WorldWideScience

Sample records for attempt case management

  1. Aripiprazole augmentation in managing comorbid obsessive–compulsive disorder and bipolar disorder: a case with suicidal attempts

    Directory of Open Access Journals (Sweden)

    Lai J

    2016-12-01

    Full Text Available Jianbo Lai,1,2 Qiaoqiao Lu,1 Peng Zhang,2,3 Tingting Xu,2,3 Yi Xu,1,2 Shaohua Hu1,2 1Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, 2The Key Laboratory of Mental Disorder’s Management in Zhejiang Province, 3Department of Psychiatry, Mental Health Centre, Xiaoshan Hospital of Zhejiang Province, Hangzhou, Zhejiang, People’s Republic of China Abstract: Comorbid obsessive–compulsive disorder (OCD and bipolar disorder (BD have long been an intractable problem in clinical practice. The increased risk of manic/hypomanic switch hinders the use of antidepressants for managing coexisting OCD symptoms in BD patients. We herein present a case of a patient with BD–OCD comorbidity, who was successfully treated with mood stabilizers and aripiprazole augmentation. The young female patient reported recurrent depressive episodes and aggravating compulsive behaviors before hospitalization. Of note, the patient repetitively attempted suicide and reported dangerous driving because of intolerable mental sufferings. The preexisting depressive episode and OCD symptoms prompted the use of paroxetine, which consequently triggered the manic switching. Her diagnosis was revised into bipolar I disorder. Minimal response with mood stabilizers prompted the addition of aripiprazole (a daily dose of 10 mg, which helped to achieve significant remission in emotional and obsessive–compulsive symptoms. This case highlights the appealing efficacy of a small dose of aripiprazole augmentation for treating BD–OCD comorbidity. Well-designed clinical trials are warranted to verify the current findings. Keywords: aripiprazole, bipolar disorder, obsessive–compulsive disorder, suicide

  2. Effectiveness of assertive case management on repeat self-harm in patients admitted for suicide attempt: Findings from ACTION-J study.

    Science.gov (United States)

    Furuno, Taku; Nakagawa, Makiko; Hino, Kosuke; Yamada, Tomoki; Kawashima, Yoshitaka; Matsuoka, Yutaka; Shirakawa, Osamu; Ishizuka, Naoki; Yonemoto, Naohiro; Kawanishi, Chiaki; Hirayasu, Yoshio

    2018-01-01

    Self-harm is an important risk factor for subsequent suicide and repetition of self-harm, and a common cause of emergency department presentations. However, there still remains limited evidence on intervention in emergency department settings for individuals who self-harm. This multicentre, randomised controlled trial was conducted at 17 general hospitals in Japan. In total, 914 adult patients admitted to emergency departments for a suicide attempt and had a DSM-IV-TR axis I disorder were randomly assigned to two groups, to receive either assertive case management (intervention) or enhanced usual care (control). Assertive case management was introduced by the case manager during emergency department admissions for suicide attempts, and continued after discharge. Interventions were provided until the end of the study period (for at least 18 months and up to 5 years). The number of overall self-harm episodes per person-year was significantly lower in the intervention group (adjusted incidence risk ratio (IRR) 0.88, 95%CI 0.80-0.96, p=0.0031). Subgroup analysis showed a greater reduction of overall self-harm episodes among patients with no previous suicide attempt at baseline (adjusted IRR 0.73, 95% CI 0.53-0.98, p=0.037). Patients younger than 20 years and patients who self-harmed but were not admitted to an emergency department were excluded. The present study showed that assertive case management following emergency admission for a suicide attempt reduced the incident rate of repeat overall self-harm. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Online Homework Management Systems: Should We Allow Multiple Attempts?

    OpenAIRE

    Rhodes, M. Taylor; Sarbaum, Jeffrey K.

    2013-01-01

    Conventional pencil and paper wisdom suggests that allowing multiple attempts on homework will lead to more time spent on homework, higher homework grades, and better exam performance. For a variety of reasons, homework is increasingly being auto-administered online. This paper discusses the results of a quasi-experiment designed to evaluate student behavior under single and multiple attempt homework settings using an online homework management system. The paper explores whether multiple atte...

  4. The patient suicide attempt – An ethical dilemma case study

    Directory of Open Access Journals (Sweden)

    Lin Jie

    2015-12-01

    Results: In Mr Green's case, the nurse chose to share the information of Mr Green's suicide attempt with other health care professionals. The nursing team followed the self-harm and suicide protocol of the hospital strictly, they maintained the effective communication with Mr Green, identified the factors which cause patient's suicide attempt, provided the appropriate nursing intervention to deal will these risk factors and collaborated with other health care professionals to prefect the further care. The patient transferred to a palliative care service with no sign of suicide attempt and other self-harm behaviors and passed away peacefully 76 days after discharged with his relatives and pastors accompany.

  5. Evaluation of attempted-suicide management in a rural district of KwaZulu-Natal

    Directory of Open Access Journals (Sweden)

    D C T Nakin

    2007-06-01

    Full Text Available Objectives. Critical aspects in the management of attempted-suicide patients have been identified in the literature. The aim of this study was to determine which of these aspects were included in the management of patients who attempted suicide in a rural district of KwaZulu-Natal. Design. Descriptive study. Setting. The two hospitals in a rural district of KwaZulu-Natal. Subjects. Attempted-suicide patients admitted to the above two hospitals between 1 June 2001 and 31 March 2002.Outcome measures. Patients were interviewed regarding how they were managed and were followed up until 3 months after the attempted suicide. Results. Medicine was given to 41% of participants on admission and 64% were counselled by a doctor. A no-suicide contract was entered into in 42% of counselled cases. Family therapy, social worker involvement and psychiatric referral were very low and there was no involvement of friends, teachers or priests. Conclusion. Management of patients who attempted suicide in this district is inadequate as there are no proper policy guidelines. It is important that health caregivers be trained in psychiatry.

  6. Attempted Suicide by Massive Warfarin Ingestion Conservatively Managed Using Phytonadione

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    Katherine L. March

    2016-01-01

    Full Text Available Treatment strategies for acute toxicity following massive ingestion of warfarin are not well described in the literature. Warfarin is the primary oral anticoagulation agent used in the treatment of thromboembolic disease, and patients with acute toxicity are at risk for life-threatening hemorrhages. Treatment options include phytonadione (vitamin K1, fresh frozen plasma (FFP, and prothrombin complex concentrates (PCCs used alone or in combination. FFP and PCC can be associated with volume complications, undesirable thromboembolic events, and increased costs. We describe the case of a 63-year-old female with acute warfarin toxicity following a massive ingestion of warfarin (420 mg–450 mg in an attempt to commit suicide. Upon arrival to the emergency department, serial INR checks were initiated to help guide dosing strategy and later adjusted based on INR response to treatment using only phytonadione.

  7. Case Management Directors

    Science.gov (United States)

    Bankston White, Cheri; Birmingham, Jackie

    2015-01-01

    Purpose and Objectives: Case management directors are in a dynamic position to affect the transition of care of patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the “moving parts” of such a complex role. This is Part 2 of a two-part article written for case management directors, particularly new ones. Part 1 covered the first 4 of 7 tracks: (1) Staffing and Human Resources, (2) Compliance and Accreditation, (3) Discharge Planning and (4) Utilization Review and Revenue Cycle. Part 2 addresses (5) Internal Departmental Relationships (Organizational), (6) External Relationships (Community Agency), and (7) Quality and Program Outcomes. This article attempts to answer the following questions: Are case management directors prepared for an expanded role that affects departments and organizations outside of their own?How does a case management director manage the transition of care of patients while managing required relationships outside the department?How does the director manage program outcomes in such a complex department? Primary Practice Setting: The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems and have frontline case managers (CMs) reporting to them. Findings/Conclusions: Part 1 found that case management directors would benefit from further research and documentation of “best practices” related to their role, particularly in the areas of leadership and management. The same conclusion applies to Part 2, which addresses the director's responsibilities outside her immediate department. Leadership and management skills apply as well to building strong, productive relationships across a broad spectrum of external organizations

  8. goal management as an attempt to evaluate nature conservation

    African Journals Online (AJOL)

    b. to indicate that qualitative re~earch designs in general, and action research particularly, would be preferable to quantitative research designs when assessing EE campaigns, and c. to illustrate, through research presently being undertaken by the author, ho\\"J attempts to evaluate EE related campaigns can be relevantly.

  9. [Suicide attempt by an interstitial cystitis patient : a case report].

    Science.gov (United States)

    Suzuki, Takahisa; Otsuka, Atsushi; Kato, Taiki; Furuse, Hiroshi; Ozono, Seiichiro

    2014-11-01

    We report a suicide attempt by an interstitial cystitis patient. A 68-year-old woman consulted several clinics with complaints of urinary frequency and bladder pain, but her symptoms did not improve. She was admitted to our hospital and diagnosed with interstitial cystitis. Hydrodistention was performed, and the urethral catheter removed one day after surgery. The next day, the patient was afraid that her symptoms had not improved and, due to this physical and mental distress, cut her wrist with a razor. Vascular anastomosis and neuroanastomosis were performed accordingly. Eighteen months after hydrodistention, the patient's symptoms of interstitial cystitis have much improved.

  10. Project management case studies

    CERN Document Server

    Kerzner, Harold R

    2013-01-01

    A new edition of the most popular book of project management case studies, expanded to include more than 100 cases plus a ""super case"" on the Iridium Project Case studies are an important part of project management education and training. This Fourth Edition of Harold Kerzner''s Project Management Case Studies features a number of new cases covering value measurement in project management. Also included is the well-received ""super case,"" which covers all aspects of project management and may be used as a capstone for a course. This new edition:Contains 100-plus case studies drawn from re

  11. Multiple Attempts for Online Assessments in an Operations Management Course: An Exploration

    Science.gov (United States)

    Orchard, Ryan K.

    2016-01-01

    In learning management systems, tools for online homework assessments include a number of alternatives for the assessment settings, including the ability to permit students to attempt an assessment multiple times, with options for how the multiple attempts are administered. A specific implementation of online assessments in an introductory…

  12. Case series of females charged with murder or attempted murder of ...

    African Journals Online (AJOL)

    Women charged with murder or attempted murders of children are usually sent for forensic psychiatric evaluation. In South Africa research and literature on this population is scarce. A case series was studied of forensic files of 32 females charged with murder or attempted murder of children. These files contained ...

  13. Case management: a case study.

    Science.gov (United States)

    Dring, R; Hiott, B; Elliott, K

    1994-06-01

    Prior to institution of case management Mr. G would have remained on the neuroscience acute care unit until nursing home placement could be arranged, a process which often took a year because of the severe shortage of Medicaid beds in South Carolina. Because case managers collaborated to identify and resolve the problem, the outcome for those such as Mr. G has changed. Case management facilitates movement of patients with complex problems from acute care to successful community reentry in a cost-effective manner.

  14. Characteristics of suicide attempts in anorexia and bulimia nervosa: a case-control study.

    Directory of Open Access Journals (Sweden)

    Sébastien Guillaume

    Full Text Available OBJECTIVE: Compared to other eating disorders, anorexia nervosa (AN has the highest rates of completed suicide whereas suicide attempt rates are similar or lower than in bulimia nervosa (BN. Attempted suicide is a key predictor of suicide, thus this mismatch is intriguing. We sought to explore whether the clinical characteristics of suicidal acts differ between suicide attempters with AN, BN or without an eating disorders (ED. METHOD: Case-control study in a cohort of suicide attempters (n = 1563. Forty-four patients with AN and 71 with BN were compared with 235 non-ED attempters matched for sex, age and education, using interview measures of suicidal intent and severity. RESULTS: AN patients were more likely to have made a serious attempt (OR = 3.4, 95% CI 1.4-7.9, with a higher expectation of dying (OR = 3.7,95% CI 1.1-13.5, and an increased risk of severity (OR = 3.4,95% CI 1.2-9.6. BN patients did not differ from the control group. Clinical markers of the severity of ED were associated with the seriousness of the attempt. CONCLUSION: There are distinct features of suicide attempts in AN. This may explain the higher suicide rates in AN. Higher completed suicide rates in AN may be partially explained by AN patients' higher desire to die and their more severe and lethal attempts.

  15. Sleep problems and suicide attempts among adolescents: a case-control study.

    Science.gov (United States)

    Koyawala, Neel; Stevens, Jack; McBee-Strayer, Sandra M; Cannon, Elizabeth A; Bridge, Jeffrey A

    2015-01-01

    This study used a case-control design to compare sleep disturbances in 40 adolescents who attempted suicide with 40 never-suicidal adolescents. Using hierarchical logistic regression analyses, we found that self-reported nighttime awakenings were significantly associated with attempted suicide, after controlling for antidepressant use, antipsychotic use, affective problems, and being bullied. In a separate regression analysis, the parent-reported total sleep problems score also predicted suicide attempt status, controlling for key covariates. No associations were found between suicide attempts and other distinct sleep problems, including falling asleep at bedtime, sleeping a lot during the day, trouble waking up in the morning, sleep duration, and parent-reported nightmares. Clinicians should be aware of sleep problems as potential risk factors for suicide attempts for adolescents.

  16. Sociodemografic and Clinical Characteristics of Suicidal Cases who Attempted to Emergency Services in Ankara

    Directory of Open Access Journals (Sweden)

    Selma ERCAN

    2016-04-01

    Full Text Available Objective: The aim of the study is to determine the sociodemografic and clinical characteristics of suicide attempted cases who were admitted to the emergency departments of the hospitals in the first six months of 2010 in Ankara. Methods: Data were obtained by examining the suicide attempted registration forms that were filled out in the emergency services of hospitals working for the Ministry of Health retrospectively. Results: The incidence of suicide attempts in women (76.5% is higher than men (23.5%. Suicide attempts are high in 15-24 group of age (59.3 %. The rate of suicide attempts is high in patients who were single (57.9 % and students who were in education level of secondary (44.6 % and high school (40.2 %. The most common hospitals that were applied are Ankara Training and Researsch Hospital (29.8% and Keçiören Training and Research Hospital (12.4%. Also Mamak (19.7% and Keçiören (17.2% are towns that cases were seen mostly. The most applied method of suicide attempted is the usage of drugs and toxic substances with the 96.2%. The increment ratio of the suicide attempts is seen paticularly from January to June. Family (16.0% and psychiatric disorder (15.2% are mainly stressors leading to suicide attempted. Discussion: All attempted suicide patients who applied to Emergency Department should be directed to Crisis Intervention Unit immediately and following-up the cases with psychiatric consultation must become obligatory as well as medical treatments. The findings have been discussed with the literature. [JCBPR 2016; 5(1.000: 5-12

  17. Strengthening evaluation through interactive problem structuring: a case study of hospital care after attempted suicide

    NARCIS (Netherlands)

    Moret-Harman, M.; Reuzel, R.; Grin, J.; Kramers, C.; van der Wilt, G.J.

    2011-01-01

    The quality of an evaluation largely depends on the quality of the underlying problem definition and the quality of the problem definition often improves as stakeholder involvement increases. By means of a study on the management of attempted suicides by drug overdose, we explored whether an

  18. A case-crossover study of acute alcohol use and suicide attempt.

    Science.gov (United States)

    Borges, Guilherme; Cherpitel, Cheryl J; MacDonald, Scott; Giesbrecht, Norman; Stockwell, Tim; Wilcox, Holly C

    2004-11-01

    Several studies have shown that acute alcohol use is associated with suicidal behavior, but the magnitude and nature of the relationship remain unclear. We report a study on the impact of acute alcohol use on suicide attempts treated in the emergency room (ER) using the case-crossover design. Seven ER studies carried out in the United States, Canada, Mexico and Australia from 1984 to 1996 with probability samples and similar methodology were merged yielding a total of 102 suicide attempters (overall 52% were male and 59% under 30 years of age). Thirty-six patients reported alcohol use within 6 hours prior to the suicide attempt. When usual alcohol consumption during the past 12 months served as the control value, the estimated relative risk (RR) for patients who reported alcohol use within 6 hours prior to the suicide attempt was 9.6 (95% confidence interval: 5.7-16.3). Although the prevalence of alcohol use differed by sex, there was no statistically significant difference in the estimated RRs (RR = 13.6 men and RR = 5.3 women, p = 0.11 for the heterogeneity test). A positive association was found between alcohol use 6 hours prior and suicide attempts in 102 ER cases in four countries. The case-crossover methodology is well suited to studies for which an external control group is not easily obtainable.

  19. [Attempted suicide during interferon therapy: a case report and literature review

    Science.gov (United States)

    Pardelli, R.; Vivaldi, I.; Maccanti, O.; Sani, S.; Menicagli, V.

    1998-01-01

    Occasionally, in the medical literature, attempted or successful suicides during interferon therapy are reported. We report a case of a 32-year-old man who developed a psychotic syndrome with attempted suicide at the third month of treatment. The cessation of interferon and an appropriate psychiatric therapy determined a complete remission of symptoms. A medical literature review, through several computerized searches, showed a lack of research into the subject. The main conclusion of our article emphasizes the importance of recognizing the early neuropsychiatric symptoms, that are reversible at the cessation of treatment.

  20. Attempted Serial Neonaticides: Case Report and a Brief Review of the Literature.

    Science.gov (United States)

    Barros, Alcina Juliana Soares; Rosa, Regis Goulart; Telles, Lisieux Elaine de Borba; Taborda, José Geraldo Vernet

    2016-01-01

    Neonaticide is an infant murder occurring on the day of birth. The case reports found in the literature are often focused on the mother as the agent in the context of pregnancy denial, dissociative symptoms, or psychosis. However, this report describes a rare case of attempted serial neonaticides, in which the acts were committed by a nurse at the nursery of a referral hospital in Brazil. The authors describe a forensic psychiatric evaluation for criminal responsibility and correlate the information from this particular case with relevant forensic themes, namely neonaticide, Munchausen by proxy syndrome, and serial healthcare killers. © 2015 American Academy of Forensic Sciences.

  1. An Unusual Case of Suicide Attempt Using Intravenous Injection of Kerosene.

    Science.gov (United States)

    Hasan, M N; Sutradhar, S R; Ahmed, S M; Chowdhury, I H

    2016-07-01

    Kerosene belongs to the hydrocarbon group of compounds, used as a fuel for lamps, as well as heating and cooking in developing countries. Accidental kerosene poisoning and intoxication usually occur by inhalation or by occupational percutaneous absorption. Adults usually ingest kerosene for the purpose of self-harm, and children may ingest accidentally. Suicidal attempt using intravenous kerosene is an extra ordinary and very rare occurrence. A very few data are available regarding effects of intravenous administration of kerosene and its management.

  2. Epidemiologic Study of Suicidal Attempt Cases in Fars Province, South of Iran, 2010-2011

    Directory of Open Access Journals (Sweden)

    Mojtaba Naghshvarian

    2016-01-01

    Full Text Available Background: The reduction of suicidal attempts as one of the most important goals is improvement of societies’ health status. The present study aimed to assess the epidemiologic aspects of suicide cases in Fars province in 2010-2011. Methods: A total of 9714 suicide cases in Fars province, south of Iran, in 2010-2011 were enrolled in this cross-sectional study through census. The study data were collected using suicide registry forms in the health centers affiliated to Fars province department of health services and analyzed using SPSS, version 17. Results: The rate of suicide attempts was 116.5 per 100,000 population in Fars province (93per 100,000 among men and 141.5 per 100,000 among women. The results showed significant differences between the suicide rates based on sex, age group, place of living, and season of the year (P<0.001. Most of these cases were female (59.4%, single (52.9%, 15-24 years old (56.4%, had high school education (25.8%, lived in urban areas (69.6% and were female homemakers (30.3%. Based on the data, however, the largest number of suicide deaths resulted from self-immolation (56.7%. Conclusion: The present study findings revealed different rates of suicidal attempts based on sex and age group. Also, the importance of education and mental support, especially among women and singles, and also preventive measures in the context of uncontrolled immigration from the countryside to the large cities seems to essential more than ever. Yet, defects in some findings, particularly information about etiology, suggest that more researches should be conducted and suicide data registry and reporting systems should be improved

  3. A Case of Attempted Bilateral Self-Enucleation in a Patient with Bipolar Disorder.

    Science.gov (United States)

    Castro, Hannah Muniz; Alvarez, John; Bota, Robert G; Yonkers, Marc; Tao, Jeremiah

    2017-03-22

    Attempted and completed self-enucleation, or removal of one's own eyes, is a rare but devastating form of self-mutilation behavior. It is often associated with psychiatric disorders, particularly schizophrenia, substance induced psychosis, and bipolar disorder. We report a case of a patient with a history of bipolar disorder who gouged his eyes bilaterally as an attempt to self-enucleate himself. On presentation, the patient was manic with both psychotic features of hyperreligous delusions and command auditory hallucinations of God telling him to take his eyes out. On presentation, the patient had no light perception vision in both eyes and his exam displayed severe proptosis, extensive conjunctival lacerations, and visibly avulsed extraocular muscles on the right side. An emergency computed tomography scan of the orbits revealed small and irregular globes, air within the orbits, and intraocular hemorrhage. He was taken to the operating room for surgical repair of his injuries. Attempted and completed self-enucleation is most commonly associated with schizophrenia and substance induced psychosis, but can also present in patients with bipolar disorder. Other less commonly associated disorders include obsessive-compulsive disorder, depression, mental retardation, neurosyphilis, Lesch-Nyhan syndrome, and structural brain lesions.

  4. A case of attempted bilateral self-enucleation in a patient with bipolar disorder

    Directory of Open Access Journals (Sweden)

    Hannah Muniz Castro

    2017-06-01

    Full Text Available Attempted and completed self-enucleation, or removal of one’s own eyes, is a rare but devastating form of self-mutilation behavior. It is often associated with psychiatric disorders, particularly schizophrenia, substance induced psychosis, and bipolar disorder. We report a case of a patient with a history of bipolar disorder who gouged his eyes bilaterally as an attempt to self-enucleate himself. On presentation, the patient was manic with both psychotic features of hyperreligous delusions and command auditory hallucinations of God telling him to take his eyes out. On presentation, the patient had no light perception vision in both eyes and his exam displayed severe proptosis, extensive conjunctival lacerations, and visibly avulsed extraocular muscles on the right side. An emergency computed tomography scan of the orbits revealed small and irregular globes, air within the orbits, and intraocular hemorrhage. He was taken to the operating room for surgical repair of his injuries. Attempted and completed self-enucleation is most commonly associated with schizophrenia and substance induced psychosis, but can also present in patients with bipolar disorder. Other less commonly associated disorders include obsessive-compulsive disorder, depression, mental retardation, neurosyphilis, Lesch-Nyhan syndrome, and structural brain lesions.

  5. Management of a complex pancreaticoduodenal lesion following a suicidal attempt with a crossbow.

    Science.gov (United States)

    Benmohamed, Nadja; Abbassi, Ziad; Naiken, Surennaidoo P; Morel, Philippe; Platon, Alexandra; Poletti, Pierre-Alexandre; Toso, Christian

    2016-12-31

    Traumatic pancreaticoduodenal lesions are rare, often involve a challenging management, and have high rates of morbidity and mortality. A 43-year-old male patient committed a suicidal attempt by shooting an arrow with a crossbow into his upper abdomen. He was successfully treated with cautious multidisciplinary approach. Crossbow lesions demonstrate low kinetics. Sharp tips of arrows result in localized damage, likely to involve several organs. Pancreatic lesions are of particular interest because of their difficult surgery. Surgical exploration and drainage can allow an efficient management of pancreatic penetrating lesions, even in the presence of a complete pancreatic duct disruption. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2016.

  6. Ectopic abdominal pregnancy due to uterine perforation after an attempt to terminate pregnancy: a case presentation.

    Science.gov (United States)

    Hernández Núñez, Jónathan; Abreu Díaz, Alexander; Michael Ndwambi, Ndivhuwo; Martínez, Fermín Luis

    2017-07-17

    Secondary abdominal ectopic pregnancy is rare in clinical practice, but may lead to an increased maternal mortality. We present the case of a patient with an abdominal pregnancy secondary to a uterine perforation caused by a voluntary attempt to interrupt pregnancy that presented with nine weeks of abdominal pain and minimal vaginal bleeding which was mistakenly diagnosed as acute pelvic inflammatory disease, urinary tract infection, and post-abortion products of conception. Finally, the abdominal ultrasound test found an abdominal ectopic pregnancy. An exploratory laparotomy was performed and the fetus and placenta were removed without difficulties with a favorable postoperative course. It was concluded that uterine perforation during curettage of the cavity went unnoticed, leading to secondary abdominal implantation of pregnancy with a inconclusive clinical presentation, where ultrasound plays a fundamental diagnostic role. Laparotomy is indicated in most of these cases.

  7. Case report: a rare case of attempted homicide with Gloriosa superba seeds.

    Science.gov (United States)

    Kande Vidanalage, Chaminda J; Ekanayeka, Rohan; Wijewardane, Deepthi K

    2016-06-21

    Gloriosa superba, well known as the glory lily or superb lily, is a tropical climbing plant that features an exotic red flower. The plant is poisonous because of high concentrations of colchicine in all parts of the plant. It is commercially grown for use in Ayurveda medicine and as a cash crop for extracting colchicine in India and Africa. It is a wild plant in Sri Lanka and commercial cultivation is rare. Accidental and suicidal poisonings with Gloriosa tubers are well known and reported. There are no case reports of poisoning by Gloriosa seeds in Sri Lanka. Google and PubMed searches showed no reported cases of poisoning with seeds or their use with homicidal intent in other parts of the world. A 27-year-old man was brought to hospital with profuse vomiting and diarrhea after drinking coriander tea, which is a common traditional treatment for common cold. The family members suspected poisoning by Gloriosa because they had seeds at home and the victim's sister-in-law who had made the herbal tea went missing from home. They were able to identify Gloriosa seeds, which looked similar to coriander, in the pot. The patient developed shock and respiratory distress and needed ventilation and intensive care. He also developed mild renal impairment, and thrombocytopenia. He developed massive generalized alopecia while recovering from acute illness. Full recovery was achieved after 15 days of hospital care. There are many poisonous plants in Asian countries. This case highlights the possibility of accidental or intentional use of Gloriosa seeds or its extracts to cause potentially fatal poisoning. It would be difficult to identify Gloriosa as the cause of poisoning without any background information because of multiple complications that can mimic a systemic infection. This case is a good example of the use of plants as biological weapons.

  8. New attempt using ablative curettage technique for managing benign premenopausal uterine bleeding.

    Science.gov (United States)

    Thabet, Saeed Mohamed Ahmad

    2010-08-01

    To assess the efficacy of a newly suggested ablative curettage technique in managing premenopausal dysfunctional uterine bleeding. A prospective controlled operative study and clinical trial was carried out at the Department of Obstetrics and Gynecology, Kasr El-Aini Hospital, Cairo University, Egypt. One hundred cases of premenopausal bleeding were divided into 50 controls and 50 studied cases. Routine diagnostic and follow-up techniques for managing premenopausal bleeding were carried out. Two operative techniques were compared: overcurettage, using Sims sharp curette, and the newly suggested dilatation and ablative curettage, using a Thabet double-bladed sharp curette. Histopathology of curetted material and the endomyometrium after ablation in the failed cases that needed hysterectomy was also included. Successful endometrial ablation and control of the premenopausal bleeding were recorded in 66% of overcurettage cases and in 90% of cases treated with ablative curettage. The latter had significantly fewer operative and postoperative complications. These advantages were also significantly reduced in both techniques compared with other ablative techniques and hysterectomy. Complete ablation could be confirmed histopathologically in the ablated endometrium and in the endomyometrium of the hysterectomy specimens. Ablative curettage is an efficient technique in managing premenopausal dysfunctional uterine bleeding, especially in developing countries where there are limited financial resources.

  9. Visualizing Changes in Strategy Use across Attempts via State Diagrams: A Case Study

    Directory of Open Access Journals (Sweden)

    Deirdre Kerr

    2016-01-01

    Full Text Available Game log data have great potential to provide actionable information about the in-game behavior of players. However, these low-level behavioral data are notoriously difficult to analyze due to the challenges associated with extracting meaning from sparse data stored at such a small grain size. This paper describes a three-step solution that uses cluster analysis to determine which strategies players use to solve levels in the game, sequence mining to identify changes in strategy across multiple attempts at the same level, and state transition diagrams to visualize the strategy sequences identified by the sequence mining. In the educational video game used in this case study, cluster analysis successfully identified 15 different in-game strategies. The sequence mining found an average of 40 different sequences of strategy use per level, which the state transition diagrams successfully displayed in an interpretable way.

  10. [Unsuccessful suicidal attempt with use of self-prepared bullet -- case report].

    Science.gov (United States)

    Malec, Katarzyna; Gasiński, Mateusz; Kuchta, Krzysztof; Kozok, Andrzej

    2013-01-01

    Gunshot injuries of the viscerocranium are rarely reported during times of peace in Europe. Penetrating wounds to the maxillofacial region pose a significant challenge for surgeons as they often comprise serious soft and bone tissue defects.We present a case report of 38-year-old male with gunshot wound to the viscerocranium after suicidal attempt. The patient's general condition was stable. The inlet wound was found in the submental region in the central line penetrating deep into the floor of the mouth, to the left, avoiding large vessels and hypoglossal nerve. No exit wound was identified. The ophthalmic examination revealed the limitation of motion in the left eyeball and diplopia in the whole field of vision. The revision was performed under general anesthesia. Control CT scan revealed the presence of one metallic fragment wedged in the hard palate. Second look of oral cavity with particular emphasis on the hard palate was performed. Shrapnel proved to be wedged in the bone of the hard palate very firmly and complete removal without damaging the function of the palate was impossible. The decision was made to withdraw from surgical removal of the remaining piece of the projectile. In most cases, it is recommended to remove all foreign material from human body. However, in the illustrated case we decided to leave small debris in the craniofacial skeleton. In our opinion, further surgical revision would result in greater tissue damage, disproportionate to the benefits of the removal of all fragments of the projectile.

  11. A service manager model: instituting case management.

    Science.gov (United States)

    Eckett, K; Vassallo, L M; Flett, M

    1996-02-01

    Using a service manager model as opposed to a traditional nurse case manager archetype fosters multidisciplinary team interaction. Benefits of this approach to the hospital, the staff and the patients are identified.

  12. A nested case-control study of the risk of suicide attempts after discharge from psychiatric care

    DEFF Research Database (Denmark)

    Christiansen, Erik; Jensen, Børge

    2008-01-01

    The literature suggests that the risk of suicide is high within the first weeks after discharge from psychiatric care, but practically no studies have estimated the risk of suicide attempt after discharge from psychiatric care. The aim of this study was to examine the risk level for suicide attempt...... after discharge from psychiatric care, and to control for effects from psychiatric diagnoses, number and length of previous admission. An analysis of the role of co-morbid substance use disorder in suicide attempts risk was completed. The study is a Danish register-based nested case-control study; 3037...... cases were identified from Register for Suicide Attempts, and 60,295 individuals, matched by gender and age, were identified for comparison. Retrospective personal data on psychiatric care was obtained from the Danish Psychiatric Central Register. Risk of suicide attempts was estimated by the use...

  13. An attempt at the computer-aided management of HIV infection

    Science.gov (United States)

    Ida, A.; Oharu, Y.; Sankey, O.

    2007-07-01

    The immune system is a complex and diverse system in the human body and HIV virus disrupts and destroys it through extremely complicated but surprisingly logical process. The purpose of this paper is to make an attempt to present a method for the computer-aided management of HIV infection process by means of a mathematical model describing the dynamics of the host pathogen interaction with HIV-1. Treatments for the AIDS disease must be changed to more efficient ones in accordance with the disease progression and the status of the immune system. The level of progression and the status are represented by parameters which are governed by our mathematical model. It is then exhibited that our model is numerically stable and uniquely solvable. With this knowledge, our mathematical model for HIV disease progression is formulated and physiological interpretations are provided. The results of our numerical simulations are visualized, and it is seen that our results agree with medical aspects from the point of view of antiretroviral therapy. It is then expected that our approach will take to address practical clinical issues and will be applied to the computer-aided management of antiretroviral therapies.

  14. Management & Communication: Project Management Case Study

    CERN Multimedia

    Nathalie Dumeaux

    2004-01-01

    We are pleased to announce the recent launch of a new workshop on Project Management. This is designed for People with budgetary, scheduling and/or organizational responsibilities in a project or a sub-project. The objectives through a management case study specially suited to CERN are: to become familiar with modern management techniques in use for structuring, planning, scheduling, costing and progress monitoring of a project or a sub-project. to understand in-depth issues associated with Deliverable-oriented Project Management, Earned Value Management, Advanced Project Cost Engineering and Project Risk Management. The full description of this workshop can be found here. The next session will be held on 8 October 2004. If you are interested in this workshop, please contact Nathalie Dumeaux, email or 78144. Programme of Seminars October to December 2004 Situation : 21.09.2004 Séminaires bilingues Dates Jours Places disponibles Project Management Case study 8 October 1 oui Intr...

  15. Factors facilitating dementia case management

    NARCIS (Netherlands)

    Dr. J. de Lange; E. Deusing; I.F.M. van Asch; J. Peeters; M. Zwaanswijk; A.M. Pot; A.L. Francke

    2016-01-01

    To obtain insight into facilitating factors for case management in dementia care, we conducted a qualitative study with 13 online focus groups (OFGs). Participants were professionals involved in dementia case management (N = 99). We used mind-maps and the method of constant comparison for analysis.

  16. Electronic case management with homeless youth.

    Science.gov (United States)

    Bender, Kimberly; Schau, Nicholas; Begun, Stephanie; Haffejee, Badiah; Barman-Adhikari, Anamika; Hathaway, Jessica

    2015-06-01

    Case management, a widely practiced form of service brokerage, is associated with a variety of positive outcomes for homeless youth, but it may be difficult to implement, as youth face logistical barriers to attending in-person meetings. As part of a larger clinical trial, the current study investigates the feasibility of providing electronic case management (ECM) to homeless youth, using cell-phones, texts, email, and Facebook. Youth were given prepaid cell-phones and a case manager who provided four ECM sessions every 2-3 weeks over a 3-month period. Contact logs were used to record how many youth engaged in ECM, how many attempts were necessary to elicit engagement, and youths' preferred technology methods for engaging. Although engagement in the number of ECM sessions varied, the majority of youth (87.5%) engaged in at least one ECM session. Youth (41%) most commonly needed one contact before they engaged in an ECM session, and the majority responded by the third attempt. While youth most commonly answered calls directly, their chosen method of returning calls was texting. The majority of youth (80%) described ECM positively, reporting themes of convenience, connection, and accountability. The use of ECM, particularly of texting, offers promising implications for providing services to homeless youth. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. A Cognitive Therapy Intervention for Suicide Attempters: An Overview of the Treatment and Case Examples

    Science.gov (United States)

    Berk, Michele S.; Henriques, Gregg R.; Warman, Debbie M.; Brown, Gregory K.; Beck, Aaron T.

    2004-01-01

    Although suicidal behavior is a serious public health problem, few effective treatments exist to treat this population. This article describes a new cognitive therapy intervention that has been developed for treating recent suicide attempters. The intervention is based on general principles of cognitive therapy and targets the automatic thoughts…

  18. Nursing case management: a rural practice model.

    Science.gov (United States)

    Stanton, M P; Packa, D

    2001-01-01

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

  19. Suicide attempt by swallowing sponge or pica disorder: a case report.

    Science.gov (United States)

    Zganjer, Vlasta; Zganjer, Mirko; Cizmić, Ante; Pajid, Anto; Zupancić, Bozidar

    2011-01-01

    There are many ways how children with mental illness have actually tried to hurt themselves. Suicidal thinking or attempts always indicate that professional help is needed (2). Every object which can be potential dangerous should be removed but this is very difficult to do. Some of children with these symptoms had Pica diseases. Pica is a medical disorder characterized by an appetite for substances largely non-nutritive (e.g. metal, coal, soil, feces, paper, soap, gum, etc.) or an abnormal appetite for some things that may be considered foods. The patient swallow sponge from a pillow over a long period of time and she came into our hospital with abdominal pain. She was 16 years old and had abdominal distension, vomiting, abdominal cramping and failure to pass gas or stool. Immediately we suspected mechanical blockade of the intestine. Diagnosis was clinically confirmed by X-rays of the abdomen and with ultrasound. The operative treatment was indicated and we found the proximal bowel distended and the distal segment collapsed. The part of bowel necrosis was removed and anastomosis was done. When patients are determined to attempt suicide or have Pica disorder it is very difficult to prevent.

  20. Suicide Attempt by Swallowing Sponge or Pica Disorder: A Case Report

    Directory of Open Access Journals (Sweden)

    Vlasta Žganjer

    2011-01-01

    Full Text Available Introduction: There are many ways how children with mental illness have actually tried to hurt themselves. Suicidal thinking or attempts always indicate that professional help is needed (2. Every object which can be potential dangerous should be removed but this is very difficult to do. Some of children with these symptoms had Pica diseases. Pica is a medical disorder characterized by an appetite for substances largely non-nutritive (e.g. metal, coal, soil, feces, paper, soap, gum, etc. or an abnormal appetite for some things that may be considered foods. Material and Methods: The patient swallow sponge from a pillow over a long period of time and she came into our hospital with abdominal pain. She was 16 years old and had abdominal distension, vomiting, abdominal cramping and failure to pass gas or stool. Immediately we suspected mechanical blockade of the intestine. Diagnosis was clinically confirmed by X-rays of the abdomen and with ultrasound. Results: The operative treatment was indicated and we found the proximal bowel distended and the distal segment collapsed. The part of bowel necrosis was removed and anastomosis was done. Conclusion: When patients are determined to attempt suicide or have Pica disorder it is very difficult to prevent.

  1. Race, nation and education—An overview of British attempts to ‘manage diversity’ since the 1950s

    OpenAIRE

    Shain, Farzana

    2013-01-01

    This paper reviews the recent history of English education in connection with British state attempts to ‘manage diversity’. It offers a new analysis on points of coherence and tension between the role of education and state policies in relation to race and ethnicity. Drawing on the Prevent strategy as an example, the paper highlights the role that education has played in the construction of ethnic minorities as ‘problems’ to be managed or contained. It is argued that assimilation into a (supe...

  2. The Managerial Nature of Case Management.

    Science.gov (United States)

    Wolk, James L.; And Others

    1994-01-01

    Contends that case managers engage in the practice of management. Employs Mintzberg's seminal research on chief executive behavior to argue that case managers' work is similarly characterized by brevity, variety, and fragmentation. Notes that case managers perform the 10 roles developed by Mintzberg. Describes roles and presents case managers'…

  3. How Supervisor Relationships and Protection Rules Affect Employees' Attempts to Manage Health Information at Work.

    Science.gov (United States)

    Westerman, Catherine Y K; Currie-Mueller, Jenna L; Motto, Justin S; Curti, Logan C

    2017-12-01

    This article explores the issue of health information sharing at work through the lens of Communication Privacy Management theory. As employees must often share some health information at work for various reasons (e.g., to obtain sick leave or accommodations), determining how much to share and how to manage health information is important. The leader-member exchange relationship, stigma, risk perceptions, and the degree of privacy of each individual's health information were investigated. The results show that leader-member exchange, stigma, and privacy contribute to an individual's willingness to disclose health information at work and that leader-member exchange impacts perceptions of risk associated with sharing health information.

  4. Delayed high anion gap metabolic acidosis after a suicide attempt: case report.

    Science.gov (United States)

    Hsiao, Po-Jen; Chen, Tsu-Yi; Chiu, Chih-Chien; Wu, Tsung-Jui; Chan, Jenq-Shyong; Wu, Chia-Chao; Chen, Jin-Shuen

    2014-09-25

    Metabolic acidosis, especially when induced by multiple drug poisoning, often makes rapid and accurate differential diagnosis of the condition challenging. We closely followed anion and osmolal gaps to differentiate among the aetiologies of metabolic acidosis caused by poisoning with unknown drugs. The patient was admitted to our emergency department (ED) in an alert and consciousness state after attempting suicide by ingestion of an uncertain quantity of rodenticides combined with an unknown liquid. Initially, metabolic acidosis (pH7.23) with normal anion gap (12.8) was observed. However, a change in consciousness and hypotension subsequently developed 6h later, combined with severe metabolic acidosis (pH7.16), high anion gap (25.5), and high osmolal gap (83). A presumed diagnosis of methanol intoxication was suspected. After 4h of high-flux haemodialysis (HD), the serum bicarbonate returned to 23 mmol/l, and the patient regained consciousness. The serum level of methanol before HD was 193.8 mg/dl. The patient was discharged nine days later without sequelae. Delayed high anion gap metabolic acidosis may occur in the ED. Frequent monitoring of anion and osmolal gaps is a feasible method to perform a rapid differential diagnosis, particularly in response to drug poisoning. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Case management as a mindset.

    Science.gov (United States)

    Mayer, G G

    1996-01-01

    Melanie Richards was a $3.5 million baby who provided the motivation for developing the case management model used by Friendly Hills HealthCare Network. Born five years ago with gastroschisis, Melanie was transferred from Friendly Hills Regional Medical Center to a tertiary care hospital, where she spent 11 1/2 months in the neonatal intensive care unit. No discharge plans were ever made, and it wasn't until Friendly Hills HealthCare Network started to manage Melanie's care that anyone imagined that this infant could go home, should go home, and would thrive at home. Case management saved Melanie's life, saved money in the long run, and is credited with changing the entire method Friendly Hills HealthCare Network uses for complicated cases.

  6. Non-operative management attempted for selective high grade blunt hepatosplenic trauma is a feasible strategy

    OpenAIRE

    Hsieh, Ting-Min; Cheng Tsai, Tsung; Liang, Jiun-Lung; Che Lin, Chih

    2014-01-01

    Background There is growing evidence of clinical data recently for successful outcomes of non-operative management (NOM) for blunt hepatic and spleen injuries (BHSI). However, the effectiveness of NOM for high-grade BHSI remains undefined. The aim of the present study was to review our experience with NOM in high-grade BHSI and compare results with the existing related data worldwide. Methods In this retrospectively protocol-driven study, 150 patients with grade 3–5 BHSI were enrolled during ...

  7. Practices of Management Development: A Malaysian Case Study

    Science.gov (United States)

    Law, Kian Aun

    2008-01-01

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

  8. "Otis": A Case Study of an Online Attempt to Purchase Children for Sex.

    Science.gov (United States)

    Litam, Stacey Diane A; Bach, Jesse Edward

    2017-10-01

    The researchers analyzed court documents to develop a case study of an individual convicted of buying sexual services from exploited children. Findings indicate that the subject deviates from preexisting victim selection processes and demonstrates characteristics inconsistent with existing sexual offender typologies that likens offender behaviors to the hunting techniques and behaviors of predatory animals. As evidenced in the case study, the individual perceived the victims solely as a means of deviant sexual satiation and did not participate in traditionally established victim acquisition techniques. In addition, the researchers propose adopting terminology that adheres to the term consumer rather than buyer as it better represents some offenders' disconnect and lack of empathy in the victim acquisition process.

  9. Suicide Attempt by Intravenous Potassium Self-Poisoning: A Case Report

    Directory of Open Access Journals (Sweden)

    Florent Battefort

    2012-01-01

    Full Text Available Introduction. Overdose of potassium is not as frequently encountered in clinical practice as hyperkalaemia due to acute or chronic renal disease. However, potassium overdoses leading to serious consequences do occur. Case Presentation. A 20-year-old nurse student presented with a cardiac arrest with asystole rhythm. Beside the patient were found four 50-mL syringes and empty vials of potassium chloride (20 mL, 10%. After initial resuscitation with epinephrine, 125 mL of a 4.2% intravenous solution of sodium bicarbonate were injected which resulted in the recovery of an effective cardiac activity. The patient recovered without sequelae. Conclusion. The difficulty in this case was to recognize the potassium poisoning. The advanced resuscitation with the use of a specific treatment helped to resuscitate the patient.

  10. [Epidemiological study of attempted suicide managed at the hospital emergency department].

    Science.gov (United States)

    Gutiérrez, E; Gamo, E; Guindeo, J; Delgado, J; Fuertes, E; Juan, S; Ordóñez, P; Pascual, P

    1997-01-01

    The authors investigate psychiatric and sociodemographic characteristics of the patients attended at the emergency department in the General Hospital of Mostoles, after their suicidal intent, and of those who repeated a suicidal intent in the first year of follow-up. It is a prospective study, with a duration of one year, in a real sample with 119 patients randomized as a stratified sample from the population attended after their intent. Data recollection was made with a psychiatric semi-structured interview and Beck's letality and suicidal intent scales. Recruitment and follow-up periods were one year long for each of them. Statistical analysis was realized with the chi square test and Fischer's exact test to evaluate associations among cualitative variable and the variance analysis of the relations between qualitative and quantitative variable. Suicide intent ratio was 82/100,000 inhabitants, being in 83% by medicament ingestion. 71% were women, 66% were between 15 and 30 years old, 50% were unmarried and 12% were separated. 33% suffered from a affective disorder, and 23% were alcohol abusers. 6% of them bad a psycotic disorder. 52% of the patients had previous psychiatric disorders and 43% had been in treatment. 46% of them had someone in their families with a psychiatric disorder. 29% were repeaters after a previous attempt. Concerning to a prior contact with the Mental Health Services in the preceding month Significant differences were observed by age, but no significant differences were observed by sex. 26% used alcohol prior to the intent, mainly men. EIB and ELB ratings were significatively higher in retired than in students. Among the patients who repeated their intent (14.5%) of the followed, 78% were women, with an age between 30 and 56 years old. 61% were diagnosed having an affective disorder and 10% had psycotic disorders. 88% of the repeaters were in psychiatric treatment for five years or more.

  11. Credit cues and impression management: a preliminary attempt to explain the credit card effect.

    Science.gov (United States)

    McCall, Michael; Trombetta, Jessica; Gipe, Aimee

    2004-08-01

    Prior research had suggested that individuals would estimate higher product values and even tip more in the presence of credit cues. In the absence of a clear theoretical interpretation of this credit card effect we propose that this tendency is an impression management strategy such that credit cue exposure influences perceptions of the self and focuses attention on individual wealth. Thus, in the presence of others, credit cues serve to enhance images of the self. Preliminary data in support of this alternative theoretical perspective are presented.

  12. The need for improved operational definition of suicide attempts: illustrations from the case of street youth.

    Science.gov (United States)

    Kidd, Sean A

    2003-06-01

    The use of inadequate operational definitions of suicidal behavior is often a limitation of suicide research. In this article, the results of an exploratory qualitative study of street youth suicidality is contrasted with the existing literature to highlight the problems associated with defining suicidal behaviors. It is argued through the use of the case example of street youth that accurate and detailed assessment of suicidal history, context, and intent is necessary to avoid substantial threats to the validity and clinical use of research findings.

  13. Five-year olds, but not chimpanzees, attempt to manage their reputations.

    Directory of Open Access Journals (Sweden)

    Jan M Engelmann

    Full Text Available Virtually all theories of the evolution of cooperation require that cooperators find ways to interact with one another selectively, to the exclusion of cheaters. This means that individuals must make reputational judgments about others as cooperators, based on either direct or indirect evidence. Humans, and possibly other species, add another component to the process: they know that they are being judged by others, and so they adjust their behavior in order to affect those judgments - so-called impression management. Here, we show for the first time that already preschool children engage in such behavior. In an experimental study, 5-year-old human children share more and steal less when they are being watched by a peer than when they are alone. In contrast, chimpanzees behave the same whether they are being watched by a groupmate or not. This species difference suggests that humans' concern for their own self-reputation, and their tendency to manage the impression they are making on others, may be unique to humans among primates.

  14. Repair of Penetrating Pericardial and Diaphragmatic Injury with Cormatrix® Patch in a Case of Suicide Attempt

    Directory of Open Access Journals (Sweden)

    Federica Jiritano

    Full Text Available Abstract The authors report the case of a suicide attempt. A 59-year-old man with self-inflicted penetrating chest trauma underwent emergency cardiothoracic surgery. Pre-operative computed tomography scan showed critical proximity between the blade and the right ventricle. Intraoperative findings showed a pericardial laceration and a huge diaphragmatic lesion with heart and abdominal organs integrity. The diaphragm muscle was repaired with a CorMatrix® patch, an acceptable alternative to the traditional synthetic mesh avoiding infection and repeated herniation.

  15. Attempted suicide by ingestion of hair dye containing p-phenylenediamine: a case report.

    Science.gov (United States)

    Beshir, Lamis; Kaballo, Babiker; Young, Donald

    2017-07-01

    Para-phenylenediamine is widely used as a chemical in hair dyes and in combination with henna. This dye is used to paint the body for decorative reasons, to speed the processing time of henna and to intensify the results. Para-phenylenediamine is widely used in the Middle East, North Africa and India. Several reports have been published of the fatal ingestion of hair dye containing para-phenylenediamine. Here, we describe the case of a 14-year-old girl who ingested the compound but whose prompt treatment prevented her death. Ingestion of para-phenylenediamine produces a typical triad of angioneurotic oedema, rhabdomyolysis and acute tubular necrosis. Awareness of signs of these associated conditions in our patient, together with a comprehensive history, facilitated appropriate treatment to be instituted. We document the steps we took to enable her complete physical recovery.

