Stress Management Techniques for Young Children.
ERIC Educational Resources Information Center
Piper, Francesca M.
The director of a not-for-profit nursery school adapted the adult stress management techniques of exercise and relaxation for use with 3- to 5-year-old children. Specifically, children were taught visualization techniques and yoga exercises involving deep breathing. The goal of the practicum was to rechannel children's negative stress-related…
The Relationship between Classroom Management Strategies and Student Misbehaviors.
ERIC Educational Resources Information Center
Skiba, Russell J.
Because research has determined that specific management techniques can have an effect on the classroom behavior of students, an observational rating scale was developed to assess the type of management techniques six elementary teachers in a program for behaviorally disordered children used to control behavior. Correlational analyses were used to…
Group decision-making techniques for natural resource management applications
Coughlan, Beth A.K.; Armour, Carl L.
1992-01-01
This report is an introduction to decision analysis and problem-solving techniques for professionals in natural resource management. Although these managers are often called upon to make complex decisions, their training in the natural sciences seldom provides exposure to the decision-making tools developed in management science. Our purpose is to being to fill this gap. We present a general analysis of the pitfalls of group problem solving, and suggestions for improved interactions followed by the specific techniques. Selected techniques are illustrated. The material is easy to understand and apply without previous training or excessive study and is applicable to natural resource management issues.
Information Requirements Specification II: Brainstorming Collective Decision-Making Technique.
ERIC Educational Resources Information Center
Telem, Moshe
1988-01-01
Information requirements specification (IRS) constitutes an Achilles heel in the system life cycle of management information systems. This article establishes a systematic overall IRS technique applicable to organizations of all types and sizes. The technique's integration of brainstorming and theory Z principles creates an effective, stimulating,…
ERIC Educational Resources Information Center
Chapman, Stanley L.; Jeffrey, D. Balfour
1978-01-01
In comprehensive wieght loss program, overweight women exposed to instruction in self-standard setting and to situational management techniques lost more weight than those instructed only in situational management techniques. Findings illustrate facilitative effect of teaching individuals to set specific, objective, and realistic goals for eating…
Chemical Waste Management and Disposal.
ERIC Educational Resources Information Center
Armour, Margaret-Ann
1988-01-01
Describes simple, efficient techniques for treating hazardous chemicals so that nontoxic and nonhazardous residues are formed. Discusses general rules for management of waste chemicals from school laboratories and general techniques for the disposal of waste or surplus chemicals. Lists specific disposal reactions. (CW)
Quality Attribute Techniques Framework
NASA Astrophysics Data System (ADS)
Chiam, Yin Kia; Zhu, Liming; Staples, Mark
The quality of software is achieved during its development. Development teams use various techniques to investigate, evaluate and control potential quality problems in their systems. These “Quality Attribute Techniques” target specific product qualities such as safety or security. This paper proposes a framework to capture important characteristics of these techniques. The framework is intended to support process tailoring, by facilitating the selection of techniques for inclusion into process models that target specific product qualities. We use risk management as a theory to accommodate techniques for many product qualities and lifecycle phases. Safety techniques have motivated the framework, and safety and performance techniques have been used to evaluate the framework. The evaluation demonstrates the ability of quality risk management to cover the development lifecycle and to accommodate two different product qualities. We identify advantages and limitations of the framework, and discuss future research on the framework.
Handbook of emergency management for state-level transportation agencies.
DOT National Transportation Integrated Search
2010-03-01
The Department of Homeland Security has mandated specific systems and techniques for the management of emergencies in the United States, including the Incident Command System, the National Incident Management System, Emergency Operations Plans, Emerg...
Poureslami, Iraj; Kwan, Susan; Lam, Stephen; Khan, Nadia A; FitzGerald, John Mark
2016-01-01
Patient education is a key component in the management of chronic obstructive pulmonary disease (COPD). Delivering effective education to ethnic groups with COPD is a challenge. The objective of this study was to develop and assess the effectiveness of culturally and linguistically specific audiovisual educational materials in supporting self-management practices in Mandarin- and Cantonese-speaking patients. Educational materials were developed using participatory approach (patients involved in the development and pilot test of educational materials), followed by a randomized controlled trial that assigned 91 patients to three intervention groups with audiovisual educational interventions and one control group (pamphlet). The patients were recruited from outpatient clinics. The primary outcomes were improved inhaler technique and perceived self-efficacy to manage COPD. The secondary outcome was improved patient understanding of pulmonary rehabilitation procedures. Subjects in all three intervention groups, compared with control subjects, demonstrated postintervention improvements in inhaler technique (P<0.001), preparedness to manage a COPD exacerbation (P<0.01), ability to achieve goals in managing COPD (P<0.01), and understanding pulmonary rehabilitation procedures (P<0.05). Culturally appropriate educational interventions designed specifically to meet the needs of Mandarin and Cantonese COPD patients are associated with significantly better understanding of self-management practices. Self-management education led to improved proper use of medications, ability to manage COPD exacerbations, and ability to achieve goals in managing COPD. A relatively simple culturally appropriate disease management education intervention improved inhaler techniques and self-management practices. Further research is needed to assess the effectiveness of self-management education on behavioral change and patient empowerment strategies.
Poureslami, Iraj; Kwan, Susan; Lam, Stephen; Khan, Nadia A; FitzGerald, John Mark
2016-01-01
Background Patient education is a key component in the management of chronic obstructive pulmonary disease (COPD). Delivering effective education to ethnic groups with COPD is a challenge. The objective of this study was to develop and assess the effectiveness of culturally and linguistically specific audiovisual educational materials in supporting self-management practices in Mandarin- and Cantonese-speaking patients. Methods Educational materials were developed using participatory approach (patients involved in the development and pilot test of educational materials), followed by a randomized controlled trial that assigned 91 patients to three intervention groups with audiovisual educational interventions and one control group (pamphlet). The patients were recruited from outpatient clinics. The primary outcomes were improved inhaler technique and perceived self-efficacy to manage COPD. The secondary outcome was improved patient understanding of pulmonary rehabilitation procedures. Results Subjects in all three intervention groups, compared with control subjects, demonstrated postintervention improvements in inhaler technique (P<0.001), preparedness to manage a COPD exacerbation (P<0.01), ability to achieve goals in managing COPD (P<0.01), and understanding pulmonary rehabilitation procedures (P<0.05). Conclusion Culturally appropriate educational interventions designed specifically to meet the needs of Mandarin and Cantonese COPD patients are associated with significantly better understanding of self-management practices. Self-management education led to improved proper use of medications, ability to manage COPD exacerbations, and ability to achieve goals in managing COPD. Clinical implication A relatively simple culturally appropriate disease management education intervention improved inhaler techniques and self-management practices. Further research is needed to assess the effectiveness of self-management education on behavioral change and patient empowerment strategies. PMID:27536093
Using Powerpoint Animations to Teach Operations Management Techniques and Concepts
ERIC Educational Resources Information Center
Treleven, Mark D.; Penlesky, Richard J.; Callarman, Thomas E.; Watts, Charles A.; Bragg, Daniel J.
2014-01-01
This article examines the value of using complex animated PowerPoint presentations to teach operations management techniques and concepts. To provide context, literature covering the use of PowerPoint animations in business education is briefly reviewed. The specific animations employed in this study are identified and their expected benefits to…
Use of GIS-based Site-specific Nitrogen Management for Improving Energy Efficiency
USDA-ARS?s Scientific Manuscript database
To our knowledge, geographical information system (GIS)-based site-specific nitrogen management (SSNM) techniques have not been used to assess agricultural energy costs and efficiency. This chapter uses SSNM case studies for corn (Zea mays L.) grown in Missouri and cotton (Gossypium hirsutum L.) gro...
DOE Office of Scientific and Technical Information (OSTI.GOV)
Cardenas, Ibsen C., E-mail: c.cardenas@utwente.nl; Halman, Johannes I.M., E-mail: J.I.M.Halman@utwente.nl
Uncertainty is virtually unavoidable in environmental impact assessments (EIAs). From the literature related to treating and managing uncertainty, we have identified specific techniques for coping with uncertainty in EIAs. Here, we have focused on basic steps in the decision-making process that take place within an EIA setting. More specifically, we have identified uncertainties involved in each decision-making step and discussed the extent to which these can be treated and managed in the context of an activity or project that may have environmental impacts. To further demonstrate the relevance of the techniques identified, we have examined the extent to which themore » EIA guidelines currently used in Colombia consider and provide guidance on managing the uncertainty involved in these assessments. Some points that should be considered in order to provide greater robustness in impact assessments in Colombia have been identified. These include the management of stakeholder values, the systematic generation of project options, and their associated impacts as well as the associated management actions, and the evaluation of uncertainties and assumptions. We believe that the relevant and specific techniques reported here can be a reference for future evaluations of other EIA guidelines in different countries. - Highlights: • uncertainty is unavoidable in environmental impact assessments, EIAs; • we have identified some open techniques to EIAs for treating and managing uncertainty in these assessments; • points for improvement that should be considered in order to provide greater robustness in EIAs in Colombia have been identified; • the paper provides substantiated a reference for possible examinations of EIAs guidelines in other countries.« less
Behavioral management of the hyperactive child.
Murray, M E
1980-09-01
This paper provides a general outline of the principles of behavioral management of the hyperactive child. The use of stimulant medications and special considerations in school are briefly discussed and then suggestions for initial parent counseling, family assessment, and the analysis of specific behavior problems are reviewed. Techniques of behavioral management are presented for the younger hyperactive child (3 to 7 years) and for the older hyperactive child (8 to 13 years). Among management techniques discussed are positive reinforcement, extinction procedures, and punishment through isolation. The problems involved in the use of corporal punishment are outlined as well as specific guidelines for parents as to when and how corporal punishment can be used effectively. A step-by-step summary of how to employ a token economy to manage both home and school behavior problems in older hyperactive children is presented.
1982-05-01
MONITORING AND MANAGEMENT , 34 7.0 NONDESTRUCTIVE EVALUATION ( NDE ) 37 8. 0 SURFACE NDE 44 9.0 PERFORMANCE AND PROOF TESTING 46 10.0 SUMMARY AND...Chemical Quality Assurance Testing 2. Processability Testing 3. Cure Monitoring and Management 4. Nondestructive Evaluation ( NDE ) 5. Performance and...the management concept for implementing the specific tests. Chemical analysis, nondestructive evaluation ( NDE ) and environmental fatigue testing of
Managing a Public Library. Parts I and II.
ERIC Educational Resources Information Center
Aronoff, Carol; Cart, Michael
1985-01-01
Discusses factors that contribute to Santa Monica Public Library's excellence, including supportive city government and citizenry, city council, library board, lean top management, and the basic management team. Specific management principles and techniques, public relations, and measures of service at Beverly Hills Public Library are also…
John H. Schomaker; David W. Lime
1988-01-01
The "nominal group" process is a proven technique to systematically arrive at a consensus about critical information needs in recreation planning and management. Using this process, 41 managers who attended a 1983 conference on river management identified 114 specific information needs grouped under 11 general questions. Clearly, some concerns of...
Shannahoff-Khalsa, David S
2004-02-01
The ancient system of Kundalini yoga includes a vast array of meditation techniques and many were discovered to be specific for treating the psychiatric disorders as we know them today. One such technique was found to be specific for treating obsessive-compulsive disorder (OCD), the fourth most common psychiatric disorder, and the tenth most disabling disorder worldwide. Two published clinical trials are described here for treating OCD using a specific Kundalini yoga protocol. This OCD protocol also includes techniques that are useful for a wide range of anxiety disorders, as well as a technique specific for learning to manage fear, one for tranquilizing an angry mind, one for meeting mental challenges, and one for turning negative thoughts into positive thoughts. Part of that protocol is included here and published in detail elsewhere. In addition, a number of other disorder-specific meditation techniques are included here to help bring these tools to the attention of the medical and scientific community. These techniques are specific for phobias, addictive and substance abuse disorders, major depressive disorders, dyslexia, grief, insomnia and other sleep disorders.
Rump, B; Cornelis, C; Woonink, F; VAN Steenbergen, J; Verweij, M; Hulscher, M
2017-05-01
Typing techniques are laboratory methods used in outbreak management to investigate the degree to which microbes found within an outbreak are related. Knowledge about relational patterns between microbes benefits outbreak management, but inevitably also tells us something about the relational patterns of the people hosting them. Since the technique is often used without explicit consent of all individuals involved, this may raise ethical questions. The aim of this study was to unravel the complex ethical deliberation of professionals over the use of such techniques. We organised group discussions (n = 3) with Dutch outbreak managers (n = 23). The topic list was based on previously identified ethical issues and discussions were analysed for recurrent themes. We found that outbreak managers first and foremost reflect on the balance of individual harm with public health benefit. This key question was approached by way of discussing four more specific ethical themes: (1) justification of governmental intervention, (2) responsibility to prevent infections, (3) scientific uncertainty and (4) legal consequences. The themes found in this study, rephrased into accessible questions, represent the shared ethical understanding of professionals and can help to articulate the ethical dimensions of using molecular science in response to infectious disease outbreaks.
43 CFR 10005.15 - Planning and management techniques applicable to the plan.
Code of Federal Regulations, 2013 CFR
2013-10-01
... facilities, instream spawning facilities, water control structures, and fencing that aid in the conservation... biological resources. (g) Applied research that targets specific biological information or management needs...
43 CFR 10005.15 - Planning and management techniques applicable to the plan.
Code of Federal Regulations, 2014 CFR
2014-10-01
... facilities, instream spawning facilities, water control structures, and fencing that aid in the conservation... biological resources. (g) Applied research that targets specific biological information or management needs...
Statistical and Economic Techniques for Site-specific Nematode Management.
Liu, Zheng; Griffin, Terry; Kirkpatrick, Terrence L
2014-03-01
Recent advances in precision agriculture technologies and spatial statistics allow realistic, site-specific estimation of nematode damage to field crops and provide a platform for the site-specific delivery of nematicides within individual fields. This paper reviews the spatial statistical techniques that model correlations among neighboring observations and develop a spatial economic analysis to determine the potential of site-specific nematicide application. The spatial econometric methodology applied in the context of site-specific crop yield response contributes to closing the gap between data analysis and realistic site-specific nematicide recommendations and helps to provide a practical method of site-specifically controlling nematodes.
Evaluation of fleet management techniques for timber highway bridges
Brent M. Phares; Travis K. Hosteng; Justin Dahlberg; Michael A. Ritter
2011-01-01
The general condition of the nation's bridges presents a complex management issue when considering cost, safety, and time. Consequently, the management of those bridges can become an overwhelming task. The need for a management system that is specific to rural systems may help to improve the management of this significant number of bridges. Although individual...
Self-Managed Studying in College Courses.
ERIC Educational Resources Information Center
Edwards, K. Anthony
In an introductory psychology course, students were taught some principles of "adjustment" using self-management techniques and were required to conduct a self-management project. The four student projects reported herein were specifically designed to improve study skills through use of Premack's principle and stimulus control. Course…
Advanced Manufacturing Processes in the Motor Vehicle Industry
DOT National Transportation Integrated Search
1983-05-01
Advanced manufacturing processes, which include a range of automation and management techniques, are aiding U.S. motor vehicle manufacturers to reduce vehicle costs. This report discusses these techniques in general and their specific applications in...
Minimally Invasive Surgery (MIS) Approaches to Thoracolumbar Trauma.
Kaye, Ian David; Passias, Peter
2018-03-01
Minimally invasive surgical (MIS) techniques offer promising improvements in the management of thoracolumbar trauma. Recent advances in MIS techniques and instrumentation for degenerative conditions have heralded a growing interest in employing these techniques for thoracolumbar trauma. Specifically, surgeons have applied these techniques to help manage flexion- and extension-distraction injuries, neurologically intact burst fractures, and cases of damage control. Minimally invasive surgical techniques offer a means to decrease blood loss, shorten operative time, reduce infection risk, and shorten hospital stays. Herein, we review thoracolumbar minimally invasive surgery with an emphasis on thoracolumbar trauma classification, minimally invasive spinal stabilization, surgical indications, patient outcomes, technical considerations, and potential complications.
Techniques for characterization and eradication of potato cyst nematode: a review.
Bairwa, Aarti; Venkatasalam, E P; Sudha, R; Umamaheswari, R; Singh, B P
2017-09-01
Correct identification of species and pathotypes is must for eradication of potato cyst nematodes (PCN). The identification of PCN species after completing the life cycle is very difficult because it is based on morphological and morphometrical characteristics. Genetically different populations of PCN are morphologically same and differentiated based on the host differential study. Later on these traditional techniques have been replaced by biochemical techniques viz, one and two dimensional gel electrophoresis, capillary gel electrophoresis, isozymes, dot blot hybridization and isoelectric focusing etc. to distinguish both the species. One and two dimensional gel electrophoresis has used to examine inter- and intra-specific differences in proteins of Globodera rostochiensis and G. pallida . Now application of PCR and DNA based characterization techniques like RAPD, AFLP and RFLP are the important tools for differentiating inter- and intra specific variation in PCN and has given opportunities to accurate identification of PCN. For managing the PCN, till now we are following integrated pest management (IPM) strategies, however these strategies are not effective to eradicate the PCN. Therefore to eradicate the PCN we need noval management practices like RNAi (RNA interference) or Gene silencing.
Unit area control in California forests
William E. Hallin
1951-01-01
There is a definite distinction between the basic concept of unit area control and the specific techniques or treatments used for specific units. Unit area control as a term was first used in connection with a cutting trial in the sugar pine-fir type; consequently, many foresters think the term refers merely to the technique used in sugar pine management, This is not...
When Management Negotiates. A Guidebook for Sound Collective Bargaining.
ERIC Educational Resources Information Center
National Association of Manufacturers, New York, NY. Industrial Relations Committee.
This guide provides management with specific procedural and tactical advice to be used while negotiating a labor union contract. The first 10 chapters suggest management techniques for collection and evaluation of pertinent information, evaluation of past negotiation experiences, formulation of company proposals, selection of the company…
Management intensity and genetics affect loblolly pine seedling performance
Scott D. Roberts; Randall J. Rousseau; B. Landis Herrin
2012-01-01
Capturing potential genetic gains from tree improvement programs requires selection of the appropriate genetic stock and application of appropriate silvicultural management techniques. Limited information is available on how specific loblolly pine varietal genotypes perform under differing growing environments and management approaches. This study was established in...
Best Practices for Management of Biocontaminated Waste ...
Report The purpose of these best practices is to provide federal, state, territorial, and local waste management entities information on techniques and methodologies that have the potential to improve the handling and management of biocontaminated waste streams after a biological agent incident. These best practices are intended to be general in nature serving as a resource to a variety of biological agents in a variety of situations; however, these best practices also present a specific homeland security scenario – a biological attack with Bacillus anthracis (B. anthracis) – to help illustrate specific waste management considerations.
Boka, V; Arapostathis, K; Vretos, N; Kotsanos, N
2014-10-01
The aim of this study was to examine the acceptance by Greek parents of nine behaviour-management techniques and its association with several possible confounding factors. Following ethical approval, 106 parents whose 3- to 12-year-old children had been receiving treatment in a university postgraduate paediatric dental clinic, and 123 parents of children from a private paediatric dental practice agreed to participate. After being shown a video with nine behaviour-management techniques, parents rated the acceptance of each technique on a 0-10 scale. They were then asked to complete a questionnaire about demographics, their previous dental experience and dental anxiety (modified Corah dental anxiety scale). The best accepted technique was tell-show-do (9.76 ± 0.69), followed by parental presence/absence (PPA) technique (7.83 ± 3.06) and nitrous oxide inhalation sedation (7.09 ± 3.02). The least accepted techniques were passive restraint (4.21 ± 3.84) and general anaesthesia (4.21 ± 4.02). No correlations were found between acceptance of any individual management technique and parental age, gender, income, education, dental experience and dental anxiety or the child's age, gender and dental experience. Parents whose children had been treated at the University clinic had lower income and educational levels, and rated passive restraint, oral sedation and general anaesthesia higher than those from the private practice. When the parents were specifically asked to choose between general anaesthesia over any of the active or passive restraint, hand-over-mouth and voice control techniques, 10% preferred general anaesthesia, and these parents reported statistically significant more negative dental experience but not higher dental anxiety. Statistical significance of differences was explored using the Tukey-Kramer method. There was no correlation between parental dental experience and dental anxiety and the acceptance of any specific behaviour-management technique. However, parents with negative dental experience would prefer general anaesthesia over any of active or passive restraint, hand-over-mouth and voice control techniques. PPA is a highly acceptable technique for Greek parents.
Application of remote sensing to solution of ecological problems
NASA Technical Reports Server (NTRS)
Adelman, A.
1972-01-01
The application of remote sensing techniques to solving ecological problems is discussed. The three phases of environmental ecological management are examined. The differences between discovery and exploitation of natural resources and their ecological management are described. The specific application of remote sensing to water management is developed.
USDA-ARS?s Scientific Manuscript database
Water quality issues continue to vex agriculture. Understanding contaminant-specific pathways could help clarify effective water quality management strategies in watersheds. Hypothesis: If conducted at nested scales, hydrograph separation techniques can identify contaminant-specific pathways that co...
The management of esophageal achalasia: from diagnosis to surgical treatment.
Dobrowolsky, Adrian; Fisichella, P Marco
2014-03-01
The goal of this review is to illustrate our approach to patients with achalasia in terms of preoperative evaluation and surgical technique. Indications, patient selection and management are herein discussed. Specifically, we illustrate the pathogenetic theories and diagnostic algorithm with current up-to-date techniques to diagnose achalasia and its manometric variants. Finally, we focus on the therapeutic approaches available today: medical and surgical. A special emphasis is given on the surgical treatment of achalasia and we provide the reader with a detailed description of our pre and postoperative management.
Overcoming learning barriers through knowledge management.
Dror, Itiel E; Makany, Tamas; Kemp, Jonathan
2011-02-01
The ability to learn highly depends on how knowledge is managed. Specifically, different techniques for note-taking utilize different cognitive processes and strategies. In this paper, we compared dyslexic and control participants when using linear and non-linear note-taking. All our participants were professionals working in the banking and financial sector. We examined comprehension, accuracy, mental imagery & complexity, metacognition, and memory. We found that participants with dyslexia, when using a non-linear note-taking technique outperformed the control group using linear note-taking and matched the performance of the control group using non-linear note-taking. These findings emphasize how different knowledge management techniques can avoid some of the barriers to learners. Copyright © 2010 John Wiley & Sons, Ltd.
Anesthesia for hip arthroscopy: a narrative review.
Yu, Hai Chuan; Al-Shehri, Mohammed; Johnston, Kelly D; Endersby, Ryan; Baghirzada, Leyla
2016-11-01
Hip arthroscopy is a minimally invasive surgical procedure indicated for the treatment of specific hip disorders. In this narrative review, we aim to examine the key components in providing anesthesia for this procedure. MEDLINE(®), PubMed, and EMBASE™ databases were searched for peer-reviewed articles discussing the anesthetic management of patients undergoing hip arthroscopy. The primary anesthetic regimen used for hip arthroscopy should balance patient factors, preferences of the surgeon, and the demands of the procedure itself. Both general and neuraxial anesthetic techniques are well suited for this mostly ambulatory surgical procedure. There is a lack of current literature specifically comparing the benefits and risks of the two techniques in this setting. Postoperative pain management consists mainly of intravenous and oral opioids; however, a variety of regional anesthesia techniques, such as lumbar plexus block and fascia iliaca block, can be performed pre- or postoperatively. Overall, hip arthroscopy is safe, although positioning-related difficulties, extravasation of irrigation fluid, hypothermia, infections, and thromboembolic events are potential perioperative complications that warrant specific monitoring and prompt treatment. Until now, the anesthetic technique for hip arthroscopy has not been well studied. Thus, increasing emphasis should be directed towards examining relevant clinical outcomes that can better inform evidence-based decision-making in the anesthetic management of hip arthroscopy patients. In the meantime, awareness of potential complications and vigilant monitoring are paramount in providing safe anesthetic care for patients undergoing hip arthroscopy.
15 CFR 923.43 - Direct State land and water use planning and regulation-Technique B.
Code of Federal Regulations, 2011 CFR
2011-01-01
... OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS... subsection 306(d)(11) of the Act for control of land and water uses within the coastal zone. The second such... specific to coastal management and the requirements of this Act. (2) Networking—The utilization of...
Cognitive Rehabilitation of Episodic Memory Disorders: From Theory to Practice
Ptak, Radek; der Linden, Martial Van; Schnider, Armin
2010-01-01
Memory disorders are among the most frequent and most debilitating cognitive impairments following acquired brain damage. Cognitive remediation strategies attempt to restore lost memory capacity, provide compensatory techniques or teach the use of external memory aids. Memory rehabilitation has strongly been influenced by memory theory, and the interaction between both has stimulated the development of techniques such as spaced retrieval, vanishing cues or errorless learning. These techniques partly rely on implicit memory and therefore enable even patients with dense amnesia to acquire new information. However, knowledge acquired in this way is often strongly domain-specific and inflexible. In addition, individual patients with amnesia respond differently to distinct interventions. The factors underlying these differences have not yet been identified. Behavioral management of memory failures therefore often relies on a careful description of environmental factors and measurement of associated behavioral disorders such as unawareness of memory failures. The current evidence suggests that patients with less severe disorders benefit from self-management techniques and mnemonics whereas rehabilitation of severely amnesic patients should focus on behavior management, the transmission of domain-specific knowledge through implicit memory processes and the compensation for memory deficits with memory aids. PMID:20700383
Iteration and Prototyping in Creating Technical Specifications.
ERIC Educational Resources Information Center
Flynt, John P.
1994-01-01
Claims that the development process for computer software can be greatly aided by the writers of specifications if they employ basic iteration and prototyping techniques. Asserts that computer software configuration management practices provide ready models for iteration and prototyping. (HB)
The Development of A Performance Measurement Concept for the Royal Australian Air Force
1992-09-01
knowledge of management accounting and performance measurement techniques. As the RAAF currently has no cost management and performance measurement system...provides a review of the current literature on management accounting for performance measurement, specifically referring to the problems of using...traditional management accounting methodologies as a basis for formulating performance measures. Chapter III explains the methodology used to conduct the
Site index determination techniques for southern bottomland hardwoods
Brian Roy Lockhart
2013-01-01
Site index is a species-specific indirect measure of forest productivity expressed as the average height of dominant and codominant trees in a stand of a specified base age. It is widely used by forest managers to make informed decisions regarding forest management practices. Unfortunately, forest managers have difficulty in determining site index for southern US...
ERIC Educational Resources Information Center
Marley, Kathryn A.; Stodnick, T. Michael; Heyl, Jeff
2013-01-01
Within operations management courses, most instructors choose to devote classroom time to teaching the topic of lean management. However, because the amount of time available for instructors to devote to this topic varies considerably, there is a great deal of latitude on which specific lean tools and techniques should be discussed. The authors…
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,…
Effective Personnel Management. The 1980 Regional Meeting NACS Traveling Troupe Presentation.
ERIC Educational Resources Information Center
Arnett, Wayne; Williams, James L.
1981-01-01
Specific suggestions are given for more effective personnel management: careful screening of applicants by one person, a well-designed application form (a sample is provided), good interview techniques, job descriptions, promotions from within, employee manuals, employee orientation, and continuing interpersonal communication. (MSE)
A review of post-modern management techniques as currently applied to Turkish forestry.
Dölarslan, Emre Sahin
2009-01-01
This paper reviews the effects of six post-modern management concepts as applied to Turkish forestry. Up to now, Turkish forestry has been constrained, both in terms of its operations and internal organization, by a highly bureaucratic system. The application of new thinking in forestry management, however, has recently resulted in new organizational and production concepts that promise to address problems specific to this Turkish industry and bring about positive changes. This paper will elucidate these specific issues and demonstrate how post-modern management thinking is influencing the administration and operational capacity of Turkish forestry within its current structure.
Preventing Challenging Behaviors in Preschool: Effective Strategies for Classroom Teachers
ERIC Educational Resources Information Center
Coleman, Janelle C.; Crosby, Megan G.; Irwin, Heather K.; Dennis, Lindsay R.; Simpson, Cynthia G.; Rose, Chad A.
2013-01-01
This article provides practical strategies and techniques that early childhood educators can implement in their classrooms to effectively manage challenging behaviors. The specific strategies addressed fall under the following categories: (a) classroom management, (b) reinforcement, and (c) communication. Suggestions are made for how parents can…
Retail Training and Education.
ERIC Educational Resources Information Center
Bloodworth, Margaret
The book provides insight into training aims, principles, techniques, aids , and courses designed to meet the training needs of specific groups of staff, such as management staff, training staff, new staff, and established staff. It also covers the training and educational elements of the Certificate of Retail Management Principles. Training…
Flexible data-management system
NASA Technical Reports Server (NTRS)
Pelouch, J. J., Jr.
1977-01-01
Combined ASRDI Data-Management and Analysis Technique (CADMAT) is system of computer programs and procedures that can be used to conduct data-management tasks. System was developed specifically for use by scientists and engineers who are confronted with management and analysis of large quantities of data organized into records of events and parametric fields. CADMAT is particularly useful when data are continually accumulated, such as when the need of retrieval and analysis is ongoing.
Degeling, Koen; Schivo, Stefano; Mehra, Niven; Koffijberg, Hendrik; Langerak, Rom; de Bono, Johann S; IJzerman, Maarten J
2017-12-01
With the advent of personalized medicine, the field of health economic modeling is being challenged and the use of patient-level dynamic modeling techniques might be required. To illustrate the usability of two such techniques, timed automata (TA) and discrete event simulation (DES), for modeling personalized treatment decisions. An early health technology assessment on the use of circulating tumor cells, compared with prostate-specific antigen and bone scintigraphy, to inform treatment decisions in metastatic castration-resistant prostate cancer was performed. Both modeling techniques were assessed quantitatively, in terms of intermediate outcomes (e.g., overtreatment) and health economic outcomes (e.g., net monetary benefit). Qualitatively, among others, model structure, agent interactions, data management (i.e., importing and exporting data), and model transparency were assessed. Both models yielded realistic and similar intermediate and health economic outcomes. Overtreatment was reduced by 6.99 and 7.02 weeks by applying circulating tumor cell as a response marker at a net monetary benefit of -€1033 and -€1104 for the TA model and the DES model, respectively. Software-specific differences were observed regarding data management features and the support for statistical distributions, which were considered better for the DES software. Regarding method-specific differences, interactions were modeled more straightforward using TA, benefiting from its compositional model structure. Both techniques prove suitable for modeling personalized treatment decisions, although DES would be preferred given the current software-specific limitations of TA. When these limitations are resolved, TA would be an interesting modeling alternative if interactions are key or its compositional structure is useful to manage multi-agent complex problems. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
School Management by Wandering Around.
ERIC Educational Resources Information Center
Frase, Larry; Hetzel, Robert
Management by wandering around (MBWA) is the catalyst that brings teachers, aides, parents, and administrators together in the pursuit of excellent schools. This book, based on common sense and hundreds of years of experience, offers specific strategies and techniques for using MBWA to obtain excellence. The building blocks of school excellence,…
Data base management system configuration specification. [computer storage devices
NASA Technical Reports Server (NTRS)
Neiers, J. W.
1979-01-01
The functional requirements and the configuration of the data base management system are described. Techniques and technology which will enable more efficient and timely transfer of useful data from the sensor to the user, extraction of information by the user, and exchange of information among the users are demonstrated.
Overcoming Learning Barriers through Knowledge Management
ERIC Educational Resources Information Center
Dror, Itiel E.; Makany, Tamas; Kemp, Jonathan
2011-01-01
The ability to learn highly depends on how knowledge is managed. Specifically, different techniques for note-taking utilize different cognitive processes and strategies. In this paper, we compared dyslexic and control participants when using linear and non-linear note-taking. All our participants were professionals working in the banking and…
Student Aggression: Prevention, Management, and Replacement Training.
ERIC Educational Resources Information Center
Goldstein, Arnold P.; And Others
American society is violent, a fact which is well-reflected in schools. This book, designed specifically for school personnel, presents the primary techniques currently being employed by educators to prevent, manage, and replace student aggression. The volume opens with a description of the origins of aggressive behavior and offers some…
Managing total corporate electricity/energy market risks
DOE Office of Scientific and Technical Information (OSTI.GOV)
Henney, A.; Keers, G.
1998-10-01
The banking industry has developed a tool kit of very useful value at risk techniques for hedging risk, but these techniques must be adapted to the special complexities of the electricity market. This paper starts with a short history of the use of value-at-risk (VAR) techniques in banking risk management and then examines the specific and, in many instances, complex risk management challenges faced by electric companies from the behavior of prices in electricity markets and from the character of generation and electric retailing risks. The third section describes the main methods for making VAR calculations along with an analysismore » of their suitability for analyzing the risks of electricity portfolios and the case for using profit at risk and downside risk as measures of risk. The final section draws the threads together and explains how to look at managing total corporate electricity market risk, which is a big step toward managing total corporate energy market risk.« less
Borovcanin, Zana; Shapiro, Janine R.
2012-01-01
Education and training in advanced airway management as part of an anesthesiology residency program is necessary to help residents attain the status of expert in difficult airway management. The Accreditation Council for Graduate Medical Education (ACGME) emphasizes that residents in anesthesiology must obtain significant experience with a broad spectrum of airway management techniques. However, there is no specific number required as a minimum clinical experience that should be obtained in order to ensure competency. We have developed a curriculum for a new Advanced Airway Techniques rotation. This rotation is supplemented with a hands-on Difficult Airway Workshop. We describe here this comprehensive advanced airway management educational program at our institution. Future studies will focus on determining if education in advanced airway management results in a decrease in airway related morbidity and mortality and overall better patients' outcome during difficult airway management. PMID:22505885
La Belle, Jeffrey T; Fairchild, Aaron; Demirok, Ugur K; Verma, Aman
2013-05-15
There is a critical need for more accurate, highly sensitive and specific assay for disease diagnosis and management. A novel, multiplexed, single sensor using rapid and label free electrochemical impedance spectroscopy tuning method has been developed. The key challenges while monitoring multiple targets is frequency overlap. Here we describe the methods to circumvent the overlap, tune by use of nanoparticle (NP) and discuss the various fabrication and characterization methods to develop this technique. First sensors were fabricated using printed circuit board (PCB) technology and nickel and gold layers were electrodeposited onto the PCB sensors. An off-chip conjugation of gold NP's to molecular recognition elements (with verification technique) is described as well. A standard covalent immobilization of the molecular recognition elements is also discussed with quality control techniques. Finally use and verification of sensitivity and specificity is also presented. By use of gold NP's of various sizes, we have demonstrated the possibility and shown little loss of sensitivity and specificity in the molecular recognition of inflammatory markers as "model" targets for our tuning system. By selection of other sized NP's or NP's of various materials, the tuning effect can be further exploited. The novel platform technology developed could be utilized in critical care, clinical management and at home health and disease management. Copyright © 2013 Elsevier Inc. All rights reserved.
1983-12-01
integration of TAEG findings with contractor findings. Critical incident interview techniques, as used by the contractor, were specifically prohibited in order...than the critical incident interview technique were to be explored for use in the identification of leadership competencies. These competencies and
A New Model for the Organizational Structure of Medical Record Departments in Hospitals in Iran
Moghaddasi, Hamid; Hosseini, Azamossadat; Sheikhtaheri, Abbas
2006-01-01
The organizational structure of medical record departments in Iran is not appropriate for the efficient management of healthcare information. In addition, there is no strong information management division to provide comprehensive information management services in hospitals in Iran. Therefore, a suggested model was designed based on four main axes: 1) specifications of a Health Information Management Division, 2) specifications of a Healthcare Information Management Department, 3) the functions of the Healthcare Information Management Department, and 4) the units of the Healthcare Information Management Department. The validity of the model was determined through use of the Delphi technique. The results of the validation process show that the majority of experts agree with the model and consider it to be appropriate and applicable for hospitals in Iran. The model is therefore recommended for hospitals in Iran. PMID:18066362
Muşat, Simona Nicoleta; Ioniţa, Diana; Paceonea, Mirela; Chiriac, Nona Delia; Stoicescu, Ileana Paula; Mihălţan, F D
2011-01-01
Identifying and promoting new management techniques for the descentralized pneumology hospitals or wards was one of the most ambitious objectives of the project "Quality in the pneumology medical services through continuous medical education and organizational flexibility", financed by the Human Resourses Development Sectorial Operational Programme 2007-2013 (ID 58451). The "Medium term Strategy on the specific management of the pneumology hospitals or wards after the descentralization of the sanitary system" presented in the article was written by the project's experts and discussed with pneumology managers and local authorities representatives. This Strategy application depends on the colaboration of the pneumology hospitals with professional associations, and local and central authorities.
Strauss, Keith J
2014-10-01
The management of image quality and radiation dose during pediatric CT scanning is dependent on how well one manages the radiographic techniques as a function of the type of exam, type of CT scanner, and patient size. The CT scanner's display of expected CT dose index volume (CTDIvol) after the projection scan provides the operator with a powerful tool prior to the patient scan to identify and manage appropriate CT techniques, provided the department has established appropriate diagnostic reference levels (DRLs). This paper provides a step-by-step process that allows the development of DRLs as a function of type of exam, of actual patient size and of the individual radiation output of each CT scanner in a department. Abdomen, pelvis, thorax and head scans are addressed. Patient sizes from newborns to large adults are discussed. The method addresses every CT scanner regardless of vendor, model or vintage. We cover adjustments to techniques to manage the impact of iterative reconstruction and provide a method to handle all available voltages other than 120 kV. This level of management of CT techniques is necessary to properly monitor radiation dose and image quality during pediatric CT scans.
Esthetic considerations in management of shortleaf pine
Robert H. Stignani
1986-01-01
Application of esthetic concerns in the management of shortleaf pine or any species should be predicated on a systematic approach. Many mitigation techniques are available, but those selected will need to be carefully tailored to the specific situation and to the unique characteristics of plant communities and landforms involved. Some additional costs should be...
Introducing Risk Management Techniques Within Project Based Software Engineering Courses
NASA Astrophysics Data System (ADS)
Port, Daniel; Boehm, Barry
2002-03-01
In 1996, USC switched its core two-semester software engineering course from a hypothetical-project, homework-and-exam course based on the Bloom taxonomy of educational objectives (knowledge, comprehension, application, analysis, synthesis, and evaluation). The revised course is a real-client team-project course based on the CRESST model of learning objectives (content understanding, problem solving, collaboration, communication, and self-regulation). We used the CRESST cognitive demands analysis to determine the necessary student skills required for software risk management and the other major project activities, and have been refining the approach over the last 5 years of experience, including revised versions for one-semester undergraduate and graduate project course at Columbia. This paper summarizes our experiences in evolving the risk management aspects of the project course. These have helped us mature more general techniques such as risk-driven specifications, domain-specific simplifier and complicator lists, and the schedule as an independent variable (SAIV) process model. The largely positive results in terms of review of pass / fail rates, client evaluations, product adoption rates, and hiring manager feedback are summarized as well.
Teaching Regular Classroom Success.
ERIC Educational Resources Information Center
Harries, Rhonda J.
1986-01-01
Seven strategies are described to encourage resource room students' development of independent organizational skills. Suggestions include use of specific duty sheets, time management instruction, and teaching of proofreading and checking techniques. (CL)
Leadership skills help financial managers achieve career success.
Kowalski, R B; Campbell, M W
2000-04-01
Financial managers who want to distinguish themselves in their organizations need to demonstrate their leadership ability. Because financial managers sometimes overlook the need for leadership skills, cultivating mentors who can teach them specific leadership skills, such as improved communications and entrepreneurship, may be necessary. Healthcare financial managers can sharpen their leadership skills by distinguishing between leadership and management, adopting a new mentoring model, evaluating the usefulness of new management techniques, understanding the connection between technology and leadership, looking for the solution beyond the problem, and being seen and heard within the organization.
An intelligent content discovery technique for health portal content management.
De Silva, Daswin; Burstein, Frada
2014-04-23
Continuous content management of health information portals is a feature vital for its sustainability and widespread acceptance. Knowledge and experience of a domain expert is essential for content management in the health domain. The rate of generation of online health resources is exponential and thereby manual examination for relevance to a specific topic and audience is a formidable challenge for domain experts. Intelligent content discovery for effective content management is a less researched topic. An existing expert-endorsed content repository can provide the necessary leverage to automatically identify relevant resources and evaluate qualitative metrics. This paper reports on the design research towards an intelligent technique for automated content discovery and ranking for health information portals. The proposed technique aims to improve efficiency of the current mostly manual process of portal content management by utilising an existing expert-endorsed content repository as a supporting base and a benchmark to evaluate the suitability of new content A model for content management was established based on a field study of potential users. The proposed technique is integral to this content management model and executes in several phases (ie, query construction, content search, text analytics and fuzzy multi-criteria ranking). The construction of multi-dimensional search queries with input from Wordnet, the use of multi-word and single-word terms as representative semantics for text analytics and the use of fuzzy multi-criteria ranking for subjective evaluation of quality metrics are original contributions reported in this paper. The feasibility of the proposed technique was examined with experiments conducted on an actual health information portal, the BCKOnline portal. Both intermediary and final results generated by the technique are presented in the paper and these help to establish benefits of the technique and its contribution towards effective content management. The prevalence of large numbers of online health resources is a key obstacle for domain experts involved in content management of health information portals and websites. The proposed technique has proven successful at search and identification of resources and the measurement of their relevance. It can be used to support the domain expert in content management and thereby ensure the health portal is up-to-date and current.
Morris, Chris; Pajon, Anne; Griffiths, Susanne L.; Daniel, Ed; Savitsky, Marc; Lin, Bill; Diprose, Jonathan M.; Wilter da Silva, Alan; Pilicheva, Katya; Troshin, Peter; van Niekerk, Johannes; Isaacs, Neil; Naismith, James; Nave, Colin; Blake, Richard; Wilson, Keith S.; Stuart, David I.; Henrick, Kim; Esnouf, Robert M.
2011-01-01
The techniques used in protein production and structural biology have been developing rapidly, but techniques for recording the laboratory information produced have not kept pace. One approach is the development of laboratory information-management systems (LIMS), which typically use a relational database schema to model and store results from a laboratory workflow. The underlying philosophy and implementation of the Protein Information Management System (PiMS), a LIMS development specifically targeted at the flexible and unpredictable workflows of protein-production research laboratories of all scales, is described. PiMS is a web-based Java application that uses either Postgres or Oracle as the underlying relational database-management system. PiMS is available under a free licence to all academic laboratories either for local installation or for use as a managed service. PMID:21460443
Perioperative Blood Management in Pediatric Spine Surgery.
Oetgen, Matthew E; Litrenta, Jody
2017-07-01
Blood management strategies are integral to successful outcomes in many types of orthopaedic surgery. These strategies minimize blood loss and transfusion requirements, ultimately decreasing complications, improving outcomes, and potentially eliminating risks associated with allogeneic transfusion. Practices to achieve these goals include preoperative evaluation and optimization of hemoglobin, the use of pharmacologic agents or anesthetic methods, intraoperative techniques to improve hemostasis and cell salvage, and the use of predonated autologous blood. Guidelines can also help manage allogeneic transfusions in the perioperative period. Although the literature on blood management has focused primarily on arthroplasty and adult spine surgery, pediatric spinal fusion for scoliosis involves a large group of patients with a specific set of risk factors for transfusion and distinct perioperative considerations. A thorough understanding of blood management techniques will improve surgical planning, limit transfusion-associated risks, maintain hemostasis, and optimize outcomes in this pediatric population.
Morris, Chris; Pajon, Anne; Griffiths, Susanne L; Daniel, Ed; Savitsky, Marc; Lin, Bill; Diprose, Jonathan M; da Silva, Alan Wilter; Pilicheva, Katya; Troshin, Peter; van Niekerk, Johannes; Isaacs, Neil; Naismith, James; Nave, Colin; Blake, Richard; Wilson, Keith S; Stuart, David I; Henrick, Kim; Esnouf, Robert M
2011-04-01
The techniques used in protein production and structural biology have been developing rapidly, but techniques for recording the laboratory information produced have not kept pace. One approach is the development of laboratory information-management systems (LIMS), which typically use a relational database schema to model and store results from a laboratory workflow. The underlying philosophy and implementation of the Protein Information Management System (PiMS), a LIMS development specifically targeted at the flexible and unpredictable workflows of protein-production research laboratories of all scales, is described. PiMS is a web-based Java application that uses either Postgres or Oracle as the underlying relational database-management system. PiMS is available under a free licence to all academic laboratories either for local installation or for use as a managed service.
OPERATIONS RESEARCH IN THE DESIGN OF MANAGEMENT INFORMATION SYSTEMS
management information systems is concerned with the identification and detailed specification of the information and data processing...of advanced data processing techniques in management information systems today, the close coordination of operations research and data systems activities has become a practical necessity for the modern business firm.... information systems in which mathematical models are employed as the basis for analysis and systems design. Operations research provides a
Crew interface specification development study for in-flight maintenance and stowage functions
NASA Technical Reports Server (NTRS)
Carl, J. G.
1971-01-01
The need and potential solutions for an orderly systems engineering approach to the definition, management and documentation requirements for in-flight maintenance, assembly, servicing, and stowage process activities of the flight crews of future spacecraft were investigated. These processes were analyzed and described using a new technique (mass/function flow diagramming), developed during the study, to give visibility to crew functions and supporting requirements, including data products. This technique is usable by NASA for specification baselines and can assist the designer in identifying both upper and lower level requirements associated with these processes. These diagrams provide increased visibility into the relationships between functions and related equipments being utilized and managed and can serve as a common communicating vehicle between the designer, program management, and the operational planner. The information and data product requirements to support the above processes were identified along with optimum formats and contents of these products. The resulting data product concepts are presented to support these in-flight maintenance and stowage processes.
NASA Technical Reports Server (NTRS)
Jamsek, Damir A.
1993-01-01
A brief example of the use of formal methods techniques in the specification of a software system is presented. The report is part of a larger effort targeted at defining a formal methods pilot project for NASA. One possible application domain that may be used to demonstrate the effective use of formal methods techniques within the NASA environment is presented. It is not intended to provide a tutorial on either formal methods techniques or the application being addressed. It should, however, provide an indication that the application being considered is suitable for a formal methods by showing how such a task may be started. The particular system being addressed is the Structured File Services (SFS), which is a part of the Data Storage and Retrieval Subsystem (DSAR), which in turn is part of the Data Management System (DMS) onboard Spacestation Freedom. This is a software system that is currently under development for NASA. An informal mathematical development is presented. Section 3 contains the same development using Penelope (23), an Ada specification and verification system. The complete text of the English version Software Requirements Specification (SRS) is reproduced in Appendix A.
Clinico-laboratory aspects of anti-nuclear and anti-native DNA antibody tests.
Webb, J
1978-01-01
Available techniques for detection of anti-nuclear antibodies are here briefly reviewed. The relatively insensitive LE cell test has been largely supplanted by the indirect immunofluorescent ANA test which should be reported in terms of titre and pattern. Specific measurement of nDNA antibodies is now a regular technique in SLE diagnosis and management.
A Bio Medical Waste Identification and Classification Algorithm Using Mltrp and Rvm.
Achuthan, Aravindan; Ayyallu Madangopal, Vasumathi
2016-10-01
We aimed to extract the histogram features for text analysis and, to classify the types of Bio Medical Waste (BMW) for garbage disposal and management. The given BMW was preprocessed by using the median filtering technique that efficiently reduced the noise in the image. After that, the histogram features of the filtered image were extracted with the help of proposed Modified Local Tetra Pattern (MLTrP) technique. Finally, the Relevance Vector Machine (RVM) was used to classify the BMW into human body parts, plastics, cotton and liquids. The BMW image was collected from the garbage image dataset for analysis. The performance of the proposed BMW identification and classification system was evaluated in terms of sensitivity, specificity, classification rate and accuracy with the help of MATLAB. When compared to the existing techniques, the proposed techniques provided the better results. This work proposes a new texture analysis and classification technique for BMW management and disposal. It can be used in many real time applications such as hospital and healthcare management systems for proper BMW disposal.
A Regev-type fully homomorphic encryption scheme using modulus switching.
Chen, Zhigang; Wang, Jian; Chen, Liqun; Song, Xinxia
2014-01-01
A critical challenge in a fully homomorphic encryption (FHE) scheme is to manage noise. Modulus switching technique is currently the most efficient noise management technique. When using the modulus switching technique to design and implement a FHE scheme, how to choose concrete parameters is an important step, but to our best knowledge, this step has drawn very little attention to the existing FHE researches in the literature. The contributions of this paper are twofold. On one hand, we propose a function of the lower bound of dimension value in the switching techniques depending on the LWE specific security levels. On the other hand, as a case study, we modify the Brakerski FHE scheme (in Crypto 2012) by using the modulus switching technique. We recommend concrete parameter values of our proposed scheme and provide security analysis. Our result shows that the modified FHE scheme is more efficient than the original Brakerski scheme in the same security level.
Hoang, Long Phi; Biesbroek, Robbert; Tri, Van Pham Dang; Kummu, Matti; van Vliet, Michelle T H; Leemans, Rik; Kabat, Pavel; Ludwig, Fulco
2018-02-24
Climate change and accelerating socioeconomic developments increasingly challenge flood-risk management in the Vietnamese Mekong River Delta-a typical large, economically dynamic and highly vulnerable delta. This study identifies and addresses the emerging challenges for flood-risk management. Furthermore, we identify and analyse response solutions, focusing on meaningful configurations of the individual solutions and how they can be tailored to specific challenges using expert surveys, content analysis techniques and statistical inferences. Our findings show that the challenges for flood-risk management are diverse, but critical challenges predominantly arise from the current governance and institutional settings. The top-three challenges include weak collaboration, conflicting management objectives and low responsiveness to new issues. We identified 114 reported solutions and developed six flood management strategies that are tailored to specific challenges. We conclude that the current technology-centric flood management approach is insufficient given the rapid socioecological changes. This approach therefore should be adapted towards a more balanced management configuration where technical and infrastructural measures are combined with institutional and governance resolutions. Insights from this study contribute to the emerging repertoire of contemporary flood management solutions, especially through their configurations and tailoring to specific challenges.
A review of risk management process in construction projects of developing countries
NASA Astrophysics Data System (ADS)
Bahamid, R. A.; Doh, S. I.
2017-11-01
In the construction industry, risk management concept is a less popular technique. There are three main stages in the systematic approach to risk management in construction industry. These stages include: a) risk response; b) risk analysis and evaluation; and c) risk identification. The high risk related to construction business affects each of its participants; while operational analysis and management of construction related risks remain an enormous task to practitioners of the industry. This paper tends towards reviewing the existing literature on construction project risk managements in developing countries specifically on risk management process. The literature lacks ample risk management process approach capable of capturing risk impact on diverse project objectives. This literature review aims at discovering the frequently used techniques in risk identification and analysis. It also attempts to identify response to clarifying the different classifications of risk sources in the existing literature of developing countries, and to identify the future research directions on project risks in the area of construction in developing countries.
Multidimensional competences of supply chain managers: an empirical study
NASA Astrophysics Data System (ADS)
Shou, Yongyi; Wang, Weijiao
2017-01-01
Supply chain manager competences have attracted increasing attention from both practitioners and scholars in recent years. This paper conducted an explorative study to understand the dimensionality of supply chain manager competences. Online job advertisements for supply chain managers were collected as secondary data, since these advertisements reflect employers' real job requirements. We adopted the multidimensional scaling (MDS) technique to process and analyse the data. Five dimensions of supply chain manager competences are identified: generic skills, functional skills, supply chain management (SCM) qualifications and leadership, SCM expertise, and industry-specific and senior management skills. Statistic tests indicate that supply chain manager competence saliences vary in different industries and regions.
Surgical Management of Perineural Spread of Head and Neck Cancers.
Solares, C Arturo; Mason, Eric; Panizza, Benedict J
2016-04-01
The surgical management of perineural spread of head and neck cancers has become an integral part in the contemporary treatment of this pathology. We now understand that tumour spreads within the epineurium and in a continuous fashion. We also can rely on the accuracy of magnetic resonance neurography in detecting and defining the extent of disease. With modern skull base techniques and a greater understanding of the anatomy in this region, specific operations can be designed to help eradicate disease. We review the current approaches and techniques used that enable us to better obtain tumour free margins and hence improve survival.
Geospatial data and techniques have long been critical to advancing the analysis and management of freshwater ecosystems. However, these data and techniques have often been limited to specific sample sites or regional analyses because of the difficulty associated with generating ...
Information management system study results. Volume 1: IMS study results
NASA Technical Reports Server (NTRS)
1971-01-01
The information management system (IMS) special emphasis task was performed as an adjunct to the modular space station study, with the objective of providing extended depth of analysis and design in selected key areas of the information management system. Specific objectives included: (1) in-depth studies of IMS requirements and design approaches; (2) design and fabricate breadboard hardware for demonstration and verification of design concepts; (3) provide a technological base to identify potential design problems and influence long range planning (4) develop hardware and techniques to permit long duration, low cost, manned space operations; (5) support SR&T areas where techniques or equipment are considered inadequate; and (6) permit an overall understanding of the IMS as an integrated component of the space station.
Mastering the Diversity Challenge: Easy On-the-Job Applications for Measurable Results.
ERIC Educational Resources Information Center
Lebo, Fern
This book provides practical, step-by-step guidelines and gives important reasons why managing diversity is good for overall business. It identifies issues specific to designated groups and provides effective techniques for creating a level playing field, as well as specific on-the-job applications for running meetings, building a team, opening…
Decay diseases of stemwood: Detection, diagnosis, and management
Walter C. Shortle; Kevin T. Smith; Kenneth R. Dudzik
1996-01-01
Three major needs exist to better relate tree biology research to practical agroforesty (Larsen 1984). The first need is to identify the specific, desired product to be yielded from the forest. Valid and appropriate management techniques to yield one product may not be appropriate to yield a different product, even from the same species of trees. The second need is to...
Coaching in the Library: A Management Strategy for Achieving Excellence. Second Edition
ERIC Educational Resources Information Center
Metz, Ruth F.
2010-01-01
Experienced librarian and coach Ruth Metz outlines a focused and results-oriented plan for achieving the best results from staff members through a coaching style of management. Real-world examples and coaching scenarios specific to library work will help librarians: (1) Be both a coach and a player by learning the terminology and techniques; (2)…
Management competencies required in ambulatory care settings.
Brooke, P P; Hudak, R P; Finstuen, K; Trounson, J
1998-01-01
A study was conducted to identify the most important competencies physician executives in medical groups and other ambulatory settings will need to have in the next five years. The specific job skills, knowledge, and abilities (SKA) that physician executives will need to acquire these competencies were also explored. The Delphi techniques were used to analyze responses from two surveys from members of the American College of Medical Practice Executives. The most important competencies were grouped into 13 management domains, each with specific SKAs. "Managing health care resources to create quality and value" and "fundamentals of business and finance" were rated as the most important competencies. The most frequently rated SKA was the "ability to build and maintain credibility and trust."
An Intelligent Content Discovery Technique for Health Portal Content Management
2014-01-01
Background Continuous content management of health information portals is a feature vital for its sustainability and widespread acceptance. Knowledge and experience of a domain expert is essential for content management in the health domain. The rate of generation of online health resources is exponential and thereby manual examination for relevance to a specific topic and audience is a formidable challenge for domain experts. Intelligent content discovery for effective content management is a less researched topic. An existing expert-endorsed content repository can provide the necessary leverage to automatically identify relevant resources and evaluate qualitative metrics. Objective This paper reports on the design research towards an intelligent technique for automated content discovery and ranking for health information portals. The proposed technique aims to improve efficiency of the current mostly manual process of portal content management by utilising an existing expert-endorsed content repository as a supporting base and a benchmark to evaluate the suitability of new content Methods A model for content management was established based on a field study of potential users. The proposed technique is integral to this content management model and executes in several phases (ie, query construction, content search, text analytics and fuzzy multi-criteria ranking). The construction of multi-dimensional search queries with input from Wordnet, the use of multi-word and single-word terms as representative semantics for text analytics and the use of fuzzy multi-criteria ranking for subjective evaluation of quality metrics are original contributions reported in this paper. Results The feasibility of the proposed technique was examined with experiments conducted on an actual health information portal, the BCKOnline portal. Both intermediary and final results generated by the technique are presented in the paper and these help to establish benefits of the technique and its contribution towards effective content management. Conclusions The prevalence of large numbers of online health resources is a key obstacle for domain experts involved in content management of health information portals and websites. The proposed technique has proven successful at search and identification of resources and the measurement of their relevance. It can be used to support the domain expert in content management and thereby ensure the health portal is up-to-date and current. PMID:25654440
Software engineering project management - A state-of-the-art report
NASA Technical Reports Server (NTRS)
Thayer, R. H.; Lehman, J. H.
1977-01-01
The management of software engineering projects in the aerospace industry was investigated. The survey assessed such features as contract type, specification preparation techniques, software documentation required by customers, planning and cost-estimating, quality control, the use of advanced program practices, software tools and test procedures, the education levels of project managers, programmers and analysts, work assignment, automatic software monitoring capabilities, design and coding reviews, production times, success rates, and organizational structure of the projects.
Kelly, Cynthia W
2008-04-01
To present a new nursing intervention category called therapeutic enhancement. Fewer than half of North Americans follow their physician's recommendations for diet and exercise, even when such are crucial to their health or recovery. It is imperative that nurses consider new ways to promote healthy behaviours. Therapeutic enhancement is intended to provide such a fresh approach. Traditional intervention techniques focusing on education, contracts, social support and more frequent interaction with physicians appear not to be effective when used alone. Successful strategies have been multidisciplinary; and have included interventions by professional nurses who assist patients to understand their disease and the disease process and that helps them to develop disease-management and self-management skills. Therapeutic enhancement incorporates The Stages of Change Theory, Commitment to Health Theory, Motivational Interviewing techniques and instrumentation specifically designed for process evaluation of health-promoting interventions. This is a critical review of approaches that, heretofore, have not been synthesised in a single published article. Based on the commonly used Stages of Change model, therapeutic enhancement is useful for patients who are at the action stage of change. Using therapeutic enhancement as well as therapeutic strategies identified in Stages of Change Theory, such as contingency management, helping relationships, counterconditioning, stimulus control and Motivational Interviewing techniques, nursing professionals can significantly increase the chances of patients moving from action to the maintenance stage of change for a specific health behaviour. Using the nursing intervention category, therapeutic enhancement can increase caregivers' success in helping patients maintain healthy behaviours.
