Rosenstein, A H; Propotnik, T
Providing cost-effective high quality healthcare services ranks as the number one concern for anyone involved with the healthcare delivery system. While quality of care should always be the number one priority, controlling healthcare costs receives most of the attention. With limited healthcare dollars and providers assuming more of the financial risk for services rendered, a whole assortment of cost-containment strategies are being introduced in an effort to maintain some semblance of financial viability. Healthcare providers can approach cost control from two different angles. On the fixed-cost operational overhead side, traditional cost-containment techniques have focused on downsizing, maximizing productivity, staffing redesign, improved purchasing contracts, standardization, inventory control, and other more individualized restructured service models. On the variable-cost clinical side, cost control has been approached by introducing a variety of cost-containment strategies designed to improve efficiency and effectiveness of provider performance. While many of these strategies, previously discussed in the Journal of Healthcare Resource Management have stressed the importance of education, guidelines, pathways, and other clinical "tools for improvement," the success of many of these tools resides in the ability to provide real-time intervention. Real-time intervention rather than the more passive retrospective variance analysis has the greatest potential for producing cost savings by actually making a recommendation that prevents the unwanted event from occurring. In many institutions, the case manager bears the responsibility for monitoring and managing these programs. This article describes various case management models currently used by different institutions.
Kerzner, Harold R
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
U.S. Department of Health & Human Services — The Disaster Case Management Program (DCM) is a time-limited process that involves a partnership between a case manager and a disaster survivor (also known as a...
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...
Mark, D D
The purpose of this article is to analyze the performance of and support for case management using a policy framework in order to increase case managers' awareness of policy making and facilitate successful planning for future policy initiatives. Feldstein's (1996) theory of opposing legislative outcomes indicates that legislation can be viewed on a continuum, ranging from legislation that meets the needs of the public to legislation considered to be in the self-interest of the participants and legislators. The current health care system requires that case managers working for publicly funded health care organizations balance the need for stewardship of U.S. tax dollars and the health care needs of consumers. It is apparent from the literature that case managers are successfully achieving this balance. However, certain conditions should exist that allow for case manager decision-making that promotes effective and efficient utilization of health care resources. Case managers must work within the context of the health care policy environment. Realizing that it is more likely that the conflicts between stewardship and the provision of health care services will continue, case managers' knowledge and influence regarding policy making becomes imperative in order to ensure that these conflicting goals do not become mutually exclusive.
Wolk, James L.; And Others
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'…
I'm going to close with some of my ideas about the characteristics that case managers exhibit. I have a great deal of professional respect for case managers. I think that you are a tenacious lot. One of the major things that case managers do is help create new alternatives to problems. You open doors; no ... you first build the door and then you open it. You're creative, persistent, and resourceful. You are sometimes asked to solve all of an organization's problems. I think that is a tremendous burden, and that you can get confused because of that role conflict and confusion. What model is best for my organization? Within that is my patient population. What is it that they need? What are the current issues that you are seeing? How is my case management role different from other roles? How large a scope of practice can I handle and be reasonably successful with the patients with whom I'm dealing? How many different kinds of approaches and models are needed within my organization? Look toward the future; think about the future in terms of your crystal balls. What trends do you see building in either the demographics or the health and social environments that are going to influence health care in the future? What effect will the aging of our population have on you and your case management practice? What issues are going to be related to those trends? How many more people do we have living in fragmented families? What's going to happens in terms of resources available for patients? How can case management influence those changes? I don't think we're going to see the pace of change in the health care industry slow down. We will continue to have health care organizations address social issues in addition to pathophysiologic ones. No matter what the role and how it evolves, case management will always be at the junction of change in health care. This will be difficult at times to deal with. It will also be a source of satisfaction for those in the role because of the
Saxton, S E
Humor is an effective tool to prevent and resolve burnout, a common problem associated with the practice of case management. Easily accessed by almost everyone, humor has many physiological and psychological benefits. The conscious use of humor in an organization requires a commitment at all levels in order for the organization to benefit as a whole. Offering formal seminars, using humor in company newsletters, and encouraging cartoon or joke sharing impacts on the physical and mental health of the employees. Techniques for bringing laughter to the workplace are outlined, as well as examples from the practice of case management.
Full Text Available Interest in Composite Content Applications has been climbing higher over the recent years due to the rising need around enabling business process improvements and addressing challenges around business process agility. Such applications can deliver substantial value by leveraging both content and process services for the better orchestration of people and processes and empower organizations to automate routine tasks and aggregate information from multiple sources in a collaborative work environment that enables rapid decision making. In this whitepaper, we have introduced Case Management and its relationship with ECM, the essential functionalities in a Case Management Product stack and expanded on leading vendors in this space along with the salient features of their case management offerings. Subsequently we have built on a sample case scenario of building a contracts management application using EMC Documentum xCelerated Composition Platform (xCP, the business needs and challenges that a well-designed Contracts Management application can address, a real-life application of xCP platform to build such a solution and the observations on the strengths and limitations of this platform, along with a few workarounds to address the limitations.
... 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...
Che, Zhenghong; Che, Zhengmei
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…
Issel, L M; Anderson, R A
Comprehensive case management has become an industry standard and its pervasiveness raises questions about the ubiquitous need for this service. Analyzed from the perspective of transaction cost analysis and access, we argue that in some cases comprehensive case management is an avoidable cost incurred because of system problems that limit access to otherwise eligible clients. Implications are discussed.
Tahan, H A
Emotional intelligence is a skill necessary for case managers because of the diversity of their work, the multiple stakeholders they have to deal with on daily basis, and the increased potential for conflict. Managers and administrators need to be cognizant of the role emotional intelligence plays in employee performance and the importance of developing training programs to assist case managers in learning to deal with change and conflict. Case managers must assume responsibility for their actions and work to develop and improve their emotional intelligence skills set. Ultimately, patients and work associates will appreciate the case manager's efforts. Finally, case managers will find work an enjoyable experience and look forward to new opportunities the future holds.
White, Lori S.
This chapter presents a series of supervision-related case studies of situations that midlevel managers might face. Individuals enrolled in a midlevel management professional development course recommended the topics selected for this chapter. Drawing upon her experience teaching the course, the author selected four case studies that individuals…
Hall, James A.; Vaughan Sarrazin, Mary S.; Huber, Diane L.; Vaughn, Thomas; Block, Robert I.; Reedy, Amanda R.; Jang, MiJin
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…
Case management is currently an important issue in France. Because neither service providers nor consumers pay for case management in this country, a cost-benefit analysis is often required by the organizations that do pay. Given the context of French social policy and the current focus on justifying case management through cost-benefit analysis, we have developed a way to evaluate its costs. This article presents the limitations of standard economic choice theory, provides a methodology based on the principles of limited rationality, and gives the results of an evaluation of four case management programs. The article provides a method to measure case management costs and efficiency, as well as the willingness of consumers to pay for services.
Lim, Jerry; Laing, Christopher M; MacCallum, Niall S; Brealey, David A
We present a case of severe peripartum hyponatraemia that occurred following a major obstetric haemorrhage causing both an ischaemic stroke and Sheehan's syndrome and outline the investigations and management strategy required. PMID:27512448
Hall, James A; Sarrazin, Mary S Vaughan; Huber, Diane L; Vaughn, Thomas; Block, Robert I; Reedy, Amanda R; Jang, Mijin
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 (TAU), or to a fourth condition of TAU only. All were assessed at intake and followed at 3, 6, and 12 months. RESULTS: Clients in all four conditions significantly decreased substance use by 3 months after intake and maintained most gains over time. However, the addition of ICM to TAU did not improve substance use outcomes. CONCLUSION: Overall, the addition of case management did not significantly improve drug treatment as hypothesized by both researchers and clinicians. Some results were mixed, possibly due to the heterogeneous sample, wide range of case management activities, or difficulty retaining participants over time.
Haber, S.B.; Barriere, M.T. (Brookhaven National Lab., Upton, NY (United States)); Roberts, K.H. (California Univ., Berkeley, CA (United States). Walter A. Haas School of Business)
Outage management issues identified from a field study conducted at a two-unit commercial pressurized water reactor (PWR), when one unit was in a refueling outage and the other unit was at full power operation, are the focus of this paper. The study was conduced as part of the US Nuclear Regulatory Commission's (NRC) organizational factors research program, and therefore the issues to be addressed are from an organizational perspective. Topics discussed refer to areas identified by the NRC as critical for safety during shutdown operations, including outage planning and control, personnel stress, and improvements in training and procedures. Specifically, issues in communication, management attention, involvement and oversight, administrative processes, organizational culture, and human resources relevant to each of the areas are highlighted by example from field data collection. Insights regarding future guidance in these areas are presented based upon additional data collection subsequent to the original study.
Haber, S.B.; Barriere, M.T. [Brookhaven National Lab., Upton, NY (United States); Roberts, K.H. [California Univ., Berkeley, CA (United States). Walter A. Haas School of Business
Outage management issues identified from a field study conducted at a two-unit commercial pressurized water reactor (PWR), when one unit was in a refueling outage and the other unit was at full power operation, are the focus of this paper. The study was conduced as part of the US Nuclear Regulatory Commission`s (NRC) organizational factors research program, and therefore the issues to be addressed are from an organizational perspective. Topics discussed refer to areas identified by the NRC as critical for safety during shutdown operations, including outage planning and control, personnel stress, and improvements in training and procedures. Specifically, issues in communication, management attention, involvement and oversight, administrative processes, organizational culture, and human resources relevant to each of the areas are highlighted by example from field data collection. Insights regarding future guidance in these areas are presented based upon additional data collection subsequent to the original study.
Asif Qumer Gill
Full Text Available Emergency management agencies are progressively using social media for the sourcing and distribution of disaster information. Emergency management agencies are often unsure as to how to best identify and assess social media concerns (e.g. information security, trust which must be addressed to develop a social media-enabled disaster information management environment. This paper adopts the Social Architecture Viewpoint Assessment (SAVA framework for identifying and assessing social media concerns from four different viewpoints: IT, Value, Resource and Management. This paper demonstrates the use of the SAVA framework in the context of an in-depth empirical case study of an Australian emergency management agency. The results of this study indicate that the SAVA framework is useful for emergency information management managers in identifying and assessing social media concerns.
BOYACI, Reviewed By Dr. Adnan
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…...
Austin, Carol D; McClelland, Robert W; Gursansky, Di
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.
Nursing Case Management as described here was developed in less than ideal conditions: a full census, a 30 per cent increase in patient volume over five years, a nursing shortage, no grants or outside funding, no clinical specialists or clinical ladder, and no computerized documentation system. No more staff or salary was added as we focused our attention on the new tools, roles, and structures necessary to achieve cost and quality outcomes. However, nursing case management has worked because of some very key elements: 1. A firm commitment to the belief that staff nurses must be accountable for the outcomes of the care that they have planned, given, managed, and continuously evaluated. 2. A combination of top-down organizational development strategies with excellent staff nurse involvement at each juncture. 3. Negotiation and collaboration with physicians and hospital administration at key turning points. This includes the relentless articulation of patient-centered care. 4. A willingness to learn and risk together as a whole department--across levels, across specialties. This includes a constant balance of moving from concrete examples and problems to reconceptualizing the issues. 5. Listening, responsiveness, humor, and acknowledging contributions of everyone. More than any other principal, the case manager must be a central caregiver to a patient to ensure cost/quality outcomes. Otherwise case management only adds to the cost of health care by adding another level of bureaucracy. Nurses have always managed the care of patients, but to stay effective and committed, they need to take increased authority in their patients' entire episode of care and develop formal collaborative practice groups. In other words: "Prospective payment has changed the health care product from a day of care (or a visit) to an entire case or episode of illness. More than just a new way of paying for care, it has changed our way of planning, managing, and thinking about health care
Jacky Siu-Lun Ting
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.
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.
You, Emily Chuanmei; Dunt, David; Doyle, Colleen
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.
We have developed and implemented a large scale, centralized case management program to prevent healthcare consumption for frequent visitors to Emergency Departments. In a randomized trial of more than 12 000 patients we demonstrate sustained reductions of up to 20-40% in health care utilization. This session will focus on results and learnings gathered during a 5-year multicenter trial, growing from a small pilot to an international concept.The results have been published in several articles...
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.
Day, Andrew; Hardcastle, Lesley; Birgden, Astrid
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…
Morrison, Gerold; Greening, Holly; Yates, Kimberly K.; Wolanski, Eric; McLusky, Donald S.
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
Singh, Vishwanath P; Badiger, N M; Managanvi, S S; Bhat, H R
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.
Jacobus N. Cronjé
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.
Reviewed by Dr. Adnan BOYACI
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
Jensen, Per Anker; Katchamart, Akarapong
on a case study of LEGO. Results: The study shows that the management model for FM creates a relevant starting point but also that stakeholder and relationship management is an essential aspect of Value Adding Management. The case study confirms the relevance of the basic concept and provides an important...
Wilmar M Wiersinga
Full Text Available 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.
Roger E. Thomas
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.
Mecha, Ezi I.; Desai, Mayur S.; Richards, Thomas C.
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…
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.
... 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), service coordination means the activities carried out by a service coordinator to assist and enable...
... case management providers; or (iii) The methodology under which case management providers will be paid..., including for foster care programs, services such as, but not limited to, the following: (1) Research... placements. (3) Recruiting or interviewing potential foster care parents. (4) Serving legal papers. (5)...
Ambrosini, Veronique; Bowman, Cliff; Collier, Nardine
Teaching case studies are widely deployed in business schools. They are contextually rich in detail, and students learn by applying and adapting theoretical concepts to specific business situations described in the case. This article proposes a new way to use teaching case studies, as research materials for academics. The article addresses three questions: (1) Can teaching cases be used as an alternative to field research? (2) When can teaching case studies be used as second...
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...
Braun, Dietmar; Benninghoff, Martin; Ramuz, Raphaël; Gorga, Adriana
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…
Dzyacky, S C
It is rare for employers who self insure to have on-site case management. Generally, self-insured employers rely on the third-party-plan administrators to control health care costs, provide enrollees with health care benefit management services, and maintain customer satisfaction. In this article, the author discusses the internal workings of an employee case management program implemented in a self-insured hospital in Northwest Indiana. Information is presented on the goals and role of the case manager, scope of practice, barriers to the program, and resources involved to deliver health care services to its enrollees. Also presented is pertinent information to track and trend data for administrative reports. In addition, customer satisfaction and the value of an on-site case manager for self-insured organizations will be addressed. The results demonstrate a reduction in the volume of inpatient admissions, length of stay, and, therefore, an improved use of the health plan.
YANG Lan-rong; ZHANG Jin-long
This paper presents a Case-Based system for assisting construction project managers in identifying risk factors and the corresponding construction project risk. The construction project risk identification model captures the case, acquired from previous completed construction projects and experience. A prototype is developed based on the proposed Case-Based system to determine risk factors along with their risk effects.
Rajita S. Jani
Results: Lower abdominal pain was most common presenting symptom of ectopic pregnancy in 96% cases. The classical triad of symptoms (amenorrhea, abdominal pain and vaginal bleeding was present in only 28% cases. PID contributed 24% cases and previous abortion contributed 28% cases indicating these two as the common risk factors. Ampulla was the commonest site for ectopic pregnancy, in 52% cases. Salpingostomy performed mainly at this site. In 6% cases ectopic pregnancy in infundibulum were treated with fimbrial expression and fimbriectomy. 22% patients were managed medically (methotraxte. These were the cases having unruptured ectopic pregnancy and ectopic mass <4 cm. Laparoscopy was done in 34% cases, in 2 cases it was converted to laparotomy. While open laparotomy was done in 40% cases. Conclusions: Ectopic pregnancy is a treatable problem. Ultrasonography plays central role in the diagnosis and management. Mode of therapy is determined by a combination of clinical symptoms, sonography findings and serum b-HCG values. Surgical management is still a cornerstone of management of ectopic pregnancy. But now scope of medical and laparoscopic management is also there. In recent years laparotomy has been replaced by laparoscopic surgery which is more conservative, minimally invasive and less time consuming which leads to quick recovery. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 374-379
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,...
Conclusion: Spontaneous epidural hematoma arising from ligamentum flavum is a rare cause of spinal cord compression. Previous reports have described success with surgical decompression. However, initial observation and conservative management may be successful as illustrated in this case.
Graham, Andrew T.
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…
Coulter, Christopher H
Employers' past solutions to rising health benefit costs--adopting managed care strategies, cost shifting to employees and reducing benefits-are no longer effectively controlling costs and are depressing the value of health benefits for employee recruitment and retention. An alternative strategy is to implement health management approaches that improve the health status of employees. These programs reduce medical costs and have a documented positive impact on workers' compensation, disability costs, absenteeism and productivity. Further, this approach is complementary to health care consumerism as a strategy for health improvement and benefit cost reduction and results in improved employee health, outlook and satisfaction.
Trombly, Robert M.; Comer, Robert W.; Villamil, Juanita E.
Explores techniques of conflict management as well as the positive and negative factors that may exert progressive or detrimental influences. Presents a case scenario, drawn from a faculty development workshop, involving a dental school faculty member, and highlights central issues of the case and relevant management concepts. (EV)
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
Improving breastfeeding rates among Black women is a potential strategy to address disparities in health outcomes that disproportionately impact Black women and children. This quality improvement (QI) initiative aimed to improve perinatal case manager knowledge and self-efficacy to promote breastfeeding among Black, low-income women who use services through Boston Healthy Start Initiative. QI methodology was used to develop and test a two-part strategy for perinatal case managers to promote a...
Al Quran, Firas A M; Rashan, Bashar A; Al-Dwairi, Ziad N
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.
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.
Mukkamala, Raghava Rao; Hildebrandt, Thomas; Slaats, Tijs
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 operational...... 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....
The world of a case manager is a busy one, and you may not have all the resources you need each and every day. If you can maintain a routine it will make the workload more manageable for you and will allow room for those surprises that invariably happen. Whether you are a new or a seasoned case manager, organizing your workload can always help smooth out the rough edges in anyone's hectic day!
workshop, and to reviewers of this paper, in particular, Sandy Brenner , Bill Curtis, Richard Martin, Joe Morin, Jock Rader, Dave Kitson, Anita ...Hart, Grace Downey, Wendy Gissendanner, Helen Joyce, Wendy Rossi, Tracy Lewis, Attilio Marini, Frank Authenreith, Jeff Herman, Ed Morris, Sandy Brenner ...CASE Tools/Environments OO-ALC/TISAC Bldg. 100 Hill AFB, UT 84056 (801)777-8045 FAX: (801) 777-8069 Sandy Brenner Secretary III, Case & SAE
Kopnina, H.; Haafkens, J.
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
McNamara, T G
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.
Markowitz, V.M.; Lewis, S.; McCarthy, J.; Olken, F.; Zorn, M.
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.
McNamara, C M
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.
Ibon Tamayo Uria
Full Text Available Citizens’ reports of sightings of undesirable animals are a common component of pest control programmes in a city. For this reason, local authorities tend to develop procedures for the capture and analysis of the resulting data sets based on these reported sightings. These procedures in turn contribute to the development of other initiatives aimed at improving public health conditions. The study presented here focuses on the methodology designed and implemented by the Madrid City Council for controlling and managing the presence of urban pests.The long experience (over 100 years of the City Council and its commitment to the incorporation of new technologies have allowed a number of important lessons to be learnt in pest control and management, which may be useful as a guide and model for cities where public health services have not yet incorporated these methods.
Martínez, Henry; Espinoza, Miguel; Huaman, César; Monge, Eduardo; Salazar, Sonia; Tapia, Abel
This is a case report of a 19 year-old woman, with an acute recurrent pancreatitis diagnose, and pancreas divisum as anatomic alteration. An extensive evaluation including specialized labs, ERCP was done. The diagnosis is suspected during ERCP and confirmed by minor papilla injection. Treatment is directed towards relieving outflow obstruction at the level of the minor papilla, with successful results.
Rafeek, Reisha N; Paryag, Amit; Al-Bayaty, Haytham
Dentinogenesis imperfecta (DI) is an inherited disorder that affects dentin and often manifests as tooth discoloration; in addition, the dentition is also extremely susceptible to wear. Treatment of DI focuses primarily on protecting affected dentin, reducing sensitivity, and improving esthetics. Routine restorative materials, such as amalgams and composites, may be used. In more severe cases, the treatment of choice is full coverage crowns, while bonding of veneers may be used to improve the esthetics of the anterior teeth. This study presents two cases of Type II DI in the same family and the management of each case. Restorative management included amalgams, composite veneers, crowns, bridges, and overdentures.
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.
Morrison, G.; Greening, H.S.; Yates, K.K.
Tampa Bay, Florida,USA, is a shallow,subtropical estuary that experienced severe cultural eutrophication between the 1940s and 1980s, a period when the human population of its watershed quadrupled. In response, citizen action led to the formation of a public- and private-sector partnership (the Tampa Bay Estuary Program), which adopted a number of management objectives to support the restoration and protection of the bay’s living resources. These included numeric chlorophyll a and water-clarity targets, as well as long-term goals addressing the spatial extent of sea grasses and other selected habitat types, to support estuarine-dependent faunal guilds.
published in a book of essays on cyber analogies that he commissioned (Axelrod, 2014). The third phase of the project developed a mathematical ...phase analyzed how historical analogies are used to make sense of novel events, comparing historical analogies invoked in three events in newspapers...from five countries. Case-based reasoning was found to be very common, with almost one historical analogy per article (963/1061). The second phase
Astor Eugênio Hexsel
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.
Pinninti, Narsimha R; Schmidt, Lisa T; Snyder, Richard P
Cognitive behavior therapy (CBT) is an evidence-based intervention for individuals with serious mental illness and potentiates standard medication management. Americans receiving publicly funded treatment for serious mental illnesses have limited access to CBT and hence we need to devise innovative ways of providing access to this important intervention. We present a case of a man who had severe disability, was medication resistant, and diagnosed with Obsessive Compulsive Disorder and Major Depressive Disorder. After being home bound for many years he was provided CBT utilizing his existing case manager as a therapy extender. The specific roles of the primary therapist and case manager as well as the improvement in quality of life of the individual are delineated. This case report opens up the possibility of further studying case managers as therapy extenders for treating serious mental illnesses.
Cangemi, C F; Miller, R J
Huntington's disease is a dominantly inherited progressive autosomal disease that affects the basal ganglia. Symptoms appear later in life and manifest as progressive mental deterioration and involuntary choreiform movements. Patients with Huntington's disease develop a progressive but variable dementia. Dysphagia, the most significant related motor symptom, hinders nutrition intake and places the patient at risk for aspiration. The combination of involuntary choreoathetoid movements, depression, and apathy leads to cachexia. Factors of considerable concern to the anesthesiologist who treats patients with Huntington's disease may include how to treat frail elderly people incapable of cooperation, how to treat patients suffering from malnourishment, and how to treat patients with an increased risk for aspiration or exaggerated responses to sodium thiopental and succinylcholine. The successful anesthetic management of a 65-yr-old woman with Huntington's disease who presented for full-mouth extractions is described.
In the post-asylum era, case managers perform much of the face-to-face work of pharmaceutical compliance for people with severe and persistent mental illness. Their work demands careful orchestration of the assemblage of compliance, including the actual medications, the ideology of biopsychiatry, the division of professional labor, and certain mundane tools. Ethnographic vignettes from an Assertive Community Treatment (ACT) team show how case managers use this assemblage in their everyday routines, but also how it undercuts key elements of the original ACT mission. Reflecting its roots in the deinstitutionalization movement, the ACT model gives case managers limitless responsibilities for clients' lives, but then narrowly defines their role as the prosthetic extension of psychiatric authority. To produce compliance, case managers depend on the medication cassette, analyzed here as a human/non-human hybrid woven into their ordinary work. The medication cassette has pre-scripted uses that enlist clinicians in biopsychiatric thinking and also silently impose compliant behavior on clients. The elements in the assemblage of compliance depend on each other, but they do not form a seamless whole, as evidenced by the dilemmas and micropolitics of the clinical front-line. Theoretical notions of assemblages and technologies of compliance, drawn from science and technology studies, illuminate a core conundrum of practice in psychiatric case management.
Redford, L J; Parkins, L G
The purpose of this article is to stir the imagination and incite the creative energies of case managers in finding ways to capitalize on communication and information technologies to improve access to care as well as the quality of care in rural communities. Today, the general dearth of services and logistics of providing services in rural areas challenges even the most seasoned case managers. Given the current economic and political climate, it is unlikely that these challenges will lessen, particularly if we continue to pursue our more traditional approaches to case management and service delivery. Telecommunications technologies are opening exciting opportunities for changing this trajectory and expanding the role and reach of case managers, while improving access to many services. This article highlights the new and the potential applications of interactive televideo in health and human services, as well as the vast opportunities offered by the Internet. There are, however, also pitfalls we must overcome to realize the full potential of these technologies. Case managers, in their roles as advocates, coordinators, and facilitators, are ideally positioned to be on the cutting edge of these technological applications and play a catalytic role in moving rural communities into the "information age."
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.
Vijay M Ravindra
Conclusions:Pregnancy presents a challenge for any patient requiring neurosurgical intervention. We present an interesting case example with a rare central nervous system neoplasm and discuss the management of intracranial pathology in pregnant patients.
Simmons, Florence M
Hospital overcrowding is primarily a shortage of inpatient beds, not a lack of emergency department capacity, as initially assumed. According to Asplin et al., many factors contribute to overcrowding, including inadequate or inflexible nurse-to-patient staffing ratios, isolation precautions, or delays in cleaning rooms after patient discharge; an overreliance on intensive care or telemetry beds; inefficient diagnostic and ancillary services on inpatient units; and delays in discharging hospitalized patients to postacute-care facilities. Hospital overcrowding presents a challenge for hospital employees and clients, often leading to frustration and dissatisfaction. Overcrowding also has a direct effect on patient care, including compromised patient safety, increased costs, increased length of stay, and increased mortality and morbidity rates. The emergency department is changed from a temporary holding area to an extended patient care unit, decreasing its ability to handle new admissions and to manage a mass casualty. Beds in the critical care units become filled with inappropriate patients if floor beds are not available, making placement of seriously ill patients difficult. Trauma patients may have to be diverted to other hospitals to receive the appropriate level of care. Patients who require specialty services may have to wait for extended periods to obtain a bed in a referral center.
Sánchez Ruiz, Lidia; Blanco Rojo, Beatriz; Simón, Rosa María
Nowadays due to the crisis, some government measures are aimed at reducing healthcare spending, affecting in some level or another the quality offered. Process management is said to be a useful tool for reducing healthcare costs by improving management without any additional economic investment. That is doing more with the same resources and without reducing the quality offered. In this study an empirical case of a Catalan hospital is presented. Overall, the usefulness of process managemen...
The purpose of this study was to identify the aspects affecting customer satisfaction and to find out how the management can improve customer service. The purpose was to give guidelines to the case company of how to improve customer service and thus gain competitive advantage over competitors. The data to this study was gathered from various online sources and literature. The core theories and concepts were CRM, creating customer satisfaction, managing employees and complaint handling pro...
Vallejos, Rolando,; Oliveira Gomes, Jefferson,; Lima, Celson; Nesello, Priscila
Part 19: Knowledge Management in Networks; International audience; This work describes a practical case combining collaborative networks and knowledge management, at SENAI environment. SENAI was founded in 1942 to support the Brazilian industry through professional and technological education, and services. In 2011 SENAI started implementing a national program targeting the industrial competitiveness all over the country. Such an ambitious program relies upon several key elements and this wor...
Rudagi B M
Full Text Available Ameloblastoma, first recognized by Cusack in 1827, is a neoplasm of odontogenic epithelium, especially of enamel organ-type tissue that has not undergone differentiation to the point of hard tissue formation. It accounts for about 1% of all oral tumors and about 9-11% of odontogenic tumors. Ameloblastoma in the mandible can progress to a great size and cause facial asymmetry, displacement of teeth, malocclusion, and pathologic fractures. A case of large ameloblastoma of mandible in a 39 year old male patient is being reported. Patient had large swelling on left lower side of the jaw since 2 years. Swelling was approximately 15 X 10cm in size. Intraorally the swelling involved buccal and lingual cortical plates and was obliterating the vestibular space. Patient did not seek medical attention because swelling was painless. The patient was investigated and treated with surgical excision and was providedwith prosthesis to correct the post operative sequale. The patient showed uneventful recovery with no recurrence after a follow up of one year.
Robert William Campos-Guzmán
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.
Sandhu, B K; Duquette, A; Kérouac, S; Rouillier, L
Less money spent on health services, cost-effectiveness, better productivity and more efficiency are some of the driving forces of contemporary "neo-liberalism" and political trends. How can nursing services and the profession's human values adapt in this difficult context? The authors describe the newest modality of patient care delivery system: nursing case management. They examine the factors and assumptions that led up to its development and point out the validity of asking some serious questions before embarking on the euphoria of case management.
Madsen, Arne Stjernholm; Ulhøi, John Parm
This case addresses the Home Communication Concept (HCC) and represents the response of a major ICT manufacturer to the reshaping of the telecom market, paved by Internet technology. The project is described from its start in summer 1997 to the end of 2001. This is a unique case study in more than...... of management during disruptive technological development, but also illustrates the internal problem of allowing a creative BDD to become "sectarian," i.e. blindly believing in itself and suspicious of the rest of the world. Using the framework presented in this paper, several fundamental concerns regarding...... existing research are identified and discussed. In closing, implications for research and management are addressed....
Hesse, Morten; Vanderplasschen, Wouter; Rapp, Richard;
). 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...... or drug related problem. Data collection & analysis Two groups of reviewers extracted the data independently . Standardized mean difference was estimated. Main results In total, we could extract results from 15 studies. Outcome on illicit drug use was reported from 7 studies with 2391 patients. The effect...
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.
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...
Adams, Sharrika D.; Hazelwood, Sherry; Hayden, Bruce
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…
Wright, J T
Epidermolysis bullosa (EB) is a group of rare genetic disorders which are of dental interest because of their specific oral manifestations and management difficulties. Two cases of recessive EB which may be classified clinically as the atrophicans-gravis Herlitz type are described. Dental therapy consisted of extractions and stainless steel crown restorations, with inhalation general anesthesia. The need for and advantages of early preventive and restorative dental care are illustrated by the cases presented.
Sohár, Gábor; Kovács, Mónika; Györkös, Andrea; Gasztonyi, Beáta
The authors present the case history of a patient suffering from hyperthyroidism. The diagnostic procedures revealed the presence of propylthiouracyl induced vasculitis with renal involvement, that recovered completely after the withdrawal of propylthiouracyl and corticosteroid treatment. Thereafter, the patient was treated with thiamasol, that caused agranulocytosis with fever. After transient litium carbonate therapy a succesful thyreoidectomy was performed. Cumulative serious side effects of antithyroid drugs are rare. This case highlights some of the challenges and complications encountered in the management of hyperthyroidism.
Marmet, C; Shell, E; Aldana, S
Based on this more thorough assessment, the lactation consultant may be able to identify all of the factors contributing to this complex case. In some situations, her skilled interventions will suffice once the underlying problem is addressed. Occasionally, she will identify a factor that falls outside of her area of expertise; when this happens, she must make the appropriate referrals. For example, a referral to a physician for a frenotomy or suspected neurological or other medical problem is appropriate. It is clear that because Baby E's problems were not resolved after 6 weeks of concerned effort, something was missed. It would certainly be appropriate for the lactation consultant to refer the dyad to another lactation consultant who has more expertise in handling clinically challenging breastfeeding problems. If possible, the referring lactation consultant should accompany the dyad so that she can improve her clinical skills. Assuming Baby E does not have underlying medical problems, the most likely causes of Baby E's difficulties are anatomical variation and/or sucking dysfunction. Because the baby is so fussy, it also would be wise to consider the possibility of allergies or food tolerance. Our first rule is " Feed the baby." The second rule is " Correct or work on correcting the problem or problems." Our goal is to achieve exclusive breastfeeding or as close an approximation as possible. We almost never give up on this goal, but we do educate the mother and work professionally with her choices. Until the baby is breastfeeding well, the lactation consultant will probably need to instruct the mother to continue using a pump ( preferably a hospital-grade, electric, bilateral pump). The mother should use the pump physiologically, pumping as many times a day as the baby would breastfeed. As soon as the situation improves, the mother should be instructed to wean gradually from the pump and any other breastfeeding equipment she is using. The goal should always be
Shelesky, Kristin; Weatherford, Ryan D.; Silbert, Janelle
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…
Glickman, Gerald N.; Comer, Robert W.; Filler, Steven J.; Fine, James Burke
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…
Trombly, Robert M; Comer, Robert W; Villamil, Juanita E
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.
