORNL) during 1990. The identification of new strategies was subject to the constraint that they should, to the maximum extent possible, make use of the existing equipment and water resources of the BWR facilities and not require major equipment modifications or additions. As a result of this effort, two of these candidate strategies were recommended for additional assessment. The first is a strategy for containment flooding to maintain the core and structural debris within the reactor vessel in the event that vessel injection cannot be restored to terminate a severe accident sequence. The second strategy pertains to the opposite case, for which vessel injection would be restored after control blade melting had begun; its purpose is to provide an injection source of borated water at the concentration necessary to preclude criticality upon recovering a damaged BWR core. Assessments of these two strategies have been performed during 1991 under the auspices of the Detailed Assessment of BWR In-Vessel Strategies Program. This paper provides a discussion of the motivation for and purpose of these strategies and the potential for their success. 33 refs., 9 figs.

  19. Managing the Chronically Overworked Team: Twenty Strategies.

    PubMed

    Hills, Laura

    2015-01-01

    Overwork, at first glance, seems like a problem that affects only the employee. But for medical practices and those who manage them, the problem is far greater than that. Chronically overworked employees may not be meeting their goals. They may be making more mistakes and letting things slip through the cracks. Ultimately, patients may have less-than-ideal experiences in a practice where the employees are stretched thin. And turnover may skyrocket in practices where employees are chronically overworked. This article offers practice managers 20 practical and affordable strategies they can use to manage a chronically overworked medical practice team. It suggests an effective technique they can use to tell their bosses that their employees are overworked. This article also suggests the costs to the practice of a chronically overworked staff, including a hidden cost many people overlook. It provides four coping strategies practice managers can teach to their overworked employees. It summarizes research exploring how overwork affects employees' sleep and eating habits, and additional research linking long hours of overwork to diminished productivity. Finally, this article provides five strategies practice managers can use to make their overworked employees feel valued.

  20. Irritable bowel syndrome: contemporary nutrition management strategies.

    PubMed

    Mullin, Gerard E; Shepherd, Sue J; Chander Roland, Bani; Ireton-Jones, Carol; Matarese, Laura E

    2014-09-01

    Irritable bowel syndrome is a complex disorder whose pathophysiology involves alterations in the enteric microbiota, visceral hypersensitivity, gut immune/barrier function, hypothalamic-pituitary-adrenal axis regulation, neurotransmitters, stress response, psychological factors, and more. The importance of diet in the management of irritable bowel syndrome has taken center stage in recent times as the literature validates the relationship of certain foods with the provocation of symptoms. Likewise, a number of elimination dietary programs have been successful in alleviating irritable bowel syndrome symptoms. Knowledge of the dietary management strategies for irritable bowel syndrome will help guide nutritionists and healthcare practitioners to deliver optimal outcomes. This tutorial reviews the nutrition management strategies for irritable bowel syndrome.

  1. Beyond PARR - PMEL's Integrated Data Management Strategy

    NASA Astrophysics Data System (ADS)

    Burger, E. F.; O'Brien, K.; Manke, A. B.; Schweitzer, R.; Smith, K. M.

    2016-12-01

    NOAA's Pacific Marine Environmental Laboratory (PMEL) hosts a wide range of scientific projects that span a number of scientific and environmental research disciplines. Each of these 14 research projects have their own data streams that are as diverse as the research. With its requirements for public access to federally funded research results and data, the 2013 White House Office of Science and Technology memo on Public Access to Research Results (PARR) changed the data management landscape for Federal agencies. In 2015, with support from the PMEL Director, Dr. Christopher Sabine, PMEL's Science Data Integration Group (SDIG) initiated a multi-year effort to formulate and implement an integrated data-management strategy for PMEL research efforts. Instead of using external requirements, such as PARR, to define our approach, we focussed on strategies to provide PMEL science projects with a unified framework for data submission, interoperable data access, data storage, and easier data archival to National Data Centers. This improves data access to PMEL scientists, their collaborators, and the public, and also provides a unified lab framework that allows our projects to meet their data management objectives, as well as those required by the PARR. We are implementing this solution in stages that allows us to test technology and architecture choices before comitting to a large scale implementation. SDIG developers have completed the first year of development where our approach is to reuse and leverage existing frameworks and standards. This presentation will describe our data management strategy, explain our phased implementation approach, the software and framework choices, and how these elements help us meet the objectives of this strategy. We will share the lessons learned in dealing with diverse and complex datasets in this first year of implementation and how these outcomes will shape our decisions for this ongoing effort. The data management capabilities now

  2. Environmental management strategy: four forces analysis.

    PubMed

    Doyle, Martin W; Von Windheim, Jesko

    2015-01-01

    We develop an analytical approach for more systematically analyzing environmental management problems in order to develop strategic plans. This approach can be deployed by agencies, non-profit organizations, corporations, or other organizations and institutions tasked with improving environmental quality. The analysis relies on assessing the underlying natural processes followed by articulation of the relevant societal forces causing environmental change: (1) science and technology, (2) governance, (3) markets and the economy, and (4) public behavior. The four forces analysis is then used to strategize which types of actions might be most effective at influencing environmental quality. Such strategy has been under-used and under-valued in environmental management outside of the corporate sector, and we suggest that this four forces analysis is a useful analytic to begin developing such strategy.

  3. Environmental Management Strategy: Four Forces Analysis

    NASA Astrophysics Data System (ADS)

    Doyle, Martin W.; Von Windheim, Jesko

    2015-01-01

    We develop an analytical approach for more systematically analyzing environmental management problems in order to develop strategic plans. This approach can be deployed by agencies, non-profit organizations, corporations, or other organizations and institutions tasked with improving environmental quality. The analysis relies on assessing the underlying natural processes followed by articulation of the relevant societal forces causing environmental change: (1) science and technology, (2) governance, (3) markets and the economy, and (4) public behavior. The four forces analysis is then used to strategize which types of actions might be most effective at influencing environmental quality. Such strategy has been under-used and under-valued in environmental management outside of the corporate sector, and we suggest that this four forces analysis is a useful analytic to begin developing such strategy.

  4. Heat management strategies for MSW landfills.

    PubMed

    Yeşiller, Nazli; Hanson, James L; Kopp, Kevin B; Yee, Emma H

    2016-10-01

    Heat is a primary byproduct of landfilling of municipal solid waste. Long-term elevated temperatures have been reported for MSW landfills under different operational conditions and climatic regions around the world. A conceptual framework is presented for management of the heat generated in MSW landfills. Three main strategies are outlined: extraction, regulation, and supplementation. Heat extraction allows for beneficial use of the excess landfill heat as an alternative energy source. Two approaches are provided for the extraction strategy: extracting all of the excess heat above baseline equilibrium conditions in a landfill and extracting only a part of the excess heat above equilibrium conditions to obtain target optimum waste temperatures for maximum gas generation. Heat regulation allows for controlling the waste temperatures to achieve uniform distribution at target levels at a landfill facility. Two approaches are provided for the regulation strategy: redistributing the excess heat across a landfill to obtain uniform target optimum waste temperatures for maximum gas generation and redistributing the excess heat across a landfill to obtain specific target temperatures. Heat supplementation allows for controlling heat generation using external thermal energy sources to achieve target waste temperatures. Two approaches are provided for the supplementation strategy: adding heat to the waste mass using an external energy source to increase waste temperatures and cooling the waste mass using an external energy source to decrease waste temperatures. For all strategies, available landfill heat energy is determined based on the difference between the waste temperatures and the target temperatures. Example analyses using data from landfill facilities with relatively low and high heat generation indicated thermal energy in the range of -48.4 to 72.4MJ/m(3) available for heat management. Further modeling and experimental analyses are needed to verify the effectiveness

  5. Management strategies for promoting successful breastfeeding.

    PubMed

    Bear, K; Tigges, B B

    1993-06-01

    Clinicians can promote a successful breastfeeding experience by providing support, anticipatory guidance and practical information. This article presents the components of early follow-up and guidelines for assessment. Management strategies for common problems are discussed, such as nipple soreness, cracked nipples, plugged ducts and mastitis, insufficient infant weight gain, perceived inadequacy of milk supply, breast-milk jaundice, sexual adjustment and failure at breastfeeding. Breastfeeding guidelines for employed mothers and adoptive mothers are indicated.

  6. Strategies for Management of Synchronous Colorectal Metastases.

    PubMed

    Castellanos, Jason A; Merchant, Nipun B

    2014-06-01

    The management of synchronous presentation of colorectal cancer and liver metastases has long been a topic of debate and discussion for surgeons due to the unique dilemma of balancing operative timing along with treatment strategy. Operative strategies for resection include staged resection with colon first approach, "reverse" staged resection with liver metastases resected first, and one-stage, or simultaneous, resection of both the primary tumor and liver metastases approach. These operative strategies can be further augmented with perioperative chemotherapy and other novel approaches that may improve resectability and patient survival. The decision on operative timing and approach, however, remains largely dependent on the surgeon's determination of disease resectability, patient fitness, and the need for neoadjuvant chemotherapy.

  7. Fluid management strategies in heart failure.

    PubMed

    Albert, Nancy M

    2012-04-01

    In patients with chronic heart failure, fluid retention (or hypervolemia) is often the stimulus for acute decompensated heart failure that requires hospitalization. The pathophysiology of fluid retention is complex and involves both hemodynamic and clinical congestion. Signs and symptoms of both hemodynamic and clinical congestion should be assessed serially during hospitalization. Core heart failure drug and cardiac device therapies should be provided, and ultrafiltration may be warranted. Critical care, intermediate care, and telemetry nurses have roles in both assessment and management of patients hospitalized with acute decompensated heart failure and fluid retention. Nurse administrators and managers have heightened their attention to fluid retention because the Medicare performance measure known as the risk-standardized 30-day all-cause readmission rate after heart failure hospitalization can be attenuated by fluid management strategies initiated by nurses during a patient's hospitalization.

  8. Opt-in medical management strategies.

    PubMed

    Fetterolf, Donald; Olson, Marty

    2008-02-01

    Historically, health plans and disease management companies have employed "opt-out" strategies for evaluating medical management outcomes across larger populations, targeting the entire population of eligible individuals and allowing those not interested to opt out. Recent observations that the predominant effort of these programs is on high-risk patients has lead some managers to suggest that the focus be on only those individuals with an anticipated higher effectiveness and lower cost to the payers of such services. They believe such "opt-in" models, in which only higher risk participants are targeted and enrolled, will deliver higher value. The use of common opt-in models, however, is not only methodologically unsound, but experience in the field suggests there may be less overall effect as well. Calculation methods for developing impact remain extremely sensitive to methodology

  9. Diabetes benefit management: evolving strategies for payers.

    PubMed

    Tzeel, Albert L

    2011-11-01

    Over the next quarter century, the burden of type 2 diabetes mellitus (T2DM) is expected to at least double. Currently, 1 in every 10 healthcare dollars is spent on diabetes management; by 2050, it has been projected that the annual costs of managing T2DM will rise to $336 billion. Without substantial, systemic changes, T2DM management costs will lead to a potentially untenable strain on the healthcare system. However, the appropriate management of diabetes can reduce associated mortality and delay comorbidities. In addition, adequate glycemic control can improve patient outcomes and significantly reduce diabetes-related complications. This article provides an overview of key concepts associated with a value-based insurance design (VBID) approach to T2DM coverage. By promoting the use of services or treatments that provide high benefits relative to cost, and by alternatively discouraging patients from utilizing services whose benefits do not justify their cost, VBID improves the quality of healthcare while simultaneously reining in spending. VBID initiatives tend to focus on chronic disease management and generally target prescription drug use. However, some programs have expanded their scope by incorporating services traditionally offered by wellness and disease management programs. The concept of VBID is growing, and it is increasingly being implemented by a diverse and growing number of public and private entities, including pharmacy benefit managers, health plans, and employers. This article provides key background on VBID strategies, with a focus on T2DM management. It also provides a road map for health plans seeking to implement VBID as part of their programs.

  10. Optimal management of familial hypercholesterolemia: treatment and management strategies

    PubMed Central

    Nemati, Mohammad Hassan; Astaneh, Behrooz

    2010-01-01

    Familial hypercholesterolemia is an autosomally dominant disorder caused by various mutations in low-density lipoprotein receptor genes. This will lead to elevated levels of total and low-density lipoprotein cholesterol, which may in turn lead to premature coronary atherosclerosis and cardiac-related death. The symptoms are more severe in the homozygous type of the disease. Different options for the treatment of affected patients are now available. Diet therapy, pharmacologic therapy, lipid apheresis, and liver transplantation are among the various treatments. We clinically review the treatment and management strategies for the disease in order to shed light on the optimal management of familial hypercholesterolemia. PMID:21191428

  11. Blood Management Strategies in Total Knee Arthroplasty

    PubMed Central

    Dan, Michael; Martinez Martos, Sara; Beller, Elaine

    2016-01-01

    A perioperative blood management program is one of a number of important elements for successful patient care in total knee arthroplasty (TKA) and surgeons should be proactive in its application. The aims of blood conservation are to reduce the risk of blood transfusion whilst at the same time maximizing hemoglobin (Hb) in the postoperative period, leading to a positive effect on outcome and cost. An individualized strategy based on patient specific risk factors, anticipated blood loss and comorbidities are useful in achieving this aim. Multiple blood conservation strategies are available in the preoperative, intraoperative and postoperative periods and can be employed in various combinations. Recent literature has highlighted the importance of preoperative Hb optimization, minimizing blood loss and evidence-based transfusion guidelines. Given TKA is an elective procedure, a zero allogenic blood transfusion rate should be the aim and an achievable goal. PMID:27595070

  12. TASKILLAN II - Pilot strategies for workload management

    NASA Technical Reports Server (NTRS)

    Segal, Leon D.; Wickens, Christopher D.

    1990-01-01

    This study focused on the strategies used by pilots in managing their workload level, and their subsequent task performance. Sixteen licensed pilots flew 42 missions on a helicopter simulation, and were evaluated on their performance of the overall mission, as well as individual tasks. Pilots were divided in four groups, defined by the presence or absence of scheduling control over tasks and the availability of intelligence concerning the type and stage of difficulties imposed during the flight. Results suggest that intelligence supported strategies that yielded significant higher performance levels, while scheduling control seemed to have no impact on performance. Both difficulty type and the stage of difficulty impacted performance significantly, with strongest effects for time stresss and difficulties imposed late in the flight.

  13. It's magic: a unique practice management strategy.

    PubMed

    Schwartz, Steven

    2003-11-15

    For thousands of years prior to the advent of modern dentistry, magic has been used to entertain, impress, and motivate individuals. Today's dental professionals are using the concept of The Magic of a Healthy Smile through their use of modern clinical techniques and as a means for practice marketing, patient education, and the reduction of patient stress and fear. This article describes how dentists/magicians have incorporated magic into their practices and the benefits of this useful patient management strategy. A script of the "Happy Tooth Magic Show" and resources for dentists to create their own dental magic show are provided.

  14. Novel strategies for managing pancreatic cancer

    PubMed Central

    Loc, Welley S; Smith, Jill P; Matters, Gail; Kester, Mark; Adair, James H

    2014-01-01

    With the incidence reports of pancreatic cancer increasing every year, research over the last several decades has been focused on the means to achieve early diagnosis in patients that are at a high risk of developing the malignancy. This review covers current strategies for managing pancreatic cancer and further discusses efforts in understanding the role of early onset symptoms leading to tumor progression. Recent investigations in this discussion include type 3c diabetes, selected biomarkers and pathways related to pancreatic intraepithelial neoplasia lesions, drug resistance, and advances in nanomedicine which may provide significant solutions for improving early detection and treatments in future medicine. PMID:25356034

  15. Strategies for pain management: a review.

    PubMed

    Sollami, Alfonso; Marino, Leonardo; Fontechiari, Simona; Fornari, Marta; Tirelli, Pierangela; Zenunaj, Elisabetta

    2015-09-09

    PROBLEM/BACKGROUND: Pain management is a major worldwide health problem. It manifests itself in a variety of forms involving in turn a multiplicity of responses and therapeutic strategies. Following from this, the training of health personnel must deal with this situation and must not only offer technical assistance, but must also deal with the psychological and social aspects of the problem. In recent years various guidelines and protocols have become popular for pain management. The aim of this paper is to present a literature review of the major international databases. Type of research: Systematic review. To identify relevant studies in the literature on pain management and identify the guidelines recognized by the scientific community. A literature search was conducted using the keywords "pain management" and "nurse" published since 2000 in English and Italian in the following databases: PubMed, CINAHL, Med Line. Excluding items which did not meet the inclusion criteria, 49 articles were included in the review. Despite a growing availability of evidence-based guidelines, drugs for pain control and the enactment of legislation to promote the use of opioid analgesics in pain therapy, a substantial proportion of the European population continues to have pain. Estimates of the prevalence of pain symptoms in the literature show that between 40% and 63% of hospitalized patients reported pain, peaking at 82.3% in cancer patients in advanced stages of the disease or terminally ill (in hospital or at home). Several studies published in recent years have agreed on a definition of some key points in the management of pain. Studies agree that pain should be recognized as the 5th vital sign, hence the need for validated scales whether single or multi-dimensional, quantitative or qualitative. The approach to the management of pain must be multi-professional, and the use of pharmacology must be in accordance with the WHO three-step approach. Several studies have demonstrated

  16. Invasive mycoses: strategies for effective management.

    PubMed

    Kontoyiannis, Dimitrios P

    2012-01-01

    Effective management of invasive fungal infections (IFIs) depends on early individualized therapy that optimizes efficacy and safety. Considering the negative consequences of IFI, for some high-risk patients the potential benefits of prophylactic therapy may outweigh the risks. When using a prophylactic, empiric, or preemptive therapeutic approach, clinicians must take into account the local epidemiology, spectrum of activity, pharmacokinetic and pharmacodynamic parameters, and safety profile of different antifungal agents, together with unique host-related factors that may affect antifungal efficacy or safety. Therapeutic drug monitoring is increasingly recognized as important or necessary when employing lipophilic triazoles (itraconazole, voriconazole, posaconazole) or flucytosine. Because early diagnostics remain limited for uncommon, yet emerging opportunistic molds (e.g., Mucorales), and treatment delay is associated with increased mortality, early effective management often depends on a high index of suspicion, taking into account predisposing factors, host cues favoring mucormycosis, and local epidemiology. Antifungal options for mucormycosis are limited, and optimal management depends on a multimodal approach that includes early diagnosis/clinical suspicion, correction of underlying predisposing factors, radical debridement of affected tissues, and extended antifungal therapy. This article discusses strategies for the effective management of invasive mycoses, with a particular focus on antifungal hepatotoxicity.

  17. Management Strategies for CLN2 Disease.

    PubMed

    Williams, Ruth E; Adams, Heather R; Blohm, Martin; Cohen-Pfeffer, Jessica L; de Los Reyes, Emily; Denecke, Jonas; Drago, Kristen; Fairhurst, Charlie; Frazier, Margie; Guelbert, Norberto; Kiss, Szilárd; Kofler, Annamaria; Lawson, John A; Lehwald, Lenora; Leung, Mary-Anne; Mikhaylova, Svetlana; Mink, Jonathan W; Nickel, Miriam; Shediac, Renée; Sims, Katherine; Specchio, Nicola; Topcu, Meral; von Löbbecke, Ina; West, Andrea; Zernikow, Boris; Schulz, Angela

    2017-04-01

    CLN2 disease (neuronal ceroid lipofuscinosis type 2) is a rare, autosomal recessive, pediatric-onset, rapidly progressive neurodegenerative lysosomal storage disorder caused by tripeptidyl peptidase 1 (TPP1) enzyme deficiency, and is characterized by language delay, seizures, rapid cognitive and motor decline, blindness, and early death. No management guidelines exist and there is a paucity of published disease-specific evidence to inform clinical practice, which currently draws upon experience from the field of childhood neurodisability. Twenty-four disease experts were surveyed on CLN2 disease management and a subset met to discuss current practice. Management goals and strategies are consistent among experts globally and are guided by the principles of pediatric palliative care. Goals and interventions evolve as the disease progresses, with a shift in focus from maintenance of function early in the disease to maintenance of quality of life. A multidisciplinary approach is critical for optimal patient care. This work represents an initial step toward the development of consensus-based management guidelines for CLN2 disease. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  18. Barrett's Esophagus: Emerging Knowledge and Management Strategies

    PubMed Central

    Bhardwaj, Atul; Stairs, Douglas B.; Mani, Haresh; McGarrity, Thomas J.

    2012-01-01

    The incidence of esophageal adenocarcinoma (EAC) has increased exponentially in the last 3 decades. Barrett's esophagus (BE) is the only known precursor of EAC. Patients with BE have a greater than 40 folds higher risk of EAC compared with the general population. Recent years have witnessed a revolution in the clinical and molecular research related to BE. However, several aspects of this condition remain controversial. Data regarding the true prevalence of BE have varied widely. Recent studies have suggested a lower incidence of EAC in nondysplastic BE (NDBE) than previously reported. There is paucity of prospective data showing a survival benefit of screening or surveillance for BE. Furthermore, the ever-increasing emphasis on healthcare cost containment has called for reexamination of the screening and surveillance strategies for BE. There is a need for identification of reliable clinical predictors or molecular biomarkers to risk-stratify patients who might benefit the most from screening or surveillance for BE. Finally, new therapies have emerged for the management of dysplastic BE. In this paper, we highlight the key areas of controversy and uncertainty surrounding BE. The paper discusses, in detail, the current literature about the molecular pathogenesis, biomarkers, histopathological diagnosis, and management strategies for BE. PMID:22701199

  19. Management strategies in hospitals: scenario planning

    PubMed Central

    Ghanem, Mohamed; Schnoor, Jörg; Heyde, Christoph-Eckhard; Kuwatsch, Sandra; Bohn, Marco; Josten, Christoph

    2015-01-01

    Background: Instead of waiting for challenges to confront hospital management, doctors and managers should act in advance to optimize and sustain value-based health. This work highlights the importance of scenario planning in hospitals, proposes an elaborated definition of the stakeholders of a hospital and defines the influence factors to which hospitals are exposed to. Methodology: Based on literature analysis as well as on personal interviews with stakeholders we propose an elaborated definition of stakeholders and designed a questionnaire that integrated the following influence factors, which have relevant impact on hospital management: political/legal, economic, social, technological and environmental forces. These influence factors are examined to develop the so-called critical uncertainties. Thorough identification of uncertainties was based on a “Stakeholder Feedback”. Results: Two key uncertainties were identified and considered in this study: the development of workload for the medical staff the profit oriented performance of the medical staff. According to the developed scenarios, complementary education of the medical staff as well as of non-medical top executives and managers of hospitals was the recommended core strategy. Complementary scenario-specific strategic options should be considered whenever needed to optimize dealing with a specific future development of the health care environment. Conclusion: Strategic planning in hospitals is essential to ensure sustainable success. It considers multiple situations and integrates internal and external insights and perspectives in addition to identifying weak signals and “blind spots”. This flows into a sound planning for multiple strategic options. It is a state of the art tool that allows dealing with the increasing challenges facing hospital management. PMID:26504735

  20. Health plans' strategies for managing outpatient specialty pharmaceuticals.

    PubMed

    Mullins, C Daniel; Lavallee, Danielle Chauncey; Pradel, Françoise G; DeVries, Andrea R; Caputo, Nadine

    2006-01-01

    Balancing increased spending for specialty pharmaceuticals while providing affordable and equitable coverage for consumers is a key issue for public and private payers. Health plans rely on an array of strategies, including both medical management and those used for more traditional pharmaceuticals. To explore specific management strategies for outpatient specialty pharmaceuticals, a survey was administered to thirty-eight Blue Cross and Blue Shield plans, focused on identifying core strategies. Prior authorization was the most commonly used strategy, implemented by 83.3 percent of respondents. Other frequently implemented management strategies included claims review (82.8 percent), formulary management (76.7 percent), and utilization review (70 percent).

  1. Relationship-Driven Classroom Management: Strategies That Promote Student Motivation.

    ERIC Educational Resources Information Center

    Vitto, John M.

    This book combines information about resiliency, classroom management, and discipline into a user-friendly discussion suitable for all teachers. The material covers both preventive strategies and reactive strategies. The chapters of part 1, "Reinventive Strategies," are: (1) "Relationship-Driven Classroom Management and Resilience"; (2)…

  2. Relationship-Driven Classroom Management: Strategies That Promote Student Motivation.

    ERIC Educational Resources Information Center

    Vitto, John M.

    This book combines information about resiliency, classroom management, and discipline into a user-friendly discussion suitable for all teachers. The material covers both preventive strategies and reactive strategies. The chapters of part 1, "Reinventive Strategies," are: (1) "Relationship-Driven Classroom Management and Resilience"; (2)…

  3. Effectiveness of alternative management strategies in meeting conservation objectives

    Treesearch

    Richards S. Holthausen; Carolyn Hull Sieg

    2007-01-01

    This chapter evaluates how well various management strategies meet a variety of conservation objectives, summarizes their effectiveness in meeting objectives for rare or little-known (RLK) species, and proposes ways to combine strategies to meet overall conservation objectives. We address two broad categories of management strategies. Species approaches result in...

  4. National launch strategy vehicle data management system

    NASA Technical Reports Server (NTRS)

    Cordes, David

    1990-01-01

    The national launch strategy vehicle data management system (NLS/VDMS) was developed as part of the 1990 NASA Summer Faculty Fellowship Program. The system was developed under the guidance of the Engineering Systems Branch of the Information Systems Office, and is intended for use within the Program Development Branch PD34. The NLS/VDMS is an on-line database system that permits the tracking of various launch vehicle configurations within the program development office. The system is designed to permit the definition of new launch vehicles, as well as the ability to display and edit existing launch vehicles. Vehicles can be grouped in logical architectures within the system. Reports generated from this package include vehicle data sheets, architecture data sheets, and vehicle flight rate reports. The topics covered include: (1) system overview; (2) initial system development; (3) supercard hypermedia authoring system; (4) the ORACLE database; and (5) system evaluation.

  5. Preparing Future Leaders: Project Management Strategies for Service Learning

    ERIC Educational Resources Information Center

    Munger, Roger; Gutowski, Amanda

    2008-01-01

    This article makes a case for teaching project management strategies in service-learning courses. The authors describe three specific documents students can create to help them manage a service-learning project and then present strategies that can help students manage their project teams. Such skills, the authors argue, provide the tools students…

  6. Preparing Future Leaders: Project Management Strategies for Service Learning

    ERIC Educational Resources Information Center

    Munger, Roger; Gutowski, Amanda

    2008-01-01

    This article makes a case for teaching project management strategies in service-learning courses. The authors describe three specific documents students can create to help them manage a service-learning project and then present strategies that can help students manage their project teams. Such skills, the authors argue, provide the tools students…

  7. Preservice Teachers' Knowledge and Perceptions of Effective Behavior Management Strategies

    ERIC Educational Resources Information Center

    Nields, Allison N.

    2014-01-01

    This study examined student teachers' perceptions and knowledge of behavior management strategies. A questionnaire that included questions about broad behavior management techniques, behavioral learning theory, and behavior management strategies related to behavioral learning theory was given to sixty-one student teacher candidates at a large…

  8. Preservice Teachers' Knowledge and Perceptions of Effective Behavior Management Strategies

    ERIC Educational Resources Information Center

    Nields, Allison N.

    2014-01-01

    This study examined student teachers' perceptions and knowledge of behavior management strategies. A questionnaire that included questions about broad behavior management techniques, behavioral learning theory, and behavior management strategies related to behavioral learning theory was given to sixty-one student teacher candidates at a large…

  9. Healthcare management strategies: interdisciplinary team factors.

    PubMed

    Andreatta, Pamela; Marzano, David

    2012-12-01

    Interdisciplinary team factors are significant contributors to clinical performance and associated patient outcomes. Quality of care and patient safety initiatives identify human factors associated with team performance as a prime improvement area for clinical patient care. The majority of references to interdisciplinary teams in obstetrics and gynecology in the literature recommends the use of multidisciplinary approaches when managing complex medical cases. The reviewed literature suggests that interdisciplinary team development is important for achieving optimally efficient and effective performance; however, few reports provide specific recommendations for how to optimally achieve these objectives in the process of providing interdisciplinary care to patients. The absence of these recommendations presents a significant challenge for those tasked with improving team performance in the workplace. The prescribed team development programs cited in the review are principally built around communication strategies and simulation-based training mechanisms. Few reports provide descriptions of optimal team-based competencies in the various contexts of obstetric and gynecology teams. However, team-based evaluation strategies and empirical data documenting the transfer of team training to applied clinical care are increasing in number and quality. Our findings suggest that research toward determining team factors that promote optimal performance in applied clinical practice requires definition of specific competencies for the variable teams serving obstetrics and gynecology.

  10. Strategies for Management of Colorectal Endometriosis.

    PubMed

    Abrão, Mauricio Simões; Borrelli, Giuliano Moysés; Clarizia, Roberto; Kho, Rosanne Marie; Ceccaroni, Marcello

    2017-01-01

    Endometriosis has clearly three distinct clinical presentations and deep endometriosis, especially compromising the rectosigmoid is probably the most concerning one for both patients and surgeons. Currently, with the available tools, it is mandatory to have a precise diagnostic of this type of disease prior to indication of treatment. Strategies to manage this form of endometriosis will take into account several involved aspects, such as age of the patient, reproductive desire or infertility, clinical symptoms, as well as the extension and localization of the disease. Treatment could vary from more conservative to more radical depending on those aspects. As we pointed out in this article, the key to manage colorectal endometriosis is to start with a good diagnosis. Knowing exactly what is the extension and localization of the disease and knowing the patient's wishes as well as the clinical complaints, surgeons are able to define the best option for each patient. Critical points should always be discussed; for example, patients chosen to have clinical treatment should be aware of important issues regarding the follow-up, while patients undergoing surgery must be advised about all surgical possibilities and related complications.

  11. Improving Recall Using Database Management Systems: A Learning Strategy.

    ERIC Educational Resources Information Center

    Jonassen, David H.

    1986-01-01

    Describes the use of microcomputer database management systems to facilitate the instructional uses of learning strategies relating to information processing skills, especially recall. Two learning strategies, cross-classification matrixing and node acquisition and integration, are highlighted. (Author/LRW)

  12. A holistic strategy for adaptive land management

    USDA-ARS?s Scientific Manuscript database

    Adaptive management is widely applied to natural resources management. Adaptive management can be generally defined as an iterative decision-making process that incorporates formulation of management objectives, actions designed to address these objectives, monitoring of results, and repeated adapta...

  13. SUSTAINABLE MSW MANAGEMENT STRATEGIES IN THE UNITED STATES

    EPA Science Inventory

    Under increasing pressure to minimize potential environmental burdens and costs for municipal solid waste (MSW) management, state and local governments often must modify programs and adopt more efficient integrated MSW management strategies that reflect dynamic shifts in MSW mana...

  14. Implementing bedside handover: strategies for change management.

    PubMed

    McMurray, Anne; Chaboyer, Wendy; Wallis, Marianne; Fetherston, Cathy

    2010-09-01

    To identify factors influencing change in two hospitals that moved from taped and verbal nursing handover to bedside handover. Bedside handover is based on patient-centred care, where patients participate in communicating relevant and timely information for care planning. Patient input reduces care fragmentation, miscommunication-related adverse events, readmissions, duplication of services and enhances satisfaction and continuity of care. Analysing change management was a component of a study aimed at developing a standard operating protocol for bedside handover communication. The research was undertaken in two regional acute care hospitals in two different states of Australia. Data collection included 532 semi-structured observations in six wards in the two hospitals and 34 in-depth interviews conducted with a purposive sample of nursing staff involved in the handovers. Observation and interview data were analysed separately then combined to generate thematic analysis of factors influencing the change process in the transition to bedside handover. Themes included embedding the change as part of the big picture, the need to link the project to standardisation initiatives, providing reassurance on safety and quality, smoothing out logistical difficulties and learning to listen. We conclude that change is more likely to be successful when it is part of a broader initiative such as a quality improvement strategy. Nurses are generally supportive of quality improvement initiatives, particularly those aimed at standardising care. For successful implementation, change managers should be mindful of clinicians' attitudes, motivation and concerns and their need for reassurance when changing their practice. This is particularly important when change is dramatic, as in moving from verbal handover, conducted in the safety of the nursing office, to bedside handover where there is greater transparency and accountability for the accuracy and appropriateness of communication

  15. Evolutionary space station fluids management strategies

    NASA Technical Reports Server (NTRS)

    1989-01-01

    Results are summarized for an 11-month study to define fluid storage and handling strategies and requirements for various specific mission case studies and their associated design impacts on the Space Station. There are a variety of fluid users which require a variety of fluids and use rates. Also, the cryogenic propellants required for NASA's STV, Planetary, and Code Z missions are enormous. The storage methods must accommodate fluids ranging from a high pressure gas or supercritical state fluid to a sub-cooled liquid (and superfluid helium). These requirements begin in the year 1994, reach a maximum of nearly 1800 metric tons in the year 2004, and trail off to the year 2018, as currently planned. It is conceivable that the cryogenic propellant needs for the STV and/or Lunar mission models will be met by LTCSF LH2/LO2 tanksets attached to the SS truss structure. Concepts and corresponding transfer and delivery operations have been presented for STV propellant provisioning from the SS. A growth orbit maneuvering vehicle (OMV) and associated servicing capability will be required to move tanksets from delivery launch vehicles to the SS or co-orbiting platforms. Also, appropriate changes to the software used for OMV operation are necessary to allow for the combined operation of the growth OMV. To support fluid management activities at the Space Station for the experimental payloads and propellant provisioning, there must be truss structure space allocated for fluid carriers and propellant tanksets, and substantial beam strengthening may be required. The Station must have two Mobile Remote Manipulator Systems (MRMS) and the growth OMV propellant handling operations for the STV at the SS. Propellant needs for the Planetary Initiatives and Code Z mission models will most likely be provided by co-orbiting propellant platform(s). Space Station impacts for Code Z mission fluid management activities will be minimal.

  16. DETERMINANTS OF NETWORK OUTCOMES: THE IMPACT OF MANAGEMENT STRATEGIES

    PubMed Central

    YSA, TAMYKO; SIERRA, VICENTA; ESTEVE, MARC

    2014-01-01

    The literature on network management is extensive. However, it generally explores network structures, neglecting the impact of management strategies. In this article we assess the effect of management strategies on network outcomes, providing empirical evidence from 119 urban revitalization networks. We go beyond current work by testing a path model for the determinants of network outcomes and considering the interactions between the constructs: management strategies, trust, complexity, and facilitative leadership. Our results suggest that management strategies have a strong effect on network outcomes and that they enhance the level of trust. We also found that facilitative leadership has a positive impact on network management as well as on trust in the network. Our findings also show that complexity has a negative impact on trust. A key finding of our research is that managers may wield more influence on network dynamics than previously theorized. PMID:25520529

  17. Strategies for sustainable management of renewable resources during environmental change.

    PubMed

    Lindkvist, Emilie; Ekeberg, Örjan; Norberg, Jon

    2017-03-15

    As a consequence of global environmental change, management strategies that can deal with unexpected change in resource dynamics are becoming increasingly important. In this paper we undertake a novel approach to studying resource growth problems using a computational form of adaptive management to find optimal strategies for prevalent natural resource management dilemmas. We scrutinize adaptive management, or learning-by-doing, to better understand how to simultaneously manage and learn about a system when its dynamics are unknown. We study important trade-offs in decision-making with respect to choosing optimal actions (harvest efforts) for sustainable management during change. This is operationalized through an artificially intelligent model where we analyze how different trends and fluctuations in growth rates of a renewable resource affect the performance of different management strategies. Our results show that the optimal strategy for managing resources with declining growth is capable of managing resources with fluctuating or increasing growth at a negligible cost, creating in a management strategy that is both efficient and robust towards future unknown changes. To obtain this strategy, adaptive management should strive for: high learning rates to new knowledge, high valuation of future outcomes and modest exploration around what is perceived as the optimal action. © 2017 The Author(s).

  18. Recreational user attitudes towards management strategies of Allegany State Park

    Treesearch

    Michael Nisengard; Miklos Gratzer

    1998-01-01

    This project examines attitudes towards management strategies of four Allegany State Park recreational user groups: cabin users, recreational vehicle users, tent users, and day users. It investigates recreational user group attitude differences, and attitude change over a ten year time period, in regard to the following park management strategy categories: park...

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

    DTIC Science & Technology

    2007-12-01

    efficiently balances readiness with supply chain system-wide costs. 15. NUMBER OF PAGES 107 14. SUBJECT TERMS Supply Chain Management , Inventory...management strategy for the SMU by incorporating operations management, business modeling, simulation, supply chain management , and logistics...management, supply chain management , and logistics engineering concepts. Next, the project group used the information gathered from these sources to

  20. Strategy Maps in University Management: A Comparative Study

    ERIC Educational Resources Information Center

    Han, Shuangmiao; Zhong, Zhou

    2015-01-01

    In this study, the conceptual use of the strategy map approach and the strategy map which it produces have been adapted from the business sector and introduced as tools for achieving more effective strategic planning and management in higher education institutions (HEIs). This study discusses the development of strategy maps as transformational…

  1. Strategy Maps in University Management: A Comparative Study

    ERIC Educational Resources Information Center

    Han, Shuangmiao; Zhong, Zhou

    2015-01-01

    In this study, the conceptual use of the strategy map approach and the strategy map which it produces have been adapted from the business sector and introduced as tools for achieving more effective strategic planning and management in higher education institutions (HEIs). This study discusses the development of strategy maps as transformational…

  2. Total Quality Management Implementation Strategy: Directorate of Quality Assurance

    DTIC Science & Technology

    1989-05-01

    Directorate of Quality Assurance Total Quality Management Implementation Strategy 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADORESS(ES) 8...that job. DTIC 7: t-I ECTE I SEP29 1989 14. SUBJECT TERMS 15. NUMBER OF PAGES TOM ( Total Quality Management ), Quality Assurance, Continuous Process...Prescribed by ANSI Std Z39-18 29d- 102 DEFENSE LOGISTICS AGENCY DIRECTORATE OF QUALITY ASSURANCE 0 TOTAL QUALITY MANAGEMENT IMPLEMENTATION STRATEGY 0 89 9

  3. 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...

  4. Strategies for Managing a Multigenerational Workforce

    ERIC Educational Resources Information Center

    Iden, Ronald

    2016-01-01

    The multigenerational workforce presents a critical challenge for business managers, and each generation has different expectations. A human resource management study of organizations with more than 500 employees reported 58% of the managers experiencing conflict between younger and older workers. The purpose of this single case study was to…

  5. Strategies for Managing a Multigenerational Workforce

    ERIC Educational Resources Information Center

    Iden, Ronald

    2016-01-01

    The multigenerational workforce presents a critical challenge for business managers, and each generation has different expectations. A human resource management study of organizations with more than 500 employees reported 58% of the managers experiencing conflict between younger and older workers. The purpose of this single case study was to…

  6. A national cohesive wildland fire management strategy

    Treesearch

    Forest Service U.S. Department of Agriculture; Office of Wildland Fire Coordination. Department of the Interior

    2011-01-01

    Addressing wildfire is not simply a fire management, fire operations, or wildland-urban interface problem - it is a larger, more complex land management and societal issue. The vision for the next century is to: Safely and effectively extinguish fire, when needed; use fire where allowable; manage our natural resources; and as a Nation, live with wildland fire. Three...

  7. Open Source for Knowledge and Learning Management: Strategies beyond Tools

    ERIC Educational Resources Information Center

    Lytras, Miltiadis, Ed.; Naeve, Ambjorn, Ed.

    2007-01-01

    In the last years, knowledge and learning management have made a significant impact on the IT research community. "Open Source for Knowledge and Learning Management: Strategies Beyond Tools" presents learning and knowledge management from a point of view where the basic tools and applications are provided by open source technologies.…

  8. Survival strategies in the era of managed care.

    PubMed

    Rudomin, M L; Spirakes, A S

    1996-02-01

    The era of managed care has forced an unprecedented restructuring of the health care environment. As hospitals downsize in response, materiel managers should consider adopting strategies that may help ensure their survival, including innovative approaches to supply management and the development of individual responses that will best position them to succeed in this new reality.

  9. Current Models and Innovative Strategies in Management Education in China.

    ERIC Educational Resources Information Center

    Wang, Zhong-Ming

    1999-01-01

    Current models of management education in China include national training, on-the-job technical training, and the national master's of business administration supervisory committee. Effective strategies being used include teamwork, process skills, action learning, cross-cultural management learning, and competency-based management development. (SK)

  10. Effects of new forest management strategies on squirrel populations.

    Treesearch

    Andrew B. Carey

    2000-01-01

    Two strategies for managing forests for multiple values have achieved prominence in debates in the Pacific Northwest: (1) legacy retention with passive management and long rotations, and (2) intensive management for timber with commercial thinnings and long rotations. Northern flying squirrels (Glaucomys sabrinus), Townsend's chipmunks (

  11. Open Source for Knowledge and Learning Management: Strategies beyond Tools

    ERIC Educational Resources Information Center

    Lytras, Miltiadis, Ed.; Naeve, Ambjorn, Ed.

    2007-01-01

    In the last years, knowledge and learning management have made a significant impact on the IT research community. "Open Source for Knowledge and Learning Management: Strategies Beyond Tools" presents learning and knowledge management from a point of view where the basic tools and applications are provided by open source technologies.…

  12. A holistic strategy for adaptive land management

    USGS Publications Warehouse

    Herrick, Jeffrey E.; Duniway, Michael C.; Pyke, David A.; Bestelmeyer, Brandon T.; Wills, Skye A.; Brown, Joel R.; Karl, Jason W.; Havstad, Kris M.

    2012-01-01

    Adaptive management is widely applied to natural resources management (Holling 1973; Walters and Holling 1990). Adaptive management can be generally defined as an iterative decision-making process that incorporates formulation of management objectives, actions designed to address these objectives, monitoring of results, and repeated adaptation of management until desired results are achieved (Brown and MacLeod 1996; Savory and Butterfield 1999). However, adaptive management is often criticized because very few projects ever complete more than one cycle, resulting in little adaptation and little knowledge gain (Lee 1999; Walters 2007). One significant criticism is that adaptive management is often used as a justification for undertaking actions with uncertain outcomes or as a surrogate for the development of specific, measurable indicators and monitoring programs (Lee 1999; Ruhl 2007).

