Jobson, Matthew; Hall, Nigel J
Hypertrophic pyloric stenosis is a common surgical cause of vomiting in infants. Following appropriate fluid resuscitation, the mainstay of treatment is pyloromyotomy. This article reviews the aetiology and pathophysiology of hypertrophic pyloric stenosis, its clinical presentation, the role of imaging, the preoperative and postoperative management, current surgical approaches and non-surgical treatment options. Contemporary postoperative feeding regimens, outcomes and complications are also discussed. Copyright © 2016 Elsevier Inc. All rights reserved.
Full Text Available Purpose: The purpose of this paper is to analyse the concept "organisational culture from a traditional and a more contemporary management perspective. Problem investigated: The concept organizational culture has assumed a very prominent place within the management literature and has been analysed from diverse multidisciplinary perspectives. Central to the importance attributed to the concept is the fact that it acts as a perceptual and behavioural determinant, which implies that it will have a significant impact on all human related institutional activities and thus the interest in the concept and its management. Researchers and management practitioners have come to assume that while the concept is difficult to manage in practice, it is possible to determine the prevailing culture of an institution, identify what is termed to be a desired culture for an institution and then analyse the cultural gap that exists. Based on the analysis conducted, it is further frequently assumed that the transition from the prevailing to a desired culture can be managed. A more contemporary management perspective, based on complexity theory, would appear to challenge the assumption of being able to actively manage the organisation's culture transformation process to ensure that a desired culture is manifest within the institution. The traditional and more contemporary approaches for dealing with the concept "organisational culture" are the focus of discussion and analysis in this paper. Methodology: A multidisciplinary literature review and analysis is undertaken to gain an insight of traditional and contemporary management theory and practice, as it relates to the concept "organisational culture" and its management. Findings: An important conclusion drawn from the study is that traditional paradigms of organisational culture management, that evolved within a more mechanistic manufacturing economy, is no longer effective for dealing with the unpredictable and
Full Text Available The main objective of this paper is to identify the system of knowledge management in contemporary process organizations in business process perspective, especially with regard to technological and social conditions. Methodology is based on literature analysis and case studies. The integration of knowledge management technologies, concepts and methods into organizational business processes is challenging research issue today. The concepts of knowledge management and business process management should be analyzed jointly in the contemporary enterprises. Despite of the growing interest among researchers and practitioners of the concept of the knowledge management referring to business process management there is a lack of articles in this area. Appropriate approach to the modelling of knowledge management processes, as well as the use of IT tools, and a motivation system are of key importance for the introduction of this solution in organizations.
Pericardial diseases are relatively common in clinical practice, either as isolated disease or as manifestation of a systemic disorder. The aim of the present study is to review more recent updates on their contemporary management. The cause of pericardial diseases is varied according to the epidemiologic background, patient population, and clinical setting. Most cases remain idiopathic, and empiric anti-inflammatory therapy should be considered as first-line therapy in most cases with the possible adjunct of colchicine in the setting of inflammatory pericardial diseases, especially relapsing or not responding to first-line drugs. A triage has been proposed to select high-risk cases requiring admission and specific cause search. The prognosis of pericardial diseases is essentially determined by the cause. The most feared complication is constriction, the risk of which is higher in bacterial forms, intermediate for postpericardiotomy syndromes and systemic inflammatory diseases, low for viral and idiopathic cases. Chronic constriction has a definite surgical therapy, whereas transient cases should be recognized and may be reversible with empirical anti-inflammatory therapy. Contemporary management of pericardial diseases is largely empirical, although first clinical trials and new studies on diagnostic modalities and prognosis of pericardial diseases are bringing the contemporary management of pericardial diseases along a more evidence-based road. Integrated cardiovascular imaging is required for optimal management of the patient with suspected pericardial disease.
Hajiyev, Perviz; Burgu, Berk
Vesicoureteral reflux (VUR) remains the most interesting topic of pediatric urology due to the dynamic nature of recent controversial publications. Starting from the need for a diagnosis to the necessity and effectiveness of treatment in preventing scars, VUR remains in the mist. Although recent strong evidence helped as fog lights in this blurriness, more data are required for achieving crystal clearance. This article aims to summarize and discuss the current state of the evidence regarding VUR management. To provide a comprehensive synthesis of the main evidence in the literature on the current and contemporary management of VUR in children; to discuss conservative management with continuous antibiotic prophylaxis (CAP), especially its effectiveness and safety; and to review the current evidence regarding contemporary surgical techniques. We conducted a nonsystematic review of the literature using the recent guidelines and PubMed database regarding surveillance, CAP, endoscopic, open, laparoscopic, and robot-assisted ureteral surgical treatment. Despite the striking results of previous studies revealing the ineffectiveness of CAP, more recent studies and their two fresh meta-analyses revealed a positive role for CAP in the contemporary management of VUR. One of the most interesting findings is the redundant rising of endoscopic correction and its final settlement to real indicated cases. Patient individualization in the contemporary management of VUR seems to be the keyword. The evidence in the literature showed a safe and effective use of laparoscopic and robot-assisted laparoscopic reimplantations. The goal of VUR treatment is to prevent the occurrence of febrile urinary tract infections and formation of scars in the renal parenchyma. The approach should be risk adapted and individualized according to current knowledge. Individual risk is influenced by the presentation age, sex, history of pyelonephritis and renal damage, grade of reflux, bladder bowel
Courson, Andy M; Stankiewicz, James A; Lal, Devyani
To analyze trends in the surgical management of frontal and fronto-ethmoid mucoceles through meta-analysis. Meta-analysis and case series. A systematic literature review on surgical management of frontal and fronto-ethmoid mucoceles was conducted. Studies were divided into historical (1975-2001) and contemporary (2002-2012) groups. A meta-analysis of these studies was performed. The historical and contemporary cohorts were compared (surgical approach, recurrence, and complications). To study evolution in surgical management, a senior surgeon's experience over 28 years was analyzed separately. Thirty-one studies were included for meta-analysis. The historical cohort included 425 mucoceles from 11 studies. The contemporary cohort included 542 mucoceles from 20 studies. More endoscopic techniques were used in the contemporary versus historical cohort (53.9% vs. 24.7%; P = contemporary). In the historical cohort, higher recurrence was noted in the external group (P = 0.03). Results from endoscopic and open approaches are comparable. Although endoscopic techniques are being increasingly adopted, comparison with our series shows that more cases could potentially be treated endoscopically. Frequent use of open approaches may reflect efficacy, or perhaps lack of expertise and equipment required for endoscopic management. Most contemporary authors favor endoscopic management, limiting open approaches for specific indications (unfavorable anatomy, lateral disease, and scarring). N/A. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Kelly, J; Corrigan, M; Cahill, RA; Redmond, HP
Experience with management of drug-packers (mules) is variable among different centres. However, despite a recorded increase in drug trafficking in general, as yet, no unified, clear guidelines exist to guide the medical management of those who only occasionally encounter these individuals. We describe our recent experience with this growing problem and discuss the most salient points concerning the contemporary management of body packers. Our recent experience demonstrates that type IV packages may now be managed conservatively for the most part. PMID:17448234
Contemporary Security Management, 3rd Edition teaches security professionals how to operate an efficient security department and how to integrate smoothly with other groups inside and outside their own organizations. Fay demonstrates the specifics of security management: * how to organize, plan, develop and manage a security operation. * how to identify vulnerabilities. * how to determine the protective resources required to offset threats. * how to implement all necessary physical and IT security measures. Security professionals share the responsibility for mitigating damage, serving as a resource to an Emergency Tactical Center, assisting the return of business continuity, and liaising with local response agencies such as police and fire departments, emergency medical responders, and emergency warning centers. At the organizational level, the book addresses budgeting, employee performance, counseling, hiring and termination, employee theft and other misconduct, and offers sound advice on building constructi...
Joglekar, Siddharth B; Lindvall, Eric M; Martirosian, Armen
Cephalomedullary interlocking nails that allow for trochanteric entry and minimally invasive fixation have revolutionized the contemporary management of subtrochanteric fractures with improved union rates and decreased incidence of fixation failure. The most successful alternative to intramedullary fixation remains the angled blade plate. Despite biomechanical superiority of contemporary intramedullary implants to previous intramedullary devices, the importance of achieving and maintaining satisfactory fracture reduction prior to and during hardware insertion cannot be overemphasized. In comminuted and more challenging fractures, additional techniques, such as limited open reduction with clamps and/or cables, can allow for canal restoration and more anatomic reductions prior to and/or during nail insertion. Published by Elsevier Inc.
Full Text Available The evolution of logistics management as a system in the recent decades can be characterized by the influence of the globalization processes and the economic integration in the European Union. Systemic logistic approach ensured revolutionizing the optimization of the logistics chain. Logistics management must be given to permanent forms of the new legal and organizational structure appropriate to the contemporary economy.
Full Text Available The evolution of logistics management as a system in the recent decades can be characterized by the influence of the globalization processes and the economic integration in the European Union. Systemic logistic approach ensured revolutionizing the optimization of the logistics chain. Logistics management must be given to permanent forms of the new legal and organizational structure appropriate to the contemporary economy.
Kusuma, Bayu Mitra Adhyatma
Judul buku : Islamic Perspective on Management: ContemporaryIssuesPenulis : Nor ‘Azizah Kamri, dkk.Penerbit : YaPEIM Management Academy (kerjasamadengan University of Malaya Press)Tebal : xiv + 463 halamanCetakan pertama : November 2013Kota terbit : Kuala Lumpur
Jowett, Nate; Hadlock, Tessa A
Bell palsy (BP) is the most common diagnosis in acute and chronic facial palsy. Although most patients fully recover, more than one-quarter will have residual dysfunction. Of these, nearly half will demonstrate severe limitations in facial expression. Though significant attention has been paid to acute management and prognosis, a paucity of literature exists addressing management of the long-term sequelae of BP. This article describes contemporary use of physical therapy, injectables, and static and dynamic surgical procedures in facial reanimation of acute and chronic BP. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Dominick, Sam M.
Viewgraphs and discussion on space station fluid management logistics are presented. Topics covered include: fluid management logistics - issues for Space Station Freedom evolution; current fluid logistics approach; evolution of Space Station Freedom fluid resupply; launch vehicle evolution; ELV logistics system approach; logistics carrier configuration; expendable fluid/propellant carrier description; fluid carrier design concept; logistics carrier orbital operations; carrier operations at space station; summary/status of orbital fluid transfer techniques; Soviet progress tanker system; and Soviet propellant resupply system observations.
Britt, Christopher J; Gourin, Christine G
The treatment of advanced laryngeal cancer has undergone a paradigm shift in recent years, with an increase in chemoradiation for organ preservation and a decrease in primary surgery. This review will summarize the contemporary management of advanced laryngeal cancer and discuss treatment-related toxicity and strategies to improve outcomes. NA.
Bell, David; Fradet, Yves
Bladder cancer is currently the fifth most common cancer in Western society, and its incidence appears to be increasing. Important advances have recently occurred in both diagnostic and therapeutic approaches to bladder neoplasms. Presentation is not unique, and physician awareness is important to identify patients who are at risk for bladder neoplasia and consequently require further investigation. A diagnostic approach and contemporary management are discussed. ImagesFigure 1Figure 4 PMID:21229043
Spagnol, Carla Aparecida
This theoretical work aimed to study Hospital Administration, focusing on Nursing Management. The author points out contemporary administration concepts, and leads us to think over how those new models of management (already in use in some institutions known as pioneers on this area) may have influence on the Nursing Management practice inserted on the context. The author concludes that Nursing is going through a transition moment, breaking paradigms, trying to get over Classical Administration beliefs and searching for flexible, humanized and shared ways to manage Nursing Care.