Study of systems and techniques for data base management
NASA Technical Reports Server (NTRS)
1976-01-01
Data management areas were studied to identify pertinent problems and issues that will affect future NASA data users in terms of performance and cost. Specific topics discussed include the identifications of potential NASA data users other than those normally discussed, consideration affecting the clustering of minicomputers, low cost computer system for information retrieval and analysis, the testing of minicomputer based data base management systems, ongoing work related to the use of dedicated systems for data base management, and the problems of data interchange among a community of NASA data users.
Optimizing construction quality management of pavements using mechanistic performance analysis.
DOT National Transportation Integrated Search
2004-08-01
This report presents a statistical-based algorithm that was developed to reconcile the results from several pavement performance models used in the state of practice with systematic process control techniques. These algorithms identify project-specif...
Reconstructive surgery during Operations Just Cause and Desert Storm.
Thurman, R T; Walker, G M; Reid 4th, D S
1995-02-01
Operations Just Cause and Desert Storm were of relatively brief duration; however, severe wounds were produced that required complex reconstructive procedures. This paper describes the type of wounds managed in theater and subsequently at three U.S. military medical centers. Specific reconstructive techniques included local and free muscle, fasciocutaneous, and composite flaps. Emphasis is placed on the application of microsurgical techniques to battle-related injuries.
Establishing Research and Management Priorities for Monoecious Hydrilla
2014-01-01
strategies. While use of high stocking rates of non-selective sterile grass carp (Ctenopharyngodon idella) has successfully controlled hydrilla in many...discussions of classical biological control agents (e.g. insects that feed specifically on hydrilla) did not yield any promising near-term candidates...possible. Diver- assisted dredging techniques and hand removal techniques were explored on the infestation in the Lake Cayuga inlet; initial results were
Riparian habitat on the Humboldt River, Deeth to Elko, Nevada
NASA Technical Reports Server (NTRS)
Price, K. P.; Ridd, M. K.
1983-01-01
A map inventory of the major habitat types existing along the Humbolt River riparian zone in Nevada is described. Through aerialphotography, 16 riparian habitats are mapped that describe the ecological relationships between soil and vegetation types, flooding and soil erosion, and the various management practices employed to date. The specific land and water management techniques and their impact on the environment are considered.
Scalable collaborative risk management technology for complex critical systems
NASA Technical Reports Server (NTRS)
Campbell, Scott; Torgerson, Leigh; Burleigh, Scott; Feather, Martin S.; Kiper, James D.
2004-01-01
We describe here our project and plans to develop methods, software tools, and infrastructure tools to address challenges relating to geographically distributed software development. Specifically, this work is creating an infrastructure that supports applications working over distributed geographical and organizational domains and is using this infrastructure to develop a tool that supports project development using risk management and analysis techniques where the participants are not collocated.
A historical perspective on ventilator management.
Shapiro, B A
1994-02-01
Paralysis via neuromuscular blockade in ICU patients requires mechanical ventilation. This review historically addresses the technological advances and scientific information upon which ventilatory management concepts are based, with special emphasis on the influence such concepts have had on the use of neuromuscular blocking agents. Specific reference is made to the scientific information and technological advances leading to the newer concepts of ventilatory management. Information from > 100 major studies in the peer-reviewed medical literature, along with the author's 25 yrs of clinical experience and academic involvement in acute respiratory care is presented. Nomenclature related to ventilatory management is specifically defined and consistently utilized to present and interpret the data. Pre-1970 ventilatory management is traced from the clinically unacceptable pressure-limited devices to the reliable performance of volume-limited ventilators. The scientific data and rationale that led to the concept of relatively large tidal volume delivery are reviewed in the light of today's concerns regarding alveolar overdistention, control-mode dyssynchrony, and auto-positive end-expiratory pressure. Also presented are the post-1970 scientific rationales for continuous positive airway pressure/positive end-expiratory pressure therapy, avoidance of alveolar hyperxia, and partial ventilatory support techniques (intermittent mandatory ventilation/synchronized intermittent mandatory ventilation). The development of pressure-support devices is discussed and the capability of pressure-control techniques is presented. The rationale for more recent concepts of total ventilatory support to avoid ventilator-induced lung injury is presented. The traditional techniques utilizing volume-preset ventilators with relatively large tidal volumes remain valid and desirable for the vast majority of patients requiring mechanical ventilation. Neuromuscular blockade is best avoided in these patients. However, adequate analgesia, amnesia, and sedation are required. For patients with severe lung disease, alveolar overdistention and hyperoxia should be avoided and may be best accomplished by total ventilatory support techniques, such as pressure control. Total ventilatory support requires neuromuscular blockade and may not provide eucapnic ventilation.
[Management of somatization in depression].
Azorin, J M
1995-12-01
Management of somatization in depression depends on understanding its mechanisms. This kind of somatization is the product of both specific and nonspecific factors which interact to create a chronic and hypocondriacal picture. Biological treatment looks like treatment of chronic depression. Antidepressants with anxiolytic properties have a place of choice. Psychotherapy is frequently used, particularly cognitive behavior therapy which allows the reattribution of somatic symptoms to psychological events. General practitioners need to be trained to these techniques as they are, more frequently than psychiatrists, involved in the management of these patients.
Disease management with ARIMA model in time series.
Sato, Renato Cesar
2013-01-01
The evaluation of infectious and noninfectious disease management can be done through the use of a time series analysis. In this study, we expect to measure the results and prevent intervention effects on the disease. Clinical studies have benefited from the use of these techniques, particularly for the wide applicability of the ARIMA model. This study briefly presents the process of using the ARIMA model. This analytical tool offers a great contribution for researchers and healthcare managers in the evaluation of healthcare interventions in specific populations.
Domestic applications for aerospace waste and water management technologies
NASA Technical Reports Server (NTRS)
Disanto, F.; Murray, R. W.
1972-01-01
Some of the aerospace developments in solid waste disposal and water purification, which are applicable to specific domestic problems are explored. Also provided is an overview of the management techniques used in defining the need, in utilizing the available tools, and in synthesizing a solution. Specifically, several water recovery processes will be compared for domestic applicability. Examples are filtration, distillation, catalytic oxidation, reverse osmosis, and electrodialysis. Solid disposal methods will be discussed, including chemical treatment, drying, incineration, and wet oxidation. The latest developments in reducing household water requirements and some concepts for reusing water will be outlined.
Preparing data for analysis using microsoft Excel.
Elliott, Alan C; Hynan, Linda S; Reisch, Joan S; Smith, Janet P
2006-09-01
A critical component essential to good research is the accurate and efficient collection and preparation of data for analysis. Most medical researchers have little or no training in data management, often causing not only excessive time spent cleaning data but also a risk that the data set contains collection or recording errors. The implementation of simple guidelines based on techniques used by professional data management teams will save researchers time and money and result in a data set better suited to answer research questions. Because Microsoft Excel is often used by researchers to collect data, specific techniques that can be implemented in Excel are presented.
Environmental Monitoring and the Gas Industry: Program Manager Handbook
DOE Office of Scientific and Technical Information (OSTI.GOV)
Gregory D. Gillispie
1997-12-01
This document has been developed for the nontechnical gas industry manager who has the responsibility for the development of waste or potentially contaminated soil and groundwater data or must make decisions based on such data for the management or remediation of these materials. It explores the pse of common analytical chemistry instrumentation and associated techniques for identification of environmentally hazardous materials. Sufficient detail is given to familiarize the nontechnical reader with the principles behind the operation of each technique. The scope and realm of the techniques and their constituent variations are portrayed through a discussion of crucial details and, wheremore » appropriate, the depiction of real-life data. It is the author's intention to provide an easily understood handbook for gas industry management. Techniques which determine the presence, composition, and quantification of gas industry wastes are discussed. Greater focus is given to traditional techniques which have been the mainstay of modem analytical benchwork. However, with the continual advancement of instrumental principles and design, several techniques have been included which are likely to receive greater attention in fiture considerations for waste-related detection. Definitions and concepts inherent to a thorough understanding of the principles common to analytical chemistry are discussed. It is also crucial that gas industry managers understand the effects of the various actions which take place before, during, and after the actual sampling step. When a series of sample collection, storage, and transport activities occur, new or inexperienced project managers may overlook or misunderstand the importance of the sequence. Each step has an impact on the final results of the measurement process; errors in judgment or decision making can be costly. Specific techniques and methodologies for the collection, storage, and transport of environmental media samples are not described or discussed in detail in thk handbook. However, the underlying philosophy regarding the importance of proper collection, storage, and transport practices, as well as pertinent references, are presented.« less
A Regev-Type Fully Homomorphic Encryption Scheme Using Modulus Switching
Chen, Zhigang; Wang, Jian; Song, Xinxia
2014-01-01
A critical challenge in a fully homomorphic encryption (FHE) scheme is to manage noise. Modulus switching technique is currently the most efficient noise management technique. When using the modulus switching technique to design and implement a FHE scheme, how to choose concrete parameters is an important step, but to our best knowledge, this step has drawn very little attention to the existing FHE researches in the literature. The contributions of this paper are twofold. On one hand, we propose a function of the lower bound of dimension value in the switching techniques depending on the LWE specific security levels. On the other hand, as a case study, we modify the Brakerski FHE scheme (in Crypto 2012) by using the modulus switching technique. We recommend concrete parameter values of our proposed scheme and provide security analysis. Our result shows that the modified FHE scheme is more efficient than the original Brakerski scheme in the same security level. PMID:25093212
DOT National Transportation Integrated Search
1981-08-01
management techniques to operate local transit systems more efficiently and economically. In particular, the ability to accurately ascertain route specific passenger flows or passenger demands has become essential for adequate resource allocation and...
Strategic leadership: a view from quantum and chaos theories.
McDaniel, R R
1997-01-01
Viewing health care from the perspective of chaos and quantum theories offers new insights into management techniques for effective and efficient delivery of health care services. This article introduces these concepts and gives specific prescriptions for managerial action.
2012-01-01
The increasing interest in combined positron emission tomography (PET) and computed tomography (CT) to guide lung cancer radiation therapy planning has been well documented. Motion management strategies during treatment simulation PET/CT imaging and treatment delivery have been proposed to improve the precision and accuracy of radiotherapy. In light of these research advances, why has translation of motion-managed PET/CT to clinical radiotherapy been slow and infrequent? Solutions to this problem are as complex as they are numerous, driven by large inter-patient variability in tumor motion trajectories across a highly heterogeneous population. Such variation dictates a comprehensive and patient-specific incorporation of motion management strategies into PET/CT-guided radiotherapy rather than a one-size-fits-all tactic. This review summarizes challenges and opportunities for clinical translation of advances in PET/CT-guided radiotherapy, as well as in respiratory motion-managed radiotherapy of lung cancer. These two concepts are then integrated into proposed patient-specific workflows that span classification schemes, PET/CT image formation, treatment planning, and adaptive image-guided radiotherapy delivery techniques. PMID:23369522
NASA Technical Reports Server (NTRS)
1995-01-01
The Formal Methods Specification and Verification Guidebook for Software and Computer Systems describes a set of techniques called Formal Methods (FM), and outlines their use in the specification and verification of computer systems and software. Development of increasingly complex systems has created a need for improved specification and verification techniques. NASA's Safety and Mission Quality Office has supported the investigation of techniques such as FM, which are now an accepted method for enhancing the quality of aerospace applications. The guidebook provides information for managers and practitioners who are interested in integrating FM into an existing systems development process. Information includes technical and administrative considerations that must be addressed when establishing the use of FM on a specific project. The guidebook is intended to aid decision makers in the successful application of FM to the development of high-quality systems at reasonable cost. This is the first volume of a planned two-volume set. The current volume focuses on administrative and planning considerations for the successful application of FM.
Ng, K H; Peh, W C G
2010-02-01
A technical note is a short article giving a brief description of a specific development, technique or procedure, or it may describe a modification of an existing technique, procedure or device applicable to medicine. The technique, procedure or device described should have practical value and should contribute to clinical diagnosis or management. It could also present a software tool, or an experimental or computational method. Technical notes are variously referred to as technical innovations or technical developments. The main criteria for publication will be the novelty of concepts involved, the validity of the technique and its potential for clinical applications.
How to Dance with Your Insurance Company.
ERIC Educational Resources Information Center
Mobley, Michael
1984-01-01
Explains how experiential programs and organizations can improve relationships with their insurance companies by understanding the insurance industry's perspective and techniques of risk management. Suggests 22 specific items of information that experiential education organizations should share with insurers to demonstrate understanding and…
Dr. Kenneth Sudduth: A giant pioneering precision agriculture
USDA-ARS?s Scientific Manuscript database
Dr. Ken Sudduth is nationally and internationally recognized for his precision agriculture research and leadership, especially in the areas of soil sensing and assessment of spatial variability for site-specific management. His many noteworthy contributions include novel techniques and methodology f...
Experimenters' reference based upon Skylab experiment management
NASA Technical Reports Server (NTRS)
1974-01-01
The methods and techniques for experiment development and integration that evolved during the Skylab Program are described to facilitate transferring this experience to experimenters in future manned space programs. Management responsibilities and the sequential process of experiment evolution from initial concept through definition, development, integration, operation and postflight analysis are outlined and amplified, as appropriate. Emphasis is placed on specific lessons learned on Skylab that are worthy of consideration by future programs.
ERIC Educational Resources Information Center
Terawaki, Yuki; Takahashi, Yuichi; Kodama, Yasushi; Yana, Kazuo
2011-01-01
This paper describes an integration of different Relational Database Management System (RDBMS) of two Course Management Systems (CMS) called Sakai and the Common Factory for Inspiration and Value in Education (CFIVE). First, when the service of CMS is provided campus-wide, the problems of user support, CMS operation and customization of CMS are…
Relationship between total quality management, critical paths, and outcomes management.
Lynn, P A
1996-09-01
Total quality management (TQM), clinical paths, and outcomes management are high-profile strategies in today's health care environment. Each strategy is distinct, yet there are interrelationships among them. TQM supports a customer-focused organizational culture, providing tools and techniques to identify and solve problems. Clinical paths are tools for enhancing patient care coordination and for identifying system-wide and patient population specific issues. Outcomes management is an integrated system for measuring the results in patient populations over time. There is a recent shift in outcomes measurement towards expanding both the nature of the outcomes examined and the timeframes in which they are studied.
Surgery and Research: A Practical Approach to Managing the Research Process
Swiatek, Peter R.; Chung, Kevin C.; Mahmoudi, Elham
2016-01-01
Following a practical project management method is essential in completing a research project on time and within budget. Although this concept is well developed in the business world, it has yet to be explored in academic surgical research. Defining and adhering to a suitable workflow would increase portability, reusability, and therefore, efficiency of the research process. In this article, we briefly review project management techniques. We specifically underline four main steps of project management: (1) definition and organization, (2) planning, (3) execution, and (4) evaluation, using practical examples from our own multidisciplinary plastic surgery research team. PMID:26710037
Hospital management training and improvement in managerial skills: Serbian experience.
Supic, Zorica Terzic; Bjegovic, Vesna; Marinkovic, Jelena; Milicevic, Milena Santric; Vasic, Vladimir
2010-06-01
The purpose of this study was to analyze the improvement of managerial skills of hospitals' top managers after a specific management training programme, and to explore possible predictors and relations. The study was conducted during the years 2006 and 2007 with cohort of 107 managers from 20 Serbian general hospitals. The managers self-assessed the improvement in their managerial skills before and after the training programme. After the training programme, all managers' skills had improved. The biggest improvement was in the following skills: organizing daily activities, motivating and guiding others, supervising the work of others, group discussion, and situation analysis. The least improved were: applying creative techniques, working well with peers, professional self-development, written communication, and operational planning. Identified predictors of improvement were: shorter years of managerial experience, type of manager, type of profession, and recognizing the importance of the managerial skills in oral communication, evidence-based decision making, and supervising the work of others. Specific training programme related to strategic management can increase managerial competencies, which are an important source of competitive advantage for organizations. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.
Management of ticks and tick-borne diseases
Ginsberg, H.S.; Stafford, K.C.; Goodman, J.L.; Dennis, D.T.; Sonenshine, D .E.
2005-01-01
The mainstays of tick management and protection from tick-borne diseases have traditionally been personal precautions and the application of acaricides. These techniques maintain their value, and current innovations hold considerable promise for future improvement in effective targeting of materials for tick control. Furthermore, an explosion of research in the past few decades has resulted in the development and expansion of several novel and potentially valuable approaches to tick control, including vaccination against tick-borne pathogen transmission and against tick attachment, host management, use of natural enemies (especially entomopathogenic fungi), and pheromone-based techniques. The situations that require tick management are diverse, and occur under varied ecological conditions. Therefore, the likelihood of finding a single ?magic bullet? for tick management is low. In practical terms, the approach to tick management or to management of tick-borne disease must be tailored to the specific conditions at hand. One area that needs increased attention is the decision-making process in applying IPM to tick control. Further development of novel tick control measures, and increased efficiency in their integration and application to achieve desired goals, holds great promise for effective future management of ticks and tick-borne diseases.
Kotsanos, N; Coolidge, T; Velonis, D; Arapostathis, K N
2009-06-01
This paper reports on the use of early introduction of a specific parental presence/absence (PPA) behavioural technique to manage the initially uncooperative child. Using a prospective design, 440 healthy children aged 3 to 10 years visited a paediatric dental practice within 33 months. Children exhibiting initially Frankl 'negative' and 'definitely negative' behaviour were empathically offered parental presence only if they were cooperative. Otherwise, the parent stepped out until behaviour improvement. t-tests and Chi-square tests were used to compare characteristics of initially cooperative and uncooperative children, as well as proportions of parents who were asked to leave the surgery. The technique's success was assessed by a one sample binomial test. 75 of the children presented as Frankl either 'negative' (30) or 'definitely negative' (45) at their first visit; 70 (93.3%, p<0.001) responded to the PPA technique by displaying positive behaviour as their first visit progressed. 38 responded without the need to ask the parent to exit the practice room, while the other 32 responded only after their parent exited. 52 children had additional appointments, and 8 required an application of PPA at a second appointment; all children cooperated in all subsequent appointments. Early and empathic application of the PPA technique appears very successful in managing initially uncooperative child patients, suggesting that a randomised controlled trial of the technique is warranted.
Crew interface specifications development for inflight maintenance and stowage functions
NASA Technical Reports Server (NTRS)
Carl, J. G.
1974-01-01
Findings and data products developed during crew specification study for inflight maintenance and stowage functions are reported. From this information base, a family of data concepts to support crew inflight troubleshooting and corrective maintenance activities was developed and specified. Recommendations are made for the improvement of inflight maintenance planning, preparations and operations in future space flight programs through the establishment of an inflight maintenance organization and specific suggestions for techniques to improve the management of the inflight maintenance function.
Straight-wire appliances: standard versus individual prescription.
Farronato, Giampietro; Periti, Giulia; Giannini, Lucia; Farronato, Davide; Maspero, Cinzia
2009-01-01
In this article the individual patient (IP) appliance is described. It consists of 250 options of bracket and band variations as the straight wire appliances. Increasing the bracket capabilities means using an increasing number of brackets, each with a specific design created for a treatment situation. The objective of IP appliance is to eliminate wire bending from orthodontic treatment and improve the treatment results. To manage this technique, a computer software is needed. Internet offers significant possibilities in managing each patient by patient basis. The clinician is required to make the diagnosis and treatment plan before ordering the appliance. Two clinical cases are described with the aim to present the advantages of this technique.
Management Of Optical Projects
NASA Astrophysics Data System (ADS)
Young, Peter S.; Olson, David R.
1981-03-01
This paper discusses the management of optical projects from the concept stage, beginning with system specifications, through design, optical fabrication and test tasks. Special emphasis is placed on effective coupling of design engineering with fabrication development and utilization of available technology. Contrasts are drawn between accepted formalized management techniques, the realities of dealing with fragile components and the necessity of an effective project team which integrates the special characteristics of highly skilled optical specialists including lens designers, optical engineers, opticians, and metrologists. Examples are drawn from the HEAO-2 X-Ray Telescope and Space Telescope projects.
Medical management of male infertility in the absence of a specific etiology.
Gudeloglu, Ahmet; Brahmbhatt, Jamin V; Parekattil, Sijo J
2014-07-01
Idiopathic male infertility can be diagnosis in approximately one-third of infertile males. The empirical medical treatment with or without assisted reproductive techniques appears common in male infertility practice. This type of management can be classified as hormonal treatment including gonadotropins, antiestrogens, and aromatase inhibitors and support with antioxidant supplements such as carnitine, lycopene, glutathione, and vitamin E. This review investigates the evidence of commonly used empirical medical management of male infertility when there is no demonstrable diagnosis. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Neugebauer, E A M; Wilkinson, R C; Kehlet, H; Schug, S A
2007-07-01
Many patients still suffer severe acute pain in the postoperative period. Although guidelines for treating acute pain are widely published and promoted, most do not consider procedure-specific differences in pain experienced or in techniques that may be most effective and appropriate for different surgical settings. The procedure-specific postoperative pain management (PROSPECT) Working Group provides procedure-specific recommendations for postoperative pain management together with supporting evidence from systematic literature reviews and related procedures at http://www.postoppain.org The methodology for PROSPECT reviews was developed and refined by discussion of the Working Group, and it adapts existing methods for formulation of consensus recommendations to the specific requirements of PROSPECT. To formulate PROSPECT recommendations, we use a methodology that takes into account study quality and source and level of evidence, and we use recognized methods for achieving group consensus, thus reducing potential bias. The new methodology is first applied in full for the 2006 update of the PROSPECT review of postoperative pain management for laparoscopic cholecystectomy. Transparency in PROSPECT processes allows the users to be fully aware of any limitations of the evidence and recommendations, thereby allowing for appropriate decisions in their own practice setting.
Blumer, Sigalit; Khoury, Rula Shehadi; Peretz, Benjamin
2018-01-01
There are no clear guidelines for managing the dental treatment of children with attention deficit hyperactivity disorder (ADHD). The use of sedation in combination with chronic ADHD medication use is also not well defined. This study surveyed the prevalence of ADHD children, management techniques and knowledge of pharmacologic therapies of these children among Israeli dentists. A specially designed questionnaire was distributed to all Israeli dentists attending a national conference in 2016. Of the 160 dentists who attended the conference, 96 completed the survey (60% response rate), and they included 46 (51%) pediatric dental specialists and 50 (49%) general dental practitioners. The medications Ritalin and Concerta were most familiar to the respondents (98.9%). Eighty-seven (91.1%) of the practitioners responded that their ADHD patients take their usual doses of any drug for treating ADHD symptoms, regardless of whether or not the dentists intended to use sedatives. The practitioners invented their own behavior management techniques with varying degrees of success. There are no specific guidelines for the most effective pharmacologic protocol (co-administration of ADHD drugs and dental sedatives) or behavior management techniques for the provision of optimal dental care to children with ADHD.
NASA Technical Reports Server (NTRS)
Raiman, Laura B.
1992-01-01
Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .
NASA Astrophysics Data System (ADS)
Raiman, Laura B.
1992-12-01
Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .
Toward integrated management of cerebral aneurysms.
Villa-Uriol, M C; Larrabide, I; Pozo, J M; Kim, M; Camara, O; De Craene, M; Zhang, C; Geers, A J; Morales, H; Bogunović, H; Cardenes, R; Frangi, A F
2010-06-28
In the last few years, some of the visionary concepts behind the virtual physiological human began to be demonstrated on various clinical domains, showing great promise for improving healthcare management. In the current work, we provide an overview of image- and biomechanics-based techniques that, when put together, provide a patient-specific pipeline for the management of intracranial aneurysms. The derivation and subsequent integration of morphological, morphodynamic, haemodynamic and structural analyses allow us to extract patient-specific models and information from which diagnostic and prognostic descriptors can be obtained. Linking such new indices with relevant clinical events should bring new insights into the processes behind aneurysm genesis, growth and rupture. The development of techniques for modelling endovascular devices such as stents and coils allows the evaluation of alternative treatment scenarios before the intervention takes place and could also contribute to the understanding and improved design of more effective devices. A key element to facilitate the clinical take-up of all these developments is their comprehensive validation. Although a number of previously published results have shown the accuracy and robustness of individual components, further efforts should be directed to demonstrate the diagnostic and prognostic efficacy of these advanced tools through large-scale clinical trials.
Findlay, I; Wong, F; Smith, C; Back, D; Davies, A; Ajuied, A
2016-03-01
Recent meta-analyses support not resurfacing the patella at the time of TKA. Several different modes of intervention are reported for non-resurfacing management of the patella at TKA. We have conducted a systematic review and meta-analysis of non-resurfacing interventions in TKA. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) study methodology and reporting system was adopted, utilising the PRISMA checklist and statement. Classes of patella interventions were defined as: 0. No intervention. 1. Osteophyte excision only. 2. Osteophyte excision, denervation, with soft tissue debridement. 3. Osteophyte excision, denervation, soft tissue debridement, and drilling or micro-fracture of eburnated bone. 4. Patellar resurfacing. A meta-analysis was conducted upon the pre- and post-operative KSS for each technique. Four hundred and twenty-three studies were identified, 12 studies met the inclusion criteria for the systematic review and eight for the meta-analysis. Two studies compared different non-resurfacing patellar techniques, the other studies used the non-resurfacing cohort as controls for their prospective RCTs comparing patellar resurfacing with non-resurfacing. The meta-analysis revealed no significant difference between the techniques. We conclude that there is no significant difference in KSS for differing non-resurfacing patellar techniques, but further trials using patellofemoral specific scores may better demonstrate superior efficacy of specific classes of patella intervention, by virtue of greater sensitivity for patellofemoral pain and dysfunction. I. Crown Copyright © 2015. Published by Elsevier B.V. All rights reserved.
DOT National Transportation Integrated Search
2016-09-29
This project piloted the findings from an initial research and development project pertaining to the detection, : quantification, and visualization of bridge deck distresses through the use of remote sensing techniques, specifically : combining optic...
Remote sensing of wildland resources: A state-of-the-art review
Robert C. Aldrich
1979-01-01
A review, with literature citations, of current remote sensing technology, applications, and costs for wildland resource management, including collection, interpretation, and processing of data gathered through photographic and nonphotographic techniques for classification and mapping, interpretive information for specific applications, measurement of resource...
Marino, Michael J; Luong, Amber; Yao, William C; Citardi, Martin J
2018-01-01
Odontogenic cysts and tumors of the maxilla may be amendable to management by endonasal endoscopic techniques, which may reduce the morbidity associated with open procedures and avoid difficult reconstruction. To perform a systematic review that evaluates the feasibility and outcomes of endoscopic techniques in the management of different odontogenic cysts. A case series of our experience with these minimally invasive techniques was assembled for insight into the technical aspects of these procedures. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used to identify English-language studies that reported the use of endoscopic techniques in the management of odontogenic cysts. Several medical literature data bases were searched for all occurrences in the title or abstract of the terms "odontogenic" and "endoscopic" between January 1, 1950, and October 1, 2016. Publications were evaluated for the technique used, histopathology, complications, recurrences, and the follow-up period. A case series of patients who presented to a tertiary rhinology clinic and who underwent treatment of odontogenic cysts by an endoscopic technique was included. A systematic review identified 16 case reports or series that described the use of endoscopic techniques for the treatment of odontogenic cysts, including 45 total patients. Histopathologies encountered were radicular (n = 16) and dentigerous cysts (n = 10), and keratocystic odontogenic tumor (n = 12). There were no reported recurrences or major complications for a mean follow-up of 29 months. A case series of patients in our institution identified seven patients without recurrence for a mean follow-up of 10 months. Endonasal endoscopic treatment of various odontogenic cysts are described in the literature and are associated with effective treatment of these lesions for an average follow-up period of >2 years. These techniques have the potential to reduce morbidity associated with the resection of these lesions, although comparative studies would better define specific indications.
Exploring the role of parent training in the treatment of childhood anxiety.
Khanna, Muniya S; Kendall, Philip C
2009-10-01
Data from a randomized clinical trial comparing the relative efficacy of individual cognitive-behavioral therapy (ICBT), family CBT (FCBT), and a family-based education/support/attention control (FESA) condition were used to examine associations between in-session therapeutic techniques related to parent training (PT) and treatment outcomes. This study explored the extent to which therapists' use of PT techniques, specifically (a) parental anxiety management, (b) transfer of control from therapist to parent to child over child's coping, (c) communication skills training, and (d) contingency management training, contributed to treatment outcome in family-based CBT. Children (N = 53; 31 males; 7.8-13.8 years of age; M = 10.1 years, SD = 2.3; 85% Caucasian, 9% African American, 4% Asian, 2% "other" background) with a principal anxiety disorder completed 16 sessions of CBT with their parents. The relative contributions of PT components on treatment outcome were evaluated. As hypothesized, both transfer-of-control and parental anxiety management techniques significantly contributed to improvement on clinician and parent ratings of child global functioning within FCBT. PT did not significantly contribute to improvement on measures of child anxiety. These preliminary findings suggest that when FCBT is conducted for child anxiety, PT (i.e., transfer-of-control and parental anxiety management techniques) may contribute to improvements in the child's global functioning. (c) 2009 APA, all rights reserved.
Clinical management of renal cell carcinoma with venous tumor thrombus.
Agochukwu, Nnenaya; Shuch, Brian
2014-06-01
Venous invasion is common in advanced renal cell carcinoma (RCC) due to the unique biology of this cancer. The presence of a tumor thrombus often makes clinical management challenging. In this review, we detail specific preoperative, perioperative, and surgical strategies involving the care of the complex kidney cancer patient with venous tumor involvement. We performed a comprehensive review of selected peer-reviewed publications regarding RCC tumor thrombus biology, medical and surgical management techniques, and immediate and long-term outcomes. The perioperative management may require special imaging techniques, preoperative testing, very recent imaging, and consultation with other surgical services. There are various approaches to these patients as the clinical presentation, stage of disease, primary tumor size, level of thrombus, degree of venous occlusion, presence of bland thrombus, and primary tumor laterality influence management. Select patients with metastatic disease can do well with cytoreductive nephrectomy and thrombectomy. Those with localized disease have a high risk of recurrence; however, some patients can exhibit durable survival with surgery alone. The evolving surgical and medical treatments are discussed. Even when these surgeries are performed in high volume centers, significant perioperative complications are common and greater complications are seen with higher thrombus extent. If surgery is attempted, it is important for urologic oncologists to follow strict attention to specific surgical principles. These general principles include complete vascular control, avoidance of thrombus embolization, close hemodynamic monitoring, and institutional resources for caval resection/replacement and venous bypass if necessary.
Management of fluid mud in estuaries, bays, and lakes. II: Measurement, modeling, and management
McAnally, W.H.; Teeter, A.; Schoellhamer, David H.; Friedrichs, C.; Hamilton, D.; Hayter, E.; Shrestha, P.; Rodriguez, H.; Sheremet, A.; Kirby, R.
2007-01-01
Techniques for measurement, modeling, and management of fluid mud are available, but research is needed to improve them. Fluid mud can be difficult to detect, measure, or sample, which has led to new instruments and new ways of using existing instruments. Multifrequency acoustic fathometers sense neither density nor viscosity and are, therefore, unreliable in measuring fluid mud. Nuclear density probes, towed sleds, seismic, and drop probes equipped with density meters offer the potential for accurate measurements. Numerical modeling of fluid mud requires solving governing equations for flow velocity, density, pressure, salinity, water surface, plus sediment submodels. A number of such models exist in one-, two-, and three-dimensional form, but they rely on empirical relationships that require substantial site-specific validation to observations. Management of fluid mud techniques can be classified as those that accomplish: Source control, formation control, and removal. Nautical depth, a fourth category, defines the channel bottom as a specific fluid mud density or alternative parameter as safe for navigation. Source control includes watershed management measures to keep fine sediment out of waterways and in-water measures such as structures and traps. Formation control methods include streamlined channels and structures plus other measures to reduce flocculation and structures that train currents. Removal methods include the traditional dredging and transport of dredged material plus agitation that contributes to formation control and/or nautical depth. Conditioning of fluid mud by dredging and aerating offers the possibility of improved navigability. Two examples—the Atchafalaya Bar Channel and Savannah Harbor—illustrate the use of measurements and management of fluid mud.
The pediatric mandible: II. Management of traumatic injury or fracture.
Smartt, James M; Low, David W; Bartlett, Scott P
2005-08-01
After studying this article, the participant should be able to: 1. Describe the changing epidemiology of mandibular fractures in children and adolescents. 2. Discuss the appropriate use of internal fixation in the treatment of pediatric mandibular fractures. 3. Describe the difficulties posed by the deciduous dentition in the use of interdental wiring. 4. Understand reasons why techniques specific to adult fractures may not be applicable to the growing mandible. 5. Understand the etiology and epidemiology of pediatric mandibular fractures. 6. Understand the reasons for conservative (closed) versus aggressive (open) treatment of mandibular injury. Fractures of the pediatric mandible are complicated by the anatomic complexity of the developing mandible, particularly by the presence of tooth buds and the eruption of deciduous and permanent teeth. Traditional methods of fracture reduction and fixation employed in adults have little applicability in the pediatric population. The authors describe the surgical techniques that have been used at their institution and those that can be used safely in the pediatric setting. In most cases, "conservative" management is the preferred option, especially in the treatment of condylar fractures. In cases requiring surgical intervention, interdental wiring, drop wires in combination with circummandibular wires, and acrylic splints are suited well to specific phases of dental maturation. Open reduction and internal fixation using monocortical screws and microplates or resorbable plates and screws are acceptable techniques in the pediatric patient, but they require special safeguards. Algorithms are presented to simplify management of these complicated injuries.
EFFECTS OF STREAM RESTORATION ON IN-STREAM WATER QUALITY IN AN URBAN WATERSHED
The purpose of this on-going project is to provide information to Municipal Separate Storm Sewer System (MS4s) operators and states on the performance of selected best management practices (BMPs), specifically, stream restoration techniques, on improving biological and in-stream ...
The Communication Audit as a Library Management Tool.
ERIC Educational Resources Information Center
Cortez, Edwin M.; Bunge, Charles A.
1987-01-01
Discusses the relationship between effective organizational communication and specific library contexts and reviews the historical development of communication audits as a means of studying communication effectiveness. The generic structure of such audits is described and two models are presented in detail, including techniques for gathering and…
The Threat or Challenge of Accountability
ERIC Educational Resources Information Center
Rosenberg, Marvin L.; Brody, Ralph
1974-01-01
Social service agencies can improve accountability to their clients in specific ways. These techniques borrow some of the language and principles of management science and can be applied successfully only if social workers accept the challenge posed by accountability and view these concepts as compatible with professional values. (Author)
[Management of Acute Type A Dissection Complicated with Acute Mesenteric Ischemia].
Abe, Tomonobu; Usui, Akihiko
2017-07-01
Acute mesenteric ischemia as malperfusion syndrome associated with acute aortic dissection is a difficult situation. The incidence is approximately 3~4% in acute type A dissection. Traditionally, most of these patients underwent immediate simple central aortic repair expecting that mesenteric artery obstruction and intestinal ischemia would be resolved by simple central aortic repair. However, short term mortality has been reported very high in this strategy. With the aid of rapidly progressing imaging techniques and newer endovascular repair techniques, results seem to be improving in recent years. Newer management strategy include aggressive and patient specific revascularization to the mesenteric arteries, delayed central aortic repair, and meticulous intensive care. Diagnosis and management of this condition require high level of expertise. Cardiac surgeons, vascular surgeons, interventional radiologists, gastroenterologists, general surgeons, anesthesiologists, intensivists must corporate to save these patients' lives. Since this is a relatively rare condition, scientific evidence is insufficient to make robust recommendations. Further studies are warranted.
Naydeck, B L; Sutton-Tyrrell, K; Burek, K; Sopko, G S
1996-06-01
Efficient communication is a challenge for the many operating components of a multicenter randomized clinical trial. Traditional management theory states that communications generally flow along a path established by a hierarchical organizational structure. A multicenter clinical trial does not fit traditional organizational models well and requires modification of traditional communication techniques. While the scientific community typically views a clinical trial as one large and cohesive enterprise, at each site the trial may actually be conducted as a small project related to the medical specialty of the investigator. Therefore overall trial management must be accomplished through collaboration rather than through direct management. In the Bypass Angioplasty Revascularization Investigation (BARI), the BARI clinical coordinating center has designed and utilized several mechanisms that facilitate effective communication and administrative control of a multicenter clinical trial. These mechanisms provide a framework of communication techniques that accommodate the specific needs of a complex organization.
Nnane, Daniel Ekane
2011-11-15
Contamination of surface waters is a pervasive threat to human health, hence, the need to better understand the sources and spatio-temporal variations of contaminants within river catchments. River catchment managers are required to sustainably monitor and manage the quality of surface waters. Catchment managers therefore need cost-effective low-cost long-term sustainable water quality monitoring and management designs to proactively protect public health and aquatic ecosystems. Multivariate and phage-lysis techniques were used to investigate spatio-temporal variations of water quality, main polluting chemophysical and microbial parameters, faecal micro-organisms sources, and to establish 'sentry' sampling sites in the Ouse River catchment, southeast England, UK. 350 river water samples were analysed for fourteen chemophysical and microbial water quality parameters in conjunction with the novel human-specific phages of Bacteroides GB-124 (Bacteroides GB-124). Annual, autumn, spring, summer, and winter principal components (PCs) explained approximately 54%, 75%, 62%, 48%, and 60%, respectively, of the total variance present in the datasets. Significant loadings of Escherichia coli, intestinal enterococci, turbidity, and human-specific Bacteroides GB-124 were observed in all datasets. Cluster analysis successfully grouped sampling sites into five clusters. Importantly, multivariate and phage-lysis techniques were useful in determining the sources and spatial extent of water contamination in the catchment. Though human faecal contamination was significant during dry periods, the main source of contamination was non-human. Bacteroides GB-124 could potentially be used for catchment routine microbial water quality monitoring. For a cost-effective low-cost long-term sustainable water quality monitoring design, E. coli or intestinal enterococci, turbidity, and Bacteroides GB-124 should be monitored all-year round in this river catchment. Copyright © 2011 Elsevier B.V. All rights reserved.
Farahmand, Touraj; Fleming, Sean W; Quilty, Edward J
2007-10-01
Urbanization often alters catchment storm responses, with a broad range of potentially significant environmental and engineering consequences. At a practical, site-specific management level, efficient and effective assessment and control of such downstream impacts requires a technical capability to rapidly identify development-induced storm hydrograph changes. The method should also speak specifically to alteration of internal watershed dynamics, require few resources to implement, and provide results that are intuitively accessible to all watershed stakeholders. In this short paper, we propose a potential method which might satisfy these criteria. Our emphasis lies upon the integration of existing concepts to provide tools for pragmatic, relatively low-cost environmental monitoring and management. The procedure involves calibration of rainfall-runoff time-series models in each of several successive time windows, which sample varying degrees of watershed urbanization. As implemented here, only precipitation and stream discharge or stage data are required. The readily generated unit impulse response functions of these time-series models might then provide a mathematically formal, yet visually based and intuitive, representation of changes in watershed storm response. Nominally, the empirical response functions capture such changes as soon as they occur, and the assessments of storm hydrograph alteration are independent of variability in meteorological forcing. We provide a preliminary example of how the technique may be applied using a low-order linear ARX model. The technique may offer a fresh perspective on such watershed management issues, and potentially also several advantages over existing approaches. Substantial further testing is required before attempting to apply the concept as a practical environmental management technique; some possible directions for additional work are suggested.
Wan, Yongshan; Qian, Yun; Migliaccio, Kati White; Li, Yuncong; Conrad, Cecilia
2014-03-01
Most studies using multivariate techniques for pollution source evaluation are conducted in free-flowing rivers with distinct point and nonpoint sources. This study expanded on previous research to a managed "canal" system discharging into the Indian River Lagoon, Florida, where water and land management is the single most important anthropogenic factor influencing water quality. Hydrometric and land use data of four drainage basins were uniquely integrated into the analysis of 25 yr of monthly water quality data collected at seven stations to determine the impact of water and land management on the spatial variability of water quality. Cluster analysis (CA) classified seven monitoring stations into four groups (CA groups). All water quality parameters identified by discriminant analysis showed distinct spatial patterns among the four CA groups. Two-step principal component analysis/factor analysis (PCA/FA) was conducted with (i) water quality data alone and (ii) water quality data in conjunction with rainfall, flow, and land use data. The results indicated that PCA/FA of water quality data alone was unable to identify factors associated with management activities. The addition of hydrometric and land use data into PCA/FA revealed close associations of nutrients and color with land management and storm-water retention in pasture and citrus lands; total suspended solids, turbidity, and NO + NO with flow and Lake Okeechobee releases; specific conductivity with supplemental irrigation supply; and dissolved O with wetland preservation. The practical implication emphasizes the importance of basin-specific land and water management for ongoing pollutant loading reduction and ecosystem restoration programs. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.
Minimal and moderate oral sedation in the adult special needs patient.
Coke, John M; Edwards, Michael D
2009-04-01
Oral minimal/moderate sedation can be an effective tool to aid in the dental management of adult special needs patients. Specific sedative drugs must be chosen by the dentist that can be used safely and effectively on these patients. This article focuses on a select number of these drugs, specific medical and pharmacologic challenges presented by adult special needs patients, and techniques to safely administer oral minimal and moderate sedation.
1983-11-03
capability. An intelligent library management system will be supported by knowledge-based techniques. In fact, until a formal specification of library...from artificial intelligence and information science 2 might also be useful, for example automatic indexing and cataloging schemes, methods for fast...Artificial Intelligence 5:1045-1058, 1977. [Burstall & Goguen 801 Burstall, R. M., and Goguen, J. A. The Semantics of Clear, a Specification Language. In
Laparoscopic partial nephrectomy: Technical considerations and an update
Dominguez-Escrig, Jose L; Vasdev, Nikhil; O’Riordon, Anna; Soomro, Naeem
2011-01-01
The widespread use of radiological imaging (ultrasound, computed tomography and magnetic resonance imaging) has resulted in a steady increase in the incidental diagnosis of small renal masses. While open partial nephrectomy (OPN) remains the reference standard for the management of small renal masses, laparoscopic partial nephrectomy (LPN) continues to evolve. LPN is currently advocated to be at par with OPN oncologically. The steep learning curve and technical demand of LPN make it challenging to establish this as a new procedure. We present a detailed up-to-date review on the previous, current and planned technical considerations for the use of LPN, highlighting important surgical techniques, including single-port and robotic surgery, techniques on improving intra-operative haemostasis and the management of complications specific to LPN. PMID:22022109
Tips and techniques for engaging and managing the reluctant, resistant or hostile young person.
McCutcheon, Louise K; Chanen, Andrew M; Fraser, Richard J; Drew, Lorelle; Brewer, Warrick
2007-10-01
Creating a collaborative doctor-patient relationship is the bedrock upon which effective treatments are delivered. The interaction between normal developmental changes and psychopathology can present particular challenges to clinicians attempting to assess and treat young people. Assuming an attitude in which young people are seen to be doing their best, rather than being deliberately difficult or manipulative, can help clinicians avoid a controlling or punitive relationship and can facilitate collaborative problem solving. Stigma, denial and avoidance, ambivalence, hopelessness and coercion are potential threats to engagement and must be addressed specifically. Challenging patients, such as the reluctant, resistant, aggressive, self-harming or intoxicated patient require specific management strategies that can be learned.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Boucher, Laurel A.
Successful collaboration requires effective communication and collective problem solving. Regardless of the subject area --- environmental remediation, waste management, program planning and budgeting --- those involved must focus their efforts in an orderly and cooperative manner. A thinking tool is a technique used to get individuals to focus on specific components of the task at the same time and to eliminate the 'noise' that accompanies communications among individuals with different objectives and different styles of communicating. For example, one of these thinking tools is a technique which enables a working group to delineate its roles, responsibilities and communication protocols somore » that it can deliver the right information to the right people at the right time. Another enables a group to objectively and collectively evaluate and improve a policy, plan, or program. A third technique enables a group to clarify its purpose and direction while generating interest and buy-in. A fourth technique makes it possible for a group with polarized opinions to acknowledge their differences as well as what they have in common. A fifth technique enables a group to consider a subject of importance from all perspectives so as to produce a more comprehensive and sustainable solution. These thinking tools make effective communication and collective problem solving possible in radioactive waste management and remediation. They can be used by a wide spectrum of professionals including policy specialists, program administrators, program and project managers, and technical specialists. (author)« less
ERIC Educational Resources Information Center
Stock, Claudette, Comp.
Remediation of learning disabilities is discussed and a table of teaching materials related to psychological and motor functions is provided. Guides on 11 behavioral manifestations and three specific learning disabilities furnish definitions and description as well as techniques for training and management. Behavioral manifestations considered…
Chapter 6. Dwarf mistletoe surveys
J.A. Muir; B. Moody
2002-01-01
Dwarf mistletoe surveys are conducted for a variety of vegetation management objectives. Various survey and sampling techniques are used either at a broad, landscape scale in forest planning or program review, or at an individual, stand, site level for specific project implementation. Standard and special surveys provide data to map mistletoe distributions and quantify...
78 FR 36533 - Information Collection; Submission for OMB Review, Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2013-06-18
... appropriate next step for RSVP projects. The data submitted at the mid-point each year will also allow CNCS to..., electronic, mechanical, or other technological collection techniques or other forms of information technology... project management responsibilities. Four of the 19 comments specifically noted that grantee time is...
The Art Association/Higher Education Partnership: Implementing Residential Professional Development
ERIC Educational Resources Information Center
Charland, William
2006-01-01
In-service professional development in education began informally in the early nineteenth-century as a means of disseminating classroom management techniques, specifically addressing ways in which corporal punishment could be delivered to a child without inflicting serious injury. This initial effort paralleled a concern regarding children's…
Laptop Computers in the Elementary Classroom: Authentic Instruction with At-Risk Students
ERIC Educational Resources Information Center
Kemker, Kate; Barron, Ann E.; Harmes, J. Christine
2007-01-01
This case study investigated the integration of laptop computers into an elementary classroom in a low socioeconomic status (SES) school. Specifically, the research examined classroom management techniques and aspects of authentic learning relative to the student projects and activities. A mixed methods approach included classroom observations,…
Continuous Quality Improvement: Making the Transition to Education.
ERIC Educational Resources Information Center
Hubbard, Dean L., Ed.
This book is a collection of case studies by 27 educational and industrial leaders describing the implementation of specific Total Quality Management techniques which have demonstrated their value. Essays and their authors are as follows: "Process Improvements Using Team Environments" (Scot M. Faulkner); "Team Effectiveness" (Robert S. Winter);…
Bountris, Panagiotis; Haritou, Maria; Pouliakis, Abraham; Margari, Niki; Kyrgiou, Maria; Spathis, Aris; Pappas, Asimakis; Panayiotides, Ioannis; Paraskevaidis, Evangelos A; Karakitsos, Petros; Koutsouris, Dimitrios-Dionyssios
2014-01-01
Nowadays, there are molecular biology techniques providing information related to cervical cancer and its cause: the human Papillomavirus (HPV), including DNA microarrays identifying HPV subtypes, mRNA techniques such as nucleic acid based amplification or flow cytometry identifying E6/E7 oncogenes, and immunocytochemistry techniques such as overexpression of p16. Each one of these techniques has its own performance, limitations and advantages, thus a combinatorial approach via computational intelligence methods could exploit the benefits of each method and produce more accurate results. In this article we propose a clinical decision support system (CDSS), composed by artificial neural networks, intelligently combining the results of classic and ancillary techniques for diagnostic accuracy improvement. We evaluated this method on 740 cases with complete series of cytological assessment, molecular tests, and colposcopy examination. The CDSS demonstrated high sensitivity (89.4%), high specificity (97.1%), high positive predictive value (89.4%), and high negative predictive value (97.1%), for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+). In comparison to the tests involved in this study and their combinations, the CDSS produced the most balanced results in terms of sensitivity, specificity, PPV, and NPV. The proposed system may reduce the referral rate for colposcopy and guide personalised management and therapeutic interventions.
Bountris, Panagiotis; Haritou, Maria; Pouliakis, Abraham; Margari, Niki; Kyrgiou, Maria; Spathis, Aris; Pappas, Asimakis; Panayiotides, Ioannis; Paraskevaidis, Evangelos A.; Karakitsos, Petros; Koutsouris, Dimitrios-Dionyssios
2014-01-01
Nowadays, there are molecular biology techniques providing information related to cervical cancer and its cause: the human Papillomavirus (HPV), including DNA microarrays identifying HPV subtypes, mRNA techniques such as nucleic acid based amplification or flow cytometry identifying E6/E7 oncogenes, and immunocytochemistry techniques such as overexpression of p16. Each one of these techniques has its own performance, limitations and advantages, thus a combinatorial approach via computational intelligence methods could exploit the benefits of each method and produce more accurate results. In this article we propose a clinical decision support system (CDSS), composed by artificial neural networks, intelligently combining the results of classic and ancillary techniques for diagnostic accuracy improvement. We evaluated this method on 740 cases with complete series of cytological assessment, molecular tests, and colposcopy examination. The CDSS demonstrated high sensitivity (89.4%), high specificity (97.1%), high positive predictive value (89.4%), and high negative predictive value (97.1%), for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+). In comparison to the tests involved in this study and their combinations, the CDSS produced the most balanced results in terms of sensitivity, specificity, PPV, and NPV. The proposed system may reduce the referral rate for colposcopy and guide personalised management and therapeutic interventions. PMID:24812614
Evaluating reliability of WSN with sleep/wake-up interfering nodes
NASA Astrophysics Data System (ADS)
Distefano, Salvatore
2013-10-01
A wireless sensor network (WSN) (singular and plural of acronyms are spelled the same) is a distributed system composed of autonomous sensor nodes wireless connected and randomly scattered into a geographical area to cooperatively monitor physical or environmental conditions. Adequate techniques and strategies are required to manage a WSN so that it works properly, observing specific quantities and metrics to evaluate the WSN operational conditions. Among them, one of the most important is the reliability. Considering a WSN as a system composed of sensor nodes the system reliability approach can be applied, thus expressing the WSN reliability in terms of its nodes' reliability. More specifically, since often standby power management policies are applied at node level and interferences among nodes may arise, a WSN can be considered as a dynamic system. In this article we therefore consider the WSN reliability evaluation problem from the dynamic system reliability perspective. Static-structural interactions are specified by the WSN topology. Sleep/wake-up standby policies and interferences due to wireless communications can be instead considered as dynamic aspects. Thus, in order to represent and to evaluate the WSN reliability, we use dynamic reliability block diagrams and Petri nets. The proposed technique allows to overcome the limits of Markov models when considering non-linear discharge processes, since they cannot adequately represent the aging processes. In order to demonstrate the effectiveness of the technique, we investigate some specific WSN network topologies, providing guidelines for their representation and evaluation.
Kelly, Kassandra C; Jordan, Erin M; Joyner, A Barry; Burdette, G Trey; Buckley, Thomas A
2014-01-01
A cornerstone of the recent consensus statements on concussion is a multifaceted concussion-assessment program at baseline and postinjury and when tracking recovery. Earlier studies of athletic trainers' (ATs') practice patterns found limited use of multifaceted protocols; however, these authors typically grouped diverse athletic training settings together. To (1) describe the concussion-management practice patterns of National Collegiate Athletic Association (NCAA) Division I ATs, (2) compare these practice patterns to earlier studies, and (3) objectively characterize the clinical examination. Cross-sectional study. Online survey. A total of 610 ATs from NCAA Division I institutions, for a response rate of 34.4%. The survey had 3 subsections: demographic questions related to the participant's experiences, concussion-assessment practice patterns, and concussion-recovery and return-to-participation practice patterns. Specific practice-pattern questions addressed balance, cognitive and mental status, neuropsychological testing, and self-reported symptoms. Finally, specific components of the clinical examination were examined. We identified high rates of multifaceted assessments (i.e., assessments using at least 3 techniques) during testing at baseline (71.2%), acute concussion assessment (79.2%), and return to participation (66.9%). The specific techniques used are provided along with their adherence with evidence-based practice findings. Respondents endorsed a diverse array of clinical examination techniques that often overlapped objective concussion-assessment protocols or were likely used to rule out associated potential conditions. Respondents were cognizant of the Third International Consensus Statement, the National Athletic Trainers' Association position statement, and the revised NCAA Sports Medicine Handbook recommendations. Athletic trainers in NCAA Division I demonstrated widespread use of multifaceted concussion-assessment techniques and appeared compliant with recent consensus statements and the NCAA Sports Medicine Handbook.
Li, Yan; Thomas, Manoj; Osei-Bryson, Kweku-Muata; Levy, Jason
2016-01-01
With the growing popularity of data analytics and data science in the field of environmental risk management, a formalized Knowledge Discovery via Data Analytics (KDDA) process that incorporates all applicable analytical techniques for a specific environmental risk management problem is essential. In this emerging field, there is limited research dealing with the use of decision support to elicit environmental risk management (ERM) objectives and identify analytical goals from ERM decision makers. In this paper, we address problem formulation in the ERM understanding phase of the KDDA process. We build a DM3 ontology to capture ERM objectives and to inference analytical goals and associated analytical techniques. A framework to assist decision making in the problem formulation process is developed. It is shown how the ontology-based knowledge system can provide structured guidance to retrieve relevant knowledge during problem formulation. The importance of not only operationalizing the KDDA approach in a real-world environment but also evaluating the effectiveness of the proposed procedure is emphasized. We demonstrate how ontology inferencing may be used to discover analytical goals and techniques by conceptualizing Hazardous Air Pollutants (HAPs) exposure shifts based on a multilevel analysis of the level of urbanization (and related economic activity) and the degree of Socio-Economic Deprivation (SED) at the local neighborhood level. The HAPs case highlights not only the role of complexity in problem formulation but also the need for integrating data from multiple sources and the importance of employing appropriate KDDA modeling techniques. Challenges and opportunities for KDDA are summarized with an emphasis on environmental risk management and HAPs. PMID:27983713
Li, Yan; Thomas, Manoj; Osei-Bryson, Kweku-Muata; Levy, Jason
2016-12-15
With the growing popularity of data analytics and data science in the field of environmental risk management, a formalized Knowledge Discovery via Data Analytics (KDDA) process that incorporates all applicable analytical techniques for a specific environmental risk management problem is essential. In this emerging field, there is limited research dealing with the use of decision support to elicit environmental risk management (ERM) objectives and identify analytical goals from ERM decision makers. In this paper, we address problem formulation in the ERM understanding phase of the KDDA process. We build a DM³ ontology to capture ERM objectives and to inference analytical goals and associated analytical techniques. A framework to assist decision making in the problem formulation process is developed. It is shown how the ontology-based knowledge system can provide structured guidance to retrieve relevant knowledge during problem formulation. The importance of not only operationalizing the KDDA approach in a real-world environment but also evaluating the effectiveness of the proposed procedure is emphasized. We demonstrate how ontology inferencing may be used to discover analytical goals and techniques by conceptualizing Hazardous Air Pollutants (HAPs) exposure shifts based on a multilevel analysis of the level of urbanization (and related economic activity) and the degree of Socio-Economic Deprivation (SED) at the local neighborhood level. The HAPs case highlights not only the role of complexity in problem formulation but also the need for integrating data from multiple sources and the importance of employing appropriate KDDA modeling techniques. Challenges and opportunities for KDDA are summarized with an emphasis on environmental risk management and HAPs.
Protecting Against Faults in JPL Spacecraft
NASA Technical Reports Server (NTRS)
Morgan, Paula
2007-01-01
A paper discusses techniques for protecting against faults in spacecraft designed and operated by NASA s Jet Propulsion Laboratory (JPL). The paper addresses, more specifically, fault-protection requirements and techniques common to most JPL spacecraft (in contradistinction to unique, mission specific techniques), standard practices in the implementation of these techniques, and fault-protection software architectures. Common requirements include those to protect onboard command, data-processing, and control computers; protect against loss of Earth/spacecraft radio communication; maintain safe temperatures; and recover from power overloads. The paper describes fault-protection techniques as part of a fault-management strategy that also includes functional redundancy, redundant hardware, and autonomous monitoring of (1) the operational and health statuses of spacecraft components, (2) temperatures inside and outside the spacecraft, and (3) allocation of power. The strategy also provides for preprogrammed automated responses to anomalous conditions. In addition, the software running in almost every JPL spacecraft incorporates a general-purpose "Safe Mode" response algorithm that configures the spacecraft in a lower-power state that is safe and predictable, thereby facilitating diagnosis of more complex faults by a team of human experts on Earth.