  13. Clinicians' strategies for managing their emotions during difficult healthcare conversations.

    PubMed

    Luff, Donna; Martin, Elliott B; Mills, Kelsey; Mazzola, Natalia M; Bell, Sigall K; Meyer, Elaine C

    2016-09-01

    To examine strategies employed by clinicians from different disciplines to manage their emotions during difficult healthcare conversations. Self-report questionnaires were collected prior to simulation-based Program to Enhance Relational and Communication Skills (PERCS) workshops for professionals representing a range of experience and specialties at a tertiary pediatric hospital. In response to an open-ended prompt, clinicians qualitatively described their own strategies for managing their emotions during difficult healthcare conversations. 126 respondents reported emotion management strategies. Respondents included physicians (42%), nurses (29%), medical interpreters (16%), psychosocial professionals (9%), and other (4%). Respondents identified 1-4 strategies. Five strategy categories were identified: Self-Care (51%), Preparatory and Relational Skills, (29%), Empathic Presence (28%), Team Approach (26%), and Professional Identity (20%). Across disciplines and experience levels, clinicians have developed strategies to manage their emotions when holding difficult healthcare conversations. These strategies support clinicians before, during and after difficult conversations. Understanding what strategies clinicians already employ to manage their emotions when holding difficult conversations has implications for educational planning and implementation. This study has potential to inform the development of education to support clinicians' awareness of their emotions and to enhance the range and effectiveness of emotion management during difficult healthcare conversations. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. 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…

  15. Environmental factors and health information technology management strategy.

    PubMed

    Menachemi, Nir; Shin, Dong Yeong; Ford, Eric W; Yu, Feliciano

    2011-01-01

    : Previous studies have provided theoretical and empirical evidence that environmental forces influence hospital strategy. : Rooted in resource dependence theory and the information uncertainty perspective, this study examined the relationship between environmental market characteristics and hospitals' selection of a health information technology (HIT) management strategy. : A cross-sectional design is used to analyze secondary data from the American Hospital Association Annual Survey, the Healthcare Information and Management Systems Society Analytics Database, and the Area Resource File. Univariate and multinomial logistic regression analyses are used. : Overall, 3,221 hospitals were studied, of which 60.9% pursed a single-vendor HIT management strategy, 28.9% pursued a best-of-suite strategy, and 10.2% used a best-of-breed strategy. Multivariate analyses controlling for hospital characteristics found that measures of environmental factors representing munificence, dynamism, and/or complexity were systematically associated with various hospital HIT management strategy use. Specifically, the number of generalist physicians per capita was positively associated with the single-vendor strategy (B = -5.64, p = .10). Hospitals in urban markets were more likely to pursue the best-of-suite strategy (B = 0.622, p < .001). Dynamism, measured as the number of managed care contracts for a given hospital, was negatively associated with the single-vendor strategy (B = 0.004, p = .049). Lastly, complexity, measured as market competition, was positively associated with the best-of-breed strategy (B = 0.623, p = .042). : By and large, environmental factors are associated with hospital HIT management strategies in mostly theoretically supported ways. Hospital leaders and policy makers interested in influencing the adoption of hospital HIT should consider how market conditions influence HIT management decisions as part of programs to promote meaningful use.

  16. Strategies to address management challenges in larger intensive care units.

    PubMed

    Matlakala, M C; Bezuidenhout, M C; Botha, A D H

    2015-10-01

    To illustrate the need for and suggest strategies that will enhance sustainable management of a large intensive care unit (ICU). The challenges faced by intensive care nursing in South Africa are well documented. However, there appear to be no strategies available to assist nurses to manage large ICUs or for ICU managers to deal with problems as they arise. Data sources to illustrate the need for strategies were challenges described by ICU managers in the management of large ICUs. A purposive sample of managers was included in individual interviews during compilation of evidence regarding the challenges experienced in the management of large ICUs. The challenges were presented at the Critical Care Society of Southern Africa Congress held on 28 August to 2 September 2012 in Sun City North-West province, South Africa. Five strategies are suggested for the challenges identified: divide the units into sections; develop a highly skilled and effective nursing workforce to ensure delivery of quality nursing care; create a culture to retain an effective ICU nursing team; manage assets; and determine the needs of ICU nurses. ICUs need measures to drive the desired strategies into actions to continuously improve the management of the unit. Future research should be aimed at investigating the effectiveness of the strategies identified. This research highlights issues relating to large ICUs and the strategies will assist ICU managers to deal with problems related to large unit sizes, shortage of trained ICU nurses, use of agency nurses, shortage of equipment and supplies and stressors in the ICU. The article will make a contribution to the body of nursing literature on management of ICUs. © 2014 John Wiley & Sons Ltd.

  17. Strategies used for managing symptoms by women with fibromyalgia.

    PubMed

    Kengen Traska, Theresa; Rutledge, Dana N; Mouttapa, Michele; Weiss, Jie; Aquino, Jordan

    2012-03-01

    The goal of this study was to describe how persons with fibromyalgia manage their lives given the multiple symptoms they experience, in particular how they use non-pharmacologic strategies, or how they incorporate these strategies along with pharmacologic agents. Persons with fibromyalgia, a widespread chronic pain condition, often suffer from considerable fatigue, sleep disturbances and morning stiffness. Medical management does not lead to a cure, and sufferers must self-manage to maintain a good quality of life. This qualitative descriptive study used group interview methodology. Data were obtained from eight women with fibromyalgia. Women's mean age was 61 (range 54-81). Participants were invited to participate in a 90- minute group interview focused on symptom management. In the interview, open-ended questions allowed them to speak freely about managing multiple fibromyalgia symptoms. Content analysis by the first and second authors led to the identification of themes, which were validated by the co-authors who attended the interviews. Participants reported many strategies to cope with fibromyalgia symptoms and manage their lives. Main strategies included: 'pacing/planning', 'distraction techniques', 'coping with touch sensitivity', 'putting on the mask' and 'medications'. In addition, 'social support' from others with fibromyalgia and from family members was reported to be very important. Study findings demonstrate that women with fibromyalgia can develop strategies that enable them to cope with a life encumbered with chronic pain and fatigue. Moreover, this study confirmed effective fibromyalgia management strategies reported in other studies. Further research is needed on risks/benefits of these and other self-management strategies used by women with fibromyalgia. Our findings suggest that nurses should discuss the self-management strategies found with persons who have fibromyalgia in the context of individual patient experiences. © 2011 Blackwell

  18. Osteoarthritis 2: pain management and treatment strategies.

    PubMed

    Swift, Amelia

    Osteoarthritis (OA) is a painful, progressive joint disorder. This article discusses pharmacological management of OA, such as non-steroidal anti-inflammatory drugs and opioids, and non-pharmacological management, including weight reduction, acupuncture and joint replacement surgery. The third part, to be published online, will cover the physical, psychological and social impact of OA.

  19. 10 Budget-Savvy Content Management Strategies

    ERIC Educational Resources Information Center

    Hillis, David J.

    2004-01-01

    Facing an overall budget reduction of 10 percent, most colleges or universities would postpone investing in a Web content management system. However, for California State University Monterey Bay (CSUMB), a large budget cut made Web content management even more important. CSUMB found an innovative way to purchase and implement a new Content…

  20. Teaching Self-Management Strategies to Adolescents.

    ERIC Educational Resources Information Center

    Young, K. Richard; And Others

    This book presents a behavioral program to teach adolescents basic self-management skills; two chapters provide the theoretical basis for the program and four chapters supply sample lesson plans. The first chapter is an introduction to behavioral self-management. It proposes a behavior change model with four major components: assessment,…

  1. 10 Budget-Savvy Content Management Strategies

    ERIC Educational Resources Information Center

    Hillis, David J.

    2004-01-01

    Facing an overall budget reduction of 10 percent, most colleges or universities would postpone investing in a Web content management system. However, for California State University Monterey Bay (CSUMB), a large budget cut made Web content management even more important. CSUMB found an innovative way to purchase and implement a new Content…

  2. Strategies and algorithms for management of the difficult airway.

    PubMed

    Heidegger, Thomas; Gerig, Hans J; Henderson, John J

    2005-12-01

    Management of the difficult airway is the most important patient safety issue in the practice of anaesthesia. Many national societies have developed algorithms and guidelines for management of the difficult airway. The key issues of this chapter are definition of terms, the advantages and disadvantages of the use of guidelines, and a comparison of different algorithms and guidelines for management of the most important clinical airway scenarios. Although there is no strong evidence of benefit for any specific strategy or algorithm for management of the difficult airway, there is strong agreement that a pre-planned strategy may lead to improved outcome.

  3. Using scenario analysis to determine managed care strategy.

    PubMed

    Krentz, S E; Gish, R S

    2000-09-01

    In today's volatile healthcare environment, traditional planning tools are inadequate to guide financial managers of provider organizations in developing managed care strategies. These tools often disregard the uncertainty surrounding market forces such as employee benefit structure, the future of Medicare managed care, and the impact of consumer behavior. Scenario analysis overcomes this limitation by acknowledging the uncertain healthcare environment and articulating a set of plausible alternative futures, thus supplying financial executives with the perspective to craft strategies that can improve the market position of their organizations. By being alert for trigger points that might signal the rise of a specific scenario, financial managers can increase their preparedness for changes in market forces.

  4. 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

  5. HMO strategies for managing workers' compensation claims.

    PubMed

    Gallagher, P A

    1996-03-01

    Health maintenance organizations (HMOs) have become very active in managing workers' compensation medical expense benefits. A survey of 316 HMOs shows that this activity takes the form of various network models and a range of services--such as utilization review and case management--that may not be linked to a provider network. Of the HMOs surveyed, 78 reported that, by using managed care services and provider discounts, they were able to save from 20 percent to 30 percent on occupational health claim costs.

  6. Adaptive Management as an Effective Strategy: Interdisciplinary Perceptions for Natural Resources Management

    NASA Astrophysics Data System (ADS)

    Dreiss, Lindsay M.; Hessenauer, Jan-Michael; Nathan, Lucas R.; O'Connor, Kelly M.; Liberati, Marjorie R.; Kloster, Danielle P.; Barclay, Janet R.; Vokoun, Jason C.; Morzillo, Anita T.

    2017-02-01

    Adaptive management is a well-established approach to managing natural resources, but there is little evidence demonstrating effectiveness of adaptive management over traditional management techniques. Peer-reviewed literature attempts to draw conclusions about adaptive management effectiveness using social perceptions, but those studies are largely restricted to employees of US federal organizations. To gain a more comprehensive insight into perceived adaptive management effectiveness, this study aimed to broaden the suite of disciplines, professional affiliations, and geographic backgrounds represented by both practitioners and scholars. A questionnaire contained a series of questions concerning factors that lead to or inhibit effective management, followed by another set of questions focused on adaptive management. Using a continuum representing strategies of both adaptive management and traditional management, respondents selected those strategies that they perceived as being effective. Overall, characteristics (i.e., strategies, stakeholders, and barriers) identified by respondents as contributing to effective management closely aligned with adaptive management. Responses were correlated to the type of adaptive management experience rather than an individual's discipline, occupational, or regional affiliation. In particular, perceptions of characteristics contributing to adaptive management effectiveness varied between respondents who identified as adaptive management scholars (i.e., no implementation experience) and adaptive management practitioners. Together, these results supported two concepts that make adaptive management effective: practitioners emphasized adaptive management's value as a long-term approach and scholars noted the importance of stakeholder involvement. Even so, more communication between practitioners and scholars regarding adaptive management effectiveness could promote interdisciplinary learning and problem solving for improved

  7. Adaptive Management as an Effective Strategy: Interdisciplinary Perceptions for Natural Resources Management.

    PubMed

    Dreiss, Lindsay M; Hessenauer, Jan-Michael; Nathan, Lucas R; O'Connor, Kelly M; Liberati, Marjorie R; Kloster, Danielle P; Barclay, Janet R; Vokoun, Jason C; Morzillo, Anita T

    2017-02-01

    Adaptive management is a well-established approach to managing natural resources, but there is little evidence demonstrating effectiveness of adaptive management over traditional management techniques. Peer-reviewed literature attempts to draw conclusions about adaptive management effectiveness using social perceptions, but those studies are largely restricted to employees of US federal organizations. To gain a more comprehensive insight into perceived adaptive management effectiveness, this study aimed to broaden the suite of disciplines, professional affiliations, and geographic backgrounds represented by both practitioners and scholars. A questionnaire contained a series of questions concerning factors that lead to or inhibit effective management, followed by another set of questions focused on adaptive management. Using a continuum representing strategies of both adaptive management and traditional management, respondents selected those strategies that they perceived as being effective. Overall, characteristics (i.e., strategies, stakeholders, and barriers) identified by respondents as contributing to effective management closely aligned with adaptive management. Responses were correlated to the type of adaptive management experience rather than an individual's discipline, occupational, or regional affiliation. In particular, perceptions of characteristics contributing to adaptive management effectiveness varied between respondents who identified as adaptive management scholars (i.e., no implementation experience) and adaptive management practitioners. Together, these results supported two concepts that make adaptive management effective: practitioners emphasized adaptive management's value as a long-term approach and scholars noted the importance of stakeholder involvement. Even so, more communication between practitioners and scholars regarding adaptive management effectiveness could promote interdisciplinary learning and problem solving for improved

  8. Emphysematous pyelonephritis with calculus: Management strategies

    PubMed Central

    Goel, Tanmaya; Reddy, Sreedhar; Thomas, Joseph

    2007-01-01

    Objective: Emphysematous pyelonephritis (EPN) with calculus is well recognized but with very few reports on its treatment. Our aim is to elucidate our experience in its successful management. Materials and Methods: Over four years, we diagnosed seven cases (eight renal units) of EPN, out of which two patients (three renal units) had EPN with urinary calculi. After the initial conservative management of EPN, the stones were tackled appropriately. Results: EPN was initially managed effectively with antibiotics and supportive care. Once the patient was stable, the stones were cleared in a step-wise fashion. The associated postoperative complications were also tackled efficiently with preservation of renal function. Conclusion: In EPN with stones, nephrectomy is not the sole option available and they can be effectively managed with open / endoscopic measures. PMID:19718324

  9. Fibromyalgia: management strategies for primary care providers.

    PubMed

    Arnold, L M; Gebke, K B; Choy, E H S

    2016-02-01

    Fibromyalgia (FM), a chronic disorder defined by widespread pain, often accompanied by fatigue and sleep disturbance, affects up to one in 20 patients in primary care. Although most patients with FM are managed in primary care, diagnosis and treatment continue to present a challenge, and patients are often referred to specialists. Furthermore, the lack of a clear patient pathway often results in patients being passed from specialist to specialist, exhaustive investigations, prescription of multiple drugs to treat different symptoms, delays in diagnosis, increased disability and increased healthcare resource utilisation. We will discuss the current and evolving understanding of FM, and recommend improvements in the management and treatment of FM, highlighting the role of the primary care physician, and the place of the medical home in FM management. We reviewed the epidemiology, pathophysiology and management of FM by searching PubMed and references from relevant articles, and selected articles on the basis of quality, relevance to the illness and importance in illustrating current management pathways and the potential for future improvements. The implementation of a framework for chronic pain management in primary care would limit unnecessary, time-consuming, and costly tests, reduce diagnostic delay and improve patient outcomes. The patient-centred medical home (PCMH), a management framework that has been successfully implemented in other chronic diseases, might improve the care of patients with FM in primary care, by bringing together a team of professionals with a range of skills and training. Although there remain several barriers to overcome, implementation of a PCMH would allow patients with FM, like those with other chronic conditions, to be successfully managed in the primary care setting. © 2016 John Wiley & Sons Ltd.

  10. 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…

  11. 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…

  12. Analysis of Human Resources Management Strategy in China Electronic Commerce Enterprises

    NASA Astrophysics Data System (ADS)

    Shao, Fang

    The paper discussed electronic-commerce's influence on enterprise human resources management, proposed and proved the human resources management strategy which electronic commerce enterprise should adopt from recruitment strategy to training strategy, keeping talent strategy and other ways.

  13. Strategies for initial management of hypertension

    PubMed Central

    Gupta, Rajeev; Guptha, Soneil

    2010-01-01

    High blood pressure (BP) is a major public health problem in India and its prevalence is rapidly increasing among urban and rural populations. Reducing systolic and diastolic BP can decrease cardiovascular risk and this can be achieved by non-pharmacological (lifestyle measures) as well as pharmacological means. Lifestyle changes should be the initial approach to hypertension management and include dietary interventions (reducing salt, increasing potassium, alcohol avoidance, and multifactorial diet control), weight reduction, tobacco cessation, physical exercise, and stress management. A number of pharmaceutical agents, well evidenced by large randomized clinical trials, are available for initial treatment of high BP. These include older molecules such as thiazide diuretics and beta-blocking agents and newer molecules, dihydropyridine calcium channel blockers (CCB), angiotensin converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARB). In view of the recent clinical trials data, some international guidelines suggest that CCB, ACE inhibitors or ARB and not beta-blockers or diuretics should be the initial therapy in hypertension management. Comprehensive hypertension management focuses on reducing overall cardiovascular risk by lifestyle measures, BP lowering and lipid management and should be the preferred initial treatment approach. PMID:21150005

  14. Meralgia paresthetica: diagnosis and management strategies.

    PubMed

    Harney, Donal; Patijn, Jacob

    2007-01-01

    Meralgia paresthetica (MP), coined from the Greek words meros (thigh and algos), meaning pain, is a neurological disorder characterized by a localized area of paresthesia and numbness on the anterolateral aspect of the thigh. The incidence of MP is more common than often reported in the literature. The etiology of MP includes mechanical factors such as obesity, pregnancy, and other conditions associated with increased intrabdominal pressure, surgery of the spine, and pelvic osteotomy. A coherent history and pertinent physical examination is essential in making the diagnosis; however, red flags such as tumor and lumbar disk herniations must be recognized and appropriately treated. While the diagnosis of MP is essentially a clinical diagnosis, sensory nerve conduction velocity studies are a useful adjunctive diagnostic tool. The management of MP includes treating the underlying cause (if any) and conservative management. Surgery should only be adopted when all nonoperative therapies have failed to manage the condition in an effective manner.

  15. Management Strategies for Mycosis Fungoides in India

    PubMed Central

    Raychaudhury, Tanumay

    2017-01-01

    Mycosis fungoides is the most common primary cutaneous T-cell lymphoma. The approach to diagnosis and further follow-up is outlined. Evidence for interventions is based classically on a Tumor Node Metastasis Blood TNMB “stage-based” approach. The treatment options in India are limited. The options as per risk stratification and prognostic index are discussed. Early stages and low-risk patients can be managed with expectant policy or skin-directed therapies including topical steroids and phototherapy; intermediate-risk patients can be opted for interferons or retinoids or low dose methotrexate along with radiotherapy including total skin electron beam therapy while high-risk patients are managed most often with single agent or multiagent palliative chemotherapy. Patients who are intermediate- or high-risk need management by a multispecialty team at tertiary care centers. PMID:28400632

  16. Municipal solid waste management strategies in Turkey.

    PubMed

    Turan, N Gamze; Coruh, Semra; Akdemir, Andaç; Ergun, Osman Nuri

    2009-01-01

    Municipal solid waste (MSW) is a major environmental problem in Turkey, as in many developing countries. Problems associated with municipal solid waste are difficult to address, but efforts towards more efficient collection and transportation and environmentally acceptable waste disposal continue in Turkey. Although strict regulations on the management of solid waste are in place, primitive disposal methods such as open dumping and discharge into surface water have been used in various parts of Turkey. This study presents a brief history of the legislative trends in Turkey for MSW management. The study also presents the MSW responsibility and management structure together with the present situation of generation, composition, recycling, and treatment. The results show that approximately 25 million ton of MSW are generated annually in Turkey. About 77% of the population receives MSW services. In spite of efforts to change open dumping areas into sanitary landfills and to build modern recycling and composting facilities, Turkey still has over 2000 open dumps.

  17. Classroom Management Strategies and Behavioral Interventions to Support Academic Achievement

    ERIC Educational Resources Information Center

    Gilpatrick, Robin Sue Holzworth

    2010-01-01

    This mixed method project study identified the need for effective classroom management strategies to dissuade student noncompliant behavior and to ensure academic success for all students. Enhancing classroom management practices is vital to improved student achievement and teacher self-efficacy. Within a constructivist framework, it is critical…

  18. A Strategy for Optimizing Item-Pool Management

    ERIC Educational Resources Information Center

    Ariel, Adelaide; van der Linden, Wim J.; Veldkamp, Bernard P.

    2006-01-01

    Item-pool management requires a balancing act between the input of new items into the pool and the output of tests assembled from it. A strategy for optimizing item-pool management is presented that is based on the idea of a periodic update of an optimal blueprint for the item pool to tune item production to test assembly. A simulation study with…

  19. Strategies for job creation through national forest management

    Treesearch

    Susan Charnley

    2014-01-01

    This chapter explores the ways in which national forest managers may contribute to community well-being by designing projects that accomplish forest management in ways that not only meet their ecological goals, but also create economic opportunities for nearby communities. The chapter summarizes a number of strategies for enhancing the economic benefits to communities...

  20. A Strategy for Optimizing Item-Pool Management

    ERIC Educational Resources Information Center

    Ariel, Adelaide; van der Linden, Wim J.; Veldkamp, Bernard P.

    2006-01-01

    Item-pool management requires a balancing act between the input of new items into the pool and the output of tests assembled from it. A strategy for optimizing item-pool management is presented that is based on the idea of a periodic update of an optimal blueprint for the item pool to tune item production to test assembly. A simulation study with…

  1. Classroom Management Strategies and Behavioral Interventions to Support Academic Achievement

    ERIC Educational Resources Information Center

    Gilpatrick, Robin Sue Holzworth

    2010-01-01

    This mixed method project study identified the need for effective classroom management strategies to dissuade student noncompliant behavior and to ensure academic success for all students. Enhancing classroom management practices is vital to improved student achievement and teacher self-efficacy. Within a constructivist framework, it is critical…

  2. A Policy Change Strategy for Head Lice Management

    ERIC Educational Resources Information Center

    Andresen, Kathleen; McCarthy, Ann Marie

    2009-01-01

    The purpose of this project was to formulate an effective change strategy for head lice management in a group of five separate school districts within one county. Despite a desire to use evidence to support their practice, school nurses often encounter educational system barriers that prevent independent management of health conditions. The use of…

  3. Socioeconomic evaluation of broad-scale land management strategies.

    Treesearch

    Lisa K. Crone; Richard W. Haynes

    2001-01-01

    This paper examines the socioeconomic effects of alternative management strategies for Forest Service and Bureau of Land Management lands in the interior Columbia basin. From a broad-scale perspective, there is little impact or variation between alternatives in terms of changes in total economic activity or social conditions in the region. However, adopting a finer...

  4. Delegation: Win-Win Strategies for Managing Early Childhood Settings.

    ERIC Educational Resources Information Center

    Hayden, Jacqueline

    1999-01-01

    This issue of the Australian Early Childhood Association Research in Practice Series provides staff management strategies for directors and others involved with the management of early childhood settings and suggests ways to effectively delegate authority and tasks in order to reduce administrative pressures and workload. The booklet presents…

  5. An ecosystem management strategy for Sierran mixed-conifer forests

    Treesearch

    Malcolm North; Peter Stine; Kevin O' Hara; William Zielinski; Scott Stephens

    2009-01-01

    Current Sierra Nevada forest management is often focused on strategically reducing fuels without an explicit strategy for ecological restoration across the landscape matrix. Summarizing recent scientific literature, we suggest managers produce different stand structures and densities across the landscape using topographic variables (i.e., slope shape, aspect, and slope...

  6. Primary care referral management: a marketing strategy for hospitals.

    PubMed

    Bender, A D; Geoghegan, S S; Lundquist, S H; Cantone, J M; Krasnick, C J

    1990-06-01

    With increasing competition among hospitals, primary care referral development and management programs offer an opportunity for hospitals to increase their admissions. Such programs require careful development, the commitment of the hospital staff to the strategy, an integration of hospital activities, and an understanding of medical practice management.

  7. A Policy Change Strategy for Head Lice Management

    ERIC Educational Resources Information Center

    Andresen, Kathleen; McCarthy, Ann Marie

    2009-01-01

    The purpose of this project was to formulate an effective change strategy for head lice management in a group of five separate school districts within one county. Despite a desire to use evidence to support their practice, school nurses often encounter educational system barriers that prevent independent management of health conditions. The use of…

  8. Modeling the cumulative watershed effects of forest management strategies

    Treesearch

    R. R. Ziemer; J. Lewis; R. M. Rice; T. E. Lisle

    1991-01-01

    Abstract - There is increasing concern over the possibility of adverse cumulative watershed effects from intensive forest management. It is impractical to address many aspects of the problem experimentally because to do so would require studying large watersheds for 100 yr or more. One such aspect is the long-term effect of forest management strategies on erosion and...

  9. Ecological principles underpinning invasive plant management tools and strategies

    USDA-ARS?s Scientific Manuscript database

    The broad focus of ecologically-based invasive plant management is to identify and repair the ecological processes facilitating plant invasion. To be useful, however, EBIPM requires that our application of management tools and strategies be based on ecological principles that determine the rate and ...

  10. Multigeneration employees: strategies for effective management.

    PubMed

    Kupperschmidt, B R

    2000-09-01

    Today's health care workforce comprises Traditional, Baby Boomer, and Generation X employees. Effective managers must understand the times and generational characteristics of these employees and they must assure that employees understand and respect one another's differences. They must foster open discussion of how generational differences influence attitudes toward work and organizations. They must provide opportunities for multigeneration employees to contribute their best concurrent with meeting organizational goals. Employees must be offered a conditional security based upon value-added results and collaboration. Managers must use leadership practices that encourage the hearts of dispirited employees.

  11. 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.

  12. Alertness Management Strategies for Operational Contexts

    DTIC Science & Technology

    2008-08-01

    or reproductive disorders. In addition, there is evidence from some studies that night work is associated with increased accide’nts. In fact, Folkard...behaviorally based strategies for avoiding insomnia in many situations, but in some cases, hypnotic medications or so- called "sleeping pills" may be necessary...preferable to being sleep deprived. Choosing the best hypnotic for each situation requires consideration of a variety of factors. From a strictly

  13. Population health management: a "start small" strategy.

    PubMed

    Sanford, Kathleen D

    2013-01-01

    Catholic Health Initiatives (CHI) is piloting population health management for a test population that comprises CHI employees and their families. CHI is using a medical home model to coordinate care. The system anticipates a reduction in its employee healthcare costs of 10 to 14 percent.

  14. Financial Planning and Management--New Strategies.

    ERIC Educational Resources Information Center

    Mann, William J.

    1979-01-01

    The goal of the future financial manager should be to educate college personnel to the level necessary to make balanced decisions. The challenge is to maintain the current operable systems and develop new approaches to maximize scarce resources through effective communication. (RC)

  15. Radiation Proctitis: Current Strategies in Management

    PubMed Central

    Do, Nhue L.; Nagle, Deborah; Poylin, Vitaliy Y.

    2011-01-01

    Radiation proctitis is a known complication following radiation therapy for pelvic malignancy. The majority of cases are treated nonsurgically, and an understanding of the available modalities is crucial in the management of these patients. In this paper, we focus on the current treatments of radiation proctitis. PMID:22144997

  16. Classroom Strategies: Classroom Management Systems. Volume 3.

    ERIC Educational Resources Information Center

    Speiss, Madeleine F.; And Others

    Classroom management is defined as procedures for arranging the classroom environment so that children learn what the teacher wants to teach them in the healthiest and most effective way possible. The Southwestern Cooperative Educational Laboratory presents a discussion of these procedures as they relate to social controls and components of…

  17. 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.

  18. Evaluating Executive Strategies (Management Strategies and Teaching-Learning Strategies) of Graduate Curriculum: Case Study in Isfahan University

    ERIC Educational Resources Information Center

    Rahmanpour, Muhammad; Ahmadi, Mojtaba; Hatami, Mostafa; Mirzaee, Hamzeh

    2017-01-01

    The present study seeks to evaluate executive strategies in graduate Curriculum of Isfahan University from the point of view of management and teaching-learning strategies. This study is an applied survey. The population comprised BA students and faculty members of the University of Isfahan. In order to do so, 141 professors and 278 students were…

  19. Change in MSW characteristics under recent management strategies in Taiwan.

    PubMed

    Chang, Yu-Min; Liu, Chien-Chung; Hung, Chao-Yang; Hu, Allen; Chen, Shiao-Shing

    2008-12-01

    Reduction and recycling initiatives such as producer responsibility and pay-as-you-throw are being implemented in Taiwan. This paper presents a study assessing the impact of recently implemented municipal solid waste (MSW) reduction and recycling management strategies on the characteristics of waste feedstock for incineration in Taiwan. Through the periodic sampling of two typical MSW incineration plants, proximate and ultimate analyses were conducted according to standard methods to explore the influence of MSW reduction and recycling management strategies on incineration feed waste characteristics. It was observed that the annual amount of MSW generated in 2005 decreased by about 10% compared to 2003 and that the characteristics of MSW have changed significantly due to recent management strategies. The heating value of the MSW generated in Taiwan increased yearly by about 5% after program implementation. A comparison of the monthly variations in chemical concentrations indicated that the chlorine content in MSW has changed. This change results from usage reduction of PVC plastic due to the recycling fund management (RFM) program, and the food waste as well as salt content reduction due to the total recycling for kitchen garbage program. This achievement will improve the reduction of dioxin emissions from MSW incineration. In summary, management strategies must be conducted in tandem with the global trend to achieve a zero-waste-discharge country. When implementing these strategies and planning for future MSW management systems, it is important to consider the changes that may occur in the composition and characteristics of MSW over time.

  20. Mistakes to avoid when planning managed care strategies.

    PubMed

    Scheur, B S

    1997-06-01

    Hospital executives, steeped in hospital business traditions, sometimes fall victim to those traditions when planning their managed care strategies. They may fail to sufficiently evaluate their hospitals' market position or set appropriate priorities for their various business strategies. They may not recruit individuals with managed care expertise, develop effective marketing plans, or construct realistic physician networks. Some hospital executives may be ill-equipped to deal with cultural clashes and reluctant to share control of their managed care organizations with physicians. Or, they may not always understand the true nature of the arrangement they have entered into, the information and technology needs of the arrangement, and their own strategic advantages. Today's hospital executives must plan their managed care strategies carefully and execute them intelligently to ensure success.

  1. Epilepsy during pregnancy: focus on management strategies

    PubMed Central

    Borgelt, Laura M; Hart, Felecia M; Bainbridge, Jacquelyn L

    2016-01-01

    In the US, more than one million women with epilepsy are of childbearing age and have over 20,000 babies each year. Patients with epilepsy who become pregnant are at risk of complications, including changes in seizure frequency, maternal morbidity and mortality, and congenital anomalies due to antiepileptic drug exposure. Appropriate management of epilepsy during pregnancy may involve frequent monitoring of antiepileptic drug serum concentrations, potential preconception switching of antiepileptic medications, making dose adjustments, minimizing peak drug concentration with more frequent dosing, and avoiding potentially teratogenic medications. Ideally, preconception planning will be done to minimize risks to both the mother and fetus during pregnancy. It is important to recognize benefits and risks of current and emerging therapies, especially with revised pregnancy labeling in prescription drug product information. This review will outline risks for epilepsy during pregnancy, review various recommendations from leading organizations, and provide an evidence-based approach for managing patients with epilepsy before, during, and after pregnancy. PMID:27703396

  2. Electronic mail communication--management strategies.

    PubMed

    Strasser, Patricia B

    2003-12-01

    Electronic communication has come a long way in the past 30 years. It will no doubt continue to improve and remain the primary communication vehicle for businesses. Occupational health nurses, like other business professionals, must use email to their advantage to improve their practice. However, electronic mail communication must be managed in the same manner as records and documents produced in any form or media.

  3. Nurses' strategies for managing pain in the postoperative setting.

    PubMed

    Manias, Elizabeth; Bucknall, Tracey; Botti, Mari

    2005-03-01

    Acute pain is a significant problem in the postoperative setting. Patients report a lack of information about pain-control measures and ineffective pain control. Nurses continue to rely on pharmacologic measures and tend to under-administer analgesics. The purpose of this study was to determine the strategies nurses used to manage patients' pain in the postoperative setting. It also sought to examine the effect of context, including organization of care, nurses' prioritization of work activities, and pressures during a working shift, on their pain-management strategies. An observational design was used in two surgical units of a metropolitan teaching hospital in Melbourne, Australia. Six fixed observation times were identified as key periods for pain activities, each comprising a 2-hour duration. An observation period was examined at least 12 times, resulting in the completion of 74 observations and the identification of 316 pain cases. Fifty-two nurses were observed during their normal day's work with postoperative patients. Six themes were identified: managing pain effectively; prioritizing pain experiences for pain management; missing pain cues for pain management; regulators and enforcers of pain management; preventing pain; and reactive management of pain. The findings highlighted the critical nature of communication between clinicians and patients and among clinicians. It also demonstrated the influence of time on management strategies and the relative importance that nurses place on nonpharmacologic measures in actual practice. This research, which portrays what happens in actual clinical practice, has facilitated the identification of new data that were not evident from other research studies.

  4. Management strategies in hospitals: scenario planning.

    PubMed

    Ghanem, Mohamed; Schnoor, Jörg; Heyde, Christoph-Eckhard; Kuwatsch, Sandra; Bohn, Marco; Josten, Christoph

    2015-01-01

    Hintergrund: Das Krankenhausmanagement ist stets Herausforderungen ausgesetzt. Anstatt auf die Herausforderungen zu warten, sollten Ärzte und Manager im Voraus handeln, um ein optimiertes und nachhaltig wertorientiertes Gesundheitswesen zu sichern. Diese Arbeit unterstreicht die Bedeutung der Szenarienplanung in Krankenhäusern, schlägt eine ausgearbeitete Definition der Stakeholder eines Krankenhauses vor und definiert die Einflussfaktoren, denen Krankenhäuser ausgesetzt sind.Methodik: Basierend auf einer Literaturanalyse sowie auf persönlichen Interviews mit Stakeholdern eines Krankenhauses schlagen wir eine ausgearbeitete Definition von Stakeholdern vor und erarbeiteten einen Fragebogen. Dieser Fragebogen berücksichtigt folgende Einflussfaktoren, die entsprechende Auswirkungen auf das Krankenhaus-Management haben: politische/rechtliche, wirtschaftliche, soziale, technologische und Umweltkräfte.Diese Einflussfaktoren werden untersucht, um die so genannten kritischen Unsicherheiten zu entwickeln. Die gründliche Identifizierung von Unsicherheiten basierte auf „Stakeholder Feedback“.Ergebnisse: Zwei Haupt-Unsicherheiten wurden identifiziert und in dieser Studie berücksichtigt:die Entwicklung der Arbeitsbelastung für das medizinische Personaldie gewinnorientierte Leistung des medizinischen Personals.Entsprechend der entwickelten Szenarien konnten wir folgende Kernstrategie empfehlen: komplementäre Ausbildung sowohl des medizinischen Personals als auch der nicht-medizinischen Top-Führungskräfte und Manager von Krankenhäusern. Ergänzende szenariospezifische strategische Optionen sollen, falls erforderlich, in Betracht gezogen werden, um eine bestimmte zukünftige Entwicklung des medizinischen Umfeldes zu optimieren.Schlussfolgerung: Strategische Planung in Krankenhäusern ist wichtig, um nachhaltigen Erfolg zu gewährleisten. Diese Planung soll mehrere Situationen berücksichtigen und integriert interne und externe Ein- und Ausblicke. Darüber hinaus

  5. [Behavioral and cognitive strategies in stress management].

    PubMed

    Légeron, P

    1993-03-01

    Stress is a specific response of the individual to all nonspecific demands. However, this process of adaptation is very complex and varies considerably from person to person. The stress response or "stress reactivity" is triggered by various stressors, ranging from live events to daily hassles and including chronic stressors. These stressors need to be identified. The stress response is not univocal: it has physiological, cognitive and behavioral components. Most of the time, physiological, cognitive and behavioral responses are maladaptive and harmful for the individual. Stress management is directed at teaching individuals specific skills to modify parts of these responses in order to reduce stress. Relaxation therapies are the cornerstone of any stress management program. They mostly include autogenic training and progressive relaxation training, sometimes biofeedback. The relaxation response is a learned response. There are a variety of different methods of inducing this response. They share the common goal of countering the physiological aspects of the stress reaction. All the relaxation techniques involve long and exacting training. But proper training leads to a gradual reduction in time and effort required to relax. When properly pursued, these techniques produce a state of relaxation quickly and on demand. Cognitive approaches to stress management derive from the constatation that the individual's interpretation of events or situations which have been labeled stressful, the individual's anticipation of the consequences of the stressor and the individual's view of his or her ability to cope with the stressor or the stress reaction are fundamental in the stress process. There are a variety of cognitive theories and techniques, ranging from Beck's cognitive therapy to Ellis' Rational-Emotive Therapy. Initial phases of these therapies are directed at teaching the individual to recognize, record, analyse and modify maladaptive cognitions. The second phase is

  6. 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

  7. 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

  8. 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.

  9. Applying disease management strategies to Medicare.

    PubMed

    Tompkins, C P; Bhalotra, S; Trisolini, M; Wallack, S S; Rasgon, S; Yeoh, H

    1999-01-01

    Medicare coverage begins for many when they have already developed one or more chronic diseases, and it often pays for the latest and costliest phases. Population-based disease modeling, patient screening, and monitoring would be appropriate interventions for chronic renal disease. Patients who have not yet advanced to end-stage renal disease would benefit from management of diabetes and hypertension, avoidance of nephrotoxic substances, and better preparation for dialysis. Administrative support could take the form of clinical guidelines, physician-led multidisciplinary teams, integrated delivery systems, provider and patient education, and new information technologies. Medicare reflects the long-term public perspective, and thus should further this new direction by supporting education, reimbursing for prevention efforts and allied health services, encouraging efficiency, and monitoring cost and quality outcomes.

  10. New Management Strategies for Ectopia Lentis.

    PubMed

    Simon, Melissa A; Origlieri, Catherine A; Dinallo, Anthony M; Forbes, Brian J; Wagner, Rudolph S; Guo, Suqin

    2015-01-01

    Ectopia lentis refers to displacement of the crystalline lens in the setting of various systemic and metabolic disorders. A literature review was conducted to investigate the management of non-traumatic ectopia lentis in the pediatric population, particularly focusing on surgical intervention. Both limbal and pars plana approaches for lensectomy are well established in the literature. Surgical options for intraocular lens implantation in pediatric eyes with ectopia lentis include anterior chamber intraocular lenses and iris-fixated or scleral-fixated posterior chamber intraocular lenses. Recently, the use of capsular tension rings has also been described with promising results. Visual rehabilitation and treatment of amblyopia are essential for patients within the amblyogenic age group following surgical intervention.

  11. Blepharitis: current strategies for diagnosis and management.

    PubMed

    Jackson, W Bruce

    2008-04-01

    The aim of this article is to present a consensus on the appropriate identification and management of patients with blepharitis based on expert clinical recommendations for 4 representative case studies and evidence from well-designed clinical trials. The case study recommendations were developed at a consensus panel meeting of Canadian ophthalmologists and a guest ophthalmologist from the U.K., with additional input from family doctors and an infectious disease/medical microbiologist, which took place in Toronto in June 2006. A MEDLINE search was also conducted of English language articles describing randomized controlled clinical trials that involved patients with blepharitis. Blepharitis involving predominantly the skin and lashes tends to be staphylococcal and (or) seborrheic in nature, whereas involvement of the meibomian glands may be either seborrheic, obstructive, or a combination (mixed). The pathophysiology of blepharitis is a complex interaction of various factors, including abnormal lid-margin secretions, microbial organisms, and abnormalities of the tear film. Blepharitis can present with a range of signs and symptoms, and is associated with various dermatological conditions, namely, seborrheic dermatitis, rosacea, and eczema. The mainstay of treatment is an eyelid hygiene regimen, which needs to be continued long term. Topical antibiotics are used to reduce the bacterial load. Topical corticosteroid preparations may be helpful in patients with marked inflammation. Blepharitis can present with a range of signs and symptoms, and its management can be complicated by a number of factors. Expert clinical recommendations and a review of the evidence on treatment supports the practice of careful lid hygiene, possibly combined with the use of topical antibiotics, with or without topical steroids. Systemic antibiotics may be appropriate in some patients.

  12. Roles of managers in academic health centers: strategies for the managed care environment.

    PubMed

    Guo, Kristina L

    2002-03-01

    This article addresses survival strategies of academic health centers (AHCs) in responding to market pressures and government reforms. Using six case studies of AHCs, the study links strategic changes in structure and management to managerial role performance. Utilizing Mintzberg's classification of work roles, the roles of liaison, monitor, entrepreneur, and resource allocator were found to be used by top-level managers as they implement strategies to enhance the viability of their AHCs. Based on these new roles, the study recommends improving management practices through education and training as well as changing organizational culture to support management decision making and foster the continued growth of managers and their AHCs.

  13. A framework for the assessment of severe accident management strategies

    SciTech Connect

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

    1993-09-01

    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 of 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.

  14. Clinical nutrition management position: responsibilities and skill development strategies.

    PubMed

    Witte, S S; Messersmith, A M

    1995-10-01

    To determine the duties of clinical nutrition managers, the factors associated with the performance of the duties, the job specifications for the position, and the skill development strategies used by clinical nutrition managers. Clinical nutrition managers from 700 randomly selected, acute-care hospitals in the United States (with 300 or more beds) received a survey questionnaire. Respondents were asked to indicate performance or nonperformance, perceived importance, and methods used to develop skills for 54 duties related to clinical nutrition management. We requested additional information about position requirements, position characteristics, and demographic information. An 82% response rate with 67% usable responses (n = 472) was achieved. Frequencies for performance and nonperformance, mean importance, and frequencies for methods of skill development were determined for each duty. chi 2 Analysis with P < .10 was used to determine if an association existed between performance of a duty and time allotted to the position, number of personnel supervised, and type of personnel supervised. This study validated 46 of the duties as responsibilities of practicing clinical nutrition manager. Three duties not validated were related to financial management. The duty performed least often was conducting research/investigative studies. The number and type of personnel supervised was found to influence performance of duties, but time allotted to position was not an influence. The major strategies used for skill development were continuing education, networking, work experience in clinical dietetics, work experience in management dietetics, and their present job. These results can be used by clinical nutrition managers to assess the characteristics of their current position and develop a plan for enhancing their scope of responsibility. The identification of duties actually performed by clinical nutrition managers can also be used to develop standards of practice with

  15. Sustainability: orthopaedic surgery wait time management strategies.

    PubMed

    Amar, Claudia; Pomey, Marie-Pascale; SanMartin, Claudia; De Coster, Carolyn; Noseworthy, Tom

    2015-01-01

    The purpose of this paper is to examine Canadian organizational and systemic factors that made it possible to keep wait times within federally established limits for at least 18 months. The research design is a multiple cases study. The paper selected three cases: Case 1 - staff were able to maintain compliance with requirements for more than 18 months; Case 2 - staff were able to meet requirements for 18 months, but unable to sustain this level; Case 3 - staff were never able to meet the requirements. For each case the authors interviewed persons involved in the strategies and collected documents. The paper analysed systemic and organizational-level factors; including governance and leadership, culture, resources, methods and tools. Findings indicate that the hospital that was able to maintain compliance with the wait time requirements had specific characteristics: an exclusive mandate to do only hip and knee replacement surgery; motivated staff who were not distracted by other concerns; and a strong team spirit. The authors' research highlights an important gradient between three cases regarding the factors that sustain waiting times. The paper show that the hospital factory model seems attractive in a super-specialized surgery context. However, patients are selected for simple surgeries, without complications, and so this cannot be considered a unique model.

  16. Caries Management Strategies for Primary Molars

    PubMed Central

    Santamaria, R.M.; Innes, N.P.T.; Machiulskiene, V.; Evans, D.J.P.; Splieth, C.H.