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,…
Lena M. O'Keefe
Full Text Available Volvulus in the pediatric population commonly occurs in the small bowel associated with malrotation or internal hernia whereas sigmoid volvulus (SV is extremely rare. Herein we report a case of SV, review the literature and provide a suggested algorithm for diagnosis and management.
Moricca, Michelle L.; Grasska, Merry A.; BMarthaler, Marcia; Morphew, Tricia; Weismuller, Penny C.; Galant, Stanley P.
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…
Smith, Pernille; Carugati, Andrea; Giangreco, Antonio
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...
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.…
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...
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.
Milosevic, Dragan Z; Srivannaboon, Sabin
The ever expanding market need for information on how to apply project management principles and the PMBOK contents to day-to-day business situations has been met by our case studies book by Harold Kerzner. That book was a spin-off from and ancillary to his best selling text but has gained a life of its own beyond adopters of that textbook. All indications are that the market is hungry for more cases while our own need to expand the content we control, both in-print and online woudl benefit from such an expansion of project management "case content".
Siddiqui, Fraz Anwar; Kabeer, Jamal; Shahabuddin, Syed
Penetrating cardiac injuries after gunshot are usually fatal and are very challenging to manage for surgeons even in fully- equipped centres. Such injuries can cause ventricular septal defect (VSD) or cardiac tamponade depending upon the distance, direction and velocity of the bullet. Stable patients can be subjected to investigations like computed tomography (CT) to avoid unnecessary intervention, but unstable patients should be rushed to the operating room. We discuss management in two cases of traversing bullet injury to the heart. In the first case, traumatic VSD was significant, requiring closure on cardiopulmonary bypass (CPB) along with repair of right and left ventricular injury. In the second case, only the repair of right and left ventricles was performed without CPB. They both had traversing bullet injury through the heart.
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.
Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Baharum, Mohd Faizal
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.
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)
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.
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
Thomas, Bejoy J.; Nishad, A.; Paulaian, Benin; Sam, Jonathan Emil
Knowledge about the external and internal anatomy of the tooth is essential for successful dental practice. Anomalies in the tooth are often encountered which poses difficulties in dental treatments. As like any other tooth, mandibular first molars are also prone for anatomic malformations. One such anatomic variation is the presence of extra root distolingually. This distolingual root is called radix entomolaris (RE). The presence of an additional root can lead to difficulties during endodontic therapy. This article is a report of two cases describing the management of the first mandibular molars with an RE and clinical guidelines for its management. PMID:27829770
Full Text Available Anaesthetic management for caesarean section of a patient with peripartum cardiomyopathy (PPCM can be challenging. These patients require analgesia/anaesthesia for normal delivery or caesarean section. In this case report we describe the anaesthetic management of a 20-year-old patient at 37 weeks of gestation, with peripartum cardiomyopathy, heart failure and pulmonary oedema. She was scheduled for emergency caesarean section because of a threat to mother’s life and fetal distress. GA was induced with Etomidate and fentanyl safely. No adverse outcome on mother or new born was observed.
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.
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.
... 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... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What are the requirements for casing...
Branch, Kristi M.; Peffers, Melissa S.; Ruegg, Rosalie T.; Vallario, Robert W.
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.
Magaly Álvarez Bárzaga
Full Text Available The anesthesiologist plays a unique role in the health care of all patients who will undergo a surgical procedure. In this sense, he is a key factor in the appropriate and timely management of the airway. There are special situations that condition a difficult airway and can have a profound impact on anesthetic morbidity and mortality. These risks increases in the case of children, that is why the case of a pediatric patient with a difficult airway caused by limitation of mouth opening, scheduled for elective surgery in order to treat this condition in the Pediatric University Hospital ¨Paquito González Cueto " in Cienfuegos, is presented.
Forchuk, Cheryl; Ouwerkerk, Alice; Yamashita, Mineko; Martin, Mary-Lou
The purpose of this study was to examine case managers' (CM) job position descriptions through content analysis. There were 29 case manager job position descriptions examined. The job descriptions could be grouped into four categories: (1) what the individuals should bring to the position, (2) what they did as CM, (3) to whom they were accountable, and (4) what was valued. Themes included focus on client as individual, focus on the external/system, or outer-directed work, and the articulation point between the individual and broader system. The CM works directly and indirectly in the system and community through education, organizing, planning, and networking, as well as through provision of direct care to the individual client. The expectations of the positions are extensive.
Disease-related malnutrition is usually caused by the joint action of the underlying disease itself and dietary deficiency. The consequences of malnutrition, if left untreated, are serious, causing a marked decline in physical and psychological health and function, and an increased rate of complications and decreased effectiveness of the medical treatments. In case a functional gastrointestinal tract is present, the recommended form of nutritional management is the use of oral nutritional supplements. However, just like to any other therapy, compliance to oral nutritional supplements is highly influenced by the consistency, taste, smell, volume consumed, and side effects. The aim of the present case report is to illustrate that nutritional management is a successful and effective treatment option of disease-related malnutrition when the selection of the oral nutritional supplement takes into consideration patient's preferences as well.
Ølholm, Anne Mette; Christensen, Janne B; Kamionka, Stine Lundstrøm
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...... of both their health needs and the skills needed to meet these. However, categorical care is generally considered to be stigmatizing and to decrease care quality. The evidence base for both arguments is unclear. The aim of this review was therefore to investigate the effectiveness of specialized hospital...... - b ased case management for ethnic minority patients. Methods: This review used a health technology assessment model, including a systematic search of literature in the PubMed, Embase, the Cochrane Library, Sociological Abstracts, the Cumulative Index to Nursing and Allied Health Literature databases...
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.
00C Ca~aegie ej=)n ’C= 4P -jý A Case for Customizable Resource Management in Networks Peter Steenkiste Allan Fisher Hui Zhang October 21, 1998 CMU-CS-98...167 School of Computer Science Carnegie Mellon University Pittsburgh, PA 15213 Abstract We envision the deployment of an electronic services market ...that will deliver a wide range of electronic ser- vices over networks. This market will allow applications to combine resources at endpoints with
Mikkiliineni, Venkata Rama Rao; Panidapu, Nagarjuna; Parasa, Mrunalini; Shaik, Mastan Saheb
Antiphospholipid antibody (APLA) syndrome is one of the most common thrombocytophilias but, unfortunately, goes unrecognized most often. It is an auto-immune disorder in which thrombotic events and a recurrent fetal loss occur in the presence of antibodies to phospholipids. It is the most common acquired hyper-coagulable state. There is a limited literature on peroperative management of patients with this syndrome. We report a case of APLA syndrome in a parturient due to its rarity and complexity.
Mukkamala, Raghava Rao; Hildebrandt, Thomas; Slaats, Tijs
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....
Full Text Available Anorectal abscesses are commonly encountered in clinical surgical practice. These abscesses require surgical management. Supralevator abscesses are thought to originate either from an ischiorectal or intersphincteric abscess extension or from an intraperitoneal source. These abscesses are quite uncommon and present a difficult surgical problem. We present a case here of a 42-year-old female with a recurrent supralevator abscess requiring multiple surgical procedures for adequate drainage and care of her abscess.
Full Text Available Fusion is a rare occurrence and its definitive diagnosis is of prime importance for successful root canal treatment. This case report discusses the endodontic and esthetic management of fused maxillary right lateral incisor. Root canal treatment was performed on the fused tooth. Nickel Chromium with ceramic crown was fabricated in the shape of lateral incisor. The patient remained asymptomatic and there was a reduction in the size of periapical radiolucency after six months.
Laleng M Darlong
Full Text Available Ascaris lumbricoides is a common intestinal parasite in tropical and temperate regions. Although usually asymptomatic, infection can lead to biliary or intestinal obstruction and very rarely obstruction of the main pancreatic duct due to its smaller lumen. We report two cases of ascariasis in the main pancreatic duct, which is not a common site, presenting as acute pancreatitis and recovering uneventfully with conservative management.
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.
Full Text Available 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.
Nilda Maria de Clodoaldo Pinto Guerra Leone
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.
Plas, A.G. van der; Deliens, L.; Watering, M. van de; Jansen, W.J.; Vissers, K.C.P.; Onwuteaka-Philipsen, B.D.
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
Kelly, Peter J.; Deane, Frank P.; Kazantzis, Nikolaos; Crowe, Trevor P.
The study examined mental health case managers' attitudes toward the use of homework and explored the relationship between clinician attitudes and systematic homework administration practices. A survey examining attitudes toward the use of homework was completed by 122 Australian mental health case managers. Case managers who held more positive…
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.
Full Text Available The scenario of quality is expanding exponentially. In the present-day world, quality is now in the driver's seat. With this globalisation of industrial products, many problems and opportunities have risen, primarily due to inconsistent standards existing in the market. The International Standards Organisation has tried (and seem to be very successful in doing so to standardise a minimum level of quality norms. These norms act as the foundation to implements total quality management (TQM. TQM has been identified as a philosophy of interdependent characteristics, such as customer focus, commitment, measurement, systematic support, and continuous improvement. This paper presents a case study on the implementation of ISO 9002: 1994 at Kerala Hitech Industries (KELTEC, with the benefits, hurdles faced, and shortcomings. Upgradation of KELTEC's quality management system to the requirements of ISO 9001: 2000 is currently under progress.
Full Text Available Pneumatosis intestinalis (PI, defined as gas within the bowel wall, is an uncommon radiographic sign which can represent a wide spectrum of diseases and a variety of underlying diagnoses. Because its etiology can vary greatly, management of PI ranges from surgical intervention to outpatient observation (see, Greenstein et al. (2007, Morris et al. (2008, and Peter et al. (2003. Since PI is infrequently encountered, clinicians may be unfamiliar with its diagnosis and management; this unfamiliarity, combined with the potential necessity for urgent intervention, may place the clinician confronted with PI in a precarious medical scenario. We present a case of pneumatosis intestinalis in a patient who posed a particularly challenging diagnostic dilemma for the primary team. Furthermore, we explore the differential diagnosis prior to revealing the intervention offered to our patient; our concise yet inclusive differential and thought process for rapid evaluation may be of benefit to clinicians presented with similar clinical scenarios.
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.
Kim, Amy; Parker, Sareeta Singh
Coccidioidomycosis is a disease known for its endemicity to the Southwest United States. However, given the current trends of more frequent tourist and business travel, an increasing number of coccidioidomycosis infections are being seen in patients in other areas of the United States. Because the majority of patients with disseminated disease experience cutaneous manifestations, dermatologists can be of primary importance in the diagnosis of this disease. We report a case of coccidioidomycosis manifesting as granulomatous cutaneous nodules on the face of an otherwise healthy white man. We attempt to provide an update on the diagnosis, management, and treatment of patients who present with cutaneous lesions caused by coccidioidomycosis infection.
Goswami, D; Kashyap, L; Batra, RK; Bhagat, C
Obstructing lesions of the central airways present with a variety of symptoms and are often associated with pneumonia or asthma-like states. Anesthesia to these patients often presents challenges right from the preoperative stabilization of underlying lung condition, mask ventilation in the supine position to maintaining oxygenation and ventilation in the intraoperative and postoperative period. We present here a case of a young woman with a central bronchial tumor with significant airway obstruction with potential for major bleeding and subsequent anesthetic management without lung sacrificing measures and cardiopulmonary bypass assistance. PMID:26955320
Full Text Available Obstructing lesions of the central airways present with a variety of symptoms and are often associated with pneumonia or asthma-like states. Anesthesia to these patients often presents challenges right from the preoperative stabilization of underlying lung condition, mask ventilation in the supine position to maintaining oxygenation and ventilation in the intraoperative and postoperative period. We present here a case of a young woman with a central bronchial tumor with significant airway obstruction with potential for major bleeding and subsequent anesthetic management without lung sacrificing measures and cardiopulmonary bypass assistance.
Prabhakar, A R; Tauro, David P; Shubha, A B
The purpose of this case report was to describe the management of a trauma-induced maxillary dentoalveolar fracture of the right maxilla in an 8-year-old boy. The child presented with swelling of the right maxillary region, difficulty in chewing and closing the mouth, and a sutured laceration on the cheek. Complete palatal displacement of the fractured fragment involving the deciduous canine and molars was observed clinically and confirmed by radiological examination. The fracture was reduced and stabilized using a custom-fabricated, open-cap acrylic splint with modified interdental wiring under general anesthesia.
Full Text Available Intratonsillar abscess is a rare complication of acute tonsillitis. It is a rarely diagnosed infection occurring in both children and adults. Herein, we present a case of intratonsillar abscess in a 25-year-old female patient, who was managed by needle aspiration which is a minimally invasive procedure and it is low cost, safe and effective along with antibiotic therapy. The aspiration of the pus from the tonsil confirms the diagnosis of intratonsillar abscess. So intratonsillar abscesses are uncommon, but should be considered in the differential diagnosis of peritonsillar abscess and tonsillitis.
Zavala Aguilar, K; Gutiérrez Pineda, F; Bozalongo de Aragón, E
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.
Petronio, Sandra; Helft, Paul R; Child, Jeffrey T
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
Full Text Available ABSTRACT: Title – Aesthetic management of fractured endodonti cally treated teeth- Case report Healthy oral cavity is primary requisite for beautif ul looks. Aesthetic requirement of severely mutilated teeth has been a challenge to de ntist. This paper presents endodontic treatment of grossly decayed tooth followed by the placement of a fibre-reinforced composite resin post. The crown reconstruction was done with f ull ceramic crown. Resin fibre post has best properties in elasticity, translucency, adaptabil ity and resistance to traction
Sheet, Jagabandhu; Mandal, Anamitra; Sengupta, Swapnadeep; Jana, Debaleena; Mukherji, Sudakshina; Swaika, Sarbari
Plunging ranula is a rare form of mucous retention cyst arising from submandibular and sublingual salivary glands, which may occasionally become huge occupying the whole of the floor of the mouth and extending into the neck, thus, restricting the neck movement as well as disfiguring the normal airway anatomy. Without fiberoptic assistance, blind or retrograde nasal intubation remains valuable choices in this type of situation. Here, we present a case of successful management of airway by blind nasal intubation in a patient posted for excision of a huge plunging ranula. PMID:25886120
Strickler, David Charles
In this Open Forum a psychiatric health care consumer recounts his experience with his state's requirement to hold case management meetings outside of the clinic. Over time, the author found that meeting elsewhere amounted to being put on public display, and he felt embarrassed and powerless to change the situation. Requiring people with psychiatric disorders to meet outside a clinical setting may violate the Health Insurance Portability and Accountability Act and human rights. This New Hampshire state policy needs to be changed because it undermines treatment and reinforces the stigma that many consumers already feel because of their disability.
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.
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.
Full Text Available Aim of study: This paper aims to test a participatory methodology to draw parallels and paradoxes as to how some forest sector-related entities and local communities view the Montemuro Mountain forest, namely in terms of its characteristics, the offered opportunities, its problems and the likely solutions for its management as well as the role played by stakeholders, which can be replicated in other case studies and can also facilitate the forest policy making process.Area 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.Abbreviations used: ZIF: Forest Intervention Zones; GAL: Local Follow-up Group; GTFs: Technical Bureaus of Forestry.
Project management education programmes are often proposed in higher education to give students competences in project planning (Gantt's chart), project organizing, human and technical resource management, quality control and also social competences (collaboration, communication), emotional ones (empathy, consideration of the other, humour, ethics), and organizational ones (leadership, political vision, and so on). This training is often given according a training-by-project type of learning with case studies. This article presents one course characterized by a pedagogical organization based upon Knowledge Management (KM) concepts: knowledge transfer and construction throughout a learning circle and social interactions. The course is supported by a rich and complex tutor organization. We have observed this course by using another KM method inspired from KADS with various return of experience formalized into cards and charts. Our intention is, according to the model of Argyris and Sch\\"on (Smith, 2001), to gai...
Moise, Imelda K; Mulhall, Peter F
Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded
Imelda K Moise
Full Text Available Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1 the structural challenges faced in implementing case management for program participants, and 2 possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty; contractual requirements (predefined catchment neighborhoods, caseload; limited support (client incentives, tailored training, and a high staff turnover rate; and logistic difficulties (organizational issues. Their approach to case management tends to be focused on linking Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1 the structural challenges faced in implementing case management for program participants, and 2 possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were
Apriani Kurnia Suci
Full Text Available Production Management is the act of designing, operating, and improving the productive systems – a system for getting the work done. Along the process, the synergy in between machineries, facilities and people could empower the sustainable of the production. In fact, for some cases, the implementation of unique system is needed for the production process. The example for this transformation production management is in the case of CV Wiracana, a handmade manufacturing company for folding hand fans from Bali. CV Wiracana's products are very unique, combined from mass production for the speed and an art for the custom made product. At one side, the market forces them to speed up the production and for this purpose, they must set up the new system on their production line. On the other side, the masterpiece also needs to be produced without jeopardizing mass production line schedule. The transformation production system needs to be done no later than 2015 as the urgency to fulfill the customer demand, business growth, compete in the industry and sustainability. The changes are expected to improve the production at least about 20% or doubled from the current production.
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.
This case report describes the chiropractic management of a 30-year-old female patient with severe postpartum pelvic pain secondary to pubic symphysis diastasis. No literature was found on the chiropractic management of postpartum symphysis pubis diastasis. The existing literature concerning chiropractic care for symphysis pubis dysfunction during pregnancy is limited and indicates a potential benefit. Separation of the pubic symphysis may include ligamentous injury to the sacroiliac joints and may lead to chronic pain. Pubic symphysis separation of 17 millimeters was present on digital radiograph. Management consisted of chiropractic adjustments, trigger point release, electrical stimulation, moist heat, sacroiliac belt, and specific stabilizing exercises. The patient's pain improved immediately following treatment on the initial visit. Pain was reduced from 8/10 VAS at the first visit to 2/10 at the fourth visit. She was able to resume normal activities and reached a final pain level of 1/10. The diastasis was reduced by 7 millimeters at 14-weeks post radiograph for a final separation of just under 10 millimeters. Collaboration between obstetricians, midwives and chiropractors may be warranted.
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.
Full Text Available Successful implementing andmanaging of change is urgently necessary for each adult educational organization. During the process, leading of the staff is becoming a key condition and the most significant factor. Beside certain personal traits of the leader, change management demands also certain leadership knowledges, skills, versatilities and behaviour which may even border on changing the organizational culture. The paper finds the significance of certain values and of organizational climate and above all the significance of leadership style which a leader will adjust to the staff and to the circumstances. The author presents a multiple qualitative case study of managing change in three adult educational organizations. The paper finds that factors of successful leading of change exist which represent an adequate approach to leading the staff during the introduction of changes in educational organizations. Its originality/value is in providing information on the important relationship between culture, leadership styles and leader’s behaviour as preconditions for successful implementing and managing of strategic change.
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)
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)
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
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
J. B. Strydom
Full Text Available To establish the perception of employees regarding diversity management at South Africa's largest residential university, the questionnaires of Gardenswartz & Rowe (1993 was adapted and a case study approach with a sample of 25 employees was used. The diversity audit measured the sample's perceptions on symptoms of diversity related problems; openness to change of the university; the status quo regarding diversity management; organisational barriers to diversity; the valuing of diversity; and the management of diversity by managers or supervisors. It was found that a high number of symptoms of diversity-related problems are perceived and that respondents believed that the university is relatively unresponsive to the need to change. The university was believed to be in a mono cultural stage of development and barriers to developing into a multicultural organisation were identified. Respondents did report a very positive attitude towards diversity but perceived that certain procedures are not supportive.
Die vraelyste van Gardenswartz en Rowe (1993 en 'n gevalstudiebenadering is benut om die persepsies van 'n steekproef van 25 personeellede aangaande die bestuur van diversiteit in 'n Suid Afrikaanse universiteit te ondersoek. Die diversiteitsaudit meet die steekproef se waameming van simptome van diversiteitsverwante probleme, die bereidwilligheid van die universiteit om te verander, die huidige stand van diversiteitsbestuur, organisatoriese hindemisse, die waarde wat aan diversiteitsbestuur geheg word, en die bestuur van diversiteit deur bestuurders en toesighouers. Die resultate toon dat 'n beduidende aantal simptome van diversiteitsverwante probleme gei'dentinseer word en dat die respondente meen dat die universiteit relatief min bewustheid vir die nodigheid van verandering toon. Respondente meen dat die universiteit in 'n monokulturele fase van onfrwikkeling is en hindemisse in die ontplooїng na 'n multikulturele organisasie
All the health care facilities examined in the case studies addressed several important organizational issues before and during the installation of their systems. All the facilities examined employee commitment. The prudent managers considered how easily their employees adapt to changes in their jobs and work environment. They considered how enthusiastic cooperation can be fostered in the creation of a liberated and reengineered office. This was determined not only by each individual's reaction to change, but also by the health care facility's track record with other system installations. For example, document image, diagnostic image, and coded data processing systems allow the integration of divergent health care information systems within complex institutions. Unfortunately, many institutions are currently struggling with how to create an information management architecture that will integrate their mature systems, such as their patient care and financial systems. Information managers must realize that if optical storage technology-based systems are used in a strategic and planned fashion, these systems can act as focal points for systems integration, not as promises to further confuse the issue. Another issue that needed attention in all the examples was the work environment. The managers considered how the work environment was going to affect the ability to integrate optical image and data systems into the institution. For example, many of these medical centers have created alliances with clinics, HMOs, and large corporate users of medical services. This created a demand for all or part of the health information outside the confines of the original institution. Since the work environment is composed of a handful of factors such as merged medical services, as many work environment factors as possible were addressed before application of the optical storage technology solution in the institutions. And finally, the third critical issue was the organization of work
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.
Silverman, Enid; Ebright, Linda; Kwiatkowski, Marianne; Cullina, Joanne
Bronchiectasis is the abnormal, irreversible dilatation of diseased bronchi. Permanently dilated airways, usually in the medium-sized bronchi, are inflamed and often obstructed with thick, purulent secretions. Known causative factors include postinfection bronchial damage, postinhalation injury, hypersensitivity reactions, and congenital airway obstructive disorders. Typical symptoms include sputum overproduction, fever, pleurisy, dyspnea, and chronic cough. Diagnosis involves radiographic studies and pulmonary function testing. Treatment includes oral, aerosolized, or intravenous antibiotic therapy according to the severity of the exacerbation, and mucus clearance by means of bronchial hygiene assistive devices, chest physiotherapy, postural drainage, and high-frequency chest compression. We present a review of bronchiectasis and offer 3 case studies illustrating current management of different presentations, including use of aerosolized antibiotics for patients infected with Pseudomonas aeruginosa. Although an adjunctive program of pulmonary rehabilitation may be useful for patients with bronchiectasis, no confirming studies have been performed to date, and additional research in this area is warranted.
frustration and inefficiency because they do not allow workers to use their expert experience to make the best judgements on how to solve the unique challenges they are faced with. However some structuring of their work is still required to ensure that laws and business rules are being followed. IT Systems...... for process control have a large role to play in structuring and organizing such processes, however most of these systems have been developed with a focus on production work and fail to support the more flexible processes required by knowledge workers. The problem arises at the core of these systems...... 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...
Goals of hemorrhage management involve promoting coagulation and reducing fibrinolysis to enhance clot formation and stability, and minimizing hemorrhagic expansion to reduce the likelihood of adverse outcomes. The optimal hemostatic regimen to obtain these goals will differ according to the clinical scenario. Two hypothetical cases of patients with hemorrhage are presented that are typical of those encountered by clinical pharmacists who practice in centers that treat trauma or surgical patients or patients in need of emergency or critical care because of serious bleeding. To maximize therapy, the clinician must be aware of how best to clinically apply hemostatic agents, their comparative benefits and disadvantages, and the optimal methods for monitoring their effectiveness and toxicities.
Full Text Available Epidermolysis bullosa (EB is a group of rare inherited skin and mucous membrane disorders in which blister formation may arise spontaneously or following a minor friction. Various patterns of inheritance are explicated for the disease. The disease has a profound effect on oral mucosa and may result in high prevalence of dental caries. General anesthesia is sometimes the only choice for dental treatments in patients with EB. The following case report describes the dental and anesthetic management of an 12.5 -year-old girl with dystrophic type of EB. The patient was followed up every 6 months. New carious lesions were detected one year after the treatment, on the last visit. Presenting a perfect dental care to children with this disorder can be challenging for the in charge specialist, both pediatric dentist and anesthesiologist.
Esfahanizade, Katayoun; Mahdavi, Ali Reza; Ansari, Ghassem; Fallahinejad Ghajari, Masoud; Esfahanizadeh, Abdolreza
Epidermolysis bullosa (EB) is a group of rare inherited skin and mucous membrane disorders in which blister formation may arise spontaneously or following a minor friction. Various patterns of inheritance are explicated for the disease. The disease has a profound effect on oral mucosa and may result in high prevalence of dental caries. General anesthesia is sometimes the only choice for dental treatments in patients with EB. The following case report describes the dental and anesthetic management of an 12.5 -year-old girl with dystrophic type of EB. The patient was followed up every 6 months. New carious lesions were detected one year after the treatment, on the last visit. Presenting a perfect dental care to children with this disorder can be challenging for the in charge specialist, both pediatric dentist and anesthesiologist.
Lee, Pei-Yi; Chang, Tsue-Rung
Cancer case management provides consecutive care during the entire process through diagnosis to treatment and follow-up. We established an integrative information system with integration of the health information system. This integrative information system shortened the time spent on case screening, follow-up data management, and monthly data summarization of case managers. It also promoted the case follow-up rate. This integrative information system may improve the quality and effectiveness for cancer case management, one important part of cancer nursing. PMID:26089680
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.
The role of the nurse in hospital is varied and some are choosing to incorporate more managerial and administrative skills into their clinical role. One such role is that of the nurse case manager (NCM). This particular role concentrates on involving the family and the patient in his or her own care, facilitation of the care plan, and open discussions between the patient, medics and nursing staff. NCMs in the author's hospital have made a remarkable contribution to patient care. It is a challenging and exceedingly demanding role in both developing and developed countries, but one that is increasingly important. The NCMs are involved in coordination, facilitation of core process and mobilization of resources, not only in hospital but at the patient's home. In this short introductory article the role of NCM is highlighted and the author discusses how this diverse role is concerned with patient care. NCMs work with multidisciplinary teams to enhance the patient's care process. Their attention is also given to cost reduction and clinical pathway management.
Walsh, Anne; Bearden, Eithne
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.
Alexandra Troy, OD
Full Text Available Background: Infantile nystagmus is a common cause of visual impairment. It can occur in isolation, but it is often found in association with other conditions, such as albinism. The condition results in varying levels of vision impairments ranging from mild to severe. Characteristics include early onset, bilateral involvement, pendular and jerk waveforms, the presence of a null point, and the lack of optokinetic nystagmus and oscillopsia (environment moving. This article provides a review of pathogenesis, epidemiology, and treatment of infantile nystagmus. A case study highlights low vision strategies and management for the condition. Case Report: A 12-year-old male with infantile nystagmus presented to the satellite low vision pediatric clinic for initial evaluation. He reported difficulty with different tasks at school secondary to his visual impairment. Low vision intervention utilized various devices and strategies to meet his distance and near goals. Discussion: With no known cure, low vision rehabilitation is important for individuals with nystagmus to allow them to reach their highest potential. Rehabilitation techniques can easily be applied by a primary care optometrist.
Full Text Available Congenital lobar emphysema (CLE is a congenital anomaly of the lower respiratory tract characterized by over inflation of alveoli of the one or more lobes of the lung. CLE is potentially reversible, though possibly life threatening cause of respiratory distress in the neonate. We are presenting a 2 week old baby who presented with sudden onset of respiratory distress related to CLE affecting the upper lobe of left lung. Lobectomy was performed under general anesthesia with one lung ventilation. The anesthetic challenges and management of this case are discussed here.
Pan, Shiyang; Mu, Yuan; Wang, Hong; Wang, Tong; Huang, Peijun; Ma, Jianfeng; Jiang, Li; Zhang, Jie; Gu, Bing; Yi, Lujiang
To meet the needs of management of medical case information and biospecimen simultaneously, we developed a novel medical case information system integrating with biospecimen management. The database established by MS SQL Server 2000 covered, basic information, clinical diagnosis, imaging diagnosis, pathological diagnosis and clinical treatment of patient; physicochemical property, inventory management and laboratory analysis of biospecimen; users log and data maintenance. The client application developed by Visual C++ 6.0 was used to implement medical case and biospecimen management, which was based on Client/Server model. This system can perform input, browse, inquest, summary of case and related biospecimen information, and can automatically synthesize case-records based on the database. Management of not only a long-term follow-up on individual, but also of grouped cases organized according to the aim of research can be achieved by the system. This system can improve the efficiency and quality of clinical researches while biospecimens are used coordinately. It realizes synthesized and dynamic management of medical case and biospecimen, which may be considered as a new management platform.
This paper describes a methodology for estimating the true internal costs of construction waste, aimed at promoting environmentally friendly waste management. The study employs cost-benefit analysis, contribution margin analysis, the polluter-pays principle and a mathematical model: the model for Efficient Use of Resources for Optimal Production Economy (EUROPE), which has been introduced previously by the author for assigning industrial costs to waste. The calculations are performed on construction waste created in a case study of a building project. Moreover, waste is regarded as, in a business sense, having the same basic status as any normal industrial product, namely the 'equality principle'. Application of the methodology is suggested to create incentives for environmental and profitability improvement in construction companies and other types of industrial sectors. The results of the case study show the generation of construction waste to substantially decrease the final operating income, due to the internal shadow price cost it creates. This paper is intended to reduce the gap between the choice of waste management procedures and their economic impact, the overall objective being to accomplish an improved industrial environmental situation.
Kilic, Elife Dogan; Serin, Huseyin; Karakus, Ozge; Ergene, Ozkan; Corbaci, E. Cihat; Kilic, Nayil
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…
In project management and particularly software project management, there has been a shift from traditional plan based project management to the agile event driven project management style. Agile project management has for some time been viewed as the new big change that will revolutionize the software industry. The concept of agile has been around for some time, and although knowledge and usage are increasing, agile is not always the answer. Understanding when to use agile and which succ...
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.
Das, U M; Viswanath, D; Subramanian, V; Agarwal, M
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.
Maruschke, M; Hakenberg, O W
Gunshot wounds to the kidney occur with different regional incidence. They are commonly combined with thoracic and abdominal injuries. Gunshot wounds may be caused by low-velocity or high-velocity bullets. The latter are usually used with military weapons and cause a higher degree of tissue damage. The therapeutic management of renal gunshot wounds has changed in recent decades resulting in more organ-preserving strategies. An imperative indication for surgical exploration of the kidney is critical renal bleeding with symptoms of hypovolaemic shock. We report the case of a 23-year-old male admitted to the hospital with combined gunshot wounds from a small-bore weapon with damage of the liver, stomach and the left kidney. There were no signs of thoracic injuries. The patient underwent transabdominal exploration with treatment of the liver and stomach lesions, removal of the bullet and preservation of the left kidney. A percutaneous nephrostomy and drainage of the retroperitoneal region were inserted; antibiotic prophylaxis was given. A 4-week postoperative intravenous pyelogram showed complete integrity of the upper left tract and good renal function.
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.
Chun-yan Li; Hong-qing Wang; Hai-yuan Liu; Jing-he Lang
Objective To investigate the clinical features and management ofureteral endometriosis.Methods Patients surgically and histologically diagnosed as ureteral endometriosis from January 2001 to January 2007 in Peking Union Medical College Hospital were retrospectively reviewed.Results Ten patients were diagnosed as ureteral endometriosis among 7561 cases with surgically and histologically proved diagnosis of endometriosis,with an incidence of 0.132%.Nine out of 10 patients were extrinsic ureteral endometriosis and concomitant with severe pelvic endometriosis,and the other was intrinsic ureteral endometriosis.Hormone therapy failed in 2 patients with urinary tract obstruction.Ureterolysis was performed in 6 patients and ureterectomy was performed in 4 patients.One ease of ureteral recurrence was observed in a postmenopausal woman without hormonal replacement therapy who received laparoscopic ureterolysis and hysterectomy with bilateral adnexectomy.No relapse was observed in the other 9 patients.Conclusions Ureteral endometriosis is a rare entity.The upper urinary tract should be evaluated in patients with severe endometriosis,even in postmenopausal women.The treatment of ureteral endometriosis usually requires surgery,while ureterolysis should not be performed in patients with extensive disease.As a form of adjuvant therapy of surgery,hormonal therapy is an appropriate option.