  16. Successful and unsuccessful attempts to resolve caribou management and timber harvesting issues in west central Alberta

    Directory of Open Access Journals (Sweden)

    David Hervieux

    1996-01-01

    Full Text Available Research studies of woodland caribou in west central Alberta began in 1979 in response to proposed timber harvesting on their winter ranges. Using results from initial studies, timber harvest guidelines were developed. A recent review of these guidelines, and the assumptions on which they were based, has resulted in a renegotiation by government and industry of timber harvesting on caribou range in west central Alberta. Caribou range in west central Alberta overlaps many jurisdictional boundaries: federal and provincial lands, four Forest Management Agreement Areas, three Alberta Land and Forest Service Regions and two Alberta Fish and Wildlife Service Regions. This jurisdictional complexity in combination with other factors such as total allocation of the timber resources, high levels of petroleum, natural gas and coal extraction activities, a high level of concern by public groups for caribou conservation and recent understanding of woodland caribou needs for abundant space has made resolution of caribou/timber harvest conflicts exceedingly slow and often relatively unproductive. This paper reviews 10 years of trying to resolve conflicts between timber harvesting and caribou conservation through meetings, committees, integrated resource planning, policy papers and public consultation. We describe what might be learned by other jurisdictions that are trying to resolve similar caribou/timber harvesting issues. We conclude with an overview of recent timber harvest planning initiatives on caribou range in west central Alberta.

  17. Hospital Waste Management - Case Study

    Directory of Open Access Journals (Sweden)

    Beatriz Edra

    2017-07-01

    Full Text Available The importance of waste management in hospitals is indisputable in preserving the environment and protecting public health, but management models are rarely discussed. This study presents the legal and conceptual frameworks of good waste management practices applicable to hospitals and associated indicators. As a case study, the overall performance of Hospital Centre of São João, in Porto, was analysed based on published reports. Data on the production of waste in their different typologies were collected from 2010 to 2016, enabling a correlation of the waste production with the kg/bed/day indicator. The aim of this study was to gather data and discuss trends in a real scenario of evolution over a six-year period in order to contribute to a future research proposal on indicators that can be used as reference for benchmarking the construction of methodological guides for hospital waste management.

  18. Management of people with intermediate-stage hepatocellular carcinoma: an attempted network meta-analysis.

    Science.gov (United States)

    Roccarina, Davide; Majumdar, Avik; Thorburn, Douglas; Davidson, Brian R; Tsochatzis, Emmanuel; Gurusamy, Kurinchi Selvan

    2017-03-10

    : for example, different methods of performing transarterial chemoembolisation. We used standard methodological procedures expected by Cochrane. We calculated the hazard ratio (HR) with 95% confidence intervals (CI) using both fixed-effect and random-effects models based on available-participant analysis with Review Manager. We assessed risk of bias according to Cochrane, controlled risk of random errors with Trial Sequential Analysis using Stata, and assessed the quality of the evidence using GRADE. Three randomised clinical trials, including 430 participants, met the inclusion criteria for this review; however, data from two trials with 412 participants could be included in only one primary outcome (i.e. mortality). All three trials were at high risk of bias. All three trials included supportive care as cointervention. The comparisons included in the two trials reporting on mortality were: systemic chemotherapy with sorafenib versus no active intervention; and transarterial chemoembolisation plus systemic chemotherapy with sorafenib versus transarterial chemoembolisation alone. The trials did not report the duration of follow-up; however, it appeared that the participants were followed up for a period of about 18 to 30 months. The majority of the participants in the trials had cirrhotic livers. The trials included participants with intermediate-stage hepatocellular carcinoma arising from viral and non-viral aetiologies. The trials did not report the portal hypertension status of the participants. The mortality was 50% to 70% over a median follow-up period of 18 to 30 months. There was no evidence of difference in mortality at maximal follow-up between systemic chemotherapy versus no chemotherapy (hazard ratio 0.85, 95% CI 0.60 to 1.18; participants = 412; studies = 2; I2 = 0%; very low quality evidence). A subgroup analysis performed by stratifying the analysis by the presence or absence of transarterial chemoembolisation as cointervention did not alter the results

  19. The impact of staff case manager-case management supervisor relationship on job satisfaction and retention of RN case managers.

    Science.gov (United States)

    Hogan, Tierney D

    2005-01-01

    A positive relationship between staff RN case managers and their case management supervisor significantly impacts job satisfaction and retention in case managers. Literature review supports the premise that staff need to trust their supervisor and that there is a connection between this trust and job satisfaction. Staff case managers need to have a voice at work and feel empowered, and a supervisor's leadership style can influence job satisfaction and retention in their staff.

  20. Case management at what expense? A case study of the emotional costs of case management.

    Science.gov (United States)

    Beilman, J P; Sowell, R L; Knox, M; Phillips, K D

    1998-01-01

    Case management, which has its historical roots in community and public health, seeks to coordinate care, decrease costs, and promote access to appropriate levels of service. The case management system in this case study underscores the potential negative outcomes that can result from ignoring the holistic approach represented by an implemented case management system as a cost control mechanism. These negative outcomes not only include those expenditures of resources usually included when describing costs of care, but include those emotional costs of the system, patient, and care managers. Several needed system changes are identified and recommendations provided.

  1. Comorbid atypical autistic traits as a potential risk factor for suicide attempts among adult depressed patients: a case-control study.

    Science.gov (United States)

    Takara, Kiyoharu; Kondo, Tsuyoshi

    2014-01-01

    The present study aims to examine if autism spectrum disorder (ASD) is a risk factor for suicide attempts among adult depressed patients and to elucidate the characteristics of suicide attempts in adult depressed patients with ASD. We conducted a case-control study. Subjects consisted of 336 retrospectively recruited first-time visit patients to our outpatient clinic with a current major depressive episode; 31 of the 336 patients had attempted suicide. The demographic backgrounds (i.e., age, gender, personal/family history of suicidality); specific psychopathology like bipolarity, agitation, and psychotic features; and comorbidity such as physical diseases, alcohol abuse, cluster B personality disorder, and ASD including pervasive developmental disorder not otherwise specified (PDD-NOS) were examined as potential risk factors for suicide attempts. We compared these variables between the suicide attempters and non-attempters. In addition, we compared suicide attempters to non-attempters within the ASD group and non-ASD group. Binary logistic regression analysis was performed using the significant independent variables from the comparisons between the suicide attempters and non-attempters, and the odds ratios (OR) and 95% confidence intervals (CI) were calculated. Logistic regression analysis demonstrated that agitation during a depressive episode (OR = 7.15, 95% CI = 2.88-17.74), past suicidal behaviors (OR = 4.32, 95% CI =1.70-10.98), and comorbid PDD-NOS (OR = 4.04, 95% CI = 1.20-13.54) were significantly associated with suicide attempts. The most prevalent suicidal method was drug overdose (59.1%) among non-ASD attempters while hanging was the most prevalent (44.4%) in ASD attempters. Depressed adults with comorbid atypical autistic traits are at higher risk for suicide attempts and may engage in methods that are more lethal.

  2. Factors Determining Correct Case Management of Acute ...

    African Journals Online (AJOL)

    ARIs) is one of the factors responsible for the high ARI mortality in developing countries. Identification of factors which influence ARI case management by health workers is key for interventions to improve Quality of case management. Objective: ...

  3. Iowa Case Management: Innovative Social Casework.

    Science.gov (United States)

    Hall, James A.; Carswell, Christopher; Walsh, Elizabeth; Huber, Diane L.; Jampoler, Jennifer S.

    2002-01-01

    Discusses an approach to case management for rural clients in drug abuse treatment. Describes the philosophy and goals of the Iowa Case Management model and compares it to other models. The model allows case managers, through a series of activities, to help clients develop and achieve goals as they finish substance abuse treatment. (JDM)

  4. Young people's risk of suicide attempts after contact with a psychiatric department - a nested case-control design using Danish register data.

    Science.gov (United States)

    Christiansen, Erik; Larsen, Kim Juul

    2012-01-01

    There seems to be an increased risk of children and adolescents committing or attempting suicide after contact with a psychiatric department. Children and adolescents living in families with low socio-economic status (SES) might have an especially increased suicide attempt risk. A complete extraction of Danish register data for every individual born in the period 1983-1989 was made. Of these 403,431 individuals, 3,465 had attempted suicide. In order to control for confounder effects from gender, age and calendar-time, a nested case-control study was designed. A total population of 72,765 individuals was used to analyze the risk of suicide attempts after contact with a psychiatric department. The case-control data were analyzed using conditional logistic regression. This study shows that a child/adolescent's risk of suicide attempt peaks immediately after discharge from last contact with a psychiatric department. The risk of suicide attempt is highest for children and adolescents suffering from personality disorders, depression and substance use disorders. Children and adolescents with previous contact with a psychiatric department and parental income in the lowest third have a significantly higher risk of suicide attempt. Suicide attempters were more likely to have been given several different diagnoses and several different psychopharmacological drugs prior to their attempted suicide. The findings in this study highlight the need for psychopathology assessment in every case of attempted suicide. This study also shows that well-known risk factors such as contact with a psychiatric department do not affect all individuals in the same way. Individuals from families with low SES had the highest risk. This suggests that the presence of factors influencing both vulnerability and resiliency, e.g., family level of SES, needs to be included in the assessment. © 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental

  5. A CASE REPORT OF RETROPHARYNGEAL PASSAGE OF ENDOTRACHEAL TUBE WHILE ATTEMPTING BLIND NASAL INTUBATION - A RARE COMPLICATION

    Directory of Open Access Journals (Sweden)

    Harinath

    2015-06-01

    Full Text Available Nasal route of intubation is commonly used for surgical procedures involving Head and Neck, Patients with intra - oral pathology, structural abnormalities, trismus, cervical spine instability, cervical spine disease and OSA. The intubation may be aided by direct laryngoscopy, flexible fibreoptic laryngoscopy or by blind technique. The classical tec hnique of blind nasal intubation requires a spontaneously breathing patient and uses breath sounds to guide placement. Most common complication associated with this technique is epistaxis. Other rare complications include - Inferior turbinate avulsion, mid dle turbinate/nasal polyp/tumour avulsion, Bacteraemia, Retropharyngeal mucosa dissection/laceration. Here we present to you a case of fracture mandible posted for ORIF for which blind nasal intubation was planned. While attempting the intubation the endot racheal tube coursed behind the retropharyngeal mucosa for a short distance before entering the trachea. Post - operatively the patient was put on Ryle’s tube feeding for 3 days followed by orals. The track healed spontaneously and the recovery was uneventfu l.

  6. Retaining a Legacy while Avoiding Trademark Infringement: A Case Study of One University's Attempt to Develop a Consistent Athletic Brand Identity

    Science.gov (United States)

    Alessandri, Sue Westcott

    2007-01-01

    This case study chronicles Syracuse University's athletic department's attempt to achieve consistency in its identity program by changing its identity during 2004, and then again in 2005. The changes were owing to high-level personnel changes on both the academic and athletic sides of the university. This case details the many issues arising from…

  7. Portfolio Manager Selection – A Case Study

    DEFF Research Database (Denmark)

    Christensen, Michael

    2017-01-01

    Within a delegated portfolio management setting, this paper presents a case study of how the manager selection process can be operationalized in practice. Investors have to pursue a thorough screening of potential portfolio managers in order to discover their quality, and this paper discusses how...... such a screening process can be performed—represented by a case study....

  8. Chapter 10: Case studies in ecosystem management: the Mammoth-June ecosystem management project, Inyo National Forest

    Science.gov (United States)

    Constance I. Millar

    1996-01-01

    To assess the various ways organizations and people come together to manage Sierran ecosystems, SNEP conducted four case studies to examine the efficacy of different institutional arrangements:The Mammoth-June case study examines how a single national forest is attempting to implement the new Forest Service policy for ecosystem analysis...

  9. Study on Case Teaching of Financial Management

    Science.gov (United States)

    Che, Zhenghong; Che, Zhengmei

    2011-01-01

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

  10. Conservative management of broken guidewire: Case reports

    Directory of Open Access Journals (Sweden)

    Shahid M Khan

    2014-10-01

    Full Text Available Fractures of coronary guidewires during percutaneous coronary intervention within a coronary vessel lumen are a rare but serious complication. There have been several cases reported in the literature, some managed with surgical intervention, others with medical therapy. We present two prospective cases from our center. Both cases were managed successfully with medical therapy.

  11. Case management roles of clinicians: a research case study.

    Science.gov (United States)

    Sterling, Y M; Noto, E C; Bowen, M R

    1994-07-01

    The purpose of this research multiple case study was to determine case management roles as demonstrated by four clinicians employed at a university medical center. Multiple sources of evidence were used to collect data, including interviews, nonparticipant observations, and chart audits. Case management was defined by the clinicians as a process for delivery of health care at the institution studied. Despite a lack of a uniform framework for case management practice, the clinicians used similar case management components. Chart audits demonstrated deficits and inconsistency in documentation that were supported by interview and observations. It was recommended that exposure to formal case management models and theory could strengthen clinical practice in this area. Additionally, investigation of factors that facilitate and/or impede consistent documentation of interventions and patient outcomes, particularly by CNSs is recommended.

  12. Disaster case management and individuals with disabilities.

    Science.gov (United States)

    Stough, Laura M; Sharp, Amy N; Decker, Curt; Wilker, Nachama

    2010-08-01

    To examine the case management and disaster recovery needs of individuals with disabilities following Hurricane Katrina. The case managers and supervisors in this study provided case management to individuals with disabilities as part of the largest coordinated disaster case management program in U.S. history, the Katrina Aid Today consortium. This study provides an account of the disaster case management needs of individuals with disabilities as well as a picture of their long-term recovery process two years following the disaster. Forty-two case managers and 12 case management supervisors from this program provided services to a collective caseload of 2,047 individuals with disabilities and their families. Interviews and telephone surveys were conducted with these participants 20-24 months after the disaster. The qualitative data were analyzed using grounded theory methodology, and descriptive statistics summarize the demographic data. Findings suggest that the disaster recovery process is typically more complex and lengthy for individuals with disabilities and requires negotiation of a service system sometimes unprepared for disability-related needs. Barriers to disaster recovery for individuals with disabilities included a lack of accessible housing, transportation, and disaster services. Supports to disaster recovery included the individual effort and advocacy of a case manager, connecting with needed resources, collaboration with other agencies, and client motivation and persistence. Results suggest that disaster recovery is facilitated by case managers with disability expertise, including knowledge about the needs of individuals with disabilities and about disability-related services.

  13. Case management of malaria: treatment and chemoprophylaxis

    National Research Council Canada - National Science Library

    Upke, I S; Moonasar, D; Raman, J; Barnes, K I; Baker, L; Blumberg, L

    2013-01-01

    .... Malaria case management encompasses prompt and effective treatment to minimise morbidity and mortality, reduce transmission and prevent the emergence and spread of antimalarial drug resistance...

  14. Fleurs-de-lis in the forest: "absolute" monarchy and attempts at resource management in eighteenth-century France.

    Science.gov (United States)

    Graham, Hamish

    2009-01-01

    The notion of "resource management" has inspired some historians to rethink the nature of the state authority in early modern Europe. Like recent work on parts of Italy and Germany, this article investigates the development and implementation of legislation that sought to regulate the management and exploitation of forests. This was self-interested policymaking: as ancien régime France strove to match Britain's naval, colonial and maritime strength, the monarchy's priority was ship timbers. Yet the most sought-after pieces of wood were large, heavy and difficult to transport. According to standard accounts, such resources became rare during the eighteenth century, and the French navy turned increasingly to timber supplies from abroad. This article offers a wider view, by finding ways to analyse bureaucratic records created by the royal forestry officials (Eaux et Forêts), which have been largely neglected by historians. A regional case study suggests that, besides extending the authority of royal agents to acquire timbers for the naval dockyards, the application of Louis XIV's Ordinance on Waterways and Forests (1669) generated huge amounts of information about the extent, nature and location of mature timber reserves across France.

  15. Is Case Management Effective for Long-Lasting Suicide Prevention?

    Science.gov (United States)

    Wang, Liang-Jen; Wu, Ya-Wen; Chen, Chih-Ken

    2015-01-01

    Case management services have been implemented in suicide prevention programs. To investigate whether case management is an effective strategy for reducing the risks of repeated suicide attempts and completed suicides in a city with high suicide rates in northern Taiwan. The Suicide Prevention Center of Keelung City (KSPC) was established in April 2005. Subjects included a consecutive sample of individuals (N = 2,496) registered in KSPC databases between January 1, 2006, and December 31, 2011, with at least one episode of nonfatal self-harm. Subjects were tracked for the duration of the study. Of all the subjects, 1,013 (40.6%) received case management services; 416 (16.7%) had at least one other deliberate self-harm episode and 52 (2.1%) eventually died by suicide. No significant differences were found in the risks of repeated self-harm and completed suicides between suicide survivors who received case management and those who refused the services. However, a significant reduction in suicide rates was found after KSPC was established. Findings suggest that case management services might not reduce the risks of suicide repetition among suicide survivors during long-term follow-up. Future investigation is warranted to determine factors impacting the downward trend of suicide rates.

  16. Life events, social support, coping strategies, and quality of life in attempted suicide: A case-control study.

    Science.gov (United States)

    Kumar, P N Suresh; George, Biju

    2013-01-01

    Though deliberate self-harm encompasses a wide variety of medical and social disciplines some of the important psychosocial variable such as life events, social support, coping strategies, and quality of life have not yet been explored in depth in India. The aim was to analyze and compare the type and severity of life events, coping strategies, social support, and quality of life of suicide attempters versus matched normal controls, and to identify the risk factors leading to suicide. A total of 50 consecutive suicide attempters were compared with same number of age, sex, and martial status matched healthy controls using Presumptive Stressful Life Events Scale, Social Support Questionnaire, AECOM Coping Style Scale, and WHO QOL-Bref. Attempters experienced significantly more life events especially untoward events whereas the control group experienced more desirable and impersonal life events. Social support, positive coping, and of QOL were significantly lower in attempters. Among all risk factors desirable life events, good education, and good social support were protective against suicide. Suicide attempters were differentiated from healthy controls based on more stressful life events, lower social support, less healthy coping, and poor QOL. Positive life events, good education, and good social support were protective factors against suicide. However, it is difficult to pinpoint a single factor responsible for suicidal behavior. It is the complex interplay of various interrelated factors and the resultant buffering effect, which is protecting the individual against deliberate self-harm.

  17. Case Managers on the Front Lines of Ethical Dilemmas: Advocacy, Autonomy, and Preventing Case Manager Burnout.

    Science.gov (United States)

    Sortedahl, Charlotte; Mottern, Nina; Campagna, Vivian

    The purpose of this article is to examine how case managers are routinely confronted by ethical dilemmas within a fragmented health care system and given the reality of financial pressures that influence life-changing decisions. The Code of Professional Conduct for Case Managers (Code), published by the Commission for Case Manager Certification, acknowledges "case managers may often confront ethical dilemmas" (Code 1996, Rev. 2015). The Code and expectations that professional case managers, particularly those who are board certified, will uphold ethical and legal practice apply to case managers in every practice setting across the full continuum of health care. This discussion acknowledges the ethical dilemmas that case managers routinely confront, which empowers them to seek support, guidance, and resources to support ethical practice. In addition, the article seeks to raise awareness of the effects of burnout and moral distress on case managers and others with whom they work closely on interdisciplinary teams.

  18. Iowa Case Management for Rural Drug Abuse

    Science.gov (United States)

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

    2009-01-01

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

  19. 75 FR 27375 - Postal Rate Case Management

    Science.gov (United States)

    2010-05-14

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

  20. Rural case management: a pilot study.

    Science.gov (United States)

    Beaulieu, J E; Hickman, M

    1994-01-01

    The long term goal of this research is to improve the quality, effectiveness and efficiency of home and community-based services for rural long term care clients. Case management has been espoused as one method to improve services. Long term care case management models have been tested in urban areas with good results, but it is not known to what extent these models are applicable to the special circumstances of rural home and community-based care. The purposes of this pilot study are: 1. To describe case management in long term home health care as practiced in rural Kentucky. 2. To analyze case management for factors that promote or impede effective and efficient delivery of long term home health care for older rural Kentuckians. 3. To propose a model appropriate to case management in long term home health care for older rural Americans.

  1. Agribusiness Cases in Supply Chain Management

    OpenAIRE

    Brown, William J.

    2002-01-01

    The paper uses case studies of three different agribusinesses to demonstrate the principles of supply chain management and how it is applied. Primary producers must learn to understand and take advantages of the opportunities available to them in the new systems of supply change management. The agribusiness cases demonstrate a practical application of supply chain management that can affect and be applied to farm businesses throughout the world.

  2. Serum lithium levels and suicide attempts: a case-controlled comparison in lithium therapy-naive individuals.

    Science.gov (United States)

    Kanehisa, Masayuki; Terao, Takeshi; Shiotsuki, Ippei; Kurosawa, Keiko; Takenaka, Ryuichi; Sakamoto, Teruo; Shigemitsu, Osamu; Ishii, Nobuyoshi; Hatano, Koji; Hirakawa, Hirofumi

    2017-11-01

    Several epidemiological studies have shown the inverse association of lithium levels in drinking water and suicide rates; however, it is necessary to perform a clinical study dealing with individual patients. We analyzed 199 patients including 31 patients with suicide attempts, 21 patients with self-harm, and 147 control patients. All were transferred to a university emergency department suffering from intoxication or injury, were aged 20 or more years, and were alive at the start of the study. The exclusion criteria consisted of suffering from schizophrenia and a past or present history of lithium therapy. These exclusions were applied because it is difficult to determine whether their suicide attempt was induced by the intent to end their life or by psychotic symptoms such as auditory hallucinations, and if the patient had received lithium therapy, the association between the small amount of lithium taken from drinking water and food and serum lithium levels cannot be detected. There was a significant difference (p = 0.043) between the three groups whereby patients with suicide attempts had significantly lower lithium levels than control patients (p = 0.012) in males but not females. Multivariate logistic regression analysis with adjustment for age and gender revealed that patients with suicide attempts had significantly lower lithium levels than control patients (p = 0.032, odds ratio 0.228, 95% CI 0.059-0.883). The limitations of the present study are the nature of observational research which cannot reveal a causal relationship and the relatively small number of subjects. The present findings suggest that higher serum lithium levels may be protective against suicide attempts in lithium therapy-naive individuals.

  3. A case study in industrial risk management

    OpenAIRE

    2011-01-01

    M.Ing. This dissertation focuses on an industrial risk management case study, which aims to illustrate how the risks involved in a new project have to be identified, approached and managed. The aim of this dissertation is therefore to act as an example of modem risk management theory and implementation in an industrial engineering environment. The first part of the dissertation focuses on the theoretical background of risk management. It starts by giving the history of risk after which a d...

  4. Rapid improvement of depressive symptoms in suicide attempters following treatment with milnacipran and tricyclic antidepressants – a case series

    Directory of Open Access Journals (Sweden)

    Kirino E

    2011-12-01

    Full Text Available Eiji Kirino, Masao GitohDepartment of Psychiatry, Juntendo University, School of Medicine, Shizuoka, JapanAbstract: Suicide is a serious social problem in many countries, including Japan. The majority of people who commit suicide suffer from depression. Suicide attempt patients suffering from serious physical injuries are initially treated in hospital emergency departments. The present post hoc analysis examined data from patients admitted to an emergency hospital for treatment of physical injuries, resulting from a suicide attempt, and initial psychiatric treatment for depression and prevention of future suicide attempts. The effects on depressive symptoms were studied in two groups of patients using the 17-item Hamilton depression scale (HAMD. One group (n = 6 had received intravenous tricyclic antidepressants (TCA (amitriptyline or clomipramine while the other group (n = 7 had been treated orally with milnacipran, a serotonin and norepinephrine reuptake inhibitor antidepressant. Prior to treatment the four highest scoring items on the HAMD scale were the same in both groups namely, item 1 (depressed mood, item 3 (suicidality, item 7 (interest in work and activities, and item 10 (psychic anxiety. After 1 week of treatment, mean global HAMD scores were significantly reduced in both groups. Treatment resulted in a significant reduction of five HAMD items in the TCA group, whereas in the milnacipran group 12 HAMD items were significantly reduced. Suicidality (item 3 was significantly improved by 1 week treatment with milnacipran, but not by TCAs. Milnacipran rapidly improved a wide range of depressive symptoms, including suicidality within the first week. The improvement with milnacipran would appear to be, at least, equivalent to that achieved with TCAs, possibly affecting a wider range of symptoms. Since milnacipran has been shown in comparative studies to be better tolerated than TCAs, this antidepressant offers an interesting option for the

  5. Islamic Banks Risk Management Case

    National Research Council Canada - National Science Library

    Zaid Alrukhayyes; Hugh Grove; Jeffrey Feldman

    2014-01-01

    ... program for risk management of its banks. Due to availability of public data in 2010, Ibrahim had collected data on nine out of the eleven Kuwait banks, which comprised the sample for the subsequent stress testing of Kuwait banks...

  6. Breaking through hospital walls: case managers build bridge to primary care.

    Science.gov (United States)

    1997-07-01

    Some case managers, dissatisfied with the fragmented nature of the health care system, are attempting to eliminate obstacles between inpatient and outpatient care by positioning themselves at the front line; the physician's office. Getting physicians to accept and value case managers, however, requires a financial incentive. Capitation, which forces physicians to pay closer attention to costs, outcomes, and patient wellness, can do the trick. In areas with less managed care penetration, you can encourage physician acceptance of case management by helping reduce the hassle of caring for chronically ill patients.

  7. 42 CFR 440.168 - Primary care case management services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Primary care case management services. 440.168... care case management services. (a) Primary care case management services means case management related... services. (b) Primary care case management services may be offered by the State— (1) As a voluntary option...

  8. Case management implications of celiac disease.

    Science.gov (United States)

    Greenberg, Liza

    2008-01-01

    The purpose of this article is to educate case managers on an autoimmune disorder, celiac disease, that is seen with increased frequency due to recent improvements in diagnostic testing. After reading this article, case managers will Outpatient case management, although patients with celiac disease may be encountered in any setting. Celiac disease is a genetic autoimmune disease affecting up to 1% of the population. The majority of people with celiac disease do not know they have it. With new diagnostic tests available on the marketplace, increasing numbers of people are being diagnosed with celiac disease. Case managers are likely to encounter patients with celiac disease as either a primary or secondary diagnosis. Celiac disease may cause gastrointestinal symptoms such as gas, diarrhea, or bloating, and is also associated with osteoporosis, other autoimmune disorders, and certain types of cancer. For children, it is a common disorder underlying growth delays. Celiac disease is present in 3%-8% of persons with diabetes and may affect glycemic control in these patients. The only known treatment of celiac disease is a lifelong gluten-free diet. The increased number of individuals diagnosed with celiac disease has led to an increase in products available, as well as in research on treatment alternatives. People with celiac disease report challenges in adhering to the gluten-free diet. Case managers can assist patients in accessing appropriate therapy, including nutrition counseling and monitoring services. They may also advocate for testing of patients in high-risk groups such as persons with diabetes, and those with unexplained gastrointestinal symptoms. In working with celiac patients, case managers should address psychosocial issues as well as knowledge deficits. Patients may need particular support integrating the gluten-free diet with other requirements, including heart healthy or diabetic diets. Case managers can help patients identify reliable sources of

  9. Management of Kounis syndrome: two case reports

    OpenAIRE

    Omri, Majdi; Kraiem, Hajer; Mejri, Olfa; Naija, Mounir; Chebili, Naoufel

    2017-01-01

    Background Kounis syndrome corresponds to the occurrence of myocardial injury following an allergic insult. This syndrome is infrequent, and is not well known. In consequence, it is usually misdiagnosed leading to inappropriate treatment. The current literature is limited to case studies and there are no international recommendations concerning this topic. Case presentation We discussed, through two case reports, the clinical presentation and the management of a 60-year-old North African man ...

  10. Developing Knowledge Generation, Communication and Management in Teacher Education: A Successful Attempt at Teaching Novice Computer Users

    Directory of Open Access Journals (Sweden)

    Esther Zaretsky

    2009-02-01

    Full Text Available This unique colloquium of research for lecturers took place in an academic college of education focused on discussing and peer reviewing through an On-Line Forum and on participating in a conference. Both aimed at enhancing the level and quality of the research activity in the college by developing knowledge generation, communication and management. This study followed studies, which indicated that lecturers do not know and experience enough about generating, communicating and managing knowledge, especially with regards to the didactics of knowledge. Most of the studies carried out by the lecturers who participated in the colloquium focused on integrating disciplines with pedagogic-didactic applications. The method of the colloquium was based on virtual peer teaching, sharing their generated knowledge and experience, and then managing it. The findings indicated that the process was advanced very fast. The lecturers were able to integrate theory and practice while carrying out their research and instruction. This certainly affected the lecturers

  11. RESULTS OF A DATING ATTEMPT -CHEMICAL AND PHYSICAL MEASUREMENTS RELEVANT TO THE CASE OF THE CRETACEOUS TERTIARY EXTINCTIONS

    Energy Technology Data Exchange (ETDEWEB)

    Asaro, Frank; Michel, Helen V.; Alvarez, Luis W.; Alvarez, Walter

    1980-09-01

    In Gubbio, Italy, a l em layer of clay between extensive limestone formations marks the boundary between the Cretaceous and Tertiary Periods. This clay layer was known to have been deposited about 65 million years ago when many life forms became extinct, but the length of time associated with the deposition was not known. In an attempt to measure this time with normally deposited meteoritic material as a clock, extensive measurements of iridium abundances (and those of many other elements) were made on the Gubbio rocks. Neutron activation analysis was the principal tool used in these studies. About 50 elements are searched for in materials like the earth's crust, about 40 are detected and about 30 are measured with useful precision. We were not able to determine exactly how long the clay deposition took. Instead the laboratory studies on the chemical and physical nature of the Cretaceous-Tertiary boundary led to the theory that an asteroid collision with the earth was responsible for the extinction of many forms of life including the dinosaurs.

  12. Another Attempt to Look Inside The “Black Box” of Performance Creation: A Case Study Approach

    Directory of Open Access Journals (Sweden)

    Rifat Kamasak

    2014-07-01

    Full Text Available This study aims to investigate the complex interaction of different resource sets and capabilities in the process of performance creation within the context of resource-based theory. In order to address this objective, a case study approach that included multiple data collection methods such as in-depth interviews, observation and documentation was utilised. Qualitative data analysis indicated organisational culture, reputational assets, human capital, business processes and networking capabilities as the most important determinants of firm performance within the context of an emerging market firm case study findings.

  13. Teaching Cases in Management - Amendopar

    Directory of Open Access Journals (Sweden)

    Renata Cesar Torres

    2011-05-01

    Full Text Available This study is a teaching case that deals with a managerial problem faced by a medium-size Brazilian company. Amendopar was a family business in the peanut products industry that operated in the Brazilian market for 47 years. The Londrina, Paraná unit was operating close to its maximum production capacity, imposing a limit to the company’s growth. Having an already well established position in its state of origin, the owners were considering expanding into other markets. There was also interest on their part because of the tax benefits they would reap by establishing a new production unit in São Paulo State. However, the challenge at this time was to decide whether it was the right time to make this move and how much investment would be required. These decisions would be made at a meeting to be held and for which the Industrial Director was preparing.

  14. Exploring Predictors of Graduate School and Career Success: A Case Study in Sport Management

    Science.gov (United States)

    LeCrom, Carrie; Rufer, Lisa; Slavich, Mark; Dwyer, Brendan; Greenhalgh, Gregory

    2016-01-01

    The following case study attempted to assess what factors contribute to graduate school and early-career success among sport management graduate students. As faculty members charged with admitting the next generation of leaders in the sport industry, how should admissions decisions be made and what factors should be considered? The authors…

  15. Leadership in school-based management: a case study in selected ...

    African Journals Online (AJOL)

    This article, derived from a qualitative case study undertaken among a number of divergent secondary schools in Gauteng province, is an attempt to conceptualise the important and pivotal leadership role of the school principal in ensuring school improvement via effective school-based management in South African ...

  16. A case of colouterine fistula managed laparoscopically.

    Science.gov (United States)

    Dadhwal, Vatsla; Ghosh, Bhaswati; Jindal, Vijay Laxmi; Vaid, Arvind; Agarwal, Sandeep; Mittal, Suneeta

    2008-01-01

    Fistulas between the uterus and bowel are rarely reported. We report successful laparoscopic management of a colouterine fistula caused by a foreign body in the uterus. Fistulas between the gastrointestinal tract and the female genital tract are usually found between the vagina and rectum as a result of complications of childbirth or iatrogenic trauma. Communication between the uterus and bowel is rarely reported. We report successful laparoscopic management of an unusual case of colouterine fistula caused by a foreign body in the uterus.

  17. BOOK REVIEW: Case Studies in Knowledge Management

    OpenAIRE

    Reviewed by Dr. Adnan BOYACI

    2005-01-01

    161Case Studies in Knowledge ManagementEdited by Murray JennexHersley: PA: Idea Group, 2005, pp. 372, ISBN 1-59140-352-9Reviewed by Dr. Adnan BOYACIAnadolu UniversityEskişehir-TurkeyKnowledge management (KM) as a structured system and the way to the effectiveness isrelatively new field for the contemporary organizations functioning in different andcompetitive domain of public and private sectors in terms of getting optimal effectivenessunderlined by the concepts such as quality, productivity…...

  18. Case management directors: how to manage in a transition-focused world: part 2.

    Science.gov (United States)

    Bankston White, Cheri; Birmingham, Jackie

    2015-01-01

    Case management directors are in a dynamic position to affect the transition of care of patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the "moving parts" of such a complex role.This is Part 2 of a two-part article written for case management directors, particularly new ones.Part 1 covered the first 4 of 7 tracks: (1) Staffing and Human Resources, (2) Compliance and Accreditation, (3) Discharge Planning and (4) Utilization Review and Revenue Cycle. Part 2 addresses (5) Internal Departmental Relationships (Organizational), (6) External Relationships (Community Agency), and (7) Quality and Program Outcomes.This article attempts to answer the following questions: : The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems and have frontline case managers (CMs) reporting to them. Part 1 found that case management directors would benefit from further research and documentation of "best practices" related to their role, particularly in the areas of leadership and management. The same conclusion applies to Part 2, which addresses the director's responsibilities outside her immediate department. Leadership and management skills apply as well to building strong, productive relationships across a broad spectrum of external organizations that include payer, provider, and regulatory agencies. At the same time, they must also develop the skills to positively influence the revenue cycle and financial health of both the organization for which they work and those to whom they transition patients. A director of case management with responsibility for transitions of care has more power and influence over patient safety than is commonly known. Few of the

  19. Using Strategic Management Study Cases In Romania

    Directory of Open Access Journals (Sweden)

    Bacanu Bogdan

    2008-04-01

    Full Text Available The paper discuss the use of study case in the teaching of strategic management and the translation of the method from United States to Romania. Some technical aspects of American experience in strategic management case researching are underlined, with a focalised approach on financial analysis and their informational context. The basic weaknesses of the method are also analysed in order to understand the practical problems in Romanian educational environment. The general value as a tool in achieving participation and in developing communication is magnified with a specific Romanian one: gathering direct information.

  20. Psychotherapeutic management of hypochondriasis: a case study

    Directory of Open Access Journals (Sweden)

    Shilpi Aggarwal

    2017-06-01

    Full Text Available Objectives: The present study aims to explore the course of hypochondriasis and to assess the efficacy of psychotherapeutic management in alleviating the symptoms associated with hypochondriasis and to improve the client’s overall functioning. Research design: Case study. Sample and method: This study was carried out in Delhi and 18 years old unmarried male was included. Treatment plan was formulated according to psychotherapeutic management wherein different management techniques were utilised to modify the client’s hypochondriacal beliefs and the associated behaviours. Result: Findings of the assessment showed significant distress and impairment in overall functioning. Stressor activates his dysfunctional belief which shifts his attention to minor bodily perturbations and results in misinterpretation of these trivial variations. Psychotherapeutic management techniques successfully restructured his dysfunctional beliefs and remarkably improved his functioning. Conclusion: On the basis of results, it can be ascertained that psychotherapeutic management is an effective approach to treat hypochondriasis.

  1. Self-injection of household cleaning detergents into a ventriculoperitoneal shunt reservoir during a suicide attempt: a case report and literature review.

    Science.gov (United States)

    Signorelli, Jason W; Osbun, Joshua W; Arias, Eric J; Reynolds, Lauren C; Chyatte, Douglas; Reynolds, Matthew R

    2016-09-01

    Self-injection of household cleaning detergents (more specifically, commercial toilet bowl cleaner) into the reservoir of a ventriculoperitoneal shunt (VPS) has never been reported in the neurosurgical literature. A right-handed 41-year-old female with a past medical history significant for bipolar depression (with multiple prior hospital admissions for suicide attempts) and pseudotumor cerebri (status-post VPS placement from a right frontal approach) successfully injected ∼5 ml of toilet bowl cleaner into her ventricular shunt reservoir during a suicide attempt. She was found unresponsive by a family member 48 h after this event and presented to our hospital in moribund neurological condition (bilaterally fixed and dilated pupils with decerebrate posturing). Head computed tomography (CT) demonstrated marked ventriculomegaly. She was taken emergently to the operating room for placement of a left frontal ventriculostomy. Cerebrospinal fluid (CSF) sampled intraoperatively showed numerous Gram-positive cocci (later determined to be Staphylococcus epidermidis). For this reason, her right-sided shunt system was also removed in its entirety. She was treated with broad-spectrum intravenous and intraventricular antibiotics for her bacterial ventriculitis and her CSF was aggressively drained to treat her hydrocephalus. Once her infection had resolved, the shunt was replaced (using a right parietal approach) and she went on to make an excellent neurological recovery. Here, the authors present the case of a patient who self-injected household cleaning detergents into her VPS reservoir-and, likely, the ventricular system-during a suicide attempt and subsequently developed hydrocephalus and ventriculitis. Following this infrequent clinical scenario, consideration should be given to temporary ventriculostomy placement and shunt removal. Moreover, in patients with a known history of psychiatric co-morbidities-and particularly those patients with prior suicide attempts

  2. Reasons 9-1-1 is called for cardiac arrest cases in which no resuscitation is attempted.

    Science.gov (United States)

    Meischke, Hendrika; Chavez, Devora; Feder, Sylvia; Rea, Tom; Albert, Tyler; Eisenberg, Mickey

    2009-01-01

    The goal of this investigation was to describe the reasons emergency medical services (EMS) is activated when resuscitation is not desired or when patients show signs of irreversible death. All medical incident report forms (MIRFs) indicating a cardiac arrest for which resuscitation was withheld were obtained from five participating fire departments. For each eligible case (N = 196), one of the emergency medical technicians (EMTs) present at the scene was interviewed and the dispatch tape of the 9-1-1 call was reviewed. Patient and caller characteristics were abstracted from the MIRFs and dispatch tapes. The EMTs were asked about the reasons for the call, whether the family expected this death, and the caller's emotional state when EMS arrived at the scene. In addition, EMS providers were asked open-ended questions about the services they provided for the patient and patient's family. Using chi-square statistics and t-tests, we compared two groups: 1) patients for whom resuscitation was not desired as indicated by a do-not-resuscitate (DNR) order, terminal illness, or hospice (n = 66) and 2) patients for whom resuscitation was not started because of signs of irreversible death (n = 130). Compared with callers for patients with signs of irreversible death, callers for patients for whom resuscitation was not desired were less likely to access EMS because they needed medical assistance (11% versus 30%) and more likely to call 9-1-1 because they thought it was "required by law" (30% versus 8%). Other common reasons in both groups for activating 9-1-1 were confusion regarding what to do and a request to confirm death. The most frequently reported service provided by EMTs for both groups was to "offer to contact a chaplain." In a third of patients for whom EMS did not initiate resuscitation, resuscitation was withheld primarily because it was not desired rather than because there was evidence of irreversible death. Efforts to improve education may prevent EMS activation

  3. Negative Life Events and Attempted Suicide in Rural China

    Science.gov (United States)

    Zhang, Wen-Chao; Jia, Cun-Xian; Zhang, Ji-Yu; Wang, Lin-Lin; Liu, Xian-Chen

    2015-01-01

    Objective This study aimed to examine the association between negative life events (NLEs) and attempted suicide in rural China. Methods Six rural counties were selected from disease surveillance points in Shandong province, China. A total of 409 suicide attempters in rural areas between October 1, 2009, and March 31, 2011, and an equal number of matched controls were interviewed. We compared negative life events experienced within 1 month, 1–3 months, 3–6months, and 6–2 months prior to attempted suicide for cases and prior to interview for controls. We used multivariate logistic regression to examine the association between NLEs and attempted suicide. Results Suicide attempters experienced more NLEs within the last year prior to suicide attempt than controls prior to interview (83.1% vs. 33.5%). There was a significant dose-response relationship between NLEs experienced within the last year and increased risk of attempted suicide. Timing of NLEs analysis showed that NLEs experienced in the last month and 6–12 months prior to suicide attempt were significantly associated with elevated risk of attempted suicide, even after adjusting for mental disorders and demographic factors. Of NLEs, quarrelling with spouse, quarrelling with other family members, conflicting with friends or neighbors, family financial difficulty, and serious illness were independently related to attempted suicide. Conclusion NLEs are significantly associated with increased risk for attempted suicide in rural China. Stress management and intervention may be important to prevent suicidal behavior in rural China. PMID:25611854

  4. Linking case management and community development.

    Science.gov (United States)

    Austin, Carol D; McClelland, Robert W; Gursansky, Di

    2006-01-01

    Case management, in various forms, is now institutionalized as a core part of policy and programs designed to deliver home- and community-based services to older adults. The case management role, in theory, requires attention to both client and system goals, although in practice the system goals that have received most attention have been gatekeeping and resource allocation. While case managers have been admonished to find and develop resources in the community, this has primarily taken the form of including informal services in individual client care plans. What has been missing is focused attention to the potential of the community as a nurturing environment with the capacity to support older adults and their caregivers. Sustainable care for older adults cannot be achieved by formal service and family support alone. This article proposes the creation of linkages between case managers, who build the service arrangements for older people, and community developers, who are responsible for building community capacity and social capital. It is argued that this linkage is essential for establishing the foundations of a caring community with the capacity to support older people.

  5. The Cocoa Shop: A Database Management Case

    Science.gov (United States)

    Pratt, Renée M. E.; Smatt, Cindi T.

    2015-01-01

    This is an example of a real-world applicable case study, which includes background information on a small local business (i.e., TCS), description of functional business requirements, and sample data. Students are asked to design and develop a database to improve the management of the company's customers, products, and purchases by emphasizing…

  6. Telehealth technology in case/disease management.

    Science.gov (United States)

    Park, Eun-Jun

    2006-01-01

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

  7. Surgical management of palatine Torus - case series

    Directory of Open Access Journals (Sweden)

    Thaís Sumie Nozu Imada

    Full Text Available INTRODUCTION: Torus palatinus is a specific name to identify exostoses developed in the hard palate along the median palatine suture. Despite of not being a pathological condition, its presence requires attention and knowledge regarding its management. Surgical removal of exostoses is indicated when the patient frequently traumatizes the area of palatine torus during mastication and speech or when it is necessary for the rehabilitation of the upper arcade with complete dentures. OBJECTIVE: The aim of this article is to present three cases of Torus palatinus and to discuss the management of them. CASE REPORT: In the first case, a 57-year-old Caucasian man sought oral rehabilitation of his edentulous maxilla but presented a hard nodules in the hard palate; in the second case, a 40-year-old Caucasian woman was referred for frequent trauma of palatal mucosa during mastication, aesthetic complaint, and discomfort caused by the trauma of her tongue in this area; and in the third case, a 45-year-old Caucasian woman presented with a lesion on the palate that caused difficulty swallowing. When the Torus palatinus was impairing the basic physiological functions of the patients, all cases were surgically treated, improving the patients' quality of life. FINAL CONSIDERATION: The dentist should be properly prepared to choose the best from among the existing surgical approaches for each individual lesion in order to improve the results and avoid possible complications.

  8. Management of people with early- or very early-stage hepatocellular carcinoma: an attempted network meta-analysis.

    Science.gov (United States)

    Majumdar, Avik; Roccarina, Davide; Thorburn, Douglas; Davidson, Brian R; Tsochatzis, Emmanuel; Gurusamy, Kurinchi Selvan

    2017-03-28

    Hepatocellular carcinoma (primary liver cancer) is classified in many ways. The Barcelona Clinic Liver Cancer (BCLC) group staging classifies the cancer based on patient's life expectancy. People with very early- or early-stage hepatocellular carcinoma have single tumour or three tumours of maximum diameter of 3 cm or less, Child-Pugh status A to B, and performance status 0 (fully functional). Management of hepatocellular carcinoma is uncertain. To assess the comparative benefits and harms of different interventions used in the treatment of early or very early hepatocellular carcinoma through a network meta-analysis and to generate rankings of the available interventions according to their safety and efficacy. However, it was not possible to assess whether the potential effect modifiers were similar across different comparisons. Therefore, we did not perform the network meta-analysis and instead assessed the benefits and harms of different interventions versus each other or versus sham or no intervention using standard Cochrane methodology. We searched CENTRAL, MEDLINE, Embase, Science Citation Index Expanded, and trials registers to September 2016 to identify randomised clinical trials (RCTs) on hepatocellular carcinoma. We included only RCTs, irrespective of language, blinding, or publication status, in participants with very early- or early-stage hepatocellular carcinoma, irrespective of the presence of cirrhosis, portal hypertension, aetiology of hepatocellular carcinoma, size and number of the tumours, and future remnant liver volume. We excluded trials including participants who were previously liver transplanted. We considered interventions compared with each other, sham, or no intervention. We calculated the odds ratio, mean difference, rate ratio, or hazard ratio with 95% confidence intervals using both fixed-effect and random-effects models based on available-participant analysis with Review Manager 5. We assessed the risk of bias according to Cochrane

  9. Hybrid Risk Management Methodology: A Case Study

    Directory of Open Access Journals (Sweden)

    Jacky Siu-Lun Ting

    2009-10-01

    Full Text Available Risk management is a decision-making process involving considerations of political, social, economic and engineering factors with relevant risk assessments relating to a potential hazard. In the last decade, a number of risk management tools are introduced and employed to manage and minimize the uncertainty and threats realization to the organizations. However, the focus of these methodologies are different; in which companies need to adopt various risk management principles to visualize a full picture of the organizational risk level. Regarding to this, this paper presents a new approach of risk management that integrates Hierarchical Holographic Modeling (HHM, Enterprise Risk Management (ERM and Business Recovery Planning (BCP for identifying and assessing risks as well as managing the consequences of realized residual risks. To illustrate the procedures of the proposed methodology, a logistic company ABC Limited is chosen to serve as a case study Through applying HHM and ERM to investigate and assess the risk, ABC Limited can be better evaluated the potential risks and then took the responsive actions (e.g. BCP to handle the risks and crisis in near future.

  10. Palliative care after attempted suicide in the absence of premorbid terminal disease: a case series and review of the literature.

    Science.gov (United States)

    Eastman, Peter; Le, Brian

    2013-02-01

    Palliative care involvement in the management of incomplete suicide in patients without terminal illness is rare. This paper documents two such cases and explores some of the clinical and ethical issues raised. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2016-10-01

    Case management has been widely implemented in the community aged care setting. In this study, we aimed to explore influences on case-managed community aged care practice from the perspectives of community aged care case managers. We conducted 33 semistructured interviews with 47 participants. We drew these participants from a list of all case managers working in aged care organizations that provided publicly funded case management program(s)/packages in Victoria, Australia. We used a multilevel framework that included such broad categories of factors as structural, organizational, case manager, client, and practice factors to guide the data analysis. Through thematic analysis, we found that policy change, organizational culture and policies, case managers' professional backgrounds, clients with culturally and linguistically diverse backgrounds, and case management models stood out as key influences on case managers' practice. In the future, researchers can use the multilevel framework to undertake implementation research in similar health contexts. © The Author(s) 2015.

  12. 10 CFR 2.332 - General case scheduling and management.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false General case scheduling and management. 2.332 Section 2... Management for NRC Adjudicatory Hearings § 2.332 General case scheduling and management. (a) Scheduling order... scheduling order must have as its objectives proper case management purposes such as: (1) Expediting the...

  13. Case management for the elderly with complex needs: cross-linking the views of their role held by elderly people, their informal caregivers and the case managers.