    2014-01-01

    Minimal invasive approaches to managing caries, such as partial caries removal techniques, are showing increasing evidence of improved outcomes over the conventional complete caries removal. There is also increasing interest in techniques where no caries is removed. We present the 1-yr results of clinical efficacy for 3 caries management options for occlusoproximal cavitated lesions in primary molars: conventional restorations (CR; complete caries removal and compomer restoration), Hall technique (HT; no caries removal, sealing in with stainless steel crowns), and nonrestorative caries treatment (NRCT; no caries removal, opening up the cavity, teaching brushing and fluoride application). In sum, 169 children (3-8 yr old; mean, 5.56 ± 1.45 yr) were enrolled in this secondary care–based, 3-arm, parallel-group, randomized clinical trial. Treatments were carried out by specialist pediatric dentists or postgraduate trainees. One lesion per child received CR, HT, or NRCT. Outcome measures were clinical failure rates, grouped as minor failure (restoration loss/need for replacement, reversible pulpitis, caries progression, etc.) and major failure (irreversible pulpitis, abscess, etc.). There were 148 children (87.6%) with a minimum follow-up of 11 mo (mean, 12.23 ± 0.98 mo). Twenty teeth were recorded as having at least 1 minor failure: NRCT, n = 8 (5%); CR, n = 11 (7%); HT, n = 1 (1%) (p = .002, 95% CI = 0.001 to 0.003). Only the comparison between NRCT and CR showed no significant difference (p = .79, 95% CI = 0.78 to 0.80). Nine (6%) experienced at least 1 major failure: NRCT, n = 4 (2%); CR, n = 5 (3%); HT, n = 0 (0%) (p = .002, 95% CI = 0.001 to 0.003). Individual comparison of NRCT and CR showed no statistically significant difference in major failures (p = .75, 95% CI = 0.73 to 0.76). Success and failure rates were not significantly affected by pediatric dentists’ level of experience (p = .13, 95% CI = 0.12 to 0.14). The HT was significantly more successful

  17. SECONDARY WASTE MANAGEMENT STRATEGY FOR EARLY LOW ACTIVITY WASTE TREATMENT

    SciTech Connect

    TW, CRAWFORD

    2008-07-17

    This study evaluates parameters relevant to River Protection Project secondary waste streams generated during Early Low Activity Waste operations and recommends a strategy for secondary waste management that considers groundwater impact, cost, and programmatic risk. The recommended strategy for managing River Protection Project secondary waste is focused on improvements in the Effiuent Treatment Facility. Baseline plans to build a Solidification Treatment Unit adjacent to Effluent Treatment Facility should be enhanced to improve solid waste performance and mitigate corrosion of tanks and piping supporting the Effiuent Treatment Facility evaporator. This approach provides a life-cycle benefit to solid waste performance and reduction of groundwater contaminants.

  18. [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.

  19. Optimal management strategies for placenta accreta.

    PubMed

    Eller, A G; Porter, T F; Soisson, P; Silver, R M

    2009-04-01

    To determine which interventions for managing placenta accreta were associated with reduced maternal morbidity. Retrospective cohort study. Two tertiary care teaching hospitals in Utah. All identified cases of placenta accreta from 1996 to 2008. Cases of placenta accreta were identified using standard ICD-9 codes for placenta accreta, placenta praevia, and caesarean hysterectomy. Medical records were then abstracted for maternal medical history, hospital course, and maternal and neonatal outcomes. Maternal and neonatal complications were compared according to antenatal suspicion of accreta, indications for delivery, preoperative preparation, attempts at placental removal before hysterectomy, and hypogastric artery ligation. Early morbidity (prolonged maternal intensive care unit admission, large volume of blood transfusion, coagulopathy, ureteral injury, or early re-operation) and late morbidity (intra-abdominal infection, hospital re-admission, or need for delayed re-operation). Results Seventy-six cases of placenta accreta were identified. When accreta was suspected, scheduled caesarean hysterectomy without attempting placental removal was associated with a significantly reduced rate of early morbidity compared with cases in which placental removal was attempted (67 versus 36%, P=0.038). Women with preoperative bilateral ureteric stents had a lower incidence of early morbidity compared with women without stents (18 versus 55%, P=0.018). Hypogastric artery ligation did not reduce maternal morbidity. Scheduled caesarean hysterectomy with preoperative ureteric stent placement and avoiding attempted placental removal are associated with reduced maternal morbidity in women with suspected placenta accreta.

  20. Future strategies in the management of coronary artery disease.

    PubMed

    Schwitter, Jürg

    2006-09-01

    New diagnostic techniques have now become available that will enable us to obtain information on coronary artery disease (CAD), which was not previously possible. This is urgently needed, since changes in CAD management are highly desirable considering that up to 60% of patients die due to an insufficient diagnostic strategy (reactive strategy). In this article, the pathophysiology of CAD and the evidence of current concepts on coronary atherosclerosis are critically reviewed. Consequently, a shift from a 'reactive strategy' of CAD management to an active strategy is proposed in order to detect and treat patients before acute myocardial infarcts occur. Reliability, repeatability, cost-effectiveness and comfort are important features of an optimal test for this active strategy. This perspective gives an overview of current and future tests with respect to these features. The novel tomographic techniques are particularly promising with respect to standardization and reproducibility, which will set the basis for the determination of test performance and, consequently, cost-effectiveness. Assessment of cost-effectiveness is increasingly important, since prevalence of CAD is high and will most likely increase, while resources will remain restricted in most countries. Considering these economic restrictions, this article also proposes new mathematical tools using data from prospective trials and large international registries as an objective means to select the best tests for CAD diagnosis and management, and to identify those patient subsets which benefit most from an active strategy.

  1. 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…

  2. Model predictive control power management strategies for HEVs: A review

    NASA Astrophysics Data System (ADS)

    Huang, Yanjun; Wang, Hong; Khajepour, Amir; He, Hongwen; Ji, Jie

    2017-02-01

    This paper presents a comprehensive review of power management strategy (PMS) utilized in hybrid electric vehicles (HEVs) with an emphasis on model predictive control (MPC) based strategies for the first time. Research on MPC-based power management systems for HEVs has intensified recently due to its many inherent merits. The categories of the existing PMSs are identified from the latest literature, and a brief study of each type is conducted. Then, the MPC approach is introduced and its advantages are discussed. Based on the acquisition method of driver behavior used for state prediction and the dynamic model used, the MPC is classified and elaborated. Factors that affect the performance of the MPC are put forward, including prediction accuracy, design parameters, and solvers. Finally, several important issues in the application of MPC-based power management strategies and latest developing trends are discussed. This paper not only provides a comprehensive analysis of MPC-based power management strategies for HEVs but also puts forward the future and emphasis of future study, which will promote the development of energy management controller with high performance and low cost for HEVs.

  3. Current strategies for endoscopic management of acute cholangitis.

    PubMed

    Isayama, Hiroyuki; Yasuda, Ichiro; Tan, Damien

    2017-04-01

    At the pancreatobiliary session of Endoscopic Forum Japan (EFJ) 2016, current strategies for the endoscopic management of acute cholangitis were discussed. The topics consisted of two major parts, namely endoscopic management of acute cholangitis caused by common bile duct stones (CBDS) and biliary stent occlusion. Endoscopists from nine Japanese high-volume centers along with two overseas centers participated in the questionnaires and discussion. Strategies for management of cholangitis due to CBDS were agreed upon, and the clinical guideline of acute cholangitis (Tokyo guidelines 2013) was accepted. The best timing for drainage in Grade 2 (moderate) cholangitis urgent or early (<24 h) was inconclusive, and more data is required on this issue. Another controversy was the feasibility of one step stone extraction in the patient with cholangitis vs stone removal after the cholangitis had resolved. There were various opinions with regards to the management of acute cholangitis due to stent occlusion, and the strategies differed according to the stricture location (distal or hilar) and stent type initially placed (Covered or uncovered metal stent). Strategies for management of cholangitis caused by CBD stones are well established according to the TG13. More evidence is required before further recommendations can be made with regards to cholangitis due to stent occlusion. We aim to clarify this in the near future with questionnaires and consensus from experts. © 2017 The Authors. Digestive Endoscopy © 2017 Japan Gastroenterological Endoscopy Society.

  4. Management Strategies for Skull Base Inverted Papilloma.

    PubMed

    Grayson, Jessica W; Khichi, Sunny S; Cho, Do-Yeon; Riley, Kristen O; Woodworth, Bradford A

    2016-07-01

    Inverted papilloma attached to the ventral skull base presents a surgical dilemma because surgical removal of the bony pedicle is critical to decrease risk of recurrence. The objective of this study is to evaluate the effectiveness of endoscopic management of skull base inverted papilloma. Case series with planned data collection. Tertiary medical center. Patients with skull base inverted papilloma. Over 7 years, 49 patients with skull base inverted papilloma were referred for surgical resection. Demographics, operative technique, pathology, complications, recurrence, and postoperative follow-up were evaluated. Average age at presentation was 57 years. Twenty-six patients (53%) had prior attempts at resection elsewhere, and 5 had squamous cell carcinoma (SCCA) arising in an inverted papilloma. Six patients (12%) suffered major complications, including skull base osteomyelitis in 2 previously irradiated patients, cerebrospinal fluid leak with pneumocephalus (n = 1), meningitis (n = 1), invasive fungal sinusitis (n = 1), and cerebrovascular accident (n = 1). The mean disease-free interval was 29 months (range, 10-78 months). One patient with SCCA recurred in the nasopharynx (overall 2% recurrence rate). He is disease-free 3 years following endoscopic nasopharyngectomy. Three patients with SCCA had endoscopic resection of the skull base, while 1 subject with inverted papilloma pedicled on the superior orbital roof had an osteoplastic flap in conjunction with a Draf III procedure. All others received endoscopic resection. Removal of the bony pedicle resulted in excellent local control of skull base inverted papillomas. Our experience demonstrates that disease eradication with limited morbidity is attainable with this approach. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  5. Strategies to improve outcomes from operative childhood management of DDH.

    PubMed

    Wedge, John H; Kelley, Simon P

    2012-07-01

    The operative management of DDH is technically challenging. To achieve excellent results, surgeons need to select the most appropriate operative treatment, minimize the risk of complications, and be aggressive in the management of serious complications, such as redislocation and AVN, when they occur. We have described specific steps and strategies to assist in each of these key steps. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. Role of Emotional Intelligence in Conflict Management Strategies of Nurses.

    PubMed

    Başoğul, Ceyda; Özgür, Gönül

    2016-09-01

    This study analyzes the emotional intelligence levels and conflict management strategies of nurses and the association between them. This cross-sectional, descriptive study was conducted with 277 nurses in a stratified random sample from a university hospital in Turkey. The data were collected from nurses who gave their informed consent to participate using a personal information form, the Rahim Organizational Conflict Inventory-II and Bar-On's Emotional Quotient Inventory (EQ-I). Data were assessed by descriptive statistics, t tests, and Pearson correlation analyses, using SPSS software. The levels of the nurses' strategies were as follows: avoiding (M = 2.98), dominating (M = 2.76), and obliging (M = 2.71) were medium; compromising (M = 1.99) and integration (M = 1.96) were low. The levels of the emotional intelligence of nurses (mean = 2.75) were medium on a 5-point scale. Integration (r = .168), obliging (r = .25), dominating (r = .18), and compromising (r = .33), which are conflict management strategies, were positively correlated with scores of emotional intelligence, and avoiding (r = -.25) was negatively correlated with scores of emotional intelligence (p < .05). The study determined that nurses' emotional intelligence affects conflict management strategies. To use effective strategies in conflict management, nurses must develop emotional intelligence. Training programs on conflict management and emotional intelligence are needed to improve effective conflict management in healthcare facilities. Copyright © 2016. Published by Elsevier B.V.

  7. A survey of managed care strategies for pregnant smokers.

    PubMed

    Barker, D C; Robinson, L A; Rosenthal, A C

    2000-01-01

    The purpose of this study was to measure the content and comprehensiveness of pregnancy specific smoking cessation strategies within managed care organisations (MCOs) responding affirmatively to the national 1997-98 Addressing Tobacco in Managed Care (ATMC) survey. This cross sectional follow up study consisted of a fax survey sent to medical directors and a 37 question telephone survey of program overseers about the smoking cessation strategy. 147 MCOs identifying a pregnancy specific smoking cessation strategy on the 1997-98 ATMC survey served as the initial sample; 88 MCOs of 128 eligible plans completed both components, with a response rate of 69%. Pregnancy specific smoking cessation strategies varied. 40% of respondents used the Agency for Health Care Policy and Research guidelines for clinical smoking cessation to design their strategy. Strategies included self help materials, quit classes, telephone support and brief counselling by providers, linkages to quality improvement efforts, and use of patient databases for outreach. Only 42% offered a postpartum relapse prevention element. Lack of patient interest, competing clinic priorities, and the lack of a smoker identification system were the most problematic barriers to implementing strategies, common to at least a quarter of respondents. A majority ranked best practice manuals and web site linkages as the most useful form of technical assistance, followed by peer-to-peer counselling, regional workshops, newsletters, on-site assistance, and national conferences. The survey provides the first profile of prenatal tobacco treatment strategies in managed care. While design limitations prevent generalisation of these results to all MCOs, such information can help guide technical assistance to plans interested in reducing smoking among pregnant women.

  8. How Managers' everyday decisions create or destroy your company's strategy.

    PubMed

    Bower, Joseph L; Gilbert, Clark G

    2007-02-01

    Senior executives have long been frustrated by the disconnection between the plans and strategies they devise and the actual behavior of the managers throughout the company. This article approaches the problem from the ground up, recognizing that every time a manager allocates resources, that decision moves the company either into or out of alignment with its announced strategy. A well-known story--Intel's exit from the memory business--illustrates this point. When discussing what businesses Intel should be in, Andy Grove asked Gordon Moore what they would do if Intel were a company that they had just acquired. When Moore answered, "Get out of memory," they decided to do just that. It turned out, though, that Intel's revenues from memory were by this time only 4% of total sales. Intel's lower-level managers had already exited the business. What Intel hadn't done was to shut down the flow of research funding into memory (which was still eating up one-third of all research expenditures); nor had the company announced its exit to the outside world. Because divisional and operating managers-as well as customers and capital markets-have such a powerful impact on the realized strategy of the firm, senior management might consider focusing less on the company's formal strategy and more on the processes by which the company allocates resources. Top managers must know the track record of the people who are making resource allocation proposals; recognize the strategic issues at stake; reach down to operational managers to work across division lines; frame resource questions to reflect the corporate perspective, especially when large sums of money are involved and conditions are highly uncertain; and create a new context that allows top executives to circumvent the regular resource allocation process when necessary.

  9. Setting priorities for waste management strategies in developing countries.

    PubMed

    Brunner, Paul H; Fellner, Johann

    2007-06-01

    This study aimed to determine whether the waste management systems, that are presently applied in affluent countries are appropriate solutions for waste management in less developed regions. For this purpose, three cities (Vienna, Damascus and Dhaka) which differ greatly in their gross domestic product and waste management were compared. The criteria for evaluation were economic parameters, and indicators as to whether the goals of waste management (protection of human health and the environment, the conservation of resources) were reached. Based on case studies, it was found that for regions spending 1-10 Euro capita(-1) year(-1) for waste management, the 'waste hierarchy' of prevention, recycling and disposal is not an appropriate strategy. In such regions, the improvement of disposal systems (complete collection, upgrading to sanitary landfilling) is the most cost-effective method to reach the objectives of solid waste management. Concepts that are widely applied in developed countries such as incineration and mechanical waste treatment are not suitable methods to reach waste management goals in countries where people cannot spend more than 10 Euro per person for the collection, treatment and disposal of their waste. It is recommended that each region first determines its economic capacity for waste management and then designs its waste management system according to this capacity and the goals of waste management.

  10. Management Strategies for Transition to Sustainable Agricultural Irrigation

    NASA Astrophysics Data System (ADS)

    Ahlfeld, D.; Mulligan, K.; Brown, C. M.; Yang, Y. E.

    2011-12-01

    In many agricultural regions of the world, aquifer overdrafting for agricultural irrigation continues. Management strategies are investigated that transition from this unsustainable use of water to a future, diminished use of irrigation. Complications arising from climate change and volatile energy prices are considered. A command and control strategy is modeled using combined simulation and optimization techniques. This strategy is compared with market based mechanisms such as cap and trade and Pigouvian pricing that are modeled using agent based methods. The formulations are designed to model the effects of different management strategies including those that seek to avoid rapid changes in basin-wide water utilization (considered a surrogate for agricultural production) over this time period. Formulations also include limits on total reduction in aquifer storage and controls on streamflow in the basin. The management formulations used in this study are developed for planning horizons of 50 to 100 years and use the Republican River Basin in the High Plains Aquifer as a case study. Historical and climate-adjusted recharge patterns are considered. Spatial and temporal variation in total irrigated acreage and the aquifer storage change determined by the solutions of the management formulations are analyzed and presented.

  11. 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…

  12. Strategies for Talent Management: Greater Philadelphia Companies in Action

    ERIC Educational Resources Information Center

    Council for Adult and Experiential Learning (NJ1), 2008

    2008-01-01

    Human capital is one of the critical issues that impacts the Greater Philadelphia region's ability to grow and prosper. The CEO Council for Growth (CEO Council) is committed to ensuring a steady and talented supply of quality workers for this region. "Strategies for Talent Management: Greater Philadelphia Companies in Action" provides…

  13. Evolution in clinical knowledge management strategy at Intermountain Healthcare.

    PubMed

    Hulse, Nathan C; Galland, Joel; Borsato, Emerson P

    2012-01-01

    In this manuscript, we present an overview of the clinical knowledge management strategy at Intermountain Healthcare in support of our electronic medical record systems. Intermountain first initiated efforts in developing a centralized enterprise knowledge repository in 2001. Applications developed, areas of emphasis served, and key areas of focus are presented. We also detail historical and current areas of emphasis, in response to business needs.

  14. 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…

  15. Role Management Strategies of Beginning Teachers in Hong Kong

    ERIC Educational Resources Information Center

    Choi, Pik Lin; Tang, Sylvia Yee Fan

    2005-01-01

    Beginning teachers encounter new challenges as the role system in contemporary society has become more and more demanding. By means of the life history method, role management strategies of four Hong Kong beginning teachers employed to cope with role demands and intra-role conflicts were located in their biographical, workplace and wider…

  16. 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…

  17. Managing Work and Family: Do Control Strategies Help?

    ERIC Educational Resources Information Center

    Versey, H. Shellae

    2015-01-01

    How can we effectively manage competing obligations from work and family without becoming overwhelmed? This question inspires the current study by examining control strategies that may facilitate better work-life balance, with a specific focus on the role of lowered aspirations and positive reappraisals, attitudes that underlie adaptive coping…

  18. Sources of Faculty Stress and Strategies for Its Management.

    ERIC Educational Resources Information Center

    Larkin, Paul; Clagett, Craig

    Views on sources of stress on college faculty and strategies for its management were obtained at small-group sessions in the 1980 faculty orientation at Prince George's Community College, Maryland. Sixteen faculty groups generated 218 responses expressing sources of job stress, a complete listing of which is appended. The responses were aggregated…

  19. The creative process in biomedical visualization: strategies and management.

    PubMed

    Anderson, P A

    1990-01-01

    The phases of the creative process (identification, preparation, incubation, insight, and elaboration/verification) are related to strategies for management of biomedical illustration projects. The idea that creativity is a mystery--and is unpredictable and uncontrollable--is not accepted. This article presents a practical way to encourage creative thinking in the biomedical visualization studio.

  20. 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…

  1. Designs, Management Tactics, and Strategies in Asynchronous Learning Discussions.

    ERIC Educational Resources Information Center

    Tu, Chih-Hsiung; Corry, Michael

    2003-01-01

    Discusses effective designs, management tactics, and strategies to produce ideal asynchronous network discussions that allow contemplation and encourage the development of critical thinking. A model of an online collaborative learning community is applied to implement the designs. A sample of online collaborative moderation guidelines is…

  2. 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…

  3. Strategic Enrollment Management: Core Strategies and Best Practices

    ERIC Educational Resources Information Center

    Bontrager, Bob

    2004-01-01

    This second of a two-part series builds on the core concepts and structural considerations discussed in the first part (in the Winter 2004 issue of "College and University") to identify the core strategies and best practices that characterize successful enrollment management (SEM) organizations. Successful SEM operations place a high premium on…

  4. Managing Student Participation: Teacher Strategies in a Virtual EFL Course

    ERIC Educational Resources Information Center

    Wang, Airong

    2014-01-01

    This paper aims to explore teacher strategies for managing student participation in a complex Multi-user Virtual Environment. Data include transcribed recordings from a task-based EFL course in Second Life. Conversational Analysis is adopted to analyze the teacher's verbal language output in the transcript, and a student questionnaire is used to…

  5. 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…

  6. San Francisco Bay Long Term Management Strategy for Dredging

    EPA Pesticide Factsheets

    The San Francisco Bay Long Term Management Strategy (LTMS) is a cooperative effort to develop a new approach to dredging and dredged material disposal in the San Francisco Bay area. The LTMS serves as the Regional Dredging Team for the San Francisco area.

  7. Managing Work and Family: Do Control Strategies Help?

    ERIC Educational Resources Information Center

    Versey, H. Shellae

    2015-01-01

    How can we effectively manage competing obligations from work and family without becoming overwhelmed? This question inspires the current study by examining control strategies that may facilitate better work-life balance, with a specific focus on the role of lowered aspirations and positive reappraisals, attitudes that underlie adaptive coping…

  8. Insecticide Resistance and Management Strategies in Urban Ecosystems

    PubMed Central

    Zhu, Fang; Lavine, Laura; O’Neal, Sally; Lavine, Mark; Foss, Carrie; Walsh, Douglas

    2016-01-01

    The increased urbanization of a growing global population makes imperative the development of sustainable integrated pest management (IPM) strategies for urban pest control. This emphasizes pests that are closely associated with the health and wellbeing of humans and domesticated animals. Concurrently there are regulatory requirements enforced to minimize inadvertent exposures to insecticides in the urban environment. Development of insecticide resistance management (IRM) strategies in urban ecosystems involves understanding the status and mechanisms of insecticide resistance and reducing insecticide selection pressure by combining multiple chemical and non-chemical approaches. In this review, we will focus on the commonly used insecticides and molecular and physiological mechanisms underlying insecticide resistance in six major urban insect pests: house fly, German cockroach, mosquitoes, red flour beetle, bed bugs and head louse. We will also discuss several strategies that may prove promising for future urban IPM programs. PMID:26751480

  9. Current Management Strategy for Active Surveillance in Prostate Cancer.

    PubMed

    Syed, Jamil S; Javier-Desloges, Juan; Tatzel, Stephanie; Bhagat, Ansh; Nguyen, Kevin A; Hwang, Kevin; Kim, Sarah; Sprenkle, Preston C

    2017-02-01

    Active surveillance has been increasingly utilized as a strategy for the management of favorable-risk, localized prostate cancer. In this review, we describe contemporary management strategies of active surveillance, with a focus on traditional stratification schemes, new prognostic tools, and patient outcomes. Patient selection, follow-up strategy, and indication for delayed intervention for active surveillance remain centered around PSA, digital rectal exam, and biopsy findings. Novel tools which include imaging, biomarkers, and genetic assays have been investigated as potential prognostic adjuncts; however, their role in active surveillance remains institutionally dependent. Although 30-50% of patients on active surveillance ultimately undergo delayed treatment, the vast majority will remain free of metastasis with a low risk of dying from prostate cancer. The optimal method for patient selection into active surveillance is unknown; however, cancer-specific mortality rates remain excellent. New prognostication tools are promising, and long-term prospective, randomized data regarding their use in active surveillance will be beneficial.

  10. Communication strategies and volunteer management for the IAU-OAD

    NASA Astrophysics Data System (ADS)

    Sankatsing Nava, Tibisay

    2015-08-01

    The IAU Office of Astronomy for Development will be developing a new communication strategy to promote its projects in a way that is relevant to stakeholders and the general public. Ideas include a magazine featuring best practices within the field of astronomy for development and setting up a workflow of communication that integrates the different outputs of the office and effectively uses the information collection tools developed by OAD team members.To accomplish these tasks the OAD will also develop a community management strategy with existing tools to effectively harness the skills of OAD volunteers for communication purposes. This talk will discuss the new communication strategy of the OAD as well the expanded community management plans.

  11. Patient Experience Shows Little Relationship with Hospital Quality Management Strategies

    PubMed Central

    Groene, Oliver; Arah, Onyebuchi A.; Klazinga, Niek S.; Wagner, Cordula; Bartels, Paul D.; Kristensen, Solvejg; Saillour, Florence; Thompson, Andrew; Thompson, Caroline A.; Pfaff, Holger; DerSarkissian, Maral; Sunol, Rosa

    2015-01-01

    Objectives Patient-reported experience measures are increasingly being used to routinely monitor the quality of care. With the increasing attention on such measures, hospital managers seek ways to systematically improve patient experience across hospital departments, in particular where outcomes are used for public reporting or reimbursement. However, it is currently unclear whether hospitals with more mature quality management systems or stronger focus on patient involvement and patient-centered care strategies perform better on patient-reported experience. We assessed the effect of such strategies on a range of patient-reported experience measures. Materials and Methods We employed a cross-sectional, multi-level study design randomly recruiting hospitals from the Czech Republic, France, Germany, Poland, Portugal, Spain, and Turkey between May 2011 and January 2012. Each hospital contributed patient level data for four conditions/pathways: acute myocardial infarction, stroke, hip fracture and deliveries. The outcome variables in this study were a set of patient-reported experience measures including a generic 6-item measure of patient experience (NORPEQ), a 3-item measure of patient-perceived discharge preparation (Health Care Transition Measure) and two single item measures of perceived involvement in care and hospital recommendation. Predictor variables included three hospital management strategies: maturity of the hospital quality management system, patient involvement in quality management functions and patient-centered care strategies. We used directed acyclic graphs to detail and guide the modeling of the complex relationships between predictor variables and outcome variables, and fitted multivariable linear mixed models with random intercept by hospital, and adjusted for fixed effects at the country level, hospital level and patient level. Results Overall, 74 hospitals and 276 hospital departments contributed data on 6,536 patients to this study (acute

  12. Forty project management strategies for the medical practice staff.

    PubMed

    Hills, Laura Sachs

    2010-01-01

    Most every medical practice will embark at one time or another on a large and complex new project. The practice may, for instance, undertake a project in office construction or renovation, practice expansion, new technology, or a new large-scale event. The medical practice staff may find itself creating the project plan, overseeing its execution, and working through the plan day to day until its completion. In short, the staff may find itself responsible for project management. This article contains 40 specific, easy-to-implement project management strategies medical practice employees can use to manage both the large and small projects they undertake on behalf of the practice. It suggests effective project management strategies the staff can use before the onset of a new project as well as strategies to help define the project, to deliver the project, and to close and review the project. This article also describes five reasons medical practices often fail at project management and suggests more effective approaches that will ensure that the projects the medical practice undertakes are completed well, on time, and within budget.

  13. Integrated Management of Childhood Illness (IMCI): a robust strategy.

    PubMed

    Patwari, A K; Raina, Neena

    2002-01-01

    Integrated Management of Childhood Illness (IMCI), a strategy fostering holistic approach to child health and development, is built upon successful experiences gained from effective child health interventions like immunization, oral rehydration therapy, management of acute respiratory infections and improved infant feeding. The core intervention of IMCI is integrated management of the five most important causes of childhood deaths-acute respiratory infections, diarrheal diseases, measles, malaria and malnutrition. Using a set of interventions for the integrated treatment and prevention of major childhood illnesses, the IMCI strategy aims to reduce death as well as the frequency and severity of illness and disability, thus contributing to improved growth and development. In health facilities, the IMCI strategy promotes the accurate identification of childhood illness (es) in the outpatient settings, ensures appropriate combined treatment of all major illnesses, strengthens the counselling of caretakers and the provision of preventive services, and speeds up the referral of severely ill children. The strategy also aims to improve the quality of care of sick children at the referral level. It also creates a scientifically sound link between the management guidelines at the community level and the management approach in a referral centre. The strategy also envisages actual situations when referral is not possible and offers the best possible options in such circumstances. In the home setting, it promotes appropriate early home care and care-seeking, improved nutrition and prevention, and the correct implementation of prescribed care. In addition to its focus on treatment of illness in the health facility as well as at home, it also provides an opportunity for important preventive interventions such as immunization and improved infant and child nutrition including breastfeeding. The IMCI strategy reduces wastage of resources and avoids duplication of efforts that may

  14. Managing burned landscapes: Evaluating future management strategies for resilient forests under a warming climate

    Treesearch

    K. L. Shive; P. Z. Fule; C. H. Sieg; B. A. Strom; M. E. Hunter

    2014-01-01

    Climate change effects on forested ecosystems worldwide include increases in drought-related mortality, changes to disturbance regimes and shifts in species distributions. Such climate-induced changes will alter the outcomes of current management strategies, complicating the selection of appropriate strategies to promote forest resilience. We modelled forest growth in...

  15. Evaluation of two communication strategies to improve udder health management.

    PubMed

    Jansen, J; Renes, R J; Lam, T J G M

    2010-02-01

    Worldwide, programs to improve udder health are implemented using communication tools and methods that inform and persuade dairy farmers. This study evaluated 2 communication strategies used in a mastitis control program in the Netherlands. To improve farmers' udder health management, tools such as instruction cards, treatment plans, checklists and software were developed following an argument-based comprehensive "central route." These tools were used during on-farm study group meetings for farmers organized by veterinarians and also during individual veterinarian-farmer interactions. The second strategy aimed at adopting a single management practice to increase the use of milking gloves during milking. This approach followed a straightforward "peripheral" route that used implicit persuasion techniques. Results of an online survey of 374 Dutch dairy farmers showed that most farmers were able and willing to use the educational management tools to increase udder health on their farms. They evaluated the tools positively regardless of the mastitis problems on their farms. This seems to indicate that the central route of communication is most effective when farmers are motivated to work on udder health in general. Results of repeated random telephone surveys before, during, and after the campaign on the use of milking gloves showed that the use of gloves increased from 20.9 to 42.0% of the respondents. Respondents' opinions about milking gloves also changed favorably, indicating that a relatively short peripheral campaign on a single action can have a sustained effect on farmers' behavior. Both communication strategies seem to be potentially successful in disseminating knowledge to a specific target group of farmers and in changing that group's behavior. However, to reach as many farmers as possible, the strategies should be combined. When optimizing these strategies, both the farmers' motivation to work on udder health and the aim of the campaign should be considered

  16. Management of constipation in the elderly: emerging therapeutic strategies.

    PubMed

    Kapoor, Shailendra

    2008-09-07

    A number of new, novel strategies for managing constipation in the elderly have emerged over the past few years. Prucalopride is one such new agent that is highly efficacious in managing chronic constipation. In fact, Camilleri et al in a recent study reported that the average number of bowel movements increased by at least one in nearly 47% of the patients who were administered a dose of 4 mg. Lubiprostone is another new agent recently approved by the FDA that shows efficacy in managing the symptoms of constipation. Neostigmine has also been successfully used for the management of recalcitrant constipation. Most of these studies have used subcutaneous neostigmine. Symbiotic yogurt containing components, such as Bifidobacterium and fructoligosaccharide, have also been recently shown to be highly effective in improving symptoms of constipation. Elderly patients especially those in hospices and nursing homes are often on opioids for pain management. Constipation secondary to opioid use is extremely common in nursing homes. Subcutaneous methylnaltrexone has recently been shown to be highly effective in the management of opioid-related constipation, and was recently approved by the FDA. Sacral nerve stimulation is another emerging strategy. A recent analysis by Mowatt et al supports the efficacy of this technique. Botulinum toxin is another agent that has already been successfully used for the management of chronic, refractory constipation in children and may be very effective for elderly constipation. Further larger studies are needed to confirm the findings noted in these studies. Constipation is clearly a major issue in the elderly and these new, emerging strategies will hopefully improve the quality of life and relieve the symptoms of constipation in this population.

  17. Climate change adaptation strategies for resource management and conservation planning.

    PubMed

    Lawler, Joshua J

    2009-04-01

    Recent rapid changes in the Earth's climate have altered ecological systems around the globe. Global warming has been linked to changes in physiology, phenology, species distributions, interspecific interactions, and disturbance regimes. Projected future climate change will undoubtedly result in even more dramatic shifts in the states of many ecosystems. These shifts will provide one of the largest challenges to natural resource managers and conservation planners. Managing natural resources and ecosystems in the face of uncertain climate requires new approaches. Here, the many adaptation strategies that have been proposed for managing natural systems in a changing climate are reviewed. Most of the recommended approaches are general principles and many are tools that managers are already using. What is new is a turning toward a more agile management perspective. To address climate change, managers will need to act over different spatial and temporal scales. The focus of restoration will need to shift from historic species assemblages to potential future ecosystem services. Active adaptive management based on potential future climate impact scenarios will need to be a part of everyday operations. And triage will likely become a critical option. Although many concepts and tools for addressing climate change have been proposed, key pieces of information are still missing. To successfully manage for climate change, a better understanding will be needed of which species and systems will likely be most affected by climate change, how to preserve and enhance the evolutionary capacity of species, how to implement effective adaptive management in new systems, and perhaps most importantly, in which situations and systems will the general adaptation strategies that have been proposed work and how can they be effectively applied.

  18. Leadership Strategies of Performance Measures Impacts in Public Sector Management: A National Content Analysis.

    ERIC Educational Resources Information Center

    Kubala, James Joseph

    A quantitative and qualitative study examined three leadership strategies found in performance-based management (human resource, scientific management and political strategies used in public sector management); a framework by which performance measurement (PM) supports leadership strategies; and how the strategies impact PM. It examined leadership…

  19. The Effectiveness of Time Management Strategies Instruction on Students' Academic Time Management and Academic Self Efficacy

    ERIC Educational Resources Information Center

    Kader, Fathi Abdul Hamid Abdul; Eissa, Mourad Ali

    2015-01-01

    This study investigated the effect of using time management strategies instruction on improving first year learning disabled students' academic time management and academic self efficacy. A total of 60 students identified with LD participated. The sample was divided into two groups; experimental (n = 30 boys) and control (n = 30 boys). ANCOVA and…

  20. Perceived barriers and effective strategies to diabetes self-management.

    PubMed

    Nagelkerk, Jean; Reick, Kay; Meengs, Leona

    2006-04-01

    This paper reports the perceived barriers to and effective strategies for self-management of adults with type 2 diabetes in a rural setting. Worldwide, diabetes is a major public health concern and financial burden. Research shows that, for people with diabetes, adhering to programs of self-care is often problematic. Despite the potential for improved metabolic control and quality of life, little is published on the barriers and effective strategies that people with diabetes successfully use to incorporate plans of care into their lifestyles. Twenty-four adults diagnosed with type 2 diabetes were recruited from a rural primary care practice to participate in one of three audiotaped focus groups. Content analysis was conducted on the focus group transcripts and validity was strengthened through independent rankings of barriers and strategies by an expert panel and by the nurse researchers. The data were collected 2002. The most frequently reported barriers were lack of knowledge of a specific diet plan, lack of understanding of the plan of care and helplessness and frustration from lack of glycaemic control and continued disease progression despite adherence. Effective strategies identified were developing a collaborative relationship with a provider, maintaining a positive attitude that prompts proactive learning and having a support person who provides encouragement and promotes accountability. These data highlight the importance of barrier and strategy identification in developing and implementing realistic self-management plans and the significance of collaborative alliances between patients and practitioners. Awareness of barriers, identification of strategies to overcome obstacles and the opportunity to problem solve with practitioners assists patients in managing a chronic illness that requires numerous daily decisions.

  1. Why Leading Consumer Product Companies Develop Proactive Chemical Management Strategies.

    PubMed

    Scruggs, Caroline E; Van Buren, Harry J

    2016-05-01

    Scholars have studied the various pressures that companies face related to socially responsible behavior when stakeholders know the particular social issues under consideration. Many have examined social responsibility in the context of environmental responsibility and the general approaches companies take regarding environmental management. The issue of currently unregulated, but potentially hazardous, chemicals in consumer products is not well understood by the general public, but a number of proactive consumer product companies have voluntarily adopted strategies to minimize use of such chemicals. These companies are exceeding regulatory requirements by restricting from their products chemicals that could harm human or environmental health, despite the fact that these actions are costly. They do not usually advertise the details of their strategies to end consumers. This article uses interviews with senior environmental directors of 20 multinational consumer product companies to investigate why these companies engage in voluntary chemicals management. The authors conclude that the most significant reasons are to achieve a competitive advantage and stay ahead of regulations, manage relationships and maintain legitimacy with stakeholders, and put managerial values into practice. Many of the characteristics related to the case of chemicals management are extendable to other areas of stakeholder management in which risks to stakeholders are either unknown or poorly understood.

  2. Specialty pharmacy cost management strategies of private health care payers.

    PubMed

    Stern, Debbie; Reissman, Debi

    2006-01-01

    The rate of increase in spending on specialty pharmaceuticals is outpacing by far the rate of increase in spending for other drugs. To explore the strategies payers are using in response to challenges related to coverage, cost, clinical management, and access of specialty pharmaceuticals and to describe the potential implications for key stakeholders, including patients, physicians, and health care purchasers. Sources of information were identified in the course of providing consulting services in the subject area of specialty pharmaceuticals to health plans, pharmacy benefit managers, employers, and pharmaceutical manufacturers. Specialty pharmaceuticals represent the fastest growing segment of drug spending due to new product approvals, high unit costs, and increasing use. Health care payers are faced with significant challenges related to coverage, cost, clinical management, and access. A variety of short- and long-term strategies have been employed to address these challenges. Current management techniques for specialty pharmaceuticals often represent a stop-gap approach for controlling rising drug costs. Optimum cost and care management methods will evolve as further research identifies the true clinical and economic value of various specialty pharmaceuticals.

  3. Why Leading Consumer Product Companies Develop Proactive Chemical Management Strategies

    PubMed Central

    Scruggs, Caroline E.; Van Buren, Harry J.

    2014-01-01

    Scholars have studied the various pressures that companies face related to socially responsible behavior when stakeholders know the particular social issues under consideration. Many have examined social responsibility in the context of environmental responsibility and the general approaches companies take regarding environmental management. The issue of currently unregulated, but potentially hazardous, chemicals in consumer products is not well understood by the general public, but a number of proactive consumer product companies have voluntarily adopted strategies to minimize use of such chemicals. These companies are exceeding regulatory requirements by restricting from their products chemicals that could harm human or environmental health, despite the fact that these actions are costly. They do not usually advertise the details of their strategies to end consumers. This article uses interviews with senior environmental directors of 20 multinational consumer product companies to investigate why these companies engage in voluntary chemicals management. The authors conclude that the most significant reasons are to achieve a competitive advantage and stay ahead of regulations, manage relationships and maintain legitimacy with stakeholders, and put managerial values into practice. Many of the characteristics related to the case of chemicals management are extendable to other areas of stakeholder management in which risks to stakeholders are either unknown or poorly understood. PMID:27471326

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

    NASA Astrophysics Data System (ADS)

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

    2015-04-01

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

  5. Management strategies and financial performance in rural and urban hospitals.

    PubMed

    Wang, B B; Wan, T T; Falk, J A; Goodwin, D

    2001-08-01

    This study identifies the difference in financial performance between rural and urban hospitals and examines whether or not that difference may be attributed to the emphasis of revenue enhancement over cost management strategies. Hospitals in Virginia were included in this study except for the two state university medical centers. Rural and urban hospitals were compared on 10 performance indicators grouped into four categories: revenues, costs, profits, and productivity. The results suggest that rural hospital profitability is dependent on cost management. Since rural hospitals achieved lower cost, better efficiency and productivity level than urban hospitals in Virginia, they demonstrate a significant higher level of profit.

  6. Financial coping strategies of mental health consumers: managing social benefits.

    PubMed

    Caplan, Mary Ager

    2014-05-01

    Mental health consumers depend on social benefits in the forms of supplemental security income and social security disability insurance for their livelihood. Although these programs pay meager benefits, little research has been undertaken into how this population makes ends meet. Using a qualitative approach, this study asks what are the financial coping strategies of mental health consumers? Seven approaches were identified: subsidies, cost-effective shopping, budgeting, prioritizing, technology, debt management, and saving money. Results illustrate the resourcefulness of mental health consumers in managing meager social benefits and highlight the need to strengthen community mental health efforts with financial capabilities education.

  7. 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.

  8. Aircrew Discourse: Exploring Strategies of Information and Action Management

    NASA Technical Reports Server (NTRS)

    Irwin, Cheryl M.; Veinott, Elizabeth S.; Shafto, Michael G. (Technical Monitor)

    1995-01-01

    This paper explores methodology issues encountered in the analysis of flightcrew communications in aviation simulation research. Examples are provided by two recent studies which are compared on three issues: level of analysis, data definition, and interpretation of the results. The data discussed were collected in a study comparing two levels of aircraft automation. The first example is an investigation of how pilots' information transfer strategies differed as a function of automation during low and high-workload flight phases. The second study focuses on how crews managed actions in the two aircraft during a ten minute, high-workload flight segment. Results indicated that crews in the two aircraft differed in their strategies of information and action management. The differences are discussed in terms of their operational and research significance.

  9. Aircrew Discourse: Exploring Strategies of Information and Action Management

    NASA Technical Reports Server (NTRS)

    Irwin, Cheryl M.; Veinott, Elizabeth S.; Shafto, Michael G. (Technical Monitor)

    1995-01-01

    This paper explores methodology issues encountered in the analysis of flightcrew communications in aviation simulation research. Examples are provided by two recent studies which are compared on three issues: level of analysis, data definition, and interpretation of the results. The data discussed were collected in a study comparing two levels of aircraft automation. The first example is an investigation of how pilots' information transfer strategies differed as a function of automation during low and high-workload flight phases. The second study focuses on how crews managed actions in the two aircraft during a ten minute, high-workload flight segment. Results indicated that crews in the two aircraft differed in their strategies of information and action management. The differences are discussed in terms of their operational and research significance.

  10. International Border Management Systems (IBMS) Program : visions and strategies.

    SciTech Connect

    McDaniel, Michael; Mohagheghi, Amir Hossein

    2011-02-01

    Sandia National Laboratories (SNL), International Border Management Systems (IBMS) Program is working to establish a long-term border security strategy with United States Central Command (CENTCOM). Efforts are being made to synthesize border security capabilities and technologies maintained at the Laboratories, and coordinate with subject matter expertise from both the New Mexico and California offices. The vision for SNL is to provide science and technology support for international projects and engagements on border security.

  11. Evolution in Clinical Knowledge Management Strategy at Intermountain Healthcare

    PubMed Central

    Hulse, Nathan C.; Galland, Joel; Borsato, Emerson P.