Eberhardt, R. N.; Bailey, W. J.
The Cryogenic Fluid Management Facility is a reusable test bed which is designed to be carried within the Shuttle cargo bay to investigate the systems and technologies associated with the efficient management of cryogens in space. Cryogenic fluid management consists of the systems and technologies for: (1) liquid storage and supply, including capillary acquisition/expulsion systems which provide single-phase liquid to the user system, (2) both passive and active thermal control systems, and (3) fluid transfer/resupply systems, including transfer lines and receiver tanks. The facility contains a storage and supply tank, a transfer line and a receiver tank, configured to provide low-g verification of fluid and thermal models of cryogenic storage and transfer processes. The facility will provide design data and criteria for future subcritical cryogenic storage and transfer system applications, such as Space Station life support, attitude control, power and fuel depot supply, resupply tankers, external tank (ET) propellant scavenging, and ground-based and space-based orbit transfer vehicles (OTV).
Full Text Available Industrial injuries and work-related disorders considerable lowering we are facing in developed countries may be due to switching to a new health and safety management system entitled “Occupational Safety and Health Management System”. The Russian Federation has prepared certain regulatory documents prescribing some suggestions regarding implementing the contemporary system for industrial injuries prevention based upon the methods for professional risks management. However, despite the efforts made by the Russian Government, reformation of the health and safety management system at various companies is being performed rather slowly that may be as well owing to poor competence of managers and specialists regarding contemporary labor safety model content, methodical and organizational novations in the sphere of occupational safety and health management.. The article refers to a number of principal issues distinguishing the new health and safety management system from conventional approach.
Naranjo-Gil, David; Sánchez-Expósito, María Jesús; Gómez-Ruiz, Laura
Public health policies must address multiple goals and complex community health needs. Recently, management control practices have emerged to provide a broader type of information for evaluating the effectiveness of healthcare policies, and relate activities and processes to multiple strategic outcomes. This study compares the effect of traditional and contemporary management control practices on the achievement of public health policies. It is also analyzed how two different uses of such practices (enabling vs. coercive) facilitate the achievement of public health policies. Relationships are explored using data collected from managers from public health agencies and public hospitals in Spain. The findings show that contemporary management control practices are more suitable than traditional practices to achieve public health policies. Furthermore, results show that public health policies are better achieved when managers use management control practices in an enabling way rather than in a coercive way.
The article presents the required management competences from the perspective of contemporary management concepts. As the main concepts we have presented: knowledge management and learning organization, Total Quality Management, processes management, Kaizen and elimination of waste, virtual and network management and time based management. The most important management competences connected with above concepts are: focus on outside and effectiveness, care about efficie...
This paper examines the contemporary trends in tree growing and management in the context of changing farmer livelihood systems in southeastern Nigeria. Data were collected in 1998-99 through a field survey involving interviews with 160 households drawn from 8 rural communities across the different agroecological ...
Nikulina Irina; Khomenko Igor; Sediakina Anna; Kanov Viktor
The main goal of the article is to provide the insight on the gender management in connection with contemporary management. There have been wide ranges of scientific discussions regarding the question of a specific management style that women use in the business practice. A traditional approach indicates that there is no such way of managing an organization as a feminine management style. The traditional approach emphasise that women tend to use the men’s leading style with slight adjustments...
Murugan, Raghavan; Hoste, Eric; Mehta, Ravindra L; Samoni, Sara; Ding, Xiaoqiang; Rosner, Mitchell H; Kellum, John A; Ronco, Claudio
Fluid management during continuous renal replacement therapy (CRRT) in critically ill patients is a dynamic process that encompasses 3 inter-related goals: maintenance of the patency of the CRRT circuit, maintenance of plasma electrolyte and acid-base homeostasis and regulation of patient fluid balance. In this article, we report the consensus recommendations of the 2016 Acute Disease Quality Initiative XVII conference on 'Precision Fluid Management in CRRT'. We discuss the principles of fluid management, describe various prescription methods to achieve circuit integrity and introduce the concept of integrated fluid balance for tailoring fluid balance to the needs of the individual patient. We suggest that these recommendations could serve to develop the best clinical practice and standards of care for fluid management in patients undergoing CRRT. Finally, we identify and highlight areas of uncertainty in fluid management and set an agenda for future research. © 2016 S. Karger AG, Basel.
Chouhan, Jyoti D; Winer, Andrew G; Johnson, Christina; Weiss, Jeffrey P; Hyacinthe, Llewellyn M
Renal trauma occurs in approximately 1%-5% of all trauma cases. Improvements in imaging and management over the last two decades have caused a shift in the treatment of this clinical condition. A systematic search of PubMed was performed to identify relevant and contemporary articles that referred to the management and evaluation of renal trauma. Computed tomography remains a mainstay of radiological evaluation in hemodynamically stable patients. There is a growing body of literature showing that conservative, non-operative management of renal trauma is safe, even for Grade IV-V renal injuries. If surgical exploration is planned due to other injuries, a conservative approach to the kidney can often be utilized. Follow up imaging may be warranted in certain circumstances. Urinoma, delayed bleeding, and hypertension are complications that require follow up. Appropriate imaging and conservative approaches are a mainstay of current renal trauma management.
Stefan C. Kane
Full Text Available The neurological complications of preeclampsia and eclampsia are responsible for a major proportion of the morbidity and mortality arising from these conditions, for women and their infants alike. This paper outlines the evidence base for contemporary management principles pertaining to the neurological sequelae of preeclampsia, primarily from the maternal perspective, but with consideration of fetal and neonatal aspects as well. It concludes with a discussion regarding future directions in the management of this potentially lethal condition.
Eleonora Gabriela Baban
Full Text Available Currently, management and leadership are considered processes of influencing activitiesat a managerial and organizational level. Management implies the existence of individuals or groups ofindividuals who develop managerial activities. Leadership is a managerial process that aims to influence interpersonal relationships between team members due to the application of management functions. This paper aims to highlight some relevant features that define the concepts of management and leadership in a contemporary context. The main objectives of the study are: 1. presenting the main concepts of management and leadership; 2. analysing the role of leaders and managers in an organization; 3. highlighting main forms of manifestations of management performance; 4.presenting main influences of public management and leadership in the management of public organization. Leadership is not only a specific part of management, but also a state of mind, which creates an adequate framework for the manifestation of creativity and performance of a team led by a good leader in order for its members to succeed professionally and to achieve performance at an organizational level.
Donnelly, Meghan; Davies, Jill K
Contemporary management of HIV in pregnancy remains a moving target. With the development of newer antiretroviral agents with lower side-effect profiles and laboratory methods for detection and monitoring of HIV, considerable progress has been made. This review examines key concepts in the pathophysiology of HIV and pregnancy with emphasis on perinatal transmission and reviews appropriate screening and diagnostic testing for HIV during pregnancy. Current recommendations for medical, pharmacologic, and obstetric management of women newly diagnosed with HIV during pregnancy and for those women with preexisting infection are discussed. Preconception counseling for HIV+ women as well as postpartum issues are addressed. Copyright © 2014 Elsevier Inc. All rights reserved.
Khanasuk, Yutthana; Ngarmukos, Srihatach
Pain management has become a very important part of postoperative care for total knee arthroplasty patients. Contemporary pain control has evolved from high-dose opioid in the past to state-of-the-art multimodal regimens. These include multiple non-opioid medication such as NSAIDs, COX-2 inhibitors, and gabapentinoid, and novel anesthetic techniques such as preemptive analgesia and ultrasound-guided peripheral nerve blocks. Another method which is gaining popularity is intraarticular injection of anesthetic cocktail during surgery. Pre-op education can also help patients cope with their pain better.
Rajjan Man Chitrakar
Full Text Available The lack of management has led to the degrading quality of public space in modern cities around the globe. Contemporary public spaces are facing challenges in terms of maintaining them as a “social space” so that they are accessible and functional for the users. Using Kathmandu as a case study, this paper explores the challenges the contemporary public spaces within urban neighbourhoods are facing in their management. The study reveals that the regulation of use is a major concern of public space management in the new neighbourhoods of Kathmandu as evident in the limited accessibility and utility of public space, due to control and commercialisation. The use of public space has also been affected by the lack of regular maintenance. The root cause of these problems lies in weak urban governance at the neighbourhood level, which has led the local community-based organisations to take a role in neighbourhood management. These findings confirm that the management of public space is a critical issue of urban development with commonalities existing across geographical regions that demand adequate consideration from the stakeholders.
Claure-Del Granado, Rolando; Mehta, Ravindra L
Fluid overload is frequently found in acute kidney injury patients in critical care units. Recent studies have shown the relationship of fluid overload with adverse outcomes; hence, manage and optimization of fluid balance becomes a central component of the management of critically ill patients. In critically ill patients, in order to restore cardiac output, systemic blood pressure and renal perfusion an adequate fluid resuscitation is essential. Achieving an appropriate level of volume management requires knowledge of the underlying pathophysiology, evaluation of volume status, and selection of appropriate solution for volume repletion, and maintenance and modulation of the tissue perfusion. Numerous recent studies have established a correlation between fluid overload and mortality in critically ill patients. Fluid overload recognition and assessment requires an accurate documentation of intakes and outputs; yet, there is a wide difference in how it is evaluated, reviewed and utilized. Accurate volume status evaluation is essential for appropriate therapy since errors of volume evaluation can result in either in lack of essential treatment or unnecessary fluid administration, and both scenarios are associated with increased mortality. There are several methods to evaluate fluid status; however, most of the tests currently used are fairly inaccurate. Diuretics, especially loop diuretics, remain a valid therapeutic alternative. Fluid overload refractory to medical therapy requires the application of extracorporeal therapies. In critically ill patients, fluid overload is related to increased mortality and also lead to several complications like pulmonary edema, cardiac failure, delayed wound healing, tissue breakdown, and impaired bowel function. Therefore, the evaluation of volume status is crucial in the early management of critically ill patients. Diuretics are frequently used as an initial therapy; however, due to their limited effectiveness the use of continuous
The Lewis Research Center's cryogenic fluid management program flight concept definition is presented in viewgraph form. Diagrams are given of the cryogenic fluid management subpallet and its configuration with the Delta launch vehicle. Information is given in outline form on feasibility studies, requirements definition, and flight experiments design.
Novicevic, Milorad M.; Buckley, M. Ronald
Addresses the manager's dilemmas and options in resolving emerging latent intergenerational conflict in the contemporary knowledge-rich workplace. Topics include a theoretical framework for generational divide management; the polarization in task requirements; social and environmental factors; differences in employee needs and expectations; and…
Kane, Stefan C.; Dennis, Alicia; da Silva Costa, Fabricio; Kornman, Louise; Brennecke, Shaun
The neurological complications of preeclampsia and eclampsia are responsible for a major proportion of the morbidity and mortality arising from these conditions, for women and their infants alike. This paper outlines the evidence base for contemporary management principles pertaining to the neurological sequelae of preeclampsia, primarily from the maternal perspective, but with consideration of fetal and neonatal aspects as well. It concludes with a discussion regarding future directions in t...