    Science.gov (United States)

    Balard, Frédéric; Gely-Nargeot, Marie-Christine; Corvol, Aline; Saint-Jean, Olivier; Somme, Dominique

    2016-11-08

    In 2009, case management interventions were a new social service in France implemented within the framework of the PRISMA-France program (2006-2010). People who had benefitted from case management intervention were individuals, over 60 years old living at home in situations deemed complex by professionals. Their informal caregivers were also considered as users of the service. This research accompanied the interventions during the implementation of PRISMA-France attempting to explore the users' (old people and their informal caregivers) and case managers' first experiences of case management. Its aim is to provide a thorough knowledge of the dispositive in order to reveal any initial failings and to ensure optimum conditions for the onset of full implementation. The study had a qualitative explorative design. Cross-linked representations of case-management were obtained through opened-ended and guided interviews with three types of informants: old people (19), their informal caregivers (11) and the case managers (5) who participated in the program during the first 6 months. Thematic analysis of the data was carried out. The analysis revealed that each group of people generated its own representations of the case manager's role, even though the three groups of informants shared the idea that the case manager is first and foremost a helper. The case managers insisted on their proximity to the old people and their role as coordinators. The informal caregivers saw the professional as a partner and potential provider of assistance in accompanying old people. The old people focused on the personal connections established with the case manager. The innovative and experimental dimension of case management in France and the flexible nature of the role generated a broad spectrum of representations by those involved. These different representations are, in part, the fruit of each individual's projected expectations of this social service. Analyzing the first representations

  14. Anesthesic Management for Escobar Syndrome: Case Report

    Directory of Open Access Journals (Sweden)

    Ayse Hande Arpaci

    2011-01-01

    Full Text Available Escobar syndrome is a rare autosomal recessive disorder which is characterized by growth retardation, axillary, antecubital, popliteal digital, and intercrural joint flexion contracture, pterygium in the eyes, cleft palate, decreased lung capacity, genital abnormalities, and spinal deformity. In this case, we presented the anesthesic management of a 2-year-old child undergoing frontal sling operation for ptosis and amblyopia etiology exploration.

  15. Corporate Information Management: A Case Study

    Science.gov (United States)

    1991-03-01

    non- replicable." [Ref. 4:p. 2] Researchers with a positivism frame of mind are apprehensive when using a case study as a research method. [Ref. 2:p. 16...34 the tremendous disparity of interests -- many difficult to reconcile with prudent management -- that DoD is given to serve through line items, general...existing lishment of regional freight consoli- but the agencies may use alterna- and emerging stand-alone technical dation centers; a change in the pri

  16. Between Taylor and the Catholic Action. The scientific management and the attempt to re-Christianize labor in Portugal (1945-1974

    Directory of Open Access Journals (Sweden)

    Ana Carina Azevedo

    2015-07-01

    Full Text Available While analyzing the period of greater affirmation of scientific management in Portugal, it began to become clear the presence of a generation of technicians linked to the Catholic Action and its youth movements, especially the “Juventude Universitária Católica”. These individuals were a constant presence in publications about the subject and they were also present in leading positions of State organisms related to labor, such as the National Institute of Industrial Research and the “Ministério das Corporações”. When we tried to understand the cause of this reality, our research led us to the Catholic discourse about labor and made us understand how this concern was related to the attempt to re-Christianize the society from within. Crossing sources from the Holy See, the Catholic Action and Portuguese publications related to labor, we intended to reconstruct a speech - the only one about the scientific management in Portugal - and a reality that had been forgotten and that will help us understand some of the characteristics of the process of development of scientific management in the country between 1945 and 1974.

  17. Making the case for OWTS management: lessons from case studies and research

    Science.gov (United States)

    Rahm, B.; Woods, F.; Hwang, S.; Walter, M. T.; Grantham, D. G.; Riha, S. J.

    2016-12-01

    On-site wastewater treatment systems (OWTS) are used in 20-25% of homes in the United States and can be an efficient and cost-effective alternative to conventional centralized systems. However, OWTS also represent a source of non-point nutrient, pathogen, and micro-contaminant pollution to surface and groundwater if they are poorly designed, sited and/or maintained. Despite their ubiquity and potential to negatively impact water resources, the contribution of OWTS to local and regional water contamination issues is poorly understood. There are no federal regulations or uniform standards for the operation, maintenance, and management of these systems. The effectiveness of educational programs and best management practices developed by the US Environmental Protection Agency, along with local and regional governments, remains uncertain. Here we describe attempts to increase our knowledge of the state of OWTS in relation to water resources and their management. Specifically, we summarize 1) efforts to modernize a NY State-wide inventory of residential OWTS using GIS-based tools; 2) research aimed at better understanding the impact of OWTS on surface and ground water in 5 upstate NY counties across a gradient of land uses; 3) lessons learned from 13 case studies of municipal OWTS management programs across the US; and 4) observations on the roles of data, education and policy in creating and evaluating successful municipal OWTS management programs. Initial results show that total numbers of OWTS in NY State continue to grow, particularly in areas associated with ex-urban migration. Research into the relationship between OWTS and nutrient and pathogen contamination in ground and surface waters, respectively, suggests location-specific variation. This has implications for management approaches: preventing failure of any individual OWTS may be just as effective as programs attempting to bring all OWTS up to a high level of performance. Case studies of management programs

  18. Electronic Document Management: A Human Resource Management Case Study

    Directory of Open Access Journals (Sweden)

    Thomas Groenewald

    2004-11-01

    Full Text Available This case study serve as exemplar regarding what can go wrong with the implementation of an electronic document management system. Knowledge agility and knowledge as capital, is outlined against the backdrop of the information society and knowledge economy. The importance of electronic document management and control is sketched thereafter. The literature review is concluded with the impact of human resource management on knowledge agility, which includes references to the learning organisation and complexity theory. The intervention methodology, comprising three phases, follows next. The results of the three phases are presented thereafter. Partial success has been achieved with improving the human efficacy of electronic document management, however the client opted to discontinue the system in use. Opsomming Die gevalle studie dien as voorbeeld van wat kan verkeerd loop met die implementering van ’n elektroniese dokumentbestuur sisteem. Teen die agtergrond van die inligtingsgemeenskap en kennishuishouding word kennissoepelheid en kennis as kapitaal bespreek. Die literatuurstudie word afgesluit met die inpak van menslikehulpbronbestuur op kennissoepelheid, wat ook die verwysings na die leerorganisasie en kompleksietydsteorie insluit. Die metodologie van die intervensie, wat uit drie fases bestaan, volg daarna. Die resultate van die drie fases word vervolgens aangebied. Slegs gedeelte welslae is behaal met die verbetering van die menslike doeltreffendheid ten opsigte van elektroniese dokumentbestuur. Die klient besluit egter om nie voort te gaan om die huidige sisteem te gebruik nie.

  19. Case management evolution: from basic to advanced practice role.

    Science.gov (United States)

    Stanton, Marietta P; Swanson, Michelle; Sherrod, Roy Ann; Packa, Donna R

    2005-01-01

    This article provides an overview of nursing case management as an advanced practice role from a theoretical and practice basis. Not all case managers will, or need to, perform case management duties at the advanced level. However, it has become abundantly clear over the past several years that nurse case managers are performing more complex duties that appear to match the competencies of other advanced practice roles. In this article, the authors will explore the issue in depth and demonstrate the differences between basic and advanced practice nursing case management on the basis of clinical practice, educational level, and research responsibilities for both the basic and advanced levels of case management practice; advanced practice competencies; and examples of advanced practice case management from current practice. Just as there are differences between basic and advanced professional and clinical nursing practice, there is a difference between basic and advanced levels of case management practice.

  20. School principals' perceptions of team management: a multiple case ...

    African Journals Online (AJOL)

    recent Draft Policy Framework: Education Leadership and Management Deve— lopment (undated). The Department of Education has also attempted to give substance to this purpose by providing manuals to guide educational mana— gers in the implementation of decentralised management structures, such as the School ...

  1. 42 CFR 440.169 - Case management services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Case management services. 440.169 Section 440.169... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.169 Case management services. (a) Case management services means services furnished to assist individuals, eligible under the...

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

    Science.gov (United States)

    Day, Andrew; Hardcastle, Lesley; Birgden, Astrid

    2012-01-01

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

  3. Increased deep sleep in a medication-free, detoxified female offender with schizophrenia, alcoholism and a history of attempted homicide: Case report

    Directory of Open Access Journals (Sweden)

    Sailas Eila

    2004-10-01

    Full Text Available Abstract Background Psychiatric sleep research has attempted to identify diagnostically sensitive and specific sleep patterns associated with particular disorders. Both schizophrenia and alcoholism are typically characterized by a severe sleep disturbance associated with decreased amounts of slow wave sleep, the physiologically significant, refreshing part of the sleep. Antisocial behaviour with severe aggression, on the contrary, has been reported to associate with increased deep sleep reflecting either specific brain pathology or a delay in the normal development of sleep patterns. The authors are not aware of previous sleep studies in patients with both schizophrenia and antisocial personality disorder. Case presentation The aim of the present case-study was to characterize the sleep architecture of a violent, medication-free and detoxified female offender with schizophrenia, alcoholism and features of antisocial personality disorder using polysomnography. The controls consisted of three healthy, age-matched women with no history of physical violence. The offender's sleep architecture was otherwise very typical for patients with schizophrenia and/or alcoholism, but an extremely high amount of deep sleep was observed in her sleep recording. Conclusions The finding strengthens the view that severe aggression is related to an abnormal sleep pattern with increased deep sleep. The authors were able to observe this phenomenon in an antisocially behaving, violent female offender with schizophrenia and alcohol dependence, the latter disorders previously reported to be associated with low levels of slow wave sleep. New studies are, however, needed to confirm and explain this preliminary finding.

  4. Perinatal conditions and parental age at birth as risk markers for subsequent suicide attempt and suicide: a population based case-control study.

    Science.gov (United States)

    Niederkrotenthaler, Thomas; Rasmussen, Finn; Mittendorfer-Rutz, Ellenor

    2012-09-01

    Restricted fetal growth and young maternal age have been associated with increased risk of suicidal behaviour later in life. Research investigating the independent and interacting effects of these risk factors with parental mental health and socio-economic status is scarce. A case-control study was effected through record linkage between Swedish registers. Individuals born 1973-1983 who were hospitalized due to a suicide attempt (n = 17,159) or committed suicide (n = 1,407) were matched to ≤10 controls by sex, month and county of birth. Controlling for parental conditions, significantly increased odds ratios (OR) for suicide attempt were found for low birth weight (OR = 1.12, 95 % CI 1.01-1.25), short birth length (OR = 1.15, 95 % CI 1.08-1.22), short and light for gestational age (OR = 1.23, 95 % CI: 1.10-1.38), short but not light for gestational age (OR = 1.18, 95 % CI: 1.09, 1.29), teenage motherhood (OR = 1.66, 95 % CI 1.53-1.80), young fatherhood (OR = 1.33, 95 % CI 1.27-1.39) and multiparity (OR = 1.40, 95 % CI 1.31-1.50). For completed suicide, increased odds ratios were found for low birth weight (OR = 1.65, 95 % CI 1.16-2.35), teenage motherhood (OR = 1.44, 95 % CI 1.09-1.90) and young fatherhood (OR = 1.20, 95 % CI 1.02-1.41). There was a synergy effect between teenage motherhood and parental psychiatric inpatient care with regard to suicide attempt in offspring [synergy index = 1.53 (95 % CI 1.27-1.84)]. Low birth weight and length, and short and light for gestational age may increase the risk of subsequent suicidal behaviour, and more research is needed to investigate underlying mechanisms. Public health implications from this study include measures to improve pre- and perinatal parental mental health, particularly in teenage pregnancies.

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

    Science.gov (United States)

    Tahan, Hussein M

    2016-01-01

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

  6. Case Management of Dengue: Lessons Learned.

    Science.gov (United States)

    Kalayanarooj, Siripen; Rothman, Alan L; Srikiatkhachorn, Anon

    2017-03-01

    The global burden of dengue and its geographic distribution have increased over the past several decades. The introduction of dengue in new areas has often been accompanied by high case-fatality rates. Drawing on the experience in managing dengue cases at the Queen Sirikit National Institute of Child Health in Bangkok, Thailand, this article provides the authors' perspectives on key clinical lessons to improve dengue-related outcomes. Parallels between this clinical experience and outcomes reported in randomized controlled trials, results of efforts to disseminate practice recommendations, and suggestions for areas for further research are also discussed. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  7. Analysis of the Case Management Process at Walter Reed Army Medical Center: Procedures for Improving Case Management

    National Research Council Canada - National Science Library

    Smith, Kevin S

    2006-01-01

    ...; and observed the users in the day-to-day operations of the case management process. The study's results revealed that there is a lack of written procedures for case managers to follow and that communication failures are present...

  8. Management case study: Tampa Bay, Florida

    Science.gov (United States)

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

    2011-01-01

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

  9. Telephonic advance care planning facilitated by health plan case managers.

    Science.gov (United States)

    Boettcher, Iris; Turner, Rozanne; Briggs, Linda

    2015-06-01

    The insurance plan case managers (CMs) of Priority Health, part of a regional healthcare system located in Michigan, work telephonically with frail patients who have multiple comorbidities. However, these CMs have lacked facilitation skills for advance care planning (ACP) discussions in this vulnerable population. In 2012, the findings of a six-month pilot study of telephonic ACP (TACP) with some of the plan's Medicare population were implemented with Medicare members under case management. Case mangers were trained and certified by Respecting Choices® to introduce and facilitate ACP discussions telephonically utilizing both First Steps and Last Steps protocols. The CMs identified appropriate patients using hospitalization and emergency room utilization data, severity of illness, and diagnostic criteria. The primary goal was to complete both the ACP discussion and the documentation for each protocol on identified patients. They also attempted to schedule facilitated conversations with the patients' healthcare advocates present. During a 12-month period, 576 health plan members were offered First Steps discussions, with 198 interested in engaging in further ACP. Some 152 members were identified for Last Steps TACP using established criteria; discussions occurred with 56 members. TACP implementation resulted in 55 new or updated First Steps documents and 4 Last Steps documents. A total of 50 discussions included the designated healthcare advocate. Following TACP implementation with the Medicare CM team and evaluation of the results, processes and methods were instituted to increase engagement and completion of discussions and documents. These included enhancements to the electronic assessment and ongoing support of the CM team to increase the engagement of patients and advocates. Dissemination of the project to the entire Medicare CM team demonstrated opportunities and lessons learned for facilitated TACP discussions. The TACP model has the potential to be

  10. Quick management of accidental tritium exposure cases.

    Science.gov (United States)

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

    2012-07-01

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

  11. Integrated case management: the 21st century challenge for HMO case managers: Part I.

    Science.gov (United States)

    Coleman, J R

    1999-01-01

    As HMOs approach the new millennium, their care and cost management strategies still will be under attack by policy-makers, legislative bodies, the media, American businesses, and the medical professions. The HMO industry will continue to be held accountable for the efficiency of its services, the quality of its care, and the performance and outcome measures that are the results of managing both the care and medical costs of its membership. This first of a two-part series put forward the concept of an integrated CM model to manage the total care of needs of HMO members at the turn of the century. This model consists of three care management approaches commonly used in mature HMOs: demand management, CM, and DM, as illustrated in Figure 1 and defined in Table 1. This article also described the new challenges facing HMOs, physicians, and nurse case managers and how they are navigating the difficult process of mapping demand management and CM approaches to the medical, social, and environmental needs of HMO members. With the costs of chronic conditions consuming 61% of the nation's annual health bill and increased numbers of the elderly joining HMOs, HMOs strongly need to implement DM approaches for economic survival reasons alone. Part two of this series will focus on the newest care management approach: disease state management.

  12. Logistics management skills development: A Zimbabwean case

    Directory of Open Access Journals (Sweden)

    Jacobus N. Cronjé

    2015-02-01

    Full Text Available Background: Since logistics emerged as an applied discipline during the latter part of the 20th century, there has been an increased need for skills development in logistics and supply chain management. However, literature suggests a general shortage of educated and skilled logistics and supply chain managers worldwide.Objectives: The purpose of this article was to benchmark an in-house training programme in logistics management in the beverage industry of Zimbabwe with international best practice.Method: A case study approach was followed focusing on the programme curriculum, content and delivery. The article reports on the nature and effectiveness of the programme. The curriculum was benchmarked with skills requirements identified in literature. Relevance was evaluated based on participant perceptions over a period of 3 years using questionnaires with both closed- and open-ended questions.Results: Findings suggested that the programme offering is in line with international practice whilst it also addresses particular issues in Third World countries. Participants perceived the programme as being practical and valuable for enhancing their job performance and career development.Conclusion: The article provides a framework for evaluating logistics training programmes. Future research could include an evaluation that measures changes in on-the-job behaviour of participants.

  13. Applying e-health to case management.

    Science.gov (United States)

    Adams, J M

    2000-01-01

    The healthcare industry is only beginning to understand e-health. E-health can be defined as the use of technology to directly improve healthcare delivery-affording patients the opportunity to participate in their own healthcare management, provider, and institution. The market is changing rapidly, and innovations, partnerships, and mergers are taking place daily. For healthcare institutions, setting a long-term, yet adaptable e-health strategy is of vital importance for the continued success of the organization. For clinicians, an understanding of and familiarity with technologies can significantly improve workflow, organization, and patient interaction. For the patient, technology can be leveraged as a means to take initiative and responsibility for his/her own health. This article defines e-health and explains the implications and benefits of e-health to nurses and their patients. The article also identifies unique opportunities e-health/e-commerce can provide case managers in promoting patient connectivity, care management, and economy in cost of care.

  14. Ethical dilemmas among nurses as they transition to hospital case management: implications for organizational ethics, part I.

    Science.gov (United States)

    O'Donnell, Lolita T

    2007-01-01

    To describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute hospital setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice in case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between their obligations to the

  15. Ethical dilemmas among nurses as they transition to hospital case management: implications for organizational ethics, part II.

    Science.gov (United States)

    O'Donnell, Lolita T

    2007-01-01

    The purpose of this study was to describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute care setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice of case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between

  16. Leadership development and succession planning in case management.

    Science.gov (United States)

    Miodonski, Kathleen; Hines, Patricia

    2013-01-01

    The director of case management is one of health care's leadership positions most frequently in demand. The lack of qualified and effective case management leaders will continue to be an issue for organizations for years to come, influenced by increasing pressures on health care reimbursement and the aging case management workforce. Organizations have an opportunity to create a program to develop future case management leaders from their internal talent. The proposed strategies are designed for the acute care hospital but also have applicability in other health care settings where there are case managers and a need for case management leadership. The business community offers leadership research and leadership development models with relevance to case management. Identifying and developing internal talent for leadership roles has been proven to be effective in preparation for advanced responsibilities, has a positive effect on staff morale, and minimizes the impact of vacant leadership positions during recruitment and onboarding activities. Creating a case management leadership development program for an organization can be an alternative to the process of external recruitment for case management department leaders. Such a program can be undertaken even in today's budget conscious environment by accessing existing resources in an organization in a creative and organized manner. The authors outline an approach for case management leaders to accept responsibility for succession planning and for case managers to accept responsibility for promoting their own career development through creation of a leadership development program.

  17. Endoscopic management of massive mercury ingestion: A case report.

    Science.gov (United States)

    Zag, Levente; Berkes, Gábor; Takács, Irma F; Szepes, Attila; Szabó, István

    2017-06-01

    Ingestion of a massive amount of metallic mercury was thought to be harmless until the last century. After that, in a number of cases, mercury ingestion has been associated with appendicitis, impaired liver function, memory deficits, aspiration leading to pneumonitis and acute renal failure. Treatment includes gastric lavage, giving laxatives and chelating agents, but rapid removal of metallic mercury with gastroscopy has not been used. An 18-year-old man was admitted to our emergency department after drinking 1000 g of metallic mercury as a suicide attempt. Except from mild umbilical tenderness, he had no other symptoms. Radiography showed a metallic density in the area of the stomach. Gastroscopy was performed to remove the mercury. One large pool and several small droplets of mercury were removed from the stomach. Blood and urine mercury levels of the patient remained low during hospitalization. No symptoms of mercury intoxication developed during the follow-up period. Massive mercury ingestion may cause several symptoms, which can be prevented with prompt treatment. We used endoscopy to remove the mercury, which shortened the exposure time and minimized the risk of aspiration. This is the first case where endoscopy was used for the management of mercury ingestion.

  18. BOOK REVIEW: Case Studies in Knowledge Management

    Directory of Open Access Journals (Sweden)

    Reviewed by Dr. Adnan BOYACI

    2005-10-01

    Full Text Available 161Case Studies in Knowledge ManagementEdited by Murray JennexHersley: PA: Idea Group, 2005, pp. 372, ISBN 1-59140-352-9Reviewed by Dr. Adnan BOYACIAnadolu UniversityEskişehir-TurkeyKnowledge management (KM as a structured system and the way to the effectiveness isrelatively new field for the contemporary organizations functioning in different andcompetitive domain of public and private sectors in terms of getting optimal effectivenessunderlined by the concepts such as quality, productivity…etc. Because of the growingimportance and the popularity of the KM either as a research topic or specialized coursesubject, a crucial need for understanding, conceptualization and implementation of KM asa system has emerged since the mid 1990’s. In this sense, the book contributes criticallyto fill the gap between theory and implementation as a teaching material.This edited book is published by Idea Group Publishing. The book has twenty chaptersdivided into seven sections. In addition to a section of authors’ biography contributing thebook and an index, there is a preface that the basic terms and key concepts underliningthe cases discussed following chapters, which is explained in a schematized way.Besides the editor, total of 47 authors have contributed to the book. These authors arefrom different countries, academic backgrounds, and institutions. Although approximatelyone third of the authors are from USA, the rest of the authors are from Canada, England,Austria, Germany, Australia, New Zealand, Egypt, Bahrain and China. The authorsrepresent a variety of universities, private companies, and military institutions. Most ofthem have strong professional backgrounds, which help them address the issues bothfrom theoretical and practical perspectives. Contributions of authors having differentbackgrounds and institutions enable the book to have very comprehensive spectrum andthis makes the book attractive practically for those working different sectors

  19. Increased deep sleep in a medication-free, detoxified female offender with schizophrenia, alcoholism and a history of attempted homicide: case report.

    Science.gov (United States)

    Lindberg, Nina; Tani, Pekka; Takala, Pirjo; Sailas, Eila; Putkonen, Hanna; Eronen, Markku; Virkkunen, Matti

    2004-10-26

    Psychiatric sleep research has attempted to identify diagnostically sensitive and specific sleep patterns associated with particular disorders. Both schizophrenia and alcoholism are typically characterized by a severe sleep disturbance associated with decreased amounts of slow wave sleep, the physiologically significant, refreshing part of the sleep. Antisocial behaviour with severe aggression, on the contrary, has been reported to associate with increased deep sleep reflecting either specific brain pathology or a delay in the normal development of sleep patterns. The authors are not aware of previous sleep studies in patients with both schizophrenia and antisocial personality disorder. The aim of the present case-study was to characterize the sleep architecture of a violent, medication-free and detoxified female offender with schizophrenia, alcoholism and features of antisocial personality disorder using polysomnography. The controls consisted of three healthy, age-matched women with no history of physical violence. The offender's sleep architecture was otherwise very typical for patients with schizophrenia and/or alcoholism, but an extremely high amount of deep sleep was observed in her sleep recording. The finding strengthens the view that severe aggression is related to an abnormal sleep pattern with increased deep sleep. The authors were able to observe this phenomenon in an antisocially behaving, violent female offender with schizophrenia and alcohol dependence, the latter disorders previously reported to be associated with low levels of slow wave sleep. New studies are, however, needed to confirm and explain this preliminary finding.

  20. Attempted suicide in Vietnam

    OpenAIRE

    Tran Thi Thanh, Huong

    2006-01-01

    Suicide and attempted suicide is currently a major public health problem in rapidly developing countries but there are limited studies on this field in Asian countries. These are the first studies on suicidal behavior in Vietnam. The aim of the studies was to: 1) investigate the prevalence of suicide attempts, plans, ideation and medical attention following a suicide attempt in Vietnam and in nine other countries, 2) investigate the relation between lifetime suicidal tho...

  1. Young People's Risk of Suicide Attempts after Contact with a Psychiatric Department--A Nested Case-Control Design Using Danish Register Data

    Science.gov (United States)

    Christiansen, Erik; Larsen, Kim Juul

    2012-01-01

    Background: There seems to be an increased risk of children and adolescents committing or attempting suicide after contact with a psychiatric department. Children and adolescents living in families with low socio-economic status (SES) might have an especially increased suicide attempt risk. Methods: A complete extraction of Danish register data…

  2. Graves′ orbitopathy: Management of difficult cases

    Science.gov (United States)

    Wiersinga, Wilmar M.

    2012-01-01

    Management of Graves′ ophthalmopathy (GO) is based on three pillars: to stop smoking, to restore and maintain euthyroidism, and to treat the eye changes according to severity and activity of GO. Difficulties are frequently encountered in each of these three management issues. The advice to discontinue smoking is straightforward, but just a small minority of smokers is able to quit smoking. Detailed information on how smoking adversely affects the outcome of Graves′ disease may convince patients they have to stop smoking right away. Controversy exists on the most appropriate treatment of Graves′ hyperthyroidism in the presence of GO. 131I therapy is associated with a risk of about 15% for worsening of GO; a preventive course of steroids is indicated in the presence of risk factors (smoking, biochemically severe hyperthyroidism, high level of TSH receptor antibodies, active GO). Alternatives are thyroidectomy or long-term treatment with antithyroid drugs, which apparently are rather neutral with respect to the course of GO. Mild GO is not always perceived as being mild by the patients themselves. Selenium improves mild GO. Moderate-to-severe GO is preferably treated with intravenous methylprednisolone pulses, but serious side effects and relapsing GO do occur. After steroid failure combination therapy with low-dose oral prednisone with either cyclosporine or retrobulbar irradiation can be effective. Dysthyroid optic neuropathy is best treated with IV pulses, followed by orbital decompression if visual functions do not improve. In resistant cases, rituximab might be considered, although failures of this drug are also described. PMID:23565365

  3. 75 FR 23582 - Annular Casing Pressure Management for Offshore Wells

    Science.gov (United States)

    2010-05-04

    ... Recommended Practice (RP) 90. As explained in API RP 90, Section 3, Annular Casing Pressure Management Program... that are problematic. The management program, as outlined in API RP 90, includes monitoring, diagnostic.... * * * * * (h) * * * (78) API RP 90, Annular Casing Pressure Management for Offshore Wells, First Edition...

  4. Management of severe partial hypodontia: case report.

    Science.gov (United States)

    Caldo-Teixeira, Angela Scarparo; Puppin-Rontani, Regina Maria

    2003-01-01

    Hypodontia is characterized by partial or total congenital missing of one or more teeth, on one or both dentitions. Heredity is the main etiological factor and the principal clinical features are reduction on number, size and form of teeth, and late eruption. Removable partial prosthesis, fixed prosthesis, overdentures and adhesive prosthesis are alternative treatments; and the indication is type dependent. The aim of this study was to describe the clinical case of an eleven-year-old child with eight missing permanent teeth of idiopathic etiology. The patient had facial and skeletal symmetry, normal development and was not related to any syndrome. Clinical characteristics: permanent teeth with good periodontal conditions (16, 12, 11, 21, 22, 26, 36, 31, 42, 46), primary teeth (53, 63, 64, 73, 83); overbite and microdontia on teeth 12 and 22. The treatment plan was done initially by documenting of the case for teeth analysis (study casting models, periapicals and panoramic x-rays, and photographs), and followed by the exodontics of teeth 73 and 83. A removable appliance in autocured acrylic resin, using teeth in acrylic for maintenance of functional space and occlusion was planned and carried out. An anterior track for vertical dimension gain was used because of his accentuated overbite. The patient will be monitored until the end of the craniofacial growth, when it will be again evaluated and forwarded for the final oral rehabilitation. Hypodontia diagnosis and management should be performed as early as possible not to interfere with the craniofacial development of the child.

  5. Prehospital airway management: A prospective case study.

    Science.gov (United States)

    Wilbers, N E R; Hamaekers, A E W; Jansen, J; Wijering, S C; Thomas, O; Wilbers-van Rens, R; van Zundert, A A J

    2011-01-01

    We conducted a one-year prospective study involving a prehospital Emergency Medical Service in the Netherlands to investigate the incidence of failed or difficult prehospital endotracheal intubation. During the study period the paramedics were asked to fill in a registration questionnaire after every endotracheal intubation. Of the 26,271 patient contacts, 256 endotracheal intubations were performed by paramedics in one year. Endotracheal intubation failed in 12 patients (4.8%). In 12.0% of 249 patients, a Cormack and Lehane grade III laryngoscopy was reported and a grade IV laryngoscopy was reported in 10.4%. The average number of endotracheal intubations per paramedic in one year was 4.2 and varied from zero to a maximum of 12. The median time between arrival on the scene and a positive capnograph was 7 min.38 s in the case of a Cormack and Lehane grade I laryngoscopy and 14 min.58 s in the case of a Cormack and Lehane grade 4 laryngoscopy. The incidence of endotracheal intubations performed by Dutch paramedics in one year was low, but endotracheal intubation was successful in 95.2%, which is comparable with findings in international literature. Early capnography should be used consistently in prehospital airway management.

  6. Register for Suicide Attempts

    DEFF Research Database (Denmark)

    Christiansen, Erik; Jensen, Børge Frank

    2004-01-01

    The Register for Suicide Attempts (RSA) is a product of the WHO research project "WHO/Euro Multicentre Study on Parasuicide", which, among other things, had the purpose of collecting data on suicide attempts from 13 European countries. Data is collected in order to calculate trends and identify...

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

    Science.gov (United States)

    Huston, Carol J

    2002-01-01

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

  8. [When a Suicide Attempt is Kid's Stuff].

    Science.gov (United States)

    Vásquez-Rojas, Rafael; Quijano-Serrano, Margarita

    2013-01-01

    Attempted suicide in children and adolescents is a disturbing and painful issue for patients, their families and physicians. Current medical literature provides little information about minors who attempt suicide, possibly because there is under-reporting of this condition as a diagnosis, or maybe because it is sometimes considered as a way for the child to draw attention. To present the experience of the Department of Psychiatry (Universidad Nacional de Colombia) at the Hospital Infantil de La Misericordia, from 2003 to 2013. An observational retrospective study was conducted by reviewing 213 cases of children and adolescents treated for attempted suicide at the Hospital Infantil de La Misericordia from January 1, 2003 to October 31, 2013, and who received hospital or outpatient care in Child Psychiatry. A review was performed of the diagnosis, the number of suicide attempts, the peak months of consultation for this reason, and the methods selected, as well as a detailed description of the group of patients under 12 years old, and those managed with outpatient follow-up. The average patient is a female teenager who becomes intoxicated with drugs. Most often, patients do not return to outpatient follow-up. Those with follow-up have multiple psychopathologies and a high level of suffering. The most common methods, other than poisoning by drugs, are hanging and jumping from heights. Patients under 12 years old generally have their first attempt by drug poisoning. There is a predominance of anxiety disorder and depression, with a strong association with cognitive dysfunction, as a vulnerability factor. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  9. 34 CFR 303.23 - Service coordination (case management).

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Service coordination (case management). 303.23 Section... Service coordination (case management). (a) General. (1) As used in this part, except in § 303.12(d)(11... any other legislation that makes reference to “case management” services. See H.R. Rep. No. 198, 102d...

  10. The Woodworker's Website: A Project Management Case Study

    Science.gov (United States)

    Jance, Marsha

    2014-01-01

    A case study that focuses on building a website for a woodworking business is discussed. Project management and linear programming techniques can be used to determine the time required to complete the website project discussed in the case. This case can be assigned to students in an undergraduate or graduate decision modeling or management science…

  11. Assessing the Risk of Re-Offending for Juvenile Offenders Using the Youth Level of Service/Case Management Inventory

    Science.gov (United States)

    Bechtel, Kristin; Lowenkamp, Christopher T.; Latessa, Edward

    2007-01-01

    The purpose of the Youth Level of Service Case Management Inventory (YLS/CMI) is to assess, classify, and assist agencies with developing treatment and service plans according to the offender's criminogenic risk factors. Given the limited research in the predictive validity for this instrument, the current study attempts to examine this issue on a…

  12. Implementation of Network Leader Sponsored Supply Chain Management Systems: A Case Study of Supplier IT Business Value

    Science.gov (United States)

    Miller, Mark S.

    2010-01-01

    This qualitative multiple-case study was conducted to explore and understand how the implementation of required relationship-specific supply chain management system (SCMS) dictated by the network leader within a supplier network affects a supplier organization. The study, on a very broad sense, attempted to research the current validity of how the…

  13. Examining End-of-Life Case Management: Systematic Review

    Directory of Open Access Journals (Sweden)

    Roger E. Thomas

    2014-01-01

    Full Text Available Case management was initiated in the 1970s to reduce care discontinuity. A literature review focused on end-of-life (EOL case management identified 17 research articles, with content analysis revealing two themes: (a seeking to determine or establish the value of EOL case management and (b identifying ways to improve EOL case management. The evidence, although limited, suggests that EOL case management is helpful to dying individuals and their families. Research is needed to more clearly illustrate its usefulness or outcomes and the extent of need for it and actual availability. Among other benefits, EOL case management may help reduce hospital utilization, a major concern with the high cost of hospital-based care and the increased desire for home-based EOL care.

  14. Young people's risk of suicide attempts after contact with a psychiatric department - a nested case-control design using Danish register data

    DEFF Research Database (Denmark)

    Christiansen, Erik; Juul Larsen, Kim

    2012-01-01

    Background:  There seems to be an increased risk of children and adolescents committing or attempting suicide after contact with a psychiatric department. Children and adolescents living in families with low socio-economic status (SES) might have an especially increased suicide attempt risk. Meth...... influencing both vulnerability and resiliency, e.g., family level of SES, needs to be included in the assessment....

  15. Intensive case management for severe mental illness

    Science.gov (United States)

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

    2014-01-01

    Background Intensive Case Management (ICM) is a community based package of care, aiming to provide long term care for severely mentally ill people who do not require immediate admission. ICM evolved from two original community models of care, Assertive Community Treatment (ACT) and Case Management (CM), where ICM emphasises the importance of small caseload (less than 20) and high intensity input. Objectives To assess the effects of Intensive Case Management (caseload 20) and with standard community care in people with severe mental illness. To evaluate whether the effect of ICM on hospitalisation depends on its fidelity to the ACT model and on the setting. Search methods For the current update of this review we searched the Cochrane Schizophrenia Group Trials Register (February 2009), which is compiled by systematic searches of major databases, hand searches and conference proceedings. Selection criteria All relevant randomised clinical trials focusing on people with severe mental illness, aged 18 to 65 years and treated in the community-care setting, where Intensive Case Management, non-Intensive Case Management or standard care were compared. Outcomes such as service use, adverse effects, global state, social functioning, mental state, behaviour, quality of life, satisfaction and costs were sought. Data collection and analysis We extracted data independently. For binary outcomes we calculated relative risk (RR) and its 95% confidence interval (CI), on an intention-to-treat basis. For continuous data we estimated mean difference (MD) between groups and its 95% confidence interval (CI). We employed a random-effects model for analyses. We performed a random-effects meta-regression analysis to examine the association of the intervention’s fidelity to the ACT model and the rate of hospital use in the setting where the trial was conducted with the treatment effect. Main results We included 38 trials (7328 participants) in this review. The trials provided data for two

  16. Knowledge Management Analysis: A Case Study

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

    Tayal, Sarup

    2016-02-01

    A case report of a pregnant woman with recalcitrant Trichomonas vaginalis is described. This case was managed with suppressive treatment with metronidazole during pregnancy and cleared with paromomycin vaginal treatment after delivery. © The Author(s) 2015.

  18. Management dilemma of cholecysto-colonic fistula: Case report

    Directory of Open Access Journals (Sweden)

    Waleed Gibreel

    2018-01-01

    Conclusion: Based on our experience with this particular case, we could safely conclude that an operation for cholecystocolonic fistula presence in the setting of biliary obstruction that failed decompressive attempts should be performed in an urgent fashion to avoid biliary sepsis development.

  19. Socio-Demographic, Clinical and Behavioral Characteristics Associated with a History of Suicide Attempts among Psychiatric Outpatients: A Case Control Study in a Northern Mexican City.

    Science.gov (United States)

    Alvarado-Esquivel, Cosme; Sánchez-Anguiano, Luis Francisco; Arnaud-Gil, Carlos Alberto; Hernández-Tinoco, Jesús; Molina-Espinoza, Luis Fernando; Rábago-Sánchez, Elizabeth

    2014-03-01

    Little is known about the epidemiology of suicide attempts among psychiatric outpatients in Mexico. This study was aimed to determine the socio-demographic, clinical and behavioral characteristics associated with suicide attempts in psychiatric outpatients in two public hospitals in Durango, Mexico. Two hundred seventy six psychiatric outpatients (154 suicide attempters and 122 patients without suicide attempt history) attended the two public hospitals in Durango City, Mexico were included in this study. Socio-demographic, clinical and behavioral characteristics were obtained retrospectively from all outpatients and compared in relation to the presence or absence of suicide attempt history. Increased prevalence of suicide attempts was associated with mental and behavioral disorders due to psychoactive substance use (F10-19) (P=0.01), schizophrenia, schizotypal and delusional disorders (F20-29) (P=0.02), mood (affective) disorders (F30-39) (Pattempts were associated with young age (OR=1.21, 95% CI: 1.06-1.39; P=0.003), female gender (OR=2.98, 95% CI: 1.55-5.73; P=0.001), urban residence (OR=2.31, 95% CI: 1.17-4.57; P=0.01), memory impairment (OR=1.91, 95% CI: 1.07-3.40; P=0.02), alcohol consumption (OR=2.39, 95% CI: 1.21-4.70; P=0.01), and sexual promiscuity (OR=3.90, 95% CI: 1.74-8.77; Pattempts with socio-demographic, clinical and behavioral characteristics in psychiatric outpatients in Mexico. Results may be useful for an optimal planning of preventive measures against suicide attempts in psychiatric outpatients.

  20. Serious Suicide Attempts.

    Science.gov (United States)

    Levi-Belz, Yossi; Beautrais, Annette

    2016-07-01

    Suicidal behavior comprises a diverse set of behaviors with significant differences among several behavioral categories. One noteworthy category includes individuals who have made serious suicide attempts, epidemiologically very similar to those completing suicide. This behavioral category is important, since interviewing survivors of a potentially lethal incident of self-harm enables a detailed investigation of the psychological process leading to the suicidal act. To achieve a consensus definition and operational criteria of serious suicide attempts. We reviewed studies that included the term serious suicide attempt or related terms (e.g., highly lethal), with a focus on the variety of operational criteria employed across studies. More than 60 papers addressing various types of serious suicide attempt were explored. We found a large variety of operational definitions, reflecting the lack of consensus regarding terminology and criteria related to the term. We undertook the challenge of developing an integrative and comprehensive set of criteria of serious suicide attempt and suggest a definition comprising three key dimensions: medical lethality, potential lethality of the method used, and severity of the objective circumstances of the suicide intent. Clinicians and researchers are strongly encouraged to consider using the term serious suicide attempt with its attendant components.

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

    Science.gov (United States)

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

    1999-01-01

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

  2. Characteristics of attempted suicide by patients with schizophrenia compared with those with mood disorders: a case-controlled study in northern Japan.

    Directory of Open Access Journals (Sweden)

    Takao Ishii

    Full Text Available Recent reports suggest a lifetime suicide risk for schizophrenia patients of approximately 5%. This figure is significantly higher than the general population suicide risk consequently, detection of those at risk is clinically important. This study was undertaken to define the characteristics of suicide attempts by schizophrenia patients compared with attempts by patients with mood disorders. All patients were diagnosed using the ICD-10 criteria. The study population comprised 65 patients with F2 disorders (schizophrenia, schizotypal and delusional disorders, i.e., "the F2 group", and 94 patients with F3 disorders (mood disorders, i.e., "the F3 group", who presented in the clinical setting of consultation-liaison psychiatry. The F2 group had a significantly younger mean age and significantly higher ratios of 'past/present psychiatric treatment' and 'more than 3 months interruption of psychiatric treatment'. In contrast, the ratios of 'physical disorder comorbidity', 'alcohol intake at suicide attempt' and 'suicide note left behind' were significantly higher in the F3 group. The F2 group attempted suicide by significantly more serious methods. Furthermore, 'hallucination-delusion' was the most prevalent motive in the F2 group and was the only factor that showed a significant association with the seriousness of the method of suicide attempt (OR = 3.36, 95% CI: 1.05-11.33.

  3. Managing a complex case of hypospadias cripple and chordee

    Directory of Open Access Journals (Sweden)

    Costin Gingu

    2017-11-01

    Full Text Available Objectives. Hypospadias is a congenital affliction in which the urethral meatus is located on the underside of the penis. These cases are usually treated during childhood by pediatric surgeons, but more complex forms tend to reoccur, and after several failed attempts end up as hypospadias cripple in the care of urologists at an adult age. The aim of this paper is to present the management of a complex case of hypospadias cripple associated with penile curvature (chordee. Materials and Methods. A 24 year old patient presented in our clinic with hypospadias cripple and ventral penile curvature. At the physical examination we found a penoscrotal urethral meatus, heavy scaring of the distal ventral penis and a ventral chordee of approximately 90 degrees in erect state. A two stage “Bracka” repair technique with buccal mucosa graft was chosen. The first stage of the surgery consisted of removing the scarred and defective distal urethral plate and the fibrotic tissue responsible for the penile curvature, preparing the corpora cavernosa for the graft, clefting the glans, harvesting two buccal mucosa grafts from both inner cheeks, and finally quilting the grafts on the defect. The second stage of the repair was performed after a period of about six months, and consisted in the tubularization of the matured graft and glans plasty. Results and Conclusions. No immediate or late complications occurred after any of the two stages of the surgery; no significant ventral chordee was observed and no urethral fistula occurred till the one year follow-up. A two stage “Bracka” repair technique is best suited for treating these patients, correcting ventral chordee in the first session.

  4. Register for Suicide Attempts.

    Science.gov (United States)

    Christiansen, Erik; Jensen, Børge Frank

    2004-11-01

    The Register for Suicide Attempts (RSA) is a product of the WHO research project "WHO/Euro Multicentre Study on Parasuicide", which, among other things, had the purpose of collecting data on suicide attempts from 13 European countries. Data is collected in order to calculate trends and identify high-risk groups. Data collection for the RSA started in 1989. The RSA is a longitudinal, person-based register. It contains information about people who have been in contact with the health care system in the County of Funen as a result of a suicide. The RSA contains 11 variables, which describe the incident in detail, and a number of variables describing the person. The RSA contains data covering the period April 1989 to December 2001 and is updated annually. Data is collected from somatic and psychiatric hospitals in an administrative district (County of Funen). The data collection is done manually by going through all the records in which a contact to the health care system, i.e. a potential suicide attempt, is described. Only incidents matching the WHO definition of an attempted suicide are registered. Data from the RSA has been used in national and international studies. The RSA is the most suitable register in Denmark for analyses of suicide attempts.

  5. Factors facilitating dementia case management: results of online focus groups.

    NARCIS (Netherlands)

    Lange, J. de; Deusing, E.; Asch, I.F. van; Peeters, J.; Zwaanswijk, M.; Pot, A.M.; Francke, A.L.

    2016-01-01

    To obtain insight into facilitating factors for case management in dementia care, we conducted a qualitative study with 13 online focus groups (OFGs). Participants were professionals involved in dementia case management (N = 99). We used mind-maps and the method of constant comparison for analysis.

  6. Management of Pulmonary Tuberculosis- A Family Case Study ...

    African Journals Online (AJOL)

    Family medicine tools including the Family circle, Family life cycle, Home visits and Family counseling were used in the management of this case. This case emphasizes the need for a thorough contact tracing, family involvement in care, home visits and individualization in the management of pulmonary tuberculosis.

  7. The emergency management of a rape case in a nutshell ...

    African Journals Online (AJOL)

    The management of a rape case in the emergency department is shrouded in an unacceptable level of lack of confidence. Since South Africa has a high incidence of rape, the contribution of health practitioners in addressing the crime successfully is essential. The medical management of such cases carries a high level of ...

  8. Factors facilitating dementia case management : Results of online focus groups

    NARCIS (Netherlands)

    Dr. J. de Lange; E. Deusing; I.F.M. van Asch; J. Peeters; M. Zwaanswijk; A.M. Pot; A.L. Francke

    2016-01-01

    To obtain insight into facilitating factors for case management in dementia care, we conducted a qualitative study with 13 online focus groups (OFGs). Participants were professionals involved in dementia case management (N = 99). We used mind-maps and the method of constant comparison for analysis.

  9. A Database of Systems Management Cases

    Science.gov (United States)

    1990-09-01

    research was based on a case writing methodology espoused by Leenders and Erskine in their book entitled Case Research: The Case Writing Process. Three...Leenders and Erskine (18:2), was used to collect data and generate the desired case studies. This method involved conducting personal interviews and...a result of these pressures, in January 1979 "the leaders of Britain, France , Germany, and the United States agreed to President Carter’s proposal to

  10. Professional relationships and power dynamics between urban community-based nurses and social work case managers: advocacy in action.

    Science.gov (United States)

    Young, Staci

    2009-01-01

    The purpose of this study was to explore how community-based case managers interface with their clients' healthcare providers and other community organizations as a function within their advocacy efforts. Case managers previously defined advocacy as occurring at individual, organizational, and community levels. The relationships they attempt to develop and maintain are consistent with case management ideology, yet this is a complex process to ensure care for vulnerable populations with many medical and socioeconomic needs. Community-based case management settings. In-depth qualitative interviews with a total of 20 nurse and social work case managers working in public housing, university-affiliated community nursing centers, local parishes, and community ministry. The case managers in this study reflected on how they interface with their clients, other healthcare providers, and community organizations on behalf of their clients. They reflect on the importance of trust and communication to facilitate this process. The advocacy work of case managers is influenced by the setting, others' perceptions of their knowledge and expertise, and power dynamics. Their ability to effectively advocate is greatly influenced by the strength of the relationships they forge. Advocacy for vulnerable clients is influenced by the existing relationship between case managers and their clients' healthcare providers. Case managers need to be persistent in their interactions with other providers to ensure that their clients have access to valuable community resources. Clear lines of communication should be established between case managers so that there is clarity around roles and expectations in service provision. Case managers should also participate in the mentoring of future health professions students so they may learn the application of advocacy work in community settings.

  11. Pain management: screening and assessment of pain as part of a comprehensive case management process.

    Science.gov (United States)

    Carter, Jolynne Jo; Watson, Annette C; Sminkey, Patrice V

    2014-01-01

    Pain management, episodic and chronic, is a major issue in health care today, affecting more than 76 million people across care-delivery settings from acute care to rehabilitation, workers' compensation to primary care. As a result, professional case managers occupy an important role within an interdisciplinary care team to address pain as part of a comprehensive case management process, from intake and assessment through care delivery and transitions of care. Pain management, as part of the comprehensive case management process, is applicable across the case management spectrum, including hospitals, accountable care organizations, patient-centered medical homes, physician practices, clinics, occupational health clinics, workers' compensation, and other settings in which case managers work with clients and their support systems. The prevalence of pain across the care continuum, affecting individuals at various stages of an individual's lifecycle, raises the importance of acute and chronic pain assessments as part of the overall case assessment. In addition to screening for pain, case management assessments must look for signs of depression, as well as the potential for abuse/misuse of opioid medications, which is an alarming public health threat. Given their clinical expertise, their roles as advocates, their ability to conduct a comprehensive client/patient assessment, and their expertise in using tools such as motivational interviewing, professional case managers-and particularly those who are board certified-occupy a central role in pain management as part of a patient-centered approach. Case managers must understand the impact of both pain and pain medications on the client's daily functions, from a health and safety perspective. Pain management should be examined through the lens of professional case management, and what a competent case manager can do to advocate for clients who are experiencing pain, whether acute or chronic, while facilitating the sharing

  12. Value adding management: A concept and a case

    DEFF Research Database (Denmark)

    Jensen, Per Anker; Katchamart, Akarapong

    2012-01-01

    Purpose: To develop a management concept that can assist facilities managers in implementing value adding strategies and practices. The FM Value Map has been developed to analyse and demonstrate the different ways FM can add value. However, there is a need to develop management tools that can...... be used more directly and proactively by facilities managers to implement adding value strategies and practices. Methodology: The development of the concept of Value Adding Management is based on the management model for FM included in the European FM standards, recent theories on added value of FM...... and real estate and the related concept of Value Management from building projects. The chapter outlines a preliminary theoretical based management concept, which is investigated, tested and discussed based on a case study of LEGO. Findings: The case study provides a clear example of a company that actual...

  13. Metropolitan transportation management center : a case study : COMPASS : effectively managing traffic and incidents

    Science.gov (United States)

    1999-10-01

    The following case study provides a snapshot of the Downsview, Ontario transportation management center. It follows the outline provided in the companion document, Metropolitan Transportation Management Center Concepts of Operation - A Cross Cutting ...

  14. Privileged Emotion Managers: The Case of Actors

    Science.gov (United States)

    Orzechowicz, David

    2008-01-01

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

  15. Interdependency Management in Universities: A Case Study

    Science.gov (United States)

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

    2015-01-01

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

  16. 75 FR 16486 - Proposed Comment Request for Review of ACF Disaster Case Management Implementation Guide; Office...