    2012-01-01

    In this manuscript, we present an overview of the clinical knowledge management strategy at Intermountain Healthcare in support of our electronic medical record systems. Intermountain first initiated efforts in developing a centralized enterprise knowledge repository in 2001. Applications developed, areas of emphasis served, and key areas of focus are presented. We also detail historical and current areas of emphasis, in response to business needs. PMID:23304309

  12. Run-to-Run Control Strategy for Diabetes Management

    DTIC Science & Technology

    2007-11-02

    quite serious ( diabetic coma), and the long- term implications of varying glucose levels ( nephropathy , retinopathy, and other tissue damage ) have...Trial Re- search Group, \\The e ect of intensive treatment of diabetes on the development and progression of long{term complications in insulin{dependent...1 RUN-TO-RUN CONTROL STRATEGY FOR DIABETES MANAGEMENT F.J. Doyle III1, B. Srinivasan2, and D. Bonvin2 1Department of Chemical Engineering, University

  13. Perioperative pain management strategies among women having reproductive surgeries.

    PubMed

    Prabhu, Malavika; Bortoletto, Pietro; Bateman, Brian T

    2017-08-01

    This review presents opioid-sparing strategies for perioperative pain management among women undergoing reproductive surgeries and procedures. Recommendations are provided regarding the use of nonsteroidal anti-inflammatory drugs, acetaminophen, other adjunctive medications, and regional anesthetic blocks. Additional considerations for chronic opioid users or patients using opioid replacement or antagonist therapy are discussed. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  14. Identification and assessment of containment and release management strategies

    SciTech Connect

    Lehner, J.R.; Lin, C.C.; Neogy, P.

    1990-01-01

    Brookhaven National Laboratory, under the auspices of the US Nuclear Regulatory Commission, is investigating accident management strategies which could help preserve containment integrity or minimize releases during a severe accident. The objective is to make use of existing plant systems and equipment in innovative ways to reduce the likelihood of containment failure or to mitigate the release of fission products to the environment if failure cannot be prevented. Many of the strategies would be implemented during the later stages of a severe accident. The identification and assessment process for containment and release strategies is described, and some insights derived from its application to a BWR Mark 1 plant are presented here. 13 refs., 2 figs.

  15. Managing work and family: Do control strategies help?

    PubMed

    Versey, H Shellae

    2015-11-01

    How can we effectively manage competing obligations from work and family without becoming overwhelmed? This question inspires the current study by examining control strategies that may facilitate better work-life balance, with a specific focus on the role of lowered aspirations and positive reappraisals, attitudes that underlie adaptive coping behaviors. Data from the Midlife in the United States Survey (MIDUS II) were used to explore the relationship between negative spillover, control strategies, and well-being among full-time working men and women (N = 2,091). In this nationally representative sample, findings indicate that while positive reappraisals function as a protective buffer, lowering aspirations exacerbate the relationship between work-family spillover and well-being, with moderating effects stronger among women. This study extends prior research tying work-life conflict to health and mental health, and suggests further investigation is needed to consider types of resources that may be effective coping strategies in balancing work and family.

  16. An environmental analysis for comparing waste management options and strategies.

    PubMed

    Marchettini, N; Ridolfi, R; Rustici, M

    2007-01-01

    The debate on different waste management practices has become an issue of utmost importance as human activities have overloaded the assimilative capacity of the biosphere. Recent Italian law on solid waste management recommends an increase in material recycling and energy recovery, and only foresees landfill disposal for inert materials and residues from recovery and recycling. A correct waste management policy should be based on the principles of sustainable development, according to which our refuse is not simply regarded as something to eliminate but rather as a potential resource. This requires the creation of an integrated waste management plan that makes full use of all available technologies. In this context, eMergy analysis is applied to evaluate three different forms of waste treatment and construct an approach capable of assessing the whole strategy of waste management. The evaluation included how much investment is needed for each type of waste management and how much "utility" is extracted from wastes, through the use of two indicators: Environmental yield ratio (EYR) and Net eMergy. Our results show that landfill is the worst system in terms of eMergy costs and eMergy benefits. Composting is the most efficient system in recovering eMergy (highest EYR) from municipal solid waste (MSW) while incineration is capable of saving the greatest quantity of eMergy per gram of MSW (highest net eMergy). This analysis has made it possible to assess the sustainability and the efficiency of individual options but could also be used to assess a greater environmental strategy for waste management, considering a system that might include landfills, incineration, composting, etc.

  17. Chronic pain management strategies used by low income overweight Latinos

    PubMed Central

    Rutledge, Dana N; Cantero, Patricia J; Ruiz, Jeanette E

    2013-01-01

    Objectives In group interviews, we examined strategies used to manage chronic pain from the perspective of the individual. Methods Sixteen low income overweight Latino adults participated in two group interviews facilitated by a trained moderator who inquired about the type of chronic pain suffered by participants, followed by more specific questions about pain management. Interviews were audio-recorded, transcribed verbatim (Spanish), back-translated into English, and analyzed using thematic analysis. Results Participants’ pain varied in type, location, and intensity. Participants discussed pain-related changes in activities and social life, and difficulties with health care providers, and as a result, we discovered five major themes: Pain-related Life Alterations, Enduring the Pain, Trying Different Strategies, Emotional Suffering, and Encounters with Health Care System/Providers. Discussion Findings indicated that there are opportunities for providers to improve care for low income overweight Latinos with chronic pain by listening respectfully to how pain alters their daily lives and assisting them in feasible self management strategies. PMID:23129787

  18. What are Robust Strategies to Manage Coastal Flooding Risks?

    NASA Astrophysics Data System (ADS)

    Wong, T. E.; Keller, K.

    2016-12-01

    As the climate changes and sea levels rise, the frontiers of environmental science, economics and public policy rely on effectively synthesizing climate data and projections from coupled physical-economic models. Approaches to design coastal flood-risk management strategies are often made under deep uncertainties surrounding the model structure, parameter values, and management objectives. A strategy which is optimal for a specific choice of objectives and model structure may perform quite poorly if this choices turns out to be wrong. A robust decision-making framework can help address this issue by mapping the deeply uncertain trade-offs between objectives. This map can then be used to identify strategies that perform well across a broad range of possible futures and relevant objectives. Here, we use a simple decision-analytical model of coastal flood-risk management to (1) examine the sensitivity of decisions to deeply uncertain projections of sea-levels and storm surges, (2) compare robust and optimal decision-making frameworks and (3) quantify the economic value of sea-level and storm surge information when facing these deep uncertainties.

  19. Delusional infestations: case series, differential diagnoses, and management strategies.

    PubMed

    Diaz, James H; Nesbitt, Lee T

    2014-01-01

    Physicians are not infrequently consulted by distraught patients with delusions of infestation who believe that they are infested with external or internal parasites and describe a crawling sensation of bugs or worms on or under their skin. Internet search engines were queried with the keywords as search terms to examine the latest articles on delusional infestations in order to describe presenting manifestations, differential diagnoses, and effective management strategies. The demographic and behavioral features of delusional infestations have remained constant and include: (1) onset in well-educated, middle-aged adults who are pet owners; (2) production of purported specimens of causative parasites; (3) pesticide overtreatment of themselves, their households, and pets; (4) excessive cleaning or vacuuming of households; (5) intense anger and resentment directed at physicians failing to confirm their self-diagnoses; and (6) sharing delusional symptoms with spouses or relatives. Although some reports have suggested that cases of delusional infestation are increasing today in the tropics, most studies have confirmed a stable incidence over time and similar disorder demographics worldwide. However, management strategies for delusional infestations have changed significantly over time with second generation, atypical antipsychotics offering safer adverse effect profiles and better prognoses than earlier therapies with first generation, typical antipsychotics. The most effective management strategies for delusional infestations include empathetic history-taking and active listening to the patient, careful exclusion of true parasitoses, and a therapeutic regimen that includes a second generation neuroleptic agent.

  20. Multidisciplinary strategies in the management of early chronic kidney disease.

    PubMed

    Martínez-Ramírez, Héctor R; Cortés-Sanabria, Laura; Rojas-Campos, Enrique; Hernández-Herrera, Aurora; Cueto-Manzano, Alfonso M

    2013-11-01

    Chronic kidney disease (CKD) is a worldwide epidemic especially in developing countries, with clear deficiencies in identification and treatment. Better care of CKD requires more than only economic resources, utilization of health research in policy-making and health systems changes that produce better outcomes. A multidisciplinary approach may facilitate and improve management of patients from early CKD in the primary health-care setting. This approach is a strategy for improving comprehensive care, initiating and maintaining healthy behaviors, promoting teamwork, eliminating barriers to achieve goals and improving the processes of care. A multidisciplinary intervention may include educational processes guided by health professional, use of self-help groups and the development of a CKD management plan. The complex and fragmented care management of patients with CKD, associated with poor outcome, enhances the importance of implementing a multidisciplinary approach in the management of this disease from the early stages. Multidisciplinary strategies should focus on the needs of patients (to increase their empowerment) and should be adapted to the resources and health systems prevailing in each country; its systematic implementation can help to improve patient care and slow the progression of CKD. Copyright © 2013 IMSS. Published by Elsevier Inc. All rights reserved.

  1. Strategy Guideline: Quality Management in Existing Homes; Cantilever Floor Example

    SciTech Connect

    Taggart, J.; Sikora, J.; Wiehagen, J.; Wood, A.

    2011-12-01

    This guideline is designed to highlight the QA process that can be applied to any residential building retrofit activity. The cantilevered floor retrofit detailed in this guideline is included only to provide an actual retrofit example to better illustrate the QA activities being presented. The goal of existing home high performing remodeling quality management systems (HPR-QMS) is to establish practices and processes that can be used throughout any remodeling project. The research presented in this document provides a comparison of a selected retrofit activity as typically done versus that same retrofit activity approached from an integrated high performance remodeling and quality management perspective. It highlights some key quality management tools and approaches that can be adopted incrementally by a high performance remodeler for this or any high performance retrofit. This example is intended as a template and establishes a methodology that can be used to develop a portfolio of high performance remodeling strategies.

  2. Contemporary Strategies in the Management of Hepatocellular Carcinoma

    PubMed Central

    Khorsandi, Shirin Elizabeth; Heaton, Nigel

    2012-01-01

    Liver transplantation is the treatment of choice for selected patients with hepatocellular carcinoma (HCC) on a background of chronic liver disease. Liver resection or locoregional ablative therapies may be indicated for patients with preserved synthetic function without significant portal hypertension. Milan criteria were introduced to select suitable patients for liver transplant with low risk of tumor recurrence and 5-year survival in excess of 70%. Currently the incidence of HCC is climbing rapidly and in a current climate of organ shortage has led to the re-evaluation of locoregional therapies and resectional surgery to manage the case load. The introduction of biological therapies has had a new dimension to care, adding to the complexities of multidisciplinary team working in the management of HCC. The aim of this paper is to give a brief overview of present day management strategies and decision making. PMID:23197879

  3. Marketing strategies in a competitive managed care environment.

    PubMed

    Cascardo-Weissman, D C

    1999-01-01

    In the new health care marketplace dominated by managed care, patients expect more from their physicians and other providers. Because cost is not an issue for the managed care patient, physicians must find a way to distinguish their practices from others in the managed care plan directory. This article provides low-cost strategies that physicians may use to do so. These include: focusing on the customer; ensuring friendly, attentive, and trained staff using patient-friendly office policies; making the patient priority number one; listening to and communicating with patients; being a patient advocate; giving patients choices to increase their control over their care; respecting the time demands on the patient and his or her family, and others.

  4. Risk Preferences, Probability Weighting, and Strategy Tradeoffs in Wildfire Management.

    PubMed

    Hand, Michael S; Wibbenmeyer, Matthew J; Calkin, David E; Thompson, Matthew P

    2015-10-01

    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 federal wildfire managers. Respondents were presented with a multiattribute lottery-choice experiment where each lottery is defined by three outcome attributes: expenditures for fire suppression, damage to private property, and exposure of firefighters to the risk of aviation-related fatalities. Respondents choose one of two strategies, each of which includes "good" (low cost/low damage) and "bad" (high cost/high damage) outcomes that occur with varying probabilities. The choice task also incorporates an information framing experiment to test whether information about fatality risk to firefighters alters managers' responses to risk. Results suggest that managers exhibit risk aversion and nonlinear probability weighting, which can result in choices that do not minimize expected expenditures, property damage, or firefighter exposure. Information framing tends to result in choices that reduce the risk of aviation fatalities, but exacerbates nonlinear probability weighting. © 2015 Society for Risk Analysis.

  5. Present and New Treatment Strategies in the Management of Glaucoma

    PubMed Central

    Kolko, M.

    2015-01-01

    Glaucoma is a neurodegenerative disease characterized by retinal ganglion cell (RGC) death and axonal loss. It remains a major cause of blindness worldwide. All current modalities of treatment are focused on lowering intraocular pressure (IOP), and it is evident that increased IOP is an important risk factor for progression of the disease. However, it is clear that a significant number of glaucoma patients show disease progression despite of pressure lowering treatments. Much attention has been given to the development of neuroprotective treatment strategies, but the identification of such has been hampered by lack of understanding of the etiology of glaucoma. Hence, in spite of many attempts no neuroprotective drug has yet been clinically approved. Even though neuroprotection is without doubt an important treatment strategy, many glaucoma subjects are diagnosed after substantial loss of RGCs. In this matter, recent approaches aim to rescue RGCs and regenerate axons in order to restore visual function in glaucoma. The present review seeks to provide an overview of the present and new treatment strategies in the management of glaucoma. The treatment strategies are divided into current available glaucoma medications, new pressure lowering targets, prospective neuroprotective interventions, and finally possible neuroregenrative strategies. PMID:26069521

  6. Clinical multi-omics strategies for the effective cancer management.

    PubMed

    Yoo, Byong Chul; Kim, Kyung-Hee; Woo, Sang Myung; Myung, Jae Kyung

    2017-08-15

    Cancer is a global health issue as a multi-factorial complex disease, and early detection and novel therapeutic strategies are required for more effective cancer management. With the development of systemic analytical -omics strategies, the therapeutic approach and study of the molecular mechanisms of carcinogenesis and cancer progression have moved from hypothesis-driven targeted investigations to data-driven untargeted investigations focusing on the integrated diagnosis, treatment, and prevention of cancer in individual patients. Predictive, preventive, and personalized medicine (PPPM) is a promising new approach to reduce the burden of cancer and facilitate more accurate prognosis, diagnosis, as well as effective treatment. Here we review the fundamentals of, and new developments in, -omics technologies, together with the key role of a variety of practical -omics strategies in PPPM for cancer treatment and diagnosis. In this review, a comprehensive and critical overview of the systematic strategy for predictive, preventive, and personalized medicine (PPPM) for cancer disease was described in a view of cancer prognostic prediction, diagnostics, and prevention as well as cancer therapy and drug responses. We have discussed multi-dimensional data obtained from various resources and integration of multisciplinary -omics strategies with computational method which could contribute the more effective PPPM for cancer. This review has provided the novel insights of the current applications of each and combined -omics technologies, which showed their powerful potential for the establishment of PPPM for cancer. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Assessment of soil sealing management responses, strategies, and targets toward ecologically sustainable urban land use management.

    PubMed

    Artmann, Martina

    2014-05-01

    Soil sealing has negative impacts on ecosystem services since urban green and soil get lost. Although there is political commitment to stop further sealing, no reversal of this trend can be observed in Europe. This paper raises the questions (1) which strategies can be regarded as being efficient toward ecologically sustainable management of urban soil sealing and (2) who has competences and should take responsibility to steer soil sealing? The analyses are conducted in Germany. The assessment of strategies is carried out using indicators as part of a content analysis. Legal-planning, informal-planning, economic-fiscal, co-operative, and informational strategies are analyzed. Results show that there is a sufficient basis of strategies to secure urban ecosystem services by protecting urban green and reducing urban gray where microclimate regulation is a main target. However, soil sealing management lacks a spatial strategically overview as well as the consideration of services provided by fertile soils.

  8. Comparing the refuge strategy for managing the evolution of insect resistance under different reproductive strategies.

    PubMed

    Crowder, David W; Carrière, Yves

    2009-12-07

    Genetically modified (GM) crops are used extensively worldwide to control diploid agricultural insect pests that reproduce sexually. However, future GM crops will likely soon target haplodiploid and parthenogenetic insects. As rapid pest adaptation could compromise these novel crops, strategies to manage resistance in haplodiploid and parthenogenetic pests are urgently needed. Here, we developed models to characterize factors that could delay or prevent the evolution of resistance to GM crops in diploid, haplodiploid, and parthenogenetic insect pests. The standard strategy for managing resistance in diploid pests relies on refuges of non-GM host plants and GM crops that produce high toxin concentrations. Although the tenets of the standard refuge strategy apply to all pests, this strategy does not greatly delay the evolution of resistance in haplodiploid or parthenogenetic pests. Two additional factors are needed to effectively delay or prevent the evolution of resistance in such pests, large recessive or smaller non-recessive fitness costs must reduce the fitness of resistance individuals in refuges (and ideally also on GM crops), and resistant individuals must have lower fitness on GM compared to non-GM crops (incomplete resistance). Recent research indicates that the magnitude and dominance of fitness costs could be increased by using specific host-plants, natural enemies, or pathogens. Furthermore, incomplete resistance could be enhanced by engineering desirable traits into novel GM crops. Thus, the sustainability of GM crops that target haplodiploid or parthenogenetic pests will require careful consideration of the effects of reproductive mode, fitness costs, and incomplete resistance.

  9. Assertive Classroom Management Strategies and Students' Performance: The Case of EFL Classroom

    ERIC Educational Resources Information Center

    Aliakbari, Mohammad; Bozorgmanesh, Bafrin

    2015-01-01

    Ample research findings support the effective role that classroom management strategies play in enhancing students' learning. Drawing upon Iranian high school teachers' classroom management strategies, this article is intended to examine the extent to which these teachers follow assertive classroom management strategies and if these strategies…

  10. Assertive Classroom Management Strategies and Students' Performance: The Case of EFL Classroom

    ERIC Educational Resources Information Center

    Aliakbari, Mohammad; Bozorgmanesh, Bafrin

    2015-01-01

    Ample research findings support the effective role that classroom management strategies play in enhancing students' learning. Drawing upon Iranian high school teachers' classroom management strategies, this article is intended to examine the extent to which these teachers follow assertive classroom management strategies and if these strategies…

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

    PubMed

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

    2013-12-01

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

  12. Building Research Relationships With Managed Care Organizations: Issues and Strategies

    PubMed Central

    LEIN, CATHERINE; COLLINS, CLARE; LYLES, JUDITH S.; HILLMAN, DONALD; SMITH, ROBERT C.

    2006-01-01

    Managed care is now the dominant form of healthcare in the United States. The need for clinical research about the organization, delivery, and outcomes of primary care services in managed care models is high, yet access to managed care organizations as sites for clinical research may be problematic. The purpose of this article is to describe issues involved in obtaining access to managed care settings for clinical research and practical strategies for successful collaboration using literature review and case description. Three steps for developing collaborative relationships with managed care organizations (MCOs) are presented: 1) assessment of organizational structure, history, and culture; 2) finding common ground; and 3) project implementation. These steps are discussed within the context of MCO systems issues and a relationship-centered approach to communication between researchers and individuals from the MCO. Successful relationships with MCOs for clinical research are possible when careful attention is paid to inclusion of MCOs as collaborators in the development of the research questions and design, and as partners in the research implementation process. PMID:17203136

  13. A Climate Change Adaptation Strategy for Management of ...

    EPA Pesticide Factsheets

    Sea level rise is causing shoreline erosion, increased coastal flooding, and marsh vulnerability to the impact of storms. Coastal marshes provide flood abatement, carbon and nutrient sequestration, water quality maintenance, and habitat for fish, shellfish, and wildlife, including species of concern, such as the saltmarsh sparrow (Ammodramus caudacutus). We present a climate change adaptation strategy (CCAS) adopted by scientific, management, and policy stakeholders for managing coastal marshes and enhancing system resiliency. A common adaptive management approach previously used for restoration projects was modified to identify climate-related vulnerabilities and plan climate change adaptive actions. As an example of implementation of the CCAS, we describe the stakeholder plans and management actions the US Fish and Wildlife Service and partners developed to build coastal resiliency in the Narrow River Estuary, RI, in the aftermath of Superstorm Sandy. When possible, an experimental BACI (before-after, control-impact) design, described as pre- and post-sampling at the impact site and one or more control sites, was incorporated into the climate change adaptation and implementation plans. Specific climate change adaptive actions and monitoring plans are described and include shoreline stabilization, restoring marsh drainage, increasing marsh elevation, and enabling upland marsh migration. The CCAS provides a framework and methodology for successfully managing coa

  14. A Climate Change Adaptation Strategy for Management of ...

    EPA Pesticide Factsheets

    Sea level rise is causing shoreline erosion, increased coastal flooding, and marsh vulnerability to the impact of storms. Coastal marshes provide flood abatement, carbon and nutrient sequestration, water quality maintenance, and habitat for fish, shellfish, and wildlife, including species of concern, such as the saltmarsh sparrow (Ammodramus caudacutus). We present a climate change adaptation strategy (CCAS) adopted by scientific, management, and policy stakeholders for managing coastal marshes and enhancing system resiliency. A common adaptive management approach previously used for restoration projects was modified to identify climate-related vulnerabilities and plan climate change adaptive actions. As an example of implementation of the CCAS, we describe the stakeholder plans and management actions the US Fish and Wildlife Service and partners developed to build coastal resiliency in the Narrow River Estuary, RI, in the aftermath of Superstorm Sandy. When possible, an experimental BACI (before-after, control-impact) design, described as pre- and post-sampling at the impact site and one or more control sites, was incorporated into the climate change adaptation and implementation plans. Specific climate change adaptive actions and monitoring plans are described and include shoreline stabilization, restoring marsh drainage, increasing marsh elevation, and enabling upland marsh migration. The CCAS provides a framework and methodology for successfully managing coa

  15. Risk evaluation mitigation strategies: the evolution of risk management policy.

    PubMed

    Hollingsworth, Kristen; Toscani, Michael

    2013-04-01

    The United States Food and Drug Administration (FDA) has the primary regulatory responsibility to ensure that medications are safe and effective both prior to drug approval and while the medication is being actively marketed by manufacturers. The responsibility for safe medications prior to marketing was signed into law in 1938 under the Federal Food, Drug, and Cosmetic Act; however, a significant risk management evolution has taken place since 1938. Additional federal rules, entitled the Food and Drug Administration Amendments Act, were established in 2007 and extended the government's oversight through the addition of a Risk Evaluation and Mitigation Strategy (REMS) for certain drugs. REMS is a mandated strategy to manage a known or potentially serious risk associated with a medication or biological product. Reasons for this extension of oversight were driven primarily by the FDA's movement to ensure that patients and providers are better informed of drug therapies and their specific benefits and risks prior to initiation. This article provides an historical perspective of the evolution of medication risk management policy and includes a review of REMS programs, an assessment of the positive and negative aspects of REMS, and provides suggestions for planning and measuring outcomes. In particular, this publication presents an overview of the evolution of the REMS program and its implications.

  16. Office-based strategies for the management of obesity.

    PubMed

    Rao, Goutham

    2010-06-15

    Roughly two thirds of U.S. adults are overweight or obese. Obesity increases the risk of hypertension, type 2 diabetes mellitus, hyperlipidemia, heart disease, pulmonary disease, hepatobiliary disease, cancer, and a number of psychosocial complications. Physicians often feel unprepared to handle this important problem. Practical office-based strategies include: (1) making recommendations for assisted self-management, including guidance on popular diets, (2) advising patients about commercial weight-loss programs, (3) advising patients about and prescribing medications, (4) recommending bariatric surgery, and (5) supplementing these strategies with counseling about lifestyle changes using a systematic approach. Family physicians should provide basic information about the effectiveness and safety of popular diets and commercial weight-loss programs, and refer patients to appropriate information sources. Sibutramine and orlistat, the only medications currently approved for the long-term treatment of obesity, should only be prescribed in combination with lifestyle changes. Bariatric surgery is an option for adults with a body mass index of 40 kg per m2 or higher, or for those with a body mass index of 35 kg per m2 or higher who have obesity-related comorbidities such as type 2 diabetes. The five A's behavioral counseling paradigm (ask, advise, assess, assist, and arrange) can be used as the basis for a systematic, practical approach to the management of obesity that incorporates evidence for managing common obesity-related behaviors.

  17. Optimal management strategies in variable environments: Stochastic optimal control methods

    USGS Publications Warehouse

    Williams, B.K.

    1985-01-01

    Dynamic optimization was used to investigate the optimal defoliation of salt desert shrubs in north-western Utah. Management was formulated in the context of optimal stochastic control theory, with objective functions composed of discounted or time-averaged biomass yields. Climatic variability and community patterns of salt desert shrublands make the application of stochastic optimal control both feasible and necessary. A primary production model was used to simulate shrub responses and harvest yields under a variety of climatic regimes and defoliation patterns. The simulation results then were used in an optimization model to determine optimal defoliation strategies. The latter model encodes an algorithm for finite state, finite action, infinite discrete time horizon Markov decision processes. Three questions were addressed: (i) What effect do changes in weather patterns have on optimal management strategies? (ii) What effect does the discounting of future returns have? (iii) How do the optimal strategies perform relative to certain fixed defoliation strategies? An analysis was performed for the three shrub species, winterfat (Ceratoides lanata), shadscale (Atriplex confertifolia) and big sagebrush (Artemisia tridentata). In general, the results indicate substantial differences among species in optimal control strategies, which are associated with differences in physiological and morphological characteristics. Optimal policies for big sagebrush varied less with variation in climate, reserve levels and discount rates than did either shadscale or winterfat. This was attributed primarily to the overwintering of photosynthetically active tissue and to metabolic activity early in the growing season. Optimal defoliation of shadscale and winterfat generally was more responsive to differences in plant vigor and climate, reflecting the sensitivity of these species to utilization and replenishment of carbohydrate reserves. Similarities could be seen in the influence of both

  18. Paradigm Shift in the Management Strategy for Epithelial Ovarian Cancer.

    PubMed

    Fujiwara, Keiichi; McAlpine, Jessica N; Lheureux, Stephanie; Matsumura, Noriomi; Oza, Amit M

    2016-01-01

    The hypothesis on the pathogenesis of epithelial ovarian cancer continues to evolve. Although epithelial ovarian cancer had been assumed to arise from the coelomic epithelium of the ovarian surface, it is now becoming clearer that the majority of serous carcinomas arise from epithelium of the distal fallopian tube, whereas clear cell and endometrioid cancers arise from endometriosis. Molecular and genomic characteristics of epithelial ovarian cancer have been extensively investigated. Our understanding of pathogenesis of the various histologic types of ovarian cancer have begun to inform changes to the strategies for management of epithelial ovarian cancer, which represent a paradigm shift not only for treatment but also for prevention, which previously had not been considered achievable. In this article, we will discuss novel attempts at the prevention of high-grade serous ovarian cancer and treatment strategies for two distinct entities in epithelial ovarian cancer: low-grade serous and clear cell ovarian carcinomas, which are relatively rare and resistant to conventional chemotherapy.

  19. Agroecological strategies for arthropod pest management in Brazil.

    PubMed

    Lemos, Felipe; Sarmento, Renato A; Teodoro, Adenir V; dos Santos, Gil R; do Nascimento, Ildon R

    2011-05-01

    There is a need to implement a new approach to pest control in which agroecological strategies are developed and adapted in a site-specific way to highly variable and diverse farm conditions typical of farms in tropical regions such as Brazil. It has become evident that the conventional agriculture based on high use of external inputs and oriented to maximize profits, has often been detrimental and unviable when considered from social and ecological perspectives. Pest problems, for example, are generally related to high input, single-crop agroecosystems. We discuss here agroecological strategies such as conservation biological control, use of natural pesticides and selectivity of synthetic and natural pesticides as a way to conserve and increase natural enemies' efficiency in Brazilian agroecosystems. In addition, we discuss some patents related to agroecological pest management.

  20. Financial management and dental school strength, Part I: Strategy.

    PubMed

    Chambers, David W; Bergstrom, Roy

    2004-04-01

    The ultimate goal of financial management in a dental school is to accumulate assets that are available for strategic growth, which is a parallel objective to the profit motive in business. Budget development is often grounded in an income statement framework where the goal is to match revenues and expenses. Only when a balance sheet perspective (assets = liabilities + equity) is adopted can strategic growth be fully addressed. Four views of budgeting are presented in this article: 1) covering expenses, 2) shopping, 3) strategic support, and 4) budgeting as strategy. These perceptions of the budgeting process form a continuum, moving from a weak strategic position (covering expenses) to a strong one (budgeting as strategy) that encourages the accumulation of assets that build equity in the organization.

  1. Determining management strategies for the Sarikum Nature Protection Area.

    PubMed

    Öztürk, Sevgi

    2015-03-01

    In recent years, many environmental problems have become important factors in promoting the economic need to develop tourist activity: climate change such as energy wars, increasing hunger and aridity, population increases in urban areas, excessive and unthinking use of natural resources, difficult international relations, economic competition, and increasing environmental stress. Trends in global tourism have changed with changes in culture and our attitude to nature. Changes in both the profile and consumption patterns of tourists have called for the need to balance the use of natural and cultural assets with the need to adequately protect them. In this study, the Sarikum Nature Protection Area (SNPA) was selected as a case study because of its significance as a Turkish wetland area and the variety of different ecosystems coexisting within it. The study focussed on management strategies, but also provides a broader strategy for an area that currently has no management plan. Strengths and weaknesses, opportunities and threats (SWOT) analyses of the area were gathered and analyzed using R'WOT analysis (ranking + SWOT), a multi-criteria assessment method, in order to determine strategies, obtain the participation of interest groups, and assess their opinions and attitudes. The analysis showed the following: the rich biological diversity and the existence of endemic species were the reserve's most significant strength; the presence of natural areas in surrounding regions was the most significant opportunity; the shortage of infrastructure and lack of legal regulation of ecotourism was the most significant weakness; and the lack of a management plan was the most immediate threat.

  2. Advanced blood management strategies for elective joint arthroplasty.

    PubMed

    Layton, Jodi L; Rubin, Lee E; Sweeney, Joseph D

    2013-03-01

    There is a high prevalence of anemia detected in the preoperative work-up of elective surgical patients preparing for total joint replacement. The impact of anemia in this population has significant implications due to elevations in postoperative morbidity and mortality. By using current clinical guidelines and medical evidence, clinicians can improve outcomes for these patients by employing a three-phase approach, focused on preoperative assessment, intraoperative hemostasis, and postoperative blood product management. Strategies to optimize preoperative hemoglobin levels, reduce intraoperative blood losses, and decrease postoperative transfusion rates can independently and collectively improve overall patient care and surgical outcomes following lower extremity total joint arthroplasty.

  3. Advanced airway management strategies for severe OSAS and craniofacial anomalies.

    PubMed

    Gungor, Anil

    Pediatric OSAS and craniofacial malformations present challenges that require innovative approaches and comprehensive treatment strategies. Synchronous airway lesions, craniofacial malformations, obstructive anomalies of the tongue base, nasal vault and choanae are commonly addressed by subspecialists from various clinical and surgical academic traditions who practice variable levels of required communication. This is not a mere social requirement but an important requisite for intelligent and effective airway management. Membership of dedicated airway, aero digestive or craniofacial teams are desirable but not required. I expect this clinical brief to help many brilliant clinicians in their pursuit of perfection. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. 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

  5. Management strategies for problem behaviors in the patient with dementia.

    PubMed

    Lehninger, F W; Ravindran, V L; Stewart, J T

    1998-04-01

    Psychiatric and behavioral problems are present in most patients with dementia and are usually the clinician's main focus of management. Differential diagnosis of these problems can be challenging, but the effort is essential for planning appropriate therapy. Pharmacologic interventions are available for treatment of depression, agitation, aggression, psychotic symptoms, wandering, and sleep disorders. Given the less than favorable risk-benefit ratio of most psychotropic drugs in the population of older patients with dementia, the importance of nonpharmacologic strategies and limiting treatment goals should not be overlooked.

  6. Strategies for Managing Mobile Devices for Use by Hospitalized Inpatients.

    PubMed

    Dykes, Patricia C; Stade, Diana; Dalal, Anuj; Clements, Marsha; Collins, Sarah; Chang, Frank; Fladger, Anne; Getty, George; Hanna, John; Kandala, Ravali; Lehmann, Lisa S; Leone, Kathleen; Massaro, Anthony F; Mlaver, Eli; McNally, Kelly; Ravindran, Sucheta; Schnock, Kumiko; Bates, David W

    2015-01-01

    Despite the potential advantages, implementation of mobile devices and ongoing management pose challenges in the hospital environment. Our team implemented the PROSPECT (Promoting Respect and Ongoing Safety through Patient-centeredness, Engagement, Communication and Technology) project at Brigham and Women's Hospital. The goal of PROSPECT is to transform the hospital environment by providing a suite of e-tools to facilitate teamwork among nurses, physicians, patients and to engage patients and care partners in their plan of care. In this paper, we describe the device-related decisions and challenges faced including device and accessory selection, integration, information and device security, infection control, user access, and ongoing operation and maintenance. We relate the strategies that we used for managing mobile devices and lessons learned based on our experiences.

  7. Clinical Decision Support Knowledge Management: Strategies for Success.

    PubMed

    Khalifa, Mohamed; Alswailem, Osama

    2015-01-01

    Clinical Decision Support Systems have been shown to increase quality of care, patient safety, improve adherence to guidelines for prevention and treatment, and avoid medication errors. Such systems depend mainly on two types of content; the clinical information related to patients and the medical knowledge related to the specialty that informs the system rules and alerts. At King Faisal Specialist Hospital and Research Center, Saudi Arabia, the Health Information Technology Affairs worked on identifying best strategies and recommendations for successful CDSS knowledge management. A review of literature was conducted to identify main areas of challenges and factors of success. A qualitative survey was used over six months' duration to collect opinions, experiences and suggestions from both IT and healthcare professionals. Recommendations were categorized into ten main topics that should be addressed during the development and implementation of CDSS knowledge management tools in the hospital.

  8. Weight management and weight loss strategies of professional jockeys.

    PubMed

    Moore, Jan M; Timperio, Anna F; Crawford, David A; Burns, Cate M; Cameron-Smith, David

    2002-03-01

    Jockeys are required to maintain very low body weight and precise weight control during competition. This study examined the weight loss and weight management strategies of professional horseracing jockeys in the state of Victoria, Australia. An anonymous, self-completed questionnaire was administered (55% response rate, n = 116). Almost half (43%) reported that maintaining riding weight was difficult or very difficult, with 75% routinely skipping meals. In preparation for racing, 60% reported that they typically required additional weight loss, with 81% restricting food intake in the 24 hours prior to racing. Additionally, sauna-induced sweating (29%) and diuretics (22%) were frequently employed to further aid in weight loss prior to racing. These rapid weight loss methods did not differ between the 51% of jockeys who followed a weight management plan compared to those who did not. The impact of these extreme weight loss practices on riding performance and health remains unknown.

  9. Strategies for Managing Mobile Devices for Use by Hospitalized Inpatients

    PubMed Central

    Dykes, Patricia C.; Stade, Diana; Dalal, Anuj; Clements, Marsha; Collins, Sarah; Chang, Frank; Fladger, Anne; Getty, George; Hanna, John; Kandala, Ravali; Lehmann, Lisa S.; Leone, Kathleen; Massaro, Anthony F.; Mlaver, Eli; McNally, Kelly; Ravindran, Sucheta; Schnock, Kumiko; Bates, David W.

    2015-01-01

    Despite the potential advantages, implementation of mobile devices and ongoing management pose challenges in the hospital environment. Our team implemented the PROSPECT (Promoting Respect and Ongoing Safety through Patient-centeredness, Engagement, Communication and Technology) project at Brigham and Women’s Hospital. The goal of PROSPECT is to transform the hospital environment by providing a suite of e-tools to facilitate teamwork among nurses, physicians, patients and to engage patients and care partners in their plan of care. In this paper, we describe the device-related decisions and challenges faced including device and accessory selection, integration, information and device security, infection control, user access, and ongoing operation and maintenance. We relate the strategies that we used for managing mobile devices and lessons learned based on our experiences. PMID:26958185

  10. Evidence-based Management Strategies for Treatment of Chronic Wounds

    PubMed Central

    Werdin, Frank; Tennenhaus, Mayer; Schaller, Hans-Eberhardt; Rennekampff, Hans-Oliver

    2009-01-01

    The care and management of patients with chronic wounds and their far-reaching effects challenge both the patient and the practitioner. Further complicating this situation is the paucity of evidence-based treatment strategies for chronic wound care. After searching both MEDLINE and Cochrane databases, we reviewed currently available articles concerning chronic wound care. Utilizing this information, we have outlined a review of current, evidence-based concepts as they pertain to the treatment of chronic wounds, focusing on fundamental treatment principles for the management of venous, arterial, diabetic, and pressure ulcers. Individualized treatment options as well as general wound management principles applicable to all varieties of chronic wounds are described. Classification and treatment guidelines as well as the adoption of the TIME acronym facilitate an organized conceptional approach to wound care. In so doing, individual aspects of generalized wound care such as debridement, infection, and moisture control as well as attention to the qualities of the wound edge are comprehensively evaluated, communicated, and addressed. Effective adjuvant agents for the therapy of chronic wounds including nutritional and social support measures are listed, as is a brief review of strategies helpful for preventing recurrence. An appreciation of evidence-based treatment pathways and an understanding of the pathophysiology of chronic wounds are important elements in the management of patients with chronic wounds. To achieve effective and long-lasting results, a multidisciplinary approach to patient care, focused on the education and coordination of patient, family as well as medical and support staff can prove invaluable. PMID:19578487

  11. Regional governance: strategies and disputes in health region management

    PubMed Central

    dos Santos, Adriano Maia; Giovanella, Ligia

    2014-01-01

    OBJECTIVE To analyze the regional governance of the health systemin relation to management strategies and disputes. METHODOLOGICAL PROCEDURES A qualitative study with health managers from 19 municipalities in the health region of Bahia, Northeastern Brazil. Data were drawn from 17 semi-structured interviews of state, regional, and municipal health policymakers and managers; a focus group; observations of the regional interagency committee; and documents in 2012. The political-institutional and the organizational components were analyzed in the light of dialectical hermeneutics. RESULTS The regional interagency committee is the chief regional governance strategy/component and functions as a strategic tool for strengthening governance. It brings together a diversity of members responsible for decision making in the healthcare territories, who need to negotiate the allocation of funding and the distribution of facilities for common use in the region. The high turnover of health secretaries, their lack of autonomy from the local executive decisions, inadequate technical training to exercise their function, and the influence of party politics on decision making stand as obstacles to the regional interagency committee’s permeability to social demands. Funding is insufficient to enable the fulfillment of the officially integrated agreed-upon program or to boost public supply by the system, requiring that public managers procure services from the private market at values higher than the national health service price schedule (Brazilian Unified Health System Table). The study determined that “facilitators” under contract to health departments accelerated access to specialized (diagnostic, therapeutic and/or surgical) services in other municipalities by direct payment to physicians for procedure costs already covered by the Brazilian Unified Health System. CONCLUSIONS The characteristics identified a regionalized system with a conflictive pattern of governance and

  12. Water Management Strategies against Water Shortage in the Alps (Invited)

    NASA Astrophysics Data System (ADS)

    de Jong, C.

    2009-12-01

    In the European Alps water has been perceived as ubiquitous and not the subject of management. Climate change and anthropogenic pressures have changed demand and supply relations rapidly and over the last 10 years, water problems have increasingly become apparent over temporal and spatial hotspots. Stakeholders in the Alpine Space have been confronted with water management problems in agriculture, tourism and hydropower to such an extent that they approached scientists to create solution strategies based on adaptation and mitigation. In this context, Alp-Water-Scarce, a European project on Water Management Strategies against Water Scarcity in the Alps was funded by the Alpine Space programme as part of the "European Territorial Cooperation" scheme. It has 17 project partners from Austria Switzerland, France, Italy and Slovenia from local governments, provinces, federal institutes and offices, universities, regional agencies, alpine societies, geological surveys, and chambers of agriculture and forestry. The Lead Partner is the Mountain Institute in Savoy, Rhone-Alpes, France. The main challenges of this project are to create local Early Warning Systems against Water Scarcity in the Alps. This system is based on strengthening existing long-term monitoring and modeling and creating new measuring networks in those countries where they do not yet exist. It is anchored strongly and actively within a Stakeholder Interaction Forum linked across comparative and contrasting regions across the Alps. The Early Warning System is based on the linkage and improvement of field monitoring and assemblage of qualitative and quantitative data derived both from natural water reservoirs as well as from anthropogenic water use in 28 selected pilot regions selected in France, Italy, Austria, Slovenia and Switzerland. The objectives are to improve water management at the short term (annual scale) and long term (using future scenarios) based on modelling and application of climate change

  13. A Review of Enrollment Management: Issues and Strategies. Management/Marketing Special Project.

    ERIC Educational Resources Information Center

    O'Brien, Ed; And Others

    This report presents findings and recommendations from a project undertaken by the Maricopa County Community College District (MCCCD) to determine reasons for a decline in business course enrollments and develop strategies to increase enrollments in management and marketing programs throughout the district. Following background information on the…

  14. Intervention strategies for the management of human error

    NASA Technical Reports Server (NTRS)

    Wiener, Earl L.

    1993-01-01

    This report examines the management of human error in the cockpit. The principles probably apply as well to other applications in the aviation realm (e.g. air traffic control, dispatch, weather, etc.) as well as other high-risk systems outside of aviation (e.g. shipping, high-technology medical procedures, military operations, nuclear power production). Management of human error is distinguished from error prevention. It is a more encompassing term, which includes not only the prevention of error, but also a means of disallowing an error, once made, from adversely affecting system output. Such techniques include: traditional human factors engineering, improvement of feedback and feedforward of information from system to crew, 'error-evident' displays which make erroneous input more obvious to the crew, trapping of errors within a system, goal-sharing between humans and machines (also called 'intent-driven' systems), paperwork management, and behaviorally based approaches, including procedures, standardization, checklist design, training, cockpit resource management, etc. Fifteen guidelines for the design and implementation of intervention strategies are included.

  15. Strategies to improve self-management in heart failure patients.

    PubMed

    Toback, Mehnosh; Clark, Nancy

    2017-02-01

    Heart failure is one of the most common causes of hospitalization, hospital readmission and death. Patients with heart failure have many complications, with multiple co-existing diagnoses which result in polypharmacy. Following instructions provided by many physicians, medication adjustments based on changes in their symptoms are required. Behavioral adjustments concerning diet and exercise regime are recommended. Therefore, the patient plays a crucial role in the management of heart failure. To review the available studies on heart failure self-management, and investigate educational, behavioral and psychosocial strategies that plays an important role to improve patient self-management. A literature review was conducted based upon the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidance. The articles identified through an extensive search using PubMed and UpToDate from 1999 to 2016. Improved self-management will increase compliance, promote patient quality-of-life, advance clinical outcomes, reduce hospital re-admission and will decrease hospitalization costs.

  16. How drug life-cycle management patent strategies may impact formulary management.

    PubMed

    Berger, Jan; Dunn, Jeffrey D; Johnson, Margaret M; Karst, Kurt R; Shear, W Chad

    2016-10-01

    Drug manufacturers may employ various life-cycle management patent strategies, which may impact managed care decision making regarding formulary planning and management strategies when single-source, branded oral pharmaceutical products move to generic status. Passage of the Hatch-Waxman Act enabled more rapid access to generic medications through the abbreviated new drug application process. Patent expirations of small-molecule medications and approvals of generic versions have led to substantial cost savings for health plans, government programs, insurers, pharmacy benefits managers, and their customers. However, considering that the cost of developing a single medication is estimated at $2.6 billion (2013 dollars), pharmaceutical patent protection enables companies to recoup investments, creating an incentive for innovation. Under current law, patent protection holds for 20 years from time of patent filing, although much of this time is spent in product development and regulatory review, leaving an effective remaining patent life of 7 to 10 years at the time of approval. To extend the product life cycle, drug manufacturers may develop variations of originator products and file for patents on isomers, metabolites, prodrugs, new drug formulations (eg, extended-release versions), and fixed-dose combinations. These additional patents and the complexities surrounding the timing of generic availability create challenges for managed care stakeholders attempting to gauge when generics may enter the market. An understanding of pharmaceutical patents and how intellectual property protection may be extended would benefit managed care stakeholders and help inform decisions regarding benefit management.