Full Text Available Purpose: This paper has been aimed at defining contemporary management flexibility determinants and the methods of its measurement. Problem investigated: This paper presents an analysis of organizational flexibility determinants related to the contemporary concepts and challenges within the area of management. The discussion includes two types of measurement of organizational flexibility based on declarative tests and quantitative criteria. The described methods are subject to evaluation. The paper also presents authors' own proposal for determinants classification, organizational flexibility assessment and an exemplary application. Methodology: The paper has been based on the results of research on organizational flexibility conducted by the Department of Business Studies Aalborg University (Denmark and Wrocław University of Economics (Poland. Conclusion: Organizational flexibility constitutes one of the major challenges of contemporary management. This issue has already been extensively discussed, however, despite numerous publications and relevant research projects many issues still need to be resolved. One of them is organizational flexibility measurement. In the first place, it needs a description of flexibility determinants relevant to a certain organization. There are no objective methods that would allow a description of the set of determinants since they are dependent on organization's special features and individually set objectives. In addition, it should be noted that those factors are subject to change, in line with the development of theory and concepts of management. The very flexibility measurement requires simultaneous application of various methods of factor analysis and polling stakeholder opinions.
Gupta, Tejpal; Sarkar, Chitra; Rajshekhar, Vedantam; Chatterjee, Sandip; Shirsat, Neelam; Muzumdar, Dattatreya; Pungavkar, Sona; Chinnaswamy, Girish; Jalali, Rakesh
The high success rate in the management medulloblastoma achieved in the western world is not exactly mirrored in developing countries including India. Socio-demographic differences, health-care disparity, and lack in uniformity of care with resultant widespread variations in the clinical practice are some of the reasons that may partly explain this difference in outcomes. Patients with medulloblastoma require a multi-disciplinary team approach involving but not limited to neuro-radiology, neurosurgery; neuropathology, molecular biology, radiation oncology, pediatric medical oncology and rehabilitative services for optimizing outcomes. The Indian Society of Neuro-Oncology (ISNO) constituted an expert multi-disciplinary panel with adequate representation from all stakeholders to prepare national consensus guidelines for the contemporary management of medulloblastoma. Minimum desirable, as well as preferable though optional recommendations (as appropriate), were developed and adopted for the pre-surgical work-up including neuroimaging; neurosurgical management including surgical principles, techniques, and complications; neuropathology reporting and molecular testing; contemporary risk-stratification in the molecular era; appropriate adjuvant therapy (radiotherapy and chemotherapy); and follow-up schedule in medulloblastoma. The current document represents a broad consensus reached amongst various stakeholders within the neuro-oncology community involved in the contemporary curative-intent management of children with medulloblastoma. It provides both general as well as specific guidelines and recommendations to be adopted by physicians and health care providers across India to achieve uniformity of care, improve disease-related outcomes, and compare results between institutions within the country.
Arias-Guillén, Marta; Wabel, Peter; Fontseré, Néstor; Carrera, Montserrat; Campistol, José Maria; Maduell, Francisco
Summary Background and objectives Achieving and maintaining optimal fluid status remains a major challenge in hemodialysis therapy. The aim of this interventional study was to assess the feasibility and clinical consequences of active fluid management guided by bioimpedance spectroscopy in chronic hemodialysis patients. Design, setting, participants, & measurements Fluid status was optimized prospectively in 55 chronic hemodialysis patients over 3 months (November 2011 to February 2012). Predialysis fluid overload was measured weekly using the Fresenius Body Composition Monitor. Time-averaged fluid overload was calculated as the average between pre- and postdialysis fluid overload. The study aimed to bring the time-averaged fluid overload of all patients into a target range of 0.5±0.75 L within the first month and maintain optimal fluid status until study end. Postweight was adjusted weekly according to a predefined protocol. Results Time-averaged fluid overload in the complete study cohort was 0.9±1.6 L at baseline and 0.6±1.1 L at study end. Time-averaged fluid overload decreased by −1.20±1.32 L (P<0.01) in the fluid-overloaded group (n=17), remained unchanged in the normovolemic group (n=26, P=0.59), and increased by 0.59±0.76 L (P=0.02) in the dehydrated group (n=12). Every 1 L change in fluid overload was accompanied by a 9.9 mmHg/L change in predialysis systolic BP (r=0.55, P<0.001). At study end, 76% of all patients were either on time-averaged fluid overload target or at least closer to target than at study start. The number of intradialytic symptoms did not change significantly in any of the subgroups. Conclusions Active fluid management guided by bioimpedance spectroscopy was associated with an improvement in overall fluid status and BP. PMID:23949235
Full Text Available Top-down controls of complex foodwebs maintain the balance among the critical groups of corals, algae, and herbivores, thus allowing the persistence of corals reefs as three-dimensional, biogenic structures with high biodiversity, heterogeneity, resistance, resilience and connectivity, and the delivery of essential goods and services to societies. On contemporary reefs world-wide, however, top-down controls have been weakened due to reduction in herbivory levels (overfishing or disease outbreak while bottom-up controls have increased due to water quality degradation (increase in sediment and nutrient load and climate forcing (seawater warming and acidification leading to algal-dominated alternate benthic states of coral reefs, which are indicative of a trajectory towards ecological extinction. Management to reverse common trajectories of degradation for coral reefs necessitates a shift from optimization in marine resource use and conservation towards building socio-economic resilience into coral reef systems while attending to the most manageable human impacts (fishing and water quality and the global-scale causes (climate change.
Goyal, Jatinder; Ramesh, Jayapal
Peripancreatic fluid collections are a well-known complication of pancreatitis and can vary from fluid-filled collections to entirely necrotic collections. Although most of the fluid-filled pseudocysts tend to resolve spontaneously with conservative management, intervention is necessary in symptomatic patients. Open surgery has been the traditional treatment modality of choice though endoscopic, laparoscopic and transcutaneous techniques offer alternative drainage approaches. During the last decade, improvement in endoscopic ultrasound technology has enabled real-time access and drainage of fluid collections that were previously not amenable to blind transmural drainage. This has initiated a trend towards use of this modality for treatment of pseudocysts. In this review, we have summarised the existing evidence for endoscopic drainage of peripancreatic fluid collections from published studies.
The US Department of Energy, Nevada Operations Office (DOE/NV) has initiated the Offsites Subproject to characterize the hazards posed to human health and the environment as a result of underground nuclear testing activities at facilities other than the Nevada Test Site (NTS). A primary Subproject objective is to gather adequate data to characterize the various Subproject sites through the collection of surface and subsurface soil samples and by drilling several wells for the collection of groundwater data. The Project Shoal Area (PSA) is one of the Subproject's Nevada sites and is subject to the requirements set forth in the Federal Facility Compliance Agreement and Consent Order (FFACO) (DOE, 1996a). In accordance with the FFACO, a Corrective Action Investigation Plan (CAIP) has been developed for work at the PSA (designated as Corrective Action Unit Number 416). This Fluid Management Plan (FMP) provides guidance for the management of fluids generated from wells constructed at the PSA. Long-term monitoring and future activities at the site, if required, will be set forth in additional documents as required by the FFACO. The ultimate method for disposition of fluids generated by site operations depends upon sample analysis and process knowledge in relation to fluid management criteria. Section 2 describes well site operations; Section 3 discusses fluid management criteria; Section 4 includes the fluid monitoring program; Section 5 presents the fluid management strategy; Section 6 provides for fluid management during routine well monitoring; and Section 7 contains reporting criteria
Results are summarized for an 11-month study to define fluid storage and handling strategies and requirements for various specific mission case studies and their associated design impacts on the Space Station. There are a variety of fluid users which require a variety of fluids and use rates. Also, the cryogenic propellants required for NASA's STV, Planetary, and Code Z missions are enormous. The storage methods must accommodate fluids ranging from a high pressure gas or supercritical state fluid to a sub-cooled liquid (and superfluid helium). These requirements begin in the year 1994, reach a maximum of nearly 1800 metric tons in the year 2004, and trail off to the year 2018, as currently planned. It is conceivable that the cryogenic propellant needs for the STV and/or Lunar mission models will be met by LTCSF LH2/LO2 tanksets attached to the SS truss structure. Concepts and corresponding transfer and delivery operations have been presented for STV propellant provisioning from the SS. A growth orbit maneuvering vehicle (OMV) and associated servicing capability will be required to move tanksets from delivery launch vehicles to the SS or co-orbiting platforms. Also, appropriate changes to the software used for OMV operation are necessary to allow for the combined operation of the growth OMV. To support fluid management activities at the Space Station for the experimental payloads and propellant provisioning, there must be truss structure space allocated for fluid carriers and propellant tanksets, and substantial beam strengthening may be required. The Station must have two Mobile Remote Manipulator Systems (MRMS) and the growth OMV propellant handling operations for the STV at the SS. Propellant needs for the Planetary Initiatives and Code Z mission models will most likely be provided by co-orbiting propellant platform(s). Space Station impacts for Code Z mission fluid management activities will be minimal.
Kline, Kristopher P; Conti, C Richard; Winchester, David E
Acute coronary syndrome (ACS) remains a major burden on morbidity and mortality in the United States. Medical professionals and students often use the mnemonic 'MONA' (morphine, oxygen, nitroglycerin and aspirin) to recall treatments for ACS; however, this list of therapies is outdated. We provide a historical perspective on 'MONA,' attempt to uncover its origin in the medical literature, and demonstrate the myriad changes that have occurred over the last 50 years of ACS management. We have developed a novel mnemonic, 'THROMBINS2' (thienopyridines, heparin/enoxaparin, renin-angiotensin system blockers, oxygen, morphine, beta blocker, intervention, nitroglycerin, statin/salicylate) to help bedside clinicians recall all the elements of contemporary ACS management. We demonstrate the mortality benefit for each component of contemporary ACS management, correlating the continued improvement with historical data on mortality after myocardial infarction. We encourage providers to utilize this mnemonic to explore options and guide treatments in ACS patients.
Asuga, Gladys Nyanchama; Scevak, Jill; Eacott, Scott
Over the past two decades, there have been calls by scholars for a more concerted effort to develop empirically grounded research studies on educational leadership management and administration in an indigenous context rather than hegemonic western contexts. This paper presents a review of contemporary literature on educational leadership from…
Zhou Gang; Wang Lushuai; Tang Yaoyang
In order to improve the safety, economy and reliability of the operation of a nuclear power plant (NPP), a novel integrated management method is proposed based on the 'integration' concept of the computer and contemporary integrated manufacture systems (CIMS). The design of integrated management system for NPP is studied. In the design of this system, information integration method based on the database and product data management (PDM) technology is adopted. In order to design and integrated management system satisfying the needs of NPP management, all activities of NPP are divided into different categories according to its characteristics. There are subsystems under the general management system to conduct the management work of different categories. All subsystems are interrelated in the environment of CIMS, but relatively independent. The application of CIMS to NPP provides a new way for scientific management of NPP, and makes the best of human, material and information resources. (authors)
Nabi, Zaheer; Talukdar, Rupjyoti; Reddy, D Nageshwar
The incidence of acute pancreatitis in children has increased over the last few decades. The development of pancreatic fluid collection is not uncommon after severe acute pancreatitis, although its natural course in children and adolescents is poorly understood. Asymptomatic fluid collections can be safely observed without any intervention. However, the presence of clinically significant symptoms warrants the drainage of these fluid collections. Endoscopic management of pancreatic fluid collection is safe and effective in adults. The use of endoscopic ultrasound (EUS)-guided procedure has improved the efficacy and safety of drainage of pancreatic fluid collections, which have not been well studied in pediatric populations, barring a scant volume of small case series. Excellent results of EUS-guided drainage in adult patients also need to be verified in children and adolescents. Endoprostheses used to drain pancreatic fluid collections include plastic and metal stents. Metal stents have wider lumens and become clogged less often than plastic stents. Fully covered metal stents specifically designed for pancreatic fluid collection are available, and initial studies have shown encouraging results in adult patients. The future of endoscopic management of pancreatic fluid collection in children appears promising. Prospective studies with larger sample sizes are required to establish their definitive role in the pediatric age group.