Sudhir M Naik
Full Text Available Background: Foreign bodies (FB are the commonest emergencies in otorhino-laryngology. The most common incidences are in the nasal cavity, ears and oropharynx. FB in the nose, ears and oropharynx have characteristic symptoms and their removal does not represent a great difficulty to the otorhino-laryngologist unless 2 the FB is in the tracheo-bronchial tree. The FB inoculation may be voluntary or accidental.Design: A retrospective study of 860 cases managed in 57 months period between January 2007 to July 2011.Setting: Department of ENT, Head and Neck Surgery, KVG Medical College, Sullia.Materials and method: 860 cases of foreign bodies were managed successfully in the OPD under topical anaesthesia and also under general anaesthesia. There were 471 males & 389 females in the study, the youngest was 4 year old girl and the oldest was 69 year old female.Result: In our study we managed 860 cases of FBs which included 505 ear cases, 118 nasal cases, 118 pharyngeal cases, 100 esophageal cases and 19 FBs in the trachea, bronchus. 429 cases were managed in the OPD under topical anaesthesia and 431 cases were managed under general anaesthesia.Conclusion: Most of the foreign bodies in the nose and ear can be managed in the outpatients itself. All the foreign bodies of the esophagus and trachea bronchus were managed under general anaesthesia after admission. Complication rates are very low when managed prudently by a trained otorhino-laryngologist.
Dillen, van S.; Hiddink, G.J.
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 19
Khan, Aliya A; Hodsman, Anthony B.; Papaioannou, Alexandra; Kendler, David; Brown, Jacques P.; Olszynski, Wojciech P.
In 2002, Osteoporosis Canada published clinical practice guidelines for the diagnosis and management of osteoporosis. The current paper supplements that guideline and provides a review and synthesis of the current literature on the diagnosis and management of osteoporosis in men.
Work of a kindergarten or school headmaster can be defined as school management, comprising both administrative and pedagogical management. An individual in the role of a headmaster has difficulties in performing numerous position-related tasks with the same desired quality, so it would be sensible to develop teamwork in the field of kindergarten management as well. Team management in kindergartens is a current issue, which needs to be explored in depth. In the school year 2011/12 we form...
Central core myopatyhy is a rarely seen hereditary neuromuscular disorder that is involved in congenitally myopathies group. The disease is characterized by muscular weakness, skeleton system deformities, increased malign hyperthermia sensitivity and anesthesia management is critically important. In these patients, prolonged muscular weakness and malign hyperthermia that can complicate the perioperative management are the most critical risks. In this case report, anesthesia management of an e...
Samar K Biswas
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
Yu, Holly, Ed.
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…
pastoral and spiritual care for patients, their relatives, and other medical personnel. Approximately 50 chaplains work in different Toronto hospitals, of whom 21 individuals were selected using purpose f ul sampling : a non-random method o f sampling in which the researcher selects “in f ormation-rich” cases f or in-depth interview. The author tried to collect data as records of action-in-process from a variety of people. Because the in-depth responses obtained by qualitative studies cannot be easily categorized, analysis must rely less on counting and correlating and more on interpretation, summary and integration. Therefore, more than anything else, the findings of this study are supported by quotations and case descriptions. The method of data analysis is qualitative description, with a phenomenological inclination: that is, the goal is to describe emotion management experiences as they are lived and felt by chaplains. Discussion of Results & Conclusions Chaplains who participated in this study are between the ages of 33 and 65. The average age is approximately 52. Also, 11 chaplains work part-time and 10 chaplains work full-time. 18 of the 21 chaplains in the sample are women. Recruiting more than 3 male chaplains was not possible due to the fact that hospital chaplaincy is a job predominantly occupied by women. In terms of ethnicity, the majority of the respondents are white, with European and Anglo-Saxon backgrounds. However, the sample also includes two Asian chaplains (with Chinese and Indian backgrounds and one from the Caribbean Islands. Moreover, the sample includes chaplains from five different religions and faith traditions. The majority of the chaplains are Christian, including five chaplains belonging to the Anglican Church, three to the Roman Catholic Church, two to the United Church of Canada, and one to the Baptist Church. The remaining four Christian chaplains did not specify their Church. Several of the chaplains are church ministers. Also
Verkade, P.J.; Meijel, B. van; Brink, C.; Os-Medendorp, H. van; Koekkoek, B.; Francke, A.L.
Background: Case management programmes for home-dwelling people with dementia and their informal carers exist in multiple forms and shapes. The aim of this research was to identify the essential components of case management for people with dementia as well as the preconditions for an effective deli
Ronnau, John; And Others
This training manual for social work practitioners is based on the Family Advocacy Model of Case Management, which states that case management with adolescents contains two important elements: work with the adolescent and work with those responsible for his/her care. This manual deals with the first of two elements and is designed to be used in…
Smith, Michael D.; Seal, David Wyatt; Hartley, Shannon
An HIV knowledge survey and qualitative interview were administered to 20 case managers in community-based programs for troubled youth to assess HIV knowledge and their perception of client HIV risk behaviors. Participants had good HIV knowledge. Case managers perceived client youth to be at high risk for HIV infection due to unsafe sexual…
该文从病案档案管理现状出发,对病案档案如何管理,从七个方面提出了具体措施与方法。%From the current situation of medical case archives management, it advanced measures and methods on how to manage medical case archives from seven aspects.
Lindahl, Marianne Larsson; Berglund, Mats; Tönnesen, Hanne
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...
... 25 Indians 1 2010-04-01 2010-04-01 false What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In...
Rendtorff, Jacob Dahl
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…
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...... systems. It takes a postmodern stance and discusses the case from the perspective of trust, responsible management, cosmopolitanization, the ‘transparent society’ and ‘green growth’ strategies. In the concluding section, the implications for the further development of a concept ‘responsible management...
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.
Singh, Anju; Agarwal, Neelam; Chopra, Seema; Sikka, Pooja; Suri, Vanita; Kumar, Bhupesh; Dutta, Pinaki
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.
The health and social care service system in the Netherlands is fragmented and poorly organized. Facing an increase in the number of elderly citizens, a more consumer-oriented and vocal citizenry, and rising competition at least in part in response to government concerns over runaway costs, Dutch government officials and social researchers have been experimenting with various forms of case management since the mid-1980s. For some types of clients, such as the mentally handicapped, case management seems to be well accepted. Many issues remain to be resolved, however, including (a) the level of clinical expertise needed by case managers for clients with complex medical problems; (b) whether case management tasks are more appropriately carried out by service providers or as a separate function; and (c) how much autonomy service providers will be expected to relinquish under the control of a case manager.
Schulte, Amanda; Musolf, Jeanne; Meurer, John R; Cohn, Jennifer H; Kelly, Kevin J
Asthma is a complex disease that involves physiological, environmental, and psychosocial factors. This paper reviews childhood asthma case management by social service professionals, lay health workers, and nurses, and it presents a new randomized controlled study using nurse case management in a local community coalition. Evidence suggests the common factor for success involves case managers spending time contacting and patiently and persistently working with the family, thus building a trusting relationship. Although case management time is an expense for a health care payer, provider, and the child and family, the positive outcomes achieved can demonstrate the benefit of these interventions to all parties involved. The described experimental study assesses the cost and effectiveness of home-based nurse case management by a community coalition for children visiting an emergency department for asthma care.
Focseneanu, B E; Marian, G
Background. Musical hallucinations occur in individuals with and without mental illness, and many patients tend to have intact reality testing. Although literature on musical hallucinations is limited, they have been associated with hearing abnormalities, adverse effects of pharmacological agents, female gender, advances in age and psychiatric illness. Aim. To present the psychiatric management of a case of an old female patient, who suddenly developed verbal and musical hallucinations with a pervasive impact on her daily activities. Method. Female, 71 years old, developed verbal and musical hallucinations 6 months before that have intensified later. She was known with bilateral hypoacusia starting with the age of 45, and magnetic resonance imaging performed 1 year before proved multiple lacunar infarcts. Because of the persistence, most of the time of these auditory hallucinations, the patient experienced pervasive difficulties with her major areas of activities. She was referred to a psychiatric department for evaluation and treatment. Results. The psychiatric consult revealed neither a depressive relapse, nor a mild cognitive impairment, and obsessive-compulsive disorder was suspected with intrusive obsessions. Patient received, as antiobsessional augmentation escitalopram 10mg/ day, an atypical antipsychotic, risperidone, which at 3 mg/ day induced extrapyramidal symptoms and cognitive impairment. Therefore, the dose of risperidone was reduced, extrapyramidal symptoms disappeared, and 300mg/ day of acidum valproicum was initiated. Discussion. Our patient presented with diminished sensory input to the auditory cortex, and it was hard to make a differential diagnosis between an organic and a mental etiology. Conclusion. The integration of musical hallucinations into a psychiatric disorder may be a difficult task, and, their treatment represents a challenge.
Ardito, M; Botuck, S; Freeman, S E; Levy, J M
To meet the needs of individuals with mental retardation and developmental disabilities (MR/DD) and their families living in urban setting, a noncenter-based model of case management was implemented. In contrast to traditional case management in which families and consumers come to the case manager and most service coordination is done by telephone or in meetings at the case manager/social worker's worksite, the case manager in a noncenter-based model is mobile and able to meet the consumer and family in their domains. In this model, case management is provided in conjunction with in-home residential habilitation and funded by Medicaid under the Home and Community Based Services Waiver. This funding stream provides monies for nontraditional services delivered in noncertified settings. Case managers used the Family Resource Scale to get an immediate indication of the resources and needs of each family. The scale highlights the adequacy of a person's basic and caregiving resources, as well as financial needs. The findings from this study suggest that an understanding of both disability and entitlements is essential for case managers who may have to help advocate for consumers around services and benefits. Moreover, to build and maintain an egalitarian and supportive relationship with families, the importance of caregiver-specified resources and needs must be recognized by case managers. Access to resource information and the ability to engage the family in problem-solving depends on a well-trained staff with the ability to respond to individuals with different needs and from a variety of circumstances. These essential skills prepare a case manager to assist families with their immediate requirements as well as to mobilize them to plan for future needs.
Doan, AnHai; Baid, Akanksha; Chai, Xiaoyong; Chen, Fei; Chen, Ting; Chu, Eric; DeRose, Pedro; Gao, Byron; Gokhale, Chaitanya; Huang, Jiansheng; Shen, Warren; Vuong, Ba-Quy
The challenge of managing unstructured data represents perhaps the largest data management opportunity for our community since managing relational data. And yet we are risking letting this opportunity go by, ceding the playing field to other players, ranging from communities such as AI, KDD, IR, Web, and Semantic Web, to industrial players such as Google, Yahoo, and Microsoft. In this essay we explore what we can do to improve upon this situation. Drawing on the lessons learned while managing relational data, we outline a structured approach to managing unstructured data. We conclude by discussing the potential implications of this approach to managing other kinds of non-relational data, and to the identify of our field.
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.
Peggie Rothe; Christopher Heywood
Corporate short-distance relocation is a significant event in the course of an organization’s lifetime. While these kinds of relocations happen frequently, they are an infrequent event from the perspective of a single organization. Therefore, few organizations have experience and knowledge on relocation management, which can result in improvised ways of managing the process. The aim of this paper is to describe different short-distance relocation management approaches applied by organizations...
M.Comm. The limited availability of South African case studies created the opportunity to compile an authentic South African business case study to be presented in a usable manner. The goal of the case study is to explore the challenges of the implementation and management of an integrated computer system. This dissertation gives a brief review on the characteristics of a business case study and the associated benefits of the case method. It also looks at the properties needed to create a ...
Karoline Doro Alves Carneiro; Cristina Dai Prá Martens
This study explores the implementation of project portfolio management in the organizational context. The objective is to analyze the methodology of project portfolio management adopted by an organization based in the project portfolio management maturity model proposed by Rad and Levin (2006). We developed an exploratory case study in a small financial institution that experienced problems with the implementation of its methodology in project portfolio management. As a result of study, we fo...
Boxelaar, Lucia; Paine, Mark; Beilin, Ruth
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.…
Hoof, van L.J.W.; Hoefnagel, E.W.J.; Schans, van der J.W.; Nielsen, J.R.; Christensen, A.; Sverdrup-Jensen, S.; Delaney, A.; Jentoft, S.; Mikalsen, K.; Karlsen, G.R.; Bodiguel, C.; Catanzano, J.; Suarez de Vivero, J.L.; Alba, I.M.; Dominquez, S.F.; Rommel, D.
This report focuses on the evaluation of the process of devolution of responsibilities in the current institutional landscape in European fisheries management. In particular the analysis focuses on how the present management systems contribute to good governance. We follow the criteria as suggested
Pandey, Krishna Nath
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.
Recently, mobile health care has been applied to manage diabetes requiring self-management. Health care by mobile applications (apps) has a great advantage when applied to patients with diabetes; the adherence to self-management activities for diabetes can be improved through mobile apps. The Food and Drug Administration (FDA) has cleared and approved the use of some mobile apps as medical devices for the management of diabetes since 2010. However, mobile apps may not be effective for all patients. We here report the effect of use of mobile-based diabetes care app (Healthy-note app) for 2 patients with diabetes, and discuss issues and strategies for effective mobile intervention. Further study is needed on improving patient's participation to increase the effect of management via a mobile app. PMID:28168183
Tomida, Takashi; Yano, Takashi; Hidaka, Naoaki; Okada, Yoshikatsu; Iwasaki, Makoto; Goshima, Hiromichi
Ten cases of delayed radiation injuries of the gastrointestinal tracts (consisting of 2 with peptic ulcer, 4 with intestinal obstruction, and 4 with rectal bleeding) are reported. Although conservative therapy or artificial colostomy was undertaken in all cases, satisfactory results were not obtained. In four cases in which subsequent resection of the gastrointestinal tracts was performed, the prognosis was favorable, but various symptoms still continued in the other non-resected cases. Delayed radiation injuries are progressive lesions involving the vasculo-connective tissue, so that cure can not be achieved. Resection of the damaged gastrointestinal tract is recommended, however, this is difficult to do in many cases. (Namekawa, K.).
César Medeiros Cupertino
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
Fay, Emily E; Norquist, Barbara; Jolley, Jennifer; Hardesty, Melissa
Background When placenta accreta complicates a delivery, the typical management is to perform a cesarean hysterectomy. Other management strategies, including leaving the placenta in situ, have been attempted and supported in some cases. This may allow for an interval hysterectomy, which can potentially decrease average blood loss and/or allow a minimally invasive approach to the hysterectomy. Cases We present two cases of women with invasive placentation managed conservatively with interval hysterectomy. One woman was managed with robotic-assisted laparoscopic surgery and the other with an open surgical approach. Conclusion These cases highlight the successful use of conservative management for invasive placentation in two stable patients and showcase the novel use of a robotic-assisted laparoscopic surgery for management of invasive placentation.
Full Text Available Increasing competition among companies, constantly growingproduct and service quality requirements, rapidly changing consumerbehavior, technology advancements and changes enablescustomer to make 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. The paper analyzespeculiarities of customer relationship management in Lithuaniancompanies. In order to reveal motives and problems of customerrelationship management implementation the survey was carriedout. 82 companies participated in the survey. At the end of thepaper conclusions are presented.
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.
Robinson, Monica; Fisher, Thomas F; Broussard, Kim
Specific aspects of the profession of occupational therapy support a distinct value for its practitioners participating fully in the development of case management and care coordination systems. The expectation in the 21st century is that the U.S. health care system must be transformed from one that promotes volume of service to one that promotes value of care. Case management and care coordination will be critical components of that transformation. Occupational therapy's principles, education, practice, approach, and perspective offer much to benefit this increased attention to case management and care coordination. Occupational therapy practitioners should promote themselves and their profession as these system changes develop.
Dillen, van, J.; Hiddink, G.J.
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 1995. Forty-five studies fulfilled the inclusion criteria. In addition, all studies were judged on ten quality criteria by two independent reviewers. Results - Especially in the last three years, man...
Maughan, E; Pankhania, M; Shah, K; Gurr, P
Laryngeal chondrosarcomas are a very rare malignancy with less than 150 cases reported in the literature. Of these, the epiglottis is the most unusual primary neoplastic subsite. Uncertainties arise owing to the extremely rare nature of the condition with regard to treatment and investigation for metastases in overtly low grade cases. We present the case of a 62-year-old woman with a low grade chondrosarcoma, arising from the tip of the epiglottis, presenting with dysphagia but no other symptoms.
HAKSÖZ, Çağrı; Haksoz, Cagri; Arslan, Özgür; Arslan, Ozgur
We present the current procurement risk management practice of Enerjisa, a major energy company in Turkey. We provide results of a managerial survey and interview conducted at Enerjisa, which illuminates the current perception of the critical procurement risks and how they are being managed effectively. Especially, we shed light on the procurement risk awareness and perception, critical drivers of procurement risks, risk assessment strategies, operational and financial hedging of procurement ...
Nowadays, sustainable management seems more likely to be a guarantee of competitiveness for companies, regardless of their size. Besides offering those strategic opportunities, sustainable management practices also play a significant role in gaining acceptance and legitimacy in the marketplace. Moreover, SMEs are continually researching ways to improve their performance. The relationship between sustainability and company performance has interested researchers for twenty years, even if the ac...
Glenn R. Gaudette
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.
Tahan, Hussein A; Huber, Diane L
Defining the roles and functions of case managers is crucial in today's healthcare environment and necessary for the case management field. One way to address this issue is through the examination of case managers' job descriptions used in various healthcare organizations. The study reported herein used qualitative analysis procedures and the latent class cluster analysis method to examine a national sample of 1028 job descriptions of case managers. The study identified the activities, role relationships, knowledge, skills, and abilities of case managers working in varied settings. It also described the changes that occurred in the practice of case management, based on these job descriptions, over 5 years: from the mid-1990s until the early 2000s. One benefit of this study was a change in one eligibility criterion of the CCM credential. Another was the development of a taxonomy of case managers' roles and functions that can be used as a step toward standardization of case managers' job descriptions.
Morales-Asencio, José Miguel
Chronic diseases are the greatest challenge for Health Care, but the conventional health care models have failed noticeably. Nurses are one of the main providers of the services developed to tackle this challenge, with special emphasis on case management, as one of the most common forms. But, one of the key problems is that case management is poorly conceptualized, and with the diversity of experience available, make its development and comparative evaluation difficult. An in-depth review on case management definition and concepts is presented in this article, with a description of the models, ingredients and the effectiveness reported in various studies. The remaining uncertainties in case management, such as the heterogeneity of designs and target populations, the weak description of the components, and the scarce use of research models for complex interventions, are also discussed. Finally, some key factors for a successful implementation of case management are detailed, such as a clear definition of accountability and roles, the existence of support to guarantee the competence of case managers, the use of valid mechanisms for case finding, adjusted caseload, accessible and team-shared record systems, or the integration of health and social services.
Moniz, Jr, Richard
Aimed at library science students and librarians with newly assigned administrative duties the book is about improving one's thinking and decision making in a role as a library manager. Most librarians get very little exposure to management issues prior to finding themselves in a management role. Furthermore, most library science students do not expect that they will need to understand management yet they quickly find that there is a need to understand this perspective to be effective at almost any library job. Effective library management is about having some tools to make decisions (such as
Nelson Oly Ndubisi
Full Text Available This paper critically examines the term "knowledge management" (KM, its components, and the initiatives of a number of organizations that parade as knowledge management pioneers and catalysts, as well as the concept of tacit knowledge. The concept of knowledge management is examined in the web sites of consultancy firms, information practitioners, and other firms that claim to have benefited immensely by implementing knowledge management solutions. In addition a pool of experienced academicians was interviewed to get their views on knowledge management and to furnish information on the knowledge management initiatives in their department/unit etc. The observation made is that the firms are either managing information under the knowledge management nomenclature or managing work practices by instituting an information sharing culture. It is concluded that information management (IM has been searched and replaced with KM. There is no value added to warrant KM to be an emerging field of management, even the ontology and epistemology of KM at best is ill-defined. In fact KM has no intrinsic meaning.
Full Text Available Abstract Introduction Placenta percreta is an obstetric emergency often associated with massive hemorrhage and emergency hysterectomy. Case presentation We present the case of a 30-year-old African woman, gravida 7, para 5, with placenta percreta managed by an alternative approach: the placenta was left in situ, methotrexate was administered, and a delayed hysterectomy was successfully performed. Conclusions Further studies are needed to develop the most appropriate management option for the most severe cases of abnormal placentation. Delayed hysterectomy may be a reasonable strategy in the most severe cases.
Full Text Available Central core myopatyhy is a rarely seen hereditary neuromuscular disorder that is involved in congenitally myopathies group. The disease is characterized by muscular weakness, skeleton system deformities, increased malign hyperthermia sensitivity and anesthesia management is critically important. In these patients, prolonged muscular weakness and malign hyperthermia that can complicate the perioperative management are the most critical risks. In this case report, anesthesia management of an electively planned caesarean section patient, taken into emergency surgery that is also previously known to have central core myopathy diagnosis will be shared. [Cukurova Med J 2013; 38(4.000: 770-773
Jarusuraisin, Ngamwong; Kesornsukon, Kanch
On December 26, 2004, tsunamis hit Southeast Asia and caused serious damage and loss of lives. In Thailand, six provinces (Ranong, Phang-Nga, Phuket, Krabi, Trang, and Satun) were impacted. The present study reports the psychiatric assessments such as Thai GHQ-60 and IES. It also reports management techniques of both cognitive behavior therapy and medication. Those were provided to a Thai female patient who was 54 years old. The patient responded to treatment quickly because of early management. The tsunami victim with Posttraumatic Stress Disorder (PTSD) is not an individual. A mass of people who faced or witnessed the tsunami are vulnerable to get PTSD any time during 6 months after trauma. These early management techniques are useful and practical for a mass of victims and survivors.
Harvey, Carol P
For undergraduate and graduate courses in human resources. A diverse approach to understanding and managing diversity. Understanding and Managing Diversity uses applications to clarify the complexity of a diverse workforce, and explains how it can be used as an organizational asset. This text also provides students with a wide range of expertise—from the perspective of experienced interdisciplinary instructors (business, psychology, economics, theology, law, politics, history, etc.) to practitioners (diversity trainers, corporate managers, etc.). Teaching and Learning Experience This program will provide a better teaching and learning experience–for you and your students. Here’s how: Provide Students with an Accessible Format: Information is presented in a logical succession to help students learn that is in a way accessible to them. Present New and Timely Diversity Topics: Topics include Racial Identity, Work-Life Balance, Diversity Leadership, and Workplace Communication. Stimulat...
Full Text Available The present study aims to discuss issues related to the degree of implementation of national waste managementstrategy by emphasizing progress in waste management at national level in three years after its development. In 2004,Romania has developed national policy documents as Waste Management Strategy and National Waste ManagementPlan (WMS, WMSP based on the ”waste hierarchy”. In the four years after the initiation of this process resultsdemonstrate the advantages of using this system in ensuring a sustainable solution to eliminate pollution from waste.Also, the amount of waste recovered at the start of the period - 2004, occupies a proportion of 5.08% of total while inthe end of 2007, the degree of recovery reached 7%. Concerning waste disposal, this was achieved by storage. Thereason is the lack of incinerators for thermal treatment of waste. Traditional collection of household and similar waste inthe mixture, is the most common, accounting for a share of about 97%.
Crane-Ross, Dushka; Lutz, Wilma J; Roth, Dee
This study examines the relationship between service empowerment and recovery. Service empowerment is defined as the extent to which consumers participate in service decisions and the level of reciprocity and respect within the relationship with their case managers. Assessments were made from two perspectives: consumers and their case managers. Structural equation models were developed to examine the direct and indirect effects of service empowerment on four recovery outcomes: Quality of Life, Level of Functioning, Consumer-Reported Symptomatology, and Case Manager-Reported Symptomatology. Consumers' perceptions of service empowerment were the most powerful predictor of recovery outcomes across the four models. Consumers' and case managers' perceptions were related but the magnitude of the relationship was small, indicating that considerable differences exist between their perceptions of service empowerment.
Jadea S. Alshammari
Full Text Available 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 approach of assignment of generating sources to landfills, transfer stations sitting, site selection for landfills, etc. but recently new integrated models have been developed and applied. Waste management system in an industrial complexes uses multi-objective mixed integer programming approach for the running of existing facilities in dynamic net work flow models with nonlinear costs of management. The latest multi-objective mixed integer programming techniques are applied to resolve the potential conflict between environmental and economic goals and to evaluate sustainable strategies for waste management. In this approach, material recycling in an economic sense exhibits huge indirect benefits, although the emphasis of environmental quality as a major objective in decision-making drives the optimal solution toward pro-recycling programs. The use of grey and fuzzy system theories as uncertainty analysis tools as an enhancement of this modeling analysis proves to be highly profitable. A multi-objective optimization model based on the goal programming approach has been developed and tested in this study for passable management of solid waste generated by a typical petroleum refining industry in the state of Kuwait. The analytic hierarchy process, a decision-making approach, including qualitative and quantitative aspects of a problem, has been integrated in the model to prioritize the conflicting goals existing in the waste management problems of the petroleum
Raslan, M.; Hiew, K.; Hoyle, A.; Ross, D.G.; Betts, C.D.; Maddineni, S.B.
Stuttering priapism is an extremely rare and poorly understood entity. We present a rare case of a 47-year-old Afro-Caribbean gentleman who required proximal shunt procedure to treat his ischemic stuttering priapism after he had failed medical management. We provided a concise review of the literature on the surgical management of ischemic priapism. This case highlighted the importance of prompt surgical intervention in prolonged stuttering priapism to avoid serious psychological and functional complications. PMID:26977408
Lerbæk, Birgitte; Aagaard, Jørgen; Andersen, Mette Braendstrup;
The context of care in assertive community treatment (ACT) can be precarious and generate ethical issues involving the principles of autonomy and paternalism. This focus group study examined case managers' situated accounts of moral reasoning. Our findings show how they expressed strong moral...... obligation towards helping the clients. Their moral reasoning reflected a paternalistic position where, on different occasions, the potential benefits of their interventions would be prioritised at the expense of protecting the clients' personal autonomy. The case managers' reasoning emphasised situational...
Murariu, Daniel; Tatsuno, Brent; Hirai, Cori-Ann M; Takamori, Ryan
Suspected cases of acute appendicitis in pregnancy are considered surgical emergencies due to the potentially devastating outcomes for both mother and unborn child if the appendix perforates. Acute appendicitis is also the number one cause of non-traumatic acute abdomen in pregnancy, as well as the number one cause of fetal death. We present a case report with a typical presentation of suspected acute appendicitis in a pregnant woman. The work up and diagnostic tools available are discussed a...
This article contends that the strategic thinking process is composed of two joint, but paradigmatically distinct, activities--analysis and synthesis. Analysis represents the scientific paradigm, whereas synthesis represents the artistic paradigm. Nevertheless, the Strategic Management course is dominated by the scientific paradigm, even though…
Balali, M.R.; Keulartz, F.W.J.; Korthals, M.
To illuminate the problems and perspectives of water management in Iran and comparable (semi-) arid Middle East and North Africa (MENA) countries, three paradigms can be distinguished: the traditional, the industrial and the reflexive paradigm. Each paradigm is characterised by its key technical sys
Roth, Kevin J.; Smith, Chad
The selection of an appropriate and effective pedagogy has been a central theme in management education for decades. There currently exists a wide range of pedagogical options designed to match course content with the most appropriate technique(s) for effective learning outcomes. Most recently, a variety of experiential learning methods have been…
Choong, Andrew; Alagaratnam, Swethan; Suliman, Samir; Gikas, Panagiotis; Briggs, Timothy; Loh, Alexander; Lotzof, Kevin
We describe the management of a 30-year-old male with type I neurofibromatosis who required an above-knee amputation for bleeding, infection, swelling, and multiple severe joint instability. Postoperatively, he continued to bleed from the stump site. Angiography revealed multiple small distal bleeding aneurysms. Hemostasis was eventually achieved with standard microcoil embolization.
Full Text Available With its origins in logistics, Supply Chain Management (SCM concept is covering all managerial aspects of the flow of materials and information from source to customer, across the entire range of materials handling and movement functions, and throughout an organization and its supply channels. In tourism, these issues relate to the whole process of providing tourism services from sourcing of raw materials, products or different services to supply and distribution, and SCM performance can ultimately be measured by customer satisfaction. Thus, an important component of tourism SCM is the demand management. Therefore, this study aims to highlight the features of the concept of SCM and demand management in tourism, with an emphasis on a hotel chain in Romania, based on research and analysis of tourist traffic indicators as well as assessment of customers satisfaction. The sources of information are the internal company statistics, as well as various hotels booking websites that offer customers’ feedback. The results of the study provide a snapshot of how the hotel demand management can influence SCM performance in tourism.
In today's heterogeneous classrooms, one-method-fits-all-students behavior management approaches are ineffective and often harmful. To succeed with all of their students, teachers should determine whether students have emotional disorders, conduct/behavior disorders, robust male-typical behavior patterns, culturally influenced behavior, learning…
Johnson, David W.; Bartholomew, Kimberly W.; Miller, Duane
Stakeholders, such as future employers, parents, and educators, have raised their expectations of college graduates in the area of computer literacy. Computer skills and understanding are especially critical for business management graduates, who are expected to use computer technology as a tool in every aspect of their career. Business students…
Full Text Available Purpose: The purpose of this article is to characterize the process of knowledge management in business clusters in terms of the benefi ts for the cluster members. The paper examines which mechanisms within the clusters promote knowledge creation between companies and other institutions. Methodology: The literature review is based on databases of books and scientifi c articles, such as EBSCO, Elsevier, JSTOR, Springer, and the Oxford Library and Kingston University London Library. The analysis of the literaturę is focused around the concepts of business clusters, knowledge management in organizations, knowledge management in clusters. Findings: The literature presented in this paper shows that network forms of organization such as clusters are conducive to inter-fi rm knowledge and skill development. Clusters as a type of network turn out to be a highly structured model of knowledge development, transfer and diffusion, produced by the interaction of social and economic relations within cluster institutions. Research implications: The article constitutes a combination of two theoretical aspects – knowledge management and business clusters. The theoretical conclusions of the literature review, mostly foreign literature, provide a basis for research in that area. Practical implications: In the Polish literature on the subject the aspect of knowledge management in business clusters has not yet been discussed. The conclusions of the presented literature analysis provide a basis for research and the development of practical recommendations for cluster managers. Knowledge-based clusters can serve as an example for developing clusters in the world. They are often clustered around research centers, making it possible to improve the exchange of knowledge between the cluster members and also providing the opportunity to better connect the world of science and business. Originality: The author has presented a unique mix of theory, knowledge management
grids share basic characteristics with Supply Chain Management. This thesis presents a linear programming model to assess power grid resilience as a...particular case of Supply Chain Management. Since resilient behavior is not an individual or specific system’s attribute but a holistic phenomenon based
Kuo, Eddie C. Y.; Jernudd, Bjorn H.
Shows how both macro- and microsociolinguistic perspectives are necessary to explain national language management. Macrolevel language planning is motivated by tasks of national consolidation by the state, notably in Singapore's case tasks of socio-ethnic integration and economic development. Microlevel language management pertains to individuals'…
Koutsoukos, Marios; Mouratidis, Antonios
The aim of the present study is to investigate the teaching techniques applied, as well as the difficulties, with which educators in teaching Natural Resource Management are confronted. For research purposes, a case study was conducted on teaching Natural Resource Management in the Third Grade of Vocational Lyceum (EPAL) in Northern Greece. It was…
Rusk, Robert Brian
This qualitative case study explored how the classroom management practices of sampled teachers in a private school in central Oregon influenced classroom disruptions. Through the study, the researcher was able to provide insight on the differences in specific classroom management processes between teachers who had a high number of Positive…
Persson, John Stouby; Schlichter, Bjarne Rerup
. Against this backdrop, we present an interpretive case study of how managers perceive and mitigate the risk areas in software development offshoring with a mature CMMI level 5 (Capability Maturity Model, Integrated) software company as the client. We find that managers perceive and mitigate most...
Villamagna, Amy M.; Murphy, Brian R.
Water resources have become an increasingly important topic of discussion in natural resources and environmental management courses. To address the need for more critical thinking in the classroom and to provide an active learning experience for undergraduate students, we present a case study based on water competition and management in the…
Latha, S Jothi; Velmurugan, N; Kavitha, M; Kumar, A R Pradeep
Variations in dental anatomy and root canal systems are often reported in the dental literature. Among them, Radix entomolaris (RE) is the presence of an additional lingual root in mandibular molars. Though RE appears relatively infrequently, knowledge of the condition will aid in its management. This article presents 2 case reports of RE and clinical guidelines for endodontic management.
Fakih, Souhiela; Marriott, Jennifer L.; Hussainy, Safeera Y.
With the increase in the overweight and obese population, it is critical that pharmacy staff are able to provide weight management advice to women at different stages of their life. This study utilized case vignettes to identify pharmacists' and pharmacy assistants' current weight management recommendations to women of different ages,…
The present book focuses on platforms for (natural) resource management. It analyses various case studies in Benin and Burkina Faso. Conditions for collective resource management in conflict and interdependent situations are the most critical issues. The present study raises the importance of socio-
Financial institutions are the protagonists of the ongoing economic crisis. Recent financial scandals and dubious management have emerged while an intense debate on the responsibility of business has risen. In academia, the stakeholder management school has earned acceptance; and one question arises: is orderly, coherent management possible when executives embrace the demands of customers and other stakeholders? A case study from the banking sector would be of interest, in order to ascertain ...