Rodgers, Kiri J.; Hursthouse, Andrew; Cuthbert, Simon
2015-01-01
As waste management regulations become more stringent, yet demand for resources continues to increase, there is a pressing need for innovative management techniques and more sophisticated supporting analysis techniques. Sequential extraction (SE) analysis, a technique previously applied to soils and sediments, offers the potential to gain a better understanding of the composition of solid wastes. SE attempts to classify potentially toxic elements (PTEs) by their associations with phases or fractions in waste, with the aim of improving resource use and reducing negative environmental impacts. In this review we explain how SE can be applied to steel wastes. These present challenges due to differences in sample characteristics compared with materials to which SE has been traditionally applied, specifically chemical composition, particle size and pH buffering capacity, which are critical when identifying a suitable SE method. We highlight the importance of delineating iron-rich phases, and find that the commonly applied BCR (The community Bureau of reference) extraction method is problematic due to difficulties with zinc speciation (a critical steel waste constituent), hence a substantially modified SEP is necessary to deal with particular characteristics of steel wastes. Successful development of SE for steel wastes could have wider implications, e.g., for the sustainable management of fly ash and mining wastes. PMID:26393631
Rodgers, Kiri J; Hursthouse, Andrew; Cuthbert, Simon
2015-09-18
As waste management regulations become more stringent, yet demand for resources continues to increase, there is a pressing need for innovative management techniques and more sophisticated supporting analysis techniques. Sequential extraction (SE) analysis, a technique previously applied to soils and sediments, offers the potential to gain a better understanding of the composition of solid wastes. SE attempts to classify potentially toxic elements (PTEs) by their associations with phases or fractions in waste, with the aim of improving resource use and reducing negative environmental impacts. In this review we explain how SE can be applied to steel wastes. These present challenges due to differences in sample characteristics compared with materials to which SE has been traditionally applied, specifically chemical composition, particle size and pH buffering capacity, which are critical when identifying a suitable SE method. We highlight the importance of delineating iron-rich phases, and find that the commonly applied BCR (The community Bureau of reference) extraction method is problematic due to difficulties with zinc speciation (a critical steel waste constituent), hence a substantially modified SEP is necessary to deal with particular characteristics of steel wastes. Successful development of SE for steel wastes could have wider implications, e.g., for the sustainable management of fly ash and mining wastes.
Cardiac imaging: working towards fully-automated machine analysis & interpretation.
Slomka, Piotr J; Dey, Damini; Sitek, Arkadiusz; Motwani, Manish; Berman, Daniel S; Germano, Guido
2017-03-01
Non-invasive imaging plays a critical role in managing patients with cardiovascular disease. Although subjective visual interpretation remains the clinical mainstay, quantitative analysis facilitates objective, evidence-based management, and advances in clinical research. This has driven developments in computing and software tools aimed at achieving fully automated image processing and quantitative analysis. In parallel, machine learning techniques have been used to rapidly integrate large amounts of clinical and quantitative imaging data to provide highly personalized individual patient-based conclusions. Areas covered: This review summarizes recent advances in automated quantitative imaging in cardiology and describes the latest techniques which incorporate machine learning principles. The review focuses on the cardiac imaging techniques which are in wide clinical use. It also discusses key issues and obstacles for these tools to become utilized in mainstream clinical practice. Expert commentary: Fully-automated processing and high-level computer interpretation of cardiac imaging are becoming a reality. Application of machine learning to the vast amounts of quantitative data generated per scan and integration with clinical data also facilitates a move to more patient-specific interpretation. These developments are unlikely to replace interpreting physicians but will provide them with highly accurate tools to detect disease, risk-stratify, and optimize patient-specific treatment. However, with each technological advance, we move further from human dependence and closer to fully-automated machine interpretation.
Matto, Holly
2005-01-01
A bio-behavioral approach to drug addiction treatment is outlined. The presented treatment model uses dual representation theory as a guiding framework for understanding the bio-behavioral processes activated during the application of expressive therapeutic methods. Specifically, the treatment model explains how visual processing techniques can supplement traditional relapse prevention therapy protocols, to help clients better manage cravings and control triggers in hard-to-treat populations such as chronic substance-dependent persons.
NASA Technical Reports Server (NTRS)
Owen, Robert B.; Gyekenyesi, Andrew L.; Inman, Daniel J.; Ha, Dong S.
2011-01-01
The Integrated Vehicle Health Management (IVHM) Project, sponsored by NASA's Aeronautics Research Mission Directorate, is conducting research to advance the state of highly integrated and complex flight-critical health management technologies and systems. An effective IVHM system requires Structural Health Monitoring (SHM). The impedance method is one such SHM technique for detection and monitoring complex structures for damage. This position paper on the impedance method presents the current state of the art, future directions, applications and possible flight test demonstrations.
NASA Technical Reports Server (NTRS)
1974-01-01
An analysis of low cost management approaches for the development of the Earth Observatory Satellite (EOS) is presented. The factors of the program which tend to increase costs are identified. The NASA/Industry interface is stressed to show how the interface can be improved to produce reduced program costs. Techniques and examples of cost reduction which can be applied to the EOS program are tabulated. Specific recommendations for actions to be taken to reduce costs in prescribed areas are submitted.
[Use of urine drug screening in the emergency department of a paediatric hospital].
Ferrer Bosch, Núria; Martínez Sánchez, Lidia; Trenchs Sainz de la Maza, Victoria; Velasco Rodríguez, Jesús; García González, Elsa; Luaces Cubells, Carles
2018-01-01
To describe the situations in which urine drug screening is used in a Paediatric Emergency Department (ED). An analysis is also made on its potential usefulness on whether it changes the patient management, and if the results are confirmed by using specific techniques. A retrospective study was conducted on patients under the age of 18 attended in the ED during 2014 and in whom urine drug screening was requested. Depending on the potential capacity of the screening result to change patient management, two groups were defined (potentially useful and not potentially useful). Urine drug screening was performed on a total of 161 patients. The screening was considered not to be potentially useful in 87 (54.0%). This was because the clinical history already explained the symptoms the patient had in 55 (34.1%) patients, in 29 (18.0%) because the patient was asymptomatic, and in 3 (1.9%) because the suspected drug was not detectable in the screening. The drug screening results changed the patient management in 5 (3.1%) cases. A toxic substance was detected in 44 (27.3%). Two out of the 44 that were positive (2.1%) were re-tested by specific techniques, and presence of the toxic substance was ruled out in both of them (false positives). Most of the drug screening tests are not justified, and it is very infrequent that they change patient management. It is very rare that the results are confirmed using more specific methods. Urine drug screening tests should be restricted to particular cases and if the result has legal implications, or if the patient denies using the drug, it should be followed by a specific toxicological study to provide a conclusive result. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.
Cancer pain and current theory for pain control.
Kahan, Brian
2014-05-01
This article discusses current trends in managing cancer pain, with specific regard to opioid transmission, descending pathway inhabitation, and ways to facilitate the endogenous antinociceptive chemicals in the human body. Various techniques for opioid and nonopioid control of potential pain situations of patients with cancer are discussed. The benefits of using pharmacogenetics to assess the appropriate medications are addressed. Finally, specific treatment of abdominal cancer pain using radiofrequency lesioning is discussed. Copyright © 2014 Elsevier Inc. All rights reserved.
Keogh, Alison; Tully, Mark A; Matthews, James; Hurley, Deirdre A
2015-12-01
Medical Research Council (MRC) guidelines recommend applying theory within complex interventions to explain how behaviour change occurs. Guidelines endorse self-management of chronic low back pain (CLBP) and osteoarthritis (OA), but evidence for its effectiveness is weak. This literature review aimed to determine the use of behaviour change theory and techniques within randomised controlled trials of group-based self-management programmes for chronic musculoskeletal pain, specifically CLBP and OA. A two-phase search strategy of electronic databases was used to identify systematic reviews and studies relevant to this area. Articles were coded for their use of behaviour change theory, and the number of behaviour change techniques (BCTs) was identified using a 93-item taxonomy, Taxonomy (v1). 25 articles of 22 studies met the inclusion criteria, of which only three reported having based their intervention on theory, and all used Social Cognitive Theory. A total of 33 BCTs were coded across all articles with the most commonly identified techniques being 'instruction on how to perform the behaviour', 'demonstration of the behaviour', 'behavioural practice', 'credible source', 'graded tasks' and 'body changes'. Results demonstrate that theoretically driven research within group based self-management programmes for chronic musculoskeletal pain is lacking, or is poorly reported. Future research that follows recommended guidelines regarding the use of theory in study design and reporting is warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.
Alzahrani, Ahmed; Qureshi, Muhammad Shuaib; Thayananthan, Vijey
2017-10-23
This paper aims to analyze possible next generation of networked radio frequency identification (NGN-RFID) system for customer relationship management (CRM) in healthcare industries. Customer relationship and its management techniques in a specific healthcare industry are considered in this development. The key objective of using NGN-RFID scheme is to enhance the handling of patients' data to improve the CRM efficiency in healthcare industries. The proposed NGN-RFID system is one of the valid points to improve the ability of CRM by analyzing different prior and current traditional approaches. The legacy of customer relationship management will be improved by using this modern NGN-RFID technology without affecting the novelty.
Schentag, J J; Paladino, J A; Birmingham, M C; Zimmer, G; Carr, J R; Hanson, S C
1995-01-01
To apply basic benchmarking techniques to hospital antibiotic expenditures and clinical pharmacy personnel and their duties, to identify cost savings strategies for clinical pharmacy services. Prospective survey of 18 hospitals ranging in size from 201 to 942 beds. Each was asked to provide antibiotic expenditures, an overview of their clinical pharmacy services, and to describe the duties of clinical pharmacists involved in antibiotic management activities. Specific information was sought on the use of pharmacokinetic dosing services, antibiotic streamlining, and oral switch in each of the hospitals. Most smaller hospitals (< 300 beds) did not employ clinical pharmacists with the specific duties of antibiotic management or streamlining. At these institutions, antibiotic management services consisted of formulary enforcement and aminoglycoside and/or vancomycin dosing services. The larger hospitals we surveyed employed clinical pharmacists designated as antibiotic management specialists, but their usual activities were aminoglycoside and/or vancomycin dosing services and formulary enforcement. In virtually all hospitals, the yearly expenses for antibiotics exceeded those of Millard Fillmore Hospitals by $2,000-3,000 per occupied bed. In a 500-bed hospital, this difference in expenditures would exceed $1.5 million yearly. Millard Fillmore Health System has similar types of patients, but employs clinical pharmacists to perform streamlining and/or switch functions at days 2-4, when cultures come back from the laboratory. The antibiotic streamlining and oral switch duties of clinical pharmacy specialists are associated with the majority of cost savings in hospital antibiotic management programs. The savings are considerable to the extent that most hospitals with 200-300 beds could readily cost-justify a full-time clinical pharmacist to perform these activities on a daily basis. Expenses of the program would be offset entirely by the reduction in the actual pharmacy expenditures on antibiotics.
Use of multicriteria analysis (MCA) for sustainable hydropower planning and management.
Vassoney, Erica; Mammoliti Mochet, Andrea; Comoglio, Claudio
2017-07-01
Multicriteria analysis (MCA) is a decision-making tool applied to a wide range of environmental management problems, including renewable energy planning and management. An interesting field of application of MCA is the evaluation and analysis of the conflicting aspects of hydropower (HP) exploitation, affecting the three pillars of sustainability and involving several different stakeholders. The present study was aimed at reviewing the state of the art of MCA applications to sustainable hydropower production and related decision-making problems, based on a detailed analysis of the scientific papers published over the last 15 years on this topic. The papers were analysed and compared, focusing on the specific features of the MCA methods applied in the described case studies, highlighting the general aspects of the MCA application (purpose, spatial scale, software used, stakeholders, etc.) and the specific operational/technical features of the selected MCA technique (methodology, criteria, evaluation, approach, sensitivity, etc.). Some specific limitations of the analysed case studies were identified and a set of "quality indexes" of an exhaustive MCA application were suggested as potential improvements for more effectively support decision-making processes in sustainable HP planning and management problems. Copyright © 2017 Elsevier Ltd. All rights reserved.
Advances in the endoscopic management of pancreatic collections.
Ruiz-Clavijo, David; de la Higuera, Belen González; Vila, Juan J
2015-04-16
Treatment of pancreatic collections has experienced great progress in recent years with the emergence of alternative minimally invasive techniques comparing to the classic surgical treatment. Such techniques have been shown to improve outcomes of morbidity vs surgical treatment. The recent emergence of endoscopic drainage is noteworthy. The advent of endoscopic ultrasonography has been crucial for treatment of these specific lesions. They can be characterized, their relationships with neighboring structures can be evaluated and the drainage guided by this technique has been clearly improved compared with the conventional endoscopic drainage. Computed tomography is the technique of choice to characterize the recently published new classification of pancreatic collections. For this reason, the radiologist's role establishing and classifying in a rigorously manner the collections according to the new nomenclature is essential to making therapeutic decisions. Ideal scenario for comprehensive treatment of these collections would be those centers with endoscopic ultrasound and interventional radiology expertise together with hepatobiliopancreatic surgery. This review describes the different types of pancreatic collections: acute peripancreatic fluid collection, pancreatic pseudocysts, acute necrotic collection and walled-off necrosis; the indications and the contraindications for endoscopic drainage, the drainage technique and their outcomes. The integrated management of pancreatic collections according to their type and evolution time is discussed.
Perioperative leadership: managing change with insights, priorities, and tools.
Taylor, David L
2014-07-01
The personal leadership of the perioperative director is a critical factor in the success of any change management initiative. This article presents an approach to perioperative nursing leadership that addresses obstacles that prevent surgical departments from achieving high performance in clinical and financial outcomes. This leadership approach consists of specific insights, priorities, and tools: key insights include self-understanding of personal barriers to leadership and accuracy at understanding economic and strategic considerations related to the OR environment; key priorities include creating a customer-centered organization, focusing on process improvement, and concentrating on culture change; and key tools include using techniques (e.g., direct engagement, collaborative leadership) to align surgical organizations with leadership priorities and mitigate specific perioperative management risks. Included in this article is a leadership development plan for perioperative directors. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.
de la Fuente, Josu; Baruchel, André; Biondi, Andrea; de Bont, Eveline; Dresse, Marie-Françoise; Suttorp, Meinolf; Millot, Frédéric
2014-10-01
Chronic myeloid leukaemia in children and young people is a relatively rare form of leukaemia that shows increased incidence with age and some evidence suggests that the molecular basis differs from that in adults. Significant advances in targeted therapy with the development and use in children of tyrosine kinase inhibitors and the ability to monitor and understand the prognostic significance of minimal residual disease by standardized molecular techniques has shifted the management of this condition from bone marrow transplantation as the main therapeutic modality to individualized treatment for each patient based on achieving specific milestones. The physiological changes occurring during childhood, particularly those affecting growth and development and the long-term use of treatment, pose specific challenges in this age group, which we are only beginning to understand. © 2014 John Wiley & Sons Ltd.
Using More of Your Existing Knowledge to Make Better Strategic Decisions
ERIC Educational Resources Information Center
Brockmann, Erich N.
2008-01-01
We contend that managers make better decisions when they are better able to tap into their vast storehouses of knowledge than their peers can. More specifically, we contend that accessing their tacit knowledge has the most noticeable and positive impact on their decision quality. Furthermore, techniques for better accessing knowledge can be…
Relax for Success: An Educator's Guide to Stress Management. [With CD-ROM].
ERIC Educational Resources Information Center
Glanz, Jeffrey
This book is designed as a practical, concise, easy-to-read guide for relieving stress. It is written specifically for educators, with examples and anecdotes that relate to professional educators' experiences. It assumes a holistic approach to stress relief that incorporates thought, verbal and action strategies and techniques. The harm that…
Play Therapy for Severe Psychological Trauma. [Videotape
ERIC Educational Resources Information Center
Gil, Eliana
In this 36-minute educational video, a play and family therapist elucidates the nature of trauma, how to recognize it clinically, and how to manage its powerful effects upon children's development with the use of specific play materials and techniques. With a reenacted clinical interview, footage from an actual play therapy session, and a detailed…
Understanding ADHD: A Practical Guide for Teachers and Parents.
ERIC Educational Resources Information Center
Bender, William N.
This book is intended as a practical guide for parents and teachers in managing children or students with attention deficit hyperactivity disorder (ADHD). Specific strategies and techniques are presented that will facilitate learning for individuals with ADHD in both the home and school environment. Chapters include: "ADHD at Home and in the…
Modern techniques for tracking fecal pollution in environmental waters require investing in DNA-based methods to determine the presence of specific fecal sources. To help water quality managers decide whether to employ routine polymerase chain reaction (PCR) or quantitative PC...
ERIC Educational Resources Information Center
Braguglia, Kay H.; Jackson, Kanata A.
2012-01-01
This article presents a reflective analysis of teaching research methodology through a three course sequence using a project-based approach. The authors reflect critically on their experiences in teaching research methods courses in an undergraduate business management program. The introduction of a range of specific techniques including student…
A Time-Cost Management System for use in Educational Planning.
ERIC Educational Resources Information Center
McIsaac, Donald N., Jr.; and Others
Prepared specifically for the Denver Public Schools, this manual nevertheless provides some of the basic understanding required for the proper execution of educational planning based upon PERT/CPM techniques. The theory of PERT/CPM and the fundamental processes involved therein are elucidated in the first part of the manual while the operating…
Factors affecting the implementation of green specifications in construction.
Lam, Patrick T I; Chan, Edwin H W; Poon, C S; Chau, C K; Chun, K P
2010-01-01
Green specifications constitute one of the important elements in green construction. New sustainability requirements and changing priorities in construction management have spurred the emerging green specifications to a faster pace of development. A cross-sectional survey has been conducted in Hong Kong in 2007 to identify principal factors leading to the success of preparing green specifications. Based on extensive construction management literature, 20 variables concerning sustainable construction were summarized. Using the Mann-Whitney U-test, the subtle differences between stakeholders in specifying construction work have been detected even with the high consistency of the responses among the groups. Moreover, five independent factors for successful specification of green construction have been categorized by factor analysis. They are related to (1) green technology and techniques, (2) reliability and quality of specification, (3) leadership and responsibility, (4) stakeholder involvement, and (5) guide and benchmarking systems. Whilst the first and fourth factors are generally more important, different stakeholder groups have different emphases. The results of the survey have been validated against established principles. 2009 Elsevier Ltd. All rights reserved.
Lewis, Rachel; Yarker, Joanna; Donaldson-Feilder, Emma; Flaxman, Paul; Munir, Fehmidah
2010-03-01
To identify the specific management behaviours associated with the effective management of stress in nursing; and to build a stress management competency framework that can be integrated and compared with nurse management frameworks. Workplace stress is a significant problem in healthcare, especially within nursing. While there is a reasonable consensus regarding the sources of stress and its impact on health and well-being, little is known about the specific line manager behaviours that are associated with the effective and ineffective management of stress. Semi-structured interviews using critical incident technique were conducted with 41 employees working within 5 National Health Service (NHS) trusts within the United Kingdom. Data were transcribed and analysed using content analysis. 19 competencies (or sets of behaviour) were identified in the management of stress in employees. The 3 most frequently reported competencies: managing workload and resources, individual consideration and participative approach, are discussed in detail with illustrative quotes. Managers are vital in the reduction and management of stress at work. Importantly, the 2 of the 3 dominant competencies, managing workload and resources and individual consideration, do not feature in the UK's NHS Knowledge and Skills Framework, suggesting there are important skills gaps with regard to managing workplace stress. The implications of this approach for training and development, performance appraisal and assessment are discussed. Interventions to support managers develop effective behaviours are required to help reduce and manage stress at work. Copyright 2009 Elsevier Ltd. All rights reserved.
Survivable algorithms and redundancy management in NASA's distributed computing systems
NASA Technical Reports Server (NTRS)
Malek, Miroslaw
1992-01-01
The design of survivable algorithms requires a solid foundation for executing them. While hardware techniques for fault-tolerant computing are relatively well understood, fault-tolerant operating systems, as well as fault-tolerant applications (survivable algorithms), are, by contrast, little understood, and much more work in this field is required. We outline some of our work that contributes to the foundation of ultrareliable operating systems and fault-tolerant algorithm design. We introduce our consensus-based framework for fault-tolerant system design. This is followed by a description of a hierarchical partitioning method for efficient consensus. A scheduler for redundancy management is introduced, and application-specific fault tolerance is described. We give an overview of our hybrid algorithm technique, which is an alternative to the formal approach given.
Initiating Intrapartum Nitrous Oxide in an Academic Hospital: Considerations and Challenges.
Migliaccio, Laura; Lawton, Robyn; Leeman, Lawrence; Holbrook, Amanda
2017-05-01
A 50%-50% mixture of nitrous oxide and oxygen has long been used for managing pain during labor in many countries, but only recently has this intrapartum analgesic technique become popular in the United States. Nitrous oxide is considered minimal sedation and a safe pain management alternative. Many facilities are now interested in providing laboring women this analgesic option. The process of establishing use of nitrous oxide in a large institution can be complicated and may seem daunting. This brief report describes the challenges that occurred during the process of initiating nitrous oxide for pain management during childbirth at an academic medical center and discusses various committee roles. Nurses at the University of New Mexico Hospital now directly oversee the administration of nitrous oxide to women in labor in accordance to an established guideline. Despite limited available research, the guideline also allows offering nitrous oxide as a pain management technique for women with opioid dependence. Key components of the guideline and specifics related to education, cost, and safety are reviewed. © 2017 by the American College of Nurse-Midwives.
Space system production cost benefits from contemporary philosophies in management and manufacturing
NASA Technical Reports Server (NTRS)
Rosmait, Russell L.
1991-01-01
The cost of manufacturing space system hardware has always been expensive. The Engineering Cost Group of the Program Planning office at Marshall is attempting to account for cost savings that result from new technologies in manufacturing and management. The objective is to identify and define contemporary philosophies in manufacturing and management. The seven broad categories that make up the areas where technological advances can assist in reducing space system costs are illustrated. Included within these broad categories is a list of the processes or techniques that specifically provide the cost savings within todays design, test, production and operations environments. The processes and techniques listed achieve savings in the following manner: increased productivity; reduced down time; reduced scrap; reduced rework; reduced man hours; and reduced material costs. In addition, it should be noted that cost savings from production and processing improvements effect 20 to 40 pct. of production costs whereas savings from management improvements effects 60 to 80 of production cost. This is important because most efforts in reducing costs are spent trying to reduce cost in the production.
Satellite based Ocean Forecasting, the SOFT project
NASA Astrophysics Data System (ADS)
Stemmann, L.; Tintoré, J.; Moneris, S.
2003-04-01
The knowledge of future oceanic conditions would have enormous impact on human marine related areas. For such reasons, a number of international efforts are being carried out to obtain reliable and manageable ocean forecasting systems. Among the possible techniques that can be used to estimate the near future states of the ocean, an ocean forecasting system based on satellite imagery is developped through the Satelitte based Ocean ForecasTing project (SOFT). SOFT, established by the European Commission, considers the development of a forecasting system of the ocean space-time variability based on satellite data by using Artificial Intelligence techniques. This system will be merged with numerical simulation approaches, via assimilation techniques, to get a hybrid SOFT-numerical forecasting system of improved performance. The results of the project will provide efficient forecasting of sea-surface temperature structures, currents, dynamic height, and biological activity associated to chlorophyll fields. All these quantities could give valuable information on the planning and management of human activities in marine environments such as navigation, fisheries, pollution control, or coastal management. A detailed identification of present or new needs and potential end-users concerned by such an operational tool is being performed. The project would study solutions adapted to these specific needs.
Telecommunications Systems Design Techniques Handbook
NASA Technical Reports Server (NTRS)
Edelson, R. E. (Editor)
1972-01-01
The Deep Space Network (DSN) increasingly supports deep space missions sponsored and managed by organizations without long experience in DSN design and operation. The document is intended as a textbook for those DSN users inexperienced in the design and specification of a DSN-compatible spacecraft telecommunications system. For experienced DSN users, the document provides a reference source of telecommunication information which summarizes knowledge previously available only in a multitude of sources. Extensive references are quoted for those who wish to explore specific areas more deeply.
Pelvic ring injuries: Surgical management and long-term outcomes
Halawi, Mohamad J.
2016-01-01
Pelvic ring injuries present a therapeutic challenge to the orthopedic surgeon. Management is based on the patient's physiological status, fracture classification, and associated injuries. Surgical stabilization is indicated in unstable injury patterns and those that fail nonsurgical management. The optimal timing for definitive fixation is not clearly defined, but early stabilization is recommended. Surgical techniques include external fixation, open reduction and internal fixation, and minimally invasive percutaneous osteosynthesis. Special considerations are required for concomitant acetabular fractures, sacral fractures, and those occurring in skeletally immature patients. Long-term outcomes are limited by lack of pelvis-specific outcome measures and burden of associated injuries. PMID:26908968
Adopting best practices: "Agility" moves from software development to healthcare project management.
Kitzmiller, Rebecca; Hunt, Eleanor; Sproat, Sara Breckenridge
2006-01-01
It is time for a change in mindset in how nurses operationalize system implementations and manage projects. Computers and systems have evolved over time from unwieldy mysterious machines of the past to ubiquitous computer use in every aspect of daily lives and work sites. Yet, disconcertingly, the process used to implement these systems has not evolved. Technology implementation does not need to be a struggle. It is time to adapt traditional plan-driven implementation methods to incorporate agile techniques. Agility is a concept borrowed from software development and is presented here because it encourages flexibility, adaptation, and continuous learning as part of the implementation process. Agility values communication and harnesses change to an advantage, which facilitates the natural evolution of an adaptable implementation process. Specific examples of agility in an implementation are described, and plan-driven implementation stages are adapted to incorporate relevant agile techniques. This comparison demonstrates how an agile approach enhances traditional implementation techniques to meet the demands of today's complex healthcare environments.
Schedule-Aware Workflow Management Systems
NASA Astrophysics Data System (ADS)
Mans, Ronny S.; Russell, Nick C.; van der Aalst, Wil M. P.; Moleman, Arnold J.; Bakker, Piet J. M.
Contemporary workflow management systems offer work-items to users through specific work-lists. Users select the work-items they will perform without having a specific schedule in mind. However, in many environments work needs to be scheduled and performed at particular times. For example, in hospitals many work-items are linked to appointments, e.g., a doctor cannot perform surgery without reserving an operating theater and making sure that the patient is present. One of the problems when applying workflow technology in such domains is the lack of calendar-based scheduling support. In this paper, we present an approach that supports the seamless integration of unscheduled (flow) and scheduled (schedule) tasks. Using CPN Tools we have developed a specification and simulation model for schedule-aware workflow management systems. Based on this a system has been realized that uses YAWL, Microsoft Exchange Server 2007, Outlook, and a dedicated scheduling service. The approach is illustrated using a real-life case study at the AMC hospital in the Netherlands. In addition, we elaborate on the experiences obtained when developing and implementing a system of this scale using formal techniques.
Associating clinical archetypes through UMLS Metathesaurus term clusters.
Lezcano, Leonardo; Sánchez-Alonso, Salvador; Sicilia, Miguel-Angel
2012-06-01
Clinical archetypes are modular definitions of clinical data, expressed using standard or open constraint-based data models as the CEN EN13606 and openEHR. There is an increasing archetype specification activity that raises the need for techniques to associate archetypes to support better management and user navigation in archetype repositories. This paper reports on a computational technique to generate tentative archetype associations by mapping them through term clusters obtained from the UMLS Metathesaurus. The terms are used to build a bipartite graph model and graph connectivity measures can be used for deriving associations.
Apollo experience report: Flight anomaly resolution
NASA Technical Reports Server (NTRS)
Lobb, J. D.
1975-01-01
The identification of flight anomalies, the determination of their causes, and the approaches taken for corrective action are described. Interrelationships of the broad range of disciplines involved with the complex systems and the team concept employed to ensure timely and accurate resolution of anomalies are discussed. The documentation techniques and the techniques for management of anomaly resolution are included. Examples of specific anomalies are presented in the original form of their progressive documentation. Flight anomaly resolution functioned as a part of the real-time mission support and postflight testing, and results were included in the postflight documentation.
FMEA: a model for reducing medical errors.
Chiozza, Maria Laura; Ponzetti, Clemente
2009-06-01
Patient safety is a management issue, in view of the fact that clinical risk management has become an important part of hospital management. Failure Mode and Effect Analysis (FMEA) is a proactive technique for error detection and reduction, firstly introduced within the aerospace industry in the 1960s. Early applications in the health care industry dating back to the 1990s included critical systems in the development and manufacture of drugs and in the prevention of medication errors in hospitals. In 2008, the Technical Committee of the International Organization for Standardization (ISO), licensed a technical specification for medical laboratories suggesting FMEA as a method for prospective risk analysis of high-risk processes. Here we describe the main steps of the FMEA process and review data available on the application of this technique to laboratory medicine. A significant reduction of the risk priority number (RPN) was obtained when applying FMEA to blood cross-matching, to clinical chemistry analytes, as well as to point-of-care testing (POCT).
Slader, C A; Reddel, H K; Spencer, L M; Belousova, E G; Armour, C L; Bosnic‐Anticevich, S Z; Thien, F C K; Jenkins, C R
2006-01-01
Background Previous studies have shown that breathing techniques reduce short acting β2 agonist use and improve quality of life (QoL) in asthma. The primary aim of this double blind study was to compare the effects of breathing exercises focusing on shallow nasal breathing with those of non‐specific upper body exercises on asthma symptoms, QoL, other measures of disease control, and inhaled corticosteroid (ICS) dose. This study also assessed the effect of peak flow monitoring on outcomes in patients using breathing techniques. Methods After a 2 week run in period, 57 subjects were randomised to one of two breathing techniques learned from instructional videos. During the following 30 weeks subjects practised their exercises twice daily and as needed for relief of symptoms. After week 16, two successive ICS downtitration steps were attempted. The primary outcome variables were QoL score and daily symptom score at week 12. Results Overall there were no clinically important differences between the groups in primary or secondary outcomes at weeks 12 or 28. The QoL score remained unchanged (0.7 at baseline v 0.5 at week 28, p = 0.11 both groups combined), as did lung function and airway responsiveness. However, across both groups, reliever use decreased by 86% (p<0.0001) and ICS dose was reduced by 50% (p<0.0001; p>0.10 between groups). Peak flow monitoring did not have a detrimental effect on asthma outcomes. Conclusion Breathing techniques may be useful in the management of patients with mild asthma symptoms who use a reliever frequently, but there is no evidence to favour shallow nasal breathing over non‐specific upper body exercises. PMID:16517572
Slader, C A; Reddel, H K; Spencer, L M; Belousova, E G; Armour, C L; Bosnic-Anticevich, S Z; Thien, F C K; Jenkins, C R
2006-08-01
Previous studies have shown that breathing techniques reduce short acting beta(2) agonist use and improve quality of life (QoL) in asthma. The primary aim of this double blind study was to compare the effects of breathing exercises focusing on shallow nasal breathing with those of non-specific upper body exercises on asthma symptoms, QoL, other measures of disease control, and inhaled corticosteroid (ICS) dose. This study also assessed the effect of peak flow monitoring on outcomes in patients using breathing techniques. After a 2 week run in period, 57 subjects were randomised to one of two breathing techniques learned from instructional videos. During the following 30 weeks subjects practised their exercises twice daily and as needed for relief of symptoms. After week 16, two successive ICS downtitration steps were attempted. The primary outcome variables were QoL score and daily symptom score at week 12. Overall there were no clinically important differences between the groups in primary or secondary outcomes at weeks 12 or 28. The QoL score remained unchanged (0.7 at baseline v 0.5 at week 28, p = 0.11 both groups combined), as did lung function and airway responsiveness. However, across both groups, reliever use decreased by 86% (p<0.0001) and ICS dose was reduced by 50% (p<0.0001; p>0.10 between groups). Peak flow monitoring did not have a detrimental effect on asthma outcomes. Breathing techniques may be useful in the management of patients with mild asthma symptoms who use a reliever frequently, but there is no evidence to favour shallow nasal breathing over non-specific upper body exercises.
RADC thermal guide for reliability engineers
NASA Astrophysics Data System (ADS)
Morrison, G. N.; Kallis, J. M.; Strattan, L. A.; Jones, I. R.; Lena, A. L.
1982-06-01
This guide was developed to provide a reliability engineer, who is not proficient in thermal design and analysis techniques, with the tools for managing and evaluating the thermal design and production of electronic equipment. It defines the requirements and tasks that should be addressed in system equipment specifications and statements of work, and describes how to evaluate performance.
System safety education focused on industrial engineering
NASA Technical Reports Server (NTRS)
Johnston, W. L.; Morris, R. S.
1971-01-01
An educational program, designed to train students with the specific skills needed to become safety specialists, is described. The discussion concentrates on application, selection, and utilization of various system safety analytical approaches. Emphasis is also placed on the management of a system safety program, its relationship with other disciplines, and new developments and applications of system safety techniques.
Claim audits: a relic of the indemnity age?
Ellender, D E
1997-09-01
Traditional claim audits offering quick fixes to specific problems or to recover overpayments will not provide benefit managers with the data and action plan they need to make informed decisions about cost-effective benefit administration. Today's benefits environment calls for a comprehensive review of claim administration, incorporating traditional audit techniques into a quality improvement audit process.
Cutaneous applications of lasers.
Ries, W R; Speyer, M T
1996-12-01
The cutaneous application of lasers today includes more selective and less damaging devices. Carbon dioxide, neodymium:yttrium-aluminum-garnet, potassium titanyl phosphate, argon, and yellow lasers are most prevalent in treating cutaneous lesions. Specific techniques in skin resurfacing, keloid excision, rhinophyma, actinic cheilitis ablation, and excision of superficial cutaneous tumors are discussed. Proper management of cutaneous vascular lesions is also presented.
Adaptive inertial shock-absorber
NASA Astrophysics Data System (ADS)
Faraj, Rami; Holnicki-Szulc, Jan; Knap, Lech; Seńko, Jarosław
2016-03-01
This paper introduces and discusses a new concept of impact absorption by means of impact energy management and storage in dedicated rotating inertial discs. The effectiveness of the concept is demonstrated in a selected case-study involving spinning management, a recently developed novel impact-absorber. A specific control technique performed on this device is demonstrated to be the main source of significant improvement in the overall efficiency of impact damping process. The influence of various parameters on the performance of the shock-absorber is investigated. Design and manufacturing challenges and directions of further research are formulated.
Acute poisoning: understanding 90% of cases in a nutshell
Greene, S; Dargan, P; Jones, A
2005-01-01
The acutely poisoned patient remains a common problem facing doctors working in acute medicine in the United Kingdom and worldwide. This review examines the initial management of the acutely poisoned patient. Aspects of general management are reviewed including immediate interventions, investigations, gastrointestinal decontamination techniques, use of antidotes, methods to increase poison elimination, and psychological assessment. More common and serious poisonings caused by paracetamol, salicylates, opioids, tricyclic antidepressants, selective serotonin reuptake inhibitors, benzodiazepines, non-steroidal anti-inflammatory drugs, and cocaine are discussed in detail. Specific aspects of common paediatric poisonings are reviewed. PMID:15811881
Acute poisoning: understanding 90% of cases in a nutshell.
Greene, S L; Dargan, P I; Jones, A L
2005-04-01
The acutely poisoned patient remains a common problem facing doctors working in acute medicine in the United Kingdom and worldwide. This review examines the initial management of the acutely poisoned patient. Aspects of general management are reviewed including immediate interventions, investigations, gastrointestinal decontamination techniques, use of antidotes, methods to increase poison elimination, and psychological assessment. More common and serious poisonings caused by paracetamol, salicylates, opioids, tricyclic antidepressants, selective serotonin reuptake inhibitors, benzodiazepines, non-steroidal anti-inflammatory drugs, and cocaine are discussed in detail. Specific aspects of common paediatric poisonings are reviewed.
Amato, A; Bottini, C; De Nardi, P; Giamundo, P; Lauretta, A; Realis Luc, A; Tegon, G; Nicholls, R J
2015-10-01
Perianal sepsis is a common condition ranging from acute abscess to chronic fistula formation. In most cases, the source is considered to be a non-specific cryptoglandular infection starting from the intersphincteric space. The key to successful treatment is the eradication of the primary track. As surgery may lead to a disturbance of continence, several sphincter-preserving techniques have been developed. This consensus statement examines the pertinent literature and provides evidence-based recommendations to improve individualized management of patients.
Aerospace management techniques: Commercial and governmental applications
NASA Technical Reports Server (NTRS)
Milliken, J. G.; Morrison, E. J.
1971-01-01
A guidebook for managers and administrators is presented as a source of useful information on new management methods in business, industry, and government. The major topics discussed include: actual and potential applications of aerospace management techniques to commercial and governmental organizations; aerospace management techniques and their use within the aerospace sector; and the aerospace sector's application of innovative management techniques.
Cardiac imaging: working towards fully-automated machine analysis & interpretation
Slomka, Piotr J; Dey, Damini; Sitek, Arkadiusz; Motwani, Manish; Berman, Daniel S; Germano, Guido
2017-01-01
Introduction Non-invasive imaging plays a critical role in managing patients with cardiovascular disease. Although subjective visual interpretation remains the clinical mainstay, quantitative analysis facilitates objective, evidence-based management, and advances in clinical research. This has driven developments in computing and software tools aimed at achieving fully automated image processing and quantitative analysis. In parallel, machine learning techniques have been used to rapidly integrate large amounts of clinical and quantitative imaging data to provide highly personalized individual patient-based conclusions. Areas covered This review summarizes recent advances in automated quantitative imaging in cardiology and describes the latest techniques which incorporate machine learning principles. The review focuses on the cardiac imaging techniques which are in wide clinical use. It also discusses key issues and obstacles for these tools to become utilized in mainstream clinical practice. Expert commentary Fully-automated processing and high-level computer interpretation of cardiac imaging are becoming a reality. Application of machine learning to the vast amounts of quantitative data generated per scan and integration with clinical data also facilitates a move to more patient-specific interpretation. These developments are unlikely to replace interpreting physicians but will provide them with highly accurate tools to detect disease, risk-stratify, and optimize patient-specific treatment. However, with each technological advance, we move further from human dependence and closer to fully-automated machine interpretation. PMID:28277804
How to optimize the lung donor.
Sales, Gabriele; Costamagna, Andrea; Fanelli, Vito; Boffini, Massimo; Pugliese, Francesco; Mascia, Luciana; Brazzi, Luca
2018-02-01
Over the last two decades, lung transplantation emerged as the standard of care for patients with advanced and terminal lung disease. Despite the increment in lung transplantation rates, in 2016 the overall mortality while on waiting list in Italy reached 10%, whereas only 39% of the wait-list patients were successfully transplanted. A number of approaches, including protective ventilatory strategy, accurate management of fluid balance, and administration of a hormonal resuscitation therapy, have been reported to improve lung donor performance before organ retrieval. These approaches, in conjunction with the use of ex-vivo lung perfusion technique contributed to expand the lung donor pool, without affecting the harvest of other organs and the outcomes of lung recipients. However, the efficacy of issues related to the ex-vivo lung perfusion technique, such as the optimal ventilation strategy, the ischemia-reperfusion induced lung injury management, the prophylaxis of germs transmission from donor to recipient and the application of targeted pharmacologic therapies to treat specific donor lung injuries are still to be explored. The main objective of the present review is to summarize the "state-of-art" strategies to optimize the donor lungs and to present the actual role of ex-vivo lung perfusion in the process of lung transplant. Moreover, different approaches about the technique reported in literature and several issues that are under investigation to treat specific donor lung injury will be discussed.
Threat and error management for anesthesiologists: a predictive risk taxonomy
Ruskin, Keith J.; Stiegler, Marjorie P.; Park, Kellie; Guffey, Patrick; Kurup, Viji; Chidester, Thomas
2015-01-01
Purpose of review Patient care in the operating room is a dynamic interaction that requires cooperation among team members and reliance upon sophisticated technology. Most human factors research in medicine has been focused on analyzing errors and implementing system-wide changes to prevent them from recurring. We describe a set of techniques that has been used successfully by the aviation industry to analyze errors and adverse events and explain how these techniques can be applied to patient care. Recent findings Threat and error management (TEM) describes adverse events in terms of risks or challenges that are present in an operational environment (threats) and the actions of specific personnel that potentiate or exacerbate those threats (errors). TEM is a technique widely used in aviation, and can be adapted for the use in a medical setting to predict high-risk situations and prevent errors in the perioperative period. A threat taxonomy is a novel way of classifying and predicting the hazards that can occur in the operating room. TEM can be used to identify error-producing situations, analyze adverse events, and design training scenarios. Summary TEM offers a multifaceted strategy for identifying hazards, reducing errors, and training physicians. A threat taxonomy may improve analysis of critical events with subsequent development of specific interventions, and may also serve as a framework for training programs in risk mitigation. PMID:24113268
Hudak, R P; Brooke, P P; Finstuen, K
2000-01-01
This analysis reviews a selected body of research that identifies the essential areas of management expertise required of future health care executives. To ensure consistency, six studies are analyzed, utilizing the Delphi technique, to query a broad spectrum of experts in different fields and sites of health care management. The analysis identifies a number of management competencies, i.e., managerial capabilities, which current and aspiring health care executives, in various settings and with differing educational backgrounds, should possess to enhance the probability of their success in current and future positions of responsibility. In addition, this review identifies the skills (technical expertise), knowledge (facts and principles) and abilities (physical, mental or legal power) required to support achievement of these competencies. Leadership and resource management, including cost and finance dimensions, are the highest-rated requisite management competencies. The dominant skills, knowledge and abilities (SKAs) are related to interpersonal skills. The lowest-rated SKAs are related to job-specific, technical skills. Recommendations include the review of this research by formal and continuing education programs to determine the content of their courses and areas for future research. Similarly, current health care executives should assess this research to assist in identifying competency gaps. Lastly, this analysis recommends that the Delphi technique, as a valid and replicable methodology, be applied toward the study of non-executive health care managers, e.g., students, clinicians, mid-level managers and integrated systems administrators, to determine their requisite management competencies and SKAs.
The Application of Modeling and Simulation in Capacity Management within the ITIL Framework
NASA Technical Reports Server (NTRS)
Rahmani, Sonya; vonderHoff, Otto
2010-01-01
Tightly integrating modeling and simulation techniques into Information Technology Infrastructure Library (ITIL) practices can be one of the driving factors behind a successful and cost-effective capacity management effort for any Information Technology (IT) system. ITIL is a best practices framework for managing IT infrastructure, development and operations. Translating ITIL theory into operational reality can be a challenge. This paper aims to highlight how to best integrate modeling and simulation into an ITIL implementation. For cases where the project team initially has difficulty gaining consensus on investing in modeling and simulation resources, a clear definition for M&S implementation into the ITIL framework, specifically its role in supporting Capacity Management, is critical to gaining the support required to garner these resources. This implementation should also help to clearly define M&S support to the overall system mission. This paper will describe the development of an integrated modeling approach and how best to tie M&S to definitive goals for evaluating system capacity and performance requirements. Specifically the paper will discuss best practices for implementing modeling and simulation into ITIL. These practices hinge on implementing integrated M&S methods that 1) encompass at least two or more predictive modeling techniques, 2) complement each one's respective strengths and weaknesses to support the validation of predicted results, and 3) are tied to the system's performance and workload monitoring efforts. How to structure two forms of modeling: statistical and simUlation in the development of "As Is" and "To Be" efforts will be used to exemplify the integrated M&S methods. The paper will show how these methods can better support the project's overall capacity management efforts.
Wilk, Szymon; Kezadri-Hamiaz, Mounira; Rosu, Daniela; Kuziemsky, Craig; Michalowski, Wojtek; Amyot, Daniel; Carrier, Marc
2016-02-01
In healthcare organizations, clinical workflows are executed by interdisciplinary healthcare teams (IHTs) that operate in ways that are difficult to manage. Responding to a need to support such teams, we designed and developed the MET4 multi-agent system that allows IHTs to manage patients according to presentation-specific clinical workflows. In this paper, we describe a significant extension of the MET4 system that allows for supporting rich team dynamics (understood as team formation, management and task-practitioner allocation), including selection and maintenance of the most responsible physician and more complex rules of selecting practitioners for the workflow tasks. In order to develop this extension, we introduced three semantic components: (1) a revised ontology describing concepts and relations pertinent to IHTs, workflows, and managed patients, (2) a set of behavioral rules describing the team dynamics, and (3) an instance base that stores facts corresponding to instances of concepts from the ontology and to relations between these instances. The semantic components are represented in first-order logic and they can be automatically processed using theorem proving and model finding techniques. We employ these techniques to find models that correspond to specific decisions controlling the dynamics of IHT. In the paper, we present the design of extended MET4 with a special focus on the new semantic components. We then describe its proof-of-concept implementation using the WADE multi-agent platform and the Z3 solver (theorem prover/model finder). We illustrate the main ideas discussed in the paper with a clinical scenario of an IHT managing a patient with chronic kidney disease.
NASA Technical Reports Server (NTRS)
Spruce, Joe
2001-01-01
Yellowstone National Park (YNP) contains a diversity of land cover. YNP managers need site-specific land cover maps, which may be produced more effectively using high-resolution hyperspectral imagery. ISODATA clustering techniques have aided operational multispectral image classification and may benefit certain hyperspectral data applications if optimally applied. In response, a study was performed for an area in northeast YNP using 11 select bands of low-altitude AVIRIS data calibrated to ground reflectance. These data were subjected to ISODATA clustering and Maximum Likelihood Classification techniques to produce a moderately detailed land cover map. The latter has good apparent overall agreement with field surveys and aerial photo interpretation.
Sastre, Sergi; Dada, Michelle; Santos, Simon; Lozano, Lluis; Alemany, Xavier; Peidro, Lluis
2015-03-01
The objective of this manuscript is to show an effective, easier and cheaper way to reduce acute acromioclavicular (AC) dislocation type III and V (Rockwood classification). Numerous procedures have been described for surgical management of acromioclavicular joint disruption. Newest devices involve an arthroscopic technique that allows nonrigid anatomic fixation of the acromioclavicular joint. Arthroscopically assisted treatment of acute AC joint dislocation is advantageous because it provides good clinical results and few complications. It also allows reviewing glenohumeral associated lesions. This surgical technique requires no specific implants to achieve a correct AC reduction. Actually, economical advantages are very important factors to decide the use of determinate surgical techniques.
Management and endoscopic techniques for digestive foreign body and food bolus impaction.
Chauvin, Armelle; Viala, Jerome; Marteau, Philippe; Hermann, Philippe; Dray, Xavier
2013-07-01
Ingested foreign bodies, food bolus impaction, migration or retention of medical devices are frequent, in children as well as in adults. Most of these foreign bodies will naturally pass through the gastro-intestinal tract. Complications are rare but sometimes severe (oesophageal perforations are the most frequent and most feared). We aimed to review the literature on therapeutic management of digestive foreign bodies and food bolus impaction, with special focus on endoscopic indications, material, timing and techniques for removal. The role of the gastroenterologist is to recognise specific situations and to plan endoscopic removal in a timely manner with the most adequate conditions and extraction tools. Risk factors and underlying pathology, for example eosinophilic esophagitis, must be investigated and if necessary treated. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Manipulation of P2X Receptor Activities by Light Stimulation.
Kim, Sang Seong
2016-01-01
P2X receptors are involved in amplification of inflammatory responses in peripheral nociceptive fibers and in mediating pain-related signals to the CNS. Control of P2X activation has significant importance in managing unwanted hypersensitive neuron responses. To overcome the limitations of chemical ligand treatment, optical stimulation methods of optogenetics and photoswitching achieve efficient control of P2X activation while allowing specificity at the target site and convenient stimulation by light illumination. There are many potential applications for photosensitive elements, such as improved uncaging methods, photoisomerizable ligands, photoswitches, and gold nanoparticles. Each technique has both advantages and downsides, and techniques are selected according to the purpose of the application. Technical advances not only provide novel approaches to manage inflammation or pain mediated by P2X receptors but also suggest a similar approach for controlling other ion channels.
Oliver, Kelly; Manton, David John
2015-01-01
Effective behavior management guides children through the complex social context of dentistry utilizing techniques based on a current understanding of the social, emotional, and cognitive development of children. Behavior management techniques facilitate effective communication and establish social and behavioral guidelines for the dental environment. Contemporary parenting styles, expectations, and attitudes of modern parents and society have influenced the use of behavior management techniques with a prevailing emphasis on communicative techniques and pharmacological management over aversive techniques.
Latest recanalization techniques for complex superficial femoral artery occlusions.
Gonzalez, L; Chen, A; Lin, P H; Pisimisis, G; Barshes, N R; Bechara, C F; Kougias, P
2012-08-01
Complex, long segment lesions of the superficial femoral artery (SFA) are common, occurring in 40% of patients with peripheral vascular disease. In particular, chronic total occlusions (CTOs) continue to pose a challenge in the endovascular management of SFA disease. Several conventional wire and catheter based techniques have been described including subintimal recanalization and retrograde techniques. In addition, advances in endovascular technology have led to the development of a series of new devices aimed specifically at facilitating the crossing of long segment SFA occlusions or establishing re-entry of the true lumen. Here we present an overview of the minimally invasive techniques used to recanalize CTOs of the SFA and the latest specialized devices available for both recanalization and re-entry, as well as a summary of the literature supporting their application.
Cao, Luong Dong; Ishiwada, Naruhiko; Takeda, Nobue; Nigo, Yukiko; Aizawa, Jirou; Kuroki, Haruo; Kohno, Yoichi
2004-02-01
To date, the technique of washed sputum examinations has not been widely used in the clinical management of lower respiratory tract infections in children. A total of 224 sputum samples from 125 pediatric patients with lower respiratory tract infections were collected for washed sputum Gram stain smears and cultures. The results with these methods were compared to find correlation rates. The value of washed sputum cultures was assessed by examining the clinical responses of the patients who received antibiotic therapies instituted on the basis of the sputum culture results. Isolation rates of Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, and Staphylococcus aureus were 22.4%, 9.4%, 4.9%, and 0.4%, respectively. For the prediction of H. influenzae, S. pneumoniae, and M. catarrhalis, the sensitivities of the washed sputum Gram stain smears compared with the culture method were 86.0%, 81.0%, and 90.9%, respectively. The specificities of the washed sputum Gram stain smear technique were 94.8%, 97.5%, and 98.1%, respectively. Overall, the sensitivity and specificity of the washed sputum Gram stain smear method were 85.5% and 87.2%, respectively. S. aureus was isolated from only one specimen; and washed sputum Gram stain smear estimation was correlated with the culture result. On the basis of the washed sputum culture results, appropriate antibiotic therapies were instituted for 93.3% of the patients with acute lower respiratory tract infections. This study suggests that the techniques of washed sputum Gram stain smear and culture are valuable and should be encouraged in clinical practice for the management of lower respiratory tract infections in children.
Gianassi, S; Bisin, S; Bindi, B; Spitaleri, I; Bambi, F
2010-01-01
The collection and handling of hematopoietic stem cells (HSCs) must meet high quality requirements. An integrated Quality Risk Management can help to identify and contain potential risks related to HSC production. Risk analysis techniques allow one to "weigh" identified hazards, considering the seriousness of their effects, frequency, and detectability, seeking to prevent the most harmful hazards. The Hazard Analysis Critical Point, recognized as the most appropriate technique to identify risks associated with physical, chemical, and biological hazards for cellular products, consists of classifying finished product specifications and limits of acceptability, identifying all off-specifications, defining activities that can cause them, and finally establishing both a monitoring system for each Critical Control Point and corrective actions for deviations. The severity of possible effects on patients, as well as the occurrence and detectability of critical parameters, are measured on quantitative scales (Risk Priority Number [RPN]). Risk analysis was performed with this technique on manipulation process of HPC performed at our blood center. The data analysis showed that hazards with higher values of RPN with greater impact on the process are loss of dose and tracking; technical skills of operators and manual transcription of data were the most critical parameters. Problems related to operator skills are handled by defining targeted training programs, while other critical parameters can be mitigated with the use of continuous control systems. The blood center management software was completed by a labeling system with forms designed to be in compliance with standards in force and by starting implementation of a cryopreservation management module. Copyright 2010 Elsevier Inc. All rights reserved.
Data mining to support simulation modeling of patient flow in hospitals.
Isken, Mark W; Rajagopalan, Balaji
2002-04-01
Spiraling health care costs in the United States are driving institutions to continually address the challenge of optimizing the use of scarce resources. One of the first steps towards optimizing resources is to utilize capacity effectively. For hospital capacity planning problems such as allocation of inpatient beds, computer simulation is often the method of choice. One of the more difficult aspects of using simulation models for such studies is the creation of a manageable set of patient types to include in the model. The objective of this paper is to demonstrate the potential of using data mining techniques, specifically clustering techniques such as K-means, to help guide the development of patient type definitions for purposes of building computer simulation or analytical models of patient flow in hospitals. Using data from a hospital in the Midwest this study brings forth several important issues that researchers need to address when applying clustering techniques in general and specifically to hospital data.
Extending the durability of cultivar resistance by limiting epidemic growth rates.
Carolan, Kevin; Helps, Joe; van den Berg, Femke; Bain, Ruairidh; Paveley, Neil; van den Bosch, Frank
2017-09-27
Cultivar resistance is an essential part of disease control programmes in many agricultural systems. The use of resistant cultivars applies a selection pressure on pathogen populations for the evolution of virulence, resulting in loss of disease control. Various techniques for the deployment of host resistance genes have been proposed to reduce the selection for virulence, but these are often difficult to apply in practice. We present a general technique to maintain the effectiveness of cultivar resistance. Derived from classical population genetics theory; any factor that reduces the population growth rates of both the virulent and avirulent strains will reduce selection. We model the specific example of fungicide application to reduce the growth rates of virulent and avirulent strains of a pathogen, demonstrating that appropriate use of fungicides reduces selection for virulence, prolonging cultivar resistance. This specific example of chemical control illustrates a general principle for the development of techniques to manage the evolution of virulence by slowing epidemic growth rates. © 2017 The Author(s).
Assessing the quality of cost management
DOE Office of Scientific and Technical Information (OSTI.GOV)
Fayne, V.; McAllister, A.; Weiner, S.B.
1995-12-31
Managing environmental programs can be effective only when good cost and cost-related management practices are developed and implemented. The Department of Energy`s Office of Environmental Management (EM), recognizing this key role of cost management, initiated several cost and cost-related management activities including the Cost Quality Management (CQM) Program. The CQM Program includes an assessment activity, Cost Quality Management Assessments (CQMAs), and a technical assistance effort to improve program/project cost effectiveness. CQMAs provide a tool for establishing a baseline of cost-management practices and for measuring improvement in those practices. The result of the CQMA program is an organization that has anmore » increasing cost-consciousness, improved cost-management skills and abilities, and a commitment to respond to the public`s concerns for both a safe environment and prudent budget outlays. The CQMA program is part of the foundation of quality management practices in DOE. The CQMA process has contributed to better cost and cost-related management practices by providing measurements and feedback; defining the components of a quality cost-management system; and helping sites develop/improve specific cost-management techniques and methods.« less
Summary of Results from the Risk Management Program for the Mars Microrover Flight Experiment
NASA Technical Reports Server (NTRS)
Shishko, Robert; Matijevic, Jacob R.
2000-01-01
On 4 July 1997, the Mars Pathfinder landed on the surface of Mars carrying the first planetary rover, known as the Sojourner. Formally known as the Microrover Flight Experiment (MFEX), the Sojourner was a low cost, high-risk technology demonstration, in which new risk management techniques were tried. This paper summarizes the activities and results of the effort to conduct a low-cost, yet meaningful risk management program for the MFEX. The specific activities focused on cost, performance, schedule, and operations risks. Just as the systems engineering process was iterative and produced successive refinements of requirements, designs, etc., so was the risk management process. Qualitative risk assessments were performed first to gain some insights for refining the microrover design and operations concept. These then evolved into more quantitative analyses. Risk management lessons from the manager's perspective is presented for other low-cost, high-risk space missions.
Data warehousing in disease management programs.
Ramick, D C
2001-01-01
Disease management programs offer the benefits of lower disease occurrence, improved patient care, and lower healthcare costs. In such programs, the key mechanism used to identify individuals at risk for targeted diseases is the data warehouse. This article surveys recent warehousing techniques from HMOs to map out critical issues relating to the preparation, design, and implementation of a successful data warehouse. Discussions of scope, data cleansing, and storage management are included in depicting warehouse preparation and design; data implementation options are contrasted. Examples are provided of data warehouse execution in disease management programs that identify members with preexisting illnesses, as well as those exhibiting high-risk conditions. The proper deployment of successful data warehouses in disease management programs benefits both the organization and the member. Organizations benefit from decreased medical costs; members benefit through an improved quality of life through disease-specific care.
The current management of carotid atherosclerotic disease: who, when and how?
Ritter, Jens C.; Tyrrell, Mark R.
2013-01-01
Ischaemic stroke represents a major health hazard in the western world, which has a severe impact on society and the health-care system. Roughly, 10% of all first ischaemic strokes can be attributed to significant atherosclerotic disease of the carotid arteries. Correct management of these lesions is essential in the prevention and treatment of carotid disease-related ischaemic events. The close relationship between diagnosis and medical and surgical management makes it necessary that all involved physicians and surgeons have profound knowledge of management strategies beyond their specific speciality. Continuous improvement in pharmacological therapy and operative techniques as well as frequently changing guidelines represent a constant challenge for the individual health-care professional. This review gives a thorough outline of the up-to-date evidence-based management of carotid artery disease and discusses its current controversies. PMID:23197661
Fast tracking the design of theory-based KT interventions through a consensus process.