Manhas, Amitoz; Nimjee, Shahid M; Agrawal, Abhishek; Zhang, Jonathan; Diaz, Orlando; Zomorodi, Ali R; Smith, Tony; Powers, Ciarán J; Sauvageau, Eric; Klucznik, Richard P; Ferrell, Andrew; Golshani, Kiarash; Stieg, Philip E; Britz, Gavin W
Aneurysmal subarachnoid hemorrhage (SAH) remains an important health issue in the United States. Despite recent improvements in the diagnosis and treatment of cerebral aneurysms, the mortality rate following aneurysm rupture. In those patients who survive, up to 50% are left severely disabled. The goal of preventing the hemorrhage or re-hemorrhage can only be achieved by successfully excluding the aneurysm from the circulation. This article is a comprehensive review by contemporary vascular neurosurgeons and interventional neuroradiolgists on the modern management of cerebral aneurysms. Copyright © 2015 Elsevier Inc. All rights reserved.
Henderson, Amanda; Winch, Sarah
Leadership strategies are important in facilitating the nursing profession to reach their optimum standards in the practice environment. To compare and contrast the central tenets of contemporary quality initiatives that are commensurate with enabling the environment so that best practice can occur. Democratic leadership, accessible and relevant education and professional development, the incorporation of evidence into practice and the ability of facilities to be responsive to change are core considerations for the successful maintenance of practice standards that are consistent with best nursing practice. While different concerns of management drive the adoption of contemporary approaches, there are many similarities in the how these approaches are translated into action in the clinical setting. Managers should focus on core principles of professional nursing that add value to practice rather than business processes.
O'Brien, Jonathan S; Perera, Marlon; Manning, Todd; Bozin, Mike; Cabarkapa, Sonja; Chen, Emily; Lawrentschuk, Nathan
In penile cancer, the optimal diagnostics and management of metastatic lymph nodes are not clear. Advances in minimally invasive staging, including dynamic sentinel lymph node biopsy, have widened the diagnostic repertoire of the urologist. We aimed to provide an objective update of the recent trends in the management of penile squamous cell carcinoma, and inguinal and pelvic lymph node metastases. We systematically reviewed several medical databases, including the Web of Science® (with MEDLINE®), Embase® and Cochrane databases, according to PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) guidelines. The search terms used were penile cancer, lymph node, sentinel node, minimally invasive, surgery and outcomes, alone and in combination. Articles pertaining to the management of lymph nodes in penile cancer were reviewed, including original research, reviews and clinical guidelines published between 1980 and 2016. Accurate and minimally invasive lymph node staging is of the utmost importance in the surgical management of penile squamous cell carcinoma. In patients with clinically node negative disease, a growing body of evidence supports the use of sentinel lymph node biopsies. Dynamic sentinel lymph node biopsy exposes the patient to minimal risk, and results in superior sensitivity and specificity profiles compared to alternate nodal staging techniques. In the presence of locoregional disease, improvements in inguinal or pelvic lymphadenectomy have reduced morbidity and improved oncologic outcomes. A multimodal approach of chemotherapy and surgery has demonstrated a survival benefit for patients with advanced disease. Recent developments in lymph node management have occurred in penile cancer, such as minimally invasive lymph node diagnosis and intervention strategies. These advances have been met with a degree of controversy in the contemporary literature. Current data suggest that dynamic sentinel lymph node biopsy provides excellent
Scott, A J; Bicknell, C D
Growing confidence in thoracic endovascular aortic repair (TEVAR) for the management of acute type B aortic dissection has resulted in controversies regarding optimum patient selection and the timing of intervention. In this review a clinical vignette to present a practical perspective on the contemporary management of acute type B dissection (ABAD) in a specialist vascular centre with particular focus on areas of debate is used. This is a narrative clinical review. Aggressive anti-impulse therapy is the cornerstone of management of all patients with ABAD. However, 20-30% of patients develop complicated ABAD defined by the presence of malperfusion syndromes, acute aortic dilatation, dissection extension, or persistent pain and hypotension. These complicated patients typically require intervention, and non-randomised series suggest TEVAR to be an effective alternative to open repair with a lower morbidity. There is considerable interest and controversy surrounding the use of TEVAR in uncomplicated ABAD patients for whom the intervention-free survival at 6 years is less than 50% for patients managed with anti-impulse therapy. Data regarding this question are sparse, but two randomised trials (ADSORB and INSTEAD) both demonstrated a higher rate of favourable aortic remodelling in patients managed with TEVAR than medical therapy alone. However, it is unclear whether this positive remodelling translates into a reduction in long-term mortality sufficient to balance the early perioperative hazards of endografting. Despite increasing adeptness at endovascular stenting, the long-term outcomes of patients with ABAD leave significant room for improvement. In particular, the optimum management of patients with uncomplicated disease is unclear and guidance from trials powered for long-term mortality is awaited. Until then, the principals of management of ABAD remain aggressive medical therapy for all patients, with TEVAR primarily reserved for those who develop complications
Full Text Available The school of today faces circumstances that differ very much from the ones in which the current educators have been educated as students, especially in the countries that are new members of the European Union as EU-27. Therefore, in order to manage knowledge in their school of today, one must understand the socio-economic development trends and their impact over the school as a subsystem of the emerging innovative society in which the innovative business leaves little or no room for the routine-loving behaviour of previous decades, centuries, and millennia. This contribution summarizes a dialectical system of this development trends and the resulting newly required attributes of the contemporary schools and teachers, but it does so on the level of provocation for readers’ creative and innovative thinking and action rather than on the level of any final answers. The Bologna Process seems to be an underused opportunity for innovation of higher education in Europe.
Olson, Thomas; Poulfelt, Flemming; Greiner, Larry
This book complements The handbook of Management Consulting: The Contemporary Consultant: Insights from Leading Experts, 1e but can also be studied separately. The book consists of 20 cases including Harvard and Stanford cases. The cases present the broad range of topics that are pertinent to cur...... current management issues facing consulting firms. These cases, together with the handbook, will prepare consultants and other business managers for a successful future in a highly competitive consulting environment.......This book complements The handbook of Management Consulting: The Contemporary Consultant: Insights from Leading Experts, 1e but can also be studied separately. The book consists of 20 cases including Harvard and Stanford cases. The cases present the broad range of topics that are pertinent...... to current management consulting. Each of the four parts of the text presents a cogent introduction by the editors, delineating topics that are critical for today's consultants to understand. The cases represent major practice areas of consulting and afford new insights into change processes and other...
Carol Raish; Armando Gonzalez-Caban; Carol J. Condie
Indigenous and traditional peoples worldwide have used fire to manipulate their environment for thousands of years. These longstanding practices still continue and have considerable relevance for todayâs land managers. This discussion explores the value of documenting and understanding historic and contemporary fire use attitudes and practices of the varied cultural/...
Symes, Richard J; Mikelberg, Frederick S
The aim of this study was to investigate contemporary practice patterns with respect to normal tension glaucoma (NTG) management and to determine whether the 2 largest NTG trials have influenced ophthalmologists' clinical practice. A survey questionnaire was sent to ophthalmologists via the American Glaucoma Society, the Canadian Glaucoma Society, and the Canadian Ophthalmological Society. The questionnaire was designed to investigate ophthalmologists' usual practice with respect to NTG and the extent to which practice has been influenced by the Collaborative Normal Tension Glaucoma Study (CNTGS) and the Low pressure Glaucoma Treatment Study (LoGTS). In total, 419 ophthalmologists completed the survey. Of these, 264 respondents were glaucoma subspecialists. The survey showed that 95% and 64% of ophthalmologists were familiar with the CNTGS and the LoGTS, respectively. Of the respondents, 70% indicated that they would initiate treatment in mild-to-moderate NTG without waiting for documented disease progression. Of the respondents, 61% of the total surveyed and 50% of the glaucoma subspecialists felt that the LoGTS results had no impact on their usual clinical practice. The first-choice topical drug for NTG was a prostaglandin analogue (88% of respondents) or brimonidine (10% of respondents). Most ophthalmologists treat NTG more aggressively than recommended by the CTNGS protocol. Most ophthalmologists felt that the LoGTS results had no impact on their normal clinical practice. The prostaglandin analogues are, by far, the most popular choice of drug for contemporary management of NTG. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
Full Text Available The article presents reflections on the role of the teacher in contemporary social reality dominated by neoliberal culture, which involves weakening democratic institutions; a corporate model of functioning in educational institutions; managerial discourse that reduces educational processes to management strategies; and the development of bureaucracy as a governance model. It is argued that “bureaucrat” and “manager” are the two versions of a professional role currently being imposed on teachers, as well as the antithesis of teachers’ civic roles.
Raven, J; Rix, P
This study sets out to investigate the theories and practices of risk assessment and management in the context of contemporary mental health practice. Although risk assessment and management policies are well established for those working in the field of community mental health care, there are noticeable anomalies and regional variations, in the criteria, procedures and decision-making strategies used. Focus group taped interviews were conducted with over 100 mental health professionals in one NHS Trust. These were compared with an extensive literature review on the topic. The main theme to emerge was lack of resources, which included time and staff in the context of a changing and increasing workload. Another important theme was the lack of access to centralized and accurate information about mental health service provision. It is essential that professionals, clients, their families and the public feel confident in professional judgements and practices to avoid a 'back to the asylum' lobby, for the care and treatment of seriously mentally ill individuals.
Ingelse, Sarah A; Wösten-van Asperen, Roelie M; Lemson, Joris; Daams, Joost G; Bem, Reinout A; van Woensel, Job B
The administration of an appropriate volume of intravenous fluids, while avoiding fluid overload, is a major challenge in the pediatric intensive care unit. Despite our efforts, fluid overload is a very common clinical observation in critically ill children, in particular in those with pediatric acute respiratory distress syndrome (PARDS). Patients with ARDS have widespread damage of the alveolar-capillary barrier, potentially making them vulnerable to fluid overload with the development of pulmonary edema leading to prolonged course of disease. Indeed, studies in adults with ARDS have shown that an increased cumulative fluid balance is associated with adverse outcome. However, age-related differences in the development and consequences of fluid overload in ARDS may exist due to disparities in immunologic response and body water distribution. This systematic review summarizes the current literature on fluid imbalance and management in PARDS, with special emphasis on potential differences with adult patients. It discusses the adverse effects associated with fluid overload and the corresponding possible pathophysiological mechanisms of its development. Our intent is to provide an incentive to develop age-specific fluid management protocols to improve PARDS outcomes.