The main objective of this thesis is to determine the effect of time management on high organizational performance using LASACO ASSURANCE Plc. as a case company. In this thesis, the employees working with the company were sent questionnaires. Their responses were critically analyzed and thus related to the theories. A quantitative approach was used as the methodology. According to the theory, time management is a method for managers to increase work performance effectiveness. Time man...
ZOU Yong-gui; CHENG Ke-fei; ZHANG Cong
Vehicle management is a very important application area of GPS/GIS. Each customer has its special requirements on GIS system when he installs it. We discuss a common structure of our GPS/GIS implementation, and present a case study on bulk concrete trucks management for bulk concrete producers. With GPS/GIS system, bulk concrete producers can improve their performance in scheduling and management.
This paper aims to explore how well green facility management has performed in Shanghai office building and finds the possible way to improve the situation. Together with two interviews, questionnaire based on benchmarking approach is conducted in a case study of the Asia Building, which lead to the conclusion that green facility management has done a fair work in Asia Building, and suggestions that laws and regulations related to green facility management should be established; governmental ...
Full Text Available As part of its public sector modernization effort, a North African government has put a lot of effort and allocated significant budgets since 1997 to modernize one of its main public sector companies. Consequently, this company, that mainly offers postal services, initiated many IT-based projects to computerize all paper-based ongoing services offered through its branches and to present new products to customers. This company was aiming to improve service quality and to diversify the range of its services. However, some of these IT-based projects inevitably faced problems. Some projects were either not completed successfully, cancelled, over-budget or taking more time than scheduled. As a result, many employees and customers of this company were dissatisfied and complained about bad planning, slowness and significant disruptions in these projects, an event that affected adversely the quality of service. This study aims at determining the causes of these project disruptions, failures or delays. To achieve this aim, 30 experienced project developers and engineers working in that company’s IT department volunteered to respond to a detailed questionnaire specifically developed for this purpose. The questionnaire included questions about project vision clarity, time/cost management, project quality assurance, risk management and human resources management. Results show that the main reasons for disruptions, failure or delays in IT projects are lack of business plan and poor documentation during and after finishing projects, lack of clear quality assurance criteria, standards and reviews, and poor project risk management practices. Ramifications of such results in terms of improving IT project management practices in the public service sector are finally presented.
Full Text Available BACKGROUND: Case management programs for chronically ill, homeless people improve health and resource utilization by linking patients with case managers focused on improving management of medical and psychosocial problems. Little is known about participants' perspectives on case management interventions. METHODS: This qualitative study used in-depth, one-on-one interviews to understand the impact of a case management program from the perspective of participants. A standardized interview guide with open-ended questions explored experiences with the case management program and feelings about readiness to leave the program. RESULTS: FOUR RECURRENT THEMES EMERGED: (1 Participants described profound social isolation prior to case management program enrollment; (2 Participants perceived that caring personal relationships with case managers were key to the program; (3 Participants valued assistance with navigating medical and social systems; and (4 Participants perceived that their health improved through both the interpersonal and the practical aspects of case management. CONCLUSIONS: Chronically ill, homeless people enrolled in a case management program perceived that social support from case managers resulted in improved health. Programs for this population should consider explicitly including comprehensive social support interventions. Further research on case management should explore the impact of different types of social support on outcomes for homeless chronically ill patients.
Full Text Available This paper offers an alternative approach to defining the management concept. The proposed methodology relies on the identification of tools supporting the given concept. The author assumed that the identification of tools’ evolution gives clearer insights into circumstances of constant development of—by its nature—a more general concept. The tools’ classification resembles a phylogenic tree and is based on the idea of an affinity diagram. To provide the proof for such reasoning, the total quality management (TQM concept was chosen. This proposition can be useful for better understanding origins and the development of management thought. It clarifies relationships among methods constituting frameworks of quality management.
Full Text Available BACKGROUND: Temporomandibular joint (TMJ ankylosis is associated with partial or complete restriction of mouth opening and poses a significant problem to the anesthesiologist making the airway management very challenging. Alternative methods of securing the airway should be kept ready because conventional laryngoscopy and intubation are impossible. Thoracic epidural anesthesia (TEA is one of the options to avoid general anesthesia in this case. We aimed to manage a case of bilateral modified radical mastectomy with TMJ ankylosis solely under thoracic epidural anesthesia. METHODOLOGY: Female patient of 32 years of age, with bilateral TMJ ankylosis with no mouth opening was posted for bilateral breast surgery. Thoracic epidural was instituted at T4-T5 interspace and 18G epidural catheters was secured. Alternative airway management strategies were included in our plan if thoracic epidural fails. OBSERVATION: Adequate preparation of the patient, counseling about anesthetic plan of management, placement of epidural catheter by an experienced anesthesiologist helped in the successful management of this case. CONCLUSION: Regional anesthesia techniques are safer alternatives to provide intraoperative anesthesia with difficult airway for bilateral breast surgeries.
Wise, Meg; Gustafson, David H; Sorkness, Christine A; Molfenter, Todd; Staresinic, Anthony; Meis, Tracy; Hawkins, Robert P; Shanovich, Kathleen Kelly; Walker, Nola P
This article reports on the development of a personalized, Web-based asthma-education program for parents whose 4- to 12-year-old children have moderate to severe asthma. Personalization includes computer-based tailored messages and a human coach to build asthma self-management skills. Computerized features include the Asthma Manager, My Calendar/Reminder, My Goals, and a tailored home page. These are integrated with monthly asthma-education phone calls from an asthma-nurse case manager. The authors discuss the development process and issues and describe the current randomized evaluation study to test whether the year-long integrated intervention can improve adherence to a daily asthma controller medication, asthma control, and parent quality of life to reduce asthma-related healthcare utilization. Implications for health education for chronic disease management are raised.
Khatami, Ameneh; Sparks, Rebecca T; Marais, Ben J
Q fever osteomyelitis, caused by infection with Coxiella burnetti, is rare but should be included in the differential diagnosis of children with culture-negative osteomyelitis, particularly if there is a history of contact with farm animals, and/or granulomatous change on histologic examination of a bone biopsy specimen. We describe a case of Q fever osteomyelitis in a 6-year-old boy in which a decision was made not to treat the patient with combination antimicrobial agents, balancing possible risks of recurrence against potential side effects of prolonged antibiotic treatment. The patient had undergone surgical debridement of a single lesion and was completely asymptomatic after recovery from surgery. This case suggests that a conservative approach of watchful waiting in an asymptomatic patient with chronic Q fever osteomyelitis may be warranted in select cases when close follow-up is possible.
Taylor, J D
In this case, a medical center learns how to evaluate each of its services along a Product Life Cycle curve. Each stage of the cycle has characteristics that suggest appropriate strategic growth and action orientations. When services were plotted along the Product Life Cycle curve, many of the services were found to be mature or making the transition from growth to maturity. At the time of the case, Memorial Medical Center's competitors were entering many of its traditional markets creating a strong competition for market share. Greater competitive emphasis on performance and price reduced profits in the medical center's mature services. The case reports the medical center's approach to modifying its action orientation in light of a better understanding of organizational competence.
Meena N. Satia
Full Text Available Functioning of health systems with respect to maternal health were previously audited using indicators like maternal mortality ratio. However, maternal morbidity as a consequence of pregnancy-related complications is not accounted for in these indicators. Thus, the World Health Organization (WHO has formulated a maternal near-miss approach to pregnancy complications for a more thorough evaluation of health care systems across the world. In practical terms, women are said to be maternal near-miss cases when they survive lethal conditions during pregnancy or in the postpartum period. We report one such case of traumatic variety of postpartum haemorrhage subsequent to a lower segment caesarean section with immediate post-operative removal of cervical cerclage threads that resulted in a maternal near-miss case.
Full Text Available Spontaneous spinal epidural hematoma is a rare cause of acute spinal cord compression. A 25-year-old male presented with a history of sudden onset of complete quadriplegia with sensory loss below the neck along with loss of bowel and bladder control. He had no history of any constitutional symptoms. He reported 10 days later. He was managed conservatively and after two weeks of intensive rehabilitation he had complete neural recovery. The spontaneous recovery of neurological impairment is attributed to the spreading of the hematoma throughout the epidural space, thus decreasing the pressure with partial neural recovery. Conservative treatment is a fair option in young patients who present late and show neurological improvement. The neurological status on presentation will guide the further approach to management.
Che Azhar, N. A.; Mansor, M. A.
In large plant industry, it is not easy to maintain machine performance without using any method such as checklist system. Manual checklist is a common maintenance checklist used in industry. All machine, equipment and parts that need to be checked will be written down for the employee to do maintenance checks. Converting the manual checklist to the Plant Maintenance Management System (PMMS) can improve the way of employees work and make plant management easier. Therefore, a new system was designed to maintain the equipment so that the activities are more efficient and cost effective. The system consists of three frames that connect to each other. The frames divide to section, equipment and checklist. This system also builds to prevent data from arbitrarily changes. Only certain officers or staffs are permitted to make modifications to data. Using this system, a company can make the office environment a paperless environment.
Full Text Available Recognizing the asset value dynamics volatility of the financial institutions and the importance of its recognition both for financial reporting purposes and risk management effect, this paper aims to provide a practical model for the assets and financial institutions evaluation especially banks. It also aims to present a model to measure the value of banking assets for the purposes of risk management as an opportunity to identify in an early moment the banking risks. The paper develops the bank assets assessment forms and the basis of mathematical modeling of this assessment in general. He identifies also the evaluation factors as for example time to maturity, interest rate market for the assets (YTM, the interest rate agreed, the early repayment of the loan, interest ceilings and floors, off-balance sheet treatment, etc..
Full Text Available Treatment of large soft tissue vascular lesions remains one of the greatest challenges in modern plastic surgery. The extent of the disease and the involved structures, but also the expectations of the patients are important in determining the way of treatment. The effective management of hemangiomas and vascular malformations of the head and neck requires a team approach, in order to understand the biologic behavior of the lesion, complete the diagnostic studies necessary to define the area of involvement, and understand the benefits and limitations of interventional radiologic and surgical procedures. The synthesis of this knowledge can help determine the best treatment. The strategic plan and subsequent management of a 34-year-old Maori man with an extensive arteriovenous intraparotid malformation is presented.
Raúl Comas Rodríguez
Full Text Available The objective of this article is to design and to implement a procedure that integrates management control tools focusing on process, to improve the efficiency and the efficacy. It was carried out an experimental study where is defined a procedure, based in the Balanced Scorecard, which integrates the process management into the strategic planning and their evaluation. As results of this work, we define the key factors of success associated with the four perspectives of the Balanced Scorecard that are linked through the cause-effect relations obtaining the strategic map that allows visualizing and communicating the enterprise strategy. The indicators evaluate the key factor of success, integrating the process with the assistance of a software. The implementation of the procedure in a commercialization enterprise contributed to integrate the process definition into the strategic planning. The alignment was evaluated and the efficiency and efficacy indicators improved the company´s performance.
Full Text Available This paper describes a model of supply chain management (SCM. It explains overall supply chain issues, strategic importance of SCM, supply chain strategies and an example of mathematical formulation. A supply chain is a global network of organizations that cooperate to improve the flows of material and information between suppliers and customers at the lowest cost and the highest speed. The objective of a supply chain is customer satisfaction. At the strategic level, a supply chain can be considered as being composed of five activities: buy, make, move, store and sell. Each activity is a module. The set of modules, along with its links, constitutes a model of the supply chain. Our paper presents some insights into the supply chain strategies of companies in Croatia. The major goal of this paper is to show a model for supply chain management in mathematical terms, with an example of mathematical formulation.
Full Text Available Abstract Background The Ministry of Health and Medical Education in the Islamic Republic of Iran has undertaken a reform of its health system, in which-lower level managers are given new roles and responsibilities in a decentralized system. To support these efforts, a United Kingdom-based university was contracted by the World Health Organization to design a series of courses for health managers and trainers. This process was also intended to develop the capacity of the National Public Health Management Centre in Tabriz, Iran, to enable it to organize relevant short courses in health management on a continuing basis. A total of seven short training courses were implemented, three in the United Kingdom and four in Tabriz, with 35 participants. A detailed evaluation of the courses was undertaken to guide future development of the training programmes. Methods The Kirkpatrick framework for evaluation of training was used to measure participants' reactions, learning, application to the job, and to a lesser extent, organizational impact. Particular emphasis was put on application of learning to the participants' job. A structured questionnaire was administered to 23 participants, out of 35, between one and 13 months after they had attended the courses. Respondents, like the training course participants, were predominantly from provincial universities, with both health system and academic responsibilities. Interviews with key informants and ex-trainees provided supplemental information, especially on organizational impact. Results Participants' preferred interactive methods for learning about health planning and management. They found the course content to be relevant, but with an overemphasis on theory compared to practical, locally-specific information. In terms of application of learning to their jobs, participants found specific information and skills to be most useful, such as health systems research and group work/problem solving. The least
Gabriela Ţigu; Bogdan Călăreţu
With its origins in logistics, Supply Chain Management (SCM) concept is covering all managerial aspects of the flow of materials and information from source to customer, across the entire range of materials handling and movement functions, and throughout an organization and its supply channels. In tourism, these issues relate to the whole process of providing tourism services from sourcing of raw materials, products or different services) to supply and distribution, and SCM performance can ul...
The purpose of this study was to increase the amount of new likes of Diamo Oy in the social media network site Facebook, eventually aiming for the creation of new customer relationships, increased visibility of the company and into strictly increasing purchasing of their products. The theoretical part of the study consists of the role of content production in the social media field and customer relationship management, of which particularly customer acquisition and retention are discussed mor...
Chau Thi Tra, Mi
In response to changes imposed by the Finnish government on the Univer-sities of Applied Sciences system in the near future, HAMK has proactive-ly adopted several programmes to prepare for future challenges and rein-force the organization’s competitiveness. However, organizational change has never been an easy, straightforward issue and how to manage change effectively has become an interest to the organization. The study aims at providing suggestions for a more successful change im-pleme...
Reifer, Donald J
This book provides readers with practical advice on how to handle the many issues that can arise as a software project unfolds. The book uses twelve case studies to communicate lessons learned addressing such issues as they occur in government, industrial and academic settings. These cases focus on addressing the things that can be done to establish and meet reasonable expectations. Such corrective actions often involve more than just dealing with project issues. For example, software practitioners may have to address obstacles placed in their way by procurement, organizational procedures an
Murariu, Daniel; Tatsuno, Brent; Hirai, Cori-Ann M; Takamori, Ryan
Suspected cases of acute appendicitis in pregnancy are considered surgical emergencies due to the potentially devastating outcomes for both mother and unborn child if the appendix perforates. Acute appendicitis is also the number one cause of non-traumatic acute abdomen in pregnancy, as well as the number one cause of fetal death. We present a case report with a typical presentation of suspected acute appendicitis in a pregnant woman. The work up and diagnostic tools available are discussed at length, as well as the finer points in treatment of this population.
Sumithra, S; Sunitha, V; Nagaraju, G
Solid waste management (SWM) is a worldwide phenomenon. It is a big challenge all over the world for human beings. The problem of municipal solid waste management (MSWM) is also prevailing in the environment of Kadapa town in India. Therefore, the present study was undertaken to find out the problems and prospects of municipal solid waste in Kadapa town. A detailed investigation was made regarding the methods of practices associated with sources, quantity generated, collection, transportation, storage, treatment and disposal of municipal solid waste in the study area. The data related to SWM in the study area was obtained through questionnaire, individual field visits, interaction with people and authentic record of municipal corporation. Status of the MSW in Kadapa town was studied. The results indicated that the major constituents of municipal solid waste were organic in nature and approximately one fourth of municipal solid waste was recyclable. Detailed data on solid waste management practices, including collection, recovery and disposal method, has been presented in this paper.
Abdur-Raouf; Kalim, Rukhsana; Siddiqi, Ahmed F.
This paper aims to identify the gaps in management education highlighted by 3 primary stakeholders: students, faculty and alumni. The study tries to address the issue of relevance and compatibility of management education and investigates areas of improvement perceived by respondents. The paper assumes that business departments of universities…
Rendtorff, Jacob Dahl
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...... in business schools following the Harvard method, wherein students are supposed to get knowledge through the reading of a case prepared by the teacher or from a business textbook. The aim of the case study is to analyze a concrete case and get general knowledge through the integrated analysis of the different...... ethical, philosophical, and economic dimensions of the case. This article presents an argument for case studies that highlight ethics and philosophy in the following parts: (1) Introduction, (2) Historical and Philosophical Definitions of Case Studies, (3) The Quality and Structure of the Case Study, (4...
QIN Xiang; WANG Dong-xin; WU Xin-min
@@ Stiff-person syndrome (SPS, also called stiff-man syndrome) is a rare neurological disease with autoimmune features. It is characterized by fluctuating and progressive muscle rigidity, and episodic spasm that prominently involve axial and limb musculature.1,2 Herein we report a case of anesthetic management of a patient with SPS for thymectomy and review several other cases.
Kawulich, Barbara B.
This manuscript shares lessons learned from conducting an action evaluation of the use of multimedia case studies in Management Information Systems (MIS) courses. Three undergraduate MIS classes took part in the study. The purpose for using case studies in these classes was to teach students about the role of MIS in business. An action evaluation…
Cevik, Yasemin Demiraslan; Andre, Thomas
This study was aimed at comparing the impact of three types of case-based approaches (worked example, faded work example, and case-based reasoning) on preservice teachers' decision making and reasoning skills related to realistic classroom management situations. Participants in this study received a short-term implementation of one of these three…
Leong, A.K. [Woodward-Clyde International, Kuala Lumpur (Malaysia)
Brownfields are turning back to green. This paper presents a case study of a former dump site for hazardous waste that has been remediated and will be developed into an enhanced wildlife management habitat. This successful remediation case combined various investigations, remedial designs, risk assessments, ecological studies, and engineering practices. 3 refs., 1 fig., 1 tab.
Full Text Available Woven coronary artery is relatively rare and can be complicated in both acute and chronic phases. A few case reports have been published until now. Herein we report a case with right woven coronary artery managed with drug-eluted stent implantation without complication.
Yakup Alsancak; Burak Sezenoz; Sedat Turkoglu; Adnan Abacı
Woven coronary artery is relatively rare and can be complicated in both acute and chronic phases. A few case reports have been published until now. Herein we report a case with right woven coronary artery managed with drug-eluted stent implantation without complication.
Alsancak, Yakup; Sezenoz, Burak; Turkoglu, Sedat; Abacı, Adnan
Woven coronary artery is relatively rare and can be complicated in both acute and chronic phases. A few case reports have been published until now. Herein we report a case with right woven coronary artery managed with drug-eluted stent implantation without complication.
Balachandran Nair, L.; Gibbert, Michael
Cases inconsistent with theoretical expectations are by default indicators for a lack of theory-data fit, and as such are prime candidates for theory building. However, the conventional tendency is to ignore inconsistent cases in Management research. The current article focuses on the theory-buildin
Maxwell, James R.; Gilberti, Anthony F.; Mupinga, Davison M.
This paper will study some of the problems associated with case studies and make recommendations using standard and innovative methodologies effectively. Human resource management (HRM) and resource development cases provide context for analysis and decision-making designs in different industries. In most HRM development and training courses…
Maile, Michael D; Patel, Rajesh A; Blum, James M; Tremper, Kevin K
Many cases of malignant hyperthermia triggered by volatile anesthetic agents have been described. However, to our knowledge, there has not been a report describing the precise changes in physiologic data of a human suffering from this process. Here we describe a case of malignant hyperthermia in which monitoring information was frequently and accurately captured by an anesthesia information management system.
Prats-Guardiola, Marta; López-Pisa, Rosa María
We present the case of a patient with long-term and clinically complex Diabetes Mellitus. She was taking part in the home care program in Primary Care. The complications of her DM affected her quality of life: blindness, kidney failure, treated with hemodialysis, and a cerebrovascular attack. We describe the evaluation following Virginia's Henderson model. This evaluation was made in the patient's home after she was discharged from the socio-health centre where she was admitted as her right leg was amputated at a supracondylar level. It was designed a care plan between the community nurse and the case manager using NANDA, NOC and NIC taxonomy. The care plan was carried out as a joint effort between the community nurse and the case manager who coordinated the planning with the rest of professionals. Results were evaluated 6 months after the initial assessment. This case, which had a high dependence and a high clinical complexity, required a multidisciplinary approach and the integration of different professionals, services and institutions to implement the patient's treatment. Because of all the above, it is important to mention the case management function to guarantee continuity, and overall and integrated care.
Full Text Available Tuberous sclerosis complex is a multi-system disorder with autosomal dominant inheritance, which can affect the brain, heart, skin, kidneys, lungs, and retina. We hereby report therapeutic challenges faced in a case of an adolescent male suffering from tuberous sclerosis.
This article offers an introduction to case-based modeling (CBM) and a demonstration of the efficacy of this instructional model. CBM is grounded primarily in the concepts and theory of experiential learning, augmented by concepts of script creation. Although it is labor intensive, the model is one that has value for instruction in various…
Full Text Available We present a case of 50 year old female with a diagnosis of intraabdominal mass suffering from pemphigus vulgaris, myasthenia gravis, hypothyroidism, diabetes mellitus. Extra care to protect skin and mucus membranes from trauma during procedures is essential. Adrenocortical suppression following prolonged steroid therapy is another hazard to be tackled in the perioperative period.
Gentilucci, James L.
Crisis communication training of school principals is problematic because it overemphasizes media relations and underemphasizes the critical importance of immediate and personal communication with students, staff, and parents--those most affected by school crises. A case study involving the death of a student in a small rural school explains why…
Casarin Santina Nunes Alves
Full Text Available Case Management is a term that is present in almost every American health care situation. It is mostly used to coordinate community services with satisfactory results for the patient within a certain period of time, with limited resources. Through time, it has been used for different purposes. The goal of this study was to show the historical evolution of case management as expressed by the American nursing literature, in the 80's and 90's, according to its use, meaning, and application, and following a theoretical framework for concept analysis. The data was extracted from two journals: "Nursing Management" and "Journal of Nursing Administration". The publications showed case management portrayed as a process that serves a common goal; where quality and cost of care were the prevalent and influential elements along time, and its practice focusing in a given population defined as of high risk and high cost for health care.
Home care is a health sector under increasing pressure. Demand is often said to be outstripping capacity, with constant change and retrenchment distinguishing features of the current context. This paper takes a reading of the current conditions of home care using data gathered during a field study of home care case management practices conducted in 2004. As economic discourses become increasingly influential in determining responses to client situations, case managers (and their managers) find themselves with limited capacity to exercise control over their practices. A growing gap between professionally influenced discourses--those presumably intended to guide practice--and organizational priorities creates a dissonance for case managers as the political-ethical dimensions of their practices are displaced by budget "realities." For front-line workers, such displacement cannot be sustained in their face-to-face encounters with clients, leading to a growing sense of frustration and powerlessness among these highly skilled practitioners.
Turner, Ryan C; Dodson, Sean C; Rosen, Charles L
A large abscess of the posterior fossa often warrants surgical intervention. We report a case of a 50-year-old male presenting with a cerebellar abscess measuring 2.8 cm x 1.6 cm located in the left cerebellar hemisphere at the level of the middle cerebellar peduncle that was treated conservatively and successfully with antibiotics. Therapeutic management options are discussed in regards to this case specifically as well as a review of the literature. This case illustrates the successful medical management of a cerebellar abscess of otogenic origin in an adult, a unique result in terms of abscess size and age of the patient.
Stroke is a leading cause of death and disability worldwide. The elderly, in whom atrial fibrillation (AF) is most prevalent, carry the greatest risk, undergoing more recurrent, deadlier strokes, with bigger deficits, slower recoveries, and more comorbidities. Evidence-based data on advanced age stroke management are scarce. Age-related cerebral changes might undermine the benefit of established stroke treatments. Nevertheless, the elderly should probably also undergo thrombolysis for ischemic stroke: they do not bleed more, and die not because of hemorrhage but of concomitant illnesses. Beyond natural bleeding risks, AF in advanced age has a high embolic potential if not anticoagulated. Standard or lower intensity warfarin anticoagulation prevents embolic stroke in the elderly with a hemorrhage risk even lower than aspirin. In fact, adverse effects seem to occur more often with aspirin. Excess anticoagulation hazards are prevented with lower starting doses, stricter corrections, more frequent International Normalized Ratio monitoring, and longer adjustment intervals. Validated prognostic scores such as CHADS(2) help minimize bleeds. Direct inhibitors have recently shown a benefit similar to warfarin with fewer hemorrhages. Carefully tailoring antithrombotics to this age group is therefore useful. Antihypertensives probably help 80-plus stroke patients as well, but the risk/benefit of lowering blood pressure in secondary stroke prevention at that age is uncertain. Evidence-based data on diabetes management and use of lipid-lowering drugs are still lacking in this age group. In summary, emerging data suggest that stroke management should be specifically targeted to the elderly to better prevent its devastating consequences in the population at the highest risk.
Gimenes, Celso Huerta; Barroso, Antonio Carlos de Oliveira; Imakuma, Kengo [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)], e-mail: firstname.lastname@example.org, e-mail: email@example.com, e-mail: firstname.lastname@example.org
To guide human resources selection and development, organizations usually have a list of the competencies they consider crucial for the various segments of their endeavor. At IPEN, a R and D institute with graduate teaching (within USP framework) and some production facilities, the elaboration of a list of the highly appraised competencies for IPEN's managers become a research theme in itself. This work has produced: a methodology to generate, validate and recycle periodically the list and descriptions of managers' competencies; and the first version of the list. Delphi questionnaires were applied via web using 'Lime Survey', a freeware that enables import and export the data as csv files and has a simple and workable language for database access. The consistency of the numerical results, as well as the consensus preferences manifested by the sample is discussed in the paper. Also a segmentation and multivariate statistical analysis to reveal differences and similarities among the various subgroups of the sample is presented providing a lot of insightful information. The merit of structuring the pertinence of the competencies according to seven BNQA's criteria is discussed. Combining the manifested preference of the sample with a factor analysis to check the most significant loads in each construct a reduced set of competencies is proposed. This reduced set can be the base for IPEN's directors to select the crucial set of managers' competence. The methodology here explained can be used each two years to co-validate and update this reduced set. (author)
Safari, Narges; Safari, Fariba; Olesen, Karin; Shahmehr, Fatemeh
This research paper investigates the influence of industry on electronic customer relationship management (e-CRM) performance. A case study approach with two cases was applied to evaluate the influence of e-CRM on customer behavioral and attitudinal loyalty along with customer pyramid. The cases covered two industries consisting of computer and automotive industries. For investigating customer behavioral loyalty and customer pyramid companies database were computed while for examining custome...
Crandall, Karen S.; Auping, Judith V.; Megargle, Robert G.
In the late 70's, a refurbishment of the analytical laboratories serving the Materials Division at NASA Lewis Research Center was undertaken. As part of the modernization efforts, a Laboratory Information Management System (LIMS) was to be included. Preliminary studies indicated a custom-designed system as the best choice in order to satisfy all of the requirements. A scaled down version of the original design has been in operation since 1984. The LIMS, a combination of computer hardware, provides the chemical characterization laboratory with an information data base, a report generator, a user interface, and networking capabilities. This paper is an account of the processes involved in designing and implementing that LIMS.
A N Sulabha
Full Text Available A post traumatic parotid sialocele is an acquired lesion that arises from extravasation of saliva into glandular or periglandular tissues secondary to disruption of the parotid duct or parenchyma. Facial trauma and surgery in the parotid region are the most common causes of this rare condition. This paper presents an unusual incidence of post traumatic parotid sialocele after Le-Fort II fracture reduction and its management by relatively simple and cost-effective technique which can be carried out in routine dental surgery suite. The results achieved justify our recommendation of scalp vein cannula for the treatment of sialocele in clinical practice.
This is a report on the management of a patient safety incident involving BowelScreen and symptomatic colonoscopy services at Wexford General Hospital (WGH). The patient safety incident relates to the work of a Consultant Endoscopist (referred to as Clinician Y) employed by WGH who undertook screening colonoscopies on behalf of the BowelScreen Programme since the commencement of the screening programme in WGH in March 2013. Clinician Y also performed non-screening colonoscopies for the diagnosis of symptomatic patients as part of routine surgical service provision at WGH.\\r\
services are a set of support services. They are meant to ensure that the employees of an organisation can carry out the tasks and activities related to the core business, without having to worry about, for example, the management of the workplace, catering and cleaning, security and safety. Facilities...... data and passive observation, and the data analysis was carried out through a systematic approach to coding supported by the qualitative data analysis software Atlas.ti (v.6). Overall, this dissertation offers several contributions to theory and practice. First of all, this work stresses the role...
Lowry, Roy K.
Since the mid 1980s, much of the marine science research effort in the United Kingdom has been focused into large scale collaborative projects involving public sector laboratories and university departments, termed Community Research Projects. Two of these, the Biogeochemical Ocean Flux Study (BOFS) and the North Sea Project incorporated large scale data collection to underpin multidisciplinary modeling efforts. The challenge of providing project data sets to support the science was met by a small team within the British Oceanographic Data Centre (BODC) operating as a topical data center. The role of the data center was to both work up the data from the ship's sensors and to combine these data with sample measurements into online databases. The working up of the data was achieved by a unique symbiosis between data center staff and project scientists. The project management, programming and data processing skills of the data center were combined with the oceanographic experience of the project communities to develop a system which has produced quality controlled, calibrated data sets from 49 research cruises in 3.5 years of operation. The data center resources required to achieve this were modest and far outweighed by the time liberated in the scientific community by the removal of the data processing burden. Two online project databases have been assembled containing a very high proportion of the data collected. As these are under the control of BODC their long term availability as part of the UK national data archive is assured. The success of the topical data center model for UK Community Research Project data management has been founded upon the strong working relationships forged between the data center and project scientists. These can only be established by frequent personal contact and hence the relatively small size of the UK has been a critical factor. However, projects covering a larger, even international scale could be successfully supported by a
Iuga, Anca N.
Applying the principles of sustainable development in Romania involves a new approach to ecological waste using basic concepts of circular economy to weigh accurately the proposed projects in this area taking into account existing environmental resources and zero waste objectives. The paper is focused on: quantitative and qualitative measures of waste prevention in Romania, the changing status of the waste by selling it as product, the mechanisms for paying for treatment and / or disposal which discourage waste generation and the use of financial resources obtained from secondary raw materials for the efficiency of waste management.
Trudel-Ferrari, C.C. [Kinectrics Inc., Toronto, ON (Canada)
This paper discussed the development of effective training and knowledge management systems for recently hired personnel in electric utilities. Case studies of best practices from electric utilities in Ontario, consultants, and universities were used to develop an overview of current training practices. Methods of identifying, attracting, and recruiting personnel were presented and knowledge management and mentoring programs were discussed. The use of training programs in developing knowledge databases was also evaluated. Knowledge management formats included qualification training; simulation training; knowledge transfer; and curriculum development. Human resources, revenue, and management issues currently challenging electric utilities were discussed along with various new training practices. 2 refs., 3 tabs., 2 figs.
Full Text Available ABSTRACT: We report successful anaesthetic management of a pat ient with hereditary spherocytosis who underwent laproscopic splenectomy, ch olecystectomy and appendioectomy. Hereditary spherocytosis is a familial hemolytic di sorder with marked heterogeneity of clinical features, ranging from asymptomatic condition to a f ulminant hemolytic anaemia. Commonly recommended perioperative management in these patien ts includes preemptive erythrocyte transfusion, aggressive hydration and avoidance of hypoxia, aplastic crisis, hypothermia and acidosis. The management of such a case is challeng ing from anaesthetic point of view because of sickling oriented anaesthetic approach. Key words: Hereditary spherocytosis, splenectomy, cholecystectomy, perioperative management.
Hala M Al-Shamlan
Full Text Available Top management usually faces an unexpected attitude from potential users during implementing an enterprise resource planning (ERP system. For one reason or another, they resist the implementation process and may cause the failure of ERP system. Therefore, top management should be deal with this problem using effective change management strategies and processes. In this paper, we discuss the successful change management strategies and processes in literature. A case study of MADAR has been presented to discover the strategies and processes used for the successful enterprise system.