Bussières, André E; Al Zoubi, Fadi; Quon, Jeffrey A; Ahmed, Sara; Thomas, Aliki; Stuber, Kent; Sajko, Sandy; French, Simon
2015-02-11
Despite available evidence for optimal management of spinal pain, poor adherence to guidelines and wide variations in healthcare services persist. One of the objectives of the Canadian Chiropractic Guideline Initiative is to develop and evaluate targeted theory- and evidence-informed interventions to improve the management of non-specific neck pain by chiropractors. In order to systematically develop a knowledge translation (KT) intervention underpinned by the Theoretical Domains Framework (TDF), we explored the factors perceived to influence the use of multimodal care to manage non-specific neck pain, and mapped behaviour change techniques to key theoretical domains. Individual telephone interviews exploring beliefs about managing neck pain were conducted with a purposive sample of 13 chiropractors. The interview guide was based upon the TDF. Interviews were digitally recorded, transcribed verbatim and analysed by two independent assessors using thematic content analysis. A 15-member expert panel formally met to design a KT intervention. Nine TDF domains were identified as likely relevant. Key beliefs (and relevant domains of the TDF) included the following: influence of formal training, colleagues and patients on clinicians (Social Influences); availability of educational material (Environmental Context and Resources); and better clinical outcomes reinforcing the use of multimodal care (Reinforcement). Facilitating factors considered important included better communication (Skills); audits of patients' treatment-related outcomes (Behavioural Regulation); awareness and agreement with guidelines (Knowledge); and tailoring of multimodal care (Memory, Attention and Decision Processes). Clinicians conveyed conflicting beliefs about perceived threats to professional autonomy (Social/Professional Role and Identity) and speed of recovery from either applying or ignoring the practice recommendations (Beliefs about Consequences). The expert panel mapped behaviour change techniques to key theoretical domains and identified relevant KT strategies and modes of delivery to increase the use of multimodal care among chiropractors. A multifaceted KT educational intervention targeting chiropractors' management of neck pain was developed. The KT intervention consisted of an online education webinar series, clinical vignettes and a video underpinned by the Brief Action Planning model. The intervention was designed to reflect key theoretical domains, behaviour change techniques and intervention components. The effectiveness of the proposed intervention remains to be tested.
PD_Manager: an mHealth platform for Parkinson's disease patient management.
Tsiouris, Kostas M; Gatsios, Dimitrios; Rigas, George; Miljkovic, Dragana; Koroušić Seljak, Barbara; Bohanec, Marko; Arredondo, Maria T; Antonini, Angelo; Konitsiotis, Spyros; Koutsouris, Dimitrios D; Fotiadis, Dimitrios I
2017-06-01
PD_Manager is a mobile health platform designed to cover most of the aspects regarding the management of Parkinson's disease (PD) in a holistic approach. Patients are unobtrusively monitored using commercial wrist and insole sensors paired with a smartphone, to automatically estimate the severity of most of the PD motor symptoms. Besides motor symptoms monitoring, the patient's mobile application also provides various non-motor self-evaluation tests for assessing cognition, mood and nutrition to motivate them in becoming more active in managing their disease. All data from the mobile application and the sensors is transferred to a cloud infrastructure to allow easy access for clinicians and further processing. Clinicians can access this information using a separate mobile application that is specifically designed for their respective needs to provide faster and more accurate assessment of PD symptoms that facilitate patient evaluation. Machine learning techniques are used to estimate symptoms and disease progression trends to further enhance the provided information. The platform is also complemented with a decision support system (DSS) that notifies clinicians for the detection of new symptoms or the worsening of existing ones. As patient's symptoms are progressing, the DSS can also provide specific suggestions regarding appropriate medication changes.
PD_Manager: an mHealth platform for Parkinson's disease patient management
Gatsios, Dimitrios; Rigas, George; Miljkovic, Dragana; Koroušić Seljak, Barbara; Bohanec, Marko; Arredondo, Maria T.; Antonini, Angelo; Konitsiotis, Spyros; Koutsouris, Dimitrios D.
2017-01-01
PD_Manager is a mobile health platform designed to cover most of the aspects regarding the management of Parkinson's disease (PD) in a holistic approach. Patients are unobtrusively monitored using commercial wrist and insole sensors paired with a smartphone, to automatically estimate the severity of most of the PD motor symptoms. Besides motor symptoms monitoring, the patient's mobile application also provides various non-motor self-evaluation tests for assessing cognition, mood and nutrition to motivate them in becoming more active in managing their disease. All data from the mobile application and the sensors is transferred to a cloud infrastructure to allow easy access for clinicians and further processing. Clinicians can access this information using a separate mobile application that is specifically designed for their respective needs to provide faster and more accurate assessment of PD symptoms that facilitate patient evaluation. Machine learning techniques are used to estimate symptoms and disease progression trends to further enhance the provided information. The platform is also complemented with a decision support system (DSS) that notifies clinicians for the detection of new symptoms or the worsening of existing ones. As patient's symptoms are progressing, the DSS can also provide specific suggestions regarding appropriate medication changes. PMID:28706727
Management of Cavoatrial Deep Venous Thrombosis: Incorporating New Strategies
Zayed, Mohamed A.; De Silva, Gayan S.; Ramaswamy, Raja S.; Sanchez, Luis A.
2017-01-01
Cavoatrial deep venous thrombosis (DVT) is diagnosed with increasing prevalence. It can be managed medically with anticoagulation or with directed interventions aimed to efficiently reduce the thrombus burden within the target venous segment. The type of management chosen depends greatly on the etiology and chronicity of the thrombosis, existing patient comorbidities, and the patient's tolerance to anticoagulants and thrombolytic agents. In addition to traditional percutaneous catheter-based pharmacomechanical thrombolysis, other catheter-based suction thrombectomy techniques have emerged in recent years. Each therapeutic modality requires operator expertise and a coordinated care paradigm to facilitate successful outcomes. Open surgical thrombectomy is alternatively reserved for specific patient conditions, including intolerance of anticoagulation, failed catheter-based interventions, or acute emergencies. PMID:28265127
Special report writer: A flexible information management system. Documentation and user's manual
NASA Technical Reports Server (NTRS)
Greene, W. A.
1976-01-01
A special report writer (SSR) was developed which performs multiple correlations on files containing several data hierarchies. Output reports are specified in a simple notation, readily learned by persons having limited familarity with ADP. The SRR system can be adopted by other NASA installations while the basic techniques themselves are compatible with the information management needs of a wide range of organizations. Specifically, the program lends itself to generalization and can be readily adapted for other file management purposes. Extensive details on the characteristics of the SRR program are presented along with a full explanation of the system for those contemplating its application to other data bases. The complete COBOL program and documentation are available.
An insight into burns in a developing country: a Sri Lankan experience.
Lau, Y S
2006-10-01
Burn injuries represent a diverse and varied challenge to medical and paramedical staff. The management of burns and their sequelae in a well-equipped, modern burns unit remains demanding despite advances in surgical techniques and development of tissue-engineered biomaterials; in a developing country, these difficulties are amplified many times. Sri Lanka has a high incidence of burn-related injuries annually due to a combination of adverse social, economic and cultural factors. The management of burn injuries remains a formidable public health problem. The epidemiology of burns, challenges faced in their management and effective strategies specific to Sri Lanka, such as the Safe Bottle Lamp campaign, are highlighted in this paper.
Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-26
... the current wetland and goose management techniques which include: Invasive species management, trash... techniques. Proposed extensive wetland restoration opportunities could include: Managing invasive species.... Some of the wetland management techniques could include managing invasive species and [[Page 44605...
Pulmonary nodule characterization, including computer analysis and quantitative features.
Bartholmai, Brian J; Koo, Chi Wan; Johnson, Geoffrey B; White, Darin B; Raghunath, Sushravya M; Rajagopalan, Srinivasan; Moynagh, Michael R; Lindell, Rebecca M; Hartman, Thomas E
2015-03-01
Pulmonary nodules are commonly detected in computed tomography (CT) chest screening of a high-risk population. The specific visual or quantitative features on CT or other modalities can be used to characterize the likelihood that a nodule is benign or malignant. Visual features on CT such as size, attenuation, location, morphology, edge characteristics, and other distinctive "signs" can be highly suggestive of a specific diagnosis and, in general, be used to determine the probability that a specific nodule is benign or malignant. Change in size, attenuation, and morphology on serial follow-up CT, or features on other modalities such as nuclear medicine studies or MRI, can also contribute to the characterization of lung nodules. Imaging analytics can objectively and reproducibly quantify nodule features on CT, nuclear medicine, and magnetic resonance imaging. Some quantitative techniques show great promise in helping to differentiate benign from malignant lesions or to stratify the risk of aggressive versus indolent neoplasm. In this article, we (1) summarize the visual characteristics, descriptors, and signs that may be helpful in management of nodules identified on screening CT, (2) discuss current quantitative and multimodality techniques that aid in the differentiation of nodules, and (3) highlight the power, pitfalls, and limitations of these various techniques.
Montuno, Michael A; Kohner, Andrew B; Foote, Kelly D; Okun, Michael S
2013-01-01
Deep brain stimulation (DBS) is an effective technique that has been utilized to treat advanced and medication-refractory movement and psychiatric disorders. In order to avoid implanted pulse generator (IPG) failure and consequent adverse symptoms, a better understanding of IPG battery longevity and management is necessary. Existing methods for battery estimation lack the specificity required for clinical incorporation. Technical challenges prevent higher accuracy longevity estimations, and a better approach to managing end of DBS battery life is needed. The literature was reviewed and DBS battery estimators were constructed by the authors and made available on the web at http://mdc.mbi.ufl.edu/surgery/dbs-battery-estimator. A clinical algorithm for management of DBS battery life was constructed. The algorithm takes into account battery estimations and clinical symptoms. Existing methods of DBS battery life estimation utilize an interpolation of averaged current drains to calculate how long a battery will last. Unfortunately, this technique can only provide general approximations. There are inherent errors in this technique, and these errors compound with each iteration of the battery estimation. Some of these errors cannot be accounted for in the estimation process, and some of the errors stem from device variation, battery voltage dependence, battery usage, battery chemistry, impedance fluctuations, interpolation error, usage patterns, and self-discharge. We present web-based battery estimators along with an algorithm for clinical management. We discuss the perils of using a battery estimator without taking into account the clinical picture. Future work will be needed to provide more reliable management of implanted device batteries; however, implementation of a clinical algorithm that accounts for both estimated battery life and for patient symptoms should improve the care of DBS patients. © 2012 International Neuromodulation Society.
Contemporary management of frontal sinus mucoceles: a meta-analysis.
Courson, Andy M; Stankiewicz, James A; Lal, Devyani
2014-02-01
To analyze trends in the surgical management of frontal and fronto-ethmoid mucoceles through meta-analysis. Meta-analysis and case series. A systematic literature review on surgical management of frontal and fronto-ethmoid mucoceles was conducted. Studies were divided into historical (1975-2001) and contemporary (2002-2012) groups. A meta-analysis of these studies was performed. The historical and contemporary cohorts were compared (surgical approach, recurrence, and complications). To study evolution in surgical management, a senior surgeon's experience over 28 years was analyzed separately. Thirty-one studies were included for meta-analysis. The historical cohort included 425 mucoceles from 11 studies. The contemporary cohort included 542 mucoceles from 20 studies. More endoscopic techniques were used in the contemporary versus historical cohort (53.9% vs. 24.7%; P = <0.001). In the authors' series, a higher percentage was treated endoscopically (82.8% of 122 mucoceles). Recurrence (P = 0.20) and major complication (P = 0.23) rates were similar between cohorts. Minor complication rates were superior for endoscopic techniques in both cohorts (P = 0.02 historical; P = <0.001 contemporary). In the historical cohort, higher recurrence was noted in the external group (P = 0.03). Results from endoscopic and open approaches are comparable. Although endoscopic techniques are being increasingly adopted, comparison with our series shows that more cases could potentially be treated endoscopically. Frequent use of open approaches may reflect efficacy, or perhaps lack of expertise and equipment required for endoscopic management. Most contemporary authors favor endoscopic management, limiting open approaches for specific indications (unfavorable anatomy, lateral disease, and scarring). N/A. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Carleton B. Edminster; C. Phillip Weatherspoon; Daniel G. Neary
2000-01-01
As part of the 1998 Joint USDA/USDI Fire Science Program, the Fire and Fire Surrogates Study was proposed to establish and evaluate cross-comparisons of fuels treatment practices and techniques to reduce wildfire risk. This study evaluates prescribed fire, thinning, and various mechanical treatment methods for treating, removing, or using woody biomass. Site-specific...
Break-even zones for cable yarding by log size
Chris B. LeDoux
1984-01-01
The use of cable logging to extract small pieces of residue wood may result in low rates of production and a high cost per unit of wood produced. However, the logging manager can improve yarding productivity and break-even in cable residue removal operations by using the proper planning techniques. In this study, break-even zones for specific young-growth stands were...
Analytical Micromechanics Modeling Technique Developed for Ceramic Matrix Composites Analysis
NASA Technical Reports Server (NTRS)
Min, James B.
2005-01-01
Ceramic matrix composites (CMCs) promise many advantages for next-generation aerospace propulsion systems. Specifically, carbon-reinforced silicon carbide (C/SiC) CMCs enable higher operational temperatures and provide potential component weight savings by virtue of their high specific strength. These attributes may provide systemwide benefits. Higher operating temperatures lessen or eliminate the need for cooling, thereby reducing both fuel consumption and the complex hardware and plumbing required for heat management. This, in turn, lowers system weight, size, and complexity, while improving efficiency, reliability, and service life, resulting in overall lower operating costs.
Limitations associated with managing chronic low back pain.
Beland, Paul
2016-04-20
Non-specific chronic low back pain is an occupational hazard for nurses. It may result in persistent and disabling pain for some people. There are many techniques for investigating, assessing and treating chronic low back pain. However, research to support some of these interventions and the assumptions that underlie them is limited. Interventions that may be beneficial are not always available to those who need them. Changes to service provision are required to rectify this situation and provide effective treatment for patients with non-specific chronic low back pain.
The development of advanced manufacturing systems
NASA Astrophysics Data System (ADS)
Doumeingts, Guy; Vallespir, Bruno; Darricau, Didier; Roboam, Michel
Various methods for the design of advanced manufacturing systems (AMSs) are reviewed. The specifications for AMSs and problems inherent in their development are first discussed. Three models, the Computer Aided Manufacturing-International model, the National Bureau of Standards model, and the GRAI model, are considered in detail. Hierarchical modeling tools such as structured analysis and design techniques, Petri nets, and the Icam definition method are used in the development of integrated manufacturing models. Finally, the GRAI method is demonstrated in the design of specifications for the production management system of the Snecma AMS.
Peña, Adolfo; Estrada, Carlos A; Soniat, Debbie; Taylor, Benjamin; Burton, Michael
2012-01-01
Pain management in hospitalized patients remains a priority area for improvement; effective strategies for consensus development are needed to prioritize interventions. To identify challenges, barriers, and perspectives of healthcare providers in managing pain among hospitalized patients. Qualitative and quantitative group consensus using a brainstorming technique for quality improvement-the nominal group technique (NGT). One medical, 1 medical-surgical, and 1 surgical hospital unit at a large academic medical center. Nurses, resident physicians, patient care technicians, and unit clerks. Responses and ranking to the NGT question: "What causes uncontrolled pain in your unit?" Twenty-seven health workers generated a total of 94 ideas. The ideas perceived contributing to a suboptimal pain control were grouped as system factors (timeliness, n = 18 ideas; communication, n = 11; pain assessment, n = 8), human factors (knowledge and experience, n = 16; provider bias, n = 8; patient factors, n = 19), and interface of system and human factors (standardization, n = 14). Knowledge, timeliness, provider bias, and patient factors were the top ranked themes. Knowledge and timeliness are considered main priorities to improve pain control. NGT is an efficient tool for identifying general and context-specific priority areas for quality improvement; teams of healthcare providers should consider using NGT to address their own challenges and barriers. Copyright © 2011 Society of Hospital Medicine.
WE-G-BRC-02: Risk Assessment for HDR Brachytherapy
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mayadev, J.
2016-06-15
Failure Mode and Effects Analysis (FMEA) originated as an industrial engineering technique used for risk management and safety improvement of complex processes. In the context of radiotherapy, the AAPM Task Group 100 advocates FMEA as the framework of choice for establishing clinical quality management protocols. However, there is concern that widespread adoption of FMEA in radiation oncology will be hampered by the perception that implementation of the tool will have a steep learning curve, be extremely time consuming and labor intensive, and require additional resources. To overcome these preconceptions and facilitate the introduction of the tool into clinical practice, themore » medical physics community must be educated in the use of this tool and the ease in which it can be implemented. Organizations with experience in FMEA should share their knowledge with others in order to increase the implementation, effectiveness and productivity of the tool. This session will include a brief, general introduction to FMEA followed by a focus on practical aspects of implementing FMEA for specific clinical procedures including HDR brachytherapy, physics plan review and radiosurgery. A description of common equipment and devices used in these procedures and how to characterize new devices for safe use in patient treatments will be presented. This will be followed by a discussion of how to customize FMEA techniques and templates to one’s own clinic. Finally, cases of common failure modes for specific procedures (described previously) will be shown and recommended intervention methodologies and outcomes reviewed. Learning Objectives: Understand the general concept of failure mode and effect analysis Learn how to characterize new equipment for safety Be able to identify potential failure modes for specific procedures and learn mitigation techniques Be able to customize FMEA examples and templates for use in any clinic.« less
WE-G-BRC-01: Risk Assessment for Radiosurgery
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kim, G.
2016-06-15
Failure Mode and Effects Analysis (FMEA) originated as an industrial engineering technique used for risk management and safety improvement of complex processes. In the context of radiotherapy, the AAPM Task Group 100 advocates FMEA as the framework of choice for establishing clinical quality management protocols. However, there is concern that widespread adoption of FMEA in radiation oncology will be hampered by the perception that implementation of the tool will have a steep learning curve, be extremely time consuming and labor intensive, and require additional resources. To overcome these preconceptions and facilitate the introduction of the tool into clinical practice, themore » medical physics community must be educated in the use of this tool and the ease in which it can be implemented. Organizations with experience in FMEA should share their knowledge with others in order to increase the implementation, effectiveness and productivity of the tool. This session will include a brief, general introduction to FMEA followed by a focus on practical aspects of implementing FMEA for specific clinical procedures including HDR brachytherapy, physics plan review and radiosurgery. A description of common equipment and devices used in these procedures and how to characterize new devices for safe use in patient treatments will be presented. This will be followed by a discussion of how to customize FMEA techniques and templates to one’s own clinic. Finally, cases of common failure modes for specific procedures (described previously) will be shown and recommended intervention methodologies and outcomes reviewed. Learning Objectives: Understand the general concept of failure mode and effect analysis Learn how to characterize new equipment for safety Be able to identify potential failure modes for specific procedures and learn mitigation techniques Be able to customize FMEA examples and templates for use in any clinic.« less
WE-G-BRC-03: Risk Assessment for Physics Plan Review
DOE Office of Scientific and Technical Information (OSTI.GOV)
Parker, S.
2016-06-15
Failure Mode and Effects Analysis (FMEA) originated as an industrial engineering technique used for risk management and safety improvement of complex processes. In the context of radiotherapy, the AAPM Task Group 100 advocates FMEA as the framework of choice for establishing clinical quality management protocols. However, there is concern that widespread adoption of FMEA in radiation oncology will be hampered by the perception that implementation of the tool will have a steep learning curve, be extremely time consuming and labor intensive, and require additional resources. To overcome these preconceptions and facilitate the introduction of the tool into clinical practice, themore » medical physics community must be educated in the use of this tool and the ease in which it can be implemented. Organizations with experience in FMEA should share their knowledge with others in order to increase the implementation, effectiveness and productivity of the tool. This session will include a brief, general introduction to FMEA followed by a focus on practical aspects of implementing FMEA for specific clinical procedures including HDR brachytherapy, physics plan review and radiosurgery. A description of common equipment and devices used in these procedures and how to characterize new devices for safe use in patient treatments will be presented. This will be followed by a discussion of how to customize FMEA techniques and templates to one’s own clinic. Finally, cases of common failure modes for specific procedures (described previously) will be shown and recommended intervention methodologies and outcomes reviewed. Learning Objectives: Understand the general concept of failure mode and effect analysis Learn how to characterize new equipment for safety Be able to identify potential failure modes for specific procedures and learn mitigation techniques Be able to customize FMEA examples and templates for use in any clinic.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
Failure Mode and Effects Analysis (FMEA) originated as an industrial engineering technique used for risk management and safety improvement of complex processes. In the context of radiotherapy, the AAPM Task Group 100 advocates FMEA as the framework of choice for establishing clinical quality management protocols. However, there is concern that widespread adoption of FMEA in radiation oncology will be hampered by the perception that implementation of the tool will have a steep learning curve, be extremely time consuming and labor intensive, and require additional resources. To overcome these preconceptions and facilitate the introduction of the tool into clinical practice, themore » medical physics community must be educated in the use of this tool and the ease in which it can be implemented. Organizations with experience in FMEA should share their knowledge with others in order to increase the implementation, effectiveness and productivity of the tool. This session will include a brief, general introduction to FMEA followed by a focus on practical aspects of implementing FMEA for specific clinical procedures including HDR brachytherapy, physics plan review and radiosurgery. A description of common equipment and devices used in these procedures and how to characterize new devices for safe use in patient treatments will be presented. This will be followed by a discussion of how to customize FMEA techniques and templates to one’s own clinic. Finally, cases of common failure modes for specific procedures (described previously) will be shown and recommended intervention methodologies and outcomes reviewed. Learning Objectives: Understand the general concept of failure mode and effect analysis Learn how to characterize new equipment for safety Be able to identify potential failure modes for specific procedures and learn mitigation techniques Be able to customize FMEA examples and templates for use in any clinic.« less
Operationalising uncertainty in data and models for integrated water resources management.
Blind, M W; Refsgaard, J C
2007-01-01
Key sources of uncertainty of importance for water resources management are (1) uncertainty in data; (2) uncertainty related to hydrological models (parameter values, model technique, model structure); and (3) uncertainty related to the context and the framing of the decision-making process. The European funded project 'Harmonised techniques and representative river basin data for assessment and use of uncertainty information in integrated water management (HarmoniRiB)' has resulted in a range of tools and methods to assess such uncertainties, focusing on items (1) and (2). The project also engaged in a number of discussions surrounding uncertainty and risk assessment in support of decision-making in water management. Based on the project's results and experiences, and on the subsequent discussions a number of conclusions can be drawn on the future needs for successful adoption of uncertainty analysis in decision support. These conclusions range from additional scientific research on specific uncertainties, dedicated guidelines for operational use to capacity building at all levels. The purpose of this paper is to elaborate on these conclusions and anchoring them in the broad objective of making uncertainty and risk assessment an essential and natural part in future decision-making processes.
The Case for Case-Mix: A New Construct for Hospital Management
Plomann, Marilyn Peacock; Garzino, Fred R.
1981-01-01
Case-mix is a useful methodology for health care management, planning and control. It provides managers with a powerful tool by providing a framework for relating resource consumption profiles with specific treatment patterns. In the long run, it will assist hospital planners in analyzing the demands which different classes of patients bring to the hospital. Decisions concerning capital financing, facilities planning, new services, and the medical and financial implications of physician activities are more efficiently analyzed within a case-mix framework. In the near term, inventory management, staffing policies and the on-going need for the astute management of cash flow will be postively and decisively affected by the use of case-mix measures. The benefits derived from a case-mix system are not limited to hospitals possessing sophisticated management information systems. The case-mix methodology also provides a useful tool for hospitals with less advanced data processing systems and management practices in applying a variety of management science techniques to their planning and control activities.
Screening_mgmt: a Python module for managing screening data.
Helfenstein, Andreas; Tammela, Päivi
2015-02-01
High-throughput screening is an established technique in drug discovery and, as such, has also found its way into academia. High-throughput screening generates a considerable amount of data, which is why specific software is used for its analysis and management. The commercially available software packages are often beyond the financial limits of small-scale academic laboratories and, furthermore, lack the flexibility to fulfill certain user-specific requirements. We have developed a Python module, screening_mgmt, which is a lightweight tool for flexible data retrieval, analysis, and storage for different screening assays in one central database. The module reads custom-made analysis scripts and plotting instructions, and it offers a graphical user interface to import, modify, and display the data in a uniform manner. During the test phase, we used this module for the management of 10,000 data points of various origins. It has provided a practical, user-friendly tool for sharing and exchanging information between researchers. © 2014 Society for Laboratory Automation and Screening.
Whither managerialism in the Italian National Health Service?
Anessi-Pessina, Eugenio; Cantù, Elena
2006-01-01
In the last decade, the Italian National Health Service has been characterized by the introduction of managerial concepts and techniques, according to the New Public Management paradigm. Recently, these reforms have been increasingly criticized. This article examines the implementation of managerialism in an attempt to evaluate its overall achievements and shortcomings. Overall, managerialism seems to have made good progress: managerial skills are improving; several management tools have been adapted to health-care and public-sector peculiarities; health-care organizations have adopted a wide range of technical solutions to fit their specific needs. At the same time, managerial innovations have often focused on structures as opposed to processes, on the way the organization looks as opposed to the way it works, on the tools it has as opposed to those it actually needs and uses. We thus suggest that research, training and policy-making should stop focusing on the technical features and theoretical virtues of specific tools and should redirect their emphasis on change management.
NASA software documentation standard software engineering program
NASA Technical Reports Server (NTRS)
1991-01-01
The NASA Software Documentation Standard (hereinafter referred to as Standard) can be applied to the documentation of all NASA software. This Standard is limited to documentation format and content requirements. It does not mandate specific management, engineering, or assurance standards or techniques. This Standard defines the format and content of documentation for software acquisition, development, and sustaining engineering. Format requirements address where information shall be recorded and content requirements address what information shall be recorded. This Standard provides a framework to allow consistency of documentation across NASA and visibility into the completeness of project documentation. This basic framework consists of four major sections (or volumes). The Management Plan contains all planning and business aspects of a software project, including engineering and assurance planning. The Product Specification contains all technical engineering information, including software requirements and design. The Assurance and Test Procedures contains all technical assurance information, including Test, Quality Assurance (QA), and Verification and Validation (V&V). The Management, Engineering, and Assurance Reports is the library and/or listing of all project reports.
Manual Therapy: The Historical, Current, and Future Role in the Treatment of Pain
Smith, A. Russell
2007-01-01
Manual therapy has been an approach in the management of patients with various disorders dating back to ancient times and continues to play a significant role in current health care. The future role of manual therapy in health care is an important area of research. This paper reviews the history of manual therapy, examines the current literature related to the use of manual techniques (including manipulation, massage, and nerve manipulation), and discusses future research topics. The literature related to manual therapy has historically been anecdotal and theoretical, and current research tends to have a generic approach with broad definitions of manual therapy and inconsistencies in the classification of specific disorders. Systematic reviews of various types of manual therapy have differed on their conclusions regarding the effectiveness of this treatment modality. The current demand in health care for evidence-based practice necessitates a movement towards more specificity in the research of the effectiveness of manual therapy, with emphasis on specific patient signs and symptoms and specific manual techniques that result in effective care. PMID:17334604
Surgical treatment of osteoporotic fractures: An update on the principles of management.
Yaacobi, Eyal; Sanchez, Daniela; Maniar, Hemil; Horwitz, Daniel S
2017-12-01
The treatment of osteoporotic fractures continues to challenge orthopedic surgeon. The fragility of the underlying bone in conjunction with the need for specific implants led to the development of explicit surgical techniques in order to minimize implant failure related complications, morbidity and mortality. From the patient's perspective, the existence of frailty, dementia and other medical related co-morbidities induce a complex situation necessitating high vigilance during the perioperative and post-operative period. This update reviews current principles and techniques essential to successful surgical treatment of these injuries. Copyright © 2017 Elsevier Ltd. All rights reserved.
Evolution of prostate biopsy techniques. Looking back on a meaningful journey.
Sivaraman, A; Sanchez-Salas, R; Castro-Marin, M; Barret, E; Guillot-Tantay, C; Prapotnich, D; Cathelineau, X
2016-10-01
The technique of prostate biopsy has evolved a long way since its inception to being a safe diagnostic procedure. The principles of the biopsy technique continue to improvise with the knowledge about prostate cancer and availability of newer treatment options like active surveillance and focal therapy. Currently, we depend on accurate cancer information from the biopsy more than ever for deciding the ideal treatment option. The aim of this review is to present the major milestones in prostate biopsy technique evolutions and its impact on the prostate cancer management. We performed a detailed non-systematic literature review to present the historical facts on the transformations in prostate biopsy techniques and also the direction of present research to improve accurate cancer detection. There is a clear change in trend in biopsy technique before and after the introduction of transrectal ultrasound and prostate specific antigen. In the earlier era, the biopsies were aimed at palpable nodules and obtaining adequate prostatic tissue for diagnosis while the later era has moved towards detection of non-palpable and early prostate cancer. Recently, there is an increasing trend towards image guided targeted biopsies to extract maximum cancer information from minimum biopsy cores. Prostate biopsy techniques have seen major changes since its inception and have a major impact on prostate cancer management. There is a great potential for research which can further support the newer treatment options like focal therapy. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.
The Influence of Proximity to a National Forest on Emotions and Fire-Management Decisions
NASA Astrophysics Data System (ADS)
Vining, Joanne; Merrick, Melinda S.
2008-02-01
Because American national forests are managed for all citizens, it is important that researchers explore the differences and similarities between citizens living both near and far from publicly managed land. We surveyed residents living at various distances from nationally managed land to collect resident perceptions of different forest fire-management techniques, to determine public preferences for these techniques, and to examine the motivations behind these preferences. Participants both close to and far away from national forests tended to favor a multipronged approach to fire management by preferring the use of a combination of two or more fire-management techniques. There were no significant differences by proximity in participants’ self-rated emotions, types of fire-management techniques preferred, or the reasons and rationales for their preferred fire-management technique(s), indicating that the proximity variable may not be as significant as previously thought.
The influence of proximity to a national forest on emotions and fire-management decisions.
Vining, Joanne; Merrick, Melinda S
2008-02-01
Because American national forests are managed for all citizens, it is important that researchers explore the differences and similarities between citizens living both near and far from publicly managed land. We surveyed residents living at various distances from nationally managed land to collect resident perceptions of different forest fire-management techniques, to determine public preferences for these techniques, and to examine the motivations behind these preferences. Participants both close to and far away from national forests tended to favor a multipronged approach to fire management by preferring the use of a combination of two or more fire-management techniques. There were no significant differences by proximity in participants' self-rated emotions, types of fire-management techniques preferred, or the reasons and rationales for their preferred fire-management technique(s), indicating that the proximity variable may not be as significant as previously thought.
Gamification in Stress Management Apps: A Critical App Review
Christmann, Corinna A; Bleser, Gabriele
2017-01-01
Background In today’s society, stress is more and more often a cause of disease. This makes stress management an important target of behavior change programs. Gamification has been suggested as one way to support health behavior change. However, it remains unclear to which extend available gamification techniques are integrated in stress management apps, and if their occurrence is linked to the use of elements from behavior change theory. Objective The aim of this study was to investigate the use of gamification techniques in stress management apps and the cooccurrence of these techniques with evidence-based stress management methods and behavior change techniques. Methods A total of 62 stress management apps from the Google Play Store were reviewed on their inclusion of 17 gamification techniques, 15 stress management methods, and 26 behavior change techniques. For this purpose, an extended taxonomy of gamification techniques was constructed and applied by 2 trained, independent raters. Results Interrater-reliability was high, with agreement coefficient (AC)=.97. Results show an average of 0.5 gamification techniques for the tested apps and reveal no correlations between the use of gamification techniques and behavior change techniques (r=.17, P=.20), or stress management methods (r=.14, P=.26). Conclusions This leads to the conclusion that designers of stress management apps do not use gamification techniques to influence the user’s behaviors and reactions. Moreover, app designers do not exploit the potential of combining gamification techniques with behavior change theory. PMID:28592397
Sexual dysfunction, Part II: Diagnosis, management, and prognosis.
Halvorsen, J G; Metz, M E
1992-01-01
Sexual problems are common but infrequently diagnosed. They are classified into four major categories: (1) sexual desire disorders, (2) sexual arousal disorders, (3) orgasmic disorders, and (4) sexual pain disorders. MEDLINE files from 1966 to the present were searched using the specific sexual dysfunctions as key words along with the general key word "sexual dysfunction" to review the published literature. Additional articles came from the reference lists of dysfunction-specific reviews. The key to diagnosis often rests on the physician's willingness to raise the issue with patients. A rational protocol can be followed to identify causative organic and psychogenic factors using the psychosexual and medical history, a comprehensive physical examination, psychological assessment instruments, laboratory tests, and special procedures. Current psychological treatment includes one or more of the following components: sensate focus exercises, cognitive-behavioral therapy, relaxation training, hypnosis and guided imagery, and group therapies. Specific techniques, such as directed self-stimulation, the stop-start and squeeze techniques, the sexological examination, systematic desensitization, and Kegel exercises, are added therapy when appropriate. Marital therapy to improve communication and resolve conflict is also part of standard therapy. Medical management can include pharmacologic agents to correct endocrine dysfunctions or to alter the progression of the sexual response. Surgical management can involve arterial revascularization, venous ligation, and penile implants. A noninvasive vacuum constriction device is also used to treat erectile disorders. The long-term prognosis of the sexual dysfunctions varies with the type of disorder and its causes. Generally good results (80 to 95 percent satisfaction) are obtained when treating vaginismus, dyspareunia, male erectile disorders, and female orgasmic dysfunctions. Long-term results are modestly successful (40 to 80 percent) when treating inhibited male orgasm and premature ejaculation. Long-term success is poorest at present for treating sexual desire disorders.
Lavery, Katherine A; O'Neill, Brenda; Parker, Michael; Elborn, J Stuart; Bradley, Judy M
2011-08-01
To investigate the efficacy of a disease-specific Expert Patient Programme (EPP) compared with usual care in patients with bronchiectasis. Proof-of-concept randomized controlled trial. Regional respiratory center. Adult patients (N=64; age, >18y) with a primary diagnosis of bronchiectasis based on a respiratory physician's assessment including a computed tomographic scan. Patients were randomly assigned to an intervention (usual care plus EPP; n=32) or control group (usual care only; n=32). The primary outcome measure was the Chronic Disease Self-efficacy Scale (CDSS). Other outcome measures included the Revised Illness Perception Questionnaire (IPQ-R), the St Georges Respiratory Questionnaire, and standard EPP questionnaires. Data were collected at baseline, postintervention, and 3 and 6 months postintervention. This disease-specific EPP for patients with bronchiectasis significantly improved self-efficacy in 6 of 10 subscales (CDSS subscales: exercise regularly [P=.02]; get information about disease [P=.03]; obtain help from community, family, and friends [P=.06]; communicate with physician [P=.85]; manage disease in general [P=.05]; do chores [P=.04]; social/recreational activities [P=.03]; manage symptoms [P<.01]; manage shortness of breath [P=.08]; control/manage depression [P=.01]) compared with usual care. There was no improvement on IPQ-R score. Patients who received the intervention reported more symptoms and decreased quality of life between 3 and 6 months postintervention and an increase in some components of self reported health care use. Patients receiving the disease-specific EPP indicated they were satisfied with the intervention and learned new self-management techniques. There were no significant differences in lung function over time. This original study indicates that a disease-specific EPP results in short-term improvements in self-efficacy. Based on these positive preliminary findings, a larger adequately powered study is justified to investigate the efficacy of a disease-specific EPP in patients with bronchiectasis. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Particle therapy for noncancer diseases
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bert, Christoph; Engenhart-Cabillic, Rita; Durante, Marco
2012-04-15
Radiation therapy using high-energy charged particles is generally acknowledged as a powerful new technique in cancer treatment. However, particle therapy in oncology is still controversial, specifically because it is unclear whether the putative clinical advantages justify the high additional costs. However, particle therapy can find important applications in the management of noncancer diseases, especially in radiosurgery. Extension to other diseases and targets (both cranial and extracranial) may widen the applications of the technique and decrease the cost/benefit ratio of the accelerator facilities. Future challenges in this field include the use of different particles and energies, motion management in particle bodymore » radiotherapy and extension to new targets currently treated by catheter ablation (atrial fibrillation and renal denervation) or stereotactic radiation therapy (trigeminal neuralgia, epilepsy, and macular degeneration). Particle body radiosurgery could be a future key application of accelerator-based particle therapy facilities in 10 years from today.« less
Managing nurses through disciplinary power: a Foucauldian analysis of workplace violence.
St-Pierre, Isabelle; Holmes, Dave
2008-04-01
This paper describes discipline as a specific technique of power which constitutes, in our view, a form of institutional violence. The need to create and maintain safe and healthy work environments for healthcare professionals is well documented. Foucault's concept of disciplinary power was used to explore institutional violence from a critical perspective. Violence is identified as an important factor in the recruitment and retention of healthcare professionals. Given the shortage of such professionals, there is an urgent need to take a fresh look at their working environments and working conditions. Power, surveillance and disciplinary techniques are used at all levels of hospital management to control and contain both human resources and costs. By associating common workplace practices with institutional violence, employers who have a policy of zero tolerance toward workplace violence will need to re-examine their current ways of operating.
Molecular techniques for the personalised management of patients with chronic myeloid leukaemia.
Alikian, Mary; Gale, Robert Peter; Apperley, Jane F; Foroni, Letizia
2017-03-01
Chronic myeloid leukemia (CML) is the paradigm for targeted cancer therapy. RT-qPCR is the gold standard for monitoring response to tyrosine kinase-inhibitor (TKI) therapy based on the reduction of blood or bone marrow BCR-ABL1 . Some patients with CML and very low or undetectable levels of BCR-ABL1 transcripts can stop TKI-therapy without CML recurrence. However, about 60 percent of patients discontinuing TKI-therapy have rapid leukaemia recurrence. This has increased the need for more sensitive and specific techniques to measure residual CML cells. The clinical challenge is to determine when it is safe to stop TKI-therapy. In this review we describe and critically evaluate the current state of CML clinical management, different technologies used to monitor measurable residual disease (MRD) focus on comparingRT-qPCR and new methods entering clinical practice. We discuss advantages and disadvantages of new methods.
Manipulation of P2X Receptor Activities by Light Stimulation
Kim, Sang Seong
2016-01-01
P2X receptors are involved in amplification of inflammatory responses in peripheral nociceptive fibers and in mediating pain-related signals to the CNS. Control of P2X activation has significant importance in managing unwanted hypersensitive neuron responses. To overcome the limitations of chemical ligand treatment, optical stimulation methods of optogenetics and photoswitching achieve efficient control of P2X activation while allowing specificity at the target site and convenient stimulation by light illumination. There are many potential applications for photosensitive elements, such as improved uncaging methods, photoisomerizable ligands, photoswitches, and gold nanoparticles. Each technique has both advantages and downsides, and techniques are selected according to the purpose of the application. Technical advances not only provide novel approaches to manage inflammation or pain mediated by P2X receptors but also suggest a similar approach for controlling other ion channels. PMID:26884649
Computer integrated manufacturing/processing in the HPI. [Hydrocarbon Processing Industry
DOE Office of Scientific and Technical Information (OSTI.GOV)
Yoshimura, J.S.
1993-05-01
Hydrocarbon Processing and Systemhouse Inc., developed a comprehensive survey on the status of computer integrated manufacturing/processing (CIM/CIP) targeted specifically to the unique requirements of the hydrocarbon processing industry. These types of surveys and other benchmarking techniques can be invaluable in assisting companies to maximize business benefits from technology investments. The survey was organized into 5 major areas: CIM/CIP planning, management perspective, functional applications, integration and technology infrastructure and trends. The CIM/CIP planning area dealt with the use and type of planning methods to plan, justify implement information technology projects. The management perspective section addressed management priorities, expenditure levels and implementationmore » barriers. The functional application area covered virtually all functional areas of organization and focused on the specific solutions and benefits in each of the functional areas. The integration section addressed the needs and integration status of the organization's functional areas. Finally, the technology infrastructure and trends section dealt with specific technologies in use as well as trends over the next three years. In February 1993, summary areas from preliminary results were presented at the 2nd International Conference on Productivity and Quality in the Hydrocarbon Processing Industry.« less
NASA Astrophysics Data System (ADS)
Peláez, Víctor; González, Roberto; San Martín, Luis Ángel; Campos, Antonio; Lobato, Vanesa
Hardware device management, and context information acquisition and abstraction are key factors to develop the ambient intelligent paradigm in smart homes. This work presents an architecture that addresses these two problems and provides a usable framework to develop applications easily. In contrast to other proposals, this work addresses performance issues specifically. Results show that the execution performance of the developed prototype is suitable for deployment in a real environment. In addition, the modular design of the system allows the user to develop applications using different techniques and different levels of abstraction.
Managing Organization Vitality. M.S. Thesis - MIT, Cambridge
NASA Technical Reports Server (NTRS)
Chandler, G. P., Jr.
1976-01-01
The three major objectives are: (1) to measure the extent to which the organization renewal techniques have been adopted by organizations in both the private and public sectors; (2) to determine the overall results of these applications; and (3) to test a number of specific hypotheses regarding situational determinants of the success of this approach. It appears that top management involvement is the single most crucial determinant of the success of organization renewal. Organization renewal has considerable potential for increasing the commitment of individuals, and can have a significant positive influence on the results of the organization.
Keeling, Jonathan W; Pryde, Julie A; Merrill, Jacqueline A
2013-01-01
The nation's 2862 local health departments (LHDs) are the primary means for assuring public health services for all populations. The objective of this study is to assess the effect of organizational network analysis on management decisions in LHDs and to demonstrate the technique's ability to detect organizational adaptation over time. We conducted a longitudinal network analysis in a full-service LHD with 113 employees serving about 187,000 persons. Network survey data were collected from employees at 3 times: months 0, 8, and 34. At time 1 the initial analysis was presented to LHD managers as an intervention with information on evidence-based management strategies to address the findings. At times 2 and 3 interviews documented managers' decision making and events in the task environment. Response rates for the 3 network analyses were 90%, 97%, and 83%. Postintervention (time 2) results showed beneficial changes in network measures of communication and integration. Screening and case identification increased for chlamydia and for gonorrhea. Outbreak mitigation was accelerated by cross-divisional teaming. Network measurements at time 3 showed LHD adaptation to H1N1 and budget constraints with increased centralization. Task redundancy increased dramatically after National Incident Management System training. Organizational network analysis supports LHD management with empirical evidence that can be translated into strategic decisions about communication, allocation of resources, and addressing knowledge gaps. Specific population health outcomes were traced directly to management decisions based on network evidence. The technique can help managers improve how LHDs function as organizations and contribute to our understanding of public health systems.
The integration of system specifications and program coding
NASA Technical Reports Server (NTRS)
Luebke, W. R.
1970-01-01
Experience in maintaining up-to-date documentation for one module of the large-scale Medical Literature Analysis and Retrieval System 2 (MEDLARS 2) is described. Several innovative techniques were explored in the development of this system's data management environment, particularly those that use PL/I as an automatic documenter. The PL/I data description section can provide automatic documentation by means of a master description of data elements that has long and highly meaningful mnemonic names and a formalized technique for the production of descriptive commentary. The techniques discussed are practical methods that employ the computer during system development in a manner that assists system implementation, provides interim documentation for customer review, and satisfies some of the deliverable documentation requirements.
Marketing and design of residential energy conservation programs for the elderly
DOE Office of Scientific and Technical Information (OSTI.GOV)
Berry, L.; Schweitzer, M.; Freeman, E.
1988-02-01
This report describes barriers to energy conservation by the elderly. Because of these barriers, they have a greater need for programs that assist with the installation of energy-efficiency improvements. In response to this need, a number of specialized programs are operated for the elderly. This report contains descriptions of 39 energy conservation programs for the elderly. Telephone interviews were conducted with the managers of these programs to identify marketing techniques and organizational structures. Interagency networking, presentations and referrals are the most common methods of recruiting clients. Other marketing techniques in order of the frequency of use are: direct mail, billmore » inserts, television, radio, printed materials, and telemarketing. Many managers consider word-of-mouth advertising from satisfied clients the most effective form of marketing. Interagency networking and support (financial, structural and in-kind) can offer real advantages in the operation of conservation programs for the elderly. The use of specific marketing techniques is probably less important to success in recruiting clients than the degree of trust potential clients have in the sponsoring organization(s). 4 figs., 10 tabs.« less
Baus, A; Keilani, C; Bich, C-S; Entine, F; Brachet, M; Duhamel, P; Amabile, J-C; Malfuson, J V; Bey, E
2018-04-01
Yttrium-90-Ibritumomab Tiuxetan (Zevalin ® ) is used in the treatment of non- Hodgkin's lymphoma. Extravasation is an iatrogenic complication that is fortunately rare. However, the treatment of this complication is often complex due to the risk of extensive skin necrosis and unpredictable evolution of localized irradiation. This vesicant drug requires emergency management when extravasation occured. Radiations burns have specificities. Therefore, wound coverage involves specific plastic surgical techniques. Here, we report the case of a man presenting a chronic and extensive skin necrosis of upper arm treated with an antero-lateral thigh free flap. Moreover, we compare our experience of Zevalin ® extravasation management to other past publications and propose recommendations to prevent this unacceptable complication. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Hoffmann, Alexandra; Bleser, Gabriele
2017-01-01
Background Chronic stress has been shown to be associated with disease. This link is not only direct but also indirect through harmful health behavior such as smoking or changing eating habits. The recent mHealth trend offers a new and promising approach to support the adoption and maintenance of appropriate stress management techniques. However, only few studies have dealt with the inclusion of evidence-based content within stress management apps for mobile phones. Objective The aim of this study was to evaluate stress management apps on the basis of a new taxonomy of effective emotion-focused stress management techniques and an established taxonomy of behavior change techniques. Methods Two trained and independent raters evaluated 62 free apps found in Google Play with regard to 26 behavior change and 15 emotion-focused stress management techniques in October 2015. Results The apps included an average of 4.3 behavior change techniques (SD 4.2) and 2.8 emotion-focused stress management techniques (SD 2.6). The behavior change technique score and stress management technique score were highly correlated (r=.82, P=.01). Conclusions The broad variation of different stress management strategies found in this sample of apps goes in line with those found in conventional stress management interventions and self-help literature. Moreover, this study provided a first step toward more detailed and standardized taxonomies, which can be used to investigate evidence-based content in stress management interventions and enable greater comparability between different intervention types. PMID:28232299
Sterzing, Florian; Kratochwil, Clemens; Fiedler, Hannah; Katayama, Sonja; Habl, Gregor; Kopka, Klaus; Afshar-Oromieh, Ali; Debus, Jürgen; Haberkorn, Uwe; Giesel, Frederik L
2016-01-01
Radiotherapy is the main therapeutic approach besides surgery of localized prostate cancer. It relies on risk stratification and exact staging. This report analyses the potential of [(68)Ga]Glu-urea-Lys(Ahx)-HBED-CC ((68)Ga-PSMA-11), a new positron emission tomography (PET) tracer targeting prostate-specific membrane antigen (PSMA) for prostate cancer staging and individualized radiotherapy planning. A cohort of 57 patients with prostate cancer scanned with (68)Ga-PSMA-11 PET/CT for radiotherapy planning was retrospectively reviewed; 15 patients were at initial diagnosis and 42 patients at time of biochemical recurrence. Staging results of conventional imaging, including bone scintigraphy, CT or MRI, were compared with (68)Ga-PSMA ligand PET/CT results and the influence on radiotherapeutic management was quantified. (68)Ga-PSMA ligand PET/CT had a dramatic impact on radiotherapy application in the presented cohort. In 50.8 % of the cases therapy was changed. The presented imaging technique of (68)Ga-PSMA PET/CT could be a key technology for individualized radiotherapy management in prostate cancer.
Recent advances in applying decision science to managing national forests
Marcot, Bruce G.; Thompson, Matthew P.; Runge, Michael C.; Thompson, Frank R.; McNulty, Steven; Cleaves, David; Tomosy, Monica; Fisher, Larry A.; Andrew, Bliss
2012-01-01
Management of federal public forests to meet sustainability goals and multiple use regulations is an immense challenge. To succeed, we suggest use of formal decision science procedures and tools in the context of structured decision making (SDM). SDM entails four stages: problem structuring (framing the problem and defining objectives and evaluation criteria), problem analysis (defining alternatives, evaluating likely consequences, identifying key uncertainties, and analyzing tradeoffs), decision point (identifying the preferred alternative), and implementation and monitoring the preferred alternative with adaptive management feedbacks. We list a wide array of models, techniques, and tools available for each stage, and provide three case studies of their selected use in National Forest land management and project plans. Successful use of SDM involves participation by decision-makers, analysts, scientists, and stakeholders. We suggest specific areas for training and instituting SDM to foster transparency, rigor, clarity, and inclusiveness in formal decision processes regarding management of national forests.
Gamification in Stress Management Apps: A Critical App Review.
Hoffmann, Alexandra; Christmann, Corinna A; Bleser, Gabriele
2017-06-07
In today's society, stress is more and more often a cause of disease. This makes stress management an important target of behavior change programs. Gamification has been suggested as one way to support health behavior change. However, it remains unclear to which extend available gamification techniques are integrated in stress management apps, and if their occurrence is linked to the use of elements from behavior change theory. The aim of this study was to investigate the use of gamification techniques in stress management apps and the cooccurrence of these techniques with evidence-based stress management methods and behavior change techniques. A total of 62 stress management apps from the Google Play Store were reviewed on their inclusion of 17 gamification techniques, 15 stress management methods, and 26 behavior change techniques. For this purpose, an extended taxonomy of gamification techniques was constructed and applied by 2 trained, independent raters. Interrater-reliability was high, with agreement coefficient (AC)=.97. Results show an average of 0.5 gamification techniques for the tested apps and reveal no correlations between the use of gamification techniques and behavior change techniques (r=.17, P=.20), or stress management methods (r=.14, P=.26). This leads to the conclusion that designers of stress management apps do not use gamification techniques to influence the user's behaviors and reactions. Moreover, app designers do not exploit the potential of combining gamification techniques with behavior change theory. ©Alexandra Hoffmann, Corinna A Christmann, Gabriele Bleser. Originally published in JMIR Serious Games (http://games.jmir.org), 07.06.2017.
Technological advances in radiotherapy of rectal cancer: opportunities and challenges.
Appelt, Ane L; Sebag-Montefiore, David
2016-07-01
This review summarizes the available evidence for the use of modern radiotherapy techniques for chemoradiotherapy for rectal cancer, with specific focus on intensity-modulated radiotherapy (IMRT) and volumetric arc therapy (VMAT) techniques. The dosimetric benefits of IMRT and VMAT are well established, but prospective clinical studies are limited, with phase I-II studies only. Recent years have seen the publication of a few larger prospective patient series as well as some retrospective cohorts, several of which include much needed late toxicity data. Overall results are encouraging, as toxicity levels - although varying across reports - appear lower than for 3D conformal radiotherapy. Innovative treatment techniques and strategies which may be facilitated by the use of IMRT/VMAT include simultaneously integrated tumour boost, adaptive treatment, selective sparing of specific organs to enable chemotherapy escalation, and nonsurgical management. Few prospective studies of IMRT and VMAT exist, which causes uncertainty not just in regards to the clinical benefit of these technologies but also in the optimal use. The priority for future research should be subgroups of patients who might receive relatively greater benefit from innovative treatment techniques, such as patients receiving chemoradiotherapy with definitive intent and patients treated with dose escalation.
Hard and soft tissue surgical complications in dental implantology.
Aziz, Shahid R
2015-05-01
This article discusses surgical complications associated with the placement of dental implants, specifically focusing on how they occur (etiology), as well as their management and prevention. Dental implant surgical complications can be classified into those of hard and soft tissues. In general, complications can be avoided with thorough preoperative treatment planning and proper surgical technique. Copyright © 2015 Elsevier Inc. All rights reserved.
Cyber Hygiene for Control System Security
Oliver, David
2015-10-08
There are many resources from government and private industry available to assist organizations in reducing their attack surface and enhancing their security posture. Furthermore, standards are being written and improved upon to make the practice of securing a network more manageable. And while the specifics of network security are complex, most system vulnerabilities can be mitigated using fairly simple cyber hygiene techniques like those offered above.
The Strategic Thinking Process: Efficient Mobilization of Human Resources for System Definition
Covvey, H. D.
1987-01-01
This paper describes the application of several group management techniques to the creation of needs specifications and information systems strategic plans in health care institutions. The overall process is called the “Strategic Thinking Process”. It is a formal methodology that can reduce the time and cost of creating key documents essential for the successful implementation of health care information systems.
Visual Purple, the Next Generation Crisis Management Decision Training Tool
2001-09-01
talents of professional Hollywood screenwriters during the scripting and writing process of the simulations. Additionally, cinematic techniques learned...cultural, and language experts for research development. Additionally, GTA provides country specific support in script writing and cinematic resources as...The result is an entirely new dimension of realism that traditional exercises often fail to capture. The scenario requires the participant to make the
Cable yarding residue after thinning young stands: a break-even simulation
Chris B. LeDoux
1984-01-01
The use of cable logging to extract small pieces of residue wood may result in low rates of production and a high cost per unit of wood produced. However, the logging manager can improve yarding productivity and break even in cable residue removal operations by using the proper planning techniques. In this study, breakeven zones for specific young-growth stands were...
2013-02-01
that the Government formulated or supplied the drawings, specifications, or other data does not license the holder or any other person or corporation ...preparation. Berk , V. H., Cybenko, G., Souza, I. G. D., & Murphy, J. P. (2012, January). “Managing Malicious Insider Risk through BANDIT.” In System... finances , human resources for example; • Tactics – Short term goals and techniques to achieve those goals; • Strategy – Long term outcomes and
NASA Astrophysics Data System (ADS)
Al-karawi, Dhurgham; Sayasneh, A.; Al-Assam, Hisham; Jassim, Sabah; Page, N.; Timmerman, D.; Bourne, T.; Du, Hongbo
2017-05-01
Ovarian cysts are a common pathology in women of all age groups. It is estimated that 5-10% of women have a surgical intervention to remove an ovarian cyst in their lifetime. Given this frequency rate, characterization of ovarian masses is essential for optimal management of patients. Patients with benign ovarian masses can be managed conservatively if they are asymptomatic. Mature teratomas are common benign ovarian cysts that occur, in most cases, in premenopausal women. These ovarian cysts can contain different types of human tissue including bone, cartilage, fat, hair, or other tissue. If they are causing no symptoms, they can be harmless and may not require surgery. Subjective assessment by ultrasound examiners has a high diagnostic accuracy when characterising mature teratomas from other types of tumours. The aim of this study is to develop a computerised technique with the potential to characterise mature teratomas and distinguish them from other types of benign ovarian tumours. Local Binary Pattern (LBP) was applied to extract texture features that are specific in distinguishing teratomas. Neural Networks (NN) was then used as a classifier for recognising mature teratomas. A pilot sample set of 130 B-mode static ovarian ultrasound images (41 mature teratomas tumours and 89 other types of benign tumours) was used to test the effectiveness of the proposed technique. Test results show an average accuracy rate of 99.4% with a sensitivity of 100%, specificity of 98.8% and positive predictive value of 98.9%. This study demonstrates that the NN and LBP techniques can accurately classify static 2D B-mode ultrasound images of benign ovarian masses into mature teratomas and other types of benign tumours.
The use of anaesthetic agents to provide anxiolysis and sedation in dentistry and oral surgery.
O'Halloran, Michael
2013-12-31
Throughout the world there is considerable variation in the techniques used to manage anxious dental patients requiring treatment. Traditionally anxious or phobic dental patients may have been sent for general anaesthesia to allow dental treatment be undertaken. While this is still the case for the more invasive oral surgical procedures, such as wisdom teeth extraction, sedation in general dentistry is becoming more popular. Various sedation techniques using many different anaesthetic agents have gained considerable popularity over the past 30 years. While the practice of sedating patients for dental procedures is invaluable in the management of suitably assessed patients, patient safety must always be the primary concern. Medical, dental and psychosocial considerations must be taken into account when evaluating the patient need and the patient suitability for sedation or general anaesthesia. The regulations that govern the practice of dental sedation vary throughout the world, in particular regarding the techniques used and the training necessary for dental practitioners to sedate patients. It is necessary for medical and dental practitioners to be up to date on current practice to ensure standards of practice, competence and safety throughout our profession. This article, the first in a two-part series, will provide information to practitioners on the practice of sedation in dentistry, the circumstances where it may be appropriate instead of general anaesthesia and the risks involved with sedation. It will also discuss the specific training and qualifications required for dental practitioners to provide sedation. The second article in this series will outline the different techniques used to administer inhalation, oral and intravenous sedation in dentistry and will focus on specific methods that are practiced.
NASA Technical Reports Server (NTRS)
Montoya, G.; Boldon, P.
1985-01-01
The Space Station Program is highly complex not only in its technological goals and requirements but also in its organizational structure. Eight Contractor teams supporting four NASA centers plus Headquarters must depend on effective exchange of information--the lifeblood of the program. The Technical and Management Information System (TMIS) is the means by which this exchange can take place. Value of the TMIS in increasing productivity comes primarily from its ability to make the right information available to whomever needs it when it is needed. Productivity of the aerospace professional and how it can be enhanced by the use of specifically recommended techniques and procedures for information management using the TMIS are discussed.
Corporate Social Responsibility in Aviation
NASA Technical Reports Server (NTRS)
Phillips, Edwin D.
2006-01-01
The dialog within aviation management education regarding ethics is incomplete without a discussion of corporate social responsibility (CSR). CSR research requires discussion involving: (a) the current emphasis on CSR in business in general and aviation specifically; (b) business and educational theory that provide a basis for aviation companies to engage in socially responsible actions; (c) techniques used by aviation and aerospace companies to fulfill this responsibility; and (d) a glimpse of teaching approaches used in university aviation management classes. The summary of this research suggests educators explain CSR theory and practice to students in industry and collegiate aviation management programs. Doing so extends the discussion of ethical behavior and matches the current high level of interest and activity within the aviation industry toward CSR.
The balanced scorecard: an incremental approach model to health care management.
Pineno, Charles J
2002-01-01
The balanced scorecard represents a technique used in strategic management to translate an organization's mission and strategy into a comprehensive set of performance measures that provide the framework for implementation of strategic management. This article develops an incremental approach for decision making by formulating a specific balanced scorecard model with an index of nonfinancial as well as financial measures. The incremental approach to costs, including profit contribution analysis and probabilities, allows decisionmakers to assess, for example, how their desire to meet different health care needs will cause changes in service design. This incremental approach to the balanced scorecard may prove to be useful in evaluating the existence of causality relationships between different objective and subjective measures to be included within the balanced scorecard.
Ontology-based knowledge management for personalized adverse drug events detection.