    Science.gov (United States)

    2010-04-01

    ... Disaster Case Management Implementation Guide; Office of Human Services Emergency Preparedness and Response... on the ACF Disaster Case Management Implementation Guide, dated December 2009. Disaster case... ] status while respecting human dignity. If necessary, Disaster case management helps transition the client...

  17. Case series of females charged with murder or attempted murder of minors and referred to Weskoppies Hospital in terms of the Criminal Procedure Act over a period of 21 years

    Directory of Open Access Journals (Sweden)

    Kwena B. Khoele

    2016-05-01

    Full Text Available Women charged with murder or attempted murders of children are usually sent for forensic psychiatric evaluation. In South Africa research and literature on this population is scarce. A case series was studied of forensic files of 32 females charged with murder or attempted murder of children. These files contained information of such females. The forensic psychiatric observation was mainly to establish whether a psychiatric diagnosis could be made, and whether they were triable and accountable. Files from 01 Jan 1990 to 31 Dec 2010 (21 years were obtained of cases observed in Weskoppies Hospital. The aim of describing these case series was to attempt to find a psychiatric profile of such cases, as well as to find other information e.g. Demographics. The findings, after forensic observation regarding their ability to follow court proceedings and their ability to contribute meaningfully to their defence (triability as well as their ability to distinguish between right and wrong, and their ability to act in accordance with the said appreciation (accountability at the time of the alleged offence were also reported. This information could contribute to make medical practitioners and mental health care workers aware of risk factors involving such cases and to encourage them to enquire about these risk factors.

  18. Management: Theory and Practice, and Cases

    OpenAIRE

    Richard L. Nolan

    2013-01-01

    This working paper reports on a major Harvard Business School project designed to enhance MBA and practicing executives in case learning. The work is built on the foundation of HBS field cases employing the monomyth "hero's journey" classic story structure along with the creation of associated fictional case characters designed to engage readers in the dimensions of human behavior, decision-making, and judgments in carrying out the work of the modern corporation. A most fortuitous event in st...

  19. Applications of comparative effectiveness research to case management.

    Science.gov (United States)

    Moreo, Kathleen; Greene, Laurence; Sapir, Tamar; Cameron, Davecia R

    2013-01-01

    This article is intended to update case managers on recent advances in comparative effectiveness research (CER) led by the Agency for Healthcare Research and Quality. The article explores potential implications and applications of CER findings to case management practice. All case management settings. An ongoing national movement to advance CER is intended to provide health care professionals with answers to questions about which diagnostic methods, therapies, devices, and services, among the available alternatives for a given disease or condition, may be most effective and safe for individual patients. Knowledge and application of CER findings may benefit case managers in their roles of improving resource utilization, controlling costs, providing stewardship, coordinating care, educating patients, and promoting treatment adherence and self-sufficiency. The findings from a 2013 study on the comparative effectiveness of outpatient case management programs have implications for improving case management models, reinforcing standards in the profession, and advancing research in the field. Continuing education on CER is important for promoting positive values and appropriate applications of its findings to case management practice.

  20. Adaptive Ecosystem Management in the Pacific Northwest: a Case Study from Coastal Oregon

    Directory of Open Access Journals (Sweden)

    Andrew N. Gray

    2000-12-01

    Full Text Available Adaptive ecosystem management has been adopted as a goal for decision making by several of the land management and regulatory agencies of the U.S. government. One of the first attempts to implement ecosystem management was undertaken on the federally managed forests of the Pacific Northwest in 1994. In addition to a network of reserve areas intended to restore habitat for late-successional terrestrial and aquatic species, "adaptive management areas" (AMAs were established. These AMAs were intended to be focal areas for implementing innovative methods of ecological conservation and restoration and meeting economic and social goals. This paper analyzes the primary ecological, social, and institutional issues of concern to one AMA in the Coast Range in northern Oregon. Based on existing knowledge, several divergent approaches are available that could meet ecological goals, but these approaches differ greatly in their social and economic implications. In particular, approaches that rely on the natural succession of the existing landscape or attempt to recreate historical patterns may not meet ecosystem goals for restoration as readily as an approach based on the active manipulation of existing structure and composition. In addition, institutions are still adjusting to recent changes in management priorities. Although some innovative projects have been developed, adaptive management in its most rigorous sense is still in its infancy. Indeed, functional social networks that support adaptive management may be required before policy and scientific innovations can be realized. The obstacles to adaptive management in this case are similar to those encountered by other efforts of this type, but the solutions will probably have to be local and idiosyncratic to be effective.

  1. Childhood suicide attempts with acetaminophen in Denmark

    DEFF Research Database (Denmark)

    Hedeland, Rikke; Jørgensen, Marianne H; Teilmann, Grete

    2013-01-01

    attempts. (3) The frequency of self-mutilation among children with suicidal behaviour. (4) The purposes and reasons for childhood suicide attempts. Methods: A retrospective case-control study based on medical records and in-hospital child psychiatric assessments at the Paediatric Department, Hillerød...

  2. The characteristics, management, and aftercare of patients with suicide attempts who attended the emergency department of a general hospital in northern Taiwan

    Directory of Open Access Journals (Sweden)

    Chen-Ju Lin

    2014-06-01

    Conclusion: Individuals who harmed themselves had a high rate of psychiatric morbidity and interpersonal problems. However, their adherence to psychiatric outpatient aftercare was low. Improved identification of the needs of patients with suicidal tendencies who did not attend outpatient services will have implications for future services provided to this patient population, and will better enable medical personnel to most effectively assist in suicide attempt interventions.

  3. The Case for Software Health Management

    Data.gov (United States)

    National Aeronautics and Space Administration — Software Health Management (SWHM) is a new field that is concerned with the development of tools and technologies to enable automated detection, diagnosis,...

  4. Mineral scale management. Part 1, Case studies

    Science.gov (United States)

    Peter W. Hart; Alan W. Rudie

    2006-01-01

    Mineral scale increases operating costs, extends downtime, and increases maintenance requirements. This paper presents several successful case studies detailing how mills have eliminated scale. Cases presented include calcium carbonate scale in a white liquor strainer, calcium oxalate scale in the D0 stage of the bleach plant, enzymatic treatment of brown stock to...

  5. A case study on the successful management of Cotard's syndrome in pregnancy: Case Reports.

    Science.gov (United States)

    Howe, G; Srinivasan, M

    1999-01-01

    Cotard's Syndrome is rare and no cases have been reported in pregnancy. We describe a case of a woman in the third trimester who attempted suicide by jumping out of a window, sustaining multiple fractures. Delivery of her baby by Caesarean section and orthopaedic intervention was necessary before electroconvulsive therapy (ECT) could be administered, resulting in a successful outcome for both mother and child. (Int J Psych Clin Pract 1999; 3: 293-295).

  6. Managing change in educational organizations: managing and leading higher education in an era of change in Greece. Case study: University of Indianapolis, Athens.

    OpenAIRE

    Kiritsis, Vasilios James

    2009-01-01

    This project attempts to contribute to the field of education, by presenting and analysing change and its management and how change has affected the operations of a foreign University branch. It describes a set of recommendations that will aid the case organization (University of Indianapolis Athens - UIA) and consequently educational organizations / institutions, in listing the various challenges affecting education and their operations in the 21st century. It is argued that identifying thes...

  7. Intercultural Management Cases for the Business Language Class

    OpenAIRE

    Grosse, Christine Uber

    2012-01-01

    This article explores the use of intercultural management cases as alternative instructional materials in business language courses. These cases use the power of story to teach about successful global leaders who effectively lead across cultures. As the cases engage and inform business language students, they also serve as a valuable resource for teaching language, communication, and culture. Additionally, the cases develop situation analysis and problemsolving skills. Three prominent CEOs se...

  8. Community case management improves use of treatment for ...

    African Journals Online (AJOL)

    Community case management improves use of treatment for childhood diarrhea, malaria and pneumonia in a remote district of Ethiopia. T Degefie, D Marsh, A Gebremariam, W Tefera, G Osborn, K Waltensperger ...

  9. Management of congestive heart failure (CHF): a case report on ...

    African Journals Online (AJOL)

    Abstract. A case report on the management of Congestive Heart Failure is presented with emphasis on the use of DIGOXIN. Keywords: Congestive heart failure, Failing heart syndrome, Digoxin, Digoxin Toxicity ...

  10. Organizational diversity and disability management: Dutch cases

    NARCIS (Netherlands)

    Kopnina, H.; Haafkens, J.

    2009-01-01

    Recent EU initiatives promote employability of the growing number of the chronically ill and disabled employees. While HRM professionals and managers could play a significant role in the prevention of job-related problems and in promotion of early job-continuation, the chronically ill remain largely

  11. Knowledge Management for Sustainable Development: The Case ...

    African Journals Online (AJOL)

    This paper seeks to demonstrate that knowledge management (KM) is a function of sustainable development (SD). The authors define the two concepts and discuss both the factors that make for successful SD process and the challenges that characterize KM. The conclusion reached is hat KM is emerging as a powerful ...

  12. ANAESTHESIA MANAGEMENT OF CSF RHINORRHEA REPAIR : A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Kirti Arvind

    2015-09-01

    Full Text Available Anaesthesiologist plays a major role in Cerebrospinal Fluid (CSF rhinorrhea repair surgery as the prognosis of which is dependent on provision of clear bloodless surgical field and surgeons satisfaction. Anaesthesiologist also plays vital role in the management of CSF Lumbar drain. This case highlights the importance of hypotensive anaesthesia during endoscopic repair of a case of spontaneous CSF Rhinorrhea with successful perioperative management of Lumbar drainage of CSF

  13. Case management for persons with substance use disorders

    DEFF Research Database (Denmark)

    Hesse, Morten; Vanderplasschen, Wouter; Rapp, Richard

    2007-01-01

    Background Patients with alcohol and other drug use disorders (AOD) frequently have multiple social, physical, and mental health treatment needs, yet have difficulty accessing community services, including drug abuse treatment.  One strategy for linking patients with AOD with relevant services......). Reference searching; personal communication; conference abstracts; book chapters on case management. Selection criteria Randomized controlled studies that compared a specific model of case management with either treatment as usual or another treatment model, included only patients with at least one alcohol...

  14. Dynamic Condition Response Graphs for Trustworthy Adaptive Case Management

    DEFF Research Database (Denmark)

    Mukkamala, Raghava Rao; Hildebrandt, Thomas; Slaats, Tijs

    2013-01-01

    By trustworthy adaptive case management we mean that it should be possible to adapt processes and goals at runtime while guaranteeing that no deadlocks and livelocks are introduced. We propose to support this by applying a formal declarative process model, DCR Graphs, and exemplify its operationa...... specified either as linear time logic (LTL) or DCR Graphs, extend the language with time and data and offer extended support for cross-organizational case management systems....

  15. Management of dental implant fractures. A case history.

    Science.gov (United States)

    Al Quran, Firas A M; Rashan, Bashar A; Al-Dwairi, Ziad N

    2009-01-01

    The widespread use of endosseous osseointegrated implants to replace missing natural teeth increases the chances of implant complications and failures, despite the high initial success rate reported in the literature. Implant fracture is one possible complication that results in ultimate failure of the dental implant. Such a complication poses a management crisis even for the most experienced clinician. This article reports on a case of implant fracture, its possible causes, and how the case was managed.

  16. Congenital eversion of upper eyelids: Case report and management

    Directory of Open Access Journals (Sweden)

    Maheshwari Rajat

    2006-01-01

    Full Text Available Congenital eversion of the upper eyelids is a rare condition, the exact cause of which remains unknown. It is more frequently associated with Down′s syndrome and black babies. If diagnosed early and treated properly, the condition can be managed without surgery. We report a case of congenital bilateral severe upper eyelid eversion in a normal infant, born by vaginal delivery. The case was conservatively managed by lubricants, antibiotics and eyelid patching.

  17. Human capital management in a knowledge economy: The case of ...

    African Journals Online (AJOL)

    This research aims to examine the existence of the human capital management through competencies and knowledge management approach in Scientific Research Centers within knowledge based economy. The study was applied to the case of Scientific Research Centers in Algeria, such as: (CREAD, CRSTRA, CDTA, ...

  18. The management of traumatic ankylosis during orthodontics: a case report.

    LENUS (Irish Health Repository)

    McNamara, T G

    2000-01-01

    Dental ankylosis may be a significant complication in orthodontic clinical practice. This case report describes the management of a malocclusion, complicated by an ankylosed maxillary central incisor, which arose during orthodontic treatment, following an acute traumatic injury. The use of the ankylosed incisor in successfully managing the significant Class II division 1 malocclusion is described.

  19. Strategic management in institutions of higher learning: the case of ...

    African Journals Online (AJOL)

    The strategic perspective in which an institution of higher learning is managed aims at ensuring that clear goals and objectives are specified by moving away from routine traditional orientation to management by considering in a systematic way, longer–term considerations of the very future of the institution. In the case of a ...

  20. Data management for genomic mapping applications: A case study

    Energy Technology Data Exchange (ETDEWEB)

    Markowitz, V.M.; Lewis, S.; McCarthy, J.; Olken, F.; Zorn, M.

    1992-05-01

    In this paper we describe a new approach to the construction of data management systems for genomic mapping applications in molecular biology, genetics, and plant breeding. We discuss the architecture of such systems and propose an incremental approach to the development of such systems. We illustrate the proposed approach and architecture with a case study of a prototype data management system for genomic maps.

  1. Improvement of Human Resource Management CASE: Okey markets

    OpenAIRE

    Bogdanov, Yury

    2015-01-01

    The target of this project is to analyse human resource management focusing on the case of an existing company, "OKEY" and find out how improve human resource management and how it could be possible to implement it in this company. In this work I have used web resources and information from the company together with an interview.

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

    Science.gov (United States)

    Graham, Andrew T.

    2016-01-01

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

  3. The management of premolar supernumeraries in three orthodontic cases.

    LENUS (Irish Health Repository)

    McNamara, C M

    1997-01-01

    This paper reviews the incidence, etiology and location of supernumerary teeth with emphasis on premolar supernumeraries and examines the management of supernumerary premolars of three patients undergoing orthodontics. These cases demonstrate that the management of premolars is assessed individually and treatments based on potential complications, which may occur during the orthodontic and surgical management of the dentition. Progress and posttreatment radiographs are recommended for the assessment of late forming supernumerary teeth.

  4. Project management: a case study in construction industry

    OpenAIRE

    Kömürcü, Ahmet Murat

    1996-01-01

    Ankara : The Faculty of Management and the Graduate School of Business Administration of Bilkent University, 1996. Thesis (Master's) -- Bilkent University, 1996. Includes bibliographical references leaves 55-56 One of the application areas that project management can effectively be applied is the construction industry. In this thesis, a case study is carried out in order to point out the importance and essentiality of project management, especially project scheduling and control. For...

  5. An Attempt at Quantifying Factors that Affect Efficiency in the Management of Solid Waste Produced by Commercial Businesses in the City of Tshwane, South Africa

    National Research Council Canada - National Science Library

    Worku, Yohannes; Muchie, Mammo

    2012-01-01

      Objective. The objective was to investigate factors that affect the efficient management of solid waste produced by commercial businesses operating in the city of Pretoria, South Africa. Methods...

  6. Between Taylor and the Catholic Action. The scientific management and the attempt to re-Christianize labor in Portugal (1945-1974)

    National Research Council Canada - National Science Library

    Ana Carina Azevedo

    2015-01-01

    While analyzing the period of greater affirmation of scientific management in Portugal, it began to become clear the presence of a generation of technicians linked to the Catholic Action and its youth...

  7. Social Customer Relationship Management: A Case Study

    OpenAIRE

    Paliouras Konstantinos; Siakas Kerstin V.

    2017-01-01

    Social Customer Relationships Management (CRM) is a current business trend providing new channels of two-way communication with customers through social media sites, such as Facebook, Twitter etc. Social CRM enables companies to interact in an easy and contemporary way directly with customers as well as to track customer interactions and their social influence. In this paper we examine the importance of CRM, e-CRM and Social CRM for businesses. We provide perspectives on objectives and types ...

  8. Power Transformer Asset Management - Pracana Case Study

    OpenAIRE

    Miguel Sérgio Vieira Correia Soares

    2017-01-01

    The power transformers comprise a great investment.The owners of this type of asset have a growing demand to extend the life of their transformer fleets. In this work, an analysis of the asset management and associated norms is made.In addition, power transformers are analyzed and their key parameters as well as the existing monitoring techniques and systems.A comparative analysis is made between health index calculation models that allow the evaluation of the condition of a power transformer...

  9. An attempt at quantifying factors that affect efficiency in the management of solid waste produced by commercial businesses in the city of Tshwane, South Africa.

    Science.gov (United States)

    Worku, Yohannes; Muchie, Mammo

    2012-01-01

    The objective was to investigate factors that affect the efficient management of solid waste produced by commercial businesses operating in the city of Pretoria, South Africa. Data was gathered from 1,034 businesses. Efficiency in solid waste management was assessed by using a structural time-based model designed for evaluating efficiency as a function of the length of time required to manage waste. Data analysis was performed using statistical procedures such as frequency tables, Pearson's chi-square tests of association, and binary logistic regression analysis. Odds ratios estimated from logistic regression analysis were used for identifying key factors that affect efficiency in the proper disposal of waste. The study showed that 857 of the 1,034 businesses selected for the study (83%) were found to be efficient enough with regards to the proper collection and disposal of solid waste. Based on odds ratios estimated from binary logistic regression analysis, efficiency in the proper management of solid waste was significantly influenced by 4 predictor variables. These 4 influential predictor variables are lack of adherence to waste management regulations, wrong perception, failure to provide customers with enough trash cans, and operation of businesses by employed managers, in a decreasing order of importance.

  10. An Attempt at Quantifying Factors that Affect Efficiency in the Management of Solid Waste Produced by Commercial Businesses in the City of Tshwane, South Africa

    Directory of Open Access Journals (Sweden)

    Yohannes Worku

    2012-01-01

    Full Text Available Objective. The objective was to investigate factors that affect the efficient management of solid waste produced by commercial businesses operating in the city of Pretoria, South Africa. Methods. Data was gathered from 1,034 businesses. Efficiency in solid waste management was assessed by using a structural time-based model designed for evaluating efficiency as a function of the length of time required to manage waste. Data analysis was performed using statistical procedures such as frequency tables, Pearson’s chi-square tests of association, and binary logistic regression analysis. Odds ratios estimated from logistic regression analysis were used for identifying key factors that affect efficiency in the proper disposal of waste. Results. The study showed that 857 of the 1,034 businesses selected for the study (83% were found to be efficient enough with regards to the proper collection and disposal of solid waste. Based on odds ratios estimated from binary logistic regression analysis, efficiency in the proper management of solid waste was significantly influenced by 4 predictor variables. These 4 influential predictor variables are lack of adherence to waste management regulations, wrong perception, failure to provide customers with enough trash cans, and operation of businesses by employed managers, in a decreasing order of importance.

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

    Science.gov (United States)

    Bonaiuto, Maria M.

    2007-01-01

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

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

    Science.gov (United States)

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

    2006-01-01

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

  13. Economic assessment of managing processionary moth in pine forests: a case-study in Portugal.

    Science.gov (United States)

    Gatto, Paola; Zocca, Alessia; Battisti, Andrea; Barrento, Maria João; Branco, Manuela; Paiva, Maria Rosa

    2009-02-01

    This paper assesses the private and social profitability of current strategies for managing processionary moth (Thaumetopoea pityocampa) in Portuguese pine forests, looking at economic and environmental costs and benefits. Costs include the expenses for forest treatment and the social costs of threats to human health (dermatitis amongst others); benefits are assessed in terms of both revenue and social benefits such as carbon fixation and recreation. The evaluation was done using Cost Benefit Analysis (CBA) as an analytical framework. While this tool is currently applied to forest and environmental assessment and specific applications to pest management strategies are to be found in agricultural economics, rather few attempts have been made in the field of forest pest management. In order to assess and compare with--without options, a case-study was analysed for the Setúbal Peninsula, south of Lisbon, an area where extensive stands of maritime pine (Pinus pinaster) grow. The exercise has shown that CBA can be a valuable tool for assessing the economic and social profitability of pest management. The results demonstrate that the loss of revenues in the no-management option is not sufficient to make pest management profitable for private forest owners in the short-term. Conversely, a social profit is gained as pest management minimizes health risks for humans and avoids possible recreational losses.

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

    Science.gov (United States)

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

    2011-08-01

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

  15. Diagnosing swine flu: the inaccuracy of case definitions during the 2009 pandemic, an attempt at refinement, and the implications for future planning

    National Research Council Canada - National Science Library

    Mahony, Andrew A; Cheng, Allen C; Olsen, Karen L; Aboltins, Craig A; Black, James F. P; Johnson, Paul D. R; Lindsay Grayson, M; Torresi, Joseph

    2013-01-01

    Background  At the onset of the pandemic H1N1/09 influenza A outbreak in Australia, health authorities devised official clinical case definitions to guide testing and access to antiviral therapy. Objectives...

  16. Teaching Cases in Management - Cordilheira de Santana

    Directory of Open Access Journals (Sweden)

    Astor Eugênio Hexsel

    2011-01-01

    Full Text Available The Cordilheira de Santana case, from now on referred to simply as Cordilheira, was conducted and reported with the main purpose of contributing to the understanding of the process of strategy formulation in the winery sector. It presents the case of a recently created small firm aiming to compete in the market by offering high quality based on reduced premium line products, with prices established in accordance. Even so, it has not achieved the expected results. The wine industry with its basis in the wineries of the extreme south of Brazil, which is the most productive sector in the whole country, is also discussed. The case study began in 2008, when Rosana, owner and director of the company, travelled from São Paulo to Porto Alegre and highly concerned that the expected results had not been achieved. Data included as a technical note on the wine industry provides information on the industry as a whole, enabling students to reconsider the firm´s positioning in the market. The teaching note that follows provides the professor with information that will allow him to explore several perspectives that will have to be faced by Rosana further. She may choose to strengthen the present strategy or to take it in a new direction.

  17. Managing and Planning an Event for Case Company X

    OpenAIRE

    Palo, Elisa

    2016-01-01

    This thesis is written for Case Company X, which is an international and sales-focused accelerator for innovative software companies. The company invests seed capital in their portfolio companies and deliver concrete results for their sales and international growth. In addition, Case Company X organizes events for startup founders. This thesis will discuss how to plan and manage an event for Case Company X. The objective of this thesis is to clarify the process of organizing a successful ...

  18. Developing the IT Knowledge Management Process for a Case Company

    OpenAIRE

    Sorvari, Olavi

    2017-01-01

    The topic of this thesis is the development of an IT knowledge management process for a case company. The case company is a global public company operating in the manufacturing industry. The company’s efforts in improving the quality of their IT operations lead to this development project mainly because the business challenges, the lack of ownership in the case company’s side and the insufficient flow of information were caused by the existing, fully outsourced process. The development pr...

  19. Species Conservation and Management: Case Studies

    Science.gov (United States)

    Akcakaya, H.R.; Burgman, M.A.; Kindvall, O.; Wood, C.C.; Sjogren-Gulve, P.; Hatfield, J.S.; McCarthy, M.A.

    2004-01-01

    This edited volume is a collection of population and metapopulation models for a wide variety of species, including plants, invertebrates, fishes, amphibians, reptiles, birds, and mammals. Each chapter of the book describes the application of RAMAS GIS 4.0 to one species, with the aim of demonstrating how various life history characteristics of the species are incorporated into the model, and how the results of the model has been or can be used in conservation and management of the species. The book comes with a CD that includes a demo version of the program, and the data files for each species.

  20. A programme to facilitate quality patient care in a case management environment

    OpenAIRE

    2014-01-01

    D.Cur. (Nursing Management) A health maintenance organisation (HMO) that implements managed care is the health care service provider for a mine group. Case management is an integral part of managed care. Case management in a managed care setting within this mine group should be to the holistic benefit of both the client/patient and the service provider. Within the case management environment, nurse case managers (CMs) and their counterparts (professional nurses) should provide and facilita...

  1. The management of stress urinary incontinence: A case report

    Directory of Open Access Journals (Sweden)

    Preshani Reddy

    2015-04-01

    Full Text Available Introduction: Conservative management is the first option for patients with stress urinary incontinence (SUI. However, successful management of women diagnosed with SUI is dependent on a proper assessment and a tailored treatment plan. This case report aims to show the effectiveness of physiotherapy management in a 42-year-old patient diagnosed with SUI.Patient presentation: The patient’s main complaints were involuntary loss of urine on coughing, sneezing and lifting of heavy objects, which started following the birth of her third child.Management and outcome: The patient was taught the ‘Knack’ manoeuvre and provided with a tailored pelvic floor exercise programme. Improvement was noted at the third visit and the patient no longer had involuntary episodes.Conclusion: This case report shows the successful outcome of conservative management in a patient with stress urinary incontinence.

  2. Disease Management, Case Management, Care Management, and Care Coordination: A Framework and a Brief Manual for Care Programs and Staff.

    Science.gov (United States)

    Ahmed, Osman I

    2016-01-01

    With the changing landscape of health care delivery in the United States since the passage of the Patient Protection and Affordable Care Act in 2010, health care organizations have struggled to keep pace with the evolving paradigm, particularly as it pertains to population health management. New nomenclature emerged to describe components of the new environment, and familiar words were put to use in an entirely different context. This article proposes a working framework for activities performed in case management, disease management, care management, and care coordination. The author offers standard working definitions for some of the most frequently used words in the health care industry with the goal of increasing consistency for their use, especially in the backdrop of the Centers for Medicaid & Medicare Services offering a "chronic case management fee" to primary care providers for managing the sickest, high-cost Medicare patients. Health care organizations performing case management, care management, disease management, and care coordination. Road map for consistency among users, in reporting, comparison, and for success of care management/coordination programs. This article offers a working framework for disease managers, case and care managers, and care coordinators. It suggests standard definitions to use for disease management, case management, care management, and care coordination. Moreover, the use of clear terminology will facilitate comparing, contrasting, and evaluating all care programs and increase consistency. The article can improve understanding of care program components and success factors, estimate program value and effectiveness, heighten awareness of consumer engagement tools, recognize current state and challenges for care programs, understand the role of health information technology solutions in care programs, and use information and knowledge gained to assess and improve care programs to design the "next generation" of programs.

  3. Teaching Cases in Management - O Chocolate Importado

    Directory of Open Access Journals (Sweden)

    Dusan Schreiber

    2009-10-01

    Full Text Available International trade plays a special role in all countries due the influence exerted in the economic and social field. At the same time, subjects such as planning and implementing the operation of export and import becomes very important, with particular relevance among entrepreneurs and academics. When it comes to this issue, the aim of this teaching case is to provide discussions about the subjects of entrepreneurship, business planning and the learning of strategists. It describes the experience of company SK, started in July of 1997, which began its businesses through exporting and importing leather and its artifacts. Later, the enterprise redirected its focus and began importing chocolates for the Brazilian market. The entrepreneur found, during the process of the business construction, a series of challenges that obliged him to make decisions and make choices. Having an amount of capital and willingness to undertake, he had to decide which path to follow and how to decide. Were there right and wrong choices? How would he plan and operationalize a start-up business? How would he evaluate opportunities and estimate the risk of an enterprise? These are some of many questions that the reader will be challenged to answer after analyzing this case.

  4. Suicide attempts: prevention of repetition.

    Science.gov (United States)

    Daigle, Marc S; Pouliot, Louise; Chagnon, François; Greenfield, Brian; Mishara, Brian

    2011-10-01

    To present an overview of promising strategies to prevent repetition of suicidal behaviours. This literature review on tertiary preventive interventions of suicide attempts was produced using the computerized databases PubMed and PsycINFO from January 1966 to September 2010, using French- and English-language limits and the key words: suicid* or deliberate self-harm and treatment* or therapy or intervention* or management. Thirteen of the 35 included studies showed statistically significant effects of fewer repeated attempts or suicides in the experimental condition. Overall, 22 studies focused on more traditional approaches, that is, pharmacological or psychological approaches. Only 2 of the 6 pharmacological treatments proved significantly superior to a placebo- a study of lithium with depression and flupenthixol with personality disorders. Eight out of 16 psychological treatments proved superior to treatment as usual or another approach: cognitive-behavioural therapy (CBT) (n = 4), (including dialectical behaviour therapy [n = 2]); psychodynamic therapy (n = 2); mixed (CBT plus psychodynamic therapy [n = 1]); and motivational approach and change in therapist (n = 1). Among the 8 studies using visit, postal, or telephone contact or green-token emergency card provision, 2 were significant: one involving telephone follow-up and the other telephone follow-up or visits. Hospitalization was not related to fewer attempts, and 1 of the 4 outreach approaches had significant results: a program involving individualized biweekly treatment. The rationale behind these single or multiple approaches still needs to be clarified. There were methodological flaws in many studies and some had very specific limited samples. There is a need for more research addressing the problem in definitions of outcomes and measurement of the dependent variables, gender-specific effects, and inclusion of high-risk groups. There is a need for the development and evaluation of new approaches that

  5. The DiaS trial: dialectical behavior therapy versus collaborative assessment and management of suicidality on self-harm in patients with a recent suicide attempt and borderline personality disorder traits - study protocol for a randomized controlled trial

    Science.gov (United States)

    2014-01-01

    Background In Denmark 8,000 to 10,000 people will attempt suicide each year. The Centre of Excellence in Suicide Prevention in the Capital Region of Denmark is treating patients with suicidal behavior, and a recent survey has shown that 30% of the patients are suffering from borderline personality disorder. The majority of patients (70% to 75%) with borderline personality disorder have a history of deliberate self-harm and 10% have a lifetime risk to die by suicide. The DiaS trial is comparing dialectical behavior therapy with collaborative assessment and management of suicidality-informed supportive psychotherapy, for the risk of repetition of deliberate self-harm in patients with a recent suicide attempt and personality traits within the spectrum of borderline personality disorder. Both treatments have previously shown effects in this group of patients on suicide ideation and self-harm compared with treatment as usual. Methods/Design The trial is designed as a single-center, two-armed, parallel-group observer-blinded randomized clinical superiority trial. We will recruit 160 participants with a recent suicide attempt and at least two traits of the borderline personality disorder from the Centre of Excellence in Suicide Prevention, Capital Region of Denmark. Randomization will be performed though a centralized and computer-generated approach that conceals the randomization sequence. The interventions that are offered are a modified version of a dialectical behavior therapy program lasting 16 weeks versus collaborative assessment and management of suicidality-informed supportive psychotherapy, where the duration treatment will vary in accordance with established methods up to 16 weeks. The primary outcome measure is the ratio of deliberate self-harming acts including suicide attempts measured at week 28. Other exploratory outcomes are included such as severity of symptoms, suicide intention and ideation, depression, hopelessness, self-esteem, impulsivity, anger

  6. The DiaS trial: dialectical behavior therapy versus collaborative assessment and management of suicidality on self-harm in patients with a recent suicide attempt and borderline personality disorder traits - study protocol for a randomized controlled trial.

    Science.gov (United States)

    Andreasson, Kate; Krogh, Jesper; Rosenbaum, Bent; Gluud, Christian; Jobes, David A; Nordentoft, Merete

    2014-05-29

    In Denmark 8,000 to 10,000 people will attempt suicide each year. The Centre of Excellence in Suicide Prevention in the Capital Region of Denmark is treating patients with suicidal behavior, and a recent survey has shown that 30% of the patients are suffering from borderline personality disorder. The majority of patients (70% to 75%) with borderline personality disorder have a history of deliberate self-harm and 10% have a lifetime risk to die by suicide. The DiaS trial is comparing dialectical behavior therapy with collaborative assessment and management of suicidality-informed supportive psychotherapy, for the risk of repetition of deliberate self-harm in patients with a recent suicide attempt and personality traits within the spectrum of borderline personality disorder. Both treatments have previously shown effects in this group of patients on suicide ideation and self-harm compared with treatment as usual. The trial is designed as a single-center, two-armed, parallel-group observer-blinded randomized clinical superiority trial. We will recruit 160 participants with a recent suicide attempt and at least two traits of the borderline personality disorder from the Centre of Excellence in Suicide Prevention, Capital Region of Denmark. Randomization will be performed though a centralized and computer-generated approach that conceals the randomization sequence. The interventions that are offered are a modified version of a dialectical behavior therapy program lasting 16 weeks versus collaborative assessment and management of suicidality-informed supportive psychotherapy, where the duration treatment will vary in accordance with established methods up to 16 weeks. The primary outcome measure is the ratio of deliberate self-harming acts including suicide attempts measured at week 28. Other exploratory outcomes are included such as severity of symptoms, suicide intention and ideation, depression, hopelessness, self-esteem, impulsivity, anger, and duration of respective

  7. Psychopathology Associated with Suicide Attempts among Rural Adolescents of China

    Science.gov (United States)

    Liu, Xianchen; Tein, Jenn-Yun; Sandler, Irwin N.; Zhao, Zhongtang

    2005-01-01

    This case control study examined the relationship between psychopathological profiles and self reported suicide attempts among rural adolescents of China. Cases consisted of 142 adolescents who reported a suicide attempt in the past 6 months in a questionnaire survey (n = 1,365). An equal number of adolescents without reporting a suicide attempt,…

  8. Successful management of difficult airway: A case series

    Directory of Open Access Journals (Sweden)

    Balraj Hariharasudhan

    2016-01-01

    Full Text Available Management of difficult airway is widely recognized as one of the important tasks of an anesthesiologist. The problems related to it are known to be primary causes of life-threatening consequences. Herewith, we present a case series of difficult airway scenarios managed successfully with different techniques and airway gadgets. The following cases were managed successfully with appropriate airway techniques: 1 Ludwig′s angina for drainage with awake fiberoptic intubation, 2 temporomandibular joint (TMJ ankylosis for bilateral gap arthroplasty with fiberoptic intubation, 3 burn contractures for the release managed with intubating laryngeal mask airway (ILMA. Airway management is one of the vital aspects of clinical care provided by an anesthesiologist. The airway-related complications have significantly decreased due to better knowledge, skills of the anesthesiologist, and an array of airway gadgets. The three case scenarios of difficult airway were successfully managed with the appropriate airway gadgets suitable for each case without any untoward complication. Most airway problems can be solved with available gadgets and techniques, but clinical judgement borne of experience and expertise is crucial in implementing the skills in any difficult airway scenario.

  9. Surviving a Suicide Attempt

    Directory of Open Access Journals (Sweden)

    Ahmed Al-Harrasi

    2016-09-01

    Full Text Available Suicide is a global phenomenon in all regions of the world affecting people of all age groups. It has detrimental consequences on patients, their families, and the community as a whole. There have been numerous risk factors described for suicide including mental illness, stressful life situations, loss of social support, and general despair. The association of suicide with Islam has not been extensively studied. The common impression from clinical practice is that being a practicing Muslim reduces the risk of suicide. Another factor associated with suicide is starting a patient on antidepressants. However, this has been questioned recently. This report describes a middle-aged man with depression and multiple social stressors who survived a serious suicide attempt. The discussion will focus on the factors that lead him to want to end his life and the impact of the assumed protective factors such as religious belief and family support on this act of self-harm. Such patients can be on the edge when there is an imbalance between risk factors (such as depression, insomnia, and psychosocial stressors and protective factors (like religious affiliation and family support. All physicians are advised to assess the suicide risk thoroughly in patients with depression regardless of any presumed protective factor.

  10. Surviving a Suicide Attempt.

    Science.gov (United States)

    Al-Harrasi, Ahmed; Al Maqbali, Mandhar; Al-Sinawi, Hamed

    2016-09-01

    Suicide is a global phenomenon in all regions of the world affecting people of all age groups. It has detrimental consequences on patients, their families, and the community as a whole. There have been numerous risk factors described for suicide including mental illness, stressful life situations, loss of social support, and general despair. The association of suicide with Islam has not been extensively studied. The common impression from clinical practice is that being a practicing Muslim reduces the risk of suicide. Another factor associated with suicide is starting a patient on antidepressants. However, this has been questioned recently. This report describes a middle-aged man with depression and multiple social stressors who survived a serious suicide attempt. The discussion will focus on the factors that lead him to want to end his life and the impact of the assumed protective factors such as religious belief and family support on this act of self-harm. Such patients can be on the edge when there is an imbalance between risk factors (such as depression, insomnia, and psychosocial stressors) and protective factors (like religious affiliation and family support). All physicians are advised to assess the suicide risk thoroughly in patients with depression regardless of any presumed protective factor.

  11. The Scanfin Merger: Managing Organisational Change (Case C)

    DEFF Research Database (Denmark)

    Smith, Pernille; Carugati, Andrea; Giangreco, Antonio

    This is the third of a four-case series (408-115-1, 908-025-1, 308-343-1 and 608-037-1). This case is about resistance to organisational change in relation to a merger. The case describes a major organisational change in a newly established department, which has been instituted to speed up...... the integration process of the merger. The main issue is how a middle manager constitutes an obstacle to this organisational change by re-inforcing the 'old' ways of working in his group. To solve this case satisfactorily students should be able to see the organisation from several different layers (employee...

  12. An attempt to replace an ivermectin-resistant Cooperia spp. population by a susceptible one on grazing pastures based on epidemiological principles and refugia management.

    Science.gov (United States)

    Fiel, C A; Steffan, P E; Muchiut, S M; Fernández, A S; Bernat, G; Riva, E; Lloberas, M M; Almada, A; Homer, D

    2017-11-15

    The maintenance of anthelmintic-susceptible parasite refugia to delay the onset of anthelmintic resistance is an almost impossible effort in many grazing livestock production countries given that current refugia consist of already resistant parasites. Rather, efforts could be focused on replacing the resistant parasite refugia by susceptible parasite ones and implementing sustainable parasite control measures from then on. To this purpose, a trial was conducted to attempt to establish a new population of ivermectin-susceptible Cooperia sp. on a beef cattle farm with proven problems of ivermectin-resistant Cooperia. During two consecutive years, 82 (Year 1) and 100 (Year 2) recently weaned and parasite-free heifers were inoculated with 40,000 or 30,000 susceptible Cooperia L3, respectively, at a time when levels of resistant parasite refugia were normally low. The animals were subsequently allowed to graze on the problem pastures during autumn until the end of spring. Levels of parasitism in the animals and on pasture were monitored monthly and animals were treated with levamisole when needed. The combination of parasitological monitoring and local epidemiological knowledge was essential to determine when treatments were to be administered. No clinical signs of gastrointestinal parasitosis in the herd were observed throughout the study and unnecessary treatments were avoided. Faecal egg counts reduction tests (FECRT) and controlled efficacy tests (CET) employing worm counts were carried out at different times throughout the study to determine the clinical efficacy (FECRT) and the absolute efficacy (CET) of ivermectin, respectively. The clinical efficacy of ivermectin increased from an initial 73% to 99.4%, while the absolute efficacy increased from 54.1% to 87.5% after just two animal production cycles. The switch from a resistant parasite population to a susceptible one requires knowledge of parasitological epidemiology, especially in relation to seasonal

  13. Successful management of 70% acetic acid ingestion on the intensive care unit: A case report.

    Science.gov (United States)

    Ratcliffe, Andrew; Baker, Andrew; Smith, Daniel

    2018-02-01

    Acetic acid is an organic acid available in concentrations from 2 to 80%. Whilst lower concentrations of 2-6% are more commonly used as the table top condiment, vinegar, much stronger solutions are regularly used in Eastern Europe as food preservatives and cleaning solutions. Oral ingestion of greater than 12% has been reported to cause haemolysis, renal failure, shock and death. Most reported cases of deliberate or accidental poisoning are from Russia and Eastern Europe in the 1980s, with very little currently in western publications. We present the case of a female patient who attempted suicide by drinking 250 ml of 70% acetic acid. Her widespread gastrointestinal injuries were managed conservatively, and despite suffering extensive upper airway and renal complications, she was successfully decannulated and discharged home after a prolonged intensive care and hospital stay.

  14. Obesity weight management and bariatric surgery case management programs: a review of literature.

    Science.gov (United States)

    Echols, Jennie

    2010-01-01

    The proportion of Americans with clinically severe obesity has vast implications for the nation's healthcare system since this population have twice as many chronic medical conditions as people with normal weight. Through the use of review of literature, this article (a) describes the types of weight loss programs; (b) reviews the results from studies on effectiveness of bariatric surgery; and (c) identifies recommendations for obesity and bariatric surgery case management programs. Disease management companies appear to be concentrating on general weight loss strategies associated with wellness and other condition-specific disease management products, whereas larger national healthcare companies with at-risk and insurance products offer specific bariatric surgery management products. Case management programs within healthcare systems, health management organizations, and insurance companies are frequently faced with the management of individuals with morbid obesity and, increasingly, those who are requesting or have undergone bariatric surgery. Research shows that morbid obesity is a disease that remains generally unresponsive to diet and drug therapy but appears to respond well to bariatric surgery. Research findings suggest that surgical treatment is more effective than pharmacological treatment of weight loss and the control of some comorbidities associated with obesity. The number of Americans having weight loss surgery increased by 804% between 1998 and 2004, which appears to be a driver for the recent development of obesity disease management and bariatric surgery case management programs. Although the immaturity and lack of studies citing outcomes of obesity disease and case management programs limit the identification of best practices based on outcomes, emerging practices can be identified and recommendations for case management can be formulated. In addition to primary prevention and treatment programs for obesity, this article describes program

  15. Hepatic hydatid cyst, laparoscopic management. Case report

    Directory of Open Access Journals (Sweden)

    Robert William Campos-Guzmán

    2015-12-01

    Full Text Available We report a case of male patient of 32 years old; with a history of thoracic surgery for hydatid cyst at 9 years of age; admission was at the general surgery Service of the Hospital II Lima Norte Callao Luis Negreiros Vega, with a history of illness of 1 year, referring abdominal pain oppressive predominance of the upper abdomen, especially on right upper quadrant. Refers concomitantly history of previous surgery in thoracic region and positive epidemiological history. After clinical evaluation by the staff of surgery, outpatient clinic and the observation and reporting of CT in which well-defined lesions in segment IV and V multicystic appearance and lesser sac showing peripheral enhancement it is observed after administration contrast; associated with positive Western Blot, surgical treatment is decided. Laparoscopic Surgery was performed consisting of cyst aspiration drainage and washing the interior with hipersodio (20% ClNa and placement of laminar drain was done. Presented a postoperative biliary fistula that was resolved in five weeks, beginning of oral tolerance on the first postoperative day and liver function controls within normal ranges discharge was performed four days after surgery.

  16. Social Customer Relationship Management: A Case Study

    Directory of Open Access Journals (Sweden)

    Paliouras Konstantinos

    2017-06-01

    Full Text Available Social Customer Relationships Management (CRM is a current business trend providing new channels of two-way communication with customers through social media sites, such as Facebook, Twitter etc. Social CRM enables companies to interact in an easy and contemporary way directly with customers as well as to track customer interactions and their social influence. In this paper we examine the importance of CRM, e-CRM and Social CRM for businesses. We provide perspectives on objectives and types of CRM, the working cycle of CRM, the stages of a CRM Strategy and technology tools that are used in CRM. Social CRM is in particularly analyzed, since this new trend requires active engagement by customers and other stakeholders. The engagement process is essential to successful Social CRM and to successful social business practices. Finally, we describe experiences from three family businesses that introduced Social CRM as a result of a project carried out as an assignment in the ‘Social Media Networking’ module of the MSc course in ‘Web Intelligence’ at the Department of Informatics of Alexander Technological Educational Institute of Thessaloniki. The assignment of the groups was to create a Social CRM Strategy in collaboration with a company. This study is a follow-up of the outcome of the projects carried out in the autumn semester 2014 and 2015. The results show that all three companies consider that Social CRM is an excellent tool for obtaining real time valuable data about customers and a cheap way to reach them.

  17. The "wins" of change: evaluating the impact of predicted changes on case management practice.

    Science.gov (United States)

    Stanton, Marietta P; Barnett Lammon, Carol Ann

    2008-01-01

    A variety of strategies were employed to identify current and future trends that would impact the practice of case management. Historical review, consultation with case management experts, literature review, and environmental scanning by practicing case managers were strategies employed to determine the impact of current and future trends on case management. The trends identified in this article have implications for case managers in a variety of settings. Case managers participating in the environmental scanning process to evaluate the impact of the identified trends on their organization included representation from acute care, home care, behavioral health, workers' compensation, and private insurance settings. The top 7 trends identified by experts in the field of case management included pay for performance, recovery audit contractors, Medicare demonstration projects, transitions of care, informatics in healthcare and case management, metrics for case management, and the impact of an aging population in case management. Practicing case managers were asked to react to these trends in terms of likelihood of occurrence in their organization and impact of these trends on their case management practice. Case management will ultimately have a higher degree of accountability for its practice if metrics to evaluate and reimbursement for case management become a reality. A multitude of performance measures exist that will be monitored and be tied to reimbursement. To ensure that agencies are accomplishing these performance measures, case management will potentially have a growing importance. Case managers perceive that these trends have a predominantly positive impact on case management.

  18. [On the case management of youth with early psychosis].

    Science.gov (United States)

    Nonaka, Takeshi

    2011-01-01

    Case management lies at the foundation of clinical activities for youth with early psychosis. While introducing the systems and skills accumulated in Anglo-American countries, the author affirms tasks associated with care management in Japan. The characteristics of case management for youths with early psychosis are as follows: 1) a primary therapeutic model, 2) emphasizing engagement by means of outreach, 3) limiting caseloads for the sake of fostering collaborative relationships, 4) adopting a method of active brokerage, and 5) establishing time limits of two or three years. The author calls for the establishment of a new training system for implementing these activities in Japan, due to the existence of significant misunderstandings of care management in that country.

  19. Mandibular condylar hyperplasia: diagnosis and management. Case report

    OpenAIRE

    Pinto, Isabel; Fonseca, Júlio; Vinagre, Alexandra; Ângelo,David; Sanz, David; Grossmann, Eduardo

    2016-01-01

    ABSTRACT BACKGROUND AND OBJECTIVES: Mandibular condylar hyperplasia is a disease where excessive growth of mandibular condyle, ramus and body elicits facial asymmetry. Its therapeutic management is not a consensus and, due to its complexity, is a challenge for maxillofacial surgeons and orthodontists. This study aimed at discussing clinical, diagnostic and therapeutic aspects of the management of this disease, and at explaining the role of condylectomy. CASE REPORT: Female patient, 19 years...

  20. Endovascular Treatment of an Iatrogenic Right Internal Jugular Vein- Right Subclavian Artery Fistula and Pseudoaneurysm During the Attempt of a Hemodialysis Catheter Insertion: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Eui Min; Kim, Hyun Lee; Kim, Dong Hyun [Chosun University, Gwangju (Korea, Republic of)

    2009-02-15

    Complications during the placement of a central venous catheter, via the right internal jugular vein puncture include local hematoma, hemothorax, pneumothorax, central vein thrombosis, and hemopericardium. Iatrogenic right internal jugular vein-right subclavian artery fistula with the formation of right subclavian artery pseudoaneurysms is an extremely rare complication in patients undergoing a central vein puncture. We report the case of a patient who developed a local hematoma at the vein puncture site and dyspnea due to a right internal jugular vein-subclavian artery fistula and a right subclavian artery pseudoaneurysm at the mediastinum after puncture of right internal jugular vein. The patient was successfully treated by embolization using microcoils.

  1. Magazine Publishing Innovation: Two Case Studies on Managing Creativity

    Directory of Open Access Journals (Sweden)

    Simon Das

    2016-06-01

    Full Text Available This paper aims to highlight a link between publishing business innovation and how editors manage creativity in the digital era. Examining the changing industrial and historical business context for the U.K. magazine publishing industry, two case studies are analyzed as representatives of different ends of the publishing company spectrum (one a newly launched magazine published by a major, the other an independent ‘magazine’ website start-up. Qualitative data analysis on publishing innovation and managing creativity is presented as a springboard for further research on magazine media management.

  2. Risk Management from Corporate and FM Perspectives: Two case studies

    DEFF Research Database (Denmark)

    Ünver, Kadir; Jensen, Per Anker

    2012-01-01

    Purpose: To investigate how Risk Management (RM) is perceived and practiced in Facilities Management (FM) and corporate management and to evaluate the potential benefits of an increased application. Theory: RM is a generic management discipline, but apparently it has not achieved the attention...... it deserves in FM. Application of RM in FM could help to increase the strategic importance and awareness of FM among corporate managers. Approach: A preliminary study with expert interviews was initially conducted followed by a main study with an interview survey in two Danish case companies - a real estate...... company and a consulting engineering company. Findings: The research showed that RM was applied in both companies to a higher degree than initially expected, but often using other terminology. The real estate company had a much stronger focus on RM in relation to the technical aspects of real estate...

