Science.gov

Sample records for nurse-based case management

  1. Nurse-based case management for aged patients with myocardial infarction: study protocol of a randomized controlled trial

    PubMed Central

    2010-01-01

    Background Aged patients with coronary heart disease (CHD) have a high prevalence of co-morbidity associated with poor quality of life, high health care costs, and increased risk for adverse outcomes. These patients are often lacking an optimal home care which may result in subsequent readmissions. However, a specific case management programme for elderly patients with myocardial infarction (MI) is not yet available. The objective of this trial is to examine the effectiveness of a nurse-based case management in patients aged 65 years and older discharged after treatment of an acute MI in hospital. The programme is expected to influence patient readmission, mortality and quality of life, and thus to reduce health care costs compared with usual care. In this paper the study protocol is described. Methods/design The KORINNA (Koronarinfarkt Nachbehandlung im Alter) study is designed as a single-center randomized two-armed parallel group trial. KORINNA is conducted in the framework of KORA (Cooperative Health Research in the Region of Augsburg). Patients assigned to the intervention group receive a nurse-based follow-up for one year including home visits and telephone calls. Key elements of the intervention are to detect problems or risks, to give advice regarding a broad range of aspects of disease management and to refer to the general practitioner, if necessary. The control group receives usual care. Twelve months after the index hospitalization all patients are re-assessed. The study has started in September 2008. According to sample size estimation a total number of 338 patients will be recruited. The primary endpoint of the study is time to first readmission to hospital or out of hospital death. Secondary endpoints are functional status, participation, quality of life, compliance, and cost-effectiveness of the intervention. For the economic evaluation cost data is retrospectively assessed by the patients. The incremental cost-effectiveness ratio (ICER) will be

  2. "Tuberculosis Case Management" Training.

    ERIC Educational Resources Information Center

    Knebel, Elisa; Kolodner, Jennifer

    2001-01-01

    The need to isolated health providers with critical knowledge in tuberculosis (TB) case management prompted the development of "Tuberculosis Case Management" CD-ROM. Features include "Learning Center,""Examination Room," and "Library." The combination of audio, video, and graphics allows participants to…

  3. Case Management Directors

    PubMed Central

    Bankston-White, Cheri; Birmingham, Jackie

    2015-01-01

    Purpose and Objectives: Case management directors are in a dynamic position to affect the transition of care for patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the “moving parts” of such a complex role. The purpose of this two-part article is to provide case management directors, particularly new ones, with a framework for understanding and fulfilling their role. We have divided the guide into seven tracks of responsibility. Part 1 discusses the first four tracks: (1) staffing and human resources, (2) compliance and accreditation, (3) discharge planning, and (4) utilization review and revenue cycle. Part 2 addresses (5) internal departmental relationships (organizational), (6) external relationships (Community agency), and (7) quality and program outcomes. Primary Practice Setting: The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems, and have frontline case managers reporting to them. Findings/Conclusions: Case management directors would benefit from further research and documentation of “best practices” related to their role, particularly in the areas of leadership and management. New directors would benefit from mentoring and networking with one another. Implications for Case Management: As new regulations and models of care bring increased emphasis and focus to transitions of care, the role of the case management director continues to evolve, growing in importance and complexity. The growing financial impact of readmissions also brings added scrutiny and increased pressure to get the transitions of care right the first time. To operate most effectively, case management directors must understand the full range of their

  4. Nursing case management: a rural practice model.

    PubMed

    Stanton, M P; Packa, D

    2001-01-01

    Nursing case management is a blend of individual case- and/or disease-management activities used in urban hospitals or community health settings. The authors propose that in rural communities, a third form of case management is also used. Nursing case management in the rural community has a broader and more diverse scope of practice than nurse case managers practicing in urban settings.

  5. What's funny about case management?

    PubMed

    Saxton, S E

    1997-01-01

    Humor is an effective tool to prevent and resolve burnout, a common problem associated with the practice of case management. Easily accessed by almost everyone, humor has many physiological and psychological benefits. The conscious use of humor in an organization requires a commitment at all levels in order for the organization to benefit as a whole. Offering formal seminars, using humor in company newsletters, and encouraging cartoon or joke sharing impacts on the physical and mental health of the employees. Techniques for bringing laughter to the workplace are outlined, as well as examples from the practice of case management.

  6. Case Studies in Broadcast Management.

    ERIC Educational Resources Information Center

    Coleman, Howard W.

    This collection of case studies, based on factual situations which have challenged broadcast managers in recent years, is designed to stimulate thinking about and solving of "real world" problems in commercial radio and television operations. Topics of a serious, long-run nature include enlarging the radio audience; station revenue and economy;…

  7. State of the art case management.

    PubMed

    Hall, J C

    1998-01-01

    Case management traditionally has been performed by occupational health nurses and rehabilitation professionals. The rapid growth of managed care was the impetus for defined standards and formal credentialing.

  8. 75 FR 27375 - Postal Rate Case Management

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-14

    ... From the Federal Register Online via the Government Publishing Office POSTAL REGULATORY COMMISSION Postal Rate Case Management AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is seeking comments relevant to management of an anticipated exigent postal rate case. It...

  9. Case Management for Families and Children.

    ERIC Educational Resources Information Center

    McManus, Marilyn C., Ed.

    1993-01-01

    This theme issue of "Focal Point" offers an overview of a range of children's mental health case management issues. Articles include: "Case Management for Families and Children" (Theresa J. Early); "Expectations of Case Management for Children with Emotional Problems: Parent Perspectives" (Richard Donner and others);…

  10. Case management - a pillar of community psychiatry.

    PubMed

    Ivezić, Sladana Strkalj; Muzinić, Lana; Filipac, Vanda

    2010-03-01

    This review is describing different models of case management, showing their similarities and differences with regards to the way they operate. Good relationship between patient and case manager, application of the biopsychosocial model, availability of psychosocial treatment methods and rehabilitation programs, and individual treatment plan are all important factors in case management's success. Large number of studies supports the application of case management in practice as effective treatment method in treating people with severe mental disorder, particularly those, who are less co-operative. Therefore, the implementation of case management into psychiatric practice should be supported.

  11. Study on Case Teaching of Financial Management

    ERIC Educational Resources Information Center

    Che, Zhenghong; Che, Zhengmei

    2011-01-01

    Case teaching is an efficient teaching method of management. It plays an important role to enhance the students' ability to practice the theory. However, case teaching of financial management has not achieved the expected results. The paper aims to study the importance, characteristics and corresponding methods of case teaching method of financial…

  12. Case Studies for Management Development in Bangladesh.

    ERIC Educational Resources Information Center

    McLean, Gary N.

    Eight case studies appropriate for use in a course in management development were prepared and are provided in this document. The typical case describes a real business situation in which a real manager had to reach a decision. The case gives quantitative and qualitative information that is, or may be, relevant to that decision. Questions for…

  13. Community case management for mental illness.

    PubMed

    Kelly, J; Stephens, I

    1999-05-01

    These case vignettes clearly illustrate the complexity which is modern psychiatric case management. In the case of Mr D, one of the salient facets of case management was medication monitoring in the context of the introduction of a new depot injection. This was a function in which nursing knowledge of medications and their side effects was undoubtedly advantageous. Any adverse experience with medication is likely to have negative ramifications regarding future compliance. Therefore, a nurse case manager is ideally suited to provide the appropriate information on psychotropic medications and to confidently answer most questions about these medications, and promptly identify any possible emerging side effects. In the case of Mr X, the management began with a practical and crisis focus involving suicide prevention. This developed into supportive psychotherapy, which required sensitive but proactive intervention and, ultimately, significant counselling skills. Mr L's case management had a different focus again, characterised by the development of a new and comprehensive case formulation and a creative nurturing of an individual's identified strength in music. The vignettes not only serve to highlight the well-established heterogeneity of mental illness, but they also importantly illuminate the heterogeneity of case management, a reality obscured in the descriptions of case management models which perhaps misleadingly have given the impression of the process as being merely a number of clearly defined tasks or functions. In actual fact, though the coordination of care appears to represent a common feature, the case management relationship remains an ever changing one, with adaptability, refined clinical skills and practical problem solving skills being the essential requisites of an effective case manager. Therefore, attempts to present this important activity in terms of any one model seem to miss the point. For the consumers of psychiatric services, the experience of

  14. Emotionally intelligent case managers make a difference.

    PubMed

    Tahan, H A

    2000-01-01

    Emotional intelligence is a skill necessary for case managers because of the diversity of their work, the multiple stakeholders they have to deal with on daily basis, and the increased potential for conflict. Managers and administrators need to be cognizant of the role emotional intelligence plays in employee performance and the importance of developing training programs to assist case managers in learning to deal with change and conflict. Case managers must assume responsibility for their actions and work to develop and improve their emotional intelligence skills set. Ultimately, patients and work associates will appreciate the case manager's efforts. Finally, case managers will find work an enjoyable experience and look forward to new opportunities the future holds.

  15. A Case Management Approach to School Counselling.

    ERIC Educational Resources Information Center

    Eng, Allen; Jevne, Ronna

    1989-01-01

    Provides an example of a functioning case management system in a K-9 school used by a practicing counselor for managing individually referred cases. Contends that this approach affords counselor a time-effective means to work with wide variety of individual referrals while simultaneously gathering a data base which can be used to address…

  16. Case Studies in Middle Management Supervision

    ERIC Educational Resources Information Center

    White, Lori S.

    2011-01-01

    This chapter presents a series of supervision-related case studies of situations that midlevel managers might face. Individuals enrolled in a midlevel management professional development course recommended the topics selected for this chapter. Drawing upon her experience teaching the course, the author selected four case studies that individuals…

  17. The Case Management Team: Building Community Connections.

    ERIC Educational Resources Information Center

    Lippert, Toni

    This guidebook presents ideas about how families and case managers can use case management to increase the integration of people with developmental disabilities into their communities, and how public officials and advocates can promote the trend toward community integration. The guide advocates implementation of the integration philosophy, which…

  18. Iowa Case Management for Rural Drug Abuse

    ERIC Educational Resources Information Center

    Hall, James A.; Vaughan Sarrazin, Mary S.; Huber, Diane L.; Vaughn, Thomas; Block, Robert I.; Reedy, Amanda R.; Jang, MiJin

    2009-01-01

    Objective: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. Method: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual…

  19. Case management in France: an economic perspective.

    PubMed

    Frossard, M

    1996-01-01

    Case management is currently an important issue in France. Because neither service providers nor consumers pay for case management in this country, a cost-benefit analysis is often required by the organizations that do pay. Given the context of French social policy and the current focus on justifying case management through cost-benefit analysis, we have developed a way to evaluate its costs. This article presents the limitations of standard economic choice theory, provides a methodology based on the principles of limited rationality, and gives the results of an evaluation of four case management programs. The article provides a method to measure case management costs and efficiency, as well as the willingness of consumers to pay for services.

  20. Hospital program weds case, disease management.

    PubMed

    1997-10-01

    To lower its readmission rates and inpatient length of stay for three high-volume chronic conditions, Memorial Hospital in Colorado Springs, CO, developed a program that combines clinical pathways with a cross-continuum disease management program. Community physicians refer patients to the program. Hospital-based care managers guide patients in the acute setting before handing them off to outpatient case managers, who coordinate the patient's transition to home care. Clinicians at Memorial sold administrators on the "care-case management" approach by arguing that increased inpatient efficiency would offset potential revenue shortfalls due to fewer admissions.

  1. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Primary care case management services. 440.168... care case management services. (a) Primary care case management services means case management related... services. (b) Primary care case management services may be offered by the State— (1) As a voluntary...

  2. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Primary care case management services. 440.168... care case management services. (a) Primary care case management services means case management related... services. (b) Primary care case management services may be offered by the State— (1) As a voluntary...

  3. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Primary care case management services. 440.168... care case management services. (a) Primary care case management services means case management related... services. (b) Primary care case management services may be offered by the State— (1) As a voluntary...

  4. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Primary care case management services. 440.168... care case management services. (a) Primary care case management services means case management related... services. (b) Primary care case management services may be offered by the State— (1) As a voluntary...

  5. Multimedia case management system implemented in Java

    NASA Astrophysics Data System (ADS)

    Stewart, Howard D.; Davis, Midge L.; Handy, Dale L.; Kvarfordt, Kent B.; Ford, Glenn

    1999-01-01

    Managing the timely access of information is a major challenge facing law enforcement agencies. One of the areas of greatest need is that of the case management process. During the course of FY98, the Office of National Drug Control Policy (ONDCP), the Counterdrug Technology Assessment Center (CTAC), the Idaho National Engineering and Environmental Laboratory (INEEL), and the Criminal Investigative Bureau (CIB) of the state of Idaho, created a Northwest testbed to develop and integrate a multimedia case management system. A system was developed to assist investigators in tracking and maintaining investigative cases and improving access to internal and external data resources. In this paper, we discuss the results of our case management system development and the ability to present state and federal information incorporating object oriented and multimedia techniques. We then outline our plans for future research and development.

  6. Managing severe peripartum hyponatraemia: A case report

    PubMed Central

    Lim, Jerry; Laing, Christopher M; MacCallum, Niall S; Brealey, David A

    2014-01-01

    We present a case of severe peripartum hyponatraemia that occurred following a major obstetric haemorrhage causing both an ischaemic stroke and Sheehan's syndrome and outline the investigations and management strategy required. PMID:27512448

  7. Polarity Analysis in Child Abuse Case Management.

    ERIC Educational Resources Information Center

    Hurst, Joe Brannan; And Others

    1993-01-01

    The use of polarity analysis in child abuse case management provides a way to identify interdependent polar opposites, their positive and negative consequences, and actions to manage them over time, rather than compete for one right solution. An example of polarity analysis is presented with the two poles being parental autonomy and the agency as…

  8. "Since I have my case manager, I am back to life" case management in Croatia.

    PubMed

    Gruber, Ema N; Ivezić-Strkalj, Sladana; Agius, Mark; Martić-Biocina, Sanja

    2008-03-01

    The authors present a case report of a patient who was treated by a case manager, a member of a Croatian Community Mental Health (CMH) Team, following the recommendations of WHO 2004 as well as the IRIS guidelines and the Basic Standards for Management of Patients with Serious Mental Illness in the Community (Agius 2005) and using the elements of Clinical case management (Muser 1998), Assertive community treatment model (Burns 1995, Scott 1995, Wolfsan 1990), the personal strength model (Rapp 1988) and Rehabilitation model (Anthony 1993). In order to emphasize the importance of the therapist-patient relationship in the treatment of chronic schizophrenic patients (Ivezic 2001) and creating the group atmosphere a Croatian model of case management is created where the patient's needs and risks are assessed by a multidisciplinary team which also conducts the recommended psychosocial interventions plan. The majority of interventions are conducted in groups. The case manager develops a confident relationship with a patient, nourishes the positive transference and aids the delivery of the treatment. The main goals of the interventions are empowerment of the patient, improvement of his abilities and decreasing of disabilities. The case manager also carries out a full assessment of the needs of the patient's family so that the family or carers are also included in the treatment or support if necessary (Gruber 2006). A case report of a patient and the work of her case manager as well as the case manager's diary (Gruber 2007) and the Croatian model of case management is presented in this article.

  9. Collaborative practice through nursing case management.

    PubMed

    Chimner, N E; Easterling, A

    1993-01-01

    A 528-bed community teaching hospital redesigned its patient care delivery system, implementing a collaborative practice model on the 30-bed inpatient rehabilitation unit in April 1990. This model is a patient-centered delivery model that encourages the healthcare team to facilitate the achievement of patient outcomes within effective time frames and with an appropriate use of resources. The collaborative practice model includes a nurse case manager's role for the staff nurse, which had as its frame-work the concept of nursing case management. Tested project management techniques were used to ensure a successful implementation process. Various strategies, such as using project teams and providing educational programs, were used to respond to the issues of role conflict and overlap, especially between social workers and nurse case managers. The implementation of this model provided a number of benefits, including improved interdisciplinary relationships and decreased length of stay.

  10. Tool Version Management Technology: A Case Study.

    DTIC Science & Technology

    1990-11-01

    Technical Report AD-A235 639 CMU/SEI-90-TR-25 Tool Version Management Technology: A Case Study Peter H. Feiler Grace F. Downey November 1990 x 91...00304 90 7 Technical Report CMU/SEI-90-TR-25 ESD-90-TR-226 November 1990 Tool Version Management Technology: A Case Study Peter H. Feiler Grace F. Downey...trademark holder. Table of Contents 1. lntroducton 1 2. The Problem 3 2.1. Tool Version Organization and Selection 3 2.2. Stability of Selected Tool

  11. Telehealth technology in case/disease management.

    PubMed

    Park, Eun-Jun

    2006-01-01

    Case managers can better coordinate and facilitate chronic illness care by adopting telehealth technology. This article overviews four major categories of telehealth technology based on patients' roles in self-management: surveillance, testing peripherals and messaging, decision support aids, and online support groups related to patients' subordinate, structured, collaborative, and autonomous roles, respectively. These various telehealth technologies should be selected on the basis of patients' care needs and preferences. Moreover, when they are integrated with other clinical information systems, case management practice can be better performed. However, the specific role functions and skill sets needed to be competent in telehealth environments have not yet been clearly identified. Considering role ambiguity and stress among telehealth clinicians, clarifying relevant roles is an urgent task.

  12. Influences on Case-Managed Community Aged Care Practice.

    PubMed

    You, Emily Chuanmei; Dunt, David; Doyle, Colleen

    2016-10-01

    Case management has been widely implemented in the community aged care setting. In this study, we aimed to explore influences on case-managed community aged care practice from the perspectives of community aged care case managers. We conducted 33 semistructured interviews with 47 participants. We drew these participants from a list of all case managers working in aged care organizations that provided publicly funded case management program(s)/packages in Victoria, Australia. We used a multilevel framework that included such broad categories of factors as structural, organizational, case manager, client, and practice factors to guide the data analysis. Through thematic analysis, we found that policy change, organizational culture and policies, case managers' professional backgrounds, clients with culturally and linguistically diverse backgrounds, and case management models stood out as key influences on case managers' practice. In the future, researchers can use the multilevel framework to undertake implementation research in similar health contexts.

  13. The Science Manager's Guide to Case Studies

    SciTech Connect

    Branch, Kristi M.; Peffers, Melissa S.; Ruegg, Rosalie T.; Vallario, Robert W.

    2001-09-24

    This guide takes the science manager through the steps of planning, implementing, validating, communicating, and using case studies. It outlines the major methods of analysis, describing their relative merits and applicability while providing relevant examples and sources of additional information. Well-designed case studies can provide a combination of rich qualitative and quantitative information, offering valuable insights into the nature, outputs, and longer-term impacts of the research. An objective, systematic, and credible approach to the evaluation of U.S. Department of Energy Office of Science programs adds value to the research process and is the subject of this guide.

  14. Case management's value is finally recognized. What happens now? .

    PubMed

    2015-10-01

    In recent years, case management has been recognized as a key in improving healthcare quality and reducing costs, but while hospitals are giving case managers more responsibilities, many administrators are not approving an increase in staff to handle the extra work. Case managers can help their hospital succeed with the Centers for Medicare & Medicaid Services' Value-based Purchasing program, the readmission reduction program, and bundled payments. Case management directors should make sure the hospital's senior leadership understands the roles and responsibilities of case managers and how their interventions can affect outcomes and the bottom line. The number of caseloads depends on the case management model, the responsibilities of case managers, and whether they have assistants or case management extenders who can take over some tasks and allow the licensed staff to work at the top of their licenses. Don't let technology replace communication and patient-centered interactions.

  15. Case Management in Community Corrections: Current Status and Future Directions

    ERIC Educational Resources Information Center

    Day, Andrew; Hardcastle, Lesley; Birgden, Astrid

    2012-01-01

    Case management is commonly regarded as the foundation of effective service provision across a wide range of human service settings. This article considers the case management that is offered to clients of community corrections, identifying the distinctive features of case management in this particular setting, and reviewing the empirical evidence…

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

    ERIC Educational Resources Information Center

    Lang, Joyce; Kragthorpe, Candice

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

  17. Integrating end-of-life care with disease management programs: a new role for case managers.

    PubMed

    Lazarus, A

    2001-03-01

    Case managers are crucial to any well-designed disease management program. However, in the progressive course of serious illness, patients, their families, and MCOs need the skills of case manager more than ever to help them through end-of-life care choices. The author describes what case managers will need in their "toolbox" to provide insight to these health plan members.

  18. Clinical ICT systems: augmenting case management.

    PubMed

    Baldwin, Lynne P; Clarke, Malcolm; Jones, Russell

    2002-01-01

    In order to improve the diagnosis and subsequent care given to patients, health-care workers involved in the management of their care, as well as the treatment itself, are increasingly looking at the role that information and communication technologies (ICTs) can play in supporting the complex interactions between patient, doctor or nurse, consultant and medical equipment. Effective communication both amongst health-care workers and between health-care workers and their patients in both primary and secondary care is vital; ICTs can play an important role in this. In this paper possible interpretations given to the term "telemedicine" are discussed, and then attention is turned to the challenges involved in human interaction and the role of ICTs. An example of a clinical ICT system (AIDMAN) is used to illustrate how face-to-face interaction has usefully been supported by way of a "virtual" consultation, which facilitates remote medical diagnosis and can provide improved case management.

  19. Management case study: Tampa Bay, Florida

    USGS Publications Warehouse

    Morrison, Gerold; Greening, Holly; Yates, Kimberly K.; Wolanski, Eric; McLusky, Donald S.

    2011-01-01

    Tampa Bay, Florida, USA, is a shallow, subtropical estuary that experienced severe cultural eutrophication between the 1940s and 1980s, a period when the human population of its watershed quadrupled. In response, citizen action led to the formation of a public- and private-sector partnership (the Tampa Bay Estuary Program), which adopted a number of management objectives to support the restoration and protection of the bay’s living resources. These included numeric chlorophyll a and water-clarity targets, as well as long-term goals addressing the spatial extent of seagrasses and other selected habitat types, to support estuarine-dependent faunal guilds. Over the past three decades, nitrogen controls involving sources such as wastewater treatment plants, stormwater conveyance systems, fertilizer manufacturing and shipping operations, and power plants have been undertaken to meet these and other management objectives. Cumulatively, these controls have resulted in a 60% reduction in annual total nitrogen (TN) loads relative to earlier worse-case (latter 1970s) conditions. As a result, annual water-clarity and chlorophyll a targets are currently met in most years, and seagrass cover measured in 2008 was the highest recorded since 1950. Factors that have contributed to the observed improvements in Tampa Bay over the past several decades include the following: (1) Development of numeric, science-based water-quality targets to meet a long-term goal of restoring seagrass acreage to 1950s levels. Empirical and mechanistic models found that annual average chlorophyll a concentrations were a primary manageable factor affecting light attenuation. The models also quantified relationships between TN loads, chlorophyll a concentrations, light attenuation, and fluctuations in seagrass cover. The availability of long-term monitoring data, and a systematic process for using the data to evaluate the effectiveness of management actions, has allowed managers to track progress and

  20. Quick management of accidental tritium exposure cases.

    PubMed

    Singh, Vishwanath P; Badiger, N M; Managanvi, S S; Bhat, H R

    2012-07-01

    Removal half-life (RHL) of tritium is one of the best means for optimising medical treatment, reduction of committed effective dose (CED) and quick/easy handling of a large group of workers for medical treatment reference. The removal of tritium from the body depends on age, temperature, relative humidity and daily rainfall; so tritium removal rate, its follow-up and proper data analysis and recording are the best techniques for management of accidental acute tritium exposed cases. The decision of referring for medical treatment or medical intervention (MI) would be based on workers' tritium RHL history taken from their bodies at the facilities. The workers with tritium intake up to 1 ALI shall not be considered for medical treatment as it is a derived limit of annual total effective dose. The short-term MI may be considered for tritium intake of 1-10 ALI; however, if the results show intake ≥100 ALI, extended strong medical/therapeutic intervention may be recommended based on the severity of exposure for maximum CED reduction requirements and annual total effective dose limit. The methodology is very useful for pressurized heavy water reactors (PHWRs) which are mainly operated by Canada and India and future fusion reactor technologies. Proper management will optimise the cases for medical treatment and enhance public acceptance of nuclear fission and fusion reactor technologies.

  1. Case management insider. The 2-midnight rule--a game-changer for case management.

    PubMed

    Cesta, Toni

    2014-04-01

    As a case manager or case management leader, it is important for you to stay in touch with how CMS continues to roll out the two-midnight rules as well as the manner of auditing on a go-forward basis. It is also important that your department continue to have a close working relationship with the billing department in your hospital to ensure that the hospital remains compliant with this new rule. Finally, it is also critical that your emergency department and its physicians are kept up to date on the rule and its implications for hospital admissions. Having a case management presence in the emergency department will help to ensure a sound review process at this important route of entry to the hospital. A working team should be created to review the cases that fall outside of the rule, and these cases should also be presented to the utilization review committee so that the hospital can continue to learn and move forward. Finally, listen to the CMS National Provider Calls (www.cms. gov/NPC) to gain additional and updated information as it becomes available! For additional information on the two-midnight rule go to www.cms.gov and search for CMS-1599-F.

  2. The role of the case manager in a disease management program.

    PubMed

    Huston, Carol J

    2002-01-01

    Disease management programs provide new opportunities and roles for case managers to provide population-based healthcare to the chronically ill. This article identifies common components of disease management programs and examines roles assumed by case managers in disease management programs such as baseline assessment, performing economic analyses of diseases and their respective associated resource utilization, developing and/or implementing care guidelines or algorithms, educational interventions, disease management program implementation, and outcomes assessment. Areas of expertise needed to be an effective case manager in a disease management program are also identified.

  3. The role of the case manager in a disease management program.

    PubMed

    Huston, C J

    2001-01-01

    Disease management programs provide new opportunities and roles for case managers to provide population-based healthcare to the chronically ill. This article identifies common components of disease management programs and examines roles assumed by case managers in disease management programs such as baseline assessment, performing economic analyses of diseases and their respective associated resource utilization, developing and/or implementing care guidelines or algorithms, educational interventions, disease management program implementation, and outcomes assessment. Areas of expertise needed to be an effective case manager in a disease management program are also identified.

  4. Quality improvement initiatives in a case management service: case study.

    PubMed

    Davies, Deborah J

    2015-01-01

    This article explores the importance of quality practices in underpinning the person-centred approach at a Community Options Program (COP) case management service in northern NSW. The NSW community care sector does not have a statutory excellence body to identify, promote and support improved practices and quality and safety across community services, and therefore the COP provider decided to establish a dedicated role to focus on the quality improvement of its service. The subsequent quality improvement initiatives have included mapping the clients' journey through the service, identifying areas to standardise practice, and creating service pathways. The clients' journey was used as the framework to identify where standardised practice was required, and a robust process was implemented to develop over 25 good practice guidelines and tools that addressed the variations in practice and enabled the service pathways to be developed. Prior to trialling the guidelines and tools, staff received education sessions on the anticipated changes to practice, and the practicality and applicability of the guidelines were evaluated at the end of the trials. This information was reviewed and the guidelines were amended accordingly before being rolled out. The guidelines have been in use for over 12 months and have provided the benchmark against which to audit practice, and have resulted in key performance improvements such as an increase in client review rates and a rise in the feedback response rate from clients, with a noticeable shift in the comments about the brokered support worker to acknowledging the role of their case manager. Formalising informal supports for those clients that lived alone also increased, which means these people are less reliant on services and there is a reduced risk of social isolation.

  5. Case Studies for Management Development in Bangladesh. Second Book.

    ERIC Educational Resources Information Center

    McLean, Gary N.

    These 15 case studies developed by faculty at institutions in Bangladesh are appropriate for use in a course in management development. The typical case describes a real business situation in which a real manager had to reach a decision. The case gives quantitative and qualitative information that is, or may be, relevant to that decision.…

  6. Intensive case management for severe mental illness

    PubMed Central

    Dieterich, Marina; Irving, Claire B; Park, Bert; Marshall, Max

    2014-01-01

    Background Intensive Case Management (ICM) is a community based package of care, aiming to provide long term care for severely mentally ill people who do not require immediate admission. ICM evolved from two original community models of care, Assertive Community Treatment (ACT) and Case Management (CM), where ICM emphasises the importance of small caseload (less than 20) and high intensity input. Objectives To assess the effects of Intensive Case Management (caseload <20) in comparison with non-Intensive Case Management (caseload > 20) and with standard community care in people with severe mental illness. To evaluate whether the effect of ICM on hospitalisation depends on its fidelity to the ACT model and on the setting. Search methods For the current update of this review we searched the Cochrane Schizophrenia Group Trials Register (February 2009), which is compiled by systematic searches of major databases, hand searches and conference proceedings. Selection criteria All relevant randomised clinical trials focusing on people with severe mental illness, aged 18 to 65 years and treated in the community-care setting, where Intensive Case Management, non-Intensive Case Management or standard care were compared. Outcomes such as service use, adverse effects, global state, social functioning, mental state, behaviour, quality of life, satisfaction and costs were sought. Data collection and analysis We extracted data independently. For binary outcomes we calculated relative risk (RR) and its 95% confidence interval (CI), on an intention-to-treat basis. For continuous data we estimated mean difference (MD) between groups and its 95% confidence interval (CI). We employed a random-effects model for analyses. We performed a random-effects meta-regression analysis to examine the association of the intervention’s fidelity to the ACT model and the rate of hospital use in the setting where the trial was conducted with the treatment effect. Main results We included 38 trials

  7. Knowledge Management Analysis: A Case Study

    ERIC Educational Resources Information Center

    Mecha, Ezi I.; Desai, Mayur S.; Richards, Thomas C.

    2009-01-01

    It is imperative for businesses to manage knowledge and stay competitive in the marketplace. Knowledge management is critical and is a key to prevent organizations from duplicating their efforts with a subsequent improvement in their efficiency. This study focuses on overview of knowledge management, analyzes the current knowledge management in…

  8. Psychiatric nursing case management: past, present, and future.

    PubMed

    Herrick, Charlotte A; Bartlett, Robin

    2004-09-01

    This literature review examines the evolution of psychiatric nursing case management in the United States. Various models, both inpatient and outpatient, are described, along with the roles of the case manager in each setting. The development of clinical pathways to monitor and document outcomes in acute settings is examined, along with the difficulties in adapting them specifically to psychiatric nursing case management. The types of data collected and the use of outcomes to support programs for the mentally ill are reviewed. Finally, recommendations for psychiatric nursing case management are made to provide guidelines for the future.

  9. Management of recalcitrant Trichomonas vaginalis in pregnancy: a case report.

    PubMed

    Tayal, Sarup

    2016-02-01

    A case report of a pregnant woman with recalcitrant Trichomonas vaginalis is described. This case was managed with suppressive treatment with metronidazole during pregnancy and cleared with paromomycin vaginal treatment after delivery.

  10. Nurse-managed wound clinic. A case study in success.

    PubMed

    Crumbley, D R; Ice, R C; Cassidy, R

    1999-01-01

    The wound Care Clinic at Naval Hospital Charleston is a nurse-managed ambulatory clinic that has demonstrated the successful application of nursing case management in caring for patients with chronic and complex wounds. Nursing case management is an outcomes-based system of assessment, planning, provision of nursing services, coordination of interdisciplinary efforts, education, and referral. Nursing case management has been shown, in the literature and at Naval Hospital Charleston, to be an extension of role of professional nursing practice and results in decreased costs, improved quality of care, faster wound healing times, decreased complications, and greater coordination of care between specialty disciplines. These positive results are illustrated in several case studies. Nursing case management has many implications for the successful implementation of any healthcare delivery system where decreased costs and improved quality of care are valued, and it has special benefit in the complex management of chronically ill patients.

  11. Problems in Office Management: Cases in Practice

    ERIC Educational Resources Information Center

    Hemby, K. Virginia; Smith, Vincent W.

    2006-01-01

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

  12. Computer-Based Case Management for the Elderly.

    ERIC Educational Resources Information Center

    Blazyk, Stan; And Others

    1987-01-01

    Notes that economic, demographic, and political factors pressure health care providers into improving discharge planning and long-term care services for clients. Examines the application of computer technology to case management and describes a computerized, hospital-based case management program for the elderly. (Author/NB)

  13. Discursive Hierarchical Patterning in Law and Management Cases

    ERIC Educational Resources Information Center

    Lung, Jane

    2008-01-01

    This paper investigates the differences in the discursive patterning of cases in Law and Management. It examines a corpus of 271 Law and Management cases and discusses the kind of information that these two disciplines call for and how discourses are constructed in discursive hierarchical patterns. A discursive hierarchical pattern is a model…

  14. A Guide to Case Management for At-Risk Youth.

    ERIC Educational Resources Information Center

    Kingsley, Christopher

    This guide addresses many of the most common questions about case management asked by employment and training administrators and practitioners. Its table of contents is organized in a question-and-answer format. The content of the guide flows directly from program administrators, practitioners, case managers, and others in the field, gathered at…

  15. Effective Case Study Methodologies in the Management of IT Courses.

    ERIC Educational Resources Information Center

    Buffington, James R.; Harper, Jeffrey S.

    Many Association to Advance Collegiate Schools of Business (AACSB) accredited schools require undergraduate Management Information Systems (MIS) majors to take a course in the management of information technology. Over half of these schools utilize case studies in the teaching of this course. Case studies are an important vehicle for teaching…

  16. Laparoscopic management of recurrent pheochromocytoma: A case report

    PubMed Central

    Garg, Harshit; Uppal, Manpreet; Sreedharan, Sreesanth Kelu; Aggarwal, Sandeep

    2016-01-01

    Recurrence of pheochromocytoma after a total adrenalectomy is uncommon. Such recurrent tumours are mostly managed by the open technique, with very few studies reporting laparoscopic management. We hereby report a case of successful laparoscopic management of a recurrent pheochromocytoma after total adrenalectomy for left adrenal pheochromocytoma. PMID:27279402

  17. Privileged Emotion Managers: The Case of Actors

    ERIC Educational Resources Information Center

    Orzechowicz, David

    2008-01-01

    Theatre provides a unique set of conditions for the management of emotions. Drawing on participant observation from one repertory theater, three university productions, and interviews with stage actors, directors, and acting instructors, I conceptualize actors as privileged emotion managers. Actors access structural resources that enable their…

  18. Interdependency Management in Universities: A Case Study

    ERIC Educational Resources Information Center

    Braun, Dietmar; Benninghoff, Martin; Ramuz, Raphaël; Gorga, Adriana

    2015-01-01

    There remains uncertainty in scientific discussions regarding the governance of universities in new public management regimes in terms of who actually "rules" in the university. Apparently, a strengthened management leadership is confronted with continuing elements of academic self-regulation and professional autonomy in knowledge…

  19. Case Management Return on Investment: An Analysis of Naval Hospital Jacksonville’s Family Practice Clinic Case Management Program

    DTIC Science & Technology

    2005-06-01

    is experiencing an expansion of duties varying from disease management to population-based services (Wolfe, 1995). Day (1996) explained that CM...common diseases . For example, the case manager may focus on diabetic patients who require minimal healthcare intervention. The population-based CM...cord injuries, neoplasm, and end stage renal disease patients. Priority group II cases are complex cases which include high cost or high-risk

  20. The effectiveness of inpatient case management. Fact or fiction?

    PubMed

    Cook, T H

    1998-04-01

    Production processes and service delivery in acute care hospitals can be fragmented. Inpatient case management has the potential to improve both processes and outcomes of hospital care. The author reports on 18 research studies that used inpatient case management as the treatment variable. These outcome studies, using case management, did not provide the evidence needed to address deficiencies in inpatient settings. However, these studies do provide clear direction for nurse administrators and nurse researchers to take concerning the next steps needed to address this critical issue.

  1. Accounting for Case Manager Effects in the Evaluation of Mental Health Services.

    ERIC Educational Resources Information Center

    Ryan, Carey S.; And Others

    1994-01-01

    Explored three methods of accounting for case manager effects in tests of efficacy of mental health services (case manager as fixed factor, case manager as random factor, service effects within case manager). Results provide support for effects attributable to case managers and some support for efficacy of habilitation-rehabilitation and community…

  2. Redesigned nursing practice: a case management model for critical care.

    PubMed

    Ritter, J; Fralic, M F; Tonges, M C; McCormac, M

    1992-03-01

    Changes within the health care system necessitate changes in nursing practice. Given the financial environment and the need to balance the cost/quality equation, case management will become increasingly important and has the potential to become the predominant care delivery system of the 1990s. This transition represents a tremendous opportunity for nursing. The CCM role offers many potential advantages and benefits for individual nurses and the profession as a whole. Nurses practicing as case managers have the opportunity to function in a highly professional, independent manner with a great deal of interdisciplinary collaboration. In addition to the challenges and satisfactions of the work itself, the nurse case manager may also enjoy a higher salary and more scheduling control and flexibility. The broader advantages of case management include its benefits to patients and institutions and its fit with current trends in the health care environment. Nurse case managers manage hospital systems to produce optimal clinical outcomes for patients in the shortest time using as few resources as possible. This approach to care delivery places nurses in a position to demonstrate the tremendous contribution they can make to achieving the institution's goal of delivering high-quality, cost-effective care. Thus, case management fits extremely well with current trends in health care financing and outcome measurement. The model described in this article illustrates one approach to implementing these important concepts in a critical care setting.

  3. Preparing health care organizations for successful case management programs.

    PubMed

    Bonvissuto, C A; Kastens, J M; Atwell, S R

    1997-01-01

    This article reports the results of a study of four hospital-based providers in varying stages of implementing case management programs. Three of the providers had most of the necessary elements in place to ensure success, such as a mix of reimbursement sources, an effective and integrated information management system, a full range of clinical services, and continuous quality improvement programs. The authors make several suggestions for key activities that must be pursued by any health care organization seeking to implement a case management program in an era of managed care, tightening reimbursement, and consumer demand for quality care. These include the need to (a) organize essential case management functions under a centralized structure; (b) set realistic, quantifiable targets, and (c) design a communications plan for the program.

  4. Nurse's Breakout Session Injury/Illness Case Management

    NASA Technical Reports Server (NTRS)

    Hesselgesser, Connie

    2001-01-01

    An overview of the work related injury and illness case management model developed at the Johnson Space Center was presented. The major accomplishments and the challenges of implementation were discussed.

  5. Effectiveness of case management for homeless persons: a systematic review.

    PubMed

    de Vet, Renée; van Luijtelaar, Maurice J A; Brilleslijper-Kater, Sonja N; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D; Wolf, Judith R L M

    2013-10-01

    We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness.

  6. The introduction of case management on a rehabilitation floor.

    PubMed

    Waterman, H; Waters, K; Awenat, Y

    1996-11-01

    An exchange for 1 day a week between a clinical nurse specialist and a lecturer gave rise to the opportunity to evaluate the introduction of case management on a newly created rehabilitation floor at an elderly care hospital. The aims of the study were to examine the feelings and concerns of new case managers, their conception of case management and their perceived educational needs. Qualitative research methods were employed to achieve the aims. Rigour was addressed, in part, through concurrent analysis of data with data collection, which encouraged probing of issues important to research participants. Thematic categories are presented under the headings: 'structure' and 'process'. The data collected revealed vividly that, as with any change, the people involved experienced anxieties and/or confusion over their new roles, but that some of the problems arose from the relocation of staff when the rehabilitation floor was established. Despite these difficulties, there was general enthusiasm for the potential of case management.

  7. Role of Academic Managers in Workload and Performance Management of Academic Staff: A Case Study

    ERIC Educational Resources Information Center

    Graham, Andrew T.

    2016-01-01

    This small-scale case study focused on academic managers to explore the ways in which they control the workload of academic staff and the extent to which they use the workload model in performance management of academic staff. The links that exist between the workload and performance management were explored to confirm or refute the conceptual…

  8. The employer's case for health management.

    PubMed

    Coulter, Christopher H

    2006-01-01

    Employers' past solutions to rising health benefit costs--adopting managed care strategies, cost shifting to employees and reducing benefits-are no longer effectively controlling costs and are depressing the value of health benefits for employee recruitment and retention. An alternative strategy is to implement health management approaches that improve the health status of employees. These programs reduce medical costs and have a documented positive impact on workers' compensation, disability costs, absenteeism and productivity. Further, this approach is complementary to health care consumerism as a strategy for health improvement and benefit cost reduction and results in improved employee health, outlook and satisfaction.

  9. Time management for case managers--so much work, so little time.

    PubMed

    Cesta, Toni

    2014-08-01

    The world of a case manager is a busy one, and you may not have all the resources you need each and every day. If you can maintain a routine it will make the workload more manageable for you and will allow room for those surprises that invariably happen. Whether you are a new or a seasoned case manager, organizing your workload can always help smooth out the rough edges in anyone's hectic day!

  10. Anesthetic management of a case of Sanjad-Sakati syndrome

    PubMed Central

    Alshoaiby, AN; Rafiq, M; Jan, R; Shahbaz, M; Faqeeh, A; Alsohaibani, MA

    2016-01-01

    Sanjad-Sakati syndrome is an autosomal recessive genetic disorder first described in Saudi Arabia. Anesthetic management of these patients is challenging due to airway difficulties, electrolyte imbalance, growth and mental retardation, and seizures. The anesthetic management of the syndrome is described in this case report. PMID:27833494

  11. Essentials of Enrollment Management: Cases in the Field

    ERIC Educational Resources Information Center

    Black, Jim

    2004-01-01

    In AACRAO's new publication Essentials of Enrollment Management: Cases in the Field experts in enrollment management representing all types of institutions reveal the evolution of the enrollment strategies implemented at their institutions, the results, and the lessons learned. The introductory chapter provides an overview of themes and models…

  12. A lesbian older adult managing identity disclosure: a case study.

    PubMed

    Jenkins, David; Walker, Charles; Cohen, Harriet; Curry, Linda

    2010-01-01

    The aim of this study was to explore the experience of an older lesbian in managing the disclosure of her sexual identity. Specifically, the team wanted to better understand the ways she managed her identity in an assisted living facility. Using a qualitative case study methodology, 2 in-depth interviews were conducted. The following 5 themes were identified in the data: keeping her own counsel, maintaining "family" connection, celebrating second chances, living outside the L box, and staying morally centered. Practice and research implications are offered and the case study is used to expand understanding of disclosure management and resiliency theory.

  13. Translating childhood tuberculosis case management research into operational policies.

    PubMed

    Safdar, N; Hinderaker, S G; Baloch, N A; Enarson, D A; Khan, M A; Morkve, O

    2011-08-01

    The control of childhood tuberculosis (TB) has been of low priority in TB programmes in high-burden settings. The objective of this paper was to describe the development and testing of tools for the management of childhood TB. The Pakistan National TB Control Programme embarked on a number of activities, including the establishment of policy guidelines for the management of childhood TB and later a guidance document, 'Case Management Desk Guide and Structured Monitoring', to demonstrate the implementation of childhood TB interventions in a programme context. Initial results showed improved case finding and treatment outcome in implementation sites compared with control districts. However, further programme attention is required to improve quality.

  14. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Case management services. 440.169 Section 440.169 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.169 Case...

  15. School Nurse Case Management: Achieving Health and Educational Outcomes

    ERIC Educational Resources Information Center

    Bonaiuto, Maria M.

    2007-01-01

    Educators and health care professionals alike understand that healthy students are likely to be successful learners. The goal of school nurse case management is to support students so that they are ready to learn. This article describes the outcomes of a 4-year process improvement project designed to show the impact of school nurse case management…

  16. Cost-Effectiveness of Case Management in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Saleh, Shadi S.; Vaughn, Thomas; Levey, Samuel; Fuortes, Laurence; Uden-Holmen, Tanya; Hall, James A.

    2006-01-01

    Objective: The purpose of this study, which is part of a larger clinical trial, was to examine the cost-effectiveness of case management for individuals treated for substance abuse in a residential setting. Method: Clients who agreed to participate were randomly assigned to one of four study groups. Two groups received face-to-face case management…

  17. Combining Cases and Computer Simulations in Strategic Management Courses

    ERIC Educational Resources Information Center

    Mitchell, Rex C.

    2004-01-01

    In this study, the author compared the effectiveness of two different strategic management course designs: one centered on case discussions and the other combining a computer-based simulation with some cases. In addition to evaluation of the research literature, the study involved experiments with six course sections composed of 130 students, Both…

  18. Management of velopharyngeal disorders. A case series.

    PubMed

    Anandakrishna, G N; Gali, Sivaranjani

    2010-07-01

    Patients with acquired defects or congenital malformations of the palate exhibit disturbances in speech, including hypernasality, nasal emission, and decreased intelligibility of speech. Maxillofacial prosthetic treatment can reestablish the palatopharyngeal integrity to provide the potential for acceptable speech. This article describes a case series of patients with palatopharyngeal disorders and their treatment approaches.

  19. Management of traumatic macular holes: case report.

    PubMed

    Brasil, Oswaldo Ferreira Moura; Brasil, Oswaldo Moura

    2008-01-01

    Traumatic macular hole is a disease whose pathogenesis is not fully understood and the best treatment guideline is controversial. We report 2 cases of traumatic macular hole with different treatment approaches. In the first case, a 9-year-old boy presented with a traumatic macular hole secondary to blunt ocular trauma with a stone, and initial vision of 20/300. He underwent surgical repair and his final vision was 20/70 with hole closure after a 1 year follow-up. In the second case, a 20-year-old woman suffered a penetrating bullet wound on the left side of her forehead. The injury caused optic nerve head avulsion in the left eye with loss of light perception. The right eye had a traumatic macular hole and signs suggestive of sclopetaria chorioretinitis, with 20/60 vision. This case was initially observed and vision improved to 20/30 with reduction of the hole diameter. Vision and hole diameter remained stable after 8 months.

  20. [Pancreas divisum: endoscopic management. Case report].

    PubMed

    Martínez, Henry; Espinoza, Miguel; Huaman, César; Monge, Eduardo; Salazar, Sonia; Tapia, Abel

    2002-01-01

    This is a case report of a 19 year-old woman, with an acute recurrent pancreatitis diagnose, and pancreas divisum as anatomic alteration. An extensive evaluation including specialized labs, ERCP was done. The diagnosis is suspected during ERCP and confirmed by minor papilla injection. Treatment is directed towards relieving outflow obstruction at the level of the minor papilla, with successful results.