Cao, Feng; Sun, Xingzhi; Wang, Xiaoyuan; Li, Bo; Li, Jing; Pan, Yue
2011-01-01
Since Adverse Drug Event (ADE) has become a leading cause of death around the world, there arises high demand for helping clinicians or patients to identify possible hazards from drug effects. Motivated by this, we present a personalized ADE detection system, with the focus on applying ontology-based knowledge management techniques to enhance ADE detection services. The development of electronic health records makes it possible to automate the personalized ADE detection, i.e., to take patient clinical conditions into account during ADE detection. Specifically, we define the ADE ontology to uniformly manage the ADE knowledge from multiple sources. We take advantage of the rich semantics from the terminology SNOMED-CT and apply it to ADE detection via the semantic query and reasoning.
Adaptive forest management for drinking water protection under climate change
NASA Astrophysics Data System (ADS)
Koeck, R.; Hochbichler, E.
2012-04-01
Drinking water resources drawn from forested catchment areas are prominent for providing water supply on our planet. Despite the fact that source waters stemming from forested watersheds have generally lower water quality problems than those stemming from agriculturally used watersheds, it has to be guaranteed that the forest stands meet high standards regarding their water protection functionality. For fulfilling these, forest management concepts have to be applied, which are adaptive regarding the specific forest site conditions and also regarding climate change scenarios. In the past century forest management in the alpine area of Austria was mainly based on the cultivation of Norway spruce, by the way neglecting specific forest site conditions, what caused in many cases highly vulnerable mono-species forest stands. The GIS based forest hydrotope model (FoHyM) provides a framework for forest management, which defines the most crucial parameters in a spatial explicit form. FoHyM stratifies the spacious drinking water protection catchments into forest hydrotopes, being operational units for forest management. The primary information layer of FoHyM is the potential natural forest community, which reflects the specific forest site conditions regarding geology, soil types, elevation above sea level, exposition and inclination adequately and hence defines the specific forest hydrotopes. For each forest hydrotope, the adequate tree species composition and forest stand structure for drinking water protection functionality was deduced, based on the plant-sociological information base provided by FoHyM. The most important overall purpose for the related elaboration of adaptive forest management concepts and measures was the improvement of forest stand stability, which can be seen as the crucial parameter for drinking water protection. Only stable forest stands can protect the fragile soil and humus layers and hence prevent erosion process which could endanger the water resources. Forest stands which are formed by a tree species set which conforms to the potential natural forest community are more stable than the currently wide-spread mono-species Norway spruce plantations, especially in times of climate change, where e.g. bark beetle infestations threat spruce with increased intensity. FoHyM also provides the relevant ecological boundary conditions for any estimation of climate change adaptations. The adaptation of the tree species distribution within each forest hydrotope to climate change conditions was fulfilled by the integration of climate change scenarios and the estimation of the eco-physiological characteristics of related tree species. Hence it was possible to define the tree species distribution related to a specific climate change scenario for each forest hydrotope. The silvicultural concepts and measures to accomplish the defined tree species distribution and forest stand structure for each forest hydrotope were defined and elaborated by taking the specific requirements of drinking water protection areas into account, what e.g. comprised the prohibition of the clear cut technique and the application of continuous cover forest management concepts. The overall purpose of these adaptive silvicultural concepts and techniques which were based on the application of FoHyM was the improvement of the water protection functionality of forest stands within drinking water protection zones.
Barré, E; Nguyen, M-L; Bruel, D; Fournel, C; Hosten, B; Lao, S; Vercellino, L; Rizzo-Padoin, N
2013-07-01
Radiopharmaceuticals extravasation is rare but may have serious clinical issues. Because no specific recommendations are being proposed to date, the goals of our working group created within the French Society of Radiopharmacy are to determine preventive measures and to establish a pragmatic management of extravasation of these drugs. Our preventive measures are to recognize the symptoms (erythema, venous discoloration, swelling), to know the risk factors (which are related to radiopharmaceutical, patient, site of injection, injection technique) and severity (from erythema to skin necrosis, depending on the radionuclide) and how to avoid them (training and awareness of staff, choice of injection site, route of drug administration test, use of a catheter for administration of therapeutic radiopharmaceuticals). Management should be immediate. It can be facilitated by a specific emergency kit. General measures recommended are the immediate cessation of injection, aspiration of fluid extravasation, delimitation of the extravasated area with an indelible pen, informing the doctor. Specific measures taking into account the radiotoxicity of the radionuclide and the type of radiopharmaceutical were also established. The patient should be informed by the doctor about the risks and how to take care of. Traceability of the incident must be ensured. A multidisciplinary reflexion is essential to manage the extravasation as early and effectively as possible. Copyright © 2013 Elsevier Masson SAS. All rights reserved.
Fierro, Michael A; Daneshmand, Mani A; Bartz, Raquel R
2018-01-01
The use of venovenous extracorporeal membrane oxygenation is increasing worldwide. These patients often require noncardiac surgery. In the perioperative period, preoperative assessment, patient transport, choice of anesthetic type, drug dosing, patient monitoring, and intraoperative and postoperative management of common patient problems will be impacted. Furthermore, common monitoring techniques will have unique limitations. Importantly, patients on venovenous extracorporeal membrane oxygenation remain subject to hypoxemia, hypercarbia, and acidemia in the perioperative setting despite extracorporeal support. Treatments of these conditions often require both manipulation of extracorporeal membrane oxygenation settings and physiologic interventions. Perioperative management of anticoagulation, as well as thresholds to transfuse blood products, remain highly controversial and must take into account the specific procedure, extracorporeal membrane oxygenation circuit function, and patient comorbidities. We will review the physiologic management of the patient requiring surgery while on venovenous extracorporeal membrane oxygenation.
Complications of Bariatric Surgery: What You Can Expect to See in Your GI Practice.
Schulman, Allison R; Thompson, Christopher C
2017-11-01
Obesity is one of the most significant health problems worldwide. Bariatric surgery has become one of the fastest growing operative procedures and has gained acceptance as the leading option for weight-loss. Despite improvement in the performance of bariatric surgical procedures, complications are not uncommon. There are a number of unique complications that arise in this patient population and require specific knowledge for proper management. Furthermore, conditions unrelated to the altered anatomy typically require a different management strategy. As such, a basic understanding of surgical anatomy, potential complications, and endoscopic tools and techniques for optimal management is essential for the practicing gastroenterologist. Gastroenterologists should be familiar with these procedures and complication management strategies. This review will cover these topics and focus on major complications that gastroenterologists will be most likely to see in their practice.
Mass-storage management for distributed image/video archives
NASA Astrophysics Data System (ADS)
Franchi, Santina; Guarda, Roberto; Prampolini, Franco
1993-04-01
The realization of image/video database requires a specific design for both database structures and mass storage management. This issue has addressed the project of the digital image/video database system that has been designed at IBM SEMEA Scientific & Technical Solution Center. Proper database structures have been defined to catalog image/video coding technique with the related parameters, and the description of image/video contents. User workstations and servers are distributed along a local area network. Image/video files are not managed directly by the DBMS server. Because of their wide size, they are stored outside the database on network devices. The database contains the pointers to the image/video files and the description of the storage devices. The system can use different kinds of storage media, organized in a hierarchical structure. Three levels of functions are available to manage the storage resources. The functions of the lower level provide media management. They allow it to catalog devices and to modify device status and device network location. The medium level manages image/video files on a physical basis. It manages file migration between high capacity media and low access time media. The functions of the upper level work on image/video file on a logical basis, as they archive, move and copy image/video data selected by user defined queries. These functions are used to support the implementation of a storage management strategy. The database information about characteristics of both storage devices and coding techniques are used by the third level functions to fit delivery/visualization requirements and to reduce archiving costs.
NASA Astrophysics Data System (ADS)
Chen, Andrew A.; Meng, Frank; Morioka, Craig A.; Churchill, Bernard M.; Kangarloo, Hooshang
2005-04-01
Managing pediatric patients with neurogenic bladder (NGB) involves regular laboratory, imaging, and physiologic testing. Using input from domain experts and current literature, we identified specific data points from these tests to develop the concept of an electronic disease vector for NGB. An information extraction engine was used to extract the desired data elements from free-text and semi-structured documents retrieved from the patient"s medical record. Finally, a Java-based presentation engine created graphical visualizations of the extracted data. After precision, recall, and timing evaluation, we conclude that these tools may enable clinically useful, automatically generated, and diagnosis-specific visualizations of patient data, potentially improving compliance and ultimately, outcomes.
Christmann, Corinna Anna; Hoffmann, Alexandra; Bleser, Gabriele
2017-02-23
Chronic stress has been shown to be associated with disease. This link is not only direct but also indirect through harmful health behavior such as smoking or changing eating habits. The recent mHealth trend offers a new and promising approach to support the adoption and maintenance of appropriate stress management techniques. However, only few studies have dealt with the inclusion of evidence-based content within stress management apps for mobile phones. The aim of this study was to evaluate stress management apps on the basis of a new taxonomy of effective emotion-focused stress management techniques and an established taxonomy of behavior change techniques. Two trained and independent raters evaluated 62 free apps found in Google Play with regard to 26 behavior change and 15 emotion-focused stress management techniques in October 2015. The apps included an average of 4.3 behavior change techniques (SD 4.2) and 2.8 emotion-focused stress management techniques (SD 2.6). The behavior change technique score and stress management technique score were highly correlated (r=.82, P=.01). The broad variation of different stress management strategies found in this sample of apps goes in line with those found in conventional stress management interventions and self-help literature. Moreover, this study provided a first step toward more detailed and standardized taxonomies, which can be used to investigate evidence-based content in stress management interventions and enable greater comparability between different intervention types. ©Corinna Anna Christmann, Alexandra Hoffmann, Gabriele Bleser. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 23.02.2017.
The development of an audit technique to assess the quality of safety barrier management.
Guldenmund, Frank; Hale, Andrew; Goossens, Louis; Betten, Jeroen; Duijm, Nijs Jan
2006-03-31
This paper describes the development of a management model to control barriers devised to prevent major hazard scenarios. Additionally, an audit technique is explained that assesses the quality of such a management system. The final purpose of the audit technique is to quantify those aspects of the management system that have a direct impact on the reliability and effectiveness of the barriers and, hence, the probability of the scenarios involved. First, an outline of the management model is given and its elements are explained. Then, the development of the audit technique is described. Because the audit technique uses actual major hazard scenarios and barriers within these as its focus, the technique achieves a concreteness and clarity that many other techniques often lack. However, this strength is also its limitation, since the full safety management system is not covered with the technique. Finally, some preliminary experiences obtained from several test sites are compiled and discussed.
Friesen, Jan; Rodriguez Sinobas, Leonor; Foglia, Laura; Ludwig, Ralf
2017-03-01
Semi-arid regions are facing the challenge of managing water resources under conditions of increasing scarcity and drought. These are recently pressured by the impact of climate change favoring the shifting from using surface water to groundwater without taking sustainability issues into account. Likewise, water scarcity raises the competition for water among users, increasing the risk of social conflicts, as the availability of fresh water in sufficient quality and quantity is already one of the major factors limiting socio-economic development. In terms of hydrology, semi-arid regions are characterized by very complex hydro- and hydrogeological systems. The complexity of the water cycle contrasts strongly with the poor data availability, (1) which limits the number of analysis techniques and methods available to researchers, (2) limits the accuracy of models and predictions, and (3) consequently challenges the capabilities to develop appropriate management measures to mitigate or adapt the environment to scarcity and drought conditions. Integrated water resources management is a holistic approach to focus on both environmental as well as on socio-economic factors influencing water availability and supply. The management approaches and solutions adopted, e.g. in form of decision support for specific water resources systems, are often highly specific for individual case studies. Copyright © 2016 Elsevier B.V. All rights reserved.
Ultralow-power electronics for biomedical applications.
Chandrakasan, Anantha P; Verma, Naveen; Daly, Denis C
2008-01-01
The electronics of a general biomedical device consist of energy delivery, analog-to-digital conversion, signal processing, and communication subsystems. Each of these blocks must be designed for minimum energy consumption. Specific design techniques, such as aggressive voltage scaling, dynamic power-performance management, and energy-efficient signaling, must be employed to adhere to the stringent energy constraint. The constraint itself is set by the energy source, so energy harvesting holds tremendous promise toward enabling sophisticated systems without straining user lifestyle. Further, once harvested, efficient delivery of the low-energy levels, as well as robust operation in the aggressive low-power modes, requires careful understanding and treatment of the specific design limitations that dominate this realm. We outline the performance and power constraints of biomedical devices, and present circuit techniques to achieve complete systems operating down to power levels of microwatts. In all cases, approaches that leverage advanced technology trends are emphasized.
Scolozzi, Paolo; Herzog, Georges
2017-07-01
We are reporting the treatment of severe maxillary hypoplasia in two patients with unilateral cleft lip and palate by using a specific approach combining the Le Fort I distraction osteogenesis technique coupled with computer-aided design/computer-aided manufacturing customized surgical guides and internal distractors based on virtual computational planning. This technology allows for the transfer of the virtual planned reconstruction to the operating room by using custom patient-specific implants, surgical splints, surgical cutting guides, and surgical guides to plate or distractor adaptation.
Efficient Execution Methods of Pivoting for Bulk Extraction of Entity-Attribute-Value-Modeled Data
Luo, Gang; Frey, Lewis J.
2017-01-01
Entity-attribute-value (EAV) tables are widely used to store data in electronic medical records and clinical study data management systems. Before they can be used by various analytical (e.g., data mining and machine learning) programs, EAV-modeled data usually must be transformed into conventional relational table format through pivot operations. This time-consuming and resource-intensive process is often performed repeatedly on a regular basis, e.g., to provide a daily refresh of the content in a clinical data warehouse. Thus, it would be beneficial to make pivot operations as efficient as possible. In this paper, we present three techniques for improving the efficiency of pivot operations: 1) filtering out EAV tuples related to unneeded clinical parameters early on; 2) supporting pivoting across multiple EAV tables; and 3) conducting multi-query optimization. We demonstrate the effectiveness of our techniques through implementation. We show that our optimized execution method of pivoting using these techniques significantly outperforms the current basic execution method of pivoting. Our techniques can be used to build a data extraction tool to simplify the specification of and improve the efficiency of extracting data from the EAV tables in electronic medical records and clinical study data management systems. PMID:25608318
Remote sensing techniques in monitoring areas affected by forest fire
NASA Astrophysics Data System (ADS)
Karagianni, Aikaterini Ch.; Lazaridou, Maria A.
2017-09-01
Forest fire is a part of nature playing a key role in shaping ecosystems. However, fire's environmental impacts can be significant, affecting wildlife habitat and timber, human settlements, man-made technical constructions and various networks (road, power networks) and polluting the air with emissions harmful to human health. Furthermore, fire's effect on the landscape may be long-lasting. Monitoring the development of a fire occurs as an important aspect at the management of natural hazards in general. Among the used methods for monitoring, satellite data and remote sensing techniques can be proven of particular importance. Satellite remote sensing offers a useful tool for forest fire detection, monitoring, management and damage assessment. Especially for fire scars detection and monitoring, satellite data derived from Landsat 8 can be a useful research tool. This paper includes critical considerations of the above and concerns in particular an example of the Greek area (Thasos Island). This specific area was hit by fires several times in the past and recently as well (September 2016). Landsat 8 satellite data are being used (pre and post fire imagery) and digital image processing techniques are applied (enhancement techniques, calculation of various indices) for fire scars detection. Visual interpretation of the example area affected by the fires is also being done, contributing to the overall study.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Chironis, N.P.
This book contains a wealth of valuable information carefully selected and compiled from recent issues of Coal Age magazine. Much of the source material has been gathered by Coal Age Editors during their visits to coal mines, research establishments, universities and technical symposiums. Equally important are the articles and data contributed by over 50 top experts, many of whom are well known to the mining industry. Specifically, this easy-to-use handbook is divided into eleven key areas of underground mining. Here you will find the latest information on continuous mining techniques, longwall and shortwall methods and equipment, specialized mining and boringmore » systems, continuous haulage techniques, improved roof control and ventilation methods, mine communications and instrumentation, power systems, fire control methods, and new mining regulations. There is also a section on engineering and management considerations, including the modern use of computer terminals, practical techniques for picking leaders and for encouraging more safety consciousness in employees, factors affecting absenteeism, and some highly important financial considerations. All of this valuable information has been thoroughly indexed to provide immediate access to the specific data needed by the reader.« less
Building Energy Modeling and Control Methods for Optimization and Renewables Integration
NASA Astrophysics Data System (ADS)
Burger, Eric M.
This dissertation presents techniques for the numerical modeling and control of building systems, with an emphasis on thermostatically controlled loads. The primary objective of this work is to address technical challenges related to the management of energy use in commercial and residential buildings. This work is motivated by the need to enhance the performance of building systems and by the potential for aggregated loads to perform load following and regulation ancillary services, thereby enabling the further adoption of intermittent renewable energy generation technologies. To increase the generalizability of the techniques, an emphasis is placed on recursive and adaptive methods which minimize the need for customization to specific buildings and applications. The techniques presented in this dissertation can be divided into two general categories: modeling and control. Modeling techniques encompass the processing of data streams from sensors and the training of numerical models. These models enable us to predict the energy use of a building and of sub-systems, such as a heating, ventilation, and air conditioning (HVAC) unit. Specifically, we first present an ensemble learning method for the short-term forecasting of total electricity demand in buildings. As the deployment of intermittent renewable energy resources continues to rise, the generation of accurate building-level electricity demand forecasts will be valuable to both grid operators and building energy management systems. Second, we present a recursive parameter estimation technique for identifying a thermostatically controlled load (TCL) model that is non-linear in the parameters. For TCLs to perform demand response services in real-time markets, online methods for parameter estimation are needed. Third, we develop a piecewise linear thermal model of a residential building and train the model using data collected from a custom-built thermostat. This model is capable of approximating unmodeled dynamics within a building by learning from sensor data. Control techniques encompass the application of optimal control theory, model predictive control, and convex distributed optimization to TCLs. First, we present the alternative control trajectory (ACT) representation, a novel method for the approximate optimization of non-convex discrete systems. This approach enables the optimal control of a population of non-convex agents using distributed convex optimization techniques. Second, we present a distributed convex optimization algorithm for the control of a TCL population. Experimental results demonstrate the application of this algorithm to the problem of renewable energy generation following. This dissertation contributes to the development of intelligent energy management systems for buildings by presenting a suite of novel and adaptable modeling and control techniques. Applications focus on optimizing the performance of building operations and on facilitating the integration of renewable energy resources.
[Blood culture negative endocarditis: a diagnostic challenge].
Wälli, F; Chuard, C; Regamey, C
2005-10-12
Blood culture negative endocarditis (BCNE) account for about 5% of all cases of endocarditis. Diagnosis and initiation of antimicrobial therapy may be delayed, with a negative impact on clinical outcome. The most common cause of BCNE is antimicrobial drug therapy before blood sampling. Other common causes include slow growing and non cultivable organisms. Identification of the etiologic agent is critical in the management of BCNE and molecular tools such as broad range 16SrRNA PCR technique followed by direct automated sequencing and microorganism-specific PCR are promising. Some authors have proposed to include these techniques among major Duke's criteria for the diagnosis of BCNE.
Characterization and evaluation of an aeolian-photovoltaic system in operation
NASA Astrophysics Data System (ADS)
Bonfatti, F.; Calzolari, P. U.; Cardinali, G. C.; Vivanti, G.; Zani, A.
Data management, analysis techniques and results of performance monitoring of a prototype combined photovoltaic (PV)-wind turbine farm power plant in northern Italy are reported. Emphasis is placed on the PV I-V characteristics and irradiance and cell temperatures. Automated instrumentation monitors and records meteorological data and generator variables such as voltages, currents, output, battery electrolyte temperature, etc. Analysis proceeds by automated selection of I-V data for specific intervals of the year when other variables can be treated as constants. The technique permits characterization of generator performance, adjusting the power plant set points for optimal output, and tracking performance degradation over time.
Modern imaging techniques: applications in the management of acute aortic pathologies.
Nagpal, Prashant; Khandelwal, Ashish; Saboo, Sachin S; Bathla, Girish; Steigner, Michael L; Rybicki, Frank J
2015-08-01
Acute aortic pathologies include traumatic and non-traumatic life-threatening emergencies of the aorta. Since the clinical manifestation of these entities can be non-specific and may overlap with other conditions presenting with chest pain, non-invasive imaging plays a crucial role in their rapid and accurate evaluation. The early diagnosis and accurate radiological assessment of acute aortic diseases is essential for improved clinical outcomes. Multidetector CT is the imaging modality of choice for evaluation of acute aortic diseases with MRI playing more of a problem-solving role. The management can be medical, endovascular or surgical depending upon pathology, and imaging remains an indispensable management-guiding tool. It is important to understand the pathogenesis, natural history, and imaging principles of acute aortic diseases for appropriate use of advanced imaging modalities. This understanding helps to formulate a more appropriate management and follow-up plan for optimised care of these patients. Imaging reporting pearls for day-to-day radiology as well as treatment options based on latest multidisciplinary guidelines are discussed. With newer techniques of image acquisition and processing, we are hopeful that imaging would further help in predicting aortic disease progression and assessing the haemodynamic parameters based on which decisions on management can be made. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
The Evolution of Public Health Emergency Management as a Field of Practice.
Rose, Dale A; Murthy, Shivani; Brooks, Jennifer; Bryant, Jeffrey
2017-09-01
The health impacts of recent global infectious disease outbreaks and other disasters have demonstrated the importance of strengthening public health systems to better protect communities from naturally occurring and human-caused threats. Public health emergency management (PHEM) is an emergent field of practice that draws on specific sets of knowledge, techniques, and organizing principles necessary for the effective management of complex health events. We highlight how the nascent field of PHEM has evolved in recent years. We explore this development by first examining multiple sites of intersection between the fields of public health and emergency management. We then analyze 2 of the principal pillars on which PHEM was built: organizational and programmatic (i.e., industry) standards and the incident management system. This is followed by a sketch of the key domains, or functional areas, of PHEM and their application to the emergency management cycle. We conclude with some observations about PHEM in a global context and discuss how the field might continue to evolve.
The Evolution of Public Health Emergency Management as a Field of Practice
Murthy, Shivani; Brooks, Jennifer; Bryant, Jeffrey
2017-01-01
The health impacts of recent global infectious disease outbreaks and other disasters have demonstrated the importance of strengthening public health systems to better protect communities from naturally occurring and human-caused threats. Public health emergency management (PHEM) is an emergent field of practice that draws on specific sets of knowledge, techniques, and organizing principles necessary for the effective management of complex health events. We highlight how the nascent field of PHEM has evolved in recent years. We explore this development by first examining multiple sites of intersection between the fields of public health and emergency management. We then analyze 2 of the principal pillars on which PHEM was built: organizational and programmatic (i.e., industry) standards and the incident management system. This is followed by a sketch of the key domains, or functional areas, of PHEM and their application to the emergency management cycle. We conclude with some observations about PHEM in a global context and discuss how the field might continue to evolve. PMID:28892444
Hepatocellular carcinoma: Advances in diagnostic imaging.
Sun, Haoran; Song, Tianqiang
2015-10-01
Thanks to the growing knowledge on biological behaviors of hepatocellular carcinomas (HCC), as well as continuous improvement in imaging techniques and experienced interpretation of imaging features of the nodules in cirrhotic liver, the detection and characterization of HCC has improved in the past decade. A number of practice guidelines for imaging diagnosis have been developed to reduce interpretation variability and standardize management of HCC, and they are constantly updated with advances in imaging techniques and evidence based data from clinical series. In this article, we strive to review the imaging techniques and the characteristic features of hepatocellular carcinoma associated with cirrhotic liver, with emphasis on the diagnostic value of advanced magnetic resonance imaging (MRI) techniques and utilization of hepatocyte-specific MRI contrast agents. We also briefly describe the concept of liver imaging reporting and data systems and discuss the consensus and controversy of major practice guidelines.
Adaptable data management for systems biology investigations.
Boyle, John; Rovira, Hector; Cavnor, Chris; Burdick, David; Killcoyne, Sarah; Shmulevich, Ilya
2009-03-06
Within research each experiment is different, the focus changes and the data is generated from a continually evolving barrage of technologies. There is a continual introduction of new techniques whose usage ranges from in-house protocols through to high-throughput instrumentation. To support these requirements data management systems are needed that can be rapidly built and readily adapted for new usage. The adaptable data management system discussed is designed to support the seamless mining and analysis of biological experiment data that is commonly used in systems biology (e.g. ChIP-chip, gene expression, proteomics, imaging, flow cytometry). We use different content graphs to represent different views upon the data. These views are designed for different roles: equipment specific views are used to gather instrumentation information; data processing oriented views are provided to enable the rapid development of analysis applications; and research project specific views are used to organize information for individual research experiments. This management system allows for both the rapid introduction of new types of information and the evolution of the knowledge it represents. Data management is an important aspect of any research enterprise. It is the foundation on which most applications are built, and must be easily extended to serve new functionality for new scientific areas. We have found that adopting a three-tier architecture for data management, built around distributed standardized content repositories, allows us to rapidly develop new applications to support a diverse user community.
Acharya, Sujeet S; Gundeti, Mohan S; Zagaja, Gregory P; Shalhav, Arieh L; Zorn, Kevin C
2009-04-01
Although malformations of the genitourinary tract are typically identified during childhood, they can remain silent until incidental detection in evaluation and treatment of other pathologies during adulthood. The advent of the minimally invasive era in urologic surgery has given rise to unique challenges in the surgical management of anomalies of the genitourinary tract. This article reviews the embryology of anomalies of Wolffian duct (WD) derivatives with specific attention to the seminal vesicles, vas deferens, ureter, and kidneys. This is followed by a discussion of the history of the laparoscopic approach to WD derivative anomalies. Finally, we present two cases to describe technical considerations when managing these anomalies when encountered during robotic-assisted radical prostatectomy. The University of Chicago Robotic Laparoscopic Radical Prostatectomy (RLRP) database was reviewed for cases where anomalies of WD derivatives were encountered. We describe how modifications in technique allowed for completion of the procedure without difficulty. None Of the 1230 RLRP procedures performed at our institution by three surgeons, only two cases (0.16%) have been noted to have a WD anomaly. These cases were able to be completed without difficulty by making simple modifications in technique. Although uncommon, it is important for the urologist to be familiar with the origin and surgical management of WD anomalies, particularly when detected incidentally during surgery. Simple modifications in technique allow for completion of RLRP without difficulty.
Paddock, Stephen W; Eliceiri, Kevin W
2014-01-01
Confocal microscopy is an established light microscopical technique for imaging fluorescently labeled specimens with significant three-dimensional structure. Applications of confocal microscopy in the biomedical sciences include the imaging of the spatial distribution of macromolecules in either fixed or living cells, the automated collection of 3D data, the imaging of multiple labeled specimens and the measurement of physiological events in living cells. The laser scanning confocal microscope continues to be chosen for most routine work although a number of instruments have been developed for more specific applications. Significant improvements have been made to all areas of the confocal approach, not only to the instruments themselves, but also to the protocols of specimen preparation, to the analysis, the display, the reproduction, sharing and management of confocal images using bioinformatics techniques.
Culture in the Cockpit-CRM in a Multicultural World
NASA Technical Reports Server (NTRS)
Engle, Michael
2000-01-01
Crew Resource Management (CRM) is fundamentally a method for enhancing personal interactions among crewmembers so that safety and efficiency are increased, and at its core involves issues of culture and social interaction. Since CRM is increasingly being adopted by foreign carriers, it is important to evaluate standard CRM techniques from a cultural standpoint, especially if some of these techniques may be enhanced by adapting them to particular cultures. The purpose of this paper is to propose a model for an ideal CRM culture, and to suggest ways that CRM may be adapted to suit particular cultures. The research method was a simple literature search to gather data on CRM techniques and multicultural crews. The results indicate that CRM can be tailored to specific cultures for maximum effectiveness.
An assessment of PERT as a technique for schedule planning and control
NASA Technical Reports Server (NTRS)
Sibbers, C. W.
1982-01-01
The PERT technique including the types of reports which can be computer generated using the NASA/LaRC PPARS System is described. An assessment is made of the effectiveness of PERT on various types of efforts as well as for specific purposes, namely, schedule planning, schedule analysis, schedule control, monitoring contractor schedule performance, and management reporting. This assessment is based primarily on the author's knowledge of the usage of PERT by NASA/LaRC personnel since the early 1960's. Both strengths and weaknesses of the technique for various applications are discussed. It is intended to serve as a reference guide for personnel performing project planning and control functions and technical personnel whose responsibilities either include schedule planning and control or require a general knowledge of the subject.
Endoscopic Management of Benign Esophageal Strictures.
Ravich, William J
2017-08-24
This paper presents the author's approach to esophageal dilation. It offers a tailored approach to the application of dilation to specific types of esophageal stenotic lesions. In patients with inflammatory stricture, recent studies confirm the importance of treating the underlying inflammatory condition in order to decrease the rate of recurrence. The paper reviews some of the novel techniques that have been suggested for the treatment of refractory benign esophageal strictures, including incisional therapy, stenting, or the injection steroids or antifibrotic agents. The endoscopist who treats esophageal strictures must be familiar with the tools of the dilation and how they are best applied to specific types of stenotic lesions. If inflammation is present, effective management requires treatment of the inflammatory process in addition to mechanical dilation of the stenotic lesion. Controlled trials of novel approaches to treatment of refractory benign esophageal strictures are limited and will be necessary to determine efficacy.
Project officer's perspective: quality assurance as a management tool.
Heiby, J
1993-06-01
Advances in the management of health programs in less developed countries (LDC) have not kept pace with the progress of the technology used. The US Agency for International Development mandated the Quality Assurance Project (QAP) to provide quality improvement technical assistance to primary health care systems in LDCs while developing appropriate quality assurance (QA) strategies. The quality of health care in recent years in the US and Europe focused on the introduction of management techniques developed for industry into health systems. The experience of the QAP and its predecessor, the PRICOR Project, shows that quality improvement techniques facilitate measurement of quality of care. A recently developed WHO model for the management of the sick child provides scientifically based standards for actual care. Since 1988, outside investigators measuring how LDC clinicians perform have revealed serious deficiencies in quality compared with the program's own standards. This prompted developed of new QA management initiatives: 1) communicating standards clearly to the program staff; 2) actively monitoring actual performance corresponds to these standards; and 3) taking action to improve performance. QA means that managers are expected to monitor service delivery, undertake problem solving, and set specific targets for quality improvement. Quality improvement methods strengthen supervision as supervisors can objectively assess health worker performance. QA strengthens the management functions that support service delivery, e.g., training, records management, finance, logistics, and supervision. Attention to quality can contribute to improved health worker motivation and effective incentive programs by recognition for a job well done and opportunities for learning new skills. These standards can also address patient satisfaction. QA challenges managers to aim for the optimal level of care attainable.
A system for the management of requests at an image data bank. M.S. Thesis
NASA Technical Reports Server (NTRS)
Debarrosaguirre, J. L. (Principal Investigator)
1984-01-01
An automated system was implemented to supersede existing manual procedures in fulfilling user requests made to a remote sensing data bank, concerning specifically LANDSAT imagery. The system controls the several production steps from request entry to the shipment of each final product. Special solutions and techniques were employed due to the severe limitations, in both hardware and software of the host minicomputer system.
ERIC Educational Resources Information Center
Crozier, Carl
This guide provides agricultural extensionists with basic information that will help them design plans for the conservation of soils and the management of water runoff in specific agricultural plots. It is based on experiences with small hillside farms in Honduras and takes into account the resources and constraints commonly encountered there.…
Shaqour, F; Taany, R; Rimawi, O; Saffarini, G
2016-01-01
Modeling groundwater properties is an important tool by means of which water resources management can judge whether these properties are within the safe limits or not. This is usually done regularly and in the aftermath of crises that are expected to reflect negatively on groundwater properties, as occurred in Jordan due to crises in neighboring countries. In this study, specific capacity and salinity of groundwater of B2/A7 aquifer in Amman Zarqa Basin were evaluated to figure out the effect of population increase in this basin as a result of refugee flux from neighboring countries to this heavily populated basin after Gulf crises 1990 and 2003. Both properties were found to exhibit a three-parameter lognormal distribution. The empirically calculated β parameter of this distribution mounted up to 0.39 m(3)/h/min for specific capacity and 238 ppm for salinity. This parameter is suggested to account for the global changes that took place all over the basin during the entire period of observation and not for local changes at every well or at certain localities in the basin. It can be considered as an exploratory result of data analysis. Formal and implicit evaluation followed this step using structural analysis and construction of experimental semivariograms that represent the spatial variability of both properties. The adopted semivariograms were then used to construct maps to illustrate the spatial variability of the properties under consideration using kriging interpolation techniques. Semivariograms show that specific capacity and salinity values are spatially dependent within 14,529 and 16,309 m, respectively. Specific capacity semivariogram exhibit a nugget effect on a small scale (324 m). This can be attributed to heterogeneity or inadequacies in measurement. Specific capacity and salinity maps show that the major changes exhibit a northwest southeast trend, near As-Samra Wastewater Treatment Plant. The results of this study suggest proper management practices.
Conceptualisation of self-management intervention for people with early stage dementia.
Martin, Faith; Turner, Andrew; Wallace, Louise M; Bradbury, Nicola
2013-06-01
Dementia is a major challenge for health and social care services. People living with dementia in the earlier stages experience a "care-gap". Although they may address this gap in care, self-management interventions have not been provided to people with dementia. It is unclear how to conceptualise self-management for this group and few published papers address intervention design. Initial focusing work used a logic mapping approach, interviews with key stakeholders, including people with dementia and their family members. An initial set of self-management targets were identified for potential intervention. Self-management for people living with dementia was conceptualised as covering five targets: (1) relationship with family, (2) maintaining an active lifestyle, (3) psychological wellbeing, (4) techniques to cope with memory changes, and (5) information about dementia. These targets were used to focus literature reviewing to explore an evidence base for the conceptualisation. We discuss the utility of the Corbin and Strauss (Unending work and care: managing chronic illness at home. Jossey-Bass, Oxford, 1988) model of self-management, specifically that self-management for people living with dementia should be conceptualised as emphasising the importance of "everyday life work" (targets 1 and 2) and "biographical work" (target 3), with inclusion of but less emphasis on specific "illness work" (targets 4, 5). We argue that self-management is possible for people with dementia, with a strengths focus and emphasis on quality of life, which can be achieved despite cognitive impairments. Further development and testing of such interventions is required to provide much needed support for people in early stages of dementia.
Intelligent Engine Systems: Thermal Management and Advanced Cooling
NASA Technical Reports Server (NTRS)
Bergholz, Robert
2008-01-01
The objective is to provide turbine-cooling technologies to meet Propulsion 21 goals related to engine fuel burn, emissions, safety, and reliability. Specifically, the GE Aviation (GEA) Advanced Turbine Cooling and Thermal Management program seeks to develop advanced cooling and flow distribution methods for HP turbines, while achieving a substantial reduction in total cooling flow and assuring acceptable turbine component safety and reliability. Enhanced cooling techniques, such as fluidic devices, controlled-vortex cooling, and directed impingement jets, offer the opportunity to incorporate both active and passive schemes. Coolant heat transfer enhancement also can be achieved from advanced designs that incorporate multi-disciplinary optimization of external film and internal cooling passage geometry.
A review of cetacean lung morphology and mechanics.
Piscitelli, Marina A; Raverty, Stephen A; Lillie, Margo A; Shadwick, Robert E
2013-12-01
Cetaceans possess diverse adaptations in respiratory structure and mechanics that are highly specialized for an array of surfacing and diving behaviors. Some of these adaptations and air management strategies are still not completely understood despite over a century of study. We have compiled the historical and contemporary knowledge of cetacean lung anatomy and mechanics in regards to normal lung function during ventilation and air management while diving. New techniques are emerging utilizing pulmonary mechanics to measure lung function in live cetaceans. Given the diversity of respiratory adaptations in cetaceans, interpretations of these results should consider species-specific anatomy, mechanics, and behavior. Copyright © 2013 Wiley Periodicals, Inc.
Proceedings of the 21st DOE/NRC Nuclear Air Cleaning Conference; Sessions 1--8
DOE Office of Scientific and Technical Information (OSTI.GOV)
First, M.W.
1991-02-01
Separate abstracts have been prepared for the papers presented at the meeting on nuclear facility air cleaning technology in the following specific areas of interest: air cleaning technologies for the management and disposal of radioactive wastes; Canadian waste management program; radiological health effects models for nuclear power plant accident consequence analysis; filter testing; US standard codes on nuclear air and gas treatment; European community nuclear codes and standards; chemical processing off-gas cleaning; incineration and vitrification; adsorbents; nuclear codes and standards; mathematical modeling techniques; filter technology; safety; containment system venting; and nuclear air cleaning programs around the world. (MB)
Radiation dose reduction in computed tomography: techniques and future perspective
Yu, Lifeng; Liu, Xin; Leng, Shuai; Kofler, James M; Ramirez-Giraldo, Juan C; Qu, Mingliang; Christner, Jodie; Fletcher, Joel G; McCollough, Cynthia H
2011-01-01
Despite universal consensus that computed tomography (CT) overwhelmingly benefits patients when used for appropriate indications, concerns have been raised regarding the potential risk of cancer induction from CT due to the exponentially increased use of CT in medicine. Keeping radiation dose as low as reasonably achievable, consistent with the diagnostic task, remains the most important strategy for decreasing this potential risk. This article summarizes the general technical strategies that are commonly used for radiation dose management in CT. Dose-management strategies for pediatric CT, cardiac CT, dual-energy CT, CT perfusion and interventional CT are specifically discussed, and future perspectives on CT dose reduction are presented. PMID:22308169
"Selling smarter, not harder": Life course effects on drug sellers' risk perceptions and management.
Fader, Jamie J
2016-10-01
Policies undergirding the American War on Drugs assume that drug offenders respond rationally to adjustments in sanction certainty and severity. Previous studies find that instead of absolute deterrence, or the termination of criminal activity, drug offenders employ restrictive deterrence, or a variety of risk management strategies. Extant research and current drug policy both fail to examine the interaction of risk perception, management techniques, and life course events or circumstances. This dynamic examination of apprehension avoidance strategies relies on in-depth interviews mapping out the careers of 20 drug sellers in Philadelphia, Pennsylvania. It examines their risk perceptions and risk management strategies and techniques, exploring rationales for shifts in offending behavior. Respondents were highly risk-averse but used a narrow definition of sanctions relevant to shaping future offending behavior, typically making small adjustments in sales techniques. Rationales for these shifts included sanctions, personal preference, and life course events or circumstances. Only one attributed lasting desistance from offending to a sanction, although life course events such as parenthood and employment were associated with short-term and planned desistance. The limited relevance of sanctions to offenders' thinking about risk avoidance contextualizes the widespread failure of policies designed to deter drug sales. Findings support a growing conclusion that severity of punishment is a less powerful deterrent than certainty and that adjustments in certainty after arrest are offense-specific. The relationship of life course events - especially employment - to desistance and resumed offending suggest that social policies may be more effective than criminal justice sanctions in reducing drug offending. Copyright © 2016 Elsevier B.V. All rights reserved.
1976-09-01
The purpose of this research effort was to determine the financial management educational needs of USAF graduate logistics positions. Goal analysis...was used to identify financial management techniques and task analysis was used to develop a method to identify the use of financial management techniques...positions. The survey identified financial management techniques in five areas: cost accounting, capital budgeting, working capital, financial forecasting, and programming. (Author)
Propulsion Health Monitoring for Enhanced Safety
NASA Technical Reports Server (NTRS)
Butz, Mark G.; Rodriguez, Hector M.
2003-01-01
This report presents the results of the NASA contract Propulsion System Health Management for Enhanced Safety performed by General Electric Aircraft Engines (GE AE), General Electric Global Research (GE GR), and Pennsylvania State University Applied Research Laboratory (PSU ARL) under the NASA Aviation Safety Program. This activity supports the overall goal of enhanced civil aviation safety through a reduction in the occurrence of safety-significant propulsion system malfunctions. Specific objectives are to develop and demonstrate vibration diagnostics techniques for the on-line detection of turbine rotor disk cracks, and model-based fault tolerant control techniques for the prevention and mitigation of in-flight engine shutdown, surge/stall, and flameout events. The disk crack detection work was performed by GE GR which focused on a radial-mode vibration monitoring technique, and PSU ARL which focused on a torsional-mode vibration monitoring technique. GE AE performed the Model-Based Fault Tolerant Control work which focused on the development of analytical techniques for detecting, isolating, and accommodating gas-path faults.
An ORCID based synchronization framework for a national CRIS ecosystem.
Mendes Moreira, João; Cunha, Alcino; Macedo, Nuno
2015-01-01
PTCRIS (Portuguese Current Research Information System) is a program aiming at the creation and sustained development of a national integrated information ecosystem, to support research management according to the best international standards and practices. This paper reports on the experience of designing and prototyping a synchronization framework for PTCRIS based on ORCID (Open Researcher and Contributor ID). This framework embraces the "input once, re-use often" principle, and will enable a substantial reduction of the research output management burden by allowing automatic information exchange between the various national systems. The design of the framework followed best practices in rigorous software engineering, namely well-established principles in the research field of consistency management, and relied on formal analysis techniques and tools for its validation and verification. The notion of consistency between the services was formally specified and discussed with the stakeholders before the technical aspects on how to preserve said consistency were explored. Formal specification languages and automated verification tools were used to analyze the specifications and generate usage scenarios, useful for validation with the stakeholder and essential to certificate compliant services.
O'Shaughnessy, Maureen A.; Shin, Alexander Y.; Kakar, Sanjeev
2016-01-01
Background Distal radius fractures involving the lunate facet can be challenging to manage. Reports have shown the volar carpal subluxation/dislocation that can occur if the facet is not appropriately stabilized. Literature Review Recent emphasis in the literature has underscored the difficulty in managing this fracture fragment, suggesting standard volar plates may not be able to adequately stabilize the fragment. This article reviews the current literature with a special emphasis on fixation with a specifically designed fragment-specific hook plate to secure the lunate facet. Case Description An extended flexor carpi radialis volar approach was made which allows access to the distal volar ulnar fracture fragment. Once provisionally stabilized with Kirschner wire fixation, a volar hook plate was applied to capture this fragment. Additional fracture stabilization was used as deemed necessary to stabilize the remaining distal radius fracture. Clinical Relevance The volar marginal rim fragment remains a challenge in distal radius fracture management. Use of a hook plate to address the volar ulnar corner allows for stable fixation without loss of reduction at intermediate-term follow-up. PMID:27104076
Problematics of open prostatectomy in an Ivorian District Hospital setting.
Mgbakor, Anthony Chukwura
2012-09-01
Benign prostatic hypertrophy forms the bulk of urology workload in many sub-Saharan African hospitals. However, its management in secondary hospitals encounters specific problems that are rarely seen in the bigger tertiary institutions. We have tried to describe these difficulties across an account of open prostatectomy in regional secondary referral hospitals in the Côte d'Ivoire. This is a retrospective account of the specific difficulties encountered in the management of 327 consecutive cases of open prostatectomy carried out between August 1991 and September 2007 mainly in two secondary referral hospitals in the Côte d'Ivoire. The difficulties were at different levels: late presentation with 309 (94.5%) of the patients having experienced at least an episode of acute retention of urine, surgery while most patients were still carrying a catheter, minimal investigations carried out, scoring the patients in the IPSS scale, shortage of funds in the course of the management, and surveillance in the immediate postoperative period. The overall results were relatively satisfactory given our conditions of work. The most frequent complications were wound infection (14.7%), bleeding requiring transfusion (8.6%) and re-operation for clot retention (4.3%). We had a case (0.3%) of the rare prostato-rectal fistula which was managed conservatively. There were 4 deaths (1.2%). Open prostatectomy is the only surgical option for the management of benign prostatic hypertrophy in most of the urology centers of sub-Saharan Africa. Concerning its management away from the Tertiary Institutes, the surgery team is faced with specific problems which demand precise adaptations. Despite difficult working conditions, the results are sufficiently encouraging and gratifying to justify its pursuit while Urologists await the availability of equipments for transurethral resection of the prostate and other novel techniques.
Schuler, M; Musekamp, G; Bengel, J; Schwarze, M; Spanier, K; Gutenbrunner, Chr; Ehlebracht-König, I; Nolte, S; Osborne, R H; Faller, H
2014-11-01
To assess stable effects of self-management programs, measurement instruments should primarily capture the attributes of interest, for example, the self-management skills of the measured persons. However, measurements of psychological constructs are always influenced by both aspects of the situation (states) and aspects of the person (traits). This study tests whether the Health Education Impact Questionnaire (heiQ™), an instrument assessing a wide range of proximal outcomes of self-management programs, is primarily influenced by person factors instead of situational factors. Furthermore, measurement invariance over time, changes in traits and predictors of change for each heiQ™ scale were examined. Subjects were N = 580 patients with rheumatism, asthma, orthopedic conditions or inflammatory bowel disease, who filled out the heiQ™ at the beginning, the end of and 3 months after a disease-specific inpatient rehabilitation program in Germany. Structural equation modeling techniques were used to estimate latent trait-change models and test for measurement invariance in each heiQ™ scale. Coefficients of consistency, occasion specificity and reliability were computed. All scales showed scalar invariance over time. Reliability coefficients were high (0.80-0.94), and consistency coefficients (0.49-0.79) were always substantially higher than occasion specificity coefficients (0.14-0.38), indicating that the heiQ™ scales primarily capture person factors. Trait-changes with small to medium effect sizes were shown in five scales and were affected by sex, age and diagnostic group. The heiQ™ can be used to assess stable effects in important outcomes of self-management programs over time, e.g., changes in self-management skills or emotional well-being.
Managing industrial risk--having a tested and proven system to prevent and assess risk.
Heller, Stephen
2006-03-17
Some relatively easy techniques exist to improve the risk picture/profile to aid in preventing losses. Today with the advent of computer system resources, focusing on specific aspects of risk through systematic scoring and comparison, the risk analysis can be relatively easy to achieve. Techniques like these demonstrate how working experience and common sense can be combined mathematically into a flexible risk management tool or risk model for analyzing risk. The risk assessment methodology provided by companies today is no longer the ideas and practices of one group or even one company. It is reflective of the practice of many companies, as well as the ideas and expertise of academia and government regulators. The use of multi-criteria decision making (MCDM) techniques for making critical decisions has been recognized for many years for a variety of purposes. In today's computer age, the easy accessing and user-friendly nature for using these techniques, makes them a favorable choice for use in the risk assessment environment. The new user of these methodologies should find many ideas directly applicable to his or her needs when approaching risk decision making. The user should find their ideas readily adapted, with slight modification, to accurately reflect a specific situation using MCDM techniques. This makes them an attractive feature for use in assessment and risk modeling. The main advantage of decision making techniques, such as MCDM, is that in the early stages of a risk assessment, accurate data on industrial risk, and failures are lacking. In most cases, it is still insufficient to perform a thorough risk assessment using purely statistical concepts. The practical advantages towards deviating from strict data-driven protocol seem to outweigh the drawbacks. Industry failure data often comes at a high cost when a loss occurs. We can benefit from this unfortunate acquisition of data through the continuous refining of our decisions by incorporating this new information into our assessments. MCDM techniques offer flexibility in accessing comparison within broad data sets to reflect our best estimation of their importance towards contribution to the risk picture. This allows for the accurate determination of the more probable and more consequential issues. This can later be refined using more intensive risk techniques and the avoidance of less critical issues.
ERIC Educational Resources Information Center
Platte Technical Community Coll., Columbus, NE.
These Project TEAMS (Techniques and Education for Achieving Management Skills) instructional materials consist of five units for use in training business and industrial supervisors. Unit 1 is designed to help managers in business or industry increase management skills in regard to leadership techniques, problem solving and decision making, and…
The interaction between biology and the management of aquatic macrophytes
Nichols, S.A.
1991-01-01
'Management' refers to controlling nuisance aquatic species and to restoring or restructing aquatic plant communities. Producing stable, diverse, aquatic plant communities containing a high percentage of desirable species is a primary management goal. There are a variety of techniques including harvesting, herbicides, water-level fluctuation, sediment alteration, nutrient limitation, light alteration, and biological controls which can be used for managing macrophytes. These techniques are briefly reviewed along with discussions of biological considerations important to the efficacy of the technique and the environmental impacts of the technique. There is a growing interest in restoring and restructing aquatic plant communities. Techniques for community restoration are discussed as are emerging management technologies using growth regulators and bioengineering. New management technologies will probably be limited by costs and environmental impacts. In the near future, better macrophyte management will come through better planning and more effective use of present technology. The challenge is to make current planning and management techniques more effective through increased biological inputs. The potential for biological input ranges from subcellular biology to species biology, to community and ecosystem biology. Some information needs are identified. ?? 1991.
DISSECT: a new mnemonic-based approach to the categorization of aortic dissection.
Dake, M D; Thompson, M; van Sambeek, M; Vermassen, F; Morales, J P
2013-08-01
Classification systems for aortic dissection provide important guides to clinical decision-making, but the relevance of traditional categorization schemes is being questioned in an era when endovascular techniques are assuming a growing role in the management of this frequently complex and catastrophic entity. In recognition of the expanding range of interventional therapies now used as alternatives to conventional treatment approaches, the Working Group on Aortic Diseases of the DEFINE Project developed a categorization system that features the specific anatomic and clinical manifestations of the disease process that are most relevant to contemporary decision-making. The DISSECT classification system is a mnemonic-based approach to the evaluation of aortic dissection. It guides clinicians through an assessment of six critical characteristics that facilitate optimal communication of the most salient details that currently influence the selection of a therapeutic option, including those findings that are key when considering an endovascular procedure, but are not taken into account by the DeBakey or Stanford categorization schemes. The six features of aortic dissection include: duration of disease; intimal tear location; size of the dissected aorta; segmental extent of aortic involvement; clinical complications of the dissection, and thrombus within the aortic false lumen. In current clinical practice, endovascular therapy is increasingly considered as an alternative to medical management or open surgical repair in select cases of type B aortic dissection. Currently, endovascular aortic repair is not used for patients with type A aortic dissection, but catheter-based techniques directed at peripheral branch vessel ischemia that may complicate type A dissection are considered valuable adjunctive interventions, when indicated. The use of a new system for categorization of aortic dissection, DISSECT, addresses the shortcomings of well-known established schemes devised more than 40 years ago, before the introduction of endovascular techniques. It will serve as a guide to support a critical analysis of contemporary therapeutic options and inform management decisions based on specific features of the disease process. Copyright © 2013 European Society for Vascular Surgery. All rights reserved.
A rational framework for production decision making in blood establishments.
Ramoa, Augusto; Maia, Salomé; Lourenço, Anália
2012-07-24
SAD_BaSe is a blood bank data analysis software, created to assist in the management of blood donations and the blood production chain in blood establishments. In particular, the system keeps track of several collection and production indicators, enables the definition of collection and production strategies, and the measurement of quality indicators required by the Quality Management System regulating the general operation of blood establishments. This paper describes the general scenario of blood establishments and its main requirements in terms of data management and analysis. It presents the architecture of SAD_BaSe and identifies its main contributions. Specifically, it brings forward the generation of customized reports driven by decision making needs and the use of data mining techniques in the analysis of donor suspensions and donation discards.
A Rational Framework for Production Decision Making in Blood Establishments.
Ramoa, Augusto; Maia, Salomé; Lourenço, Anália
2012-12-01
SAD_BaSe is a blood bank data analysis software, created to assist in the management of blood donations and the blood production chain in blood establishments. In particular, the system keeps track of several collection and production indicators, enables the definition of collection and production strategies, and the measurement of quality indicators required by the Quality Management System regulating the general operation of blood establishments. This paper describes the general scenario of blood establishments and its main requirements in terms of data management and analysis. It presents the architecture of SAD_BaSe and identifies its main contributions. Specifically, it brings forward the generation of customized reports driven by decision making needs and the use of data mining techniques in the analysis of donor suspensions and donation discards.
NASA Technical Reports Server (NTRS)
Wheeler, D. J.; Ridd, M. K.; Merola, J. A.
1984-01-01
A basic geographic information system (GIS) for the North Cache Soil Conservation District (SCD) was sought for selected resource problems. Since the resource management issues in the North Cache SCD are very complex, it is not feasible in the initial phase to generate all the physical, socioeconomic, and political baseline data needed for resolving all management issues. A selection of critical varables becomes essential. Thus, there are foud specific objectives: (1) assess resource management needs and determine which resource factors ae most fundamental for building a beginning data base; (2) evaluate the variety of data gathering and analysis techniques for the resource factors selected; (3) incorporate the resulting data into a useful and efficient digital data base; and (4) demonstrate the application of the data base to selected real world resoource management issues.
Nanotechnology: a promising method for oral cancer detection and diagnosis.
Chen, Xiao-Jie; Zhang, Xue-Qiong; Liu, Qi; Zhang, Jing; Zhou, Gang
2018-06-11
Oral cancer is a common and aggressive cancer with high morbidity, mortality, and recurrence rate globally. Early detection is of utmost importance for cancer prevention and disease management. Currently, tissue biopsy remains the gold standard for oral cancer diagnosis, but it is invasive, which may cause patient discomfort. The application of traditional noninvasive methods-such as vital staining, exfoliative cytology, and molecular imaging-is limited by insufficient sensitivity and specificity. Thus, there is an urgent need for exploring noninvasive, highly sensitive, and specific diagnostic techniques. Nano detection systems are known as new emerging noninvasive strategies that bring the detection sensitivity of biomarkers to nano-scale. Moreover, compared to current imaging contrast agents, nanoparticles are more biocompatible, easier to synthesize, and able to target specific surface molecules. Nanoparticles generate localized surface plasmon resonances at near-infrared wavelengths, providing higher image contrast and resolution. Therefore, using nano-based techniques can help clinicians to detect and better monitor diseases during different phases of oral malignancy. Here, we review the progress of nanotechnology-based methods in oral cancer detection and diagnosis.
Management of sleep disorders in stroke.
Im, Kyoung Bin; Strader, Scott; Dyken, Mark Eric
2010-09-01
Scientific studies have proven a very strong association between stroke and obstructive sleep apnea (OSA). The prevalence of OSA is very high in patients with acute stroke, and untreated OSA is a stroke risk factor. In the stroke patient population, symptoms of OSA may atypically appear as isolated insomnia, hypersomnia, a dysfunction of circadian rhythm, a parasomnia, or a sleep-related movement disorder. Thus, we believe that in patients with acute stroke, OSA should be addressed first, using full in-laboratory, attended polysomnography (PSG), before other specific sleep disorders are aggressively addressed with specific therapeutic interventions. When OSA is diagnosed, supportive techniques including the application of continuous positive airway pressure (CPAP) therapy, positional therapies, or both should be considered first-line treatments. If OSA is ruled out by PSG, the therapeutic emphasis for sleep-related complaints is routinely based on instituting good sleep hygiene practices and using cognitive behavioral techniques (cognitive therapies, sleep restriction, stimulus control, and progressive relaxation therapies) because patients with stroke may be prone to the adverse effects of many of the medications that are otherwise routinely prescribed for a variety of specific sleep disorders.
NASA Technical Reports Server (NTRS)
Dabney, James B.; Arthur, James Douglas
2017-01-01
Agile methods have gained wide acceptance over the past several years, to the point that they are now a standard management and execution approach for small-scale software development projects. While conventional Agile methods are not generally applicable to large multi-year and mission-critical systems, Agile hybrids are now being developed (such as SAFe) to exploit the productivity improvements of Agile while retaining the necessary process rigor and coordination needs of these projects. From the perspective of Independent Verification and Validation (IVV), however, the adoption of these hybrid Agile frameworks is becoming somewhat problematic. Hence, we find it prudent to question the compatibility of conventional IVV techniques with (hybrid) Agile practices.This paper documents our investigation of (a) relevant literature, (b) the modification and adoption of Agile frameworks to accommodate the development of large scale, mission critical systems, and (c) the compatibility of standard IVV techniques within hybrid Agile development frameworks. Specific to the latter, we found that the IVV methods employed within a hybrid Agile process can be divided into three groups: (1) early lifecycle IVV techniques that are fully compatible with the hybrid lifecycles, (2) IVV techniques that focus on tracing requirements, test objectives, etc. are somewhat incompatible, but can be tailored with a modest effort, and (3) IVV techniques involving an assessment requiring artifact completeness that are simply not compatible with hybrid Agile processes, e.g., those that assume complete requirement specification early in the development lifecycle.
Zinken, Katarzyna M; Cradock, Sue; Skinner, T Chas
2008-08-01
The paper presents the development of a coding tool for self-efficacy orientated interventions in diabetes self-management programmes (Analysis System for Self-Efficacy Training, ASSET) and explores its construct validity and clinical utility. Based on four sources of self-efficacy (i.e., mastery experience, role modelling, verbal persuasion and physiological and affective states), published self-efficacy based interventions for diabetes care were analysed in order to identify specific verbal behavioural techniques. Video-recorded facilitating behaviours were evaluated using ASSET. The reliability between four coders was high (K=0.71). ASSET enabled assessment of both self-efficacy based techniques and participants' response to those techniques. Individual patterns of delivery and shifts over time across facilitators were found. In the presented intervention we observed that self-efficacy utterances were followed by longer patient verbal responses than non-self-efficacy utterances. These detailed analyses with ASSET provide rich data and give the researcher an insight into the underlying mechanism of the intervention process. By providing a detailed description of self-efficacy strategies ASSET can be used by health care professionals to guide reflective practice and support training programmes.
Persistent atrial fibrillation vs paroxysmal atrial fibrillation: differences in management.