Howard, Ryan; Kurz, Sarah; Sherman, Matthew A; Underhill, Joshua; Eliason, Jonathan L; Coleman, Dawn M
Secondary aortoduodenal fistula (SADF) is a rare, life-threatening complication of abdominal aortic reconstruction. Clinical presentation varies and treatment requires complex surgical repair associated with considerable morbidity and mortality. This retrospective study examines the contemporary management of SADF at a tertiary vascular surgical practice. Thirteen patients were managed for SADF between 2004 and 2014. Vascular and duodenal reconstructions were considered. Primary end points included bile leak, major complications, and mortality. Of the 13 patients presenting with SADF, 6 presented with luminal blood loss. During mean follow-up (632 days), the rate of major complication was 77%. Overall, 38% developed duodenal leak. All leaks occurred after graft explantation with extra-anatomic bypass, and the majority of these patients (80%) had no preceding history of acute gastrointestinal (GI) bleed. There were no leaks identified after duodenal exclusion with gastrojejunostomy. Patients that developed duodenal leak had longer mean intensive care unit length of stay (LOS; 7.0 vs. 2.3 days, P = 0.004), longer mean overall hospital LOS (36.6 vs. 18.5 days, P = 0.012), and greater late mortality (40% vs. 13%). There were 2 SADF-related deaths. Overall mortality trended higher in females (67% vs. 20%, P = 0.125) and those that presented without acute GI bleed (43% vs. 17%, P = 0.308). Surgical reconstruction for SADF results in major morbidity. Those presenting with acute GI bleed trended toward better outcomes than those without. Duodenal leak remains a serious complication. Duodenal exclusion may represent a more appropriate and conservative approach for management of the duodenal defect in select patients. Copyright © 2015 Elsevier Inc. All rights reserved.
Taniguchi, Hideki; Sasaki, Toshio; Fujita, Hisae
Preoperative fluid and electrolyte management is usually performed by intravenous therapy. We investigated the safety and effectiveness of oral rehydration therapy (ORT) for preoperative fluid and electrolyte management of surgical patients. The study consisted of two studies, designed as a prospective observational study. In a pilot study, 20 surgical patients consumed 1000 mL of an oral rehydration solution (ORS) until 2 h before induction of general anesthesia. Parameters such as serum electrolyte concentrations, fractional excretion of sodium (FENa) as an index of renal blood flow, volume of esophageal-pharyngeal fluid and gastric fluid (EPGF), and patient satisfaction with ORT were assessed. In a follow-up study to assess the safety of ORT, 1078 surgical patients, who consumed ORS until 2 h before induction of general anesthesia, were assessed. In the pilot study, water, electrolytes, and carbohydrate were effectively and safely supplied by ORT. The FENa value was increased at 2 h following ORT. The volume of EPGF collected following the induction of anesthesia was 5.3±5.6 mL. In the follow-up study, a small amount of vomiting occurred in one patient, and no aspiration occurred in the patients. These results suggest that ORT is a safe and effective therapy for the preoperative fluid and electrolyte management of selected surgical patients.
Doherty, Michael P.; Gaby, Joseph D.; Salerno, Louis J.; Sutherlin, Steven G.
In support of the U.S. Space Exploration Policy, focused cryogenic fluid management technology efforts are underway within the National Aeronautics and Space Administration. Under the auspices of the Exploration Technology Development Program, cryogenic fluid management technology efforts are being conducted by the Cryogenic Fluid Management Project. Cryogenic Fluid Management Project objectives are to develop storage, transfer, and handling technologies for cryogens to support high performance demands of lunar, and ultimately, Mars missions in the application areas of propulsion, surface systems, and Earth-based ground operations. The targeted use of cryogens and cryogenic technologies for these application areas is anticipated to significantly reduce propellant launch mass and required on-orbit margins, to reduce and even eliminate storage tank boil-off losses for long term missions, to economize ground pad storage and transfer operations, and to expand operational and architectural operations at destination. This paper organizes Cryogenic Fluid Management Project technology efforts according to Exploration Architecture target areas, and discusses the scope of trade studies, analytical modeling, and test efforts presently underway, as well as future plans, to address those target areas. The target areas are: liquid methane/liquid oxygen for propelling the Altair Lander Ascent Stage, liquid hydrogen/liquid oxygen for propelling the Altair Lander Descent Stage and Ares V Earth Departure Stage, liquefaction, zero boil-off, and propellant scavenging for Lunar Surface Systems, cold helium and zero boil-off technologies for Earth-Based Ground Operations, and architecture definition studies for long term storage and on-orbit transfer and pressurization of LH2, cryogenic Mars landing and ascent vehicles, and cryogenic production via in situ resource utilization on Mars.
Because of the role of the kidneys in maintaining homeostasis in the body, kidney disease leads to derangements of fluid, electrolyte, and acid-base balance. The most effective therapy of a uremic crisis is careful management of fluid balance, which involves thoughtful assessment of hydration, a fluid treatment plan personalized for the specific patient, and repeated and frequent reassessment of fluid and electrolyte balance. Disorders of sodium, chloride, potassium, calcium, and phosphorus are commonly encountered in kidney disease and some may be life-threatening. Treatment of metabolic acidosis and nutritional support is frequently needed. Copyright © 2016 Elsevier Inc. All rights reserved.
Sarah A Ingelse
Full Text Available The administration of an appropriate volume of intravenous fluids, while avoiding fluid overload, is a major challenge in the pediatric intensive care unit. Despite our efforts, fluid overload is a very common clinical observation in critically ill children, in particular in those with pediatric acute respiratory distress syndrome (PARDS. Patients with ARDS have widespread damage of the alveolar capillary barrier, potentially making them vulnerable to fluid overload with the development of pulmonary edema leading to prolonged course of disease. Indeed, studies in adults with ARDS have shown that an increased cumulative fluid balance is associated with adverse outcome. However, age-related differences in the development and consequences of fluid overload in ARDS may exist due to disparities in immunologic response and body water distribution. This systematic review summarizes the current literature on fluid imbalance and management in PARDS, with special emphasis on potential differences with adult patients. It discusses the adverse effects associated with fluid overload and the corresponding possible pathophysiological mechanisms of its development. Our intent is to provide an incentive to develop age-specific fluid management protocols to improve PARDS outcomes.
Bain, Daniel J.; Arrigo, Jennifer A.S.; Green, Mark B.; Pellerin, Brian A.; Vörösmarty, Charles J.
Hydrologic science has largely built its understanding of the hydrologic cycle using contemporary data sources (i.e., last 100 years). However, as we try to meet water demand over the next 100 years at scales from local to global, we need to expand our scope and embrace other data that address human activities and the alteration of hydrologic systems. For example, the accumulation of human impacts on water systems requires exploration of incompletely documented eras. When examining these historical periods, basic questions relevant to modern systems arise: (1) How is better information incorporated into water management strategies? (2) Does any point in the past (e.g., colonial/pre-European conditions in North America) provide a suitable restoration target? and (3) How can understanding legacies improve our ability to plan for future conditions? Beginning to answer these questions indicates the vital need to incorporate disparate data and less accepted methods to meet looming water management challenges.
Dolejs, Scott C; Guzman, Michael J; Fajardo, Alyssa D; Holcomb, Bryan K; Robb, Bruce W; Waters, Joshua A
Sigmoid volvulus is an uncommon cause of bowel obstruction that is historically associated with high morbidity and mortality. The objective of this study was to evaluate contemporary management of sigmoid volvulus and the safety of primary anastomosis in patients with sigmoid volvulus. The National Surgical Quality Improvement Project from 2012 to 2015 was queried for patients with colonic volvulus who underwent left-sided colonic resection. A propensity score-matched analysis was performed to compare patients with sigmoid volvulus undergoing colectomy with primary anastomosis without proximal diversion to colectomy with end colostomy. Two thousand five hundred thirty-eight patients with sigmoid volvulus were included for analysis. Patients had a median age of 68 years (interquartile range, 55-80) and 79% were fully independent preoperatively. Fifty-one percent of operations were performed emergently. One thousand eight hundred thirteen (71%) patients underwent colectomy with anastomosis, 240 (10%) colectomy with anastomosis and proximal diversion, and 485 (19%) colectomy with end colostomy. Overall, 30-day mortality and morbidity were 5 and 40%, respectively. After propensity score matching, mortality, overall morbidity, and serious morbidity were similar between groups. Sigmoid volvulus occurs in elderly and debilitated patients with significant morbidity, mortality, and lifestyle implications. In selected patients, anastomosis without proximal diversion in patients with sigmoid volvulus results in similar outcomes to colectomy with end colostomy.
Fluid management impacts strongly on the optimization of space construction. Large quantities of liquids are needed for propellants and life support. The mass of propellant liquids is comparable to that required for the structures. There may be a strong dynamic interaction between the stored liquids and the space structure unless the design minimizes the interaction. The constraints of cost and time required optimization of the supply/resupply strategy. The proper selection and design of the fluid management methods for: slosh control; stratification control; acquisition; transfer; gauging; venting; dumping; contamination control; selection of tank configuration and size; the storage state and the control system can improve the entire system performance substantially. Our effort consists of building mathematical/computer models of the various fluid management methods and testing them against the available experimental data. The results of the models are used as inputs to the system operations studies. During the past year, the emphasis has been on modeling: the transfer of cryogens; sloshing and the storage configuration. The work has been intermeshed with ongoing NASA design and development studies to leverage the funds provided by the Center.
N ational C ancer I nstitute Managing Chemotherapy Side Effects Swelling (Fluid retention) “My hands and feet were swollen and puffy. My nurse helped me understand why I had to stop eating salty ...
Wang, Hsiu-Che; Jewell-Larsen, Nels E.; Mamishev, Alexander V.
Optimal thermal management is critical in modern consumer electronics. Typically, a thermal management scheme for an electronic system involves several physical principles. In many cases, it is highly desirable to enhance heat transfer at the solid-air interface while maintaining small size of the thermal management solution. The enhancement of heat transfer at the solid-air interface can be achieved by several physical principles. One principle that is getting increased attention of thermal management design engineers is electrostatic fluid acceleration. This paper discusses recent breakthroughs in state-of-the-art of electrostatic fluid accelerators (EFAs). The paper compares and contrasts EFAs’ design and performance metrics to those of other airside cooling technologies used in small form factor applications. Since the energy efficiency, flow rate, and acoustic emissions are highly influenced by the scale of the airside cooling devices, the paper also presents the analysis of fundamental effect of scaling laws on heat transfer performance. The presented review and analysis helps drawing conclusions regarding achievable comparative performance and practicality of using different design approaches and physical principles for different applications. -- Highlights: ► Discuss breakthrough in state-of-the-art of electrostatic fluid accelerators (EFA). ► Compare EFAs' performance metrics to those of other airside cooling technologies. ► Show analysis of fundamental effect of scaling laws on heat transfer performance
Oliver, Kelly; Manton, David John
Effective behavior management guides children through the complex social context of dentistry utilizing techniques based on a current understanding of the social, emotional, and cognitive development of children. Behavior management techniques facilitate effective communication and establish social and behavioral guidelines for the dental environment. Contemporary parenting styles, expectations, and attitudes of modern parents and society have influenced the use of behavior management techniques with a prevailing emphasis on communicative techniques and pharmacological management over aversive techniques.
Rosko, Andrew J; Vankoevering, Kyle K; McLean, Scott A; Johnson, Timothy M; Moyer, Jeffrey S
The incidence of melanoma is increasing, with 76 380 new cases of invasive melanoma and 68 480 new cases of melanoma in situ expected in 2016. To review the contemporary management of early-stage melanoma. We searched PubMed, MEDLINE, and the Cochrane Database of Systematic Reviews databases from January 1, 2011, to May 1, 2016, yielding 966 articles. We focused our search on early-stage (melanoma in situ, stage I, and stage II) cutaneous melanoma. After excluding articles, 41 articles were manually reviewed. A review of the bibliographies of selected articles generated additional references. While the majority of recent advances have been in the treatment of advanced melanoma, surgical excision with margins based on the presence and depth of invasion continues to be the cornerstone of management. Sentinel lymph node biopsy plays a central role in the staging and treatment of melanoma. Accurate diagnosis and adequate surgical excision are critical in reducing local recurrences and improving outcomes. Sentinel lymph node biopsy is useful in staging the regional nodal basin and guiding treatment in appropriately selected patients.