  1. A CASE STUDY OF ENVIRONMENTAL DATA MANAGEMENT

    EPA Science Inventory

    In order to support our ongoing research in watershed ecology and global climate change, we gather and analyze environmental data from several government agencies. This case study demonstrates a researcher’s approach to accessing, organizing, and using intersectoral data. T...

  2. Management case study: Tampa Bay, Florida

    USGS Publications Warehouse

    Morrison, G.; Greening, H.S.; Yates, K.K.

    2012-01-01

    Tampa Bay, Florida,USA, is a shallow,subtropical estuary that experienced severe cultural eutrophication between the 1940s and 1980s, a period when the human population of its watershed quadrupled. In response, citizen action led to the formation of a public- and private-sector partnership (the Tampa Bay Estuary Program), which adopted a number of management objectives to support the restoration and protection of the bay’s living resources. These included numeric chlorophyll a and water-clarity targets, as well as long-term goals addressing the spatial extent of sea grasses and other selected habitat types, to support estuarine-dependent faunal guilds.

  3. Case Study and Maturity Model for Business Process Management Implementation

    NASA Astrophysics Data System (ADS)

    Rohloff, Michael

    This paper presents the implementation of Business Process Management in a large international company. The business case illustrates the main objectives and approach taken with the BPM initiative. It introduces a process management maturity assessment which was developed to assess the implementation of Business Process Management and the achievements. The maturity model is based on nine categories which comprehensively cover all aspects which impact the success of Business Process Management. Some findings of the first assessment cycle are pinpointed to illustrate the benefits and best practice exchange as a result of the assessment.

  4. Case-based Influence in Conflict Management

    DTIC Science & Technology

    2014-10-31

    published in a book of essays on cyber analogies that he commissioned (Axelrod, 2014). The third phase of the project developed a mathematical ...phase analyzed how historical analogies are used to make sense of novel events, comparing historical analogies invoked in three events in newspapers...from five countries. Case-based reasoning was found to be very common, with almost one historical analogy per article (963/1061). The second phase

  5. Case manager as therapy extender for cognitive behavior therapy of serious mental illness: a case report.

    PubMed

    Pinninti, Narsimha R; Schmidt, Lisa T; Snyder, Richard P

    2014-05-01

    Cognitive behavior therapy (CBT) is an evidence-based intervention for individuals with serious mental illness and potentiates standard medication management. Americans receiving publicly funded treatment for serious mental illnesses have limited access to CBT and hence we need to devise innovative ways of providing access to this important intervention. We present a case of a man who had severe disability, was medication resistant, and diagnosed with Obsessive Compulsive Disorder and Major Depressive Disorder. After being home bound for many years he was provided CBT utilizing his existing case manager as a therapy extender. The specific roles of the primary therapist and case manager as well as the improvement in quality of life of the individual are delineated. This case report opens up the possibility of further studying case managers as therapy extenders for treating serious mental illnesses.

  6. Huntington's disease: review and anesthetic case management.

    PubMed

    Cangemi, C F; Miller, R J

    1998-01-01

    Huntington's disease is a dominantly inherited progressive autosomal disease that affects the basal ganglia. Symptoms appear later in life and manifest as progressive mental deterioration and involuntary choreiform movements. Patients with Huntington's disease develop a progressive but variable dementia. Dysphagia, the most significant related motor symptom, hinders nutrition intake and places the patient at risk for aspiration. The combination of involuntary choreoathetoid movements, depression, and apathy leads to cachexia. Factors of considerable concern to the anesthesiologist who treats patients with Huntington's disease may include how to treat frail elderly people incapable of cooperation, how to treat patients suffering from malnourishment, and how to treat patients with an increased risk for aspiration or exaggerated responses to sodium thiopental and succinylcholine. The successful anesthetic management of a 65-yr-old woman with Huntington's disease who presented for full-mouth extractions is described.

  7. Interactive televideo and the Internet in rural case management.

    PubMed

    Redford, L J; Parkins, L G

    1997-01-01

    The purpose of this article is to stir the imagination and incite the creative energies of case managers in finding ways to capitalize on communication and information technologies to improve access to care as well as the quality of care in rural communities. Today, the general dearth of services and logistics of providing services in rural areas challenges even the most seasoned case managers. Given the current economic and political climate, it is unlikely that these challenges will lessen, particularly if we continue to pursue our more traditional approaches to case management and service delivery. Telecommunications technologies are opening exciting opportunities for changing this trajectory and expanding the role and reach of case managers, while improving access to many services. This article highlights the new and the potential applications of interactive televideo in health and human services, as well as the vast opportunities offered by the Internet. There are, however, also pitfalls we must overcome to realize the full potential of these technologies. Case managers, in their roles as advocates, coordinators, and facilitators, are ideally positioned to be on the cutting edge of these technological applications and play a catalytic role in moving rural communities into the "information age."

  8. Otitis externa: management of the recalcitrant case.

    PubMed

    Selesnick, S H

    1994-05-01

    Most cases of otitis externa respond to routine treatment, however, there is a subset of patients who frequently develop otitis externa that is usually severe and recalcitrant to routine therapy. These patients include the immunocompromised, those with AIDS, transplant recipients, severe diabetics, patients treated with high dose steroids or chemotherapeutic agents, and those who are malnourished or are chronically ill. Local factors that lead to worsening of otitis externa include dermatitides and prior local irradiation. Patients who find topical therapy painful may be noncompliant with medications, and they too, may develop recalcitrant otitis externa. For successful treatment, a broad understanding of external auditory canal anatomy, the microbiology and pathophysiology of otitis externa, and available treatment options, including topical and systemic medications, must be attained. These topics are reviewed.

  9. Integrated dementia care in The Netherlands: a multiple case study of case management programmes.

    PubMed

    Minkman, Mirella M N; Ligthart, Suzanne A; Huijsman, Robbert

    2009-09-01

    The number of dementia patients is growing, and they require a variety of services, making integrated care essential for the ability to continue living in the community. Many healthcare systems in developed countries are exploring new approaches for delivering health and social care. The purpose of this study was to describe and analyse a new approach in extensive case management programmes concerned with long-term dementia care in The Netherlands. The focus is on the characteristics, and success and failure factors of these programmes.A multiple case study was conducted in eight regional dementia care provider networks in The Netherlands. Based on a literature study, a questionnaire was developed for the responsible managers and case managers of the eight case management programmes. During 16 semistructured face-to-face interviews with both respondent groups, a deeper insight into the dementia care programmes was provided. Project documentation for all the cases was studied. The eight programmes were developed independently to improve the quality and continuity of long-term dementia care. The programmes show overlap in terms of their vision, tasks of case managers, case management process and the participating partners in the local dementia care networks. Differences concern the targeted dementia patient groups as well as the background of the case managers and their position in the local dementia care provider network. Factors for success concern the expert knowledge of case managers, investment in a strong provider network and coherent conditions for effective inter-organizational cooperation to deliver integrated care. When explored, caregiver and patient satisfaction was high. Further research into the effects on client outcomes, service use and costs is recommended in order to further analyse the impact of this approach in long-term care. To facilitate implementation, with a focus on joint responsibilities of the involved care providers, policy

  10. Interdisciplinary Management of Gingivitis Artefacta Major: A Case Series

    PubMed Central

    Pattnaik, Naina; Satpathy, Anurag; Mohanty, Rinkee; Nayak, Rashmita; Sahoo, Surjeet

    2015-01-01

    Cases described here discuss interdisciplinary (periodontal and behavioral) approach in the management of rare and difficult to diagnose self-inflicted injuries of gingiva such as gingivitis artefacta major. Self-inflicted injuries to the gingiva are rare and their management by periodontal therapy alone is inadequate. Proper management of this condition requires early detection and effective psychological treatment through behavioral therapy in addition to the treatment of dental lesion. Three male patients in their twenties presented with traumatic injuries of gingiva with history of self-injury and underlying emotional disturbances. Following basic periodontal intervention, their self-inflicting behavior was confirmed on psychiatric consultation. All of them underwent cognitive behavior therapy and were able to successfully curb their self-inflicting behavior prior to any definitive dental procedures. These cases illustrate the essentiality of behavioral intervention in addition to periodontal procedures in the management of such lesions. PMID:26664762

  11. Building Perinatal Case Manager Capacity Using Quality Improvement.

    PubMed

    Fitzgerald, Elaine

    2015-01-01

    Improving breastfeeding rates among Black women is a potential strategy to address disparities in health outcomes that disproportionately impact Black women and children. This quality improvement (QI) initiative aimed to improve perinatal case manager knowledge and self-efficacy to promote breastfeeding among Black, low-income women who use services through Boston Healthy Start Initiative. QI methodology was used to develop and test a two-part strategy for perinatal case managers to promote and support breastfeeding. A positive change was observed in infant feeding knowledge and case manager self-efficacy to promote breastfeeding. Among the 24 mothers participating in this QI initiative, 100% initiated and continued breastfeeding at 1 week postpartum, and 92% were breastfeeding at 2 weeks postpartum.

  12. Call to action: sharing our case management resources in case of an event.

    PubMed

    Powell, Suzanne K

    2012-01-01

    Disasters happen. Disaster drills are geared to bring out the worst and best of an organization's preparedness. Case management departments can be prepared, but sharing our thoughts, procedures, and resources can benefit all.

  13. A case study of nursing case management in a rural hospital.

    PubMed

    Anderson-Loftin, W; Wood, D; Whitfield, L

    1995-01-01

    This article describes the process of implementing a New England model of case management in a rural hospital and the modifications necessary in adapting an urban model to a rural setting. Nursing case management at this institution has been associated with a decrease in the length of stay by 1.7 days at an estimated cost savings of $65,932 for the 16-month study period. Case management has also been instrumental in improving quality of care through a program of continuous quality improvement and in redesigning the RN role. The vision for the future is to extend the nurse case manager role outside the hospital walls to the community in a collaborative plan that would bill nursing services through physicians' offices.

  14. Managing Bullying and Managing Difference: A Case Study of One Secondary School

    ERIC Educational Resources Information Center

    Dixon, Roz; Smith, Peter; Jenks, Chris

    2004-01-01

    Much work on school bullying focuses on developing our understanding of the various factors that contribute to bullying and its management. This case study focuses on the possible connections between parts and offers a metaperspective of one mainstream secondary school. Demonstrating that bullying and its management is embedded within the network…

  15. [Case management. The nursing business of care or cost].

    PubMed

    Sandhu, B K; Duquette, A; Kérouac, S; Rouillier, L

    1992-01-01

    Less money spent on health services, cost-effectiveness, better productivity and more efficiency are some of the driving forces of contemporary "neo-liberalism" and political trends. How can nursing services and the profession's human values adapt in this difficult context? The authors describe the newest modality of patient care delivery system: nursing case management. They examine the factors and assumptions that led up to its development and point out the validity of asking some serious questions before embarking on the euphoria of case management.

  16. Giant Inguinal Herniae Managed by Primary Repair: A Case Series

    PubMed Central

    Anand, Madhur; Naku, Narang; Hajong, Debobratta; Singh, K Lenish

    2017-01-01

    Giant inguinal hernia are usually found in developing countries due to delay in seeking medical attention. The management of such hernias may sometimes require procedures to increase the intra-peritoneal capacity prior to the repair of the giant hernia. Otherwise patients may develop abdominal compartment syndrome leading to various unwanted complications. Primary repair of giant hernias are possible in some cases without having significant post-operative complications. In this present case series, we have managed a total of four patients of giant inguinal hernia by primary repair without much post-operative complications. PMID:28384934

  17. The business of for-profit case management.

    PubMed

    Cress, C

    1992-01-01

    The growing number of older Americans is creating a major market for home care and case management services. Large corporations are entering the field to cash in on the beckoning profits. Individuals who are moving from not-for-profit case management agencies to start their own for-profit businesses bring solid values and much needed experience. However, they must learn to respect their knowledge for its financial worth and to apply solid business skills if they are to succeed against the large diversified corporations entering the field.

  18. Evaluation of Probation Case Management (PCM) for Drug-Involved Women Offenders

    ERIC Educational Resources Information Center

    Chan, Monica; Guydish, Joseph; Prem, Rosemary; Jessup, Martha A.; Cervantes, Armando; Bostrom, Alan

    2005-01-01

    Based on availability of case management services, drug-involved women offenders entered either a probation case management (PCM) intervention(n = 65) or standard probation(n = 44). Participants were placed in the case management condition until all slots were filled, then placed in standard probation until case management slots opened.…

  19. Student Affairs Case Management: Merging Social Work Theory with Student Affairs Practice

    ERIC Educational Resources Information Center

    Adams, Sharrika D.; Hazelwood, Sherry; Hayden, Bruce

    2014-01-01

    Case management is a functional area in higher education and student affairs that emerged after the mass shootings at Virginia Tech in 2007. Although new to higher education, case management emerged from established social work practice. This article compares social work theory and case management standards with a new case management model for…

  20. Case I: Managing people--the case of the frustrated faculty member.

    PubMed

    Glickman, Gerald N; Comer, Robert W; Filler, Steven J; Fine, James Burke

    2002-04-01

    Managing people is a continuing leadership challenge. The foundation discipline for managing people relates to human resource management and faculty development in academic settings. In human resource management, administrators are challenged to balance the needs of individuals and the expectations of the organization for the mutual benefit of both. A primary goal of management is to lead and develop people and manage the organization in alignment with the mission and vision of the organization. The purpose of this paper is, first, to present an overview of human resource management and faculty development fundamentals including motivating, mentoring, and performance counseling. Second, a hypothetical case is presented for readers to apply theory to situation. Finally, the case is analyzed by reviewing central issues and the management concepts that may apply to the scenario. These include managing resources, mentoring, motivation, and development. In this case-based analysis, Dr. Orsten is a junior faculty member employed in a developing school. With a shortage of faculty in her field, she succumbs to the pressures of teaching and administration at the expense of her own professional advancement through research. The tenure clock is ticking, however, and Dr. Orsten has serious doubts about her ability to redirect her priorities and earn tenure. Dr. Hightower, the Associate Dean, also faces a dilemma: there is a shortage of faculty in Dr. Orsten's specialty, and the system is poised to exercise the "up-or-out" option.

  1. [Rare side effects in management of hyperthyroidism. Case report].

    PubMed

    Sohár, Gábor; Kovács, Mónika; Györkös, Andrea; Gasztonyi, Beáta

    2016-05-29

    The authors present the case history of a patient suffering from hyperthyroidism. The diagnostic procedures revealed the presence of propylthiouracyl induced vasculitis with renal involvement, that recovered completely after the withdrawal of propylthiouracyl and corticosteroid treatment. Thereafter, the patient was treated with thiamasol, that caused agranulocytosis with fever. After transient litium carbonate therapy a succesful thyreoidectomy was performed. Cumulative serious side effects of antithyroid drugs are rare. This case highlights some of the challenges and complications encountered in the management of hyperthyroidism.

  2. Assessing infant suck dysfunction: case management.

    PubMed

    Marmet, C; Shell, E; Aldana, S

    2000-11-01

    Based on this more thorough assessment, the lactation consultant may be able to identify all of the factors contributing to this complex case. In some situations, her skilled interventions will suffice once the underlying problem is addressed. Occasionally, she will identify a factor that falls outside of her area of expertise; when this happens, she must make the appropriate referrals. For example, a referral to a physician for a frenotomy or suspected neurological or other medical problem is appropriate. It is clear that because Baby E's problems were not resolved after 6 weeks of concerned effort, something was missed. It would certainly be appropriate for the lactation consultant to refer the dyad to another lactation consultant who has more expertise in handling clinically challenging breastfeeding problems. If possible, the referring lactation consultant should accompany the dyad so that she can improve her clinical skills. Assuming Baby E does not have underlying medical problems, the most likely causes of Baby E's difficulties are anatomical variation and/or sucking dysfunction. Because the baby is so fussy, it also would be wise to consider the possibility of allergies or food tolerance. Our first rule is " Feed the baby." The second rule is " Correct or work on correcting the problem or problems." Our goal is to achieve exclusive breastfeeding or as close an approximation as possible. We almost never give up on this goal, but we do educate the mother and work professionally with her choices. Until the baby is breastfeeding well, the lactation consultant will probably need to instruct the mother to continue using a pump ( preferably a hospital-grade, electric, bilateral pump). The mother should use the pump physiologically, pumping as many times a day as the baby would breastfeed. As soon as the situation improves, the mother should be instructed to wean gradually from the pump and any other breastfeeding equipment she is using. The goal should always be

  3. Case management of childhood tuberculosis in children's hospitals in Khartoum.

    PubMed

    Osman, T; El Sony, A

    2014-07-08

    No published information is available on the case management of childhood tuberculosis (TB) in Sudan. The aim of this study was to describe the case management of childhood TB in 4 children's hospitals in Khartoum State, Sudan. Data on 467 children aged 0-14 years registered in 2009 were collected from patient records; 52.9% males and 53.0% aged 5-14 years. Most cases were registered as new cases (89.5%) and most had pulmonary TB (72.4%). Of all cases, 31.0% had sputum smear microscopy done, 35.8% had X-ray and none had a record of being culture confirmed. Category III regimen was given to 58.5%. Reported outcomes were: cured (1.5%), completed treatment (14.6%), transferred out (13.1%), default (17.3%), death (4.3%) and treatment failure (0.6%). Age was significantly associated with treatment outcome, while sex, type of patient, site of TB and treatment category were not significant. Case management of childhood TB is suboptimal in this region.

  4. Responding to the Increased Needs of College Students: A Case Study of Case Management

    ERIC Educational Resources Information Center

    Shelesky, Kristin; Weatherford, Ryan D.; Silbert, Janelle

    2016-01-01

    The psychological needs of college students lead to overwhelming demand on college counseling centers' resources. In this article, we review models of case management in Higher Education including the administrative, behavioral intervention, and counseling center models. We also present a case study of the 3-year development of a counseling center…

  5. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Primary care case management services. 440.168 Section 440.168 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.168...

  6. Impact of School Nurse Case Management on Students with Asthma

    ERIC Educational Resources Information Center

    Taras, Howard; Wright, Sandra; Brennan, Jesse; Campana, Jack; Lofgren, RoseMarie

    2004-01-01

    This project determined asthma prevalence in a large school district, absentee rates, and potential effects of school nurse case management for student asthma over three years. Data were derived from an asthma tracking tool used by nurses in one school district for every student reported as having asthma by their parent. School nurses began…

  7. Management of Federally Sponsored Libraries: Case Studies and Analysis.

    ERIC Educational Resources Information Center

    Missar, Charles D., Ed.

    This book provides insight into how managers of federally sponsored libraries view their roles and carry out their duties. Seven federally supported libraries were selected to serve as case studies. These libraries represent a cross-section of various types, and the nine chapters are written by librarians from these facilities. The discussion…

  8. Magic from Social Networks that Talk to Management: Four Cases

    ERIC Educational Resources Information Center

    Sugarman, Barry

    2010-01-01

    Purpose: The purpose of this paper is to understand how social networks can help to produce the "magic" of extraordinary results for organizations. Design/methodology/approach: In this exploratory study four cases (from published reports) are compared in order to illustrate different management approaches to utilizing the power of networks.…

  9. Case Studies in Managing School Library Media Centers.

    ERIC Educational Resources Information Center

    Callison, Daniel; Morris, Jacqueline

    Thirty-two case studies illustrating problem areas and situations that develop in the modern environment of the electronic school library media program are presented for use by library science students and library/media center managers. Based on input from practicing librarians at the elementary and secondary levels, the studies are designed to…

  10. Anaesthetic Management in Brugada Syndrome - A Case Report

    PubMed Central

    Pragathee, Shanmugam

    2017-01-01

    Brugada Syndrome (BS) is a rare congenital cardiac disorder involving cardiac sodium channels, sometimes presenting with ventricular arrhythmia and sudden cardiac death. Here, we are reporting a case of BS who presented for laparotomy due to obstructed inguinal hernia which was managed satisfactorily with combined epidural and general anaesthesia without any complications. PMID:28384965

  11. Managing Educational Change: A Case of Two Leadership Approaches

    ERIC Educational Resources Information Center

    Chow, Alice

    2013-01-01

    This article reports a case study that investigated the ways in which heads of subject departments managed the development and application of new assessment strategies in one secondary school in Hong Kong. The data of the study were gathered through participant observation and interviews with 12 teachers who participated in an assessment for…

  12. Successful School Management in India: Case Studies of Navodaya Vidyalayas

    ERIC Educational Resources Information Center

    Khaparde, M. S.; Srivastava, Ashok K.; Meganathan, R.

    2004-01-01

    This research explored the management devices followed in successful schools in the Indian context. In-depth case studies of three successful Navodaya schools were carried out. The schools were identified on the basis of the academic performance of students in the last three years in the national examinations and their participation in…

  13. Management of Drooling in Cerebral Palsy: Three Single Case Studies.

    ERIC Educational Resources Information Center

    Owen, S. E.; Stern, L. M.

    1992-01-01

    This study examined use of benztropine drug therapy to control drooling in 3 children (ages 5, 9, and 12) with moderately severe cerebral palsy. Significant improvement in all three cases suggested a role for medication in the management of drooling in prepubescent children who fail to respond to physical therapy or behavioral programs. (DB)

  14. Linklng guidelines for case management to risk of institutionalization.

    PubMed

    Hadjistavropoulos, Heather; Bierlein, Cecily; Sagan, Mark; Quine, Allisson

    2003-01-01

    In this study, we developed time-and-need-based community case management guidelines by tracking case management activity for 234 elderly clients over their first 6 months of care. Clients were interviewed at the time services began and again 6 months later to determine physical, emotional, and cognitive status. We found that the Regina Risk Indicator Tool (RRIT), a brief measure of risk for requiring institutional care, differentiated clients needing varying amounts of case management. Using these results, an expert panel devised guidelines for ranges of case management time for clients at different levels of need: low risk, some risk, and high risk. Quality measures, response times for initial contact and assessment, and service review parameters were also incorporated into the guidelines. Tools for workload measurement, quality review, client satisfaction, and service provider communication were developed. Focus group analysis of the guidelines with various stakeholders and a pilot implementation guided further revision. Future directions are outlined in the article, including the need to focus on outcomes of the guidelines and study of guideline implementation processes.

  15. Management Science in Higher Education Institutions: Case Studies from Greece

    ERIC Educational Resources Information Center

    Saiti, Anna

    2010-01-01

    Regardless of the source of funding, university quality is based on knowledge, teaching, and research, and hence cannot be run like private enterprises as they are expert organisations that provide solely a public service. The purpose of this paper is to investigate, through the analysis of case studies, whether or not management theory,…

  16. Medical Training Skills Curriculum for Case Management Assistants.

    ERIC Educational Resources Information Center

    Family Planning Council of Southeastern Pennsylvania, Philadelphia.

    This manual helps service care providers working with HIV-infected people learn how HIV affects the body's major systems, emphasizing the structure and functions of each system and direct and indirect effects of HIV on each system. The curriculum was developed for case management assistants (CMAs) who work in homes of HIV-infected people. Lessons…

  17. Case Management and Rehabilitation Counseling: Procedures and Techniques. Fourth Edition

    ERIC Educational Resources Information Center

    Roessler, Richard T.; Rubin, Stanford E.

    2006-01-01

    "Case Management and Rehabilitation Counseling" discusses procedures that are useful to rehabilitation professionals working in many settings. Specifically, this book reviews the finer points relating to diagnosing, arranging services, monitoring program outcomes, arranging for placement, planning for accommodations, ethical decision making,…

  18. 34 CFR 303.34 - Service coordination services (case management).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false Service coordination services (case management). 303.34 Section 303.34 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF... INFANTS AND TODDLERS WITH DISABILITIES General Definitions Used in This Part § 303.34 Service...

  19. 34 CFR 303.34 - Service coordination services (case management).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true Service coordination services (case management). 303.34 Section 303.34 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF... INFANTS AND TODDLERS WITH DISABILITIES General Definitions Used in This Part § 303.34 Service...

  20. 34 CFR 303.34 - Service coordination services (case management).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false Service coordination services (case management). 303.34 Section 303.34 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF... INFANTS AND TODDLERS WITH DISABILITIES General Definitions Used in This Part § 303.34 Service...

  1. Practices of Management Development: A Malaysian Case Study

    ERIC Educational Resources Information Center

    Law, Kian Aun

    2008-01-01

    This paper deals with a case study of Management Development (MD) practices at Malaysian Assurance Alliance (MAA). The aim of this research is to investigate how a large Malaysian insurance corporation developed and integrated MD initiatives with current organizational needs and tasks. Attempts were made to map and categorize the MD initiatives…

  2. Technology Solutions Case Study: Moisture Management of High-Walls

    SciTech Connect

    2013-12-01

    Moisture management of high-R walls is important to ensure optimal performance. This case study, developed by Building America team Building Science Corporation, focuses on how eight high-R walls handle the three main sources of moisture—construction moisture, air leakage condensation, and bulk water leaks.

  3. School Asthma Screening and Case Management: Attendance and Learning Outcomes

    ERIC Educational Resources Information Center

    Moricca, Michelle L.; Grasska, Merry A.; BMarthaler, Marcia; Morphew, Tricia; Weismuller, Penny C.; Galant, Stanley P.

    2013-01-01

    Asthma is related to school absenteeism and underperformance in elementary students. This pilot study assessed whether school nurse case management (CM) in children identified with asthma impacts academic performance and school absenteeism in one school. A validated questionnaire was used to identify children at risk for asthma and CM was provided…

  4. Managing Residual Contaminants – Reuse and Isolation Case Studies

    SciTech Connect

    Kevin M. Kostelnik, Ph.D.; James H. Clarke, Ph. D.

    2008-03-01

    Contaminants remaining on sites after regulatory-approved environmental remediation operations are complete represent continued risk to human health and the environment. Many sites require continued management efforts to: (1) protect the integrity of the engineered remedy/control, (2) limit the exposure of individuals to residual contamination by limiting reuse activities, (3) maintain ready access to accurate records/information, and (4) protect against vulnerabilities from intentional threats/actions. This paper presents performance information from selected case studies to provide insight into various management approaches employed for addressing the risks associated with residual contaminants. The case studies involve sites remediated within the U.S. CERCLA framework, and illustrate two prevailing management approaches for addressing the risks. Sacrifice Zones are sites that are purposefully isolated to prevent human access onto the property. Reuse Sites provide limited access for specific use.

  5. Chiropractic management of chronic idiopathic meralgia paresthetica: a case study

    PubMed Central

    Houle, Sébastien

    2012-01-01

    Objectives This report describes the case of a patient with chronic idiopathic meralgia paresthetica associated with bilateral sacroiliac joint dysfunction who was managed with chiropractic care. Clinical Features A 35-year-old white woman presented to a private chiropractic clinic with a complaint of numbness in the right anterolateral thigh region. Neurological assessment revealed a diminution of sensibility and discrimination on the right lateral femoral cutaneous nerve territory. Pain was rated as 8.5 on a numeric pain scale of 0 to 10. Musculoskeletal examination of the pelvic region disclosed bilateral sacroiliac joint dysfunction. Intervention and Outcomes Chiropractic management included pelvic mobilizations, myofascial therapy, transverse friction massage, and stretching exercises. After 3 visits (2 weeks later), result of neurological evaluation was normal, with no residual numbness over the lateral thigh. Conclusion In the present case, chiropractic management with standard and applied kinesiology techniques resulted in recovery of meralgia paresthetica symptoms for this patient. PMID:22942840

  6. Evaluation method for determining management priorities for special case waste

    SciTech Connect

    Kudera, D.E.; Wickland, C.E.

    1990-08-01

    The U.S. Department of Energy (DOE) Radioactive Waste Technical Support Program (TSP) began the Special Case Waste (SCW) Inventory and Characterization Project in April 1989. The collection of data has been completed and a final draft report, Department of Energy Special Case Radioactive Waste Inventory and Characterization Data Report (DOE/LLW-96), was submitted in May 1990. A second final draft report, Supplemental Data Report to the Department of Energy Special Case Radioactive Waste Inventory and Characterization Data Report (DOE/LLW-95), containing additional and more detailed data and graphical presentations, was completed in July 1990. These two reports contain details on the special case waste categories and summaries of the total volumes and curies associated with each category of waste. It is anticipated that some version or combination of these two reports will be included in the final version of this report, which will describe an evaluation method for determining management priorities for special case waste. Preliminary analysis of the inventory data indicates that approximately 1,000,000 m{sup 3} of special case waste exist in the DOE system with possible insufficient treatment/storage/disposal capability or capacity. To help DOE prioritize the actions required to manage this large volume of special case waste, an evaluation method is required.

  7. Surviving shot through the heart: Management in two cases.

    PubMed

    Siddiqui, Fraz Anwar; Kabeer, Jamal; Shahabuddin, Syed

    2015-01-01

    Penetrating cardiac injuries after gunshot are usually fatal and are very challenging to manage for surgeons even in fully- equipped centres. Such injuries can cause ventricular septal defect (VSD) or cardiac tamponade depending upon the distance, direction and velocity of the bullet. Stable patients can be subjected to investigations like computed tomography (CT) to avoid unnecessary intervention, but unstable patients should be rushed to the operating room. We discuss management in two cases of traversing bullet injury to the heart. In the first case, traumatic VSD was significant, requiring closure on cardiopulmonary bypass (CPB) along with repair of right and left ventricular injury. In the second case, only the repair of right and left ventricles was performed without CPB. They both had traversing bullet injury through the heart.

  8. Management of bilateral temporomandibular joint ankylosis in children: case report.

    PubMed

    Akama, M K; Guthua, S; Chindia, M L; Kahuho, S K

    2009-01-01

    Long standing temporomandibular joint (TMJ) ankylosis may cause severe facial deformity and growth retardation as well as psychological problems when it occurs in children. Different kinds of opinion have been advanced as regards its management. This article discusses the aetiology and management of bilateral TMJ ankylosis in form of a case report in a patient with severe facial deformity, malocclusion and retarded growth following bilateral TMJ ankylosis secondary to trauma. The patient was successfully managed by placement of costochondral grafts and interpositional arthroplasty with partial temporal myofascialflaps. Good mouth opening was achieved and subsequent follow-ups showed improved mandibular and general body growth as well as psychosocial performance. The aim of this paper is to discuss the management challenges posed by bilateral TMJ ankylosis.

  9. A Standardized Certification Program for Case Managers Serving Frail Elderly Texans. Module I: Foundations of Case Management and Intake Interview.

    ERIC Educational Resources Information Center

    Lusky, Richard A.; And Others

    This learning module is one of three training modules that were developed for members of the Texas Gerontological Consortium for Continuing Education to use in preparing case managers working in human service professions coordinating community-based programs for frail elderly Texans. Module I deals with the following topics: foundations of case…

  10. Energy management study: A proposed case of government building

    NASA Astrophysics Data System (ADS)

    Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Baharum, Mohd Faizal

    2015-05-01

    Align with the current needs of the sustainable and green technology in Malaysian construction industry, this research is conducted to seek and identify opportunities to better manage energy use including the process of understand when, where, and how energy is used in a building. The purpose of this research is to provide a best practice guideline as a practical tool to assist construction industry in Malaysia to improve the energy efficiency of the office building during the post-production by reviewing the current practice of the building operation and maintenance in order to optimum the usage and reduce the amount of energy input into the building. Therefore, this paper will review the concept of maintenance management, current issue in energy management, and on how the research process will be conducted. There are several process involves and focuses on technical and management techniques such as energy metering, tracing, harvesting, and auditing based on the case study that will be accomplish soon. Accordingly, a case study is appropriate to be selected as a strategic research approach in which involves an empirical investigation of a particular contemporary phenomenon within its real life context using multiple sources of evidence for the data collection process. A Government office building will be selected as an appropriate case study for this research. In the end of this research, it will recommend a strategic approach or model in a specific guideline for enabling energy-efficient operation and maintenance in the office building.

  11. Energy management study: A proposed case of government building

    SciTech Connect

    Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Baharum, Mohd Faizal

    2015-05-15

    Align with the current needs of the sustainable and green technology in Malaysian construction industry, this research is conducted to seek and identify opportunities to better manage energy use including the process of understand when, where, and how energy is used in a building. The purpose of this research is to provide a best practice guideline as a practical tool to assist construction industry in Malaysia to improve the energy efficiency of the office building during the post-production by reviewing the current practice of the building operation and maintenance in order to optimum the usage and reduce the amount of energy input into the building. Therefore, this paper will review the concept of maintenance management, current issue in energy management, and on how the research process will be conducted. There are several process involves and focuses on technical and management techniques such as energy metering, tracing, harvesting, and auditing based on the case study that will be accomplish soon. Accordingly, a case study is appropriate to be selected as a strategic research approach in which involves an empirical investigation of a particular contemporary phenomenon within its real life context using multiple sources of evidence for the data collection process. A Government office building will be selected as an appropriate case study for this research. In the end of this research, it will recommend a strategic approach or model in a specific guideline for enabling energy-efficient operation and maintenance in the office building.

  12. Nursing Case Management: Adapting to the Challenges of Today’s Healthcare Environment

    DTIC Science & Technology

    1993-05-01

    nursing practice model; Peplau case manag-ment model, Carondelet St. Marys nursing :ase management model and the New England Medical Center nursing case...environment and health is implied, but few of the NCM models specify a relationship to nursing conceptual models. The Peplau case management model is one of

  13. Management challenges in a case of gender identity disorder.

    PubMed

    Rathi, Anubhav; Bhatia, Manjeet Singh

    2014-01-01

    Gender identity disorder (GID) is a complex disorder and can be defined as a group of disorders whose common feature is a strong and persistent preference for living as a person of the other sex. It is associated with significant impairment in social, occupational, interpersonal, and other areas of functioning. We describe the case of an adolescent, biologically male who was brought to our outpatient department primarily with symptoms of adjustment disorder with GID and the management provided. The role of a psychiatrist in the management, ethical and legal issues involved is also discussed.

  14. [Hepatic subcapsular hematoma: a case report and management update].

    PubMed

    Berveiller, P; Vandenbroucke, L; Popowski, T; Afriat, R; Sauvanet, E; Giovangrandi, Y

    2012-06-01

    Hepatic subcapsular hematoma (HSH) is a rare complication of pregnancy that keeps a materno-fetal high mortality rate. Given this severity, HSH management requires a prompt diagnosis and an appropriate care. Before focusing on the current management strategy of HSH, we illustrate this article with a clinical case presenting an original method of abdominal exploration, which has not been described to our knowledge. Thus, taking into account the presence of a moderate hemoperitoneum during a caesarean section procedure for HSH, introduction of laparoscopy through the same incision allowed a satisfactory evaluation of the abdominal cavity and hepatic area without performing an invasive midline laparotomy.

  15. It takes data to justify ED case management.

    PubMed

    2012-10-01

    When it comes to justifying staff in the emergency department, case management directors need to provide financial data, not anecdotal information to the hospital's finance department. Experts recommend the following: Track your facility's avoidable admissions and patients admitted in the wrong status and calculate how much reimbursement the hospital lost. Collect information on people treated for non-emergent conditions who didn't pay and what the hospital lost. Add up the number of frequent utilizers who use the emergency department to manage their chronic conditions and how many could have benefitted from a referral to community services.

  16. Case reports and clinical guidelines for managing radix entomolaris

    PubMed Central

    Thomas, Bejoy J.; Nishad, A.; Paulaian, Benin; Sam, Jonathan Emil

    2016-01-01

    Knowledge about the external and internal anatomy of the tooth is essential for successful dental practice. Anomalies in the tooth are often encountered which poses difficulties in dental treatments. As like any other tooth, mandibular first molars are also prone for anatomic malformations. One such anatomic variation is the presence of extra root distolingually. This distolingual root is called radix entomolaris (RE). The presence of an additional root can lead to difficulties during endodontic therapy. This article is a report of two cases describing the management of the first mandibular molars with an RE and clinical guidelines for its management. PMID:27829770

  17. The chiropractic management of two cases of cervical spondylotic radiculopathy

    PubMed Central

    Dufton, John A.; Giantomaso, Tony

    2003-01-01

    Cervical spondylotic radiculopathy (CSR) is one of the potential sources of radiculopathy, particularly in patients aged 40 to 60 years. The hallmark sign of cervical-brachial pain presents in the majority of the cases, however a definitive clinical diagnosis is often difficult in the absence of reliable and valid diagnostic tests. Two cases of presumed CSR illustrate the usefulness of applying a comprehensive mechanical assessment that guides the patient's rehabilitation regardless of the traditional anatomical diagnosis. A brief overview of the epidemiology, clinical presentation, and management of CSR is also presented.

  18. Conservative management of abnormally invasive placenta: four case reports.

    PubMed

    Ramoni, Angela; Strobl, Eva-Maria; Tiechl, Johanna; Ritter, Magdalena; Marth, Christian

    2013-04-01

    Prenatal diagnosis of placenta increta and percreta is essential to avoid potentially life-threatening hemorrhage by optimizing peripartal management. Invasive placentation presents significant challenges at cesarean section even for highly skilled surgeons. In the four cases of placenta increta/percreta presented here we tried to avoid hysterectomy by leaving the placenta behind and tried to accelerate regression of placental tissue by administering methotrexate. The outcome in each of the four women was different, but no major bleeding occurred in any of the cases. Close follow-up for many weeks is mandatory.

  19. Application of integrative information system improves the quality and effectiveness of cancer case management.

    PubMed

    Lee, Pei-Yi; Chang, Tsue-Rung

    2015-01-01

    Cancer case management provides consecutive care during the entire process through diagnosis to treatment and follow-up. We established an integrative information system with integration of the health information system. This integrative information system shortened the time spent on case screening, follow-up data management, and monthly data summarization of case managers. It also promoted the case follow-up rate. This integrative information system may improve the quality and effectiveness for cancer case management, one important part of cancer nursing.

  20. Productive interdisciplinary team relationships: the hospitalist and the case manager.

    PubMed

    Amin, Alpesh N; Owen, Mary M

    2006-01-01

    Since the introduction of the National Patient Safety Goals (Joint Commission International Center for Patient Safety, 2005) into the Joint Commission on Accreditation of Healthcare Organizations standards, there appears to be a positive movement toward improvement in patient care outcomes and safety. Case management has been an integral part of the care team, and has emphasized standards of performance in quality of care, collaboration and resource utilization since 1995. When Leapfrog defined hospitalist intensivists as one of the three requirements necessary to be a safe hospital, an opportunity was borne to create a professional partnership. With the patient and the safety as the central focus of care, case managers and hospitalists are beginning to exponentially change the face of healthcare. This article will demonstrate the value of this partnership.

  1. [Management of chicken pox purpura fulminans: a pediatric case report].

    PubMed

    Domergue, S; Rodiere, M; Bigorre, M; Guye, E; Captier, G

    2006-06-01

    The authors report a case of a 4 years old girl who had presented a chicken-pox purpura fulminans. Lesions appeared 5 days after chicken-pox start and were quickly evoluted in cutaneous and sub-cutaneous necrosis on external side of thighs and behind side of right calf. A medical management was done with fresh plasma, blood, antithrombine 3, and fibrin. Specifics treatments were done: heparin and activated C protein. Surgical treatment was realised 5 weeks later. It consisted of clean necrosis areas and put a thin skin graft witch was took on the scalp. The evolution was fast good. The follow-up is 3 years without big esthetic and functional consequences. Some cases of this pathology were described in literature with serious lesions. The management should be multidisciplinary. Surgical treatment should be realised when lesions are stabilized. Scalp is a donor site for skin graft very interesting because of big quantity of skin and not esthetic consequence.

  2. The relationship between case manager expectations and outcomes of persons diagnosed with schizophrenia.

    PubMed

    O'Connell, Maria J; Stein, Catherine H

    2011-08-01

    The present study examined the relationship between case managers' expectations about the abilities of persons diagnosed with schizophrenia and the outcomes (as indicated via chart review) of a randomly selected sample of clients diagnosed with schizophrenia on their caseload. Results indicate that clients of case managers with higher expectations averaged significantly more months of progress in employment than clients of case managers with lower expectations. Case manager expectations were also better predictors of the number of days employed than other case manager and consumer characteristics, however the type of expectation was a critical determinant of the direction of the effect. Case manager expectations were not related to outcomes in living situation.

  3. Clinical Management of Two Root Resorption Cases in Endodontic Practice

    PubMed Central

    2016-01-01

    Root resorption is a pathological process involving loss of hard dental tissues. It may occur as a consequence of dental trauma, orthodontic treatment, and bleaching, and occasionally it accompanies periodontal disease. Although the mechanism of resorption process is examined in detail, its etiology is not fully understood. Wide open apical foramen is more difficult to manage and the root canal may often overfill. In this report we present two cases of root resorption and describe means for its clinical management. We conclude that useful measure of a success or failure in managing root resorption is the persistence of the resorption process. It is a clear sign of an active ongoing inflammatory process and shows the clinical need for retreatment. PMID:27648314

  4. Management of haemangioma with sclerosing agent: a case report

    PubMed Central

    M K, Parvathidevi; Koppal, Shrinivas; Rukmangada, Thriveni; Byatnal, Amit R

    2013-01-01

    The use of multiple weekly intralesional injections of 3% sodium tetradecyl sulfate as a sclerosing agent for the management of facial haemangiomas is a safe treatment with acceptable results. As presented in this case report, this technique offers the patient considerable relief of symptoms with minimal complications. However, the possibility of second-stage surgery to correct residual deformity is still considered. Sclerotherapy with 3% sodium tetradecyl sulfate provides a good preparation for further surgery. PMID:24130207

  5. Oral bullous lichen planus: Case report and review of management

    PubMed Central

    Patil, Archana; Prasad, Shiva; Ashok, L.; Sujatha, G. P.

    2012-01-01

    A 34-year-old female patient with the chief complaint of burning sensation in the oral cavity associated with generalized pruritis, scalp and skin lesions diagnosed as Bullous lichen planus and treated with systemic prednisolone, levamisole, benzydamine oral rinse. Patient is in follow up since 1 year and free of lesions. Here we report the case and review current modalities in the management of oral lichen planus. PMID:23293497

  6. Anesthetic management in a case of antiphospholipid antibody syndrome.

    PubMed

    Mikkiliineni, Venkata Rama Rao; Panidapu, Nagarjuna; Parasa, Mrunalini; Shaik, Mastan Saheb

    2015-01-01

    Antiphospholipid antibody (APLA) syndrome is one of the most common thrombocytophilias but, unfortunately, goes unrecognized most often. It is an auto-immune disorder in which thrombotic events and a recurrent fetal loss occur in the presence of antibodies to phospholipids. It is the most common acquired hyper-coagulable state. There is a limited literature on peroperative management of patients with this syndrome. We report a case of APLA syndrome in a parturient due to its rarity and complexity.

  7. A Case for Customizable Resource Management in Networks,

    DTIC Science & Technology

    2007-11-02

    00C Ca~aegie ej=)n ’C= 4P -jý A Case for Customizable Resource Management in Networks Peter Steenkiste Allan Fisher Hui Zhang October 21, 1998 CMU-CS-98...167 School of Computer Science Carnegie Mellon University Pittsburgh, PA 15213 Abstract We envision the deployment of an electronic services market ...that will deliver a wide range of electronic ser- vices over networks. This market will allow applications to combine resources at endpoints with

  8. Intracranial epidermoid tumor; microneurosurgical management: An experience of 23 cases

    PubMed Central

    Chowdhury, Forhad Hossain; Haque, Mohammod Raziul; Sarker, Mainul Haque

    2013-01-01

    Objectives: An intracranial epidermoid tumor is relatively a rare tumor, accounting for approximately 0.1% of all intracranial space occupying lesions. These are also known as pearly tumor due to their pearl like appearance. In this series, the localization of the tumor, presenting age and symptoms, imaging criteria for diagnosis, surgical management strategy with completeness of excision and overall outcome were studied prospectively. Here, we report our short experience of intracranial epidermoid as a whole. Materials and Methods: Between January 2006 to December 2010, 23 cases of intracranial epidermoid were diagnosed preoperatively with almost certainty by computed tomography (CT) and magnetic resonance imaging (MRI) of brain in plain, contrast and other relevant studies. All of them underwent operation in Dhaka Medical College Hospital and in some Private Hospital in Dhaka, Bangladesh. All patients were followed-up routinely by clinical examination and neuroimaging. Average follow-up was 39 (range-71-11months) months. Patients of the series were prospectively studied. Results: Supratentorial epidermoids were 04 cases and infratemporal epidermoids were 19 cases. Clinical features and surgical strategy varies according to the location and extension of the tumors. Age range was 19-71 years (37.46 years). Common clinical features were headache, cerebellar features, seizure, vertigo, hearing impairment and features of raised intracranial pressure (ICP). Investigation was CT scan or/+ MRI of brain in all cases. Pre-operative complete excision was 20 cases, but post-operative images showed complete excision in 17 cases. Content of tumor was pearly white/white material in all cases except one, where content was putty material. Re-operation for residual/recurrent tumor was nil. Complications included pre-operative mortality one case, persisted sixth nerve palsy in one case, transient memory disturbance one case, and extra dural hematoma one case. One senior patient

  9. Conservative management of retrocaval Ureter: A case series

    PubMed Central

    Yen, Jia Min; Lee, Lui Shiong; Cheng, Christopher Wai Sam

    2015-01-01

    Introduction Retrocaval ureter is a rare congenital anomaly with the ureter passage posterior to the inferior vena cava. Surgical repair is suggested for patients with significant functional obstruction. However, there is little literature to suggest the management of asymptomatic patients. Case presentation Case 1 patient is a 29 year-old Indonesian man and case 2 patient is a 41 year-old Malay man. Both patients were asymptomatic and well. Discussion This report is the short follow-up, therefore making it impossible to elucidate the natural history of uncorrected retrocaval ureters. Conclusion At 8 month and 6 month respectively, they remained well without symptoms. Our report suggests that immediate surgical repair is not always needed. Longer follow-up with larger patient population is needed to formally elucidate the natural history of this uncommon condition. PMID:26322820

  10. Endodontic management of dens invaginatus Type IIIb: Case series

    PubMed Central

    Martins, Jorge N. R.; da Costa, Rui Pereira; Anderson, Craig; Quaresma, Sérgio André; Corte-Real, Luís S. M.; Monroe, Adam D.