Margulescu, Andrei D; Mont, Lluis
2017-08-01
Atrial fibrillation (AF) is the most common human arrhythmia. AF is a progressive disease, initially being nonsustained and induced by trigger activity, and progressing towards persistent AF through alteration of the atrial myocardial substrate. Treatment of AF aims to decrease the risk of stroke and improve the quality of life, by preventing recurrences (rhythm control) or controlling the heart rate during AF (rate control). In the last 20 years, catheter-based and, less frequently, surgical and hybrid ablation techniques have proven more successful compared with drug therapy in achieving rhythm control in patients with AF. However, the efficiency of ablation techniques varies greatly, being highest in paroxysmal and lowest in long-term persistent AF. Areas covered: In this review, we discuss the fundamental differences between paroxysmal and persistent AF and the potential impact of those differences on patient management, emphasizing the available therapeutic strategies to achieve rhythm control. Expert commentary: Treatment to prevent AF recurrences is suboptimal, particularly in patients with persistent AF. Emerging technologies, such as documentation of atrial fibrosis using magnetic resonance imaging and documentation of electrical substrate using advanced electrocardiographic imaging techniques are likely to provide valuable insights about patient-specific tailoring of treatments.
MO-B-201-00: Motion Management in Current Stereotactic Body Radiation Therapy (SBRT) Practice
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
The motion management in stereotactic body radiation therapy (SBRT) is a key to success for a SBRT program, and still an on-going challenging task. A major factor is that moving structures behave differently than standing structures when examined by imaging modalities, and thus require special considerations and employments. Understanding the motion effects to these different imaging processes is a prerequisite for a decent motion management program. The commonly used motion control techniques to physically restrict tumor motion, if adopted correctly, effectively increase the conformity and accuracy of hypofractionated treatment. The effective application of such requires one to understand the mechanicsmore » of the application and the related physiology especially related to respiration. The image-guided radiation beam control, or tumor tracking, further realized the endeavor for precision-targeting. During tumor tracking, the respiratory motion is often constantly monitored by non-ionizing beam sources using the body surface as its surrogate. This then has to synchronize with the actual internal tumor motion. The latter is often accomplished by stereo X-ray imaging or similar techniques. With these advanced technologies, one may drastically reduce the treated volume and increase the clinicians’ confidence for a high fractional ablative radiation dose. However, the challenges in implementing the motion management may not be trivial and is dependent on each clinic case. This session of presentations is intended to provide an overview of the current techniques used in managing the tumor motion in SBRT, specifically for routine lung SBRT, proton based treatments, and newly-developed MR guided RT. Learning Objectives: Through this presentation, the audience will understand basic roles of commonly used imaging modalities for lung cancer studies; familiarize the major advantages and limitations of each discussed motion control methods; familiarize the major advantages and limitations of each discussed radiation beam control methodology and tumor tacking method; understand the key points in motion management for a high quality SBRT program.« less
MO-B-201-01: Overcoming the Challenges of Motion Management in Current Lung SBRT Practice
DOE Office of Scientific and Technical Information (OSTI.GOV)
Shang, C.
The motion management in stereotactic body radiation therapy (SBRT) is a key to success for a SBRT program, and still an on-going challenging task. A major factor is that moving structures behave differently than standing structures when examined by imaging modalities, and thus require special considerations and employments. Understanding the motion effects to these different imaging processes is a prerequisite for a decent motion management program. The commonly used motion control techniques to physically restrict tumor motion, if adopted correctly, effectively increase the conformity and accuracy of hypofractionated treatment. The effective application of such requires one to understand the mechanicsmore » of the application and the related physiology especially related to respiration. The image-guided radiation beam control, or tumor tracking, further realized the endeavor for precision-targeting. During tumor tracking, the respiratory motion is often constantly monitored by non-ionizing beam sources using the body surface as its surrogate. This then has to synchronize with the actual internal tumor motion. The latter is often accomplished by stereo X-ray imaging or similar techniques. With these advanced technologies, one may drastically reduce the treated volume and increase the clinicians’ confidence for a high fractional ablative radiation dose. However, the challenges in implementing the motion management may not be trivial and is dependent on each clinic case. This session of presentations is intended to provide an overview of the current techniques used in managing the tumor motion in SBRT, specifically for routine lung SBRT, proton based treatments, and newly-developed MR guided RT. Learning Objectives: Through this presentation, the audience will understand basic roles of commonly used imaging modalities for lung cancer studies; familiarize the major advantages and limitations of each discussed motion control methods; familiarize the major advantages and limitations of each discussed radiation beam control methodology and tumor tacking method; understand the key points in motion management for a high quality SBRT program.« less
MO-B-201-02: Motion Management for Proton Lung SBR
DOE Office of Scientific and Technical Information (OSTI.GOV)
Flampouri, S.
The motion management in stereotactic body radiation therapy (SBRT) is a key to success for a SBRT program, and still an on-going challenging task. A major factor is that moving structures behave differently than standing structures when examined by imaging modalities, and thus require special considerations and employments. Understanding the motion effects to these different imaging processes is a prerequisite for a decent motion management program. The commonly used motion control techniques to physically restrict tumor motion, if adopted correctly, effectively increase the conformity and accuracy of hypofractionated treatment. The effective application of such requires one to understand the mechanicsmore » of the application and the related physiology especially related to respiration. The image-guided radiation beam control, or tumor tracking, further realized the endeavor for precision-targeting. During tumor tracking, the respiratory motion is often constantly monitored by non-ionizing beam sources using the body surface as its surrogate. This then has to synchronize with the actual internal tumor motion. The latter is often accomplished by stereo X-ray imaging or similar techniques. With these advanced technologies, one may drastically reduce the treated volume and increase the clinicians’ confidence for a high fractional ablative radiation dose. However, the challenges in implementing the motion management may not be trivial and is dependent on each clinic case. This session of presentations is intended to provide an overview of the current techniques used in managing the tumor motion in SBRT, specifically for routine lung SBRT, proton based treatments, and newly-developed MR guided RT. Learning Objectives: Through this presentation, the audience will understand basic roles of commonly used imaging modalities for lung cancer studies; familiarize the major advantages and limitations of each discussed motion control methods; familiarize the major advantages and limitations of each discussed radiation beam control methodology and tumor tacking method; understand the key points in motion management for a high quality SBRT program.« less
Improving Soil Seed Bank Management.
Haring, Steven C; Flessner, Michael L
2018-05-08
Problems associated with simplified weed management motivate efforts for diversification. Integrated weed management uses fundamentals of weed biology and applied ecology to provide a framework for diversified weed management programs; the soil seed bank comprises a necessary part of this framework. By targeting seeds, growers can inhibit the propagule pressure on which annual weeds depend for agricultural invasion. Some current management practices affect weed seed banks, such as crop rotation and tillage, but these tools are often used without specific intention to manage weed seeds. Difficulties quantifying the weed seed bank, understanding seed bank phenology, and linking seed banks to emerged weed communities challenge existing soil seed bank management practices. Improved seed bank quantification methods could include DNA profiling of the soil seed bank, mark and recapture, or 3D LIDAR mapping. Successful and sustainable soil seed bank management must constrain functionally diverse and changing weed communities. Harvest weed seed controls represent a step forward, but over-reliance on this singular technique could make it short-lived. Researchers must explore tools inspired by other pest management disciplines, such as gene drives or habitat modification for predatory organisms. Future weed seed bank management will combine multiple complementary practices that enhance diverse agroecosystems. This article is protected by copyright. All rights reserved.
Management Techniques for Librarians.
ERIC Educational Resources Information Center
Evans, G. Edward
This textbook on library management techniques is concerned with basic management problems. Examples of problems in planning, organization, and coordination are drawn from situations in libraries or information centers. After an introduction to library management, the history of management is covered. Several styles of management and organization…
Economic Techniques of Occupational Health and Safety Management
NASA Astrophysics Data System (ADS)
Sidorov, Aleksandr I.; Beregovaya, Irina B.; Khanzhina, Olga A.
2016-10-01
The article deals with the issues on economic techniques of occupational health and safety management. Authors’ definition of safety management is given. It is represented as a task-oriented process to identify, establish and maintain such a state of work environment in which there are no possible effects of hazardous and harmful factors, or their influence does not go beyond certain limits. It was noted that management techniques that are the part of the control mechanism, are divided into administrative, organizational and administrative, social and psychological and economic. The economic management techniques are proposed to be classified depending on the management subject, management object, in relation to an enterprise environment, depending on a control action. Technoeconomic study, feasibility study, planning, financial incentives, preferential crediting of enterprises, pricing, profit sharing and equity, preferential tax treatment for enterprises, economic regulations and standards setting have been distinguished as economic techniques.
NASA Astrophysics Data System (ADS)
Gebhardt, Steffen; Wehrmann, Thilo; Klinger, Verena; Schettler, Ingo; Huth, Juliane; Künzer, Claudia; Dech, Stefan
2010-10-01
The German-Vietnamese water-related information system for the Mekong Delta (WISDOM) project supports business processes in Integrated Water Resources Management in Vietnam. Multiple disciplines bring together earth and ground based observation themes, such as environmental monitoring, water management, demographics, economy, information technology, and infrastructural systems. This paper introduces the components of the web-based WISDOM system including data, logic and presentation tier. It focuses on the data models upon which the database management system is built, including techniques for tagging or linking metadata with the stored information. The model also uses ordered groupings of spatial, thematic and temporal reference objects to semantically tag datasets to enable fast data retrieval, such as finding all data in a specific administrative unit belonging to a specific theme. A spatial database extension is employed by the PostgreSQL database. This object-oriented database was chosen over a relational database to tag spatial objects to tabular data, improving the retrieval of census and observational data at regional, provincial, and local areas. While the spatial database hinders processing raster data, a "work-around" was built into WISDOM to permit efficient management of both raster and vector data. The data model also incorporates styling aspects of the spatial datasets through styled layer descriptions (SLD) and web mapping service (WMS) layer specifications, allowing retrieval of rendered maps. Metadata elements of the spatial data are based on the ISO19115 standard. XML structured information of the SLD and metadata are stored in an XML database. The data models and the data management system are robust for managing the large quantity of spatial objects, sensor observations, census and document data. The operational WISDOM information system prototype contains modules for data management, automatic data integration, and web services for data retrieval, analysis, and distribution. The graphical user interfaces facilitate metadata cataloguing, data warehousing, web sensor data analysis and thematic mapping.
Lemoignan, Josée; Chasen, Martin; Bhargava, Ravi
2010-12-01
The purpose of the study was to determine how frequently each domain of activity was addressed and how frequently specific interventions were used by an occupational therapist (OT) with cancer patients who attended an 8-week Cancer Nutrition and Rehabilitation (CNR) program. Sixty-two patients with cancer were assessed. All received interventions by the OT within the CNR program. The following activity domains: (1) self-care, (2) productivity, and (3) leisure that were addressed during appointments with the OT were recorded following each visit. Seven categories of interventions were predetermined and their use was recorded using a checklist. Descriptive statistics were conducted and revealed that 36% of the therapist's time was spent assessing patients' functional capacity while 64% was spent providing interventions. The OT's interventions addressed leisure and exercise (54%), productive activities such as housework and paid employment (32%), and basic activities of daily living (14%). The frequency of specific interventions provided were as follows: 40% in teaching of energy conservation and activity management techniques, 33% in goal setting/support and counseling, 9% in cognitive retraining/stimulation, 6% in communication with community agencies, and 4% in teaching of joint and bone protection techniques, help with management of neuropathies, and education on scar management respectively. It is suggested that OTs practicing in oncology use a variety of interventions to better address productive and leisure activities. The data suggests that limitations in these areas were more prevalent than in self-care activities. Further study is needed to examine OT interventions in oncology.
2011-01-01
Background Improvements in the techniques for metabolomics analyses and growing interest in metabolomic approaches are resulting in the generation of increasing numbers of metabolomic profiles. Platforms are required for profile management, as a function of experimental design, and for metabolite identification, to facilitate the mining of the corresponding data. Various databases have been created, including organism-specific knowledgebases and analytical technique-specific spectral databases. However, there is currently no platform meeting the requirements for both profile management and metabolite identification for nuclear magnetic resonance (NMR) experiments. Description MeRy-B, the first platform for plant 1H-NMR metabolomic profiles, is designed (i) to provide a knowledgebase of curated plant profiles and metabolites obtained by NMR, together with the corresponding experimental and analytical metadata, (ii) for queries and visualization of the data, (iii) to discriminate between profiles with spectrum visualization tools and statistical analysis, (iv) to facilitate compound identification. It contains lists of plant metabolites and unknown compounds, with information about experimental conditions, the factors studied and metabolite concentrations for several plant species, compiled from more than one thousand annotated NMR profiles for various organs or tissues. Conclusion MeRy-B manages all the data generated by NMR-based plant metabolomics experiments, from description of the biological source to identification of the metabolites and determinations of their concentrations. It is the first database allowing the display and overlay of NMR metabolomic profiles selected through queries on data or metadata. MeRy-B is available from http://www.cbib.u-bordeaux2.fr/MERYB/index.php. PMID:21668943
Piwowar, Valentina; Thiel, Felicitas
2014-10-01
Response shift (RS) can threaten the internal validity of pre-post designs. As RS may indicate a redefinition of the target construct, its occurrence in training evaluation is rather likely. The most common approach to deal with RS is to implement a retrospective pretest (then-test) instead of the traditional pre-test. In health psychology, an adapted measurement invariance approach (MIad) was developed as an alternative technique to study RS. Results produced by identifying RS with the two approaches were rarely studied simultaneously or within an experimental framework. To study RS in two different treatment conditions and compare results produced by both techniques in identifying various types of RS. We further studied validity aspects of the then-test. We evaluated RS by applying the then-test procedure (TP) and the measurement invariance apporach MIad within an experimental design: Participants either attended a short-term or a long-term classroom management training program. Participants were 146 student teachers in their first year of master's study. Pre (before training), post, and then self-ratings (after training) on classroom management knowledge were administered. Results indicated that the two approaches do not yield the same results. The MIad identified more and also group-specific RS as opposed to the findings of the TP, which found less and only little evidence for group-specific RS. Further research is needed to study the usability and validity of the respective approaches. In particular, the usability of the then-test seems to be challenged. © The Author(s) 2014.
Tan, J K
1999-11-01
The critical success factor (CSF) approach is a technique that will aid health administrators, planners and managers to identify, specify and sort among the most relevant and critical factors determining an organization's survival and success. Following a top-down management perspective, this paper discusses the CSF methodology as a strategic information management process comprising several important phases: (i) understanding the external factors such as the organization's industry, market and environment; (ii) achieving strong support and championship from top management; (iii) encouraging the proactive involvement of management and staff in generic CSF identification; (iv) educating and directing the participation of staff members in CSF verification and further refinement of generic CSFs into specific CSFs; and (v) aggregating, prioritizing and translating activity-related CSFs into organizational information requirements for the design of the organization's management information infrastructure. The implementation of this CSF approach is illustrated in the context of a British Columbia community hospital, with insights provided into key issues for future health researchers and practitioners.
Managing Documents in the Wider Area: Intelligent Document Management.
ERIC Educational Resources Information Center
Bittleston, Richard
1995-01-01
Discusses techniques for managing documents in wide area networks, reviews technique limitations, and offers recommendations to database designers. Presented techniques include: increasing bandwidth, reducing data traffic, synchronizing documentation, partial synchronization, audit trials, navigation, and distribution control and security. Two…
ERIC Educational Resources Information Center
Ferguson, Albert S.
Experiences with various modern management techniques and practices in selected small, private church-related colleges were studied. For comparative purposes, practices in public colleges and universities were also assessed. Management techniques used in small companies were identified through review of the literature and the management seminars…
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hermann, Laura
2013-07-01
The complex interplay of politics, economics and culture undermines attempts to define universal best practices for public engagement in the management of nuclear materials. In the international context, communicators must rely on careful adaptation and creative execution to make standard communication techniques succeed in their local communities. Nuclear professionals need an approach to assess and adapt culturally specific public engagement strategies to meet the demands of their particular political, economic and social structures. Using participant interviews and public sources, the Potomac Communications Group reviewed country-specific examples of nuclear-related communication efforts to provide insight into a proposed approach. The review consideredmore » a spectrum of cultural dimensions related to diversity, authority, conformity, proximity and time. Comparisons help to identify cross-cultural influences of various public engagement tactics and to inform a framework for communicators. While not prescriptive in its application, the framework offers a way for communicators to assess the salience of outreach tactics in specific situations. The approach can guide communicators to evaluate and tailor engagement strategies to achieve localized public outreach goals. (authors)« less
THE RECOGNITION AND TREATMENT OF SUPERIOR LABRAL (SLAP) LESIONS IN THE OVERHEAD ATHLETE
Macrina, Leonard C.; Cain, E. Lyle; Dugas, Jeffrey R.; Andrews, James R.
2013-01-01
The overhead athlete presents with a unique profile that may predispose them to specific pathology. Injury to the superior aspect of the glenoid labrum (SLAP lesions) poses a significant challenge to the rehabilitation specialist due to the complex nature and wide variety of etiological factors associated with these lesions. A thorough clinical evaluation and proper identification of the extent of labral injury is important in order to determine the most appropriate non‐operative and/or surgical management. Postoperative rehabilitation is based on the specific surgical procedure that has been performed, as well as the extent, location, and mechanism of labral pathology and associated lesions. Emphasis is placed on protecting the healing labrum while gradually restoring range of motion, strength, and dynamic stability of the glenohumeral joint. The purpose of this paper is to provide an overview of the anatomy and pathomechanics of SLAP lesions and review specific clinical examination techniques used to identify these lesions in the overhead athlete. Furthermore, a review of the current surgical management and postoperative rehabilitation guidelines is provided. Level of Evidence: 5 PMID:24175139
NASA Astrophysics Data System (ADS)
Holzinger, Andreas; Stickel, Christian; Fassold, Markus; Ebner, Martin
Interface consistency is an important basic concept in web design and has an effect on performance and satisfaction of end users. Consistency also has significant effects on the learning performance of both expert and novice end users. Consequently, the evaluation of consistency within a e-learning system and the ensuing eradication of irritating discrepancies in the user interface redesign is a big issue. In this paper, we report of our experiences with the Shadow Expert Technique (SET) during the evaluation of the consistency of the user interface of a large university learning management system. The main objective of this new usability evaluation method is to understand the interaction processes of end users with a specific system interface. Two teams of usability experts worked independently from each other in order to maximize the objectivity of the results. The outcome of this SET method is a list of recommended changes to improve the user interaction processes, hence to facilitate high consistency.
[The management of the metastatic disease by the surgeons].
Mery, Eliane; Golzio, Muriel; Thibault, Benoît; Ferron, Gwenael; Querleu, Denis; Delord, Jean-Pierre; Couderc, Bettina
2013-04-01
The high rate of recurrence after apparently complete surgery and/or complete clinical response to chemotherapy implies that most patients have undetected minimal residual disease. Novel techniques such as laparoscopic or laparotomic fluorescence may prove to be crucial in reassessing the definition of primary outcome in ovarian cancer management. For this purpose, the importance of fluorescence in the peroperative detection of human ovarian adenocarcinoma cells has to be validated in animal models prior to be used in clinic by determining its efficiency in detecting infra-millimetric tumor metastases. In the preclinical data presented, a fluorescent RAFT-(cRGD)4 tracer molecule (AngioStamp(®)) with a very high affinity for the αvβ3 integrin was used. Infrared fluorescence was visualized with Fluobeam(®), an open fluorescent imaging system that could potentially be used in peroperative conditions in the future. We showed that this novel technique allowed the specific detection of residual tumor deposits and inframillimetric metastases in mice and dogs.
[Awake craniotomy. Considerations in special situations].
Solera Ruiz, I; Uña Orejón, R; Valero, I; Laroche, F
2013-01-01
Awake craniotomy was the earliest surgical procedure known, and it has become fashionable again. In the past it was used for the surgical management of intractable epilepsy, but nowadays, its indications are increasing, and it is a widely recognized technique for the resection of mass lesions involving the eloquent cortex, and for deep brain stimulation. The procedure is safe, provides excellent results, and saves money and resources. The anesthesiologist should know the principles underlying neuroanesthesia, the technique of scalp blockade, and the sedation protocols, as well as feeling comfortable with advanced airway management. The main anesthetic aim is to keep patients cooperating when required (analgesia-based anesthesia). This review attempts to summarize the most recent evidence from the clinical literature, a long as the number of patients undergoing craniotomies in the awake state are increasing, specifically in the pediatric population. Copyright © 2011 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.
Using ProHits to store, annotate and analyze affinity purification - mass spectrometry (AP-MS) data
Liu, Guomin; Zhang, Jianping; Choi, Hyungwon; Lambert, Jean-Philippe; Srikumar, Tharan; Larsen, Brett; Nesvizhskii, Alexey I.; Raught, Brian; Tyers, Mike; Gingras, Anne-Claude
2012-01-01
Affinity purification coupled with mass spectrometry (AP-MS) is a robust technique used to identify protein-protein interactions. With recent improvements in sample preparation, and dramatic advances in MS instrumentation speed and sensitivity, this technique is becoming more widely used throughout the scientific community. To meet the needs of research groups both large and small, we have developed software solutions for tracking, scoring and analyzing AP-MS data. Here, we provide details for the installation and utilization of ProHits, a Laboratory Information Management System designed specifically for AP-MS interaction proteomics. This protocol explains: (i) how to install the complete ProHits system, including modules for the management of mass spectrometry files and the analysis of interaction data, and (ii) alternative options for the use of pre-existing search results in simpler versions of ProHits, including a virtual machine implementation of our ProHits Lite software. We also describe how to use the main features of the software to analyze AP-MS data. PMID:22948730
Gosálbez, J; Wright, W M D; Jiang, W; Carrión, A; Genovés, V; Bosch, I
2018-08-01
In this paper, the study of frequency-dependent ultrasonic attenuation in strongly heterogeneous cementitious materials is addressed. To accurately determine the attenuation over a wide frequency range, it is necessary to have suitable excitation techniques. We have analysed two kinds of ultrasound techniques: contact ultrasound and airborne non-contact ultrasound. The mathematical formulation for frequency-dependent attenuation has been established and it has been revealed that each technique may achieve similar results but requires specific different calibration processes. In particular, the airborne non-contact technique suffers high attenuation due to energy losses at the air-material interfaces. Thus, its bandwidth is limited to low frequencies but it does not require physical contact between transducer and specimen. In contrast, the classical contact technique can manage higher frequencies but the measurement depends on the pressure between the transducer and the specimen. Cement specimens have been tested with both techniques and frequency attenuation dependence has been estimated. Similar results were achieved at overlapping bandwidth and it has been demonstrated that the airborne non-contact ultrasound technique could be a viable alternative to the classical contact technique. Copyright © 2018 Elsevier B.V. All rights reserved.
Cancer and the cardiopulmonary system
DOE Office of Scientific and Technical Information (OSTI.GOV)
Khalil, A.M.; Ewer, M.S.
1984-01-01
This volume addresses the problems induced in the cardiopulmonary function by certain advanced diagnostic techniques and treatment modalities for cancer, reviews the cardiopulmonary changes resulting from cancer itself, and assesses the limitations to surgical and nonsurgical management of diverse neoplastic conditions. Information on the effects of various tumors on cardiopulmonary function and on the spectrum of adverse cardiopulmonary reactions caused by chemotherapy and radiation theorapy is provided, with specific practical guidance on diagnosis and treatment.
MSFC Skylab experimenter's reference
NASA Technical Reports Server (NTRS)
1974-01-01
The methods and techniques for experiment development and integration that evolved during the Skylab Program are described to facilitate transferring this experience to experimenters in future manned space programs. Management responsibilities and the sequential process of experiment evolution from initial concept through definition, development, integration, operation and postflight analysis are outlined in the main text and amplified, as appropriate, in appendixes. Emphasis is placed on specific lessons learned on Skylab that are worthy of consideration by future programs.
DOE limited standard: Operations assessments
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
1996-05-01
Purpose of this standard is to provide DOE Field Element assessors with a guide for conducting operations assessments, and provide DOE Field Element managers with the criteria of the EM Operations Assessment Program. Sections 6.1 to 6.21 provide examples of how to assess specific areas; the general techniques of operations assessments (Section 5) may be applied to other areas of health and safety (e.g. fire protection, criticality safety, quality assurance, occupational safety, etc.).
Marini, C; Fossa, F; Paoli, C; Bellingeri, M; Gnone, G; Vassallo, P
2015-03-01
Habitat modeling is an important tool to investigate the quality of the habitat for a species within a certain area, to predict species distribution and to understand the ecological processes behind it. Many species have been investigated by means of habitat modeling techniques mainly to address effective management and protection policies and cetaceans play an important role in this context. The bottlenose dolphin (Tursiops truncatus) has been investigated with habitat modeling techniques since 1997. The objectives of this work were to predict the distribution of bottlenose dolphin in a coastal area through the use of static morphological features and to compare the prediction performances of three different modeling techniques: Generalized Linear Model (GLM), Generalized Additive Model (GAM) and Random Forest (RF). Four static variables were tested: depth, bottom slope, distance from 100 m bathymetric contour and distance from coast. RF revealed itself both the most accurate and the most precise modeling technique with very high distribution probabilities predicted in presence cells (90.4% of mean predicted probabilities) and with 66.7% of presence cells with a predicted probability comprised between 90% and 100%. The bottlenose distribution obtained with RF allowed the identification of specific areas with particularly high presence probability along the coastal zone; the recognition of these core areas may be the starting point to develop effective management practices to improve T. truncatus protection. Copyright © 2014 Elsevier Ltd. All rights reserved.
Reduction mammoplasty operative techniques for improved outcomes in the treatment of gigantomastia.
Degeorge, Brent R; Colen, David L; Mericli, Alexander F; Drake, David B
2013-01-01
Gigantomastia, or excessive breast hypertrophy, which is broadly defined as macromastia requiring a surgical reduction of more than 1500 g of breast tissue per breast, poses a unique problem to the reconstructive surgeon. Various procedures have been described for reduction mammoplasty with specific skin incisions, patterns of breast parenchymal resection, and blood supply to the nipple-areolar complex; however, not all of these techniques can be directly applied in the setting of gigantomastia. We outline a simplified method for preoperative evaluation and operative technique, which has been optimized for the management of gigantomastia. A retrospective chart review of patients who have undergone reduction mammoplasty from 2006 to 2011 by a single surgeon at the University of Virginia was performed. Patients were subdivided based on weight of breast tissue resection into 2 groups: macromastia (<1500 g resection per breast) and gigantomastia (>1500 g resection per breast). Endpoints including patient demographics, operative techniques, and complication rates were recorded. The mean resection weights in the macromastia and gigantomastia groups, respectively, were 681 g ± 283 g and 2554 g ± 421 g. There were no differences in major complications between the 2 groups. The rate of free nipple graft utilization was not significantly different between the 2 groups. Our surgical approach to gigantomastia has advantages when applied to extremely large-volume breast reduction and provides both esthetic and reproducible results. The preoperative assessment and operative techniques described herein have been adapted to the management of gigantomastia to reduce the rates of surgical complications.
Classification, prevention and management of entero-atmospheric fistula: a state-of-the-art review.
Di Saverio, Salomone; Tarasconi, Antonio; Walczak, Dominik A; Cirocchi, Roberto; Mandrioli, Matteo; Birindelli, Arianna; Tugnoli, Gregorio
2016-02-01
Entero-atmospheric fistula (EAF) is an enteric fistula occurring in the setting of an open abdomen, thus creating a communication between the GI tract and the external atmosphere. Management and nursing of patients suffering EAF carries several challenges, and prevention of EAF should be the first and best treatment option. Here, we present a novel modified classification of EAF and review the current state of the art in its prevention and management including nutritional issues and feeding strategies. We also provide an overview on surgical management principles, highlighting several surgical techniques for dealing with EAF that have been reported in the literature throughout the years. The treatment strategy for EAF should be multidisciplinary and multifaceted. Surgical treatment is most often multistep and should be tailored to the single patient, based on the type and characteristics of the EAF, following its correct identification and classification. The specific experience of surgeons and nursing staff in the management of EAF could be enhanced, applying distinct simulation-based ex vivo training models.
Utility of the advanced chronic kidney disease patient management tools: case studies.
Patwardhan, Meenal B; Matchar, David B; Samsa, Gregory P; Haley, William E
2008-01-01
Appropriate management of advanced chronic kidney disease (CKD) delays or limits its progression. The Advanced CKD Patient Management Toolkit was developed using a process-improvement technique to assist patient management and address CKD-specific management issues. We pilot tested the toolkit in 2 community nephrology practices, assessed the utility of individual tools, and evaluated the impact on conformance to an advanced CKD guideline through patient chart abstraction. Tool use was distinct in the 2 sites and depended on the site champion's involvement, the extent of process reconfiguration demanded by a tool, and its perceived value. Baseline conformance varied across guideline recommendations (averaged 54%). Posttrial conformance increased in all clinical areas (averaged 59%). Valuable features of the toolkit in real-world settings were its ability to: facilitate tool selection, direct implementation efforts in response to a baseline performance audit, and allow selection of tool versions and customizing them. Our results suggest that systematically created, multifaceted, and customizable tools can promote guideline conformance.
NASA Astrophysics Data System (ADS)
Zhao, F. R.; Healey, S. P.; McCarter, J. B.; Garrard, C.; Zhu, Z.; Huang, C.
2016-12-01
Natural disturbances and land management directly alter C stored in biomass and soil pools, and forest recovery following these events are critical for long-term regional C balance. The Greater Yellowstone Ecosystem (GYE), located in Central Rocky Mountains of United States, is of different land ownerships within similar environmental settings, making it an ideal site to examine the impacts of land management, disturbance and forest recovery on regional C dynamics. Recent advances in the remote sensing of vegetation condition and change, along with new techniques linking remote sensing with inventory records, have allowed investigations that are much more tightly constrained to actual landscape environments instead of hypothetical or generalized conditions. These new capabilities are built into the Forest Carbon Management Framework (ForCaMF), which is being used by the National Forest System to not only model, but to monitor across very specific management units, the impact of different kinds of disturbance on carbon storage. In this study, we used the ForCaMF approach to examine three C related management questions in GYE National Parks and National Forests: 1) what was the carbon storage impact of fire disturbance and management activities from 1985 to 2010 in the GYE National Parks and National Forests? 2) Using an historic fire that occurred in 1988 as a basis for comparison, what difference would active post-fire forest restoration make in subsequent C storage? 3) In light of the fact that GYE National Forests significantly reduced harvest rates in the 1990s, how would maintaining high harvest rates of the 1980s impacted C storage? Simulation results show that recent forest fires in the GYE National Parks induced an accumulative C storage loss of about 12 Mg/ha, compared with C storage loss up to 2 Mg/ha in the GYE National Forests by harvests. If the high harvest rates as of the 1980s had been maintained, C emissions from the National Forests ( 11 Mg/ha) would approach fire-induced C storage loss in the National Parks during the study interval. New monitoring techniques such as ForCaMF leverage broadly available but locally specific monitoring resources to assess C dynamics on real landscapes. Resulting insights should have very practical applications in support of adaptive forest management across the country.
Influence of anglers' specializations on catch, harvest, and bycatch of targeted taxa
Pope, Kevin L.; Chizinski, Christopher J.; Wiley, Christopher L.; Martin, Dustin R.
2016-01-01
Fishery managers often use catch per unit effort (CPUE) of a given taxon derived from a group of anglers, those that sought said taxon, to evaluate fishery objectives because managers assume CPUE for this group of anglers is most sensitive to changes in fish taxon density. Further, likelihood of harvest may differ for sought and non-sought taxa if taxon sought is a defining characteristic of anglers’ attitude toward harvest. We predicted that taxon-specific catch across parties and reservoirs would be influenced by targeted taxon after controlling for number of anglers in a party and time spent fishing (combine to quantify fishing effort of party); we also predicted similar trends for taxon-specific harvest. We used creel-survey data collected from anglers that varied in taxon targeted, from generalists (targeting “anything” [no primary target taxa, but rather targeting all fishes]) to target specialists (e.g., anglers targeting largemouth bass Micropterus salmoides) in 19 Nebraska reservoirs during 2009–2011 to test our predictions. Taxon-specific catch and harvest were, in general, positively related to fishing effort. More importantly, we observed differences of catch and harvest among anglers grouped by taxon targeted for each of the eight taxa assessed. Anglers targeting a specific taxon had the greatest catch for that taxon and anglers targeting anything typically had the second highest catch for that taxon. In addition, anglers tended to catch more of closely related taxa and of taxa commonly targeted with similar fishing techniques. We encourage managers to consider taxon-specific objectives of target and non-target catch and harvest.
Schnick, Rosalie A.; Morton, John M.; Mochalski, Jeffrey C.; Beall, Jonathan T.
1982-01-01
Extensive information is provided on techniques that can reduce or eliminate the negative impact of man's activities (particularly those related to navigation) on large river systems, with special reference to the Upper Mississippi River. These techniques should help resource managers who are concerned with such river systems to establish sound environmental programs. Discussion of each technique or group of techniques include (1) situation to be mitigated or enhanced; (2) description of technique; (3) impacts on the environment; (4) costs; and (5) evaluation for use on the Upper Mississippi River Systems. The techniques are divided into four primary categories: Bank Stabilization Techniques, Dredging and Disposal of Dredged Material, Fishery Management Techniques, and Wildlife Management Techniques. Because techniques have been grouped by function, rather than by structure, some structures are discussed in several contexts. For example, gabions are discussed for use in revetments, river training structures, and breakwaters. The measures covered under Bank Stabilization Techniques include the use of riprap revetments, other revetments, bulkheads, river training structures, breakwater structures, chemical soil stabilizers, erosion-control mattings, and filter fabrics; the planting of vegetation; the creation of islands; the creation of berms or enrichment of beaches; and the control of water level and boat traffic. The discussions of Dredging and the Disposal of Dredged Material consider dredges, dredging methods, and disposal of dredged material. The following subjects are considered under Fishery Management Techniques: fish attractors; spawning structures; nursery ponds, coves, and marshes; fish screens and barriers; fish passage; water control structures; management of water levels and flows; wing dam modification; side channel modification; aeration techniques; control of nuisance aquatic plants; and manipulated of fish populations. Wildlife Management Techniques include treatments of artificial nest structures, island creation or development, marsh creation or development, greentree reservoirs and mast management, vegetation control, water level control, and revegetation.
Network acceleration techniques
NASA Technical Reports Server (NTRS)
Crowley, Patricia (Inventor); Maccabe, Arthur Barney (Inventor); Awrach, James Michael (Inventor)
2012-01-01
Splintered offloading techniques with receive batch processing are described for network acceleration. Such techniques offload specific functionality to a NIC while maintaining the bulk of the protocol processing in the host operating system ("OS"). The resulting protocol implementation allows the application to bypass the protocol processing of the received data. Such can be accomplished this by moving data from the NIC directly to the application through direct memory access ("DMA") and batch processing the receive headers in the host OS when the host OS is interrupted to perform other work. Batch processing receive headers allows the data path to be separated from the control path. Unlike operating system bypass, however, the operating system still fully manages the network resource and has relevant feedback about traffic and flows. Embodiments of the present disclosure can therefore address the challenges of networks with extreme bandwidth delay products (BWDP).
Partial Thickness Rotator Cuff Tears: Current Concepts
Matthewson, Graeme; Beach, Cara J.; Nelson, Atiba A.; Woodmass, Jarret M.; Ono, Yohei; Boorman, Richard S.; Lo, Ian K. Y.; Thornton, Gail M.
2015-01-01
Partial thickness rotator cuff tears are a common cause of pain in the adult shoulder. Despite their high prevalence, the diagnosis and treatment of partial thickness rotator cuff tears remains controversial. While recent studies have helped to elucidate the anatomy and natural history of disease progression, the optimal treatment, both nonoperative and operative, is unclear. Although the advent of arthroscopy has improved the accuracy of the diagnosis of partial thickness rotator cuff tears, the number of surgical techniques used to repair these tears has also increased. While multiple repair techniques have been described, there is currently no significant clinical evidence supporting more complex surgical techniques over standard rotator cuff repair. Further research is required to determine the clinical indications for surgical and nonsurgical management, when formal rotator cuff repair is specifically indicated and when biologic adjunctive therapy may be utilized. PMID:26171251
Design-for-Six-Sigma To Develop a Bioprocess Knowledge Management Framework.
Junker, Beth; Maheshwari, Gargi; Ranheim, Todd; Altaras, Nedim; Stankevicz, Michael; Harmon, Lori; Rios, Sandra; D'anjou, Marc
2011-01-01
Owing to the high costs associated with biopharmaceutical development, considerable pressure has developed for the biopharmaceutical industry to increase productivity by becoming more lean and flexible. The ability to reuse knowledge was identified as one key advantage to streamline productivity, efficiently use resources, and ultimately perform better than the competition. A knowledge management (KM) strategy was assembled for bioprocess-related information using the technique of Design-for-Six-Sigma (DFSS). This strategy supported quality-by-design and process validation efforts for pipeline as well as licensed products. The DFSS technique was selected because it was both streamlined and efficient. These characteristics permitted development of a KM strategy with minimized team leader and team member resources. DFSS also placed a high emphasis on the voice of the customer, information considered crucial to the selection of solutions most appropriate for the current knowledge-based challenges of the organization. The KM strategy developed was comprised of nine workstreams, constructed from related solution buckets which in turn were assembled from the individual solution tasks that were identified. Each workstream's detailed design was evaluated against published and established best practices, as well as the KM strategy project charter and design inputs. Gaps and risks were identified and mitigated as necessary to improve the robustness of the proposed strategy. Aggregated resources (specifically expense/capital funds and staff) and timing were estimated to obtain vital management sponsorship for implementation. Where possible, existing governance and divisional/corporate information technology efforts were leveraged to minimize the additional bioprocess resources required for implementation. Finally, leading and lagging indicator metrics were selected to track the success of pilots and eventual implementation. A knowledge management framework was assembled for bioprocess-related information using a streamlined and efficient technique that minimized team leader and member resources. The technique also highly emphasized input from the staff, who generated and used the knowledge, information considered crucial to selection of solutions most appropriate for the current knowledge-based challenges in the organization. The framework developed was comprised of nine workstreams, constructed from related solution buckets which were assembled from individual solution tasks that were identified. Each workstream's detailed design was evaluated against published and established best practices, as well as the project charter and design inputs. Gaps and risks were identified and mitigated to improve robustness of the proposed framework. Aggregated resources (specifically expense/capital funds and staff) and timing were estimated to obtain vital management sponsorship for implementation. Where possible, existing governance and information technology efforts were leveraged to minimize additional bioprocess resources required for implementation. Finally, metrics were selected to track the success of pilots and eventual implementation.
Review of Congenital Mitral Valve Stenosis: Analysis, Repair Techniques and Outcomes.
Baird, Christopher W; Marx, Gerald R; Borisuk, Michele; Emani, Sitram; del Nido, Pedro J
2015-06-01
The spectrum of congenital mitral valve stenosis (MS) consists of a complex of defects that result in obstruction to left ventricular inflow. This spectrum includes patients with underdeveloped left heart structures (Fig. 1) to those with isolated congenital MS. The specific mitral valve defects can further be divided into categories based on the relationship to the mitral valve annulus including valvar, supravalvar and subvalvar components. Clinically, these patients present based on the degree of obstruction, associated mitral regurgitation, secondary pulmonary hypertension, associated lung disease and/or associated cardiac lesions. There are a number of factors that contribute to the successful outcomes in these patients including pre-operative imaging, aggressive surgical techniques and peri-operative management.
NASA Astrophysics Data System (ADS)
Díaz-Pereira, Elvira; Asunción Romero-Díaz, María; de Vente, Joris
2016-04-01
Under climate change, sustainable management of soil and water resources is increasingly important, especially in rainfed agroecosystems of semiarid environments. Water harvesting refers to a range of techniques for the collection and management of flood or rainwater for domestic and agricultural use and for water retention in natural ecosystems. Water harvesting represents a good example of sustainable management of water resources that contribute to water and food security. However, there are often environmental and socioeconomic constraints for implementation of water harvesting techniques, so each condition asks for a specific solution. Here we aim to highlight the environmental and socioeconomic benefits, requirements and limitations of different water harvesting techniques and to characterize their implications for provisioning, regulating, supporting, and cultural ecosystem services. We reviewed 62 water harvesting techniques for semiarid regions extracted from the WOCAT (World Overview of Conservation Approaches and Technologies) database. We discuss aspects related to: i) human and environmental characteristics, ii) cost-benefit ratio during implementation and maintenance phases, iii) socioeconomic and environmental impacts at local and regional scales, and, iv) impacts on ecosystem services. Our review reveals that water harvesting represents very diverse methods of collecting and managing floodwaters and surface runoff. We grouped techniques as 'floodwater harvesting', 'macro-catchment water harvesting', 'micro-catchment water harvesting', and 'rooftop and courtyard' water harvesting. Almost half of all technologies originates from traditional knowledge. The implementation of water harvesting is generally positive on the short-term, to very positive on the long-term, while its maintenance is very positive at short and long-term. However, perception depends on the type of water harvesting and local conditions. Most relevant socioeconomic benefits from water harvesting are increased crop yield and farm income. Their implementation also leads to an improved food security and knowledge of soil erosion and conservation and to strengthening of social networks. Their main environmental benefits include an increased soil moisture content and water availability, reduced soil loss and reduced downstream flooding and siltation. These impacts have positive implications for a range of regulating (flood control), provisioning (food production), supporting (nutrient cycling) and cultural (aesthetic value) ecosystem services. Despite their many perceived potential benefits, the main constraints for local implementation of water harvesting techniques are due to labour constraints, implementation costs and the loss of productive land. This highlights the need for political solutions including incentives for implementation for most effective water harvesting techniques adapted to local environmental and socioeconomic conditions.
Success stories and emerging themes in conservation physiology
Madliger, Christine L.; Cooke, Steven J.; Crespi, Erica J.; Funk, Jennifer L.; Hultine, Kevin R.; Hunt, Kathleen E.; Rohr, Jason R.; Sinclair, Brent J.; Suski, Cory D.; Willis, Craig K. R.; Love, Oliver P.
2016-01-01
The potential benefits of physiology for conservation are well established and include greater specificity of management techniques, determination of cause–effect relationships, increased sensitivity of health and disturbance monitoring and greater capacity for predicting future change. While descriptions of the specific avenues in which conservation and physiology can be integrated are readily available and important to the continuing expansion of the discipline of ‘conservation physiology’, to date there has been no assessment of how the field has specifically contributed to conservation success. However, the goal of conservation physiology is to foster conservation solutions and it is therefore important to assess whether physiological approaches contribute to downstream conservation outcomes and management decisions. Here, we present eight areas of conservation concern, ranging from chemical contamination to invasive species to ecotourism, where physiological approaches have led to beneficial changes in human behaviour, management or policy. We also discuss the shared characteristics of these successes, identifying emerging themes in the discipline. Specifically, we conclude that conservation physiology: (i) goes beyond documenting change to provide solutions; (ii) offers a diversity of physiological metrics beyond glucocorticoids (stress hormones); (iii) includes approaches that are transferable among species, locations and times; (iv) simultaneously allows for human use and benefits to wildlife; and (v) is characterized by successes that can be difficult to find in the primary literature. Overall, we submit that the field of conservation physiology has a strong foundation of achievements characterized by a diversity of conservation issues, taxa, physiological traits, ecosystem types and spatial scales. We hope that these concrete successes will encourage the continued evolution and use of physiological tools within conservation-based research and management plans. PMID:27382466
Success stories and emerging themes in conservation physiology.
Madliger, Christine L; Cooke, Steven J; Crespi, Erica J; Funk, Jennifer L; Hultine, Kevin R; Hunt, Kathleen E; Rohr, Jason R; Sinclair, Brent J; Suski, Cory D; Willis, Craig K R; Love, Oliver P
2016-01-01
The potential benefits of physiology for conservation are well established and include greater specificity of management techniques, determination of cause-effect relationships, increased sensitivity of health and disturbance monitoring and greater capacity for predicting future change. While descriptions of the specific avenues in which conservation and physiology can be integrated are readily available and important to the continuing expansion of the discipline of 'conservation physiology', to date there has been no assessment of how the field has specifically contributed to conservation success. However, the goal of conservation physiology is to foster conservation solutions and it is therefore important to assess whether physiological approaches contribute to downstream conservation outcomes and management decisions. Here, we present eight areas of conservation concern, ranging from chemical contamination to invasive species to ecotourism, where physiological approaches have led to beneficial changes in human behaviour, management or policy. We also discuss the shared characteristics of these successes, identifying emerging themes in the discipline. Specifically, we conclude that conservation physiology: (i) goes beyond documenting change to provide solutions; (ii) offers a diversity of physiological metrics beyond glucocorticoids (stress hormones); (iii) includes approaches that are transferable among species, locations and times; (iv) simultaneously allows for human use and benefits to wildlife; and (v) is characterized by successes that can be difficult to find in the primary literature. Overall, we submit that the field of conservation physiology has a strong foundation of achievements characterized by a diversity of conservation issues, taxa, physiological traits, ecosystem types and spatial scales. We hope that these concrete successes will encourage the continued evolution and use of physiological tools within conservation-based research and management plans.
Fernández de Gorostiza, Erlantz; Mabe, Jon
2018-01-01
Industrial wireless applications often share the communication channel with other wireless technologies and communication protocols. This coexistence produces interferences and transmission errors which require appropriate mechanisms to manage retransmissions. Nevertheless, these mechanisms increase the network latency and overhead due to the retransmissions. Thus, the loss of data packets and the measures to handle them produce an undesirable drop in the QoS and hinder the overall robustness and energy efficiency of the network. Interference avoidance mechanisms, such as frequency hopping techniques, reduce the need for retransmissions due to interferences but they are often tailored to specific scenarios and are not easily adapted to other use cases. On the other hand, the total absence of interference avoidance mechanisms introduces a security risk because the communication channel may be intentionally attacked and interfered with to hinder or totally block it. In this paper we propose a method for supporting the design of communication solutions under dynamic channel interference conditions and we implement dynamic management policies for frequency hopping technique and channel selection at runtime. The method considers several standard frequency hopping techniques and quality metrics, and the quality and status of the available frequency channels to propose the best combined solution to minimize the side effects of interferences. A simulation tool has been developed and used in this work to validate the method. PMID:29473910
Computer assisted audit techniques for UNIX (UNIX-CAATS)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Polk, W.T.
1991-12-31
Federal and DOE regulations impose specific requirements for internal controls of computer systems. These controls include adequate separation of duties and sufficient controls for access of system and data. The DOE Inspector General`s Office has the responsibility to examine internal controls, as well as efficient use of computer system resources. As a result, DOE supported NIST development of computer assisted audit techniques to examine BSD UNIX computers (UNIX-CAATS). These systems were selected due to the increasing number of UNIX workstations in use within DOE. This paper describes the design and development of these techniques, as well as the results ofmore » testing at NIST and the first audit at a DOE site. UNIX-CAATS consists of tools which examine security of passwords, file systems, and network access. In addition, a tool was developed to examine efficiency of disk utilization. Test results at NIST indicated inadequate password management, as well as weak network resource controls. File system security was considered adequate. Audit results at a DOE site indicated weak password management and inefficient disk utilization. During the audit, we also found improvements to UNIX-CAATS were needed when applied to large systems. NIST plans to enhance the techniques developed for DOE/IG in future work. This future work would leverage currently available tools, along with needed enhancements. These enhancements would enable DOE/IG to audit large systems, such as supercomputers.« less
Computer assisted audit techniques for UNIX (UNIX-CAATS)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Polk, W.T.
1991-01-01
Federal and DOE regulations impose specific requirements for internal controls of computer systems. These controls include adequate separation of duties and sufficient controls for access of system and data. The DOE Inspector General's Office has the responsibility to examine internal controls, as well as efficient use of computer system resources. As a result, DOE supported NIST development of computer assisted audit techniques to examine BSD UNIX computers (UNIX-CAATS). These systems were selected due to the increasing number of UNIX workstations in use within DOE. This paper describes the design and development of these techniques, as well as the results ofmore » testing at NIST and the first audit at a DOE site. UNIX-CAATS consists of tools which examine security of passwords, file systems, and network access. In addition, a tool was developed to examine efficiency of disk utilization. Test results at NIST indicated inadequate password management, as well as weak network resource controls. File system security was considered adequate. Audit results at a DOE site indicated weak password management and inefficient disk utilization. During the audit, we also found improvements to UNIX-CAATS were needed when applied to large systems. NIST plans to enhance the techniques developed for DOE/IG in future work. This future work would leverage currently available tools, along with needed enhancements. These enhancements would enable DOE/IG to audit large systems, such as supercomputers.« less
Fernández de Gorostiza, Erlantz; Berzosa, Jorge; Mabe, Jon; Cortiñas, Roberto
2018-02-23
Industrial wireless applications often share the communication channel with other wireless technologies and communication protocols. This coexistence produces interferences and transmission errors which require appropriate mechanisms to manage retransmissions. Nevertheless, these mechanisms increase the network latency and overhead due to the retransmissions. Thus, the loss of data packets and the measures to handle them produce an undesirable drop in the QoS and hinder the overall robustness and energy efficiency of the network. Interference avoidance mechanisms, such as frequency hopping techniques, reduce the need for retransmissions due to interferences but they are often tailored to specific scenarios and are not easily adapted to other use cases. On the other hand, the total absence of interference avoidance mechanisms introduces a security risk because the communication channel may be intentionally attacked and interfered with to hinder or totally block it. In this paper we propose a method for supporting the design of communication solutions under dynamic channel interference conditions and we implement dynamic management policies for frequency hopping technique and channel selection at runtime. The method considers several standard frequency hopping techniques and quality metrics, and the quality and status of the available frequency channels to propose the best combined solution to minimize the side effects of interferences. A simulation tool has been developed and used in this work to validate the method.
Whitham, Charlotte E. L.
2015-01-01
Accurate and spatially-appropriate ecosystem service valuations are vital for decision-makers and land managers. Many approaches for estimating ecosystem service value (ESV) exist, but their appropriateness under specific conditions or logistical limitations is not uniform. The most accurate techniques are therefore not always adopted. Six different assessment approaches were used to estimate ESV for a National Nature Reserve in southwest China, across different management zones. These approaches incorporated two different land-use land cover (LULC) maps and development of three economic valuation techniques, using globally or locally-derived data. The differences in ESV across management zones for the six approaches were largely influenced by the classifications of forest and farmland and how they corresponded with valuation coefficients. With realistic limits on access to time, data, skills and resources, and using acquired estimates from globally-relevant sources, the Buffer zone was estimated as the most valuable (2.494 million ± 1.371 million CNY yr-1 km-2) and the Non-protected zone as the least valuable (770,000 ± 4,600 CNY yr-1 km-2). However, for both LULC maps, when using the locally-based and more time and skill-intensive valuation approaches, this pattern was generally reversed. This paper provides a detailed practical example of how ESV can differ widely depending on the availability and appropriateness of LULC maps and valuation approaches used, highlighting pitfalls for the managers of protected areas. PMID:26086191
Cooke, Steven J; Hinch, Scott G; Donaldson, Michael R; Clark, Timothy D; Eliason, Erika J; Crossin, Glenn T; Raby, Graham D; Jeffries, Ken M; Lapointe, Mike; Miller, Kristi; Patterson, David A; Farrell, Anthony P
2012-06-19
Despite growing interest in conservation physiology, practical examples of how physiology has helped to understand or to solve conservation problems remain scarce. Over the past decade, an interdisciplinary research team has used a conservation physiology approach to address topical conservation concerns for Pacific salmon. Here, we review how novel applications of tools such as physiological telemetry, functional genomics and laboratory experiments on cardiorespiratory physiology have shed light on the effect of fisheries capture and release, disease and individual condition, and stock-specific consequences of warming river temperatures, respectively, and discuss how these findings have or have not benefited Pacific salmon management. Overall, physiological tools have provided remarkable insights into the effects of fisheries capture and have helped to enhance techniques for facilitating recovery from fisheries capture. Stock-specific cardiorespiratory thresholds for thermal tolerances have been identified for sockeye salmon and can be used by managers to better predict migration success, representing a rare example that links a physiological scope to fitness in the wild population. Functional genomics approaches have identified physiological signatures predictive of individual migration mortality. Although fisheries managers are primarily concerned with population-level processes, understanding the causes of en route mortality provides a mechanistic explanation and can be used to refine management models. We discuss the challenges that we have overcome, as well as those that we continue to face, in making conservation physiology relevant to managers of Pacific salmon.
Cooke, Steven J.; Hinch, Scott G.; Donaldson, Michael R.; Clark, Timothy D.; Eliason, Erika J.; Crossin, Glenn T.; Raby, Graham D.; Jeffries, Ken M.; Lapointe, Mike; Miller, Kristi; Patterson, David A.; Farrell, Anthony P.
2012-01-01
Despite growing interest in conservation physiology, practical examples of how physiology has helped to understand or to solve conservation problems remain scarce. Over the past decade, an interdisciplinary research team has used a conservation physiology approach to address topical conservation concerns for Pacific salmon. Here, we review how novel applications of tools such as physiological telemetry, functional genomics and laboratory experiments on cardiorespiratory physiology have shed light on the effect of fisheries capture and release, disease and individual condition, and stock-specific consequences of warming river temperatures, respectively, and discuss how these findings have or have not benefited Pacific salmon management. Overall, physiological tools have provided remarkable insights into the effects of fisheries capture and have helped to enhance techniques for facilitating recovery from fisheries capture. Stock-specific cardiorespiratory thresholds for thermal tolerances have been identified for sockeye salmon and can be used by managers to better predict migration success, representing a rare example that links a physiological scope to fitness in the wild population. Functional genomics approaches have identified physiological signatures predictive of individual migration mortality. Although fisheries managers are primarily concerned with population-level processes, understanding the causes of en route mortality provides a mechanistic explanation and can be used to refine management models. We discuss the challenges that we have overcome, as well as those that we continue to face, in making conservation physiology relevant to managers of Pacific salmon. PMID:22566681
Adaptable data management for systems biology investigations
Boyle, John; Rovira, Hector; Cavnor, Chris; Burdick, David; Killcoyne, Sarah; Shmulevich, Ilya
2009-01-01
Background Within research each experiment is different, the focus changes and the data is generated from a continually evolving barrage of technologies. There is a continual introduction of new techniques whose usage ranges from in-house protocols through to high-throughput instrumentation. To support these requirements data management systems are needed that can be rapidly built and readily adapted for new usage. Results The adaptable data management system discussed is designed to support the seamless mining and analysis of biological experiment data that is commonly used in systems biology (e.g. ChIP-chip, gene expression, proteomics, imaging, flow cytometry). We use different content graphs to represent different views upon the data. These views are designed for different roles: equipment specific views are used to gather instrumentation information; data processing oriented views are provided to enable the rapid development of analysis applications; and research project specific views are used to organize information for individual research experiments. This management system allows for both the rapid introduction of new types of information and the evolution of the knowledge it represents. Conclusion Data management is an important aspect of any research enterprise. It is the foundation on which most applications are built, and must be easily extended to serve new functionality for new scientific areas. We have found that adopting a three-tier architecture for data management, built around distributed standardized content repositories, allows us to rapidly develop new applications to support a diverse user community. PMID:19265554
Laczka, Olivier F; Labbate, Maurizio; Seymour, Justin R; Bourne, David G; Fielder, Stewart S; Doblin, Martina A
2014-01-01
Bacteria from the genus Vibrio are a common and environmentally important group of bacteria within coastal environments and include species pathogenic to aquaculture organisms. Their distribution and abundance are linked to specific environmental parameters, including temperature, salinity and nutrient enrichment. Accurate and efficient detection of Vibrios in environmental samples provides a potential important indicator of overall ecosystem health while also allowing rapid management responses for species pathogenic to humans or species implicated in disease of economically important aquacultured fish and invertebrates. In this study, we developed a surface immuno-functionalisation protocol, based on an avidin-biotin type covalent binding strategy, allowing specific sandwich-type detection of bacteria from the Vibrio genus. The assay was optimized on 12 diverse Vibrio strains, including species that have implications for aquaculture industries, reaching detection limits between 7×10(3) to 3×10(4) cells mL(-1). Current techniques for the detection of total Vibrios rely on laborious or inefficient analyses resulting in delayed management decisions. This work represents a novel approach for a rapid, accurate, sensitive and robust tool for quantifying Vibrios directly in industrial systems and in the environment, thereby facilitating rapid management responses.