  17. Managing differences: the central challenge of global strategy.

    PubMed

    Ghemawat, Pankaj

    2007-03-01

    The main goal of any international strategy should be to manage the large differences that arise at the borders of markets. Yet executives often fail to exploit market and production discrepancies, focusing instead on the tensions between standardization and localization. In this article, Pankaj Ghemawat presents a new framework that encompasses all three effective responses to the challenges of globalization. He calls it the AAA Triangle. The A's stand for the three distinct types of international strategy. Through adaptation, companies seek to boost revenues and market share by maximizing their local relevance. Through aggregation, they attempt to deliver economies of scale by creating regional, or sometimes global, operations. And through arbitrage, they exploit disparities between national or regional markets, often by locating different parts of the supply chain in different places--for instance, call centers in India, factories in China, and retail shops in Western Europe. Ghemawat draws on several examples that illustrate how organizations use and balance these strategies and describes the trade-offs they make as they do so. Because most enterprises should draw from all three A's to some extent, the framework can be used to develop a summary scorecard indicating how well the company is globalizing. However, given the tensions among the strategies, it's not enough simply to tick off the corresponding boxes. Strategic choice requires some degree of prioritization--and the framework can help with that as well. While it is possible to make progress on all three strategies, companies usually must focus on one or two when trying to build competitive advantage.

  18. Management strategy evaluation of pheromone-baited trapping techniques to improve management of invasive sea lamprey

    USGS Publications Warehouse

    Dawson, Heather; Jones, Michael L.; Irwin, Brian J.; Johnson, Nicholas; Wagner, Michael C.; Szymanski, Melissa

    2016-01-01

    We applied a management strategy evaluation (MSE) model to examine the potential cost-effectiveness of using pheromone-baited trapping along with conventional lampricide treatment to manage invasive sea lamprey. Four pheromone-baited trapping strategies were modeled: (1) stream activation wherein pheromone was applied to existing traps to achieve 10−12 mol/L in-stream concentration, (2) stream activation plus two additional traps downstream with pheromone applied at 2.5 mg/hr (reverse-intercept approach), (3) trap activation wherein pheromone was applied at 10 mg/hr to existing traps, and (4) trap activation and reverse-intercept approach. Each new strategy was applied, with remaining funds applied to conventional lampricide control. Simulating deployment of these hybrid strategies on fourteen Lake Michigan streams resulted in increases of 17 and 11% (strategies 1 and 2) and decreases of 4 and 7% (strategies 3 and 4) of the lakewide mean abundance of adult sea lamprey relative to status quo. MSE revealed performance targets for trap efficacy to guide additional research because results indicate that combining lampricides and high efficacy trapping technologies can reduce sea lamprey abundance on average without increasing control costs.

  19. Aortic Dissection in Pregnancy: Management Strategy and Outcomes.

    PubMed

    Zhu, Jun-Ming; Ma, Wei-Guo; Peterss, Sven; Wang, Long-Fei; Qiao, Zhi-Yu; Ziganshin, Bulat A; Zheng, Jun; Liu, Yong-Min; Elefteriades, John A; Sun, Li-Zhong

    2017-04-01

    Aortic dissection in pregnancy is a rare but lethal catastrophe. Clinical experiences are limited. We report our experience in 25 patients focusing on etiology, management strategies, and outcomes. Between June 1998 and February 2015, we treated 25 pregnant women (mean age, 31.6 ± 4.7 years) in whom aortic dissection developed at a mean of 28 ± 10 gestational weeks (GWs). Type A aortic dissection (TAAD) was present in 20 (80%) and type B (TBAD) in 5 (20%). Marfan syndrome was seen in 17 (68%). Management strategy was based on dissection type and GWs. TAADs were managed surgically in 19 (95.0%) and medically in 1 (5.0%). Maternal and fetal mortalities were, respectively, 14.3% (1 of 7) and 0 (0 of 7) in the "delivery first" group (7 of 20), 16.7% (1 of 6) and 33.3% (2 of 6) in "single-stage delivery and aortic repair" group (6 of 20), 16.7% (1 of 6) and 66.7% (4 of 6) in "aortic repair first" group (6 of 20), and 100% (1 of 1) and 100% (1 of 1) in the "medical management" group (1 of 20). TBADs were managed surgically in 60% (3 of 5) and endovascularly and medically in 20% each (1 of 5). No maternal deaths occurred. Fetal mortality was 100% in the surgical group and 0% in the other groups. During late follow-up, which was complete in 95.2% (20 of 21), 3 maternal and 2 fetal deaths occurred in the TAAD group. Overall maternal survival was 68.6% at 5 years. Marfan syndrome predominates among women with aortic dissection in pregnancy. For TAADs, after 28 GWs, delivery followed by surgical repair can achieve maternal and fetal survival adequately; before 28 GWs, maternal survival should be prioritized given the high risk of fetal death. For TBADs in pregnancy, nonsurgical management is preferred. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Regulations, Policies and Strategies for LLRW Management in Bangladesh - 12368

    SciTech Connect

    Mollah, A.S.

    2012-07-01

    Low level radioactive waste (LLW) is generated from various nuclear applications in Bangladesh. The major sources of radioactive waste in the country are at present: (a) the 3 MW TRIGA Mark-II research reactor; (b) the radioisotope production facility; (c) the medical, industrial and research facilities that use radionuclides; and (d) the industrial facility for processing monazite sands. Radioactive waste needs to be safely managed because it is potentially hazardous to human health and the environment. According to Nuclear Safety and Radiation Control Act-93, the Bangladesh Atomic Energy Commission (BAEC) is the governmental body responsible for the receipt and final disposal of radioactive wastes in the whole country. Waste management policy has become an important environmental, social, and economical issue for LLW in Bangladesh. Policy and strategies will serve as a basic guide for radioactive waste management in Bangladesh. The waste generator is responsible for on-site collection, conditioning and temporary storage of the waste arising from his practice. The Central Waste Processing and Storage Unit (CWPSU) of BAEC is the designated national facility with the requisite facility for the treatment, conditioning and storage of radioactive waste until a final disposal facility is established and becomes operational. The Regulatory Authority is responsible for the enforcement of compliance with provisions of the waste management regulation and other relevant requirements by the waste generator and the CWPSU. The objective of this paper is to present, in a concise form, basic information about the radioactive waste management infrastructure, regulations, policies and strategies including the total inventory of low level radioactive waste in the country. For improvement and strengthening in terms of operational capability, safety and security of RW including spent radioactive sources and overall security of the facility (CWPSF), the facility is expected to serve

  1. Flexible and robust strategies for waste management in Sweden

    SciTech Connect

    Finnveden, Goeran Bjoerklund, Anna; Reich, Marcus Carlsson; Eriksson, Ola; Soerbom, Adrienne

    2007-07-01

    Treatment of solid waste continues to be on the political agenda. Waste disposal issues are often viewed from an environmental perspective, but economic and social aspects also need to be considered when deciding on waste strategies and policy instruments. The aim of this paper is to suggest flexible and robust strategies for waste management in Sweden, and to discuss different policy instruments. Emphasis is on environmental aspects, but social and economic aspects are also considered. The results show that most waste treatment methods have a role to play in a robust and flexible integrated waste management system, and that the waste hierarchy is valid as a rule of thumb from an environmental perspective. A review of social aspects shows that there is a general willingness among people to source separate wastes. A package of policy instruments can include landfill tax, an incineration tax which is differentiated with respect to the content of fossil fuels and a weight based incineration tax, as well as support to the use of biogas and recycled materials.

  2. Strategies for dosing and switching antipsychotics for optimal clinical management.

    PubMed

    Buckley, Peter F; Correll, Christoph U

    2008-01-01

    Optimal clinical management of schizophrenia and bipolar disorder can be achieved through careful antipsychotic dosing and, if necessary, switching to another well-chosen antipsychotic using suitable switching strategies. For severely ill patients treated in clinical practice, adequate dosing may not result from following the relatively low dosing levels and abrupt titration schedules typically used in clinical registration trials. Data from recent effectiveness trials, naturalistic studies, and the Roadmap Expert Consensus Survey provide evidence of specific dose levels and titration schedules for antipsychotic agents that may be appropriate in clinical practice. Discontinuation and frequent switching of medication are common among patients treated with antipsychotics, but data suggest that an adequate trial of the first antipsychotic medication should be undertaken before switching to another antipsychotic medication. Making a decision to switch from a typical to an atypical antipsychotic or between atypical antipsychotics should involve consideration of variables relating to the patient, illness, medication, and the patient's environment. Switching can improve efficacy and tolerability but may also result in predictable side effects or withdrawal symptoms, including weight gain and metabolic effects as well as effects associated with prolactin changes. Many side effects that occur during switching are attributable to receptor profiles and antimuscarinic or antihistaminic blockade. Individualized switching strategies that include careful choice of medication, dose, and titration and tapering schedules; management of symptoms; and patient psychoeducation can reduce or treat side effects, increasing the likelihood of a successful switch and greater adherence and efficacy.

  3. Recent Advances in Nanosystems and Strategies for Managing Leishmaniasis.

    PubMed

    Vaghela, Rudra; Kulkarni, Parthasarathi K; Osmani, Riyaz Ali M; Bhosale, Rohit R; Naga Sravan Kumar Varma, V

    2016-04-01

    Parasitic infection such as Leishmaniasis, a neglected tropical disease, presents a significant global burden which is responsible for high mortality rate especially in less developed countries. Its intracellular nature and disseminated locations of parasite, limited number of chemotherapeutic agents, increasing incidences of resistance to first line drugs and toxicities, poses a great challenge to formulation scientists that have necessitated effective management of leishmanial infection by modulating the delivery of existing drugs. Over the past decade, research on development of alternative treatments such as nanotechnology-based drug delivery systems (nanoparticles, nanosuspensions, liposomes etc.), use of natural products as well as development of antileishmanial vaccine have been extensively investigated. The present review focuses on different facets of therapeutic strategies, existing miscellaneous drug delivery systems and approaches intended for management, as well as treatment of the infection, with an aim to summarize the current trends and strategies adopted for antileishmanial therapy in a systematic manner. Moreover, the article encloses an eclectic collection of patents allied to new-fangled chemotherapeutics for antileishmanial therapy.

  4. A mathematically guided strategy for risk assessment and management.

    SciTech Connect

    Cooper, James Arlin

    2005-03-01

    Strategies for risk assessment and management of high consequence operations are often based on factors such as physical analysis, analysis of software and other logical processing, and analysis of statistically determined human actions. Conventional analysis methods work well for processing objective information. However, in practical situations, much or most of the data available are subjective. Also, there are potential resultant pitfalls where conventional analysis might be unrealistic, such as improperly using event tree and fault tree failure descriptions where failures or events are soft (partial) rather than crisp (binary), neglecting or misinterpreting dependence (positive, negative, correlation), and aggregating nonlinear contributions linearly. There are also personnel issues that transcend basic human factors statistics. For example, sustained productivity and safety in critical operations can depend on the morale of involved personnel. In addition, motivation is significantly influenced by 'latent effects', which are pre-occurring influences. This paper addresses these challenges and proposes techniques for subjective risk analysis, latent effects risk analysis and a hybrid analysis that also includes objective risk analysis. The goal is an improved strategy for risk management.

  5. Management Development Programs: The Effects of Management Level and Corporate Strategy. [and] Invited Reaction: Level and Strategy Should and Do Make a Difference!

    ERIC Educational Resources Information Center

    Blakely, Gerald L.; And Others

    1994-01-01

    Consensus of survey responses from 155 of 600 human resource managers was as follows: management development programs emphasized technical skills at lower levels, entrepreneurial skills at senior levels; organizations with corporate growth strategies focused on more areas than those with stability or retrenchment strategies. (Muschewske's reaction…

  6. Habitat Demonstration Unit Project Leadership and Management Strategies

    NASA Technical Reports Server (NTRS)

    Kennedy, Kriss J.

    2011-01-01

    This paper gives an overview of the National Aeronautics and Space Administration (NASA) led multi-center Habitat Demonstration Unit (HDU) project leadership and management strategies. The HDU project team constructed and tested an analog prototype lunar surface habitat/laboratory called the Pressurized Excursion Module (PEM) during 2010. The prototype unit subsystems were integrated in a short amount of time, utilizing a tiger team approach that brought together over 20 habitation-related technologies and innovations from a variety of NASA centers. This paper describes the leadership and management strategies as well as lessons learned pertaining to leading and managing a multi-center diverse team in a rapid prototype environment. The PEM configuration went from a paper design to an operational surface habitat demonstration unit in less than 12 months. The HDU project is part of the strategic plan from the Exploration Systems Mission Directorate (ESMD) Directorate Integration Office (DIO) and the Exploration Mission Systems Office (EMSO) to test destination elements in analog environments. The 2011 HDU-Deep Space Habitat (DSH) configuration will build upon the PEM work, and emphasize validity of crew operations (remote working and living), EVA operations, mission operations, logistics operations, and science operations that might be required in a deep space context for Near Earth Object (NEO) exploration mission architectures. The 2011 HDU-DSH will be field-tested during the 2011 Desert Research and Technologies Studies (DRaTS) field tests. The HDU project is a "technology-pull" project that integrates technologies and innovations from multiple NASA centers. This project will repurpose the HDU 2010 demo unit that was field tested in the 2010 DRaTS, adding habitation functionality to the prototype unit. This paper will describe the strategy of establishing a multi-center project management team that put in place the key multi-center leadership skills and

  7. TRALI risk reduction: donor and component management strategies.

    PubMed

    Eder, Anne F; Benjamin, Richard J

    2009-01-01

    Transfusion-related lung injury (TRALI) occurs in approximately 1 in 5,000 transfusions and may cause considerably more morbidity and mortality that is not recognized in clinical practice. Based on the current understanding of the etiology of TRALI, blood centers have implemented or are evaluating various donor and component management strategies in an effort to mitigate the risk of TRALI. Many cases of TRALI are likely caused by antibodies to leukocyte antigens (HLA or HNA) in blood components. Approximately 10 to 20% of female blood donors with a history of pregnancy and 1 to 5% of male blood donors harbor these antibodies. Alternatively, TRALI may be mediated by other bioactive lipids or substances that accumulate during storage and cause a reaction when transfused to susceptible patients. The complex interplay among various donor-, component-, and patient-related factors underlying TRALI guarantees that effective prevention will not be a single or simple intervention but rather will require a multifaceted approach. Perhaps, the most important risk reduction strategy is the effort to ensure appropriate use of blood products and eliminate unnecessary transfusions. Blood collection agencies, however, have more proximate control over donor selection and component management than transfusion practice. AABB has provided some guidance on deferring donors implicated in TRALI and minimizing the preparation of high plasma volume components from donors who have anti-leukocyte antibodies or are at increased risk of leukocyte alloimmunization. Blood centers have taken various approaches to mitigate the risk of TRALI, and the possible benefit and the inherent limitations of the current strategies will be reviewed.

  8. Improving VBAC rates: the combined impact of two management strategies.

    PubMed

    Gardner, Kate; Henry, Amanda; Thou, Steven; Davis, Greg; Miller, Trent

    2014-08-01

    Caesarean section rates in Australia have risen to >30%, with repeat caesarean delivery the most common indication. One method of reducing caesarean delivery rates is to increase rates of vaginal birth after caesarean section (VBAC). To determine the combined effect of two management strategies on the rates of successful VBAC in women experiencing their first pregnancy following primary caesarean section. Prospective cohort study from May 2009 to October 2010 at a metropolitan Australian teaching hospital. The strategies studied were (i) allocating responsibility for VBAC candidates attempting labour to the hospital's three high-risk obstetric consultants and (ii) implementing a next birth after caesarean (NBAC) antenatal clinic designed to counsel and support women deciding on mode of birth for their next pregnancy after a primary caesarean section. Data were collected from Obstetrix, a NBAC logbook and medical records of 396 eligible women who gave birth during the study period. Overall VBAC rates improved from 17.2% in 2006 prior to implementation of the combined strategies, to 27.0% over the studied period (P < 0.001). Of those women who desired and attempted a VBAC, the success rate was 64.4%. Regression analysis identified an increased likelihood of attempted vaginal birth where malpresentation was the indication for previous caesarean, while Eastern Asian ethnicity was associated with increased likelihood of choosing repeat caesarean. A dedicated NBAC clinic and more consistent approach to labour management can help improve VBAC rates. Further targeted counselling towards women with previous malpresentation and/or East Asian descent may further improve VBAC attempt rates. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  9. Defining a data management strategy for USGS Chesapeake Bay studies

    USGS Publications Warehouse

    Ladino, Cassandra

    2013-01-01

    The mission of U.S. Geological Survey’s (USGS) Chesapeake Bay studies is to provide integrated science for improved understanding and management of the Chesapeake Bay ecosystem. Collective USGS efforts in the Chesapeake Bay watershed began in the 1980s, and by the mid-1990s the USGS adopted the watershed as one of its national place-based study areas. Great focus and effort by the USGS have been directed toward Chesapeake Bay studies for almost three decades. The USGS plays a key role in using “ecosystem-based adaptive management, which will provide science to improve the efficiency and accountability of Chesapeake Bay Program activities” (Phillips, 2011). Each year USGS Chesapeake Bay studies produce published research, monitoring data, and models addressing aspects of bay restoration such as, but not limited to, fish health, water quality, land-cover change, and habitat loss. The USGS is responsible for collaborating and sharing this information with other Federal agencies and partners as described under the President’s Executive Order 13508—Strategy for Protecting and Restoring the Chesapeake Bay Watershed signed by President Obama in 2009. Historically, the USGS Chesapeake Bay studies have relied on national USGS databases to store only major nationally available sources of data such as streamflow and water-quality data collected through local monitoring programs and projects, leaving a multitude of other important project data out of the data management process. This practice has led to inefficient methods of finding Chesapeake Bay studies data and underutilization of data resources. Data management by definition is “the business functions that develop and execute plans, policies, practices and projects that acquire, control, protect, deliver and enhance the value of data and information.” (Mosley, 2008a). In other words, data management is a way to preserve, integrate, and share data to address the needs of the Chesapeake Bay studies to better

  10. Management strategies in apple orchards influence earwig community.

    PubMed

    Malagnoux, Laure; Marliac, Gaëlle; Simon, Sylvaine; Rault, Magali; Capowiez, Yvan

    2015-04-01

    Our aim was to assess whether different apple orchard management strategies (low-input, organic, Integrated Pest Management (IPM)) would have an effect on earwigs, which are important natural enemies of apple pests. These commercial orchards were as well compared to abandoned orchards. The density of Forficula auricularia and Forficula pubescens was studied for three years in 74 orchards around Avignon. The pesticide usage, some orchard characteristics and two small-scale landscape parameters were characterized. Pesticide use was significantly different between low-input, organic and IPM orchards with particularly significant differences in the number of insecticide applications (2.2, 4.9 and 9.2 respectively). Pesticide use had a much stronger impact on earwig community than other characteristics. F. auricularia density was significantly lower in IPM orchards (0.47 individuals per tree) compared to organic, low-input and abandoned orchards (3.1, 4.5 and 1.6 individuals per tree, respectively). F. pubescens was almost absent from IPM orchards and its abundance was higher in abandoned or low-input orchards compared to organic orchards (1.5 and 2.8 vs 0.8 individuals per tree). The percentage of F. pubescens in the earwig community decreased from abandoned (52%) to low-input (40%), organic (15%) and IPM orchards (0.5%). These results were confirmed by LD50 assays showing that for the two pesticides causing mortality close to normal application rates (chlorpyrifos-ethyl and acetamiprid), F. pubescens was significantly more sensitive than F. auricularia. Since earwigs are also easy to capture and identify, they may be useful to estimate the effects of management strategies and their modification in pome fruit orchards.

  11. A randomized trial of a telephone care-management strategy.

    PubMed

    Wennberg, David E; Marr, Amy; Lang, Lance; O'Malley, Stephen; Bennett, George

    2010-09-23

    Studies have shown that telephone interventions designed to promote patients' self-management skills and improve patient-physician communication can increase patients' satisfaction and their use of preventive services. The effect of such a strategy on health care costs remains controversial. We conducted a stratified, randomized study of 174,120 subjects to assess the effect of a telephone-based care-management strategy on medical costs and resource utilization. Health coaches contacted subjects with selected medical conditions and predicted high health care costs to instruct them about shared decision making, self-care, and behavioral change. The subjects were randomly assigned to either a usual-support group or an enhanced-support group. Although the same telephone intervention was delivered to the two groups, a greater number of subjects in the enhanced-support group were made eligible for coaching through the lowering of cutoff points for predicted future costs and expansion of the number of qualifying health conditions. Primary outcome measures at 1 year were total medical costs and number of hospital admissions. At baseline, medical costs and resource utilization were similar in the two groups. After 12 months, 10.4% of the enhanced-support group and 3.7% of the usual-support group received the telephone intervention. The average monthly medical and pharmacy costs per person in the enhanced-support group were 3.6% ($7.96) lower than those in the usual-support group ($213.82 vs. $221.78, P=0.05); a 10.1% reduction in annual hospital admissions (P<0.001) accounted for the majority of savings. The cost of this intervention program was less than $2.00 per person per month. A targeted telephone care-management program was successful in reducing medical costs and hospitalizations in this population-based study. (Funded by Health Dialog Services; ClinicalTrials.gov number, NCT00793260.)

  12. Regional Sediment Management Strategies for the Vicinity of St. Augustine Inlet, St. Johns County, Florida

    DTIC Science & Technology

    2016-07-01

    pathways and sediment fluxes across the study area. The CMS application aided in defining the results of various ebb shoal dredging strategies over...ER D C/ CH L TR -1 6- 12 Regional Sediment Management (RSM) Program Regional Sediment Management Strategies for the Vicinity of St. Augustine...default. Regional Sediment Management (RSM) Program ERDC/CHL TR-16-12 July 2016 Regional Sediment Management Strategies for the Vicinity of St

  13. Surgical strategies for management of the open abdomen.

    PubMed

    Regner, Justin L; Kobayashi, Leslie; Coimbra, Raul

    2012-03-01

    Since the mid-1990s the surgical community has seen a surge in the prevalence of open abdomens (OAs) reported in the surgical literature and in clinical practice. The OA has proven to be effective in decreasing mortality and immediate postoperative complications; however, it may come at the cost of delayed morbidity and the need for further surgical procedures. Indications for leaving the abdomen open have broadened to include damage control surgery, abdominal compartment syndrome, and abdominal sepsis. The surgical options for management of the OA are now more diverse and sophisticated, but there is a lack of prospective randomized controlled trials demonstrating the superiority of any particular method. Additionally, critical care strategies for optimization of the patient with an OA are still being developed. Review of the literature suggests a bimodal distribution of primary closure rates, with early closure dependent on postoperative intensive care management and delayed closure more affected by the choice of the temporary abdominal closure technique. Invariably, a small fraction of patients requiring OA management fail to have primary fascial closure and require some form of biologic fascial bridge with delayed ventral hernia repair in the future.

  14. Evolving strategies for optimal care management and plan benefit designs.

    PubMed

    Cruickshank, John M

    2012-11-01

    As a prevalent, complex disease, diabetes presents a challenge to managed care. Strategies to optimize type 2 diabetes care management and treatment outcomes have been evolving over the past several years. Novel economic incentive programs (eg, those outlined in the Patient Protection and Affordable Care Act of 2010 that tie revenue from Medicare Advantage plans to the quality of healthcare delivered) are being implemented, as are evidence-based interventions designed to optimize treatment, reduce clinical complications, and lower the total financial burden of the disease. Another step that can improve outcomes is to align managed care diabetes treatment algorithms with national treatment guidelines. In addition, designing the pharmacy benefit to emphasize the overall value of treatment and minimize out-of-pocket expenses for patients can be an effective approach to reducing prescription abandonment. The implementation of emerging models of care that encourage collaboration between providers, support lifestyle changes, and engage patients to become partners in their own treatment also appears to be effective.

  15. Household energy management strategies in Bulgaria's transitioning energy sector

    NASA Astrophysics Data System (ADS)

    Carper, Mark Daniel Lynn

    Recent transition literature of post-socialist states has addressed the shortcomings of a rapid blanket implementation of neo-liberal policies and practices placed upon a landscape barren of the needed institutions and experiences. Included in these observations are the policy-making oversight of spatial socioeconomic variations and their individual and diverse methods of coping with their individual challenges. Of such literature addressing the case of Bulgaria, a good portion deals with the spatial consequences of restructuring as well as with embedded disputes over access to and control of resources. With few exceptions, studies of Bulgaria's changing energy sector have largely been at the state level and have not been placed within the context of spatial disparities of socioeconomic response. By exploring the variations of household energy management strategies across space, my dissertation places this resource within such a theoretical context and offers analysis based on respective levels of economic and human development, inherited material infrastructures, the organization and activities of institutions, and fuel and technological availability. A closed survey was distributed to explore six investigational themes across four geographic realms. The investigational themes include materials of housing construction, methods of household heating, use of electrical appliances, energy conservation strategies, awareness and use of energy conservation technologies, and attitudes toward the transitioning energy sector. The geographic realms include countrywide results, the urban-rural divide, regional variations, and urban divisions of the capital city, Sofia. Results conclude that, indeed, energy management strategies at the household level have been shaped by multiple variables, many of which differ across space. These variables include price sensitivity, degree of dependence on remnant technologies, fuel and substitute availability, and level of human and

  16. Unique strategies for technical information management at Johnson Space Center

    NASA Technical Reports Server (NTRS)

    Krishen, Vijay

    1994-01-01

    In addition to the current NASA manned programs, the maturation of Space Station and the introduction of the Space Exploration programs are anticipated to add substantially to the number and variety of data and documentation at NASA Johnson Space Center (JSC). This growth in the next decade has been estimated at five to ten fold compared to the current numbers. There will be an increased requirement for the tracking and currency of space program data and documents with National pressures to realize economic benefits from the research and technological developments of space programs. From a global perspective the demand for NASA's technical data and documentation is anticipated to increase at local, national, and international levels. The primary users will be government, industry, and academia. In our present national strategy, NASA's research and technology will assume a great role in the revitalization of the economy and gaining international competitiveness. Thus, greater demand will be placed on NASA's data and documentation resources. In this paper the strategies and procedures developed by DDMS, Inc., to accommodate the present and future information utilization needs are presented. The DDMS, Inc., strategies and procedures rely on understanding user requirements, library management issues, and technological applications for acquiring, searching, storing, and retrieving specific information accurately and quickly. The proposed approach responds to changing customer requirements and product deliveries. The unique features of the proposed strategy include: (1) To establish customer driven data and documentation management through an innovative and unique methods to identify needs and requirements. (2) To implement a structured process which responds to user needs, aimed at minimizing costs and maximizing services, resulting in increased productivity. (3) To provide a process of standardization of services and procedures. This standardization is the central

  17. Turnaround Management Strategies: The Adaptive Model and the Constructive Model. ASHE 1983 Annual Meeting Paper.

    ERIC Educational Resources Information Center

    Chaffee, Ellen E.

    The use of two management strategies by 14 liberal arts and comprehensive colleges attempting to recover from serious financial decline during 1973-1976 were studied. The adaptive model of strategy, based on resource dependence, involves managing demands in order to satisfy critical-resource providers. The constructive model of strategy, based on…

  18. Managing organizational change: strategies for the female health care supervisor.

    PubMed

    Davies, G

    1990-07-01

    In responding to resistance to change in the current health care organization, the new female supervisor can learn to support her staff in encountering and accepting these changes. The strategies and skills discussed above are characteristic of a supervisory style that may naturally occur for women, but also can be incorporated into the leadership style of men in health care management today. Health care leaders of tomorrow must work from an androgynous framework in which the behavior patterns and responses of each gender are learned and used appropriately by both men and women. Sargent suggests that the best managers are androgynous and that this is the inevitable wave of the future. Whether man or woman, a supervisor should learn, accept, and use methods that are characteristic of both sexes to be successful in managing people. Women and men must learn from each other's strengths and share these diverse skills. Given that women now outnumber men in health care management positions and organizations are changing to a more nurturing environment, the androgynous supervisor will be the successful leader of the future. Finally, women in health care supervisory positions have the potential to bring change where it is badly needed. Women in these roles often have a system wide view of health care policy issues that recognizes less federal commitment to social programs. Many women in health care positions believe that the issues of children, women, the elderly, the poor, and the homeless need focused attention. The growing number of women in health care supervisory and leadership roles is an important factor in changing national health policy for the benefit of these groups.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Contract management of Ontario's cancer surgery wait times strategy.

    PubMed

    Cheng, Siu Mee; Irish, Jonathan C; Thompson, Leslee J

    2007-01-01

    The province of Ontario, as a result of the First Ministers' Meeting, was committed to addressing surgery wait times in Ontario. The Ministry of Health and Long-Term Care's response to this commitment was the Wait Times Strategy (WTS) initiative, which addressed access issues with the aim of positively impacting wait times in cancer surgery. Cancer Care Ontario (CCO) was tasked with managing the cancer surgery WTS. CCO engaged in accountability agreements with Ontario hospitals to provide incremental cancer surgery volumes, in return for one-time funding. Through the use of accountability agreements, CCO was able to tie service volume delivery, quality care initiatives and reporting requirements to funding. Other elements of the cancer surgery WTS implementation included the development of wait times definitions, guidelines and targets; the use of a performance management system; facilitation by existing regional cancer leads and continued development of regional cancer programs. Eight key lessons were learned: (1) baseline volume guarantees are critical to ensuring that wait times are positively impacted; (2) there is a need to create a balance between accountability and systems management; (3) clinical quality initiatives can be tied to funding initiatives; (4) allocations of services should be informed by many factors; (5) regional leadership is key to ensuring that local needs are met; (6) data are invaluable in improving performance; (7) there is regional disparity in service delivery, capacity and resources across the province; and (8) program sustainability is an underlying goal of the WTS for cancer surgery. The implication is that accountability agreements can be leveraged to create sustainable health management systems.

  20. Developing an information resources management strategy for regulatory veterinary medicine: a national imperative.

    PubMed

    Miller, L E; Honeycutt, T L; Cowen, P; Morrow, W E; Hueston, W D

    1994-10-15

    Lack of a standardized information technology management strategy has resulted in state and federal information systems evolving separately, rather than in tandem. Absence of an information management strategy will eventually affect regulatory program management, epidemiologic research, and domestic and international livestock trade. Producers will ultimately pay the price for the lack of regulatory coordination of US animal health and disease information. The longer the development of state and federal information technology management strategies is postponed, the more cost-, labor-, and time-intensive correcting the deficiency will be. Development of a national information resources management environment is the first step in constructing state and federal information technology strategies.

  1. Conservation values and management strategies of coastal windbreaks

    NASA Astrophysics Data System (ADS)

    Lee, M. J.; Song, G. Z. M.

    2015-12-01

    Taiwan is surrounded by oceans, so that the citizens' daily lives and the industrial activities in coast areas are exposed to and affected by strong winds and dust storms caused by the winter monsoon. Tree windbreaks present the functions of windproof, dust inhibition, damp-proof, and climate moderation. However, in recent years, the construction of roads, establishment industrial districts, development of recreation areas, building of wind turbines, and the cultivation of local citizens have greatly changed the width and integrity of tree windbreak belts, and in turn affected their functionality. Our study focus on tree windbreaks right next to the estuary of the Zhoushui River in Taiwan. Through environmental investigations, questionnaire surveys for local citizens, and vegetation sureys, the current functions of windbreaks and impacts of human disturbances on windbreaks will be evaluated. The conservation values and management strategies of tree windbreaks will be proposed after all.

  2. Management Strategies in Advanced Uterine Leiomyosarcoma: Focus on Trabectedin.

    PubMed

    Amant, Frédéric; Lorusso, Domenica; Mustea, Alexander; Duffaud, Florence; Pautier, Patricia

    2015-01-01

    The treatment of advanced uterine leiomyosarcomas (U-LMS) represents a considerable challenge. Radiological diagnosis prior to hysterectomy is difficult, with the diagnosis frequently made postoperatively. Whilst a total abdominal hysterectomy is the cornerstone of management of early disease, the role of routine adjuvant pelvic radiotherapy and adjuvant chemotherapy is less clear, since they may improve local tumor control in high risk patients but are not associated with an overall survival benefit. For recurrent or disseminated U-LMS, cytotoxic chemotherapy remains the mainstay of treatment. There have been few active chemotherapy drugs approved for advanced disease, although newer drugs such as trabectedin with its pleiotropic mechanism of actions represent an important addition to the standard front-line systemic therapy with doxorubicin and ifosfamide. In this review, we outline the therapeutic potential and in particular the emerging evidence-based strategy of therapy with trabectedin in patients with advanced U-LMS.

  3. Antioxidant Strategies in the Management of Diabetic Neuropathy

    PubMed Central

    Oyenihi, Ayodeji Babatunde; Ayeleso, Ademola Olabode; Masola, Bubuya

    2015-01-01

    Chronic hyperglycaemia (an abnormally high glucose concentration in the blood) resulting from defects in insulin secretion/action, or both, is the major hallmark of diabetes in which it is known to be involved in the progression of the condition to different complications that include diabetic neuropathy. Diabetic neuropathy (diabetes-induced nerve damage) is the most common diabetic complication and can be devastating because it can lead to disability. There is an increasing body of evidence associating diabetic neuropathy with oxidative stress. Oxidative stress results from the production of oxygen free radicals in the body in excess of its ability to eliminate them by antioxidant activity. Antioxidants have different mechanisms and sites of actions by which they exert their biochemical effects and ameliorate nerve dysfunction in diabetes by acting directly against oxidative damage. This review will examine different strategies for managing diabetic neuropathy which rely on exogenous antioxidants. PMID:25821809

  4. STRATEGIES AND TECHNOLOGY FOR MANAGING HIGH-CARBON ASH

    SciTech Connect

    Robert Hurt; Eric Suuberg; John Veranth; Xu Chen

    2002-09-10

    The overall objective of the present project is to identify and assess strategies and solutions for the management of industry problems related to carbon in ash. Specific research issues to be addressed include: (1) the effect of parent fuel selection on ash properties and adsorptivity, including a first ever examination of the air entrainment behavior of ashes from alternative (non-coal) fuels; (2) the effect of various low-NOx firing modes on ash properties and adsorptivity; and (3) the kinetics and mechanism of ash ozonation. This data will provide scientific and engineering support of the ongoing process development activities. During this fourth project period we completed the characterization of ozone-treated carbon surfaces and wrote a comprehensive report on the mechanism through which ozone suppresses the adsorption of concrete surfactants.

  5. Morbidly Adherent Placenta: Interprofessional Management Strategies for the Intrapartum Period.

    PubMed

    Baird, Suzanne McMurtry; Troiano, Nan H; Kennedy, Margaret Betsy Babb

    "Morbidly adherent placenta" is a term that describes the continuum of placenta accreta, increta, and percreta. The incidence of this type of abnormal placentation has increased significantly over recent decades. The reason is probably multifactorial but, partly, because of factors such as the increasing number of cesarean births. Women at greatest risk are those who have myometrial damage caused by a previous cesarean birth, with either anterior or posterior placenta previa overlying the uterine scar. This condition poses significant risks of morbidity and/or mortality to the pregnant woman and her fetus. A multidisciplinary approach to care throughout pregnancy is essential. This article describes the classification of morbidly adherent placenta, risk factors, methods of diagnosis, potential maternal and fetal complications, and intrapartum clinical management strategies to optimize outcomes.

  6. STRATEGIES AND TECHNOLOGY FOR MANAGING HIGH-CARBON ASH

    SciTech Connect

    Robert Hurt; Eric Suuberg; John Veranth; Xu Chen

    2003-05-20

    The overall objective of the present project is to identify and assess strategies and solutions for the management of industry problems related to carbon in ash. Specific research issues to be addressed include: (1) the effect of parent fuel selection on ash properties and adsorptivity, including a first ever examination of the air entrainment behavior of ashes from alternative (non-coal) fuels; (2) the effect of various low-NOx firing modes on ash properties and adsorptivity; and (3) the kinetics and mechanism of ash ozonation. This data will provide scientific and engineering support of the ongoing process development activities. During this fourth project period we completed the characterization of ozone-treated carbon surfaces and wrote a comprehensive report on the mechanism through which ozone suppresses the adsorption of concrete surfactants.

  7. Blending Effective Behavior Management and Literacy Strategies for Preschoolers Exhibiting Negative Behavior

    ERIC Educational Resources Information Center

    Smith, Jaime

    2009-01-01

    Sometimes students will exhibit various aggressive behaviors in the preschool classroom. Early childhood educators need to have behavior management strategies to manage the students' negative behaviors within the classroom setting. This article will provide a rationale for embedding literacy instruction within behavior management strategies to…

  8. Dementia Management Strategies and Adjustment of Family Members of Older Patients.

    ERIC Educational Resources Information Center

    Hinrichsen, Gregory A.; Niederehe, George

    1994-01-01

    Examined how strategies to manage dementia problems in 152 older people were associated with adjustment of family members while providing assistance to relative. Identified three dementia management strategies (criticism, encouragement, and active management) that were associated with three indices of family members' emotional adjustment (burden,…

  9. Blending Effective Behavior Management and Literacy Strategies for Preschoolers Exhibiting Negative Behavior

    ERIC Educational Resources Information Center

    Smith, Jaime

    2009-01-01

    Sometimes students will exhibit various aggressive behaviors in the preschool classroom. Early childhood educators need to have behavior management strategies to manage the students' negative behaviors within the classroom setting. This article will provide a rationale for embedding literacy instruction within behavior management strategies to…

  10. Perioperative Pain Management Strategies for Amputation: A Topical Review.

    PubMed

    Kent, Michael L; Hsia, Hung-Lun John; Van de Ven, Thomas J; Buchheit, Thomas E

    2017-03-01

    To review acute pain management strategies in patients undergoing amputation with consideration of preoperative patient factors, pharmacologic/interventional modalities, and multidisciplinary care models to alleviate suffering in the immediate post-amputation setting. Regardless of surgical indication, patients undergoing amputation suffer from significant residual limb pain and phantom limb pain in the acute postoperative phase. Most studies have primarily focused on strategies to prevent persistent pain with inclusion of immediate postoperative outcomes as secondary measures. Pharmacologic agents, including gabapentin, ketamine, and calcitonin, and interventional modalities such as neuraxial and perineural catheters, have been examined in the perioperative period. Focused Literature Review. Pharmacologic agents (gabapentin, ketamine, calcitonin) have not shown consistent efficacy. Neuraxial analgesia has demonstrated both an opioid sparing and analgesic benefit while results have been mixed regarding perineural catheters in the immediate post-amputation setting. However, several early studies of perineural catheters employed sub-optimal techniques (distal surgical placement), and prolonged use of perineural catheters may provide a sustained benefit. Regardless of analgesic technique, a multidisciplinary approach is necessary for optimal care. Patient-tailored analgesic regimens utilizing catheter-based techniques are essential in the acute post-amputation phase and should be implemented in all patients undergoing amputation. Future research should focus on improved measurement of acute pain and comparisons of effective analgesic regimens instead of single techniques.

  11. Statin Intolerance: A Literature Review and Management Strategies.

    PubMed

    Saxon, David R; Eckel, Robert H

    Statin intolerance is a commonly encountered clinical problem for which useful management strategies exist. Although many patients report statin-related muscle symptoms, studies indicate that the majority of these patients can tolerate a statin upon re-challenge. Alternative statin dosing strategies are an effective way to modify and reintroduce statin therapy for patients reporting adverse symptoms. Correction of vitamin D deficiency and hypothyroidism may improve statin tolerability in some patients. CoQ10 supplementation has been found to be of no benefit for statin-related muscle symptoms in most recent clinical trials. PCSK9 inhibitors are a new therapeutic option that if confirmed as safe and effective by outcomes trials may be of substantial benefit to select patients at high ASCVD risk who are unable to achieve adequate low-density lipoprotein cholesterol (LDL-C) lowering on maximally tolerated statin therapy. Other available medications to lower LDL-C in statin intolerant patients include ezetimibe, bile acid sequestrants, niacin, and fibrates. Published by Elsevier Inc.

  12. Current nutritional recommendations and novel dietary strategies to manage sarcopenia

    PubMed Central

    Calvani, Riccardo; Miccheli, Alfredo; Landi, Francesco; Bossola, Maurizio; Cesari, Matteo; Leeuwenburgh, Christiaan; Sieber, Cornel C.; Bernabei, Roberto; Marzetti, Emanuele

    2015-01-01

    Sarcopenia, the loss of skeletal muscle mass and function that occurs with aging, is associated with increased risk for several adverse health outcomes, including frailty, disability, falls, loss of independent living, and mortality. At present, no pharmacological treatment exists that is able to definitely halt the progression of sarcopenia. Likewise, no pharmacological remedies are yet available to prevent the onset of age-related muscle wasting. In this scenario, the combination of nutritional interventions and physical exercise appears to be the most effective strategy presently available for the management of sarcopenia. The purposes of this review are to summarize the current knowledge on the role of nutrition as a countermeasure for sarcopenia, illustrate the mechanisms of action of relevant dietary agents on the aging muscle, and introduce novel nutritional strategies that may help preserve muscle mass and function into old age. Issues related to the identification of the optimal timing of nutritional interventions in the context of primary and secondary prevention are also discussed. Finally, the prospect of elaborating personalized dietary and physical exercise recommendations through the implementation of integrated, high-throughput analytic approaches is illustrated. PMID:26082911

  13. Intraoperative nonpharmacotherapeutic blood management strategies in total knee arthroplasty.

    PubMed

    Banerjee, Samik; Issa, Kimona; Kapadia, Bhaveen H; Khanuja, Harpal S; Harwin, Steven F; McInerney, Vincent K; Mont, Michael A

    2013-12-01

    Substantial amounts of perioperative blood loss occur during total knee arthroplasty (TKA) that may require allogeneic transfusion in more than 30% of patients. Increased blood loss leads to poor physical functioning, increases infection risks, and prolongs hospitalization, which may eventually affect the overall clinical outcomes of TKA. In addition, allogeneic blood transfusions are associated with increased risks of transfusion reactions, immunosuppression, and a variety of immunological reactions. These concerns have led surgeons and anesthesiologists to develop various strategies to conserve blood, reduce costs, and decrease complications related to blood transfusions. Multiple nonpharmacologic intraoperative blood-saving measures have been used including acute normovolemic hemodilution, hypotensive anesthesia, tourniquets, bipolar sealants, intraoperative blood salvage systems, intramedullary femoral plugs, computer-assisted surgery, and the use of patient-specific instrumentation. However, no clear protocol exists currently to help surgeons choose the appropriate method for blood preservation. The aim of this article was to review the various nonpharmacologic intraoperative blood management strategies that have been used in TKA and to analyze their effectiveness and potential complications according to current evidence.