    2016-01-01

    Dens invaginatus may be seen as a developmental malformation. It is characterized by an invagination of the enamel and dentin, creating a lumen inside the affected tooth, which may extend as deep as the apical foramen. Oehlers Type IIIb is considered the most challenging clinical conditions. The purpose of this study is to discuss the nonsurgical endodontic management of vital and necrotic dens invaginatus Type IIIb cases. Due to the complex anatomical consideration of dens invaginatus Type IIIb, endodontic treatment is extremely technique sensitive. A conservative approach was used in a vital case to treat the invaginated lumen only, to preserve the vitality of the pulp, and a more invasive approach was used in a necrotic case to debride the lumen and necrotic pulp for proper disinfection of the root canal system. Although different, all the approaches were successful. The clinical signs and symptoms were resolved. The vital case remains vital after 19 months, and the recall radiographs were able to show satisfactory periapical healing both in vital and necrotic cases. Due to the highly complex anatomy of dens invaginatus Type IIIb, the decision of preserving the pulp vitality may not be related only to pulpal diagnosis but also to the technical requirements of the treatment. Although very technically sensitive, it may be possible to treat the invaginated lumen exclusively, while preserving the vitality of the pulp. Necrotic cases may require a more aggressive approach to achieve a favorable prognosis. PMID:28042276

  11. Neurosurgical management of anterior meningo-encephaloceles about 60 cases

    PubMed Central

    Rifi, Loubna; Barkat, Amina; El Khamlichi, Abdeslam; Boulaadas, Malek; El Ouahabi, Abdessamad

    2015-01-01

    Anterior meningo-encephaloceles (AME) are congenital malformations characterized by herniation of brain tissue and meninges through a defect in the cranium, in frontal, orbital, nasal and ethmoidal regions. The management of this complex congenital malformation is controversial according to whether use, an intracranial, extra-cranial or combined approach. This is the first largest series published in Africa, in which we present our experience in the operative management of AME; we share our recommendation in technical consideration for surgical approach with review of the literature. All patients beneficed of neuro-radiological investigations including Plan X rays, Spiral Three dimensional CT scan and MRI. Ophthalmologic and maxillo-facial evaluations were done in all the cases. MEA are surgically approached in various ways, mainly on the basis of its location and type, by cranio-facial approach in one-step, or in two stages by intracranial approach followed by facial approach, only by cranial approach or facial approach. The surgical results were evaluated in the follow up on the basis of disappearance of cranio-facial tumefaction with correction of hypertelorism. 60 children with AME were treated in our department between January 1992 and December 2012. The mean age at time of surgery was 14 months (20 days to 18 years) with slight men predominance (28 females/32 males). Cranio-facial team operated 21 patients, 16 were operated in two stages by intracranial approach followed by facial approach, 20 cases beneficed the neurosurgical approach and three only the facial approach Some post operative complications were observed: 2 cases of post operative hydrocephalus underwent shunt; CSF fistulas in three cases cured by spinal drainage, one death due to per operative hypothermia, 3 cases of recurrence how needed second surgery. After mean follow up for 80 months (1 year to 19 years) theses techniques permitted a good cosmetics results in 42 cases, average cosmetics

  12. Videophones for intensive case management of psychiatric outpatients.

    PubMed

    Nieves, J Edwin; Godleski, Linda S; Stack, Kathleen M; Zinanni, Tracy

    2009-01-01

    When visiting patients with serious mental illness at their homes, case managers carried a portable videophone. This was used to access the hospital clinical team via the home telephone line, when an acute clinical need arose in addressing questions related to medication management and treatment planning; travel was therefore avoided. In an acceptability study lasting 12 months, 24 patients received the supplemental videophone mental health service and 19 of them completed a satisfaction survey. Only one patient was not satisfied with the videophone treatment, while 74% of them were very satisfied. Specific areas of satisfaction concerned the savings of time and travel, assistance with medication questions and increased involvement in treatment. No patient reported any difficulty in using the equipment. Staff members were enthusiastic about the decrease in travel time and there were no complaints about the videophone process or encounters. During the study, 135 h of the case manager's time was saved by using the videophone for urgent access visits, equivalent to a saving of $4000 in salary costs. In addition, the patients saved 135 h in travel time. We believe that there are other potential uses of videophones for seriously mentally ill patients, including discharge planning, intensive post-discharge monitoring and transition to community life.

  13. [Tasks of case managers in statutory accident insurance].

    PubMed

    Böhnert, W

    1997-02-01

    The present article gives an outline of vocational rehabilitation in the Federal Republic of Germany from the perspective of the statutory accident insurance scheme. Termed "Berufshilfe", occupational assistance, the services and benefits provided under the scheme also encompass elements of medical and social rehabilitation of persons who have incurred an industrial injury or occupational disease. Given the scheme's comprehensive catalog of benefits and services, a multitude of possibilities result for assistance to eligible workers and their relatives, which are illustrated by examples. Central to the presentation is the work of the "Berufshelfer", the accident insurance agency's case manager for vocational rehabilitation service provision. Along with competence of the accident insurance agency for medical, vocational and social rehabilitation, this case manager is the point of contact for all those involved in rehabilitation in the individual case, hence in particular for the individual affected, his or her relatives, physicians, rehabilitation facilities, employers as well as third parties, moreover being the point of liaison among these various parties and the administration. The primary objective of these entire efforts is to achieve lasting reintegration of people with physical or emotional disablement in employment, career, and society.

  14. Case management in a DUI lab: effect on drugs reported.

    PubMed

    Tiscione, Nicholas B; Shan, Xiaoqin; Yeatman, Dustin Tate

    2014-10-01

    An evaluation of an internal laboratory decision to implement a protocol for limiting drug testing based on ethanol concentration in laboratory analysis for driving under the influence (DUI) cases is presented. The described case management strategy is supported by known impairment of ethanol at relatively high concentrations, difficulty assigning a level of contributing impairment from drugs in the presence of high ethanol levels and the likelihood that the drug results may be suppressed at trial. Although the results of this study reinforce the assertion that such protocols lead to the under reporting of drugs in DUI cases, for the majority of cases, 95% in this study, the drug analysis results were not significant and did not warrant the time and resources needed for the additional blood drug testing. Furthermore, the study demonstrated that a high drug positivity rate does not necessarily mean that those drug results are legally or pharmacologically meaningful. Additional research should be conducted with quantitative drug results and casework impact of blood drug screen protocols as previous studies only report drug positivity rates and not whether the drug results would be meaningful to the case.

  15. 30 CFR 250.519 - What are the requirements for casing pressure management?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... management? 250.519 Section 250.519 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL ENFORCEMENT... Gas Well-Completion Operations Casing Pressure Management § 250.519 What are the requirements for casing pressure management? Once you install your wellhead, you must meet the casing pressure...

  16. 30 CFR 250.518 - What are the requirements for casing pressure management?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... management? 250.518 Section 250.518 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL ENFORCEMENT... Gas Well-Completion Operations Casing Pressure Management § 250.518 What are the requirements for casing pressure management? Once you install your wellhead, you must meet the casing pressure...

  17. 30 CFR 250.519 - What are the requirements for casing pressure management?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... management? 250.519 Section 250.519 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL ENFORCEMENT... Gas Well-Completion Operations Casing Pressure Management § 250.519 What are the requirements for casing pressure management? Once you install your wellhead, you must meet the casing pressure...

  18. Designing a system of case management for a rural nursing clinic for elderly patients with depression.

    PubMed

    Stanton, Marietta P; Dunkin, Jeri W; Williams Thomas, L Kathleen

    2007-01-01

    This article provides an overview of the process and procedures used to develop and implement a system of case management for middle-aged and older depressed adults in a rural health nursing clinic. This system included on-site case management for elderly clients and telephonic follow-up by case managers on an ongoing basis.

  19. Sustainable watershed management: an international multi-watershed case study.

    PubMed

    Wagner, Walter; Gawel, James; Furuma, Hiroak; De Souza, Marcelo Pereira; Teixeira, Denilson; Rios, Leonardo; Ohgaki, Shinichiro; Zehnder, Alexander J B; Hemond, Harold F

    2002-02-01

    Global freshwater resources are being increasingly polluted and depleted, threatening sustainable development and human and ecosystem health. Utilizing case studies from 4 different watersheds in the United States, Japan, Switzerland, and Brazil, this paper identifies the most relevant sustainability deficits and derives general vectors for more sustainable water management. As a consequence of the demographic and economic developments experienced in the last few decades, each watershed has suffered declines in water quality, streamflow and biotic resources. However, the extent and the cultural perception of these water-related problems vary substantially in the different watersheds, leading to specific water-management strategies. In industrialized countries, exemplified by the US, Switzerland, and Japan, these strategies have primarily consisted of finance- and energy-intensive technologies, allowing these countries to meet water requirements while minimizing human health risks. But, from a sustainability point of view, such strategies, relying on limited natural resources, are not long-term solutions. For newly industrialized countries such as Brazil, expensive technologies for water management are often not economically feasible, thus limiting the extent to which newly industrialized and developing countries can utilize the expertise offered by the industrialized world. Sustainable water management has to be achieved by a common learning process involving industrialized, newly industrialized, and developing countries, following general sustainability guidelines as exemplified in this paper.

  20. Managing environmental sensitivity: an overview illustrated with a case report

    PubMed Central

    Busse, Jason W.; Reid, Steven; Leznoff, Arthur; Barsky, Arthur J.; Qureshi, Roohi; Guyatt, Gordon H.

    2008-01-01

    While the adverse impact of certain environmental agents is well established and affect individuals in a predictable dose-dependent manner, the validity of some exposure syndromes, such as environmental sensitivity, attributed to the influence of environmental chemicals in low, usually harmless doses, is less certain. Diagnosis of environmental sensitivity is subjective, and both standard medical and complementary and alternative treatment often fails to provide clinically meaningful functional gains. Existing evidence suggests that in many individuals with these syndromes, psychosocial factors play a prominent role. In this article we present an approach to managing patients presenting with sensitivities to environmental agents that includes identifying and managing organic disease, obtaining a thorough biopsychosocial history, confirming a diagnosis, and developing a rehabilitative process that focuses on support and improvements in function. A case of multiple chemical sensitivity illustrates this approach. PMID:18516285

  1. Anaesthetic management in a case of huge plunging ranula

    PubMed Central

    Sheet, Jagabandhu; Mandal, Anamitra; Sengupta, Swapnadeep; Jana, Debaleena; Mukherji, Sudakshina; Swaika, Sarbari

    2014-01-01

    Plunging ranula is a rare form of mucous retention cyst arising from submandibular and sublingual salivary glands, which may occasionally become huge occupying the whole of the floor of the mouth and extending into the neck, thus, restricting the neck movement as well as disfiguring the normal airway anatomy. Without fiberoptic assistance, blind or retrograde nasal intubation remains valuable choices in this type of situation. Here, we present a case of successful management of airway by blind nasal intubation in a patient posted for excision of a huge plunging ranula. PMID:25886120

  2. A case of error disclosure: a communication privacy management analysis.

    PubMed

    Petronio, Sandra; Helft, Paul R; Child, Jeffrey T

    2013-12-01

    To better understand the process of disclosing medical errors to patients, this research offers a case analysis using Petronios's theoretical frame of Communication Privacy Management (CPM). Given the resistance clinicians often feel about error disclosure, insights into the way choices are made by the clinicians in telling patients about the mistake has the potential to address reasons for resistance. Applying the evidenced-based CPM theory, developed over the last 35 years and dedicated to studying disclosure phenomenon, to disclosing medical mistakes potentially has the ability to reshape thinking about the error disclosure process. Using a composite case representing a surgical mistake, analysis based on CPM theory is offered to gain insights into conversational routines and disclosure management choices of revealing a medical error. The results of this analysis show that an underlying assumption of health information ownership by the patient and family can be at odds with the way the clinician tends to control disclosure about the error. In addition, the case analysis illustrates that there are embedded patterns of disclosure that emerge out of conversations the clinician has with the patient and the patient's family members. These patterns unfold privacy management decisions on the part of the clinician that impact how the patient is told about the error and the way that patients interpret the meaning of the disclosure. These findings suggest the need for a better understanding of how patients manage their private health information in relationship to their expectations for the way they see the clinician caring for or controlling their health information about errors. Significance for public healthMuch of the mission central to public health sits squarely on the ability to communicate effectively. This case analysis offers an in-depth assessment of how error disclosure is complicated by misunderstandings, assuming ownership and control over information

  3. Coccidioidomycosis: case report and update on diagnosis and management.

    PubMed

    Kim, Amy; Parker, Sareeta Singh

    2002-05-01

    Coccidioidomycosis is a disease known for its endemicity to the Southwest United States. However, given the current trends of more frequent tourist and business travel, an increasing number of coccidioidomycosis infections are being seen in patients in other areas of the United States. Because the majority of patients with disseminated disease experience cutaneous manifestations, dermatologists can be of primary importance in the diagnosis of this disease. We report a case of coccidioidomycosis manifesting as granulomatous cutaneous nodules on the face of an otherwise healthy white man. We attempt to provide an update on the diagnosis, management, and treatment of patients who present with cutaneous lesions caused by coccidioidomycosis infection.

  4. Esthetic management of anterior dental anomalies: A clinical case.

    PubMed

    Chafaie, Amir

    2016-09-01

    Many types of dental abnormality can be observed in the anterior sectors, where they can cause genuine esthetic problems for our patients. While conventional prosthetic treatments offer the best solutions in terms of esthetic result and durability, they involve the sacrifice of significant quantities of mineralized dental material and cannot be undertaken before the periodontal tissues are mature. Other less invasive alternatives should be envisaged as transitional, or sometimes even permanent, solutions for the management of these anomalies in children and adolescents. This article discusses these options and presents a clinical case where composite resin veneers and microabrasion of the enamel were used to treat dental agenesis and enamel dysplasia.

  5. Case study: negative reinforcement and behavioral management of conversion disorder.

    PubMed

    Campo, J V; Negrini, B J

    2000-06-01

    Behavioral interventions have been advocated for conversion disorder, but controlled trials are lacking. The authors report the case of a 12-year-old boy with conversion disorder after 3 months of persistent right arm pain and immobility whose symptoms rapidly resolved after an outpatient behavioral intervention using negative reinforcement. The importance of careful assessment, frank discussion of the diagnosis, patient and family psychoeducation, and a rehabilitative mindset are emphasized. Negative reinforcement may be a powerful tool in the management of pediatric conversion disorder, with the potential to reduce parental anxiety and prevent unnecessary physical assessments and interventions.

  6. Management of Ectopically Erupting Maxillary Incisors: A Case Series

    PubMed Central

    Suresh, Kotumachagi Sangappa; Uma, HL; Nagarathna, J

    2015-01-01

    ABSTRACT Eruption disturbances related to the position include ectopic eruption and transpositions. The occurrence of ectopic eruption is most commonly associated with maxillary incisors. The normal eruption, position and morphology of these teeth are crucial to craniofacial development, facial esthetics as well as phonetics. It is essential that the clinicians have thorough knowledge of the eruption disturbances in order to make an appropriate, as well as timely intervention, as dictated by the complexity of the problem. How to cite this article: Suresh KS, Uma HL, Nagarathna J, Kumar P. Management of Ectopically Erupting Maxillary Incisors: A Case Series. Int J Clin Pediatr Dent 2015;8(3):227-233. PMID:26604543

  7. ED case managers are crucial to help maximize reimbursement.

    PubMed

    2011-08-01

    As payers tighten their belts and recoup payments for inappropriate care and regulators increase penalties for fraud and abuse, hospitals need to ensure all admissions are appropriate and patient are placed in the right level of care. Hospitals are likely to have to return reimbursement for patients who don't meet inpatient criteria. Improper admissions can exacerbate capacity problems and result in hospital-acquired conditions. Correcting inappropriate admissions retrospectively can be a red flag to auditors. ED case managers can impact length of stay by ensuring that care starts in the emergency department.

  8. Pineal cyst apoplexy: report of an unusual case managed conservatively.

    PubMed

    Ayhan, Selim; Bal, Ercan; Palaoglu, Selcuk; Cila, Aysenur

    2011-01-01

    Pineal cyst apoplexy is a very rare entity with previously reported symptoms of severe frontal or occipital headache, gaze paresis and visual field defects, nausea or vomiting, syncope, ataxia, hearing loss and sudden death. The treatment options for symptomatic pineal cysts are observation, shunting, aspiration via stereotactic guidance or endoscopy, third ventriculostomy, ventriculocysternostomy, and/or surgical resection by craniotomy and microsurgery. Here, the authors report an unusual case of a 28-year-old male patient with pineal cyst apoplexy, presenting with headache, insomnia, and sexual dysfunction symptoms who is being managed conservatively and observed for two years by an academic tertiary care unit.

  9. Analysis of Selection Process for Management Education: Korean Military Case.

    DTIC Science & Technology

    1984-06-01

    OF SELECTION PROCESS FOR MANAGE.Y"FNT EDUCATION: KOREAN MILITARY CASE I ~~by 4 . m 3 Durk Kwan, Park * June 1984 * L.D Thesis Advisor: T. r.Swenson A...Anlyisof selection ?2-ocess for "aster’s Thcsis Vianajertent Eclucat ’on Korean M itiaryJue14 Cas 6 PERFORM-NO R RIEPCRT N-uMBER *7 A.~OR(., 8 CONTRACT...predicted [Ref. E]. 14 Chaptiz IV iresents the ierscnal characteristics tc takce into acccunt :or miana ~einent education and the identificatioz imethcd

  10. Management of Ectopically Erupting Maxillary Incisors: A Case Series.

    PubMed

    Suresh, Kotumachagi Sangappa; Uma, H L; Nagarathna, J; Kumar, Pravin

    2015-01-01

    Eruption disturbances related to the position include ectopic eruption and transpositions. The occurrence of ectopic eruption is most commonly associated with maxillary incisors. The normal eruption, position and morphology of these teeth are crucial to craniofacial development, facial esthetics as well as phonetics. It is essential that the clinicians have thorough knowledge of the eruption disturbances in order to make an appropriate, as well as timely intervention, as dictated by the complexity of the problem. How to cite this article: Suresh KS, Uma HL, Nagarathna J, Kumar P. Management of Ectopically Erupting Maxillary Incisors: A Case Series. Int J Clin Pediatr Dent 2015;8(3):227-233.

  11. [Rehabilitation networking illustrated by case management after occupational accidents].

    PubMed

    Mehrhoff, F

    2000-08-01

    No net without a spider! After work accidents the victims can rely on the infrastructure created by the German accident insurance scheme (Berufsgenossenschaften). A surgeon, a so-called transit physician, is responsible after acute treatments also for all phases of rehabilitation. A Case Manager (Berufshelfer), an employee of the Berufsgenossenschaften, advises the victim in all matters, including vocational rehabilitation and personal concerns. Both factors combine to form a network that orientates on the social needs of the injured worker, on the financial tasks of the insurance agency and on incentives to the rehabilitation facilities. The goals comprise "rehabilitation before compensation" and "job retention instead of job loss".

  12. Management of Acute Patellar Dislocation: A Case Report

    PubMed Central

    Enix, Dennis E.; Sudkamp, Kasey; Scali, Frank; Keating, Robbyn; Welk, Aaron

    2015-01-01

    Objective The purpose of this case study is to describe the evaluation and management of patellar dislocations and the different approaches used from providers in different countries. Clinical Features An individual dislocated her left patella while traveling abroad and received subsequent care in Thailand, China, and the United States. Intervention and Outcome Nonoperative treatment protocols including manual closed reduction of the patella, casting of the leg, and rehabilitation exercises were employed. Conclusion Receipt of care when abroad can be challenging. The patient’s knee range of motion and pain continued to improve when she was diligent about performing the home exercise program. This case highlights the importance of a thorough examination, a proper regimen of care, and patient counseling to ensure a full recovery and minimize the chance of re-injury. PMID:26778935

  13. Managed care and ERISA: synopsis and case law review.

    PubMed

    Gerbasi, Joan B

    2003-01-01

    Managed care organizations (MCOs) have become the predominant health care model in the United States. Through cost containment arrangements with providers, incentives for patients to pursue less costly care and reductions in the provision of unnecessary care, MCOs are more intimately involved in the delivery of health care than their former fee-for-service insurance company counterparts. However, this new role has not implied increased liability, largely because of The Employee Retirement Income Security Act of 1974 (ERISA). This article provides an overview of ERISA and a review of the important legal cases in this area, including the three most recent Supreme Court cases. Courts have struggled with interpreting ERISA, and decisions have been difficult to reconcile. Frustration with this statute and the failure of the U.S. Congress to amend it, has led to more liberal interpretations of ERISA in recent years.

  14. Meta-case based realization of design rationale management systems

    SciTech Connect

    Paul, G.

    1996-12-31

    System design is an iterative, creative, and cooperative process where informal ideas are transformed into a detailed definition of how a system can be implemented. Design rationale aims at capturing and preserving the why underlying the what, the argument behind the artifact in the design process. Recording deliberations of the design process therefore promises benefits for the overall system engineering life cycle. Providing adequate computer support for design rationale is an interesting issue and a real need for effective application. A design rationale management system (DRMS) supports the capturing, storing and retrieval of interaction rationale in a shared corporate knowledge base and allows organizational learning through long-term and inter-project reuse. The intent of meta-CASE systems is to capture the specification of a required CASE tool and then generate the tool for actual production from the specification. In this paper we identify the requirements for a DRMS and investigate the applicability of meta-CASE tools for the implementation of DRMS`s. Furthermore we describe the experiences gained in the development of two DRMS`s adopting the meta CASE tools MaestroII GED/TCI and Hardy.

  15. Providers' Perspectives on Case Management of a Healthy Start Program: A Qualitative Study.

    PubMed

    Moise, Imelda K; Mulhall, Peter F

    2016-01-01

    Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded

  16. Providers' Perspectives on Case Management of a Healthy Start Program: A Qualitative Study

    PubMed Central

    Moise, Imelda K.; Mulhall, Peter F.

    2016-01-01

    Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded

  17. HIPAA Privacy 101: essentials for case management practice.

    PubMed

    DiBenedetto, Deborah V

    2003-01-01

    The Health Insurance Portability and Accountability Act (HIPAA) has significant impact on the delivery of healthcare in the United States. The Administrative Simplification (AS) requirements of HIPAA are aimed at reducing administrative costs and burdens in the healthcare industry. The core components of HIPAA's AS requirements address healthcare transactions, code sets, security, unique identifiers, and privacy of health information. HIPAA's privacy standard limits the nonconsensual use and release of private health information, gives patients new rights to access their medical records and to know who else has accessed them, restricts most disclosure of health information to the minimum needed for the intended purpose, establishes new criminal and civil sanctions for improper use or disclosure, and establishes new requirements for access to records by researchers and others. This article focuses on HIPAA's privacy requirements as related to case management of workers compensation populations, the treatment of protected health information, and how case managers can ensure they provide appropriate services while navigating the requirements of HIPAA's privacy standard.

  18. 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.

  19. Chiropractic management of postpartum pubic symphysis diastasis: A case report.

    PubMed

    Henry, Lucian

    2015-03-01

    This case report describes the chiropractic management of a 30-year-old female patient with severe postpartum pelvic pain secondary to pubic symphysis diastasis. No literature was found on the chiropractic management of postpartum symphysis pubis diastasis. The existing literature concerning chiropractic care for symphysis pubis dysfunction during pregnancy is limited and indicates a potential benefit. Separation of the pubic symphysis may include ligamentous injury to the sacroiliac joints and may lead to chronic pain. Pubic symphysis separation of 17 millimeters was present on digital radiograph. Management consisted of chiropractic adjustments, trigger point release, electrical stimulation, moist heat, sacroiliac belt, and specific stabilizing exercises. The patient's pain improved immediately following treatment on the initial visit. Pain was reduced from 8/10 VAS at the first visit to 2/10 at the fourth visit. She was able to resume normal activities and reached a final pain level of 1/10. The diastasis was reduced by 7 millimeters at 14-weeks post radiograph for a final separation of just under 10 millimeters. Collaboration between obstetricians, midwives and chiropractors may be warranted.

  20. Chiropractic management of postpartum pubic symphysis diastasis: A case report

    PubMed Central

    Henry, Lucian

    2015-01-01

    This case report describes the chiropractic management of a 30-year-old female patient with severe postpartum pelvic pain secondary to pubic symphysis diastasis. No literature was found on the chiropractic management of postpartum symphysis pubis diastasis. The existing literature concerning chiropractic care for symphysis pubis dysfunction during pregnancy is limited and indicates a potential benefit. Separation of the pubic symphysis may include ligamentous injury to the sacroiliac joints and may lead to chronic pain. Pubic symphysis separation of 17 millimeters was present on digital radiograph. Management consisted of chiropractic adjustments, trigger point release, electrical stimulation, moist heat, sacroiliac belt, and specific stabilizing exercises. The patient’s pain improved immediately following treatment on the initial visit. Pain was reduced from 8/10 VAS at the first visit to 2/10 at the fourth visit. She was able to resume normal activities and reached a final pain level of 1/10. The diastasis was reduced by 7 millimeters at 14-weeks post radiograph for a final separation of just under 10 millimeters. Collaboration between obstetricians, midwives and chiropractors may be warranted. PMID:25729083

  1. A case study of type 2 diabetes self-management

    PubMed Central

    Wu, Hsin-i

    2005-01-01

    Background It has been established that careful diabetes self-management is essential in avoiding chronic complications that compromise health. Disciplined diet control and regular exercise are the keys for the type 2 diabetes self-management. An ability to maintain one's blood glucose at a relatively flat level, not fluctuating wildly with meals and hypoglycemic medical intervention, would be the goal for self-management. Hemoglobin A1c (HbA1c or simply A1c) is a measure of a long-term blood plasma glucose average, a reliable index to reflect one's diabetic condition. A simple regimen that could reduce the elevated A1c levels without altering much of type 2 diabetic patients' daily routine denotes a successful self-management strategy. Methods A relatively simple model that relates the food impact on blood glucose excursions for type 2 diabetes was studied. Meal is treated as a bolus injection of glucose. Medical intervention of hypoglycaemic drug or injection, if any, is lumped with secreted insulin as a damping factor. Lunch was used for test meals. The recovery period of a blood glucose excursion returning to the pre-prandial level, the maximal reach, and the area under the excursion curve were used to characterize one's ability to regulate glucose metabolism. A case study is presented here to illustrate the possibility of devising an individual-based self-management regimen. Results Results of the lunch study for a type 2 diabetic subject indicate that the recovery time of the post-prandial blood glucose level can be adjusted to 4 hours, which is comparable to the typical time interval for non-diabetics: 3 to 4 hours. A moderate lifestyle adjustment of light supper coupled with morning swimming of 20 laps in a 25 m pool for 40 minutes enabled the subject to reduce his A1c level from 6.7 to 6.0 in six months and to maintain this level for the subsequent six months. Conclusions The preliminary result of this case study is encouraging. An individual life

  2. The laparoscopic management of Swyer syndrome: Case series

    PubMed Central

    Malhotra, Neena; Dadhwal, Vatsla; Sharma, Kandala Aparna; Gupta, Deepika; Agarwal, Sumita; Deka, Dipika

    2015-01-01

    Swyer syndrome, also known as 46 XY pure gonadal dysgenesis, is a rare endocrine disorder. Affected individuals are phenotypically female with female genitalia, normal Mullerian structures, absent testicular tissue, and a 46 XY chromosomal constitution. We report a series of eight cases of Swyer syndrome, of which six were managed by laparoscopic gonadectomy. The two other cases had to undergo an exploratory laparotomy in view of their presentation with adnexal masses. Two of the girls were siblings. The chief presenting complaint was primary amenorrhea. Four girls also presented with a history of poor development of secondary sexual characters. The average age at presentation was 16.19±2.85 years. The average height was 158.33 ±4.63 cm, and the average weight was 49.33±8.44 kg. Breast development was either Tanner 2 or 3 in four girls, whereas three girls had a Tanner 1 underdeveloped breasts. Axillary and pelvic hair was sparse in all the girls. The vagina was well canalized in all the girls. Hormonal evaluation revealed hypergonadotropic hypogonadism with a mean follicle-stimulating hormone (FSH) level of 95.81 mIU/L and a mean luteinizing (LH) level of 24.15 mIU/L. Imaging analysis revealed the presence of a small uterus in all the cases, except one. Bilateral ovaries were either not visualized or streak gonads were present. Adnexal mass was detected in two of the six cases with raised carcinoembryonic antigen (CA) 125 levels in one case. Genetic analysis revealed a karyotype of 46 XY in six girls, 46 XY/45 X in one, and the culture repeatedly failed in one girl. Because of the risk of malignancy, bilateral gonadectomy was performed in all cases. Histopathological analysis revealed that three of the six cases had dysgerminoma. The patients have been started on hormone replacement therapy. Laparoscopy is a minimally invasive modality for the definitive diagnosis and treatment of cases with Swyer syndrome. An early diagnosis of Swyer syndrome is possible

  3. Health information management using optical storage technology: case studies.

    PubMed

    Kohn, D

    1992-05-01

    All the health care facilities examined in the case studies addressed several important organizational issues before and during the installation of their systems. All the facilities examined employee commitment. The prudent managers considered how easily their employees adapt to changes in their jobs and work environment. They considered how enthusiastic cooperation can be fostered in the creation of a liberated and reengineered office. This was determined not only by each individual's reaction to change, but also by the health care facility's track record with other system installations. For example, document image, diagnostic image, and coded data processing systems allow the integration of divergent health care information systems within complex institutions. Unfortunately, many institutions are currently struggling with how to create an information management architecture that will integrate their mature systems, such as their patient care and financial systems. Information managers must realize that if optical storage technology-based systems are used in a strategic and planned fashion, these systems can act as focal points for systems integration, not as promises to further confuse the issue. Another issue that needed attention in all the examples was the work environment. The managers considered how the work environment was going to affect the ability to integrate optical image and data systems into the institution. For example, many of these medical centers have created alliances with clinics, HMOs, and large corporate users of medical services. This created a demand for all or part of the health information outside the confines of the original institution. Since the work environment is composed of a handful of factors such as merged medical services, as many work environment factors as possible were addressed before application of the optical storage technology solution in the institutions. And finally, the third critical issue was the organization of work

  4. CM experts: hospitals need ED case managers now more than ever.

    PubMed

    2012-10-01

    It's no longer a luxury for hospitals to have case managers in their emergency departments, according to some case management experts--it's a necessity to make sure patients are admitted in the proper status and to ensure that those being discharged from the emergency department have what they need to manage their conditions. Hospitals need to ensure that patients meet medical necessity criteria to avoid losing reimbursement. Case managers can help provide a smooth transition from the emergency department back to the community and connect patients with post-discharge services. Case managers can work with patients who frequently utilize the emergency department and educate them about more appropriate venues of care.

  5. 22 CFR 96.43 - Case tracking, data management, and reporting.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Case tracking, data management, and reporting... Accreditation and Approval Responding to Complaints and Records and Reports Management § 96.43 Case tracking, data management, and reporting. (a) When acting as the primary provider, the agency or person...

  6. 22 CFR 96.43 - Case tracking, data management, and reporting.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Case tracking, data management, and reporting... Accreditation and Approval Responding to Complaints and Records and Reports Management § 96.43 Case tracking, data management, and reporting. (a) When acting as the primary provider, the agency or person...

  7. 22 CFR 96.43 - Case tracking, data management, and reporting.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Case tracking, data management, and reporting... Accreditation and Approval Responding to Complaints and Records and Reports Management § 96.43 Case tracking, data management, and reporting. (a) When acting as the primary provider, the agency or person...

  8. 22 CFR 96.43 - Case tracking, data management, and reporting.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Case tracking, data management, and reporting... Accreditation and Approval Responding to Complaints and Records and Reports Management § 96.43 Case tracking, data management, and reporting. (a) When acting as the primary provider, the agency or person...

  9. 22 CFR 96.43 - Case tracking, data management, and reporting.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Case tracking, data management, and reporting... Accreditation and Approval Responding to Complaints and Records and Reports Management § 96.43 Case tracking, data management, and reporting. (a) When acting as the primary provider, the agency or person...

  10. 30 CFR 250.518 - What are the requirements for casing pressure management?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 2 2011-07-01 2011-07-01 false What are the requirements for casing pressure management? 250.518 Section 250.518 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, REGULATION, AND... SHELF Oil and Gas Well-Completion Operations Casing Pressure Management § 250.518 What are...

  11. How would case managers' practice change in a consumer-directed care environment in Australia?

    PubMed

    You, Emily Chuanmei; Dunt, David; Doyle, Colleen

    2017-01-01

    The aim of this study was to explore case managers' perceived changes in their practice in the future when consumer-directed care (CDC) is widely implemented in Australia's community aged care system. Purposeful sampling was used and semi-structured individual and group interviews were conducted between September 2012 and March 2013. Participants were drawn from a list of all case managers who administered publicly funded community aged care packages in Victoria, Australia. Empowerment theory was used to guide the analysis and interpretation of the data. The thematic analysis revealed that case managers had mixed views about CDC. They also perceived changes in case managers' practice in the future when CDC is widely implemented. These might specifically include: first, case managers would not directly manage clients' budgets. While some case managers were concerned about losing power for this change, others believed that they would still have important financial roles to perform, such as setting rules, providing financial support and monitoring clients' use of budgets. Second, case managers would focus on performing roles in providing information, and empowering, facilitating and educating clients. These would help to strengthen clients' capacities and assist them to self-manage their care. Third, case managers would work in partnership with clients through frequent or skilful communication, mutual goal setting and goal facilitation. Fourth, case managers would manage more clients. In addition, they would provide less support to each individual client and perform less care co-ordination role. The findings suggest case managers paying attention to power balance regarding budget management in a CDC environment. Furthermore, they might frequently or skilfully communicate with, empower, facilitate and educate clients; work together with them to set up goals; and facilitate them to achieve goals. New research using empowerment theory to examine the actual practice of

  12. Toe Necrosis, Etiologies and Management, a Case Series

    PubMed Central

    Issa, Abdelfatah Abou; Newman, Mackenzie; Simman, Richard

    2014-01-01

    Toe necrosis may have vast different etiologies. These include ischemia, embolus, and others. (1) The most common etiology is ischemia. It is a reduction in blood supply to a viable tissue that can lead to susceptibility to infection and tissue death. Peripheral ischemia, which is rooted in the lower limbs, is a major risk factor for toe necrosis because the basal metabolic requirements of tissue are not being sufficiently met. As a result, pain, ulcers, and gangrene commonly occur. (2) Other causes of direct and indirect toe necrosis and related lower limb gangrene include mechanical trauma, infectious, pharmacological sensitivity, cancer, blue toe syndrome, and other granulomatous diseases, such as Churg-Strauss syndrome. We present a case series of toes necrosis which resulted from different etiologies and their management. PMID:26199887

  13. Current management of bronchiectasis: review and 3 case studies.

    PubMed

    Silverman, Enid; Ebright, Linda; Kwiatkowski, Marianne; Cullina, Joanne

    2003-01-01

    Bronchiectasis is the abnormal, irreversible dilatation of diseased bronchi. Permanently dilated airways, usually in the medium-sized bronchi, are inflamed and often obstructed with thick, purulent secretions. Known causative factors include postinfection bronchial damage, postinhalation injury, hypersensitivity reactions, and congenital airway obstructive disorders. Typical symptoms include sputum overproduction, fever, pleurisy, dyspnea, and chronic cough. Diagnosis involves radiographic studies and pulmonary function testing. Treatment includes oral, aerosolized, or intravenous antibiotic therapy according to the severity of the exacerbation, and mucus clearance by means of bronchial hygiene assistive devices, chest physiotherapy, postural drainage, and high-frequency chest compression. We present a review of bronchiectasis and offer 3 case studies illustrating current management of different presentations, including use of aerosolized antibiotics for patients infected with Pseudomonas aeruginosa. Although an adjunctive program of pulmonary rehabilitation may be useful for patients with bronchiectasis, no confirming studies have been performed to date, and additional research in this area is warranted.

  14. Burns from illegal drug manufacture: case series and management.

    PubMed

    Porter, C J W; Armstrong, J R

    2004-01-01

    This case series presents our experience with burns sustained while manufacturing illegal drugs. All adult burn admissions in an 18-month period were retrospectively reviewed. All patients suspected of sustaining burns from illegal drug manufacture were contacted. Information regarding the burn mechanism was sought. Nine of the 64 adult burn admissions were caused by explosions during the manufacture of cannabis oil. Young males with hand and face burns were heavily represented. First-aid treatment was often ignored in favor of hiding incriminating evidence. Only two patients gave honest admission histories. Illegal drug manufacture is becoming more common as synthetic drugs become more consumer desirable. Burns sustained may be thermal and/or chemical. Dishonest patient histories negatively influence burn management. A high level of suspicion is required for diagnosing and treating burns from illegal drug manufacture. Public education is unlikely to be effective as the financial rewards outweigh the perceived risks.

  15. Conservation markets for wildlife management with case studies from whaling.

    PubMed

    Gerber, Leah R; Costello, Christopher; Gaines, Steven D

    2014-01-01

    Although market-based incentives have helped resolve many environmental challenges, conservation markets still play a relatively minor role in wildlife management. Establishing property rights for environmental goods and allowing trade between resource extractors and resource conservationists may offer a path forward in conserving charismatic species like whales, wolves, turtles, and sharks. In this paper, we provide a conceptual model for implementing a conservation market for wildlife and evaluate how such a market could be applied to three case studies for whales (minke [Balaenoptera acutorostrata], bowhead [Balaena mysticetus], and gray [Eschrictius robustus]). We show that, if designed and operated properly, such a market could ensure persistence of imperiled populations, while simultaneously improving the welfare of resource harvesters.

  16. Psychosis management in patients with hiv: case report.

    PubMed

    Calvo-Rivera, M Pilar; Porras, Alejandro; Trigo-Rodríguez, Marta; Martínez-Ortega, José M; Gutiérrez-Rojas, Luis

    2017-03-01

    Human immunodeficiency virus (HIV) infection can cause neuropsychiatric disorders such as cognitive impairment, behavioural difficulties or psychiatric symptoms –for instance, mania and psychosis. HIV patients with psychiatric comorbidities need an appropriate treatment which tackles the HIV infection as much as the particular mental symptoms. Here we present the case of a patient suffering from delusions, which turned out to be caused by encephalitis secondary to a previously unknown HIV infection. A review of psychosis in HIV-infected patients is also presented. This review is focused on the epidemiology, etiopathogenesis and clinical presentation of HIV-induced psychosis, as well as the recommended pharmacological treatment (antiretroviral therapy and antipsychotic medication) and the expected treatment response. We also present wide information concerning pharmacological interactions between antiretroviral and antipsychotic medications that we hope will help the clinician to better manage this complex condition.

  17. Key concepts in the management of difficult hemorrhagic cases.

    PubMed

    MacLaren, Robert

    2007-09-01

    Goals of hemorrhage management involve promoting coagulation and reducing fibrinolysis to enhance clot formation and stability, and minimizing hemorrhagic expansion to reduce the likelihood of adverse outcomes. The optimal hemostatic regimen to obtain these goals will differ according to the clinical scenario. Two hypothetical cases of patients with hemorrhage are presented that are typical of those encountered by clinical pharmacists who practice in centers that treat trauma or surgical patients or patients in need of emergency or critical care because of serious bleeding. To maximize therapy, the clinician must be aware of how best to clinically apply hemostatic agents, their comparative benefits and disadvantages, and the optimal methods for monitoring their effectiveness and toxicities.

  18. Application of integrative information system improves the quality and effectiveness of cancer case management

    PubMed Central

    Lee, Pei-Yi; Chang, Tsue-Rung

    2015-01-01

    Cancer case management provides consecutive care during the entire process through diagnosis to treatment and follow-up. We established an integrative information system with integration of the health information system. This integrative information system shortened the time spent on case screening, follow-up data management, and monthly data summarization of case managers. It also promoted the case follow-up rate. This integrative information system may improve the quality and effectiveness for cancer case management, one important part of cancer nursing. PMID:26089680

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

    PubMed Central

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

    2014-01-01

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

  20. [Start of TB case-registration and case-management system in Japan].

    PubMed

    Shimao, Tadao

    2010-07-01

    TB control in Japan started in 1951 through legislation of TB Control Law, consisting of three major components; mass health examination, vaccination and promotion of adequate methods of treatment for TB cases. Mass health examination was first targeted for younger generation below 30 years of age as it was believed that TB was highly prevalent among them, however, it was expanded to cover whole population based on the results of TB Prevalence Survey in 1953 revealing high prevalence of TB in all age groups except children and low awareness of TB cases. Methods of treatment for TB were developing rapidly in late 1950s and early 1960s; initially artificial pneumothorax, then surgical collapse treatment such as thoracoplasty, then pulmonary resection, and finally long term combined use of INH, SM and PAS. Up to surgical treatment era, most TB patients earnestly followed doctor's instruction, however, in chemotherapy era, as most symptoms improved rapidly after the initiation of chemotherapy, patients felt as if they were cured, and it had become difficult to maintain high adherence to treatment. Such behavior was found oftener in patients detected in early stage through mass health examinations. 1947, it was legislated for all doctors to report all diagnosed TB cases to an adjacent health center, and the cases are registered at the health center covering his (her) residence, however, standardized formula of registration was not indicated. In accordance with the progress of TB control program, the number of TB registered cases increased, and the need for standardized registration and case-management had become apparent in mid 1950s, and some preliminary trials had been done. In response to this request, the Ministry of Health and Welfare organized a research group headed by Dr. Misonou K, and the staffs of prefectural health department and enthusiastic staffs working in health centers (HCs), staffs of NIPH (National Institute of Public Health) and RIT (Research

  1. Case analysis online: a strategic management case model for the health industry.

    PubMed

    Walsh, Anne; Bearden, Eithne

    2004-01-01

    Despite the plethora of methods and tools available to support strategic management, the challenge for health executives in the next century will relate to their ability to access and interpret data from multiple and intricate communication networks. Integrated digital networks and satellite systems will expand the scope and ease of sharing information between business divisions, and networked systems will facilitate the use of virtual case discussions across universities. While the internet is frequently used to support clinical decisions in the healthcare industry, few executives rely upon the internetfor strategic analysis. Although electronic technologies can easily synthesize data from multiple information channels, research as well as technical issues may deter their application in strategic analysis. As digital models transform access to information, online models may become increasingly relevant in designing strategic solutions. While there are various pedagogical models available to support the strategic management process, this framework was designed to enhance strategic analysis through the application of technology and electronic research. A strategic analysis framework, which incorporated internet research and case analysis in a strategic managementcourse, is described alongwith design and application issues that emerged during the case analysis process.

  2. Paradise nearly Gained. Volume 2: Case Studies of Impact and Diversity for Frontline Management Initiative Practice.

    ERIC Educational Resources Information Center

    Barratt-Pugh, Llandis; Soutar, Geoffrey N.

    This document presents the case studies from a multi-phase study of the impact of Australia's Frontline Management Initiative (FMI), which provides a framework for competency-based development of frontline managers in Australian enterprises. Nineteen organizational case studies and one individual case study of the FMI's impacts are included. The…

  3. Prototyping with Application Generators: Lessons Learned from the Naval Aviation Logistics Command Management Information System Case

    DTIC Science & Technology

    1992-10-01

    Prototyping with Application Generators: Lessons Learned from the Naval Aviation Logistics Command Management Information System Case. This study... management information system to automate manual Naval aviation maintenance tasks-NALCOMIS. With the use of a fourth-generation programming language

  4. A rare case of post-splenectomy gastric volvulus managed by laparoscopic anterior gastropexy

    PubMed Central

    Gupta, Rahul Amreesh; Das, Rinki; Verma, Ganga Ram

    2017-01-01

    We report an extremely rare case of recurrent gastric volvulus after open splenectomy for hereditary spherocytosis. The initial episode was managed by endoscopic derotation. Later, for recurrent symptoms, she was successfully managed by laparoscopic anterior gastropexy. PMID:28281486

  5. [Research and development of medical case database: a novel medical case information system integrating with biospecimen management].

    PubMed

    Pan, Shiyang; Mu, Yuan; Wang, Hong; Wang, Tong; Huang, Peijun; Ma, Jianfeng; Jiang, Li; Zhang, Jie; Gu, Bing; Yi, Lujiang

    2010-04-01

    To meet the needs of management of medical case information and biospecimen simultaneously, we developed a novel medical case information system integrating with biospecimen management. The database established by MS SQL Server 2000 covered, basic information, clinical diagnosis, imaging diagnosis, pathological diagnosis and clinical treatment of patient; physicochemical property, inventory management and laboratory analysis of biospecimen; users log and data maintenance. The client application developed by Visual C++ 6.0 was used to implement medical case and biospecimen management, which was based on Client/Server model. This system can perform input, browse, inquest, summary of case and related biospecimen information, and can automatically synthesize case-records based on the database. Management of not only a long-term follow-up on individual, but also of grouped cases organized according to the aim of research can be achieved by the system. This system can improve the efficiency and quality of clinical researches while biospecimens are used coordinately. It realizes synthesized and dynamic management of medical case and biospecimen, which may be considered as a new management platform.

  6. The Development and Use of an Interactive Case-Mix Management System

    PubMed Central

    Van De Moortel, Victor; More, Roy

    1984-01-01

    A study was undertaken to understand the information needs for case-mix management. The results of the study were used in the development of an interactive case-mix management system on a microcomputer. The system has been installed in 16 hospitals. The results of this effort will be helpful now for case-mix management as well as in future information handling projects.

  7. Construction waste management based on industrial management models: a Swedish case study.

    PubMed

    Stenis, Jan

    2005-02-01

    This paper describes a methodology for estimating the true internal costs of construction waste, aimed at promoting environmentally friendly waste management. The study employs cost-benefit analysis, contribution margin analysis, the polluter-pays principle and a mathematical model: the model for Efficient Use of Resources for Optimal Production Economy (EUROPE), which has been introduced previously by the author for assigning industrial costs to waste. The calculations are performed on construction waste created in a case study of a building project. Moreover, waste is regarded as, in a business sense, having the same basic status as any normal industrial product, namely the 'equality principle'. Application of the methodology is suggested to create incentives for environmental and profitability improvement in construction companies and other types of industrial sectors. The results of the case study show the generation of construction waste to substantially decrease the final operating income, due to the internal shadow price cost it creates. This paper is intended to reduce the gap between the choice of waste management procedures and their economic impact, the overall objective being to accomplish an improved industrial environmental situation.

  8. [Case management for school students with chronic disease: the current situation and future direction].