  3. Disaster waste management in Italy: Analysis of recent case studies.

    Science.gov (United States)

    Gabrielli, Francesco; Amato, Alessia; Balducci, Susanna; Magi Galluzzi, Lorenzo; Beolchini, Francesca

    2018-01-01

    The geomorphology of the Italian territory causes the incidence of many disasters like earthquakes and floods, with the consequent production of large volumes of waste. The management of such huge flows, produced in a very short time, may have a high impact on the whole emergency response. Moreover, historical data related to disaster waste management are often not easily accessible; on the other hand, the availability of data concerning previous events could support the emergency managers, that have to take a decision in a very short time. In this context, the present paper analyses four relevant recent case studies in Italy, dealing with disaster waste management after geologic and hydrologic natural events. Significant differences have been observed in the quantity and types of generated wastes, and, also, in the management approach. Such differences are mainly associated with the kind of disaster (i.e. earthquake vs. flood), to the geographical location (i.e. internal vs. coastal area), to the urbanisation level (i.e. industrial vs. urban). The study allowed the identification of both strengths and weaknesses of the applied waste management strategies, that represent "lessons to learn" for future scenarios. Even though it deals with Italian case studies, this manuscript may have a high impact also at international level, making available for the first-time emergency waste management data, that are considered an indispensable support for decision makers. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Intensive Care Unit-Acquired Weakness: Implications for Case Management.

    Science.gov (United States)

    Harvey, Nina R; Stanton, Marietta P

    The purpose of this case study is to provide a specific example of the disease trajectory for one patient's experience with intensive care unit-acquired weakness (ICUAW). This case study provides those in case management with an overview of some of the common signs and symptoms of ICUAW, as well as the possible prognosis and recovery from ICUAW. The events in this case study take place in the acute care setting including the intensive care unit of a mid-sized health center, a general medical-surgical (med-surg) unit, and a long-term acute care facility. ICUAW affects the clinical, functional, and financial outcomes of patients. If the patient survives, their quality of life and the quality of life of their family members could be severely impacted. Case management practice has a significant role in coordinating care for those diagnosed with ICUAW. Case managers can use knowledge about ICUAW to improve the patient's transition throughout the hospital stay, improve discharge recommendations, and improve the patient's short-term and long-term outcomes. This may reduce unnecessary utilization of health care resources.

  5. Case I: Managing People--The Case of the Frustrated Faculty Member.

    Science.gov (United States)

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

    2002-01-01

    Presents an overview of some critical theories in human relations management. Offers a hypothetical case, drawn from a faculty development workshop, involving a dental school faculty member and her dean, for discussion and application of principles. Finally, presents the central issues of the case along with a review of relevant management…

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

    Science.gov (United States)

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

    2016-01-01

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

  7. 30 CFR 250.518 - What are the requirements for casing pressure management?

    Science.gov (United States)

    2010-07-01

    ... Operations Casing Pressure Management § 250.518 What are the requirements for casing pressure management? Once you install your wellhead, you must meet the casing pressure management requirements of API RP 90... management? 250.518 Section 250.518 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR...

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

    Science.gov (United States)

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

    2014-01-01

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

  9. Transgenerational Patterns of Suicide Attempt.

    Science.gov (United States)

    Sorenson, Susan B.; Rutter, Carolyn M.

    1991-01-01

    Using data from 2,304 community residents, found self-reports of suicide attempts were more common among persons with than without family history of suicide. Nearly one in four suicide attempters reported family history of suicide. Being female and unmarried, respondent mental disorder, parent mental disorder, and parent suicide attempt exerted…

  10. Case III: Managing conflict--the case of the faculty stuck in the middle.

    Science.gov (United States)

    Trombly, Robert M; Comer, Robert W; Villamil, Juanita E

    2002-04-01

    The need for administrative faculty members to have superior leadership and management skills to handle their increasingly complex responsibilities is well established. As a part of the 2000-01 ADEA Leadership Institute curriculum, fellows were responsible for developing situational case studies for a faculty development workshop to develop participants' leadership and management skills. The case presented here involved managing conflicts in the dental academic setting. The foundation of conflict management centers on communication techniques including transparent communication, open discussion, open confrontation, and active listening. Management options such as avoidance, accommodation, competition, negotiation, and collaboration are potential strategies for the faculty leader. This case study involves a fictitious public dental school, New Horizons University, which has embarked on solutions to address limited resources, but unwittingly has created conflicts between individuals and groups of faculty members. The case discussion analyzes the cause of conflicts, presents the positive and negative potential of the conflicts, reviews techniques of conflict management, and discusses specific management concepts regarding resource allocation and equity theory.

  11. Computational and the real energy performance of a single-family residential building in Poland – an attempt to compare: a case study

    Directory of Open Access Journals (Sweden)

    Kowalski Piotr

    2017-01-01

    Full Text Available The paper presents energy use for heating and ventilation (one of the energy performance components determined in three ways. A case of a single family building located near Wroclaw in Poland is analyzed. The first and the second variant are both computational and the third presents actual measured energy consumption. Computational variants are based on the Polish methodology for the EPC (the Energy Performance Certificate. This methodology is based on ‘the Energy Performance of Buildings Directive 2010/31/EU’. Energy use for heating and ventilation is calculated using monthly method presented in EN ISO 13790. In the first computational option standard input data (parameters such as indoor and outdoor air temperature etc. are taken from standards and regulations are implemented. In the second variant this input data are partially taken from measurements. The results of energy use from both computational variants are compared to the actual measured energy consumption. On the basis of this comparison the influence of three factors: solar radiation heat gains, building air tightness and the SCOP of the heat pump on energy use calculations are analyzed. Conclusions aim to point the differences between them and the actual energy consumption.

  12. Case Study: The nutritional management of short bowel syndrome in ...

    African Journals Online (AJOL)

    SASPEN Case Study: The nutritional management of short bowel syndrome in a very low-birthweight neonate. Lize Rossouw, Chief Dietician, Groote Schuur Hospital, Cape Town. Correspondence to: Elizabeth van der Merwe, e-mail: elizabeth.vandermerwe@westerncape.gov.za. Keywords: NEC, necrotising enterocolitis, ...

  13. Records management and service delivery: the case of Department ...

    African Journals Online (AJOL)

    Ngulup

    Abstract. This article explores the role of records management in the delivery of public service in. Botswana with specific reference to the Corporate Services Division at the Ministry of. Health headquarters. This study used the case study approach and was complemented by triangulation of both quantitative and qualitative ...

  14. Healthcare waste generation and its management system: the case ...

    African Journals Online (AJOL)

    Healthcare waste generation and its management system: the case of health centers in West Gojjam Zone, Amhara Region, Ethiopia. ... Operational guidelines were not found in all assessed health centers. Nine out 70 (13%) interviewed healthcare workers had needle injuries during the last 12 months prior this study.

  15. Conservative management of cervical ectopic pregnancy: case report

    African Journals Online (AJOL)

    Historically surgery has been the mainstay of treatment, usually with a poor prognosis. Recently there has been a trend toward conservative management with improved prognosis. Spontaneous abortion of a cervical pregnancy is usually associated with profuse haemorrhage or sepsis. A case undergoing spontaneous ...

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

    Science.gov (United States)

    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,…

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

    Science.gov (United States)

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

    2013-01-01

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

  18. Evaluation of Michigan's Foster Care Case Management System

    Science.gov (United States)

    Johnson, Kristen; Wagner, Dennis

    2005-01-01

    Objective: In 1997, Michigan's Family Independence Agency piloted case management procedures designed to expedite permanency and improve services to children in foster care. Method: A 3-year evaluation examined outcomes in nine pilot and nine comparison counties to determine if children in the pilot counties achieved permanency, either returned…

  19. Case study: Industrial Portfolio Management for New Products

    DEFF Research Database (Denmark)

    Larsson, Flemming

    This report describes the content of a case-study, which was carried out in a Scandinavian company. The purpose of the study is to identify and indicate the current company approach to portfolio management (tools, methods, and processes) for new products combined with suggestions for improvement...

  20. Risk management in public sector construction projects: Case ...

    African Journals Online (AJOL)

    Construction projects are facing problems that impede their expected performance. Time, cost, quality, and competition limitations place constraints on projects. These challenges require incisive risk-management (RM) practices. This article presents the findings of a multiple case study, which determined how and why ...

  1. A case of selective non-operative management of penetrating ...

    African Journals Online (AJOL)

    This case report focuses on the application of selective non operative management (SNOM) of penetrating abdominal trauma in a complex patient who was also pregnant at the time of injury. It goes on to contextualize SNOM in terms of its historical evolution as a strategy in South Africa and its appropriate safe application in ...

  2. Management of Chronic Subdural Haematoma in a Case of ...

    African Journals Online (AJOL)

    this case conservative management has also resulted in ... right side. Hemiparesis developed gradually over a period of 20 days which corresponded to slow increase in the size of the chronic subdural haematoma and pressure effect over motor cortex. ... enlargement of chronic subdural haematomas was thought to be due ...

  3. Management of Bilateral Femoral Fractures in Pregnancy: A Case ...

    African Journals Online (AJOL)

    OBJECTIVE: We report here the management of bilateral femoral fractures in a pregnant woman who was presented to us at about 35 weeks of gestation following a road traffic accident. CASE REPORT: A 39 year old pregnant civil servant was referred to us 9 days after sustaining injuries to both lower limbs from a road ...

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

    Science.gov (United States)

    Chow, Alice

    2013-01-01

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

  5. Knowledge and pattern of malaria case management among ...

    African Journals Online (AJOL)

    Majority of the workers (70%) had not had any recent training on malaria case management. In spite of this, knowledge of malaria was good among the respondents (95% were able to define malaria and 98.1% were able to list the symptoms of malaria respectively). More than half of the respondents (55%) were also able to

  6. Management of Clostridium Difficile: Case study and review of the ...

    African Journals Online (AJOL)

    Management of Clostridium Difficile: Case study and review of the basic tenets. M Roberts, C Kiire. Abstract. No Abstract. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Article Metrics. Metrics Loading ... Metrics powered by PLOS ALM

  7. Bilateral Orbital Cellulitis: A Case Report and Management ...

    African Journals Online (AJOL)

    To report a case of bilateral orbital cellulitis in a conscious 11-year-old Nigerian girl and the management challenges. Bilateral orbital cellulitis secondary to rhinosinusitis is uncommon but has been reported in the literature in other countries where the diagnosis was made with the aid of necessary tools such as the ...

  8. Bilateral orbital cellulitis: A case report and management challenges ...

    African Journals Online (AJOL)

    To report a case of bilateral orbital cellulitis in a conscious 11-year-old Nigerian girl and the management challenges. Bilateral orbital cellulitis secondary to rhinosinusitis is uncommon but has been reported in the literature in other countries where the diagnosis was made with the aid of necessary tools such as the ...

  9. Multidisciplinary conservative management in classical Volkmann's contracture: A case report

    NARCIS (Netherlands)

    Reinders, M.F.; Geertzen, J.H.B.; Eisma, W.H.

    1996-01-01

    This clinical note describes the case of a nine-year-old girl with classical Volkmann's contracture of the left forearm. The report demonstrates the results and follow-up of conservative orthotic management used as a mode of treatment by a multidisciplinary team. When using an orthosis it is

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

    Energy Technology Data Exchange (ETDEWEB)

    None

    2013-12-01

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

  11. Steak House Syndrome: Case Report And Review Of Management ...

    African Journals Online (AJOL)

    METHOD: Case report and review of relevant literature on management of Steakhouse Syndrome. RESULT: The literature is awash with various treatment options for food impaction in the oesophagus. Endoscopic removal remains the safest. Other options include the use of agents that relaxes the oesophageal sphincter, ...

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

    Science.gov (United States)

    Saiti, Anna

    2010-01-01

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

  13. A single centre case series of gallstone sigmoid ileus management

    Directory of Open Access Journals (Sweden)

    Nicholas Farkas

    2017-01-01

    Conclusions: This is the first case series highlighting the differing strategies and challenges faced by clinicians managing gallstone sigmoid ileus. Conservative measures (including manual evacuation, endoscopy, lithotripsy and surgery all play important roles in relieving large bowel obstruction. It is essential to tailor care to individual patients’ needs given the complexities of this potentially life threatening condition.

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

    Science.gov (United States)

    Sugarman, Barry

    2010-01-01

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

  15. The value of play for conflict management: a case study

    African Journals Online (AJOL)

    Erna Kinsey

    This is a case study of a conflict management intervention in two secondary schools in post-apartheid South Africa. The feature of the intervention that we examine is the use of play as an educational strategy. The literature attests that play can facilitate change by allowing learners freedom to change their be- haviour and ...

  16. Does the organisation model of case management dementia make a difference in satisfaction with case management and caregiver burden? An evaluation study.

    NARCIS (Netherlands)

    Peeters, J.M.; Pot, A.M.; Lange, J. de; Spreeuwenberg, P.M.; Francke, A.L.

    2016-01-01

    Background<\\strong> In the Netherlands, various organisational models of dementia case management exist. In this study the following four models are distinguished, based on differences in the availability of the service and in the case management function: Model 1: the case management

  17. Does the organisational model of dementia case management make a difference in satisfaction with case management and caregiver burden? An evaluation study

    NARCIS (Netherlands)

    A.L. Francke; P.M. Spreeuwenberg; A.M. Pot; J.M. Peeters; Dr. J. de Lange

    2016-01-01

    In the Netherlands, various organisational models of dementia case management exist. In this study the following four models are distinguished, based on differences in the availability of the service and in the case management function: Model 1: the case management service is available from first

  18. VALUE OF STUDYING THE TIME OF OCCURRENCE OF SUICIDE ATTEMPT IN PEOPLE ATTENDING HOSPITAL FOLLOWING SUICIDE ATTEMPT

    Directory of Open Access Journals (Sweden)

    Srinivasagopalan, Nappinnai, Solayappan

    2015-01-01

    Full Text Available Background It is unclear whether any particular time of the day is Vulnerable for suicide attempts. Suicide attempt is a known risk factor for future completed suicide. Aim To investigate the relationship between the time of suicide attempt and the sociodemograpic and illness characteristics of suicide attempters. Method Time of attempt, clinical and demographic data and illness variables of 74 patients presenting to hospital following suicide attempt were analyzed. Results Our results showed 8.a.m. to 11.59 a.m. is the most preferred time of attempt and it is statistically significant. Suicide attempt is significantly more in the day time (between 8 a.m. to 11.59 a.m.. The above time period is significantly associated with place of attempt of the suicide attempters. This is the time period where more young males (20 – 29 years from rural back ground, married, illiterates and unemployed (significant no. of house wives also attempt suicide during this time. Depression is the common psychiatric illness and pesticide is the common mode of attempt. More number of cases attempt during the months of August, September and October. Majority of them have experienced more than 5 life events before the attempt. Therefore we conclude that forenoon (8 a.m. to 11.59 a.m. is the most vulnerable period for attempting suicide. Conclusion The assessment of patients with history of suicide attempt in relation to the time of attempt is beneficial in formulating suicide prevention strategies.

  19. Management of idiopathic pulmonary fibrosis: selected case reports

    Directory of Open Access Journals (Sweden)

    Michael Kreuter

    2014-06-01

    Full Text Available In 2011, revised international guidelines were issued jointly by the American Thoracic Society, the European Respiratory Society, the Japanese Respiratory Society and the Latin American Thoracic Association, which provide a valuable framework for the diagnosis and management of idiopathic pulmonary fibrosis (IPF. However, due to the complexity of IPF, these guidelines may not comprehensively account for the management of individual IPF patients in clinical practice. We describe three patient cases that were presented and discussed during the 2013 AIR: Advancing IPF Research meeting in Nice, France. These cases highlight the heterogeneity in the presentation, history and clinical course of IPF, together with expert insights regarding the diagnosis and management of IPF in the real-life setting.

  20. Implementation of Risk Management in Malaysian Construction Industry: Case Studies

    Directory of Open Access Journals (Sweden)

    Hamzah Abdul-Rahman

    2015-01-01

    Full Text Available Construction industries are exposed to wide array of risks, such as financial, design, and contractual ones, which might have a direct impact on their performance toward achieving the desired objectives. Risk Management is a proactive decision-making process used to minimize and manage the risks in the most efficient and appropriate manner. However, most construction firms in Malaysia do not apply formal risk management in their projects. Thus, this study aims to identify the actual process of risk management that is being applied in the construction projects and to determine the effects of risk management implementation on the performance of the construction projects in terms of time and cost. The data were obtained from four case studies in Kuala Lumpur, Malaysia, through semistructured interviews. It was found that the implementation of risk management process in Malaysian construction industry is still at a low level, mainly due to the fact that most of the construction employees involved in risk management are not fully aware of the available risk management techniques that can be applied in construction projects.

  1. Conflict resolution through ecosystem-based management: the case of Swedish moose management

    Directory of Open Access Journals (Sweden)

    Camilla Sandström

    2013-08-01

    Full Text Available Swedish moose (Alces alces management has over the years transformed from a situation similar to what Hardin (1968 defined as a tragedy of the commons – i.e. where open access and unrestricted demands lead to over-exploitation – into a situation characterized by an abundance of moose. While high numbers of moose are preferred by hunters, they damage forests through grazing, causing conflicts between hunters and forest owners. In an attempt to resolve these disputes, the Swedish government is introducing a new local ecosystem-based management system. This paper analyzes this shift from managing a single resource to the broader perspective of ecosystem management and discusses to what extent it will contribute to conflict resolution. The results suggest that some of the problems highlighted may be solved through the implementation of an ecosystem management system. However, several challenges remain to be tackled, such as how to establish robust partnerships between forest owners and hunters for managing moose on land with a fragmented property rights structure. This can lead to different and conflicting objectives and, consequently, difficulties in reaching collective action.

  2. Clinical Laboratory Tycoon case study: are you management material?

    Science.gov (United States)

    Thompson, Amy L

    2009-01-01

    Many clinical laboratory scientists find themselves in a management position during their career, but have limited training to assume this role. The Clinical Laboratory Tycoon case study was designed to submerge students into the laboratory business by having the participant act as a laboratory manager with the capacity to make all the decisions about his or her own lab. The student participant completed a set of modules that each related to varying aspects of managing a laboratory including selecting what tests to offer, hiring employees, marketing the services, setting goals, budgeting, and evaluating overall success. This Clinical Laboratory Tycoon case study was used to instruct clinical laboratory science students in a university based clinical laboratory science program as part of their seminar in teaching, research, and management course. The size of these classes range from ten to twenty students and results reported in this paper are collected from a class size of sixteen students. The study could also be adapted for use in a hospital based program or as continuing education for laboratory employees. At the conclusion of the study, the student participants reported what they had learned during their time as managers and how their perspective changed. Student participants reported that they gained an understanding and appreciation for the responsibilities of the laboratory manager. For some, this study helped to define career goals.

  3. DENTAL MANAGEMENT NEEDS OF HOSPITALIZED LEUKEMIC PATIENTS (CASE REPORT

    Directory of Open Access Journals (Sweden)

    Indriasti Indah Wardhany

    2015-06-01

    Full Text Available Leukemia is myeloproliferative disorders characterized by differentiation and proliferation of malignantly transformed hematopoetic stem cells, leading to suppression of normal cells, causing anemia, thrombocytopenia, and deficiency of normally functioning leukocytes. It has been classified as either acute or chronic and by cell type. The etiology of leukemia, in most cases, is unknown. Dental management of consideration of the leukemic patient should include history, examination, and screening laboratory tests. This case report is about dental management needs on several cases of hospitalized leukemic patients. Most of the patients have had oral hygiene and need an invasive dental treatment. Although, based on laboratory tests and patient overall condition, these patients considered as high-risk patients, the dentists should perform dental to prevent further oral infection severity.

  4. An epidemiologic perspective on a case management program.

    Science.gov (United States)

    Kahler, Deborah; Salber, Patricia; Wilson, Thomas

    2010-01-01

    to improve a case management (CM) program using the principles and tools of epidemiology. Specifically, to use epidemiology to describe the population being managed, to analyze factors influencing outcomes, to assess the degree to which the CM process (or intervention) is related to those outcomes, to utilize the findings in order to make recommendations (to take action) for both better evaluation and improved and more efficient CM process, to provide an estimate of the impact of the CM program based on the comparison of pre-CM and post-CM interventions, and finally to discuss the caveat that pre-CM period probably does not provide a prediction of patterns to be expected in the post-CM period had CM not been present (an ideal, but difficult-to-find referent population for this kind of effectiveness analysis). a Medicare Advantage health plan. there were a total of 12,185 individuals who met the continuous enrollment requirement of 6 months (28 days) prior to initial contact with the CM department and 6 months after the contact date: 53% were female; the average age was 73.9 (standard deviation = ± 9.5). There was a linear relationship between the average "dose" of CM-as measured by the number of times a case manager had contact with a case-and the risk profile of the case-as measured by a standard risk assessment tool provided by the Centers for Medicare & Medicaid Services. The month-to-month costs for the study population prior to CM showed a sharp rise in the month prior to the initial contact with CM and a sharp decline beginning before the contact. This pattern was consistent across different risk profiles and our operational definition of CM "dose."The average costs 6 months prior to CM were higher than the average costs 6 months after the CM. The difference in cost varied by "dose" category. When coupled with the number of cases per dosage category, the greatest value for the CM program was in the management of moderate risk cases called two to four times

  5. Penetrating Brain Injury after Suicide Attempt with Speargun

    Directory of Open Access Journals (Sweden)

    John Ross Williams

    2014-07-01

    Full Text Available Penetrating cranial injury by mechanisms other than are exceedingly rare, and so strategies and guidelines for the management of PBI are largely informed by data from higher-velocity penetrating injuries. Here we present a case of penetrating brain injury by the low velocity mechanism of a harpoon from an underwater fishing speargun in an attempted suicide by a 56-year-old Caucasian male. The case raised a number of interesting points in management of lower-velocity penetrating brain injury (LVPBI, including benefit in delaying foreign body removal to allow for tamponade; the importance of history taking in establishing the social/legal significance of the events surrounding the injury; the use of cerebral angiogram in all cases of PBI; advantages of using DECT to reduce artifact when available; and antibiotic prophylaxis in the context of idiosyncratic histories of usage of penetrating objects before coming in contact with the intracranial environment. We present here the management of the case in full along with an extended discussion and review of existing literature regarding key points in management of LVPBI vs. higher velocity forms of intracranial injury.

  6. APPLIED KNOWLEDGE MANAGEMENT IN SMALL DESIGN FIRMS: CASE STUDY

    Directory of Open Access Journals (Sweden)

    Christian Donin

    2016-09-01

    Full Text Available Knowledge is the new strategic imperative of organizations. The ability to manage knowledge is a crucial part of any organizations operational processes. The creation and diffusion of knowledge have become ever more important factors in competitiveness. This paper investigates the Knowledge Management and flow information and in small design firms. It is divided into three main parts. The first part of this paper describes the importance of Knowledge Management for organizations are described together with responsibilities needed to ensure successful Knowledge Management implementations and the Spiral of Organizational Knowledge Creation conception. The second part approaches literature available about process and organizational structure and information flow related to Brazilian design firms. Finally, this paper presents a case study of small design office of Civil Engineering identifying organizational process, verifying the types of communication practices and identifying the types of dynamic process of The Spiral of Organizational Knowledge Creation, KM strategy and dynamic through Knowledge Transfer.

  7. Reasons for attempted suicide in later life.

    Science.gov (United States)

    Van Orden, Kimberly A; Wiktorsson, Stefan; Duberstein, Paul; Berg, Anne Ingeborg; Fässberg, Madeleine Mellqvist; Waern, Margda

    2015-05-01

    Using the Interpersonal Theory of Suicide as a guiding framework, we investigated older adults' causal attributions for suicidal behavior. We hypothesized that older adults who attributed their suicidal behavior to thwarted belongingness or perceived burdensomeness would be more likely to use more immediately lethal means and to re-attempt suicide during the 12-month follow-up. Prospective cohort study in western Sweden. A total of 101 older adults who presented to medical emergency rooms for suicide attempts. Participants were asked why they attempted suicide. Attributions included: a desire to escape (N = 29), reduced functioning and autonomy (N = 24), psychological problems, including depression (N = 24), somatic problems and physical pain (N = 16), perceived burdensomeness (N = 13), social problems that reflected either thwarted belongingness or family conflict (N = 13), and lack of meaning in life (N = 8); 41 participants provided more than one reason. No specific reason was given by 28 participants, 15 of whom reported not understanding or remembering why they attempted suicide and 13 reported simply wanting to die (or go to sleep and not wake up). As hypothesized, patients who attributed the attempt to thwarted belongingness were more likely to use more immediately lethal means for their index attempt and were more likely to re-attempt during follow-up. This was not the case for those reporting burdensomeness. People who attribute suicide attempts to thwarted belongingness use more lethal methods and have a poorer prognosis. Replications across diverse cultural settings are needed to determine whether attributing suicide attempts to thwarted belongingness may warrant increased monitoring. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  8. Sociodemographic profile of suicide attempters among the rural agrarian community of central India

    Directory of Open Access Journals (Sweden)

    Kshirod Kumar Mishra

    2015-01-01

    Full Text Available Background: Suicides, attempted suicides and different form of suicidal behaviors are on the rise in most part of the world. It is generally assumed that official suicidal rate are underestimated from the true rate by 20-100 % due to prevailing socio-cultural issues, religious attitude, stigma attached, and legal process involved. Attempted suicides occur 8-20 times more frequently than complete suicide. Statistics on attempted suicide or deliberate self harm are not usually available officially. Materials and Methods: All the cases of attempted suicide who were admitted and referred for psychiatric evaluation and management to a rural medical college of central India during a period of one Year (April 13-March-14, following initial recovery they were evaluated on a semi-structured performa on socio demographic profile, mode of attempt and reason for attempt. Data collected was analyzed using suitable statistical methods. Results: Total 68 cases were evaluated during the study period. 43% of the cases were involved in farming. Among 85% of the study population pesticide consumption was the common mode of attempt, which is easily available among the agrarian community of rural India. Interpersonal conflict in the family due to indebtedness, financial loss due to crop failure was the commonest reason for attempt. Conclusion: Though there is reduced reporting in the incidents of suicide cases in media from this region, still quite a number of people attempt suicide due to financial constraint from crop failure, ongoing indebtedness, and poor socioeconomic condition culminating into poor mental health among the rural agrarian community of central Maharashtra.

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

    Science.gov (United States)

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

    2015-05-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd [School of Technology Management and Logistics, Universiti Utara Malaysia, 06010 Sintok, Kedah (Malaysia); Baharum, Mohd Faizal [School of Building, Housing and Planning, Universiti Sains Malaysia, 11800 Penang (Malaysia)

    2015-05-15

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

  11. The Impact of Comprehensive Case Management on HIV Client Outcomes.

    Directory of Open Access Journals (Sweden)

    Mark Brennan-Ing

    Full Text Available In 1990, New York State instituted Comprehensive Medicaid Case Management, also known as Target Case Management (TCM, for people dealing with multiple comorbid conditions, including HIV. The goal of TCM is to assist clients in navigating the health care system to increase care engagement and treatment adherence for individuals with complex needs. HIV-positive individuals engaged in care are more likely to be virally suppressed, improving clinical outcomes and decreasing chances of HIV transmission. The purpose of this study was to understand the impact of TCM management on outcomes for people with HIV. Data were obtained from Amida Care, which operates not-for-profit managed care Medicaid and Medicare Special Needs Plans (SNPs for HIV clients. Changes in clinical, cost, as well as medical and pharmacy utilization data among TCM clients were examined between January 2011 through September 2012 from the start of case management enrollment through the end of the study period (i.e., up to 6 months after disenrollment. Additionally, CD4 counts were compared between Amida Care TCM clients and non-TCM clients. Notable findings include increased CD4 counts for TCM clients over the one-year study period, achieving parity with non-TCM clients (i.e., Mean CD4 count > 500. When looking exclusively at TCM clients, there were increases in medication costs over time, which were concomitant with increased care engagement. Current findings demonstrate that TCM is able to achieve its goals of improving care engagement and treatment adherence. Subsequent policy changes resulting from the Affordable Care Act and the New York State Medicaid Redesign have made the Health Home the administrator of TCM services. Government entities charged with securing and managing TCM and care coordination for people with HIV should provide thoughtful and reasonable guidance and oversight in order to maintain optimal clinical outcomes for TCM clients and reduce the transmission of

  12. Management challenges in a case of gender identity disorder

    Directory of Open Access Journals (Sweden)

    Anubhav Rathi

    2014-01-01

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

  13. Hemostasis by esophageal stent placement for management of esophageal tumor bleeding:a case report.

    Science.gov (United States)

    Isono, Yoshiaki; Saito, Tomonori; Tochio, Tomomasa; Kumazawa, Hiroaki; Tanaka, Hiroki; Matsusaki, Shimpei; Sase, Tomohiro; Okano, Hiroshi; Baba, Youichirou; Mukai, Katsumi

    2016-01-01

    A 67-year-old male was diagnosed with advanced esophageal cancer. A computed tomography scan showed multiple intra-abdominal lymphadenopathies. Because the tumor was thought to be unresectable, we initiated chemotherapy. Twelve months later, the patient was admitted to our hospital because of hematemesis. Gastroduodenoscopy revealed oozing bleeding from the esophageal tumor. Hemostasis was not achieved with conservative treatment, and frequent blood transfusions were required. Endoscopic hemostasis was difficult to achieve because of the malignant esophageal stenosis. To treat the malignant esophageal stricture and esophageal tumor bleeding, we attempted to insert an esophageal covered self-expandable metallic stent. After the procedure, hemostasis was achieved by mechanical tamponade. Here we report a rare case of esophageal tumor bleeding that was managed with mechanical tamponade using an esophageal covered self-expandable metallic stent.

  14. Cognitive Distortions and Suicide Attempts.

    Science.gov (United States)

    Jager-Hyman, Shari; Cunningham, Amy; Wenzel, Amy; Mattei, Stephanie; Brown, Gregory K; Beck, Aaron T

    2014-08-01

    Although theorists have posited that suicidal individuals are more likely than non-suicidal individuals to experience cognitive distortions, little empirical work has examined whether those who recently attempted suicide are more likely to engage in cognitive distortions than those who have not recently attempted suicide. In the present study, 111 participants who attempted suicide in the 30 days prior to participation and 57 psychiatric control participants completed measures of cognitive distortions, depression, and hopelessness. Findings support the hypothesis that individuals who recently attempted suicide are more likely than psychiatric controls to experience cognitive distortions, even when controlling for depression and hopelessness. Fortune telling was the only cognitive distortion uniquely associated with suicide attempt status. However, fortune telling was no longer significantly associated with suicide attempt status when controlling for hopelessness. Findings underscore the importance of directly targeting cognitive distortions when treating individuals at risk for suicide.

  15. Integrated Hydrographical Basin Management. Study Case – Crasna River Basin

    Science.gov (United States)

    Visescu, Mircea; Beilicci, Erika; Beilicci, Robert

    2017-10-01

    Hydrographical basins are important from hydrological, economic and ecological points of view. They receive and channel the runoff from rainfall and snowmelt which, when adequate managed, can provide fresh water necessary for water supply, irrigation, food industry, animal husbandry, hydrotechnical arrangements and recreation. Hydrographical basin planning and management follows the efficient use of available water resources in order to satisfy environmental, economic and social necessities and constraints. This can be facilitated by a decision support system that links hydrological, meteorological, engineering, water quality, agriculture, environmental, and other information in an integrated framework. In the last few decades different modelling tools for resolving problems regarding water quantity and quality were developed, respectively water resources management. Watershed models have been developed to the understanding of water cycle and pollution dynamics, and used to evaluate the impacts of hydrotechnical arrangements and land use management options on water quantity, quality, mitigation measures and possible global changes. Models have been used for planning monitoring network and to develop plans for intervention in case of hydrological disasters: floods, flash floods, drought and pollution. MIKE HYDRO Basin is a multi-purpose, map-centric decision support tool for integrated hydrographical basin analysis, planning and management. MIKE HYDRO Basin is designed for analyzing water sharing issues at international, national and local hydrographical basin level. MIKE HYDRO Basin uses a simplified mathematical representation of the hydrographical basin including the configuration of river and reservoir systems, catchment hydrology and existing and potential water user schemes with their various demands including a rigorous irrigation scheme module. This paper analyzes the importance and principles of integrated hydrographical basin management and develop a case

  16. Managing Brand Equity : a Case Study of PT. X

    OpenAIRE

    Effendi, Vincent; Liemmongan, Joseph Shalom

    2017-01-01

    Food & beverages is a tremendously growing industry in the recent and future years. It is a heavy and competitive industry with a steep prospect for Entrepreneurs in Surabaya. This research explore an immense opportunity to explore the impact of having a brand equity towards the purchase intention of F&B's industry for the case of PT. X.This Case Study found that there are discrepancies and similarities in the perspective of Owners/Brand Managers of PT. X and their consumers in influe...

  17. Management of C-shaped canals: Two case reports

    Directory of Open Access Journals (Sweden)

    Nilesh Suryakant Kadam

    2013-01-01

    Full Text Available A C-shaped canal with varying configuration is commonly observed in single-rooted mandibular second molars. Cooke and Cox (1979 first documented the C-shaped canal in endodontic literature. The presence of high incidence of transverse anastomoses, lateral canals, and apical deltas makes it difficult to clean and seal the root canal system in these teeth. The main reason for failure in endodontic treatment of mandibular second molars is the inability to detect the presence of C-shaped canals prior to an endodontic therapy. This case report presents successful management of two rare cases of C-shaped canal configurations.

  18. The Science Manager's Guide to Case Studies

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-09-24

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

  19. Flood risk management: cases studies in French Mediterranean area

    Directory of Open Access Journals (Sweden)

    Defossez Stéphanie

    2016-01-01

    Full Text Available In France, for a long time, flood risk management has only oriented to controlling flood hazard with structural measures such as dikes. But since 1990’s many events have proved they have not totally efficient measures. So, institutions decided it’s necessary to manage flood risk with others ways like prevention. Risk management is so organize about holistic policies with different stakeholders and societies exposed at risk. Our study have the aim to demonstrate through several examples how flood risk is manage in French Mediterranean area. Post event feedback permit us to evaluate damage and crisis management. This method is use for show if this strategies is efficient or not. This study demonstrate how is risk management in France. Regulations are they efficient, so have they an influence about the reduction of deaths and damages? Individual measures are they more important than collective action? Finally, what policies and strategies are used and effective? The main results about cases studies show that natural event has most important that publics policies and it determines preventive policies.

  20. Contingency for Cost Control in Project Management: A Case Study

    Directory of Open Access Journals (Sweden)

    Gary Jackson

    2012-11-01

    Full Text Available This paper provides a case study of the application of cost management techniques for project management of capital works within a major Australian electricity corporation. Historical data was collected from the corporation's archived files to establish the performance status of completed capital works projects. A survey of the corporation's project staff was also conducted to determine the current usage of cost management techniques and further explore the findings of the historical data search.The research indicates a reluctance to utilise formal cost management procedures on minor projects, estimated to cost less than $1 million. The time constraints allocated to project management planning and the perceived cost to implement procedures were identified as contributing to the limited use of formal cost management on minor projects.The paper concludes that increased risk of poor budget performance is inevitable if formal cost control is not applied to capital works projects, and recommends informal risk assessment and cost contingency measures to address this issue.

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

    Science.gov (United States)

    Amin, Alpesh N; Owen, Mary M

    2006-01-01

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

  2. Flexible Process Notations for Cross-organizational Case Management Systems

    DEFF Research Database (Denmark)

    Slaats, Tijs

    2016-01-01

    : the notations in which the processes are defined. Traditional process notations are flow-based: control of the process flows from one activity to the next. This paradigm inherently encourages modellers to think in terms of strict orderings instead of supporting flexibility. Flow-based models that do try...... of the process and techniques for runtime adaptation. This dissertation reports on the results of the Technologies for Flexible Cross-organizational Case Management Systems (FLExCMS) research project which was started in cooperation between ITU and the company Exformatics A/S. The goals of the project were...... these tools within customer projects, we report on a number of case studies based on these projects. Finally we report on a new angle of research within the Business Process Management field tentatively called Hybrid BPM Technologies, which aims to combine the advantages of both the flow- and constraint...

  3. Friedreich's ataxia cardiomyopathy: case based discussion and management issues.

    LENUS (Irish Health Repository)

    Hanley, A

    2010-04-01

    Cardiac involvement is common in Friedreich\\'s Ataxia and is a common cause of premature death. Evidence regarding treatment of congestive heart failure in patients with Friedreich\\'s Ataxia is lacking. The case of a 31-year-old male with advanced Friedreich\\'s Ataxia who presented with an acute diarrhoeal illness and features of acute heart failure is discussed. We then review the reported cardiac manifestations of Friedreich\\'s Ataxia and discuss management options.

  4. Towards Trustworthy Adaptive Case Management with Dynamic Condition Response Graphs

    DEFF Research Database (Denmark)

    Mukkamala, Raghava Rao; Hildebrandt, Thomas; Slaats, Tijs

    2013-01-01

    We describe how the declarative Dynamic Condition Response (DCR) Graphs process model can be used for trustworthy adaptive case management by leveraging the flexible execution, dynamic composition and adaptation supported by DCR Graphs. The dynamically composed and adapted graphs are verified...... for deadlock freedom and liveness in the SPIN model checker by utilizing a mapping from DCR Graphs to PROMELA code. We exemplify the approach by a small workflow extracted from a field study at a danish hospital....

  5. Nutritional management of Eosinophilic Gastroenteropathies: Case series from the community

    OpenAIRE

    Basilious Alfred; Liem Joel

    2011-01-01

    Abstract Eosinophilic gastroenteropathies, such as eosinophilic esophagitis and eosinophilic colitis, have classically been treated with swallowed inhaled corticosteroids or oral corticosteroids. More recent studies have found elimination and elemental diets to be effective treatment alternatives to steroids. In this case series we describe the treatment of three children using nutritional management in a community setting. Elimination diets and elemental diets based on patch testing and skin...

  6. Surgical management of a periapical cyst injury. Case Report

    OpenAIRE

    Medina Mosqueira, María; Estudiante de la especialidad de Endodoncia-Carielogía, Facultad de Odontología de la Universidad Nacional Mayor de San Marcos.

    2014-01-01

    Diagnosis and surgical management of dental root injuries suppose an extremely controversial question for dentist. Bearing in mind, that periapical cyst represents the most frequent injury in the maxilla, and that its differential diagnosis with chronic apical periodontitis shows a special complexity, decisions taken for its treatment acquires a major transcendence. the aim of this clinical case is to show clinical, radiographic Periapical Cyst diagnosis as long as its treatment by apicoectom...

  7. The Nordic maintenance care program – case management of chiropractic patients with low back pain: A survey of Swedish chiropractors

    Directory of Open Access Journals (Sweden)

    Jørgensen Kristian

    2008-06-01

    Full Text Available Abstract Background Chiropractic treatment for low back pain (LBP can often be divided into two phases: Initial treatment of the problem to attempt to remove pain and bring it back into its pre-clinical or maximum improvement status, and "maintenance care", during which it is attempted to maintain this status. Although the use of chiropractic maintenance care has been described and discussed in the literature, there is no information as to its precise indications. The objective of this study is to investigate if there is agreement among Swedish chiropractors on the overall patient management for various types of LBP-scenarios, with a special emphasis on maintenance care. Method The design was a mailed questionnaire survey. Members of the Swedish Chiropractors' Association, who were participants in previous practice-based research, were sent a closed-end questionnaire consisting of nine case scenarios and six clinical management alternatives and the possibility to create one's own alternative, resulting in a "nine-by-seven" table. The research team defined its own pre hoc choice of "clinically logical" answers based on the team's clinical experience. The frequency of findings was compared to the suggestions of the research team. Results Replies were received from 59 (60% of the 99 persons who were invited to take part in the study. A pattern of self-reported clinical management strategies emerged, largely corresponding to the "clinically logical" answers suggested by the research team. In general, patients of concern would be referred out for a second opinion, cases with early recovery and without a history of previous low back pain would be quickly closed, and cases with quick recovery and a history of recurring events would be considered for maintenance care. However, also other management patterns were noted, in particular in the direction of maintenance care. Conclusion To a reasonable extent, Swedish chiropractors participating in this

  8. Stock management and vendor managed inventory: a case study in a supermarket network

    Directory of Open Access Journals (Sweden)

    Letícia de Cassia Teixeira Vilhena

    2015-04-01

    Full Text Available Among logistics activities, inventory management stands out for cost increasing, demand fluctuations and for ensuring reasonable operational resources use. Therefore, a tool that enables more efficient inventory management Vendor Managed Inventory - VMI. It enables inventory monitoring by the supplier, being his responsibility immediately resupply when safety stock is reached. In face of such importance, this study aims to analyze VMI adoption in a food retailer inventory. So, a qualitative approach was used, presenting a case study, with semi-structured interviews with a script of questions. Thus, through this research we could identify advantages such as stock and delivery cost reduction.

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

    Directory of Open Access Journals (Sweden)

    Jozef Mincik

    2016-01-01

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

  10. Cost-effectiveness of depression case management in small practices.

    Science.gov (United States)

    Gensichen, Jochen; Petersen, Juliana J; Von Korff, Michael; Heider, Dirk; Baron, Steffen; König, Jochem; Freytag, Antje; Krauth, Christian; Gerlach, Ferdinand M; König, Hans-Helmut

    2013-06-01

    Case management undertaken by healthcare assistants in small primary care practices is effective in improving depression symptoms and adherence in patients with major depression. To evaluate the cost-effectiveness of depression case management by healthcare assistants in small primary care practices. Cost-effectiveness analysis on the basis of a pragmatic randomised controlled trial (2005-2008): practice-based healthcare assistants in 74 practices provided case management to 562 patients with major depression over 1 year. Our primary outcome was the incremental cost-effectiveness ratio (ICER) calculated as the ratio of differences in mean costs and mean number of quality-adjusted life-years (QALYs). Our secondary outcome was the mean depression-free days (DFDs) between the intervention and control group at 24-month follow-up. The study was registered at the International Standard Randomised Controlled Trial Number Registry: ISRCTN66386086. Intervention v. control group: no significant difference in QALYs; significantly more DFDs (mean: 373 v. 311, PDFDs. The intervention was likely to be cost-effective.

  11. Integration of QR codes into an anesthesia information management system for resident case log management.

    Science.gov (United States)

    Avidan, Alexander; Weissman, Charles; Levin, Phillip D

    2015-04-01

    Quick response (QR) codes containing anesthesia syllabus data were introduced into an anesthesia information management system. The code was generated automatically at the conclusion of each case and available for resident case logging using a smartphone or tablet. The goal of this study was to evaluate the use and usability/user-friendliness of such system. Resident case logging practices were assessed prior to introducing the QR codes. QR code use and satisfactions amongst residents was reassessed at three and six months. Before QR code introduction only 12/23 (52.2%) residents maintained a case log. Most of the remaining residents (9/23, 39.1%) expected to receive a case list from the anesthesia information management system database at the end of their residency. At three months and six months 17/26 (65.4%) and 15/25 (60.0%) residents, respectively, were using the QR codes. Satisfaction was rated as very good or good. QR codes for residents' case logging with smartphones or tablets were successfully introduced in an anesthesia information management system and used by most residents. QR codes can be successfully implemented into medical practice to support data transfer. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Managing knowledge: a technology transfer case study in IEN

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Ana Gabriella Amorim Abreu [Instituto de Engenharia Nuclear (IEN), Rio de Janeiro, RJ (Brazil). Servico de Transferencia de Tecnologia], e-mail: agaap@ien.gov.br

    2009-07-01

    Knowledge management is paramount nowadays. In order to enable the members of an organization to deal with their current situations effectively it is mandatory to know and enhance its intellectual capital. Managing the organization knowledge is important to the extent that it allows and reinforce its mission (what we are trying to accomplish?), and performance (how do we deliver the results?). As a result of a knowledge management effort, the organization can create value for itself and for society as a whole. In this paper, we argue that a technology developed at a research institute and transferred to an industry is knowledge to be managed in order to create value, both for the society and for the Institute. In order to manage such knowledge, it is proposed an approach to enhance the value creation potential of a technology transfer. This paper propose an investigation to expand the understanding on how a public research institute and a private firm could introduce their value creation wishes into a technology transfer agreement in a way to reflect and provide the realization of those wishes. It is proposed that, from the identification of the organizations expectations it is possible to infer which agreement attributes will contribute to that value creation and to establish satisfactory agreement configurations. These configurations have the potential to generate those consequences, given that, through the transfer, each organization seeks to increase potential benefits and to reduce potential sacrifices. Supported by exchange flow and value creation models, by the knowledge management and the means-end theory, an approach to increase the value creation potential of a technology transfer is proposed. Evidences from a case study sustain the proposed approach. The case study unity is the Instituto de Engenharia Nuclear, a public research institute. (author)

  13. Suicide attempts in multiple sclerosis

    DEFF Research Database (Denmark)

    Stenager, Elsebeth Nylev; Jensen, Børge; Stenager, Maria

    2011-01-01

    The purposes of the study were (1) to estimate the risk of suicide attempts in multiple sclerosis (MS) patients in Denmark and compare the risk to the background population in the County of Funen, Denmark; (2) to estimate the risk of suicide attempts in MS patients receiving immunomodulating...

  14. Management in Practice : A Multiple Case Study of Contemporary Managers in a Management Theory Context

    OpenAIRE

    Lange, Julien; Schörling, Egon

    2011-01-01

    Purpose The purpose of this thesis is to investigate the distance between theory and practice in the field of management. Theoretical perspective In the literature review we have chosen to give insights on the concepts that aresurrounding management students: organization, management, leadership and culture. Bydoing we were able to get a better understanding of the concepts that are fundamental tomanagement studies. In addition to that, by selecting these concepts we could assimilate thekey p...

  15. Case management for medical aid beneficiaries in Korea: findings from case-control study.

    Science.gov (United States)

    Shin, Hee-Sun; Oh, Jin-Joo

    2014-12-01

    This study was to evaluate effects of case management provided for 7 months for medical aid in Korea. This study was a retrospective comparative study using secondary data analysis. Data from two pre-existing survey were reanalyzed. The data were collected through door to-door interviews using the structured questionnaire. For the medical service use, claims data from the Korea National Health Insurance Corporation was used. Subjects were 73 in the intervention group and 118 in the control group. There was no significant change in the intervention group in self-care ability (p = .296), medication adherence (p = .194) or quality of life (p = .903) compared to those of the control group. For hospital visiting days, it appeared to decrease in the intervention group (p = .038) but with no significant difference from that of the control group (p = .157). Neither were there significant differences in medical expenditures (p = .605). Although the effect of case management in this study appeared extremely limited, the short intervention period and characteristics of the medical aid beneficiaries and the limit of controlling only the demand side were discussed as factors to be considered. Nurses have been carrying out professional roles in case management in Korea. However more efforts are needed to develop case management as an area for nursing specialization. Copyright © 2014. Published by Elsevier B.V.

  16. Strategic Management in Business Information Technology: A Case Study

    Directory of Open Access Journals (Sweden)

    Marcos Weber

    2013-09-01

    Full Text Available The Information Technology (IT sector is regarded as strategic for national economy. In Brazil, this sector is formed mostly of micro and small businesses. This article aims at understanding how does the strategic management process occurs in a small IT company, according to the schools of strategy and the strategy-as-practice approach. The method applied was a single case study of a small IT company, located in Rio Grande do Sul. The analyzed data revealed that the company adopts an informal strategic management centered on its directors, which may be related to the entrepreneurial school of strategy. However, data also indicate the presence of features of other schools of strategy along the company trajectory. We analyzed the strategy as social practice at the strategic level and also at the tactical level of the organization, through the guidance of managers, their interactions with customers and suppliers, their decision-making processes, among other practices related to everyday life. The results of the article shed light on the process of strategic management in micro and small IT companies, generating insights that can be useful for managers of similar companies.

  17. The role of requirements management in the design of built environments: a case study

    Directory of Open Access Journals (Sweden)

    Camila Pegoraro

    2011-12-01

    Full Text Available Due to the known difficulties on managing the design process of built environments, researchers and entrepreneurs have continuously developed and implemented best practices from areas such as Project Management (PM. However, there are still gaps to be filled, such as difficulties on monitoring the stakeholder’s requirements and their dynamics. In attempt to eliminate this gap, this paper aims to analyze if requirements management (RM can be integrated to PM and which are the main advantages and disadvantages of this integration. The research includes a literature review which presents PM and RM concepts, the last one based on software engineering approach. Moreover, a case study was performed in a construction company, using semi-structured interviews. The research showed that the use of RM is advantageous, even not solving all the projects difficulties, and that the proper structuring of the projects is a condition for the success of RM implementation. The main contribution is a generic and systematic proposal for integrating the stages of the RM to the projects.