Yip, Hon Chi; Teoh, Anthony Yuen Bun
In the past decade, there has been a progressive paradigm shift in the management of peri-pancreatic fluid collections after acute pancreatitis. Refinements in the definitions of fluid collections from the updated Atlanta classification have enabled better communication amongst physicians in an effort to formulate optimal treatments. Endoscopic ultrasound (EUS)-guided drainage of pancreatic pseudocysts has emerged as the procedure of choice over surgical cystogastrostomy. The approach provides similar success rates with low complications and better quality of life compared with surgery. However, an endoscopic "step up" approach in the management of pancreatic walled-off necrosis has also been advocated. Both endoscopic and percutaneous drainage routes may be used depending on the anatomical location of the collections. New-generation large diameter EUS-specific stent systems have also recently been described. The device allows precise and effective drainage of the collections and permits endoscopic necrosectomy through the stents.
Jamdar, Saurabh; Siriwardena, Ajith K
Pancreatic necrosis complicating severe acute pancreatitis is a challenging scenario in contemporary critical care practice; it requires multidisciplinary care in a setting where there is a relatively limited evidence base to support decision making. This commentary provides a concise overview of current management of patients with infected necrosis, focusing on detection, the role of pharmacologic intervention, and the timing and nature of surgical interventions. Fine-needle aspiration of necrosis remains the mainstay for establishment of infection. Pharmacological intervention includes antibiotic therapy as an adjunct to surgical debridement/drainage and, more recently, drotrecogin alfa. Specific concerns remain regarding the suitability of drotrecogin alfa in this setting. Early surgical intervention is unhelpful; surgery is indicated when there is strong evidence for infection of necrotic tissue, with the current trend being toward 'less drastic' surgical interventions. PMID:16356213
Malbrain, Manu L N G; Van Regenmortel, Niels; Saugel, Bernd; De Tavernier, Brecht; Van Gaal, Pieter-Jan; Joannes-Boyau, Olivier; Teboul, Jean-Louis; Rice, Todd W; Mythen, Monty; Monnet, Xavier
In patients with septic shock, the administration of fluids during initial hemodynamic resuscitation remains a major therapeutic challenge. We are faced with many open questions regarding the type, dose and timing of intravenous fluid administration. There are only four major indications for intravenous fluid administration: aside from resuscitation, intravenous fluids have many other uses including maintenance and replacement of total body water and electrolytes, as carriers for medications and for parenteral nutrition. In this paradigm-shifting review, we discuss different fluid management strategies including early adequate goal-directed fluid management, late conservative fluid management and late goal-directed fluid removal. In addition, we expand on the concept of the "four D's" of fluid therapy, namely drug, dosing, duration and de-escalation. During the treatment of patients with septic shock, four phases of fluid therapy should be considered in order to provide answers to four basic questions. These four phases are the resuscitation phase, the optimization phase, the stabilization phase and the evacuation phase. The four questions are "When to start intravenous fluids?", "When to stop intravenous fluids?", "When to start de-resuscitation or active fluid removal?" and finally "When to stop de-resuscitation?" In analogy to the way we handle antibiotics in critically ill patients, it is time for fluid stewardship.
Hyam, D M
The management of third molars requires a significant assessment and decision process both for the patient and the clinician. The clinician must always identify the indication for third molar surgery, assess the risks of the proposed procedure, and then modify their plan to account for the patient's current and future health, their social and financial setting, and the patient's tolerance of risk. In doing this, the clinician can tailor a solution to meet the individual patient's needs. This decision to remove a third molar is made in the fluid setting of the patient's quality of life and requires regular review. This article gives the clinician the tools, the matrix, and the confidence to guide patients through this process, and outlines some of the pitfalls and common points of bias within the process. © 2018 Australian Dental Association.
The low-g fluids management group with the Center for Space Construction is engaged in active research on the following topics: gauging; venting; controlling contamination; sloshing; transfer; acquisition; and two-phase flow. Our basic understanding of each of these topics at present is inadequate to design space structures optimally. A brief report is presented on each topic showing the present status, recent accomplishings by our group and our plans for future research. Reports are presented in graphic and outline form.
Hu, Q; Li, Y; Pan, H L; Liu, J T; Zhuang, B T
Vane type propellant management device (PMD) is one of the key components of the vane-type surface tension tank (STT), and its fluid orbital performance directly determines the STT's success or failure. In present paper, numerical analysis and microgravity experiment study on fluid orbital performance of a vane type PMD were carried out. By using two-phase flow model of volume of fluid (VOF), fluid flow characteristics in the tank with the vane type PMD were numerically calculated, and the rules of fluid transfer and distribution were gotten. A abbreviate model test system of the vane type PMD is established and microgravity drop tower tests were performed, then fluid management and transmission rules of the vane type PMD were obtained under microgravity environment. The analysis and tests results show that the vane type PMD has good and initiative fluid orbital management ability and meets the demands of fluid orbital extrusion in the vane type STT. The results offer valuable guidance for the design and optimization of the new generation of vane type PMD, and also provide a new approach for fluid management and control in space environment
Kommalapati, Anuhya; Tella, Sri Harsha; Goyal, Gaurav; Ma, Wen Wee; Mahipal, Amit
Pancreatic cancer is the third most common cause of cancer deaths in the United States. Surgical resection with negative margins still constitutes the cornerstone of potentially curative therapy, but is possible only in 15-20% of patients at the time of initial diagnosis. Accumulating evidence suggests that the neoadjuvant approach may improve R0 resection rate in localized resectable and borderline resectable diseases, and potentially downstage locally advanced disease to achieve surgical resection, though the impact on survival is to be determined. Despite advancements in the last decade in developing effective combinational chemo-radio therapeutic options, preoperative treatment strategies, and better peri-operative care, pancreatic cancer continues to carry a dismal prognosis in the majority. Prodigious efforts are currently being made in optimizing the neoadjuvant therapy with a better toxicity profile, developing novel agents, imaging techniques, and identification of biomarkers for the disease. Advancement in our understanding of the tumor microenvironment and molecular pathology is urgently needed to facilitate the development of novel targeted and immunotherapies for this setting. In this review, we detail the current literature on contemporary management of resectable, borderline resectable and locally advanced pancreatic cancer with a focus on future directions in the field.
Hemangi S Karnik
Full Text Available Fluid management in neurosurgical paediatric patients can be a real challenge due to their different pathophysiology, sensitivity to fluid loss, inability to accurately judge the degree of abnormality and adequacy of replacement in face of limited monitoring. For infants and children undergoing neurosurgical procedures, isotonic fluids should be used for maintenance and replacement to avoid increase in intracranial pressure and maintain cerebral perfusion. Routine use of added dextrose is not needed, but blood glucose monitoring should be done in high risk population. Preoperative deficits and intraoperative blood loss should be closely monitored and treated. Hyponataemia and other electrolyte derangements are common and should be monitored.
Using readily available experimental thermophoretic particle-velocity data it is shown, contrary to current teachings, that for the case of compressible flows independent dye- and particle-tracer velocity measurements of the local fluid velocity at a point in a flowing fluid do not generally result in the same fluid velocity measure. Rather, tracer-velocity equality holds only for incompressible flows. For compressible fluids, each type of tracer is shown to monitor a fundamentally different fluid velocity, with (i) a dye (or any other such molecular-tagging scheme) measuring the fluid's mass velocity v appearing in the continuity equation and (ii) a small, physicochemically and thermally inert, macroscopic (i.e., non-Brownian), solid particle measuring the fluid's volume velocity v(v). The term "compressibility" as used here includes not only pressure effects on density, but also temperature effects thereon. (For example, owing to a liquid's generally nonzero isobaric coefficient of thermal expansion, nonisothermal liquid flows are to be regarded as compressible despite the general perception of liquids as being incompressible.) Recognition of the fact that two independent fluid velocities, mass- and volume-based, are formally required to model continuum fluid behavior impacts on the foundations of contemporary (monovelocity) fluid mechanics. Included therein are the Navier-Stokes-Fourier equations, which are now seen to apply only to incompressible fluids (a fact well-known, empirically, to experimental gas kineticists). The findings of a difference in tracer velocities heralds the introduction into fluid mechanics of a general bipartite theory of fluid mechanics, bivelocity hydrodynamics [Brenner, Int. J. Eng. Sci. 54, 67 (2012)], differing from conventional hydrodynamics in situations entailing compressible flows and reducing to conventional hydrodynamics when the flow is incompressible, while being applicable to both liquids and gases.
Holte, Kathrine; Kristensen, Billy Bjarne; Valentiner, Lotte
BACKGROUND: There are few data describing the relationship between amount of perioperative fluid and organ function. In this study we investigated the effects of two levels of intravascular fluid administration ("liberal" versus "restrictive") in knee arthroplasty on physiological recovery...... with a standardized volume of colloid. All other aspects of perioperative management (including anesthesia, preoperative fluid status, and postoperative management) were standardized. Primary outcome variables included pulmonary function (spirometry), exercise capacity ("timed up and go" test), coagulation...... as the primary outcome variable. METHODS: In a double-blind study, 48 ASA I-III patients undergoing fast-track elective knee arthroplasty were randomized to restrictive or liberal perioperative intravascular fluid administration. Patients received a fixed rate infusion of Ringer's lactate solution...
Nathamuni Rengarajan Krishnaswamy
Full Text Available Although patients with Class III malocclusions constitute a small percentage of the average orthodontic practice, providing them with optimal treatment is a daunting task. The treatment approach is dependent upon the growth status of the individual and the severity of the skeletal dysplasia. For growing individuals, facemask therapy to protract the maxilla is ineffective because of its dependence on dental anchorage to bring forth skeletal correction. Orthodontic camouflage in nongrowing mild skeletal Class III individuals is met with limited success because of the anatomical boundaries and the conventional biomechanics. Orthognathic surgery to correct the maxillomandibular relations is time-consuming, and the facial esthetics is compromised during the orthodontic decompensation period. Contemporary solutions to overcome these limitations are now viable with the use of temporary anchorage devices and by performing surgery prior to orthodontic decompensation. The rationale for employing these contemporary approaches will be discussed in this study with illustrative cases.