    PubMed

    Huang, Chun-Hsia; Chen, I-Ju; Yu, Shu

    2005-04-01

    This paper aims to investigate the importance of management of chronic illness in schools epidemiological data. By examining the current state of such management, we found that school nurses, family members, mentors and school administrators lack sufficient knowledge to conduct effective case management for students with chronic diseases. This paper seeks to indicate principles for the conduct of case management of chronic disease in Taiwan. Incorporating practices, regulations, information systems, policy, and evaluation systems, recommendations are made with the hope that a well-planned system of case management of chronic disease can be established in schools to further enhance the quality of health care and life generally for school children.

  9. Adaption of Talent Management Scale into Turkish: Sinop University Case

    ERIC Educational Resources Information Center

    Kilic, Elife Dogan; Serin, Huseyin; Karakus, Ozge; Ergene, Ozkan; Corbaci, E. Cihat; Kilic, Nayil

    2017-01-01

    As a result of globalization, talented employees have been needed in the workplace anymore. With being hired of talented employees, new understanding of management has appeared and talent management has gained importance due to this new understanding. Talent management is a kind of management understanding according to which employees feel…

  10. Knowledge Management in Preserving Ecosystems: The Case of Seoul

    ERIC Educational Resources Information Center

    Lee, Jeongseok

    2009-01-01

    This study explores the utility of employing knowledge management as a framework for understanding how public managers perform ecosystem management. It applies the grounded theory method to build a model. The model is generated by applying the concept of knowledge process to an investigation of how the urban ecosystem is publicly managed by civil…

  11. Laparoscopic management of primary abdominal pregnancy: a case report.

    PubMed

    Altay, Mehmet Metin; Dündar, Betül; Erol, Ahmet Okyar; Kurtaran, Volkan; Gelişen, Orhan

    2010-01-01

    This is a case report of a primary abdominal pregnancy managed by laparoscopic intervention. A 22 year old, gravida 1, woman was admitted to our emergency room with vaginal bleeding and pain in lower abdomen. She was 4 weeks pregnant according to her last menstrual period. She had undergone right salpingoophorectomy previously. Pelvic examination revealed cervical motion tenderness, bilateral adnexal tenderness and rebound tenderness. Her vital signs were normal. Beta hCG was 15826 IU/ml and hemoglobin was 10.0 g/dl. Transvaginal sonography showed an endometrium of 3 mm thickness and free fluid in the pelvis. Upon admission to the Early Pregnancy Clinic, abdominal pain became worse and hemoglobin decreased to 8.0 g/dL. Therefore, we performed a laparoscopy which showed that the uterus, left tube and ovary were completely normal with absence of the right ovary and tube. Approximately 500 cc blood was aspirated from the pelvis. Between the right sacrouterine ligament and rectum, there was a bleeding area 2 cm in width which was removed with forceps and sent for frozen pathological examination,which revealed 'placental tissue fragments'. Endometrial sampling was reported to be 'secretory endometrium'. A rapid decrease in the beta HCG post operative titer confirmed the resolution of the pregnancy. Primary abdominal pregnancy is extremely rare. The diagnosis is confirmed according to Studdiford's criteria. In the literature, there only a few cases of abdominal pregnancy in which laparoscopic procedure has been used effectively as treatment. However, laparoscopic procedure is usually successful in treatment of abdominal pregnancy if the gestational age is early enough.

  12. HIPAA Business Associate Contracts: the value of contracts for case managers.

    PubMed

    Muller, Lynn S

    2003-01-01

    Case Managers are in the middle of the upcoming HIPAA regulation changes, with the issuance of the Final Privacy Rule. Every case obliges case managers to work with Individually Identifiable Health Information (IIHI) and Protected Health Information (PHI). The purpose of this article is to provide case managers in all practice settings with a clear understanding of a "Business Associate," of a "Covered Entity," and of the specifics of a Business Associate Contract. This information will demonstrate how case managers can benefit from the use of these contracts in their business life. As an essential component of an organization's compliance plan, Business Associate Contracts can become a sword or a shield. This article is particularly helpful to case managers in independent practice, as well as those who work for Covered Entities.

  13. Physician-management relationships at HCA: a case study.

    PubMed

    Campbell, P; Kane, N M

    1990-01-01

    The questions of whether Hospital Corporation of America (HCA), a for-profit hospital company, fostered an environment detrimental to the physician-patient relationship during the period of implementation of the Medicare Prospective Payment System (PPS) was explored. The transition to PPS provided an opportunity to evaluate whether hospital ownership differences affected responses to a payment system which encouraged institutional intervention in the practice of medicine. A case study approach was used to observe the influence of the then largest for-profit hospital corporation upon physicians' medical practice in four owned hospitals. Findings indicated that HCA hospital managers were most directly influenced by the local competitive environment and their own personal agendas in responding to PPS incentives. Corporate influence actually softened payment system incentives to intervene in medical practice by providing a generous supply of capital, and by fostering a corporate culture conducive to cooperative relationships with physicians. Better public understanding of the determinants of hospital behavior is needed to preserve or enhance important social goals such as the physician-patient relationship; easily measurable characteristics such as ownership or bed size explain little about hospital behavior or motivation.

  14. Pain in diabetic neuropathy case study: whole patient management.

    PubMed

    Marchettini, P; Teloni, L; Formaglio, F; Lacerenza, M

    2004-04-01

    Painful diabetic peripheral neuropathy (DPN) is described as a superficial burning pain associated with other positive and/or negative sensory systems affecting the feet and lower extremities. It is one of the most commonly encountered neuropathic pain syndromes in clinical practice. Presentation may be complicated by multiple symptoms, including allodynia, hyperalgesia, other less well characterized dysesthesias, and serious disruption of social functioning and mood. Peripheral nerve function may deteriorate, which can account for patient reports of diminution of pain after several years of follow-up. Although current understanding holds that the pathogenesis of DPN is multifactorial in nature, long-term studies have shown that rigorous glycemic control is the most relevant factor in clinical intervention and can delay the onset and slow the progression of neuropathy. In addition to glycemic control, other treatment approaches must be examined in order to restore quality of life for patients experiencing painful DPN. Differential diagnosis is required to isolate DPN from other unexplained chronic pain. Neurologic testing in painful DPN is an area of active research and is used to assess the neurologic pathways giving rise to the pain, the degree of neural damage and the degree of subclinical damage. Current treatment options for DPN include mainly antidepressants and anticonvulsants, with other agents such as tramadol, dextromethorphan and memantine being employed or studied. This review article includes a case study of a patient with painful DPN to demonstrate the current management strategies for this neuropathic pain syndrome.

  15. Content and Workflow Management for Library Websites: Case Studies

    ERIC Educational Resources Information Center

    Yu, Holly, Ed.

    2005-01-01

    Using database-driven web pages or web content management (WCM) systems to manage increasingly diverse web content and to streamline workflows is a commonly practiced solution recognized in libraries today. However, limited library web content management models and funding constraints prevent many libraries from purchasing commercially available…

  16. Benefits of photograph transmission for trauma management in isolated areas: cases from the French tele-medical assistance service.

    PubMed

    Dehours, Emilie; Tourneret, Marie-Laure; Roux, Patrick; Tabarly, Julien

    2016-01-01

    French maritime tele-medical assistance is currently performed by a telephone consultation associated with complementary transmission of data (photographs, electrocardiograms, etc.) over the internet. Five case reports are presented to illustrate how photo transmission is useful to managing initial care and monitoring isolated patients. Case reports included: Case 1: management of a hand burn; Case 2: management of a finger wound; Case 3: management of an ocular foreign body; Case 4: management of a subungual haematoma; Case 5: management of phlegmon. In conclusions, photo transmission improves our practice of maritime tele-medical medicine. New high-definition technologies will help in the development of videoconferences on ships.

  17. Louisiana's Ventilator Assisted Care Program: Case Management Services to Link Tertiary with Community-Based Care.

    ERIC Educational Resources Information Center

    Kirkhart, Kathryn A.; And Others

    1988-01-01

    The Ventilator Assisted Care Program provides centralized case management services to ventilator-using youths and their families in Louisiana. Case managers develop individualized, comprehensive plans to be implemented locally using community resources; plans are based on needs identified by tertiary care providers and family members and are…

  18. Pakistan-Specific Cases for the Advanced Management Course in Public Administration.

    ERIC Educational Resources Information Center

    McLean, Gary N., Ed.

    A compilation of management case studies concerning public administration in Pakistan and accompanying teaching notes, this document is intended to foster discussion in classes such as the advanced management course in public administration at the National Institute of Public Administration in Lahore, Pakistan. Included are case studies entitled…

  19. HIV Risk Behavior among Delinquent and Mentally Ill Teens: Case Manager Perspectives

    ERIC Educational Resources Information Center

    Smith, Michael D.; Seal, David Wyatt; Hartley, Shannon

    2006-01-01

    An HIV knowledge survey and qualitative interview were administered to 20 case managers in community-based programs for troubled youth to assess HIV knowledge and their perception of client HIV risk behaviors. Participants had good HIV knowledge. Case managers perceived client youth to be at high risk for HIV infection due to unsafe sexual…

  20. HIV/AIDS Case Managers and Client HIV Status Disclosure: Perceived Client Needs, Practices, and Services

    ERIC Educational Resources Information Center

    Kalichman, Seth C.; Klein, Susan J.; Kalichman, Moira O.; O'Connell, Daniel A.; Freedman, Jay A.; Eaton, Lisa; Cain, Demetria

    2007-01-01

    People living with HIV/AIDS often need assistance in deciding whether or how to disclose their HIV status to others, and case managers are in a unique position to offer this assistance. The current study surveyed 223 case managers providing services to people living with HIV/AIDS in New York State. The survey was conducted anonymously, and case…

  1. Case Studies, Ethics, Philosophy, and Liberal Learning for the Management Profession

    ERIC Educational Resources Information Center

    Rendtorff, Jacob Dahl

    2015-01-01

    Case studies can be an important methodology for ethics and philosophy in humanistic management and liberal education as well as in the social sciences because they integrate a deeper, reflective, philosophical, and ethical understanding of the organization. A case study approach based on philosophy of management contributes to putting into…

  2. Academic Case Management: Promising Interventions for Closing Achievement Gaps in Multicultural Urban Settings

    ERIC Educational Resources Information Center

    Van Kannel-Ray, Nancy; Zeller, Pamela J.; Lacefield, Warren E.

    2009-01-01

    This article explains how individual academic case manager intervention programs were implemented in three urban middle schools. Academic case managers helped students integrate their personal lives with academic expectations by helping students learn to cope with their own personal challenges with the goal of improving their academic performance.…

  3. Defining, Delivering, and Documenting the Outcomes of Case Management by School Nurses

    ERIC Educational Resources Information Center

    Engelke, Martha Keehner; Guttu, Martha; Warren, Michelle B.

    2009-01-01

    Case management is a component of school nurse practice that provides an opportunity to demonstrate the contribution that school nurses make to the health and academic success of children, particularly children with chronic health conditions. However, case management programs vary in their mission and scope, leading to confusion about what it…

  4. How Far Gender Role Is Successful in School Management? Cross Case Analysis from Pakistan

    ERIC Educational Resources Information Center

    Safdar, Qamar

    2007-01-01

    This article reports a case study research about the management of successful schools with special emphasis on female leadership, to prove that gender does matter in successful school management. A cross case analysis was conducted with three different school leaderships, especially with regard to their profiles, personal, academic and…

  5. Introducing Case Management to Students in a Virtual World: An Exploratory Study

    ERIC Educational Resources Information Center

    Levine, Joanne; Adams, Ruifang Hope

    2013-01-01

    This paper discusses a small, exploratory study introducing students to case management using role-plays conducted in a virtual world. Data from pre- and posttest questionnaires (to assess self-efficacy regarding a range of case management tasks) suggest students felt more confident in their abilities after virtual role-play participation. Also…

  6. Perceptions about Services and Dropout from a Substance Abuse Case Management Program

    ERIC Educational Resources Information Center

    Sosin, Michael R.; Durkin, Elizabeth

    2007-01-01

    This article uses event history analysis to examine certain determinants of dropout from a case management program that serves homeless adults with substance abuse problems. The examined determinants are perceptions of conventional treatment services: (a) client perceptions concerning the value of the conventional services that case managers help…

  7. 32 CFR 105.13 - Case management for Unrestricted Reports of sexual assault.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... sexual assaults are entered into DSAID or a DSAID Service interface system within 48 hours of the report... 32 National Defense 1 2013-07-01 2013-07-01 false Case management for Unrestricted Reports of....13 Case management for Unrestricted Reports of sexual assault. (a) General. (1) The...

  8. Case Studies for School Administrators: Managing Change in Education.

    ERIC Educational Resources Information Center

    Benham, Maenette K. P. Ah Nee

    This book examines case-based learning in educational leadership courses, discusses case-based learning as an educational tool, exemplifies methods of writing a case study, and contains 14 case-studies by teachers and administrators. "Stakeholders in a House of Cards," by Audrey Burgher, discusses integrating technology with innovation.…

  9. Pediatric asthma case management: a review of evidence and an experimental study design.

    PubMed

    Schulte, Amanda; Musolf, Jeanne; Meurer, John R; Cohn, Jennifer H; Kelly, Kevin J

    2004-08-01

    Asthma is a complex disease that involves physiological, environmental, and psychosocial factors. This paper reviews childhood asthma case management by social service professionals, lay health workers, and nurses, and it presents a new randomized controlled study using nurse case management in a local community coalition. Evidence suggests the common factor for success involves case managers spending time contacting and patiently and persistently working with the family, thus building a trusting relationship. Although case management time is an expense for a health care payer, provider, and the child and family, the positive outcomes achieved can demonstrate the benefit of these interventions to all parties involved. The described experimental study assesses the cost and effectiveness of home-based nurse case management by a community coalition for children visiting an emergency department for asthma care.

  10. Delivering home-based case management to families with children with mental retardation and developmental disabilities.

    PubMed

    Ardito, M; Botuck, S; Freeman, S E; Levy, J M

    1997-01-01

    To meet the needs of individuals with mental retardation and developmental disabilities (MR/DD) and their families living in urban setting, a noncenter-based model of case management was implemented. In contrast to traditional case management in which families and consumers come to the case manager and most service coordination is done by telephone or in meetings at the case manager/social worker's worksite, the case manager in a noncenter-based model is mobile and able to meet the consumer and family in their domains. In this model, case management is provided in conjunction with in-home residential habilitation and funded by Medicaid under the Home and Community Based Services Waiver. This funding stream provides monies for nontraditional services delivered in noncertified settings. Case managers used the Family Resource Scale to get an immediate indication of the resources and needs of each family. The scale highlights the adequacy of a person's basic and caregiving resources, as well as financial needs. The findings from this study suggest that an understanding of both disability and entitlements is essential for case managers who may have to help advocate for consumers around services and benefits. Moreover, to build and maintain an egalitarian and supportive relationship with families, the importance of caregiver-specified resources and needs must be recognized by case managers. Access to resource information and the ability to engage the family in problem-solving depends on a well-trained staff with the ability to respond to individuals with different needs and from a variety of circumstances. These essential skills prepare a case manager to assist families with their immediate requirements as well as to mobilize them to plan for future needs.

  11. Case Studies for Management Development in Bangladesh. Fourth Book. Parepared for the World Bank/Bangladesh Management Education and Training Project.

    ERIC Educational Resources Information Center

    McLean, Gary N.

    This document contains five case studies of management and finance situations in Bangladesh, which are intended to foster classroom discussion and thereby advance management development in that country. One to four discussion questions follow each case study. The titles and authors of the case studies on management are: "Azir Ahmed & Co.,…

  12. The integrated scheduling system: A case study in project management

    NASA Technical Reports Server (NTRS)

    Bishop, Peter C.; Learned, David B.; Yoes, Cissy A.

    1989-01-01

    A prototype project management system was developed for the Level III Project Office for the Space Station Freedom. The main goal was to establish a framework for the Space Station Project Office whereby Project and Office Managers can jointly establish and review scheduled milestones and activities. The objective was to assist office managers in communicating their objectives, milestones, schedules, and other project information more effectively and efficiently. Consideration of sophisticated project management systems was included, but each of the systems had limitations in meeting the stated objectives.

  13. Interdisciplinary Programs Focused Populations: The Case of Health Management Program

    ERIC Educational Resources Information Center

    Davidovitch, Nitza; Yavich, Roman

    2015-01-01

    The Ariel University has a unique interdisciplinary program in healthcare management that targets experienced healthcare professionals who wish to earn an academic degree. Only one academic study has been held so far on the integration of graduates of an academic university-level school in healthcare management in the field. In the current study,…

  14. The Management of Decline in Education: The Case of Quebec.

    ERIC Educational Resources Information Center

    Crespo, Manuel; Hache, Jean B.

    1982-01-01

    Examines the social and organizational contexts of enrollment decline in Quebec (Canada) and describes the management strategies adopted by Quebec school districts to survive within reduced budgets and to try to increase budgets. Proposes a contingency model of the districts' management strategies and discusses the strategies' consequences and…

  15. Open Source Course Management Systems: A Case Study

    ERIC Educational Resources Information Center

    Remy, Eric

    2005-01-01

    In Fall 2003, Randolph-Macon Woman's College rolled out Claroline, an Open Source course management system for all the classes on campus. This document will cover some background on both Open Source in general and course management systems in specific, discuss technical challenges in the introduction and integration of the system and give some…

  16. Change Management and Complexity: The Case for Narrative Action Research

    ERIC Educational Resources Information Center

    Boxelaar, Lucia; Paine, Mark; Beilin, Ruth

    2007-01-01

    Post-modern theorists have challenged the totalizing and unifying ambitions of change management practices. This paper explores how a narrative action research approach may be used to combine our modernist commitment to facilitate change and collaboration in the land management context with a post-modern sensitivity to complexity and difference.…

  17. The Management of Small Primary Schools: The Case of Cyprus

    ERIC Educational Resources Information Center

    Tsiakkiros, Andreas; Pashiardis, Petros

    2002-01-01

    The main goal of the present study was to investigate the perceptions of Cypriot teachers on the management of small primary schools. From the wide range of issues identified in the literature, seven areas were chosen for examination: management and leadership; teachers in small schools; advice and support; pupils in small schools; curriculum and…

  18. Diabetes Management via a Mobile Application: a Case Report

    PubMed Central

    2017-01-01

    Recently, mobile health care has been applied to manage diabetes requiring self-management. Health care by mobile applications (apps) has a great advantage when applied to patients with diabetes; the adherence to self-management activities for diabetes can be improved through mobile apps. The Food and Drug Administration (FDA) has cleared and approved the use of some mobile apps as medical devices for the management of diabetes since 2010. However, mobile apps may not be effective for all patients. We here report the effect of use of mobile-based diabetes care app (Healthy-note app) for 2 patients with diabetes, and discuss issues and strategies for effective mobile intervention. Further study is needed on improving patient's participation to increase the effect of management via a mobile app. PMID:28168183

  19. Balancing formal and informal care for older persons: how case managers respond.

    PubMed

    Peckham, Allie; Williams, A Paul; Neysmith, Sheila

    2014-06-01

    This study examined how front-line home and community-care (H&CC) case managers view the role of informal caregivers, and the factors that contribute to H&CC managers' resource allocation decisions. The study research used two methods of data collection: (a) secondary analysis of the results from balance of care (BoC) simulations conducted in nine regions of Ontario, and (b) in-depth follow-up interviews with participating BoC case managers. Results suggest that case managers unanimously agree that the unit of care in the H&CC sector is not confined to the individual, as in acute care, but encompasses both the individual and the caregiver. We found, however, considerable variation in the mix and volume of H&CC services recommended by case managers. We conclude that variability in decision making may reflect the lack of regulations, best practices, and accountability guidelines in the H&CC sector.

  20. Anesthetic management of Shah–Waardenburg syndrome: Experience of two cases and review of literature

    PubMed Central

    Ambi, Uday S.; Adarsh, E. S.; Hatti, Ramesh; Samalad, Vijaymahantesh

    2012-01-01

    Waardenburg syndrome (WS) is a rare autosomally inherited and genetically heterogeneous disorder of neural crest cell development. Literature regarding the anesthetic management of these cases is limited. We present 2 cases of Shah–Waardenburg syndrome and discuss them in the context of review of previously published cases. PMID:22754447

  1. A Randomized Controlled Trial of Consensus-Based Child Abuse Case Management

    ERIC Educational Resources Information Center

    Goldbeck, L.; Laib-Koehnemund, A.; Fegert, J. M.

    2007-01-01

    Objective: This study evaluates the effects of expert-assisted child abuse and neglect case management in the German child welfare and healthcare system as perceived by the case workers themselves. Methods: Case workers with different professions (social workers, counselors, clinic-based and office-based psychotherapists, and physicians)…

  2. Conservative Management of Invasive Placentation: Two Cases with Different Surgical Approaches.

    PubMed

    Fay, Emily E; Norquist, Barbara; Jolley, Jennifer; Hardesty, Melissa

    2016-04-01

    Background When placenta accreta complicates a delivery, the typical management is to perform a cesarean hysterectomy. Other management strategies, including leaving the placenta in situ, have been attempted and supported in some cases. This may allow for an interval hysterectomy, which can potentially decrease average blood loss and/or allow a minimally invasive approach to the hysterectomy. Cases We present two cases of women with invasive placentation managed conservatively with interval hysterectomy. One woman was managed with robotic-assisted laparoscopic surgery and the other with an open surgical approach. Conclusion These cases highlight the successful use of conservative management for invasive placentation in two stable patients and showcase the novel use of a robotic-assisted laparoscopic surgery for management of invasive placentation.

  3. Conservative Management of Invasive Placentation: Two Cases with Different Surgical Approaches

    PubMed Central

    Fay, Emily E.; Norquist, Barbara; Jolley, Jennifer; Hardesty, Melissa

    2016-01-01

    Background When placenta accreta complicates a delivery, the typical management is to perform a cesarean hysterectomy. Other management strategies, including leaving the placenta in situ, have been attempted and supported in some cases. This may allow for an interval hysterectomy, which can potentially decrease average blood loss and/or allow a minimally invasive approach to the hysterectomy. Cases We present two cases of women with invasive placentation managed conservatively with interval hysterectomy. One woman was managed with robotic-assisted laparoscopic surgery and the other with an open surgical approach. Conclusion These cases highlight the successful use of conservative management for invasive placentation in two stable patients and showcase the novel use of a robotic-assisted laparoscopic surgery for management of invasive placentation. PMID:27294007

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

    PubMed

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

    1996-01-01

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

  5. Training managers for high productivity: Guidelines and a case history

    NASA Technical Reports Server (NTRS)

    Ranftl, R. M.

    1985-01-01

    Hughes Aircrafts 13-year productivity study clearly identifies management as the key link in the entire productivity chain. This fact led to the establishment of a long-term series of seminars on personal, managerial, organizational, and operational productivity for all levels and sectors of line and staff management. To inspire the work force to higher levels of productivity and creativity management, itself, must first be inspired. In turn they have to clearly understand the productive and creative processes, fashion an effective productivity improvement plan with sound strategy and implementation, create an optimal environmental chemistry, and provide the outstanding leadership necessary to propel their organizations to achieve full potential. The primary goals of the seminars are to (1) ignite that spark of inspiration, enabling productive action to follow, (2) provide participants a credible roadmap and effective tools for implementation, and (3) develop a dedicated commitment to leadership and productivity throughout the management team.

  6. Negotiating case decisions in substance abuse managed care.

    PubMed

    Sosin, Michael R

    2002-09-01

    In substance abuse managed care, the number of treatment sessions that a provider can deliver is constrained by the policies and procedures of the specialized managed care organizations (MCOs) that typically administer the substance abuse portions of healthcare plans. Managed care organizations commonly are alleged to control treatment providers through rules, but they also might rely on a particular patterned authorization of discretion, whereby they determine when and how frequently to respond to providers' appeals of rule-based decisions. The current paper uses data from a national random sample of managed care contracts between MCOs and substance abuse providers to test the hypotheses that (1) managed care organizations' "logics" about the types of provider discretion to allow affect the rate to which they concede to appeals, and (2) the rate of conceding to appeals, in turn, affects the providers' duration of substance abuse treatment. Results from generalized linear estimation models support the hypotheses and suggest that many MCOs pattern discretion to balance strict rules with concern about the quality or cost of care. The results more generally suggest that MCOs use discretion in planned ways, and thus that the patterns of control are more complex and sophisticated than commonly described in the literatures on managed care, transaction cost economics, or other perspectives.

  7. The CCMC's national study of case manager job descriptions: an understanding of the activities, role relationships, knowledges, skills, and abilities.

    PubMed

    Tahan, Hussein A; Huber, Diane L

    2006-01-01

    Defining the roles and functions of case managers is crucial in today's healthcare environment and necessary for the case management field. One way to address this issue is through the examination of case managers' job descriptions used in various healthcare organizations. The study reported herein used qualitative analysis procedures and the latent class cluster analysis method to examine a national sample of 1028 job descriptions of case managers. The study identified the activities, role relationships, knowledge, skills, and abilities of case managers working in varied settings. It also described the changes that occurred in the practice of case management, based on these job descriptions, over 5 years: from the mid-1990s until the early 2000s. One benefit of this study was a change in one eligibility criterion of the CCM credential. Another was the development of a taxonomy of case managers' roles and functions that can be used as a step toward standardization of case managers' job descriptions.

  8. [Case management and complex chronic diseases: concepts, models, evidence and uncertainties].

    PubMed

    Morales-Asencio, José Miguel

    2014-01-01

    Chronic diseases are the greatest challenge for Health Care, but the conventional health care models have failed noticeably. Nurses are one of the main providers of the services developed to tackle this challenge, with special emphasis on case management, as one of the most common forms. But, one of the key problems is that case management is poorly conceptualized, and with the diversity of experience available, make its development and comparative evaluation difficult. An in-depth review on case management definition and concepts is presented in this article, with a description of the models, ingredients and the effectiveness reported in various studies. The remaining uncertainties in case management, such as the heterogeneity of designs and target populations, the weak description of the components, and the scarce use of research models for complex interventions, are also discussed. Finally, some key factors for a successful implementation of case management are detailed, such as a clear definition of accountability and roles, the existence of support to guarantee the competence of case managers, the use of valid mechanisms for case finding, adjusted caseload, accessible and team-shared record systems, or the integration of health and social services.

  9. 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.

  10. Environmental and habitat management: the case of Ethiopia and Ghana.

    PubMed

    Kidane-Mariam, Tadesse

    2003-03-01

    This article examines the environment and habitat management experiences of Ethiopia and Ghana in the postindependence period (1960-2000). Based on extensive archival research, semistructured focused interviews of environment and habitat officers of the World Bank, the United Nations System and the International Union for the Conservation of Nature (IUCN) and personal professional field experiences, the paper argues that the uncritical adoption of externally generated discourses, narratives, policy guidelines, and strategies of environmental and habitat management has structured thought and action in both countries. The experience of both countries in defining and responding to environmental and human settlement management is explored from a political ecology perspective. The analysis indicates that both countries have essentially adopted a technocratic, state-centered, and unsustainable management strategy framework based on population control, poverty reduction, sustainable development, and capacity-building. It also suggests that international organizations such as the World Bank, INCN, and the United Nations system have been important sources of thought and action in both countries. Conversely, regional international organizations such as the Economic Commission for Africa, the Organization of African Unity and the African Development Bank have largely served as conduits for the diffusion of global discourses, narratives, policies and strategies. The need for adopting management policies and strategies that are based on principles of multiple engagement, decentralization, incentives, public education, and participation is underscored.

  11. Interim Evaluation of the Pilot Program of the Truancy Case Management Partnership Intervention in the District of Columbia

    ERIC Educational Resources Information Center

    Liberman, Akiva; Cahill, Meagan; Cramer, Lindsey

    2012-01-01

    The Case Management Partnership Initiative (CMPI) addresses chronic truancy by linking truant ninth graders and their families to social services and case management, along with regular interagency case management meetings. A pilot was conducted at Anacostia and Ballou High Schools in 2011-2012. The implementation evaluation found that the pilot…

  12. Medical waste management in China: a case study of Nanjing.

    PubMed

    Yong, Zhang; Gang, Xiao; Guanxing, Wang; Tao, Zhou; Dawei, Jiang

    2009-04-01

    Medical waste management is of great importance due to its infectious and hazardous nature that can cause undesirable effects on humans and the environment. The objective of this study was to analyze and evaluate the present status of medical waste management in the light of medical waste control regulations in Nanjing. A comprehensive inspection survey was conducted for 15 hospitals, 3 disposal companies and 200 patients. Field visits and a questionnaire survey method were implemented to collect information regarding different medical waste management aspects, including medical waste generation, segregation and collection, storage, training and education, transportation, disposal, and public awareness. The results indicated that the medical waste generation rate ranges from 0.5 to 0.8 kg/bed day with a weighted average of 0.68 kg/bed day. The segregated collection of various types of medical waste has been conducted in 73% of the hospitals, but 20% of the hospitals still use unqualified staff for medical waste collection, and 93.3% of the hospitals have temporary storage areas. Additionally, 93.3% of the hospitals have provided training for staff; however, only 20% of the hospitals have ongoing training and education. It was found that the centralized disposal system has been constructed based on incineration technology, and the disposal cost of medical waste is about 580 US$/ton. The results also suggested that there is not sufficient public understanding of medical waste management, and 77% of respondents think medical waste management is an important factor in selecting hospital services. The problematic areas of medical waste management in Nanjing are addressed by proposing some recommendations that will ensure that potential health and environmental risks of medical waste are minimized.

  13. Consumer and case manager perspectives of service empowerment: relationship to mental health recovery.

    PubMed

    Crane-Ross, Dushka; Lutz, Wilma J; Roth, Dee

    2006-04-01

    This study examines the relationship between service empowerment and recovery. Service empowerment is defined as the extent to which consumers participate in service decisions and the level of reciprocity and respect within the relationship with their case managers. Assessments were made from two perspectives: consumers and their case managers. Structural equation models were developed to examine the direct and indirect effects of service empowerment on four recovery outcomes: Quality of Life, Level of Functioning, Consumer-Reported Symptomatology, and Case Manager-Reported Symptomatology. Consumers' perceptions of service empowerment were the most powerful predictor of recovery outcomes across the four models. Consumers' and case managers' perceptions were related but the magnitude of the relationship was small, indicating that considerable differences exist between their perceptions of service empowerment.

  14. Surgical Management of Stuttering Ischemic Priapism: A Case Report and Concise Clinical Review

    PubMed Central

    Raslan, M.; Hiew, K.; Hoyle, A.; Ross, D.G.; Betts, C.D.; Maddineni, S.B.

    2016-01-01

    Stuttering priapism is an extremely rare and poorly understood entity. We present a rare case of a 47-year-old Afro-Caribbean gentleman who required proximal shunt procedure to treat his ischemic stuttering priapism after he had failed medical management. We provided a concise review of the literature on the surgical management of ischemic priapism. This case highlighted the importance of prompt surgical intervention in prolonged stuttering priapism to avoid serious psychological and functional complications. PMID:26977408

  15. A disease management case study in infectious disease.

    PubMed

    Wert, S M

    1996-01-01

    One of the earliest attempts at risk sharing between a managed-care organization and a pharmaceutical company is the infectious disease management program developed since late 1993 by Intergroup of Arizona and Eli Lilly and Company (Indianapolis, Indiana) in conjunction with the Center for Pharmaceutical Economics at The University of Arizona (Tucson, Arizona) and other entities. In the first phase of the program, protocols were built around eight infectious disease states, and it was recognized that second-line antibiotics were often prescribed when more economical first-line antibiotics would be equally effective. The second phase of the program emphasized developing treatment algorithms focused on patient outcomes, using merged medical and pharmacy claims databases to determine the effects of the antibiotic changes. To implement the program successfully, some significant shifts in corporate, medical, and patient mind-sets had to be addressed. A primary goal was to encourage a movement from a rebate, volume-driven, cost structure to a shared-risk, appropriate-use, reimbursement method in which both managed-care and the pharmaceutical company incentives could mesh as far as possible. Over the long term, it is hoped that this project will lay the groundwork for other disease management programs for high-impact, frequently occurring diseases.

  16. The endovascular management of a neurofibromatosis vasculopathy: a case report.

    PubMed

    Choong, Andrew; Alagaratnam, Swethan; Suliman, Samir; Gikas, Panagiotis; Briggs, Timothy; Loh, Alexander; Lotzof, Kevin

    2012-10-01

    We describe the management of a 30-year-old male with type I neurofibromatosis who required an above-knee amputation for bleeding, infection, swelling, and multiple severe joint instability. Postoperatively, he continued to bleed from the stump site. Angiography revealed multiple small distal bleeding aneurysms. Hemostasis was eventually achieved with standard microcoil embolization.

  17. Human Performance Technology and Knowledge Management: A Case Study

    ERIC Educational Resources Information Center

    Massey, Anne P.; Montoya-Weiss, Mitzi M.; O'Driscoll, Tony M.

    2005-01-01

    As organizations respond to competitive environments and strive to enhance performance, knowledge management (KM) has increasingly become a strategic activity. A KM strategy entails consciously helping people share and put knowledge into action. A key challenge is how to develop and implement KM solutions that provide performance support to…

  18. Time Management in Higher Education Administration: A Case Study

    ERIC Educational Resources Information Center

    Lewis, Darrell R.; Dahl, Tor

    1976-01-01

    Drawing on data from a staff development project for administrators in a college at a major American university, it was determined that there is considerable commonality across individuals and that it is possible to deal with such issues as time management, job stress, and enjoyment on an organizational level. (Editor/JT)

  19. The Art of Strategic Management: A Case-Based Exercise

    ERIC Educational Resources Information Center

    Maranville, Steven

    2011-01-01

    This article contends that the strategic thinking process is composed of two joint, but paradigmatically distinct, activities--analysis and synthesis. Analysis represents the scientific paradigm, whereas synthesis represents the artistic paradigm. Nevertheless, the Strategic Management course is dominated by the scientific paradigm, even though…

  20. Time Management in Higher Education Administration: A Case Study.

    ERIC Educational Resources Information Center

    Lewis, Darrell R.; Dahl, Tor

    How do departmental chairpersons and deans in a major university setting manage their time? What are the major administrative activities and functions associated with such responsibilities? What relationships do these have with an ability to delegate, to control one's time for planning and self-initiated activities, or personal sense of…

  1. Improving Computer Literacy of Business Management Majors: A Case Study

    ERIC Educational Resources Information Center

    Johnson, David W.; Bartholomew, Kimberly W.; Miller, Duane

    2006-01-01

    Stakeholders, such as future employers, parents, and educators, have raised their expectations of college graduates in the area of computer literacy. Computer skills and understanding are especially critical for business management graduates, who are expected to use computer technology as a tool in every aspect of their career. Business students…

  2. Strategies Nurse Managers Used to Offset Challenges during Electronic Medical Records Implementation: A Case Study

    ERIC Educational Resources Information Center

    Easterling, Latasha

    2015-01-01

    The purpose of this qualitative, descriptive case study was to discover successful approaches used, by nurse managers, to reduce barriers during the implementation of electronic medical record system in one hospital. Fourteen nurse managers were interviewed from an academic health science center in Mississippi. A pilot study was conducted to…

  3. Balancing Macro- and Micro-Sociolinguistic Perspectives in Language Management: The Case of Singapore.

    ERIC Educational Resources Information Center

    Kuo, Eddie C. Y.; Jernudd, Bjorn H.

    1993-01-01

    Shows how both macro- and microsociolinguistic perspectives are necessary to explain national language management. Macrolevel language planning is motivated by tasks of national consolidation by the state, notably in Singapore's case tasks of socio-ethnic integration and economic development. Microlevel language management pertains to individuals'…

  4. Water Resources Management in the Lerma-Chapala Basin, Mexico: A Case Study

    ERIC Educational Resources Information Center

    Villamagna, Amy M.; Murphy, Brian R.

    2008-01-01

    Water resources have become an increasingly important topic of discussion in natural resources and environmental management courses. To address the need for more critical thinking in the classroom and to provide an active learning experience for undergraduate students, we present a case study based on water competition and management in the…

  5. Exploring Weight Management Recommendations across Australian Community Pharmacies Using Case Vignettes

    ERIC Educational Resources Information Center

    Fakih, Souhiela; Marriott, Jennifer L.; Hussainy, Safeera Y.

    2014-01-01

    With the increase in the overweight and obese population, it is critical that pharmacy staff are able to provide weight management advice to women at different stages of their life. This study utilized case vignettes to identify pharmacists' and pharmacy assistants' current weight management recommendations to women of different ages, life stages…

  6. Reflections on Case Management in Youth Support Using a Program Example

    ERIC Educational Resources Information Center

    Kennedy, Rosemary; Kennedy, Barry

    2010-01-01

    Using Moxley's (1997) program development framework as an agenda for a dialogue that juxtaposes an academic perspective with that of a seasoned youth program manager, this paper focuses on the relatively unexplored terrain of case management programs. In doing so, it exposes the convergences and divergences between academic and program manager…

  7. A Case Study of Classroom Management Practices and the Influence on Classroom Disruptions

    ERIC Educational Resources Information Center

    Rusk, Robert Brian

    2016-01-01

    This qualitative case study explored how the classroom management practices of sampled teachers in a private school in central Oregon influenced classroom disruptions. Through the study, the researcher was able to provide insight on the differences in specific classroom management processes between teachers who had a high number of Positive…

  8. Teaching Natural Resource Management-Teaching Techniques and Difficulties in Greek Vocational Lyceum: A Case Study

    ERIC Educational Resources Information Center

    Koutsoukos, Marios; Mouratidis, Antonios

    2016-01-01

    The aim of the present study is to investigate the teaching techniques applied, as well as the difficulties, with which educators in teaching Natural Resource Management are confronted. For research purposes, a case study was conducted on teaching Natural Resource Management in the Third Grade of Vocational Lyceum (EPAL) in Northern Greece. It was…

  9. Knowledge Management and the Practice of Knowledge Sharing and Learning at Work: A Case Study

    ERIC Educational Resources Information Center

    Elmholdt, Claus

    2004-01-01

    This article offers a critique of knowledge management. The critique is empirically based on the case study of a Danish software production company's (A-Soft) knowledge management strategy of implementing an information technology (IT) tool known as 'knowledge centre' (KC). The article argues: (1) the discourses on knowledge and learning informing…

  10. Developing Teacher Leadership and the Management Team Concept: A Case Study.

    ERIC Educational Resources Information Center

    Whitaker, Kathryn S.

    1997-01-01

    Presents findings of a case study that examined the use of teacher leaders on an elementary school management team and perceptions of teachers and staff members. Team members were positive about using teacher leaders on a management team but found a need for clearer definitions of leadership roles and better communication between the staff and…

  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. Conservative Management of Retained Cardiac Missiles: Case Report and Literature Review

    DTIC Science & Technology

    2009-08-01

    for their management cannot be made. Exploration with treatment of the cardiac injury is war- ranted in the patient that presents with hemorrhage, great...thoracotomy or median sternotomy to identify and manage associated injuries. An uncommon situation exists when a patient suffers a penetrating injury that...case of successful nonoperative management of an RCM diagnosed in a patient 1 week after a mortar blast injury and provide an updated review of the

  13. Development and pilot of Case Manager: a virtual-patient experience for veterinary students.

    PubMed

    Byron, Julie K; Johnson, Susan E; Allen, L Clare V; Brilmyer, Cheryl; Griffiths, Robert P

    2014-01-01

    There is an increasing demand in veterinary education to engage students, teach and reinforce clinical reasoning, and provide access anytime/anywhere to quality learning opportunities. In addition, accrediting bodies are asking for more concrete documentation of essential clinical-skills outcomes. Unfortunately, during the clinical year in a referral hospital setting, students are at the mercy of chance regarding the types of cases they will encounter and the opportunities they will have to participate. Patient- and case-simulation technology is becoming more popular as a way to achieve these objectives in human and veterinary medical education. Many of the current options available to the veterinary medical education community to develop virtual-patient cases are too time-consuming, cost prohibitive, or difficult for the instructor or learner to use. In response, we developed a learning tool, Case Manager, which is low-cost and user-friendly. Case Manager was designed to meet the demands of veterinary education by providing students with an opportunity to cultivate clinical reasoning skills and allowing for real-time student feedback. We launched a pilot test with 37 senior veterinary medical students as part of their Small Animal Internal Medicine clinical rotation. Students reported that Case Manager increased their engagement with the material, improved diagnostic and problem-solving skills, and broadened their exposure to a variety of cases. In addition, students felt that Case Manager was superior to a more traditional, less interactive case presentation format.

  14. [Management of uterine fibromas. Report of 219 cases].

    PubMed

    Mahbouli, S; Messaoudi, Y; Chandoul, Y; Zayene, H; Messaoudi, F; Basly, M; Messaoudi, L; Chibani, M; Rachdi, R

    2001-10-01

    This study is about 219 uterine fibroma treated surgically between 1994 and 1998. The surgical operation represent 19.1% of the gynecological interventions. The average age of our patients was of 41.7 years with 30.6% of nulliparous. The main motives of consultation were: the confusion of the menstrual cycle in 56.6%, the pelvic pains in 32%, the increase of the volume of the belly in 10% and the infertility in 10% of cases. The surgical indications were dominated by the big size of the womb in 68% of cases and hemorrhagic complications in 57.7% of cases. The myomectomy indicated for women young and avid for pregnancy was realized in 94 cases; 80.8% by abdominal way, 13.8% by hysteroscopic way and 5.3% by coelioscopy. Hysterectomy proposed for women near menopauses was realized in 125 cases: 70.4% by abdominal way and 29.6% by vaginal way. The complications per- and post-operating are rare, represented essentially by the bleeding and the urinary infections.

  15. Case Studies for Management Development in Bangladesh. Third Book. Prepared for the World Bank/Bangladesh Management Education and Training Project.

    ERIC Educational Resources Information Center

    McLean, Gary N.

    This document contains 10 case studies of management situations in Bangladesh, which are intended to foster classroom discussion and thereby advance management development in that country. Two to four discussion questions follow each case study. Three case studies on the subject of pay and compensation were prepared by Abu Hossain Siddique; the…

  16. A Case of Pediatric Q Fever Osteomyelitis Managed Without Antibiotics.

    PubMed

    Khatami, Ameneh; Sparks, Rebecca T; Marais, Ben J

    2015-12-01

    Q fever osteomyelitis, caused by infection with Coxiella burnetti, is rare but should be included in the differential diagnosis of children with culture-negative osteomyelitis, particularly if there is a history of contact with farm animals, and/or granulomatous change on histologic examination of a bone biopsy specimen. We describe a case of Q fever osteomyelitis in a 6-year-old boy in which a decision was made not to treat the patient with combination antimicrobial agents, balancing possible risks of recurrence against potential side effects of prolonged antibiotic treatment. The patient had undergone surgical debridement of a single lesion and was completely asymptomatic after recovery from surgery. This case suggests that a conservative approach of watchful waiting in an asymptomatic patient with chronic Q fever osteomyelitis may be warranted in select cases when close follow-up is possible.

  17. Case seven. Managing mature operations in a competitive environment.

    PubMed

    Taylor, J D

    1990-01-01

    In this case, a medical center learns how to evaluate each of its services along a Product Life Cycle curve. Each stage of the cycle has characteristics that suggest appropriate strategic growth and action orientations. When services were plotted along the Product Life Cycle curve, many of the services were found to be mature or making the transition from growth to maturity. At the time of the case, Memorial Medical Center's competitors were entering many of its traditional markets creating a strong competition for market share. Greater competitive emphasis on performance and price reduced profits in the medical center's mature services. The case reports the medical center's approach to modifying its action orientation in light of a better understanding of organizational competence.

  18. Laboratory Management of Drug-Facilitated Sexual Assault Cases.

    PubMed

    LeBeau, M A

    2010-01-01

    Over the past two decades, cases of drug-facilitated sexual assaults (DFSA) have increased in forensic laboratories in many parts of the world. Investigators of DFSA allegations know of the many challenges associated with these cases, but forensic toxicologists find that delays in the reporting of such crimes to law enforcement and subsequent lags in specimen collection are particularly important concerns. These delays are usually a result of the traumatic experience of sexual assaults, as well as the amnesic effect of the drugs typically used to commit DFSA. Unfortunately, such a delay in specimen collection may be the difference between detecting traces of a drug (or metabolite) and reporting a negative result. Therefore, it is imperative for toxicology laboratories to properly prepare for DFSA cases by developing forms, policies, and procedures to ensure that truly meaningful analyses are performed. This article provides guidance in the steps laboratories may take to best prepare themselves to analyze evidentiary specimens from DFSA investigations.

  19. Training evaluation: a case study of training Iranian health managers

    PubMed Central

    Omar, Maye; Gerein, Nancy; Tarin, Ehsanullah; Butcher, Christopher; Pearson, Stephen; Heidari, Gholamreza

    2009-01-01

    Background The Ministry of Health and Medical Education in the Islamic Republic of Iran has undertaken a reform of its health system, in which-lower level managers are given new roles and responsibilities in a decentralized system. To support these efforts, a United Kingdom-based university was contracted by the World Health Organization to design a series of courses for health managers and trainers. This process was also intended to develop the capacity of the National Public Health Management Centre in Tabriz, Iran, to enable it to organize relevant short courses in health management on a continuing basis. A total of seven short training courses were implemented, three in the United Kingdom and four in Tabriz, with 35 participants. A detailed evaluation of the courses was undertaken to guide future development of the training programmes. Methods The Kirkpatrick framework for evaluation of training was used to measure participants' reactions, learning, application to the job, and to a lesser extent, organizational impact. Particular emphasis was put on application of learning to the participants' job. A structured questionnaire was administered to 23 participants, out of 35, between one and 13 months after they had attended the courses. Respondents, like the training course participants, were predominantly from provincial universities, with both health system and academic responsibilities. Interviews with key informants and ex-trainees provided supplemental information, especially on organizational impact. Results Participants' preferred interactive methods for learning about health planning and management. They found the course content to be relevant, but with an overemphasis on theory compared to practical, locally-specific information. In terms of application of learning to their jobs, participants found specific information and skills to be most useful, such as health systems research and group work/problem solving. The least useful areas were those that dealt

  20. Cavernous Hemangioma of Tongue: Management of Two Cases

    PubMed Central

    Puppala, Niharika; Deshmukh, Sudhanwa N; B, Jagadesh; S, Anuradha

    2014-01-01

    Hemangiomas are benign tumours of infancy and childhood, most commonly located in the head and neck region and occur more frequently in the lips, tongue and palate. The treatment depends upon lesion location, size and evolution stage and the patient’s age. This paper describes the management of cavernous hemangioma in a 2 -year -old child and 14 -year -old child using different approaches. PMID:25478463

  1. Identification and management of filament-wound case stiffness parameters

    NASA Technical Reports Server (NTRS)

    Verderaime, V.; Rheinfurth, M.