  14. Human resource management strategies and the retention of older RNs.

    PubMed

    Armstrong-Stassen, Marjorie

    2005-01-01

    This study investigated the human resource management strategies that are most important in retaining older RNs in the workforce and the extent to which hospitals are currently engaging in these practices. The participants (n=361) were RNs aged 50 and over employed in hospitals across Ontario. Along with flexible work schedules, the human resource practices rated as most important in the decision of these RNs to remain in the workforce involved compensation (improving benefits; offering incentives for continued employment), recognition and respect (showing appreciation for a job well done; recognizing the experience, knowledge, skill and expertise of older nurses; ensuring that older nurses are treated with respect by others in the organization) and pre- and post-retirement arrangements (retirement with callback; partial or phased retirement options). There were significant differences between the importance that RNs attributed to the 34 human resource practices and the extent to which their hospitals are currently engaged in each practice, with the largest discrepancies occurring for those practices that RNs indicated were most important in their decision to remain in the workforce. While some hospitals may have difficulty in implementing strategies that have budgetary implications, all could implement recognition and respect with minimal financial consequences.

  15. Integrated design strategy for product life-cycle management

    NASA Astrophysics Data System (ADS)

    Johnson, G. Patrick

    2001-02-01

    Two major trends suggest new considerations for environmentally conscious manufacturing (ECM) -- the continuation of dematerialization and the growing trend toward goods becoming services. A diversity of existing research could be integrated around those trends in ways that can enhance ECM. Major research-based achievements in information, computation, and communications systems, sophisticated and inexpensive sensing capabilities, highly automated and precise manufacturing technologies, and new materials continue to drive the phenomenon of dematerialization - the reduction of the material and energy content of per capita GDP. Knowledge is also growing about the sociology, economics, mathematics, management and organization of complex socio-economic systems. And that has driven a trend towards goods evolving into services. But even with these significant trends, the value of material, energy, information and human resources incorporated into the manufacture, use and disposal of modern products and services often far exceeds the benefits realized. Multi-disciplinary research integrating these drivers with advances in ECM concepts could be the basis for a new strategy of production. It is argued that a strategy of integrating information resources with physical and human resources over product life cycles, together with considering products as streams of service over time, could lead to significant economic payoff. That strategy leads to an overall design concept to minimize costs of all resources over the product life cycle to more fully capture benefits of all resources incorporated into modern products. It is possible by including life cycle monitoring, periodic component replacement, re-manufacture, salvage and human factor skill enhancement into initial design.

  16. Contemporary strategies in the diagnosis and management of heart failure.

    PubMed

    Dunlay, Shannon M; Pereira, Naveen L; Kushwaha, Sudhir S

    2014-05-01

    Heart failure (HF) is an important public health problem, and strategies are needed to improve outcomes and decrease health care resource utilization and costs. Its prevalence has increased as the population ages, and HF continues to be associated with a high mortality rate and frequent need for hospitalization. The total cost of care for patients with HF was $30.7 billion in 2012, and it is estimated to more than double to $69.8 billion by 2030. Given this reality, there has been recent investigation into ways of identifying and preventing HF in patients at risk (stage A HF) and those with cardiac structural and functional abnormalities but no clinical HF symptoms (stage B). For patients who have symptoms of HF (stage C), there has been important research into the most effective ways to decongest patients hospitalized with acute decompensated HF and prevent future hospital readmissions. Successful strategies to treat patients with HF and preserved ejection fraction, which has increased in prevalence, continue to be sought. We are in the midst of a rapid evolution in our ability to care for patients with end-stage HF (stage D) because of the introduction of and improvements in mechanical circulatory support. Left ventricular assist devices used as destination therapy offer an important therapeutic option to patients who do not qualify for heart transplant because of advanced age or excessive comorbidity. This review provides a thorough update on contemporary strategies in the diagnosis and management of HF by stage (A to D) that have emerged during the past several years. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  17. French consensus. Management of patients with hypersomnia: Which strategy?

    PubMed

    Lopez, R; Arnulf, I; Drouot, X; Lecendreux, M; Dauvilliers, Y

    Central hypersomnias principally involves type 1 narcolepsy (NT1), type 2 narcolepsy (NT2) and idiopathic hypersomnia (IH). Despite great progress made in understanding the physiopathology of NT1 with low cerebrospinal fluid hypocretin-1 levels, current treatment remains symptomatic. The same applies to NT2 and IH, for which the physiopathology is still largely unknown. Controlling excessive daytime sleepiness (EDS), cataplexy, hypnagogic hallucinations, sleep paralysis and disturbed night-time sleep are key therapeutic targets in NT1. For IH and NT2, reducing EDS is the main objective. Based on European and American directives for the treatment of narcolepsy, we propose French recommendations for managing central hypersomnias as well as strategies in the case of drug-resistance. Stimulating treatments target EDS, and Modafinil is the first-line treatment. Other stimulants such as methylphenidate, pitolisant, and exceptionally dextro-amphetamine can be prescribed. Selective serotonin and noradrenaline reuptake inhibitor antidepressants are effective for the management of cataplexy in NT1. Sodium oxybate is an effective treatment for several symptoms, including EDS, cataplexy and disturbed night-time sleep. Treatment of central hypersomnia must also take into consideration frequent cardiovascular, metabolic and psychiatric comorbidities, particularly in NT1. New therapies are currently under study with the development of new stimulants and anti-cataplectics. The next few years will see innovative emerging therapies, based on a physiopathological approach, aiming to restore hypocretinergic transmission or to interrupt the autoimmune processes causing the loss of hypocretin neurons.

  18. Information Management Strategies in Early Adolescence: Developmental Change in Use and Transactional Associations with Psychological Adjustment

    ERIC Educational Resources Information Center

    Laird, Robert D.; Marrero, Matthew D.; Melching, Jessica A.; Kuhn, Emily S.

    2013-01-01

    Adolescents use various strategies to manage their parents' access to information. This study tested developmental change in strategy use, longitudinal associations between disclosing and concealing strategies, and longitudinal associations linking disclosing and concealing strategies with antisocial behavior and depressive symptoms. Self-report…

  19. Information Management Strategies in Early Adolescence: Developmental Change in Use and Transactional Associations with Psychological Adjustment

    ERIC Educational Resources Information Center

    Laird, Robert D.; Marrero, Matthew D.; Melching, Jessica A.; Kuhn, Emily S.

    2013-01-01

    Adolescents use various strategies to manage their parents' access to information. This study tested developmental change in strategy use, longitudinal associations between disclosing and concealing strategies, and longitudinal associations linking disclosing and concealing strategies with antisocial behavior and depressive symptoms. Self-report…

  20. Goat farming systems in Martinique: management and breeding strategies.

    PubMed

    Alexandre, G; Leimbacher, F; Maurice, O; Domarin, D; Naves, M; Mandonnet, N

    2009-04-01

    To be successful, initiatives to improve farmer's goat production should directly address the needs and objectives of the keepers while promoting rational use of local genetic resources. A survey was carried out to implement a genetic policy governing meat goat farming in Martinique (11,400 heads and 33,400 ha arable land). The questionnaire comprised a total of 27 items with 306 modalities, and included questions on farm structure, crop and animal productions, management of feeding, reproduction and health control. The sample consisted of 33 farmers with 644 ha and 2,680 goats (1,286 does and 52 bucks), 97% of does in the studied sample were crossbred, 56% of bucks were" imported" breeds (Boer or Anglo-Nubian). The number of goats per farm varied from 16 to 582. The feeding system was predominantly grazing, according to a rotation (55% of cases) or continuous grazing system (42%). On 62% of farms, the males remained with the females permanently, also 83% of farmers did not resort to methods of controlled-mating. The first criteria used for choosing animals (80 to 90% of answers) of both sex, were development and conformation. Assuming that adaptive together with productive traits are important in tropical zones, it is advisable to better define the maternal lineage of the local livestock (presently very sparse records), to improve reproduction management and culling strategies (poor and inadequate management practices do not support any genetic improvement programme), and to guide the farmers in their decisions by employing concerted interprofessional actions (choice of meat breed, market studies).

  1. Retaining Staff Employees: The Relationship between Human Resources Management Strategies and Organizational Commitment.

    ERIC Educational Resources Information Center

    Buck, Jeffrey M.; Watson, John L.

    2002-01-01

    Explored whether an institution's human resources management (HRM) strategies can influence individuals' organizational commitment levels, which ultimately can affect staff turnover rates. Found significant relationship between certain HRM strategies and commitment constructs. (EV)

  2. Retaining Staff Employees: The Relationship between Human Resources Management Strategies and Organizational Commitment.

    ERIC Educational Resources Information Center

    Buck, Jeffrey M.; Watson, John L.

    2002-01-01

    Explored whether an institution's human resources management (HRM) strategies can influence individuals' organizational commitment levels, which ultimately can affect staff turnover rates. Found significant relationship between certain HRM strategies and commitment constructs. (EV)

  3. Green supply chain management strategy selection using analytic network process: case study at PT XYZ

    NASA Astrophysics Data System (ADS)

    Adelina, W.; Kusumastuti, R. D.

    2017-01-01

    This study is about business strategy selection for green supply chain management (GSCM) for PT XYZ by using Analytic Network Process (ANP). GSCM is initiated as a response to reduce environmental impacts from industrial activities. The purposes of this study are identifying criteria and sub criteria in selecting GSCM Strategy, and analysing a suitable GSCM strategy for PT XYZ. This study proposes ANP network with 6 criteria and 29 sub criteria, which are obtained from the literature and experts’ judgements. One of the six criteria contains GSCM strategy options, namely risk-based strategy, efficiency-based strategy, innovation-based strategy, and closed loop strategy. ANP solves complex GSCM strategy-selection by using a more structured process and considering green perspectives from experts. The result indicates that innovation-based strategy is the most suitable green supply chain management strategy for PT XYZ.

  4. Mathematics, Pricing, Market Risk Management and Trading Strategies for Financial Derivatives (2/3)

    ScienceCinema

    None

    2016-07-12

    Market Trading and Risk Management of Vanilla FX Options - Measures of Market Risk - Implied Volatility - FX Risk Reversals, FX Strangles - Valuation and Risk Calculations - Risk Management - Market Trading Strategies

  5. Mathematics, Pricing, Market Risk Management and Trading Strategies for Financial Derivatives (2/3)

    SciTech Connect

    2009-11-04

    Market Trading and Risk Management of Vanilla FX Options - Measures of Market Risk - Implied Volatility - FX Risk Reversals, FX Strangles - Valuation and Risk Calculations - Risk Management - Market Trading Strategies

  6. 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.

  7. Employee stress management: An examination of adaptive and maladaptive coping strategies on employee health.

    PubMed

    Holton, M Kim; Barry, Adam E; Chaney, J Don

    2015-01-01

    Employees commonly report feeling stressed at work. Examine how employees cope with work and personal stress, whether their coping strategies are adaptive (protective to health) or maladaptive (detrimental to health), and if the manner in which employees cope with stress influences perceived stress management. In this cross-sectional study, a random sample of 2,500 full-time university non-student employees (i.e. faculty, salaried professionals, and hourly non-professionals) were surveyed on health related behaviors including stress and coping. Approximately 1,277 completed the survey (51% ). Hierarchical logistic regression was used to assess the ability of adaptive and maladaptive coping strategies to predict self-reported stress management, while controlling for multiple demographic variables. Over half of employees surveyed reported effective stress management. Most frequently used adaptive coping strategies were communication with friend/family member and exercise, while most frequently used maladaptive coping strategies were drinking alcohol and eating more than usual. Both adaptive and maladaptive coping strategies made significant (p < 0.05) contributions to predicting employee's perceived stress management. Only adaptive coping strategies (B = 0.265) predicted whether someone would self-identify as effectively managing stress. Use of maladaptive coping strategies decreased likelihood of self-reporting effective stress management. Actual coping strategies employed may influence employees' perceived stress management. Adaptive coping strategies may be more influential than maladaptive coping strategies on perceived stress management. Results illustrate themes for effective workplace stress management programs. Stress management programs focused on increasing use of adaptive coping may have a greater impact on employee stress management than those focused on decreasing use of maladaptive coping. Coping is not only a reaction to stressful experiences but also

  8. An optimized strategy for the management of spent steam generators

    SciTech Connect

    Cantrel, Eric; Denissen, Luc; Davain, Henri; Leveau, Jean-Phillipe; Lauwers, Johan; Gillet, Thierry

    2007-07-01

    The decommissioning of the BR3 (Belgian Reactor 3) approaches its final phase. The electro-mechanical dismantling is almost completed and the program related to the decontamination of the building structures has been initiated. The issue of the evacuation of the primary circuit large components, and more specifically of the Steam Generator (SG), has been dealt successfully, applying innovative technologies to lead to remarkable results in terms of waste volume minimization and occupational radiation exposure. The strategy applied for the evacuation of the BR3 SG resulted from the elaboration and comparison of the following scenarios: - Closed loop chemical decontamination prior to dismantling, cutting and unconditional release or release after melting, - Cutting of the components without decontamination and evacuation of the materials in their respective waste categories, - Cutting, decontamination of the SG secondary side and evacuation of the full SG primary side to the melting facility for recycling. While the availability of the in-house developed MEDOC{sup R} process made the clearance of the SG bundle technically feasible, nuclear safety requirements and financial aspects were also in favour of the closed loop decontamination: minimization of contamination spreading and staff exposure during all subsequent manipulations, minimization of radwaste costs. For the segmentation of this component, different techniques have been considered: An abrasive water jet (AWJ) cutting tool, A prototype diamond wire developed for this application. The diamond wire allowed to cut in a single pass both the carbon steel shell and the stainless steel tube bundle. While the implementation of the diamond wire saw is rather simple, working conditions must be optimised to limit wearing of the wire and secondary waste production. Existing experience can be extrapolated to different legal frameworks in order to propose a financially and technically optimised 'all-in' strategy for the

  9. Pattern-based Strategy: Strategically Aligning Information Management for Mission Success

    DTIC Science & Technology

    2011-03-17

    Pattern-based Strategy Strategically Aligning Information Management for Mission Success g o v 3/17/2011 w w w . i n l . g w Report...TYPE 3. DATES COVERED 00-00-2011 to 00-00-2011 4. TITLE AND SUBTITLE Pattern-based Strategy. Strategically Aligning Information Management for... Information ManagementManager of IM Strategic Planning – Enterprise Architect Idaho National Laboratory Mission • Ensure the nation’s energy security

  10. Land use and management in PR China: problems and strategies.

    PubMed

    Cai, Y

    1990-10-01

    The conflict between population and land in China results from high population density, declining availability of arable land, decrease in cropland, overgrazing, inability to afford imported grain, and expansion of land use for urbanization. Unwise decisions have been made. These decisions have resulted in land degradation, soil erosion, deforestation, degradation of grasslands, waste of land for freight storage or waste disposal due to low grain prices, and nonagricultural constructions on croplands. Ineffective land management problems are identified as: 1) the lack of an economic means of guiding land use and land is not valued; the lack of any mechanism to ensure economic land use including public lands which are not accounted for with rent; 2) the lack of integration of departments into the decision making structure and too many departments making decisions about the same land; 3) the lack of choice in land use which results in higher government departments being unaware of local conditions, and the lack of appropriate investment which results in short-term exploitation; and 4) surveys are inadequate for decision making. The strategies suggested for improvement in land use management include low resources expenditure in production and appropriate goods consumption. The goal is to sustain subsistence with gradual improvement through development. Land resources must be conserved and the environment protected. The solutions to depend on food imports or reduce the nutritional level deny the equally plausible solution to generate a higher level of input. The profit motive and scientific agricultural practices could accomplish this end. Reclamation for cropland is possible for 8 million hectares of wasteland in wide areas in Sanjiang Plain and 3.4 million hectares in small pockets in Eastern Monsoon China. Traditional agriculture must be transformed and an optimum scale of land operation established. Land tenure reform is necessary. Regional conditions must prevail

  11. Ecologically Significant Monitoring Strategies for Watershed Managers and Applied Ecohydrologists

    NASA Astrophysics Data System (ADS)

    Buchanan, B. P.; Walter, T.

    2007-12-01

    Upper Klamath Lake in Southern Oregon is home to a unique and increasingly rare strain of redband rainbow trout (Oncorhynchus mykiss newberrii). Populations connected to perennial lake systems such as the Upper Klamath have evolved adfluvial life histories and may possess unique adaptations that underscore their importance as units of conservation. Anthropogenic disturbance including stream channelization, timber harvest, livestock grazing and irrigation diversion have resulted in a 41 percent reduction in the redband's historic habitat and the disappearance of 11 redband trout populations throughout Oregon, Washington, and Idaho. In an effort to actively conserve this sensitive subspecies, a stream creation project was undertaken with the goal of increasing viable spawning and rearing habitat in Crooked Creek, a tributary to Upper Klamath Lake. A combination of analogue, empirical and analytical techniques were employed in the design of the created channel morphology (i.e. channel planform, profile, and cross-section), the sizing of bed substrate and spawning gravels and the design of in-stream habitat and scour structures. The project, completed in the fall of 1996, was qualitatively judged a success (e.g. trout were observed actively spawning and young-of-the-year were collected during unsystematic surveys). Unfortunately, as is often the case in the stream enhancement/restoration field, funding and personnel time were lacking for the implementation of a robust post-construction monitoring plan. Thus, project success was ascertained through cursory analyses and anecdotal reports. An opportunity to implement a similar stream creation project in a nearby watershed has afforded us the chance to return to the project site and conduct a more comprehensive, quantitative analysis of the project's success. A discussion of the original design methods and a review of several state of the art monitoring strategies are provided to assist watershed managers and applied

  12. New Management Strategies of Oral Tongue Cancer in Bangladesh.

    PubMed

    Sultana, Jachmen; Bashar, Abul; Molla, Motiur Rahman

    2014-12-01

    Malignancies of the tongue represent one of the greatest management challenges for the maxillofacial surgeons as well as oncologists, because of the adverse effects of treatment on oral and pharyngeal function, the eventual quality of life, and the poor prognosis of advanced disease. Therefore, it is important to use judgment and experience in determining the best method of treatment. We reviewed forty cases of oral tongue cancer patients admitted in the Dental and Facio-Maxillary Surgical Oncology department in National Institute of Cancer Research and Hospital, and department of Oral and Maxillofacial Surgery, Dhaka Dental College and Hospital, Dhaka, Bangladesh, during the past four years and followed till the lesion healed or recurred and followed later on upto two years. All cases were thoroughly examined, investigated with routine blood examinations and radiography of the involved region. Preoperative biopsy of the lesion and staging was done in each and every case. Postoperative biopsy was taken where there was a doubt about the possibility of recurrence. Squamous cell carcinoma (well differentiated) is by far the most common malignancy of the oral tongue. Generally a correlation is recognized between tumor size, nodal presence, metastasis, and eventual prognosis. When surgeons detect oral tongue cancer at an early stage, they can often treat it with surgery or can, often treat it with surgery or radiation. In later stages the cancer may require a combination of surgery, radiation and chemotherapy. Standard and uniform protocol has not been explored till now for the practice in our country. So current management strategies of oral tongue cancer cannot be underestimated.

  13. Caries management by risk assessment: A review on current strategies for caries prevention and management

    PubMed Central

    Maheswari, S. Uma; Raja, Jacob; Kumar, Arvind; Seelan, R. Gnana

    2015-01-01

    The current trend in treating dental caries is using nondestructive risk-based caries management strategies rather than focusing on the restorative treatment alone. Currently, there have been many changes in understanding of the multifaceted nature of caries process and its management. Caries Management by Risk Assessment (CAMBRA) which is an evidence-based approach focuses on determining many factors causing the expression of disease and take corrective action. The clinicians can ascertain what behaviors are increasing a patient's risk for disease and disease progression by evaluating the current caries risk of a patient. With this modern CAMBRA protocol, a novel treatment plan can be designed to arrest dental caries thereby decreasing the chance of cavitation. After the recognition of the multi factorial nature of caries involving the biofilm, the contemporary approaches focused mainly on the various options to cope with the locally out-of-balance oral biofilm and stop the progression of the disease. The initial caries lesions can be diagnosed with modern diagnostic aids and with the help of CAMBRA, reestablishment of the integrity of the tooth surface early on in the caries process will bring great rewards for patients. This review focuses on the repair of hard tooth tissues using noninvasive strategies. PMID:26538870

  14. Do fibromyalgia patients use active pain management strategies? A cohort study.

    PubMed

    Gauffin, Jarno; Hankama, Tiina; Hannonen, Pekka; Kautiainen, Hannu; Pohjolainen, Timo; Haanpää, Maija

    2013-05-01

    The aim of this study was to examine the types of pain management strategies used by patients with fibromyalgia. A total of 158 patients with primary fibromyalgia attended a clinical visit to confirm the diagnosis. They completed 3 questionnaires: (i) a self-made questionnaire, (ii) Beck Depression Inventory IA (BDI IA), and (iii) Finnish version of Fibromyalgia Impact Questionnaire. The self-made questionnaire included questions about: intensity of current pain; general well-being; pain management strategies, including pain medications; efficacy of the pain management methods; current health problems other than fibromyalgia. The pain management strategies were subcategorized (e.g., physical exercise, massage and heat treatment). The strategies were also divided into active and passive types. The most frequently reported pain management strategies were physical exercise (54%), physical therapy (32%) and cold treatment (27%). The use of active pain management strategies, BDI IA < 10 points and age were independent predictors of the reported pain management efficacy. Patients who used active pain management strategies reported better efficacy with the BDI IA score ≥ 10 points. Active pain management strategies are most efficacious for fibromyalgia patients, regardless of the severity of fibromyalgia or optional comorbid depression.

  15. The community resource management area mechanism: a strategy to manage African forest resources for REDD+.

    PubMed

    Asare, Rebecca A; Kyei, Andrew; Mason, John J

    2013-01-01

    Climate change poses a significant threat to Africa, and deforestation rates have increased in recent years. Mitigation initiatives such as REDD+ are widely considered as potentially efficient ways to generate emission reductions (or removals), conserve or sustainably manage forests, and bring benefits to communities, but effective implementation models are lacking. This paper presents the case of Ghana's Community Resource Management Area (CREMA) mechanism, an innovative natural resource governance and landscape-level planning tool that authorizes communities to manage their natural resources for economic and livelihood benefits. This paper argues that while the CREMA was originally developed to facilitate community-based wildlife management and habitat protection, it offers a promising community-based structure and process for managing African forest resources for REDD+. At a theoretical level, it conforms to the ecological, socio-cultural and economic factors that drive resource-users' decision process and practices. And from a practical mitigation standpoint, the CREMA has the potential to help solve many of the key challenges for REDD+ in Africa, including definition of boundaries, smallholder aggregation, free prior and informed consent, ensuring permanence, preventing leakage, clarifying land tenure and carbon rights, as well as enabling equitable benefit-sharing arrangements. Ultimately, CREMA's potential as a forest management and climate change mitigation strategy that generates livelihood benefits for smallholder farmers and forest users will depend upon the willingness of African governments to support the mechanism and give it full legislative backing, and the motivation of communities to adopt the CREMA and integrate democratic decision-making and planning with their traditional values and natural resource management systems.

  16. The community resource management area mechanism: a strategy to manage African forest resources for REDD+

    PubMed Central

    Asare, Rebecca A.; Kyei, Andrew; Mason, John J.

    2013-01-01

    Climate change poses a significant threat to Africa, and deforestation rates have increased in recent years. Mitigation initiatives such as REDD+ are widely considered as potentially efficient ways to generate emission reductions (or removals), conserve or sustainably manage forests, and bring benefits to communities, but effective implementation models are lacking. This paper presents the case of Ghana's Community Resource Management Area (CREMA) mechanism, an innovative natural resource governance and landscape-level planning tool that authorizes communities to manage their natural resources for economic and livelihood benefits. This paper argues that while the CREMA was originally developed to facilitate community-based wildlife management and habitat protection, it offers a promising community-based structure and process for managing African forest resources for REDD+. At a theoretical level, it conforms to the ecological, socio-cultural and economic factors that drive resource-users’ decision process and practices. And from a practical mitigation standpoint, the CREMA has the potential to help solve many of the key challenges for REDD+ in Africa, including definition of boundaries, smallholder aggregation, free prior and informed consent, ensuring permanence, preventing leakage, clarifying land tenure and carbon rights, as well as enabling equitable benefit-sharing arrangements. Ultimately, CREMA's potential as a forest management and climate change mitigation strategy that generates livelihood benefits for smallholder farmers and forest users will depend upon the willingness of African governments to support the mechanism and give it full legislative backing, and the motivation of communities to adopt the CREMA and integrate democratic decision-making and planning with their traditional values and natural resource management systems. PMID:23878338

  17. STRATEGIES AND TECHNOLOGY FOR MANAGING HIGH-CARBON ASH

    SciTech Connect

    Robert Hurt; Eric Suuberg; John Veranth

    2001-06-22

    The overall objective of the present project is to identify and assess strategies and solutions for the management of industry problems related to carbon in ash. Specific research issues to be addressed include: (1) the effect of parent fuel selection on ash properties and adsorptivity, including a first ever examination of the air entrainment behavior of ashes from alternative (non-coal) fuels; (2) the effect of various low-NOx firing modes on ash properties and adsorptivity; and (3) the kinetics and mechanism of ash ozonation. This data will provide scientific and engineering support of the ongoing process development activities. This first project period, experiments were carried out to better understand the fundamental nature of the ozonation effect on ash. Carbon surfaces were characterized by surfactant adsorption, and by X-ray Photoelectron Spectroscopy before and after oxidation, both by air at 440 C and by ozone at room temperature. The results strongly suggest that the beneficial effect of ozonation is in large part due to chemical modification of the carbon surfaces.

  18. STRATEGIES AND TECHNOLOGY FOR MANAGING HIGH-CARBON ASH

    SciTech Connect

    Robert Hurt; Eric Suuberg; John Veranth; Xu Chen; Indrek Kulaots

    2004-02-13

    The overall objective of the present project was to identify and assess strategies and solutions for the management of industry problems related to carbon in ash. Specific issues addressed included: (1) the effect of parent fuel selection on ash properties and adsorptivity, including a first ever examination of the air entrainment behavior of ashes from alternative (non-coal) fuels; (2) the effect of various low-NOx firing modes on ash properties and adsorptivity based on pilot-plant studies; and (3) the kinetics and mechanism of ash ozonation. This laboratory data has provided scientific and engineering support and underpinning for parallel process development activities. The development work on the ash ozonation process has now transitioned into a scale-up and commercialization project involving a multi-industry team and scheduled to begin in 2004. This report describes and documents the laboratory and pilot-scale work in the above three areas done at Brown University and the University of Utah during this three-year project.

  19. Surgical Management of Rib Fractures: Strategies and Literature Review.

    PubMed

    de Jong, M B; Kokke, M C; Hietbrink, F; Leenen, L P H

    2014-06-01

    Rib fractures can cause significant problems in trauma patients, often resulting in pain and difficulty with respiration. To prevent pulmonary complications and decrease the morbidity and mortality rates of patients with rib fractures, currently there is a trend to provide surgical management of patients with flail chest. However, the indications for rib fracture fixation require further specification. Past and current strategies are described according to a review of the medical literature. A systematic review was performed including current indications for rib fracture fixation. MEDLINE (2000-2013) was searched, as well as Embase (2000-2013) and Cochrane Databases, using the keywords rib, fracture, fixation, plate, repair, and surgery. Three retrospective studies were found that described different techniques for rib fracture fixation. The results demonstrated a reduced number of ventilation days, decreased long-term morbidity and pain, and satisfactory rehabilitation after surgical treatment. In addition to flail chest, age, Injury Severity Score, and the number of rib fractures were important predictive factors for morbidity and mortality. Surgical rib fracture fixation might be indicated in a broader range of cases than is currently performed. Prospective randomized trials are needed for further confirmation. © The Finnish Surgical Society 2014.

  20. Real Time Energy Management Control Strategies for Hybrid Powertrains

    NASA Astrophysics Data System (ADS)

    Zaher, Mohamed Hegazi Mohamed

    In order to improve fuel efficiency and reduce emissions of mobile vehicles, various hybrid power-train concepts have been developed over the years. This thesis focuses on embedded control of hybrid powertrain concepts for mobile vehicle applications. Optimal robust control approach is used to develop a real time energy management strategy for continuous operations. The main idea is to store the normally wasted mechanical regenerative energy in energy storage devices for later usage. The regenerative energy recovery opportunity exists in any condition where the speed of motion is in opposite direction to the applied force or torque. This is the case when the vehicle is braking, decelerating, or the motion is driven by gravitational force, or load driven. There are three main concepts for regernerative energy storing devices in hybrid vehicles: electric, hydraulic, and flywheel. The real time control challenge is to balance the system power demand from the engine and the hybrid storage device, without depleting the energy storage device or stalling the engine in any work cycle, while making optimal use of the energy saving opportunities in a given operational, often repetitive cycle. In the worst case scenario, only engine is used and hybrid system completely disabled. A rule based control is developed and tuned for different work cycles and linked to a gain scheduling algorithm. A gain scheduling algorithm identifies the cycle being performed by the machine and its position via GPS, and maps them to the gains.

  1. Sports-related concussions: diagnosis, complications, and current management strategies.

    PubMed

    Hobbs, Jonathan G; Young, Jacob S; Bailes, Julian E

    2016-04-01

    Sports-related concussions (SRCs) are traumatic events that affect up to 3.8 million athletes per year. The initial diagnosis and management is often instituted on the field of play by coaches, athletic trainers, and team physicians. SRCs are usually transient episodes of neurological dysfunction following a traumatic impact, with most symptoms resolving in 7-10 days; however, a small percentage of patients will suffer protracted symptoms for years after the event and may develop chronic neurodegenerative disease. Rarely, SRCs are associated with complications, such as skull fractures, epidural or subdural hematomas, and edema requiring neurosurgical evaluation. Current standards of care are based on a paradigm of rest and gradual return to play, with decisions driven by subjective and objective information gleaned from a detailed history and physical examination. Advanced imaging techniques such as functional MRI, and detailed understanding of the complex pathophysiological process underlying SRCs and how they affect the athletes acutely and long-term, may change the way physicians treat athletes who suffer a concussion. It is hoped that these advances will allow a more accurate assessment of when an athlete is truly safe to return to play, decreasing the risk of secondary impact injuries, and provide avenues for therapeutic strategies targeting the complex biochemical cascade that results from a traumatic injury to the brain.

  2. ICT Solutions for Highly-Customized Water Demand Management Strategies

    NASA Astrophysics Data System (ADS)

    Giuliani, M.; Cominola, A.; Castelletti, A.; Fraternali, P.; Guardiola, J.; Barba, J.; Pulido-Velazquez, M.; Rizzoli, A. E.

    2016-12-01

    The recent deployment of smart metering networks is opening new opportunities for advancing the design of residential water demand management strategies (WDMS) relying on improved understanding of water consumers' behaviors. Recent applications showed that retrieving information on users' consumption behaviors, along with their explanatory and/or causal factors, is key to spot potential areas where targeting water saving efforts, and to design user-tailored WDMS. In this study, we explore the potential of ICT-based solutions in supporting the design and implementation of highly customized WDMS. On one side, the collection of consumption data at high spatial and temporal resolutions requires big data analytics and machine learning techniques to extract typical consumption features from the metered population of water users. On the other side, ICT solutions and gamifications can be used as effective means for facilitating both users' engagement and the collection of socio-psychographic users' information. This latter allows interpreting and improving the extracted profiles, ultimately supporting the customization of WDMS, such as awareness campaigns or personalized recommendations. Our approach is implemented in the SmartH2O platform and demonstrated in a pilot application in Valencia, Spain. Results show how the analysis of the smart metered consumption data, combined with the information retrieved from an ICT gamified web user portal, successfully identify the typical consumption profiles of the metered users and supports the design of alternative WDMS targeting the different users' profiles.

  3. STRATEGIES AND TECHNOLOGY FOR MANAGING HIGH-CARBON ASH

    SciTech Connect

    Robert Hurt; Eric Suuberg; John Veranth

    2001-12-26

    The overall objective of the present project is to identify and assess strategies and solutions for the management of industry problems related to carbon in ash. Specific research issues to be addressed include: the effect of parent fuel selection on ash properties and adsorptivity, including a first ever examination of the air entrainment behavior of ashes from alternative (non-coal) fuels; the effect of various low-NOx firing modes on ash properties and adsorptivity; and the kinetics and mechanism of ash ozonation. This data will provide scientific and engineering support of the ongoing process development activities. This first project period, experiments were carried out to better understand the fundamental nature of the ozonation effect on ash. Carbon surfaces were characterized by surfactant adsorption, and by X-ray Photoelectron Spectroscopy before and after oxidation, both by air at 440 C and by ozone at room temperature. The results strongly suggest that the beneficial effect of ozonation is in large part due to chemical modification of the carbon surfaces.

  4. Selection of a management strategy for pediatric brainstem tumors

    SciTech Connect

    Halperin, E.C.; Wehn, S.M.; Scott, J.W.; Djang, W.; Oakes, W.J.; Friedman, H.S.

    1989-01-01

    Brainstem tumors arise in portions of the rhombencephalon and mesencephalon. Some authorities include diencephalic tumors in this group. We have reviewed our clinical experience of 69 children (less than 21 years of age) with brainstem tumors evaluated and treated at Duke University Medical Center (DUMC) from 1960 to 1986. There were 19 patients with group 1 tumors (thalamus, third ventricle region, or midbrain) and 50 with group II tumors (pons, medulla oblongata). The common presenting signs and symptoms were ataxia, headache, motor loss, and cranial nerve palsies. The most commonly employed diagnostic imaging studies were air examinations and CT. Preradiotherapy confirmation of malignancy was obtained in five group I patients (astrocytoma, 4; germinoma, 1) and 8 group II patients (astrocytoma, 3; anaplastic astrocytoma, 2; glioblastoma multiforme, 3). All patients received radiotherapy. The 5-year survival rate for the entire population was 40%. The survival rate for group I patients was significantly better than that observed for group II patients. In the 50 group II patients neither patient sex nor age nor presence of cranial nerve palsies nor pretreatment CT scan findings nor field size influenced survival. A long duration of symptoms positively influenced survival. The vast majority of tumor recurrences were within the radiation field. Half of the patients had either stable or improved Karnofsky status 6 months following completion of irradiation. The management strategy for childhood brainstem tumors is discussed.

  5. Managing Air Quality - Control Strategies to Achieve Air Pollution Reduction

    EPA Pesticide Factsheets

    Considerations in designing an effective control strategy related to air quality, controlling pollution sources, need for regional or national controls, steps to developing a control strategy, and additional EPA resources.

  6. The Alignment of Global Management Strategies, International Communication Approaches, and Individual Rhetorical Choices.

    ERIC Educational Resources Information Center

    Leininger, Carol

    1997-01-01

    Suggests that thinking about international communication within a framework that aligns an organization's global management strategies with international communication practices enhances not only consulting practice but teaching as well. Describes the framework, and argues it introduces ways of thinking about global management strategies and their…

  7. 23 CFR 630.1108 - Work zone safety management measures and strategies.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 23 Highways 1 2013-04-01 2013-04-01 false Work zone safety management measures and strategies. 630... AND TRAFFIC OPERATIONS PRECONSTRUCTION PROCEDURES Temporary Traffic Control Devices § 630.1108 Work zone safety management measures and strategies. (a) Positive Protection Devices. The need...

  8. 23 CFR 630.1108 - Work zone safety management measures and strategies.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 23 Highways 1 2011-04-01 2011-04-01 false Work zone safety management measures and strategies. 630... AND TRAFFIC OPERATIONS PRECONSTRUCTION PROCEDURES Temporary Traffic Control Devices § 630.1108 Work zone safety management measures and strategies. (a) Positive Protection Devices. The need...

  9. Simulating the Effects of Alternative Forest Management Strategies on Landscape Structure

    Treesearch

    Eric J. Gustafson; Thomas Crow

    1996-01-01

    Quantitative, spatial tools are needed to assess the long-term spatial consequences of alternative management strategies for land use planning and resource management. We constructed a timber harvest allocation model (HARVEST) that provides a visual and quantitative means to predict the spatial pattern of forest openings produced by alternative harvest strategies....

  10. Impact of Managerial Power on Persuasive Strategy Selection by Female and Male Managers.

    ERIC Educational Resources Information Center

    Hirokawa, Randy Y.; And Others

    1990-01-01

    Investigates the persuasive communication of male and female middle managers, focusing on the mediating influence of a manager's power on his or her selection of anticipated compliance-gaining message strategies. Finds no marked differences between the genders in the types of strategies and tactics used to influence subordinates. (KEH)

  11. 23 CFR 630.1108 - Work zone safety management measures and strategies.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Work zone safety management measures and strategies. 630... AND TRAFFIC OPERATIONS PRECONSTRUCTION PROCEDURES Temporary Traffic Control Devices § 630.1108 Work zone safety management measures and strategies. (a) Positive Protection Devices. The need...

  12. The Alignment of Global Management Strategies, International Communication Approaches, and Individual Rhetorical Choices.

    ERIC Educational Resources Information Center

    Leininger, Carol

    1997-01-01

    Suggests that thinking about international communication within a framework that aligns an organization's global management strategies with international communication practices enhances not only consulting practice but teaching as well. Describes the framework, and argues it introduces ways of thinking about global management strategies and their…

  13. Urban Teachers' Professed Classroom Management Strategies: Reflections of Culturally Responsive Teaching

    ERIC Educational Resources Information Center

    Brown, Dave F.

    2004-01-01

    Thirteen urban educators teaching from 1st through 12th grade selected from 7 cities across the United States were interviewed in this qualitative research study to determine if the classroom management strategies they use reflect the research on culturally responsive teaching. Participants revealed using several management strategies that reflect…

  14. Classroom Management Strategies to Address the Needs of Sudanese Refugee Learners: Advice to Teachers. Support Document

    ERIC Educational Resources Information Center

    Burgoyne, Ursula; Hull, Oksana

    2007-01-01

    "Classroom Management Strategies to Address the Needs of Sudanese Refugee Learners" (ED499673) examined the extent to which English language, literacy and numeracy teachers used classroom management strategies to meet the needs of adult Sudanese refugee learners. The researchers found that while teachers met the needs of these learners…

  15. Stream chemistry responses to four range management strategies in eastern Oregon.

    Treesearch

    A.R. Tiedemann; D.A. Higgins; T.M. Quigley; H.R. Sanderson

    1989-01-01

    Responses of stream chemistry parameters, nitrate-N (NO3-N), phosphate (PO4), calcium (Ca), magnesium (Mg), potassium (K), sodium (Na), and hydrogen ion activity (pH) were measured on 13 wildland watersheds managed at four different grazing strategies. Range management strategies tested were (A) no grazing, (B) grazing without control of livestock distribution (8.2 ha/...

  16. 23 CFR 630.1108 - Work zone safety management measures and strategies.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 23 Highways 1 2012-04-01 2012-04-01 false Work zone safety management measures and strategies. 630... zone safety management measures and strategies. (a) Positive Protection Devices. The need for longitudinal traffic barrier and other positive protection devices shall be based on an engineering study. The...

  17. How Do Motivational Regulation Strategies Affect Achievement: Mediated by Effort Management and Moderated by Intelligence

    ERIC Educational Resources Information Center

    Schwinger, Malte; Steinmayr, Ricarda; Spinath, Birgit

    2009-01-01

    It was assumed that the effect of motivational regulation strategies on achievement is mediated by effort management and moderated by intelligence. A sample of 231 11th and 12th grade German high-school students provided self-reports on their use of motivational regulation strategies and effort management and completed an intelligence test.…

  18. Preservice Teachers' Knowledge of Effective Classroom Management Strategies: Shy or Withdrawn Students.

    ERIC Educational Resources Information Center

    Lacina-Gifford, Lorna J.; Kher, Neelam; Besant, Kyesha

    This study identified preservice teachers' knowledge about effective and ineffective classroom management strategies. A group of 108 preservice teachers at a southern rural public university generated classroom management strategies in response to hypothetical vignettes depicting shy and withdrawn student behavior. Researchers coded the extended…

  19. A Cross-Sectional Study of Student Teachers' Behaviour Management Strategies throughout Their Training Years

    ERIC Educational Resources Information Center

    Woodcock, Stuart; Reupert, Andrea

    2012-01-01

    Despite the importance of behaviour management, many student teachers report being inadequately trained in this area. The aim of this study was to identify the strategies, confidence and reported levels of success in regard to various behaviour management strategies, across 509 first, second, third and fourth year student teachers training to be…

  20. Learning in the Panic Zone: Strategies for Managing Learner Anxiety

    ERIC Educational Resources Information Center

    Palethorpe, Rob; Wilson, John P.

    2011-01-01

    Purpose: This study aims to highlight the value of stressful and challenging environments as a strategy to enhance learning and to provide an inventory of strategies for use in cases where participants experience anxiety-related blockages to learning. Design/methodology/approach: This article adopted a qualitative research strategy which consisted…

  1. Self-management as a strategy to improve the classroom behavior of adolescents with ADHD.

    PubMed

    Shapiro, E S; DuPaul, G J; Bradley-Klug, K L

    1998-01-01

    This article reports on the application of a self-management strategy for improving the classroom behavior of students with attention-deficit/hyperactivity disorder (ADHD). Based on the work of Rhode, Morgan, and Young (1983), the intervention focuses on teaching students to systematically rate their own behavior according to the rating of their teacher. Although, historically, self-management strategies based on cognitive control have not been found to be effective for students with ADHD, strategies based on contingency management have not been widely reported in the literature. A description of the intervention and two case study illustrations are provided. Potential limitations and implications for research in using this strategy are discussed.

  2. Development of Strategies for Sustainable Irrigation Water Management in Russia

    NASA Astrophysics Data System (ADS)

    Zeyliger, Anatoly; Ermolaeva, Olga

    2013-04-01

    During 1960 - 1990 years irrigated areas in Russia have increased rapidly, helping to boost agricultural output. Although the impressive achievements of irrigation in this period its large experience indicates problems and failures of irrigation water management. In addition to large water use and low irrigation water efficiency, environmental concerns (excessive water depletion, water quality reduction, water logging, soil degradation) are usually considered like the most significant problem of the irrigation sector. Despite of considerable shrinking of irrigated areas in Russia and decreasing of water withdrawal for irrigation purposes during two last decades a degradation of environment as well as degradation of soil and water resources in irrigated areas was prolonged and will probably continue if current irrigation practices are maintained. Nowadays, in different regions of Russia there are societal demand to restore agricultural irrigation in Russia as answer to challenges from climate pattern changes and degradation of land & water resources. In the respect of these demands there is a need to develop strategies for sustainability of agricultural irrigation in Russia that should be based on three main societal objectives: costeffective use of water in irrigated agriculture at farm level, and satisfactory preserving the natural environment. Therefore sustainable irrigation water management is not only an objective at farm level but also an overall goal at the local and regional as well. A way to achieve sustainability in irrigation water management is to solve the local conflicts arising from the interactions between water use at irrigation areas and surrounding environment. Thus should be based on the development of irrigation framework program including on the irrigation water management issues, policies & decisions making at federal and regional levels should be based on the indicators of environment & irrigation water efficiency monitoring promoting the

  3. Specific Classroom Management Strategies for the Middle/Secondary Education Classroom.

    ERIC Educational Resources Information Center

    McFarland, Katherine P.