Herbert, Joseph A; Valentine, Michael S; Saravanan, Nivi; Schneck, Matthew B; Pidaparti, Ramana; Fowler, Alpha A; Reynolds, Angela M; Heise, Rebecca L
Approximately 800 thousand patients require mechanical ventilation in the United States annually with an in-hospital mortality rate of over 30%. The majority of patients requiring mechanical ventilation are over the age of 65 and advanced age is known to increase the severity of ventilator-induced lung injury (VILI) and in-hospital mortality rates. However, the mechanisms which predispose aging ventilator patients to increased mortality rates are not fully understood. Ventilation with conservative fluid management decreases mortality rates in acute respiratory distress patients, but to date there has been no investigation of the effect of conservative fluid management on VILI and ventilator associated mortality rates. We hypothesized that age-associated increases in susceptibility and incidence of pulmonary edema strongly promote age-related increases in ventilator associated mortality. 2month old and 20month old male C57BL6 mice were mechanically ventilated with either high tidal volume (HVT) or low tidal volume (LVT) for up to 4h with either liberal or conservative fluid support. During ventilation, lung compliance, total lung capacity, and hysteresis curves were quantified. Following ventilation, bronchoalveolar lavage fluid was analyzed for total protein content and inflammatory cell infiltration. Wet to dry ratios were used to directly measure edema in excised lungs. Lung histology was performed to quantify alveolar barrier damage/destruction. Age matched non-ventilated mice were used as controls. At 4h, both advanced age and HVT ventilation significantly increased markers of inflammation and injury, degraded pulmonary mechanics, and decreased survival rates. Conservative fluid support significantly diminished pulmonary edema and improved pulmonary mechanics by 1h in advanced age HVT subjects. In 4h ventilations, conservative fluid support significantly diminished pulmonary edema, improved lung mechanics, and resulted in significantly lower mortality rates in
Tala, H; Tuttle, R M
Risk assessment is the cornerstone of contemporary management of thyroid cancer. Following thyroid surgery, an initial risk assessment of recurrence and disease-specific mortality is made using important intra-operative findings, histologic characteristics of the tumor, molecular profile of the tumor, post-operative serum thyroglobulin and any available cross-sectional imaging studies. This initial risk assessment is used to guide recommendations regarding the need for remnant ablation, external beam irradiation, systemic therapy, degree of TSH suppression, and follow-up disease detection strategy over the first 2 years after initial therapy. While this initial risk stratification provides valuable information, it is a static representation of the patient in the first few weeks post-operatively that does not change over time. Depending on how the patient responds to our initial therapies, the risk of recurrence and death may change significantly during follow-up. In order to account for differences in response to therapy in individual patients and to incorporate the impact of treatment on our initial risk estimates, we recommend a re-stratification of risk at the 2-year point of follow-up. This re-stratification provides an updated risk estimate that can be used to guide ongoing management recommendations including the frequency and intensity of follow-up, degree of ongoing TSH suppression, and need for additional therapies. Ongoing management recommendations must be tailored to realistic, evolving risk estimates that are actively updated during follow-up. By individualizing therapy on the basis of initial and ongoing risk assessments, we can maximize the beneficial effects of aggressive therapy in patients with thyroid cancer who are likely to benefit from it, while minimizing potential complications and side effects in low-risk patients destined to have a full healthy and productive life after minimal therapeutic intervention. Copyright (c) 2010 The Royal College
Rosmait, Russell L.
The cost of manufacturing space system hardware has always been expensive. The Engineering Cost Group of the Program Planning office at Marshall is attempting to account for cost savings that result from new technologies in manufacturing and management. The objective is to identify and define contemporary philosophies in manufacturing and management. The seven broad categories that make up the areas where technological advances can assist in reducing space system costs are illustrated. Included within these broad categories is a list of the processes or techniques that specifically provide the cost savings within todays design, test, production and operations environments. The processes and techniques listed achieve savings in the following manner: increased productivity; reduced down time; reduced scrap; reduced rework; reduced man hours; and reduced material costs. In addition, it should be noted that cost savings from production and processing improvements effect 20 to 40 pct. of production costs whereas savings from management improvements effects 60 to 80 of production cost. This is important because most efforts in reducing costs are spent trying to reduce cost in the production.
Full Text Available The purpose of this paper is to provide an analysis of the contemporary motivation system at the Russian enterprises. The purpose of the analysis is to find out the main motivators at the enterprises; to highlight the advantages and disadvantages of the existing motivation system and to predict the future development of the motivation system. The given research has been developed by using sociological methods, such as interviews, the analysis of the statistics and simulation method. By analyzing the existing works, the authors have identified the main motivators in connection with the management development periods. Tracing the features of these motivators, the authors have defined the period that corresponds to the incentive system at the Russian enterprises. In practical sphere, the proposed research can be used to develop the motivation system at the Russian enterprises, to make it effective and to predict the potential problems that can appear in the future.
He, Hong S.; Shifley, Stephen R.; Thompson, Frank R.
With 207 million ha of forest covering 22% of its land area, China ranks fifth in the world in forest area. Rapid economic growth, climate change, and forest disturbances pose new, complex challenges for forest research and management. Progress in meeting these challenges is relevant beyond China, because China's forests represent 34% of Asia's forests and 5% of the worlds' forests. To provide a broader understanding of these management challenges and of research and policies that address them, we organized this special issue on contemporary forest research and management issues in China. At the national level, papers review major forest types and the evolution of sustainable forestry, the development of China's forest-certification efforts, the establishment of a forest inventory system, and achievements and challenges in insect pest control in China. Papers focused on Northern China address historical, social, and political factors that have shaped the region's forests; the use of forest landscape models to assess how forest management can achieve multiple objectives; and analysis and modeling of fuels and fire behavior. Papers addressing Central and South China describe the "Grain for Green" program, which converts low productivity cropland to grassland and woodland to address erosion and soil carbon sequestration; the potential effects of climate change on CO2 efflux and soil respiration; and relationships between climate and net primary productivity. China shares many forest management and research issues with other countries, but in other cases China's capacity to respond to forest management challenges is unique and bears watching by the rest of the world.
Full Text Available The article outlines the issues related to the topic of management of formalised marketing and media activities in outsourcing companies in the age of competitiveness, with particular emphasis on contemporary marketing approach. General management of the organisation and management of marketing and media activities, particularly in their formalised form, both have a significant effect on improving company competitiveness in the market. Outsourcing companies constitute a specific sector of services which without a very well-functioning marketing and media activities would not be able to operate and develop in the market. The article presents selected aspects connected with the management of marketing and media activities, with particular emphasis on formalisation of marketing activities in outsourcing companies. The analysis presented below focuses on the efficiency of the implemented formalisation of marketing and media activities in outsourcing companies in relation to their competitiveness, with special recognition of contemporary marketing approach.
Aydelott, J. C.; Rudland, R. S.
The NASA Lewis Research Center is responsible for the planning and execution of a scientific program which will provide advance in space cryogenic fluid management technology. A number of future space missions were identified that require or could benefit from this technology. These fluid management technology needs were prioritized and a shuttle attached reuseable test bed, the cryogenic fluid management facility (CFMF), is being designed to provide the experimental data necessary for the technology development effort.
Taking up the contemporary challenge to sensitize and synergize instructional, industrial and governmental functionaries along this line are leading global faculties such as the Academy of Project Management (APM), Project Management Institute (PMI), and Business Analyst (BA) Times, amongst others. This work is ...
Kiremit, Murat Can; Guven, Selcuk; Sarica, Kemal; Ozturk, Ahmet; Buldu, Ibrahim; Kafkasli, Alper; Balasar, Mehmet; Istanbulluoglu, Okan; Horuz, Rahim; Cetinel, Cihangir Ali; Kandemir, Abdulkadir; Albayrak, Selami
To evaluate contemporary management approaches to medium-sized (10-20 mm) renal stones. A total of 935 patients treated for medium-sized renal stones (10-20 mm) between July 2012 and March 2014 were included in the study program. Contemporary minimally invasive approaches applied in the management of such stones were evaluated and compared. The cohort consisted of 561 male (60%) and 374 female (40%) patients. Of the 935 patients with medium-sized renal calculi, 535 (57.2%) were treated with shockwave lithotripsy (SWL), 201 (21.4%) with retrograde intrarenal surgery (RIRS), 110 (11.7%) with minimally invasive percutaneous nephrolithotomy (miniperc), and the remaining 89 (11.7%) patients with micropercutaneous nephrolithotomy (microperc). In the SWL group, stones were located mostly in the pelvis (51%), while in the miniperc and microperc groups, they were located mainly in the lower pole (46%, 53%, respectively). Stone-free rates after a single session were 77.2%, 86.1%, 88.8%, and 83.6% in the SWL, RIRS, microperc, and miniperc groups, respectively. Although no serious complications (above Clavien level III) were noted in any of the groups evaluated, Clavien I to II complications were common in the miniperc group. Although SWL is the preferred treatment option for patients with medium-sized (10-20 mm) renal stones, endourologic methods also have been found to have a significant role. Relatively lower complication rates along with higher stone-free status observed with the RIRS technique compared with percutaneous approaches have made this method a valuable option in the management of such stones in recent years.
Columbo, Jesse A.; Trus, Thadeus; Nolan, Brian; Goodney, Philip; Rzucidlo, Eva; Powell, Richard; Walsh, Daniel; Stone, David
Objective Optimal diagnosis and management of median arcuate ligament (MAL) syndrome (MALS) remains unclear in contemporary practice. The advent and evolution of laparoscopic and endovascular techniques has redirected management toward a less invasive therapeutic algorithm. This study examined our contemporary outcomes of patients treated for MALS. Methods All patients treated for MALS at Dartmouth-Hitchcock Medical Center from 2000 to 2013 were retrospectively reviewed. Demographics and comorbidities were recorded. Freedom from symptoms and freedom from reintervention were the primary end points. Return to work or school was assessed. Follow-up by clinic visits and telephone allowed quantitative comparisons among the patients. Results During the study interval, 21 patients (24% male), with a median age of 42 years, were treated for MALS. All patients complained of abdominal pain in the presence of a celiac stenosis, 16 (76%) also reported weight loss at the time of presentation, and 57% had a concomitant psychiatric history. Diagnostic imaging most commonly used included duplex ultrasound (81%), computed tomography angiography (66%), angiography (57%), and magnetic resonance angiography (5%). Fourteen patients (67%) underwent multiple diagnostic studies. All patients underwent initial laparoscopic MAL release. Seven patients (33%) underwent subsequent celiac stent placement in the setting of recurrent or unresolved symptoms with persistent celiac stenosis at a mean interval of 49 days. Two patients required surgical bypass after an endovascular intervention failed. The 6-month freedom from symptoms was 75% and freedom from reintervention was 64%. Eighteen patients (81%) reported early symptom improvement and weight gain, and 66% were able to return to work. Conclusions A multidisciplinary treatment approach using initial laparoscopic release and subsequent stent placement and bypass surgery provides symptom improvement in most patients treated for MALS. The
M M Akulich
Full Text Available The article considers the contradictions and conflicts of the contemporary Russian education focusing on the opportunities for conflict management. The research is based on the institutional and system approaches, in particular on the sociological conceptions of social conflict and social cohesion. The author conducted a historical and sociological analysis of social conflicts and social cohesion in the educational sphere, and such conflicts seem to be the result of the contradictions inherent in this social institution. The article identifies basic types of conflicts in the Russian education, and the ways of resolving them by the subjects of the educational system for such conflicts are manageable, especially within the interaction of educational system and society. To verify the proposed typology of conflicts in the contemporary Russian education the author conducted an empirical study to develop a system of practical measures that will help to improve the quality of learning of pupils and students, and will have a positive impact on the functioning and development of the contemporary Russian society. Thus, the article may be useful to sociologists, teachers, educational managers and readers interested in the specifics of social conflicts and the ways for resolving conflict situations.