Full Text Available Introduction: For decades, acetabular fractures were treated conservatively. Judet et al. in 1960s established the operative treatment of these fractures by continuous improvement of pre-operative evaluation and classification of fractures. Several studies demonstrated that accurate fracture reduction decreases the incidence of post-traumatic arthritis and improves functional outcome.Case Series: We report 67 consecutive patients who underwent surgical treatment for acetabular fracture; 44 patients were available for follow-up. In 35 (79.5% cases, congruent reductions were achieved. The final mean Harris hip score was 81.8 (53-95. Functional outcomes according to Harris score were excellent and good in 31 patients (70.5%.Conclusions: The results of internal fixation of displaced acetabular fractures in our series were satisfactory.
Full Text Available Laugier's fractures are rare because they are located deep in the elbow joint and are thus protected from any direct trauma. Laugier's fractures have been insufficiently described in the literature. Surgical treatment does not have an alternative, and timely diagnosis and surgical and physical therapy. We presented a case report of a 23 years' old man, sustained a Laugier's fracture in June 2012 after falling from motocycle (low energy trauma and hit with his flexed elbow against the street.
Full Text Available Oligodontia or severe hypodontia is a rare developmental dental anomaly which is described as congenital absence of 6 or more teeth excluding the third molars. In this case report, the treatment of a 31-yearold woman with congenital absence of 9 permanent teeth is described. The treatment with occlusal appliance and fixed a partial dentures ended up in functional and aesthetic results.
Fergus, Todd; Pacanowski, John P; Fasseas, Panayotis; Nanjundappa, A; Habeeb Ahmed, M; Dieter, Robert S
Subclavian stenosis is a highly prevalent and underrecognized clinical entity. In patients with a history of coronary artery bypass grafting utilizing a left internal mammary artery, subclavian artery stenosis can cause coronary-subclavian steal, leading to myocardial ischemia. Traditionally, this has been treated surgically with a vascular bypass operation. Two cases of coronary-subclavian steal syndrome are presented, 1 treated percutaneously with angioplasty and stent, and 1 treated with a combined endovascular-surgical procedure.
De Rossi, Moara; De Rossi, Andiara; Queiroz, Alexandra Mussolino de; Nelson Filho, Paulo
This paper describes the case of a 12-year-old male patient who presented a severe lateral luxation of the maxillary central incisors due to a bicycle fall. Treatment involved suture of the soft tissues lacerations, and repositioning and splinting of the injured teeth, followed by endodontic treatment and periodontal surgery. After a 2-year follow-up, clinical and radiographic evaluation revealed that the incisors presented satisfactory esthetic and functional demands.
Full Text Available Objectives: To assess the incidence, clinical features, diagnosis and treatm ent of complications of cholesteatomatous chronic otitis media (CCOM seen in the ENT/Head and Neck Surgery Clinic, University Clinical Center of Kosova, Prishtina. Materials and Methods: This is a retrospective study of the medical records of patients with complications of CCOM who had undergone surgical treatment at the ENT Clinic of the University Clinical Center of Kosovo for the period time of 1994 to 2011. Results: From a total of 2765 patients suffering from COM, 502 (18.08% had cholesteatoma. From this group, in 145 patients had complications. The mean age was 30 years. Eighty-two (56.55% cases had extracranial complications (ECC and 49 patients (33.79% intracranial complications (ICC. For the ECC cases, we found that subperiostal mastoid abscess occurred in 25%, facial nerve palsy was seen in 13% and labyrinthine fistula in 9.6 %. For the ICC cases, meningitis (12% and perisinusal abscess (11% were the most common complications. The most frequent radiological diagnostic procedures were mastoid X-rays, which were performed in 70% of the patients, and computed tomography in 20%. Patients with ECC were treated in the ENT Clinic, whereas patients with ICC, after otologgic surgical procedures, were transferred to the Neurosurgery Clinic. In this series, 5 patients (3.4% died as a result of complications. Conclusions: The incidence of cholesteatoma and its complications in our country still poses a challenge that requires higher dedication. Application of sophisticated diagnostic methods, CT and MRI is going to assist in choosing the adequate surgical approach, especially in cases with intracranial complications
Full Text Available Aesthetics of the teeth is of great importance to patients , including tooth color. Of the various causes of tooth discoloration fluorosis , enamel hypoplasia , medication staining etc. is commonly encountered. The treatment options for discoloration are varied depending on individual case basis. The purpose of this article is to report the advanced treatment options for generalized intrinsic discoloration encompassing power bleaching to veneers to full mouth rehabilitation w ith porcelain laminates and ceramic crowns
Kopman, Aaron F; Sinha, Nidhi
We present a case of prolonged recovery from mivacurium. Neuromuscular monitoring using acceleromyography was extremely helpful following attempted reversal of residual block in determining when tracheal extubation could be safely performed. If a method of objective estimation of the TOF ratio had not been available, tracheal extubation would have taken place at a time when the train-of-four fade ratio was below 0.40.
Dax Abraham; Nikhil Bahuguna; Rishi Manan
The purpose of this article is to emphasize the use of Cone Beam Computed Tomography (CBCT) for root canal treatment. Two case reports are presented where CBCT has been used to locate and eventually treat extra canals in maxillary first molars. Dental clinicians should be aware of the anatomical variations in maxillary molars. CBCT should be an essential part of the diagnosis prior to initiating root canal treatment.
Fernanda Chagas Borelli
Full Text Available This case describes the story of Kenner, a company that traditionally focused only on its product and is now realizing that its target market has changed drastically: from young higher-income consumers they are now lower-income consumers. Because of the excessive care with product quality, part of the company did not accept this new consumer, believing that the original consumer of the product should be their target market. As part of the restructuring of the company, in 2007 a marketing department was created, concerned with getting to know its consumers and their preferences better. In 2009, the year the case is set, the image of the company still appeared to be defined by its consumers, being associated with criminals, guns, drugs and violence. It was necessary to take control of the situation and decide on the market positioning the company would adopt. But before this, it was necessary to decide what the company’s target market would be. The case invites the reader to analyze the company’s situation and present and evaluate different alternatives in order to debate concepts of market segmentation, target market decisions and market positioning, as well as decisions related to the marketing mix.
Hasan Emre Aydın
Full Text Available These days, as a consequence of the improvement in technology and increase in the use of motor vehicles, spine injuries have become common. Spine traumas, which often occur after motor vehicle accidents, are observed mostly in cervical regions, particularly in the subaxial cervical region, which is also known as the subcervical region, and neurological damage occurs in 70% of the patients. Despite still being controversial, the common ranging for neurological evaluation is the American Spinal Injury Association ranging, which includes the motor and sensory loss and accordingly, the impairment rate. In subaxial cervical traumas, acute neurological deterioration is an indication and therefore requires urgent surgical treatment. The choice of anterior or posterior approach substantially depends on the traumatization mechanism, affected tissues, and neurological deterioration occurring after. The state of patient and instability are the most two important factors affecting the treatment decision. Although the anterior approach is accepted as a routinely available and easily applicable surgical technique, it lacks in the burst fractures involving the three colons, which shows a stabilization disorder. The anterior plate screw technique and posterior lateral mass screw application applied in our clinic are reviewed in literature and are discussed in two cases. Although the best clinical results are achieved in cases where only anterior surgery is performed and in cases where instability is excessive, in unstable compression and blow-out fractures, even if neurological deficit and three colon involvement are not observed in the patient, the requirement of posterior fusion is observed.
Full Text Available 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 vision, glare and her dissatisfaction with her current auto-focus spectacle-mounted telescope device, which she reported as being heavy as well as cosmetically unacceptable. We describe how low-vision rehabilitation using multiple visual aids, namely spectacles, special iris-tinted contact lenses with clear pupils, and bi-level telemicroscopic apparatus devices improved her quality of life. Subsequent to rehabilitation our patient is happier and continues to use the visual aids. Conclusions Contact lenses with a special iris tint and clear pupil area are useful aids to reduce the glare experienced by albinos. Bi-level telemicroscopic apparatus telemicroscopes fitted onto our patient’s prescription spectacles were cosmetically acceptable and able to improve her distance vision. As a result these low-vision rehabilitation approaches improved the quality of life of our albino patient.
Kasnazani Kalandar A
Full Text Available Abstract Introduction Fasciola hepatica, an endemic parasite common in Iraq and its neighboring countries, is a very rare cause of cholestasis worldwide. Humans can become definitive hosts of this parasite through their ingestion of a contaminated water plant, for example, contaminated watercress. Symptoms of cholestasis may appear suddenly and, in some cases, are preceded by long periods of fever, eosinophilia, and vague gastrointestinal symptoms. Here we report the case of a woman with a sudden onset of symptoms of cholangitis. Her infection was proved by endoscopic retrograde cholangiography to be due to Fasciola hepatica infestation. Case presentation A 38-year-old Kurdish woman from the northern region of Iraq presented with fever, right upper quadrant abdominal pain, and jaundice. An examination of the patient revealed elevated total serum bilirubin and liver enzymes. An ultrasonography also showed a dilatation of her common bile duct. During endoscopic retrograde cholangiopancreatography, a filling defect was identified in her common bile duct. After sphincterotomy and balloon extraction, one live Fasiola hepatica was extracted and physically removed. Conclusion Fasciola hepatica should be a part of the differential diagnosis of common bile duct obstruction. When endoscopic retrograde cholangiopancreatography is available, the disease can be easily diagnosed and treated.
Full Text Available A uterocutaneous fistula is a rare clinical presentation that occurs following Cesarean section and other pelvic operations. There are only a few reports discussing the treatments. We describe a patient with successful surgical management and review the literature. A 25-year-old woman referred to our department 13 months after her first Cesarean section. She had a history of an abdominal mass and collection 2 months after surgery and some fistula opening with discharge from her previous incision. She had a previous surgical operation and antibiotic therapy without complete response. We performed fistulography to evaluate the tracts. In the operation — she had fistula tracts, one of which was between the uterus and skin. We debrided the necrotic tissue in the uterus, excised the fistula tracts, and drained the uterine cavity. At 8 months’ postoperative follow-up, she had no recurrence. A uterocutaneous fistula is a rare condition with many causes and needs proper investigation and timely medical and surgical management.
CHANG Luh-maan; CHEN Po-han
One of the key elements in real estate management is streamlining the construction process. Thus,the facilities can be built on a faster, cheaper, and higher quality base. Consequently, it will enhance the owner's competitiveness. Due to the high cost and lengthy duration of mega-construction projects in recent years,Build-Operate-Transfer (BOT) contracts are getting popular in delivering constructed projects in the public sector. With BOT, the public owners are able to focus on the effectiveness of fair resource allocation as well as bring the efficiency of private enterprise into governmental operations.This paper uses Taiwan High Speed Rail project to exemplify the BOT method in executing the constructed projects in the chain of real estate management processes. The paper explains the reasons for building HSR and adopting BOT approach.The detail of the HSR project and the feasibility analysis of the project will be presented in this paper. The feasibility analysis comprises the comparisons of different transportation means, the financial analysis, and other benefits from HSR. Finally, conclusions will be drawn.
Full Text Available Problem statement: This case study presented students with a situation based in the healthcare industry, highlighting the importance of contract review, clear communications and interestbased negotiations in order to avoid the costly consequences that could be associated with contract related disputes. The case allowed students to understand how clearly written contracts play a deciding role in the success of business partnerships. Students practiced negotiation skills while discussing the performance clauses of the contract and considering effective amendments to that contract with the purpose of extending a business relationship. Approach: The author interviewed a project manager working for a preferred implementation vendor which had a contract with a large hospital provider in Colorado and California. The purpose of the interview and the case study focused on contract law, contract management, enterprise risk management and negotiation skills. The case study is based on class room use with practical, real-life contract management scenarios. Results: The team projects submitted for this case study in case management highlighted the receptivity of students in understanding the benefit of preserving business relationships, avoiding litigation and carefully wording the specifics of complex contracts. The students excelled in practicing interest-based bargaining skills and writing contract amendments that reflected the specifics of the complex contract problem presented. Conclusion/Recommendations: Case studies focused on real business situations resonate well with upper division students in business law classes; the complexities of the situations and of the contract language did not deter students from brainstorming solutions to the problems presented and in writing amendments to the contract such that the business relationship was preserved. The results of the students work on this case study problem were presented to the
Richards, N T; Darby, S; Howie, A J; Adu, D; Michael, J
There is great debate as to whether the benefit gained from the knowledge of renal histology outweighs the risk to the patient from the biopsy procedure. We conducted a prospective study of 276 native renal biopsies performed on 266 patients from a single centre in 1991 to assess the effect of the knowledge of renal histology on patient management. Biopsies were performed under ultrasound guidance using the Trucut biopsy needle. The indications for biopsy were: non-nephrotic proteinuria alone (25), haematuria and proteinuria (28), nephrotic range proteinuria (28), acute renal failure (31), haematuria alone (36), and chronic renal failure (128). Two hundred and sixty-three biopsies were successful. The mean number of glomeruli obtained was 23, range 0-115. Eight patients developed macroscopic haematuria of which two required blood transfusion. The result of the biopsy altered management in 24/28 (86%) of cases of nephrotic range proteinuria, 22/31 (71%) of cases of acute renal failure, 58/128 (45%) of cases of chronic renal failure, 9/28 (32%) of cases with haematuria and proteinuria, 3/25 (12%) of cases with non-nephrotic proteinuria alone, and 1/36 (3%) of cases with haematuria alone. management was altered in 42% of cases overall. These data suggest that knowledge of renal histology is essential in the management of patients with renal disease.
Estrella, Jenny Lynn D C; Soriano-Estrella, Agnes L
Cases of gestational trophoblastic neoplasia (GTN) with uterine rupture are often catastrophic owing to profuse bleeding, which could be potentially lethal. Management often entails removal of the uterus. Among patients in the reproductive age who have not completed their desired family size, such a procedure could be unacceptable. To address this, uterine resection of localized disease has been performed to preserve fertility. However, in some cases, resection would not leave much of the uterus for future fertility. Hence, primary repair of the rupture could be done. Two cases of uterine rupture in low-risk GTN conservatively managed with primary uterine rupture repair using hemostatic stitches and postoperative single-agent chemotherapy are presented. Both patients were in their early reproductive years and with a great desire to preserve future fertility. The extent of the disease was evaluated in both cases intraoperatively before considering this conservative approach. Such management proved to be effective for both cases. The 2 cases presented are the first reported successful cases in literature on which primary repair of uterine tumor rupture by oversewing with figure-of-eight stitches were done. One should then consider this as a new option in the management of patients who have GTN with uterine rupture, highly desirous of pregnancy, with large uterine tumors but relatively small areas of rupture for which simple stitches would suffice in providing adequate hemostasis.
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.
Lily A. Ray
Full Text Available Sustainability science promotes place-based resource management because natural processes vary among ecosystems. When local science is limited, land managers may be forced to generalize from other ecosystems that function differently. One proposed solution is to draw upon the traditional ecological knowledge that indigenous groups have accumulated through resource use. Integrating traditional ecological knowledge with conventional resource management is difficult, especially when the two offer competing explanations of local environments. Although resource managers may discount traditional ecological knowledge that contradicts conventional resource management, we investigate the possibility that these disagreements can arise when nonlocal resource management generalizations displace place-based science. Specifically, we compare claims about wildfires made by Athabascan forest users residing in or near the Koyukuk National Wildlife Refuge and in the U.S. Fish and Wildlife Service fire management plan for that refuge. We focus on two aspects of fire ecology and management: the drivers of landscape flammability and the feasibility of using wildfires and prescribed burns to achieve resource management objectives. The results indicated that some disagreements came from reliance of the federal fire management plan on generalized national narratives at the expense of place-based science. We propose that in some cases, conflicts between traditional ecological knowledge and conventional resource management, rather than indicating a dead end, can identify topics requiring in-depth, place-based research.
Pregnancy with Rh isoimmunization is a grave situation. Two women with indirect Coombs test (ICT) positive were managed conservatively with a favorable outcome. Peak systolic velocity (PSV) of middle cerebral artery (MCA) was measured every 2 weeks, and pregnancy continued till the value remained <1.5 mean of median. In one woman, the pregnancy could be prolonged to 37 weeks when delivery was induced and the neonate did not develop hyperbilirubinemia. In the second woman with bad obstetric history, when a highly positive ICT was reported, intravenous immunoglobulin (IVIG) was given in a single dose of 5 g every 2 weeks starting at 27 weeks, for a total of three doses, along with measurement of PSV of MCA. Labor could be prolonged to 34 weeks when preterm spontaneous delivery occurred. The neonate could be salvaged with exchange transfusion and IVIG. The neonate is healthy with normal tone and no evidence of kernicterus.
Shubhangi Nigwekar P, Chaitanya Gupte P, Prajakta Kharche M, Akshay Beedkar U, Neeta Misra S, ParagTupe N
Full Text Available ABSTRACT Dermoids are congenital lesions representing normal tissue in abnormal location. Orbital dermoid cysts are divided into superficial and deep dermoids. Depending on type and location, superficial ocular dermoid cysts are divided into limbal, dermoid cyst and epibulbar dermoid cyst or dermolipoma. The most common location for the epibulbar dermoid cyst is inferotemporal region of eye. They are usually asymptomatic or may present with inflammatory response due to leakage of cyst contents or may cause local irritation due to protruding hair and do cause cosmetic blemish to a school going child. For local irritation and cosmetic reasons, complete surgical excision with intact capsule of epibulbar dermoid cyst is mandatory to prevent acute inflammatory response and its recurrence. In this article we are presenting the clinical features and surgical management of an inferotemporal epibulbar dermoid in a male patient.
Pregnancy with Rh isoimmunization is a grave situation. Two women with indirect Coombs test (ICT) positive were managed conservatively with a favorable outcome. Peak systolic velocity (PSV) of middle cerebral artery (MCA) was measured every 2 weeks, and pregnancy continued till the value remained <1.5 mean of median. In one woman, the pregnancy could be prolonged to 37 weeks when delivery was induced and the neonate did not develop hyperbilirubinemia. In the second woman with bad obstetric history, when a highly positive ICT was reported, intravenous immunoglobulin (IVIG) was given in a single dose of 5 g every 2 weeks starting at 27 weeks, for a total of three doses, along with measurement of PSV of MCA. Labor could be prolonged to 34 weeks when preterm spontaneous delivery occurred. The neonate could be salvaged with exchange transfusion and IVIG. The neonate is healthy with normal tone and no evidence of kernicterus.
Warner, Nafisseh S; Warner, Matthew A; Moeschler, Susan M; Hoelzer, Bryan C
Acute pain following amputation can be challenging to treat due to multiple underlying mechanisms and variable clinical responses to treatment. Furthermore, poorly controlled preoperative pain is a risk factor for developing chronic pain. Evidence suggests that epidural analgesia and peripheral nerve blockade may decrease the severity of residual limb pain and the prevalence of phantom pain after lower extremity amputation. We present the perioperative analgesic management of a patient with gangrene of the bilateral upper and lower extremities as a result of septic shock and prolonged vasopressor administration who underwent four-limb amputation in a single procedure. A multimodal analgesic regimen was utilized, including titration of preoperative opioid and neuropathic pain agents, perioperative intravenous, epidural and peripheral nerve catheter infusions, and postoperative oral medication titration. More than 8 months postoperatively, the patient has satisfactory pain control with no evidence for phantom limb pain. To our knowledge, there have been no publications to date concerning analgesic regimens in four-limb amputation.
Full Text Available Supernumerary tooth may closely resemble the teeth of the group to which it belongs, i.e. molars, premolars or anterior teeth, or it may bear little resemblancein size or shape to which it is associated. Many complications can be associated with supernumeraries, like impaction, delayed eruption or ectopic eruption of adjacent teeth, crowding, development of median diastema and eruption into floor of the nasal cavity. This may also cause the formation of follicular cysts with significant bone destruction. Early intervention to remove it is usually required to obtain reasonable alignment and occlusal relationship. This article will present the clinical management of an (i impacted supernumerary tooth impeding the eruption of maxillary central incisor and (ii erupted supernumerary tooth with midline diastema.
Full Text Available A 34 year old lady was found to be in acute pain due to metastatic phaeochromocytoma following involvement of L5 , S1 & S2 vertebrae. She was treated with series of MIBG scanning and ablation and surgical option was refused by the patient. She was suffering from rapidly increasing radicular pain of the lower limbs which was being managed with oral and injectable opioids. The team of doctors treating her decided to give epidural opioids and bupivacaine initi ally but the total dose of the drug and frequency was found to be gradually increased. Therefore , continous administration of intathecal opiods and bupivacaine was given but the same problem occured after a few weeks and pain relief was minimal. Ultimately intrathecal absolute alcohol was given as there were no more options left. The patient had dramatic pain relief till her death.
Lazarevic, Aleksandar; Prnjat, Ognjen
The Grid technology is evolving into a global, service-orientated architecture, a universal platform for delivering future high demand computational services. Strong adoption of the Grid and the utility computing concept is leading to an increasing number of Grid installations running a wide range of applications of different size and complexity. In this paper we address the problem of elivering deadline/economy based scheduling in a heterogeneous application environment using statistical properties of job historical executions and its associated meta-data. This approach is motivated by a study of six-month computational load generated by Grid applications in a multi-purpose Grid cluster serving a community of twenty e-Science projects. The observed job statistics, resource utilisation and user behaviour is discussed in the context of management approaches and models most suitable for supporting a probabilistic and autonomous scheduling architecture.
Baranauskaitė-Fedorova, Inga; Dvarionienė, Jolanta; Nikiforov, Vladimir A
Investigation on the sources, discharges and related risks for the environment of the pharmaceutical substance (PhS) diclofenac (DCF) was performed in Lithuania, a country of the Baltic Sea region, for the first time. The investigation only refers to DCF as a PhS for human use; emissions from animal husbandry were not considered. In the first stage of the research, the main sources and pathways of DCF via substance flow analysis were identified within the country. During the second stage, DCF flows along the wastewater treatment plants (WWTPs) in two different cities were measured in order to assess the current levels of pharmaceutical residues in the environment. Furthermore, environmental risk assessment was carried out by taking into account the parameters of consumption data and elimination rate in WWTPs. Then, the assessment of different technical and managerial removal approaches was accomplished in an environmental management model of wastewater containing PhS, based on the framework of environmental systems theory.
Sawalha, Ihab H; Anchor, John R
Despite their considerable growth in last few decades, emerging markets (EM) face numerous risks that have the potential to slow down or obstruct their development. Three main issues are discussed in this paper: first, the risks facing organisations operating in emerging markets and Jordan in particular; secondly, the role of business continuity management (BCM) in emerging markets; and thirdly, potential factors that underpin the role of BCM in emerging markets. These issues are significant, as they represent the role of BCM in highly dynamic and fast changing business environments. The paper provides a discussion of the significance of BCM in reducing or preventing risks facing organisations operating in emerging markets, especially those in Jordan.
Full Text Available Glanzmann's thrombasthenia (GT is a rare, genetically inherited platelet disorder in which the platelet glycoprotein IIb/IIIa (GP IIb/IIIa complex is either deficient or, dysfunctional. The incidence is about 1 in 1,000,000. This case report deals with a 4 year-old girl diagnosed with GT presenting with dental caries and periapical lesions in the primary mandibular first molars. To provide the best care, an interdisciplinary approach was followed by a team consisting of pediatric dentists, pediatricians and anesthesiologists. Complete oral rehabilitation was planned under general anesthesia which included extractions, multiple esthetic restorations and space maintainers with the utmost care to prevent unwarranted bleeding.
Varkey, Indu; Rai, Kavita; Hegde, Amitha M; Vijaya, Mangalpady Shenoy; Oommen, Vinod Idicula
Glanzmann's thrombasthenia (GT) is a rare, genetically inherited platelet disorder in which the platelet glycoprotein IIb/IIIa (GP IIb/IIIa) complex is either deficient or, dysfunctional. The incidence is about 1 in 1,000,000. This case report deals with a 4 year-old girl diagnosed with GT presenting with dental caries and periapical lesions in the primary mandibular first molars. To provide the best care, an interdisciplinary approach was followed by a team consisting of pediatric dentists, pediatricians and anesthesiologists. Complete oral rehabilitation was planned under general anesthesia which included extractions, multiple esthetic restorations and space maintainers with the utmost care to prevent unwarranted bleeding.
Full Text Available Staphylococcal toxic shock syndrome (TSS is most frequently produced by TSS toxin-1 (TSST-1 and Staphylococcal enterotoxin B (SEB, and only rarely by enterotoxins A, C, D, E, and H. Various clinical pictures can occur depending on severity, patient age and immune status of the host. Severe forms, complicated by sepsis, are associated with a death rate of 50-60%. The case of a Caucasian female infant, aged seven weeks, hospitalized with a diffuse skin rash, characterized as allergodermia, who initially developed TSS with axillary intertrigo, is reported.
Full Text Available Ankylosis is a condition frequently associated with primary molars, wherein the ankylosed primary teeth remain in a fixed position, while the adjacent teeth continue to erupt, moving occlusally. In this case report, a five-year-old boy, who had a retained and submerged left lower second primary molar, was presented. Luxation of ankylosed primary molar was considered as a treatment approach. After four months, the tooth erupted to the occlusal level, and there was evidence of further development of a permanent successor in radiographic evaluation. After one year, tooth mobility, bone formation, and development of a permanent successor were in good condition.
relationship management is proposed – the concept of Customer Attractiveness. Customer Attractiveness is founded on the revised understanding of the supplier relationship management task and focuses on influencing suppliers by being an attractive customer, hereby motivating the necessary commitment to long......Companies are increasingly relying on suppliers when developing and manufacturing industrial products. Therefore the supplier relationships of the company need to be managed. This dissertation looks at existing theoretical approaches to supplier relationship management. By studying a number...... of supplier relationships of the company Danfoss Drives, an alternative understanding of the supplier relationship management task is proposed. The case study methodology forms the basis for the applied research design. The alternative understanding sees the management task as one of influencing suppliers...
The discipline of diversity management has reached high popularity in the private and public sectors of the Nordic countries. In spite of the common use, the term diversity management contains an embedded complexity and equivocality leaving it diverse in itself. Thereby the management of diverse...... human resources becomes a highly complex task imbedded in an ongoing debate on political, scientific and business oriented arguments. Based on this confusing blend of concepts, statements, claims, and arguments, organizations strive to build their strategy for diversity management. This paper set out...... to deconstruct the concept of diversity management and relate the findings to the common application of the term. In the process of analysis, two distinct approaches to or discourses within diversity management emerge in the rhetoric: 'the argument of social responsibility' and 'the business case argument...
Fitzner, Karen; Greenwood, Deborah; Payne, Hildegarde; Thomson, John; Vukovljak, Lana; McCulloch, Amber; Specker, James E
Diabetes affects 7.8% of Americans, nearly 24 million people, and costs $174 billion yearly. People with diabetes benefit from self-management; disease management (DM) programs are effective in managing populations with diabetes. Little has been published on the intersection of diabetes education and DM. Our hypothesis was that diabetes educators and their interventions integrate well with DM and effectively support providers' care delivery. A literature review was conducted for papers published within the past 3 years and identified using the search terms "diabetes educator" and "disease management." Those that primarily addressed community health workers or the primary care/community setting were excluded. Two case studies were conducted to augment the literature. Ten of 30 manuscripts identified in the literature review were applicable and indicate that techniques and interventions based on cognitive theories and behavioral change can be effective when coupled with diabetes DM. Better diabetes self-management through diabetes education encourages participation in DM programs and adherence to recommended care in programs offered by DM organizations or those that are provider based. Improved health outcomes and reduced cost can be achieved by blending diabetes education and DM. Diabetes educators are a critical part of the management team and, with their arsenal of goal setting and behavior change techniques, are an essential component for the success of diabetes DM programs. Additional research needs to be undertaken to identify effective ways to integrate diabetes educators and education into DM and to assess clinical, behavioral, and economic outcomes arising from such programs.
Somme, Dominique; Corvol, Aline; Couturier, Yves; Pimouguet, Clément; Moreau, Olivier; Perivier, Samuel; Balard, Frédéric; de Stampa, Matthieu
Case management is a relatively new career field in France. It was first introduced on an experimental basis in 2007-2008, and was then developedfollowing the National Alzheimer Plan and finally enshrined in legislation in 2012. This careerfield is based on a set of tasks widely described internationally: identifying the right level of intervention, standardized multidimensional assessment, planning all aid (care and social services), implementation of the plan, monitoring and reassessment and periodic reassessment of all needs in a continuous and long-term process. The specific, systematic and dedicated nature of these tasks to these tasks makes training essential. Regulations also stipulate that the professional must acquire additional training by a dedicated inter-university degree. This requirement is a French specificity The authors present the history of case management and training in France and analyze the various international training frameworks identified by an Internet search. Moreover, based on the opinions expressed by case managers at different times of the scientific assessment and a review ofseveral studies conducted by inter-university case management program students, this article highlights the specific training needs of case managers and how the proposed training can meet these needs.
Goh Bee See
Full Text Available Objective: This is a series of five cases of branchial anomalies which were diagnosed and treated in a span of six years in the Department of Otorhinolaryngology, Head & Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre (UKMMC. The main objective of this article is to highlight the use of endoscopic electrocautery in the management of branchial fistula. Case report: five cases were reported of the age group between 11 months old to 16 years who presented with an intermittent mucoid discharge from an external opening in the neck since birth and three cases were on the left side and the other two cases were bilateral fistula. Direct laryngoscopy under general anaesthesia was done as part of diagnostic and therapeutic management for the patients. Conclusion: Endoscopic electrocautery is a safe method and appears to be an effective alternative to open excision for branchial fistula.
Employers, who pay for much of the healthcare in this country, are not waiting for government to restructure the healthcare system. In this cover story, PROFILES examines how two firms formed their own managed care networks to control healthcare cost and quality, and what hospitals did to become players. By understanding the employer' point of view, hospital marketers can better anticipate their needs and develop a marketing strategy to form closer relationships with employers, provide quality care at a lower cost, and increase their market share.
Song, X; Ravesteijn, W; Frostell, B; Wennersten, R
The emerging water crisis in China shows that the current institutional frameworks and policies with regard to water resources management are incapable of achieving an effective and satisfactory situation that includes Integrated River Basin Management (IRBM). This paper analyses this framework and related policies, examines their deficiencies in relation to all water stress problems and explores alternatives focusing on river basins. Water resources management reforms in modern China are reviewed and the main problems involved in transforming the current river management system into an IRBM-based system are analysed. The Huai River basin is used as an example of current river basin management, with quantitative data serving to show the scale and scope of the problems in the country as a whole. The institutional reforms required are discussed and a conceptual institutional framework is proposed to facilitate the implementation of IRBM in China. In particular, the roles, power and responsibilities of River Basin Commissions (RBCs) should be legally strengthened; the functions of supervising, decision-making and execution should be separated; and cross-sectoral legislation, institutional coordination and public participation at all levels should be promoted.
Lim, K I; Dy, C; Pugash, D; Williams, K P
Monoamniotic twin pregnancy discordant for anencephaly (MATDA) is a rare occurrence with only seven prior reported cases. Selective termination has been advocated in managing discordant monoamniotic twins. We report two cases managed expectantly with good outcomes and review other previously reported cases. The first case was a primigravid woman diagnosed with MATDA at 18 weeks. She was managed expectantly until 32 + 5 weeks when a Cesarean section was performed for preterm labor. The surviving female infant weighed 1610 g. The second case was a multigravid woman who was diagnosed with MATDA at 17 + 5 weeks and was managed as an outpatient. An emergency Cesarean section was performed at 31 weeks for non-reassuring monitoring and the surviving male infant weighed 1790 g. In both cases, the survivors were discharged home in good condition. A review of these two cases and those in the literature suggests that expectant management should be considered among management options for this rare condition.
Full Text Available This case presents a crisis in an organization after the news of a nationwide political scandal involving the institution broke. It presents the organization's scenario of growth and prosperity before the crisis and its goals for the future. It also describes how the institution was affected by the corruption scheme and its reflections on the organization's business. It reveals the measures taken to reverse the situation that threatened its image and reputation, including reviewed strategic planning and the need to restructure the company. Finally, it encourages the reader to evaluate the measures taken by the organization and propose alternatives, as well as reflecting on the steps to resume growth in the context that this type of political involvement is dealt with in Brazil.
Full Text Available Children are uniquely susceptible to cranio facial trauma because of their greater cranial mass to body ratio. Below the age of 5, the incidence of pediatric facial fractures in relation to the total is very low ranging from 0.6-1.2%. Maxillo-facial injuries may be quite dramatic causing parents to panic and the child to cry uncontrollably with blood, tooth and soft tissue debris in the mouth. The facial disfigurement caused by trauma can have a deep psychological impact on the tender minds of young children and their parents. This case report documents the trauma and follow up care of a 4-year-old patient with maxillofacial injuries.