    This paper presents detailed classroom management strategies for teachers working in middle- and secondary-level classrooms. The strategies include: (1) plan lessons that are well organized and fully developed, showing all the components of the teaching-learning cycle using a variety of strategies and activities that reflect multiple learning…

  4. Self-Management Strategies in Recovery From Mood and Anxiety Disorders.

    PubMed

    Villaggi, Benjamin; Provencher, Hélène; Coulombe, Simon; Meunier, Sophie; Radziszewski, Stephanie; Hudon, Catherine; Roberge, Pasquale; Provencher, Martin D; Houle, Janie

    2015-01-01

    Mood and anxiety disorders are the most prevalent mental disorders. People with such disorders implement self-management strategies to reduce or prevent their symptoms and to optimize their health and well-being. Even though self-management strategies are known to be essential to recovery, few researchers have examined them. The aim of this study is to explore strategies used by people recovering from depressive, anxiety, and bipolar disorders by asking 50 of them to describe their own strategies. Strategies were classified according to dimensions of recovery: social, existential, functional, physical, and clinical. Within these themes, 60 distinct strategies were found to be used synergistically to promote personal recovery as well as symptom reduction. Findings highlight the diversity of strategies used by people, whether they have depressive, anxiety, or bipolar disorders. This study underscores the importance of supporting self-management in a way that respects individual experience.

  5. Self-Management Strategies in Recovery From Mood and Anxiety Disorders

    PubMed Central

    Villaggi, Benjamin; Provencher, Hélène; Coulombe, Simon; Meunier, Sophie; Radziszewski, Stephanie; Hudon, Catherine; Roberge, Pasquale; Provencher, Martin D.; Houle, Janie

    2015-01-01

    Mood and anxiety disorders are the most prevalent mental disorders. People with such disorders implement self-management strategies to reduce or prevent their symptoms and to optimize their health and well-being. Even though self-management strategies are known to be essential to recovery, few researchers have examined them. The aim of this study is to explore strategies used by people recovering from depressive, anxiety, and bipolar disorders by asking 50 of them to describe their own strategies. Strategies were classified according to dimensions of recovery: social, existential, functional, physical, and clinical. Within these themes, 60 distinct strategies were found to be used synergistically to promote personal recovery as well as symptom reduction. Findings highlight the diversity of strategies used by people, whether they have depressive, anxiety, or bipolar disorders. This study underscores the importance of supporting self-management in a way that respects individual experience. PMID:28462317

  6. STRATEGIES AND TECHNOLOGY FOR MANAGING HIGH-CARBON ASH

    SciTech Connect

    Robert Hurt; Eric Suuberg; JOhn Veranth

    2002-08-30

    The overall objective of the present project is to identify and assess strategies and solutions for the management of industry problems related to carbon in ash. Specific research issues to be addressed include: (1) the effect of parent fuel selection on ash properties and adsorptivity, including a first ever examination of the air entrainment behavior of ashes from alternative (non-coal) fuels; (2) the effect of various low-NOx firing modes on ash properties and adsorptivity; and (3) the kinetics and mechanism of ash ozonation. This data will provide scientific and engineering support of the ongoing process development activities. During this third project period, an extensive battery of surface analysis tools was used to characterize the surfaces of untreated, air-oxidized, and ozone-treated carbons. Most of the work focused on carbon black chosen as a model carbon material suitable for understanding the fundamental surface mechanisms without interference from inorganic matter. In addition to the XPS work described in previous reports, the overall analytical test battery includes: FTIR spectrometry, thermal desorption in nitrogen and in hydrogen/helium, mixtures, surface acidity, hygroscopic behavior, contact angle measurement with standard liquids to determine surface energy and its polar and dispersive components. Most of this characterization work was completed this quarter, with the remainder planned for next quarter. The present report gives only a brief overview of the new data. By the end of next quarter, a complete picture of the ozone surface mechanism should be at hand and a comprehensive discussion of this phase of the work will be presented in that report--the fourth period covering March 1, 2002 to August 31, 3002.

  7. Vaccination strategies for managing brucellosis in Yellowstone bison.

    PubMed

    Treanor, John J; Johnson, Joseph S; Wallen, Rick L; Cilles, Sara; Crowley, Philip H; Cox, John J; Maehr, David S; White, P J; Plumb, Glenn E

    2010-10-01

    Concerns over migratory bison (Bison bison) at Yellowstone National Park transmitting brucellosis (Brucella abortus) to cattle herds on adjacent lands led to proposals for bison vaccination. We developed an individual-based model to evaluate how brucellosis infection might respond under alternate vaccination strategies, including: (1) vaccination of female calves and yearlings captured at the park boundary when bison move outside the primary conservation area; (2) combining boundary vaccination with the remote delivery of vaccine to female calves and yearlings distributed throughout the park; and (3) vaccinating all female bison (including adults) during boundary capture and throughout the park using remote delivery of vaccine. Simulations suggested Alternative 3 would be most effective, with brucellosis seroprevalence decreasing by 66% (from 0.47 to 0.16) over a 30-year period resulting from 29% of the population receiving protection through vaccination. Under this alternative, bison would receive multiple vaccinations that extend the duration of vaccine protection and defend against recurring infection in latently infected animals. The initial decrease in population seroprevalence will likely be slow due to high initial seroprevalence (40-60%), long-lived antibodies, and the culling of some vaccinated bison that were subsequently exposed to field strain Brucella and reacted positively on serologic tests. Vaccination is unlikely to eradicate B. abortus from Yellowstone bison, but could be an effective tool for reducing the level of infection. Our approach and findings have applicability world-wide for managers dealing with intractable wildlife diseases that cross wildlife-livestock and wildlife-human interfaces and affect public health or economic well-being. Published by Elsevier Ltd.

  8. Nonadherence with antipsychotic medication in schizophrenia: challenges and management strategies

    PubMed Central

    Haddad, Peter M; Brain, Cecilia; Scott, Jan

    2014-01-01

    Nonadherence with medication occurs in all chronic medical disorders. It is a particular challenge in schizophrenia due to the illness’s association with social isolation, stigma, and comorbid substance misuse, plus the effect of symptom domains on adherence, including positive and negative symptoms, lack of insight, depression, and cognitive impairment. Nonadherence lies on a spectrum, is often covert, and is underestimated by clinicians, but affects more than one third of patients with schizophrenia per annum. It increases the risk of relapse, rehospitalization, and self-harm, increases inpatient costs, and lowers quality of life. It results from multiple patient, clinician, illness, medication, and service factors, but a useful distinction is between intentional and unintentional nonadherence. There is no gold standard approach to the measurement of adherence as all methods have pros and cons. Interventions to improve adherence include psychoeducation and other psychosocial interventions, antipsychotic long-acting injections, electronic reminders, service-based interventions, and financial incentives. These overlap, all have some evidence of effectiveness, and the intervention adopted should be tailored to the individual. Psychosocial interventions that utilize combined approaches seem more effective than unidimensional approaches. There is increasing interest in electronic reminders and monitoring systems to enhance adherence, eg, Short Message Service text messaging and real-time medication monitoring linked to smart pill containers or an electronic ingestible event marker. Financial incentives to enhance antipsychotic adherence raise ethical issues, and their place in practice remains unclear. Simple pragmatic strategies to improve medication adherence include shared decision-making, regular assessment of adherence, simplification of the medication regimen, ensuring that treatment is effective and that side effects are managed, and promoting a positive

  9. Factors that influence producer decisions to implement management strategies.

    PubMed

    Field, Thomas G

    2014-12-01

    Cow-calf enterprises in the USA are widely divergent in size, locale, resource availability, management skill, and market focus. Furthermore, variation exists in dependence on the cow-calf enterprise as a primary source of income, perception about the utility of a particular management practice or technology, and assessment of cost: benefit resulting from implementation impact decisions. Enterprises with larger cow inventories, greater dependence on income from the cattle enterprise, and that retain ownership further into the supply chain beyond the cow-calf operation are more likely to institute management protocols such as vaccination programs, defined calving seasons, and reproductive technologies. Successful cow-calf managers place the highest priority on herd nutrition, pasture and range management, herd health, financial management marketing, production management, and genetics. Management practices are more likely to be adopted when they align with a manager's perception of the utility, labor availability, favorable cost: benefit outcomes and profit motivation.

  10. Management matters: Testing a mitigation strategy of nitrous oxide emissions on managed grassland

    NASA Astrophysics Data System (ADS)

    Fuchs, Kathrin; Hörtnagl, Lukas; Eugster, Werner; Koller, Patrick; Käslin, Florian; Merbold, Lutz

    2017-04-01

    The magnitude of greenhouse gas (GHG) exchange between managed grasslands and the atmosphere depends besides climate predominantly on management practices. While natural or extensively managed grasslands are known to function as GHG sinks, intensively managed grasslands are characterized by substantial nitrous oxide (N2O) emissions diminishing their sink function. One potential N2O mitigation strategy is to reduce the required amount of nitrogen (N) fertilizer input by using biological nitrogen fixation (BNF) via legumes. However, the effect of legumes on nitrous oxide emissions is still not fully understood. In this study we quantify net GHG fluxes from two differently managed grassland parcels (mitigation, control) and relate our results to productivity (yields). In addition, we aim at revealing the influence of various driver variables on N2O exchange. Our experimental setup consisted of an eddy covariance tower that measured the net exchange of the three major anthropogenic GHGs, nitrous oxide (N2O), methane (CH4) and carbon dioxide (CO2). Both grassland parcels can be covered with this tower due to two prevailing wind directions. GHG flux measurements were accompanied by measurements of commonly known driver variables such as water filled pore space, soil temperature, soil oxygen concentrations and mineral N to disentangle the soil meteorological influence of N2O fluxes from human drivers. Following organic fertilizer application, we measured elevated N2O emissions (>1 nmol m-2 s-1) at the control parcel and unchanged N2O emissions at the treatment parcel. Net annual fluxes were 54% and 50% lower at the experimental parcel in 2015 and 2016, respectively. Annual yields did not significantly differ between parcels, but were slightly lower at the experimental parcel compared to the control parcel. Significantly lower nitrous oxide fluxes under experimental management indicate that nitrous oxide emissions can be effectively reduced at very low costs with a clover

  11. Alarm Fatigue: Use of an Evidence-Based Alarm Management Strategy.

    PubMed

    Turmell, Jacob W; Coke, Lola; Catinella, Rachel; Hosford, Tracy; Majeski, Amy

    The purpose of this article is to describe the impact of an evidence-based alarm management strategy on patient safety. An alarm management program reduced alarms up to 30%. Evaluation of patients on continuous cardiac monitoring showed a 3.5% decrease in census. This alarm management strategy has the potential to save $136 500 and 841 hours of registered nurses' time per year. No patient harm occurred during the 2-year project.

  12. Corporate political strategy: incorporating the management of public policy issues into hospital strategy.

    PubMed

    Bigelow, B; Arndt, M; Stone, M M

    1997-01-01

    Hospitals engage in a variety of strategies designed to anticipate, shape, and respond to public policy issues. This article describes corporate political strategy and argues for its need throughout a public policy issue's life cycle.

  13. A randomised controlled trial of four management strategies for dyspepsia: relationships between symptom subgroups and strategy outcome.

    PubMed Central

    Lewin van den Broek, N T; Numans, M E; Buskens, E; Verheij, T J; de Wit, N J; Smout, A J

    2001-01-01

    BACKGROUND: The first step in the management of uncomplicated dyspepsia in primary care often consists of prescribing empirical therapy, but in certain cases prompt endoscopy might be preferred. Any decision is usually based on the patient's symptoms and the presumed underlying pathology that causes these symptoms. AIM: To assess the relationship between symptom subgroups and the effect of management strategies on primary care patients with dyspepsia. DESIGN OF STUDY: Randomised controlled trial. SETTING: All patients presenting successively with a new episode of dyspepsia between January 1995 and November 1997. METHOD: The results of four management strategies in dyspeptic primary care patients were compared and the value of subgrouping within this trial was estimated. Patients were allocated to one of either (a) empirical treatment in which therapy was based on the presented symptoms, or empirical treatment with (b) omeprazole or (c) cisapride regardless of the presented symptoms, or (d) prompt endoscopy followed by the appropriate treatment. Patients were retrospectively classified into the subgroups for each strategy using baseline data. The yield of each strategy was measured by counting the number of strategy failures in the first year. RESULTS: Of the 349 included patients, 326 were analysed. No statistically significant difference could be demonstrated between the strategies or between the symptom subgroups. However, patients in the reflux-like subgroup showed a trend towards a better outcome in all empirical strategies. Ulcer-like dyspepsia seemed to benefit from omeprazole. The non-specific subgroup seemed to benefit from cisapride but also had the highest proportion of strategy failure. Prompt endoscopy did not appear especially useful in any subgroup. CONCLUSION: Although this study has relatively low power, we conclude that the use of symptom subgroups seems to be a sensible approach when choosing empirical therapy in dyspepsia. Patients with reflux

  14. An Integrated Approach Is Needed for Ecosystem Based Fisheries Management: Insights from Ecosystem-Level Management Strategy Evaluation

    PubMed Central

    Fulton, Elizabeth A.; Smith, Anthony D. M.; Smith, David C.; Johnson, Penelope

    2014-01-01

    An ecosystem approach is widely seen as a desirable goal for fisheries management but there is little consensus on what strategies or measures are needed to achieve it. Management strategy evaluation (MSE) is a tool that has been widely used to develop and test single species fisheries management strategies and is now being extended to support ecosystem based fisheries management (EBFM). We describe the application of MSE to investigate alternative strategies for achieving EBFM goals for a complex multispecies fishery in southeastern Australia. The study was undertaken as part of a stakeholder driven process to review and improve the ecological, economic and social performance of the fishery. An integrated management strategy, involving combinations of measures including quotas, gear controls and spatial management, performed best against a wide range of objectives and this strategy was subsequently adopted in the fishery, leading to marked improvements in performance. Although particular to one fishery, the conclusion that an integrated package of measures outperforms single focus measures we argue is likely to apply widely in fisheries that aim to achieve EBFM goals. PMID:24454722

  15. An integrated approach is needed for ecosystem based fisheries management: insights from ecosystem-level management strategy evaluation.

    PubMed

    Fulton, Elizabeth A; Smith, Anthony D M; Smith, David C; Johnson, Penelope

    2014-01-01

    An ecosystem approach is widely seen as a desirable goal for fisheries management but there is little consensus on what strategies or measures are needed to achieve it. Management strategy evaluation (MSE) is a tool that has been widely used to develop and test single species fisheries management strategies and is now being extended to support ecosystem based fisheries management (EBFM). We describe the application of MSE to investigate alternative strategies for achieving EBFM goals for a complex multispecies fishery in southeastern Australia. The study was undertaken as part of a stakeholder driven process to review and improve the ecological, economic and social performance of the fishery. An integrated management strategy, involving combinations of measures including quotas, gear controls and spatial management, performed best against a wide range of objectives and this strategy was subsequently adopted in the fishery, leading to marked improvements in performance. Although particular to one fishery, the conclusion that an integrated package of measures outperforms single focus measures we argue is likely to apply widely in fisheries that aim to achieve EBFM goals.

  16. Management strategies for the conservation of forest birds

    Treesearch

    Kathleen E. Franzreb; Deborah M. Finch; Petra Bohall Wood; David E. Capen

    1999-01-01

    We recommend that managers of forest-associated bird species follow a five-step hierarchy in establishing and implementing management programs. In essence, a manager must evaluate the composition and physiognomy of the landscape mosaic in the context of the regional and subregional goals and objectives. Then he/she can explore alternatives that allow manipulation of...

  17. Sport & Fitness Management: Career Strategies and Professional Content.

    ERIC Educational Resources Information Center

    Parks, Janet B., Ed.; Zanger, Beverly R. K., Ed.

    This textbook provides a comprehensive introduction to the field of sport management. An introductory chapter gives the definition and direction of sport and fitness management. Part 1 describes sport and fitness management careers. The 12 chapters deal with the professional options: intercollegiate athletics, professional sport, facility…

  18. Sport & Fitness Management: Career Strategies and Professional Content.

    ERIC Educational Resources Information Center

    Parks, Janet B., Ed.; Zanger, Beverly R. K., Ed.

    This textbook provides a comprehensive introduction to the field of sport management. An introductory chapter gives the definition and direction of sport and fitness management. Part 1 describes sport and fitness management careers. The 12 chapters deal with the professional options: intercollegiate athletics, professional sport, facility…

  19. Forest management strategy, spatial heterogeneity, and winter birds in Washington.

    Treesearch

    B. Haveri; A.B. Carey

    2000-01-01

    Ecological management of second-growth forest holds great promise for conservation of biodiversity, yet little experimental evidence exists to compare alternative management approaches. Wintering birds are one of several groups of species most likely to be influenced by forest management activities. We compared species richness and proportion of stand area used over...

  20. 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...

  1. Teaching Life Management in California Community Colleges: A Catalog of Instructional Resources and Teaching Strategies.

    ERIC Educational Resources Information Center

    California Community Colleges, Sacramento. Office of the Chancellor.

    Based on a Secretary's Commission on Achieving Necessary Skills (SCANS) Life Management Retreat held in June 1996, this two-part compilation provides instructional resources and teaching strategies developed by life management faculty in California's community colleges. Following an introduction to the teaching of life and home management and a…

  2. Essentials of Advocacy in Case Management: Part 2: Client Advocacy Model and Case Manager's Advocacy Strategies and Competencies.

    PubMed

    Tahan, Hussein M

    2016-01-01

    This article describes a client advocacy model for use by case managers. It delineates necessary competencies for the case manager and shares important strategies for effective client advocacy. All practice settings across the continuum of health and human services and case managers of diverse professional backgrounds. Advocacy is a primary role and necessary competency of professional case managers functioning in various care settings. It is rooted in ethical theory and principles. Successful case managers apply ethical principles of advocacy at every step of the case management process and in the decisions they make. Part II of this two-part article presents a client advocacy model for case managers to apply in their practice, describes the role of advocacy in client engagement, and identifies important strategies and a set of essential competencies for effective case management advocacy. Part I already explored the ethical theories and principles of advocacy, the perception of case management-related professional organizations of advocacy, and the common types of advocacy based on scope, complexity, impact, and reach. Acquiring foundational knowledge, skills, and competencies in what advocacy is and how to effectively enact its related behaviors is essential for success of case managers and for achieving desired outcomes for both the clients and health care agencies/providers alike. Case management leaders are urged to use the knowledge shared in this article to develop advocacy training and competency management programs for their case managers.

  3. 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.

  4. Self-management in young adults with bipolar disorder: Strategies and challenges.

    PubMed

    Nicholas, Jennifer; Boydell, Katherine; Christensen, Helen

    2017-02-01

    Early adoption of effective self-management strategies for bipolar disorder (BD) results in better clinical outcomes and increased quality of life. Therefore, facilitation of these strategies in young adults who are early in their illness course is vital. However, an understanding of self-management practices and needs of young adults with BD is lacking. This study explores young adult's perspectives of disorder self-management practices and challenges. Young adults with BD completed an online survey about disorder management strategies and challenges. Self-management was investigated through self-report and ratings of literature-derived strategies. Results were analysed using descriptive statistics and qualitative thematic analysis. Eighty-nine participants aged 18-30 (M=24.4; SD=3.9) completed the survey. Adherence to treatment, disorder psychoeducation, and sleep-management were the strategies rated most helpful. Six participant-reported self-management strategies were identified (1) Maintaining a healthy lifestyle; (2) Treatment attendance and adherence; (3) Participation in meaningful activities; (4) Engagement with social support; (5) Meditation and relaxation practices; and (6) Symptom monitoring. The most common self-management challenges experienced by young adults concerned the nature of the disorder, interpersonal relationships, and stigma. Participants likely represent a sub-set of young adults engaged with healthcare and therefore may not be representative of the population. Strategies reported vital by those successfully managing their disorder are not adequately utilised by young adults with BD. Both differences in strategy use and perceived self-management challenges represent important areas of clinical support and intervention. This increased understanding will help facilitate self-management skill development in this population. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Symptom self-management strategies in patients with non-metastatic prostate cancer.

    PubMed

    Hsiao, Chao-Pin; Moore, Ida M Ki; Insel, Kathleen C; Merkle, Carrie J

    2014-02-01

    To explore the association between symptoms, symptom distress and symptom self-management and to identify effective strategies of symptom self-management in men with non-metastatic prostate cancer following radical prostatectomy or radiation therapy. Men receiving treatments for localised prostate cancer experience symptoms of urinary incontinence, urinary obstruction/irritation, bowel difficulties and sexual dysfunction. Understanding patients' symptom experiences and identifying strategies that they use to manage these symptoms are imperative for symptom management planning. A descriptive, cross-sectional study was conducted with a sample of 53 men, who were within three months of the initiation of their treatment. The Symptom Indexes and the Strategy and Effectiveness of Symptom Self-Management questionnaires were used to measure symptoms, symptom distress and symptom self-management. Descriptive statistics, t-tests, correlations and multiple regressions were used to analyse the data. Symptoms were significantly correlated with symptom-related distress (r = 0·67, p < 0·01). Frequency of symptoms was significantly associated with symptom self-management strategies for urinary (β = 0·50, p < 0·01), bowel (β = 0·71, p < 0·01) and sexual problems (β = 0·28, p = 0·05). The most effective strategies were as follows: pads and doing Kegel exercise for managing urinary problems, rest and endurance for bowel symptoms, and expressing feelings and finding alternative ways to express affection for management of sexual dysfunction. Assessing symptom self-management among men with newly diagnosed prostate cancer can help healthcare providers develop strategies that will enhance health-related quality of life. Results provide information on effective strategies that patients with prostate cancer found to reduce their symptoms. The strategies used provide a foundation for developing and testing interventions for personalised symptom management. © 2013 Blackwell

  6. 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.

  7. Strategic threat management: an exploration of nursing strategies in the pediatric intensive care unit.

    PubMed

    Durso, Francis T; Ferguson, Ashley N; Kazi, Sadaf; Cunningham, Charlene; Ryan, Christina

    2015-03-01

    Part of the work of a critical care nurse is to manage the threats that arise that could impede efficient and effective job performance. Nurses manage threats by employing various strategies to keep performance high and workload manageable. We investigated strategic threat management by using the Threat-Strategy Interview. Threats frequently involved technology, staff, or organizational components. The threats were managed by a toolbox of multifaceted strategies, the most frequent of which involved staff-, treatment- (patient + technology), examination- (patient + clinician), and patient-oriented strategies. The profile of strategies for a particular threat often leveraged work facets similar to the work facet that characterized the threat. In such cases, the nurse's strategy was directed at eliminating the threat (not working around it). A description at both a domain invariant level - useful for understanding strategic threat management generally - and a description at an operational, specific level - useful for guiding interventions-- are presented. A structural description of the relationship among threats, strategies, and the cues that trigger them is presented in the form of an evidence accumulation framework of strategic threat management.

  8. College and University Middle Management and Institutional Strategy

    ERIC Educational Resources Information Center

    Fugazzotto, Sam J.

    2009-01-01

    Colleges and universities generally do not allow for the top-down style of leadership that many definitions of strategy assume. Rather, postsecondary institutions are loosely coupled professional bureaucracies composed of individual employees and academic units that can pursue individual strategies with little or no input from management…

  9. College and University Middle Management and Institutional Strategy

    ERIC Educational Resources Information Center

    Fugazzotto, Sam J.

    2009-01-01

    Colleges and universities generally do not allow for the top-down style of leadership that many definitions of strategy assume. Rather, postsecondary institutions are loosely coupled professional bureaucracies composed of individual employees and academic units that can pursue individual strategies with little or no input from management…

  10. Weight management strategies for women: a review for nurses.

    PubMed

    Stramiello, Giovanna M

    2009-10-01

    Upon completion of this activity, the learner will be able to: 1. Cite the statistics surrounding overweight and obesity and list the potential health effects of overweight and obesity. 2. List and explain different strategies for weight loss, including their risks and benefits as shown by the current evidence. 3. List effective strategies for maintaining weight loss and cite examples from the literature.

  11. E-waste: impacts, issues and management strategies.

    PubMed

    Hussain, Mumtaz; Mumtaz, Saniea

    2014-01-01

    of matter is that vested business interests have surpassed ethical values. Existing scenarios of unbridled e-waste generation has attained alarming levels for humanity. This warrants immediate attention by public and private sectors, civil society, NGOs, industrialists and the business community for the protection of nature and natural resources from future destruction. Multipronged strategies need to be adopted for the management of e-waste encompassing administrative, technical, environmental, regulatory, legislative, educative, stakeholders' participation and global cooperation.

  12. 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.

  13. The Influence of Group Training in the Incredible Years Teacher Classroom Management Program on Preschool Teachers' Classroom Management Strategies

    ERIC Educational Resources Information Center

    Carlson, John S.; Tiret, Holly B.; Bender, Stacy L.; Benson, Laurie

    2011-01-01

    This study examined changes in preschool teachers' perceptions of classroom management strategies following group training in the recently revised Incredible Years Teacher Classroom Management Program (C. Webster-Stratton, 2006). The authors used a pre/post follow-up design across 2 groups that each met for 8 sessions over an 8-10-week period for…

  14. The Influence of Group Training in the Incredible Years Teacher Classroom Management Program on Preschool Teachers' Classroom Management Strategies

    ERIC Educational Resources Information Center

    Carlson, John S.; Tiret, Holly B.; Bender, Stacy L.; Benson, Laurie

    2011-01-01

    This study examined changes in preschool teachers' perceptions of classroom management strategies following group training in the recently revised Incredible Years Teacher Classroom Management Program (C. Webster-Stratton, 2006). The authors used a pre/post follow-up design across 2 groups that each met for 8 sessions over an 8-10-week period for…

  15. Review and Evaluation of Reservoir Management Strategies for Harmful Algal Blooms

    DTIC Science & Technology

    2017-07-28

    ER D C/ EL T R- 17 -1 1 Review and Evaluation of Reservoir Management Strategies for Harmful Algal Blooms En vi ro nm en ta l L ab or...ERDC/EL TR-17-11 July 2017 Review and Evaluation of Reservoir Management Strategies for Harmful Algal Blooms Brook D. Herman, Jed O. Eberly...1000 Under Project Number WOTS-16-014, “Review and Evaluation of Reservoir Management Strategies for Harmful Algal Blooms” ERDC/EL TR-17-11 ii

  16. Severe gout: Strategies and innovations for effective management.

    PubMed

    Pascual, Eliseo; Andrés, Mariano; Vázquez-Mellado, Janitzia; Dalbeth, Nicola

    2016-12-05

    Severe gout is characterised by frequent polyarticular flares, numerous tophi, joint damage, and musculoskeletal disability. This is a preventable condition and in many cases, represents a disease that has been insufficiently managed for years. Standard management recommendations may be insufficient for patients with severe gout; these patients frequently require intensive individualised pharmacological management with combinations of urate-lowering therapy and anti-inflammatory agents. In this article, we aim to integrate recent therapeutic advances to provide a practical framework for optimal management of severe gout.

  17. Atrial Fibrillation Management Strategies in Routine Clinical Practice: Insights from the International RealiseAF Survey

    PubMed Central

    Chiang, Chern-En; Naditch-Brûlé, Lisa; Brette, Sandrine; Silva-Cardoso, José; Gamra, Habib; Murin, Jan; Zharinov, Oleg J.; Steg, Philippe Gabriel

    2016-01-01

    Background Atrial fibrillation (AF) can be managed with rhythm- or rate-control strategies. There are few data from routine clinical practice on the frequency with which each strategy is used and their correlates in terms of patients’ clinical characteristics, AF control, and symptom burden. Methods RealiseAF was an international, cross-sectional, observational survey of 11,198 patients with AF. The aim of this analysis was to describe patient profiles and symptoms according to the AF management strategy used. A multivariate logistic regression identified factors associated with AF management strategy at the end of the visit. Results Among 10,497 eligible patients, 53.7% used a rate-control strategy, compared with 34.5% who used a rhythm-control strategy. In 11.8% of patients, no clear strategy was stated. The proportion of patients with AF-related symptoms (EHRA Class > = II) was 78.1% (n = 4396/5630) for those using a rate-control strategy vs. 67.8% for those using a rhythm-control strategy (p<0.001). Multivariate logistic regression analysis revealed that age <75 years or the paroxysmal or persistent form of AF favored the choice of a rhythm-control strategy. A change in strategy was infrequent, even in patients with European Heart Rhythm Association (EHRA) Class > = II. Conclusions In the RealiseAF routine clinical practice survey, rate control was more commonly used than rhythm control, and a change in strategy was uncommon, even in symptomatic patients. In almost 12% of patients, no clear strategy was stated. Physician awareness regarding optimal management strategies for AF may be improved. PMID:26800084

  18. Management of Agricultural Weather Risks: traditional procedures and new management strategies

    NASA Astrophysics Data System (ADS)

    Burgaz, F.

    2009-04-01

    Throughout history, agriculture has progressed as an outcome of farmers' efforts to design and apply adaptation strategies aiming to mitigate the impact of adverse meteorological phenomena on their farms' economy. The survival and sustainability of farmholdings, regardless of size or type of production, is directly related to their capacity to withstand the consequences of such phenomena and continue to yield a harvest year after year. While substantial differences can be identified in the intensity and frequency of the damage borne, depending on the country, region and type of production, no farm is exempt from the effects of uncontrollable risks. In this endeavour to mitigate such consequences and successfully manage natural risks, the first protective step must be taken by the farm itself, which must adopt measures that pursue more favourable crop development or a heightened ability to handle risks and their adverse effects. But when the damage inflicted is of an intensity that cannot be accommodated by the farmer, instruments must be deployed that spread or transfer risk to third parties, a process known as risk insurance. Experience shows that of the various such instruments in place, insurance constitutes the most appropriate risk management model and the one that has reached the highest levels of development and acceptance among farmers.

  19. A framework for evaluation of flood management strategies.

    PubMed

    Hansson, K; Danielson, M; Ekenberg, L

    2008-02-01

    The resulting impact of disasters on society depends on the affected country's economic strength prior to the disaster. The larger the disaster and the smaller the economy, the more significant is the impact. This is clearest seen in developing countries, where weak economies become even weaker afterwards. Deliberate strategies for the sharing of losses from hazardous events may aid a country or a community in efficiently using scarce prevention and mitigation resources, thus being better prepared for the effects of a disaster. Nevertheless, many governments lack an adequate institutional system for applying cost effective and reliable technologies for disaster prevention, early warnings, and mitigation. Modelling by event analyses and strategy models is one way of planning ahead, but these models have so far not been linked together. An approach to this problem was taken during a large study in Hungary, the Tisza case study, where a number of policy strategies for spreading of flood loss were formulated. In these strategies, a set of parameters of particular interest were extracted from interviews with stakeholders in the region. However, the study was focused on emerging economies, and, in particular, on insurance strategies. The scope is now extended to become a functional framework also for developing countries. In general, they have a higher degree of vulnerability. The paper takes northern Vietnam as an example of a developing region. We identify important parameters and discuss their importance for flood strategy formulations. Based on the policy strategies in the Tisza case, we extract data from the strategies and propose a framework for loss spread in developing and emerging economies. The parameter set can straightforwardly be included in a simulation and decision model for policy formulation and evaluation, taking multiple stakeholders into account.

  20. Clinical Practice Strategies outside the Realm of Managed Care.

    ERIC Educational Resources Information Center

    Walfish, Steven

    While more and more psychologists criticize managed care companies, most must depend upon them in order to maintain their practices. In this study, psychologists were surveyed and asked to identify activities in their own independent practice that fall outside of the purview of managed care. A total of 180 specific activities were identified that…

  1. A Study of Personal Information Management Strategies for Online Faculty

    ERIC Educational Resources Information Center

    Kearns, Lorna R.; Frey, Barbara A.; Tomer, Christinger; Alman, Susan

    2014-01-01

    The literature suggests that personal information management is a serious challenge for many computer users. Online faculty are especially challenged because of the large number of electronic files necessitated by teaching online. Those who have experience in this environment may offer valuable insights regarding information management challenges…

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

    ERIC Educational Resources Information Center

    Halverson, Don E.

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

  3. Self-Management Strategies to Support Students with ASD

    ERIC Educational Resources Information Center

    Schulze, Margaret A.

    2016-01-01

    Self-management is a set of procedures that students can be taught to apply to their own behaviors to change them. In self-management, students are taught to observe, assess, and modify their own behavior. These procedures include such things as self-identifying and observing a target behavior and setting a goal to change it. Self-management…

  4. Rethinking Classroom Management: Strategies for Prevention, Intervention, and Problem Solving.

    ERIC Educational Resources Information Center

    Belvel, Patricia Sequeira; Jordan, Maya Marcia

    This book illustrates an approach to achieving a positive, harmonious classroom environment which enables educators to evolve effectively from managers to leaders by rethinking their roles as teachers, discussing how to create classrooms where students are more self-managing and demonstrate mutual respect, self-esteem, and responsibility. Key…

  5. Self-Management Strategies to Support Students with ASD

    ERIC Educational Resources Information Center

    Schulze, Margaret A.

    2016-01-01

    Self-management is a set of procedures that students can be taught to apply to their own behaviors to change them. In self-management, students are taught to observe, assess, and modify their own behavior. These procedures include such things as self-identifying and observing a target behavior and setting a goal to change it. Self-management…

  6. Automation Power Energy Management Strategy for Mobile Telecom Industry

    NASA Astrophysics Data System (ADS)

    Hwang, Jong-Ching; Chen, Jung-Chin; Pan, Jeng-Shyang; Huang, Yi-Chao

    The aim of this research is to study the power energy cost reduction of the mobile telecom industry through the supervisor control and data acquisition (SCADA) system application during globalization and liberalization competition. Yet this management system can be proposed functions: operating monitors, the analysis on load characteristics and dropping the cost of management.

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

    ERIC Educational Resources Information Center

    Halverson, Don E.

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

  8. An uneven-aged management strategy: lessons learned

    Treesearch

    Mark T. Smith; John D. Exline

    2002-01-01

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

  9. The Relationship between Classroom Management Strategies and Student Misbehaviors.

    ERIC Educational Resources Information Center

    Skiba, Russell J.

    Because research has determined that specific management techniques can have an effect on the classroom behavior of students, an observational rating scale was developed to assess the type of management techniques six elementary teachers in a program for behaviorally disordered children used to control behavior. Correlational analyses were used to…

  10. Rethinking Student Loan Debt: Tools and Strategies for Debt Management.

    ERIC Educational Resources Information Center

    Mason, Susan G.

    2001-01-01

    Analyzes student loan debt at the University of Missouri-St. Louis School of Optometry, showing the need for a comprehensive debt management program. Presents a model for determining manageable amounts of student loan debt developed from conventional lending criteria and data on earnings for optometrists. (EV)

  11. Symptom management strategies of Jordanian patients following coronary artery bypass grafting surgery.

    PubMed

    Al-Daakak, Zaher Mohammed; Ammouri, Ali Ahmad; Isac, Chandrani; Gharaibeh, Huda; Al-Zaru, Ibtisam

    2016-08-01

    The aim of this study was to explore the symptom management strategies utilized by post coronary artery bypass graft (CABG) patients and its associations with demographic variables. A clear understanding of the use of symptom management strategies following CABG surgery may help nurses in developing educational program and interventions that help patients and their families during recovery period after discharge. A cross-sectional, descriptive design was utilized. A convenience sample of 100 Jordanian patients post CABG surgery selected from five hospitals was surveyed between November 2012 and June 2013 using the Cardiac Symptom Survey. Chi squared analyses were used to examine the associations between the symptoms management strategies and selected demographic variables. Frequency of symptom management strategies utilized by post CABG patients revealed that most frequently employed strategies were use of medications (79%), repositioning (54%) and the rest (45%). Symptom management strategies utilized for poor appetite, sleeping problem and fatigue had significant associations with demographic variables. By providing information about the symptoms expected after surgery and possible ways to manage them, will strengthen the patients psychologically and will make CABG experience within the realm of self-management and coping.

  12. Development of risk-based air quality management strategies under impacts of climate change.

    PubMed

    Liao, Kuo-Jen; Amar, Praveen; Tagaris, Efthimios; Russell, Armistead G

    2012-05-01

    Climate change is forecast to adversely affect air quality through perturbations in meteorological conditions, photochemical reactions, and precursor emissions. To protect the environment and human health from air pollution, there is an increasing recognition of the necessity of developing effective air quality management strategies under the impacts of climate change. This paper presents a framework for developing risk-based air quality management strategies that can help policy makers improve their decision-making processes in response to current and future climate change about 30-50 years from now. Development of air quality management strategies under the impacts of climate change is fundamentally a risk assessment and risk management process involving four steps: (1) assessment of the impacts of climate change and associated uncertainties; (2) determination of air quality targets; (3) selections of potential air quality management options; and (4) identification of preferred air quality management strategies that minimize control costs, maximize benefits, or limit the adverse effects of climate change on air quality when considering the scarcity of resources. The main challenge relates to the level of uncertainties associated with climate change forecasts and advancements in future control measures, since they will significantly affect the risk assessment results and development of effective air quality management plans. The concept presented in this paper can help decision makers make appropriate responses to climate change, since it provides an integrated approach for climate risk assessment and management when developing air quality management strategies. Development of climate-responsive air quality management strategies is fundamentally a risk assessment and risk management process. The risk assessment process includes quantification of climate change impacts on air quality and associated uncertainties. Risk management for air quality under the impacts of

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

    PubMed Central

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

    2015-01-01

    Objectives 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. Design 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. Participants All had a clinical diagnosis of MS, significant fatigue, were ambulatory and had attended at least 4 of 6 scheduled FACETS sessions. Methods Participants (n=72) were posted the FMSQ with a prepaid return envelope 4 months after the end of the FACETS programme. Results 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. Conclusions Individuals’ comments highlighted the complex, multifaceted nature of fatigue

  14. Grassland birds: An overview of threats and recommended management strategies

    USGS Publications Warehouse

    Vickery, P.D.; Herkert, J.R.; Knopf, F.L.; Ruth, J.; Keller, C.E.; Bonney, Rick; Pashley, David N.; Cooper, Robert; Niles, Larry

    2000-01-01

    Grassland ecosystems are dependent on periodic disturbance for habitat maintenance. Historically, grazing by native herbivores and prairie fires were the agents principally responsible for maintaining grassland areas. However, elimination of native herbivores, wide-spread fire suppression, and conversion for agriculture have greatly altered grasslands in the United States and Canada. Because of these landscape changes, many grassland birds are increasingly dependent on land managers for habitat creation, maintenance, and health. Grazing, prescribed burning, and mowing/haying are the most frequently used, and versatile, grassland management techniques. Grassland birds prefer a wide range of grass heights and densities, with some species preferring short sparse vegetation, and others preferring taller, more dense vegetation. Due to differences in species habitat preferences and regional differences in soils and floristics, the responses of individual grassland species to specific grassland management practices can be variable and often are regionally dependent. As a result, management of grassland areas is best directed toward the creation of a mosaic of grassland habitat types. This habitat mosaic is probably best maintained through some type of rotational management system in which sections of large grassland areas receive management on a regular schedule. Such a rotational system would provide a variety of habitat types in every year, would ensure the availability of suitable habitat for birds at either end of the grassland management spectrum, and also would provide habitat for birds whose preferences lie between these extremes.

  15. Behavior Disorders after Severe Head Injury: Their Nature and Causes and Strategies for Management.

    ERIC Educational Resources Information Center

    Eames, Peter

    1988-01-01

    The article discusses the multifactorial causation of behavior disorders after head injury, arguing that management strategies must be based on an understanding of their general nature and on specific knowledge of the individual's history and injury. (DB)

  16. Management of Computer-Based Instruction: Design of an Adaptive Control Strategy.

    ERIC Educational Resources Information Center

    Tennyson, Robert D.; Rothen, Wolfgang

    1979-01-01

    Theoretical and research literature on learner, program, and adaptive control as forms of instructional management are critiqued in reference to the design of computer-based instruction. An adaptive control strategy using an online, iterative algorithmic model is proposed. (RAO)

  17. 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

  18. An Implementation Strategy of Evidence-Based Application Lifecycle Management

    NASA Astrophysics Data System (ADS)

    Kim, Jeong Ah; Choi, Seungyong

    Application lifecycle management (ALM) facilitate and integrate facilitate and integrate requirements management, architecture, coding, testing, tracking, and release management. Process automation and seamless traceability among tools are getting important. In this paper, we suggest new approach to achieve the seamless traceability and process automation. For these features, knowledge formalization is critical. Evidence-based medicine is good reference architecture to ALM2. Software Engineering ontology is powerful solution to semantic gap between tools and guideline-based process execution environment can be practical solution to process automation.

  19. Improving nursing students' communication skills using crew resource management strategies.

    PubMed

    Aebersold, Michelle; Tschannen, Dana; Sculli, Gary

    2013-03-01

    To provide optimal patient care, all members of the health care team must effectively communicate patient status and the current plan of care. The Crew Resource Management (CRM) training system has been successfully used in the aviation industry to manage human error and reduce risk in the operational environment. CRM focuses on behaviors that support communication and teamwork and is modifiable to be used in nursing education. A version of CRM-nursing crew resource management-was implemented in a group of senior undergraduate nursing students. Students were satisfied with the program, and in a subsequent simulation they demonstrated the ability to use the communication techniques learned.

  20. The 'Toolbox' of strategies for managing Haemonchus contortus in goats: What's in and what's out.

    PubMed

    Kearney, P E; Murray, P J; Hoy, J M; Hohenhaus, M; Kotze, A

    2016-04-15

    A dynamic and innovative approach to managing the blood-consuming nematode Haemonchus contortus in goats is critical to crack dependence on veterinary anthelmintics. H. contortus management strategies have been the subject of intense research for decades, and must be selected to create a tailored, individualized program for goat farms. Through the selection and combination of strategies from the Toolbox, an effective management program for H. contortus can be designed according to the unique conditions of each particular farm. This Toolbox investigates strategies including vaccines, bioactive forages, pasture/grazing management, behavioural management, natural immunity, FAMACHA, Refugia and strategic drenching, mineral/vitamin supplementation, copper Oxide Wire Particles (COWPs), breeding and selection/selecting resistant and resilient individuals, biological control and anthelmintic drugs. Barbervax(®), the ground-breaking Haemonchus vaccine developed and currently commercially available on a pilot scale for sheep, is prime for trialling in goats and would be an invaluable inclusion to this Toolbox. The specialised behaviours of goats, specifically their preferences to browse a variety of plants and accompanying physiological adaptations to the consumption of secondary compounds contained in browse, have long been unappreciated and thus overlooked as a valuable, sustainable strategy for Haemonchus management. These strategies are discussed in this review as to their value for inclusion into the 'Toolbox' currently, and the future implications of ongoing research for goat producers. Combining and manipulating strategies such as browsing behaviour, pasture management, bioactive forages and identifying and treating individual animals for haemonchosis, in addition to continuous evaluation of strategy effectiveness, is conducted using a model farm scenario. Selecting strategies from the Toolbox, with regard to their current availability, feasibility, economical cost

  1. Environmental performance evaluation and strategy management using balanced scorecard.

    PubMed

    Hsu, Yu-Lung; Liu, Chun-Chu

    2010-11-01

    Recently, environmental protection and regulations such as WEEE, ELV, and RoHS are rapidly emerging as an important issue for business to consider. The trend of swinging from end-of-pipe control to product design, green innovation, and even the establishment of image or brand has affected corporations in almost every corner in the world, and enlarged to the all modern global production network. Corporations must take proactive environmental strategies to response the challenges. This study adopts balanced scorecard structure and aim at automobile industries to understand the relationships of internal and external, financial and non-financial, and outcome and driving factors. Further relying on these relationships to draw the "map of environment strategy" to probe and understand the feasibility of environmental performance evaluation and environmental strategy control.