    1983-01-01

    The high specific strength and the high specific modules made graphite epoxy laminate an expedient material substitute for the Shuttle Solid Rocket Motor steel case to substantially increase the payload performance without increasing the composite case axial growth during thrust build up which was constrained to minimize liftoff excitation effects on existing structural elements and interfaces. Parameters associated with axial growth were identified for quality and manufacturing controls. Included is an innovative method for experimentally verifying extensional elastic properties on a laminate pressurized test bottle.

  2. Municipal Solid Waste Management in Kadapa Town: A Case Study.

    PubMed

    Sumithra, S; Sunitha, V; Nagaraju, G

    2014-01-01

    Solid waste management (SWM) is a worldwide phenomenon. It is a big challenge all over the world for human beings. The problem of municipal solid waste management (MSWM) is also prevailing in the environment of Kadapa town in India. Therefore, the present study was undertaken to find out the problems and prospects of municipal solid waste in Kadapa town. A detailed investigation was made regarding the methods of practices associated with sources, quantity generated, collection, transportation, storage, treatment and disposal of municipal solid waste in the study area. The data related to SWM in the study area was obtained through questionnaire, individual field visits, interaction with people and authentic record of municipal corporation. Status of the MSW in Kadapa town was studied. The results indicated that the major constituents of municipal solid waste were organic in nature and approximately one fourth of municipal solid waste was recyclable. Detailed data on solid waste management practices, including collection, recovery and disposal method, has been presented in this paper.

  3. Medical waste management in Turkey: A case study of Istanbul.

    PubMed

    Birpinar, Mehmet Emin; Bilgili, Mehmet Sinan; Erdoğan, Tuğba

    2009-01-01

    The objective of this study was to analyze the present status of medical waste management in the light of the Medical Waste Control Regulation (MWCR) in Istanbul, the largest city in Turkey. About 17% of the hospitals, 20% of bed capacity, and 54% of private hospitals in Turkey are located in Istanbul. The first regulation about medical waste management in Turkey was published in 1993, and as a candidate state, it was changed in 2005 in accordance with EU Environmental Directives. In this work, a survey of 14 questions about the amount, collection, and temporary storage of medical wastes was applied to 192 hospitals in Istanbul through face-to-face interviews. It was found that the estimated quantity of medical waste from the hospitals is about 22tons/day and the average generation rate is 0.63kg/bed-day. Recyclable materials are collected separately at a rate of 83%. Separate collection of different types of wastes is consistently practiced, but 25% of the hospitals still use inappropriate containers for medical waste collection. Almost 77% of the hospitals use appropriate equipment for the medical waste collection personnel. The percentage of the hospitals that have temporary storage depots is 63%. Medical waste management in Istanbul is carried out by applying the MWCR.

  4. Teaching and Learning about Managing People: Human Resource Management for Education Settings--A Queensland Case.

    ERIC Educational Resources Information Center

    McCrea, Nadine L.; Ehrich, Lisa C.

    1996-01-01

    Describes the development of a human resource management (HRM) elective for educators aspiring to management positions in various educational settings. The unit is part of a graduate diploma offered within the Faculty of Education at one Australian university. The paper argues the necessity of HRM studies in postgraduate education courses. (SM)

  5. Gaps in Management Education: A Case Study of University of Management and Technology

    ERIC Educational Resources Information Center

    Abdur-Raouf; Kalim, Rukhsana; Siddiqi, Ahmed F.

    2010-01-01

    This paper aims to identify the gaps in management education highlighted by 3 primary stakeholders: students, faculty and alumni. The study tries to address the issue of relevance and compatibility of management education and investigates areas of improvement perceived by respondents. The paper assumes that business departments of universities…

  6. A case of malignant hyperthermia captured by an anesthesia information management system.

    PubMed

    Maile, Michael D; Patel, Rajesh A; Blum, James M; Tremper, Kevin K

    2011-04-01

    Many cases of malignant hyperthermia triggered by volatile anesthetic agents have been described. However, to our knowledge, there has not been a report describing the precise changes in physiologic data of a human suffering from this process. Here we describe a case of malignant hyperthermia in which monitoring information was frequently and accurately captured by an anesthesia information management system.

  7. Diffusion of Innovation: A Case Study of Course Management System Adoption

    ERIC Educational Resources Information Center

    Powell, Phillip, Ed.D.

    2008-01-01

    The purpose of this study was to examine the processes of evaluation, selection, adoption and diffusion of a course management system (CMS). This study incorporated a cross-case analysis using a multiple case study approach, which included two institutions, each having six participants. The participants were placed into three categories: faculty,…

  8. Learning from Action Evaluation of the Use of Multimedia Case Studies in Management Information Systems Courses

    ERIC Educational Resources Information Center

    Kawulich, Barbara B.

    2011-01-01

    This manuscript shares lessons learned from conducting an action evaluation of the use of multimedia case studies in Management Information Systems (MIS) courses. Three undergraduate MIS classes took part in the study. The purpose for using case studies in these classes was to teach students about the role of MIS in business. An action evaluation…

  9. Examining Preservice Teachers' Classroom Management Decisions in Three Case-Based Teaching Approaches

    ERIC Educational Resources Information Center

    Demiraslan-Çevik, Yasemin; Andre, Thomas

    2013-01-01

    This study was aimed at comparing the impact of three types of case-based approaches (worked example, faded work example, and case-based reasoning) on preservice teachers' decision making and reasoning skills related to realistic classroom management situations. Participants in this study received a short-term implementation of one of these three…

  10. Woven Coronary Artery Disease Successfully Managed with Percutaneous Coronary Intervention: A New Case Report.

    PubMed

    Alsancak, Yakup; Sezenoz, Burak; Turkoglu, Sedat; Abacı, Adnan

    2015-01-01

    Woven coronary artery is relatively rare and can be complicated in both acute and chronic phases. A few case reports have been published until now. Herein we report a case with right woven coronary artery managed with drug-eluted stent implantation without complication.

  11. Turning a hazardous waste lagoon into reclaimed land for wildlife management: A case study

    SciTech Connect

    Leong, A.K.

    1996-12-31

    Brownfields are turning back to green. This paper presents a case study of a former dump site for hazardous waste that has been remediated and will be developed into an enhanced wildlife management habitat. This successful remediation case combined various investigations, remedial designs, risk assessments, ecological studies, and engineering practices. 3 refs., 1 fig., 1 tab.

  12. Christ Siemens Touraine syndrome: Two case reports and felicitous approaches to prosthetic management.

    PubMed

    Renahan, Navanith; Raj, Renju; Varma, R Balagopal; Kumar, J Suresh

    2015-01-01

    Ectodermal dysplasia is a heterogeneous group of inherited disorders, which exhibit a classic triad of hypohydrosis, hypotrichosis, and hypodontia. Hypohidrotic or anhidrotic ectodermal dysplasia or Christ Siemens Touraine syndrome is the most common condition among ectodermal dysplasia patients. This is a case report on two Christ Siemens Touraine syndrome cases and two different approaches to prosthetic management.

  13. Productivity and Job Security: Case Studies of Continuing Education for Engineers, Technicians, and Managers.

    ERIC Educational Resources Information Center

    Belitsky, A. Harvey

    This report, the third in a series on productivity and job security, presents three case studies which detail various forms of continuing education and training. Four important factors in the cases are identified: employment stability, management support for training, adaptation to changing job requirements, and training evaluation. The first case…

  14. Use of Case Study Methods in Human Resource Management, Development, and Training Courses: Strategies and Techniques

    ERIC Educational Resources Information Center

    Maxwell, James R.; Gilberti, Anthony F.; Mupinga, Davison M.

    2006-01-01

    This paper will study some of the problems associated with case studies and make recommendations using standard and innovative methodologies effectively. Human resource management (HRM) and resource development cases provide context for analysis and decision-making designs in different industries. In most HRM development and training courses…

  15. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What case management responsibilities does the social services worker have? 20.318 Section 20.318 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case...

  16. True and False Allegations of Child Sexual Abuse: Assessment and Case Management.

    ERIC Educational Resources Information Center

    Ney, Tara, Ed.

    This book addresses the clinical, legal, and ethical issues arising in child sexual abuse cases; the assessment and case management of allegations; research issues; and practice recommendations. Chapter titles are as follows: "Assessing Allegations in Child Sexual Abuse: An Overview" (Tara Ney); "The Nature of Allegations of Child…

  17. [Integral approach by the case manager and the community nurse to a complex case of diabetes mellitus in the home].

    PubMed

    Prats-Guardiola, Marta; López-Pisa, Rosa María

    2010-01-01

    We present the case of a patient with long-term and clinically complex Diabetes Mellitus. She was taking part in the home care program in Primary Care. The complications of her DM affected her quality of life: blindness, kidney failure, treated with hemodialysis, and a cerebrovascular attack. We describe the evaluation following Virginia's Henderson model. This evaluation was made in the patient's home after she was discharged from the socio-health centre where she was admitted as her right leg was amputated at a supracondylar level. It was designed a care plan between the community nurse and the case manager using NANDA, NOC and NIC taxonomy. The care plan was carried out as a joint effort between the community nurse and the case manager who coordinated the planning with the rest of professionals. Results were evaluated 6 months after the initial assessment. This case, which had a high dependence and a high clinical complexity, required a multidisciplinary approach and the integration of different professionals, services and institutions to implement the patient's treatment. Because of all the above, it is important to mention the case management function to guarantee continuity, and overall and integrated care.

  18. Challenges in the management of a case of tuberous sclerosis

    PubMed Central

    Rathi, Anubhav; Bhatia, Manjeet Singh; Jhanjee, Anurag

    2012-01-01

    Tuberous sclerosis complex is a multi-system disorder with autosomal dominant inheritance, which can affect the brain, heart, skin, kidneys, lungs, and retina. We hereby report therapeutic challenges faced in a case of an adolescent male suffering from tuberous sclerosis. PMID:24250049

  19. Dilemmas in Managing Pregnant Women With Ebola: 2 Case Reports.

    PubMed

    Caluwaerts, Séverine; Fautsch, Tessy; Lagrou, Daphne; Moreau, Michel; Modet Camara, Alseny; Günther, Stephan; Di Caro, Antonino; Borremans, Benny; Raymond Koundouno, Fara; Akoi Bore, Joseph; Logue, Christopher H; Richter, Martin; Wölfel, Roman; Kuisma, Eeva; Kurth, Andreas; Thomas, Stephen; Burkhardt, Gillian; Erland, Elin; Lionetto, Fanshen; Lledo Weber, Patricia; de la Rosa, Olimpia; Macpherson, Hassan; Van Herp, Michel

    2016-04-01

    We report 2 cases of Ebola viral disease (EVD) in pregnant women who survived, initially with intact pregnancies. Respectively 31-32 days after negativation of the maternal blood EVD-polymerase chain reaction (PCR) both patients delivered a stillborn fetus with persistent EVD-PCR amniotic fluid positivity.

  20. A Case of Diprosopus: Perinatal Counseling and Management

    PubMed Central

    Thornton, Kimberly M.; Bennett, Timothy; Singh, Vivekanand; Mardis, Neil; Linebarger, Jennifer; Kilbride, Howard; Voos, Kristin

    2014-01-01

    Diprosopus is a rare congenital malformation associated with high mortality. Here, we describe a patient with diprosopus, multiple life-threatening anomalies, and genetic mutations. Prenatal diagnosis and counseling made a beneficial impact on the family and medical providers in the care of this case. PMID:25254133

  1. Management of critically ill surgical patients Case reports.

    PubMed

    Mangiante, Gerardo; Padoan, Roberto; Mengardo, Valentina; Bencivenga, Maria; de Manzoni, Giovanni

    2016-01-01

    The acute abdomen (AA) still remains a challenging situation for surgeons. New pathological conditions have been imposed to our attention in this field in recent years. The definition of abdominal compartmental syndrome (ACS) in surgical practice and the introduction of new biological matrices, with the concepts of tension-free (TS) repair of incisional hernias, prompted us to set up new therapeutic strategies for the treatment of patients with AA. Thus we reviewed the cases of AA that we observed in recent years in which we performed a laparostomy in order to prevent or to treat an ACS. They are all cases of acute abdomen (AA), but from different origin, including chronic diseases, as in the course of inflammatory bowel disease (IBD), and acute pancreatitis. In all the cases, the open abdominal cavity was covered with a polyethylene sheet. The edges of the wound were sutured to the plastic sheet, and a traction exerted by a device that causes a negative pressure was added. This method was adopted in several cases without randomization, and resulted in excellent patient's outcomes.

  2. Case-Based Modeling for Learning Management and Interpersonal Skills

    ERIC Educational Resources Information Center

    Lyons, Paul

    2008-01-01

    This article offers an introduction to case-based modeling (CBM) and a demonstration of the efficacy of this instructional model. CBM is grounded primarily in the concepts and theory of experiential learning, augmented by concepts of script creation. Although it is labor intensive, the model is one that has value for instruction in various…

  3. Secondary School Art: A Case for Increased Senior Management Support

    ERIC Educational Resources Information Center

    Etherington, Margaret

    2015-01-01

    This case study explores the way that school art in England remains a marginalised subject at secondary level, despite the expansion of art-based career opportunities. A recent government document evaluating art, craft and design education highlights the potential role of head teachers in raising an art department's profile. The current study…

  4. Medical management of cerebellar abscess: a case report and review of the literature.

    PubMed

    Turner, Ryan C; Dodson, Sean C; Rosen, Charles L

    2011-01-01

    A large abscess of the posterior fossa often warrants surgical intervention. We report a case of a 50-year-old male presenting with a cerebellar abscess measuring 2.8 cm x 1.6 cm located in the left cerebellar hemisphere at the level of the middle cerebellar peduncle that was treated conservatively and successfully with antibiotics. Therapeutic management options are discussed in regards to this case specifically as well as a review of the literature. This case illustrates the successful medical management of a cerebellar abscess of otogenic origin in an adult, a unique result in terms of abscess size and age of the patient.

  5. Building the case for asthma as a disease management program.

    PubMed

    Eisenberg, Steven S

    2004-01-01

    Asthma is a common disease that affects between 5.5% and 7.0% of the population. It is an example of a disease where good guidelines and an accepted model of treatment exist, but have not been fully implemented. In the latter part of 2000, Blue Cross Blue Shield of Minnesota (BCBSM) had existing and successful disease management (DM) programs for diabetes and heart disease and was looking to expand the concept to other diseases. Asthma was one of the conditions under consideration. This study, done in conjunction with PharMetrics, Inc. of Watertown, MA was done to establish the opportunity present to help Blue Cross members with the disease, and to help decide whether developing such a program made sense for the health plan. In addition, if the answer to the second question were yes, the study would lay the groundwork for that program. Using 2 years of BCBSM claims data, the study identified, stratified, and analyzed the cohort of BCBSM members with a diagnosis of asthma according to severity of illness, individual drug or drug combination treatment, emergency room usage, hospitalization, and total episode costs for asthma. Health plan results were bench-marked against the experience of others across the country represented in the (then) 20+ million managed care lives in PharMetrics' Integrated Outcomes Database. The results showed that in some of the recommended guidelines for asthma care BCBSM members led the nation in compliance, but that there was ample opportunity for improvement thus justifying moving forward in developing a disease management program. The results also seemed to validate many of the recommendations for asthma care expressed in the Expert Panel Report 2 on the diagnosis and treatment of asthma from the National Heart Lung and Blood Institute of the National Institutes of Health.

  6. The case for an elderly targeted stroke management.

    PubMed

    Fustinoni, Osvaldo

    2011-01-01

    Stroke is a leading cause of death and disability worldwide. The elderly, in whom atrial fibrillation (AF) is most prevalent, carry the greatest risk, undergoing more recurrent, deadlier strokes, with bigger deficits, slower recoveries, and more comorbidities. Evidence-based data on advanced age stroke management are scarce. Age-related cerebral changes might undermine the benefit of established stroke treatments. Nevertheless, the elderly should probably also undergo thrombolysis for ischemic stroke: they do not bleed more, and die not because of hemorrhage but of concomitant illnesses. Beyond natural bleeding risks, AF in advanced age has a high embolic potential if not anticoagulated. Standard or lower intensity warfarin anticoagulation prevents embolic stroke in the elderly with a hemorrhage risk even lower than aspirin. In fact, adverse effects seem to occur more often with aspirin. Excess anticoagulation hazards are prevented with lower starting doses, stricter corrections, more frequent International Normalized Ratio monitoring, and longer adjustment intervals. Validated prognostic scores such as CHADS(2) help minimize bleeds. Direct inhibitors have recently shown a benefit similar to warfarin with fewer hemorrhages. Carefully tailoring antithrombotics to this age group is therefore useful. Antihypertensives probably help 80-plus stroke patients as well, but the risk/benefit of lowering blood pressure in secondary stroke prevention at that age is uncertain. Evidence-based data on diabetes management and use of lipid-lowering drugs are still lacking in this age group. In summary, emerging data suggest that stroke management should be specifically targeted to the elderly to better prevent its devastating consequences in the population at the highest risk.

  7. The Case for an Elderly Targeted Stroke Management

    PubMed Central

    Fustinoni, Osvaldo

    2011-01-01

    Stroke is a leading cause of death and disability worldwide. The elderly, in whom atrial fibrillation (AF) is most prevalent, carry the greatest risk, undergoing more recurrent, deadlier strokes, with bigger deficits, slower recoveries, and more comorbidities. Evidence-based data on advanced age stroke management are scarce. Age-related cerebral changes might undermine the benefit of established stroke treatments. Nevertheless, the elderly should probably also undergo thrombolysis for ischemic stroke: they do not bleed more, and die not because of hemorrhage but of concomitant illnesses. Beyond natural bleeding risks, AF in advanced age has a high embolic potential if not anticoagulated. Standard or lower intensity warfarin anticoagulation prevents embolic stroke in the elderly with a hemorrhage risk even lower than aspirin. In fact, adverse effects seem to occur more often with aspirin. Excess anticoagulation hazards are prevented with lower starting doses, stricter corrections, more frequent International Normalized Ratio monitoring, and longer adjustment intervals. Validated prognostic scores such as CHADS2 help minimize bleeds. Direct inhibitors have recently shown a benefit similar to warfarin with fewer hemorrhages. Carefully tailoring antithrombotics to this age group is therefore useful. Antihypertensives probably help 80-plus stroke patients as well, but the risk/benefit of lowering blood pressure in secondary stroke prevention at that age is uncertain. Evidence-based data on diabetes management and use of lipid-lowering drugs are still lacking in this age group. In summary, emerging data suggest that stroke management should be specifically targeted to the elderly to better prevent its devastating consequences in the population at the highest risk. PMID:22232616

  8. Waste Management in the Circular Economy. The Case of Romania.

    NASA Astrophysics Data System (ADS)

    Iuga, Anca N.

    2016-11-01

    Applying the principles of sustainable development in Romania involves a new approach to ecological waste using basic concepts of circular economy to weigh accurately the proposed projects in this area taking into account existing environmental resources and zero waste objectives. The paper is focused on: quantitative and qualitative measures of waste prevention in Romania, the changing status of the waste by selling it as product, the mechanisms for paying for treatment and / or disposal which discourage waste generation and the use of financial resources obtained from secondary raw materials for the efficiency of waste management.

  9. Dental management of Parkinson's disease: a case report.

    PubMed

    Katyayan, Preeti Agarwal; Katyayan, Manish Khan; Nugala, Babitha

    2013-01-01

    Parkinson's disease is an idiopathic, slowly progressive disorder of the central nervous system characterized by resting tremor, muscular rigidity, slow and decreased movement (bradykinesia), and postural instability. Oral healthcare providers can expect to be called upon to care for patients with this progressively debilitating disease. To provide competent care to patients with Parkinson's disease, clinicians must understand the disease, its treatment and its impact on the patient's ability to undergo and respond to dental care. The successful prosthodontic management of a 74-year-old completely edentulous Parkinson's disease patient is presented, with the conclusion that a prosthodontic intervention may contribute to improvement in the quality of life of a Parkinson's disease patient.

  10. Prosthetic management of soft palate cleft--a case report.

    PubMed

    Dosumu, O O; Ogunrinde, T J; Ogundipe, O T

    2006-09-01

    The treatment of cleft in the soft palate can be achieved essentially by surgical reconstruction or prosthetic obturation. The goals of prosthetic intervention are to prevent food and liquid leakage into the nose and to improve speech intelligibility by ensuring functional velopharyngeal port closure. In this report, the prosthetic management of a 5-year-old child with soft palatal cleft is presented. The impression of the cleft was taken with tissue conditioner, Visco -gel, TM (De Trey, Amalgamated Dental London) and the pharyngeal obturator (speech bulb) was made in clear acrylic resin. Patient tolerated the appliance well and was referred to speech therapist for speech articulation.

  11. Laboratory Information Management System (LIMS): A case study

    NASA Technical Reports Server (NTRS)

    Crandall, Karen S.; Auping, Judith V.; Megargle, Robert G.

    1987-01-01

    In the late 70's, a refurbishment of the analytical laboratories serving the Materials Division at NASA Lewis Research Center was undertaken. As part of the modernization efforts, a Laboratory Information Management System (LIMS) was to be included. Preliminary studies indicated a custom-designed system as the best choice in order to satisfy all of the requirements. A scaled down version of the original design has been in operation since 1984. The LIMS, a combination of computer hardware, provides the chemical characterization laboratory with an information data base, a report generator, a user interface, and networking capabilities. This paper is an account of the processes involved in designing and implementing that LIMS.

  12. Data management for community research projects: A JGOFS case study

    NASA Technical Reports Server (NTRS)

    Lowry, Roy K.

    1992-01-01

    Since the mid 1980s, much of the marine science research effort in the United Kingdom has been focused into large scale collaborative projects involving public sector laboratories and university departments, termed Community Research Projects. Two of these, the Biogeochemical Ocean Flux Study (BOFS) and the North Sea Project incorporated large scale data collection to underpin multidisciplinary modeling efforts. The challenge of providing project data sets to support the science was met by a small team within the British Oceanographic Data Centre (BODC) operating as a topical data center. The role of the data center was to both work up the data from the ship's sensors and to combine these data with sample measurements into online databases. The working up of the data was achieved by a unique symbiosis between data center staff and project scientists. The project management, programming and data processing skills of the data center were combined with the oceanographic experience of the project communities to develop a system which has produced quality controlled, calibrated data sets from 49 research cruises in 3.5 years of operation. The data center resources required to achieve this were modest and far outweighed by the time liberated in the scientific community by the removal of the data processing burden. Two online project databases have been assembled containing a very high proportion of the data collected. As these are under the control of BODC their long term availability as part of the UK national data archive is assured. The success of the topical data center model for UK Community Research Project data management has been founded upon the strong working relationships forged between the data center and project scientists. These can only be established by frequent personal contact and hence the relatively small size of the UK has been a critical factor. However, projects covering a larger, even international scale could be successfully supported by a

  13. Method of sealing casings of subsurface materials management system

    DOEpatents

    Nickelson, Reva A.; Richardson, John G.; Kostelnik, Kevin M.; Sloan, Paul A.

    2007-02-06

    Systems, components, and methods relating to subterranean containment barriers. Laterally adjacent tubular casings having male interlock structures and multiple female interlock structures defining recesses for receiving a male interlock structure are used to create subterranean barriers for containing and treating buried waste and its effluents. The multiple female interlock structures enable the barriers to be varied around subsurface objects and to form barrier sidewalls. The barrier may be used for treating and monitoring a zone of interest.

  14. Uterocutaneous Fistula Following Cesarean Section: Successful Management of a Case

    PubMed Central

    Maddah, Ghodratollah; Fattahi, Asieh Sadat; Rahnama, Ali; Jamshidi, Shirin Taraz

    2016-01-01

    A uterocutaneous fistula is a rare clinical presentation that occurs following Cesarean section and other pelvic operations. There are only a few reports discussing the treatments. We describe a patient with successful surgical management and review the literature. A 25-year-old woman referred to our department 13 months after her first Cesarean section. She had a history of an abdominal mass and collection 2 months after surgery and some fistula opening with discharge from her previous incision. She had a previous surgical operation and antibiotic therapy without complete response. We performed fistulography to evaluate the tracts. In the operation — she had fistula tracts, one of which was between the uterus and skin. We debrided the necrotic tissue in the uterus, excised the fistula tracts, and drained the uterine cavity. At 8 months’ postoperative follow-up, she had no recurrence. A uterocutaneous fistula is a rare condition with many causes and needs proper investigation and timely medical and surgical management. PMID:26989289

  15. Ubiquitous Indoor Geolocation: a Case Study of Jewellery Management System

    NASA Astrophysics Data System (ADS)

    Nikparvar, B.; Sadeghi-Niaraki, A.; Azari, P.

    2014-10-01

    Addressing and geolocation for indoor environments are important fields of research in the recent years. The problem of finding location of objects in indoor spaces is proposed to solve in two ways. The first, is to assign coordinates to objects and second is to divide space into cells and detect the presence or absence of objects in each cell to track them. In this paper the second approach is discussed by using Radio Frequency Identification technology to identify and track high value objects in jewellery retail industry. In Ubiquitous Sensor Networks, the reactivity or proactivity of the environment are important issues. Reactive environments wait for a request to response to it. Instead, in proactive spaces, the environment acts in advance to deal with an expected action. In this research, a geo-sensor network containing RFID readers, tags, and antennas which continuously exchange radio frequency signal streams is proposed to manage and monitor jewellery galleries ubiquitously. The system is also equipped with a GIS representation which provides a more user-friendly system to manage a jewellery gallery.

  16. Interdisciplinary management of severe intrusion injuries in permanent incisors: a case series.

    PubMed

    Nazzal, H; Dhaliwal, H K; Littlewood, S J; Spencer, R J; Day, P F

    2014-11-01

    Intrusion injuries to the permanent dentition are amoung the most severe types of dental injuries, occurring in 0.3-1.9% of all dental trauma cases. The current clinical guidelines in the management of intrusion injuries are based on level B evidence due to the infrequent nature of this type of injury, coupled with a lack of high quality evidence-based studies. This paper presents four cases of severe intrusion injuries that were successfully managed using an interdisciplinary approach. The cases described here highlight the benefits of orthodontic repositioning of severely intruded teeth in the short and medium terms. Although orthodontic repositioning was unsuccessful in the final case, this did not preclude subsequent surgical repositioning. Interdisciplinary collaboration allowed two of the cases described to be effectively managed with premolar autotransplantation alongside orthodontic treatment. The cases demonstrated here indicate the difficulties in providing the current recommended treatment modalities at non-specialist clinics. They accentuate the importance of an immediate referral of such complex cases to a specialist centre where interdisciplinary management is readily available.

  17. A Case Study of Obsolescence Management Constraints During Development of Sustainment-Dominated Systems

    NASA Astrophysics Data System (ADS)

    Welch, Jonathan

    This case study focused on obsolescence management constraints that occur during development of sustainment-dominated systems. Obsolescence management constraints were explored in systems expected to last 20 years or more and that tend to use commercial off-the-shelf products. The field of obsolescence has received little study, but obsolescence has a large cost for military systems. Because developing complex systems takes an average of 3 to 8 years, and commercial off-the-shelf components are typically obsolete within 3 to 5 years, military systems are often deployed with obsolescence issues that are transferred to the sustainment community to determine solutions. The main problem addressed in the study was to identify the constraints that have caused 70% of military systems under development to be obsolete when they are delivered. The purpose of the study was to use a qualitative case study to identify constraints that interfered with obsolescence management occurring during the development stages of a program. The participants of this case study were managers, subordinates, and end-users who were logistics and obsolescence experts. Researchers largely agree that proactive obsolescence management is a lower cost solution for sustainment-dominated systems. Program managers must understand the constraints and understand the impact of not implementing proactive solutions early in the development program lifecycle. The conclusion of the study found several constraints that prevented the development program from early adoption of obsolescence management theories, specifically pro-active theories. There were three major themes identified: (a) management commitment, (b) lack of details in the statement of work, and (c) vendor management. Each major theme includes several subthemes. The recommendation is future researchers should explore two areas: (a) comparing the cost of managing obsolescence early in the development process versus the costs of managing later, (b

  18. Rh isoimmunized pregnancy managed noninvasively: A report of two cases.

    PubMed

    Jain, Deepti

    2017-01-01

    Pregnancy with Rh isoimmunization is a grave situation. Two women with indirect Coombs test (ICT) positive were managed conservatively with a favorable outcome. Peak systolic velocity (PSV) of middle cerebral artery (MCA) was measured every 2 weeks, and pregnancy continued till the value remained <1.5 mean of median. In one woman, the pregnancy could be prolonged to 37 weeks when delivery was induced and the neonate did not develop hyperbilirubinemia. In the second woman with bad obstetric history, when a highly positive ICT was reported, intravenous immunoglobulin (IVIG) was given in a single dose of 5 g every 2 weeks starting at 27 weeks, for a total of three doses, along with measurement of PSV of MCA. Labor could be prolonged to 34 weeks when preterm spontaneous delivery occurred. The neonate could be salvaged with exchange transfusion and IVIG. The neonate is healthy with normal tone and no evidence of kernicterus.

  19. Rh isoimmunized pregnancy managed noninvasively: A report of two cases

    PubMed Central

    Jain, Deepti

    2017-01-01

    Pregnancy with Rh isoimmunization is a grave situation. Two women with indirect Coombs test (ICT) positive were managed conservatively with a favorable outcome. Peak systolic velocity (PSV) of middle cerebral artery (MCA) was measured every 2 weeks, and pregnancy continued till the value remained <1.5 mean of median. In one woman, the pregnancy could be prolonged to 37 weeks when delivery was induced and the neonate did not develop hyperbilirubinemia. In the second woman with bad obstetric history, when a highly positive ICT was reported, intravenous immunoglobulin (IVIG) was given in a single dose of 5 g every 2 weeks starting at 27 weeks, for a total of three doses, along with measurement of PSV of MCA. Labor could be prolonged to 34 weeks when preterm spontaneous delivery occurred. The neonate could be salvaged with exchange transfusion and IVIG. The neonate is healthy with normal tone and no evidence of kernicterus. PMID:28251113

  20. Pain Management in Four-Limb Amputation: A Case Report.

    PubMed

    Warner, Nafisseh S; Warner, Matthew A; Moeschler, Susan M; Hoelzer, Bryan C

    2015-09-01

    Acute pain following amputation can be challenging to treat due to multiple underlying mechanisms and variable clinical responses to treatment. Furthermore, poorly controlled preoperative pain is a risk factor for developing chronic pain. Evidence suggests that epidural analgesia and peripheral nerve blockade may decrease the severity of residual limb pain and the prevalence of phantom pain after lower extremity amputation. We present the perioperative analgesic management of a patient with gangrene of the bilateral upper and lower extremities as a result of septic shock and prolonged vasopressor administration who underwent four-limb amputation in a single procedure. A multimodal analgesic regimen was utilized, including titration of preoperative opioid and neuropathic pain agents, perioperative intravenous, epidural and peripheral nerve catheter infusions, and postoperative oral medication titration. More than 8 months postoperatively, the patient has satisfactory pain control with no evidence for phantom limb pain. To our knowledge, there have been no publications to date concerning analgesic regimens in four-limb amputation.

  1. Business continuity management in emerging markets: the case of Jordan.

    PubMed

    Sawalha, Ihab H; Anchor, John R

    2012-01-01

    Despite their considerable growth in last few decades, emerging markets (EM) face numerous risks that have the potential to slow down or obstruct their development. Three main issues are discussed in this paper: first, the risks facing organisations operating in emerging markets and Jordan in particular; secondly, the role of business continuity management (BCM) in emerging markets; and thirdly, potential factors that underpin the role of BCM in emerging markets. These issues are significant, as they represent the role of BCM in highly dynamic and fast changing business environments. The paper provides a discussion of the significance of BCM in reducing or preventing risks facing organisations operating in emerging markets, especially those in Jordan.

  2. Diagnosis and management of occlusal wear: a case report.

    PubMed

    Thirumurthy, V R; Bindhoo, Y A; Jacob, Sunil Joseph; Kurien, Anjana; Limson, K S; Vidhiyasagar, P

    2013-09-01

    The rationale for doing full mouth rehabilitation are, when occlusal forces become traumatic hampering the health of periodontal tissues, extensive occlusal diseases, trauma, temporomandibular joint disease and congenital disorders with malformed dentition. Literature exposes that full mouth fixed rehabilitation is one of the taxing procedures in the field of Prosthodontics. A critical aspect for successful occlusal rehabilitation is to determine the aetiology, correct sequence of treatment and most importantly the occlusal vertical dimension and centric relation in which to plan the treatment. A systematic approach in managing these patients can lead to a predictable and favourable prognosis. This article presents the stages of prosthodontic rehabilitation, from diagnosis to final treatment and follow-up, of a bruxer patient with severely worn dentition.

  3. Managing discovery risks--A Tevatron case study

    SciTech Connect

    Bakul Banerjee

    2004-07-28

    To meet the increasing need for higher performance, Management of Fermi National Accelerator Laboratory has undertaken various projects to improve systems associated with the Tevatron high-energy particle collider located at Batavia, Illinois. One of the larger projects is the Tevatron Beam Position Monitor (BPM) system. The objective of this project is to replace the existing BPM electronics and software system that was originally installed during early 1980s, along with the original construction of the Tevatron.The original system consists of 236 beam position monitors located around the underground tunnel of the accelerator. Above ground control systems are attached to these monitors using pickup cables. When the Tevatron collider is operational, signals received from the BPMs are used to perform a number of control and diagnostic tasks. The original system can only capture the proton signals from the collider. The new system, when fully operational, will be able to capture combined proton and antiproton signals and will be able to separate the antiproton signal from the combined signal at high resolution. This significant enhancement was beyond the range of technical capabilities when the Tevatron was constructed about two decades ago. To take advantage of exceptional progress made in the hardware and software area in past two decades, Department of Energy approved funding of the BPM electronics and software replacement project. The approximate length of the project is sixteen months with a budget of four million dollars not including overhead, escalation, and contingencies. Apart from cost and schedule risks, there are two major risks associated with this research and development project. The primary risk is the risk of discovery. Since the Tevatron beam path is highly complex, BPMs have to acquire and process a large amount of data. In this environment, analysis of data to separate antiproton signals is even more complex. Finding an optimum algorithm that can

  4. Management of pharmaceutical substances in the environment: Lithuanian case study.

    PubMed

    Baranauskaitė-Fedorova, Inga; Dvarionienė, Jolanta; Nikiforov, Vladimir A

    2016-09-01

    Investigation on the sources, discharges and related risks for the environment of the pharmaceutical substance (PhS) diclofenac (DCF) was performed in Lithuania, a country of the Baltic Sea region, for the first time. The investigation only refers to DCF as a PhS for human use; emissions from animal husbandry were not considered. In the first stage of the research, the main sources and pathways of DCF via substance flow analysis were identified within the country. During the second stage, DCF flows along the wastewater treatment plants (WWTPs) in two different cities were measured in order to assess the current levels of pharmaceutical residues in the environment. Furthermore, environmental risk assessment was carried out by taking into account the parameters of consumption data and elimination rate in WWTPs. Then, the assessment of different technical and managerial removal approaches was accomplished in an environmental management model of wastewater containing PhS, based on the framework of environmental systems theory.

  5. [Hybrid management of an infectious pseudoaneurysm. Report of one case].

    PubMed

    Sagüés C, Rodrigo; Soto G, Sebastián

    2011-08-01

    We report a 61-year-old male with a four months history of progressive back pain, fever, weight loss and hematuria. A CAT scan showed a spondylitis with destruction of L1 and L2 vertebral bodies and a big pseudoaneurysm of the posterior wall of the visceral aorta. A hybrid approach was used to repair the lesion in two stages; a surgical superior mesenteric artery revascularization followed by the placement of an endovascular stent graft in the affected segment of the aorta 48 hours later, excluding the lesion from circulation. In the postoperative period, no evidence of mesenteric vascular insufficiency was detected but the patient developed a systemic inflammatory response that was managed adequately. A CAT scan performed one month later confirmed the exclusion of the pseudoaneurysm. One year after surgery, the patient is able to walk and without evidences of infection or pseudoaneurysm.

  6. Dilated cardiomyopathy in acromegaly: Case report and anesthesia management

    PubMed Central

    Nair, Abhijit S.; Nirale, Anand M.; Sriprakash, K.; Gopal, T. V. S.

    2013-01-01

    Patients who are diagnosed having acromegaly develop a lot of cardiovascular Complications such as hypertension, arrhythmias, systolic and diastolic dysfunction, valvular dysfunction and heart failure. Dilated cardiomyopathy (DCM) with systolic and diastolic dysfunction is relatively rare but is associated with an increased mortality. We report a case of acromegaly diagnosed at 52 years of age in a known diabetic, non-hypertensive male who had DCM with severe left ventricular dysfunction, global hypokinesia, moderate mitral regurgitation, and grade II diastolic dysfunction who was treated with diuretics, digitalis, and vasodilators. He was diagnosed with a growth hormone secreting pituitary macroadenoma and underwent endoscopic excision of the pituitary tumor under general anesthesia. PMID:25885996

  7. An assessment of patient education and self-management in diabetes disease management--two case studies.

    PubMed

    Fitzner, Karen; Greenwood, Deborah; Payne, Hildegarde; Thomson, John; Vukovljak, Lana; McCulloch, Amber; Specker, James E

    2008-12-01

    Diabetes affects 7.8% of Americans, nearly 24 million people, and costs $174 billion yearly. People with diabetes benefit from self-management; disease management (DM) programs are effective in managing populations with diabetes. Little has been published on the intersection of diabetes education and DM. Our hypothesis was that diabetes educators and their interventions integrate well with DM and effectively support providers' care delivery. A literature review was conducted for papers published within the past 3 years and identified using the search terms "diabetes educator" and "disease management." Those that primarily addressed community health workers or the primary care/community setting were excluded. Two case studies were conducted to augment the literature. Ten of 30 manuscripts identified in the literature review were applicable and indicate that techniques and interventions based on cognitive theories and behavioral change can be effective when coupled with diabetes DM. Better diabetes self-management through diabetes education encourages participation in DM programs and adherence to recommended care in programs offered by DM organizations or those that are provider based. Improved health outcomes and reduced cost can be achieved by blending diabetes education and DM. Diabetes educators are a critical part of the management team and, with their arsenal of goal setting and behavior change techniques, are an essential component for the success of diabetes DM programs. Additional research needs to be undertaken to identify effective ways to integrate diabetes educators and education into DM and to assess clinical, behavioral, and economic outcomes arising from such programs.

  8. How Widely Applicable is River Basin Management? An Analysis of Wastewater Management in an Arid Transboundary Case

    NASA Astrophysics Data System (ADS)

    Dombrowsky, Ines; Almog, Ram; Becker, Nir; Feitelson, Eran; Klawitter, Simone; Lindemann, Stefan; Mutlak, Natalie

    2010-05-01

    The basin scale has been promoted universally as the optimal management unit that allows for the internalization of all external effects caused by multiple water uses. However, the basin scale has been put forward largely on the basis of experience in temperate zones. Hence whether the basin scale is the best scale for management in other settings remains questionable. To address these questions this paper analyzes the economic viability and the political feasibility of alternative management options in the Kidron/Wadi Nar region. The Kidron/Wadi Nar is a small basin in which wastewater from eastern Jerusalem flows through the desert to the Dead Sea. Various options for managing these wastewater flows were analyzed ex ante on the basis of both a cost benefit and a multi-criteria analysis. The paper finds that due to economies of scale, a pure basin approach is not desirable from a physical and economic perspective. Furthermore, in terms of political feasibility, it seems that the option which prompts the fewest objections from influential stakeholder groups in the two entities under the current asymmetrical political setting is not a basin solution either, but a two plant solution based on an outsourcing arrangement. These findings imply that the river basin management approach can not be considered the best management approach for the arid transboundary case at hand, and hence is not unequivocally universally applicable.

  9. Assertive community treatment (ACT) case managers' professional identities: A focus group study.

    PubMed

    Lerbaek, Birgitte; Aagaard, Jørgen; Andersen, Mette Braendstrup; Buus, Niels

    2016-12-01

    Assertive community treatment (ACT) case managers provide healthcare services to people with severe and persistent mental illness. These case managers take on generic roles in multidisciplinary teams and provide all-around services in the clients' private homes. This focus group study aimed to gain insight into Danish ACT case managers' professional identity work by examining their discussions of ethical dilemmas and collaboration in their everyday practice. Data were collected during five focus groups at three ACT teams in the North Denmark Region and subjected to discourse analysis emphasizing how identity work was accomplished through talk. The findings indicated that the case managers constructed professional identities by actively positioning themselves and the particular ACT approach in relation to other mental healthcare professionals and clients. They represented themselves as achieving better client-related outcomes by being more assertive and persistent, and as responsible caregivers who provided the help that their clients needed when other services had failed to do so. They depicted their services as being focused on the clients' well-being, and their persistent efforts to establish and sustain interpersonal relationships with clients were an important part of their service. Basic nursing tasks were described as an important part of their everyday work, and even though such tasks were not distinctive for ACT case managers, the representations of their work seemed to give them a sense of worth as professionals and legitimized a unique role in the community mental healthcare services.

  10. Client satisfaction with a new group-based model of case management for supported housing services.

    PubMed

    Tsai, Jack; Reddy, Navin; Rosenheck, Robert A

    2014-04-01

    Supportive housing typically offers rental subsidies and individual intensive community-based case management and has become a predominant service model for homeless adults. Alternative case management models have not been adequately explored. This study evaluates satisfaction with a novel group-intensive peer support (GIPS) model of case management for the Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program. A total of 95 HUD-VASH clients rated their satisfaction with services and responded to open-ended questions about what they liked best and least about the program. Quantitative and qualitative analyses compared clients who attended groups as part of the GIPS model and those who did not. No significant difference in satisfaction between group and non-group attenders were found. Clients reported what they liked best about the program was the staff; those who attended groups reported what they liked best was the social interaction and peer support. These findings suggest clients who attend groups for their primary source of case management may be as satisfied as those who receive only individual case management. GIPS offers a feasible and acceptable service model and should be further explored along with other alternative models of care in supportive housing services.

  11. Do-it-yourself managed care. Case study I: Randall's Medical Network. Case study II: Hershey's Managed Care Plan.

    PubMed

    1993-01-01

    Employers, who pay for much of the healthcare in this country, are not waiting for government to restructure the healthcare system. In this cover story, PROFILES examines how two firms formed their own managed care networks to control healthcare cost and quality, and what hospitals did to become players. By understanding the employer' point of view, hospital marketers can better anticipate their needs and develop a marketing strategy to form closer relationships with employers, provide quality care at a lower cost, and increase their market share.

  12. Managing water resources for sustainable development: the case of integrated river basin management in China.

    PubMed

    Song, X; Ravesteijn, W; Frostell, B; Wennersten, R

    2010-01-01

    The emerging water crisis in China shows that the current institutional frameworks and policies with regard to water resources management are incapable of achieving an effective and satisfactory situation that includes Integrated River Basin Management (IRBM). This paper analyses this framework and related policies, examines their deficiencies in relation to all water stress problems and explores alternatives focusing on river basins. Water resources management reforms in modern China are reviewed and the main problems involved in transforming the current river management system into an IRBM-based system are analysed. The Huai River basin is used as an example of current river basin management, with quantitative data serving to show the scale and scope of the problems in the country as a whole. The institutional reforms required are discussed and a conceptual institutional framework is proposed to facilitate the implementation of IRBM in China. In particular, the roles, power and responsibilities of River Basin Commissions (RBCs) should be legally strengthened; the functions of supervising, decision-making and execution should be separated; and cross-sectoral legislation, institutional coordination and public participation at all levels should be promoted.

  13. Monoamniotic twins discordant for anencephaly managed conservatively with good outcomes: two case reports and a review of the literature.

    PubMed

    Lim, K I; Dy, C; Pugash, D; Williams, K P

    2005-08-01

    Monoamniotic twin pregnancy discordant for anencephaly (MATDA) is a rare occurrence with only seven prior reported cases. Selective termination has been advocated in managing discordant monoamniotic twins. We report two cases managed expectantly with good outcomes and review other previously reported cases. The first case was a primigravid woman diagnosed with MATDA at 18 weeks. She was managed expectantly until 32 + 5 weeks when a Cesarean section was performed for preterm labor. The surviving female infant weighed 1610 g. The second case was a multigravid woman who was diagnosed with MATDA at 17 + 5 weeks and was managed as an outpatient. An emergency Cesarean section was performed at 31 weeks for non-reassuring monitoring and the surviving male infant weighed 1790 g. In both cases, the survivors were discharged home in good condition. A review of these two cases and those in the literature suggests that expectant management should be considered among management options for this rare condition.

  14. [Hyperammonemic encephalopathy: nutritional assessment and management of a case].

    PubMed

    Oliva Rodríguez, R; Suleiman Martos, Y; Pereira Cunnil, J L; Serrano Aguayo, P; García Alfaro, C; García Luna, P P

    2012-01-01

    OTC deficiency is a disorder of the urea cycle X-linked. It is manifested in men as severe hyperammonemia in the first days of life. In women the disease is milder severity. Various conditions cause decompensation with hyperammonemia. It could be fatal or cause permanent neurological damage. We report a 36 years old woman admitted for surgery, she suffered a decompensation in conjunction with surgical wound infection. Hyperammonemia caused neurological deterioration with decreased level of consciousness, tetraparesis and neurogenic dysphagia. The treatment consisting of low-protein diet, ammonium chelating drugs and dialytic measures, was effective in controlling hyperammonaemia and improving neurological status. This case illustrates the importance of nutritional support of patients with disorders of the urea cycle in the hospital because the descompensations are more frecuent here.