Full Text Available When a patient receiving new oral anticoagulants (NOACs requires an invasive procedure, the consequences of bleeding if anticoagulation is continued and the risk of thrombosis if it is omitted need to be carefully considered. In addition to the bleeding risk of the procedure, it is of paramount importance to evaluate the renal function, especially for dabigatran that is eliminated predominantly via the renal pathway. NOAC therapy should be stopped for at least 24 h before the intervention, and a longer interruption should be considered in cases of high bleeding risk procedures and/or renal failure. A base-line assessment of coagulation should be performed and intervention should be postponed (if possible if high levels of anticoagulation parameters are found. In the post-surgical period, if oral anticoagulant therapy cannot be re-started, patients should temporarily receive low molecular weight heparins and re-start NOACs as soon as possible.
Full Text Available Pain due to cancer is one of the most distressing symptoms experienced by the patients at some or the other time during the course of treatment or disease progression. The multidimensional nature of cancer pain is characterized by various dimensions including physical, social, psychological, and spiritual; which together constitute the term "total pain". Young cancer patients illustrate their unique psychological and developmental needs. This case report highlights the concept of "total cancer pain" in a young adult and demonstrates his distinctive social, spiritual, and psychological sufferings. The report emphasizes that addressing all these concerns is considerably significant in order to provide optimal pain relief to the patient. In the present scenario, it has been done by a skillful multiprofessional team communicating effectively with both the patient and the carer.
Varkey, Indu; Rai, Kavita; Hegde, Amitha M.; Vijaya, Mangalpady Shenoy; Oommen, Vinod Idicula
Glanzmann’s thrombasthenia (GT) is a rare, genetically inherited platelet disorder in which the platelet glycoprotein IIb/IIIa (GP IIb/IIIa) complex is either deficient or, dysfunctional. The incidence is about 1 in 1,000,000. This case report deals with a 4 year-old girl diagnosed with GT presenting with dental caries and periapical lesions in the primary mandibular first molars. To provide the best care, an interdisciplinary approach was followed by a team consisting of pediatric dentists, pediatricians and anesthesiologists. Complete oral rehabilitation was planned under general anesthesia which included extractions, multiple esthetic restorations and space maintainers with the utmost care to prevent unwarranted bleeding. PMID:24910701
Singh, Virendra; Verma, Ajay; Attresh, Gyanander; Batra, Jitender
Condylar hyperplasia of the mandible is a clinical condition of over-development and growth because of excessive cellular growth of one condylar part of the mandible leading to facial asymmetry, mandibular deviation and enlargement of condyle. The elongation of the condylar neck in turn leads to malocclusion and articular dysfunction. In the past the interceptive and corrective procedures of growth and deformity in condylar hyperplasia were either condylectomy or high condylotomy. However, the deformity ceases after growth is completed. Therefore, other surgical procedures have to be undertaken to correct the manifested deformity of condylar hyperplasia. Further it has to be stressed that no single procedure can completely correct the deformity. So in addition to condylectomy, other orthognathic surgical procedures both on body and ramus and also on maxilla can be undertaken to correct the canting of occlusion. Two rare cases of unilateral hyperplasia encountered in our hospital are presented which required different lines of treatment.
Satyarthee Guru Dutta
Full Text Available Combined fracture involving atlas together associated with axis (CAAF accounts for approximately 3 % of traumatic cervical spine injury, CAAF are rarely reported, so modalities of management and outcome are not well understood, due to paucity of literature and only few reports reported in the form of isolated case report. CAFF management possess challenge as it is associated with high incidence non-union with previously conservative method. However, missed diagnosis and subsequent delay may be associated with catastrophic worsening in neurological deficit. So early diagnosis and management remains the key for successful neurological outcome. Such fractures are rare. Authors report five such cases of CAFF, all required surgical management with good outcome with no mortality. Current study, all cases were males (n=5, commonest mode of injury was fall (n=3, time interval since injury was within 24 hours in (n=4, however rest one presented after a gap of eight months. Commonest clinical feature was neck pain (n=3, neurological deficit (n=2, neck tenderness and swelling tenderness (n=3 Neuroimaging including X-ray, CT scan and MRI were carried out for all cases revealed fracture of arches of atlas (n=5, one case had multiple site fracture of both arches, odontoid fracture (n=2, lateral mass of atlas fracture in 1 cases. Astonishingly two cases had disruption of transverse ligament. Surgical procedures performed considering economic consideration included occipito-cervcial fusion (n=3, transarticular C1-C2 fusion and anterior odontoid screw fixation in one cases each. Management options in CAFF and review of literature discussed in present study.
Nicoleta- Luminiţa STRÂMBEANU RISTEA
Full Text Available The paper aimed to present the benefits of implementing HACCP (Hazard Analysis and Critical Control Points to company S.C. "DOBRE AND SONS" S.R.L. Constanta, Romania. The data have been provided by the above mentioned manufacturer. The objectives of S.C. "DOBRE AND SONS" S.R.L. are protecting the health of the consumers of the products and their satisfaction regarding the consumption of products that are nutritional, tasty, fresh, free from microbiological, chemical and physical hazard, as well as possessing stable properties during the validity for consumption. In this respect, there has been implemented and maintained an integrated management system of food quality and safety according to SR EN ISO 9001:2008, SR EN ISO 22000:2005 and according to IFS standard, version 5/2007, which consists of determining the potential biological, chemical and physical hazards that might affect the safety of bread and bakery products, or the health of the consumer. HACCP team is analyzing hazard using one of the recommended techniques: brainstorming or the cause - effect diagram. In conclusion, the company S.C. "DOBRE AND SONS" S.R.L. Constanta, Romania provides awareness and employee involvement at all levels in achieving the appointed objectives.
Ramón Garrote Jurado
Full Text Available In this article the use of Learning Management Systems (LMS at the School of Engineering, University of Borås, in the year 2004 and the academic year 2009-2010 is investigated. The tools in the LMS were classified into four groups (tools for distribution, tools for communication, tools for interaction and tools for course administration and the pattern of use was analyzed. The preliminary interpretation of the results was discussed with a group of teachers from the School of Engineering with long experience of using LMS. High expectations about LMS as a tool to facilitate flexible education, student centered methods and the creation of an effective learning environment is abundant in the literature. This study, however, shows that in most of the surveyed courses the available LMS is predominantly used to distribute documents to students. The authors argue that a more elaborate use of LMS and a transformation of pedagogical practices towards social constructivist, learner centered procedures should be treated as an integrated process of professional development.
Călin Emilian HINȚEA
Full Text Available Strategic planning is an excellent tool that local governments can (and should use in order to deal effi ciently with change, which means that planning is an important aspect of public sector reform, arguably one of the defi ning elements of the public policy landscape for the past three decades (Pollitt and Bouckaert, 2011. Our main objective with this research is twofold: to analyze why and how local public administration uses strategic planning as a managerial tool for managing change (reform, and to identify whether the planning efforts display a specifi c reform pattern. We employed a quantitative methodology – online survey – to collect data on the strategic planning process at the local level in Romania, with a specifi c framework for the strategic profi le (Hinţea, 2015 and another three dimension model – NPM, NWS, NPG1 – for the reform component (Pollitt and Bouckaert, 2011. Our analysis indicates that over 70% of strategic planning efforts are done because it is a mandatory condition for accessing EU funds. Major issues concern implementation, monitoring and evaluation with only around a third of organizations having a formal body responsible for this. Although the process has mixed characteristics, NWS type elements are more common/preferred, while NPM seem least common/preferred by local authorities
Full Text Available The elderly, in whom atrial fibrillation is most prevalent, carry the greatest risk, undergoing more recurrent, deadlier strokes, with bigger deficits, slower recoveries, and more comorbidities. Age-related cerebral changes might undermine the benefit of established stroke treatments. Nevertheless, the elderly should probably also undergo thrombolysis for ischemic stroke: they do not bleed more, and die not because of hemorrhage but of concomitant illnesses. Beyond natural bleeding risks, atrial fibrillation in advanced age has a high embolic potential if not anticoagulated. Standard or lower intensity warfarin anticoagulation prevents embolic stroke in the elderly with a hemorrhage risk even lower than aspirin. Excess anticoagulation hazards are prevented with lower starting doses, stricter corrections, more frequent INR monitoring. Direct thrombin inhibitors have recently shown a benefit similar to warfarin with fewer hemorrhages. Antihypertensives probably help 80-plus stroke patients as well, but the risk/benefit of lowering blood pressure in secondary stroke prevention at that age is uncertain. In summary, emerging data suggest that stroke management should be specifically targeted to the elderly.
Full Text Available Problem statement: Predicting customer's future orders has an essential role in planning appropriate strategy in a Supply Chain Management (SCM implementation. Purpose of this study is to identify how predicting future orders can facilitate managing activities across companies. Approach: A case study conducted in four Iranian automotive organisations to understand the actual results of order prediction in managing organisational processes. Results: Results of case study highlighted that more than 86% of activities completed before actual orders were received in these organisations. Conclusion: The findings show the high level of order management in these organisations which are the results of accessing to the right and timely information. This study would give invaluable information to all researchers who investigate the impact of order prediction in fulfilling organisational activities.
Full Text Available Sustainable resources management requires a major transformation of existing resource governance and management systems. These have evolved over a long time under an unsustainable management paradigm, e.g., the transformation from the traditionally prevailing technocratic flood protection toward the holistic integrated flood management approach. We analyzed such transformative changes using three case studies in Europe with a long history of severe flooding: the Hungarian Tisza and the German and Dutch Rhine. A framework based on societal learning and on an evolutionary understanding of societal change was applied to identify drivers and barriers for change. Results confirmed the importance of informal learning and actor networks and their connection to formal policy processes. Enhancing a society's capacity to adapt is a long-term process that evolves over decades, and in this case, was punctuated by disastrous flood events that promoted windows of opportunity for change.
From time to time in my responsibilities as a medical social worker, I become involved with a "complicated" case. Translation: a case was referred to the social worker to intervene and "fix" the problem because no one else knew what to do with the client or the issues surrounding the client. Necessity is the mother of invention, so when all else failed, that was my cue to be creative.
María Victoria Flores Trujillo
Full Text Available An efficient management of education in the 21st century requires that educational institutions not only promote the use of Information and Communication Technologies (ICT, but also manage strategic changes in the organization that facilitate the adaptation of this to the educational demands of the century XXI. In this context, this article tries to formulate, from the findings of a fieldwork, some considerations of educational management for the integration of policies in favor of the use of ICT in the Simón Bolívar University. As theoretical references is taken into account the model TPACK, formulated by XXX and the "connectivist" system formulated by Siemens, which gives account of a "new way of learning" with the use of technologies. From a holistic point of view, it takes into account the study by competences in the curricula.
Presidential Helicopter Acquisition: Program Established Knowledge -Based Business Case and Entered System Development with Plans for Managing Challenges...Presidential Helicopter Acquisition: Program Established Knowledge -Based Business Case and Entered System Development with Plans for Managing...progress by establishing a knowledge - based business case for entry into system development that included an approved cost, schedule and performance
Purpose: The purpose of this paper is to discuss the role of principals in light of public management reforms taking place in the German educational system and in reference to the empirical patterns uncovered by the papers contained in the Special Issue. Policy makers have created new expectations and new technologies that seem to suggest to…
De Mari, G
Displays the results of a handful of graduates of the postgraduate Master of IT Management at TU Delft. This title presents summaries of eight these written between 2003 and 2008, selected to provide a picture of a range of graduation projects
Sonal S Khatavkar
Full Text Available Hereditary spherocytosis (HS is a familial hemolytic disorder with marked heterogeneity of clinical features ranging from asymptomatic condition to a fulminant hemolytic anemia. HS is characterized by the strong family history of anemia, jaundice, splenomegaly and cholelithiasis. Anesthetic Management of HS with liver dysfunction is very challenging since most of the anesthetic drugs are metabolized by the liver. Hereby, we report anesthetic management in a case of HS with splenomegaly and gall stones for elective splenectomy and cholecystectomy.
Jackson Gomes Soares Souza; Carlos Hideo Arima; Renata Maria Nogueira de Oliveira; Getulio Akabane; Napoleão Verardi Galegale
Public institutions bound to the Brazilian federal public sector must apply security measures, policies, procedures and guidelines as information assets protection measures. This case study sought to determine whether the management of information security risks is applied in a federal public institution according to Information Technology (I.T.) managers perceptions and the results expose the importance of the roles played by people, responsibilities, policies, standards, procedures and thei...
This thesis examines the possibility of implementing sustainable wetland management in Tanzania through the examination of policies, legislation, and the institutional aspects of natural resource management. Malagarasi-Muyovosi Ramsar Site (MMRS) which is one of the most important wetlands in Tanzania is a case study for this investigation. This Ramsar site faces many challenges, which keeps its resources under pressure of degradation. Also thousands of communities depend upon these wetlands ...
Full Text Available We report a 25-year-old systemically healthy male who presented with periocular necrotizing fasciitis (NF in the left eyelid. This was associated with the presence of immunologically mediated marginal kerato-conjunctivitis, in the same eye. This potentially dangerous lid infection and the associated ocular surface infection resolved successfully, with medical management. We report this case to highlight the successful conservative management of periocular NF and the hitherto unreported anterior segment involvement.
What barriers obstruct the success of knowledge management programs? This paper has integrated studies on the barriers to knowledge management (KM) into a theoretical framework. Based on this framework, five cases documenting failed KM initiatives were analysed. The analysis gives a clear picture about why certain KM projects fail. The high failure rate of KM can be explained by the supply-IT based approach many organisations adopt when it comes to their KM programs. To increase the success r...
Thomas, Paul; Stoddart, Gilly; Nota, Johnny; Teh, Ling; Wells, Victoria; Dhillon, Gouri; Leese, Yvonne
Background Poor communication between community matrons (CMs), in-hours and out-of-hours (OoH) general practitioners (GPs) causes uncertainty and inefficiencies. Setting A practice-based commissioning group in West London and the associated CMs who case manage high users of hospital services. Question What helps good communication between CMs, GPs and OoH services to ensure that the right patients are case managed and hospital admissions are avoided? Methods Whole system participatory action research, with four stages: 1) identify communication problems as perceived by a wide range of stakeholders; 2) draw a diagram of the existing communication system, and with stakeholders redraw this to overcome its weaknesses; 3) pilot the changes proposed; 4) gain consensus among stakeholders about policy. Results Stakeholders agreed that standards should be adopted to improve communication for the care of patients who are case managed by CMs. Routine passage of information between GP, CMs and the OoH services would achieve this, and is feasible. Specifically: routine information (termed Special Patient Notes) should be sent to the OoH service about vulnerable patients, including those who are case managed by CMsclear information about CM attachment to general practices and how to refer to them should be easily accessibleGPs and CMs should meet quarterly for mutual learning and to discuss patientsthe OoH service electronically should cascade information to GPs, CMs and others named in the Special Patient Notescommissioners should routinely gather data to compare clusters of general practices for i) referrals to CMs, ii) posting Special Patient Notes, iii) unscheduled consultations and hospital admissions of all patients including those being case managed. Discussion This project revealed system-wide communication problems for the care of patients being case managed by CMs, and ways to overcome these. Commissioners could insist that these are adopted locally, and gather data to
Mohamed A. El-Naggari
Full Text Available Cystinosis is a rare metabolic disorder characterised by lysosomal cystine accumulation leading to multi-organ damage; clinically, the kidneys are the first organ affected. Respiratory insufficiency caused by overall respiratory muscle myopathy is a life-threatening complication. Treatment with cysteamine should be initiated rapidly and continued lifelong to prolong renal function and protect the extra-renal organs. We report the case of a four-year-old Omani girl, diagnosed with infantile nephropathic cystinosis at 21 months. Cysteamine was prescribed but with no compliance to medications. She presented to the Child Health Department of Sultan Qaboos University Hospital, Oman, two years later with severe failure to thrive, electrolyte disturbance and respiratory failure. The hypoventilation and early respiratory dysfunction, due to intercostal and diaphragm myopathy, was treated by non-invasive positive-pressure ventilation. The patient was discharged after four months of intensive rehabilitation with no ventilator support. No standard treatment options have yet been established for respiratory dysfunction in cystinosis.
Full Text Available Although hemangiomas are common in infancy and childhood, they are probably developmental abnormalities rather than true neoplasms. In present case we have treated a child aged 10 years with haemangioma of the right side of the Neck. After thorough investigation we posted this for intralesional infiltration of Sclerosing agent (Inj. Polidocanol 3% in 1:3 dilution with normal saline. Approximately 2 ml Inj. Polidocanol diluted with saline was injected into the lesion. And the same procedure was repeated in three sittings after one week interval. The size and vascularity was reduced dramatically after single procedure. Patient was followed up after one and two months interval. There was no sign of any recurrence. This Procedure was chosen as it is cosmetically more acceptable, can be used for the haemangiomas at inaccessible areas where surgery is difficult, day care procedure and cost effective. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-1, 56-59 DOI: http://dx.doi.org/10.3126/jcmsn.v8i1.6828
The prevalence of genital piercing among women is increasing. As the popularity increases, the number of complications from infection, injury, and retained jewelry is likely to rise. Techniques to remove embedded jewelry are not well described in the literature. The purpose of this report was to describe a case of a patient with a retained clitoral glans piercing, discuss a simple technique for outpatient removal, and review current evidence regarding associated risks of clitoral piercings. A 24-year-old female presented to the emergency department with an embedded clitoral glans piercing. Local anesthetic was injected into the periclitoral skin and a small superficial vertical incision was made to remove the ball of the retained barbell safely. In conclusion, among patients with retained genital piercing, outpatient removal of embedded jewelry is feasible. While the practice of female genital piercing is not regulated, piercing of the glans of the clitoris is associated with increased injury to the nerves and blood supply of the clitoris structures leading to future fibrosis and diminished function compared to piercing of the clitoral hood. PMID:28299217
Full Text Available BACKGROUND : Symmastia is defined as medial confluence of the breast. The term 'symmastia' is modified from Greek (sym meaning 'together', and mastos meaning 'breast' and was first presented by Spence et al. in 1983. Two forms of symmastia exist: congenital and acquir ed form. Congenital symmastia is a rare condition in which web - like soft tissue traverses the sternum to connect the breasts medially. There is few publication of this condition. Treatment options for this condition are also few. MATERIAL AND METHOD : Thoug h Periareolar approach, and vertical reduction mammoplasty has been described as a method to reduce the size of the breast as well as correct symmastia . We used z plasty in our case because the patient was not willing for reduction of the size of the breas t. RESULT : The patient had well defined midline groove, symmetric breast on each side. CONCLUSION : Z plasty can be an innovative method for creation of midline groove in congenital symmastia in patients of low socioeconomic status as an alternative to redu ction mammoplasty and liposuction
Lucas A.B.D Oliveira
Full Text Available Problem statement: The Higher Education Institutions (IHL have intensified process of introducing undergraduate and graduate courses to more remote regions, which expanded the scope of what these institutions and allowed the formation of population of these regions. This expansion (whether by on-campus or distance learning presents new challenges for university management and integration of the players involved in this process. The purpose of this article was to demonstrate importance of information systems for university management and integration, focusing on decentralization and expansion of IHsL. Approach: The investigation was descriptive and the article is practical in nature. A case study was conducted at the Federal University of Rio Grande do Norte (Brazil. The research proposal of article was to answer the following question: How does an information system contribute to managing university expansion? Results: Results showed the relevance of integrated management systems, given university expansion and broadened horizons observed in recent years. The system analyzed proved to be extremely efficient, since practically all university activities can be monitored and evaluated. Conclusion: It was concluded that using integrated management systems during higher learning expansion maximizes this process, resulting in credible and rapid procedures that are more efficient and more effective.
Hefny, Ashraf F; Saadeldin, Yousif A; Abu-Zidan, Fikri M
Ascaris lumbricoides is the largest and most prevalent of the human helminths. Ascariasis causes a unique type of intestinal obstruction with specific problems, having high morbidity and mortality. There is no management algorithm available in the literature to treat such cases. We aimed in this study to develop an algorithm for the management of intestinal obstruction due to ascariasis. A medline search of the English literature on the management of intestinal obstruction due to ascariasis was performed. Management of one of our patients with intestinal obstruction due to ascariasis is presented herein as an example of such cases. Intestinal obstruction due to ascariasis is a serious disease with a high morbidity and mortality, especially postoperatively. A management algorithm for the treatment was developed. The management of intestinal obstruction due to ascariasis was challenging and required difficult decisions. We think that this algorithm will be of great assistance in facilitating a rapid and successful treatment. This algorithm may prove to be of a great value for physicians treating such cases.
Prerana N Shah
Full Text Available Successful anaesthetic management for caesarean section in a case with previous pituitary tumour resection, with residual tumour, is reported. The pituitary gland undergoes global hyperplasia during pregnancy. Functional pituitary tumours may exhibit symptomatic enlargement during pregnancy. Growth hormone secreting tumour is associated with acromegaly which has associated anaesthetic implications of difficult airway, systemic hypertension, and diabetes and electrolyte imbalance. Intracranial space occupying lesions can increase intra cranial pressure and compromise cerebral perfusion or cause herniation. We report management of this case.
Lafferty, C L
This article asserts that in light of changing conditions in the healthcare environment, transformational leadership is the most appropriate leadership style for the hospice registered nurse case manager. The author defines transformational leadership and, tracing from early leadership theories, demonstrates how the transformational-transactional leadership paradigm emerged from preceding leadership theories. The components of transformational leadership--transformational behavior and transformational characteristics--are linked to hospice theory and hospice-specific nursing practices. The expanding role of the hospice R.N. case manager is addressed in light of transformational leadership and culture building. Specific actions are proposed in the arenas of research, education, and community, corporate, and legislative involvement.
Full Text Available High output ileostomies are important complications of stoma formation following bowel surgery. Adequate management of such stomas might prevent severe morbidity and mortality when this potentially fatal complication develops. In this case report, we describe a female patient with a recent ileostomy formation following panproctocolectomy for ulcerative colitis who presented with progressively increasing shortness of breath. The patient was found to have a hypochloraemic metabolic acidosis on arterial blood gases. She rapidly improved with adequate sodium and fluid replacement and with the use of a course of proton pump inhibitors. This case highlights the importance of recognising high output ileostomies early and important management issues in their regard.
Utkucan, Ece; Lobach, Matthew; Larson, Wyeth
This thesis explores how to apply an approach of strategic sustainable development to e-waste management through a case study at the National University of Rwanda (NUR). Interviews and surveys were conducted, and workshops and presentations were hosted during a site visit to NUR. No e-waste management system is in place in Rwanda, while the country is working to increase ICT capacity. At NUR, awareness of e-waste challenges is low, and management currently consists of storage and limited low-...
Full Text Available People with depressive illness often have symptoms of overt or suppressed anger. Those with anger traits face exaggerated problem during symptomatic period of depression. Pharmacological management helps in control of depressive and anxiety symptoms, but rarely address anger symptoms. Non-pharmacological management like cognitive-behavioral therapy (CBT is effective in depression as well as in anger management, but is not used frequently in anger associated or exacerbated by depression. We present the case of a 27-year-old male suffering from moderate depressive episode with associated anger outburst. He underwent CBT, which resulted in a significant decrease in anger symptoms as well as in severity of depression.
Hacı Ahmet Yolasığmaz
Full Text Available Forest management plans were firstly prepared and implemented in Turkey between 1963 and 1973. All forests in Turkey have been managed with timber oriented forest management philosophy; however, there have been some developments about inventory and silviculture techniques for approximately 40 years. Last decade, Turkey participated in Convention of Biological Diversity in Rio (1992 and included in both Pan – European and Near East Region Conventions. Nowadays, Turkish forest management philosophy has changed from timber management to ecosystem-based multiple-use forest planning with the principles of “sustainable forest management” criteria and indicators drafted in a few national and international agreements. Thus, Turkish forestry is underway in a restructuring process. This paper presents evolution of the traditional forest management philosophy in Turkey since 1963. This study was carried out in Artvin Planning Unit. Past two decade planning periods (managed under timber management approach was compared with current case study data used for forest multiple use management approach based on ecosystem in terms of distribution of age class, site class and change of volume and increment. In conclusion, former applications and techniques for adaptation of improvement must be analyzed and interpreted properly. Monetary resources and experts as well as legal, technique and scientific framework must be provided.
Collins, Ross D; de Neufville, Richard; Claro, João; Oliveira, Tiago; Pacheco, Abílio P
Forest fires are a serious management challenge in many regions, complicating the appropriate allocation to suppression and prevention efforts. Using a System Dynamics (SD) model, this paper explores how interactions between physical and political systems in forest fire management impact the effectiveness of different allocations. A core issue is that apparently sound management can have unintended consequences. An instinctive management response to periods of worsening fire severity is to increase fire suppression capacity, an approach with immediate appeal as it directly treats the symptom of devastating fires and appeases the public. However, the SD analysis indicates that a policy emphasizing suppression can degrade the long-run effectiveness of forest fire management. By crowding out efforts to preventative fuel removal, it exacerbates fuel loads and leads to greater fires, which further balloon suppression budgets. The business management literature refers to this problem as the firefighting trap, wherein focus on fixing problems diverts attention from preventing them, and thus leads to inferior outcomes. The paper illustrates these phenomena through a case study of Portugal, showing that a balanced approach to suppression and prevention efforts can mitigate the self-reinforcing consequences of this trap, and better manage long-term fire damages. These insights can help policymakers and fire managers better appreciate the interconnected systems in which their authorities reside and the dynamics that may undermine seemingly rational management decisions.
Marcela Camacho Montoya
Full Text Available The theories of human development from human capabilities have, as theoretical references, the competencies of affiliation, achievement and power, as well as the analysis of business management. This article aims to compare experiences of productive systems of social interest from an analysis of the particular cases of the Furmos and Corpoc companies. The starting point was a previous project conducted in Corpoc; information was gathered through interviews and work sessions, and the institutions were characterized. It was found that the Corpoc management model is flat associative with a single leader and the Furmos model is a strategic associative partnership management model. Their members depend on the leader with their motivations and achievements, and their projects do not have a management model. Therefore, the lack of a suitable formulation of management models prevents the continuity and success of social production projects in the two institutions.
Ali Zangi Abadi
Full Text Available These days, there are several reports indicating on reduction on renewable resources. On the other hand, there is an increase on the population, which increases production of garbage in the world. With limitation on governmental budget, there is growing concern on having efficient strategic planning for waste management. The proposed study of this paper performs a SWOT analysis to find all strength, weakness, opportunities as well as possible threats associated with waste management organization located in city of Shiraz, located in south west of Iran. Based on the results, appropriated locating strategies for burying garbage, training and increasing awareness regarding production and collection, attracting foreign investment in the field of recycling garbage, reconsidering environmental rules and burying garbage and its separation standards are the most important strategies.
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. 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.
Full Text Available This case study discusses Environmental Management Accounting (EMA which are illustrated with the case example of Neumann Gruppe Vietnam Ltd., a medium-sized coffee refining and exporting enterprise in Southern Vietnam. It examines the relevance of environment-related supply chain information for corporate environmental and financial decision making and reveals possibilities for improving eco-efficiency at the site level and for its supply chain.
Full Text Available The aim of this paper is to present a case study regarding the information technologies impact in decision making process on the management of some Romanian companies. The main parameters which can define the IT impact were established. The results of investigation and the most important correlations between the monitored parameters are also presented. At the end of the paper there are the conclusions on the impact of information technologies obtained from the case study.
Full Text Available In Case Management are identified the characteristics that involve elderly and their families by providing adequate planning to meet their needs. Case studies of three subjects were prepared containing relevant information to the preparation of action plans that have been divided into categories. The actions aim to promote quality of life of the aged, as well as of their families and caregivers. The work highlighted the possibility and need of insertion of the method to the Gerontologist performance.
Full Text Available Management of orthodontic cases often requires extraction of permanent teeth. The decision making regarding extractions depends upon the arch length tooth material discrepancies, the growth pattern, general profile, and arch asymmetries. Unique orthodontic problems may command special treatment lines to be taken. The present report describes a case with unilateral buccally blocked out canine and bilateral posterior crossbite, for which unilateral premolar extractions were performed achieve esthetic and functionally stable occlusion.
Gaur, Aditi; Maheshwari, Sandhya; Verma, Sanjeev Kumar; Mohd. Tariq
Management of orthodontic cases often requires extraction of permanent teeth. The decision making regarding extractions depends upon the arch length tooth material discrepancies, the growth pattern, general profile, and arch asymmetries. Unique orthodontic problems may command special treatment lines to be taken. The present report describes a case with unilateral buccally blocked out canine and bilateral posterior crossbite, for which unilateral premolar extractions were performed achieve esthetic and functionally stable occlusion. PMID:27041913
Gibeau, Joanne M.; Steinfeldt, Lois C; Stine, Mark J.; Tullis, Katherine V.; Lynch, H. Keith
The design of a computerized system for the management of data in multi-phase epidemiologic case-control studies is described. Typical study phases include case-control selection, abstracting of data from medical records, and interview of study subjects or next of kin. In consultation with project personnel, requirements for the system were established: integration of data from all study phases into one data base, accurate follow-up of subjects through the study, sophisticated data editing ca...
Sira, James; Uppal, Sandeep; Dezso, Atilla
We report the case of a deliberate application of cyanoacrylate adhesive (commonly called "superglue") to the nose of a 9-year-old boy during a fight. The glue was successfully removed under general anesthesia without causing trauma to the nasal mucosa. To the best of our knowledge, only 1 other case of cyanoacrylate injury to the nasal cavity has been published in the literature. We also provide an algorithm to guide clinicians in the future management of this unusual circumstance.
Full Text Available Abstract Background In Germany, case management in a palliative care unit was first implemented in 2005 at the Department of Palliative Medicine at the University Hospital Cologne. One of the purposes of this case management is to deal with enquiries from patients and their relatives as well as medical professionals. Using the Case Management Process Model of the Case Management Society of America as a reference, this study analysed (a how this case management was used by different enquiring groups and (b how patients were identified for case management and for palliative care services. The first thousand enquiries were analysed considering patient variables, properties of the enquiring persons and the content of the consultations. Results Most enquiries to the case management were made by telephone. The majority of requests regarded patients with oncological disease (84.3 %. The largest enquiring group was composed of patients and relatives (40.8 %, followed by internal professionals of the hospital (36.1 %. Most of the enquiring persons asked for a patient’s admission to the palliative care ward (46.4 %. The second most frequent request was for consultation and advice (30.9 %, followed by requests for the palliative home care service (13.3 %. Frequent reasons for actual admissions were the need for the treatment of pain, the presence of symptoms and the need for nursing care. More than half of the enquiries concerning admission to the palliative care ward were followed by an admission. Conclusions Case management has been made public among the relevant target groups. Case management as described by the Case Management Process Model helps to identify patients likely to benefit from case management and palliative care services. In addition, with the help of case management palliative patients may be allocated to particular health care services.
Full Text Available Genetic engineering (GE offers an expanding array of strategies for enhancing disease resistance of crop plants in sustainable ways, including the potential for reduced pesticide usage. Certain GE applications involve transgenesis, in some cases creating a metabolic pathway novel to the GE crop. In other cases, only cisgenessis is employed. In yet other cases, engineered genetic changes can be so minimal as to be indistinguishable from natural mutations. Thus, GE crops vary substantially and should be evaluated for risks, benefits, and social considerations on a case-by-case basis. Deployment of GE traits should be with an eye towards long-term sustainability; several options are discussed. Selected risks and concerns of GE are also considered, along with genome editing, a technology that greatly expands the capacity of molecular biologists to make more precise and targeted genetic edits. While GE is merely a suite of tools to supplement other breeding techniques, if wisely used, certain GE tools and applications can contribute to sustainability goals.
You, Emily Chuanmei; Dunt, David; Doyle, Colleen
This study aimed to explore the perceptions of case managers about their roles in providing community aged care in Australia. Purposeful sampling was used and 33 qualitative semi-structured interviews with 47 participants were conducted. Participants were drawn from a list of all case managers working in aged care organisations that provided publicly funded case-managed community aged care programmes in the State of Victoria, Australia. Participant selection criteria included age, gender, job titles, professional backgrounds, practice locations, organisational attributes and organisational size. Data collection was implemented between September 2012 and March 2013. Thematic analysis was performed. Participants believed that case managers performed diverse roles based on clients' needs. They also articulated 16 important roles of case managers, including advisors, advocates, carers, communicators, co-ordinators, educators, empowering clients, engaging clients and families, liaising with people, managing budgets, navigators, negotiators, networking with people, facilitators, problem solvers and supporters. However, they were concerned about brokers, mediators and counsellors in terms of the terminology or case managers' willingness to perform these roles. Moreover, they perceived that neither gatekeepers nor direct service provision was case managers' role. The findings of this study suggest that case managers working in community aged care sectors may be more effective if they practised the 16 roles aforementioned. With the value of helping rather than obstructing clients to access services, they may not act as gatekeepers. In addition, they may not provide services directly as opposed to their peers working in medical care settings. The findings will also assist organisations to design job descriptions specifying case managers' roles and associated job responsibilities. Clear job descriptions will further benefit the organisations in staff recruitment, orientation
Full Text Available A case of facial palsy with lagophthalmos with exposure keratitis was corrected surgically by a method of temporalis transfer. When the slings were tightened leaving 1 cm gap in the palpebral aperture, lagophthalmos persisted. A secondary tightening procedure causing overlap of the upper lid over the lower yielded good results.