Use Management Techniques in Office Practice
ERIC Educational Resources Information Center
Holehan, E. Lee
1977-01-01
Notes that authenticity can be added to student work projects in an office practice class by having the teacher assume the role of the office manager or supervisor and putting office management techniques into practice. Ways in which such techniques may be infused into classes are examined. (TA)
Oosterkamp, B C M; van der Sanden, W J M; Frencken, J E F M; Kuijpers-Jagtman, A M
2016-02-01
White spot lesions (WSLs) are a side effect of orthodontic treatment, causing esthetic problems and a risk of deeper enamel and dentine lesions. Many strategies have been developed for preventing WSLs, but great variability exists in preventive measures between orthodontists. This study developed statements on which a clinical practice guideline (CPG) can be developed in order to help orthodontists select preventive measures based on the best available evidence. A nominal group technique (RAND-e modified Delphi procedure) was used. A multidisciplinary expert panel rated 264 practice- and evidence-based statements related to the management of WSLs. To provide panel members with the same knowledge, a total of six articles obtained from a systematic review of the literature were read by the panel in preparation of three consensus rounds. According to the technique, a threshold of 75% of all ratings within any 3-point section of the 9-point scale regarding a specific statement was accepted as consensus. After the first and second consensus rounds, consensus was reached on 37.5 and 31.1% of statements, respectively. For the remaining 31.4% of statements, consensus was reached during a 4-h consensus meeting. Statements on the management of WSLs derived from a systematic literature review combined with expert opinion were formally integrated toward consensus through a nominal group technique. These statements formed the basis for developing a CPG on the management of WSLs before and during orthodontic treatment. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Liew, Steven; Sundaram, Hema; De Boulle, Koenraad L.; Goodman, Greg J.; Monheit, Gary; Wu, Yan; Trindade de Almeida, Ada R.; Swift, Arthur; Vieira Braz, André
2016-01-01
Background: Although the safety profile of hyaluronic acid fillers is favorable, adverse reactions can occur. Clinicians and patients can benefit from ongoing guidance on adverse reactions to hyaluronic acid fillers and their management. Methods: A multinational, multidisciplinary group of experts in cosmetic medicine convened the Global Aesthetics Consensus Group to review the properties and clinical uses of Hylacross and Vycross hyaluronic acid products and develop updated consensus recommendations for early and late complications associated with hyaluronic acid fillers. Results: The consensus panel provided specific recommendations focusing on early and late complications of hyaluronic acid fillers and their management. The impact of patient-, product-, and technique-related factors on such reactions was described. Most of these were noted to be mild and transient. Serious adverse events are rare. Early adverse reactions to hyaluronic acid fillers include vascular infarction and compromise; inflammatory reactions; injection-related events; and inappropriate placement of filler material. Among late reactions are nodules, granulomas, and skin discoloration. Most adverse events can be avoided with proper planning and technique. Detailed understanding of facial anatomy, proper patient and product selection, and appropriate technique can further reduce the risks. Should adverse reactions occur, the clinician must be prepared and have tools available for effective treatment. Conclusions: Adverse reactions with hyaluronic acid fillers are uncommon. Clinicians should take steps to further reduce the risk and be prepared to treat any complications that arise. PMID:27219265
Kolehmainen, Niina; Francis, Jill J
2012-10-18
It is widely agreed that interventions to change professionals' practice need to be clearly specified. This involves (1) selecting and defining the intervention techniques, (2) operationalising the techniques and deciding their delivery, and (3) formulating hypotheses about the mechanisms through which the techniques are thought to result in change. Descriptions of methods to achieve these objectives are limited. This paper reports methods and illustrates outputs from a study to meet these objectives, specifically from the Good Goals study to improve occupational therapists' caseload management practice. (1) Behaviour change techniques were identified and selected from an existing matrix that maps techniques to determinants. An existing coding manual was used to define the techniques. (2) A team of occupational therapists generated context-relevant, acceptable modes of delivery for the techniques; these data were compared and contrasted with previously collected data, literature on caseload management, and the aims of the intervention. (3) Hypotheses about the mechanisms of change were formulated by drawing on the matrix and on theories of behaviour change. (1) Eight behaviour change techniques were selected: goal specified; self-monitoring; contract; graded tasks; increasing skills (problem solving, decision making, goal setting); coping skills; rehearsal of relevant skills; social processes of encouragement, support, and pressure; demonstration by others; and feedback. (2) A range of modes of delivery were generated (e.g., graded tasks' consisting of series of clinical cases and situations that become increasingly difficult). Conditions for acceptable delivery were identified (e.g., 'self-monitoring' was acceptable only if delivered at team level). The modes of delivery were specified as face-to-face training, task sheets, group tasks, DVDs, and team-based weekly meetings. (3) The eight techniques were hypothesized to target caseload management practice through eleven mediating variables. Three domains were hypothesized to be most likely to change: beliefs about capabilities, motivation and goals, and behavioural regulation. The project provides an exemplar of a systematic and reportable development of a quality-improvement intervention, with its methods likely to be applicable to other projects. A subsequent study of the intervention has provided early indication that use of systematic methods to specify interventions may help to maximize acceptability and effectiveness.
A Survey Of Techniques for Managing and Leveraging Caches in GPUs
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mittal, Sparsh
2014-09-01
Initially introduced as special-purpose accelerators for graphics applications, graphics processing units (GPUs) have now emerged as general purpose computing platforms for a wide range of applications. To address the requirements of these applications, modern GPUs include sizable hardware-managed caches. However, several factors, such as unique architecture of GPU, rise of CPU–GPU heterogeneous computing, etc., demand effective management of caches to achieve high performance and energy efficiency. Recently, several techniques have been proposed for this purpose. In this paper, we survey several architectural and system-level techniques proposed for managing and leveraging GPU caches. We also discuss the importance and challenges ofmore » cache management in GPUs. The aim of this paper is to provide the readers insights into cache management techniques for GPUs and motivate them to propose even better techniques for leveraging the full potential of caches in the GPUs of tomorrow.« less
Patel, Santosh; Lutz, Jan M; Panchagnula, Umakanth; Bansal, Sujesh
2012-04-01
Colorectal surgery is commonly performed for colorectal cancer and other pathology such as diverticular and inflammatory bowel disease. Despite significant advances, such as laparoscopic techniques and multidisciplinary recovery programs, morbidity and mortality remain high and vary among surgical centers. The use of scoring systems and assessment of functional capacity may help in identifying high-risk patients and predicting complications. An understanding of perioperative factors affecting colon blood flow and oxygenation, suppression of stress response, optimal fluid therapy, and multimodal pain management are essential. These fundamental principles are more important than any specific choice of anesthetic agents. Anesthesiologists can significantly contribute to enhance recovery and improve the quality of perioperative care.
Optical processing for future computer networks
NASA Technical Reports Server (NTRS)
Husain, A.; Haugen, P. R.; Hutcheson, L. D.; Warrior, J.; Murray, N.; Beatty, M.
1986-01-01
In the development of future data management systems, such as the NASA Space Station, a major problem represents the design and implementation of a high performance communication network which is self-correcting and repairing, flexible, and evolvable. To obtain the goal of designing such a network, it will be essential to incorporate distributed adaptive network control techniques. The present paper provides an outline of the functional and communication network requirements for the Space Station data management system. Attention is given to the mathematical representation of the operations being carried out to provide the required functionality at each layer of communication protocol on the model. The possible implementation of specific communication functions in optics is also considered.
ERM Ideas and Innovations: Digital Repository Management as ERM
ERIC Educational Resources Information Center
Pinkas, María M.; Lin, Na
2014-01-01
This article describes the application of electronic resources management (ERM) to digital repository management at the Health Sciences and Human Services Library at the University of Maryland, Baltimore. The authors discuss electronic resources management techniques, through the application of "Techniques for Electronic Management,"…
Honoré, Paul; Granjeaud, Samuel; Tagett, Rebecca; Deraco, Stéphane; Beaudoing, Emmanuel; Rougemont, Jacques; Debono, Stéphane; Hingamp, Pascal
2006-09-20
High throughput gene expression profiling (GEP) is becoming a routine technique in life science laboratories. With experimental designs that repeatedly span thousands of genes and hundreds of samples, relying on a dedicated database infrastructure is no longer an option.GEP technology is a fast moving target, with new approaches constantly broadening the field diversity. This technology heterogeneity, compounded by the informatics complexity of GEP databases, means that software developments have so far focused on mainstream techniques, leaving less typical yet established techniques such as Nylon microarrays at best partially supported. MAF (MicroArray Facility) is the laboratory database system we have developed for managing the design, production and hybridization of spotted microarrays. Although it can support the widely used glass microarrays and oligo-chips, MAF was designed with the specific idiosyncrasies of Nylon based microarrays in mind. Notably single channel radioactive probes, microarray stripping and reuse, vector control hybridizations and spike-in controls are all natively supported by the software suite. MicroArray Facility is MIAME supportive and dynamically provides feedback on missing annotations to help users estimate effective MIAME compliance. Genomic data such as clone identifiers and gene symbols are also directly annotated by MAF software using standard public resources. The MAGE-ML data format is implemented for full data export. Journalized database operations (audit tracking), data anonymization, material traceability and user/project level confidentiality policies are also managed by MAF. MicroArray Facility is a complete data management system for microarray producers and end-users. Particular care has been devoted to adequately model Nylon based microarrays. The MAF system, developed and implemented in both private and academic environments, has proved a robust solution for shared facilities and industry service providers alike.
Honoré, Paul; Granjeaud, Samuel; Tagett, Rebecca; Deraco, Stéphane; Beaudoing, Emmanuel; Rougemont, Jacques; Debono, Stéphane; Hingamp, Pascal
2006-01-01
Background High throughput gene expression profiling (GEP) is becoming a routine technique in life science laboratories. With experimental designs that repeatedly span thousands of genes and hundreds of samples, relying on a dedicated database infrastructure is no longer an option. GEP technology is a fast moving target, with new approaches constantly broadening the field diversity. This technology heterogeneity, compounded by the informatics complexity of GEP databases, means that software developments have so far focused on mainstream techniques, leaving less typical yet established techniques such as Nylon microarrays at best partially supported. Results MAF (MicroArray Facility) is the laboratory database system we have developed for managing the design, production and hybridization of spotted microarrays. Although it can support the widely used glass microarrays and oligo-chips, MAF was designed with the specific idiosyncrasies of Nylon based microarrays in mind. Notably single channel radioactive probes, microarray stripping and reuse, vector control hybridizations and spike-in controls are all natively supported by the software suite. MicroArray Facility is MIAME supportive and dynamically provides feedback on missing annotations to help users estimate effective MIAME compliance. Genomic data such as clone identifiers and gene symbols are also directly annotated by MAF software using standard public resources. The MAGE-ML data format is implemented for full data export. Journalized database operations (audit tracking), data anonymization, material traceability and user/project level confidentiality policies are also managed by MAF. Conclusion MicroArray Facility is a complete data management system for microarray producers and end-users. Particular care has been devoted to adequately model Nylon based microarrays. The MAF system, developed and implemented in both private and academic environments, has proved a robust solution for shared facilities and industry service providers alike. PMID:16987406
Aukema, T S; Rutgers, E J Th; Vogel, W V; Teertstra, H J; Oldenburg, H S; Vrancken Peeters, M T F D; Wesseling, J; Russell, N S; Valdés Olmos, R A
2010-04-01
The aim of this study was to evaluate the impact of (18)F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG PET/CT) on clinical management in patients with locoregional breast cancer recurrence amenable for locoregional treatment and to compare the PET/CT results with the conventional imaging data. From January 2006 to August 2008, all patients with locoregional breast cancer recurrence underwent whole-body PET/CT. PET/CT findings were compared with results of the conventional imaging techniques and final pathology. The impact of PET/CT results on clinical management was evaluated based on clinical decisions obtained from patient files. 56 patients were included. In 32 patients (57%) PET/CT revealed additional tumour localisations. Distant metastases were detected in 11 patients on conventional imaging and in 23 patients on PET/CT images (p < 0.01). In 25 patients (45%), PET/CT detected additional lesions not visible on conventional imaging. PET/CT had an impact on clinical management in 27 patients (48%) by detecting more extensive locoregional disease or distant metastases. In 20 patients (36%) extensive surgery was prevented and treatment was changed to palliative treatment. The sensitivity, specificity, accuracy, positive and negative predictive values of FDG PET/CT were respectively 97%, 92%, 95%, 94% and 96%. PET/CT, in addition to conventional imaging techniques, plays an important role in staging patients with locoregional breast cancer recurrence since its result changed the clinical management in almost half of the patients. PET/CT could potentially replace conventional staging imaging in patients with a locoregional breast cancer recurrence. Copyright (c) 2009 Elsevier Ltd. All rights reserved.
Representation of Knowledge on Some Management Accounting Techniques in Textbooks
ERIC Educational Resources Information Center
Golyagina, Alena; Valuckas, Danielius
2016-01-01
This paper examines the coverage of management accounting techniques in several popular management accounting texts, assessing each technique's claimed position within practice, its benefits and limitations, and the information sources substantiating these claims. Employing the notion of research genres, the study reveals that textbooks in their…
Frutos-Pascual, Maite; García Zapirain, Begoña; Méndez Zorrilla, Amaia
2014-01-01
Attention Deficit with Hyperactivity Disorder (ADHD) is one of the most prevalent disorders within the child population today. Inattention problems can lead to greater difficulties in completing assignments, as well as problems with time management and prioritisation of tasks. This article presents an intelligent tele-therapy tool based on Serious Games for Health, aimed at the improvement of time management skills and the prioritisation of tasks. This tele-system is based on the use of decision trees within Django, a high-level Python Web framework. The technologies and techniques used were selected so as to boost user involvement and to enable the system to be easily customised. This article shows the preliminary results of the pilot-phase in an experiment performed to evaluate the use of adaptive tele-therapies within a group of typically developing children and adolescents aged between 12 and 19 years old without ADHD. To do so, we relied on the collection of parameters and the conduct of surveys for assessing time management skills, as well as measuring system usability and availability. The results of a time management survey highlighted that the users involved in the trial did not use any specific or effective time management techniques, scoring 1.98 and 2.30 out of 5 points in this area for ages under 15 and over 16 years old, respectively. The final calculations based on the usability questionnaire resulted in an average score of 78.75 out of 100. The creation of a customisable tool capable of working with different skills, in conjunction with the replication of the current study, may help to understand these users’ needs, as well as boosting time management skills among teenagers with and without ADHD. PMID:24402063
Frutos-Pascual, Maite; Zapirain, Begoña García; Zorrilla, Amaia Méndez
2014-01-07
Attention Deficit with Hyperactivity Disorder (ADHD) is one of the most prevalent disorders within the child population today. Inattention problems can lead to greater difficulties in completing assignments, as well as problems with time management and prioritisation of tasks. This article presents an intelligent tele-therapy tool based on Serious Games for Health, aimed at the improvement of time management skills and the prioritisation of tasks. This tele-system is based on the use of decision trees within Django, a high-level Python Web framework. The technologies and techniques used were selected so as to boost user involvement and to enable the system to be easily customised. This article shows the preliminary results of the pilot-phase in an experiment performed to evaluate the use of adaptive tele-therapies within a group of typically developing children and adolescents aged between 12 and 19 years old without ADHD. To do so, we relied on the collection of parameters and the conduct of surveys for assessing time management skills, as well as measuring system usability and availability. The results of a time management survey highlighted that the users involved in the trial did not use any specific or effective time management techniques, scoring 1.98 and 2.30 out of 5 points in this area for ages under 15 and over 16 years old, respectively. The final calculations based on the usability questionnaire resulted in an average score of 78.75 out of 100. The creation of a customisable tool capable of working with different skills, in conjunction with the replication of the current study, may help to understand these users' needs, as well as boosting time management skills among teenagers with and without ADHD.
Nahin, Richard L; Boineau, Robin; Khalsa, Partap S; Stussman, Barbara J; Weber, Wendy J
2016-09-01
Although most pain is acute and resolves within a few days or weeks, millions of Americans have persistent or recurring pain that may become chronic and debilitating. Medications may provide only partial relief from this chronic pain and can be associated with unwanted effects. As a result, many individuals turn to complementary health approaches as part of their pain management strategy. This article examines the clinical trial evidence for the efficacy and safety of several specific approaches-acupuncture, manipulation, massage therapy, relaxation techniques including meditation, selected natural product supplements (chondroitin, glucosamine, methylsulfonylmethane, S-adenosylmethionine), tai chi, and yoga-as used to manage chronic pain and related disability associated with back pain, fibromyalgia, osteoarthritis, neck pain, and severe headaches or migraines. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
Mergers and acquisitions in professional organizations: a complex adaptive systems approach.
Walls, M E; McDaniel, R R
1999-09-01
Nurse managers face unique challenges as they cope with mergers and acquisitions among health care organizations. These challenges can be better understood if it is recognized that health care institutions are professional organizations and that the transformations required are extremely difficult. These difficulties are caused, in part, by the institutionalized nature of professional organizations, and this nature is explicated. Professional organizations are stubborn. They are repositories of expertise and values that are societal in origin and difficult to change. When professional organizations are understood as complex adaptive systems, complexity theory offers insight that provide strategies for managing mergers and acquisitions that may not be apparent when more traditional conceptualizations of professional organizations are used. Specific managerial techniques consistent with both the institutionalized characteristics and the complex adaptive systems characteristics of professional organizations are offered to nurse managers.
Aylin Alagöz, B; Yenigün, Orhan; Erdinçler, Ayşen
2018-01-01
This study investigates the effect of ultrasonication and microwave sludge disintegration/pre-treatment techniques on the anaerobic co-digestion efficiency of wastewater sludges with olive and grape pomaces. The effects of both co-digestion and sludge pre-treatment techniques were evaluated in terms of the organic removal efficiency and the biogas production. The "co-digestion" of wastewater sludge with both types of pomaces was revealed to be a much more efficient way for the biogas production compared to the single (mono) sludge digestion. The ultrasonication and microwave pre-treatments applied to the sludge samples caused to a further increase in biogas and methane yields. Based on applied specific energies, ultrasonication pre-treatment was found much more effective than microwave irradiation. The specific energy applied in microwave pre-treatment (87,000kj/kgTS) was almost 9 times higher than that of used in ultrasonication (10,000kj/kgTS), resulting only 10-15% increases in biogas/methane yield. Co-digestion of winery and olive industry residues with pre-treated wastewater sludges appears to be a suitable technique for waste management and energy production. Copyright © 2017 Elsevier B.V. All rights reserved.
Biometrics based key management of double random phase encoding scheme using error control codes
NASA Astrophysics Data System (ADS)
Saini, Nirmala; Sinha, Aloka
2013-08-01
In this paper, an optical security system has been proposed in which key of the double random phase encoding technique is linked to the biometrics of the user to make it user specific. The error in recognition due to the biometric variation is corrected by encoding the key using the BCH code. A user specific shuffling key is used to increase the separation between genuine and impostor Hamming distance distribution. This shuffling key is then further secured using the RSA public key encryption to enhance the security of the system. XOR operation is performed between the encoded key and the feature vector obtained from the biometrics. The RSA encoded shuffling key and the data obtained from the XOR operation are stored into a token. The main advantage of the present technique is that the key retrieval is possible only in the simultaneous presence of the token and the biometrics of the user which not only authenticates the presence of the original input but also secures the key of the system. Computational experiments showed the effectiveness of the proposed technique for key retrieval in the decryption process by using the live biometrics of the user.
Knowledge management in healthcare: towards 'knowledge-driven' decision-support services.
Abidi, S S
2001-09-01
In this paper, we highlight the involvement of Knowledge Management in a healthcare enterprise. We argue that the 'knowledge quotient' of a healthcare enterprise can be enhanced by procuring diverse facets of knowledge from the seemingly placid healthcare data repositories, and subsequently operationalising the procured knowledge to derive a suite of Strategic Healthcare Decision-Support Services that can impact strategic decision-making, planning and management of the healthcare enterprise. In this paper, we firstly present a reference Knowledge Management environment-a Healthcare Enterprise Memory-with the functionality to acquire, share and operationalise the various modalities of healthcare knowledge. Next, we present the functional and architectural specification of a Strategic Healthcare Decision-Support Services Info-structure, which effectuates a synergy between knowledge procurement (vis-à-vis Data Mining) and knowledge operationalisation (vis-à-vis Knowledge Management) techniques to generate a suite of strategic knowledge-driven decision-support services. In conclusion, we argue that the proposed Healthcare Enterprise Memory is an attempt to rethink the possible sources of leverage to improve healthcare delivery, hereby providing a valuable strategic planning and management resource to healthcare policy makers.
Psychological approaches for the nursing management of chronic pain: part 2.
Richardson, Clifford; Adams, Nicola; Poole, Helen
2006-09-01
The aim of this article was to present the ways that nurses can integrate psychological approaches into their management of chronic pain conditions using a biopsychosocial framework. Communication, the importance of the patient-practitioner interaction, the role of education and provision of information, reassurance and reduction of anxiety and the use of coping strategies training in the management of chronic pain are reviewed alongside the key skills of nursing. This is the second part of a two-part article. Part 1 was a discussion of psychosocial factors associated with chronic pain conditions and the psychological approaches used in the management of these conditions. It is identified that key nursing skills often equate to the requirements of the psychological approaches, therefore specific techniques from a cognitive-behavioural framework can be readily applied, integrated and used by nurses in the management of chronic pain conditions. Commonly utilized nursing skills are similar to those required for cognitive-behavioural therapy. It is reasonable to assume therefore that nurses can and should be involved in effectively managing the psychological aspects associated with chronic pain conditions.
A knock to the system: A new sociotechnical systems approach to sport-related concussion.
Clacy, Amanda; Goode, Natassia; Sharman, Rachael; Lovell, Geoff P; Salmon, Paul M
2017-11-01
Broader contextual factors that influence concussion management have tended to be overlooked. To address this, the present study used a sociotechnical systems approach to identify perceived responsibilities and applied strategies for three domains of concussion management (i.e., prevention, identification and treatment). Participants were 118 members of the community rugby union system in Australia (69.2% male). Participants from throughout the rugby system (e.g., players, parents, coaches, club management) were asked open-ended questions about their perceived responsibilities and the strategies they use for concussion management. It was found that (a) proper training, technique correction and education were recurrent prevention themes; (b) the majority of key stakeholders felt that they could consistently identify concussion; however, medical aids (medics) were the only system actors who stated a responsibility to use standardised concussion assessment measures and (c) less than one third of the respondents indicated their involvement in treating concussion. This study identifies specific junctures in the system that prevents effective concussion management strategies. A sociotechnical systems approach improves the understanding of concussion prevention, and management beliefs and behaviours.
McGee, M
1994-07-01
This article offers insights into the relationship of llama owners to their animals and the role of veterinarians as part of the animal care team. The effect of human behavior and handling techniques on llama behavior and marketability are discussed. Progressive ideas for nonforceful llama handling equipment, procedures, and training ideas are outlined in detail. Included are specific training plans for routine herd management chores such as injections and toenail trimming. This article is useful for both veterinarians and llama owners.
Biosafety principles and practices for the veterinary diagnostic laboratory.
Kozlovac, Joseph; Schmitt, Beverly
2015-01-01
Good biosafety and biocontainment programs and practices are critical components of the successful operation of any veterinary diagnostic laboratory. In this chapter we provide information and guidance on critical biosafety management program elements, facility requirements, protective equipment, and procedures necessary to ensure that the laboratory worker and the environment are adequately protected in the challenging work environment of the veterinary diagnostic laboratory in general and provide specific guidance for those laboratories employing molecular diagnostic techniques.
Brain Stimulation in the Treatment of Chronic Neuropathic and Non-Cancerous Pain
Plow, EB; Pascual-Leone, A; Machado, A
2012-01-01
Chronic neuropathic pain is one of the most prevalent and debilitating disorders. Conventional medical management, however, remains frustrating for both patients and clinicians owing to poor specificity of pharmacotherapy, delayed-onset of analgesia and extensive side-effects. Neuromodulation presents as a promising alternative, or at least an adjunct, as it is more specific in inducing analgesia without associated risks of pharmacotherapy. Here, we discuss common clinical and investigational methods of neuromodulation. Compared to clinical spinal cord stimulation (SCS), investigational techniques of cerebral neuromodulation, both invasive [deep brain stimulation (DBS) and motor cortical stimulation (MCS)] and noninvasive [repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS)], may be more advantageous. By adaptively targeting the multi-dimensional experience of pain, subtended by integrative pain circuitry in the brain, including somatosensory and thalamocortical, limbic and cognitive, cerebral methods may modulate the sensory-discriminative, affective-emotional and evaluative-cognitive spheres of the pain neuromatrix. Despite promise, the current state of results alludes to the possibility that cerebral neuromodulation has thus far not been effective in producing analgesia as intended in patients with chronic pain disorders. These techniques, thus, remain investigational and off-label. We discuss issues implicated in inadequate efficacy, variability of responsiveness and poor retention of benefit, while recommending design and conceptual refinements for future trials of cerebral neuromodulation in management of chronic neuropathic pain. PMID:22484179
Zheng, Tingting; Gao, Zhigang; Luo, Yong; Liu, Xianming; Zhao, Weijie; Lin, Bingcheng
2016-02-01
Clenbuterol (CL), as a feed additive, has been banned in many countries due to its potential threat to human health. In detection of CL, a fast, low-cost technique with high accuracy and specificity would be ideal for its administrative on-field inspections. Among the attempts to pursue a reliable detection tool of CL, a technique that combines surface enhanced Raman spectroscopy (SERS) and immunoassay, is close to meet the requirements as above. However, multiple steps of interactions between CL analyte, antibody, and antigen are involved in this method, and under conventional setup, the operation of SERS/immunoassay were unwieldy. In this paper, to facilitate a more manageable sample manipulation for SERS-immunoassay measurement, a 3D paper chip was suggested. A switch-on-chip multilayered (abbreviated as SoCM-) microfluidic paper-based analysis device (μPad) was fabricated to provide operators with manual switches on the interactions between different microfluids. Besides, on a detection slip we made on the main body of our SoCM-μPad, antigen was anchored in pattern. With this architecture, multistep interactions between the CL analyte in swine hair extract and the SERS probe-modified antibody and antigen, were managed for on-chip SERS-immunoassay detection. This would be very attractive for fast, cheap, accurate, and on-site specific detection of CL from real samples. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Noya, Belkisyolé Alarcón de; Díaz-Bello, Zoraida; Colmenares, Cecilia; Zavala-Jaspe, Reinaldo; Abate, Teresa; Contreras, Rosa; Losada, Sandra; Artigas, Domingo; Mauriello, Luciano; Ruiz-Guevara, Raiza; Noya, Oscar
2012-11-01
Orally transmitted Chagas disease (ChD), which is a well-known entity in the Brazilian Amazon Region, was first documented in Venezuela in December 2007, when 103 people attending an urban public school in Caracas became infected by ingesting juice that was contaminated with Trypanosoma cruzi. The infection occurred 45-50 days prior to the initiation of the sampling performed in the current study. Parasitological methods were used to diagnose the first nine symptomatic patients; T. cruzi was found in all of them. However, because this outbreak was managed as a sudden emergency during Christmas time, we needed to rapidly evaluate 1,000 people at risk, so we decided to use conventional serology to detect specific IgM and IgG antibodies via ELISA as well as indirect haemagglutination, which produced positive test results for 9.1%, 11.9% and 9.9% of the individuals tested, respectively. In other more restricted patient groups, polymerase chain reaction (PCR) provided more sensitive results (80.4%) than blood cultures (16.2%) and animal inoculations (11.6%). Although the classical diagnosis of acute ChD is mainly based on parasitological findings, highly sensitive and specific serological techniques can provide rapid results during large and severe outbreaks, as described herein. The use of these serological techniques allows prompt treatment of all individuals suspected of being infected, resulting in reduced rates of morbidity and mortality.
Twidwell, Dirac; Wonkka, Carissa L; Sindelar, Michael T; Weir, John R
2015-01-01
Fire is widely recognized as a critical ecological and evolutionary driver that needs to be at the forefront of land management actions if conservation targets are to be met. However, the prevailing view is that prescribed fire is riskier than other land management techniques. Perceived risks associated with the application of fire limits its use and reduces agency support for prescribed burning in the private sector. As a result, considerably less cost-share support is given for prescribed fire compared to mechanical techniques. This study tests the general perception that fire is a riskier technique relative to other land management options. Due to the lack of data available to directly test this notion, we use a combination of approaches including 1) a comparison of fatalities resulting from different occupations that are proxies for techniques employed in land management, 2) a comparison of fatalities resulting from wildland fire versus prescribed fire, and 3) an exploration of causal factors responsible for wildland fire-related fatalities. This approach establishes a first approximation of the relative risk of fatality to private citizens using prescribed fire compared to other management techniques that are readily used in ecosystem management. Our data do not support using risks of landowner fatalities as justification for the use of alternative land management techniques, such as mechanical (machine-related) equipment, over prescribed fire. Vehicles and heavy machinery are consistently leading reasons for fatalities within occupations selected as proxies for management techniques employed by ranchers and agricultural producers, and also constitute a large proportion of fatalities among firefighters. Our study provides the foundation for agencies to establish data-driven decisions regarding the degree of support they provide for prescribed burning on private lands.
Twidwell, Dirac; Wonkka, Carissa L.; Sindelar, Michael T.; Weir, John R.
2015-01-01
Fire is widely recognized as a critical ecological and evolutionary driver that needs to be at the forefront of land management actions if conservation targets are to be met. However, the prevailing view is that prescribed fire is riskier than other land management techniques. Perceived risks associated with the application of fire limits its use and reduces agency support for prescribed burning in the private sector. As a result, considerably less cost-share support is given for prescribed fire compared to mechanical techniques. This study tests the general perception that fire is a riskier technique relative to other land management options. Due to the lack of data available to directly test this notion, we use a combination of approaches including 1) a comparison of fatalities resulting from different occupations that are proxies for techniques employed in land management, 2) a comparison of fatalities resulting from wildland fire versus prescribed fire, and 3) an exploration of causal factors responsible for wildland fire-related fatalities. This approach establishes a first approximation of the relative risk of fatality to private citizens using prescribed fire compared to other management techniques that are readily used in ecosystem management. Our data do not support using risks of landowner fatalities as justification for the use of alternative land management techniques, such as mechanical (machine-related) equipment, over prescribed fire. Vehicles and heavy machinery are consistently leading reasons for fatalities within occupations selected as proxies for management techniques employed by ranchers and agricultural producers, and also constitute a large proportion of fatalities among firefighters. Our study provides the foundation for agencies to establish data-driven decisions regarding the degree of support they provide for prescribed burning on private lands. PMID:26465329
Network-Based Management Procedures.
ERIC Educational Resources Information Center
Buckner, Allen L.
Network-based management procedures serve as valuable aids in organizational management, achievement of objectives, problem solving, and decisionmaking. Network techniques especially applicable to educational management systems are the program evaluation and review technique (PERT) and the critical path method (CPM). Other network charting…
How I report breast magnetic resonance imaging studies for breast cancer staging and screening.
Vinnicombe, Sarah
2016-07-25
Magnetic resonance imaging (MRI) of the breast is the most sensitive imaging technique for the diagnosis and local staging of primary breast cancer and yet, despite the fact that it has been in use for 20 years, there is little evidence that its widespread uncritical adoption has had a positive impact on patient-related outcomes.This has been attributed previously to the low specificity that might be expected with such a sensitive modality, but with modern techniques and protocols, the specificity and positive predictive value for malignancy can exceed that of breast ultrasound and mammography. A more likely explanation is that historically, clinicians have acted on MRI findings and altered surgical plans without prior histological confirmation. Furthermore, modern adjuvant therapy for breast cancer has improved so much that it has become a very tall order to show a an improvement in outcomes such as local recurrence rates.In order to obtain clinically useful information, it is necessary to understand the strengths and weaknesses of the technique and the physiological processes reflected in breast MRI. An appropriate indication for the scan, proper patient preparation and good scan technique, with rigorous quality assurance, are all essential prerequisites for a diagnostically relevant study.The use of recognised descriptors from a standardised lexicon is helpful, since assessment can then dictate subsequent recommendations for management, as in the American College of Radiology BI-RADS (Breast Imaging Reporting and Data System) lexicon (Morris et al., ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System, 2013). It also enables audit of the service. However, perhaps the most critical factor in the generation of a meaningful report is for the reporting radiologist to have a thorough understanding of the clinical question and of the findings that will influence management. This has never been more important than at present, when we are in the throes of a remarkable paradigm shift in the treatment of both early stage and locally advanced breast cancer.
Visibility Equalizer Cutaway Visualization of Mesoscopic Biological Models.
Le Muzic, M; Mindek, P; Sorger, J; Autin, L; Goodsell, D; Viola, I
2016-06-01
In scientific illustrations and visualization, cutaway views are often employed as an effective technique for occlusion management in densely packed scenes. We propose a novel method for authoring cutaway illustrations of mesoscopic biological models. In contrast to the existing cutaway algorithms, we take advantage of the specific nature of the biological models. These models consist of thousands of instances with a comparably smaller number of different types. Our method constitutes a two stage process. In the first step, clipping objects are placed in the scene, creating a cutaway visualization of the model. During this process, a hierarchical list of stacked bars inform the user about the instance visibility distribution of each individual molecular type in the scene. In the second step, the visibility of each molecular type is fine-tuned through these bars, which at this point act as interactive visibility equalizers. An evaluation of our technique with domain experts confirmed that our equalizer-based approach for visibility specification was valuable and effective for both, scientific and educational purposes.
Visibility Equalizer Cutaway Visualization of Mesoscopic Biological Models
Le Muzic, M.; Mindek, P.; Sorger, J.; Autin, L.; Goodsell, D.; Viola, I.
2017-01-01
In scientific illustrations and visualization, cutaway views are often employed as an effective technique for occlusion management in densely packed scenes. We propose a novel method for authoring cutaway illustrations of mesoscopic biological models. In contrast to the existing cutaway algorithms, we take advantage of the specific nature of the biological models. These models consist of thousands of instances with a comparably smaller number of different types. Our method constitutes a two stage process. In the first step, clipping objects are placed in the scene, creating a cutaway visualization of the model. During this process, a hierarchical list of stacked bars inform the user about the instance visibility distribution of each individual molecular type in the scene. In the second step, the visibility of each molecular type is fine-tuned through these bars, which at this point act as interactive visibility equalizers. An evaluation of our technique with domain experts confirmed that our equalizer-based approach for visibility specification was valuable and effective for both, scientific and educational purposes. PMID:28344374
Continuous integration for concurrent MOOSE framework and application development on GitHub
Slaughter, Andrew E.; Peterson, John W.; Gaston, Derek R.; ...
2015-11-20
For the past several years, Idaho National Laboratory’s MOOSE framework team has employed modern software engineering techniques (continuous integration, joint application/framework source code repos- itories, automated regression testing, etc.) in developing closed-source multiphysics simulation software (Gaston et al., Journal of Open Research Software vol. 2, article e10, 2014). In March 2014, the MOOSE framework was released under an open source license on GitHub, significantly expanding and diversifying the pool of current active and potential future contributors on the project. Despite this recent growth, the same philosophy of concurrent framework and application development continues to guide the project’s development roadmap. Severalmore » specific practices, including techniques for managing multiple repositories, conducting automated regression testing, and implementing a cascading build process are discussed in this short paper. Furthermore, special attention is given to describing the manner in which these practices naturally synergize with the GitHub API and GitHub-specific features such as issue tracking, Pull Requests, and project forks.« less
Continuous integration for concurrent MOOSE framework and application development on GitHub
DOE Office of Scientific and Technical Information (OSTI.GOV)
Slaughter, Andrew E.; Peterson, John W.; Gaston, Derek R.
For the past several years, Idaho National Laboratory’s MOOSE framework team has employed modern software engineering techniques (continuous integration, joint application/framework source code repos- itories, automated regression testing, etc.) in developing closed-source multiphysics simulation software (Gaston et al., Journal of Open Research Software vol. 2, article e10, 2014). In March 2014, the MOOSE framework was released under an open source license on GitHub, significantly expanding and diversifying the pool of current active and potential future contributors on the project. Despite this recent growth, the same philosophy of concurrent framework and application development continues to guide the project’s development roadmap. Severalmore » specific practices, including techniques for managing multiple repositories, conducting automated regression testing, and implementing a cascading build process are discussed in this short paper. Furthermore, special attention is given to describing the manner in which these practices naturally synergize with the GitHub API and GitHub-specific features such as issue tracking, Pull Requests, and project forks.« less
Multimodal Self-Management for Children: An Holistic Program for Teachers.
ERIC Educational Resources Information Center
O'Keefe, Edward J.
This paper describes an innovative program for teaching self-management to children in elementary and secondary schools. The background of techniques for teaching self-management is briefly reviewed, the application of self-management techniques is noted, deficits in self-management programs are considered, and Lazarus's multimodal model of…
Software-Enabled Project Management Techniques and Their Relationship to the Triple Constraints
ERIC Educational Resources Information Center
Elleh, Festus U.
2013-01-01
This study investigated the relationship between software-enabled project management techniques and the triple constraints (time, cost, and scope). There was the dearth of academic literature that focused on the relationship between software-enabled project management techniques and the triple constraints (time, cost, and scope). Based on the gap…
ERIC Educational Resources Information Center
Shah, Akhtar H.
2014-01-01
Many projects fail despite the use of evidence-based project management practices such as Performance Measurement Baseline (PMB), Earned Value Management (EVM) and Risk Management (RM). Although previous researchers have found that integrated project management techniques could be more valuable than the same techniques used by themselves, these…
Computer Training for Entrepreneurial Meteorologists.
NASA Astrophysics Data System (ADS)
Koval, Joseph P.; Young, George S.
2001-05-01
Computer applications of increasing diversity form a growing part of the undergraduate education of meteorologists in the early twenty-first century. The advent of the Internet economy, as well as a waning demand for traditional forecasters brought about by better numerical models and statistical forecasting techniques has greatly increased the need for operational and commercial meteorologists to acquire computer skills beyond the traditional techniques of numerical analysis and applied statistics. Specifically, students with the skills to develop data distribution products are in high demand in the private sector job market. Meeting these demands requires greater breadth, depth, and efficiency in computer instruction. The authors suggest that computer instruction for undergraduate meteorologists should include three key elements: a data distribution focus, emphasis on the techniques required to learn computer programming on an as-needed basis, and a project orientation to promote management skills and support student morale. In an exploration of this approach, the authors have reinvented the Applications of Computers to Meteorology course in the Department of Meteorology at The Pennsylvania State University to teach computer programming within the framework of an Internet product development cycle. Because the computer skills required for data distribution programming change rapidly, specific languages are valuable for only a limited time. A key goal of this course was therefore to help students learn how to retrain efficiently as technologies evolve. The crux of the course was a semester-long project during which students developed an Internet data distribution product. As project management skills are also important in the job market, the course teamed students in groups of four for this product development project. The success, failures, and lessons learned from this experiment are discussed and conclusions drawn concerning undergraduate instructional methods for computer applications in meteorology.
A Novel Silicon Micromachined Integrated MCM Thermal Management System
NASA Technical Reports Server (NTRS)
Kazmierczak, M. J.; Henderson, H. T.; Gerner, F. M.
1997-01-01
"Micromachining" is a chemical means of etching three-dimensional structures, typically in single- crystalline silicon. These techniques are leading toward what is coming to be referred to as MEMS (Micro Electro Mechanical Systems), where in addition to the ordinary two-dimensional (planar) microelectronics, it is possible to build three-dimensional n-ticromotors, electrically- actuated raicrovalves, hydraulic systems and much more on the same microchip. These techniques become possible because of differential etching rates of various crystallographic planes and materials used for semiconductor n-ticrofabfication. The University of Cincinnati group in collaboration with Karl Baker at NASA Lewis were the first to form micro heat pipes in silicon by the above techniques. Current work now in progress using MEMS technology is now directed towards the development of the next generation in MCM (Multi Chip Module) packaging. Here we propose to develop a complete electronic thermal management system which will allow densifica6on in chip stacking by perhaps two orders of magnitude. Furthermore the proposed technique will allow ordinary conu-nercial integrated chips to be utilized. Basically, the new technique involves etching square holes into a silicon substrate and then inserting and bonding commercially available integrated chips into these holes. For example, over a 100 1/4 in. by 1 /4 in. integrated chips can be placed on a 4 in. by 4 in. silicon substrate to form a Multi-Chip Module (MCM). Placing these MCM's in-line within an integrated rack then allows for three-diniensional stacking. Increased miniaturization of microelectronic circuits will lead to very high local heat fluxes. A high performance thermal management system will be specifically designed to remove the generated energy. More specifically, a compact heat exchanger with milli / microchannels will be developed and tested to remove the heat through the back side of this MCM assembly for moderate and high heat flux applications, respectively. The high heat load application of particular interest in mind is the motor controller developed by Martin Marietta for Nasa to control the thruster's directional actuators on space vechicles. Work is also proposed to develop highly advanced and improved porous wick structures for use in advanced heat loops. The porous wick will be micromachined from silicon using MEMS technology, thus permitting far superior control of pore size and pore distribution (over wicks made from sintered n-ietals), which in turn is expected to led to significantly improved heat loop performance.
A quantitative evaluation of the public response to climate engineering
NASA Astrophysics Data System (ADS)
Wright, Malcolm J.; Teagle, Damon A. H.; Feetham, Pamela M.
2014-02-01
Atmospheric greenhouse gas concentrations continue to increase, with CO2 passing 400 parts per million in May 2013. To avoid severe climate change and the attendant economic and social dislocation, existing energy efficiency and emissions control initiatives may need support from some form of climate engineering. As climate engineering will be controversial, there is a pressing need to inform the public and understand their concerns before policy decisions are taken. So far, engagement has been exploratory, small-scale or technique-specific. We depart from past research to draw on the associative methods used by corporations to evaluate brands. A systematic, quantitative and comparative approach for evaluating public reaction to climate engineering is developed. Its application reveals that the overall public evaluation of climate engineering is negative. Where there are positive associations they favour carbon dioxide removal (CDR) over solar radiation management (SRM) techniques. Therefore, as SRM techniques become more widely known they are more likely to elicit negative reactions. Two climate engineering techniques, enhanced weathering and cloud brightening, have indistinct concept images and so are less likely to draw public attention than other CDR or SRM techniques.
Domino: Extracting, Comparing, and Manipulating Subsets across Multiple Tabular Datasets
Gratzl, Samuel; Gehlenborg, Nils; Lex, Alexander; Pfister, Hanspeter; Streit, Marc
2016-01-01
Answering questions about complex issues often requires analysts to take into account information contained in multiple interconnected datasets. A common strategy in analyzing and visualizing large and heterogeneous data is dividing it into meaningful subsets. Interesting subsets can then be selected and the associated data and the relationships between the subsets visualized. However, neither the extraction and manipulation nor the comparison of subsets is well supported by state-of-the-art techniques. In this paper we present Domino, a novel multiform visualization technique for effectively representing subsets and the relationships between them. By providing comprehensive tools to arrange, combine, and extract subsets, Domino allows users to create both common visualization techniques and advanced visualizations tailored to specific use cases. In addition to the novel technique, we present an implementation that enables analysts to manage the wide range of options that our approach offers. Innovative interactive features such as placeholders and live previews support rapid creation of complex analysis setups. We introduce the technique and the implementation using a simple example and demonstrate scalability and effectiveness in a use case from the field of cancer genomics. PMID:26356916
Hyperspectral Imagery Data for Remote Sensing
NASA Technical Reports Server (NTRS)
Garegnani, Jerry; Gualtney, Lawrence
1999-01-01
In order for remotely sensed data to be useful in a practical application for agriculture, an information product must be made available to the land management decision maker within 24 to 48 hours of data acquisition. Hyperspectral imagery data is proving useful in differentiation of plant species potentially allowing identification of non-healthy areas and pest infestations within crop fields that may require the farm managers attention. Currently however, extracting the needed site-specific feature information from the vast spectral content of large hyperspectral image files is a labor intensive and time consuming task prohibiting the necessary fast turnaround from raw data to final product. We illustrate the methods, techniques and technologies necessary to produce field-level information products from imagery and other related spatial data that are useful to the farm manager for specific decisions that must be made throughout the growing season. We also propose to demonstrate the cost effectiveness of an integrated system, from acquisition to final product distribution, to utilize imagery for decisions on a working farm in conjunction with a commercial agricultural services company and their crop scouts. The demonstration farm is Chesapeake Farms, a 3000 acre research farm in Chestertown, Maryland on the Eastern Shore and is owned by the DuPont Corporation.
Łudzik, Joanna; Witkowski, Alexander Michael; Roterman-Konieczna, Irena
Dermoscopically equivocal skin lesions may present a diagnostic challenge in daily clinical practice and are regularly sent for second expert opinion. We present a new approach to handling these cases in a consultation referral system that enables communication between the initial doctor at the image upload site and dermatology experts at a distance via cloud-based telemedicine. In our study we retrospectively evaluated 100 equivocal cases with complete digital dermoscopy-reflectance confocal microscopy image sets and compared suggested management of the initial doctor to a second expert confocal reader. We evaluated the effect of reader concordance on final management of these lesions resulting in a single reader overall sensitivity of 89% and specificity of 66% and double reader concordance method sensitivity of 98% and specificity of 54%. In conclusion, we found that application of double reader evaluation of these image sets with automatic referral of lesions for removal in the case of discordant diagnosis between two doctors improved the sensitivity of diagnosis in this subset of lesions and may increase the safety threshold of management choice reducing potential misdiagnosis in telemedicine settings. This paper concerns the application of telemedicine in practical medicine.
Anderson, D P; Ramsey, D S L; de Lisle, G W; Bosson, M; Cross, M L; Nugent, G
2015-06-01
Disease surveillance for the management of bovine tuberculosis (TB) in New Zealand has focussed, to a large extent, on the development of tools specific for monitoring Mycobacterium bovis infection in wildlife. Diagnostic techniques have been modified progressively over 30 years of surveillance of TB in wildlife, from initial characterisation of gross TB lesions in a variety of wildlife, through development of sensitive culture techniques to identify viable mycobacteria, to molecular identification of individual M. bovis strains. Of key importance in disease surveillance has been the elucidation of the roles that different wildlife species play in the transmission of infection, specifically defining brushtail possums (Trichosurus vulpecula) as true maintenance hosts compared to those that are predominantly spillover hosts, but which may serve as useful sentinel species to indicate TB persistence. Epidemiological modelling has played a major role in TB surveillance, initially providing the theoretical support for large-scale possum population control and setting targets at which control effort should be deployed to ensure disease eradication. As TB prevalence in livestock and wildlife declined throughout the 2000s, more varied field tools were developed to gather surveillance data from the diminishing possum populations, and to provide information on changing TB prevalence. Accordingly, ever more precise (but disparate) surveillance information began to be integrated into multi-faceted decision-assist models to support TB management decisions, particularly to provide informed parameters at which control effort could be halted, culminating in the Proof of Freedom modelling framework that now allows an area to be declared TB-free within chosen confidence limits. As New Zealand moves from large-scale TB control to regional eradication of disease in the coming years, further integrative models will need to be developed to support management decisions, based on combined field data of possum and TB prevalence, sentinel information, risk assessment in relation to financial benefits, and changing political and environmental needs.
Rosland, Ann-Marie; Heisler, Michele; Piette, John D.
2013-01-01
In general, social support from family members affects chronic illness outcomes, but evidence on which specific family behaviors are most important to adult patient outcomes has not been summarized. We systematically reviewed studies examining the effect of specific family member behaviors and communication patterns on adult chronic illness self-management and clinical outcomes. Thirty studies meeting inclusion criteria were identified, representing 22 participant cohorts, and including adults with arthritis, chronic cardiovascular disease, diabetes, and/or end stage renal disease. Family emphasis on self-reliance and personal achievement, family cohesion, and attentive responses to symptoms were associated with better patient outcomes. Critical, overprotective, controlling, and distracting family responses to illness management were associated with negative patient outcomes. Study limitations included cross-sectional designs (11 cohorts), however results from longitudinal studies were similar. Findings suggest that future interventions aiming to improve chronic illness outcomes should emphasize increased family use of attentive coping techniques and family support for the patient’s autonomous motivation. PMID:21691845
Peterson-Carmichael, Stacey; Seddon, Paul C.; Cheifetz, Ira M.; Frerichs, Inéz; Hall, Graham L.; Hammer, Jürg; Hantos, Zoltán; van Kaam, Anton H.; McEvoy, Cindy T.; Newth, Christopher J. L.; Pillow, J. Jane; Rafferty, Gerrard F.; Rosenfeld, Margaret; Stocks, Janet; Ranganathan, Sarath C.
2016-01-01
Ready access to physiologic measures, including respiratory mechanics, lung volumes, and ventilation/perfusion inhomogeneity, could optimize the clinical management of the critically ill pediatric or neonatal patient and minimize lung injury. There are many techniques for measuring respiratory function in infants and children but very limited information on the technical ease and applicability of these tests in the pediatric and neonatal intensive care unit (PICU, NICU) environments. This report summarizes the proceedings of a 2011 American Thoracic Society Workshop critically reviewing techniques available for ventilated and spontaneously breathing infants and children in the ICU. It outlines for each test how readily it is performed at the bedside and how it may impact patient management as well as indicating future areas of potential research collaboration. From expert panel discussions and literature reviews, we conclude that many of the techniques can aid in optimizing respiratory support in the PICU and NICU, quantifying the effect of therapeutic interventions, and guiding ventilator weaning and extubation. Most techniques now have commercially available equipment for the PICU and NICU, and many can generate continuous data points to help with ventilator weaning and other interventions. Technical and validation studies in the PICU and NICU are published for the majority of techniques; some have been used as outcome measures in clinical trials, but few have been assessed specifically for their ability to improve clinical outcomes. Although they show considerable promise, these techniques still require further study in the PICU and NICU together with increased availability of commercial equipment before wider incorporation into daily clinical practice. PMID:26848609
Estevez, Claudio; Kailas, Aravind
2012-01-01
Millimeter-wave technology shows high potential for future wireless personal area networks, reaching over 1 Gbps transmissions using simple modulation techniques. Current specifications consider dividing the spectrum into effortlessly separable spectrum ranges. These low requirements open a research area in time and space multiplexing techniques for millimeter-waves. In this work a process-stacking multiplexing access algorithm is designed for single channel operation. The concept is intuitive, but its implementation is not trivial. The key to stacking single channel events is to operate while simultaneously obtaining and handling a-posteriori time-frame information of scheduled events. This information is used to shift a global time pointer that the wireless access point manages and uses to synchronize all serviced nodes. The performance of the proposed multiplexing access technique is lower bounded by the performance of legacy TDMA and can significantly improve the effective throughput. Work is validated by simulation results.
Hemodynamic monitoring in the critically ill.
Voga, G
1995-06-01
Monitoring of vital functions is one of the most important and essential tools in the management of critically ill patients in the ICU. Today it is possible to detect and analyze a great variety of physiological signals by various noninvasive and invasive techniques. An intensivist should be able to select and perform the most appropriate monitoring method for the individual patient considering risk-benefit ratio of the particular monitoring technique and the need for immediate therapy, specific diagnosis, continuous monitoring and evaluation of morphology should be included. Despite rapid development of noninvasive monitoring techniques, invasive hemodynamic monitoring in still one of the most basic ICU procedures. It enables monitoring of pressures, flow and saturation, pressures in the systemic and pulmonary circulation, estimation of cardiac performance and judgment of the adequacy of the cardiocirculatory system. Carefully and correctly obtained information are basis for proper hemodynamic assessment which usually effects the therapeutic decisions.
Caries Detection Methods Based on Changes in Optical Properties between Healthy and Carious Tissue
Karlsson, Lena
2010-01-01
A conservative, noninvasive or minimally invasive approach to clinical management of dental caries requires diagnostic techniques capable of detecting and quantifying lesions at an early stage, when progression can be arrested or reversed. Objective evidence of initiation of the disease can be detected in the form of distinct changes in the optical properties of the affected tooth structure. Caries detection methods based on changes in a specific optical property are collectively referred to as optically based methods. This paper presents a simple overview of the feasibility of three such technologies for quantitative or semiquantitative assessment of caries lesions. Two of the techniques are well-established: quantitative light-induced fluorescence, which is used primarily in caries research, and laser-induced fluorescence, a commercially available method used in clinical dental practice. The third technique, based on near-infrared transillumination of dental enamel is in the developmental stages. PMID:20454579
Air-to-air radar flight testing
NASA Astrophysics Data System (ADS)
Scott, Randall E.
1988-06-01
This volume in the AGARD Flight Test Techniques Series describes flight test techniques, flight test instrumentation, ground simulation, data reduction and analysis methods used to determine the performance characteristics of a modern air-to-air (a/a) radar system. Following a general coverage of specification requirements, test plans, support requirements, development and operational testing, and management information systems, the report goes into more detailed flight test techniques covering a/a radar capabilities of: detection, manual acquisition, automatic acquisition, tracking a single target, and detection and tracking of multiple targets. There follows a section on additional flight test considerations such as electromagnetic compatibility, electronic countermeasures, displays and controls, degraded and backup modes, radome effects, environmental considerations, and use of testbeds. Other sections cover ground simulation, flight test instrumentation, and data reduction and analysis. The final sections deal with reporting and a discussion of considerations for the future and how they may affect radar flight testing.
Stein, Benjamin E; Srikumaran, Umasuthan; Tan, Eric W; Freehill, Michael T; Wilckens, John H
2012-11-21
The utilization of peripheral nerve blocks in orthopaedic surgery has paralleled the rise in the number of ambulatory surgical procedures performed. Optimization of pain control in the perioperative orthopaedic patient contributes to improved patient satisfaction, early mobilization, decreased length of hospitalization, and decreased associated hospital and patient costs. Our purpose was to provide a concise, pertinent review of the use of peripheral nerve blocks in various orthopaedic procedures of the lower extremity, with specific focus on procedural anatomy, indications, patient outcome measures, and complications. We reviewed the literature and reference textbooks on commonly performed lower-extremity peripheral nerve block procedures in orthopaedic surgery, focusing on those most commonly used. The use of lower-extremity peripheral nerve blocks is a safe and effective approach to perioperative pain management. Different techniques and timing can have an important impact on patient satisfaction, and each technique has specific indications and complications. For major hip surgery, one of the most commonly used is the lumbar plexus block, which can result in early mobilization, reduced postoperative pain, and decreased opioid-associated adverse events. Associated complications include epidural spread of anesthesia, retroperitoneal hematoma formation, and postoperative falls. For arthroscopic and open knee procedures, the femoral nerve block is frequently used adjunctively. It provides improved early postoperative pain control, early mobilization with therapy, and increased patient satisfaction compared with intra-articular or intravenous opioids alone; it also provides cost savings. However, some studies have shown no significant difference in outcome measures compared with intra-articular opioids alone for arthroscopic anterior cruciate ligament reconstruction. Associated complications include nerve injury, intravascular injection, and postoperative falls. The use of peripheral nerve blocks in lower-extremity surgery is becoming a mainstay of perioperative pain management strategy.
Extended memory management under RTOS
NASA Technical Reports Server (NTRS)
Plummer, M.
1981-01-01
A technique for extended memory management in ROLM 1666 computers using FORTRAN is presented. A general software system is described for which the technique can be ideally applied. The memory manager interface with the system is described. The protocols by which the manager is invoked are presented, as well as the methods used by the manager.
Clinical-outcome-based demand management in health services.
Brogan, C; Lawrence, D; Mayhew, L
2008-01-01
THE PROBLEM OF MANAGING DEMAND: Most healthcare systems have 'third-party payers' who face the problem of keeping within budgets despite pressures to increase resources due to the ageing population, new technologies and patient demands to lower thresholds for care. This paper uses the UK National Health Service as a case study to suggest techniques for system-based demand management, which aims to control demand and costs whilst maintaining the cost-effectiveness of the system. The technique for managing demand in primary, elective and urgent care consists of managing treatment thresholds for appropriate care, using a whole-systems approach and costing the care elements in the system. It is important to analyse activity in relation to capacity and demand. Examples of using these techniques in practice are given. The practical effects of using such techniques need evaluation. If these techniques are not used, managing demand and limiting healthcare expenditure will be at the expense of clinical outcomes and unmet need, which will perpetuate financial crises.
The design and implementation of hydrographical information management system (HIMS)
NASA Astrophysics Data System (ADS)
Sui, Haigang; Hua, Li; Wang, Qi; Zhang, Anming
2005-10-01
With the development of hydrographical work and information techniques, the large variety of hydrographical information including electronic charts, documents and other materials are widely used, and the traditional management mode and techniques are unsuitable for the development of the Chinese Marine Safety Administration Bureau (CMSAB). How to manage all kinds of hydrographical information has become an important and urgent problem. A lot of advanced techniques including GIS, RS, spatial database management and VR techniques are introduced for solving these problems. Some design principles and key techniques of the HIMS including the mixed mode base on B/S, C/S and stand-alone computer mode, multi-source & multi-scale data organization and management, multi-source data integration and diverse visualization of digital chart, efficient security control strategies are illustrated in detail. Based on the above ideas and strategies, an integrated system named Hydrographical Information Management System (HIMS) was developed. And the HIMS has been applied in the Shanghai Marine Safety Administration Bureau and obtained good evaluation.
Prostate Cancer: Serum and Tissue Markers
Miller, Gary J; Brawer, Michael K; Sakr, Wael A; Thrasher, J Brantley; Townsend, Ronald
2001-01-01
The detection of prostate cancer, its clinical staging, and the prediction of its prognosis remain topics of paramount importance in clinical management. The digital rectal exam, although once the “gold standard,” has been largely supplanted by a variety of techniques including serum and tissue-based assays. This article reviews recent progress in the development of prostate-specific antigen assays with greater specificity; molecular markers for prostate cancer (DNA ploidy, nuclear morphometry, markers of proliferation, and cell adhesion molecules); the link between vitamin D deficiency and the clinical emergence of prostate cancer; the possible correlation of serum insulin-like growth factor levels with the risk for developing prostate cancer; and the latest advances in radiologic staging. PMID:16985995
High-level user interfaces for transfer function design with semantics.
Salama, Christof Rezk; Keller, Maik; Kohlmann, Peter
2006-01-01
Many sophisticated techniques for the visualization of volumetric data such as medical data have been published. While existing techniques are mature from a technical point of view, managing the complexity of visual parameters is still difficult for non-expert users. To this end, this paper presents new ideas to facilitate the specification of optical properties for direct volume rendering. We introduce an additional level of abstraction for parametric models of transfer functions. The proposed framework allows visualization experts to design high-level transfer function models which can intuitively be used by non-expert users. The results are user interfaces which provide semantic information for specialized visualization problems. The proposed method is based on principal component analysis as well as on concepts borrowed from computer animation.
Shaw, C D
2000-06-01
This paper is a summary of the operation, findings and conclusions of a European Union project on external peer review techniques, termed 'ExPeRT', to research the scope, mechanisms and use of external quality mechanisms in the improvement of health care. Many of the themes outlined are described in detail in other papers that have been prepared specifically for this issue of The International Journal for Quality in Health Care. Although the emphasis of this project and of this issue of the Journal is on Europe, the conclusions are more widely relevant.