  18. Farmers' use of nutrient management: lessons from watershed case studies.

    Science.gov (United States)

    Osmond, Deanna L; Hoag, Dana L K; Luloff, Al E; Meals, Donald W; Neas, Kathy

    2015-03-01

    Nutrient enrichment of water resources has degraded coastal waters throughout the world, including in the United States (e.g., Chesapeake Bay, Gulf of Mexico, and Neuse Estuary). Agricultural nonpoint sources have significant impacts on water resources. As a result, nutrient management planning is the primary tool recommended to reduce nutrient losses from agricultural fields. Its effectiveness requires nutrient management plans be used by farmers. There is little literature describing nutrient management decision-making. Here, two case studies are described that address this gap: (i) a synthesis of the National Institute of Food and Agriculture, the Conservation Effects Assessment Project, and (ii) field surveys from three nutrient-impaired river basins/watersheds in North Carolina (Neuse, Tar-Pamlico, and Jordan Lake drainage areas). Results indicate farmers generally did not fully apply nutrient management plans or follow basic soil test recommendations even when they had them. Farmers were found to be hesitant to apply N at university-recommended rates because they did not trust the recommendations, viewed abundant N as insurance, or used recommendations made by fertilizer dealers. Exceptions were noted when watershed education, technical support, and funding resources focused on nutrient management that included easing management demands, actively and consistently working directly with a small group of farmers, and providing significant resource allocations to fund agency personnel and cost-share funds to farmers. Without better dialogue with farmers and meaningful investment in strategies that reward farmers for taking what they perceive as risks relative to nutrient reduction, little progress in true adoption of nutrient management will be made. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  19. Attempted eyelid closure affects intraocular pressure measurement.

    Science.gov (United States)

    Gandhi, P D; Gürses-Ozden, R; Liebmann, J M; Ritch, R

    2001-04-01

    To evaluate the effect of attempted eyelid closure on intraocular pressure measurement. Normal subjects underwent intraocular pressure measurement in both eyes using Goldmann applanation tonometry and Tono-pen XL (Mentor, Inc, Norwell, Massachusetts) by the same examiner holding the eyelids open, both with and without the subject simultaneously attempting forced eyelid closure. Subjects were seated during all measurements and waited 5 minutes between measurements with each instrument; the order of measurement was randomized. Thirty eyes of 15 subjects (six men, nine women) were enrolled. Mean age was 30.5 +/- 5.2 years (range, 24 to 40 years). With Goldmann applanation tonometry, intraocular pressure increased in both eyes with attempted eyelid closure by a mean of 1.5 +/- 2.0 mm Hg (P =.0002, paired t test; range, -2 to 8 mm Hg). With the Tono-pen XL, intraocular pressure also increased in both eyes with attempted eyelid closure by a mean of 1.9 +/- 2.7 mm Hg (P =.0002, paired t test; range, -2 to 9 mm Hg). Tono-pen XL mean intraocular pressure values in both eyes (14.4 +/- 2.3 mm Hg) consistently overestimated those of Goldmann applanation tonometry (13.0 +/- 2.2 mm Hg) by a mean of 1.4 +/- 2.3 mm Hg. Attempted forced eyelid closure is a common and statistically significant source of error in routine outpatient measurement of intraocular pressure and could influence clinical management of glaucoma.

  20. Airport Managers' Perspectives on Security and Safety Management Systems in Aviation Operations: A Multiple Case Study

    Science.gov (United States)

    Brown, Willie L., Jr.

    Global terrorism continues to persist despite the great efforts of various countries to protect and safely secure their citizens. As airports form the entry and exit ports of a country, they are one of the most vulnerable locations to terror attacks. Managers of international airports constantly face similar challenges in developing and implementing airport security protocols. Consequently, the technological advances of today have brought both positive and negative impacts on security and terrorism of airports, which are mostly managed by the airport managers. The roles of the managers have greatly increased over the years due to technological advances. The developments in technology have had different roles in security, both in countering terrorism and, at the same time, increasing the communication methods of the terrorists. The purpose of this qualitative multiple case study was to investigate the perspectives of airport managers with regard to societal security and social interactions in the socio-technical systems of the National Terrorism Advisory System (NTAS). Through the data gained regarding managers' perception and experiences, the researcher hoped to enable the development of security measures and policies that are appropriate for airports as socio-technical systems. The researcher conducted interviews with airport managers to gather relevant data to fulfill the rationale of the study. Ten to twelve airport managers based in three commercial aviation airports in Maryland, United States participated in the study. The researcher used a qualitative thematic analysis procedure to analyze the data responses of participants in the interview sessions.

  1. Important Case Management Goals in Community Aged Care Practice and Key Influences.

    Science.gov (United States)

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

    To investigate important case management goals and key influences on the achievement of the goals in community aged care practice from the perspectives of case managers in Australia. We surveyed 154 case managers, representing 17.1% of the target population in the State of Victoria, Australia. The key information collected was case managers' characteristics and their selections of important case management goals. We also conducted 33 interviews with 47 case managers to explore their perceptions of important case-managed community aged care goals and the key influences on the achievement of these goals. Descriptive analysis, logistic regression, and qualitative thematic analysis were performed. The survey findings showed that important case management goals included improving client outcomes, improving care quality, enhancing care coordination and accessibility, and reducing nursing home admissions. The interview findings indicated that important case management goals were divided into client-centered goals (e.g., maintaining clients safely at home), case managers' personal goals (e.g., gaining professional development), and organizational goals/expectations/values (e.g., expecting case managers to manage budgets wisely). Finally, the mixed research methods determined constraints of organizational resources and policies, clients' risky decisions, and case managers' work experience and employment status as key influences or significant factors associated with the achievement of case management goals. Client-centered goals are of particular importance among those important case management goals. Case managers helping clients establish reasonable expectations and organizations developing favorable professional development policies and establishing reasonable job requirements and expectations will facilitate the achievement of case management goals.

  2. Tidal River Management (TRM and Tidal Basin Management (TBM: A case study on Bangladesh

    Directory of Open Access Journals (Sweden)

    Talchabhadel Rocky

    2016-01-01

    Full Text Available Bangladesh is the biggest delta of the world. Construction of numbers of polders is one of the flood resilient approach. But the presence of coastal polders de-linked the flood plain. The siltation in river causes riverbeds to become higher than the adjacent crop lands, and vast area under the polders became permanently water logged rendering large tract of land uncultivable. The current practice is temporarily de-poldering by cutting embankment. This is a natural water management process with very little human interventions but it needs strong participation and consensus with a great deal of sacrifice by the stakeholders for a specific period (3 to 5 years or even more[1]. An attempt has been made to study the phenomena of tidal basin management reviewing some secondary data and processes involved in successfully operated tidal basins of Bangladesh. And preliminary laboratory experiments are carried out to precisely look into the suspended sediment transport. With varying outflow discharge and sediment supply, the transport processes are investigated. 3D sediment transport model developed using openFOAM has good agreement with experimental result and can be used to better understand effectiveness of tidal basin management.

  3. Teaching Cases in Management - Sabor de Casa Restaurant

    Directory of Open Access Journals (Sweden)

    Nilda Maria de Clodoaldo Pinto Guerra Leone

    2009-01-01

    Full Text Available Small family businesses present a series of peculiarities and challenges, especially when it comes to the management of human resources. This case describes the true situation of an enterprise, Restaurante Sabor de Casa, and portrays the relationship between the founder and successor and its consequences on the practice and policy of human resources. The story is told from the point of view of the successor, who thinks about the situation of the company and his deep involvement in the dynamic and complex stage of working with his mother, the founder of the company, whose performance is that of an entrepreneur, albeit a traditional one. It shows his reflections on the directions the company has taken, the opinions of employees, based on research conducted in 2006 by university students and their questions about the way the contributions of the employees are managed, mainly by recognizing their importance for both the present and the future of the company. This case deals with the complexity of the management of human resources in a family organizational environment.

  4. Empowerment and change management in Aboriginal organisations: a case study.

    Science.gov (United States)

    McEwan, Alexandra B; Tsey, Komla; McCalman, Janya; Travers, Helen J

    2010-08-01

    The social organisation of work, management styles and social relationships in the workplace all matter for health. It is now well recognised that people who have control over their work have better health and that stress in the workplace increases the level of disease. In the context of organisational change, the potential benefits of empowerment strategies are two-fold: a positive impact on the organisation's effectiveness and enhancements in staff health, wellbeing and sense of control. This case study describes the University of Queensland Empowerment Research Program's experience working with the Apunipima Cape York Health Council in a change management process. Participatory action research and empowerment strategies were utilised to facilitate shifts in work culture and group cohesion towards achieving Apunipima's vision of being an effective lead agency for Indigenous health reform in Cape York. As part of the project, staff morale and confidence were monitored using a pictorial tool, Change Curve, which outlined the phases of organisational change. The project findings indicated that organisational change did not follow a clear linear trajectory. In some ways the dynamics mapped over a period of 18 months mirror the type of struggles individuals commonly encounter as a part of personal growth and development. In this case, one of the factors which influenced the program's success was the willingness of executive employees to actively support and participate in the change management process.

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

    Science.gov (United States)

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

    2014-10-01

    An evaluation of an internal laboratory decision to implement a protocol for limiting drug testing based on ethanol concentration in laboratory analysis for driving under the influence (DUI) cases is presented. The described case management strategy is supported by known impairment of ethanol at relatively high concentrations, difficulty assigning a level of contributing impairment from drugs in the presence of high ethanol levels and the likelihood that the drug results may be suppressed at trial. Although the results of this study reinforce the assertion that such protocols lead to the under reporting of drugs in DUI cases, for the majority of cases, 95% in this study, the drug analysis results were not significant and did not warrant the time and resources needed for the additional blood drug testing. Furthermore, the study demonstrated that a high drug positivity rate does not necessarily mean that those drug results are legally or pharmacologically meaningful. Additional research should be conducted with quantitative drug results and casework impact of blood drug screen protocols as previous studies only report drug positivity rates and not whether the drug results would be meaningful to the case. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. [Study protocol of a prevention of recurrent suicidal behaviour program based on case management (PSyMAC)].

    Science.gov (United States)

    Sáiz, Pilar A; Rodríguez-Revuelta, Julia; González-Blanco, Leticia; Burón, Patricia; Al-Halabí, Susana; Garrido, Marlen; García-Alvarez, Leticia; García-Portilla, Paz; Bobes, Julio

    2014-01-01

    Prevention of suicidal behaviour is a public health priority in the European Union. A previous suicide attempt is the best risk predictor for future attempts, as well as completed suicides. The primary aim of this article is to describe a controlled study protocol designed for prevention of recurrent suicidal behaviour that proposes case management, and includes a psychoeducation program, as compared with the standard intervention (PSyMAC). Patients admitted from January 2011 to June 2013 to the emergency room of the Hospital Universitario Central de Asturias were evaluated using a protocol including sociodemographic, psychiatric, and psychosocial assessment. Patients were randomly assigned to either a group receiving continuous case management including participation in a psychoeducation program (experimental group), or a control group receiving standard care. The primary objective is to examine whether or not the period of time until recurrent suicidal behaviour in the experimental group is significantly different from that of the control group. PSyMAC proposes low cost and easily adaptable interventions to the usual clinical setting that can help to compensate the shortcoming of specific action protocols and suicidal behaviour prevention programs in our country. The evaluation of PSyMAC results will determine their real effectivity as a case-magament program to reduce suicidal risk. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

  7. Knowledge management in local government: The case of Stellenbosch Municipality

    Directory of Open Access Journals (Sweden)

    Shamin Gaffoor

    2010-08-01

    Full Text Available Knowledge management (KM was a well-founded management approach that held significant benefits for public sector organisations. KM as a management philosophy had an impact on various components of an organisation and it could therefore significantly advance organisational efficiency. The successful implementation of KM initiatives had to be ensured because, different organisational processes and departments had to collaborate and functional silos had to be eliminated. KM required long-term commitment and dedication from all organisational members. Furthermore, there were certain knowledge management enablers in an organisation that needed to be developed and that were necessary for the achievement of organisational effectiveness. These enablers were the organisational culture, human resources, information technology, organisational structure and, the organisation’s strategy and leadership. This article assessed each of these enablers and how they impacted on an organisation’s KM efforts. Stellenbosch Municipality was used as a case in point. The article further examined how local governments were able to effectively implement KM practices as strategic tools used to achieve service delivery and operational goals. The article concluded with a number of recommended strategies, (1 to develop the KM enablers that were present in organisations and (2 to aid the implementation of successful organisational KM initiatives.

  8. [Airway management in Ludwig's angina - a challenge: case report].

    Science.gov (United States)

    Fellini, Roberto Taboada; Volquind, Daniel; Schnor, Otávio Haygert; Angeletti, Marcelo Gustavo; Souza, Olívia Egger de

    2015-07-31

    Ludwig's angina (LA) is an infection of the submandibular space, first described by Wilhelm Frederick von Ludwig in 1836. It represents an entity difficult to manage due to the rapid progression and difficulty in maintaining airway patency, a major challenge in medical practice, resulting in asphyxia and death in 8-10% of patients. Describe a case of a patient with Ludwig's angina undergoing surgery, with emphasis on airway management, in addition to reviewing the articles published in the literature on this topic. Male patient, 21 years, drug addict, admitted by the emergency department and diagnosed with LA. Difficult airway was identified during the anesthetic examination. In additional tests, significant deviation from the tracheal axis was seen. Undergoing bilateral thoracoscopic pleural drainage, we opted for airway management through tracheal intubation using fiberoptic bronchoscopy, and balanced general anesthesia was proposed. There were no complications during the surgical-anesthetic act. After the procedure, the patient remained intubated and mechanically ventilated in the intensive care unit. Airway management in patients with Ludwig's angina remains challenging. The choice of the safest technique should be based on clinical signs, technical conditions available, and the urgent need to preserve the patient's life. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  9. Nutritional management of Eosinophilic Gastroenteropathies: Case series from the community

    Directory of Open Access Journals (Sweden)

    Basilious Alfred

    2011-05-01

    Full Text Available Abstract Eosinophilic gastroenteropathies, such as eosinophilic esophagitis and eosinophilic colitis, have classically been treated with swallowed inhaled corticosteroids or oral corticosteroids. More recent studies have found elimination and elemental diets to be effective treatment alternatives to steroids. In this case series we describe the treatment of three children using nutritional management in a community setting. Elimination diets and elemental diets based on patch testing and skin prick tests reduced the eosinophil counts to normal levels in all three children. Food items which tested positive were then reintroduced while symptoms and eosinophil counts were monitored. Nutritional management of eosinophilic esophagitis and eosinophilic colitis was found to be effective in reducing symptoms. However, obstacles facing patients who choose this type of therapy include limitations due to the cost of repeated endoscopies, palatability of elimination/elemental diets and the availability of subspecialists trained in management (e.g. Allergy, Gastroenterology, and Pathology. It may be a worthwhile endeavour to overcome these obstacles as nutritional management minimizes the potential long-term effects of chronic steroid therapy.

  10. Nutritional management of Eosinophilic Gastroenteropathies: Case series from the community.

    Science.gov (United States)

    Basilious, Alfred; Liem, Joel

    2011-05-30

    Eosinophilic gastroenteropathies, such as eosinophilic esophagitis and eosinophilic colitis, have classically been treated with swallowed inhaled corticosteroids or oral corticosteroids. More recent studies have found elimination and elemental diets to be effective treatment alternatives to steroids. In this case series we describe the treatment of three children using nutritional management in a community setting. Elimination diets and elemental diets based on patch testing and skin prick tests reduced the eosinophil counts to normal levels in all three children. Food items which tested positive were then reintroduced while symptoms and eosinophil counts were monitored. Nutritional management of eosinophilic esophagitis and eosinophilic colitis was found to be effective in reducing symptoms. However, obstacles facing patients who choose this type of therapy include limitations due to the cost of repeated endoscopies, palatability of elimination/elemental diets and the availability of subspecialists trained in management (e.g. Allergy, Gastroenterology, and Pathology). It may be a worthwhile endeavour to overcome these obstacles as nutritional management minimizes the potential long-term effects of chronic steroid therapy.

  11. Determining climate change management priorities: A case study from Wisconsin

    Science.gov (United States)

    LeDee, Olivia E.; Ribic, Christine

    2015-01-01

    A burgeoning dialogue exists regarding how to allocate resources to maximize the likelihood of long-term biodiversity conservation within the context of climate change. To make effective decisions in natural resource management, an iterative, collaborative, and learning-based decision process may be more successful than a strictly consultative approach. One important, early step in a decision process is to identify priority species or systems. Although this promotes the conservation of select species or systems, it may inadvertently alter the future of non-target species and systems. We describe a process to screen terrestrial wildlife for potential sensitivity to climate change and then use the results to engage natural resource professionals in a process of identifying priorities for monitoring, research, and adaptation strategy implementation. We demonstrate this approach using a case study from Wisconsin. In Wisconsin, experts identified 23 out of 353 species with sufficient empirical research and management understanding to inform targeted action. Habitat management and management of hydrological conditions were the common strategies for targeted action. Although there may be an interest in adaptation strategy implementation for many species and systems, experts considered existing information inadequate to inform targeted action. According to experts, 40% of the vertebrate species in Wisconsin will require near-term intervention for climate adaptation. These results will inform state-wide conservation planning as well as regional efforts.

  12. [Lean logistics management in healthcare: a case study].

    Science.gov (United States)

    Aguilar-Escobar, V G; Garrido-Vega, P

    2013-01-01

    To study the applicability of the principles of Lean Production to manage the supply chain of a hospital. In particular, to determine which Lean practices and principles are applicable, the benefits obtained and the main barriers for its implementation. Managing the hospital supply chain is an important issue, both for its effect on the quality of care and its impact on costs. This study is based on a case study. 2005-10. Hospital Virgen Macarena in Seville. Process of implementing a comprehensive logistics management plan based on Lean principles and technological investments. The implementation of the comprehensive plan has reduced inventory, decreased lead times and improved service quality. Also, there have been other important improvements: enhanced employee satisfaction and increased staff productivity, both dedicated to health and the logistics. The experience analysed has shown the applicability and appropriateness of Lean principles and some of its techniques in managing the logistics of hospitals. It also identifies some of the main difficulties that may arise. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

  13. Managers' views on and experiences with moral case deliberation in nursing teams

    NARCIS (Netherlands)

    Weidema, F.C.; Molewijk, A.C.; Kamsteeg, F.; Widdershoven, G.A.M.

    2015-01-01

    Aims: Providing management insights regarding moral case deliberation (MCD) from the experiential perspective of nursing managers. Background: MCD concerns systematic group-wise reflection on ethical issues. Attention to implementing MCD in health care is increasing, and managers' experiences

  14. The rehabilitation management after hip arthroplasty: a case report

    Directory of Open Access Journals (Sweden)

    Adina BURCHICI

    2017-03-01

    Full Text Available Aim: In this paper we describe the physical therapy management of a 64-year-old female following a bilateral hip arthroplasty. Method: The patient featured in this study, after the surgical intervention had undergone specific recovery treatment consisting of: posture techniques, static (isometric contractions and dynamic kinetic techniques (passive motion, passive-actives, actives, actives with resistance, massage, respiratory gymnastics and reeducation of walking. Results: At the end of the rehabilitation program, hip muscular strength and joint range of motion were improved significantly. The Harris hip score was significantly improved, in comparison to the preoperative one. Conclusion: This case illustrates the importance of the rehabilitation management after bilateral hip replacement.

  15. Palliative care case management in primary care settings: A nationwide survey

    NARCIS (Netherlands)

    Plas, A.G. van der; Deliens, L.; Watering, M. van de; Jansen, W.J.; Vissers, K.C.P.; Onwuteaka-Philipsen, B.D.

    2013-01-01

    BACKGROUND: In case management an individual or small team is responsible for navigating the patient through complex care. Characteristics of case management within and throughout different target groups and settings vary widely. Case management is relatively new in palliative care. Insight into the

  16. Palliative care case management in primary care settings: A nationwide survey

    NARCIS (Netherlands)

    van der Plas, A.G.M.; Deliens, L.; van de Watering, M.; Jansen, W.J.J.; Vissers, K.C.; Onwuteaka-Philipsen, B.D.

    2013-01-01

    Background: In case management an individual or small team is responsible for navigating the patient through complex care. Characteristics of case management within and throughout different target groups and settings vary widely. Case management is relatively new in palliative care. Insight into the

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

    Science.gov (United States)

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

    2013-12-01

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

  18. Quality in translation: case management in the international marketplace.

    Science.gov (United States)

    Beichl, Lisa; Craig, Kathy

    2009-01-01

    This article identifies three categories of case management (CM), in-country, international, and micro, that are poised to serve as the quality proxy for the international medical patient in the rapidly emerging globalized healthcare marketplace. The content concentrates on describing in-country CM and international CM (ICM). Because CM professionals are the providers of patient-centered quality and safety improvements, they are capable of filling the chasm between the travel industry and the regulators who specialize in accrediting hospital systems. In-country and ICM case managers are equipped to perform surveillance and intervention at the level of the international patient's bedside, activate network connections, and use culture-sensitive communication skills to safeguard patients in their individual sojourns abroad. The article discusses useful concepts and sources, including an algorithmic tool under development that is geared to identify and quantify risks for lay and business individuals who seek to engage the global medical market. The article's information is provided for front-line and front-office healthcare practitioners to understand or enter the worldwide medical marketplace. Content is targeted to CM generalists, specialists, and business developers interested in learning about safeguarding the patients who travel internationally to receive medical care. It can also be applied by those within and outside the healthcare practice arena, particularly those interested in the development of quality initiatives. All research and syntheses were executed by the authors. Sources included scholarly treatises, business correspondence, medical tourism literature, corporate Internet profiles, news releases, and healthcare industry investigative and monitoring agencies. International health insurance, economics, and financing expertise stems from one author (L.B.). Clinical competencies stem from the international practice experiences of one author (K.C.). This

  19. Anaesthetic management of a case of idiopathic intracranial hypertension

    Directory of Open Access Journals (Sweden)

    Bina P Butala

    2013-01-01

    Full Text Available Idiopathic intracranial hypertension (IIH is a rare headache syndrome characterized by prolonged elevation of intracranial pressure without related pathology in either the brain or the composition of cerebrospinal fluid. Herein, we provide a brief review of the clinical presentation of IIH and the anaesthetic considerations in a female posted for transcervical resection of the endometrium and right nephrectomy with the disorder. Most of patients with IIH are reported during pregnancy and came for management of labour and delivery. To our knowledge no such case has been described previously.

  20. Conservative Management of Theca Lutein Cyst Accident: A Case Report

    Directory of Open Access Journals (Sweden)

    Radha Bai Prabhu T

    2017-10-01

    Full Text Available Theca lutein cysts can occur in 20-25% of molar pregnancies. These cysts can undergo complications such as torsion, rupture, and haemorrhage. As these are functional cysts, when there are complications such as torsion they can be managed conservatively by aspirating the cysts under ultrasound guidance or by detorsion at the time of laparoscopy. By simple detorsion, ovaries can be preserved in 80-90% of cases. In order to prevent recurrence adnexal fixation can be undertaken by plicating the ovarian ligament.

  1. A Case of Error Disclosure: A Communication Privacy Management Analysis

    Science.gov (United States)

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

    2013-01-01

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

  2. Exformatics Declarative Case Management Workflows as DCR Graphs

    DEFF Research Database (Denmark)

    Slaats, Tijs; Mukkamala, Raghava Rao; Hildebrandt, Thomas

    2013-01-01

    with researchers at IT University of Copenhagen (ITU) to create tools for the declarative workflow language Dynamic Condition Response Graphs (DCR Graphs) and incorporate them into their products and in teaching at ITU. In this paper we give a status report over the work. We start with an informal introduction......Declarative workflow languages have been a growing research subject over the past ten years, but applications of the declarative approach in industry are still uncommon. Over the past two years Exformatics A/S, a Danish provider of Electronic Case Management systems, has been cooperating...

  3. The complexities of managing forest resources in post-decentralization Indonesia: a case study from Sintang District, West Kalimantan

    NARCIS (Netherlands)

    Yasmi, Y.; Anshari, Gusti Z.; Alqadrie, S.; Budiarto, T.; Ngusmanto,; Abidin, E.; Komarudin, H.; McGrath, S.; Zulkifli,; Afifudin,

    2005-01-01

    The study attempted to understand the dynamics and complexities of forest resources management following decentralization, the interactions among stakeholders in forest resources management, and the impacts of the new legislation on local community livelihoods in Sintang District, West Kalimantan.

  4. Nonsurgical Management of a Large Periapical Lesion: A Case Report.

    Science.gov (United States)

    Ghorbanzadeh, Sajedeh; Ashraf, Hengameh; Hosseinpour, Sepanta; Ghorbanzadeh, Fatemeh

    2017-01-01

    This case report describes the non-surgical management of a large cyst-like periapical lesion in the mandible of a 16-year-old female with the chief complaint of periodic swelling and pus drainage from the mandibular anterior region gingivae with no history of pain and traumatic accident in this area. Both mandibular central incisors had extensive caries. Root canals of both mandibular central incisors were filled with calcium hydroxide. After 10 days, endodontic therapy was carried out on both teeth. Clinical and radiographic re-evaluations at 3 and 12 months revealed progressing bone healing. This case report shows that appropriate diagnosis in combination with root canal treatment as a conservative non-surgical approach can lead to complete healing of large lesions without invasive treatments.

  5. Severe ovarian hyperstimulation syndrome: Intensive care management of two cases

    Directory of Open Access Journals (Sweden)

    Praveen Talawar

    2011-01-01

    Full Text Available Severe ovarian hyperstimulation syndrome (OHSS is characterized by increased capillary permeability and fluid retention in the third space. It is generally a complication of assisted reproduction therapy (ART with exogenous gonadotropins, but cases with natural onset of OHSS have been reported. The massive extravascular exudation can cause tense ascites, pleural and pericardial effusion, hypovolemic shock, oliguria, electrolyte imbalance (hyponatremia and hyperkalemia, and hemoconcentration, with a tendency for hypercoagulability and risk of life-threatening thromboembolic complications. The patient can rarely develop multi-organ failure (adult respiratory distress syndrome, renal failure and death. With increasing use of ART, this syndrome may be seen more frequently in the intensive care unit (ICU, requiring multidisciplinary care. We report the management of two cases of severe OHSS, which required admission to the ICU in our hospital.

  6. Contract case managers prove cost effective in federal workers' compensation programs.

    Science.gov (United States)

    Mallon, Timothy Michael; Cloeren, Marianne; Firestone, Lisa Michelle; Burch, Helen Christine

    2008-03-01

    This pilot study examined whether contract case managers are cost effective in reducing workers' compensation (WC) costs and preventing injuries. We placed contract medical case managers at four installations where they employed private industry best practices. A needs assessment was performed and site-specific targeted interventions were developed. Case managers improved WC program effectiveness by ensuring command support, and strengthening the case management process. They minimized lost work time and provided the WC team resources to review the oldest cases. Case managers cost $1.25 million and they generated $4.4 million in savings for a 3.52 return on investment. Case managers removed 73 workers from long-term rolls by making use of vocational rehabilitation, finding modified duty jobs, offering workers medical retirement, and terminating benefits when workers refused to work after being offered a job. This study of medical case managers demonstrates they can reduce WC costs.

  7. Quality Management in Project Management Consulting. A Case Study in an International Consulting Company

    Directory of Open Access Journals (Sweden)

    Eduard-Gabriel Ceptureanu

    2017-02-01

    Full Text Available The present paper addresses quality management from the specific perspective of project management consulting service providers, in the framework of large infrastructure projects. Because of their supposed superiority in knowledge and experience, project management consultants have an ultimate responsibility for the proper implementing of the project. Therefore, quality management in consulting organizations should focus on critical success factors. As there is no consensus yet regarding the most important aspects of the consulting activity on which depend the achievement of the project aims, there is scope for further investigating this subject. Here, the case of a project management consulting organization involved in large infrastructure projects in Romania, Bulgaria, Moldova, Ukraine and Serbia is analyzed. Data collected through a questionnaire-based survey among international consultants and support personnel suggest that factors related to leadership style and communication skills are more closely tied to the success of the project than more technical aspects. The results constitute an empirical evidence of main success factors for specialized consulting services in project management and can be useful in improving business and project performance and achieving business excellence.

  8. 25 CFR 20.515 - What is required for case management?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What is required for case management? 20.515 Section 20... quality case management; this requires the supervisor's review of case plans every 90 days. ... AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.515 What is required for case...

  9. Case Mix Management Systems: An Opportunity to Integrate Medical Records and Financial Management System Data Bases

    Science.gov (United States)

    Rusnak, James E.

    1987-01-01

    Due to previous systems selections, many hospitals (health care facilities) are faced with the problem of fragmented data bases containing clinical, demographic and financial information. Projects to select and implement a Case Mix Management System (CMMS) provide an opportunity to reduce the number of separate physical files and to migrate towards systems with an integrated data base. The number of CMMS candidate systems is often restricted due to data base and system interface issues. The hospital must insure the CMMS project provides a means to implement an integrated on-line hospital information data base for use by departments in operating under a DRG-based Prospective Payment System. This paper presents guidelines for use in selecting a Case Mix Mangement System to meet the hospital's financial and operations planning, budgeting, marketing, and other management needs, while considering the data base implications of the implementation.

  10. What do case managers do? An investigation of case manager interventions and their relationship to client outcome.

    Science.gov (United States)

    Björkman, T; Hansson, L

    2000-01-01

    The aim of the present study, which forms part of a wider case management multicenter study, was to explore the content of case managers' work, service patterns, and their relationship to client outcome. Client background characteristics were registered at admission, and needs of care and psychosocial functioning were assessed at admission to the service and after 18 months. In seven of the services an extended follow-up was performed, which included assessments regarding quality of life, level of symptoms and social network. The study comprised 176 severely mentally ill clients, of whom 153 participated in a general 18-month follow-up (87%), with 113 clients out of 134 participating in an extended follow-up sample (84%). The investigation of service patterns showed that clients received services in a great variety of life areas using a number of different types of interventions. The results support the assumption that severely mentally ill clients are in need of case management services that offer more than brokerage services and coordination. A more active rehabilitation-oriented approach was found towards younger clients and clients who had a job, which may reflect a higher level of ambition in assisting younger clients to gain access to and stay in education and the labor market. Several types of intervention were related to client outcome. Brokerage, intervention planning and more interventions in the area of skills relating to activities of daily living were related to a more pronounced decrease in needs of care. More time spent on indirect work on behalf of the clients was related to a better outcome with regard to psychiatric symptoms and social network. The results indicate that specific service components have a more obvious distinct impact than others on outcome, and that this increase in effectiveness varies with the outcome targeted.

  11. The value of play for conflict management: a case study

    Directory of Open Access Journals (Sweden)

    Lyn Snodgrass

    2009-02-01

    Full Text Available This is a case study of a conflict management intervention in two secondary schools in post-apartheid South Africa. The feature of the intervention that we examine is the use of play as an educational strategy. The literature attests that play can facilitate change by allowing learners freedom to change their behaviour and opportunities to explore their new identities. The context of the case revealed that conflicts had become deeply entrenched over time. The literature on conflict management suggests that such situations can change if approached in the right way. In the article we describe the intervention and evaluate it with the help of feedback received from participants and facilitators. In the evaluation we found that the participants were able to overcome prejudices and develop democratic approaches to conflict. The evaluation was repeated several months later, when it was found that the benefits of the workshop had been maintained, with the result that the participants were engaging in healthier relationships.

  12. Multidisciplinary Clinical Management of Paraneoplastic Pemphigus – A Case Report

    Directory of Open Access Journals (Sweden)

    Sadaksharam Jayachandran

    2017-10-01

    Full Text Available Paraneoplastic pemphigus is a rare immunobullous disorder commonly associated with lymphoproliferative neoplasms and less commonly in carcinomas with a poor prognosis. The neoplasms produce autoantibodies that react with members of plakin family to produce a suprabasilar split and varied clinical presentations in the skin and mucous membrane. Oral erosions are the first manifestation most resistant to treatment and persist even after the underlying tumour has been resected or treated. We report here a rare case of paraneoplastic pemphigus with an underlying squamous cell carcinoma of the oesophagus that constitutes only 8% of the neoplasms associated with this condition. It was successfully managed by a multidisciplinary approach involving the Departments of Dermatology, Surgical Oncology and Oral Medicine. The oral erosions were resistant to treatment however, a patient-tailored treatment was advocated using professionally administered debridement with hydrogen peroxide diluted with hypotonic saline, high potency topical steroids, analgesic oral rinses and topical anaesthetics with systemically administered immunomodulators. Hence, management of such cases exhibiting systemic and oral manifestations require a multidisciplinary team approach to improve the quality of life of the patients.

  13. Misconceptions And Myths In The Management Of Animal Bite Cases

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    Sekhon A.S

    2002-01-01

    Full Text Available Research question : What are the common myths and misconceptions in the management of animal bite cases among patients attending antirabies clinic, Rajindra Hospital Patiala. Objectives: 1. To find out beliefs and misconceptions among patients attending Antirabies clinic. 2. To study distribution of bites in relation to different variables. Setting: Antirabies clinic, Rajindra Hospital, Patiala (Deptt. of Community Medicine. Study design: Retrospective study. Sample size: 4.585 patients who attended the Antirabies clinic in a period of 3 years and 9 months. Statistical analysis: Simple proportions. Study variables : Age, sex, place, literacy, class of bite, myths. Results: Out of 4.585 patients, 71.4% were males and 61.8% reported from urban area. Majority of the patients were in age group 15-30 years and 59.2% were literate. Majority (95% of cases were of dog bite followed by monkey bite (1.8% buffalo bite(1.6% and cat bit (1.3%. 38.6% patients presented with class III bites. Common practices prevalent in the management of wounds were washing with soap and water (21.02%, with only water (9.53%, application of chilies (14.18%, dettol and antiseptic (5.45%, cowdung (0.46% and carbon (0.89%.

  14. Managing Transition in an Artistic Company With Entrepreneurial Management : A Case Study of Groupe Bernard Loiseau

    OpenAIRE

    Paris, Thomas; Leroy, Frédéric

    2014-01-01

    International audience; The important role of entrepreneurship in the dynamics of the arts sector and the influence of the leader's personality make succession a key issue in creative industries. What happens to an artistic organization when its founder leaves? How does it evolve? Can it adopt a style of management that is compatible with the founder's absence? This article focuses on the case of Groupe Bernard Loiseau, an iconic French company in the culinary arts whose owner and chef died s...

  15. Management of common bile duct stones with a biliary endoprosthesis. Report on 40 cases.

    Science.gov (United States)

    Peters, R; Macmathuna, P; Lombard, M; Karani, J; Westaby, D

    1992-01-01

    Endoscopic placement of a biliary endoprosthesis has been proposed for the management of choledocholithiasis when stone extraction is difficult or considered hazardous. Over a two year period this approach was used in 40 such patients. There were 24 women and 16 men with a median age of 76 years. In seven patients with severe cholangitis no attempt was made to extract the stones. Twenty three (57.5%) patients underwent a sphincterotomy and four (10%) needle knife papillotomy. The endoprosthesis insertion was considered a temporary measure in 13 (32.5%) patients and definitive treatment in 27 (67.5%). Bile duct drainage was established in all patients. Early complications occurred in six patients (15%), but were without sequelae. Late complications developed in eight (20%) of the patients and included biliary colic (four), cholangitis (three), and cholecystitis (one). Two patients (one cholangitis and one cholecystitis) died as a consequence of the complication. Only patients without a sphincterotomy developed cholangitis. A total of eight patients (20%) underwent surgery (one as an emergency) and nine a repeat endoscopic retrograde cholangio pancreatography (two as an emergency) to clear the duct. The remaining 23 patients are asymptomatic at a median of 13 months (range five to 24 months). Biliary endoprosthesis insertion for choledocholithiasis is an important alternative means of establishing drainage in selected cases, and is probably the optimum method of management for the elderly and or debilitated patients with previous cholecystectomy. Caution must be exercised, however, in patients with an in situ gall bladder. PMID:1446871

  16. [Inadequate management of a difficult airway. Case SENSAR of the trimester].

    Science.gov (United States)

    2015-01-01

    A clinical case reported to SENSAR is presented (www.sensar.org). A patient came to the operating room for surgery for parathyroidectomy. She had several predictors of difficult airway management, including a story of difficulties in previous intubations in other hospitals, as the patient reported. Therefore, after evaluation in preoperative consultation, fibreoptic bronchoscopy intubation was recommended. The day of surgery after induction of general anesthesia direct laryngoscopy was performed, without recognizing any glottic structure (Cormack-Lehane grade iv). Conventional laryngoscope was changed to a videolaryngoscope (Airtraq(®)) to try to improve the laryngoscopic view, but there were difficulties with handling and insertion of it, causing minor injuries to the lingual mucosa. Finally, tracheal intubation was achieved after several attempts. Analysis of the incident revealed the active error due to lack of experience of the professional who performed intubation maneuvers, favored by latent factors or contributors as were the complex pathology of the patient and the absence of protocols to difficult airway management in the hospital. Communication and analysis of this incident served to highlight the importance of the security protocols in Anesthesia, and as a result a working group that conducted the current algorithm approach to a difficult airway management was formed, established guidelines for further information patient and deals since clinical training and professional practice for the management of airway devices availables in the hospital. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Alarm management in gas pipeline plant: a case study

    Energy Technology Data Exchange (ETDEWEB)

    Araujo, Juliano; Lima, Marcelo; Leitao, Gustavo; Guedes, Luiz Affonso [Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN (Brazil); Branco, Nicolau; Coelho, Robson; Elias, Gustavo Passos; Nunes, Marcelo [Transportadora Brasileira Gasoduto Bolivia-Brasil (TBG), Rio de Janeiro, RJ (Brazil)

    2009-07-01

    In order to improve the requirements of industrial processes, many decision support systems have been introduced in recent years. In this context, the alarm management systems have great relevance. On the other hand, the informatics revolution allowed a great increase of information concerning the operation of the industrial processes. Currently, process operators handle an excessive number of about 1.500 alarms per day. Thus, this overdose of information implies in the discredit of alarms. Then, in order to improve the operation activities of industrial processes, it is mandatory to incorporate procedures to evaluate and rationalize alarms. Since the EMMUA191 Standard is the reference guide to alarm management, but it does not specify how to execute an alarm management procedure, in this paper, a systematic procedure to evaluate alarms configurations in industrial processes is proposed. This procedure is in line with EMMUA191 and is composed by the following steps: to use statistics analyses to identify problematic alarms, such as occurrence, intermittency, correlation, and flooding calculation; to indicate problematic alarm group; and to propose a set of actions to be implemented. To validate our proposal, we present a case study in a gas pipeline plant using the BR-AlarmExpert software. (author)

  18. Octreotide for the Management of Chylothorax in newborns, case report

    Directory of Open Access Journals (Sweden)

    Reza Saeidi

    2015-02-01

    Full Text Available Chylothorax is the most common cause of pleural effusion in neonates. It is usually idiopathic. Neonatal chylothorax successfully respond to octreotide treatment and can reduce the duration of hospitalization. A number of therapeutic interventions have been used to reduce chyle production and promote resolution of a chylothorax. Initial management typically includes restriction or temporary cessation of enteral feedings. Enteral feedings high in medium-chain triglycerides (MCT or parenteral nutrition may be used. These strategies alone are not successful in all patients. In the last several years, octreotide has become another option for management of patients with chylothorax. octreotide has a number of effects on the gastrointestinal system, including a decrease in splanchnic blood flow and inhibition of serotonin, gastrin, vasoactive intestinal peptide, secretin, motilin, and pancreatic polypeptide. We report an infant who had spontaneous chylothorax with patent ductus arteriosus that was managed primarily as congenital heart disease. Our case was treated successfully with octreotide without the need to insertion of chest tube.

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

    Directory of Open Access Journals (Sweden)

    Wu Hsin-i

    2005-01-01

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

  20. Zika virus infections in pregnancy: epidemics and case management

    Directory of Open Access Journals (Sweden)

    Fatih sahiner

    2016-03-01

    Full Text Available Zika virus is an RNA virus belonging to the Flaviviridae family, and is primarily transmitted by Aedes mosquitoes. Only a small number of cases had been described until 2007 when the first major Zika virus outbreak occurred on Yap Island, Micronesia. Approximately 80% of people infected with Zika virus do not exhibit any symptoms. Symptomatic infections are generally moderate and characterized by acute onset of fever, maculopapular rash, arthralgia, or conjunctivitis. The virus has recently attracted a broad interest due to the emerging cases of microcephaly that are possibly associated with mothers infected by the Zika virus during pregnancy, and the regional increases in the incidence of Guillain-Barre syndrome during the epidemic periods. Although the relationship between Zika virus infection and these abnormalities is not obviously understood yet, Zika virus testing is recommended for infants with microcephaly or intracranial calcifications whose mothers were potentially infected with the Zika virus during pregnancy. Every day, new reports are being published about the outbreaks associated with this virus; nevertheless, no new cases of this virus have been reported in Turkey. Despite this, we cannot currently exclude the possibility of the encounter with the virus because of the presence of Aedes mosquitoes, which are responsible for the spread of the virus, are prevalent in Turkey, and an increasing number of travel-related cases are being reported from different countries. In the light of the current knowledge on this virus, this review aims to discuss the course of Zika virus infections in detail, especially congenital infection, and presenting current information about the case management and preventive measures. [Cukurova Med J 2016; 41(1.000: 143-151

  1. What is case management in palliative care? An expert panel study

    Directory of Open Access Journals (Sweden)

    van der Plas Annicka G M

    2012-06-01

    Full Text Available Abstract Background Case management is a heterogeneous concept of care that consists of assessment, planning, implementing, coordinating, monitoring, and evaluating the options and services required to meet the client's health and service needs. This paper describes the result of an expert panel procedure to gain insight into the aims and characteristics of case management in palliative care in the Netherlands. Methods A modified version of the RAND®/University of California at Los Angeles (UCLA appropriateness method was used to formulate and rate a list of aims and characteristics of case management in palliative care. A total of 76 health care professionals, researchers and policy makers were invited to join the expert panel, of which 61% participated in at least one round. Results Nine out of ten aims of case management were met with agreement. The most important areas of disagreement with regard to characteristics of case management were hands-on nursing care by the case manager, target group of case management, performance of other tasks besides case management and accessibility of the case manager. Conclusions Although aims are agreed upon, case management in palliative care shows a high level of variability in implementation choices. Case management should aim at maintaining continuity of care to ensure that patients and those close to them experience care as personalised, coherent and consistent.

  2. Knowledge management and cognitive theory: An African case study

    Directory of Open Access Journals (Sweden)

    A. Misch

    2006-12-01

    Full Text Available Purpose: The aim of this paper is to report on research into whether knowledge can be managed more effectively by taking into consideration the nature and complexity of information being received by members of an organisation; the cognitive abilities of those members; and finally the nature and composition of the hierarchical structure of the organisation within which those members operate. Design/Methodology/Approach: The research reported on in this paper was carried out using a case study approach, with the focus on a single organisation to which the authors had special access. Data was gathered using a combination of interviews and a focus group, with participants drawn from a cross-section of members of the case study organisation. Analysis was conducted within the framework associated with the primary theoretical model (Jaques & Clement, 1991 that underpins this research. Findings: This research helps to further an understanding of how individual and organisational performance may be influenced by issues such as cognitive processes and the relationship to information complexity. The research findings support the work of Jaques and Clement (1991. Implications: This research had important implications for the organisation in the case study investigation. Other organisations would need to evaluate the research findings in terms of their applicability to other organisations in the same industry, in the same country (South Africa or elsewhere in other industries or in other countries on the African continent. Originality/Value: This research is original in terms of the application of cognitive theory in conjunction with knowledge management principles in the context of the legal profession in South Africa. It has potential value in many other industries and countries.

  3. Case managers speak out: responding to depression in community long-term care.

    Science.gov (United States)

    Munson, Michelle; Proctor, Enola; Morrow-Howell, Nancy; Fedoravicius, Nicole; Ware, Norma

    2007-08-01

    This study sought to understand how case managers in one publicly funded health and social service system, community long-term care, understand and address depression among their clients. Four focus groups with a total of 18 case managers were conducted. Case managers were asked a series of questions about their perspectives on the recognition and treatment of depression, including subthreshold depression, in community long-term care. Case managers perceived addressing depression as complex because of competing demands. Furthermore, case managers perceived conflict between their current role and what it would take to expand their role to include addressing depression. Case managers suggested that in order to successfully improve the detection and treatment of depression in community long-term care, systemic changes, such as increased support and training, may be necessary, along with a shift in the professional role of case managers.

  4. Mainstreaming Disaster Risk Management into Management Education: Case of the Mona School of Business & Management

    Directory of Open Access Journals (Sweden)

    INDIANNA MINTO-COY

    Full Text Available The purpose of this paper is to provide a background to and guide for mainstreaming Disaster Risk Management (DRM into higher education and training institutions in Small Island Developing States (SIDS, with the aim of increasing awareness and understanding of the complexity of DRM issues in business and management, based on their general and specific vulnerabilities. SIDS are considered a special category within the discussion on DRM, given a number of vulnerabilities generally and specifically. Furthermore, little attention has been paid to the business impact of disasters in such settings. It is proposed that one major route to improving this situation is through the educational and training institutions, which play a major role in shaping thinking and practices in such settings.

  5. Suicide attempt with a mix of synthetic cannabinoids and synthetic cathinones: Case report of non-fatal intoxication with AB-CHMINACA, AB-FUBINACA, alpha-PHP, alpha-PVP and 4-CMC.

    Science.gov (United States)

    Klavž, Janez; Gorenjak, Maksimiljan; Marinšek, Martin

    2016-08-01

    We report on a case of intoxication with a mix of new psychoactive substances. A 38-year-old male was brought to the emergency department (ED) following the ingestion of an unknown drug in a suicide attempt. During the transport, he became progressively more somnolent and unresponsive to painful stimuli. Urine and stomach content were collected on admission to be screened for drugs of abuse and medicinal drugs. After admission, the patient's next of kin presented five small grip seal plastic bags containing different powders/crystals, and they were sent for analysis along with urine and stomach content to the toxicology laboratory. An easy and rapid sample preparation technique was applied for the extraction of urine and stomach content. Samples were extracted with liquid-liquid extraction (LLE) technique and analysed using gas chromatography-mass spectrometry (GC-MS). A small amount of powder material from the bags was diluted in methanol and injected directly into the GC-MS instrument. Obtained spectra (EI) were evaluated against SWGDRUG library. Five different designer drugs were identified in the powder material, including synthetic cannabinoids (AB-CHMINACA, AB-FUBINACA) and synthetic cathinones (alpha-PHP, alpha-PVP and 4-CMC). With the exception of 4-CMC, all of these substances were also detected in the stomach content along with the prescription drugs. This is the first time that a positive identification of these five drugs has been made by a clinical laboratory in Slovenia. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Anesthetic management of a patient with multiple sclerosis - case report

    Directory of Open Access Journals (Sweden)

    Eduardo Barbin Zuccolotto

    Full Text Available Abstract Background and objectives: Multiple sclerosis is a demyelinating disease of the brain and spinal cord, characterized by muscle weakness, cognitive dysfunction, memory loss, and personality disorders. Factors that promote disease exacerbation are stress, physical trauma, infection, surgery, and hyperthermia. The objective is to describe the anesthetic management of a case referred to urological surgery. Case report: A female patient, 44 years of age, with multiple sclerosis, diagnosed with nephrolithiasis, referred for endoscopic ureterolythotripsy. Balanced general anesthesia was chosen, with midazolam, propofol and remifentanil target-controlled infusion; sevoflurane via laryngeal mask airway; and spontaneous ventilation. Because the patient had respiratory difficulty presenting with chest wall rigidity, it was decided to discontinue the infusion of remifentanil. There was no other complication or exacerbation of disease postoperatively. Conclusion: The use of neuromuscular blockers (depolarizing and non-depolarizing is a problem in these patients. As there was no need for muscle relaxation in this case, muscle relaxants were omitted. We conclude that the combination of propofol and sevoflurane was satisfactory, not resulting in hemodynamic instability or disease exacerbation.

  7. Palliative care case management in primary care settings: a nationwide survey.

    Science.gov (United States)

    van der Plas, Annicka G M; Deliens, Luc; van de Watering, Marlies; Jansen, Wim J J; Vissers, Kris C; Onwuteaka-Philipsen, Bregje D

    2013-11-01

    In case management an individual or small team is responsible for navigating the patient through complex care. Characteristics of case management within and throughout different target groups and settings vary widely. Case management is relatively new in palliative care. Insight into the content of care and organisational characteristics of case management in palliative care is needed. To investigate how many case management initiatives for palliative care there are in the Netherlands for patients living at home; to describe the characteristics of these initiatives with regard to content and organisation of care. Primary care. A nationwide survey of all 50 coordinators of networks in palliative care in the Netherlands was conducted. Additional respondents were found through snowball sampling. We looked at 33 possible initiatives using interviews (n=33) and questionnaires (n=30). We identified 20 initiatives for case management. All stated that case management is supplemental to other care. In all initiatives the case managers are registered nurses and most possess higher vocational education and/or further training. All initiatives seek to identify the multidimensional care needs of the patients and the relatives and friends who care for them. Almost all provide information and support and refer patients who need care. Differences are found between the organisations offering the case management, their target groups, the names of the initiatives and whether direct patient care is provided by the case manager. In the Netherlands, case management in palliative care is new. Several models of delivery were identified. Research is needed to gain insight into the best way to deliver case management. By describing characteristics of case management in palliative care, an important first step is made in identifying effective elements of case management. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Multidimensional profile of people who have attempted to commit suicide

    OpenAIRE

    Núñez Gómez, Nicolás Arturo; Olivera Plaza, Silvia Leonor; Losada Ramirez, Ivan Daniel; Díaz Monroy, Lusi Guillermo; Rojas Vega, Homero Abraham

    2010-01-01

    The purpose of this study is to establish a multidimensional profile of people who have attempted to commit suicide. 116 cases of people with reported suicide attempts in emergency rooms and educational institutions in the department of Huila were studied. This was a descriptive study, with a semi-structured interview, personality test, depression inventory, alcohol evaluation, ideation and suicide attempt evaluations. The multidimensional profile consisted of adolescents from rural areas, ci...