Full Text Available Knowledge is recognised as being an important asset in organisations these days. Despite this, many organisations are not doing enough to effectively manage this important asset for its competitive advantage. In response to this, knowledge management which is defined as a process that effectively creates, captures, shares and uses organisation-wide knowledge to improve the organisation’s performance was conceived and has since gained widespread acceptance the world over. Despite its widespread acceptance, little is known about the current levels of knowledge management within the Malaysian context, in particular amongst the Multimedia Super Corridor (MSC status companies in Malaysia. Furthermore, the extent to which cultural factors impact upon knowledge management practice in these companies is not known. This study investigated the various cultural factors (collaboration, mutual trust, leadership and incentives/rewards using a multiple case study approach operating within a critical realism research paradigm and found that these factors have impact on the level of knowledge management practice. The study also established that cultural factors do play an important role in facilitating knowledge management practice in these MSC status companies in Malaysia. It was found that collaboration, mutual trust, leadership, kiasu-ism and incentives/rewards have significant impact on the level of knowledge management practice. In view of the findings of this study, it is suggested that the relevant authorities pay adequate attention on these cultural factors to ensure that the knowledge management initiatives undertaken by Malaysian companies are effectively deployed.
Doloriert, Clair; Whitworth, Kieran
Purpose: This study aims to explore knowledge management (KM) practice in the "back office" of two English football clubs. Design/methodology/approach: The paper takes the form of a comparative case study of two medium-sized businesses using multi-method data including unstructured interviews, structured questionnaires and document analysis. Data…
Kondrat, David C.; Early, Theresa J.
The working alliance between clients and helpers has been identified as a common factor of treatment effectiveness, yet very little research has explored variables associated with working alliance between mental health case managers and their consumers. This study explored the potential covariates of working alliance within community mental health…
Poythress, Norman G.; Dembo, Richard; DuDell, Gary; Wareham, Jennifer
In this issue we describe a clinical trials study of the impact of adding specific case manager overlay services to "treatment as usual" services for youths in a Juvenile Arbitration Program. In this first article we describe the experimental intervention, the Arbitration Intervention Worker (AIW) service, which was provided to a randomly selected…
Romero, Cristobal; Ventura, Sebastian; Garcia, Enrique
Educational data mining is an emerging discipline, concerned with developing methods for exploring the unique types of data that come from the educational context. This work is a survey of the specific application of data mining in learning management systems and a case study tutorial with the Moodle system. Our objective is to introduce it both…
LeCrom, Carrie; Rufer, Lisa; Slavich, Mark; Dwyer, Brendan; Greenhalgh, Gregory
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…
Cross, Lara E.; Morrison, William; Peterson, Patricia; Domene, Jose F.
This article examines how a rural Canadian secure custody facility for youth implemented positive psychology principles in its case management protocols and residential programming. A directed content analysis design was utilized to identify specific factors of positive psychology in the facility's policy and programming manual, as well as in…
Gensichen, J; Beyer, M; Muth, C; Gerlach, FM; Von Korff, M; Ormel, J
Background. Deficits in the care of depression lead to poor medication adherence, which increases the risk of an unfavourable outcome for this care. This review evaluates effects on symptoms and medication adherence of case management in primary health care. Method. A systematic literature search wa
Bazoukis, George; Papadatos, Stamatis S; Michelongona, Paschalia; Fragkou, Archodula; Yalouris, Athanasios
We describe a patient with elemental mercury aspiration and retention in the appendix after elemental mercury ingestion. Conservative management was proved to be successful for the removal of the mercury from the appendix while we do not suggest bronchoalveolar lavage in cases of small amount elemental mercury aspiration.
Giannikas, Christina Nicole
This study focuses on primary language education within a Greek region: specifically, on the positive effects of classroom management and organisation on a student-centred approach of teaching. In the case of the Greek education system, language teachers are encouraged to adopt student-centred approaches in their classroom but have not received…
For decades, policymakers and educators have focused on public school equity and adequacy, while paying little attention to efficiency. This qualitative single case study was designed to capture explicit information about Lean management, operations, and culture in a K-12 Michigan school district engaged in Lean training and implementation for a…
This article examines one specific organisational development tool in depth and uses a case study to investigate whether using the tool is more than a tick-box exercise and really can add value and help organisations to develop and improve. The People Management Self-Assessment Tool (SAT) is used to examine higher education institutions' (HEIs)…
Chen, M.C.; Ruijs, A.J.W.; Wesseler, J.H.H.
Municipalities of small islands have limited capacities for waste disposal. In the case of Green Island, Taiwan, continuing with business as usual would only allow the disposal of waste on the island for another 8 years. Three alternatives for solid waste management (SWM) are compared. The cost-effe
Requena, A; Velasco, J G; Pinilla, J; Gonzalez-Gonzalez, A
The coexistence of leukemia and pregnancy is extremely rare. This paper describes two cases of acute promyelocytic leukemia diagnosed during the second trimester of pregnancy and the most suitable approach to the management of this situation is analyzed. Possible teratogenic effects of mono- or polychemotherapy during pregnancy, depending upon the gestational age at which chemotherapy is given, are discussed.
Oeseburg, Barth; Wynia, Klaske; Middel, Berry; Reijneveld, Sijmen A.
Background: Financial constraints and quality requirements demand that interventions selected are most effective. A previous systematic review of the effectiveness of the patient advocacy case management model was not found. Objective: The objective of this study was to evaluate the effects of patie
Childress, Stacey, Ed.; Elmore, Richard F., Ed.; Grossman, Allen, Ed.; Johnson, Susan Moore, Ed.
"Managing School Districts for High Performance" brings together more than twenty case studies and other readings that offer a powerful and transformative approach to advancing and sustaining the work of school improvement. At the center of this work is the concept of organizational coherence: aligning organizational design, human…
Stoffers, J.; Mordant-Dols, A.
Professionals' willingness to change is a necessity for successful implementation of changes in the organisation. This study focused on the influence of a transformational leadership style on professionals' willingness to change. This multiple case study was performed in three project management org
Torpey, Michael John
This article is about conflict in an educational workplace setting. It reports on a case study investigating the emergence, development, and management of conflict among diverse native English speakers working as language instructors within a Japanese university. The example of conflict presented, which deals with divergent assumptions about the…
Alan F. Isles
Full Text Available We describe a case of bilateral inhalation and alveolarisation of barium in an infant following a barium swallow for investigation of dusky spells associated with feeds. A bronchoscopy subsequently revealed the presence of a mid-tracheal tracheo-oesophageal cleft. We review the literature on barium aspiration, its consequences and make recommendations for management.
O'Mahony, Kim; Garavan, Thomas N.
Purpose: This paper aims to report and analyse the lessons learned from a case study on the implementation of a quality management system within an IT Division in a higher education (HE) organisation. Design/methodology/approach: The paper is based on a review of the relevant literatures and the use of primary sources such as document analysis,…
Rachel M. Gorodetsky
Conclusion:This case adds to the limited pool of literature regarding dabigatran overdose and outcomes, and suggests that a patient with an overdose of this magnitude may be safely managed without acute intervention. Literature review suggests that aPTT might be an appropriate method for monitoring anticoagulant effects related to this drug in the clinical setting.
Eckartz, Silja Mareike
The business case (BC) is an artifact that is used to justify an investment in terms of its expected costs, benefits and risks. In the field of IT it is commonly used to justify an investment into an IT project in order to get the investment approval from upper management. Decision makers also may u
Andre, Pierre; And Others
Deals with conflicts associated with the management, disposal, and storage of hazardous wastes from the perspective of interests expressed in the local community. Analyzes three case studies to demonstrate the changing roles and relative importance of local and nonlocal interests. Draws conclusions regarding the significance of the analysis for…
Alt, Albert G.
This case study examined a multi-college community college district in northern California in a primarily rural area, to understand how their practices compared to management best practices designed to improve student success, barriers that may exist in implementing best practices, and how the institution may improve its own practices. The problem…
Wiepking, P.; Bekkers, R.H.F.P.
We study causes and consequences of financial management in households in the specific case of charitable giving. We test hypotheses using couples in the Giving in the Netherlands Panel Study (n = 1,101). We find that more relationship specific investments lead to deciding on charitable giving as on
Verdonck, A.; Bertrand, J.; Carels, C.E.L.; Swinnen, S.; Schoenaers, J.
This case report describes the combined orthodontic and orthognathic management of a 14-year-old girl affected with Apert syndrome. She presented with a severe Class III skeletal relationship, midfacial hypoplasia and an large anterior open bite. Intraorally, she had severe crowding, a narrow maxill
Sims, Laura; Sinclair, A. John
Based on an ongoing qualitative case study in Costa Rica, this article presents the participatory work that the Instituto Costarricense de Electricidad (ICE) is doing with farmers to protect watersheds from erosion and contamination. Specifically, it includes a description of ICE's Watershed Management Agricultural Programme and how farmers…
MacKenzie, Brian; Ojaveer, Henn; Eero, Margit
A recent historical marine ecological case study (cod in the eastern Baltic Sea) is used to show how long-term data and knowledge of fluctuations can contribute to revisions of fishery management policy. The case study first developed new longer analytical time series of spawner biomass and recru......A recent historical marine ecological case study (cod in the eastern Baltic Sea) is used to show how long-term data and knowledge of fluctuations can contribute to revisions of fishery management policy. The case study first developed new longer analytical time series of spawner biomass...... and recruitment back to the 1920s, which extended knowledge of population dynamics into a time period when ecosystem state was characterized by temporally varying combinations of exploitation, climate-hydrographic conditions, marine mammal predation and eutrophication. Recovery of spatially resolved historical...... catch data from the late 1500s to early 1600s also contributed new perspectives to cod population dynamics under alternative ecosystem forcings. These new perspectives have contributed, and will likely continue to contribute to new management policies (e.g., revision of fishery management reference...
Good, Mary Ellen
This paper presents strategies for the clinical nurse specialist (CNS) in the school setting to use in case management of migrant children with dental disease. Although dental disease is the major health problem of all school-age children in the nation, the problem is even more severe for children of migrant farmworkers. Leininger's transcultural…
Zoffness, Rachel; Garland, Ann; Brookman-Frazee, Lauren; Roesch, Scott
Youth with disruptive behavior problems (DBPs) represent the majority of youth served in usual care (UC) psychotherapy, and are at high risk for maladaptive outcomes. Little is known about UC psychotherapeutic strategies utilized with this population. Researchers and clinicians suggest that case management (CM) is a major activity occurring in…
Doloriert, Clair; Whitworth, Kieran
Purpose: This study aims to explore knowledge management (KM) practice in the "back office" of two English football clubs. Design/methodology/approach: The paper takes the form of a comparative case study of two medium-sized businesses using multi-method data including unstructured interviews, structured questionnaires and document…
... with people with developmental disabilities, refugees, and migrants to address their needs, strengths... to a Case Manager who will capture information about the individual's situation and then serve as his....email@example.com . FOR FURTHER INFORMATION CONTACT: CAPT Roberta P. Lavin, Director, Office of...
van den Brink, Rob H. S.; Troquete, Nadine A. C.; Beintema, Harry; Mulder, Tamara; van Os, Titus W. D. P.; Schoevers, Robert A.; Wiersma, Durk
Background: In outpatient forensic psychiatry, assessment of re-offending risk and treatment needs by case managers may be hampered by an incomplete view of client functioning. The client's appreciation of his own problem behaviour is not systematically used for these purposes. The current study tes
Bezyak, Jill L.; Chan, Fong; Lee, Eun-Jeong; Catalano, Denise; Chiu, Chung-Yi
The "Physical Activity Scale for Individuals With Physical Disabilities" was examined as a physical activity measure for people with severe mental illness. Case manager ratings were more closely related to body mass index than clients' ratings, challenging the accuracy of self-report physical activity measures for individuals with severe mental…
Chun, Hong; Gang, Yu; Xiaochun, Zhu; Jin, Tang; Bo, Xia; Limin, Wang; Cuifen, Lui
Evaluate the diagnosis and management of intradiaphragmatic extralobar pulmonary sequestration (IDEPS). We retrospectively reviewed cases of bronchopulmonary sequestrations (BPS) diagnosed in our hospital from March 2011 to May 2014, in order to identify patients with IDEPS. Diagnosis of IDEPS was confirmed using prenatal Doppler ultrasound, postnatal intravascular enhanced computed tomography, and surgery. The 11 cases diagnosed with IDEPSs were confirmed with histopathology. In our first case we did not find any mass from abdominal surgery; we then turned to transthoracic surgery. Three patients underwent thoracoscopy, and seven underwent thoracotomy. IDEPS is better approached through the chest. Thoracoscopy in experienced hands a favorable approach.
Zi Zeng; Ting Shuai; Li-Juan Yi; Yan Wang; Guo-Min Song
Background: Case management is a term used to describe the activities performed by a physician or other health care professional to ensure the coordination of medical services required by a patient. Managed care requires the incorporation of information pertaining to patient evaluation, treatment planning, referrals, and follow-up care to ensure that payment for services is received and that care is ongoing and comprehensive. The objective of this review was to assess the efficacy of case management in patients with type 2 diabetes mellitus with respect to outcomes such as glycosylated hemoglobin (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), and low-density lipoprotein (LDL). Methods: Databases including PubMed, Embase, Web of Science, the Cochrane Library, the China Na-tional Knowledge Infrastructure (CNKI), VIP, Wan Fang and the Chinese Biomedical Literature Database (CBM) were searched for randomized controlled trials (RCTs) dating as late as Jan, 2015. Reference sections of the included studies were also searched. Results: Twelve studies, involving 11 RCTs that evaluated a total of 4000 patients, were included in this analysis. Two of the 12 studies evaluated the same RCT. Seven of the 12 studies reported HbA1c as an outcome, and three trials reported changes in SBP, DBP and LDL levels as outcomes. The pooled results indicated that statistically significant improvements in HbA1c (MD ¼ ?0.35, 95% CI (?0.68, ?0.02), P ¼ 0.04) and LDL levels (MD ¼ ?2.49, 95%CI (?4.04, ?0.93), P ¼ 0.002) were associated with the case management group compared with control group;however, no statistically significant differences in DBP (MD ¼ ?0.08, 95%CI (?0.68, 0.52), P ¼ 0.8) and SBP (MD ¼ ?0.96, 95%CI (?5.77, 3.84), P ¼ 0.69) were observed. Conclusions: Case management was effective in improving HbA1c and LDL levels in patients with type 2 diabetes mellitus. Although no statistically significant differences in DBP and SBP between the case
JI Cun-liang; ZHANG Bing-xi; HU Gui-zhi
@@ Relapsing polychondritis (RP) is a rare disorder of unknown cause.It is characterized by recurrent inflammation of cartilage and connective tissue.Airway complications are the most serious manifestations.1,2 The anesthetic management of patients with RP is challenging.Airway management is of primary importance because of the potential for collapse of supporting airway structures with resulting inability to intubate and ventilate the patient) Although it tends to occur in middle age (＞40 years),it has been reported in younger individuals.Herein we report a case of anesthetic management of a child with RP for tracheotomy combined with insertion of T tube stent and review several other cases.
Joo, Moon Kyung; Park, Jong-Jae; Lee, Beom Jae; Kim, Ji Hoon; Yeon, Jong Eun; Kim, Jae Seon; Byun, Kwan Soo; Bak, Young-Tae
Invasive gastric Candida infection in patient with co-morbidity can cause stenotic change if it is developed at anatomically narrowing portion, such as distal antrum, pylorus, or duodenal bulb. However, proper management of benign stenosis by diffuse gastric Candidasis is still under controversy and palliative bypass surgery has several shortcomings because high risk operative group may be included in this case. Palliative placement of self-expandable metallic stent has been settled as a standard management of malignant gastric pyloric obstruction and it is expected to be applied in benign stenotic lesions due to its gradual dilation effect. We described a case of stenosis by diffuse gastric Candidasis at anastomosis of subtotal gastrectomy, which was managed by temporary placement of self-expandable metallic stent.
Full Text Available Manufacturers and wholesalers are increasingly cost conscious in response to today’s hyper-competitive environment. Lateral transshipment (LT has been proposed as a viable solution to drive total inventory costs down whilst increasing customer service level. Our study proposes five LT decision rules with a case-based roadmap to guide professional inventory management. Results of this large fast moving consumer goods case study company demonstrate superior inventory management performance with implementing a combined reactive and proactive LT strategy to determine whether to transship emergency stock from other warehouse or to backorder from suppliers, size of transshipment, favorite wholesaler, preferred supplier, and extra quantity for preventive LT, which are the key LT decision points among the professional supply chain management practitioners.
Keehner Engelke, Martha; Guttu, Martha; Warren, Michelle B; Swanson, Melvin
More children with chronic illnesses are attending school, and some of them struggle academically because of issues related to their health. School-based case management has been suggested as one strategy to improve the academic success of these children. This study tracked the academic, health, and quality of life outcomes for 114 children with asthma, diabetes, severe allergies, seizures, or sickle-cell anemia in 5 different school districts who were provided case management by school nurses. The children ranged in age from 5 to 19 years. At the end of the school year, children experienced an improvement in quality of life and gained skills and knowledge to manage their illness more effectively. Classroom participation, grades, and participation in extracurricular activities also increased for many children. The study provides evidence of the positive impact school nurses have on children with chronic illness and suggests ways they can measure the outcomes of their interventions.
Geng, Yong; Zhu, Qinghua; Haight, Murray
Industrial parks play a significant role in the production and use of goods and services. The proper management of solid waste is a major challenge for industrial parks due to the large quantity of wastes and the variability of waste characteristics from these types of developments. Therefore, integrated solid waste management has become very crucial to the industrial park managers. Such an approach requires industrial park managers to assess the overall use of resources, and to seek waste reduction, reuse and recycling opportunities both at the individual company level and among different tenant companies. The adoption of this method can bring both economic and environmental benefits. This paper introduces the planning efforts of a real case in China. It first presents the basic information on Tianjin Economic Development Area (TEDA), and then introduces its current practices on solid waste management. The main focus of this paper is to describe how to plan an integrated solid waste management system at TEDA. Benefits and challenges are all identified and analyzed. The experiences and methods from this case study should be applied in other industrial parks so as to improve the overall eco-efficiency of the whole industrial park.
Satoh, Ken; Motomiya, Masakichi
Tuberculosis control law was enacted in 1951 and has been the basis for the management of TB cases over the long post-war period. This law has legalized the use of public founds for the treatment of TB patients for the first time and has provided the authentic basis for mandatory hospitalization, routine health examination, vaccination, notification and registration of TB cases. However, this law was abrogated in 2001 and was joined to the comprehensive infectious diseases control law, in order to facilitate a prophylactic measure against TB infection and to protect human rights of TB patients. Concurrently the medical care system and the formalities connected to hospitalization treatment of TB patients were reviewed. The purpose of the present overview is to explain how TB cases are managed under the newly-enacted law.
Kuhbier, Jörn W.
Full Text Available Cobra bites are quite rare in European countries as these snakes are not native there. Toxins are devastating for tissue resulting in massive necrosis, thus plastic surgery might play a role in reconstruction of the lost tissue. A case of a male patient bitten by a thai cobra in the left index finger is presented. Antitoxin administration was delayed due to secondary patient admission. Progressive tissue necrosis made radical debridement necessary, resulting in the need for plastic surgical defect coverage with a flap. While a radical debridement to prevent toxic necrosis due to lytic enzymes in cobra venom has been favoured beforehand, large case studies led to a more restrained initial surgical intervention. However, antitoxin administration should be first line therapy in management of these cases. If severe necrosis is present as it might occur in delayed admission, a plastic surgical management of the patient might be advantageous.
Ricardo Aurélio Quinhões Pinto
Full Text Available This research aims to analyze the impact of the lean philosophy applied to inventory management as differential competitive performance in a metallurgical company and at the same time, establish parameters for comparison with the old management model, the Theory of Constraints. This is a descriptive case study, ex-post facto and sectional time. The first stage consisted of an exploratory survey and questionnaires. To collect data, personal interviews with managers in the areas of logistics, operations and employees on the shop floor were performed. As a result, it was observed that after the implementation of lean philosophy, the company achieved greater interactivity in information management between internal and external factors, which allowed the reduction of production costs, improved product quality disposing of large stocks security without compromising the level of service offered to the customer.
Maya, Ernest T; Buntugu, Kennedy A; Aki, Lovelace; Srofenyoh, Emmanuel K
Postpartum haemorrhage is one of the major causes of maternal mortality worldwide. The leading cause of primary postpartum haemorrhage is uterine atony and active management of the third stage of labour with oxytocin is recommended for preventing primary postpartum haemorrhage. Parenteral oxytocin is also the drug of choice for medical management of postpartum haemorrhage secondary to uterine atony. Condom uterine balloon tamponade is .a low cost technique that can be used as a second-line option for treatment. We report retrospectively three cases of primary PPH secondary to uterine atony which were managed successfully with condom tamponade. Condom tamponade is effective in managing post partum haemorrhage secondary to uterine atony and we advocate for the training of all skilled attendants on how to insert the condom tamponade.
Robson dos Santos
Full Text Available This research considers the increasing concern of society in general environmental issues, shows the importance of an Environmental Management System to improve the image of a company towards society in which it is embedded. Shows that proper waste management can result in financial and environmental benefits for companies that practice. To address the practical issues of the theme, was chosen the company McDonald's, as a service company fast food, that have a quantity of waste, and creates conditions for application of the techniques of environmental management in this sector. Thus, this article aims to demonstrate through case study and descriptive research, the commitment that this large network of fast-food has with the preservation of the environment through its waste management and investments in economic, social and environmental the country.
Samar K Basak
Full Text Available Purpose: To analyze the complications and their managements in Descemet′s stripping endothelial keratoplasty (DSEK in consecutive 430 cases by single surgeon in a tertiary eye hospital. Materials and Methods: 430 eyes of 366 patients with endothelial dysfunctions scheduled for DSEK, were analyzed retrospectively. In all cases donor dissection was performed manually, and ′Taco′ insertion and unfolding technique was used. Intra-operative and postoperative complications with their managements and outcomes were reviewed retrospectively. Periodic endothelial cell density was analyzed for each patient till the last visit. Follow-up period was between 3 to 60 months (mean 18.7 months. Results: 13 (3.0% eyes had operative complications during donor dissection and 16 (3.7% had during recipient procedure. In 7 (1.6% eyes, donor lenticule was replaced with a new one during the surgery. In early postoperative period, 21 (4.9% eyes had donor dislocation and 12 (2.8% eyes had air-induced pupillary block; and they were managed immediately. 2 cases had primary graft failure and in 1 case had postoperative bacterial endophthalmitis requiring evisceration. In late postoperative period, 48 (11.3% eyes had secondary glaucoma and 14 (3.3% eyes had late secondary graft failure. Endothelial rejection occurred in 5 (1.2% cases. Mean endothelial cell loss was 19.7% after 3 months and 54.2% after 5 years. Total graft failure in this series was 31 (7.2% and in 17 cases re-DSEK was performed successfully. Conclusions: Both operative and postoperative complications do occur in DSEK. Most of these complications can be managed by medical or appropriate surgical means. Some of the complications can be avoided and reduced with experience.
Full Text Available Contemporary management accounting techniques (such as TQM, BSC, JIT are widely lauded by academia but the proposed relevance to business has not necessarily the view held by industry (e.g. Burns & Vaivio, 2001; Chenhall & Langfield-Smith, 1998; Innes et al., 2000. The purpose of this article is to investigate the acquisition by a modern multi-national firm of a major IT-based management accounting program to assess the relevance and usefulness of its functionality by identifying the type(s of systems that are utilised and the rationale for upgrading or modifying its system(s. This study relies on a single case based on two in-depth semi structured interviews with accounting and finance professionals in a multi-national manufacturing company that recently implemented a modern management accounting system. The findings indicate that despite demonstrating some relevance of the management accounting information, the manufacturer deactivated components of the system that were deemed irrelevant at particular levels of the organisation. This paper provides evidence about the non-reliance on management accounting information in a multinational company operating in Australia. The findings in the study imply that relevance is linked to implementation, planning and training will help managers to better prepare themselves in setting up contemporary management accounting systems.
George Lawrence Kinyata
Full Text Available The aim of the paper was to investigate the role of knowledge management in higher education institutions. The case study was based on the Stefano Moshi Memorial University College (SMMUCo. The study relied on both secondary and primary data; primary data was obtained mainly through a questionnaire, observations, as well as short interviews/discussions with students and lecturers, since the researcher is a lecturer at SMMUCo. The findings show that the current University website and the general state of IT infrastructure is not adequate in supporting the knowledge management activities, for example both students and lecturers pointed out a lack of an information system where they could login to access specific information (e.g. individual course results, lecture notes, news bulletins and updates from the management. The paper concludes by highlighting the development of the knowledge management model, which SMMUCo could implement in order to achieve effective knowledge management. The model suggests that in order to build the knowledge management capabilities, the university should effectively align its key resources, namely: (a Employees (both academic and administrative staff, (b University content (e.g. lecture notes, programs, policies etc., and (c ICT infrastructure. The use of relevant technologies is highly recommended, since technology is viewed as a resource that can improve knowledge management.
Svensson, Ola (Risk Analysis, Social and Decision Research Unit, Dept. of Psychology, Stockholm Univ., Stockholm (Sweden)); Salo, Ilkka (Dept. of Psychology, Lund Univ., Lund (Sweden))
A systems perspective on safety management is introduced followed by two briefly presented case studies of safety management in non-nuclear contexts. The first study concerns a car manufacturer and the second study a road traffic tunnel system. The risks of a car accident in the first case study are evident. The great exposure generates many incidents and accidents. In the second study, the rather low traffic intensity through the tunnel produces few incidents and accidents and only a few fatal accidents over the years. Yet, the risk of the individual traveler is much greater in the tunnel than on the average road. The case studies are presented in a systems perspective with emphasis on information feedback about the risks of the systems. The first case study illustrates high quality safety management, while the second case study shows many weaknesses of the safety management in the tunnel system. Some differences in safety management between the case studies are noted. The last part of the study presents an organizational perspective on safety management and offers alternative theoretical perspectives on the concept of safety management. The report shows that further studies are needed both (1) to develop a frame of reference for describing safety management across industries and activities and (2) to collect data illustrating of good and poor safety management. Then, the results can be used to strengthen and/or improving safety management in the nuclear power industry and its regulators
Full Text Available Clinical cases are primary and vital evidence for Traditional Chinese Medicine (TCM clinical research. A great deal of medical knowledge is hidden in the clinical cases of the highly experienced TCM practitioner. With a deep Chinese culture background and years of clinical experience, an experienced TCM specialist usually has his or her unique clinical pattern and diagnosis idea. Preserving huge clinical cases of experienced TCM practitioners as well as exploring the inherent knowledge is then an important but arduous task. The novel system ISMAC (Intelligent System for Management and Analysis of Clinical Cases in TCM is designed and implemented for customized management and intelligent analysis of TCM clinical data. Customized templates with standard and expert-standard symptoms, diseases, syndromes, and Chinese Medince Formula (CMF are constructed in ISMAC, according to the clinical diagnosis and treatment characteristic of each TCM specialist. With these templates, clinical cases are archived in order to maintain their original characteristics. Varying data analysis and mining methods, grouped as Basic Analysis, Association Rule, Feature Reduction, Cluster, Pattern Classification, and Pattern Prediction, are implemented in the system. With a flexible dataset retrieval mechanism, ISMAC is a powerful and convenient system for clinical case analysis and clinical knowledge discovery.
Full Text Available Up to 10% of asthmatics have “difficult asthma”; however, they account for 80% of asthma-related expenditure and run the highest risk of acute severe exacerbations. An estimated 75% of admissions for asthma are avoidable. Guidelines advise that these patients be managed by an experienced specialist multidisciplinary team (MDT. We aimed to assess the impact of a case management strategy delivered via specialist MDTs on acute healthcare utilisation of patients with frequent asthma admissions. An MDT (consultant, specialist nurse, physiotherapist and psychologist case management strategy was introduced in 2010 at University Hospital Southampton Foundation Trust (Southampton, UK to support patients with frequent asthma admissions during admission and then in clinic. To assess efficacy, we systematically searched the hospital database for patients acutely admitted for asthma on two or more occasions in 2010, 2011 and 2012. Data were collected retrospectively covering patient demographics, admission details, asthma severity and comorbidity. From 2010 to 2012, 84 patients were admitted on two or more occasions per year (80% female, mean body mass index 31 kg·m−2 and 55% psychological comorbidity. After introducing an MDT approach repeat asthma admissions fell by 33% from 127 in 2010 to 84 in 2012 (p=0.0004. In addition, bed days fell by 52% from 895 in 2010 to 430 in 2010 (p=0.015. An MDT case management approach significantly reduces hospitalisation in difficult asthma patients with prior frequent admission.
Full Text Available Abstract Background Not much is known about the French chiropractic profession on, for example, level of consensus on clinical issues. Objectives The first objective was to investigate if French chiropractors' management choices appeared reasonable for various neck problem scenarios. The second objective was to investigate if there was agreement between chiropractors on the patient management. The third objective was to see to which degree and at what stages chiropractors would consider to interact with other health-care practitioners, such as physiotherapists, general practitioners and specialists. Method A questionnaire was sent to a randomly selected sample of all French chiropractors known to the national chiropractic college. It consisted of an invitation to participate in the study, a brief case description, and drawings of five stages of how a case of neck pain gradually evolves into a brachialgia to end up with a compromised spinal cord. Each stage offered five management choices. Participants were asked at what stages patients would be treated solely by the chiropractor and when patients would be referred out for second opinion or other care without chiropractic treatment, plus an open ended option, resulting in a "five-by-six" table. The percentages of respondents choosing the different management strategies were identified for the different scenarios and the 95% confidence intervals were calculated. There was a pre hoc agreement on when chiropractic care would or would not be suitable. Consensus was arbitrarily defined as "moderate" when 50- 69% of respondents agreed on the same management choice and as "excellent" when 70% or more provided the same answer. It was expected that inter professional contacts would be rare. Results The response rate was 53% out of 254 potential participants. The first two uncomplicated cases would generally have been treated by the chiropractors. As the patient worsened, the responses tended towards
The scope of case management has expanded to include persons with chronic, nonpsychotic disorders, in particular, persons diagnosed with borderline personality disorder. Despite more widespread use, literature about case management for persons with this disorder is limited. To address this gap in knowledge, a study of the day-to-day experiences of case managers who care for persons with borderline personality disorder was conducted. Seventeen community mental health center case managers gave their informed consent to participate in individual, in-depth interviews. The interviews were analyzed using an interpretive phenomenological research approach. The analysis showed a pattern of monitoring self-involvement. The case managers monitored themselves in terms of expressing concern and setting boundaries. These shared practices highlight a central and unique component of being a case manager for persons with borderline personality disorder, that is, the case manager's focus of attention is on self. By focusing on the self, case managers seek to retain control of the nature of the relationship. The author asserts that the matter to be resolved is not to determine whether retaining or relinquishing control is better, but rather, how best to help practitioners maintain a helpful relationship over time with persons who have borderline personality disorder. In an effort to accomplish this goal, questions about current helping practices and suggestions for working collaboratively with persons who have this diagnosis are provided.
Víctor M. Toledo
Full Text Available The quest for an appropriate system of management for tropical ecosystems necessitates that ecologists consider the accumulated experiences of indigenous peoples in their long-term management of local resources, a subject of current ethnoecology. This paper provides data and empirical evidence of an indigenous multiple-use strategy (MUS of tropical forest management existing in Mexico, that can be considered a case of adaptive management. This conclusion is based on the observation that some indigenous communities avoid common modernization routes toward specialized, unsustainable, and ecologically disruptive systems of production, and yet probably achieve the most successful tropical forest utilization design, in terms of biodiversity conservation, resilience, and sustainability. This analysis relies on an exhaustive review of the literature and the authors' field research. Apparently, this MUS represents an endogenous reaction of indigenous communities to the intensification of natural resource use, responding to technological, demographic, cultural, and economic changes in the contemporary world. This transforms traditional shifting cultivators into multiple-use strategists. Based on a case study, three main features (biodiversity, resilience, and permanence considered relevant to achieving adaptive and sustainable management of tropical ecosystems are discussed.