Towards a Conceptual Model of Diabetes Self-Management among Chinese Immigrants in the United States
Zeng, Bin; Sun, Wenjie; Gary, Rebecca A.; Li, Changwei; Liu, Tingting
2014-01-01
Background: Chinese immigrants have been disproportionally affected by type 2 diabetes. This paper presents the state of science regarding the factors that may influence diabetes self-management among Chinese immigrants in the US and the potential health outcomes. Design: Using Walker and Avant’s techniques, a search of the literature was conducted from CINAHL, PubMed, OVID, and Web of Science. Findings: Factors most relevant to diabetes self-management were grouped under five categories: socio-demographic characteristics, behavioral and psychological characteristics, social support, linguistic barriers, and cultural characteristics. Potential outcomes derived from improved diabetes self-management include quality of life, glycosylated hemoglobin, and blood pressure and other cardiovascular risk factors. Discussion: A conceptual model was provided to guide future research. Based on the review of the literature, specific research topics that need to fill the gaps in the literature were provided, including family-focused interventions for Chinese immigrant patients with diabetes and the effectiveness of these interventions to improve family functioning. PMID:24978878
Determining if disease management saves money: an introduction to meta-analysis.
Linden, Ariel; Adams, John L
2007-06-01
Disease management (DM) programmes have long been promoted as a major medical cost-saving mechanism, even though the scant research that exists on the topic has provided conflicting results. In a 2004 literature review, the Congressional Budget Office stated that 'there is insufficient evidence to conclude that disease management programs can generally reduce the overall cost of health care services'. To address this question more accurately, a meta-analysis was warranted. Meta-analysis is the quantitative technique used to pool the results of many studies on the same topic and summarize them statistically. This method is also quite suitable for individual DM firms to assess whether their programmes are effective at the aggregate level. This paper describes the elements of a rigorous meta-analytic process and discusses potential biases. A hypothetical DM organization is then evaluated with a specific emphasis on medical cost-savings, simulating a case in which different populations are served, evaluation methodologies are employed, and diseases are managed.
Zeng, Bin; Sun, Wenjie; Gary, Rebecca A; Li, Changwei; Liu, Tingting
2014-06-27
Chinese immigrants have been disproportionally affected by type 2 diabetes. This paper presents the state of science regarding the factors that may influence diabetes self-management among Chinese immigrants in the US and the potential health outcomes. Using Walker and Avant's techniques, a search of the literature was conducted from CINAHL, PubMed, OVID, and Web of Science. Factors most relevant to diabetes self-management were grouped under five categories: socio-demographic characteristics, behavioral and psychological characteristics, social support, linguistic barriers, and cultural characteristics. Potential outcomes derived from improved diabetes self-management include quality of life, glycosylated hemoglobin, and blood pressure and other cardiovascular risk factors. A conceptual model was provided to guide future research. Based on the review of the literature, specific research topics that need to fill the gaps in the literature were provided, including family-focused interventions for Chinese immigrant patients with diabetes and the effectiveness of these interventions to improve family functioning.
Thompson, John
2002-11-01
This paper discusses the management of meat tenderness using a carcass grading scheme which utilizes the concept of total quality management of those factors which impact on beef palatability. The scheme called Meat Standards Australia (MSA) has identified the Critical Control Points (CCPs) from the production, pre-slaughter, processing and value adding sectors of the beef supply chain and quantified their relative importance using large-scale consumer testing. These CCPs have been used to manage beef palatability in two ways. Firstly, CCPs from the pre-slaughter and processing sectors have been used as mandatory criteria for carcasses to be graded. Secondly, other CCPs from the production and processing sectors have been incorporated into a model to predict palatability for individual muscles. The evidence for the importance of CCPs from the production (breed, growth path and HGP implants), pre-slaughter and processing (pH/temperature window, alternative carcass suspension, marbling and ageing) sectors are reviewed and the accuracy of the model to predict palatability for specific muscle×cooking techniques is presented.
Time management: a review for physicians.
Brunicardi, F. C.; Hobson, F. L.
1996-01-01
This article reviews the basic concepts and techniques of time management as they relate to a medical lifestyle. Essential tools are described to help the physician reassess and sharpen skills for handling intensifying demands and constraints of juggling patient care, research, teaching, and family responsibilities. The historical background and principles of time management for three popular "best selling" techniques are critiqued. In addition, a fourth technique, or model, of time management is introduced for physician use. PMID:8855650
NASA Astrophysics Data System (ADS)
Ahmad, M. F.; Rasi, R. Z.; Zakuan, N.; Hisyamudin, M. N. N.
2015-12-01
In today's highly competitive market, Total Quality Management (TQM) is vital management tool in ensuring a company can success in their business. In order to survive in the global market with intense competition amongst regions and enterprises, the adoption of tools and techniques are essential in improving business performance. There are consistent results between TQM and business performance. However, only few previous studies have examined the mediator effect namely statistical process control (SPC) between TQM and business performance. A mediator is a third variable that changes the association between an independent variable and an outcome variable. This study present research proposed a TQM performance model with mediator effect of SPC with structural equation modelling, which is a more comprehensive model for developing countries, specifically for Malaysia. A questionnaire was prepared and sent to 1500 companies from automotive industry and the related vendors in Malaysia, giving a 21.8 per cent rate. Attempts were made at findings significant impact of mediator between TQM practices and business performance showed that SPC is important tools and techniques in TQM implementation. The result concludes that SPC is partial correlation between and TQM and BP with indirect effect (IE) is 0.25 which can be categorised as high moderator effect.
Technology development for phosphoric acid fuel cell powerplant, phase 2
NASA Technical Reports Server (NTRS)
Christner, L.
1979-01-01
A technique for producing an acid inventory control member by spraying FEP onto a partially screened carbon paper backing is discussed. Theoretical analysis of the acid management indicates that the vapor composition of 103% H3PO4 is approximately 1.0 ppm P4O10. An SEM evaluation of corrosion resistance of phenolic resins and graphite/phenolic resin composites in H3PO4 at 185 C shows specific surface etching. Carbonization of graphite/phenolic bipolar plates is achieved without blistering.
Laboratory data base for isomer-specific determination of polychlorinated biphenyls
DOE Office of Scientific and Technical Information (OSTI.GOV)
Schwartz, T.R.; Campbell, R.D.; Stalling, D.L.
1984-07-01
A computer-assisted technique for quantitative determination of polychlorinated biphenyl isomers is described. PCB isomers were identified by use of a retention index system with n-alkyl trichloroacetates as retention index marker compounds. A laboratory data base system was developed to aid in editing and quantitation of data generated from capillary gas chromatographic data. Data base management was provided by computer programs written in DSM-11 (Digital Standard MUMPS) for the PDP-11 family of computers. 13 references, 4 figures, 2 tables.
A Software Engineering Environment for the Navy.
1982-03-31
Engineering Pr.cess . - 55 ?art II: Description of A Software Engineering Env.Lonnmeut 1. Data Base ........................................ 7 -3 L.I...Methodology to Tool 1-54 2.2.2.2-6 Flow of Management: Activity to Methodology to Tool 21- 55 2.2.2.2-7 Pipelining for Activity-Specific Tools 11-56 A.1.1-1 A...testing techniques. 2.2. 2 Methodciogies and Tools: Correctness Analysis Pai e T- 4Metboioioo ies aews - Pev2.ews Jeicrmine the in ernai ’ Qolc .. ness and
Identifying sediment sources in the sediment TMDL process
Gellis, Allen C.; Fitzpatrick, Faith A.; Schubauer-Berigan, Joseph P.; Landy, R.B.; Gorman Sanisaca, Lillian E.
2015-01-01
Sediment is an important pollutant contributing to aquatic-habitat degradation in many waterways of the United States. This paper discusses the application of sediment budgets in conjunction with sediment fingerprinting as tools to determine the sources of sediment in impaired waterways. These approaches complement monitoring, assessment, and modeling of sediment erosion, transport, and storage in watersheds. Combining the sediment fingerprinting and sediment budget approaches can help determine specific adaptive management plans and techniques applied to targeting hot spots or areas of high erosion.
General aviation energy-conservation research programs at NASA-Lewis Research Center
NASA Technical Reports Server (NTRS)
Willis, E. A.
1977-01-01
The major thrust of NASA's nonturbine general aviation engine programs is directed toward (1) reduced specific fuel consumption, (2) improved fuel tolerance; and (3) emission reduction. Current and planned future programs in such areas as lean operation, improved fuel management, advanced cooling techniques and advanced engine concepts, are described. These are expected to lay the technology base, by the mid to latter 1980's, for engines whose total fuel costs are as much as 30% lower than today's conventional engines.
Nursing care of the brain injury patient on a locked neurobehavioral unit.
Becker, Christine
2012-01-01
Behavioral problems after a brain injury can be extremely challenging for those working with brain injured people. Nursing staff must be familiar with commonly used post brain injury medications and their effects, behavioral management plans, appropriate use of restrictive devices, and verbal or physical crisis intervention techniques when necessary. Rehabilitation nurses caring for brain injured patients on a locked neurobehavioral unit must maintain continual training and specific competence in this environment to ensure patient and staff safety. © 2012 Association of Rehabilitation Nurses.
1980-02-01
maneuver conditions, and transmit the net axial thrust force between the turbine and fan sections due to pressure and aero dynamic gas loads . 49 Lm...stiffness composite material shaft. Both~~ balancing demonstration and the composite shaft design ad as their objective the management of small turbofan ...CONFIGURATIONS 99 LIST OF ILLUSTRATIONS Figure Title Page 1 High Speed Balancing Program Schedule 4 2 Teledyne CAE Model 471-11DX Turbofan Engine
Data Mining for Financial Applications
NASA Astrophysics Data System (ADS)
Kovalerchuk, Boris; Vityaev, Evgenii
This chapter describes Data Mining in finance by discussing financial tasks, specifics of methodologies and techniques in this Data Mining area. It includes time dependence, data selection, forecast horizon, measures of success, quality of patterns, hypothesis evaluation, problem ID, method profile, attribute-based and relational methodologies. The second part of the chapter discusses Data Mining models and practice in finance. It covers use of neural networks in portfolio management, design of interpretable trading rules and discovering money laundering schemes using decision rules and relational Data Mining methodology.
[Management of dysphagia in the institutionalized elderly patient: current situation].
Botella Trelis, J J; Ferrero López, M I
2002-01-01
Elderly patients suffering from dysphagia, institutionalised either in hospital or nursing homes, have been studied. Etiology, characteristics and complications of dysphagia were studied as well as the most frequently used strategies to improve the management of swallowing disorders. A retrospective study of the complications of dysphagia found during the last 4 years in our hospital were conducted in addition to a cross-sectional study of the techniques used to manage dysphagia. A postal questionnaire was sent to all the registered nursing homes in the Valencian Community. Inhospital patients: 58% of physicians estimated that no less than 20% of patients under their care presented dysphagia. 13% of the total number of hospital diets were specific for swallowing disorders. All the patients suffering from dysphagia used a liquid thickener. Nursing Homes residents: 107 questionnaires were returned. This represents 7057 residents of which 3.6% were suffering from dysphagia. 54% of nursing homes have a specific diet for the management of dysphagia, 51% used nasogastric feeding and 30% consider PEG. The most frequent complications were 75% lung aspirations, 39% dehydration, 32% malnourishment and 31% pneumonia. Dysphagia is an important problem in elderly people. In our hospital there is a correct use of a dysphagia diet but it could be more widespread and further measures should be taken. Complications are frequent but are not correctly documented in the medical records. Nursing home residents have frequent and important complications when suffering dysphagia. Interventions towards a better management of dysphagia should be recommended and implemented.
An Update on the Management of Neonatal Brachial Plexus Palsy-Replacing Old Paradigms: A Review.
Smith, Brandon W; Daunter, Alecia K; Yang, Lynda J-S; Wilson, Thomas J
2018-06-01
Neonatal brachial plexus palsy (NBPP) can result in persistent deficits for those who develop it. Advances in surgical technique have resulted in the availability of safe, reliable options for treatment. Prevailing paradigms include, "all neonatal brachial plexus palsy recovers," "wait a year to see if recovery occurs," and "don't move the arm." Practicing by these principles places these patients at a disadvantage. Thus, the importance of this review is to provide an update on the management of NBPP to replace old beliefs with new paradigms. Changes within denervated muscle begin at the moment of injury, but without reinnervation become irreversible 18 to 24 months following denervation. These time-sensitive, irreversible changes are the scientific basis for the recommendations herein for the early management of NBPP and put into question the old paradigms. Early referral has become increasingly important because improved outcomes can be achieved using new management algorithms that allow surgery to be offered to patients unlikely to recover sufficiently with conservative management. Mounting evidence supports improved outcomes for appropriately selected patients with surgical management compared with natural history. Primary nerve surgery options now include nerve graft repair and nerve transfer. Specific indications continue to be elucidated, but both techniques offer a significant chance of restoration of function. Mounting data support both the safety and effectiveness of surgery for patients with persistent NBPP. Despite this support, primary nerve surgery for NBPP continues to be underused. Surgery is but one part of the multidisciplinary care of NBPP. Early referral and implementation of multidisciplinary strategies give these children the best chance of functional recovery. Primary care physicians, nerve surgeons, physiatrists, and occupational and physical therapists must partner to continue to modify current treatment paradigms to provide improved quality care to neonates and children affected by NBPP.
Kinser, Patricia; Masho, Saba
2015-01-01
Perinatal health disparities are of particular concern with pregnant, urban, African-American (AA) adolescents, who have high rates of stress and depression during pregnancy, higher rates of adverse pregnancy and neonatal outcomes, and many barriers to effective treatment. The purpose of this study was to explore pregnant, urban, AA teenagers' experience of stress and depression and examine their perceptions of adjunctive nonpharmacologic management strategies, such as yoga. This community-based, qualitative study used nontherapeutic focus groups to allow for exploration of attitudes, concerns, beliefs, and values regarding stress and depression in pregnancy and nonpharmacologic management approaches, such as mind-body therapies and other prenatal activities. The sample consisted of pregnant, AA, low-income adolescents (n=17) who resided in a large urban area in the United States. The themes that arose in the focus group discussions were that 1) stress and depression symptoms are pervasive in daily life, 2) participants felt a generalized sense of isolation, 3) stress/depression management techniques should be group based, interactive, and focused on the specific needs of teenagers, and 4) yoga is an appealing stress management technique to this population. Findings from this study suggest that pregnant, urban, adolescents are highly stressed; they interpret depression-like symptoms to be signs of stress; they desire group-based, interactive activities; and they are interested in yoga classes for stress/depression management and relationship building. It is imperative that health care providers and researchers focus on these needs, particularly when designing prevention and intervention strategies. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Kinser, Patricia; Masho, Saba
2015-01-01
Purpose Perinatal health disparities are of particular concern with pregnant urban African American adolescents who have high rates of stress and depression during pregnancy, higher rates of adverse pregnancy and neonatal outcomes, and many barriers to effective treatment. The purpose of this study was to explore pregnant urban African American teenagers’ experience of stress and depression and examine their perceptions of adjunctive non-pharmacologic management strategies, such as yoga. Methods This community-based qualitative study utilized non-therapeutic focus groups to allow for exploration of attitudes, concerns, beliefs and values regarding stress and depression in pregnancy and non-pharmacologic management approaches, such as mind-body therapies and other prenatal activities. Findings The sample consisted of pregnant African-American low-income adolescents (n=17) who resided in a large urban area in the United States. The themes that arose in the focus group discussions were: (1) stress and depression symptoms are pervasive in daily life; (2) participants felt a generalized sense of isolation; (3) stress/depression-management techniques should be group-based, interactive, and focused on the specific needs of teenagers; (4) yoga is an appealing stress-management technique to this population. Conclusions The findings from this study suggest that pregnant urban adolescents are highly stressed, they interpret depression-like symptoms to be signs of stress, they desire group-based, interactive activities, and they are interested in yoga classes for stress/depression management and relationship-building. It is imperative that healthcare providers and researchers focus on these needs, particularly when designing prevention and intervention strategies. PMID:25648492
Airway Problems in Neonates—A Review of the Current Investigation and Management Strategies
Mok, Quen
2017-01-01
Airway problems in the neonatal population are often life threatening and raise challenging issues in diagnosis and management. The airway problems can result from congenital or acquired lesions and can be broadly classified into those causing obstruction or those due to an abnormal “communication” in the airway. Many different investigations are now available to identify the diagnosis and quantify the severity of the problem, and these tests can be simple or invasive. Bronchography and bronchoscopy are essential to determine the extent and severity of the airway problem and to plan treatment strategy. Further imaging techniques help to delineate other commonly associated abnormalities. Echocardiography is also important to confirm any associated cardiac abnormality. In this review, the merits and disadvantages of the various investigations now available to the clinician will be discussed. The current therapeutic strategies are discussed, and the review will focus on the most challenging conditions that cause the biggest management conundrums, specifically laryngotracheal cleft, congenital tracheal stenosis, and tracheobronchomalacia. Management of acquired stenosis secondary to airway injury from endotracheal intubation will also be discussed as this is a common problem. Slide tracheoplasty is the preferred surgical option for long-segment tracheal stenosis, and results have improved significantly. Stents are occasionally required for residual or recurrent stenosis following surgical repair. There is sufficient evidence that a multidisciplinary team approach for managing complex airway issues provides the best results for the patient. There is ongoing progress in the field with newer diagnostic tools as well as development of innovative management techniques, such as biodegradable stents and stem cell-based tracheal transplants, leading to a much better prognosis for these children in the future. PMID:28424763
Management of dredge material in the Republic of Ireland - A review.
Sheehan, C; Harrington, J
2012-05-01
As an island nation the Republic of Ireland's ports and harbours are key to the economic wellbeing of the country as they are the primary transport link to the United Kingdom, mainland Europe and beyond. This paper examines the main aspects of the Irish dredging industry with comparison to international practice and standards, including the source of the dredge material and volumes generated annually, the dredging plant employed and the management processes currently practised. Relevant European and Irish legislation governing dredging, disposal at sea and waste licensing are presented. The potential impacts of disposal at sea are discussed with the implications for the Irish dredging industry of recently introduced European Directives assessed. Beneficial use rates for dredge material and the techniques implemented in Ireland are examined and compared with international practice. Recent notable beneficial use projects for dredge material and proposed innovative dredge material management techniques for specific dredging projects in Ireland are presented. Proposals to encourage greater beneficial use of dredge material and minimise disposal at sea for Ireland are presented including the introduction of environmental credits, tax breaks and a grant system for pilot schemes. An alternative disposal at sea charge fee structure is also recommended to encourage alternative dredge material management practices. Ireland's management of contaminated sediment is also presented with recent projects described highlighting the current practice of primarily exporting contaminated sediment to mainland Europe. Alternative methods of treatment of contaminated sediment are assessed in an Irish context. Future issues and challenges facing the Irish dredging industry are assessed and a critical analysis of the current approaches to dredge material management is presented. Copyright © 2011 Elsevier Ltd. All rights reserved.
Prognostics for Microgrid Components
NASA Technical Reports Server (NTRS)
Saxena, Abhinav
2012-01-01
Prognostics is the science of predicting future performance and potential failures based on targeted condition monitoring. Moving away from the traditional reliability centric view, prognostics aims at detecting and quantifying the time to impending failures. This advance warning provides the opportunity to take actions that can preserve uptime, reduce cost of damage, or extend the life of the component. The talk will focus on the concepts and basics of prognostics from the viewpoint of condition-based systems health management. Differences with other techniques used in systems health management and philosophies of prognostics used in other domains will be shown. Examples relevant to micro grid systems and subsystems will be used to illustrate various types of prediction scenarios and the resources it take to set up a desired prognostic system. Specifically, the implementation results for power storage and power semiconductor components will demonstrate specific solution approaches of prognostics. The role of constituent elements of prognostics, such as model, prediction algorithms, failure threshold, run-to-failure data, requirements and specifications, and post-prognostic reasoning will be explained. A discussion on performance evaluation and performance metrics will conclude the technical discussion followed by general comments on open research problems and challenges in prognostics.
ERIC Educational Resources Information Center
Chuadhry, Muhammad Asif; Shah, Syed Manzoor Hussain
2012-01-01
Management provides formal coordination in an organization for achieving pre-determined goals. The educational manager particulary performs his duties by using different planning and management techniques. These techniques are equally important for the manager of other sectors. The present study was focused on the impact of managerial skills…
The Relationship between Anger Management Techniques and Discipline Reports
ERIC Educational Resources Information Center
Brooks, LaTorea; McGahey, James Todd; Jenkins, Marvin
2017-01-01
The purpose of this study was to target students who show aggressive and bullying behavior due to a lack of anger management and self-control skills. Two groups of boys in grades 2-4 participated in anger managements groups that either followed an anger management curriculum or followed the anger management curriculum plus breathing techniques.…
Modeling and Analysis of Commercial Building Electrical Loads for Demand Side Management
NASA Astrophysics Data System (ADS)
Berardino, Jonathan
In recent years there has been a push in the electric power industry for more customer involvement in the electricity markets. Traditionally the end user has played a passive role in the planning and operation of the power grid. However, many energy markets have begun opening up opportunities to consumers who wish to commit a certain amount of their electrical load under various demand side management programs. The potential benefits of more demand participation include reduced operating costs and new revenue opportunities for the consumer, as well as more reliable and secure operations for the utilities. The management of these load resources creates challenges and opportunities to the end user that were not present in previous market structures. This work examines the behavior of commercial-type building electrical loads and their capacity for supporting demand side management actions. This work is motivated by the need for accurate and dynamic tools to aid in the advancement of demand side operations. A dynamic load model is proposed for capturing the response of controllable building loads. Building-specific load forecasting techniques are developed, with particular focus paid to the integration of building management system (BMS) information. These approaches are tested using Drexel University building data. The application of building-specific load forecasts and dynamic load modeling to the optimal scheduling of multi-building systems in the energy market is proposed. Sources of potential load uncertainty are introduced in the proposed energy management problem formulation in order to investigate the impact on the resulting load schedule.
On the influence of latency estimation on dynamic group communication using overlays
NASA Astrophysics Data System (ADS)
Vik, Knut-Helge; Griwodz, Carsten; Halvorsen, Pål
2009-01-01
Distributed interactive applications tend to have stringent latency requirements and some may have high bandwidth demands. Many of them have also very dynamic user groups for which all-to-all communication is needed. In online multiplayer games, for example, such groups are determined through region-of-interest management in the application. We have investigated a variety of group management approaches for overlay networks in earlier work and shown that several useful tree heuristics exist. However, these heuristics require full knowledge of all overlay link latencies. Since this is not scalable, we investigate the effects that latency estimation techqniues have ton the quality of overlay tree constructions. We do this by evaluating one example of our group management approaches in Planetlab and examing how latency estimation techqniues influence their quality. Specifically, we investigate how two well-known latency estimation techniques, Vivaldi and Netvigator, affect the quality of tree building.
Closed Loop Requirements and Analysis Management
NASA Technical Reports Server (NTRS)
Lamoreaux, Michael; Verhoef, Brett
2015-01-01
Effective systems engineering involves the use of analysis in the derivation of requirements and verification of designs against those requirements. The initial development of requirements often depends on analysis for the technical definition of specific aspects of a product. Following the allocation of system-level requirements to a product's components, the closure of those requirements often involves analytical approaches to verify that the requirement criteria have been satisfied. Meanwhile, changes that occur in between these two processes need to be managed in order to achieve a closed-loop requirement derivation/verification process. Herein are presented concepts for employing emerging Team center capabilities to jointly manage requirements and analysis data such that analytical techniques are utilized to effectively derive and allocate requirements, analyses are consulted and updated during the change evaluation processes, and analyses are leveraged during the design verification process. Recommendations on concept validation case studies are also discussed.
An intelligent user interface for browsing satellite data catalogs
NASA Technical Reports Server (NTRS)
Cromp, Robert F.; Crook, Sharon
1989-01-01
A large scale domain-independent spatial data management expert system that serves as a front-end to databases containing spatial data is described. This system is unique for two reasons. First, it uses spatial search techniques to generate a list of all the primary keys that fall within a user's spatial constraints prior to invoking the database management system, thus substantially decreasing the amount of time required to answer a user's query. Second, a domain-independent query expert system uses a domain-specific rule base to preprocess the user's English query, effectively mapping a broad class of queries into a smaller subset that can be handled by a commercial natural language processing system. The methods used by the spatial search module and the query expert system are explained, and the system architecture for the spatial data management expert system is described. The system is applied to data from the International Ultraviolet Explorer (IUE) satellite, and results are given.
Reynolds, Stacey
2015-01-01
This review describes and summarizes the available evidence related to the treatment and management of Barth syndrome. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used to identify articles published between December 2004 and January 2015. The Cochrane Population, Intervention, Control, Outcome, Study Design (PICOS) approach was used to guide the article selection and evaluation process. Of the 128 articles screened, 28 articles matched the systematic review inclusion criteria. The results of this review indicate the need for a flexible and multidisciplinary approach to manage the symptoms most commonly associated with Barth syndrome. It is recommended that a comprehensive care team should include individuals with Barth syndrome, their family members and caregivers, as well as medical, rehabilitative, nutritional, psychological, and educational professionals. The evidence for specific treatments, therapies, and techniques for individuals with Barth syndrome is currently lacking in both quality and quantity.
Standard cost elements for technology programs
NASA Technical Reports Server (NTRS)
Christensen, Carisa B.; Wagenfuehrer, Carl
1992-01-01
The suitable structure for an effective and accurate cost estimate for general purposes is discussed in the context of a NASA technology program. Cost elements are defined for research, management, and facility-construction portions of technology programs. Attention is given to the mechanisms for insuring the viability of spending programs, and the need for program managers is established for effecting timely fund disbursement. Formal, structures, and intuitive techniques are discussed for cost-estimate development, and cost-estimate defensibility can be improved with increased documentation. NASA policies for cash management are examined to demonstrate the importance of the ability to obligate funds and the ability to cost contracted funds. The NASA approach to consistent cost justification is set forth with a list of standard cost-element definitions. The cost elements reflect the three primary concerns of cost estimates: the identification of major assumptions, the specification of secondary analytic assumptions, and the status of program factors.
Chokshi, Dave A.; Parker, Michael; Kwiatkowski, Dominic P.
2006-01-01
Genomic epidemiology is a field of research that seeks to improve the prevention and management of common diseases through an understanding of their molecular origins. It involves studying thousands of individuals, often from different populations, with exacting techniques. The scale and complexity of such research has required the formation of research consortia. Members of these consortia need to agree on policies for managing shared resources and handling genetic data. Here we consider data-sharing and intellectual property policies for an international research consortium working on the genomic epidemiology of malaria. We outline specific guidelines governing how samples and data are transferred among its members; how results are released into the public domain; when to seek protection for intellectual property; and how intellectual property should be managed. We outline some pragmatic solutions founded on the basic principles of promoting innovation and access. PMID:16710548
Jadhav, Pravin R; Neal, Lauren; Florian, Jeff; Chen, Ying; Naeger, Lisa; Robertson, Sarah; Soon, Guoxing; Birnkrant, Debra
2010-09-01
This article presents a prototype for an operational innovation in knowledge management (KM). These operational innovations are geared toward managing knowledge efficiently and accessing all available information by embracing advances in bioinformatics and allied fields. The specific components of the proposed KM system are (1) a database to archive hepatitis C virus (HCV) treatment data in a structured format and retrieve information in a query-capable manner and (2) an automated analysis tool to inform trial design elements for HCV drug development. The proposed framework is intended to benefit drug development by increasing efficiency of dose selection and improving the consistency of advice from US Food and Drug Administration (FDA). It is also hoped that the framework will encourage collaboration among FDA, industry, and academic scientists to guide the HCV drug development process using model-based quantitative analysis techniques.
NREPS Applications for Water Supply and Management in California and Tennessee
NASA Technical Reports Server (NTRS)
Gatlin, P.; Scott, M.; Carery, L. D.; Petersen, W. A.
2011-01-01
Management of water resources is a balancing act between temporally and spatially limited sources and competitive needs which can often exceed the supply. In order to manage water resources over a region such as the San Joaquin Valley or the Tennessee River Valley, it is pertinent to know the amount of water that has fallen in the watershed and where the water is going within it. Since rain gauge networks are typically sparsely spaced, it is typical that the majority of rainfall on the region may not be measured. To mitigate this under-sampling of rainfall, weather radar has long been employed to provide areal rainfall estimates. The Next-Generation Weather Radars (NEXRAD) make it possible to estimate rainfall over the majority of the conterminous United States. The NEXRAD Rainfall Estimation Processing System (NREPS) was developed specifically for the purpose of using weather radar to estimate rainfall for water resources management. The NREPS is tailored to meet customer needs on spatial and temporal scales relevant to the hydrologic or land-surface models of the end-user. It utilizes several techniques to mitigate artifacts in the NEXRAD data from contaminating the rainfall field. These techniques include clutter filtering, correction for occultation by topography as well as accounting for the vertical profile of reflectivity. This presentation will focus on improvements made to the NREPS system to map rainfall in the San Joaquin Valley for NASA s Water Supply and Management Project in California, but also ongoing rainfall mapping work in the Tennessee River watershed for the Tennessee Valley Authority and possible future applications in other areas of the continent.
ERIC Educational Resources Information Center
Tran, Van Dat
2015-01-01
This study reports students' perceptions of the classroom management techniques utilized in fourteen classrooms at eight junior high schools in one province in Vietnam. It examines data from 498 students in fifteen high schools in one district in Vietnam in grades 10 to 12 to identify how teachers' use of various management techniques, and the…
Principles and management of adrenal cancer
DOE Office of Scientific and Technical Information (OSTI.GOV)
Javadpour, N.
1987-01-01
This book provides information on adrenal diseases of latest developments and guides the clinicians in the care of their patients. The book is divided into two parts. The first section gives an overview of the embryology, anatomy, physiology, markers, pathology, imaging and the current progress in the field. The second edition covers specific diseases of the adrenal cortex and medulla. The increasingly significant roles played by steroids, catecholamines, blockers, computed tomography and magnetic resonance are elucidated and discussed. The contents include: Overview of progress; current problems, and perspectives - embryology anatomy, physiology, and biologic markers; pathology; advances in diagnosis; imagingmore » techniques; adrenal disorders in childhood; primary aldosteronism; Cushing's syndrome; carcinoma; pheochromocytoma; neuroblastoma; metastatic disease; surgical management; and subject index.« less
WE-B-BRD-00: MRI for Radiation Oncology
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
The use of MRI in radiation therapy is rapidly increasing. Applications vary from the MRI simulator, to the MRI fused with CT, and to the integrated MRI+RT system. Compared with the standard MRI QA, a broader scope of QA features has to be defined in order to maximize the benefits of using MRI in radiation therapy. These QA features include geometric fidelity, image registration, motion management, cross-system alignment, and hardware interference. Advanced MRI techniques require a specific type of QA, as they are being widely used in radiation therapy planning, dose calculations, post-implant dosimetry, and prognoses. A vigorous and adaptivemore » QA program is crucial to defining the responsibility of the entire radiation therapy group and detecting deviations from the performance of high-quality treatment. As a drastic departure from CT simulation, MRI simulation requires changes in the work flow of treatment planning and image guidance. MRI guided radiotherapy platforms are being developed and commercialized to take the advantage of the advance in knowledge, technology and clinical experience. This symposium will from an educational perspective discuss the scope and specific issues related to MRI guided radiotherapy. Learning Objectives: Understand the difference between a standard and a radiotherapy-specific MRI QA program. Understand the effects of MRI artifacts (geometric distortion and motion) on radiotherapy. Understand advanced MRI techniques (ultrashort echo, fast MRI including dynamic MRI and 4DMRI, diffusion, perfusion, and MRS) and related QA. Understand the methods to prepare MRI for treatment planning (electron density assignment, multimodality image registration, segmentation and motion management). Current status of MRI guided treatment platforms. Dr. Jihong Wang has a research grant with Elekta-MRL project. Dr. Ke Sheng receives research grants from Varian Medical systems.« less
STS-61 mission director's post-mission report
NASA Technical Reports Server (NTRS)
Newman, Ronald L.
1995-01-01
To ensure the success of the complex Hubble Space Telescope servicing mission, STS-61, NASA established a number of independent review groups to assess management, design, planning, and preparation for the mission. One of the resulting recommendations for mission success was that an overall Mission Director be appointed to coordinate management activities of the Space Shuttle and Hubble programs and to consolidate results of the team reviews and expedite responses to recommendations. This report presents pre-mission events important to the experience base of mission management, with related Mission Director's recommendations following the event(s) to which they apply. All Mission Director's recommendations are presented collectively in an appendix. Other appendixes contain recommendations from the various review groups, including Payload Officers, the JSC Extravehicular Activity (EVA) Section, JSC EVA Management Office, JSC Crew and Thermal Systems Division, and the STS-61 crew itself. This report also lists mission events in chronological order and includes as an appendix a post-mission summary by the lead Payload Deployment and Retrieval System Officer. Recommendations range from those pertaining to specific component use or operating techniques to those for improved management, review, planning, and safety procedures.
Toward interactive scheduling systems for managing medical resources.
Oddi, A; Cesta, A
2000-10-01
Managers of medico-hospital facilities are facing two general problems when allocating resources to activities: (1) to find an agreement between several and contrasting requirements; (2) to manage dynamic and uncertain situations when constraints suddenly change over time due to medical needs. This paper describes the results of a research aimed at applying constraint-based scheduling techniques to the management of medical resources. A mixed-initiative problem solving approach is adopted in which a user and a decision support system interact to incrementally achieve a satisfactory solution to the problem. A running prototype is described called Interactive Scheduler which offers a set of functionalities for a mixed-initiative interaction to cope with the medical resource management. Interactive Scheduler is endowed with a representation schema used for describing the medical environment, a set of algorithms that address the specific problems of the domain, and an innovative interaction module that offers functionalities for the dialogue between the support system and its user. A particular contribution of this work is the explicit representation of constraint violations, and the definition of scheduling algorithms that aim at minimizing the amount of constraint violations in a solution.
The management of lower gastrointestinal bleeding.
Marion, Y; Lebreton, G; Le Pennec, V; Hourna, E; Viennot, S; Alves, A
2014-06-01
Lower gastrointestinal (LGI) bleeding is generally less severe than upper gastrointestinal (UGI) bleeding with spontaneous cessation of bleeding in 80% of cases and a mortality of 2-4%. However, unlike UGI bleeding, there is no consensual agreement about management. Once the patient has been stabilized, the main objective and greatest difficulty is to identify the location of bleeding in order to provide specific appropriate treatment. While upper endoscopy and colonoscopy remain the essential first-line examinations, the development and availability of angiography have made this an important imaging modality for cases of active bleeding; they allow diagnostic localization of bleeding and guide subsequent therapy, whether therapeutic embolization, interventional colonoscopy or, if other techniques fail or are unavailable, surgery directed at the precise site of bleeding. Furthermore, newly developed endoscopic techniques, particularly video capsule enteroscopy, now allow minimally invasive exploration of the small intestine; if this is positive, it will guide subsequent assisted enteroscopy or surgery. Other small bowel imaging techniques include enteroclysis by CT or magnetic resonance imaging. At the present time, exploratory surgery is no longer a first-line approach. In view of the lesser gravity of LGI bleeding, it is most reasonable to simply stabilize the patient initially for subsequent transfer to a specialized center, if minimally invasive techniques are not available at the local hospital. In all cases, the complexity and diversity of LGI bleeding require a multidisciplinary collaboration involving the gastroenterologist, radiologist, intensivist and surgeon to optimize diagnosis and treatment of the patient. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
Flores, Bruno C; White, Jonathan A; Batjer, H Hunt; Samson, Duke S
2018-05-04
OBJECTIVE Paraclinoid internal carotid artery (ICA) aneurysms frequently require temporary occlusion to facilitate safe clipping. Brisk retrograde flow through the ophthalmic artery and cavernous ICA branches make simple trapping inadequate to soften the aneurysm. The retrograde suction decompression (RSD), or Dallas RSD, technique was described in 1990 in an attempt to overcome some of those treatment limitations. A frequent criticism of the RSD technique is an allegedly high risk of cervical ICA dissection. An endovascular modification was introduced in 1991 (endovascular RSD) but no studies have compared the 2 RSD variations. METHODS The authors performed a systematic review of MEDLINE/PubMed and Web of Science and identified all studies from 1990-2016 in which either Dallas RSD or endovascular RSD was used for treatment of paraclinoid aneurysms. A pooled analysis of the data was completed to identify important demographic and treatment-specific variables. The primary outcome measure was defined as successful aneurysm obliteration. Secondary outcome variables were divided into overall and RSD-specific morbidity and mortality rates. RESULTS Twenty-six RSD studies met the inclusion criteria (525 patients, 78.9% female). The mean patient age was 53.5 years. Most aneurysms were unruptured (56.6%) and giant (49%). The most common presentations were subarachnoid hemorrhage (43.6%) and vision changes (25.3%). The aneurysm obliteration rate was 95%. The mean temporary occlusion time was 12.7 minutes. Transient or permanent morbidity was seen in 19.9% of the patients. The RSD-specific complication rate was low (1.3%). The overall mortality rate was 4.2%, with 2 deaths (0.4%) attributable to the RSD technique itself. Good or fair outcome were reported in 90.7% of the patients. Aneurysm obliteration rates were similar in the 2 subgroups (Dallas RSD 94.3%, endovascular RSD 96.3%, p = 0.33). Despite a higher frequency of complex (giant or ruptured) aneurysms, Dallas RSD was associated with lower RSD-related morbidity (0.6% vs 2.9%, p = 0.03), compared with the endovascular RSD subgroup. There was a trend toward higher mortality in the endovascular RSD subgroup (6.4% vs 3.1%, p = 0.08). The proportion of patients with poor neurological outcome at last follow-up was significantly higher in the endovascular RSD group (15.4% vs 7.2%, p < 0.01). CONCLUSIONS The treatment of paraclinoid ICA aneurysms using the RSD technique is associated with high aneurysm obliteration rates, good long-term neurological outcome, and low RSD-related morbidity and mortality. Review of the RSD literature showed no evidence of a higher complication rate associated with the Dallas technique compared with similar endovascular methods. On a subgroup analysis of Dallas RSD and endovascular RSD, both groups achieved similar obliteration rates, but a lower RSD-related morbidity was seen in the Dallas technique subgroup. Twenty-five years after its initial publication, RSD remains a useful neurosurgical technique for the management of large and giant paraclinoid aneurysms.
A Unique Bonding Technique for Immediate Orthognathic Surgery
Ayinipully, Hariprasad; Paul, Rosaline Tina; Ponnambathayil, Shaji Aboobacker; Rasheed, Althaf Thanimoottil
2015-01-01
Introduction A challenge in orthodontics is achieving ideal bracket position which determines treatment results and finishing. A new bonding method is done indirectly on the cast and bonded directly on the teeth, but it does not require conventional trays to carry the brackets to the teeth. Materials and Methods Heavy sized archwires like 0.019″x0.025″ or 0.018″ SS are bent to the malocclusion to generate a template which comprises of an Bracket -Archwire Assembly (BAA). This assembly is transferred onto the teeth using the molar bands with tubes which serves as a jig for proper orientation of the BAA, then the adhesive is cured at one shot to complete the bonding procedure. Results Two surgical cases successfully bonded with this technique is presented in this article. Conclusion This bonding method finds specific advantages in surgical orthodontics – when the surgeon decides on a surgery-first treatment objective, management of single or a couple of periodontally extruded teeth, management of impacted teeth and in patients needing fixed functional appliance immediately before the completion of growth spurt. PMID:26266212
Gholami, Mohammad; Brennan, Robert W
2016-01-06
In this paper, we investigate alternative distributed clustering techniques for wireless sensor node tracking in an industrial environment. The research builds on extant work on wireless sensor node clustering by reporting on: (1) the development of a novel distributed management approach for tracking mobile nodes in an industrial wireless sensor network; and (2) an objective comparison of alternative cluster management approaches for wireless sensor networks. To perform this comparison, we focus on two main clustering approaches proposed in the literature: pre-defined clusters and ad hoc clusters. These approaches are compared in the context of their reconfigurability: more specifically, we investigate the trade-off between the cost and the effectiveness of competing strategies aimed at adapting to changes in the sensing environment. To support this work, we introduce three new metrics: a cost/efficiency measure, a performance measure, and a resource consumption measure. The results of our experiments show that ad hoc clusters adapt more readily to changes in the sensing environment, but this higher level of adaptability is at the cost of overall efficiency.
Gholami, Mohammad; Brennan, Robert W.
2016-01-01
In this paper, we investigate alternative distributed clustering techniques for wireless sensor node tracking in an industrial environment. The research builds on extant work on wireless sensor node clustering by reporting on: (1) the development of a novel distributed management approach for tracking mobile nodes in an industrial wireless sensor network; and (2) an objective comparison of alternative cluster management approaches for wireless sensor networks. To perform this comparison, we focus on two main clustering approaches proposed in the literature: pre-defined clusters and ad hoc clusters. These approaches are compared in the context of their reconfigurability: more specifically, we investigate the trade-off between the cost and the effectiveness of competing strategies aimed at adapting to changes in the sensing environment. To support this work, we introduce three new metrics: a cost/efficiency measure, a performance measure, and a resource consumption measure. The results of our experiments show that ad hoc clusters adapt more readily to changes in the sensing environment, but this higher level of adaptability is at the cost of overall efficiency. PMID:26751447
Towards Application of NASA Standard for Models and Simulations in Aeronautical Design Process
NASA Astrophysics Data System (ADS)
Vincent, Luc; Dunyach, Jean-Claude; Huet, Sandrine; Pelissier, Guillaume; Merlet, Joseph
2012-08-01
Even powerful computational techniques like simulation endure limitations in their validity domain. Consequently using simulation models requires cautions to avoid making biased design decisions for new aeronautical products on the basis of inadequate simulation results. Thus the fidelity, accuracy and validity of simulation models shall be monitored in context all along the design phases to build confidence in achievement of the goals of modelling and simulation.In the CRESCENDO project, we adapt the Credibility Assessment Scale method from NASA standard for models and simulations from space programme to the aircraft design in order to assess the quality of simulations. The proposed eight quality assurance metrics aggregate information to indicate the levels of confidence in results. They are displayed in management dashboard and can secure design trade-off decisions at programme milestones.The application of this technique is illustrated in aircraft design context with specific thermal Finite Elements Analysis. This use case shows how to judge the fitness- for-purpose of simulation as Virtual testing means and then green-light the continuation of Simulation Lifecycle Management (SLM) process.
Quirk, S; Becker, N; Smith, W L
2012-07-01
Respiratory motion complicates radiotherapy treatment of thoracic and abdominal tumours. Simplified respiratory motions such as sinusoidal and single patient traces are often used to determine the impact of motion on respiratory management techniques in radiotherapy. Such simplifications only accurately model a small portion of patients, as most patients exhibit variability and irregularity beyond these models. We have preformed a comprehensive analysis of respiratory motion and developed a software tool that allows for explicit inclusion of variability. We utilize our realistic respiratory generator to customize respiratory traces to test the robustness of the estimate of internal gross target volumes (IGTV) by 4DCT and CBCT. We confirmed that good agreement is found between 4DCT and CBCT for regular breathing motion. When amplitude variability was introduced the accuracy of the estimate slightly, but the absolute differences were still < 3 mm for both modalities. Poor agreement was shown with the addition of baseline drifts. Both modalities were found to underestimate the IGTV by as much as 30% for 4DCT and 25% for CBCT. Both large and small drifts deteriorated the estimate accuracy. The respiratory trace generator was advantageous for examining the difference between 4DCT and CBCT IGTV estimation under variable motions. It provided useful implementation abilities to test specific attributes of respiratory motion and detected issues that were not seen with the regular motion studies. This is just one example of how the respiratory trace generator can be utilized to test applications of respiratory management techniques. © 2012 American Association of Physicists in Medicine.
Clinical bacteriology in low-resource settings: today's solutions.
Ombelet, Sien; Ronat, Jean-Baptiste; Walsh, Timothy; Yansouni, Cedric P; Cox, Janneke; Vlieghe, Erika; Martiny, Delphine; Semret, Makeda; Vandenberg, Olivier; Jacobs, Jan
2018-03-05
Low-resource settings are disproportionately burdened by infectious diseases and antimicrobial resistance. Good quality clinical bacteriology through a well functioning reference laboratory network is necessary for effective resistance control, but low-resource settings face infrastructural, technical, and behavioural challenges in the implementation of clinical bacteriology. In this Personal View, we explore what constitutes successful implementation of clinical bacteriology in low-resource settings and describe a framework for implementation that is suitable for general referral hospitals in low-income and middle-income countries with a moderate infrastructure. Most microbiological techniques and equipment are not developed for the specific needs of such settings. Pending the arrival of a new generation diagnostics for these settings, we suggest focus on improving, adapting, and implementing conventional, culture-based techniques. Priorities in low-resource settings include harmonised, quality assured, and tropicalised equipment, consumables, and techniques, and rationalised bacterial identification and testing for antimicrobial resistance. Diagnostics should be integrated into clinical care and patient management; clinically relevant specimens must be appropriately selected and prioritised. Open-access training materials and information management tools should be developed. Also important is the need for onsite validation and field adoption of diagnostics in low-resource settings, with considerable shortening of the time between development and implementation of diagnostics. We argue that the implementation of clinical bacteriology in low-resource settings improves patient management, provides valuable surveillance for local antibiotic treatment guidelines and national policies, and supports containment of antimicrobial resistance and the prevention and control of hospital-acquired infections. Copyright © 2018 Elsevier Ltd. All rights reserved.
Pattern of parental acceptance of management techniques used in pediatric dentistry.
Peretz, Benjamin; Kharouba, Johnny; Blumer, Sigalit
2013-01-01
To evaluate parents' acceptance of management techniques in Israeli pediatric dental clinics. Ninety parents who accompanied their children to three pediatric dental clinics provided information on selected parameters including their attitudes about management techniques. 68.9% of the parents preferred to stay in the treatment room. The most accepted technique was positive reinforcement (81.1%) followed by tell-show-do (TSD) (76.7%, with younger parents more accepting than older, p = 0.049). The least accepted techniques were restraint (1.1%) and voice control (7.8%, especially by parents with the highest dental anxiety, p = 0.002). Sedation was unacceptable by 15.6% of the parents: those with the lowest dental anxiety agreed to sedation significantly more than those with greater dental anxiety (p = 0.031). Parents preferred more positive approaches and management techniques that involve demonstrations geared for the child's level of understanding. Restraint and voice control were more strongly rejected than sedation.
Lin, Yun-Bin; Lin, Yu-Pin; Deng, Dong-Po; Chen, Kuan-Wei
2008-02-19
In Taiwan, earthquakes have long been recognized as a major cause oflandslides that are wide spread by floods brought by typhoons followed. Distinguishingbetween landslide spatial patterns in different disturbance regimes is fundamental fordisaster monitoring, management, and land-cover restoration. To circumscribe landslides,this study adopts the normalized difference vegetation index (NDVI), which can bedetermined by simply applying mathematical operations of near-infrared and visible-redspectral data immediately after remotely sensed data is acquired. In real-time disastermonitoring, the NDVI is more effective than using land-cover classifications generatedfrom remotely sensed data as land-cover classification tasks are extremely time consuming.Directional two-dimensional (2D) wavelet analysis has an advantage over traditionalspectrum analysis in that it determines localized variations along a specific direction whenidentifying dominant modes of change, and where those modes are located in multi-temporal remotely sensed images. Open geospatial techniques comprise a series ofsolutions developed based on Open Geospatial Consortium specifications that can beapplied to encode data for interoperability and develop an open geospatial service for sharing data. This study presents a novel approach and framework that uses directional 2Dwavelet analysis of real-time NDVI images to effectively identify landslide patterns andshare resulting patterns via open geospatial techniques. As a case study, this study analyzedNDVI images derived from SPOT HRV images before and after the ChiChi earthquake(7.3 on the Richter scale) that hit the Chenyulan basin in Taiwan, as well as images aftertwo large typhoons (Xangsane and Toraji) to delineate the spatial patterns of landslidescaused by major disturbances. Disturbed spatial patterns of landslides that followed theseevents were successfully delineated using 2D wavelet analysis, and results of patternrecognitions of landslides were distributed simultaneously to other agents using geographymarkup language. Real-time information allows successive platforms (agents) to work withlocal geospatial data for disaster management. Furthermore, the proposed is suitable fordetecting landslides in various regions on continental, regional, and local scales usingremotely sensed data in various resolutions derived from SPOT HRV, IKONOS, andQuickBird multispectral images.
A quality risk management model approach for cell therapy manufacturing.
Lopez, Fabio; Di Bartolo, Chiara; Piazza, Tommaso; Passannanti, Antonino; Gerlach, Jörg C; Gridelli, Bruno; Triolo, Fabio
2010-12-01
International regulatory authorities view risk management as an essential production need for the development of innovative, somatic cell-based therapies in regenerative medicine. The available risk management guidelines, however, provide little guidance on specific risk analysis approaches and procedures applicable in clinical cell therapy manufacturing. This raises a number of problems. Cell manufacturing is a poorly automated process, prone to operator-introduced variations, and affected by heterogeneity of the processed organs/tissues and lot-dependent variability of reagent (e.g., collagenase) efficiency. In this study, the principal challenges faced in a cell-based product manufacturing context (i.e., high dependence on human intervention and absence of reference standards for acceptable risk levels) are identified and addressed, and a risk management model approach applicable to manufacturing of cells for clinical use is described for the first time. The use of the heuristic and pseudo-quantitative failure mode and effect analysis/failure mode and critical effect analysis risk analysis technique associated with direct estimation of severity, occurrence, and detection is, in this specific context, as effective as, but more efficient than, the analytic hierarchy process. Moreover, a severity/occurrence matrix and Pareto analysis can be successfully adopted to identify priority failure modes on which to act to mitigate risks. The application of this approach to clinical cell therapy manufacturing in regenerative medicine is also discussed. © 2010 Society for Risk Analysis.
The Hall Technique for managing carious primary molars.
Innes, Nicola; Evans, Dafydd; Hall, Norna
2009-10-01
The Hall Technique, a method of managing carious primary molars effectively with preformed metal crowns, without the use of local anaesthesia, caries removal or tooth preparation of any kind, is described.The technique is illustrated with a case report.The evidence underpinning the technique is discussed, along with indications and contra-indications for its use, and details of where clinicians can obtain further information on the technique if they are considering using it. Research evidence has indicated that the Hall Technique is effective in managing dental caries in primary molar teeth when used by General Dental Practitioners, and is preferred by them, their child patients and the children's parents to conventional restorative methods for these teeth.
NASA Technical Reports Server (NTRS)
Campbell, R.; Dyer, M. K.; Hoard, E. G.; Little, D. G.; Taylor, A. C.
1972-01-01
Constructive recommendations are suggested for pollution problems from offshore energy resources industries on outer continental shelf. Technical management techniques for pollution identification and control offer possible applications to space engineering and management.
Véliz, Pedro L; Berra, Esperanza M; Jorna, Ana R
2015-07-01
INTRODUCTION Medical specialties' core curricula should take into account functions to be carried out, positions to be filled and populations to be served. The functions in the professional profile for specialty training of Cuban intensive care and emergency medicine specialists do not include all the activities that they actually perform in professional practice. OBJECTIVE Define the specific functions and procedural skills required of Cuban specialists in intensive care and emergency medicine. METHODS The study was conducted from April 2011 to September 2013. A three-stage methodological strategy was designed using qualitative techniques. By purposive maximum variation sampling, 82 professionals were selected. Documentary analysis and key informant criteria were used in the first stage. Two expert groups were formed in the second stage: one used various group techniques (focus group, oral and written brainstorming) and the second used a three-round Delphi method. In the final stage, a third group of experts was questioned in semistructured in-depth interviews, and a two-round Delphi method was employed to assess priorities. RESULTS Ultimately, 78 specific functions were defined: 47 (60.3%) patient care, 16 (20.5%) managerial, 6 (7.7%) teaching, and 9 (11.5%) research. Thirty-one procedural skills were identified. The specific functions and procedural skills defined relate to the profession's requirements in clinical care of the critically ill, management of patient services, teaching and research at the specialist's different occupational levels. CONCLUSIONS The specific functions and procedural skills required of intensive care and emergency medicine specialists were precisely identified by a scientific method. This product is key to improving the quality of teaching, research, administration and patient care in this specialty in Cuba. The specific functions and procedural skills identified are theoretical, practical, methodological and social contributions to inform future curricular reform and to help intensive care specialists enhance their performance in comprehensive patient care. KEYWORDS Intensive care, urgent care, emergency medicine, continuing medical education, curriculum, diagnostic techniques and procedures, medical residency, Cuba.
ERIC Educational Resources Information Center
Morrison, James L.; Ashley, William C.
This handbook was designed to accompany a three-day workshop for senior administrators in higher education on proactive management techniques in higher education. Proactive management allows for anticipating change and managing uncertainty in place of crisis management or reactive actions. The workshop covered: (1) strategic thinking; (2)…
NASA Astrophysics Data System (ADS)
Lavrieux, Marlène; Meusburger, Katrin; Birkholz, Axel; Alewell, Christine
2017-04-01
Slope destabilization and associated sediment transfer are among the major causes of aquatic ecosystems and surface water quality impairment. Through land uses and agricultural practices, human activities modify the soil erosive risk and the catchment connectivity, becoming a key factor of sediment dynamics. Hence, restoration and management plans of water bodies can only be efficient if the sediment sources and the proportion attributable to different land uses and agricultural practices are identified. Several sediment fingerprinting methods, based on the geochemical (elemental composition), color, magnetic or isotopic (137Cs) sediment properties, are currently in use. However, these tools are not suitable for a land-use based fingerprinting. New organic geochemical approaches are now developed to discriminate source-soil contributions under different land-uses: The compound-specific stable isotopes (CSSI) technique, based on the biomarkers isotopic signature (here, fatty acids δ13C) variability within the plant species, The analysis of highly specific (i.e. source-family- or even source-species-specific) biomarkers assemblages, which use is until now mainly restricted to palaeoenvironmental reconstructions, and which offer also promising prospects for tracing current sediment origin. The approach was applied to reconstruct the spatio-temporal variability of the main sediment sources of Baldegg Lake (Lucern Canton, Switzerland), which suffers from a substantial eutrophication, despite several restoration attempts during the last 40 years. The sediment supplying areas and the exported volumes were identified using CSSI technique and highly specific biomarkers, coupled to a sediment connectivity model. The sediment origin variability was defined through the analysis of suspended river sediments sampled at high flow conditions (short term), and by the analysis of a lake sediment core covering the last 130 years (long term). The results show the utility of biomarkers and CSSI to track organic sources in contrasted land-use settings. Associated to other fingerprinting methods, this approach could in the future become a decision support tool for catchments management.
Functional Imaging for Prostate Cancer: Therapeutic Implications
Aparici, Carina Mari; Seo, Youngho
2012-01-01
Functional radionuclide imaging modalities, now commonly combined with anatomical imaging modalities CT or MRI (SPECT/CT, PET/CT, and PET/MRI) are promising tools for the management of prostate cancer particularly for therapeutic implications. Sensitive detection capability of prostate cancer using these imaging modalities is one issue; however, the treatment of prostate cancer using the information that can be obtained from functional radionuclide imaging techniques is another challenging area. There are not many SPECT or PET radiotracers that can cover the full spectrum of the management of prostate cancer from initial detection, to staging, prognosis predictor, and all the way to treatment response assessment. However, when used appropriately, the information from functional radionuclide imaging improves, and sometimes significantly changes, the whole course of the cancer management. The limitations of using SPECT and PET radiotracers with regards to therapeutic implications are not so much different from their limitations solely for the task of detecting prostate cancer; however, the specific imaging target and how this target is reliably imaged by SPECT and PET can potentially make significant impact in the treatment of prostate cancer. Finally, while the localized prostate cancer is considered manageable, there is still significant need for improvement in noninvasive imaging of metastatic prostate cancer, in treatment guidance, and in response assessment from functional imaging including radionuclide-based techniques. In this review article, we present the rationale of using functional radionuclide imaging and the therapeutic implications for each of radionuclide imaging agent that have been studied in human subjects. PMID:22840598
Current role of modern radiotherapy techniques in the management of breast cancer
Ozyigit, Gokhan; Gultekin, Melis
2014-01-01
Breast cancer is the most common type of malignancy in females. Advances in systemic therapies and radiotherapy (RT) provided long survival rates in breast cancer patients. RT has a major role in the management of breast cancer. During the past 15 years several developments took place in the field of imaging and irradiation techniques, intensity modulated RT, hypofractionation and partial-breast irradiation. Currently, improvements in the RT technology allow us a subsequent decrease in the treatment-related complications such as fibrosis and long-term cardiac toxicity while improving the loco-regional control rates and cosmetic results. Thus, it is crucial that modern radiotherapy techniques should be carried out with maximum care and efficiency. Several randomized trials provided evidence for the feasibility of modern radiotherapy techniques in the management of breast cancer. However, the role of modern radiotherapy techniques in the management of breast cancer will continue to be defined by the mature results of randomized trials. Current review will provide an up-to-date evidence based data on the role of modern radiotherapy techniques in the management of breast cancer. PMID:25114857
Historical Group Debriefing Following Combat
1993-05-01
participants shortly after its termination. Debriefing has been recommended by several authors as a stress management technique suitable for groups which...termination. Debriefing has been recommended by several authors as a stress management technique suitable for groups which have been exposed to traumatic...the event and the participants’ reactions, and (b) application of a "stress management " technique (e.g., working-through negative emotions, psycho
NASA Astrophysics Data System (ADS)
Wang, Juan; Wang, Jian; Li, Lijuan; Zhou, Kun
2014-08-01
In order to solve the information fusion, process integration, collaborative design and manufacturing for ultra-precision optical elements within life-cycle management, this paper presents a digital management platform which is based on product data and business processes by adopting the modern manufacturing technique, information technique and modern management technique. The architecture and system integration of the digital management platform are discussed in this paper. The digital management platform can realize information sharing and interaction for information-flow, control-flow and value-stream from user's needs to offline in life-cycle, and it can also enhance process control, collaborative research and service ability of ultra-precision optical elements.