  15. Clinical Management of Glanzmann’s Thrombasthenia: A Case Report

    PubMed Central

    Varkey, Indu; Rai, Kavita; Hegde, Amitha M.; Vijaya, Mangalpady Shenoy; Oommen, Vinod Idicula

    2014-01-01

    Glanzmann’s thrombasthenia (GT) is a rare, genetically inherited platelet disorder in which the platelet glycoprotein IIb/IIIa (GP IIb/IIIa) complex is either deficient or, dysfunctional. The incidence is about 1 in 1,000,000. This case report deals with a 4 year-old girl diagnosed with GT presenting with dental caries and periapical lesions in the primary mandibular first molars. To provide the best care, an interdisciplinary approach was followed by a team consisting of pediatric dentists, pediatricians and anesthesiologists. Complete oral rehabilitation was planned under general anesthesia which included extractions, multiple esthetic restorations and space maintainers with the utmost care to prevent unwarranted bleeding. PMID:24910701

  16. Multidisciplinary surgical management of Cowden syndrome: Report of a case

    PubMed Central

    Staderini, Edoardo; Gallenzi, Patrizia

    2016-01-01

    Cowden’s Syndrome (CS) is a rare congenital autosomal dominant disorder that affects around 1/200000 patients with an incomplete penetrance and variable expressivity, characterized by alterations in a tumor suppressor gene. A 14-year-old Caucasian male patient came to the attention of the authors complaining of palm nodules, gingival bleeding and painful pedunculated lesions on the lips and on the labial side of anterior sextants. After genetic investigation the final diagnosis of a Cowden Syndrome was made. The lesions were surgically removed under general anesthesia and no clinical signs of recurrence were found three months after surgical excision. Considering the severe symptoms of the syndrome and the strong tendency to malignant development of the associated lesions all clinicians should focus their efforts to the early diagnosis and, when possible, multidisciplinary treatment. Key words:Early diagnosis, multiple hamartoma syndrome, oral papillomatosis, cancer predisposition, case report. PMID:27703620

  17. Dental management of patient with Williams Syndrome - A case report

    PubMed Central

    Wong, Daniel; Ramachandra, Srinivas Sulugodu; Singh, Ashish Kumar

    2015-01-01

    Williams syndrome is a multisystemic rare genetic disorder caused by deletion of 26–28 genes in the long arm of chromosome 7. It is characterized by developmental and physical abnormalities including congenital cardiovascular abnormalities, mental retardation, neurological features, growth deficiency, genitourinary manifestations, gastrointestinal problems, musculoskeletal problems, unique behavioral characteristics, and dental problems. Dental abnormalities include malocclusion, hypodontia, malformed teeth, taurodontism, pulp stones, increased space between teeth, enamel hypoplasia, and high prevalence of dental caries. Authors report a 17-year-old female patient with underlying Williams syndrome. Oral features and problems seen in the patient are listed. Malocclusion and screwdriver shaped teeth were noticed. Generalized widening of the periodontal ligament space with vital teeth was seen. This finding has not been reported in cases of Williams syndrome earlier. Precautions taken during dental treatment in patients with Williams syndrome are also discussed. PMID:26321847

  18. Ortho-surgical management of condylar hyperplasia: Rare case reports.

    PubMed

    Singh, Virendra; Verma, Ajay; Attresh, Gyanander; Batra, Jitender

    2014-01-01

    Condylar hyperplasia of the mandible is a clinical condition of over-development and growth because of excessive cellular growth of one condylar part of the mandible leading to facial asymmetry, mandibular deviation and enlargement of condyle. The elongation of the condylar neck in turn leads to malocclusion and articular dysfunction. In the past the interceptive and corrective procedures of growth and deformity in condylar hyperplasia were either condylectomy or high condylotomy. However, the deformity ceases after growth is completed. Therefore, other surgical procedures have to be undertaken to correct the manifested deformity of condylar hyperplasia. Further it has to be stressed that no single procedure can completely correct the deformity. So in addition to condylectomy, other orthognathic surgical procedures both on body and ramus and also on maxilla can be undertaken to correct the canting of occlusion. Two rare cases of unilateral hyperplasia encountered in our hospital are presented which required different lines of treatment.

  19. CCSDS SLE Service Management: Real-World Use Cases

    NASA Technical Reports Server (NTRS)

    Barkley, Erik; Pechkam, Paul; Pietras, John; Quintela, Paula

    2006-01-01

    The purpose of this paper is to illustrate how the standard SLE-SM services can be applied to the operations of current TT&C providers. It begins with a brief overview of the scope and operating environment of the SLE-SM services, then describes several use cases in which SLE-SM services can be applied to existing operational situations. The paper also addresses how SLE-SM services can be adopted in an evolutionary fashion. The paper concludes with a brief identification of additions to SLE-SM that are under consideration to make SLE-SM applicable to an even broader range of network operations concepts, policies, and procedures.

  20. Phaeochromocytoma--investigation and management of 10 cases.

    PubMed Central

    Deal, J E; Sever, P S; Barratt, T M; Dillon, M J

    1990-01-01

    Since 1960 we have diagnosed phaeochromocytoma (paraganglioma) in 10 children. The cases include a 15 year old girl who over a three year period presented with multiple paragangliomata and an associated malignant carotid body tumour. All children were hypertensive, eight of 10 presenting with severe headaches. Diagnosis was based on finding a raised urinary vanillylmandelic acid excretion and plasma noradrenaline concentration. In addition six of eight children were hypercalcaemic with raised plasma calcitonin concentrations; plasma parathyroid hormone concentrations were high in two of seven and four out of eight children had raised plasma renin activities on presentation. No child, however, was found to have a multiple endocrine neoplasia syndrome. Despite the introduction of newer techniques for the detection of catecholamine producing tumours we found that selective arteriography and venous catecholamine sampling were superior for tumour localisation compared with ultrasound scanning, computed tomography, and metaiodo-benzyl-guanidine (MIBG) scanning. Images Figure 1 PMID:2334202

  1. Case for Open-Source PEV Charge Management Data Framework

    SciTech Connect

    Markel, T.; Kuss, M.; Foster, J.; Manz, D.; Mahony, M.; Nielsen, M.; Reid, A.; Wilk, R. D.

    2012-01-01

    The future growth of electrified transportation could be enhanced through interaction with smart grid system architectures. This paper summarizes current literature regarding plug-in electric vehicle - renewables integration and highlights areas of need to implement such integration at a multi-utility scale. Future smart grid implementations hold the key to transferring information and control parameters between distributed and centralized decision agents. The discussion highlights the opportunity to leverage federal investments in grid renovation and electric vehicle introduction to create system-wide value from improved reliability and reduced fossil fuel consumption. An approach to scaling a previously defined 'green signal' methodology for electric vehicles will be detailed across a utility grid balancing region. The research will include a synopsis of the communications opportunities and challenges of coordinating the responses of many resources. The results are expected to show that, with some variation in the charge profiles of individual vehicles, the aggregate set can interface with grid management methods to significantly influence the ability to integrate distributed and centralized renewables to improve environmental quality.

  2. Conservative management of Achilles Tendinopathy: a case report

    PubMed Central

    Papa, John A.

    2012-01-01

    Objective: To chronicle the conservative treatment and management of a 77-year old female patient presenting with chronic pain of 8 months duration in the midportion of the achilles tendon diagnosed as achilles tendinopathy. Clinical features: The main clinical feature was pain in the midportion of the achilles tendon, 2 to 6 cm proximal to the calcaneal insertion. Symptom onset was gradual and unrelated to any acute trauma or overt injury mechanism. Intervention and outcome: The conservative treatment approach consisted of medical acupuncture with electrical stimulation, Graston Technique®, eccentric calf training, and rehabilitative exercise prescription. Outcome measures included verbal pain rating scale, lower extremity functional scale (LEFS), and a return to activities of daily living (ADLs). The patient attained long-term resolution of her complaint and at 12 month follow-up reported no recurrence of symptoms. Conclusion: A combination of conservative rehabilitation strategies may be used by chiropractors to treat midportion achilles tendinopathy and allow an individual to return to pain free ADLs in a timely manner. PMID:22997472

  3. Controversies in the management of parathyroid carcinoma: A case series and review of the literature.

    PubMed

    Medas, Fabio; Erdas, Enrico; Loi, Giulia; Podda, Francesco; Pisano, Giuseppe; Nicolosi, Angelo; Calò, Pietro Giorgio

    2016-04-01

    Parathyroid carcinoma is a rare malignancy representing less than 1% of primary hyperparathyroidism cases. Its management is controversial due to lack of large-scale, multicentric studies. We report 8 new cases of parathyroid carcinoma and review the literature. Preoperative diagnosis of carcinoma was possible in 2 (25%) cases. Unclear surgical margins were present in 5 (62.5%) patients; 4 of them underwent subsequent re-exploration and ipsilateral hemithyroidectomy, in one case associated to central lymph node dissection. Recurrent disease is reported in 2 (25%) patients. Considering the high incidence of local recurrence in case of unclear surgical margins, a re-exploration with ipsilateral hemithyroidectomy is indicated in these patients. A neck dissection should be performed only in case of clinically involved lymph nodes, avoiding prophylactic lymphectomy. An aggressive approach is indicated in case of local or distant recurrence to reduce hypercalcemia.

  4. Case management and patient reactions: a study of STD care in a province in Zambia.

    PubMed

    Hanson, S; Engvall, J; Sunkutu, R M; Kamanga, J; Mushanga, M; Höjer, B

    1997-05-01

    Sexually transmitted disease (STD) case management was evaluated through observation and interviews at 2 urban and 4 rural health centres and 2 district hospital STD clinics in one urban and 2 rural districts in Central Province, Zambia. The analysis was limited to 59 patients (42 men and 17 women) who paid first visits for their disease and were managed by a clinical officer. The evaluation suffered from the lack of a standard for case management. Results showed that the patients engaged in risky sexual behaviour without being aware of the risks. At the health institutions, few patients were informed about condoms, the risk of HIV, and abstinence from sex during treatment and few were asked to notify their partners. Clinical officers with special STD training performed better than others but sill informed only one-fifth of the patients. Few clinical officers managed patients according to the syndromic approach recommended by the STD control programme.

  5. Peripheral vascular complications during TAVR: Management and potential role of chronic steroid use; A case report

    PubMed Central

    Fudim, Marat; Green, Kelly D; Fredi, Joseph L; Robbins, Mark A; Zhao, David

    2014-01-01

    Purpose To report a case of a major vascular complication during TAVR and the endovascular management thereof. Additionally, we discuss a possible correlation with long-term steroid use. Case Report A 79 year old woman with a history of critical aortic stenosis underwent elective transcatheter aortic valve replacement (TAVR). Her procedure was complicated by rupture of her right iliac artery, life threatening retroperitoneal hemorrhage, and thrombus extending into the distal right lower extremity. This case was emergently managed by stent placement, thrombectomy, and tPA via a percutaneous approach. Conclusions Peripheral vascular complications are common during percutaneous TAVR, and chronic steroid use may predispose patients. Endovascular management is often possible and may potentially save valuable time in emergent situations. PMID:23793293

  6. Management of Psychosis Associated With a Prolactinoma: Case Report and Review of the Literature

    PubMed Central

    Ali, Shirin; Miller, Karen Klahr; Freudenreich, Oliver

    2013-01-01

    Background Prolactinomas are the most common pituitary tumors; they are treated with dopamine agonists, which may cause psychotic symptoms as a side effect. Psychosis is treated with dopamine-receptor blockers that may result in elevated serum prolactin and symptomatic hyperprolactinemia. Objective The authors will review a case of a patient with a prolactinoma as well as schizophrenia and illustrate the management of psychosis in this case. Method The review describes the management of prolactinoma, symptoms of hyperprolactinemia, and long-term effects of hyperprolactinemia. Results In the case presentation reviewed, the patient was finally discharged on risperidone long-acting injection and testosterone supplementation, with no growth of the adenoma after 3 years. Discussion This review provides recommendations and treatment strategy for management of prolactinoma in a patient with schizophrenia. PMID:20833935

  7. Management of infections complicating the orbitocranial approaches: Report of two cases and review of literature

    PubMed Central

    Patel, Akash J.; Duckworth, Edward A. M.

    2015-01-01

    Background: The orbitocranial approaches are now indispensible for treating lesions of the skull base, providing access to lesions in the anterior and middle cranial fossae, as well as the upper clivus and anterior brainstem. The management of infectious complications of the orbitocranial approaches, however, has evaded the literature. Case Description: We present two cases of patients who underwent orbitocranial approach whose clinical course was complicated by wound infection and osteomyelitis. One patient was treated with antibiotics and then had a custom implant placed for cranioplasty. The other case was managed with removal of bone and wire-mesh cranioplasty. Conclusion: Management of orbitocraniotomy infections can be difficult due to the complex geometry of the flap and to cosmetic considerations. Once the infection involves the bone, the bone can be replaced after cleaning or discarded and a cranioplasty performed. Cranioplasty can be performed with wire-mesh or a custom implant made by computer-assisted modeling. PMID:26060598

  8. Managing resistance to change: the social worker's role in case management.

    PubMed

    Kiernan-Stern, Mary

    2005-01-01

    From time to time in my responsibilities as a medical social worker, I become involved with a "complicated" case. Translation: a case was referred to the social worker to intervene and "fix" the problem because no one else knew what to do with the client or the issues surrounding the client. Necessity is the mother of invention, so when all else failed, that was my cue to be creative.

  9. Presidential Helicopter Acquisition: Program Established Knowledge-Based Business Case and Entered System Development with Plans for Managing Challenges

    DTIC Science & Technology

    2015-04-14

    Presidential Helicopter Acquisition: Program Established Knowledge-Based Business Case and Entered System Development with Plans for Managing Challenges...Presidential Helicopter Acquisition: Program Established Knowledge-Based Business Case and Entered System Development with Plans for Managing...progress by establishing a knowledge- based business case for entry into system development that included an approved cost, schedule and performance

  10. Public Management Reform without Managers: The Case of German Public Schools

    ERIC Educational Resources Information Center

    Mintrop, Rick

    2015-01-01

    Purpose: The purpose of this paper is to discuss the role of principals in light of public management reforms taking place in the German educational system and in reference to the empirical patterns uncovered by the papers contained in the Special Issue. Policy makers have created new expectations and new technologies that seem to suggest to…

  11. Perioperative Management of a Patient With an Intrathecal Drug Delivery Device Infusing Ziconotide: A Case Report.

    PubMed

    Patel, Sephalie; Hafez, Osama; Sexton, Wade J; Edwards, David A

    2017-02-15

    Intrathecal ziconotide is used for the treatment of chronic pain and is delivered by an implanted drug delivery device. Anesthesiologists should be familiar with the perioperative management of the pump as well as the potential adverse events related to continued ziconotide infusion during general anesthesia. A case is presented demonstrating the perioperative management of an intrathecal drug delivery device infusing ziconotide in a patient presenting for radical cystectomy with pelvic lymphadenectomy and ileal conduit diversion.

  12. Management of the critical airway when an EXIT procedure is not an option: A case report.

    PubMed

    Diercks, Gillian R; Hartnick, Christopher J; Bates, Sara V

    2015-12-01

    Perinatal imaging facilitates detection of congenital head and neck masses to plan fetal procedures which secure the airway. Ex utero intrapartum therapy (EXIT) procedures are preferred to protect the neonatal airway. Herein we present a case in which a neonate with a large oropharyngeal lymphovascular malformation was delivered and the airway successfully managed without an EXIT procedure using a multidisciplinary approach. Preparations for the non-EXIT delivery and critical airway management are described.

  13. In-home behavioral health case management: an integrated model for high-risk populations.

    PubMed

    Theis, Gerald A; Kozlowski, Deirdre; Behrens, Jenna

    2006-01-01

    The escalating health care costs attributed to high-risk populations have fueled a need for a proactive approach to deal with people affected by complex mental health issues that often coexist with chronic medical conditions. Through an in-home behavioral health case management (CM) program, patients with mental illnesses (some with coexisting medical conditions) receive integrated medical and mental health services through a disease-management approach that has proven effective in treating high-risk patients.

  14. Welfare Reform: Bibliographies of Case Management and Agency/Client Contracting.

    DTIC Science & Technology

    1988-03-11

    use in considering pro- posed welfare legislation. The bibliographies identify 109 literature cita - tions for case management as applied in the social...subject to copyright state- ments, as follows. (c) APA -these citations are reprinted with the permission (fee waived) of the American Psychological...management of reality rather than on * symptomatology, foster their clients’ community adjustment. (12 ref) (c) APA V4 Pae9GOHD84 SWlaeRfrmBbigahe 444 *4

  15. Risk-based requirements management framework with applications to assurance cases

    NASA Astrophysics Data System (ADS)

    Feng, D.; Eyster, C.

    The current regulatory approach for assuring device safety primarily focuses on compliance with prescriptive safety regulations and relevant safety standards. This approach, however, does not always lead to a safe system design even though safety regulations and standards have been met. In the medical device industry, several high profile recalls involving infusion pumps have prompted the regulatory agency to reconsider how device safety should be managed, reviewed and approved. An assurance case has been cited as a promising tool to address this growing concern. Assurance cases have been used in safety-critical systems for some time. Most assurance cases, if not all, in literature today are developed in an ad hoc fashion, independent from risk management and requirement development. An assurance case is a resource-intensive endeavor that requires additional effort and documentation from equipment manufacturers. Without a well-organized requirements infrastructure in place, such “ additional effort” can be substantial, to the point where the cost of adoption outweighs the benefit of adoption. In this paper, the authors present a Risk-Based Requirements and Assurance Management (RBRAM) methodology. The RBRAM is an elaborate framework that combines Risk-Based Requirements Management (RBRM) with assurance case methods. Such an integrated framework can help manufacturers leverage an existing risk management to present a comprehensive assurance case with minimal additional effort while providing a supplementary means to reexamine the integrity of the system design in terms of the mission objective. Although the example used is from the medical industry, the authors believe that the RBRAM methodology underlines the fundamental principle of risk management, and offers a simple, yet effective framework applicable to aerospace industry, perhaps, to any industry.

  16. Child abuse. An update on surgical management in 256 cases.

    PubMed Central

    Caniano, D A; Beaver, B L; Boles, E T

    1986-01-01

    In the period January 1982-July 1984, 1512 cases of suspected child abuse were evaluated in the emergency department of a major children's hospital, of which 256 (17%) required hospitalization. Failure-to-thrive with caloric malnutrition was present in 66 (26%), burns in 56 (22%), central nervous system injury in 53 (22%), soft tissue trauma in 21 (8%), ingestions in 20 (8%), skeletal injury in 15 (6%), neglect of an underlying disease in 10 (4%), sexual abuse in nine (3%), near-drowning in four (1%), and abdominal trauma in two (1%). Two-thirds of the children required surgical care and one-third of the surgical group needed operations. The majority of the patients were toddlers between 18 and 36 months of age. A long hospitalization occurred with a mean stay of 9.3 days. Mortality was 7% for the entire group, but children with central nervous system injury had a much higher mortality (26%) and morbidity (21%). PMID:3947158

  17. Management of Retained Genital Piercings: A Case Report and Review

    PubMed Central

    2017-01-01

    The prevalence of genital piercing among women is increasing. As the popularity increases, the number of complications from infection, injury, and retained jewelry is likely to rise. Techniques to remove embedded jewelry are not well described in the literature. The purpose of this report was to describe a case of a patient with a retained clitoral glans piercing, discuss a simple technique for outpatient removal, and review current evidence regarding associated risks of clitoral piercings. A 24-year-old female presented to the emergency department with an embedded clitoral glans piercing. Local anesthetic was injected into the periclitoral skin and a small superficial vertical incision was made to remove the ball of the retained barbell safely. In conclusion, among patients with retained genital piercing, outpatient removal of embedded jewelry is feasible. While the practice of female genital piercing is not regulated, piercing of the glans of the clitoris is associated with increased injury to the nerves and blood supply of the clitoris structures leading to future fibrosis and diminished function compared to piercing of the clitoral hood. PMID:28299217

  18. Implant success lies in complications management: A report of two cases.

    PubMed

    Rani, Sapna; Devi, Jyoti; Verma, Mahesh

    2016-01-01

    At present, implant supported or retained prostheses are considered as a first therapeutic alternative for patients. Although the success rate of dental implants is very high, no treatment is without complications; same applies to implants also. Implant failure can be due to biological factors, i.e., loss of osseointegration or due to technical complications. This case report presents implant complications involving both factors along with the management of these cases. In implant supported overdenture patient, loss of implant on the right side and implant body fracture of the left side implant is reported and in another patient abutment screw fracture and its management is reported.

  19. Modified Esthetic Splint Design for Management of Multiple Traumatic Injuries in Children: A Case Report

    PubMed Central

    Garla, Bharath Kumar; Deshmukh, Seema; Murthy, Prashanth Sadashiva; Satish, G

    2015-01-01

    Traumatic injuries to the dento-alveolar structures are emergencies that compromise the quality of life of the patients. In addition to symptomatic management, definitive functional restoration and suitable rehabilitation becomes a major treatment objective in such cases. The dynamics of the traumatic forces may cause multiple injuries of different grades to the oral and para-oral structures, which makes comprehensive management a greater challenge to the dentist. The present case report elaborates a modified esthetic splint designed to treat multiple dental injuries in children, which can promote healing, restore optimal functionality along with esthetic rehabilitation to psychologically benefit the child during the time of recovery. PMID:26435631

  20. Broad Ligament Pregnancy – Success Story of a Laparoscopically Managed Case

    PubMed Central

    Nair, Sobha S.

    2016-01-01

    Abdominal pregnancies constitute 1% of ectopic pregnancies, among which broad ligament pregnancy is a rare form. The maternal mortality rate has been reported to be as high as 20%. The diagnosis is seldom established before surgery. Laparoscopic management of broad ligament ectopic pregnancy is the ideal form of treatment in appropriately selected patients. We present the case report of successful laparoscopic treatment of a 3x3.5cm broad ligament pregnancy. A search of literature shows that ours is the 6th case report of such a rare ectopic pregnancy managed endoscopically successfully. PMID:27630914

  1. COMPLEX MANAGEMENT OF FRAILTY FRACTURES--CASE REPORT.

    PubMed

    Costescu, Elena Puin; Dronic, Aliona; Alexa, Loana Dana; Alexa, O

    2016-01-01

    Frailty fractures encompass pelvic ring fractures in the elderly--a condition more frequently encountered in women, usually with pre-existing osteoporosis. The incidence of these fractures is increasing, following the increase in average life expectancy. Most of the times, they are the result of a minor injury, of which the patient has little or no recollection; the clinical signs and symptoms, radiological changes and the degree of fracture stability vary greatly. As such, there is a wide range of therapeutic options and one of the most important decisions for the physician is choosing between surgery and conservative treatment. We present the case of an elderly female patient with multiple pelvic ring fractures, and a medical history of cardiovascular disease and osteoporosis; the orthopedic examination recommended conservative treatment which was carried out in the Geriatric Clinic of the "Dr. C.I. Parhon" Hospital. Following the complete physical examination and through geriatric evaluation, a complex therapeutic plan was devised, which included: recovery through physiotherapy, adequate nutrition, psychological support, treatment of the cardiovascular comorbidities and prevention of the consequences of extended bed rest. The treatment lasted for 60 days and the outcome was favorable: decreased bone frailty, mainly through preserving muscle tone and osteoarticular function, correction of malnutrition, improvement of depression and partial recovery of patient's mobility; the results of our therapy made it possible for the patient to return home, where she leaves alone. She will need help with daily household chores, but she intends to continue the recovery therapy as means of increasing her quality of life and independence.

  2. Natal tooth and cultural impact on its management in a tropical neonatal unit: a case report.

    PubMed

    Eseigbe, E E; Adama, S J; Amuda, J T; Eseigbe, P

    2013-09-01

    The incidence of natal tooth is uncommon and its management could be fraught with challenges. A 3 day old female presented with features of sepsis and a natal tooth. Treatment for sepsis was permitted and successfully instituted but definitive management of the natal tooth was deferred, for cultural reasons, by the parents. The case documents the occurrence of natal tooth and highlights the impact of cultural beliefs on management of some medical conditions. It underscores the need to develop the relationship between orthodox medical care and cultural beliefs, in susceptible communities, with a view to achieving optimal health care delivery.

  3. Forest fire management to avoid unintended consequences: a case study of Portugal using system dynamics.

    PubMed

    Collins, Ross D; de Neufville, Richard; Claro, João; Oliveira, Tiago; Pacheco, Abílio P

    2013-11-30

    Forest fires are a serious management challenge in many regions, complicating the appropriate allocation to suppression and prevention efforts. Using a System Dynamics (SD) model, this paper explores how interactions between physical and political systems in forest fire management impact the effectiveness of different allocations. A core issue is that apparently sound management can have unintended consequences. An instinctive management response to periods of worsening fire severity is to increase fire suppression capacity, an approach with immediate appeal as it directly treats the symptom of devastating fires and appeases the public. However, the SD analysis indicates that a policy emphasizing suppression can degrade the long-run effectiveness of forest fire management. By crowding out efforts to preventative fuel removal, it exacerbates fuel loads and leads to greater fires, which further balloon suppression budgets. The business management literature refers to this problem as the firefighting trap, wherein focus on fixing problems diverts attention from preventing them, and thus leads to inferior outcomes. The paper illustrates these phenomena through a case study of Portugal, showing that a balanced approach to suppression and prevention efforts can mitigate the self-reinforcing consequences of this trap, and better manage long-term fire damages. These insights can help policymakers and fire managers better appreciate the interconnected systems in which their authorities reside and the dynamics that may undermine seemingly rational management decisions.

  4. Anesthetic management of a patient with giant retroperitoneal liposarcoma: case report with literature review

    PubMed Central

    Feng, Dandan; Xu, Fangxia; Wang, Meng; Gu, Xiaoping; Ma, Zhengliang

    2015-01-01

    Patients with giant retroperitoneal liposarcomas are considered at great risks of perioperative complications and require meticulous anaesthetic management. There have been few reports about anaesthetic management of giant retroperitoneal liposarcoma. We present the case of a 66-year-old patient who suffered from a giant retroperitoneal liposarcoma (diameter 45 cm and weigh 4.5 kg), needing a resection surgery under general anesthesia. We successfully managed anesthesia procedures in this patient using FloTrac/VigileoTM monitoring system without major perioperative complications. The surgery was completed uneventfully and the patient recovered smoothly. After reviewing the literature, we summarize FloTrac/VigileoTM monitoring system is useful to help anaesthesiologists adjust infusion rate to maintain the stability of circulatory state. Anesthetic monitoring, fluid management and temperature control need to be focused in the anesthetic management. PMID:26770605

  5. Integrative Management of Commercialized Wild Mushroom: A Case Study of Thelephora ganbajun in Yunnan, Southwest China

    NASA Astrophysics Data System (ADS)

    He, Jun; Zhou, Zhimei; Yang, Huixian; Xu, Jianchu

    2011-07-01

    The management of wild mushroom is interdisciplinary in nature, whereby the biophysical considerations have to be incorporated into the context of a wide range of social, economic and political concerns. However, to date, little documentation exists illustrating an interdisciplinary approach to management of wild mushrooms. Moreover, the empirical case studies necessary for developing applicable and practical methods are even more rare. This paper adopted an interdisciplinary approach combining participatory methods to improve the habitat management of Thelephora ganbajun, an endemic and one of the most economically valuable mushroom species in Southwest China. The paper documents an empirical case of how an interdisciplinary approach facilitated the development of a scientific basis for policy and management practice, and built the local capacity to create, adopt and sustain the new rules and techniques of mushroom management. With this integrative perspective, a sustainable management strategy was developed, which was found not only technically feasible for farmers, but also acceptable to the government from an ecological and policy-related perspective. More importantly, this approach has greatly contributed to raising the income of farmers. The paper highlights how the integration of biophysical and socioeconomic factors and different knowledge systems provided a holistic perspective to problem diagnosis and resolution, which helped to cope with conventional scientific dilemmas. Finally, it concludes that the success of this interdisciplinary approach is significant in the context of policy decentralization and reform for incorporating indigenous knowledge and local participation in forest management.

  6. Best practices in care management for Asian American elders: the case of Alzheimer's disease.

    PubMed

    Arnsberger, Pamela

    2005-01-01

    This article addresses practice concerns and special issues for professionals doing case management for older Asian Americans using Alzheimer's disease as the case example. Highlighted are cross-cultural issues in assessment for depression in this population, as well as caregiving and community service utilization issues. The research is based on the author's own work and the literature, as well as results from a population-based study of caregivers of the elderly in California.

  7. Lip repositioning with reversible trial for the management of excessive gingival display: a case series.

    PubMed

    Jacobs, Paul J; Jacobs, Bryan P

    2013-01-01

    Lip repositioning surgery is a largely unknown and underutilized treatment modality for excessive gingival display. It involves precise resection of maxillary mucosal tissues with reattachment of the lip in a more coronal position. This limits lip elevation on smiling and increases lip fullness. While this is an elective treatment, no reported cases have yet offered patients the ability to preview the outcome in a reversible manner. This case series presents seven patients who were successfully managed with trial, and then definitive, lip repositioning.

  8. The community case management of pneumonia in Africa: a review of the evidence

    PubMed Central

    Druetz, Thomas; Siekmans, Kendra; Goossens, Sylvie; Ridde, Valéry; Haddad, Slim

    2015-01-01

    Pneumonia causes around 750 000 child deaths per year in sub-Saharan African (SSA) countries. The lack of accessibility to prompt and effective treatment is an important contributor to this burden. Community case management of pneumonia (CCMp) uses trained community health workers (CHWs) to administer antibiotics to suspected child pneumonia cases in villages. This strategy has been gaining momentum in low- and middle-income countries, and the World Health Organization and United Nations children’s fund have recently encouraged countries to broaden community case management to other diseases. Recommendations in favour CCMp are based on three meta-analyses showing its efficacy to reduce childhood mortality and morbidity attributable to pneumonia although most of the studies in the meta-analyses were conducted in Asian countries. This is problematic as community case management strategies have been implemented in very different ways in Asian and SSA countries, partly due to differences in malaria prevalence. Therefore, we conducted a narrative synthesis to systematically review the evidence on CCMp in SSA. Results show that there is a lack of evidence concerning its efficacy and effectiveness in SSA, irrespective of whether case management is integrated with other diseases or not. CHWs encounter difficulties in counting the respiratory rate. Their adherence to the guidelines is poorer when they are required to manage several illnesses or children with severe signs. CCMp thus encompasses issues of over-treatment and missed treatment, with potentially negative consequences such as increased lethality in severe cases and antibiotics resistance. The current lack of evidence concerning its efficacy, effectiveness and the factors leading to successful implementation, coupled with CHWs' poor adherence, demand a thorough examination of the legitimacy of implementing CCMp in SSA countries. PMID:24371218

  9. What is the role of a case manager in community aged care? A qualitative study in Australia.

    PubMed

    You, Emily Chuanmei; Dunt, David; Doyle, Colleen

    2016-07-01

    This study aimed to explore the perceptions of case managers about their roles in providing community aged care in Australia. Purposeful sampling was used and 33 qualitative semi-structured interviews with 47 participants were conducted. Participants were drawn from a list of all case managers working in aged care organisations that provided publicly funded case-managed community aged care programmes in the State of Victoria, Australia. Participant selection criteria included age, gender, job titles, professional backgrounds, practice locations, organisational attributes and organisational size. Data collection was implemented between September 2012 and March 2013. Thematic analysis was performed. Participants believed that case managers performed diverse roles based on clients' needs. They also articulated 16 important roles of case managers, including advisors, advocates, carers, communicators, co-ordinators, educators, empowering clients, engaging clients and families, liaising with people, managing budgets, navigators, negotiators, networking with people, facilitators, problem solvers and supporters. However, they were concerned about brokers, mediators and counsellors in terms of the terminology or case managers' willingness to perform these roles. Moreover, they perceived that neither gatekeepers nor direct service provision was case managers' role. The findings of this study suggest that case managers working in community aged care sectors may be more effective if they practised the 16 roles aforementioned. With the value of helping rather than obstructing clients to access services, they may not act as gatekeepers. In addition, they may not provide services directly as opposed to their peers working in medical care settings. The findings will also assist organisations to design job descriptions specifying case managers' roles and associated job responsibilities. Clear job descriptions will further benefit the organisations in staff recruitment, orientation

  10. Octreotide for conservative management of intractable high output post operative chylous fistula: a case report.

    PubMed

    Prabhu, Sundararaman; Thomas, Shaji

    2015-03-01

    A case of high output post neck dissection chylous fistula is presented, which was successfully managed conservatively with octreotide; a long acting somatostatin analogue. Routine measures had failed, and secondary complications precluded thoracoscopic ligation. We discuss the spectrum of problems associated with chylous fistula and review the rationale behind the use of octreotide.

  11. Integrated Project Management: A Case Study in Integrating Cost, Schedule, Technical, and Risk Areas

    NASA Technical Reports Server (NTRS)

    Smith, Greg

    2004-01-01

    This viewgraph presentation describes a case study as a model for integrated project management. The ISS Program Office (ISSPO) developed replacement fluid filtration cartridges in house for the International Space Station (ISS). The presentation includes a step-by-step procedure and organizational charts for how the fluid filtration problem was approached.

  12. Student-Centered and Teacher-Centered Classroom Management: A Case Study of Three Elementary Teachers

    ERIC Educational Resources Information Center

    Garrett, Tracey

    2008-01-01

    The major purpose of this case study was to document the classroom management beliefs and practices of three teachers reputed to implement student-centered instruction and to examine the relationship between their instructional and managerial approaches. More specifically, do teachers who use student-centered instruction also implement…

  13. A Case Study of Conflict in an Educational Workplace: Managing Personal and Cultural Differences

    ERIC Educational Resources Information Center

    Torpey, Michael John

    2006-01-01

    This article is about conflict in an educational workplace setting. It reports on a case study investigating the emergence, development, and management of conflict among diverse native English speakers working as language instructors within a Japanese university. The example of conflict presented, which deals with divergent assumptions about the…

  14. A Case Study of Knowledge Management in the "Back Office" of Two English Football Clubs

    ERIC Educational Resources Information Center

    Doloriert, Clair; Whitworth, Kieran

    2011-01-01

    Purpose: This study aims to explore knowledge management (KM) practice in the "back office" of two English football clubs. Design/methodology/approach: The paper takes the form of a comparative case study of two medium-sized businesses using multi-method data including unstructured interviews, structured questionnaires and document…

  15. Physical Activity in Individuals with Severe Mental Illness: Client versus Case Manager Ratings

    ERIC Educational Resources Information Center

    Bezyak, Jill L.; Chan, Fong; Lee, Eun-Jeong; Catalano, Denise; Chiu, Chung-Yi

    2012-01-01

    The "Physical Activity Scale for Individuals With Physical Disabilities" was examined as a physical activity measure for people with severe mental illness. Case manager ratings were more closely related to body mass index than clients' ratings, challenging the accuracy of self-report physical activity measures for individuals with severe mental…

  16. School Nurse Case Management for Children with Chronic Illness: Health, Academic, and Quality of Life Outcomes

    ERIC Educational Resources Information Center

    Engelke, Martha Keehner; Guttu, Martha; Warren, Michelle B.; Swanson, Melvin

    2008-01-01

    More children with chronic illnesses are attending school, and some of them struggle academically because of issues related to their health. School-based case management has been suggested as one strategy to improve the academic success of these children. This study tracked the academic, health, and quality of life outcomes for 114 children with…

  17. Case Management as a Significant Component of Usual Care Psychotherapy for Youth with Disruptive Behavior Problems

    ERIC Educational Resources Information Center

    Zoffness, Rachel; Garland, Ann; Brookman-Frazee, Lauren; Roesch, Scott

    2009-01-01

    Youth with disruptive behavior problems (DBPs) represent the majority of youth served in usual care (UC) psychotherapy, and are at high risk for maladaptive outcomes. Little is known about UC psychotherapeutic strategies utilized with this population. Researchers and clinicians suggest that case management (CM) is a major activity occurring in…

  18. Case Studies to Deepen Understanding and Enhance Classroom Management Skills in Preschool Teacher Training

    ERIC Educational Resources Information Center

    Tal, Clodie

    2010-01-01

    This article adds to the existing body of data that demonstrates how the use of in-depth case studies that include social episode analysis can deepen the teaching students' and researchers' understanding of the perceptions and skills needed for Classroom Management (CM). In this article, CM is defined as a meta-skill that integrates cognitive…

  19. The Benefits of Management and Organisation: A Case Study in Young Language Learners' Classrooms

    ERIC Educational Resources Information Center

    Giannikas, Christina Nicole

    2013-01-01

    This study focuses on primary language education within a Greek region: specifically, on the positive effects of classroom management and organisation on a student-centred approach of teaching. In the case of the Greek education system, language teachers are encouraged to adopt student-centred approaches in their classroom but have not received…

  20. Evaluation and endodontic management of a patient with 6 single-rooted molars: a case report.

    PubMed

    Jaikrishnan, S; Kottoor, Jojo; Mathew, Joy; Kumar, Sanjana Ravi; George, Saira; Hari, Krishna

    2015-01-01

    This case report describes a patient with unusual tooth morphology involving the bilateral presence of 6 maxillary and mandibular first and second molars with a single root and a single canal. The article also discusses the endodontic management of a single-rooted maxillary molar and the use of cone beam computed tomography for evaluation and diagnosis of these anatomical variations.

  1. Hazardous Waste Management and Community Involvement in Canada: The Case of Montreal's Rural-Urban Fringe.

    ERIC Educational Resources Information Center

    Andre, Pierre; And Others

    1995-01-01

    Deals with conflicts associated with the management, disposal, and storage of hazardous wastes from the perspective of interests expressed in the local community. Analyzes three case studies to demonstrate the changing roles and relative importance of local and nonlocal interests. Draws conclusions regarding the significance of the analysis for…

  2. A case of spontaneous coronary artery dissection in early pregnancy managed by PCI.

    PubMed

    Magarkar, Vilas; Lathi, Pravir

    2016-09-01

    Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome in pregnant and peripartum women. This report presents a rare case of spontaneous coronary artery dissection in early pregnancy managed by coronary angioplasty and, combined obstetric and cardiac care, resulting in the delivery of a normal infant through cesarean section.

  3. Assessment and management of elemental mercury poisoning-a case report.

    PubMed

    Bazoukis, George; Papadatos, Stamatis S; Michelongona, Paschalia; Fragkou, Archodula; Yalouris, Athanasios

    2017-02-01

    We describe a patient with elemental mercury aspiration and retention in the appendix after elemental mercury ingestion. Conservative management was proved to be successful for the removal of the mercury from the appendix while we do not suggest bronchoalveolar lavage in cases of small amount elemental mercury aspiration.

  4. Implementing a Quality Management Framework in a Higher Education Organisation: A Case Study

    ERIC Educational Resources Information Center

    O'Mahony, Kim; Garavan, Thomas N.

    2012-01-01

    Purpose: This paper aims to report and analyse the lessons learned from a case study on the implementation of a quality management system within an IT Division in a higher education (HE) organisation. Design/methodology/approach: The paper is based on a review of the relevant literatures and the use of primary sources such as document analysis,…

  5. Learning through Participatory Resource Management Programs: Case Studies from Costa Rica

    ERIC Educational Resources Information Center

    Sims, Laura; Sinclair, A. John

    2008-01-01

    Based on an ongoing qualitative case study in Costa Rica, this article presents the participatory work that the Instituto Costarricense de Electricidad (ICE) is doing with farmers to protect watersheds from erosion and contamination. Specifically, it includes a description of ICE's Watershed Management Agricultural Programme and how farmers…

  6. 25 CFR 20.515 - What is required for case management?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What is required for case management? 20.515 Section 20.515 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.515 What is required for...

  7. 25 CFR 20.515 - What is required for case management?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false What is required for case management? 20.515 Section 20.515 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.515 What is required for...

  8. 25 CFR 20.515 - What is required for case management?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false What is required for case management? 20.515 Section 20.515 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.515 What is required for...

  9. 25 CFR 20.515 - What is required for case management?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true What is required for case management? 20.515 Section 20.515 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.515 What is required for...

  10. 25 CFR 20.515 - What is required for case management?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false What is required for case management? 20.515 Section 20.515 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.515 What is required for...

  11. The Influence of Lean on K-12 District Management: A Case Study

    ERIC Educational Resources Information Center

    Brown, Beverly

    2011-01-01

    For decades, policymakers and educators have focused on public school equity and adequacy, while paying little attention to efficiency. This qualitative single case study was designed to capture explicit information about Lean management, operations, and culture in a K-12 Michigan school district engaged in Lean training and implementation for a…

  12. Enforced Cultural Change in Academe. A Practical Case Study: Implementing Management Systems in Higher Education.

    ERIC Educational Resources Information Center

    Spencer-Matthews, Sarah

    2001-01-01

    An action research project sought to implement a quality management system in an academic department in an Australian higher education institution. The case study revealed that technical change was attained, but adoption of a quality culture achieved only token acceptance. (EV)

  13. Managing School Districts for High Performance: Cases in Public Education Leadership

    ERIC Educational Resources Information Center

    Childress, Stacey, Ed.; Elmore, Richard F., Ed.; Grossman, Allen, Ed.; Johnson, Susan Moore, Ed.

    2007-01-01

    "Managing School Districts for High Performance" brings together more than twenty case studies and other readings that offer a powerful and transformative approach to advancing and sustaining the work of school improvement. At the center of this work is the concept of organizational coherence: aligning organizational design, human…

  14. Evidence-Based Assessment in Case Management to Improve Abnormal Cancer Screen Follow-Up

    ERIC Educational Resources Information Center

    Vourlekis, Betsy; Ell, Kathleen; Padgett, Deborah

    2005-01-01

    The authors describe an evidence-based assessment protocol for intensive case management to improve screening diagnostic follow-up developed through a research project in breast and cervical cancer early detection funded by the Centers for Disease Control and Prevention. Three components of an evidence-based approach to assessment are presented…

  15. Case Management of Young Children with Behaviour and Mental Health Disorders in School

    ERIC Educational Resources Information Center

    Browne, Graeme; Cashin, Andrew; Graham, Iain

    2012-01-01

    When young children with behaviour and mental health disorders do not receive appropriate specialised support their problems can escalate over time. Their parents find the transition to and early years of schooling stressful and difficult. This paper argues that case management can be an effective strategy for this group of children. Although…

  16. Problems in Knowledge Management: A Case Study of a Knowledge-Intensive Company.

    ERIC Educational Resources Information Center

    van Zolingen, S. J.; Streumer, J. N.; Stooker, M.

    2001-01-01

    A case study of a knowledge-intensive company demonstrated that most knowledge management problems occur in the first three stages of the process (acquiring, codifying, disseminating) rather than in developing and applying. Identifying missing core knowledge, maintaining adequate information systems, and improving dissemination through communities…

  17. Exploring Predictors of Graduate School and Career Success: A Case Study in Sport Management

    ERIC Educational Resources Information Center

    LeCrom, Carrie; Rufer, Lisa; Slavich, Mark; Dwyer, Brendan; Greenhalgh, Gregory

    2016-01-01

    The following case study attempted to assess what factors contribute to graduate school and early-career success among sport management graduate students. As faculty members charged with admitting the next generation of leaders in the sport industry, how should admissions decisions be made and what factors should be considered? The authors…

  18. Data Mining in Course Management Systems: Moodle Case Study and Tutorial

    ERIC Educational Resources Information Center

    Romero, Cristobal; Ventura, Sebastian; Garcia, Enrique

    2008-01-01

    Educational data mining is an emerging discipline, concerned with developing methods for exploring the unique types of data that come from the educational context. This work is a survey of the specific application of data mining in learning management systems and a case study tutorial with the Moodle system. Our objective is to introduce it both…

  19. HEFCE's People Management Self-Assessment Tool: Ticking Boxes or Adding Value? A Case Study

    ERIC Educational Resources Information Center

    McDonald, Claire

    2009-01-01

    This article examines one specific organisational development tool in depth and uses a case study to investigate whether using the tool is more than a tick-box exercise and really can add value and help organisations to develop and improve. The People Management Self-Assessment Tool (SAT) is used to examine higher education institutions' (HEIs)…

  20. The Impact of Management Decision-Making on Student Success in Community Colleges: A Case Study

    ERIC Educational Resources Information Center

    Alt, Albert G.

    2012-01-01

    This case study examined a multi-college community college district in northern California in a primarily rural area, to understand how their practices compared to management best practices designed to improve student success, barriers that may exist in implementing best practices, and how the institution may improve its own practices. The problem…

  1. Managing Criticism in Ph.D. Supervision: A Qualitative Case Study

    ERIC Educational Resources Information Center

    Li, Sarah; Seale, Clive

    2007-01-01

    This article is part of a larger study which presents findings from an in-depth longitudinal case study of a student's Ph.D. journey. It shows how criticism is produced and managed in the supervisory relationship. As well as an overview of types of criticism produced across a range of supervisory interactions, the article presents a micro-analysis…

  2. An Exploration of the Working Alliance in Mental Health Case Management

    ERIC Educational Resources Information Center

    Kondrat, David C.; Early, Theresa J.

    2010-01-01

    The working alliance between clients and helpers has been identified as a common factor of treatment effectiveness, yet very little research has explored variables associated with working alliance between mental health case managers and their consumers. This study explored the potential covariates of working alliance within community mental health…

  3. 75 FR 16486 - Proposed Comment Request for Review of ACF Disaster Case Management Implementation Guide; Office...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-01

    .../her advocate and help him/ her organize and access disaster-related resources, human services, health... HUMAN SERVICES Administration for Children and Families Proposed Comment Request for Review of ACF Disaster Case Management Implementation Guide; Office of Human Services Emergency Preparedness and...

  4. Investigating Positive Psychology Approaches in Case Management and Residential Programming with Incarcerated Youth

    ERIC Educational Resources Information Center

    Cross, Lara E.; Morrison, William; Peterson, Patricia; Domene, Jose F.

    2012-01-01

    This article examines how a rural Canadian secure custody facility for youth implemented positive psychology principles in its case management protocols and residential programming. A directed content analysis design was utilized to identify specific factors of positive psychology in the facility's policy and programming manual, as well as in…

  5. The Clinical Nurse Specialist in the School Setting: Case Management of Migrant Children with Dental Disease.

    ERIC Educational Resources Information Center

    Good, Mary Ellen

    This paper presents strategies for the clinical nurse specialist (CNS) in the school setting to use in case management of migrant children with dental disease. Although dental disease is the major health problem of all school-age children in the nation, the problem is even more severe for children of migrant farmworkers. Leininger's transcultural…

  6. Enhanced Case Management versus Substance Abuse Treatment Alone among Substance Abusers with Depression

    ERIC Educational Resources Information Center

    Striley, Catherine W.; Nattala, Prasanthi; Ben Abdallah, Arbi; Dennis, Michael L.; Cottler, Linda B.