Childs, Susan R; Casely, Emma M; Kuehler, Bianca M; Ward, Stephen; Halmshaw, Charlotte L; Thomas, Sarah E; Goodall, Ian D; Bantel, Carsten
Recent research has confirmed that between 25% and 33% of all hospitalized patients experience unacceptable levels of pain. Studies further indicate that this reduces patient satisfaction levels, lengthens hospital stays, and increases cost. Hospitals are aiming to discharge patients earlier, and this can interfere with adequate pain management. Therefore, the pain service at Chelsea and Westminster Hospital has adapted to this changing model of care. An increasing body of evidence demonstrates that psychological factors are key components of patients’ pain experiences in both acute and chronic pain. Therefore, it is reasonable to suggest a clinical psychologist should be involved in inpatient pain management. This small study discusses three cases that highlight how patient care could be improved by including a clinical psychologist as part of the inpatient pain team. Two cases particularly highlight the active role of the psychologist in the diagnosis and management of common conditions such as fear and anxiety, along with other psychiatric comorbidities. The management therefore employed an eclectic approach adapted from chronic pain and comprising of behavioral, cognitive behavioral, and dialectical behavioral therapeutic techniques blended with brief counseling. The third case exemplifies the importance of nurse-patient interactions and the quality of nurse-patient relationships on patient outcomes. Here, the psychologist helped to optimize communication and to resolve a difficult and potentially risk-laden situation. This small case series discusses the benefits derived from the involvement of a clinical psychologist in the management of inpatient pain, and therefore illustrates the need for novel initiatives for inpatient pain services. However, future research is warranted to validate this approach. PMID:25506221
Lisa S. Patchner
Full Text Available The employment of social workers within managed care organizations is a new phenomenon. As such, this case study utilized an exploratory-descriptive design that assessed social workers as case managers within a Medicaid HMO. The semi-structured interviews, focus groups, and participant observation suggested that the use of case management services, delivered primarily by social workers,was effective in addressing the bio-psychosocial needs of Medicaid consumers within a provider-driven HMO. Study findings recommend specific knowledge and skills that social workers need in order to prepare for practice within managed care environments.
Perceptions on safety in community care have been relatively unexplored. A project that sought to understand the multiple perspectives on safety in the NHS case-management programme was carried out in relation to the structure, process, and outcome of care. This article presents a component of the nursing perspective that highlights an important element in the structure of nursing care that could potentially impede the nurses' ability to be fully effective and safe. A single case study of the case-management programme was undertaken. Three primary care organisations from three strategic health authorities participated, and three focus groups were conducted (one within each organisation). In total, 17 case management nurses participated. Data were audiotaped and transcribed verbatim and subjected to framework analysis. Nursing staff attitudes were identified as a structure of care that influence safety outcomes, particularly their perceptions of the care setting and the implications it has on their role and patient behaviour. Greater understanding of the expected role of the community nurse is necessary, and relevant training is required for nurses to be successful in empowering patients to perform more safely. In addition, efforts need to be made to improve patients' trust in the health-care system to prevent harm and promote more effective utilisation of resources.
Javangula Kalyana C
Full Text Available Abstract Introduction Keloid scars following median sternotomy are rare and occur more frequently in pigmented skin. Different management strategies have been described with variable success. We present a case of keloid scar formation following cardiac surgery including our management and the final aesthetic result. Case description A 64 year old female of fair complexion underwent mitral valve replacement. The procedure and postoperative recovery were uncomplicated, however, during the following year, thick keloid scars formed over the incision sites. Initial non surgical measures failed to relieve pain and did not offer any tangible aesthetic benefit. Eventually surgical excision was attempted. She presented to our clinic for nine months follow up with significant improvement in pain and aesthetic result. Discussion and Evaluation Several theories have attempted to explore the pathophysiology of keloid scar formation. A number of predisposing factors have been documented however none existed in this case. A variety of invasive and non invasive approaches have been described but significant differences in success rates and methodology of investigations still precludes a standardized management protocol. Conclusions In this case study a rare presentation of keloid scar has been presented. The variety of methods used to improve pain and aesthetic result demonstrates the propensity of keloid scars to recur and the therapeutic challenges that surgeons have to face in their quest for a satisfactory patient outcome.
Full Text Available The field of performance measurement and management (PMM is well filled with frameworks, models and guidelines addressing what to measure and how to design a performance measurement system (PMS. However, what has been less examined so far is how to ensure that PM evolve in tandem with their environments. Further, the few approaches available today are prescriptive and outlines how or what practitioners should do in order to manage change in their PM. Thus, a gap exists in understanding how organisations manage change in their PM in practice. Thus, the purpose of this paper is to outline and compare the approaches of three case companies for managing PM change. In order to fulfil the purpose of the paper, the data presented has been collected through the deployment of case studies. The choice of case studies as means for data collection stems from the possibility of an in-depth and holistic examination of the formulated phenomenon. All three case companies belong to the same company-group that operates within the transportation industry. The industrial footprint of the company is global with operations and sales spread out over the world. The findings suggest that all three companies have processes in place for managing change in PM. However, the approaches differ in design and context. Even though the case companies had different approaches in place to manage change in PM, they shared several commonalities. Commonalities were shared in the way of execution, process input and challenges in IT and culture. Furthermore, employee involvement seemed to be the biggest challenge for all three companies. The findings put forward in this paper are limited as they are confined to three companies from the same company-group. More studies, both from within and outside the company-group, are needed in order to establish a solid base of empirical data for generalisation. However, this paper makes a contribution both through describing how three companies
Full Text Available Congenital lobar emphysema (CLE is a rare clinical entity presenting as acute respiratory distress in infants. Its diagnosis is difficult as clinically and radio logically it mimics pneumonia or pneumothorax. Its early recognition and management with thoracotomy is lifesa ving. Inhalation induction is preferred and spontaneous ventilation should be maintained until either the chest is opened or one lung ventilation of the contralateral lung is achieved. In this case report, we describe the challenges faced in the anaestheti c management of this condition
H. van Aswegen
Full Text Available Atelectasis is common in intubated and ventilated patients. Thereasons for the atelectasis are multifactorial. Atelectasis, if prolonged, may lead to hypoxaemia, pulmonary infection and fibrosis. The effectiveness of manual hyperinflation as an adjunct to standard respiratory physiotherapy management of patients in the ICU to re-inflate collapsed lung regions, to improve gas exchange and respiratory compliance and to assist with the removal of secretions, have been proclaimed by numerous authors. This case report demonstrates the effectiveness of the addition of manual hyperinflation to the physiotherapy management of an intubated patient with acute atelectasis.
Supply Chain Management/ Strategic Acquisition: The Case for Professional Pay in the Army Acquisition Corps COL John Lemondes, USA This article assesses the opinions of Army Acquisition Workforce members who will serve in or are competing for program manager/command, or other leadership positions within the Army Acquisition Corps (AAC) on the subject of professional pay. A survey by the author determined: (a) whether professional pay would reduce loss of Army officers at the LTC/20-year point, with a lesser emphasis on COL/26-year point;
Christina Nicole Giannikas
Full Text Available This study focuses on primary language education within a Greek region: specifically, on the positive effects of classroom management and organisation on a student-centred approach of teaching. In the case of the Greek education system, language teachers are encouraged to adopt student-centred approaches in their classroom but have not received any guidance on how to do so. Language educators are reluctant to abandon their teacher-centred ways, because they have not been trained to apply classroom management and organisation techniques that could support a student-centred environment.
Ludmir, Jonathan; Kapoor, Karan; George, Praveen; Khural, Jasjeet; Barr, Brian
Left ventricular pseudoaneurysm is a rare complication of myocardial infarction that carries a high mortality rate. Although conventional wisdom suggests prompt surgical repair in order to mitigate risk of expansion and rupture, there are some data to support non-operative management in asymptomatic individuals with likely chronic pseudoaneurysms, particularly when surgical candidacy is poor. We present a case of a medically managed left ventricular pseudoaneurysm subsequent to inferior ST-segment elevation myocardial infarction with 6-month follow-up data. PMID:28197266
Tan, Josh; Krzeminski, Sylvia; Hazeghazam, Maryam; Bandlamuri, Meghana; Carlson, Richard W.
Malignant catatonia (MC) is a life-threatening manifestation which can occur in the setting of an underlying neuropsychiatric syndrome or general medical illness and shares clinical and pathophysiological features and medical comorbidities with the Neuroleptic Malignant Syndrome (NMS). The subsequent diagnosis and definitive therapy of MC are typically delayed, which increases morbidity and mortality. We present two cases of MC and review recent literature of MC and NMS, illustrating factors which delay diagnosis and management. When clinical features suggest MC or NMS, we propose early critical care consultation and stabilization with collaborative psychiatric management. PMID:28250995
Full Text Available Malignant catatonia (MC is a life-threatening manifestation which can occur in the setting of an underlying neuropsychiatric syndrome or general medical illness and shares clinical and pathophysiological features and medical comorbidities with the Neuroleptic Malignant Syndrome (NMS. The subsequent diagnosis and definitive therapy of MC are typically delayed, which increases morbidity and mortality. We present two cases of MC and review recent literature of MC and NMS, illustrating factors which delay diagnosis and management. When clinical features suggest MC or NMS, we propose early critical care consultation and stabilization with collaborative psychiatric management.
Park, Julia; Tan, Josh; Krzeminski, Sylvia; Hazeghazam, Maryam; Bandlamuri, Meghana; Carlson, Richard W
Malignant catatonia (MC) is a life-threatening manifestation which can occur in the setting of an underlying neuropsychiatric syndrome or general medical illness and shares clinical and pathophysiological features and medical comorbidities with the Neuroleptic Malignant Syndrome (NMS). The subsequent diagnosis and definitive therapy of MC are typically delayed, which increases morbidity and mortality. We present two cases of MC and review recent literature of MC and NMS, illustrating factors which delay diagnosis and management. When clinical features suggest MC or NMS, we propose early critical care consultation and stabilization with collaborative psychiatric management.
The supply chain plays an increasing significant role in current global business operation process.It is not just considered as a crucial factor for leading the company to achieve their strategic goals,but also assisting firm’s to enhance the competitiveness in its own industry.This report choses the Swedish forest company-S?dra Cell as a case company to analysis its supply chain management advantages and disadvantages. It also states the role of supply chain management theory in assisting organization to achieve its strategic goal and marketing strategies.
Jackson Gomes Soares Souza
Full Text Available Public institutions bound to the Brazilian federal public sector must apply security measures, policies, procedures and guidelines as information assets protection measures. This case study sought to determine whether the management of information security risks is applied in a federal public institution according to Information Technology (I.T. managers perceptions and the results expose the importance of the roles played by people, responsibilities, policies, standards, procedures and their implementation aiming greater control of information security risks and opportunities related to information technology security.
Daim, Tugrul; Kim, Jisun
Technologies such as renewable energy alternatives including wind, solar and biomass, storage technologies and electric engines are creating a different landscape for the electricity industry. Using sources and ideas from technologies such as renewable energy alternatives, Research and Technology Management in the Electricity Industry explores a different landscape for this industry and applies it to the electric industry supported by real industry cases. Divided into three sections, Research and Technology Management in the Electricity Industry introduces a range of methods and tools includ
Karimi, Mohsen; Hulsebus, Elise; Murdison, Kenneth; Wiles, Henry
Complex muscular ventricular septal defect poses difficult surgical management and is associated with high morbidity and mortality despite advancements in surgical therapy. Device closure of muscular ventricular septal defect has been encouraging and has been used in hybrid approach at a few centres. However, device closure has some limitations in patients with complex muscular ventricular septal defect. We report a case of perventricular device closure of a complex muscular ventricular septal defect in a beating heart with entrapped right ventricular disc and its surgical management.
Akhilesh Kumar Tiwari
Full Text Available Peripartum cardiomyopathy is a rare cause of dilated cardiomyopathy in parturients, occurring in approximately one in 1000 deliveries, manifesting during the last few months or the first 5 months of the postpartum period. It can result in severe ventricular dysfunction during late puerperium. The major concern while managing these patients is to optimize fluid administration and avoid myocardial depression, while maintaining stable intraoperative hemodynamics. We present a case series of five parturients that were posted for elective cesarean section and managed successfully by the epidural volume extension technique.
Full Text Available Vallecular Cysts (VC are laryngeal cysts found most frequently at true vocal cords followed by epiglottis and vallecula, which develops due to obstruction of the submucosal gland. In children, they present with stridor, respiratory distress, feeding difficulty, failure to thrive or as an incidental finding on laryngoscopy. The anaesthesiologist can face the risk of obstructed breathing during mask holding, obscured laryngeal view, loss of airway, rupture of cyst and potential aspiration of cyst contents. Various techniques of airway management have been described in literature. We report a series of three cases with VC where we managed the airway successfully. We also discuss the relevant literature review.
Sukhminder Jit Singh Bajwa
Full Text Available Situs inversus totalis is a rare condition with a predicted incidence of one in 10,000 among the general population, the aetiologic factors for which are still not completely understood. In a patient with situs inversus totalis, not just the diagnosis of any acute abdomen pathology is difficult due to distorted anatomy and transposition of thoraco abdominal viscera but equally challenging is the anaesthetic management during the respective surgical procedure. We are reporting a patient who had situs inversus totalis and was operated for open cholecystectomy. The present case report lays an emphasis on the potential difficulties during anaesthetic management and its various implications.
Full Text Available Mandibular fractures are relatively less frequent in children when compared to adults, which may be due to the child′s protected anatomic features and infrequent exposure of children to alcohol related traffic accidents. Treatment principles of mandibular fractures differ from that of adults due to concerns regarding mandibular growth and development of dentition. A case of a 4.5-year-old boy with fractured body of mandible managed by closed reduction using open occlusal acrylic splint and circum mandibular wiring is presented. This article also provides a review of literature regarding the management of mandibular body fracture in young children.
Full Text Available Stakeholder participation is increasingly seen as central in natural resource management. It is also required by the European Union Water Framework Directive, which identifies three levels of participation; information, consultation, and active involvement. In this paper we discuss the active involvement of stakeholders, using our experience from a case study in the Himmerfjärden region, which is a coastal area southwest of Stockholm, Sweden. Our study used the systems approach proposed by the European Union research project called Science and Policy Integration for Coastal System Assessment (SPICOSA, in which local stakeholders and a study site team constructed an integrated simulation model of a crucial coastal management issue. In this case the issue was nitrogen enrichment. We showed how stakeholder participation in the modeling process helped identify interesting and currently relevant management scenarios, and how the modeling process facilitated communication of the likely ecological, economic, and social effects of these scenarios to the stakeholders. In addition, stakeholders also reported social gains in terms of network building. We managed to actively involve local stakeholders in water issues, and the research process clearly strengthened the social capital in the Himmerfjärden region, and created a basis for future collaboration regarding water management. Our experience indicates that the approach we tried is a useful tool for promoting active stakeholder involvement in water management projects. Also, the results of our science and policy integration approach indicated that the study site team assumed a leadership role, which is a commonly recognized factor in successful natural resource management.
Full Text Available A better understanding of case management practices is required to improve inpatient pediatric care in resource-limited settings. Here we utilize data from a unique health facility-based surveillance system at six Ugandan hospitals to evaluate the quality of pediatric case management and the factors associated with appropriate care.All children up to the age of 14 years admitted to six district or regional hospitals over 15 months were included in the study. Four case management categories were defined for analysis: suspected malaria, selected illnesses requiring antibiotics, suspected anemia, and diarrhea. The quality of case management for each category was determined by comparing recorded treatments with evidence-based best practices as defined in national guidelines. Associations between variables of interest and the receipt of appropriate case management were estimated using multivariable logistic regression.A total of 30,351 admissions were screened for inclusion in the analysis. Ninety-two percent of children met criteria for suspected malaria and 81% received appropriate case management. Thirty-two percent of children had selected illnesses requiring antibiotics and 89% received appropriate antibiotics. Thirty percent of children met criteria for suspected anemia and 38% received appropriate case management. Twelve percent of children had diarrhea and 18% received appropriate case management. Multivariable logistic regression revealed large differences in the quality of care between health facilities. There was also a strong association between a positive malaria diagnostic test result and the odds of receiving appropriate case management for comorbid non-malarial illnesses - children with a positive malaria test were more likely to receive appropriate care for anemia and less likely for illnesses requiring antibiotics and diarrhea.Appropriate management of suspected anemia and diarrhea occurred infrequently. Pediatric quality
Full Text Available This report presents a case of severe intrusive luxation of multiple anterior teeth in an 11-year-old girl. The teeth were repositioned successfully by endodontic and orthodontic management. The case was monitored for 7 years. Depending on the severity of the injury, different clinical approaches for treatment of intrusive luxation may be used. Despite the variety of treatment modalities, rehabilitation of intruded teeth is always a challenge and a multidisciplinary approach is important to achieve a successful result. In this case, intruded teeth were endodontically treated with multiple calcium hydroxide dressings and repositioned orthodontically. The follow-up of such cases is very important as the repair process after intrusion is complex. After 7 years, no clinical or radiographic pathology was detected.
Full Text Available Spontaneous rectus sheath hematoma (SRSH is an uncommon medical emergency in the elderly. We present a case of SRSH with an atypical clinical presentation and discuss literature regarding diagnosis and proper management. A 75-year-old female patient was transferred to the emergency department due to acute dyspnoea and confusion. Her medical history revealed a viral infection of the upper respiratory tract, and no coughing or use of anticoagulants. The clinical examination showed tenderness of the left lower abdomen, although palpation was misleading due to patient’s obesity. Laboratory investigations showed light anaemia. Ultrasonography and computed tomography revealed a large rectus sheath hematoma of the left abdominal wall. Despite further deterioration of the patient, conservative management including bed rest, fluid replacement, blood products transfusion, and proper analgesia was successful. No surgical intervention was needed. Prompt diagnosis and management of SRSH plays significant role in the prognosis, especially in elder patients. Independently of size and severity, conservative management remains the first therapeutic choice. Only by failure of supportive management, progressive and large hematoma or uncontrollable hemodynamic patients, interventional management including surgery or less invasive newer techniques is indicated.
Calice, Ivana; Moens, Yves
Modern spirometry, like no other monitoring technique, allows insight into breath-to-breath respiratory mechanics. Spirometers continuously measure volume, airway pressure, and flow while calculating and continuously displaying respiratory system compliance and resistance in the form of loops. The aim of this case series is to show how observation of spirometric loops, similar to electrocardiogram or CO2 curve monitoring, can improve safety of anesthetic management in small animals. Spirometric monitoring cases described in this case series are based on use of the anaesthesia monitor Capnomac Ultima with a side stream spirometry sensor. The cases illustrate how recognition and understanding of spirometric loops allows for easy diagnosis of iatrogenic pneumothorax, incorrect ventilator settings, leaks in the system, kinked or partially obstructed endotracheal tube, and spontaneous breathing interfering with intermittent positive-pressure ventilation. The case series demonstrates the potential of spirometry to improve the quality and safety of anesthetic management, and, hence, its use can be recommended during intermittent positive-pressure ventilation and procedures in which interference with ventilation can be expected.
P S Nagaraja
Full Text Available Truncus arteriosus (TA is a rare congenital heart disease defined as a single arterial vessel arising from the heart that gives origin to the systemic, pulmonary and coronary circulations. The truncal valve in majority of the cases is tricuspid though quadricuspid and bicuspid valves have been reported. Patients with TA typically have a large nonrestrictive sub truncal ventricular septal defect. Survival of these infants beyond 1-year is uncommon. Here, we report a unique case of 12-year-old female patient with persistent TA who underwent surgical repair by using transesophageal echocardiography as a monitoring device during the perioperative management.
GAI Ke-ke; PAN Jing
The article discusses several hemispheres of human resource management based on a typical case review. The study presents the main problems of the case from both employees and organizations; the issued problems involve compensa- tions and benefits, restructuring, job design, and training. Based on the analysis of the ease, two alternative solutions state that the potential routes for the organizations to avoid serious negative results. The study intreduces a number of recommen- dations that can be used as a reference for other organizations to avoid similar risks.
David Martínez-Cecilia; Sebástian Rufián-Pe(n)a; Alvaro Arjona-Sánchez; Manuel Gómez-(A)lvarez; Eva Torres-Tordera; Antonio Luque-Molina; Victor Valentí-Azcárate; Javier Brice(n)o-Delgado; Francisco-Javier Padillo; Pedro López-Cillero
Duodenal diverticula are a relatively common condition.They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.
Chen Wen Hsing
Full Text Available The study aims to analyze the IT architecture management practices associated with their degree of maturity and the influence of institutional and strategic factors on the decisions involved through a case study in a large telecom organization. The case study allowed us to identify practices that led the company to its current stage of maturity and identify practices that can lead the company to the next stage. The strategic influence was mentioned by most respondents and the institutional influence was present in decisions related to innovation and those dealing with a higher level of uncertainties.
Full Text Available Introduction: Talon cusp is an uncommon odontogenic anomaly which most frequently affects maxillary permanent incisors. Its presence causes the problem in esthetics, prevention of caries, and occlusal accommodation for the patient and problems in the diagnosis and clinical management for the dentist. Case Report: This article reports a case of talon cusp on the palatal surface of the permanent maxillary central incisor. Discussion: Since, the presence of talon cusp usually demands that definitive treatment be instituted; it represents a problem of clinical significance. The dentist should be able to diagnose it as the maxillary incisor is also the principal site for supernumerary tooth.
Extend case transfer architecture inter-organization workflow management fits the needs of Collaboration commerce. However, during the third step of extend case transfer architecture, modifications of private workflows might cause some fatal problems, such as dead locks, live locks and dead tasks. These problems could change the soundness and efficiency of overall work flow. This paper presents a Petri net based approach to protect the inheritance of public work flows in private domains, and discusses an implementation of our collaboration commerce workflow model.
Messikomer, Carla M; Cirka, Carol C
This paper presents a complex, but realistic, picture of the lived experience in assisted living (AL), and provokes thoughtful reflection about the operational and ethical challenges faced in the delivery of care to an increasingly frail population in a typical AL facility. Developed from the findings of a two-year qualitative research project, the case represents a composite of selected data collected at five AL facilities that participated in the study. Students will participate in individual and small group exercises that challenge them to identify everyday ethical concerns in AL, and to suggest ways that management can address these issues. The case is suitable for cross-disciplinary use, and can be effectively applied in the fields of management, health care administration, sociology, gerontology, social work, and nursing, either on the graduate or undergraduate level. It is especially well suited to courses that incorporate the topics of long-term care, senior housing, or ethics.
Marshall, Sarah L; Crowe, Trevor P; Oades, Lindsay G; Deane, Frank F; Kavanagh, David J
This Open Forum examines research on case management that draws on consumer perspectives. It clarifies the extent of consumer involvement and whether evaluations were informed by recovery perspectives. Searches of three databases revealed 13 studies that sought to investigate consumer perspectives. Only one study asked consumers about experiences of recovery. Most evaluations did not adequately assess consumers' views, and active consumer participation in research was rare. Supporting an individual's recovery requires commitment to a recovery paradigm that incorporates traditional symptom reduction and improved functioning, with broader recovery principles, and a shift in focus from illness to well-being. It also requires greater involvement of consumers in the implementation of case management and ownership of their own recovery process, not just in research that evaluates the practice.
Strausburg, Matthew; Travers, Jeffrey; Mousdicas, Nico
Exposure to hydrofluoric acid can cause severe skin damage via both corrosive and chemical means. Dermatologists should be aware of the various clinical presentations and knowledgeable of how to manage such patients. A case of a man with exposure of the hands after use of a consumer product containing hydrofluoric acid is presented. The presentation may vary depending on the concentration and duration of exposure. Patients experiencing exposure are at risk of serious complications, including death, resulting from electrolyte abnormalities. Information regarding the source of exposure will allow the physician to better predict the patient's course. The use of immediate flushing with water and the use of topical calcium gluconate can prevent extensive damage to the area of exposure and potentially fatal complications that may occur. More extensive burns may necessitate more invasive therapies. The treatment and the management and monitoring of such cases will allow for more optimal outcomes.
Full Text Available Gingival enlargement is one of the side effects associated with certain drugs. Amlodipine, a calcium channel blocker, used as antihypertensive drug has been found associated with gingival hyperplasia. This case series presents diagnosis and management of amlodipine-induced gingival hyperplasia. Amlodipine-induced gingival enlargement was diagnosed and managed by thorough scaling and root planning. Drug substitution and surgical intervention was performed in first two cases. The pathogenesis of gingival enlargement is uncertain and the treatment is still largely limited to the maintenance of an improved level of oral hygiene and surgical removal of the overgrown tissue. Several factors may influence the relationship between the drugs and gingival tissues as discussed by Seymour et al. Meticulous oral hygiene maintenance, switchover to alternative drug, professional scaling and root planning and surgical excision of enlarged gingival tissue may help overcome the effect of these drugs.
Hamilton, M.C.; Thekdi, S.A.; Jenicek, E.M.;
of emergent conditions and help to avoid regret and belated action. The purpose of this paper is to present several case studies in natural resources and infrastructure systems management where scenario analysis has been used to aide decision making under uncertainty. The case studies include several resource...... to scenario analysis provides insight into both high-performing and robust initiatives/policies, and, perhaps more importantly, influential scenarios. Identifying the scenarios that are most influential to policy making helps to direct further investigative analysis, modeling, and data-collection efforts......Management of natural resources and infrastructure systems for sustainability is complicated by uncertainties in the human and natural environment. Moreover, decisions are further complicated by contradictory views, values, and concerns that are rarely made explicit. Scenario analysis can play...
Full Text Available In recent years, the energy efficiency of thermal power plant largely contributes to that of the industry. A thorough understanding of influencing factors, as well as the establishment of scientific and comprehensive diagnosis model, plays a key role in the operational efficiency and competitiveness for the thermal power plant. Referring to domestic and abroad researches towards energy efficiency management, based on Cloud model and data envelopment analysis (DEA model, a qualitative and quantitative index system and a comprehensive diagnostic model (CDM are construed. To testify rationality and usability of CDM, case studies of large-scaled Chinese thermal power plants have been conducted. In this case, CDM excavates such qualitative factors as technology, management, and so forth. The results shows that, compared with conventional model, which only considered production running parameters, the CDM bears better adaption to reality. It can provide entities with efficient instruments for energy efficiency diagnosis.
Full Text Available Objective: To document the case management of uncomplicated malaria fever at community pharmacies located in the two major cities of Pakistan; Islamabad (national capital and Rawalpindi (twin city. Method: A comparative, cross-sectional study was designed to document the management of uncomplicated malaria fever at community pharmacies in twin cities of Pakistan through simulated patient visits. Visits were conducted in 238 randomly selected pharmacies to request advice for a simulated patient case of malaria. The pharmacy’s management was scored on a checklist including history taking and provision of advice and information. Kruskal-Wallis test and Mann-Whitney U test were used to compare management of uncomplicated malaria fever by different types of dispensers working at community pharmacies situated at different locations in the twin cities.Results: The simulated patients were handled by salesmen (74.8%, n=178, pharmacist (5.4%, n=13 and diploma holders (19.8 %, n=47. Medication was dispensed in 83.1 % (n=198 of the visits, but only few of the treated cases were in accordance to standard treatment guidelines for malaria. However, in 14.8% (n=35 of the cases the simulated patients were directly referred to a physician. There was a significant difference observed in the process of history taking performed by different dispensers (e.g. pharmacist, pharmacy assistant, pharmacy diploma holders and salesman while no significant differences in the provision of advice by these dispensers was observed. Pharmacists were seen more frequently involved in the process of history taking if available at the community pharmacies. On the other hand, no significant differences were observed in the case management (history taking and provision of advice for the treatment of malaria fever among community pharmacies situated at different locations (e.g. near hospital/super market/small market in the twin cities.Conclusion: The results of the study revealed that
Annica Charlotte Sandström
Full Text Available The challenge of establishing adaptive management systems is a widely discussed topic in the literature on natural resource management. Adaptive management essentially focuses on achieving a governance process that is both sensitive to and has the capacity to continuously react to changes within the ecosystem being managed. The adoption of a network approach that perceives governance structures as social networks, searching for the kind of network features promoting this important feature, has been requested by researchers in the field. In particular, the possibilities associated with the application of a formal network approach, using the tools and concepts of social network analysis (SNA, have been identified as having significant potential for advancing this branch of research. This paper aims to address the relation between network structure and adaptability using an empirical approach. With the point of departure in a previously generated theoretical framework as well as related hypotheses, this paper presents a case study of a governance process within a fish management area in Sweden. The hypotheses state that, although higher levels of network density and centralisation promote the rule-forming process, the level of network heterogeneity is important for the existence and spread of ecological knowledge among the actors involved. According to the empirical results, restricted by the single-case study design, this assumption is still a well-working hypothesis. However, in order to advance our knowledge concerning these issues and test the validity of the hypotheses, more empirical work using a similar approach in multiple case study designs is needed.
Sands, Ashley E.
Astronomy data management refers to all actions taken upon data over the course of the entire research process. It includes activities involving the collection, organization, analysis, release, storage, archiving, preservation, and curation of research data. Astronomers have cultivated data management tools, infrastructures, and local practices to ensure the use and future reuse of their data. However, new sky surveys will soon amass petabytes of data requiring new data management strategies.The goal of this dissertation, to be completed in 2015, is to identify and understand data management practices and the infrastructure and expertise required to support best practices. This will benefit the astronomy community in efforts toward an integrated scholarly communication framework.This dissertation employs qualitative, social science research methods (including interviews, observations, and document analysis) to conduct case studies of data management practices, covering the entire data lifecycle, amongst three populations: Sloan Digital Sky Survey (SDSS) collaboration team members; Individual and small-group users of SDSS data; and Large Synoptic Survey Telescope (LSST) collaboration team members. I have been observing the collection, release, and archiving of data by the SDSS collaboration, the data practices of individuals and small groups using SDSS data in journal articles, and the LSST collaboration's planning and building of infrastructure to produce data.Preliminary results demonstrate that current data management practices in astronomy are complex, situational, and heterogeneous. Astronomers often have different management repertoires for working on sky surveys and for their own data collections, varying their data practices as they move between projects. The multitude of practices complicates coordinated efforts to maintain data.While astronomy expertise proves critical to managing astronomy data in the short, medium, and long term, the larger astronomy
Francisco Javier Pereda Pérez
Full Text Available Purpose: To analyze the assessment of management skills in the public sector of Cordoba (Spain, trying to find out the possible relationship or influence between the administration of belonging to a set of management skills.Design/methodology/approach: Initial Theoretical study on the public sector, public management and managerial skills, conducting fieldwork affecting four administrations and application of statistical techniques contrast, which, finally, the analysis of their results and the conclusions drawn from them.Findings and Originality/value: The findings of an investigation into the management skills in the context of the public sector in the Province of Córdoba (Spain are presented. At present the personal, interpersonal and managerial skills to manage, are becoming increasingly important in companies and organizations. The strong commitment to the development of management skills becomes a true competitive advantage capable of leading business improvement processes in organizations, especially those in which the human resource is crucial, as is the case of the public sector.Research limitations/implications: To progress in research on management skills in the public sector, it would be desirable to develop more sector research to comparative studies the results of which lead to the establishment of specific labor policies aimed at improving the selection of public employees, developing training policies that emphasize the enhancement of skills and a true career based on merit and efficient performance.Social implications: The selection, training and development of public employees, and greater give greater importance to human resource processes in which the skills and competencies should fill the role they need.Originality / value: The better knowledge of the public sector, the importance of having competent public managers , and basically point out the critical importance of developing leadership skills at all levels
Full Text Available Burkina Faso is actively pursuing the implementation of Integrated Water Resources Management (IWRM in its development plans. Several policy and institutional mechanisms have been put in place, including the adoption of a national IWRM action plan (PAGIRE and the establishment so far of 30 local water management committees (Comités Locaux de l’Eau, or CLE. The stated purpose of the CLE is to take responsibility for managing water at sub-basin level. The two case studies discussed in this paper illustrate gaps between the policy objective of promoting IWRM on the one hand, and the realities associated with its practical on-the-ground implementation on the other. A significant adjustment that occurred in practice is the fact that the two CLE studied have been set up as entities focused on reservoir management, whereas it is envisioned that a CLE would constitute a platform for sub-basin management. This reflects a concern to minimise conflict and optimally manage the country’s primary water resource and illustrates the type of pragmatic actions that have to be taken to make IWRM a reality. It is also observed that the local water management committees have not been able to satisfactorily address questions regarding access to, and allocation of, water, which are crucial for the satisfactory functioning of the reservoirs. Water resources in the reservoirs appear to be controlled by the dominant user. In order to correct this trend, measures to build mutual trust and confidence among water users 'condemned' to work together to manage their common resource are suggested, foremost of which is the need to collect and share reliable data. Awareness of power relationships among water user groups and building on functioning, already existing formal or informal arrangements for water sharing are key determinants for successful implementation of the water reform process underway.