  2. Inspect, Detect, Correct: Structural Integrated Pest Management Strategies at School.

    ERIC Educational Resources Information Center

    Jochim, Jerry

    2003-01-01

    Describes a model integrated pest management (IPM) program for schools used in Monroe County, Indiana. Addresses how to implement an IPM program, specific school problem areas, specific pest problems and solutions, and common questions. (EV)

  3. Inspect, Detect, Correct: Structural Integrated Pest Management Strategies at School.

    ERIC Educational Resources Information Center

    Jochim, Jerry

    2003-01-01

    Describes a model integrated pest management (IPM) program for schools used in Monroe County, Indiana. Addresses how to implement an IPM program, specific school problem areas, specific pest problems and solutions, and common questions. (EV)

  4. USING SPMDS TO ACCESS MANAGMENT STRATEGIES FOR PCB CONTAMINATED SEDIMENTS

    EPA Science Inventory

    Dredging, in-place treatment, capping and monitored natural recovery, used together or separately are the primary approaches for managing contaminated sediment risks. Understanding how well different approaches work in different environments is critical for choosing an appropria...

  5. USING SPMDS TO ASSESS MANAGEMENT STRATEGIES FOR PCB CONTAMINATED SEDIMENTS.

    EPA Science Inventory

    Abstract: Dredging in-place treatment, capping and monitored natural recovery, used together or separately are the primary approaches for managing contaminated sediment risks. Understanding how well different approaches work in different environments is critical for choosing an...

  6. A typology for strategies to connect citizen science and management.

    PubMed

    Freitag, Amy

    2016-09-01

    One of the often cited benefits of citizen science is better connecting citizens and their science to adaptive management outcomes. However, there is no consensus as to whether this is a reasonable expectation, and if so, how best to approach creating a successful link to management. This review finds cases where the citizen science-management link is explicitly discussed and places each case into a meta-analysis framework that will help define some general successful approaches to forming such a link. We categorize the types of linkages between citizen science and management along two main axes: cooperative to adversarial and deliberate to serendipitous. Cooperative and deliberate types of linkages are the most common, likely due to a mix of causes: that such links are the most commonly written about in the scientific literature, because such links tend to exist for longer amounts of time, and because other types of links tend to drift toward the cooperative/deliberate approach over time.

  7. USING SPMDS TO ASSESS MANAGEMENT STRATEGIES FOR PCB CONTAMINATED SEDIMENTS.

    EPA Science Inventory

    Abstract: Dredging in-place treatment, capping and monitored natural recovery, used together or separately are the primary approaches for managing contaminated sediment risks. Understanding how well different approaches work in different environments is critical for choosing an...

  8. USING SPMDS TO ACCESS MANAGEMENT STRATEGIES FOR PCB CONTAMINATED SEDIMENTS

    EPA Science Inventory

    Dredging, in-place treatment, capping and monitored natural recovery, used together or separately are the primary approaches for managing contaminated sediment risks. Understanding how well different approaches work in different environments is critical for choosing an appropria...

  9. USING SPMDS TO ACCESS MANAGMENT STRATEGIES FOR PCB CONTAMINATED SEDIMENTS

    EPA Science Inventory

    Dredging, in-place treatment, capping and monitored natural recovery, used together or separately are the primary approaches for managing contaminated sediment risks. Understanding how well different approaches work in different environments is critical for choosing an appropria...

  10. Environmental management strategies: The 21st century perspective

    SciTech Connect

    Crognale, G.

    1999-07-01

    This book provides a look at how to integrate EH and S issues throughout your organization. Specialists in the field have contributed their first-hand accounts and actual case studies to give a balanced overview of how environmental management issues affect everyone in an organization. Moving away from a regulations-driven viewpoint, a proactive view is taken that integrates environmental issues into the fabric of the organization at every level. Issues covered in the book include federal regulations from OSHA, EC, and EPA; meeting ISO 14001; assessing the value of EH and S as a management tool; progressive environmental stewardship and effective communications; risk management; EH and S software and other resources; and future trends in environmental management.

  11. Professional coaching as an effective strategy to retaining frontline managers.

    PubMed

    Karsten, Margo; Baggot, Deirdre; Brown, Amy; Cahill, Michael

    2010-03-01

    Historically, executive coaching has been reserved only for the c-suite in healthcare organizations. Expanding this resource to directors and managers has been assumed to be cost-prohibitive. The authors describe an intervention whereby executive coaching was expanded beyond the c-suite, during a critical transition time for the organization in an attempt to positively impact management turnover, staff turnover, and employee satisfaction.

  12. Management of urinary tract infections: historical perspective and current strategies: Part 2--Modern management.

    PubMed

    Nickel, J Curtis

    2005-01-01

    emergence of resistance, limiting the clinical usefulness of this therapy in the modern management of UTI. Fluoroquinolones offer an attractive alternative to TMP/SMX, and American and European guidelines recommend their empirical use in areas where TMP/SMX resistance is 10% or higher. The development of antimicrobial therapy was the defining moment of 20th century medicine and one of the key innovations in medical history. While the initial promise of antimicrobials has been validated in clinical practice, overuse of certain agents has led to the emergence of resistance, illustrating the importance of using evidence based strategies to select therapy.

  13. Use of single large or several small policies as strategies to manage people-park interactions.

    PubMed

    Mackenzie, Catrina A; Baird, Timothy D; Hartter, Joel

    2014-12-01

    Biodiversity conservation has been criticized for undermining or ignoring social well-being. Currently efforts to mutually promote social justice, rural development, and biodiversity conservation, which have been contentious and yielded mixed results, continue to spread despite a general dearth of effective management strategies. We contend that social and economic concerns should be integral to conservation planning and propose that the scale of these phenomena is also critical. To evaluate the merit of this proposal, we adopted and expanded a conservation management strategy framework developed by Joel Heinen and examined how population density, economic disparity, and ethnic heterogeneity vary spatially surrounding 2 contrasting protected areas in East Africa: Kibale National Park in Uganda and Tarangire National Park in Tanzania. Analyses of demographic, wealth, and ethnicity data from regional censuses and household surveys conducted in 2009 and 2010 indicated that choice of scale (landscape or community) changed the management strategies recommended by the model. Therefore, "several small" people-park management strategies varying around a given protected area may be more appropriate than a "single large" people-park strategy applied across an entire protected area. Correspondingly, scale adjusted Heinen recommendations offered new strategies for effective conservation management within these human landscapes not incorporated in current in situ management plans. © 2014 Society for Conservation Biology.

  14. Comparing Student Perceptions of Coping Strategies and School Interventions in Managing Bullying and Cyberbullying Incidents

    ERIC Educational Resources Information Center

    Paul, Simone; Smith, Peter K.; Blumberg, Herbert H.

    2012-01-01

    A total of 407 students in a central London secondary school participated in a survey of different approaches to managing traditional bullying and cyberbullying. Student perceptions of individual coping strategies and school interventions for traditional bullying and cyberbullying were measured. Rankings of the strategies for traditional bullying…

  15. Women's Danger Management Strategies in an Inner-City Housing Project

    ERIC Educational Resources Information Center

    Jarrett, Robin L.; Jefferson, Stephanie M.

    2004-01-01

    The danger management strategies of low-income African American women who live in a public housing community characterized by chronic violence are examined. Based on qualitative interviews with 18 single mothers, we explored the violent community dangers with which women contend, the nature of this violence, the strategies used to deal with…

  16. Women's Danger Management Strategies in an Inner-City Housing Project

    ERIC Educational Resources Information Center

    Jarrett, Robin L.; Jefferson, Stephanie M.

    2004-01-01

    The danger management strategies of low-income African American women who live in a public housing community characterized by chronic violence are examined. Based on qualitative interviews with 18 single mothers, we explored the violent community dangers with which women contend, the nature of this violence, the strategies used to deal with…

  17. 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.…

  18. 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.…

  19. Identification and evaluation of PWR in-vessel severe accident management strategies

    SciTech Connect

    Dukelow, J S; Harrison, D G; Morgenstern, M

    1992-03-01

    This reports documents work performed the NRC/RES Accident Management Guidance Program to evaluate possible strategies for mitigating the consequences of PWR severe accidents. The selection and evaluation of strategies was limited to the in-vessel phase of the severe accident, i.e., after the initiation of core degradation and prior to RPV failure. A parallel project at BNL has been considering strategies applicable to the ex-vessel phase of PWR severe accidents.

  20. [Waste management strategy and the role of the environmental protection and energy efficiency fund].

    PubMed

    Kalambura, Sanja

    2006-09-01

    On 14 October 2005, the Croatian Parliament adopted the National Strategy of Waste Management pursuant to Article 8 of the Waste Act. This strategy defines its objectives and the means to reach them, and gives an overview of the current situation in waste management. It seeks to provide a realistic framework for the effective reduction of national waste load and for a sustainable waste management. This Strategy defines 15 major waste flows which are in concordance with the EU practice. It also defines waste management buildings and plants, and looks into the remediation of municipal waste landfills. According to the Strategy, waste management will be present on all levels of administration: from national to local, and will include all areas of production, consumption, and everyday life. Founded on the EU's general principles of waste management, this Strategy provides the ideal framework for a sustained waste management in Croatia by the year 2025. Environmental Protection and Energy Efficiency Fund is one of the key administration bodies within the waste management system. It collects taxes for motor vehicles, for sulphur and nitrogen oxide pollution sources, for environmental hazardous and non-hazardous industrial waste load, and for the use of the environment. The Fund participates in the ongoing municipal landfill remediation projects and programmes all over Croatia (currently 161 landfills are being remedied) and helps to establish new regional and county waste management centres. It co-finances clean production technology projects, projects whose aim is to reduce the emission of harmful gases, projects for reusable energy sources and for more efficient use of energy, projects for remediation of unregulated municipal landfills, projects for primary recycling, and projects for biodiversity landscapes. According to an estimate, the implementation of the National Strategy of Waste Management will cost over 24 billion Croatian kunas (about 3.3 billion Euros

  1. 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

  2. Participatory Development Strategies for Open Source Content Management Systems

    ERIC Educational Resources Information Center

    Panke, Stefanie; Kohls, Christian; Gaiser, Birgit

    2007-01-01

    Stefanie Panke, Christian Kohls, and Birgit Gaiser maintain that effective strategies for the development of educational technology can only arise when the process is understood, analyzed, and assessed as a social phenomenon, and when the experience of users is integrated within the design process. To illustrate, they describe the early…

  3. Strategies for Science Student Achievement & Productive School Management

    ERIC Educational Resources Information Center

    Johnson, William L.

    2010-01-01

    There is an increasing literature pertaining to student achievement and school productivity. This session will present school and classroom strategies used in high school science classes at Robert E. Lee High School (5A) in Tyler, Texas. This year, 84% of the students at Lee passed the science TAKS test. Lee is also ranked in the top 1500 high…

  4. Investigating the Usability of Classroom Management Strategies among Elementary Schoolteachers

    ERIC Educational Resources Information Center

    Briesch, Amy M.; Briesch, Jacquelyn M.; Chafouleas, Sandra M.

    2015-01-01

    Although teachers are often asked to implement classroom interventions to address student behavior, little is known about their perceived usability of many evidence-based strategies. One thousand five elementary schoolteachers completed the Usage Rating Profile-Intervention-Revised (URP-IR) with regard to the use of one of five evidence-based…

  5. Classroom Management Strategies for Difficult Students: Promoting Change through Relationships

    ERIC Educational Resources Information Center

    Beaty-O'Ferrall, Mary Ellen; Green, Alan; Hanna, Fred

    2010-01-01

    Teachers in middle level schools face overwhelming demands and challenges in their classrooms. They are expected to know content and pedagogy, develop engaging lessons that meet the needs of diverse learners, and use a variety of instructional strategies that will boost student achievement while they simultaneously develop positive relationships…

  6. An Exploration of Persevering Students' Management of Problem Solving Strategies.

    ERIC Educational Resources Information Center

    Taplin, Margaret

    1995-01-01

    Interviewers asked (n=10) 6th- and (n=10) 10th-grade students to solve nonroutine number problems. Task analysis of perseverers, those students who continued after reaching "dead-ends," found that students who were ultimately successful were more inclined to be flexible in their strategies. (28 references) (MKR)

  7. Expense Management Strategies within Financially Successful Christian Universities

    ERIC Educational Resources Information Center

    Fletcher, Wayne L.

    2015-01-01

    This study identified the business strategies and tactics employed by three financially successful Christian institutions of higher education to drive a positive net income. In addition, this study explored the linkages between operational decisions and the institutions' Christian mission. The three institutions in this study declared an…

  8. Management of acute appendicitis: an imaging strategy in children.

    PubMed

    Neufeld, David; Vainrib, Michael; Buklan, Genady; Gutermacher, Michael; Paran, Haim; Werner, Myriam; Rathause, Valeria; Zissin, Rivka; Lazar, Ludwig; Erez, Ilan

    2010-02-01

    The pre-operative diagnosis of acute appendicitis (AA) has markedly changed during the last couple of decades due to the advent of modern imaging technology. Nowadays, the use of imaging has dramatically changed the way we approach children admitted to emergency room for abdominal pain with suspected AA. This change is mainly manifested in our diagnostic strategy.

  9. A Study of Organizational Downsizing and Information Management Strategies.

    DTIC Science & Technology

    1992-09-01

    operations. Various sources covered types of downsizing strategies (Lawrence and Mittman, 1991:33-37), dealing with employee morale (Alevras and Frigeri ...AFB AL: Air University, January 1991. Alevras, Joan and Arnold Frigeri . "Picking Up the Pieces after Downsizing," Training and Development Joural, 41

  10. Managing sexual difficulties: a qualitative investigation of coping strategies.

    PubMed

    Mitchell, Kirstin Rebecca; King, Michael; Nazareth, Irwin; Wellings, Kaye

    2011-07-01

    Biomedical interventions offer effective treatment for only a small proportion of individuals experiencing sexual difficulties. Where treatment fails, individuals have to find ways to cope and adjust. Currently, little is known about how individuals do this. This article presents data from 32 semi-structured interviews with individuals representing a range of sexual function experience. Three broad coping approaches are identified. The first, changing circumstances to fit goals, included strategies such as seeking biomedical treatment and ending a relationship. The second approach, changing goals to fit circumstances, included strategies such as changing one's definition of "good-enough" sex. The final approach, living with a gap between goal and circumstances, included strategies such as normalizing and avoiding the problem. Several factors appeared to be key in determining successful adjustment: the severity of the problem, causal attributions made about the problem, and the partnership context. The findings are explained in terms of Brandstadter's distinction between accommodative and assimilative coping strategies, and suggest that a flexible definition of good-enough sex, as well as a flexible stance toward the importance of sex, may enhance the process of adjustment.

  11. Participatory Development Strategies for Open Source Content Management Systems

    ERIC Educational Resources Information Center

    Panke, Stefanie; Kohls, Christian; Gaiser, Birgit

    2007-01-01

    Stefanie Panke, Christian Kohls, and Birgit Gaiser maintain that effective strategies for the development of educational technology can only arise when the process is understood, analyzed, and assessed as a social phenomenon, and when the experience of users is integrated within the design process. To illustrate, they describe the early…

  12. Investigating the Usability of Classroom Management Strategies among Elementary Schoolteachers

    ERIC Educational Resources Information Center

    Briesch, Amy M.; Briesch, Jacquelyn M.; Chafouleas, Sandra M.

    2015-01-01

    Although teachers are often asked to implement classroom interventions to address student behavior, little is known about their perceived usability of many evidence-based strategies. One thousand five elementary schoolteachers completed the Usage Rating Profile-Intervention-Revised (URP-IR) with regard to the use of one of five evidence-based…

  13. Scaling Performance Assessments: Strategies for Managing Local Item Dependence.

    ERIC Educational Resources Information Center

    Yen, Wendy M.

    1993-01-01

    Results from the Maryland School Performance Assessment Program for 5,392 elementary school students and from the Comprehensive Tests of Basic Skills (multiple choice) for a national sample are used to explore local item independence (LID) of test items. Some strategies are suggested for measuring LID in performance assessments. (SLD)

  14. Strife and Progress: Portfolio Strategies for Managing Urban Schools

    ERIC Educational Resources Information Center

    Campbell, Christine; Gross, Betheny; Hill, Paul T.

    2012-01-01

    Deficient urban schooling remains one of America's most pressing--and stubborn--public policy problems. This important new book details and evaluates a radical and promising new approach to K-12 education reform. "Strife and Progress" explains for a broad audience the "portfolio strategy" for providing urban education--its…

  15. Expense Management Strategies within Financially Successful Christian Universities

    ERIC Educational Resources Information Center

    Fletcher, Wayne L.

    2015-01-01

    This study identified the business strategies and tactics employed by three financially successful Christian institutions of higher education to drive a positive net income. In addition, this study explored the linkages between operational decisions and the institutions' Christian mission. The three institutions in this study declared an…

  16. Continuing Developments in PV Risk Management: Strategies, Solutions, and Implications

    SciTech Connect

    Lowder, T.; Mendelsohn, M.; Speer, B.; Hill, R.

    2013-02-01

    As the PV industry matures, successful risk management practices will become more imperative to ensure investor confidence, control costs, and facilitate further growth. This report discusses several key aspects of risk management during the commercial- and utility-scale project life cycle, from identification of risks, to the process of mitigating and allocating those risks among project parties, to transferring those risks through insurance. The report also explores novel techniques in PV risk management, options to offload risks onto the capital markets, and innovative insurance policies (namely warranty policies) that address risks unique to the PV sector. One of the major justifications for robust risk management in the PV industry is the cost-reduction opportunities it affords. If the PV industry can demonstrate the capability to successfully manage its risks, thereby inspiring confidence in financiers, it may be able to obtain a lower cost of capital in future transactions. A lower cost of capital translates to a lower cost of energy, which will in turn enhance PV?s competitiveness at a time when it will have to rely less on subsidies to support its market penetration.

  17. Do personality traits of nurses have an effect on conflict management strategies?

    PubMed

    Erdenk, Nigar; Altuntaş, Serap

    2017-07-01

    This research was conducted in a descriptive, correlational and cross-sectional design to determine whether personality traits of nurses have an effect on conflict management strategies. It is known that integration, avoidance and compromise conflict management strategies are the most frequent strategies used among nurses and obligation and domination are the least frequent. However, the reasons behind their strategy choice are not known. It is predicted that one of the reasons is the personality characteristics of the nurses. The study was conducted with the participation of 237 nurses working in three different hospitals. Research data were collected by using the 'Personal Information Form', 'Rahim Organisational Conflict Inventory-II' and 'Five Factor Personality Inventory' between December 2013 and February 2014. Ethical approval and the organisations' approvals were obtained before data collection. The collected data were analysed using frequency and percentage distributions, descriptive statistics, Pearson product-moment correlation analysis, t-test, Cronbach's alpha coefficient and simple linear regression analysis tests. The majority of nurses had conflict especially with patients' relatives several times a month. It was found that the personality traits of nurses were mostly 'conscientiousness' and 'openness' and when they had a conflict, they tended to use 'integration' strategy. It was also found that the personality traits of nurses had an effect on some of the conflict management strategies adopted by them. It was found that the personality traits of nurses had an effect on some conflict management strategies adopted by them. Nurse managers should support nurses who adopt appropriate conflict management strategies and there should be conflict management programmes that can teach appropriate skills to other nurses. © 2017 John Wiley & Sons Ltd.

  18. Strategies used by respiratory nurses to stimulate self-management in patients with COPD.

    PubMed

    Verbrugge, Remco; de Boer, Fijgje; Georges, Jean-Jacques

    2013-10-01

    To gain an insight into strategies, adopted by Dutch respiratory nurses during clinic sessions, to improve self-management of patients with chronic obstructive pulmonary disease. Chronic obstructive pulmonary disease is highly prevalent and a significant cause of morbidity and mortality, impacting on quality of life and healthcare expenditure. Health promotion is therefore an important consideration. By applying specific strategies, respiratory nurses can play a major role in the promotion of self-management. Research has shown that respiratory nurses, who run clinics, have insufficient knowledge of evidence-based strategies that can be adopted to promote self-management among chronic obstructive pulmonary disease patients. It appears that respiratory nurses adopt their own strategies during clinic sessions. A qualitative research study was carried out using Grounded Theory method. Data were collected during open interviews conducted by an external researcher with a nursing background. The interviews were analysed through coding after which categories were developed. Fourteen respiratory nurses were interviewed. The results show that respiratory nurses emphasise quitting smoking during the consult. Attention is also paid to inhalation medication and techniques. Other self-management strategies that respiratory nurses use are: application of specific interviewing techniques, referring to other healthcare professionals and providing tools for coping with the illness in everyday life. The main emphasis during the clinic session is directed at quitting smoking. Other self-management strategies such as providing information regarding nutrition and exercise, instilling confidence and becoming an equal discussion partner, gain less attention. During the clinic session, respiratory nurses should also focus on these self-management strategies in addition to quitting smoking. Further research should be directed at self-management strategies used by respiratory nurses in

  19. Evaluation and management of overactive bladder: strategies for optimizing care

    PubMed Central

    Willis-Gray, Marcella G; Dieter, Alexis A; Geller, Elizabeth J

    2016-01-01

    Overactive bladder (OAB) is a common condition affecting millions of men and women worldwide. It is an embarrassing condition with far-reaching consequences. Although many treatment options exist, no single treatment has been proven to be most effective. Often a combination of therapy is required to successfully manage OAB symptoms. In this review, we provide an overview of OAB, including risk factors for development of OAB; keys to diagnosis; therapeutic options including conservative and medical management, as well as treatments for refractory OAB; when to consider referral to a specialist; and resources for clinicians and patients. The aim of this review is to inform clinicians regarding OAB management in order to improve patient counseling and care. PMID:27556018

  20. Fatigue Management Strategies for the Stratospheric Observatory for Infrared Astronomy

    NASA Technical Reports Server (NTRS)

    Bendrick, Gregg

    2012-01-01

    Operation of the Stratospheric Observatory for Infrared Astronomy entails a great deal of night-time work, with the potential for both acute and chronic sleep loss, as well as circadian rhythm dysynchrony. Such fatigue can result in performance decrements, with an increased risk of operator error. The NASA Dryden Flight Research Center manages this fatigue risk by means of a layered approach, to include: 1) Education and Training 2) Work Schedule Scoring 3) Obtained Sleep Metrics 4) Workplace and Operational Mitigations and 5) Incident or Accident Investigation. Specifically, quantitative estimation of the work schedule score, as well as the obtained sleep metric, allows Supervisors and Managers to better manage the risk of fatigue within the context of mission requirements.

  1. Behavioral management at the Phoenix Zoo: new strategies and perspectives.

    PubMed

    Tresz, Hilda

    2006-01-01

    It all started with a seemingly simple decision to re-evaluate and document the Phoenix Zoo's behavioral management protocol. The purpose of this project was to present proactive standards for the care and psychological well-being of our living collection, while meeting or exceeding the guidelines of the Animal Welfare Act (U. S. Department of Agriculture Animal and Plant Health and Inspection Service, Animal Care, 1999). Preparing the protocol was a catalyst to re-evaluate the zoo's philosophy and application of behavioral management. It suggested a restructuring of collection management and the rethinking of future goals and practices. Gradually, the process became more focused and organized. Behavioral enrichment, training, animal behavior issues, and exhibit architecture were embraced as essential components for providing quality of life. Staff from all levels worked side-by-side on assignments. Our way of thinking and working was changing.

  2. Molecular pathogenesis and management strategies of ectopia lentis.

    PubMed

    Chandra, A; Charteris, D

    2014-02-01

    Ectopia lentis (EL) is a condition that can either herald underlying systemic conditions, or be isolated. The recent expansion in the genetics of these conditions has furthered the understanding of the underlying molecular aetiology. It is becoming apparent that novel genes, and in particular the ADAMTS (a disintegrin and metalloproteinase with thrombospondin motifs) family, are important in ocular development. The common link in these genes seems to be EL. The clinical management of EL is challenging. In particular, the options for addressing surgically induced aphakia in the context of an ectopic capsule are varied. Little evidence exists to direct management of these issues. This review summarises the molecular pathogenesis of EL and conditions associated with it, using the genetic aetiology as a framework. Furthermore, it summarises some of the issues involved in its clinical management.

  3. Hypoglycaemia in anesthesiology practice: Diagnostic, preventive, and management strategies.

    PubMed

    Kalra, Sanjay; Bajwa, Sukhminder Jit Singh; Baruah, Manash; Sehgal, Vishal

    2013-10-01

    Diabetes mellitus has emerged as one of the fastest growing non communicable diseases worldwide. Management of diabetic patients during surgical and critically illness is of paramount challenge to anesthesiologist and intensivist. Among its major acute complications, hypoglycemia has been given lesser attention as compared to other major acute complications; diabetic ketoacidosis and hyperosmolar non ketotic coma. However, newer studies and literary evidence have established the serious concerns of morbidity and mortality, both long- and short-term, related to hypoglycemia. basis. Invariably, diabetic patients are encountered in our daily routine practice of anesthesia. During fasting status as well as the perioperative period, it is hypoglycemia that is of high concern to anesthesiologist. Management has to be based on clinical, pharmacological, social, and psychological basis, so as to completely prevent the complications arising from an acute episode of hypoglycemia. This review aims to highlight various aspects of hypoglycemia and its management both from endocrine and anesthesia perspective.

  4. Healthy Eating and Exercise: Strategies for Weight Management in the Rural Midwest

    ERIC Educational Resources Information Center

    Nothwehr, Faryle; Peterson, N. Andrew

    2005-01-01

    Obesity prevalence has increased dramatically in the United States. Rural areas have been especially affected, yet few weight management studies have been conducted in these populations. This study was designed to assess weight management attitudes and strategies used when rural adults in particular attempt to lose weight, employing measures that…

  5. A New Taxonomy of Cognitive Strategies for the Management of Pain.

    ERIC Educational Resources Information Center

    Fernandez, Ephrem P.

    This paper presents cognitive strategies as one major approach to pain management. They are discussed as part of a trimodal system of pain management that also includes behavioral manipulations and physical intervention. The need for a standardized classification to deal with terminological inconsistency in the literature on cognitive management…

  6. Six Strategies for Breaking Out of Another HRD Box--Management's Resistance to Change Itself

    ERIC Educational Resources Information Center

    Bowen, Robert; Mok, Paul

    1976-01-01

    Many human resources development (HRD) people play out self-fulfilling roles of incongruency with top management, but when management resistance to change is real, the six strategies offered in the article can be used by HRD specialists to help themselves and their companies. (Author/AJ)

  7. The Impact of Managerialism on the Strategy Work of University Middle Managers

    ERIC Educational Resources Information Center

    Davis, Annemarie; Jansen van Rensburg, Mari; Venter, Peet

    2016-01-01

    In an attempt to understand the effects of managerialism on university managers in a developing country, we set out to gather rich data on the strategy work of middle managers through a single case study at a South African university. Managerialism has the potential to solve inefficiencies in university systems and processes, as it could help to…

  8. Classroom Management in Secondary Schools: A Study of Student Teachers' Successful Strategies

    ERIC Educational Resources Information Center

    Zuckerman, June Trop

    2007-01-01

    The purpose of this paper is to identify strategies for preventing and managing classroom discipline problems that any teacher, even a student teacher, can use successfully. Sixty-eight student science teachers, during their first weeks of student teaching, each reported, in an account of a well-remembered event about classroom management,…

  9. 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…

  10. Engaging Students in Classroom Guidance: Management Strategies for Middle School Counselors

    ERIC Educational Resources Information Center

    Geltner, Jill A.; Clark, Mary Ann

    2005-01-01

    Classroom guidance for all students is an important element of the program delivery system for middle school counselors. Effective classroom management is essential to implementing classroom guidance and may be challenging at times. This article presents strategies and management techniques to facilitate middle school counselors' planning and…

  11. The Impact of Managerialism on the Strategy Work of University Middle Managers

    ERIC Educational Resources Information Center

    Davis, Annemarie; Jansen van Rensburg, Mari; Venter, Peet

    2016-01-01

    In an attempt to understand the effects of managerialism on university managers in a developing country, we set out to gather rich data on the strategy work of middle managers through a single case study at a South African university. Managerialism has the potential to solve inefficiencies in university systems and processes, as it could help to…

  12. Rethinking Knowledge Management: Strategies for Enhancing District-Level Teacher and Leader Tacit Knowledge Sharing

    ERIC Educational Resources Information Center

    Edge, Karen

    2013-01-01

    Grounded within knowledge management (KM) theory and conceptions of tacit and explicit knowledge, this article draws on historical evidence from the Early Years Literacy Project (EYLP), a four-year instructional renewal strategy implemented across 100 schools in a large Canadian school district. The EYLP management approach included a series of…

  13. Irrigation and drainage management strategies to enhance cranberry production and optimize water use in North America

    USDA-ARS?s Scientific Manuscript database

    Recent funding, as well as technological and management changes, have led to important advances in irrigation and drainage strategies for the North American cranberry industry. This paper represents a synthesis of water management research on cranberry, as well as an introduction to a special issue ...

  14. Effective Strategy Formation Models for Inventory Management under the Conditions of Uncertainty

    ERIC Educational Resources Information Center

    Kosorukov, Oleg Anatolyevich; Sviridova, Olga Alexandrovna

    2015-01-01

    The article deals with the problem of modeling the commodity flows management of a trading company under the conditions of uncertain demand and long supply. The Author presents an analysis of modifications of diversified inventory management system with random demand, for which one can find the optimal inventory control strategies, including those…

  15. Understanding beef-cattle farming management strategies by identifying motivations behind farmers' priorities.

    PubMed

    Magne, M A; Cerf, M; Ingrand, S

    2012-06-01

    This study aimed to identify and better understand management strategies that help livestock farmers adapt to changes in their production contexts, a fundamental challenge. A total of nine beef-cattle farmers were interviewed three times over 1 year to discuss 13 dimensions of livestock farming (e.g. reproduction, feeding, sales, etc.). Characterisation of management strategies rested on three main factors: (i) ranking of the dimensions according to the degree to which farmers desired to control them, (ii) reasons for the ranking and (iii) management guidelines. Although farmers agreed upon the rank of certain dimensions, such as herd management, they differed on that of others, such as sales and administration/regulations. Four motivation categories were identified: risk, pleasure, efficiency and ability to control the dimension. Three management guidelines were identified, which indicated that farmers managed for future survival of their farms at different scales (animal/herd v. whole-farm), involving different resources (biological v. financial) and based on different animal categories (reproductive cows v. animals sold). These results improve understanding of individual livestock farmers and their current management strategies by integrating the motivations behind their strategies. For this reason, they constitute methodological elements that agricultural advisors can use to provide relevant information to farmers while accommodating differences in farm management.

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

    ERIC Educational Resources Information Center

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

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

  17. Managing Spaces: (Re)working Relations of Strategy and Spatiality in Vocational Education and Training

    ERIC Educational Resources Information Center

    Mulcahy, Dianne

    2007-01-01

    The adoption of a more "open" national training market in vocational education and training (VET) in Australia has led to considerable changes in VET organizations and considerable challenges for VET managers. Recent research has established the critical role that 'strategy' plays in leading and managing these organizations and the…

  18. Classroom Management in Secondary Schools: A Study of Student Teachers' Successful Strategies

    ERIC Educational Resources Information Center

    Zuckerman, June Trop

    2007-01-01

    The purpose of this paper is to identify strategies for preventing and managing classroom discipline problems that any teacher, even a student teacher, can use successfully. Sixty-eight student science teachers, during their first weeks of student teaching, each reported, in an account of a well-remembered event about classroom management,…

  19. Governing University Strategy: Perceptions and Practice of Governance and Management Roles

    ERIC Educational Resources Information Center

    Rytmeister, Catherine

    2009-01-01

    Intertwined trends of massification, internationalisation and marketisation constitute and drive change in higher education at all levels. Consequences at the institutional level include: increased competition, adoption of corporate management forms, accrual of power to executive management, and greater emphasis on strategy. As Government policy…

  20. Teachers' Reported Knowledge and Implementation of Research-Based Classroom and Behavior Management Strategies

    ERIC Educational Resources Information Center

    Moore, Tara C.; Wehby, Joseph H.; Oliver, Regina M.; Chow, Jason C.; Gordon, Jason R.; Mahany, Laura A.

    2017-01-01

    Teachers' reported knowledge about and implementation of research-based classroom and behavior management strategies were examined. A total of 160 elementary teachers from two districts in different regions of the same state completed the researcher-developed "Survey of Classroom and Behavior Management." On average, teachers reported to…

  1. 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…

  2. Chapter 7. Management strategies for dwarf mistletoes: Biological, chemical, and genetic approaches

    Treesearch

    S. F. Shamoun; L. E. DeWald

    2002-01-01

    The opportunity and need for management of mistletoe populations with biological, chemical, and genetic approaches are greatest for application to the dwarf mistletoes. Although much information is available on these management strategies (see reviews by Hawksworth 1972, Knutson 1978), significant research and development are still required for these to become...

  3. Healthy Eating and Exercise: Strategies for Weight Management in the Rural Midwest

    ERIC Educational Resources Information Center

    Nothwehr, Faryle; Peterson, N. Andrew

    2005-01-01

    Obesity prevalence has increased dramatically in the United States. Rural areas have been especially affected, yet few weight management studies have been conducted in these populations. This study was designed to assess weight management attitudes and strategies used when rural adults in particular attempt to lose weight, employing measures that…

  4. Management Strategies for Administrators in Small Schools. Small Schools Network Information Exchange, Number 7.

    ERIC Educational Resources Information Center

    Regional Laboratory for Educational Improvement of the Northeast & Islands, Andover, MA.

    This information packet contains journal articles, book chapters, conference papers, and ERIC clearinghouse publications on small schools management strategies for superintendents and principals. Topics cover (1) elements of formal team management; (2) role of the administrator in creating the environment necessary for effective schools; (3)…

  5. Rethinking Knowledge Management: Strategies for Enhancing District-Level Teacher and Leader Tacit Knowledge Sharing

    ERIC Educational Resources Information Center

    Edge, Karen

    2013-01-01

    Grounded within knowledge management (KM) theory and conceptions of tacit and explicit knowledge, this article draws on historical evidence from the Early Years Literacy Project (EYLP), a four-year instructional renewal strategy implemented across 100 schools in a large Canadian school district. The EYLP management approach included a series of…

  6. 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,…

  7. Canadian Wildland Fire Strategy: A vision for an innovative and integrated approach to managing the risks

    Treesearch

    Canadian Wildland Fire Strategy Project Management Team

    2006-01-01

    The Canadian Wildland Fire Strategy (CWFS) provides a vision for a new, innovative, and integrated approach to wildland fire management in Canada. It was developed under the auspices of the Canadian Council of Forest Ministers and seeks to balance the social, ecological, and economic aspects of wildland fire through a risk management framework that emphasizes hazard...

  8. Governing University Strategy: Perceptions and Practice of Governance and Management Roles

    ERIC Educational Resources Information Center

    Rytmeister, Catherine

    2009-01-01

    Intertwined trends of massification, internationalisation and marketisation constitute and drive change in higher education at all levels. Consequences at the institutional level include: increased competition, adoption of corporate management forms, accrual of power to executive management, and greater emphasis on strategy. As Government policy…

  9. 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...

  10. Managing Spaces: (Re)working Relations of Strategy and Spatiality in Vocational Education and Training

    ERIC Educational Resources Information Center

    Mulcahy, Dianne

    2007-01-01

    The adoption of a more "open" national training market in vocational education and training (VET) in Australia has led to considerable changes in VET organizations and considerable challenges for VET managers. Recent research has established the critical role that 'strategy' plays in leading and managing these organizations and the…

  11. Management and Training across Cultures: Importance of Non-Verbal Communication Strategies--A Case Study.

    ERIC Educational Resources Information Center

    Potoker, Elaine

    Noting that cross-cultural and language barriers pose formidable challenges to managers, a case study examined the application of selective nonverbal communication strategies (nonverbal cues, learning by observation, and the organization of learning) for management and training development efforts within diverse cultural environments. Source…

  12. Strategies in the Nutritional Management of Gestational Diabetes

    PubMed Central

    Hernandez, Teri L.; Anderson, Molly A.; Chartier-Logan, Catherine; Friedman, Jacob E.; Barbour, Linda A.

    2013-01-01

    Elucidating the optimal macronutrient composition for dietary management of gestational diabetes mellitus(GDM) has enormous potential to improve perinatal outcomes. Diet therapy may result in significant cost savings if effective in deterring the need for expensive medical management within this growing population. In only 6 randomized controlled trials(RCTs) in 250 women, data suggest that a diet higher in complex carbohydrate and fiber, low in simple sugar, and lower in saturated fat may be effective in blunting postprandial hyperglycemia, preventing worsened insulin resistance and excess fetal growth. The use of diet in GDM remains an area in grave need for high-quality RCTs. PMID:24047934

  13. Management strategies for persistent epithelial defects of the cornea

    PubMed Central

    Katzman, Lee R.; Jeng, Bennie H.

    2014-01-01

    Management of patients with persistent epithelial defects of the cornea can be challenging to even the seasoned ophthalmologist. It is essential that one understands not only the pathophysiology of the failure of the epithelium to migrate and close a wound appropriately, but also the mechanism of action of the available treatment modalities at one’s disposal. This article serves as a review of current standard therapies, recently introduced alternative therapies gaining in popularity, and a look into the newest developments that may change the way we manage corneal surface disease. PMID:25278792

  14. Some legal and managerial strategies for managing healthcare fraud.

    PubMed

    Paul, R J; Townsend, J B

    1997-01-01

    Healthcare fraud is an increasingly serious problem in the industry. The problem is complicated by disagreement over its basic causes and how it can be managed. Attempts to manage healthcare fraud introduce privacy issues as well as the proper role of the government. Even law enforcement officials appear to be undecided concerning jurisdiction and prosecution. Healthcare fraud is everyone's loss and will require the cooperation of all if it is to be controlled. The medical and legal as well as insurance organizations and the public must get involved.

  15. A multipronged, nutritional-based strategy for managing Alzheimer's disease.

    PubMed

    Glick, J Leslie; McMillan, Philip A

    2016-06-01

    A nutritional-based strategy has been proposed in order to improve cognitive performance of Alzheimer's disease (AD) patients. The strategy requires daily dietary supplementation with magnesium (Mg), folic acid, and vitamins B6 and B12, daily consumption of silicic acid-rich mineral water in order to lower the body burden of Al, and several plasma exchange procedures in order to replace Aβ-bound albumin with fresh albumin. Evidence suggests that the deteriorating cognitive performance associated with AD may be improved by supplementation with either Mg alone or with the combination of the above three B vitamins (B vitamin combo), or by drinking silicic acid-rich mineral water, or by undergoing plasma exchange. However, for the following reasons the combination of all four therapeutic approaches may have a synergistic effect on improving cognitive performance of AD patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Developing a multiscale fire treatment strategy for species habitat management

    Treesearch

    Steven P. Norman; Danny C. Lee; David A. Tallmon

    2008-01-01

    Reintroducing fire to manage vegetation and fuel may have poorly understood consequences for wildlife. Prescribed burning can reduce down wood and snags that provide critical habitat and mechanical thinning designed to reduce fire hazards may alter forest structures that are preferred by some species. Moreover, fine scale fuel treatments may alter wildlife and habitat...

  17. Strategies for healthcare facilities, construction, and real estate management.

    PubMed

    Lee, James G

    2012-05-01

    Adventist HealthCare offers the following lessons learned in improving the value of healthcare facilities, construction, and real estate management: Use an integrated approach. Ensure that the objectives of the approach align the hospital or health system's mission and values. Embrace innovation. Develop a plan that applies to the whole organization, rather than specific business units. Ensure commitment of senior leaders.

  18. Organization Development Strategies in Educational Policy Planning and Management.

    ERIC Educational Resources Information Center

    Jones, B. Kathryn; Biles, Stephen

    1990-01-01

    This synthesis reviews organizational development (OD) and its decision tools, describes OD applications in educational organizations, explores OD's limitations, and predicts how OD will influence future educational decision making. Findings identify eight specific management and planning areas where OD can be used to improve organizational…

  19. Coagulopathy in a subtype of choledochal cyst and management strategy.

    PubMed

    Diao, Mei; Li, Long; Cheng, Wei

    2014-08-14

    To evaluated our management algorithm of the coagulopathy. We evaluated our management algorithm of the coagulopathy. Between October 2001 and January 2013, 160 CDC children with coagulopathy (fibrinogen, FIB < 2 g/L) were recruited. FIB ≥ 1 g/L is generally required for safe elective surgery. We used FIB level as an indicator when: (1) patients with FIB levels between 1-2 g/L underwent one-stage definitive operation; and (2) patients with FIB < 1 g/L underwent 3 d of medical treatment. Thereafter, those with FIB ≥ 1 g/L underwent one-stage definitive operation whereas those with FIB < 1 g/L underwent external biliary drainage to allow liver function improvement. Those patients with liver function improvements underwent definitive operation after 7 d of drainage. After preoperative optimization, 92.5% of CDC children with coagulopathy underwent successful one-stage definitive operation. The remaining 7.5% of CDC children required initial external bile drainage, and underwent definitive operation 11 d after the admission. The mean operative time and postoperative recovery duration were comparable to those with normal coagulations. The median follow-up period was 57 mo. No blood transfusion or other postoperative complications were encountered. Following our management protocol, the majority of CDC children with coagulopathy can be managed with one-stage definitive operation.

  20. Coagulopathy in a subtype of choledochal cyst and management strategy

    PubMed Central

    Diao, Mei; Li, Long; Cheng, Wei

    2014-01-01

    AIM: To evaluated our management algorithm of the coagulopathy. We evaluated our management algorithm of the coagulopathy. METHODS: Between October 2001 and January 2013, 160 CDC children with coagulopathy (fibrinogen, FIB < 2 g/L) were recruited. FIB ≥ 1 g/L is generally required for safe elective surgery. We used FIB level as an indicator when: (1) patients with FIB levels between 1-2 g/L underwent one-stage definitive operation; and (2) patients with FIB < 1 g/L underwent 3 d of medical treatment. Thereafter, those with FIB ≥ 1 g/L underwent one-stage definitive operation whereas those with FIB < 1 g/L underwent external biliary drainage to allow liver function improvement. Those patients with liver function improvements underwent definitive operation after 7 d of drainage. RESULTS: After preoperative optimization, 92.5% of CDC children with coagulopathy underwent successful one-stage definitive operation. The remaining 7.5% of CDC children required initial external bile drainage, and underwent definitive operation 11 d after the admission. The mean operative time and postoperative recovery duration were comparable to those with normal coagulations. The median follow-up period was 57 mo. No blood transfusion or other postoperative complications were encountered. CONCLUSION: Following our management protocol, the majority of CDC children with coagulopathy can be managed with one-stage definitive operation. PMID:25132782