    2013-01-01

    This pilot study evaluated the effectiveness of enhanced case management for substance abusers with comorbid major depression, which was an integrated approach to care. One hundred and 20 participants admitted to drug treatment who also met Computerized Diagnostic Interview Schedule criteria for major depression at baseline were randomized to…

  7. Social Network Assessment: A Critical Component in Case Management for Functionally Impaired Older Persons.

    ERIC Educational Resources Information Center

    Kaufman, Allan V.

    1990-01-01

    Presents a framework that identifies variables associated with relationship dynamics that exist between older persons and their social network members. Suggests framework can be used by case managers to help them assess the characteristics and functioning of their clients' social network relations and develop service strategies that maximize the…

  8. A Randomized Trial of Probation Case Management for Drug-Involved Women Offenders

    ERIC Educational Resources Information Center

    Guydish, Joseph; Chan, Monica; Bostrom, Alan; Jessup, Martha A.; Davis, Thomas B.; Marsh, Cheryl

    2011-01-01

    This article reports findings from a clinical trial of a probation case management (PCM) intervention for drug-involved women offenders. Participants were randomly assigned to PCM (n = 92) or standard probation (n = 91) and followed for 12 months using measures of substance abuse, psychiatric symptoms, social support, and service utilization.…

  9. The Courage to Collaborate: The Case for Labor-Management Partnerships in Education

    ERIC Educational Resources Information Center

    Futernick, Ken

    2016-01-01

    In "The Courage to Collaborate," school turnaround expert Ken Futernick makes the case that collaboration between school management and teacher unions is a necessary condition for educational improvement. The author cites evidence showing that collaboration often leads to increased trust, stronger professional relationships, better…

  10. Process and Outcomes of School Nurse Case Management for Students with Asthma

    ERIC Educational Resources Information Center

    Engelke, Martha Keehner; Swanson, Melvin; Guttu, Martha

    2014-01-01

    There have been many studies that have examined the impact of school-based asthma programs on students with asthma. However, most studies do not provide adequate elaboration on the components of the program. Therefore, replication of these programs is difficult. This study examines the process of school nurse case management, which includes the…

  11. Applying Case-Based Reasoning in Knowledge Management to Support Organizational Performance

    ERIC Educational Resources Information Center

    Wang, Feng-Kwei

    2006-01-01

    Research and practice in human performance technology (HPT) has recently accelerated the search for innovative approaches to supplement or replace traditional training interventions for improving organizational performance. This article examines a knowledge management framework built upon the theories and techniques of case-based reasoning (CBR)…

  12. Case Management Agency Systems of Administering Long-Term Care: Evidence from the Channeling Demonstration.

    ERIC Educational Resources Information Center

    Kemper, Peter

    1990-01-01

    Examines what was learned from channeling demonstration about potential of case management agency systems for administering home care benefits. Considers both advantages (substitution of lower cost for higher cost services, negotiation of lower prices for services, quality assurance) and disadvantages (difficulty controlling participation rates,…

  13. Bladder Endometriosis and Endocervicosis: Presentation of 2 Cases with Endoscopic Management and Review of Literature

    PubMed Central

    Fuentes Pastor, Javier; Ballestero Diego, Roberto; Correas Gómez, Miguel Ángel; Torres Díez, Eduardo; Fernández Flórez, Alejandro; Ballesteros Olmos, Gerardo; Gutierrez Baños, Jose Luis

    2014-01-01

    Urinary tract endometriosis and endocervicosis are an uncommon pathologic finding, with a common embryological origin. We present 2 cases of female patients with bladder mass. The first one was a finding of a nodular formation in the bladder during study of a nonviable foetus and the second was an incidental finding of a neoformation in the fundus of the bladder during the realization of an ultrasound. In both cases, we performed a surgical management with transurethral resection. Histopathological examination revealed a bladder endometrioma in the first case and endocervicosis with associated endometriosis in the second. PMID:25184072

  14. School nurse case management for children with chronic illness: health, academic, and quality of life outcomes.

    PubMed

    Keehner Engelke, Martha; Guttu, Martha; Warren, Michelle B; Swanson, Melvin

    2008-08-01

    More children with chronic illnesses are attending school, and some of them struggle academically because of issues related to their health. School-based case management has been suggested as one strategy to improve the academic success of these children. This study tracked the academic, health, and quality of life outcomes for 114 children with asthma, diabetes, severe allergies, seizures, or sickle-cell anemia in 5 different school districts who were provided case management by school nurses. The children ranged in age from 5 to 19 years. At the end of the school year, children experienced an improvement in quality of life and gained skills and knowledge to manage their illness more effectively. Classroom participation, grades, and participation in extracurricular activities also increased for many children. The study provides evidence of the positive impact school nurses have on children with chronic illness and suggests ways they can measure the outcomes of their interventions.

  15. Educating Resident Physicians Using Virtual Case-Based Simulation Improves Diabetes Management: A Randomized Controlled Trial

    PubMed Central

    Sperl-Hillen, JoAnn; O’Connor, Patrick J.; Ekstrom, Heidi L.; Rush, William A.; Asche, Stephen E.; Fernandes, Omar D.; Apana, Deepika; Amundson, Gerald H.; Johnson, Paul E.; Curran, Debra M.

    2014-01-01

    Purpose To test a virtual case-based Simulated Diabetes Education (SimDE) intervention developed to teach primary care residents how to manage diabetes. Method Nineteen primary care residency programs, with 341 volunteer residents in all post-graduate years (PGY), were randomly assigned to a SimDE intervention group or control group (CG). The web-based interactive educational intervention used computerized virtual patients who responded to provider actions through programmed simulation models. Eighteen distinct learning cases (L-cases) were assigned to SimDE residents over 6 months from 2010–2011. Impact was assessed using performance on 4 virtual assessment cases (A-cases), an objective knowledge test, and pre-post changes in self-assessed diabetes knowledge and confidence. Group comparisons were analyzed using generalized linear mixed models, controlling for clustering of residents within residency programs and differences in baseline knowledge. Results The percentage of residents appropriately achieving A-case composite clinical goals for glucose, blood pressure, and lipids was: A-Case 1, SimDE = 21.2%, CG = 1.8%, P = .002; A-Case 2, SimDE = 15.7%, CG = 4.7%, P = .02; A-Case 3, SimDE = 48.0%, CG = 10.4%, P < .001; A-Case 4, SimDE = 42.1%, CG = 18.7%, P = .004. The mean knowledge score and pre-post changes in self-assessed knowledge and confidence were significantly better for SimDE group than CG participants. Conclusions A virtual case-based simulated diabetes education intervention improved diabetes management skills, knowledge, and confidence for primary care residents. PMID:25006707

  16. Population-based worksite obesity management interventions: a qualitative case study.

    PubMed

    Romney, Martha C; Thomson, Erin; Kash, Kathryn

    2011-06-01

    Due to the increased prevalence of obesity and associated direct and indirect costs to employers, weight management programs have become an integral component of employer and insurer benefits plans. The programs vary in foci, scope, breadth, and implementation. The aim of this study was to explore promising employer-sponsored population-based obesity management programs. A case study that utilized a telephonic semi-structured questionnaire was conducted with small and large organizations located in different regions of the United States that had been recruited to participate. Eight employers and 1 health care advocacy coalition who met the inclusion criteria were interviewed about features of their weight management programs. The case study revealed a number of themes consistent with reports in the literature and reflecting cited best practices. Key findings include confirmation that weight management is a significant component of the wellness strategy in all participating organizations because employers are invested in population health programs and cost savings. Based upon their experience and knowledge, occupational health specialists are responsible for designing, implementing, managing, and evaluating employee health programs. Almost all employers utilize electronic media as a prominent component of wellness and disease management initiatives. Experience has shown that incentives-both financial and nonmonetary-are effective motivators for employee engagement and outcomes. However, while employers report success, favorable outcomes have been difficult to quantify.

  17. [Management of tuberculosis (TB) cases from view points of public health].

    PubMed

    Satoh, Ken; Motomiya, Masakichi

    2011-08-01

    Tuberculosis control law was enacted in 1951 and has been the basis for the management of TB cases over the long post-war period. This law has legalized the use of public founds for the treatment of TB patients for the first time and has provided the authentic basis for mandatory hospitalization, routine health examination, vaccination, notification and registration of TB cases. However, this law was abrogated in 2001 and was joined to the comprehensive infectious diseases control law, in order to facilitate a prophylactic measure against TB infection and to protect human rights of TB patients. Concurrently the medical care system and the formalities connected to hospitalization treatment of TB patients were reviewed. The purpose of the present overview is to explain how TB cases are managed under the newly-enacted law.

  18. Clinical presentation, diagnosis and management of Cryptococcus gattii cases: Lessons learned from British Columbia

    PubMed Central

    Galanis, Eleni; Hoang, Linda; Kibsey, Pamela; Morshed, Muhammad; Phillips, Peter

    2009-01-01

    The environmental fungus Cryptococcus gattii emerged on Vancouver Island, British Columbia (BC), in 1999. By the end of 2006, it led to 176 cases and eight deaths – one of the highest burdens of C gattii disease worldwide. The present paper describes three cases, and the BC experience in the diagnosis and management of this infection. All three cases presented with pulmonary findings, including cryptococcomas and infiltrates. One also presented with brain cryptococcomas. Cases were diagnosed by chest and brain imaging, and laboratory evidence including serum or cerebrospinal fluid cryptococcal antigen detection and culture of respiratory or cerebrospinal fluid specimens. Genotyping of fungal isolates confirmed infection with C gattii VGIIa. Pulmonary cases were treated with fluconazole. One patient with central nervous system disease was treated with amphotericin B followed by fluconazole. Although this infection remains rare, clinicians should be aware of it in patients with a compatible clinical presentation who are either living in or returning from a trip to BC. PMID:20190892

  19. Giant idiopathic renal arteriovenous fistula managed by coils and amplatzer device: Case report and literature review

    PubMed Central

    Nagpal, Prashant; Bathla, Girish; Saboo, Sachin S; Khandelwal, Ashish; Goyal, Abhishek; Rybicki, Frank J; Steigner, Michael L

    2016-01-01

    An idiopathic renal arteriovenous (AV) fistula is a rare malformation of the kidney that may present insidiously with heart failure or hematuria. The treatment may be challenging due to large fistula size that may limit endovascular management. The authors report a case of an 85-year-old Caucasian woman who presented with acute heart failure and was found to have a right renal AV fistula. Since she had no prior history of renal intervention or trauma, a diagnosis of idiopathic renal AV fistula was made. She was managed by endoluminal occlusion using multiple stainless steel coils and Amplatzer vascular plug II device. The follow-up computed tomography showed complete occlusion of the fistula. This report highlights the late presentation of this rare disease and presents the utility of the combination of coils and Amplatzer device for management of a large fistula. It also reiterates that even if large, these fistulas can be managed by endovascular occlusion. PMID:27900325

  20. Condom Tamponade in the Management of Primary Postpartum Haemorrhage: A Report of three cases in Ghana.

    PubMed

    Maya, Ernest T; Buntugu, Kennedy A; Aki, Lovelace; Srofenyoh, Emmanuel K

    2015-09-01

    Postpartum haemorrhage is one of the major causes of maternal mortality worldwide. The leading cause of primary postpartum haemorrhage is uterine atony and active management of the third stage of labour with oxytocin is recommended for preventing primary postpartum haemorrhage. Parenteral oxytocin is also the drug of choice for medical management of postpartum haemorrhage secondary to uterine atony. Condom uterine balloon tamponade is .a low cost technique that can be used as a second-line option for treatment. We report retrospectively three cases of primary PPH secondary to uterine atony which were managed successfully with condom tamponade. Condom tamponade is effective in managing post partum haemorrhage secondary to uterine atony and we advocate for the training of all skilled attendants on how to insert the condom tamponade.

  1. Ecosystem Services Insights into Water Resources Management in China: A Case of Xi’an City

    PubMed Central

    Liu, Jingya; Li, Jing; Gao, Ziyi; Yang, Min; Qin, Keyu; Yang, Xiaonan

    2016-01-01

    Global climate and environmental changes are endangering global water resources; and several approaches have been tested to manage and reduce the pressure on these decreasing resources. This study uses the case study of Xi’an City in China to test reasonable and effective methods to address water resource shortages. The study generated a framework combining ecosystem services and water resource management. Seven ecosystem indicators were classified as supply services, regulating services, or cultural services. Index values for each indicator were calculated, and based on questionnaire results, each index’s weight was calculated. Using the Likert method, we calculated ecosystem service supplies in every region of the city. We found that the ecosystem’s service capability is closely related to water resources, providing a method for managing water resources. Using Xi’an City as an example, we apply the ecosystem services concept to water resources management, providing a method for decision makers. PMID:27886137

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

    PubMed

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

    2017-02-01

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

  3. Economic assessment of managing processionary moth in pine forests: a case-study in Portugal.

    PubMed

    Gatto, Paola; Zocca, Alessia; Battisti, Andrea; Barrento, Maria João; Branco, Manuela; Paiva, Maria Rosa

    2009-02-01

    This paper assesses the private and social profitability of current strategies for managing processionary moth (Thaumetopoea pityocampa) in Portuguese pine forests, looking at economic and environmental costs and benefits. Costs include the expenses for forest treatment and the social costs of threats to human health (dermatitis amongst others); benefits are assessed in terms of both revenue and social benefits such as carbon fixation and recreation. The evaluation was done using Cost Benefit Analysis (CBA) as an analytical framework. While this tool is currently applied to forest and environmental assessment and specific applications to pest management strategies are to be found in agricultural economics, rather few attempts have been made in the field of forest pest management. In order to assess and compare with--without options, a case-study was analysed for the Setúbal Peninsula, south of Lisbon, an area where extensive stands of maritime pine (Pinus pinaster) grow. The exercise has shown that CBA can be a valuable tool for assessing the economic and social profitability of pest management. The results demonstrate that the loss of revenues in the no-management option is not sufficient to make pest management profitable for private forest owners in the short-term. Conversely, a social profit is gained as pest management minimizes health risks for humans and avoids possible recreational losses.

  4. ISMAC: An Intelligent System for Customized Clinical Case Management and Analysis

    PubMed Central

    You, Mingyu; Chen, Chong; Li, Guo-Zheng; Yan, Shi-Xing; Sun, Sheng; Zeng, Xue-Qiang; Zhao, Qing-Ce; Xu, Liao-Yu; Huang, Su-Ying

    2015-01-01

    Clinical cases are primary and vital evidence for Traditional Chinese Medicine (TCM) clinical research. A great deal of medical knowledge is hidden in the clinical cases of the highly experienced TCM practitioner. With a deep Chinese culture background and years of clinical experience, an experienced TCM specialist usually has his or her unique clinical pattern and diagnosis idea. Preserving huge clinical cases of experienced TCM practitioners as well as exploring the inherent knowledge is then an important but arduous task. The novel system ISMAC (Intelligent System for Management and Analysis of Clinical Cases in TCM) is designed and implemented for customized management and intelligent analysis of TCM clinical data. Customized templates with standard and expert-standard symptoms, diseases, syndromes, and Chinese Medince Formula (CMF) are constructed in ISMAC, according to the clinical diagnosis and treatment characteristic of each TCM specialist. With these templates, clinical cases are archived in order to maintain their original characteristics. Varying data analysis and mining methods, grouped as Basic Analysis, Association Rule, Feature Reduction, Cluster, Pattern Classification, and Pattern Prediction, are implemented in the system. With a flexible dataset retrieval mechanism, ISMAC is a powerful and convenient system for clinical case analysis and clinical knowledge discovery. PMID:26495425

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

    PubMed

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

    2016-07-01

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

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

    PubMed Central

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

    2016-01-01

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

  7. Case management of chiropractic patients with cervical brachialgia: A survey of French chiropractors

    PubMed Central

    2011-01-01

    Background Not much is known about the French chiropractic profession on, for example, level of consensus on clinical issues. Objectives The first objective was to investigate if French chiropractors' management choices appeared reasonable for various neck problem scenarios. The second objective was to investigate if there was agreement between chiropractors on the patient management. The third objective was to see to which degree and at what stages chiropractors would consider to interact with other health-care practitioners, such as physiotherapists, general practitioners and specialists. Method A questionnaire was sent to a randomly selected sample of all French chiropractors known to the national chiropractic college. It consisted of an invitation to participate in the study, a brief case description, and drawings of five stages of how a case of neck pain gradually evolves into a brachialgia to end up with a compromised spinal cord. Each stage offered five management choices. Participants were asked at what stages patients would be treated solely by the chiropractor and when patients would be referred out for second opinion or other care without chiropractic treatment, plus an open ended option, resulting in a "five-by-six" table. The percentages of respondents choosing the different management strategies were identified for the different scenarios and the 95% confidence intervals were calculated. There was a pre hoc agreement on when chiropractic care would or would not be suitable. Consensus was arbitrarily defined as "moderate" when 50- 69% of respondents agreed on the same management choice and as "excellent" when 70% or more provided the same answer. It was expected that inter professional contacts would be rare. Results The response rate was 53% out of 254 potential participants. The first two uncomplicated cases would generally have been treated by the chiropractors. As the patient worsened, the responses tended towards external assistance and for the

  8. Administrators in Action--Managing Public Monies and Processing Emotion in School Activities: A Teaching Case Study

    ERIC Educational Resources Information Center

    Tenuto, Penny L.; Gardiner, Mary E.; Yamamoto, Julie K.

    2015-01-01

    This teaching case describes school administrators in action performing day-to-day leadership tasks, managing public funds in school activities, and interacting with others appropriately. The case focuses on administrative challenges in handling and managing school activity funds. A method for processing emotion is discussed to assist…

  9. The clinical psychologist and the management of inpatient pain: a small case series

    PubMed Central

    Childs, Susan R; Casely, Emma M; Kuehler, Bianca M; Ward, Stephen; Halmshaw, Charlotte L; Thomas, Sarah E; Goodall, Ian D; Bantel, Carsten

    2014-01-01

    Recent research has confirmed that between 25% and 33% of all hospitalized patients experience unacceptable levels of pain. Studies further indicate that this reduces patient satisfaction levels, lengthens hospital stays, and increases cost. Hospitals are aiming to discharge patients earlier, and this can interfere with adequate pain management. Therefore, the pain service at Chelsea and Westminster Hospital has adapted to this changing model of care. An increasing body of evidence demonstrates that psychological factors are key components of patients’ pain experiences in both acute and chronic pain. Therefore, it is reasonable to suggest a clinical psychologist should be involved in inpatient pain management. This small study discusses three cases that highlight how patient care could be improved by including a clinical psychologist as part of the inpatient pain team. Two cases particularly highlight the active role of the psychologist in the diagnosis and management of common conditions such as fear and anxiety, along with other psychiatric comorbidities. The management therefore employed an eclectic approach adapted from chronic pain and comprising of behavioral, cognitive behavioral, and dialectical behavioral therapeutic techniques blended with brief counseling. The third case exemplifies the importance of nurse-patient interactions and the quality of nurse-patient relationships on patient outcomes. Here, the psychologist helped to optimize communication and to resolve a difficult and potentially risk-laden situation. This small case series discusses the benefits derived from the involvement of a clinical psychologist in the management of inpatient pain, and therefore illustrates the need for novel initiatives for inpatient pain services. However, future research is warranted to validate this approach. PMID:25506221

  10. Ayurvedic management of life-threatening skin emergency erythroderma: A case study

    PubMed Central

    Singh, Sarvesh Kumar; Rajoria, Kshipra

    2015-01-01

    Erythroderma or generalized exfoliative dermatitis is a skin disorder that requires attention equivalent to medical emergencies. It is more prevalent in male population. It accounts for 35 cases/100,000 cases in dermatologic outpatient departments. In erythroderma even with proper management there are certain metabolic burdens and complications which make it more critical. The primary aim, in this case, was to treat the patient with Ayurvedic management. A 18-year-old patient, suffering from erythroderma, was treated on the line of Kapala Kushtha and Audumbera Kushtha. The patient had primarily suffered from psoriasis for 8 years. Erythroderma was developed due to abrupt self-medication with an unknown amount of intramuscular methylprednisolone several times in last month. Rasamanikya-125 mg, Arogyavardhini Vati-1 g, Kaishora Guggulu-1 g, Khadirarista-20 ml, and Panchatikta Ghrita-20 ml, all drugs twice a day with 3-4 times local application of Jatyadi Taila were administered. A decoction of Jwarhara Kashaya was also administered in the dose of 40 ml twice a day. The patient had relief from the acute phase after 20 days of treatment and complete remission after 3 months of treatment. This case study demonstrates that Ayurvedic management may be useful in erythroderma like acute and life-threatening condition. PMID:26730142

  11. Ayurvedic management of life-threatening skin emergency erythroderma: A case study.

    PubMed

    Singh, Sarvesh Kumar; Rajoria, Kshipra

    2015-01-01

    Erythroderma or generalized exfoliative dermatitis is a skin disorder that requires attention equivalent to medical emergencies. It is more prevalent in male population. It accounts for 35 cases/100,000 cases in dermatologic outpatient departments. In erythroderma even with proper management there are certain metabolic burdens and complications which make it more critical. The primary aim, in this case, was to treat the patient with Ayurvedic management. A 18-year-old patient, suffering from erythroderma, was treated on the line of Kapala Kushtha and Audumbera Kushtha. The patient had primarily suffered from psoriasis for 8 years. Erythroderma was developed due to abrupt self-medication with an unknown amount of intramuscular methylprednisolone several times in last month. Rasamanikya-125 mg, Arogyavardhini Vati-1 g, Kaishora Guggulu-1 g, Khadirarista-20 ml, and Panchatikta Ghrita-20 ml, all drugs twice a day with 3-4 times local application of Jatyadi Taila were administered. A decoction of Jwarhara Kashaya was also administered in the dose of 40 ml twice a day. The patient had relief from the acute phase after 20 days of treatment and complete remission after 3 months of treatment. This case study demonstrates that Ayurvedic management may be useful in erythroderma like acute and life-threatening condition.

  12. Implications of case managers' perceptions and attitude on safety of home-delivered care.

    PubMed

    Jones, Sarahjane

    2015-12-01

    Perceptions on safety in community care have been relatively unexplored. A project that sought to understand the multiple perspectives on safety in the NHS case-management programme was carried out in relation to the structure, process, and outcome of care. This article presents a component of the nursing perspective that highlights an important element in the structure of nursing care that could potentially impede the nurses' ability to be fully effective and safe. A single case study of the case-management programme was undertaken. Three primary care organisations from three strategic health authorities participated, and three focus groups were conducted (one within each organisation). In total, 17 case management nurses participated. Data were audiotaped and transcribed verbatim and subjected to framework analysis. Nursing staff attitudes were identified as a structure of care that influence safety outcomes, particularly their perceptions of the care setting and the implications it has on their role and patient behaviour. Greater understanding of the expected role of the community nurse is necessary, and relevant training is required for nurses to be successful in empowering patients to perform more safely. In addition, efforts need to be made to improve patients' trust in the health-care system to prevent harm and promote more effective utilisation of resources.

  13. Valuing stormwater, rainwater and wastewater in the soft path for water management: Australian case studies.

    PubMed

    Chanan, A; Vigneswaran, S; Kandasamy, J

    2010-01-01

    A Water Sensitive City is now commonly acknowledged best practice for designing the cities of the future. In Australia, the National Water Initiative has allocated high priority towards offering insight into successful water sensitive urban development projects, to facilitate capacity building within the industry. This paper shares innovative water sensitive projects implemented at Kogarah City Council, in Sydney. Four key projects are discussed, demonstrating how stormwater, rainwater and wastewater can be incorporated into decentralised water systems to offer sustainable water management of the future. The case studies included in the paper highlight Kogarah's journey towards the Soft Path for Water Management.

  14. Multidisciplinary Management of An Unusual Isolated Alveolar Bone Infection- A Rare Case Report

    PubMed Central

    B, Dixit Mala; S, Kulkarni Rahul; M, Ramugade Manoj

    2015-01-01

    Restoration of proximal defect of tooth is of paramount importance as its improper restoration usually results in fracture of the restoration or deteriorated periodontal health. The article reports a case with a discreet mass of alveolar bone necrosis closed to the overhanged amalgam restoration in the proximal box of the maxillary molar. As a result of this improper proximal restoration it led to deep periodontal pocket and subsequent alveolar bone necrosis which was managed successfully with combined Endodontic-Periodontic treatment. This article highlights the unfortunate sequelae of bone necrosis as a consequence of an incorrect or overlooked dental treatment and its comprehensive management. PMID:26155587

  15. Malignant Catatonia Warrants Early Psychiatric-Critical Care Collaborative Management: Two Cases and Literature Review

    PubMed Central

    Tan, Josh; Krzeminski, Sylvia; Hazeghazam, Maryam; Bandlamuri, Meghana; Carlson, Richard W.

    2017-01-01

    Malignant catatonia (MC) is a life-threatening manifestation which can occur in the setting of an underlying neuropsychiatric syndrome or general medical illness and shares clinical and pathophysiological features and medical comorbidities with the Neuroleptic Malignant Syndrome (NMS). The subsequent diagnosis and definitive therapy of MC are typically delayed, which increases morbidity and mortality. We present two cases of MC and review recent literature of MC and NMS, illustrating factors which delay diagnosis and management. When clinical features suggest MC or NMS, we propose early critical care consultation and stabilization with collaborative psychiatric management. PMID:28250995

  16. Malignant Catatonia Warrants Early Psychiatric-Critical Care Collaborative Management: Two Cases and Literature Review.

    PubMed

    Park, Julia; Tan, Josh; Krzeminski, Sylvia; Hazeghazam, Maryam; Bandlamuri, Meghana; Carlson, Richard W

    2017-01-01

    Malignant catatonia (MC) is a life-threatening manifestation which can occur in the setting of an underlying neuropsychiatric syndrome or general medical illness and shares clinical and pathophysiological features and medical comorbidities with the Neuroleptic Malignant Syndrome (NMS). The subsequent diagnosis and definitive therapy of MC are typically delayed, which increases morbidity and mortality. We present two cases of MC and review recent literature of MC and NMS, illustrating factors which delay diagnosis and management. When clinical features suggest MC or NMS, we propose early critical care consultation and stabilization with collaborative psychiatric management.

  17. Outcomes for patients with congestive heart failure in a nursing case management model.

    PubMed

    Morrison, R S; Beckworth, V

    1998-01-01

    Congestive heart failure is a leading cause of hospital admissions, costing an estimated $7 billion in 1990. Hospital-based nursing case management has been used to reduce costs of care while maintaining quality of care. This study describes the outcomes for 50 patients with congestive heart failure in a hospital-based nursing care management model, providing general outcomes, physiologic status, physical functioning, health knowledge, and family caregiver status. The number of medications was the only predictor of length of stay using regression analysis.

  18. Left Ventricular Pseudoaneurysm Following Inferior Myocardial Infarction: A Case for Conservative Management

    PubMed Central

    Ludmir, Jonathan; Kapoor, Karan; George, Praveen; Khural, Jasjeet; Barr, Brian

    2016-01-01

    Left ventricular pseudoaneurysm is a rare complication of myocardial infarction that carries a high mortality rate. Although conventional wisdom suggests prompt surgical repair in order to mitigate risk of expansion and rupture, there are some data to support non-operative management in asymptomatic individuals with likely chronic pseudoaneurysms, particularly when surgical candidacy is poor. We present a case of a medically managed left ventricular pseudoaneurysm subsequent to inferior ST-segment elevation myocardial infarction with 6-month follow-up data. PMID:28197266

  19. Developing a computer algorithm to identify epilepsy cases in managed care organizations.

    PubMed

    Holden, E Wayne; Grossman, Elizabeth; Nguyen, Hoang Thanh; Gunter, Margaret J; Grebosky, Becky; Von Worley, Ann; Nelson, Leila; Robinson, Scott; Thurman, David J

    2005-02-01

    The goal of this study was to develop an algorithm for detecting epilepsy cases in managed care organizations (MCOs). A data set of potential epilepsy cases was constructed from an MCO's administrative data system for all health plan members continuously enrolled in the MCO for at least 1 year within the study period of July 1, 1996 through June 30, 1998. Epilepsy status was determined using medical record review for a sample of 617 cases. The best algorithm for detecting epilepsy cases was developed by examining combinations of diagnosis, diagnostic procedures, and medication use. The best algorithm derived in the exploratory phase was then applied to a new set of data from the same MCO covering the period of July 1, 1998 through June 30, 2000. A stratified sample based on ethnicity and age was drawn from the preliminary algorithm-identified epilepsy cases and non-cases. Medical record review was completed for 644 cases to determine the accuracy of the algorithm. Data from both phases were combined to permit refinement of logistic regression models and to provide more stable estimates of the parameters. The best model used diagnoses and antiepileptic drugs as predictors and had a positive predictive value of 84% (sensitivity 82%, specificity 94%). The best model correctly classified 90% of the cases. A stable algorithm that can be used to identify epilepsy patients within MCOs was developed. Implications for use of the algorithm in other health care settings are discussed.

  20. Management of traumatic hemipelvectomy: an institutional experience on four consecutive cases

    PubMed Central

    2013-01-01

    Background and objective The incidence of traumatic hemipelvectomy is rare, but it is a devastating injury. Recently, an increasing number of patients with traumatic hemipelvectomy are admitted to trauma centers alive due to improvements of the pre-hospital care. Successful management requires prompt recognition of the nature of this injury and meticulous surgical technique. We present our successful experiences on four cases of traumatic hemipelvectomy in the past nine years. Patients and methods Four cases with traumatic hemipelvectomy were admited to our hospital from June 21, 2002 to September 3, 2011. All injuries occurred due to vehicle accident and all patients were in a state of severe hypotension, with two of them having anal lacerations. These four cases were treated immediately with resuscitation, control of hemorrhage, early amputation, repeated debridement and closure of the wounds. An angiographic embolization was given to control hemorrhage in two of the cases preoperatively. One case underwent fecal diversion. Wound infection occurred in all of cases which was successfully controlled by repeated debridements, effective anti-biotic regimen, split-thickness skin grafts. Results All four cases were saved successfully with well-healed wounds during follow up from 1 to 7 years. They were able to walk by themself using crutches. Conclusion Adhering to the surgery principles of damage control including appropriate resuscitation, hemorrhage control, coagulopathy correction and multiple debridements and closure of the wounds in reasonable period of time can save the life of cases suffering from severe pelvic ring injury. PMID:23953033

  1. Laparoscopic Management of a Very Rare Case: Cystic Artery Pseudoaneurysm Secondary to Acute Cholecystitis

    PubMed Central

    Ferahman, Sina; Demiryas, Süleyman; Samanci, Cesur

    2016-01-01

    Pseudoaneurysm of a cystic artery is a rare entity that commonly occurs secondary to biliary procedures. Most of the cases in literature are consisted of ruptured aneurysms and to our knowledge, except our case, there were only 3 cases with unruptured aneurysms, which incidentally were detected by radiological methods. When cystic artery pseudoaneurysm is present with acute cholecystitis, most of the reports in literature suggested open cholecystectomy with the ligation of the cystic artery as a main treatment option. In this paper we present a case of acute cholecystitis with unruptured cystic artery pseudoaneurysm that incidentally was detected by computed tomography (CT). Cystic artery pseudoaneurysm was handled laparoscopically with simultaneous cholecystectomy. Due to high risk of rupture, surgeons have evaded laparoscopic approach to acute cholecystitis, which accompanied cystic artery pseudoaneurysm. However herein, we proved that laparoscopic management of cystic artery pseudoaneurysm with simultaneous cholecystectomy is feasible and reliable method. PMID:27635274

  2. Perioprosthetic and Implant-Supported Rehabilitation of Complex Cases: Clinical Management and Timing Strategy

    PubMed Central

    Landi, Luca; Piccinelli, Stefano; Raia, Roberto; Marinotti, Fabio

    2016-01-01

    Treatment of complex perioprosthetic cases is one of the clinical challenges of everyday practice. Only a complete and thorough diagnostic setup may allow the clinician to formulate a realistic prognosis to select the abutments to support prosthetic rehabilitation. Clinical, radiographic, or laboratory parameters used separately are useless to correctly assign a reliable prognosis to single teeth except in the case of a clearly hopeless tooth. Therefore, it is crucial to gather the greatest quantity of data to determine the role that every single element can play in the prosthetic rehabilitation of the case. The following report deals with the management of a multidisciplinary periodontally compromised case in which a treatment strategy and chronology were designed to reach clinical predictability while reducing the duration of the therapy. PMID:27891261

  3. A prototype case-based reasoning human assistant for space crew assessment and mission management

    NASA Technical Reports Server (NTRS)

    Owen, Robert B.; Holland, Albert W.; Wood, Joanna

    1993-01-01

    We present a prototype human assistant system for space crew assessment and mission management. Our system is based on case episodes from American and Russian space missions and analog environments such as polar stations and undersea habitats. The general domain of small groups in isolated and confined environments represents a near ideal application area for case-based reasoning (CBR) - there are few reliable rules to follow, and most domain knowledge is in the form of cases. We define the problem domain and outline a unique knowledge representation system driven by conflict and communication triggers. The prototype system is able to represent, index, and retrieve case studies of human performance. We index by social, behavioral, and environmental factors. We present the problem domain, our current implementation, our research approach for an operational system, and prototype performance and results.

  4. Do expert assessments converge? An exploratory case study of evaluating and managing a blood supply risk

    PubMed Central

    2011-01-01

    Background Examining professional assessments of a blood product recall/withdrawal and its implications for risk and public health, the paper introduces ideas about perceptions of minimal risk and its management. It also describes the context of publicly funded blood transfusion in Canada and the withdrawal event that is the basis of this study. Methods Interviews with 45 experts from administration, medicine, blood supply, laboratory services and risk assessment took place using a multi-level sampling framework in the aftermath of the recall. These experts either directly dealt with the withdrawal or were involved in the management of the blood supply at the national level. Data from these interviews were coded in NVivo for analysis and interpretation. Analytically, data were interpreted to derive typifications to relate interview responses to risk management heuristics. Results While all those interviewed agreed on the importance of patient safety, differences in the ways in which the risk was contextualized and explicated were discerned. Risk was seen in terms of patient safety, liability or precaution. These different risk logics are illustrated by selected quotations. Conclusions Expert assessments did not fully converge and it is possible that these different risk logics and discourses may affect the risk management process more generally, although not necessarily in a negative way. Patient safety is not to be compromised but management of blood risk in publicly funded systems may vary. We suggest ways of managing blood risk using formal and safety case approaches. PMID:21864330

  5. A Clinico-Mycological Study on Suspected Cases of Chromoblastomycosis: Challenges in Diagnosis and Management

    PubMed Central

    Majumdar, Banashree; Jain, Atul; Maiti, Prasanta Kumar; Chatterjee, Gobinda

    2015-01-01

    Introduction Verrucous plaques mimicking chromoblastomycosis are frequently seen in dermatology outpatient departments (OPD). However, no scientific evaluation has been carried out till date from eastern India. So this present endeavour is aimed at a thorough study of those cases to readdress the challenges in diagnosis and management in chromoblastomycosis from this part of the country. Aim The study is to observe the incidence of proved chromoblastomycosis cases from clinically mimicking conditions and to note therapeutic prospects by use of different antifungal agents. Materials and Methods Twenty clinically suspected cases attending dermatology OPD were included in this study. Relevant histories were taken. Apart from routine hematological and biochemical investigations, scrapings from lesions were examined by direct microscopy with KOH wet mount, calcoflour white mount and fungal culture. Histopatholgical examination was also done. Any fungal growth was identified by growth characteristics and morphological features. Results Sclerotic bodies were detected in five samples. Of them three were found to be culture positive. Two growths were identified as Fonsecaea pedrosoi and one as Cladosporium carrionii. Rest 12 cases were diagnosed as either lupus vulgaris (3 cases; 15%), atypical mycobacterial infections (3 cases, 15%), Hypertrophic lichen planus (2, 10%), Hypertrophic DLE plaque (2; 10%), Wart (1, 5%) or fixed cutaneous sporothricosis (1, 5%), zygomycosis (1, 5%). Three cases (15%) were lost in follow up. Cases of chromoblastomycosis were managed with prolonged use of antifungal alone or in combination with saturated solution of potassium iodide and/or debridement. They were followed up for at least six months post treatment. Conclusion A database comprising diagnostic clues and effective therapeutic intervention have been proposed for these rare subcutaneous mycoses. PMID:26816977

  6. Modern Spirometry Supports Anesthetic Management in Small Animal Clinical Practice: A Case Series.

    PubMed

    Calice, Ivana; Moens, Yves

    2016-01-01

    Modern spirometry, like no other monitoring technique, allows insight into breath-to-breath respiratory mechanics. Spirometers continuously measure volume, airway pressure, and flow while calculating and continuously displaying respiratory system compliance and resistance in the form of loops. The aim of this case series is to show how observation of spirometric loops, similar to electrocardiogram or CO2 curve monitoring, can improve safety of anesthetic management in small animals. Spirometric monitoring cases described in this case series are based on use of the anaesthesia monitor Capnomac Ultima with a side stream spirometry sensor. The cases illustrate how recognition and understanding of spirometric loops allows for easy diagnosis of iatrogenic pneumothorax, incorrect ventilator settings, leaks in the system, kinked or partially obstructed endotracheal tube, and spontaneous breathing interfering with intermittent positive-pressure ventilation. The case series demonstrates the potential of spirometry to improve the quality and safety of anesthetic management, and, hence, its use can be recommended during intermittent positive-pressure ventilation and procedures in which interference with ventilation can be expected.

  7. Management dilemmas in a rare case of pituitary apoplexy in the setting of dengue hemorrhagic fever

    PubMed Central

    Balaparameswara Rao, S. J.; Savardekar, Amey R.; Nandeesh, B. N.; Arivazhagan, A.

    2017-01-01

    Background: Pituitary apoplexy occurs due to infarction or hemorrhage, within a pituitary adenoma or a nontumorous pituitary gland and can have catastrophic consequences. Dengue hemorrhagic fever (DHF) is a severe manifestation of the spectrum of dengue virus infection and is characterized by high-grade fever, thrombocytopenia, hemorrhagic tendencies, and increased vascular permeability. Cases of incidentalomas complicated by DHF and presenting with apoplexy are extremely rare. Case Description: We describe the case of a 45-year-old gentleman who suffered an attack of pituitary apoplexy while being treated for DHF. The issues pertaining to the management of hydrocephalus, timing of surgical intervention, and treatment of electrolyte imbalances encountered in the dual setting of DHF and pituitary apoplexy are discussed with reference to the outcome in our case. Conclusion: Although patients suffering from DHF harbor multiple factors, which may be precipitants of pituitary apoplexy, the association between these two conditions is rare and only few case reports document their coexistence. We review the pertinent literature and discuss the management dilemmas faced by us while dealing with these dual pathological states. PMID:28217383

  8. Challenges in the diagnosis and management of sleeping sickness in Tanzania: a case report.

    PubMed

    Sindato, C; Kibona, S N; Nkya, G M; Mbilu, T J N K; Manga, C; Kaboya, J S; Rawille, F

    2008-07-01

    In Tanzania sleeping sickness presents a serious threat to human health with a country-wide average of 400 cases reported annually. Both wild and domestic animals have been found to play a significant role in the epidemiology of sleeping sickness. Serengeti National Park in northern Tanzania, has experienced a number of sleeping sickness epidemics since 1922. The epidemics were associated with abundant game animals in the areas and Glossina swynnertoni was incriminated as the main vector. However since 2001 there has been no case of sleeping sickness reported from the park. This case report highlights on the possibility of resurgence and challenges in the diagnosis and management of sleeping sickness in Serengeti. A 38 years old Tanzanian man working in the Serengeti National Park who had experienced various tsetse bites was presented with a febrile condition and history of unsuccessful case management at different health facilities. Blood and cerebrospinal fluid (CSF) samples were examined for the presence oftrypanosomes using wet film, Field's stain and concentration techniques. Typanosoma brucei rhodesiense were detected in both the blood and CSF samples. The patient was treated successfully with melarsoprol. The results of this case study highlight the possibility of resurgence of sleeping sickness in the park hence calls for the need to create more awareness among the community and clinicians. There is need for early reporting to health facility and strengthening the diagnostic capacity of healthcare facilities in and around national parks endemic for sleeping sickness.

  9. Challenges in the management of a rare case of extensive retroperitoneal haemangioma in a pregnant woman

    PubMed Central

    Tan, Shu-Qi; Lim, Jason Shau Khng; Tan, Yin Ru; Tan, Hak Koon

    2014-01-01

    Haemangioma of the retroperitoneal space is a rare benign capillary malformation, which can grow significantly in pregnancy due to the multiple associated cardiovascular changes. We herein describe the case of a pregnant woman with an extensive right retroperitoneal haemangioma extending from the level of the renal hilum, across the lateral anterior abdominal wall and into the thigh. We also highlight the challenges faced in the management of the patient’s delivery process. To the best of our knowledge, this is the first case of such nature and severity described in the English literature. PMID:25631977

  10. [Erythermalgia and type 1 diabetes: diagnosis and management issues. A case report].

    PubMed

    Deghima, S; Chabane, W; Djorane, H; Azzouz, M; Hannachi, R; Boudiba, A

    2015-01-01

    Erythermalgia is a very rare acrosyndrome mainly characterized by lower limbs pain. It is either primitive or secondary. Concomittence of erythermalgia and diabetes is a coincidence and since the latter induces neuropathic and vascular lesions, erythermalgia is then considered as a consequence. We report the case of a young type 1 diabetic patient who presents with severe form of erythermalgia. Through this case report and a review of the literature, we shall explain the etiopathogenic mecanisms involved in erythermalgia in a diabetic patient and highlight the diagnosis and management challenges.

  11. Multimodal approach for the management of Hunan hand syndrome: a case report.

    PubMed

    Saxena, Ashok Kumar; Mandhyan, Rajani

    2013-03-01

    Hunan hand syndrome, a form of painful contact dermatitis, is a rare case finding. It is usually seen in people with continuous and prolonged exposure to chili peppers. The main ingredient in chili peppers is capsaicin that leads to the clinical condition, Hunan hand syndrome. This is paradoxical to the use of capsaicin as local application for relief of pain in various clinical situations, such as diabetic neuropathy and postherpetic neuralgia. We report a case of Hunan hand syndrome, managed successfully by using a multimodal approach comprised of a continuous stellate ganglion block, gabapentin, local ice water, and fluocinonide application.

  12. Anesthetic management of a child with Aicardi syndrome undergoing laparoscopic Nissen's fundoplication: a case report.

    PubMed

    Terakawa, Yui; Miwa, Takaaki; Mizuno, Yoshiko; Ichinohe, Tatsuya; Kaneko, Yuzuru; Ka, Koui

    2011-02-01

    Aicardi syndrome (AS) is a rare congenital syndrome and is characterized by the triad of infantile spasm, agenesis of the corpus callosum, and anomaly of chorioretinal lacunae. We here report a case of a patient with AS under general anesthesia. Although there is no report in which muscle relaxants were used in AS patients, vecuronium bromide was used for artificial pneumoperitoneum in this case. Careful management is important for AS patients during an operation that significantly affects respiratory function. In addition, it is possible that muscle relaxants be administered safely in AS patients. Careful monitoring such as epileptiform electroencephalogram and bispectral index monitors may be needed for the early detection of epileptic activities.

  13. Challenges in the management of a rare case of extensive retroperitoneal haemangioma in a pregnant woman.

    PubMed

    Tan, Shu-Qi; Lim, Jason Shau Khng; Tan, Yin Ru; Tan, Hak Koon

    2014-11-01

    Haemangioma of the retroperitoneal space is a rare benign capillary malformation, which can grow significantly in pregnancy due to the multiple associated cardiovascular changes. We herein describe the case of a pregnant woman with an extensive right retroperitoneal haemangioma extending from the level of the renal hilum, across the lateral anterior abdominal wall and into the thigh. We also highlight the challenges faced in the management of the patient's delivery process. To the best of our knowledge, this is the first case of such nature and severity described in the English literature.

  14. The importance of work or productive activity in life care planning and case management

    PubMed Central

    Reid, Christine; Riddick-Grisham, Susan

    2015-01-01

    Abstract INTRODUCTION: The importance of work or productive activity for the well-being, community integration, and quality of life of people living with disabilities is addressed, with implications for life care planning and case management. BACKGROUND: The role of work or productive activity in our society, and consequences of deprivation if rehabilitation services do not address vocational effects of disabilities, is explored. A continuum of productivity options is introduced; types of vocational rehabilitation assessment processes and interventions are described. PURPOSE: The role of vocational rehabilitation services in life care planning and case management is discussed, focusing on quality of life for people living with disabilities. CONCLUSION: Rehabilitation and health care professionals should understand the importance of work or other productive activity, and support the development of appropriate plans to address those needs among people who have disabilities. PMID:26409330

  15. Bladder pseudodiverticulum and debilitating dyspareunia: diagnostic and management dilemmas of a rare case.

    PubMed

    Nayyar, Rishi; Sood, Rajeev; Nayyar, Bharti Uppal; Khattar, Nikhil

    2015-05-01

    Dyspareunia in a woman often lacks a well-defined cause with complex etiology. Similarly wide-mouthed nonobstructive bladder diverticula are mostly managed conservatively with no single etiology. Herein a rare case of dyspareunia and urinary symptoms is described, which started following a lower segment cesarean section (LSCS). Ultrasonography, micturating cystogram, and cystoscopy revealed a large wide-mouthed bladder diverticulum. After 3 years of failed and varied conservative therapy and management dilemmas, exploration was done for diverticulectomy which revealed a diagnostic surprise. A post-LSCS thick adhesive band was found between the uterus and anterior abdominal wall as a direct cause for both the bladder diverticulum and dyspareunia. Adhesions after LSCS may cause varied symptoms which may be difficult to diagnose and leave the patient refractory to conservative therapy. Laparoscopy or exploration may be useful in such cases.

  16. Managing everyday ethics in assisted living: a research-based case analysis for the classroom.

    PubMed

    Messikomer, Carla M; Cirka, Carol C

    2008-01-01

    This paper presents a complex, but realistic, picture of the lived experience in assisted living (AL), and provokes thoughtful reflection about the operational and ethical challenges faced in the delivery of care to an increasingly frail population in a typical AL facility. Developed from the findings of a two-year qualitative research project, the case represents a composite of selected data collected at five AL facilities that participated in the study. Students will participate in individual and small group exercises that challenge them to identify everyday ethical concerns in AL, and to suggest ways that management can address these issues. The case is suitable for cross-disciplinary use, and can be effectively applied in the fields of management, health care administration, sociology, gerontology, social work, and nursing, either on the graduate or undergraduate level. It is especially well suited to courses that incorporate the topics of long-term care, senior housing, or ethics.