  9. Management of lercanidipine overdose with hyperinsulinaemic euglycaemia therapy: case report

    Directory of Open Access Journals (Sweden)

    Messer Ben

    2011-01-01

    Full Text Available Abstract This case report describes the first reported overdose of the dihydropyridine calcium channel blocker (CCB lercanidipine. A 49 yr old male presented to the Emergency Department 3 hrs after the ingestion of 560 mg of lercanidipine. In the department he had a witnessed seizure within 15 minutes of arrival attributed to the overdose. Following immediate recovery of consciousness after the seizure, he had refractory hypotension and bradycardia which failed to respond to fluid resuscitation, glucagon therapy, and intravenous calcium. He went on to require vasopressor support with noradrenaline and was treated with high dose insulin therapy which was successful in achieving cardiovascular stability. Vasopressor therapy was no longer required within one half life of lercanidipine, and the total stay on intensive care was one day before transfer to a ward. Calcium channel blocker overdose is an uncommon but life-threatening overdose. Treatment for severe toxicity is similar to b-blocker overdose. Hypotension is treated with intravenous fluid therapy, intravenous calcium and possibly glucagon with vasopressor or inotropic support as required. Atropine is used to attempt reversal of bradycardia. High doses of intravenous insulin with intravenous dextrose as required (hyperinsulinaemic euglycaemia or HIET, has also been successfully reported. Experimental animal data suggests that HIET is of benefit and potentially superior to fluid therapy, calcium, glucagon and potentially vasopressor therapy. HIET effectively and sustainably reverses hypotension, bradycardia and improves myocardial contractility and metabolism. Current advice in calcium channel blocker overdose is to begin therapy early in toxicity, starting with a 1.0 IU/kg insulin bolus followed by an infusion of 0.5 IU/kg/hr of insulin and dextrose as required titrated to clinical response.

  10. [Case study shows that the case manager function for cancer patients is used unevenly across the different cancer forms].

    Science.gov (United States)

    Jakobsen, Stein Finne; Bjerrum, Anne; Grønberg, Tanja Le; Thomsen, Pauline; Topp, Charlotte

    2015-06-08

    This case study of the obligatory case manager function for cancer patients explores by whom and for what the function is used. It draws on quantitative data from a database, focus group interviews with case managers at Rigshospitalet and telephone interviews with patients and relatives. The conclusion is that across the different cancer forms patients are using the function unevenly. This can probably be explained by the varying organizational set-ups for patient trajectories across departments. The individual patients and relatives express satisfaction with the information and assistance received from the case managers.

  11. A combined disease management and process modeling approach for assessing and improving care processes: a fall management case-study

    NARCIS (Netherlands)

    Askari, Marjan; Westerhof, Richard; Eslami, Saied; Medlock, Stephanie; de Rooij, Sophia E.; Abu-Hanna, Ameen

    2013-01-01

    To propose a combined disease management and process modeling approach for evaluating and improving care processes, and demonstrate its usability and usefulness in a real-world fall management case study. We identified essential disease management related concepts and mapped them into explicit

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

    Science.gov (United States)

    Chafaie, Amir

    2016-09-01

    Many types of dental abnormality can be observed in the anterior sectors, where they can cause genuine esthetic problems for our patients. While conventional prosthetic treatments offer the best solutions in terms of esthetic result and durability, they involve the sacrifice of significant quantities of mineralized dental material and cannot be undertaken before the periodontal tissues are mature. Other less invasive alternatives should be envisaged as transitional, or sometimes even permanent, solutions for the management of these anomalies in children and adolescents. This article discusses these options and presents a clinical case where composite resin veneers and microabrasion of the enamel were used to treat dental agenesis and enamel dysplasia. Copyright © 2016 CEO. Published by Elsevier Masson SAS. All rights reserved.

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

    Science.gov (United States)

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

    2014-01-01

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

  14. How case managers can help reduce medical errors.

    Science.gov (United States)

    Spath, P

    1999-06-01

    Although mistakes are inevitable, even in the best-run organizations, the tools used for care coordination--such as clinical pathways, standing order sets, algorithms, and other "point of care" reminders--are among the most important weapons in the fight against medical errors in hospitals. For example, establish maximum doses for high-risk drugs, and incorporate these criteria into pathways or standing orders. Preprinted order sets and protocols allow staff to focus their attention on relevant patient care issues, rather than spending time rewriting orders and possibly introducing errors into the system. Case managers can be particularly effective in helping other caregivers catch and correct mistakes before the patient is harmed.

  15. [Management of onychocryptosis in primary care: A clinical case].

    Science.gov (United States)

    Zavala Aguilar, K; Gutiérrez Pineda, F; Bozalongo de Aragón, E

    2013-09-01

    Onychocryptosis (ingrown toenail) is a condition commonly seen in Primary Care clinics. It is uncomfortable and restrictive for patients and has a high incidence in males between second and third decades of life. It is of unknown origin, with a number of predisposing triggering factors being involved. Treatment depends on the stage of the ingrown nail and the procedures may range from conservative to minor surgery that can be performed by the Primary Care physician in the health centre. We report the case of a 25-year onychocryptosis that did not respond to conservative management, and was extracted with partial matricectomy of the nail. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  16. Hospital‑based case management for migrant patients

    DEFF Research Database (Denmark)

    Ølholm, Anne Mette; Christensen, Janne B; Kamionka, Stine Lundstrøm

    2016-01-01

    Background: Although inequality in access to health care for migrant patients is well described, less is known about inequalities originating within the health - c are system regarding choice of diagnostic procedure, diagnostic delay, treatment options, secondary prevention and follow - u p offered...... to patients with a refugee or immigrant background. Provision of specialized services for migrant patients, including case management with multidisciplinary physical, cognitive and social interventions, has been suggested as a way to tackle inequalities in response to a growing recognition of the complexity...... minority patients. Despite using broad search criteria and searching a wide range of migrant health - r elated information networks and databases, no other hospital - b ased migrant health clinics were identified. The single relevant study indicated that benefits of a specialized hospital - b ased migrant...

  17. Learning Strategy in Class Management: A Reflection from Manado Case

    Science.gov (United States)

    Suardi Wekke, Ismail; Yandra, Alexander; Hamuddin, Budianto

    2017-12-01

    This article is a research conducted with qualitative approach with various case studies underlining a strategy that becomes the basis for classroom management. The article discusses and links to the learning revolution that becomes today’s demands, including a discussion that analyses the condition of learners. The article based its data preliminary study conducted in Manado in the province of North Sulawesi in Indonesia. This region has its own characteristics with the encounter of Muslims and the Protestant community for century. Due to its uniqueness 3 Moslem schools and 3 Protestant schools in Manado were selected to study. Data collection was conducted for a year, from May 2016 to April 2017. The study employ four stages research steps: identification, data collection, data validity checking, and directed discussion. The stages include observation and in-depth interviews and conducting focus group discussions. Two important thought about the essence of learning strategy and learning revolution in class were shared briefly within this article.

  18. [Anesthetic management in a case of myotonic distrophy with dexmedetomidine].

    Science.gov (United States)

    Yoshino, Toshihiro; Kanazawa, Masahiro; Suzuki, Toshiyasu

    2009-08-01

    We encountered a 53-year-old woman with myotonic dystrophy for a total abdominal hysterectomy. In patients with myotonic dystrophy, hypersensitivity to anesthetic drugs, especially muscle relaxants and opioids, may complicate postoperative management. Combined spinal and epidural block was used in this patient to prevent the occurrence of potential postoperative complications associated with general anesthesia, including respiratory depression. In addition, dexmedetomidine was used for sedation during surgery, because the patient had mental retardation associated with this disease. Airway obstruction was observed after the initial administration of dexmedetomidine at 2 microg x kg(-1) x hr(-1). Therefore, the dose of the drug was reduced to a maintenance dose of 0.2% microg x kg(-1) x hr(-1), resulting in adequate sedation. Dexmedetomidine was proved to be useful in this case; however, use of the drug should be carefully started at a low initial dose in patients with myotonic dystrophy.

  19. Stuck in the middle: The emotional labours of case managers in the personal injury compensation system.

    Science.gov (United States)

    Newnam, Sharon; Petersen, Alan; Keleher, Helen; Collie, Alex; Vogel, Adam; McClure, Rod

    2016-10-17

    Case managers within injury compensation systems are confronted with various emotional demands. Employing the concept of emotional labour, this paper explores distinctive aspects of these demands. The findings are drawn from focus groups with 21 Australian case managers. Case managers work was characterised by extra-role commitments, emotional control, stress and balancing tensions arising from differing stakeholder expectations about outcomes related to compensation and return to work. By examining the experiences of case managers, the findings add to the literature on the emotional labour of front line service workers, especially with respect to the demands involved in managing the conflicting demands of work.

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

    Science.gov (United States)

    Walsh, Anne; Bearden, Eithne

    2004-01-01

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

  1. Dyskeratosis Congenita- Management and Review of Complications: A Case Report

    Directory of Open Access Journals (Sweden)

    Shivam Sinha

    2013-07-01

    Full Text Available Among the inherited bone marrow failure disorders, dyskeratosis congenita is an X-linked inherited disorder arising as a consequence of short telomere and mutations in telomere biology. Production of the altered protein dyskerin, leads to vulnerable skin, nails, and teeth which lead to higher permeability for noxious agents which can induce carcinogenesis accounting for the classical triad of skin pigmentation, nail dystrophy and oral leukoplakia. This condition is fatal and patients succumb to aplastic anemia, malignancy or immunocompromised state. We present a young male with the classic clinical triad and avascular necrosis of both femoral heads, with no evidence of hematologic anomaly or any malignancy. He was managed for osteonecrosis with uncemented total hip arthroplasty for the symptomatic left hip. Our case represents a benign form of such a fatal and rare condition, which if detected and managed early can result in improved quality of life for the patient suffering from this disorder. This patient is under our meticulous follow-up for the last 2 years in order to determine any late development of complications before being labelled as a variant of this syndrome.

  2. Social Business Process Management: Croatian IT Company Case Study

    Directory of Open Access Journals (Sweden)

    Vukšić Vesna Bosilj

    2017-03-01

    Full Text Available Background: Social business process management is an integration of social software into the business process management (BPM. Its main goal is to overcome the limitations of classical BPM by applying social software principles within the BPM lifecycle. Since BPM is a holistic discipline it is important to also include cultural and social aspects into BPM studies. Objectives: The main aim of this paper is to examine the link between organizational culture, social software usage and BPM maturity in the observed company. Methods/Approach: A case study methodology has been used for this study. An interview has been conducted in combination with a survey approach. Results: Results of the research revealed a high usage of social BPM within the observed company in combination with a high level of BPM maturity and a clan organizational culture. Conclusions: The observed IT company has knowledge intensive processes and uses social BPM to deal with the process change and optimization. The clan culture is, by its characteristics, a favourable organizational culture for social BPM.

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

    Science.gov (United States)

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

    2013-05-01

    Estimate the efficacy of Case Management (CM) for women at high risk for bearing a child with Fetal Alcohol Spectrum Disorders (FASD). Women were recruited from antenatal clinics and engaged in 18 months of CM. A South African community with a subculture of heavy, regular, weekend, recreational drinking and high documented rates of FASD. Forty-one women who were high risk for bearing a child with FASD. Statistical analysis of trends in drinking and other risk factors. At intake 87.8% were pregnant, most had previous alcohol-exposed pregnancies, most/all of their friends drink alcohol (67.5%), and 50.0% had stressful lives. CM was particularly valuable for pregnant women, as statistically significant reductions in alcohol risk were obtained for them in multiple variables: total drinks on weekends after six months of CM (p = .026) and estimated peak blood alcohol concentration (BAC) at six (p managers reduced maternal drinking at critical times, and therefore, alcohol exposure levels to the fetus.

  4. Environmental management and firm performance: a case study.

    Science.gov (United States)

    Claver, Enrique; López, María D; Molina, José F; Tarí, Juan J

    2007-09-01

    This study has as its aim to help to clarify the relationship between environmental management and economic performance by integrating it into a wider framework that includes the relationship between environmental strategy and firm performance, the latter being understood as the combination of environmental performance, competitive advantage and economic performance. A case study of the COATO farming cooperative showed us that its environmental management, focused on prevention logic, has had a positive net effect on its environmental performance. Besides, the order in which these practices were adopted favoured the development of new organisational capabilities that have contributed to the appearance of advantages derived from the greater accumulated experience of employees in creating new projects that are designed to reduce residues and pollution. COATO has also obtained a competitive advantage in differentiation thanks to an improved brand image and to its increased credibility in business relationships. Finally, a positive correlation exists between the pioneering proactive strategy adopted by this cooperative and the improvement of its firm performance with respect to the other firms in its sector.

  5. Integrating education, group support, and case management for diabetic Hispanics.

    Science.gov (United States)

    Brown, Sharon A; García, Alexandra A; Winter, Mary; Silva, Lita; Brown, Adama; Hanis, Craig L

    2011-01-01

    Culturally tailored diabetes self-management education (DSME) improves glycemic control and other health outcomes in Mexican Americans but sociocultural barriers to health improvements remain. This study explored the feasibility of adding a nurse case manager (NCM) to DSME to foster DSME attendance and increase utilization of other available health care services. The setting was a rural community on the Texas-Mexico border in one of the poorest counties in the United States. Using a repeated measures pretest, post-test control group design, we enrolled 165 Mexican American adults into: 1) an experimental group that received a DSME intervention plus access to a NCM; or 2) a control group that received DSME only. Both experimental and control groups received the DSME intervention, reported positive changes in diet and physical activity, and showed improved clinical outcomes; there were no significant group differences. A statistically significant reduction in body mass index was seen in women compared to men, regardless of group or number of NCM contacts. For individuals having the most NCM contacts, DSME attendance rates were greater. Participants expressed acceptance of the NCM; they preferred face-to-face contact rather than by telephone. Our previously tested, culturally tailored DSME continues to be an effective strategy for improving glycemic control in Mexican Americans. This feasibility study provided partial support for the NCM model for underserved border communities, but additional research is needed on resource utilization and the nature of NCM contacts.

  6. Dyskeratosis Congenita- Management and Review of Complications: A Case Report

    Science.gov (United States)

    Sinha, Shivam; Trivedi, Vikas; Krishna, Arvind; Rao, Nidhi

    2013-01-01

    Among the inherited bone marrow failure disorders, dyskeratosis congenita is an X-linked inherited disorder arising as a consequence of short telomere and mutations in telomere biology. Production of the altered protein dyskerin, leads to vulnerable skin, nails, and teeth which lead to higher permeability for noxious agents which can induce carcinogenesis accounting for the classical triad of skin pigmentation, nail dystrophy and oral leukoplakia. This condition is fatal and patients succumb to aplastic anemia, malignancy or immunocompromised state. We present a young male with the classic clinical triad and avascular necrosis of both femoral heads, with no evidence of hematologic anomaly or any malignancy. He was managed for osteonecrosis with uncemented total hip arthroplasty for the symptomatic left hip. Our case represents a benign form of such a fatal and rare condition, which if detected and managed early can result in improved quality of life for the patient suffering from this disorder. This patient is under our meticulous follow-up for the last 2 years in order to determine any late development of complications before being labelled as a variant of this syndrome. PMID:23904924

  7. Successful management of iliocostal impingement syndrome: A case series.

    Science.gov (United States)

    Brubaker, Morgan L; Sinaki, Mehrsheed

    2016-06-01

    Iliocostal impingement syndrome is a rare, painful, and disabling condition associated with thoracic hyperkyphosis and kyphoscoliosis. There is little published literature regarding management of this syndrome. The purpose of this case series is to report treatment outcomes for iliocostal impingement syndrome with improving posture and back muscle strength. Thirty-eight women with thoracic hyperkyphosis or kyphoscoliosis and back and/or flank pain were diagnosed with iliocostal impingement syndrome on the basis of symptoms and spine radiographs. They were instructed in weighted kypho-orthosis use and taught a home back-extensor strengthening program. Outcome measures included posture evaluation and pain level. All patients reported immediate pain reduction with weighted kypho-orthosis trial. Nineteen patients returned within 2 years, and all had continued pain relief and posture improvement. Our findings suggest that successful management of iliocostal impingement syndrome is possible with a weighted kypho-orthosis and back strengthening program focusing on posture improvement. Iliocostal syndrome is a rare, painful, and disabling condition that severely affects quality of life. This report discusses our diagnostic and treatment approach to this syndrome, which has proven successful in our patient population. © The International Society for Prosthetics and Orthotics 2015.

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

    Science.gov (United States)

    2010-04-01

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

  9. The management of bilateral posterior fracture dislocations of the shoulder: a case series illustrating management options.

    Science.gov (United States)

    Uppal, Harpal S; Robinson, Peter W; Packham, Iain; Crowther, Mark

    2016-04-01

    Although dislocation of the shoulder is a relatively common event, the overwhelming majority of injuries are anterior. Posterior shoulder dislocation is more uncommon, comprising between 3% and 5% of all shoulder dislocations. One percent of shoulder dislocations involve a fracture, whereas only 0.9% of the 1500 cases reported by Neer (J Bone Joint Surg Am 1970; 52:1077-89; J Bone Joint Surg Am 1970; 52:1090-103) concerned posterior fracture dislocations. Bilateral posterior fracture dislocation is an even rarer event, comprising just 5% of all posterior fracture dislocations. Given the rarity and relative poor outcome often observed after these severe injuries, it is important that upper limb function is optimized. Bilateral posterior fracture dislocations of the shoulder pose a difficult clinical challenge that requires careful management planning. To date, there have been three isolated case reports of using contralateral osteochondral humeral autograft and hemiarthroplasty. We report our experiences and clinical outcomes in managing four such cases using a variety and combination of treatments, including the first reported use of reverse shoulder arthroplasty with contralateral osteochondral humeral autografting. Shoulders reconstructed with humeral autograft demonstrated superior Oxford Shoulder Scores and an improved range of motion, as measured by a markerless machine vision system, compared to hemiarthroplasty. Our results support the use of a contralateral humeral autograft in bilateral posterior shoulder fracture dislocation.

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

    Science.gov (United States)

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

    2017-01-01

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

  11. Suicide Attempt in a Recently Diagnosed HIV Positive Subject: Is ...

    African Journals Online (AJOL)

    Suicide and attempted suicide are recognized neuropsychiatric complications of HIV/AIDS and one of the risk factors is recent notification of seropositivity. A case of attempted suicide in a recently diagnosed HIV positive subject without adequate counseling is reported. Subject presented at a government hospital with ...

  12. Suicide attempts and suicides in Bolivia from 2007 to 2012

    DEFF Research Database (Denmark)

    Jørs, Erik; Christoffersen, Mette; Veirum, Nikoline Høgsgaard

    2014-01-01

    profiles as well as the likely background and means used for suicide attempts and suicides in Bolivia. METHOD: This study presents 1124 cases from four different sources of information: (i) emergency ward data with suicide attempts by poisoning from the year 2007, (ii) psychiatric ward data including...

  13. Interactive modelling with stakeholders in two cases in flood management

    Science.gov (United States)

    Leskens, Johannes; Brugnach, Marcela

    2013-04-01

    New policies on flood management called Multi-Level Safety (MLS), demand for an integral and collaborative approach. The goal of MLS is to minimize flood risks by a coherent package of protection measures, crisis management and flood resilience measures. To achieve this, various stakeholders, such as water boards, municipalities and provinces, have to collaborate in composing these measures. Besides the many advances this integral and collaborative approach gives, the decision-making environment becomes also more complex. Participants have to consider more criteria than they used to do and have to take a wide network of participants into account, all with specific perspectives, cultures and preferences. In response, sophisticated models are developed to support decision-makers in grasping this complexity. These models provide predictions of flood events and offer the opportunity to test the effectiveness of various measures under different criteria. Recent model advances in computation speed and model flexibility allow stakeholders to directly interact with a hydrological hydraulic model during meetings. Besides a better understanding of the decision content, these interactive models are supposed to support the incorporation of stakeholder knowledge in modelling and to support mutual understanding of different perspectives of stakeholders To explore the support of interactive modelling in integral and collaborate policies, such as MLS, we tested a prototype of an interactive flood model (3Di) with respect to a conventional model (Sobek) in two cases. The two cases included the designing of flood protection measures in Amsterdam and a flood event exercise in Delft. These case studies yielded two main results. First, we observed that in the exploration phase of a decision-making process, stakeholders participated actively in interactive modelling sessions. This increased the technical understanding of complex problems and the insight in the effectiveness of various

  14. Prevalence and profile of suicide attempters with abdominal pain as the reason of attempt: A retrospective study

    Directory of Open Access Journals (Sweden)

    Shivanand Kattimani

    2016-01-01

    Full Text Available Background and Aims: Suicide attempt is a complex human behavior with multiple determinants. Literature suggests toward abdominal pain as a risk factor for a suicide attempt, but such patients need to be characterized further. This retrospective study aimed to compare individuals with abdominal pain as the reason of suicide attempt to those reporting other reasons for such attempt. Methods: This retrospective chart review-based case-control study was conducted among individuals registered at the crisis intervention clinic of a Tertiary Care Hospital in South India. Information was extracted from the records using a structured profroma. Characteristics of those with abdominal pain as the reason of suicide attempt were compared with age- and gender-matched controls. Results: Of 427 persons registered in the clinic in the period, abdominal pain was the stated reason for the attempt in 37 (8.7% of the sample. Suicide attempters whose stated reason for attempted suicide as abdominal pain had lower education (P = 0.042, were more likely to suffer from physical illness (P < 0.001, were more likely to have a recent visit to a health care professional (P = 0.047, were less likely to give hint prior to attempt (P = 0.010, and had lesser stressful life events compared to the controls (P = 0.024. Conclusions: There seem to be certain differences between suicide attempters who report abdominal pain versus other causes for a suicide attempt.

  15. Mental health professionals' determinations of adolescent suicide attempts.

    Science.gov (United States)

    Wagner, Barry M; Wong, Steven A; Jobes, David A

    2002-01-01

    The degree of ambiguity in the term suicide attempt was examined among 14 expert suicidologists, and 59 general mental health clinicians who either did or did not receive a standard definition of the term. The participants judged whether each of ten vignettes of actual adolescent self-harm behaviors was a suicide attempt. Low levels of agreement were found within each group, although agreement was better for the most and least serious cases. Possible explanations were examined, including how professionals weight suicidal intent and medical lethality in their suicide attempt decisions, and the use of a "fuzzy," natural language conceptualization of suicide attempts was proposed.

  16. The Challenges of 'Teaching by Being': The Case of Participatory Resource Management

    Science.gov (United States)

    Buchy, Marlene

    2004-01-01

    In 1997 a new unit, Participatory Resource Management, was developed and offered in the School of Resource, Environment and Society, at the Australian National University. The challenges of the unit were multiple, ranging from introducing social science material into a science curriculum, to attempting to change practitioners' attitudes towards…

  17. Filicide, attempted filicide, and psychotic disorders.

    Science.gov (United States)

    Valença, Alexandre M; Mendlowicz, Mauro V; Nascimento, Isabella; Nardi, Antonio E

    2011-03-01

    The objective of the study was to describe and discuss the cases of two women who faced criminal charges, one for attempting to murder her three children and the other for killing her 1-year-old boy. After a forensic psychiatric assessment of their level of criminal responsibility, these patients were considered not guilty by reason of insanity and were committed to forensic mental hospitals. These two patients received a diagnosis of paranoid schizophrenia, according to the DSM-IV-TR criteria. In both cases, psychotic symptoms were present before the manifestation of violent behavior, in the form of persecutory delusions, auditory hallucinations, and pathological impulsivity. The investigation into cases of filicide may contribute powerfully to expand our understanding of motivational factors underlying this phenomenon and enhance the odds for effective prevention. © 2011 American Academy of Forensic Sciences.

  18. 26 CFR 301.7454-2 - Burden of proof in foundation manager, etc. cases.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Burden of proof in foundation manager, etc... Actions by the United States § 301.7454-2 Burden of proof in foundation manager, etc. cases. (a) Foundation manager. In any proceeding involving the issue whether a foundation manager as defined in section...

  19. Productivity--a key to managing cost-per-case. Part 1.

    Science.gov (United States)

    Orefice, J J; Jennings, M C

    1983-08-01

    Productivity and productivity management are critical to effective case-mix management. Case-mix management expands on traditional productivity management to include the relationship between such intermediate products as patient days, tests and meals, and the ultimate end product, the case. As hospitals search to increase the profitability of specific case types, they must focus on two critical productivity control points. First, they must examine length of stay and ancillary utilization as one level of productivity. Then they must turn to more traditional analyses and review departmental productivity in the production of the intermediate products. No case-mix management system is complete unless it focuses on both of these critical relationships. Part two of this article will explore performance reporting and its role in managing both productivity and case mix.

  20. Metropolitan transportation management center : a case study : Long Island INFORM : identifying incidents and informing travelers

    Science.gov (United States)

    1999-10-01

    The following case study provides a snapshot of Long Island's INFORM transportation management center. It follows the outline provided in the companion document, Metropolitan Transportation Management Center Concepts of Operation - A Cross Cutting St...

  1. Surgical Management of Accidentally Displaced Mandibular Third Molar into the Pterygomandibular Space: A Case Report

    Directory of Open Access Journals (Sweden)

    I-Yueh Huang

    2007-07-01

    Full Text Available Surgical removal of the mandibular third molar is a regular surgical procedure in dental clinics, and like all operations, it may have some complications, such as infection, bleeding, nerve injuries, trismus and so on. An accidentally displaced lower third molar is a relatively rare complication, but may cause severe tissue injury and medicolegal problems. As few papers and cases have been published on this topic, we report this case to remind dentists on ways to prevent and manage this complication. The patient, a 28-year-old male, had his right lower mandibular third molar extraction in January 2006. The dentist resected the crown and attempted to remove the root but found that it had suddenly disappeared from the socket. Assuming that the root had been suctioned out he closed the wound. The patient was not followed up regularly because he studied abroad. About 3 months later, the patient felt a foreign body sensation over his right throat, and visited a local hospital in Australia. He was told after a computed tomography (CT scan that there was a root-like radio-opaque image in the pterygomandibular space. The patient came to our hospital for further examination and management in June 2006. We rechecked with both Panorex and CT and confirmed the location of the displaced root. Surgery for retrieving the displaced root was performed under general anesthesia by conventional method without difficulty, and the wound healed uneventfully except for a temporary numbness of the right tongue. This case reminds us that the best way to prevent a displaced mandibular third molar is to evaluate the condition of the tooth carefully preoperatively, select adequate instruments and technique, and take good care during extraction. If an accident does occur, dentists should decide whether to retrieve it immediately by themselves or refer the case to an oral and maxillofacial surgeon, and should not try to remove the displaced root without proper assurance

  2. Case management in aftercare of involuntarily committed patients with substance abuse

    DEFF Research Database (Denmark)

    Lindahl, Marianne Larsson; Berglund, Mats; Tönnesen, Hanne

    2013-01-01

    Case management has since the 1970s been widely used to co-ordinate services for mental health patients. The methodology has expanded to support patients in many different types of conditions. This study is one of very few randomized trials on case management in a European setting. It examined...... the impact of case management on substance abuse and use of service after discharge from court-ordered institutional care....

  3. How do case managers spend time on their functions and activities?

    Science.gov (United States)

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

    2016-04-02

    Case management has been a widely accepted approach to practice in various care settings. This study aimed to explore how community aged care case managers allocated their time to case management functions, how frequently they performed specific case management activities, and what factors influenced the frequency of their activities. The study involved 154 survey participants, or 17.1% of the target case managers in the State of Victoria, Australia. Key information collected included participants' socio-demographic characteristics, proportions of time allocated to six core case management functions, and frequency ratings of 41 specific activities within seven case management functions. Ordinal regression analyses were performed to determine significant factors associated with participants' frequency ratings of their activities. Participants allocated the largest proportion of time to care coordination (22.0%), and the smallest proportion of time to outcome evaluation (8.0%). Over 70% of the participants assigned high frequency ratings to 31 of the 41 case management activities. The remaining ten activities, including all four outcome evaluation activities, three needs assessment activities, one care planning activity, one care coordination activity, and one general functions-related activity were less commonly performed very frequently. The regression analyses indicated that some case manager and client factors were significantly associated with frequency ratings of nine of the ten activities aforementioned. The two main findings of the regression analyses were: First, emphasising achieving more case management goals was significantly associated with higher frequency of three outcome evaluation activities; second, longer work experience was significantly associated with higher frequency of one care coordination activity and one outcome evaluation activity. The frequent performance of most case management activities and relative absence of factors influencing their

  4. Suicide attempts among children and adolescents: partial or total injury?

    OpenAIRE

    Michelle Alexandra Gomes Alves; Matilde Meire Miranda Cadete

    2015-01-01

    This study sought to verify the records on file and the number of cases of attempted suicide among children and adolescents who were attended by Emergency Care health professionals in the municipality of Matozinhos, Minas Gerais, Brazil. Documentary and descriptive research was conducted, the data for which was collected by means of an investigation of Outpatient Records from 2008 to 2010. Of the 73,000 files evaluated, those dealing with cases of attempted suicide among children and adolesce...

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

    Science.gov (United States)

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

    2017-01-01

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

  6. Case management decision making: goal transformation through discretion and client interpretation.

    Science.gov (United States)

    Corazzini, K N

    2000-01-01

    This study examines the decision-making strategies employed by case managers in a state-funded home care program for the elderly. Specifically, this study applies Lipsky's (1980) theory of street-level bureaucracy to gerontological research on case management decision making in an effort to demonstrate the presence of case management discretion, and the impact of that discretion on home care implementation. Drawing upon individual interviews and focus group interviews, results suggest the applicability of the proposed framework, and indicate the need for policy planners to identify factors for case manager discretion that result in undesirable home care goal transformation.

  7. Diagnostic challenges and case management of the first imported case of Plasmodium knowlesi in Sri Lanka.

    Science.gov (United States)

    Dewanee Ranaweera, A; Danansuriya, Manjula N; Pahalagedera, Kusumawathie; de A W Gunasekera, W M Kumudunayana T; Dharmawardena, Priyani; Mak, Keng Wai; Wong, Pei-Sze Jeslyn; Li, Mei-Zhi Irene; Tan, Cheong Huat; Hapuarachchi, Hapuarachchige C; Herath, Hema D B; Fernando, Deepika

    2017-03-21

    Sri Lanka has achieved 'malaria-free' status and is now in the phase of prevention of re-introduction of malaria. Imported malaria remains a challenge to resurgence of the disease. The diagnostic challenges encountered and the rapid response initiated to manage a Plasmodium infection, which was later confirmed as Plasmodium knowlesi, the first reported case from Sri Lanka, is discussed. An army officer who returned from Malaysia in October 2016 was found to be positive for Plasmodium both by microscopy and rapid diagnostic test (RDT) by the Anti Malaria Campaign Sri Lanka (AMC) during his third visit to a health care provider. Microscopy findings were suspicious of P. knowlesi infection as the smears showed parasite stages similar to both Plasmodium malariae and Plasmodium falciparum. Nested PCR at AMC confirmed Plasmodium genus, but not the species. In the absence of species confirmation, the patient was treated as a case of P. falciparum. The presence of P. knowlesi was later confirmed by a semi-nested PCR assay performed at the Environmental Health Institute, National Environmental Agency in Singapore. The parasite strain was also characterized by sequencing the circumsporozoite gene. Extensive case investigation including parasitological and entomological surveillance was carried out. Plasmodium knowlesi should be suspected in patients returning from countries in the South Asian region where the parasite is prevalent and when blood smear results are inconclusive.

  8. Creating the strategic basis for corporate environmental management - a case study

    DEFF Research Database (Denmark)

    Larsen, Lars Bjørn

    1998-01-01

    The concept of Strategic Environmental Audit is introduced, as a first attempt to develop an operational tool, which can be used to develop a corporate environmental strategy in order to create the strategic basis for a sound response to the environmental challenge. The initial concept...... of developing environmental strategies using the SEA concept is illustrated by a case study....

  9. A Case Study of Inventory Management in a Manufacturing Company in China

    Directory of Open Access Journals (Sweden)

    Shen Hong

    2016-12-01

    Full Text Available In this paper, we focus on inventory management in a manufacturing company in China. This study aims to identify the key factors that influence inventory management practices, investigate efficient and effective inventory management approaches, and examine the impact of supplier cooperation on supply chain improvement. A case study approach is used to identify the key factors that influence inventory management in a factory. Efficient and effective inventory management practices are derived from the case study and may provide practical guidance for foreign manufacturers in China. This study provides a valuable tool for identifying the key factors in inventory management which can be applied to similar problems encountered in actual manufactories.

  10. Knowledge Management Audit - a methodology and case study

    Directory of Open Access Journals (Sweden)

    Thomas Lauer

    2001-11-01

    Full Text Available The strategic importance of knowledge in today’s organisation has been discussed extensively and research has looked at various issues in developing knowledge management systems. Both the characterisation of knowledge and alternate models for understanding the acquisition and use of such knowledge have taken on significant prominence. This is due to the complexities associated with acquiring and representing knowledge, and the varied nature of its use in knowledge work. However, the role of the knowledge workers and the processes that guide their knowledge work as they meet the knowledge goals of an organisation have received little attention. This paper proposes a knowledge audit (an assessment of the way knowledge processes meet an organisation’s knowledge goals methodology to understand the “gaps” in the needs of a knowledge worker before one develops KM systems. The methodology also uses “process change” research to help build a socio-technical environment critical for knowledge work. The audit methodology is applied to a particular case and the implementation of the audit recommendations is discussed. Future implications of such an audit are also discussed.

  11. Management of dentoalveolar injuries in children: A case report

    Directory of Open Access Journals (Sweden)

    Das U

    2007-01-01

    Full Text Available Children aged 6-15 years old experience more injuries to their teeth and the injuries sustained are more serious as evidenced by a higher percentage of luxations, avulsions, fractures and dislocations. The mandible is the most frequently fractured facial bone and mandibular alveolar injuries have been reported to range between 8.1-50.6%. Those with mandibular or midface fractures have a higher incidence of associated chest, extremity, abdomen and cervical spine injuries. The growing patient with facial injuries presents the clinician with a series of thought-provoking circumstances. Dentoalveolar and mandibular injuries are especially important to understand because of the potential complications related to tooth eruption, alveolar development, occlusion and facial growth. However, the principles involved in the treatment for children need to be modified by certain anatomical, physiological and psychological factors specifically related to childhood. This case report documents the trauma, management and follow-up care of an 11-year-old boy who sustained undisplaced infraorbital, nasal fractures and mandibular dentoalveolar fracture along with other associated injuries of the extremities.

  12. Managing menorrhagia in a familial case of factor V deficiency.

    Science.gov (United States)

    Stalnaker, M; Esquivel, P

    2015-02-01

    Factor V deficiency is a rare coagulation disorder. Excessive uterine bleeding is common in affected women. We describe a case of 2 siblings with Factor V deficiency and menorrhagia who achieved control of bleeding with differing treatments. Patient 1 is a 16-year-old female with Factor V deficiency and menorrhagia which was previously controlled with oral contraceptives (OC). She developed heavy bleeding treated with fresh frozen plasma, anti-inhibitor coagulant complex (AICC), and OC taper. A levonorgestrel IUD was placed with good control of her menorrhagia. Patient 2 is the 12-year-old sister of Patient 1. She was treated with AICC, aminocaproic acid, and her menorrhagia was ultimately controlled with continuous OCs. Factor V deficiency is a rare cause of menorrhagia. Various treatment modalities are available. In these adolescent sisters desiring future fertility, menorrhagia was managed with OCs and an IUD. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  13. Management of the proximal tibia fractures by mini external fixation: A case series of 30 cases

    Directory of Open Access Journals (Sweden)

    Samar K Biswas

    2014-01-01

    Full Text Available Background: Management of high velocity trauma is a challenging problem because of morbidity of trauma and sometime residual problems of failure of proper healing of fractures with the restriction of movements of knee, shortening, and added risk of compartment syndrome in the proximal tibia fracture. There is always risk of post-operative infection and infected non-union in extensive open surgical procedure and internal fixation. Hence, there is always look out for the middle path procedure for a solution to the above said problems with the added advantage of less hospital stay and early return to work by minimal invasive procedure and stabilization of fracture reduction by multiple K-wire fixation with a frame applied externally. Stabilization of fracture with reduced pain allows early movements of neighbouring joint knee and ankle; hence, reduces the chances of fracture diseases. With this we have been stimulated to take-up the study of managing the proximal tibia fracture by mini external fixator. Aim: The aim of this study was to manage proximal tibia fractures by mini external fixator and evaluate the results and efficacy of this method. Material and Method: A total of 30 patients having proximal tibial fractures admitted at our center between 2008 and 2010 were taken and the procedure carried out was closed manipulative reduction and stabilization with mini external fixator. All acute proximal tibia fractures including tibial plateau fractures above 17 years of age of either sex were included in the study. Fracture more than 3 weeks old were excluded from the study. Result: Out of 30 cases 13 were excellent, 14 cases good, and 3 showed fair. It was found that type 5 and 6 of Schatzker′s classification have lesser outcome type of fractures Conclusion: We have found that management of the proximal tibia fractures by mini external fixation method has a better outcome. Early mobilization of knee in the proximal tibia fractures after

  14. StakeS-holder Management and Crisis Resilience A case study in a public transportation company

    OpenAIRE

    Aurélien Acquier; Sébastien Gand; Mathias Szpirglas

    2006-01-01

    International audience; Stakeholder perspectives on crisis management provide a useful descriptive framework for analyzing crises and making crisis narratives. However, their "actionability" for crisis management, i.e. possibility to use stakeholder management models into operational crisis management processes, remains an under-investigated question. The purpose of this article is to discuss the operational value of stakeholder frameworks for crisis management. Drawing on a qualitative case ...

  15. The Role of Information Systems and Technology in Case Management: a case study in health and welfare insurance

    Directory of Open Access Journals (Sweden)

    Helen Richardson

    2003-05-01

    Full Text Available This study reports the role of information system and technology (IST in supporting case management at the Accident Compensation Corporation (ACC of New Zealand. Case management is a managerial approach that seeks to gain improved business performance by enhancing both employee and customer satisfaction. Despite millions of dollars spent annually by health, social, and insurance agencies in automating case management, little research has been conducted into the role of IST in this practice. The findings of this study show that for ACC, IST’s most valuable role is enhancing the relationship between client and case manager rather than replacing it for, even after the addition of IST, the most valuable knowledge continues to accrue from the face to face interaction of client and case manager. The findings also show two distinct phases to the development of case managers as knowledge workers. The first phase focuses on control of the processes and the second on the delivery and sharing of information resources.

  16. Facilities Management and Value Adding - The LEGO case

    DEFF Research Database (Denmark)

    Jensen, Per Anker; Katchamart, Akarapong

    Purpose: To investigate how Facilities Management (FM) can add value and develop a management concept that can assist facilities managers in implementing value adding strategies and practices. Background: Earlier research has shown an increased focus on added value of FM and a FM Value Map has been...... developed to analyse and demonstrate the different ways FM can add value. However, there is a need to develop management tools that can be used more directly and proactively by facilities managers to implement adding value strategies and practices. Approach: The development of the concept is based...... example of how Value Adding Management can be implemented and added value measured. Practical Implications: The concept of Value Adding Management is expected to increase the awareness of the impacts and strategic importance of FM for organisations and can be a practical tool for facilities managers...

  17. Strategic Choices: The Case Of Management Accounting System

    National Research Council Canada - National Science Library

    Muhammad H Al-Hazmi

    2010-01-01

      While the popularity of strategic management accounting (SMA) has been growing over the last decade, there is still not an extensive literature, which directly addresses the relationship between management accounting system and strategy...

  18. Surgical management of giant cell tumor of axis vertebra: review of fourteen cases in literature with a case illustration

    Directory of Open Access Journals (Sweden)

    Satyarthee Guru Dutta

    2017-09-01

    Full Text Available Primary spinal giant cell tumor (PSGCT considered as rare primary neoplasm, with predilection for subarticular location and commonly located at knee joint region, sacrum or distal radius, however, spinal involvent is uncommon and comparatively much rarer in the cervical spine. Further occurrence of giant cell tumor in the Axis vertebra is extremely uncommon and easily misdiagnosed and, thus, treatment is still debated and various treatment modalities and different surgical approaches were utilized during evolution of surgical management. Authors could collect only 14 cases of primary giant cell tumor affecting Axis vertebra in a detailed Pubmed and Medline search, out of which 12 cases were primary and rest two case was recurrent. So authors reviewed in total thirteen cases primary giant cell tumor of Axis managed surgically, including our case. Out of 13 PSGCT, twelve cases were managed with surgical resection and the rest one case was managed with monoclonal antibody using Denosomab monotherapy without any surgical intervention. In the surgical group (n=12, nine cases had two staged surgical procedure, first being posterior fixation followed by anterior approach with resection of tumor while, the rest three had one stage surgical resection including current case. Authors reports a unique case of spinal giant cell tumor developing in a- 38 - year male with history of renal transplant, presented with neck pain and difficulty in walking, neuroimaging revealed a osteolytic mass lesion involving body of axis vertebra with extension into right sided lamina, underwent two stage complete surgical intervention. Authors describes management of such rare locally recurring primary bony pathology affecting axis vertebra as it is not only interesting and challenging and different management modalities, various, surgical approaches and issue of renal osteodystrophy along with pertinent literature is also reviewed briefly.

  19. To what extent do primary care practice nurses act as case managers life style counselling regarding weight management?

    NARCIS (Netherlands)

    Dillen, van S.; Hiddink, G.J.

    2014-01-01

    Background - In this review study, we are the first to explore whether the practice nurse (PN) can act as case manager lifestyle counselling regarding weight management in primary care. Methods - Multiple electronic databases (MEDLINE, PsycINFO) were searched to identify relevant literature after

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

    Science.gov (United States)

    Yu, Holly, Ed.

    2005-01-01

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

  1. Are previous suicide attempts a risk factor for completed suicide?

    Science.gov (United States)

    Goñi-Sarriés, Adriana; Blanco, Miriam; Azcárate, Leire; Peinado, Rubén; López-Goñi, José J

    2018-02-01

    A previous suicide attempt is a clinically relevant factor for completed suicide. In this paper people who committed suicide on their first attempt are compared with those who did so after previous attempts. A review of the Computerised Clinical Histories in the Navarro Health Service-Osasunbidea (2010-2013) in Spain. Of the 166 cases, 31.9% (n = 53) presented at least one prior attempt. Of these 53, 65.3% modified the method of suicide. Women presented significantly more attempts (χ2 = 14.3; df = 3; p = .002). Three sub-samples were identified according to the attempts and diagnoses. The diagnoses of personality disorders (90.9%; n = 10) and women under 51 years of age with a diagnosis of affective, anxiety, or substance abuse disorders (82.4%; n = 14) presented the highest numbers of attempts. People without a psychiatric diagnosis and with psychotic or organic mental disorders presented the smallest proportion of attempts (13.2%; n = 10) together with people over 51 years of age diagnosed with affective, anxiety, or substance abuse disorders (22.5%; n = 9). Prior attempts are suicide risk factors only in specific clinical sub-samples. Prevention and intervention programs should consider these results.

  2. Popular management discourses as constituents of organizations : A case study of Stephen R. Covey's discourses on organizational conflict management

    OpenAIRE

    Smidte-Hegelund, Marija

    2015-01-01

    The aim of this study is to examine what current discourses within the expanding popular management culture carry to organizations in terms of worldview, knowledge view, ideologies, norms, and values, and how these discourses shape leader’s roles in modern organizations. A case study is conducted on a conflict management book by a popular management guru, Stephen R. Covey. The three main study questions concern: 1) ontology and epistemology found in the discourses, 2) how the ideas of ‘right’...

  3. Barriers to implementation of case management for patients with dementia: a systematic mixed studies review.

    Science.gov (United States)

    Khanassov, Vladimir; Vedel, Isabelle; Pluye, Pierre

    2014-01-01

    Results of case management designed for patients with dementia and their caregivers in community-based primary health care (CBPHC) were inconsistent. Our objective was to identify the relationships between key outcomes of case management and barriers to implementation. We conducted a systematic mixed studies review (including quantitative and qualitative studies). Literature search was performed in MEDLINE, PsycINFO, Embase, and Cochrane Library (1995 up to August 2012). Case management intervention studies were used to assess clinical outcomes for patients, service use, caregiver outcomes, satisfaction, and cost-effectiveness. Qualitative studies were used to examine barriers to case management implementation. Patterns in the relationships between barriers to implementation and outcomes were identified using the configurational comparative method. The quality of studies was assessed using the Mixed Methods Appraisal Tool. Forty-three studies were selected (31 quantitative and 12 qualitative). Case management had a limited positive effect on behavioral symptoms of dementia and length of hospital stay for patients and on burden and depression for informal caregivers. Interventions that addressed a greater number of barriers to implementation resulted in increased number of positive outcomes. Results suggested that high-intensity case management was necessary and sufficient to produce positive clinical outcomes for patients and to optimize service use. Effective communication within the CBPHC team was necessary and sufficient for positive outcomes for caregivers. Clinicians and managers who implement case management in CBPHC should take into account high-intensity case management (small caseload, regular proactive patient follow-up, regular contact between case managers and family physicians) and effective communication between case managers and other CBPHC professionals and services. © 2014 Annals of Family Medicine, Inc.

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

    Science.gov (United States)

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

    2016-01-01

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

  5. Validation and operationalization of intensive family case management : a Delphi study

    NARCIS (Netherlands)

    Busschers, Inge; Boendermaker, Leonieke; Dinkgreve, Marc

    2016-01-01

    Few evidence-based methods for case management in child protection and child welfare are available. That is why Youth Protection Amsterdam Area developed a new method, by integrating their best practices: Intensive Family Case Management (IFCM). Because IFCM was developed in practice, clarity about

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

    Science.gov (United States)

    Levine, Joanne; Adams, Ruifang Hope

    2013-01-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

    Rendtorff, Jacob Dahl

    2015-01-01

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

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

    Science.gov (United States)

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

    2007-01-01

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

  11. Case management interviews and the return to work of disabled employees

    DEFF Research Database (Denmark)

    Høgelund, Jan; Holm, Anders

    In response to an increasing number of sickness and disability beneficiaries, many countries have launched policies that emphasize the role of case management. This study measures the effect of case-management interview (CMI) on long-term sick-listed employees’ probability of returning to work...

  12. Trust and responsible eco managing. The case of state controlled repacking

    DEFF Research Database (Denmark)

    Rittenhofer, Iris

    The paper is concerned with a case of local management of eco certification. With outset in a case study, the paper explores the relation of eco certification to economy, society and culture. The paper emphasizes the multidimensional quality of local eco management of global organic agrifood...

  13. Recovery-oriented services for individuals with mental illness and case managers' experience of professional burnout.

    Science.gov (United States)

    Kraus, Shane W; Stein, Catherine H

    2013-02-01

    Present cross-sectional study examined perceptions of recovery-oriented services and reports of professional burnout and job satisfaction in a sample of 114 case managers working in community mental health centers across Ohio. The research examined the relative contribution of demographic characteristics, the structure of case management services, and case managers' beliefs about recovery-oriented services in describing their reports of professional burnout and job satisfaction. Regardless of individual characteristics of case managers and reports of the structure of their jobs, case managers who perceived their agency to offer higher levels of recovery-oriented services also reported lower levels of depersonalization and emotional exhaustion at work, and higher levels of professional accomplishment and job satisfaction. Directions for future research in the area are discussed.

  14. Aspects and Intensity of Pediatric Palliative Case Management Provided by a Hospital-Based Case Management Team: A Comparative Study Between Children With Malignant and Nonmalignant Disease.

    Science.gov (United States)

    Jagt-van Kampen, Charissa T; Colenbrander, Derk A; Bosman, Diederik K; Grootenhuis, Martha A; Kars, Marijke C; Schouten-van Meeteren, Antoinette Yn

    2018-01-01

    Anticipating case management is considered crucial in pediatric palliative care. In 2012, our children's university hospital initiated a specialized pediatric palliative care team (PPCT) to deliver inbound and outbound case management for children with life-shortening disease. The aim of this report is to gain insight in the first 9 months of this PPCT. Aspects of care during the first 9 months of the PPCT are presented, and comparison is made between patients with malignant disease (MD) and nonmalignant disease (NMD) in a retrospective study design. Insight in the aspects of care of all patients with a life-shortening disease was retrieved from web-based files and the hour registrations from the PPCT. Forty-three children were supported by the PPCT during the first 9 months: 22 with MD with a median of 50 (1-267) days and 29 minutes (4-615) of case management per patient per day and 21 patients with NMD with a median of 79.5 (5-211) days and 16 minutes of case management per day (6-64). Our data show significantly more interprofessional contacts for patients with MD and more in-hospital contacts for patients with NMD. The median number of admission days per patient was 11 (0-22) for MD (44% for anticancer therapy) and 44 (0-303) for NMD (36% for infectious diseases). This overview of aspects of pediatric palliative case management shows shorter but more intensive case management for MD in comparison with NMD. This insight in palliative case management guides the design of a PPCT.

  15. Anesthetic considerations and difficult airway management in a case of Noonan syndrome

    Science.gov (United States)

    Bajwa, Sukhminder Jit Singh; Gupta, Sachin; Kaur, Jasbir; Panda, Aparajita; Bajwa, Sukhwinder Kaur; Singh, Amarjit; Parmar, S. S.; Prasad, Seema

    2011-01-01

    Noonan syndrome is a genetically transmitted autosomal dominant disorder characterized by various anatomic anomalies and pathophysiologic derangements. Anesthetic management in such cases poses a multitude of challenges, especially related to the airway management and maintenance of cardiovascular stability. We report a case of a 9-year-old male child weighing 24 kg, who was diagnosed as a case of Noonan syndrome and had undergone ligation of patent ductus arteriosus during early childhood. The child was operated on for release of bilateral neck bands under general anesthesia. The case report pertains to the successful airway and anesthetic management in the background of difficult airway and existence of various cardiac lesions. PMID:21957424

  16. Anesthetic considerations and difficult airway management in a case of Noonan syndrome

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2011-01-01

    Full Text Available Noonan syndrome is a genetically transmitted autosomal dominant disorder characterized by various anatomic anomalies and pathophysiologic derangements. Anesthetic management in such cases poses a multitude of challenges, especially related to the airway management and maintenance of cardiovascular stability. We report a case of a 9-year-old male child weighing 24 kg, who was diagnosed as a case of Noonan syndrome and had undergone ligation of patent ductus arteriosus during early childhood. The child was operated on for release of bilateral neck bands under general anesthesia. The case report pertains to the successful airway and anesthetic management in the background of difficult airway and existence of various cardiac lesions.

  17. Nurturing a service orientated paradigm of management within a traditionally manufacturing enterprise: A South African case study

    Directory of Open Access Journals (Sweden)

    Richard Weeks

    2011-12-01

    Full Text Available Purpose: The purpose of this paper is to analyse and draw a correlation between service science theory and practice as it relates to the complexity of engendering a services orientated paradigm of management within a traditionally manufacturing enterprise. It is suggested that the traditional manufacturing paradigm is founded on scientific management principles whereas that of service science is far more multidisciplinary and complex in nature. It would seem that the service science paradigm is directed at co-creational value in contrast to a transactional paradigm of management that form the foundation of the manufacturing era. Problem investigated: With the emergence of an essentially services orientated global economy, manufacturing enterprises are increasing adding a range of services to the value offerings they make available to clients. The first part of this paper constitutes a literature study directed at gaining a theoretical understanding and insight into the underlying principles of management involved in moving from an essentially manufacturing management setting to one that incorporates services and in some instances where services assume the dominant paradigm of management. The second part of the paper attempts to correlate the theoretical insights gain from the literature study with relation to that of practice by means of a case study undertaken at a South African manufacturing enterprise that has implemented a servitization strategy. Methodology: A multidisciplinary literature review and analysis is undertaken to gain an insight of contemporary management theory and practice, as it relates to servitization or the transition from an essentially manufacturing to a services inclusive operational setting. With the insights gained from the literature research serving as a source of information and reference a case study was undertaken at a South African enterprise to determine if a correlation exists between theory as expressed in

  18. Nurturing a service orientated paradigm of management within a traditionally manufacturing enterprise: A South African case study

    Directory of Open Access Journals (Sweden)

    Richard Weeks

    2011-12-01

    Full Text Available Purpose: The purpose of this paper is to analyse and draw a correlation between service science theory and practice as it relates to the complexity of engendering a services orientated paradigm of management within a traditionally manufacturing enterprise. It is suggested that the traditional manufacturing paradigm is founded on scientific management principles whereas that of service science is far more multidisciplinary and complex in nature. It would seem that the service science paradigm is directed at co-creational value in contrast to a transactional paradigm of management that form the foundation of the manufacturing era. Problem investigated: With the emergence of an essentially services orientated global economy, manufacturing enterprises are increasing adding a range of services to the value offerings they make available to clients. The first part of this paper constitutes a literature study directed at gaining a theoretical understanding and insight into the underlying principles of management involved in moving from an essentially manufacturing management setting to one that incorporates services and in some instances where services assume the dominant paradigm of management. The second part of the paper attempts to correlate the theoretical insights gain from the literature study with relation to that of practice by means of a case study undertaken at a South African manufacturing enterprise that has implemented a servitization strategy. Methodology: A multidisciplinary literature review and analysis is undertaken to gain an insight of contemporary management theory and practice, as it relates to servitization or the transition from an essentially manufacturing to a services inclusive operational setting. With the insights gained from the literature research serving as a source of information and reference a case study was undertaken at a South African enterprise to determine if a correlation exists between theory as expressed in

  19. Management of Pseudohypoparathyroidism Type 1a during Pregnancy and Labor: A Case Report

    Directory of Open Access Journals (Sweden)

    Anju Singh

    2012-01-01

    Full Text Available Pseudohypoparathyroidism is rare during pregnancy and poses multiple challenges related to its diagnosis and management during pregnancy. We hereby report a case of a young woman who was diagnosed to have type 1a pseudohypoparathyroidism. She was managed by multidisciplinary team and had good maternal and perinatal outcome. Management-related issues are discussed here in detail.

  20. Using Role-Play and Case Studies to Improve Preservice Teacher Attitudes toward Classroom Management

    Science.gov (United States)

    Rudolph, Amanda

    2008-01-01

    Classroom management is a concern for preservice teachers (Charles, 2008). Teacher educators struggle to find the most effective ways to teach preservice teachers classroom management. Role-playing, combined with classroom management content, may offer a productive approach. As such, this study focused on the use of role-play with case studies to…

  1. Experimental application of Business Process Management technology to manage clinical pathways: a pediatric kidney transplantation follow up case.

    Science.gov (United States)

    Andellini, Martina; Fernandez Riesgo, Sandra; Morolli, Federica; Ritrovato, Matteo; Cosoli, Piero; Petruzzellis, Silverio; Rosso, Nicola

    2017-11-03

    To test the application of Business Process Management technology to manage clinical pathways, using a pediatric kidney transplantation as case study, and to identify the benefits obtained from using this technology. Using a Business Process Management platform, we implemented a specific application to manage the clinical pathway of pediatric patients, and monitored the activities of the coordinator in charge of the case management during a 6-month period (from June 2015 to November 2015) using two methodologies: the traditional procedure and the one under study. The application helped physicians and nurses to optimize the amount of time and resources devoted to management purposes. In particular, time reduction was close to 60%. In addition, the reduction of data duplication, the integrated event management and the efficient data collection improved the quality of the service. The use of Business Process Management technology, usually related to well-defined processes with high management costs, is an established procedure in multiple environments; its use in healthcare, however, is innovative. The use of already accepted clinical pathways is known to improve outcomes. The combination of these two techniques, well established in their respective areas of application, could represent a revolution in clinical pathway management. The study has demonstrated that the use of this technology in a clinical environment, using a proper architecture and identifying a well-defined process, leads to real benefits in terms of resources optimization and quality improvement.

  2. Management of a case of double aortic arch with tracheal compression complicated with postoperative tracheal restenosis

    Directory of Open Access Journals (Sweden)

    Hemang Gandhi

    2017-01-01

    Full Text Available Tracheal stenosis in association with the double aortic arch (DAA is uncommon; however, it carries a high risk of morbidity, mortality, and restenosis. Although surgery is the mainstay of managing a case of the DAA with tracheal stenosis, management of tracheal restenosis requires a multidisciplinary approach. In this case report, we present our successful experience in managing a child of DAA with tracheal stenosis who developed tracheal restenosis after sliding tracheoplasty of trachea.

  3. Quality management in shipping. Case study: Maersk Line Denmark

    Directory of Open Access Journals (Sweden)

    Anca MADAR

    2016-07-01

    Full Text Available Quality assurance has become very important to the majority of production or service companies with international activity. Maritime transport companies were also required to take measures to implement a quality management system. Because of navigation accidents that had a significant impact on shipping, there was designed a ship safety management code. To put into practice the quality management system, each company adopts specific quality strategies according to their activity.

  4. Implementation of Risk Management in Malaysian Construction Industry: Case Studies

    OpenAIRE

    Hamzah Abdul-Rahman; Chen Wang; Farhanim Sheik Mohamad

    2015-01-01

    Construction industries are exposed to wide array of risks, such as financial, design, and contractual ones, which might have a direct impact on their performance toward achieving the desired objectives. Risk Management is a proactive decision-making process used to minimize and manage the risks in the most efficient and appropriate manner. However, most construction firms in Malaysia do not apply formal risk management in their projects. Thus, this study aims to identify the actual process o...

  5. Airway management of an unusual case of recurrent rhinoscleroma

    Directory of Open Access Journals (Sweden)

    Nita D′souza

    2011-01-01

    Full Text Available Rhinoscleroma is a rare entity encountered in anesthesia practice. We discuss the management of a patient after its recurrence, involving the upper respiratory tract i.e. nasopharynx and oropharynx, which compromised the airway. The pateint was referred for anesthesia on three different occasions with different presentations owing to the recurrence of symptoms.The presence of an oropharyngeal membrane with a small opening made airway management a challenge. The patient was successfully managed on all three occasions. Imaging facilitated assessment and subsequent airway management.

  6. Peculiarities of Customer Relationships Management: a Case of Lithuanian Companies

    National Research Council Canada - National Science Library

    Gintarė Bliujūtė; Renata Korsakienė

    2014-01-01

    ... decisions which product or service to buy. Inthis context, customer relationship management is becoming animportant tool creating preconditions to maintain loyal customersand improve company’s performance...

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

    Science.gov (United States)

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

    1989-01-01

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

  8. BestPractices Corporate Energy Management Case Study: Alcoa Teams with DOE to Reduce Energy Consumption

    Energy Technology Data Exchange (ETDEWEB)

    2004-05-01

    This is the first in a series of DOE Industrial Technologies Program case studies on corporate energy management. The case study highlights Alcoa Aluminum's successful results and activities through its corporate energy management approach and collaboration with DOE. Case studies in this series will be used to encourage other energy-intensive industrial plants to adopt a corporate strategy, and to promote the concept of replicating results with a company or industry.

  9. [Mother's filicide with suicide attempt].

    Science.gov (United States)

    Misić-Pavkov, Gordana; Gajić, Zoran; Golubović, Boris; Bozić, Ksenija

    2010-01-01

    Filicide is the killing of a son or daughter by a parent. The paper examines interaction between stress and maternal psychopathology that led to the killing. After prolonged conflict with her ex-husband and father of her only child, the respondent committed filicide. Two years before committing filicide, after she had divorced the father of the child, the respondent attempted suicide and had to be hospitalized. On that occasion, she was diagnosed with depressive disorder, which was not treated after hospitalization. Having killed her daughter by cutting her throat, she tried to commit suicide in the same manner, by slitting her throat. During further observation, the respondent was found to suffer from acute psychotic disorder, depressive disorder and histrionic personality disorder. These disorders in interaction with stress do not provide us with an explanation for an unusual and psychopathological motivation analysis of killing the child. Filicide is a violent act, most frequently multifactorial in its nature. Histrionic personality disorder in mother cannot explain the filicide act. Only interactive and dynamic evaluation of this psychiatric disorder in its longitudinal, development aspects and its potentiality to enable the expression of some other psychiatric disorders, especially dissociative states, as well as the importance of prolonged and acute stress and its subjective importance for the individual can shed some more light on the mental state of the mother at the time of filicide.

  10. The mapping competences of the nurse Case/Care Manager in the context of Intensive Care.

    Science.gov (United States)

    Alfieri, Emanuela; Ferrini, Anna Chiara; Gianfrancesco, Francesca; Lise, Gianluca; Messana, Giovanni; Tirelli, Lorenzo; Lorenzo, Ana; Sarli, Leopoldo

    2017-03-15

    Since the recent introduction of the Case/Care Manager's professional figure, it is quite difficult to identify properly his/her own particular features, which could be mainly be found revising mainly in American studies. Therefore, the present study intended to identify the Case/Care Manager's skills and professional profile in an Intensive Care Unit experience, taking into consideration the staff's activities, perception and expectations towards the Case/Care Manager. In particular, it has been compared the experience of an Intensive Care Units where the Case/Care Manager's profile is operational to a different Unit where a Case/Care Manager is not yet in force. a Levati's model was used to map the Case/Care Manager's skills, involving each unit whole working staff, executives and caregivers through semi-structured interviews. It has been taken into consideration the Anaesthesia Unit and Emergency Unit of Cesena's healthcare organisation (AUSL of Romagna) and a Cardiology Intensive Care Unit of Piacenza's healthcare organisation, where the Case/Care Manager's profile has not been experimented yet. Firstly, it a data collection in each healthcare organization has been organised. Subsequently, semi-structured interviews to doctors, unit nurses, caregivers, nurses' coordinators and medical staff have been used to compare each healthcare system. The interviewees' described their expectations in relation to the Case/Care Manager working in a critical area. Then, every data collected during interviews has been organised to map a Case/Care Manager's essential professional profile to work in a critical area together with medical staff. Piacenza's O.U. critical area experience reported a major demand for patients' and patient's families' assistance. On the other hand, the very same aspects seem to have been better achieved in Cesena's O.U., where a Case/Care Manager's recent introduction has actually helped to overcome the void in organising systems. a Case/Care Manager

  11. Knowledge Management: The Case for Kenya | Mosoti | Journal of ...

    African Journals Online (AJOL)

    Most organizations in the developed and the developing world are opting for change in management, looking for ways to improve their ability to create new ideas and to develop the best environment for creation of ideas. Knowledge management is now recognized as an organization's most valuable asset. Because ...

  12. Experiences in New Public Management in Africa: The Case of ...

    African Journals Online (AJOL)

    The present paper contributes to the debate on procedural rationality by focusing attention on performance management systems (PMS), which has emerged with the advent of New Public Management (NPM). It starts by providing the context of the changing role of the state since the 1980s as a background to public sector ...

  13. Effect of Newsroom Management Styles on Journalists: A Case Study.

    Science.gov (United States)

    Gaziano, Cecilie; Coulson, David C.

    1988-01-01

    Determines whether a relationship exists between type of newsroom management style--authoritarian or democratic--and journalists' attitudes toward their newspaper supervisors, jobs, readers, and community. Finds that differences in management style do not appear to influence the relationship with editors or attitudes toward their audience. (RC)

  14. Financial Management and Culture: The American Indian Case

    Science.gov (United States)

    Danes, Sharon M.; Garbow, Jennifer; Jokela, Becky Hagen

    2016-01-01

    Study investigates distal and proximal contextual influences of the American Indian culture that affect financial decisions and behaviors. Primary household financial managers were interviewed. Study was grounded in Deacon and Firebaugh's "Family Resource Management" theory. Findings indicated that American Indians view many concepts…

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

    Science.gov (United States)

    Davidovitch, Nitza; Yavich, Roman

    2015-01-01

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

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

    Science.gov (United States)

    Boxelaar, Lucia; Paine, Mark; Beilin, Ruth

    2007-01-01

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

  17. Case Report: Management of Anesthesia in a Pregnant Patient with ...

    African Journals Online (AJOL)

    Congenital heart diseases (CHDs) affect approximately 0.8% of all the newborns with malformed structured heart or large vessels. Nowadays, due to the progress in medical methods and management, most women with CHD are expected to reach childbearing age. Noticeable improvement in anesthesia management is ...

  18. Stadium disasters in Africa: The case for crowd management | Singh ...

    African Journals Online (AJOL)

    Managers of sport and recreation facilities have numerous legal duties. One of these duties is an obligation to take reasonable precautions to ensure safe activity programmes and facilities for all participants, spectators and staff. The responsibility of a facility manager to ensure the safety of patrons is known as premises ...

  19. Performance Management in Parastatals: The Cases of the ...

    African Journals Online (AJOL)

    current brain drain and the effects of the liberalisation of the transport sector in. Zimbabwe. In a bid to recover from this crunch, both organisations instituted performance management systems, which were borrowed from the public sector. Now the question is, “have these performance management systems improved the

  20. Administrative and Caseload Management Information Systems: The Case of Probation.

    Science.gov (United States)

    Eskridge, Chris W.

    1984-01-01

    Reviews the concept, present operations, and problems of information systems in general, and in probation administration specifically. Describes two different models of information systems-administrative management information systems and caseload management information systems. Explores the feasibility of statewide, multi-state, and nationwide…

  1. Asset management maturity in public infrastructure: the case of Rijkswaterstaat

    NARCIS (Netherlands)

    Volker, L.; Ligtvoet, A.; van den Boomen, M.; Wessels, Peter; van der Lei, T.E.; Herder, P.M.

    2013-01-01

    In times of restructuring governmental policies and resources, the
    need for strategic asset management is growing. Maturity models offer
    organisations a structure to assist them in improving their asset management
    performance. We present the results of a repeated maturity measurement

  2. Paradigms of knowledge management with systems modelling case studies

    CERN Document Server

    Pandey, Krishna Nath

    2016-01-01

    This book has been written by studying the knowledge management implementation at POWERGRID India, one of the largest power distribution companies in the world. The patterns which have led to models, both hypothesized and data-enabled, have been provided. The book suggests ways and means to follow for knowledge management implementation, especially for organizations with multiple business verticals to follow. The book underlines that knowledge is both an entity and organizational asset which can be managed. A holistic view of knowledge management implementation has been provided. It also emphasizes the phenomenological importance of human resource parameters as compared to that of technological parameters. Various hypotheses have been tested to validate the significant models hypothesized. This work will prove useful to corporations, researchers, and independent professionals working to study or implement knowledge management paradigms.

  3. Gaining Traction in Research Data Management Support: A Case Study

    Directory of Open Access Journals (Sweden)

    Donna L. O'Malley

    2014-12-01

    Full Text Available With the implementation of an institutional repository, librarians at the University of Vermont (UVM began receiving inquiries about data management. In an effort to explore research data management roles for librarians at UVM the author led workshops based on Module One of the New England Collaborative Data Management Curriculum (NECDMC with two audiences. In addition, the author consulted with faculty and staff from around the university to ascertain their support of research data management and integrate that information into the workshops. The first workshop was directed at UVM librarians and resulted in an understanding of their willingness to engage with research data management patron services. The second workshop was conducted for students and faculty. It built upon the first workshop and, in addition, experimented with a sixty-minute version of the NECDMC module. This second workshop will be added to an existing series of Dana Library workshops for graduate students and early-career researchers in fall 2014.

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

    Science.gov (United States)

    Jo, In-Young; Yoo, Seung-Hyun; Lee, Da Young; Park, Cheol-Young; Kim, Eun Mi

    2017-01-01

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

  5. Trichloroacetic Acid Ingestion: Self-Harm Attempt

    Directory of Open Access Journals (Sweden)

    E. R. Black

    2017-01-01

    Full Text Available Objective. Trichloroacetic acid (TCAA, or trichloroethanoic acid, is a chemical analogue of acetic acid where three methyl group hydrogen atoms are replaced by chlorine. TCAAs are also abbreviated and referred to as TCAs, causing confusion with the psychiatric antidepressant drug class, especially among patients. TCAAs exist in dermatological treatments such as chemical peels or wart chemoablation medication. TCAA ingestion or overdose can cause gastric irritation symptoms including vomiting, diarrhea, or lassitude. This symptomatology is less severe than TCA overdose, where symptoms may include elevated body temperature, blurred vision, dilated pupils, sleepiness, confusion, seizures, rapid heart rate, and cardiac arrest. Owing to the vast difference in symptoms, the need for clinical intervention differs greatly. While overdose of either in a self-harm attempt can warrant psychiatric hospital admission, the risk of death in TCAA ingestion is far less. Case Report. A patient ingested TCAA in the form of a commercially available dermatological chemical peel as a self-harm attempt, thinking that it was a more injurious TCA. Conclusion. Awareness among physicians, particularly psychiatrists, regarding this relatively obscure chemical compound (TCAA and its use by suicidal patients mistakenly believing it to be a substance that can be significantly more lethal (TCA, is imperative.

  6. Attempts to Transform an Organization

    DEFF Research Database (Denmark)

    Risberg, Annette

    This paper builds on a case study of diversity work in a Swedish municipality, Malmö. It focuses on certain actors partaking in the diversity work done in the municipality that of a gender and diversity committee and its members – here called diversity ambassadors. I will describe the work of the...

  7. Socio-demographic and clinical profile of patients with attempted suicide attending emergency services at the mental health institute in Northern India

    Directory of Open Access Journals (Sweden)

    Vijender Singh

    2014-01-01

    Full Text Available Background: Attempted suicide is one of the major emergencies in psychiatry. Suicide attempts are considered to be the best predictors of an eventual completed suicide. Data of patients presenting with attempted suicide to the emergency settings at mental health institute settings is scanty in India. Aims: The study was carried out to assess the socio-demographic and clinical profile of the patients with suicidal attempt attending emergency services at a teaching Mental Health Institute in Northern India. Methods: Case records of all patients with attempted suicide attending emergency services at Institute of Human Behaviour and Allied Sciences (IHBAS for one calendar year were reviewed. Socio-demographic and clinical details of the patients were retrieved on a Performa specifically designed for this study. Results: Of all the patients who attended emergency services during the study period, 56 patients had suicidal attempts. Majority of them were married (66%, males (57%, in the age group of 20-40 years (61%, were from nuclear families (80.4% and had urban domicile (83.9%. Severe Mental Illnesses were found in about 70% of the cases with duration of illness more than 24 months in 39.2%. Thirty six (64.3% patients had 1 suicide attempt while 18 (32.3% had 2 or more attempts in preceding one month. In 70% - 80% of the cases, the lethality and intentionality of the index episode was found to be moderate to high. Most of the cases needed inpatient treatment. Conclusion: Assessment and management of patients presenting to emergency room with suicidal behavior is a key factor in preventing suicide. There is a pressing need to identify the socio-demographic and clinical factors affecting risk of suicide in a given case. Every case presenting with suicidal ideations or attempt should be evaluated in detail.

  8. A case for safety leadership team training of hospital managers.

    Science.gov (United States)

    Singer, Sara J; Hayes, Jennifer; Cooper, Jeffrey B; Vogt, Jay W; Sales, Michael; Aristidou, Angela; Gray, Garry C; Kiang, Mathew V; Meyer, Gregg S

    2011-01-01

    Delivering safe patient care remains an elusive goal. Resolving problems in complex organizations like hospitals requires managers to work together. Safety leadership training that encourages managers to exercise learning-oriented, team-based leadership behaviors could promote systemic problem solving and enhance patient safety. Despite the need for such training, few programs teach multidisciplinary groups of managers about specific behaviors that can enhance their role as leadership teams in the realm of patient safety. The aims of this study were to describe a learning-oriented, team-based, safety leadership training program composed of reinforcing exercises and to provide evidence confirming the need for such training and demonstrating behavior change among management groups after training. Twelve groups of managers from an academic medical center based in the Northeast United States were randomly selected to participate in the program and exposed to its customized, experience-based, integrated, multimodal curriculum. We extracted data from transcripts of four training sessions over 15 months with groups of managers about the need for the training in these groups and change in participants' awareness, professional behaviors, and group activity. Training transcripts confirmed the need for safety leadership team training and provided evidence of the potential for training to increase targeted behaviors. The training increased awareness and use of leadership behaviors among many managers and led to new routines and coordinated effort among most management groups. Enhanced learning-oriented leadership often helped promote a learning orientation in managers' work areas. Team-based training that promotes specific learning-oriented leader behaviors can promote behavioral change among multidisciplinary groups of hospital managers.

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

    Science.gov (United States)

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

    2007-01-01

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

  10. Anesthetic management of Shah-Waardenburg syndrome: Experience of two cases and review of literature

    Directory of Open Access Journals (Sweden)

    Uday S Ambi

    2012-01-01

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

  11. A Healthcare Project: Managing Knowledge through Electronic Medical Record -Empirical Cases

    OpenAIRE

    Rocco Reina; Teresa Cetani; Assunta Lacroce; Marzia Ventura

    2012-01-01

    The paper aims at analysing the complex relations between knowledge management and project management on an empirical case in healthcare system represented by Electronic Medical Record (EMR); the effective goal is to underline the approach and the practical methods used by the project teams to maximize the level of knowledge plugged in EMR in two selected Italian hospitals. First, the research analyzes the main references about knowledge management and project management; then, it shows the j...

  12. LOCAL AREA NETWORK MANAGEMENT (Case Study at Assessment and Development Information Technology Units Brawijaya University Malang)

    OpenAIRE

    Hadiwijaya, Mohammad Firman

    2015-01-01

    The purpose of this study was to know the management local area network at Assessment and Development Information Technology units, furthermore this study focusing on network management functions that applied by Assessment and Development Information Technology Units. This study will explain about the implementation of network management functions in the local area network management. The research method employ in this research is by using descriptive qualitative method by study case approach...

  13. Optimization Case Study: ISR Allocation in the Global Force Management Process

    Science.gov (United States)

    2016-09-01

    REPORT TYPE AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE OPTIMIZATION CASE STUDY: ISR ALLOCATION IN THE GLOBAL FORCE MANAGEMENT PROCESS 5...Force Management Initial Capabilities Document. Washington, DC: Department of Defense. Joint Chiefs of Staff. 2014a. Global Force Management Allocation...Defense. ———. 2012b. Capability Development Document for Global Force Management Data Initiative Increment 2 Next Steps: Manpower and Personnel

  14. Investigation into knowledge management in SMEs: Case of a Finnish telecomunications company

    OpenAIRE

    Le, Trang

    2017-01-01

    The study investigates knowledge management in a Finnish SMEs and proposes appropriate practices to improve the status quo of the case company. Knowledge management is the management practice to leverage organizational knowledge to add value to the organization. Knowledge management is a significant source of competitive advantage, a crucial element of organization core competencies and a fundamental need for the learning organization. In spites of its enormous contribution to the organizatio...

  15. Earnings management: estudo de caso do Banco Nacional Earnings management: Central Bank's case study

    Directory of Open Access Journals (Sweden)

    César Medeiros Cupertino

    2006-08-01

    Full Text Available Este artigo promove um estudo de caso de uma das maiores instituições financeiras brasileiras da década de 90: o Banco Nacional S.A. (BNSA. O BNSA teve sua intervenção decretada pelo Banco Central do Brasil em 1995, após ser identificada a existência de ativos insolventes, originados por gerenciamento fraudulento dos lucros da entidade. O estudo visa investigar a gestão fraudulenta de lucros do Banco Nacional S.A., tanto nos seus aspectos motivadores, quanto em relação aos seus efeitos na composição patrimonial da entidade. A abordagem metodológica contempla: (i pesquisa explicativa, quanto aos objetivos do estudo; (ii estudo de caso, quanto aos procedimentos aplicados e (iii pesquisa qualitativa, quanto à abordagem do problema. Constatou-se que pode haver interesses inconciliáveis entre o agente e o principal, conforme disciplinado pela teoria da agência. O artigo, ainda, ressalta a importância do conhecimento dos dados financeiros na identificação dos fatos de interesse, dos ajustes pertinentes e da correta evidenciação da situação patrimonial da entidade.This paper features a case study of one of the main Brazilian banks of the 90's: Banco Nacional S/A (BNSA. The bank had its intervention decreed by Central Bank of Brazil in 1995, after the existence of insolvent assets, originated by fraudulent earnings management, were identified. The study aims to investigate the fraudulent earnings management of BNSA, both in motivational aspects and in relation of the effects in its balance sheet structure. The methodological approach of the study encompasses: (i an explanatory research, regarding the intended aim of the study; (ii case study, regarding the applied procedures; and (iii a qualitative research, regarding the approach to the problem. It was concluded that irreconcilable conflicts of interest might occur between the agent and the principal, according to the Agency Theory. The paper also emphasizes the importance of

  16. Collaborations in leadership: the nurse case management and nursing administration connection.

    Science.gov (United States)

    Carr, Dana Deravin

    2009-01-01

    With a multiple decade's long surge in managed care and the growth of case management as a profession, there is increasing recognition of the leadership role that case managers employ daily as they coordinate and facilitate patient-centered initiatives. Now, more than ever, case managers are being called upon to further expand their leadership capabilities and take a more active role in professional partnering to ensure the continued attainment of clinical, fiscal, and quality outcomes. All settings, particularly acute care hospitals and integrated delivery systems. The collaboration between nurse case managers and nursing administration provides a framework for the establishment of a collegial and supportive working relationship: one that is built on the strength of mutual goals, shared leadership abilities, respect, and professional loyalty.

  17. Management of visual disturbances in albinism: a case report

    OpenAIRE

    Omar Rokiah; Idris Siti; Meng Chung; Knight Victor

    2012-01-01

    Abstract Introduction A number of vision defects have been reported in association with albinism, such as photophobia, nystagmus and astigmatism. In many cases only prescription sunglasses are prescribed. In this report, the effectiveness of low-vision rehabilitation in albinism, which included prescription of multiple visual aids, is discussed. Case presentation We present the case of a 21-year-old Asian woman with albinism and associated vision defects. Her problems were blurring of distant...

  18. When attempts at robbing prey turn fatal

    Science.gov (United States)

    Dejean, Alain; Corbara, Bruno; Azémar, Frédéric; Carpenter, James M.

    2012-07-01

    Because group-hunting arboreal ants spread-eagle insect prey for a long time before retrieving them, these prey can be coveted by predatory flying insects. Yet, attempting to rob these prey is risky if the ant species is also an effective predator. Here, we show that trying to rob prey from Azteca andreae workers is a fatal error as 268 out of 276 potential cleptobionts (97.1 %) were captured in turn. The ant workers hunt in a group and use the "Velcro®" principle to cling firmly to the leaves of their host tree, permitting them to capture very large prey. Exceptions were one social wasp, plus some Trigona spp. workers and flies that landed directly on the prey and were able to take off immediately when attacked. We conclude that in this situation, previously captured prey attract potential cleptobionts that are captured in turn in most of the cases.

  19. Novel approach in the management of an oral premalignant condition - A case report

    Directory of Open Access Journals (Sweden)

    Sankaranarayanan S

    2007-01-01

    Full Text Available Oral submucous fibrosis is a progressive oral disease first described by Pindborg and Sirsat 3 decades ago. It is a premalignant condition. The signs and symptoms depend on the involvement of the different sites in the oral cavity. The patient feels burning sensation for normal diet and trismus which may be so severe. If not properly treated the risk of malignant change in advanced cases of OSMF is relatively high. Wide ranges of treatment such as medical management, surgical therapy and physiotherapy have been attempted in the past, but none of them has proved to be a cure for this chronic fibrotic disease.Histopathologically as the disease progresses, (i change in the morphology of collagen, (ii increased accumulation of amorphous collagen, and (iii decreased collagen degradation results in decrease in number of blood vessels are observed in the affected area compared to the normal area. With an aim of bringing more blood supply to the affected area which is expected to bring ?more nutrients and help in collagen degradation, earlier application of vasodilators and studies with curcumin have been done, but still with - no significant outcome.As an alternative approach to improve the blood circulation, we have tried Autologous bone marrow stem cells which have been earlier applied in several diseases such as ischemic peripheral vascular diseases, ischemic heart diseases etc with proven improvement in angiogenesis. A 38 year old patient with oral submucosal fibrosis, proven by histopathology, and endothelial markers was injected 175 million BMMNCs into the area affected. The paramaters such as blanching, fibrous band have significantly improved, 4 weeks after the injection. We could observe positive changes clinically to prove the improvement. The mouth opening has improved to 35 mm from the previous 30.0 mm. Further histopathology and SEM studies with larger samples are done for establishing stem cell therapy’s safety and efficacy.

  20. Continuous improvement processes using Lean Management tools. A case study

    Directory of Open Access Journals (Sweden)

    Pârv Luminița

    2017-01-01

    Full Text Available The paper describes how Lean Management may be applied in the university setting to improve the management processes. The correlation of didactic, educational and research activities with the stakeholders needs is one of the main objectives of the university. In this respect, an indicator used to analyse a university, for the purposes of fulfilling its mission, respectively for the purposes of streamlining its didactic and scientific activity, is related to the number of graduates on the labour market, acting in their area of specialization. This work presents a best practice of Lean Management at Transilvania University of Brasov, Romania.

  1. Endoscopic management of patients with post-surgical leaks involving the gastrointestinal tract: A large case series

    Science.gov (United States)

    Caruso, Angelo; Cellini, Carlo; Sica, Mariano; Zullo, Angelo; Mirante, Vincenzo Giorgio; Bertani, Helga; Frazzoni, Marzio; Mutignani, Massimiliano; Galloro, Giuseppe; Conigliaro, Rita

    2016-01-01

    Background Post-surgical anastomotic leaks often require a re-intervention, are associated with a definite morbidity and mortality, and with relevant costs. We described a large series of patients with different post-surgical leaks involving the gastrointestinal tract managed with endoscopy as initial approach. Methods This was a retrospective analysis of prospectively collected cases with anastomotic leaks managed with different endoscopic approaches (with surgical or radiological drainage when needed) in two endoscopic centres during 5 years. Interventions included: (1) over-the-scope clip (OTSC) positioning; (2) placement of a covered self-expanding metal stent (SEMS); (3) fibrin glue injection (Tissucol); and (4) endo-sponge application, according to both the endoscopic feature and patient’s status. Results A total of 76 patients underwent endoscopic treatment for a leak either in the upper (47 cases) or lower (29 cases) gastrointestinal tract, and the approach was successful in 39 (83%) and 22 (75.9%) patients, respectively, accounting for an overall 80.3% success rate. Leak closure was achieved in 84.9% and 78.3% of patients managed by using a single or a combination of endoscopic devices. Overall, leak closure failed in 15 (19.7%) patients, and the surgical approach was successful in all 14 patients who underwent re-intervention, whilst one patient died due to sepsis at 7 days. Conclusions Our data suggest that an endoscopic approach, with surgical or radiological drainage when needed, is successful and safe in the majority of patients with anastomotic gastrointestinal leaks. Therefore, an endoscopic treatment could be attempted before resorting to more invasive, costly and risky re-intervention. PMID:28408994

  2. Sustainability Management Program for Industries- A Case Study

    Directory of Open Access Journals (Sweden)

    Long Su Weng Alwin

    2017-01-01

    Full Text Available This research studied the effectiveness of Sustainability Management Program in improving production efficiency of the manufacturing site with verified result using the regression analysis. For this study, a dairy manufacturing industry located in Malaysia was selected and major energy consuming equipment in the industryplant were identified. Sustainability Management Program (SMP was carried out for three years and energy consumption and product has improved regression coefficients of 0.625 in 2013, 0.826 in 2014, and 0.878 in 2015 as the manufacturing site becomes more energy efficient. This suggests that the energy management should be carried out in a continuous manner with energy management team responsible for energy saving practices.

  3. Determinants of Key Account Management Effectiveness: The Case ...

    African Journals Online (AJOL)

    Dires Abebe Fenta

    . Page 129 corps and access to marketing and sales resources are categorized. KAM esprit de corps is defined as the extent to which people involved in the management of key accounts feel obligated to common goals and to each other.

  4. Stakeholders’ perception of forest management: a Portuguese mountain case study

    Energy Technology Data Exchange (ETDEWEB)

    Marta-Costa, A.; Torres-Manso, F.; Pinto, R.; Tibério, L.; Carneiro, I.

    2016-07-01

    Aim of study: The Natura 2000 Network “Montemuro Mountain” Site in Portugal. Material and methods: This study combined several consultation and citizen participation techniques. Main results: The perceptions shared by the stakeholders are some similar, others not similar and others still quite paradoxical regarding forest characteristics and the opportunities they offer. The study has shown that it is possible to implement and improve citizen participation methodologies. This can be a viable way towards more effective forest management and fire prevention as this may help blunt conflicts of interest in forest space management. However, for participation to be truly effective and representative, a policy regarding training and awareness of the importance of information is necessary. Research highlights: The stakeholder perceptions on forests and forest management are assessed; forest fires and agrarian abandonment are central for territory’s development; depopulation, old age and absenteeism emphasize degradation of forest areas; Conscious citizen participation benefit policymaking and forest management. (Author)

  5. Surgical management of hydatid liver cysts: A case report | Odimba ...

    African Journals Online (AJOL)

    , M Nthele, D Ndjovu. Abstract. The discovery of huge and compressing cystic masses on the right liver, associated with right hypochondrium complaints usually presents a diagnostic and management challenge to the surgeon, especially in ...

  6. A combined disease management and process modeling approach for assessing and improving care processes: a fall management case-study.

    Science.gov (United States)

    Askari, Marjan; Westerhof, Richard; Eslami, Saied; Medlock, Stephanie; de Rooij, Sophia E; Abu-Hanna, Ameen

    2013-10-01

    To propose a combined disease management and process modeling approach for evaluating and improving care processes, and demonstrate its usability and usefulness in a real-world fall management case study. We identified essential disease management related concepts and mapped them into explicit questions meant to expose areas for improvement in the respective care processes. We applied the disease management oriented questions to a process model of a comprehensive real world fall prevention and treatment program covering primary and secondary care. We relied on interviews and observations to complete the process models, which were captured in UML activity diagrams. A preliminary evaluation of the usability of our approach by gauging the experience of the modeler and an external validator was conducted, and the usefulness of the method was evaluated by gathering feedback from stakeholders at an invitational conference of 75 attendees. The process model of the fall management program was organized around the clinical tasks of case finding, risk profiling, decision making, coordination and interventions. Applying the disease management questions to the process models exposed weaknesses in the process including: absence of program ownership, under-detection of falls in primary care, and lack of efficient communication among stakeholders due to missing awareness about other stakeholders' workflow. The modelers experienced the approach as usable and the attendees of the invitational conference found the analysis results to be valid. The proposed disease management view of process modeling was usable and useful for systematically identifying areas of improvement in a fall management program. Although specifically applied to fall management, we believe our case study is characteristic of various disease management settings, suggesting the wider applicability of the approach. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  7. Case Study Methodology and the Rational Management of Interaction.

    Science.gov (United States)

    Lakomski, Gabriele

    1987-01-01

    Argues that the case study method of assessing human interactions in organizations provides incomplete information and contains inadequate judgment criteria. Examines epistemological assumptions on which case study or interpretive methodology rests (including cultural analysis of organizations) and recommends an alternative problem-solving model…

  8. Perioperative Management of Patients with Psoriatic Arthritis: Case ...

    African Journals Online (AJOL)

    Case presentation: We report the case of a 32 year old lady on treatment for skin psoriasis and arthritis who presents with bilateral hip pain. Investigations reveal grade 2 avascular necrosis of femoral head on magnetic resonance imaging. She also had dyslipidemia, obesity and osteoporosis that may be the consequence ...

  9. Use Case Modelling of Bingham University Library Management ...

    African Journals Online (AJOL)

    SOFTLINKS DIGITAL

    1,2 Department of Computer Science, Faculty of Science and Technology,. Bingham University ... keys things, (i) the actor or actors involved .... Special Requirement. None. Related Use Case. Generate Barcode. Return Book. This use case documents the procedure of returning a book and calculating the fine amount if the ...

  10. Diffusion of a quality management system: a case study

    OpenAIRE

    Solomon, Noel Phillip; Bester, Andre; Moll, C. M.

    2017-01-01

    The diffusion of a quality management system (QMS) to improve business performance depends upon the quality management strategy used. The aim of Eskom’s QMS strategy was to create a sustainable quality drive throughout the company to improve customer and stakeholder satisfaction. This research project’s objective is to determine how the diffusion of a QMS can improve the electricity supply industry in the Western Cape division of the electricity sector in South Africa. A quantitative research...

  11. Managing Employee Expectations During An Acquisition: A Case Study Approach

    OpenAIRE

    Pankaj Kumar, Riddhi Doshi; Avinash, V. Kothari

    2010-01-01

    Over the last decade, Mergers and Acquisitions (M&A) have been viewed as a popular strategy for growth, diversification and achieving a more global presence. Despite the growing number of transactions worldwide, the rate of failure reported has been rather high. The failure has been attributed to many reasons such as leadership, communication, culture and the list goes on. During these trying times, management of the employees’ expectations is pivotal. This Management research focuses to unco...

  12. CUSTOMER RELATIONSHIP MANAGEMENT : case study Coca-Cola Company

    OpenAIRE

    Ling, Xiaojing

    2017-01-01

    The Coca-Cola Company is an American multinational beverage corporation, a manufacturer, retailer and marketer of non-alcoholic beverage concentrates and syrups with its headquarter in Atlanta, Georgia. This thesis is aimed to affirm the superiority of the Coca-Cola Company and to find out its shortcomings in managing customer relationships based on studying the customer relationship management strategy for Coca-Cola Company and discussing the comparison between Coca-Cola and Pepsi Cola, then...

  13. A Typical Case Study: Solid Waste Management in Petroleum Refineries

    OpenAIRE

    Jadea S. Alshammari; Fatma K. Gad; Ahmed A.M. Elgibaly; Abdul R. Khan

    2008-01-01

    The current environmental concerns have forced developed and developing countries to reduce air, water and land pollution for sustainable growth. Solid refinery waste is cocktail of hydrocarbons, water, heavy metal and fine solids and is substantial in quantity. The principal processes of waste management focus mainly on waste source reduction, reusing, recycling, composting, incineration with or without energy recovery, fuel production and land filling. Waste management models have a common ...

  14. A Case Study: Data Management in Biomedical Engineering

    Directory of Open Access Journals (Sweden)

    Glenn R. Gaudette

    2012-01-01

    Full Text Available In a biomedical engineering lab at Worcester Polytechnic Institute, co-author Dr. Glenn R. Gaudette and his research team are investigating the effects of stem cell therapy on the regeneration of function in damaged cardiac tissue in laboratory rats. Each instance of stem cell experimentation on a rat yields hundreds of data sets that must be carefully captured, documented and securely stored so that the data will be easily accessed and retrieved for papers, reports, further research, and validation of findings, while meeting NIH guidelines for data sharing. After a brief introduction to the bioengineering field and stem cell research, this paper focuses on the experimental workflow and the data generated in one instance of stem cell experimentation; the lab’s data management practices; and how Dr. Gaudette teaches data management to the lab’s incoming graduate students each semester. The co-authors discuss the haphazard manner by which engineering and science students typically learn data management practices, and advocate for the integration of formal data management instruction in higher education STEM curricula. The paper concludes with a discussion of the Frameworks for a Data Management Curriculum developed collaboratively by the co-authors’ institutions -- the University of Massachusetts Medical School and Worcester Polytechnic Institute -- to teach data management best practices to students in the sciences, health sciences, and engineering.

  15. Is Insulin Pump a game changer in the management of Diabetes Mellitus: A case series

    Directory of Open Access Journals (Sweden)

    Haider Ghazanfar

    2016-02-01

    Full Text Available Prevalence of diabetes has drastically increased over the past decade and it has a debilitating effect on one’s quality of life. The Insulin Pump is a relatively new modality in the management of Diabetic patients. The objective of our case series was to assess the impact of insulin pump on glycemic control and quality of life of diabetic patients. In this case series we have presented four Type 2 diabetic cases which presented with different common complications associated with diabetes as well as its management, particularly the complication of hypoglycemic episodes. Worldwide introduction of insulin pump can prove to be a trend changer in the management of diabetes

  16. Adolescent and Adult Clients in Prenatal Case Management: Differences in Problems and Interventions Used.

    Science.gov (United States)

    Issel, L Michele; Gilmet, Kelsey; Chihara, Izumi; Slaughter-Acey, Jamie

    2015-12-01

    This study sought to characterize differences between pregnant adolescents and adults in the types of problems addressed by case managers, and to assess subsequent differences in the types of interventions used with both groups. Data stem from 3947 client encounters, provided by 223 case managers in 92 Medicaid-reimbursed prenatal case management programs; the clients were confirmed to be either adolescents (types and number of problems, the types of intervention received, and the mean number of intervention minutes between adolescents and adults. Adolescents experienced an average of 3.9 problems whereas adults experienced an average of 3.2 problems (p PCM programs serving high risk population.

  17. Preventing repetition of attempted suicide-III

    DEFF Research Database (Denmark)

    Lahoz, Titia; Hvid, Marianne; Wang, August G

    2016-01-01

    to suicide attempters had a significant preventive effect on the prevalence of suicide attempts and significantly reduced the number of patients repeating a suicide attempt. AIMS: In this 5-year RCT follow-up the aim was to investigate the sustainability of the suicide preventive effect shown in a 1-year...... follow-up study. METHOD: One hundred and thirty-three suicide attempters were included at this 5-year follow-up RCT study at Copenhagen University Hospital, Amager, and randomized to a rapid outreach suicide preventive intervention (OPAC) or TAU. RESULTS: Offering OPAC intervention to patients after...... a suicide attempt has a significant preventive effect on the total of suicide attempts and significantly reduces the number of patients repeating a suicide attempt. The suicide preventive effect lasts up to 265 weeks. After 3-4 years the effect on the number of patients repeating a suicide attempt...

  18. "Because somebody cared about me. That's how it changed things": homeless, chronically ill patients' perspectives on case management

    National Research Council Canada - National Science Library

    Davis, Elizabeth; Tamayo, Aracely; Fernandez, Alicia

    2012-01-01

    .... Little is known about participants' perspectives on case management interventions. This qualitative study used in-depth, one-on-one interviews to understand the impact of a case management program from the perspective of participants...

  19. [Laparoscopic management of gastroesophageal reflux disease. Experience with 100 cases].

    Science.gov (United States)

    Bernal-Gómez, R; Olivares-Ontiveros, O; García-Vázquez, A; Silva-Sánchez, V; Noyola-Cedillo, S; Quezada-Salcedo, J E; Morales-Trejo, R M

    2001-01-01

    To evaluate the results of laparoscopic Nissen-Rossetti funduplication and to compare them with the results obtained in open surgery. Prospective, observational, longitudinal, pre and post-procedure. Beneficencia Española, Hospital Angeles, and Hospital Francisco Galindo Chávez, ISSSTE, in Torreón, Coahuila, Mexico. From December 1992 to February 1999, 100 patients with surgical indications due to gastroesophageal reflux disease (GERD) prospectively underwent a laparoscopic Nissen-Rossetti procedure. A clinical and endoscopic follow up from 3 months to 9 years was performed in 87 cases. Symptomatic control was achieved in 98% (85/87) of the cases and remission of overall endoscopic esophagitis in 79% (69/87); excluding Barrett cases, esophagitis remission was observed in 93% (67/72) of the subjects. The following recurrences took place: two with G-II and two with G-III esophagitis, one requiring pyloroplasty due gastric stasis, and other patient with G-IV esophagitis, who has needed to continue with postoperative dilations. Of 16 cases with Barrett's esophagus, two-showed remission and one did not return control. Perioperative complications included gastric perforations (3), acute pulmonary edema during the immediate postoperative period (1), deep vein thrombosis (1), and late esophageal perforation (1). All were resolved satisfactorily. Surgical mortality was 0 in the 100 cases undergoing the procedure. Eighty-six percent of cases had a 24-h hospital stay. Early morbidity: dysphagia in 60 patients, early satiety in 91 cases, abdominal distention in 25 cases, all this symptomatology disappears during the subsequent 3 months. Persistent morbidity: flatulence in 60% of patients, difficulty for vomiting in 10% of cases. The laparoscopic procedure is as effective as the open method with the advantage of being minimally invasive.

  20. Creating clinical and economic "wins" through integrated case management: lessons for physicians and health system administrators.

    Science.gov (United States)

    Kathol, Roger G; Lattimer, Cheri; Gold, Gold; Perez, Rebecca; Gutteridge, Deborah

    2011-01-01

    This article describes an innovative integrated approach to case management using a standardized complexity assessment grid and communication tool, which is designed to identify barriers to improvement in 4 domains: biological, psychological, social, and health system; to create and implement holistic care plans based on "anchored barriers; and to document ongoing targeted outcomes. Adult and pediatric case and disease managers working for hospitals or clinics, health care delivery systems, general medical health plans, care management vendors, government agencies, and employers can effectively employ integrated case management procedures. Integrated case management augments traditional care coordination by allowing trained medical or mental health managers to assist with cross-disciplinary barriers without handoffs; to connect multidomain barriers to mutually agreed-upon care plan goals and activities; and to measure clinical, functional, fiscal, quality of life, and satisfaction outcomes as a part of the management process, especially in high-cost, complex patients. Integrated case management provides a step-by-step interdisciplinary approach for helping complex patients that has the potential to maximize clinical and functional value, while reducing total health-related costs.