  17. Case management and long-term conditions: the evolution of community matrons.

    PubMed

    Bentley, Allison

    2014-07-01

    It is now 10 years since the NHS Improvement Plan described a new clinical role for nurses and introduced the concept of community matrons for long-term conditions. This included conditions such as chronic obstructive pulmonary disease, diabetes, dementia, neurological conditions, heart failure, stroke and people with long and enduring mental illness. Despite initial concerns and scepticism about the role, community matrons continue to work with people to provide advanced clinical nursing care, often within a case-management model. Community matrons have continued to shape and develop this role around the main aims of preventing unnecessary emergency admissions, improving quality of life and outcomes for patients, and coordinating all elements of care. This article reviews the evidence, implementation and evolvement of case management within the role of the community matron.

  18. A review of consumer involvement in evaluations of case management: consistency with a recovery paradigm.

    PubMed

    Marshall, Sarah L; Crowe, Trevor P; Oades, Lindsay G; Deane, Frank F; Kavanagh, David J

    2007-03-01

    This Open Forum examines research on case management that draws on consumer perspectives. It clarifies the extent of consumer involvement and whether evaluations were informed by recovery perspectives. Searches of three databases revealed 13 studies that sought to investigate consumer perspectives. Only one study asked consumers about experiences of recovery. Most evaluations did not adequately assess consumers' views, and active consumer participation in research was rare. Supporting an individual's recovery requires commitment to a recovery paradigm that incorporates traditional symptom reduction and improved functioning, with broader recovery principles, and a shift in focus from illness to well-being. It also requires greater involvement of consumers in the implementation of case management and ownership of their own recovery process, not just in research that evaluates the practice.

  19. ANTERIOR CRUCIATE LIGAMENT INJURY DIAGNOSIS AND MANAGEMENT IN A PEDIATRIC PATIENT: A CASE REPORT

    PubMed Central

    Duby, Cherie

    2012-01-01

    The management of the skeletally immature athlete sustaining injury to the anterior cruciate ligament and other knee structures provides multiple challenges for both the treating clinicians and parents of the injured child. The diagnostic process and subsequent decision making present additional complexities because of the developmental anatomy and the potential for disturbance of normal growth patterns by some surgical interventions. In the following case report, the course to appropriate management of a young athlete is detailed, including the contributions of imaging results. The reconstructive options available to orthopedic surgeons and the patient's post‐operative progression are also briefly discussed. Rehabilitation practitioners require an understanding of the unique issues present when providing care for pediatric and adolescent athletes with knee injuries in order to assist in optimal decision making in the phases during which they are involved. Level of Evidence: 5 (Single Case Report) PMID:23316431

  20. Using foresight methods to anticipate future threats: the case of disease management.

    PubMed

    Ma, Sai; Seid, Michael

    2006-01-01

    We describe a unique foresight framework for health care managers to use in longer-term planning. This framework uses scenario-building to envision plausible alternate futures of the U.S. health care system and links those broad futures to business-model-specific "load-bearing" assumptions. Because the framework we describe simultaneously addresses very broad and very specific issues, it can be easily applied to a broad range of health care issues by using the broad framework and business-specific assumptions for the particular case at hand. We illustrate this method using the case of disease management, pointing out that although the industry continues to grow rapidly, its future also contains great uncertainties.

  1. Case studies illustrating the management of trigeminal neuropathic pain using topical 5% lidocaine plasters

    PubMed Central

    Yilmaz, Zehra; Renton, Tara

    2013-01-01

    Chronic trigeminal pain, with its severe related functional problems, is difficult to treat. Treatment is often empirically based on medications used for other chronic pain conditions. Systemic sodium channel and calcium channel blocking agents may cause a multitude of complications that are often poorly tolerated by the patient. Aim: The aim of this case report was to assess the efficacy of topical 5% lidocaine plasters in reducing pain and reducing adjuvant medication in patients with orofacial neuropathic pain. Method: Fourteen patients with chronic orofacial pain conditions referred to the oral surgery department were instructed to wear 5% lidocaine plasters for 12 hours each day over the painful area. The conditions included post-surgical neuropathy (n = 10), multiple sclerosis-related pain (n = 1), persistent idiopathic facial pain (n = 1), Ramsay Hunt syndrome (post-herpetic neuralgia, n = 1) and trigeminal neuralgia (n = 1). Data were collected on patient demographics, pain levels and medication. Results: Pain levels improved in 12 out of 14 patients. Nine patients had a reduction in adjuvant medication, two of whom completely stopped adjuvant treatment. Conclusion: This case series demonstrates that of the use of 5% lidocaine plasters may play a useful role in the management of chronic trigeminal pain. A suggested novel approach for the management of orofacial pain, for clinicians, is presented. Summary points Management of chronic orofacial pain continues to be a major challenge to the clinician. Patients are often placed on a multitude of medications in an attempt to alleviate pain without success. Topical 5% lidocaine plasters, currently used for the management of post-herpetic neuralgia, offer the option of locally targeting trigeminal pain without the multiple side-effects of systemic medication. This case series demonstrates that lidocaine plasters decrease verbal pain scores in extraoral, trigeminal and neuropathic pain, and reduce the use of other

  2. Managing Astronomy Research Data: Case Studies of Big and Small Research Projects

    NASA Astrophysics Data System (ADS)

    Sands, Ashley E.

    2015-01-01

    Astronomy data management refers to all actions taken upon data over the course of the entire research process. It includes activities involving the collection, organization, analysis, release, storage, archiving, preservation, and curation of research data. Astronomers have cultivated data management tools, infrastructures, and local practices to ensure the use and future reuse of their data. However, new sky surveys will soon amass petabytes of data requiring new data management strategies.The goal of this dissertation, to be completed in 2015, is to identify and understand data management practices and the infrastructure and expertise required to support best practices. This will benefit the astronomy community in efforts toward an integrated scholarly communication framework.This dissertation employs qualitative, social science research methods (including interviews, observations, and document analysis) to conduct case studies of data management practices, covering the entire data lifecycle, amongst three populations: Sloan Digital Sky Survey (SDSS) collaboration team members; Individual and small-group users of SDSS data; and Large Synoptic Survey Telescope (LSST) collaboration team members. I have been observing the collection, release, and archiving of data by the SDSS collaboration, the data practices of individuals and small groups using SDSS data in journal articles, and the LSST collaboration's planning and building of infrastructure to produce data.Preliminary results demonstrate that current data management practices in astronomy are complex, situational, and heterogeneous. Astronomers often have different management repertoires for working on sky surveys and for their own data collections, varying their data practices as they move between projects. The multitude of practices complicates coordinated efforts to maintain data.While astronomy expertise proves critical to managing astronomy data in the short, medium, and long term, the larger astronomy

  3. Diminished social motivation negatively impacts reputation management: autism spectrum disorders as a case in point.

    PubMed

    Chevallier, Coralie; Molesworth, Catherine; Happé, Francesca

    2012-01-01

    Human beings are endowed with a unique motivation to be included in social interactions. This natural social motivation, in turn, is thought to encourage behaviours such as flattery or self-deprecation aimed to ease interaction and to enhance the reputation of the individual who produces them. If this is the case, diminished social interest should affect reputation management. Here, we use Autism Spectrum Disorders (ASDs)--primarily characterised by pervasive social disinterest--as a model to investigate the effect of social motivation on reputation management. Children first rated a set of pictures and were then given the opportunity to inflate their initial ratings in front of an experimenter who declared that she had drawn the picture. Contrary to the controls, children with ASD did not enhance their ratings in the drawer's presence. Moreover, participants' flattery behaviour correlated with self-reports of social enjoyment. Our findings point to a link between diminished social interest and reputation management.

  4. Structured storage in ATLAS Distributed Data Management: use cases and experiences

    NASA Astrophysics Data System (ADS)

    Lassnig, Mario; Garonne, Vincent; Molfetas, Angelos; Beermann, Thomas; Dimitrov, Gancho; Canali, Luca; Zang, Donal; Azzurra Chinzer, Lisa

    2012-12-01

    The distributed data management system of the high-energy physics experiment ATLAS has a critical dependency on the Oracle Relational Database Management System. Recently however, the increased appearance of data warehouselike workload in the experiment has put considerable and increasing strain on the Oracle database. In particular, the analysis of archived data, and the aggregation of data for summary purposes has been especially demanding. For this reason, structured storage systems were evaluated to offload the Oracle database, and to handle processing of data in a non-transactional way. This includes distributed file systems like HDFS that support parallel execution of computational tasks on distributed data, as well as non-relational databases like HBase, Cassandra, or MongoDB. In this paper, the most important analysis and aggregation use cases of the data management system are presented, and how structured storage systems were established to process them.

  5. Supporting the risk management process with land information: a case study of Australia.

    PubMed

    Potts, Katie Elizabeth; Rajabifard, Abbas; Bennett, Rohan Mark

    2017-04-01

    It is frequently argued that, at the parcel level, stakeholders are capable of and well supported in managing their land-related risks. Yet, evidence from the contemporary Australian context suggests otherwise: numerous large-scale disaster events have revealed that citizens are ill-prepared to respond and recover adequately. This paper begins with the premise that information, specifically land information, could better support parcel-level risk preparation, mitigation, response, and recovery. State land administration organisations in Australia primarily maintain this information and make it accessible. Land information is used regularly across all levels of government to support risk management activities; however, such application has not always occurred at the parcel and citizen level. Via a case study approach, this paper initially explores the land information available in Australia to stakeholders interested in parcel-level detail, and then goes on to propose how the utilisation of parcel-level land information could serve to enhance risk management practices.

  6. Diminished Social Motivation Negatively Impacts Reputation Management: Autism Spectrum Disorders as a Case in Point

    PubMed Central

    Chevallier, Coralie; Molesworth, Catherine; Happé, Francesca

    2012-01-01

    Human beings are endowed with a unique motivation to be included in social interactions. This natural social motivation, in turn, is thought to encourage behaviours such as flattery or self-deprecation aimed to ease interaction and to enhance the reputation of the individual who produces them. If this is the case, diminished social interest should affect reputation management. Here, we use Autism Spectrum Disorders (ASDs) –primarily characterised by pervasive social disinterest– as a model to investigate the effect of social motivation on reputation management. Children first rated a set of pictures and were then given the opportunity to inflate their initial ratings in front of an experimenter who declared that she had drawn the picture. Contrary to the controls, children with ASD did not enhance their ratings in the drawer's presence. Moreover, participants' flattery behaviour correlated with self-reports of social enjoyment. Our findings point to a link between diminished social interest and reputation management. PMID:22303483

  7. Increase Return on Investment of Software Development Life Cycle by Managing the Risk - A Case Study

    DTIC Science & Technology

    2015-04-01

    Image designed by Diane Fleischer INCREASE RETURN on Investment of Software Development Life Cycle by Managing the Risk —A Case Study...for increasing the return on investment during the Software Development Life Cycle (SDLC) through selected quantitative analyses employing both the...defect rate, return on investment (ROI), software development life cycle (SDLC) DE FE N SE A C Q U IS IT IO N UN IVERSITY ALU M N I A SSO C IATIO N R

  8. Successful management of aluminium phosphide poisoning using intravenous lipid emulsion: Report of two cases

    PubMed Central

    Baruah, Udismita; Sahni, Ameeta; Sachdeva, Harish C.

    2015-01-01

    Aluminum phosphide (ALP) is a cheap, easily available agricultural pesticide which causes lethal poisoning by liberation of phosphine and inhibition of cytochrome c oxidase thereby leading to cellular hypoxia. Although there is no known specific antidote, clinical trials are still going on. We present here two cases of ALP poisoning who were successfully managed by treatment with lipid emulsion and intravenous magnesium sulfate. PMID:26816450

  9. Postpyelolithotomy Renal Artery Pseudoaneurysm Management with Percutaneous Thrombin Injection: A Case Report

    SciTech Connect

    Gupta, Vivek Galwa, Ramprakash; Khandelwal, N.; Bapuraj, J. R.

    2008-03-15

    Renal artery pseudoaneurysm leading to life-threatening hematuria can occur after a surgical procedure such as pyelolithotomy, albeit rarely. With recent advances in transarterial embolization techniques, this minimally invasive procedure has become the treatment of choice, replacing surgery. We present a case of massive hematuria due to renal artery pseudoaneurysm developing after pyelolithotomy that was managed with percutaneus thrombin injection directly into the pseudoaneurysm.

  10. Presentation and management of cervicofacial necrotising fasciitis: report of nine cases.

    PubMed

    Koech, K J; Chindia, M L

    2009-10-01

    Cervicofacial necrotising fasciitis (CNF) is an acute soft tissue infection that primarily involves the subcutaneous, adipose and fascial planes of the head and neck region. Secondary ischaemia of the skin results in widespread ulceration and suppuration. It is imperative that early diagnosis is made and judicious medical and surgical intervention instituted. We present a case series of patients with CNF diagnosed and managed at the division of oral and maxillofacial surgery of the Kenyatta National Hospital in Kenya.

  11. Arrow shaft injury of the wrist and hand: case report, management, and surgical technique.

    PubMed

    Launikitis, Robert A; Viegas, Steven F

    2009-01-01

    A case of accidental, self-inflicted injury to the hand from a hollow carbon shaft arrow which broke in its midshaft while attempting to shoot the arrow from a compound bow is presented. Basic knowledge of low velocity gunshot wounds and arrow injuries was applied in the treatment of this injury along with a unique management technique. The outcome, including hand function was good without any functional loss.

  12. A Management Case Study: The Implementation of the Rapid Acquisition of Manufactured Parts (RAMP) Program

    DTIC Science & Technology

    1993-06-01

    manufacturing needs based on the dollars available to support this new technology. In December 1987, the staif at NAVSUP awarded the current RAMP contract to...describes the implementation of the Navy’s Rapid Acquisition of Manufactured Parts (RAMP) program. The RAMP program was implemented in 1989 by the Naval...time and cost for manufactured spare parts. This management case study concentrates on the examination of how new technology is implemented into current

  13. The management of blood phobia and a hypersensitive gag reflex by hypnotherapy: a case report.

    PubMed

    Noble, Suzanne

    2002-03-01

    Coping with a hypersensitive gag reflex can be a cause for concern for both the patient and the operator. This report describes a case of blood phobia directed solely towards the oral cavity, linked with the inability to tolerate dentures due to a hypersensitive gag reflex. Management by hypnotherapy using a systematic desensitization technique allowed for extraction of teeth and permanent elimination of the gagging problem.

  14. ENM 590: Case Studies in Engineering Management. Condition Based Maintenance Plus Return on Investment Analysis

    DTIC Science & Technology

    2011-01-12

    Maintenance Plus Return on Investment Analysis Ken Fischer Date: 01/12/11 Report Documentation Page Form ApprovedOMB No. 0704...4. TITLE AND SUBTITLE ENM 590 Case Studies in Engineering Management condition Based Maintenance Plus Return on Investment Analysis 5a. CONTRACT...NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Ken Fischer 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7

  15. Esthetic management of a primary double tooth using a silicone putty guide: a case report.

    PubMed

    Agarwal, Ravi; Chaudhry, Kalpna; Yeluri, Ramakrishna; Munshi, Autar Krishen

    2013-03-01

    The term double tooth is often used to describe fusion and gemination. The development of isolated large or joined teeth is not rare, but the literature is confusing when the appropriate terminology is presented. The objective of this paper is to present a case of a primary double tooth in a 5-year-old girl with a history of trauma. The tooth was endodontically treated and esthetic management was carried out using a silicone putty guide.

  16. Acupuncture for the Management of Postdural Puncture Headache: A Case Report.

    PubMed

    Chang, Alexandra; Acquah, Joseph; Reddy, Sanjay; Chao, Maria T

    2016-01-01

    Postdural puncture headache (PDPH) is a recognized complication of neuraxial anesthesia. This case report documents 1 patient who developed PDPH following epidural anesthesia for postoperative pain control. The patient declined conventional treatments, including an epidural blood patch and intravenous caffeine. This report documents successful use of adjunct acupuncture for the management of PDPH. Additional research on acupuncture as a potential adjunctive therapy for PDPH is needed, particularly for patients who are reluctant to receive more invasive treatments.

  17. Management of a large, recurrent simple cyst of the liver by total excision: a case report.

    PubMed

    Sriussadaporn, Suvit; Sriussadaporn, Sukanya; Pak-art, Rattaplee; Krittayakirana, Krittaya; Prichayuhd, Supparerk

    2011-04-01

    Simple cysts are common benign lesions of the liver. Treatment is reserved for symptomatic patients. Current management includes percutaneous aspiration with instillation of sclerosing agents, wide excision or unroofing, or fenestration of the cyst wall (> 50%) either by open or laparoscopic surgery. Total excision of the cyst wall is infrequently mentioned. The authors report a case of a large, recurrent simple cyst of the liver that was successfully treated by total excision.

  18. Fibrodysplasia Ossificans Progressiva: Difficulty in Diagnosis and Management A case report and literature review

    PubMed Central

    Kamal, Achmad Fauzi; Novriansyah, Robin; Rahyussalim; Prabowo, Yogi; Siregar, Nurjati Chairani

    2015-01-01

    Introduction: Fibrodysplasia ossificans progressiva (FOP) is a rare autosomal dominant genetic disorder and characterized by postnatal progressive heterotopic ossification of the connective tissue. There are difficulties in diagnosing FOP, thus delayed or misdiagnosis and mismanagement is common. 3D printers have now become widely available and inexpensive, and can be used to rapidly produce life-size models based on CT scans of an individual patient. The availability of patient specific, accurate and detailed models of complex acetabular fractures can aid planning of surgical management on a patient specific basis. Case Report: We present the diagnosis and surgical management of a 9-year old Indonesian girl with FOP. She presented with extensive involvement of cervical spine and both shoulders. Total excision of occipito-cervico-lumbar and paravertebral ossification and also exostoses at bilateral shoulder was done. At three years follow up, she had local recurrence with similar range of movement of the shoulder and cervical spine. Conclusion: FOP is an extremely rare case. It is difficult to diagnose and manage FOP, therefore delayed or misdiagnosis and also inappropriate management is common. PMID:27299014

  19. Understanding the incomprehensible: a guide to the new Medicare prescription drug benefit for case managers.

    PubMed

    Marshall, Carter L

    2004-01-01

    Much of the health news over the last few months has centered on problems elderly patients encounter in obtaining and effectively using the prescription drug discount cards that became available on June 1 under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. This article focuses on the next prescription drug newsmaker, Medicare Part D, that will supercede the discount cards on January 1, 2006. There are many complex issues that case managers must evaluate when assisting beneficiaries with queries about "what to do." This article attempts to clarify the "incomprehensible" twists and turns of these issues and provides access to a "Medicare Drug Prescription Benefit Calculator" that may assist the beneficiary and case manager in decision making. Case managers need to understand that there are many opposing viewpoints on this benefit, and it promises to become the subject of a major national debate. For this reason, substantial changes may occur prior to the launch of Part D. If you think discount drug cards are confusing, "you ain't seen nothin' yet!"

  20. Geriatric Case Managers' Perspectives on Suicide Among Community-Dwelling Older Adults.

    PubMed

    Slovak, Karen; Pope, Natalie D; Brewer, Thomas W

    2016-01-01

    It has been suggested that clinical screening for suicide, along with firearm assessment and safety counseling, are important in service provision to older adults. It is unclear, however, how geriatric case managers respond to these issues. This study surveyed geriatric case managers (n=161) from Area Agencies on Aging in Ohio on their knowledge, attitudes, and behaviors related to suicide, firearm assessment, and safety counseling. Results indicated that the majority of respondents (70%) agree their clients are at risk for suicide. However, few (30%) in this study reported that they assess for firearms and less than half (48%) discuss firearms with their clients/family members when specifically assessing for suicide. Analyses identified barriers that contribute to the decreased likelihood that routine firearm assessment and safety counseling would occur, such as lack of training and time. Implications include the need for training with geriatric case managers that addresses barriers to suicide, firearm assessment and safety counseling as a means to decrease these population risks.

  1. Effect of diabetic case management intervention on health service utilization in Korea.

    PubMed

    Shin, Soon Ae; Kim, Hyeongsu; Lee, Kunsei; Lin, Vivian; Liu, George

    2015-12-01

    This study is to estimate the effectiveness of a diabetic case management programme on health-care service utilization. The study population included 6007 as the intervention group and 956,766 as the control group. As the indicators of health-care service utilization, numbers of medical ambulatory consultations, days of medication prescribed and medical expenses for one year were used, and we analysed the claim data of the health insurance from 2005 to 2007. The study population was classified into three subgroups based on the number of medical ambulatory consultations per year before this intervention. In the under-serviced subgroup, the intervention group showed a significant increase in the number of consultations (3.2), days of prescribed medication (66.4) and medical expenses (287,900 KRW) compared with the control group. Conversely, in the over-serviced subgroup, the intervention group showed a less decrease days of prescribed medication (1.6) compared with the control group. This showed that the case management programme led the intervention group to optimize their utilization of health-care services by subgroups. It is necessary to evaluate the appropriateness of health-care usage and clinical outcome to show the direct effectiveness of the case management programme by subgroups.

  2. Exploring the life cycle management of industrial solid waste in the case of copper slag.

    PubMed

    Song, Xiaolong; Yang, Jianxin; Lu, Bin; Li, Bo

    2013-06-01

    Industrial solid waste has potential impacts on soil, water and air quality, as well as human health, during its whole life stages. A framework for the life cycle management of industrial solid waste, which integrates the source reduction process, is presented and applied to copper slag management. Three management scenarios of copper slag are developed: (i) production of cement after electric furnace treatment, (ii) production of cement after flotation, and (iii) source reduction before the recycling process. A life cycle assessment is carried out to estimate the environmental burdens of these three scenarios. Life cycle assessment results showed that the environmental burdens of the three scenarios are 2710.09, 2061.19 and 2145.02 Pt respectively. In consideration of the closed-loop recycling process, the environmental performance of the flotation approach excelled that of the electric furnace approach. Additionally, although flash smelting promotes the source reduction of copper slag compared with bath smelting, it did not reduce the overall environmental burdens resulting from the complete copper slag management process. Moreover, it led to the shifting of environmental burdens from ecosystem quality damage and resources depletion to human health damage. The case study shows that it is necessary to integrate the generation process into the whole life cycle of industrial solid waste, and to make an integrated assessment for quantifying the contribution of source reduction, rather than to simply follow the priority of source reduction and the hierarchy of waste management.

  3. Ocean acidification: Linking science to management solutions using the Great Barrier Reef as a case study.

    PubMed

    Albright, Rebecca; Anthony, Kenneth R N; Baird, Mark; Beeden, Roger; Byrne, Maria; Collier, Catherine; Dove, Sophie; Fabricius, Katharina; Hoegh-Guldberg, Ove; Kelly, Ryan P; Lough, Janice; Mongin, Mathieu; Munday, Philip L; Pears, Rachel J; Russell, Bayden D; Tilbrook, Bronte; Abal, Eva

    2016-11-01

    Coral reefs are one of the most vulnerable ecosystems to ocean acidification. While our understanding of the potential impacts of ocean acidification on coral reef ecosystems is growing, gaps remain that limit our ability to translate scientific knowledge into management action. To guide solution-based research, we review the current knowledge of ocean acidification impacts on coral reefs alongside management needs and priorities. We use the world's largest continuous reef system, Australia's Great Barrier Reef (GBR), as a case study. We integrate scientific knowledge gained from a variety of approaches (e.g., laboratory studies, field observations, and ecosystem modelling) and scales (e.g., cell, organism, ecosystem) that underpin a systems-level understanding of how ocean acidification is likely to impact the GBR and associated goods and services. We then discuss local and regional management options that may be effective to help mitigate the effects of ocean acidification on the GBR, with likely application to other coral reef systems. We develop a research framework for linking solution-based ocean acidification research to practical management options. The framework assists in identifying effective and cost-efficient options for supporting ecosystem resilience. The framework enables on-the-ground OA management to be the focus, while not losing sight of CO2 mitigation as the ultimate solution.

  4. The problem of sustainable groundwater management: the case of La Mancha aquifers, Spain

    NASA Astrophysics Data System (ADS)

    Esteban, Encarna; Albiac, José

    2012-08-01

    Gisser and Sánchez (Water Resour Res 16(4):638-642, 1980) compared two different strategies to manage aquifers: "free market" and policy regulation. They stated that the outcome of both is practically the same, and that policy regulation could not improve social welfare. This study challenges this argument by analyzing the management strategies in two large aquifers located in southern Spain, the Eastern La Mancha and the Western La Mancha aquifers. The appeal of this case stems from the fact that management of the Eastern La Mancha aquifer is almost sustainable. In stark contrast, its neighboring Western La Mancha aquifer is being grossly mismanaged. The results engage two major questions from previous groundwater literature. The first question is whether or not aquifer management requires policy intervention. The answer depends upon the consideration and magnitude of environmental damages in the model. The second question addresses the nature of groundwater policies. The contrast in management outcomes between the Western and the Eastern La Mancha aquifers is related to the different types of policy instruments implemented for each aquifer. The results of these policies underline the importance of nurturing the stakeholders' collective action under the appropriate institutional setting.

  5. Improving IT Service Management Processes: A Case Study on IT Service Support

    NASA Astrophysics Data System (ADS)

    Lahtela, Antti; Jäntti, Marko

    IT services and IT service management play a very important role in the today's IT industry. Software as service approach enables IT customers to focus on using the software while IT service providers take care of the installation, configuration, support and maintenance activities. Various process frameworks can be used to improve IT service management processes. The most widely used IT service management framework is the IT Infrastructure Library (ITIL) that provides best practices for IT service providers on how to design, manage and support IT services. Despite the IT service management process frameworks, implementing an effective service support interface between an IT service provider and an IT customer is a big challenge. The research problem in this study is: what types of challenges are related to the service support interface between an IT service provider and IT customers. The main contribution of this paper is present challenges in a service support interface identified during a case study with a large IT service provider company in Finland.

  6. Successful management of aggressive fibromatosis of the neck using wide surgical excision: a case report

    PubMed Central

    2011-01-01

    Introduction Aggressive fibromatosis is a benign tumor, thought to arise from deep musculoaponeurotic structures, rarely found in the head or neck. However, when it does occur in the head and neck region, it tends to be more aggressive and associated with significant morbidity, which may be attributed to the vital vascular, neurological or anatomical structures in close proximity. Case presentation We report the case of a 39-year-old Pakistani man who presented with a two-month history of a lump on the right side of his neck. The mass was excised and histopathological analysis revealed a case of aggressive fibromatosis. Conclusion Due to the rarity of the condition no guidelines are available on the indications and extent of each modality. Due to its aggressive behavior and tendency to invade local structures and recur, a multi-modality management strategy is usually employed. On the basis of this case, we suggest that aggressive surgery is a viable management option and may be successfully used as a single modality treatment. PMID:21707981

  7. Surgical versus conservative management of adult intussusception: Case series and review

    PubMed Central

    Aydin, Nail; Roth, Andrew; Misra, Subhasis

    2016-01-01

    Introduction Intussusception is the telescoping of a segment of bowel into its adjacent segment. It is a known cause of abdominal pain in the pediatric population, however, it is rare in the adult. Adults do not always present with the typical symptoms seen in young children, making the clinical diagnosis more difficult. The etiology of adult intussusception can be idiopathic, benign, or malignant. Diagnosis is most accurately made with computed tomography, which is sensitive in detecting intussusception as well as potential lead points. Presentation of cases This study presents four adult patients with intussusception. The first three patients are adults with idiopathic intussusception and no evidence of a lead point. The fourth case involves intussusception secondary to a jejunal carcinoid tumor which was treated surgically. Each case has unique features in terms of length and number of intussusceptions, duration of symptoms, and recurrence. Discussion Surgical treatment was once argued to be universally appropriate for adult intussusceptions; however, with increased use of advanced imaging, newer literature is demonstrating that this is not true in all cases. Idiopathic intussusception presents with nonspecific symptoms and can be managed with supportive care when the history and clinical picture indicate low probability of a neoplasm. Conclusion This study aims to raise awareness to the potential diagnosis and management of intussusceptions, particularly the symptomatic idiopathic type in the young adult. PMID:26859872

  8. Environmental and economic assessment of municipal sewage sludge management - a case study in Beijing, China.

    PubMed

    Li, Xinyi; Takaoka, Masaki; Zhu, Fenfen; Wang, Jiawei; Oshita, Kazuyuki; Mizuno, Tadao

    2013-01-01

    A case study was conducted in Beijing to identify municipal sewage sludge (SS) management systems appropriate for a sound material-cycle society. The environmental and economic impacts of four realistic SS-handling scenarios were investigated: stabilization by thermal drying, increased inclusion of SS in cement manufacture, and using either dried or carbonized SS as substitute fuel for coal-fired power generation plants. The results showed that the current sludge management system had the lowest operating cost but higher greenhouse gas (GHG) emissions and a low recycling rate. The case with the use of carbonized SS reused in coal-fired power plants had higher energy consumption and almost the same GHG emissions as the current system. On the other hand, the case including more SS in cement manufacture had the same level of energy consumption with much lower GHG emissions. The case with the use of dried SS in coal-fired power plants also resulted in lower energy consumption and lower GHG emissions than at present. Furthermore, sensitivity analysis showed that drying SS with surplus heat from cement plants used less energy and emitted less GHG compared to the other two drying methods.

  9. Health service providers in Somalia: their readiness to provide malaria case-management

    PubMed Central

    Noor, Abdisalan M; Rage, Ismail A; Moonen, Bruno; Snow, Robert W

    2009-01-01

    Background Studies have highlighted the inadequacies of the public health sector in sub-Saharan African countries in providing appropriate malaria case management. The readiness of the public health sector to provide malaria case-management in Somalia, a country where there has been no functioning central government for almost two decades, was investigated. Methods Three districts were purposively sampled in each of the two self-declared states of Puntland and Somaliland and the south-central region of Somalia, in April-November 2007. A survey and mapping of all public and private health service providers was undertaken. Information was recorded on services provided, types of anti-malarial drugs used and stock, numbers and qualifications of staff, sources of financial support and presence of malaria diagnostic services, new treatment guidelines and job aides for malaria case-management. All settlements were mapped and a semi-quantitative approach was used to estimate their population size. Distances from settlements to public health services were computed. Results There were 45 public health facilities, 227 public health professionals, and 194 private pharmacies for approximately 0.6 million people in the three districts. The median distance to public health facilities was 6 km. 62.3% of public health facilities prescribed the nationally recommended anti-malarial drug and 37.7% prescribed chloroquine as first-line therapy. 66.7% of public facilities did not have in stock the recommended first-line malaria therapy. Diagnosis of malaria using rapid diagnostic tests (RDT) or microscopy was performed routinely in over 90% of the recommended public facilities but only 50% of these had RDT in stock at the time of survey. National treatment guidelines were available in 31.3% of public health facilities recommended by the national strategy. Only 8.8% of the private pharmacies prescribed artesunate plus sulphadoxine/pyrimethamine, while 53.1% prescribed chloroquine as first

  10. Public participation in integrated water resources management: the case of Tanzania

    NASA Astrophysics Data System (ADS)

    Dungumaro, Esther W.; Madulu, Ndalahwa F.

    Effective and sustainable management of water resources is vital for ensuring sustainable development. However, efforts of water resource management seem to demonstrate inappropriate practices, especially when compared to water consumption trends in developing countries in general, and sub-Saharan Africa in particular. Being a major and vital ingredient to human kind, water resources influence all sectors. However, there have been increased problems over time that subject water resources to a number of crisis and pressures. Poor water resources management have stimulated and sustained a number of problems related to health, socio-economic and environment, which need to be solved. These problems are accelerated and magnified by the countries’, communities’ and individuals’ struggles for economic and social development as many development initiatives are affected by water availability and vice versa. Integrated water resources management (IWRM), is a process, a change, and an approach that mainstream water resource use and management into the national economic in an equitable manner without compromising the sustainability of vital ecosystems. This paper analyses the importance of community participation in the process of IWRM. The paper describes reasons that justify the need for an IWRM approach and explains the rationale for community participation. Successful cases in community involvement have been cited from different areas to demonstrate the importance of IWRM. The paper concludes that the public/community involvement is crucial for a successful and sustainable water resource management. It has been emphasized that natural resources management related policies including water requires the use of knowledge, experience and opinions of local communities who are the key stakeholders in resource conservation. This could be ensured through public/community participation.

  11. Complete heart block in pregnancy: case report, analysis, and review of anesthetic management.

    PubMed

    Sundararaman, Lalitha; Hochman Cohn, Jennifer; Ranasinghe, J Sudharma

    2016-09-01

    Maternal complete heart block can pose significant challenges for the anesthesiologist in the antepartum, peripartum, and postpartum periods. Some patients may present for the first time in the puerperium with dizziness, weakness, syncope, or congestive heart failure as a result of the additional hemodynamic burden that accompanies pregnancy. Although there is an increase in permanent pacemaker placement in young symptomatic patients before pregnancy, prophylactic placement of pacemakers in asymptomatic parturients is not always indicated. The need for temporary or permanent pacemakers in asymptomatic women should be assessed on a case-by-case basis; many of these patients may be safely managed during labor and delivery without pacing. The parturient with complete heart block must be followed vigilantly during pregnancy and post delivery, as the need for pacemaker insertion can also arise in the postpartum period. We present a case of third-degree heart block in a 26-year-old parturient.

  12. A taxonomy for homework used by mental health case managers when working with individuals diagnosed with severe mental illness.

    PubMed

    Kelly, Peter J; Deane, Frank P; King, Robert; Kazantzis, Nikolaos; Crowe, Trevor P

    2007-12-01

    A survey was completed by 122 case managers describing the types of homework assignments commonly used with individuals diagnosed with severe mental illness (SMI). Homework types were categorized using a 12-item homework description taxonomy and in relation to the 22 domains of the Camberwell Assessment of Need (CAN). Case managers predominately reported using behaviourally based homework tasks such as scheduling activities and the development of personal hygiene skills. Homework focused on CAN areas of need in relation to Company, Psychological Distress, Psychotic Symptoms and Daytime Activities. The applications of the taxonomy for both researchers and case managers are discussed.

  13. Occam's razor in the management of ventriculoperitoneal shunt dysfunction: Diagnosis and management of an unusual pediatric case.

    PubMed

    Dadlani, Ravi; Dadlani, Reena; Ghosal, Nandita; Hegde, Alangar

    2015-01-01

    Ventriculoperitoneal (VP) shunt surgery is probably the commonest surgical procedure in neurosurgery. Belying its technical simplicity is the myriad complications associated with it. Shunt malfunction is a common complication associated with this surgery, second only to shunt related infections, which may be associated with it. Sterile cerebrospinal fluid (CSF) eosinophilia (CE) has been reported with VP shunts, which may or may not be related to the dysfunction. Eosinophilia in the CSF has also been associated with a number of other conditions including parasitic infestations in the brain. This may be unrelated to the shunt surgery. We present a case of a child, operated earlier for hydrocephalus, who presented with sub-acute loss of vision and bilateral oculomotor paresis. CSF from a chamber tap revealed eosinophilia. The commonest presenting symptom of shunt malfunction is raised intracranial pressure. There are no reports in the literature of VP shunt malfunction presenting with bilateral oculomotor paresis and decreased visual acuity. The associated CE complicated the clinical picture, especially since the initial brain radiology was normal. We discuss the clinical differential diagnosis of this very interesting presentation, management dilemmas and outcome in this child. This rare clinical presentation was found to be the result of a shunt malfunction and not due to any rare parasitic infestation of the brain. Occam's razor dictates that the simplest explanation in a given situation is usually the most accurate, as is seen in this case.

  14. A case of severe ectopic ACTH syndrome from an occult primary – diagnostic and management dilemmas

    PubMed Central

    Griffin, Katherine; Amer, Saima

    2015-01-01

    Summary Resection of primary tumour is the management of choice in patients with ectopic ACTH syndrome. However, tumours may remain unidentified or occult in spite of extensive efforts at trying to locate them. This can, therefore, pose a major management issue as uncontrolled hypercortisolaemia can lead to life-threatening infections. We present the case of a 66-year-old gentleman with ectopic ACTH syndrome from an occult primary tumour with multiple significant complications from hypercortisolaemia. Ectopic nature of his ACTH-dependent Cushing's syndrome was confirmed by non-suppression with high-dose dexamethasone suppression test and bilateral inferior petrosal sinus sampling. The primary ectopic source remained unidentified in spite of extensive anatomical and functional imaging studies, including CT scans and Dotatate-PET scan. Medical adrenolytic treatment at maximum tolerated doses failed to control his hypercortisolaemia, which led to recurrent intra-abdominal and pelvic abscesses, requiring multiple surgical interventions. Laparoscopic bilateral adrenalectomy was considered but decided against given concerns of technical difficulties due to recurrent intra-abdominal infections and his moribund state. Eventually, alcohol ablation of adrenal glands by retrograde adrenal vein approach was attempted, which resulted in biochemical remission of Cushing's syndrome. Our case emphasizes the importance of aggressive management of hypercortisolaemia in order to reduce the associated morbidity and mortality and also demonstrates that techniques like percutaneous adrenal ablation using a retrograde venous approach may be extremely helpful in patients who are otherwise unable to undergo bilateral adrenalectomy. Learning points Evaluation and management of patients with ectopic ACTH syndrome from an unidentified primary tumour can be very challenging.Persisting hypercortisolaemia in this setting can lead to debilitating and even life-threatening complications and hence

  15. Impact of a COPD comprehensive case management program on hospital length of stay and readmission rates

    PubMed Central

    Alshabanat, Abdulmajeed; Otterstatter, Michael C; Sin, Don D; Road, Jeremy; Rempel, Carmen; Burns, Jane; van Eeden, Stephan F; FitzGerald, JM

    2017-01-01

    Background COPD accounts for the highest rate of hospital admissions among major chronic diseases. COPD hospitalizations are associated with impaired quality of life, high health care utilization, and poor prognosis and result in an economic and a social burden that is both substantial and increasing. Aim The aim of this study is to determine the efficacy of a comprehensive case management program (CCMP) in reducing length of stay (LOS) and risk of hospital admissions and readmissions in patients with COPD. Materials and methodology We retrospectively compared outcomes across five large hospitals in Vancouver, BC, Canada, following the implementation of a systems approach to the management of COPD patients who were identified in the hospital and followed up in the community for 90 days. We compared numbers, rates, and intervals of readmission and LOS during 2 years of active program delivery compared to 1 year prior to program implementation. Results A total of 1,564 patients with a clinical diagnosis of COPD were identified from 2,719 hospital admissions during the 3 years of study. The disease management program reduced COPD-related hospitalizations by 30% and hospitalizations for all causes by 13.6%. Similarly, the rate of readmission for all causes showed a significant decline, with hazard ratios (HRs) of 0.55 (year 1) and 0.51 (year 2) of intervention (P<0.001). In addition, patients’ mean LOS (days) for COPD-related admissions declined significantly from 10.8 to 6.8 (P<0.05). Conclusion A comprehensive disease management program for COPD patients, including education, case management, and follow-up, was associated with significant reduction in hospital admissions and LOS. PMID:28356728

  16. Fibrous Dysplasia: An Overview of Disease Process, Indications for Surgical Management, and a Case Report

    PubMed Central

    Salcedo, Samuel E.; Borad, Vedant; Richards, Sara S.; Workman, Adrienne D.; Ray, Andrea O.

    2015-01-01

    Introduction: First described by Von Recklinghausen in 1891, fibrous dysplasia is a developmental defect of osseous tissue such that bone is produced with an abnormally thin cortex and marrow is replaced with fibrous tissue that demonstrates characteristic ground-glass appearance on x-ray examination. The underlying defect in fibrous dysplasia is a mutation of the GNAS1 gene, which leads to constitutive activation of gene products that preclude the maturation of osteoprogenitor cells and lead to development of abnormal bone matrix, trabeculae, and collagen, produced by undifferentiated mesenchymal cells. There exists a mainly self-limiting form of fibrous dysplasia classified as monostotic, which is characterized by dysplastic bone in a single location that remains relatively stable throughout life and a polyostotic form, which can exhibit aggressive growth placing adjacent structures at risk for compressive sequelae. Methods: We present the surgical management of an unusual case of monostotic fibrous dysplasia, which exhibited aggressive growth with mass effect, and late presentation, both uncharacteristic features for the monostotic form. The authors also performed a comprehensive review of the literature and discuss the disease process, management options, and indications for surgical treatment. Results: An overview of the disease process and management options is presented. The authors also present details of reconstruction in an unusual form of symptomatic monostotic fibrous dysplasia. Conclusion: Conservative management is usually the mainstay of therapy in asymptomatic cases of fibrous dysplasia. In patients fulfilling criteria for surgical management, craniofacial reconstruction offers a viable option in the surgeon's armamentarium, providing good functional and cosmetic outcomes. PMID:25848443

  17. The political economy of a public health case management program's transition into medical homes.

    PubMed

    Wells, Rebecca; Cilenti, Dorothy; Issel, L Michele

    2015-11-01

    Throughout the United States, public health leaders are experimenting with how best to integrate services for individuals with complex needs. To that end, North Carolina implemented a policy incorporating both local public health departments and other providers into medical homes for low income pregnant women and young children at risk of developmental delays. To understand how this transition occurred within local communities, a pre-post comparative case study was conducted. A total of 42 people in four local health departments across the state were interviewed immediately before the 2011 policy change and six months later: 32 professionals (24 twice) and 10 pregnant women receiving case management at the time of the policy implementation. We used constant comparative analysis of interview and supplemental data to identify three key consequences of the policy implementation. One, having medical homes increased the centrality of other providers relative to local health departments. Two, a shift from focusing on personal relationships toward medical efficiency diverged in some respects from both case managers' and mothers' goals. Three, health department staff re-interpreted state policies to fit their public health values. Using a political economy perspective, these changes are interpreted as reflecting shifts in public health's broader ideological environment. To a large extent, the state successfully induced more connection between health department-based case managers and external providers. However, limited provider engagement may constrain the implementation of the envisioned medical homes. The increased focus on medical risk may also undermine health departments' role in supporting health over time by attenuating staff relationships with mothers. This study helps clarify how state public health policy innovations unfold at local levels, and why front line practice may in some respects diverge from policy intent.

  18. Conservative chiropractic management of urinary incontinence using applied kinesiology: a retrospective case-series report

    PubMed Central

    Cuthbert, Scott C.; Rosner, Anthony L.

    2012-01-01

    Objective The purpose of this case series is to describe the chiropractic management of 21 patients with daily stress and occasional total urinary incontinence (UI). Clinical Features Twenty-one case files of patients 13 to 90 years of age with UI from a chiropractic clinic were reviewed. The patients had a 4-month to 49-year history of UI and associated muscle dysfunction and low back and/or pelvic pain. Eighteen wore an incontinence pad throughout the day and night at the time of their appointments because of unpredictable UI. Intervention and Outcome Patients were evaluated for muscle impairments in the lumbar spine, pelvis, and pelvic floor and low back and/or hip pain. Positive manual muscle test results of the pelvis, lumbar spine muscles, and pelvic floor muscles were the most common findings. Lumbosacral dysfunction was found in 13 of the cases with pain provocation tests (applied kinesiology sensorimotor challenge); in 8 cases, this sensorimotor challenge was absent. Chiropractic manipulative therapy and soft tissue treatment addressed the soft tissue and articular dysfunctions. Chiropractic manipulative therapy involved high-velocity, low-amplitude manipulation; Cox flexion distraction manipulation; and/or use of a percussion instrument for the treatment of myofascial trigger points. Urinary incontinence symptoms resolved in 10 patients, considerably improved in 7 cases, and slightly improved in 4 cases. Periodic follow-up examinations for the past 6 years, and no less than 2 years, indicate that for each participant in this case-series report, the improvements of UI remained stable. Conclusion The patients reported in this retrospective case series showed improvement in UI symptoms that persisted over time. PMID:22942842

  19. From waste to sustainable materials management: Three case studies of the transition journey.

    PubMed

    Silva, Angie; Rosano, Michele; Stocker, Laura; Gorissen, Leen

    2017-03-01

    Waste policy is increasingly moving on from the 'prevention of waste' to a 'sustainable materials policy' focused agenda recognising individual wastes as a resource. In order to comparatively analyse policy developments in enhanced waste management, three case studies were selected; San Francisco's Zero Waste Program, Flanders's Sustainable Materials Management Initiative and Japan's Sound Material-Cycle Society Plan. These case studies were chosen as an opportunity to investigate the variety of leading approaches, governance structures, and enhanced waste policy outcomes, emerging globally. This paper concludes that the current transitional state of waste management across the world, is only in the first leg of the journey towards Circular Economy closed loop production models of waste as a resource material. It is suggested that further development in government policy, planning and behaviour change is required. A focus on material policy and incorporating multiple front runners across industry and knowledge institutions are offered as potential directions in the movement away from end-pipe land-fill solutions.

  20. Guyon Canal Syndrome: lack of management in a case of unresolved handlebar palsy

    PubMed Central

    Brown, Courtney K.; Stainsby, Brynne; Sovak, Guy

    2014-01-01

    Objective: To present the clinical diagnostic features including management of Guyon canal syndrome in a case with unresolved sensory deficits in a young female cyclist. Clinical Presentation: After 14 days of cycling across Canada, a 23-year old female experienced sensory loss, followed by atrophy and a “claw” hand appearance of her left hand. Intervention and Outcome: Treatment included cervical chiropractic manipulation, soft tissue therapy and the use of cycling gloves. Seven years after the initial injury a lack of sensation in the ulnar nerve distribution of her left hand has persisted. Discussion: This case demonstrates that a lack of proper management can lead to permanent sensory loss and is worth highlighting. Various therapists evaluated the patient’s symptoms and provided minimal care. No diagnosis was given, nor were appropriate measures taken for her to understand the risks of continuing to ride. Summary: Although treatment for Guyon Canal Syndrome can be as easy as cessation from cycling until symptoms subside, other treatment options could be utilized to help manage ulnar nerve compression injuries in cyclists. PMID:25550666