Gueli, Sarah L; Lerman, Jerrold
To explore the interrelationships among the pharmacokinetics of sevoflurane, epileptiform electroencephalographic (EEG) activity and awareness in children. To also describe the revised perioperative fluid management strategy espoused by Holliday and Segar and noninvasive measures that may predict who will respond positively to fluid loading. The depth of anesthesia during the early washin period with sevoflurane 8% is one-third less than during halothane. Eight percent sevoflurane rarely causes clinical seizures; more commonly, it causes epileptiform EEG activity that only weakly portends seizure activity. When preceded by nitrous oxide, midazolam or normocapnia, the risk of inducing epileptiform activity during spontaneous respiration is exceedingly small. Decreasing the inspired concentration of sevoflurane upon loss of the eyelash reflex to prevent epileptiform activity has not been shown to reduce the risk of clinical seizures, but more importantly, it may increase the risk of awareness if the child is stimulated. Isotonic intravenous solutions should be infused in volumes of 20-40 ml/kg over 2-4 h in children undergoing elective surgery. Postoperatively, these infusions may be continued at rates of 2/1/0.5 ml/kg/h; serum sodium concentration should be measured periodically. Noninvasive measures currently do not reliably identify those children who will respond positively to fluid boluses. Sevoflurane is a well tolerated induction agent that rarely causes seizures in children, but may cause awareness if the inspired concentration is prematurely reduced. Perioperative isotonic fluids should be infused at 20-40 ml/kg over 2-4 h during elective surgery. Noninvasive metrics do not predict a child's responsiveness to fluid loading.
Iqbal, Muhammad Waqas; Youssef, Ramy F; Neisius, Andreas; Kuntz, Nicholas; Hanna, Jonathan; Ferrandino, Michael N; Preminger, Glenn M; Lipkin, Michael E
Struvite stones have been associated with significant morbidity and mortality, yet there has not been a report on the medical management of struvite stones in almost 20 years. We report on the contemporary outcomes of the surgical and medical management of struvite stones in a contemporary series. A retrospective review of patients who were treated with percutaneous nephrolithotomy (PCNL) for struvite stones at Duke University Medical Center between January 2005 and September 2012 identified a total of 75 patients. Of these, 43 patients had adequate follow-up and were included in this analysis. Stone activity, defined as either stone recurrence or stone-related events, and predictors of activity were evaluated after combined surgical and medical treatment. The study included 43 patients with either pure (35%) or mixed (65%) struvite stones with a median age of 55±15 years (range 21-89 years). The stone-free rate after PCNL was 42%. Stone recurrence occurred in 23% of patients. Postoperatively, 30% of patients had a stone-related event, while 60% of residual stones remained stable with no growth after a median follow-up of 22 months (range 6-67 mos). Kidney function remained stable during follow-up. Independent predictors of stone activity included the presence of residual stones >0.4 cm(2), preoperative large stone burden (>10 cm(2)), and the presence of medical comorbidities (P<0.05). Struvite stones can be managed safely with PCNL followed by medical therapy. The majority of patients with residual fragments demonstrated no evidence of stone growth on medical therapy. With careful follow-up and medical management, kidney function can be maintained and stone morbidity can be minimized. Initial large stone burden, residual stones after surgery, and associated medical comorbidities may have deleterious effect on stone recurrence or residual stone-related events.
Verma, Himanshu; Meda, Narendranadh; Vora, Simit; George, Robbie K; Tripathi, Ramesh K
Primary aortic mural thrombus (PAMT) is an uncommon condition but an important source of noncardiogenic emboli with a difficult diagnosis and a high rate of complications, including high mortality. We report our experience of thromboembolic disease from PAMT and review its contemporary management. Retrospective analysis of prospectively collected data of all patients who presented with acute occlusion of a limb or visceral vessels between January 2011 and September 2013 was performed. A total of 88 patients presented with acute occlusion of the extremities or visceral arteries. All underwent extensive evaluation for the possible source of the embolism. Of these 88 patients, 19 patients (mean age, 41.2 years; male:female ratio, 1:2.1) were found to have aortic mural thrombus as the source of distal embolism. Thrombus was located in the thoracic aorta in 10 patients, in the perivisceral aorta in three patients, and in the infrarenal aorta in six patients. Thrombus in the thoracic aorta was treated with stent grafts in four patients, bare metal stents in three patients, and anticoagulation alone in two patients. In the suprarenal abdominal aorta, all three patients underwent trapdoor aortic thrombectomy. Infrarenal aortic thrombus was managed by aortobifemoral embolectomy in two patients, aortic stenting in two patients, surgical thrombectomy in one patient, and anticoagulation alone in one patient. Successful treatment, defined as freedom from further embolic events or recurrence of thrombus, was achieved in 14 of 19 patients (76.4%) with a mean follow-up period of 16.2 months (range, 2-28 months). There were four (21%) thrombus-related deaths, all due to primary thromboembolic insults. One patient needed a below-knee amputation because of a recurrent thrombotic episode. Symptomatic PAMT is an uncommon but important source of noncardiogenic embolus. It appears to occur more frequently in young women. Endovascular coverage of the aortic thrombus, when feasible
Leone, Andrew; Diorio, Gregory J; Pettaway, Curtis; Master, Viraj; Spiess, Philippe E
Penile cancer is a rare disease that causes considerable physical and psychological patient morbidity, especially at advanced stages. Patients with low-stage nodal metastasis can achieve durable survival with surgery alone, but those with extensive locoregional metastasis have overall low survival. Contemporary management strategies for lymph node involvement in penile cancer aim to minimize the morbidity associated with traditional radical inguinal lymphadenectomy through appropriate risk stratification while optimizing oncological outcomes. Modified (or superficial) inguinal lymph node dissection and dynamic sentinel lymph node biopsy are diagnostic modalities that have been recommended in patients with high-risk primary penile tumours and nonpalpable inguinal lymph nodes. In addition, advances in minimally invasive and robot-assisted lymphadenectomy techniques are being investigated in patients with penile cancer and might further decrease lymphadenectomy-related adverse effects. The management of patients with advanced disease has evolved to include multimodal treatment with systemic chemotherapy before surgical intervention and can include adjuvant chemotherapy after pelvic lymphadenectomy. The role of radiotherapy in the neoadjuvant or adjuvant setting remains largely unclear, owing to a lack of high-level evidence of possible benefits. New targeted therapies have shown efficacy in squamous cell carcinomas of other sites and might also prove effective in patients with penile cancer.
DeSimone, Michael L; Asombang, Akwi W; Berzin, Tyler M
For patients recovering from acute pancreatitis, the development of a pancreatic fluid collection (PFC) predicts a more complex course of recovery, and introduces difficult management decisions with regard to when, whether, and how the collection should be drained. Most PFCs resolve spontaneously and drainage is indicated only in pseudocysts and walled-off pancreatic necrosis when the collections are causing symptoms and/or local complications such as biliary obstruction. Historical approaches to PFC drainage have included surgical (open or laparoscopic cystgastrostomy or pancreatic debridement), and the placement of percutaneous drains. Endoscopic drainage techniques have emerged in the last several years as the preferred approach for most patients, when local expertise is available. Lumen-apposing metal stents (LAMS) have recently been developed as a tool to facilitate potentially safer and easier endoscopic drainage of pancreatic fluid collections, and less commonly, for other indications, such as gallbladder drainage. Physicians considering LAMS placement must be aware of the complications most commonly associated with LAMS including bleeding, migration, buried stent, stent occlusion, and perforation. Because of the patient complexity associated with severe pancreatitis, management of pancreatic fluid collections can be a complex and multidisciplinary endeavor. Successful and safe use of LAMS for patients with pancreatic fluid collections requires that the endoscopist have a full understanding of the potential complications of LAMS techniques, including how to recognize and manage expected complications.
Dasgupta, Indranil; Farrington, Ken; Davies, Simon J; Davenport, Andrew; Mitra, Sandip
Fluid management in haemodialysis (HD) affects patient experience, morbidity and mortality. Standards for best practice are lacking. A national survey of the United Kingdom was undertaken to define prevalent practice. An online questionnaire was distributed to all UK renal centres. Forty-five of 74 centres (173 dialysis units), serving 62% (n = 14,697) of UK HD population responded. Seventy-eight per cent had no agreed policy for managing fluid balance in patients on HD; 44% did not assess fluid status routinely. Clinical assessment was the norm; 27% used bio-impedance-based device. To achieve a target-weight, 53% reduced weight as far as tolerated. Twenty-two per cent measured residual renal function (RRF). Ninety-one per cent had no policy for fluid overload. Sixty-four per cent restricted salt and water. Ninety-three per cent used diuretics in patients with RRF. Thirty-eight per cent felt management was adequate; 77% felt there was a need for better evidence. Ninety-one per cent would participate in a study addressing this. There is an urgent need for establishing an evidence base on the optimal approaches to fluid management. © 2016 S. Karger AG, Basel.
Julius Simoni Leere
Full Text Available IntroductionPrimary hyperparathyroidism is increasingly an asymptomatic disease at diagnosis, but the recognized guidelines for management are based on evidence obtained from studies on patients with symptomatic disease, and surgery is not always indicated. Other patients are unable to undergo surgery, and thus a medical treatment is warranted. This systematic review provides an overview of the existing literature on contemporary pharmaceutical options available for the medical management of primary hyperparathyroidism.MethodsDatabases of medical literature were searched for articles including terms for primary hyperparathyroidism and each of the included drugs. Data on s-calcium, s-parathyroid hormone, bone turnover markers, bone mineral density (BMD and hard endpoints were extracted and tabulated, and level of evidence was determined. Changes in s-calcium were estimated and a meta-regression analysis was performed.ResultsThe 1,999 articles were screened for eligibility and 54 were included in the review. Weighted mean changes calculated for each drug in s-total calcium (mean change from baseline ± SEM were pamidronate (0.31 ± 0.034 mmol/l; alendronate (0.07 ± 0.05 mmol/l; clodronate (0.20 ± 0.040 mmol/l; mixed bisphosphonates (0.16 ± 0.049 mmol/l; and cinacalcet (0.37 ± 0.013 mmol/l. The meta-analysis revealed a significant decrease of effect on s-calcium with time for the bisphosphonates (Coef. −0.049 ± 0.023, p = 0.035, while cinacalcet proved to maintain its effect on s-calcium over time. Bisphosphonates improved BMD while cinacalcet had no effect.DiscussionThe included studies demonstrate advantages and drawbacks of the available pharmaceutical options that can prove helpful in the clinical setting. The great variation in how primary hyperparathyroidism is manifested requires that management should rely on an individual evaluation when counseling patients. Combining resorptive agents with
The purpose of this thesis was to describe pathophysiological aspects of perioperative fluid administration and create a rational background for future, clinical outcome studies. In laparoscopic cholecystectomy, we have found "liberal" crystalloid administration ( approximately 3 liters) to improve....... Based on the current evidence, administration of liters intravenous fluid without specific indication in major surgical procedures should be avoided, while administration of liters in patients with anastomoses may not be recommended, an issue needing clarification in large-scale clinical studies...... perioperative physiology and clinical outcome, which has implication for fluid management in other laparoscopic procedures such as laparoscopic fundoplication, laparoscopic repair of ventral hernia, hysterectomy etc., where 2-3 liters crystalloid should be administered based on the present evidence. That equal...
Brennan, P A; Ammar, M; Matharu, J
Benign parotid tumours have historically often been managed surgically by superficial parotidectomy. While this approach usually gives a generous cuff of surrounding normal parotid tissue to increase tumour margins, it requires a much larger incision than the increasingly used extracapsular dissection (ECD) technique. Furthermore, superficial parotidectomy can result in marked facial hollowing, Frey syndrome and an increased risk of both temporary and permanent facial nerve weakness. ECD has been popularised as a safe alternative to parotidectomy primarily for the removal of mobile, benign parotid tumours with safe outcomes and reduced risk to the facial nerve. In this article, we review the growing body of evidence for ECD and include our own experience confirming the move away from superficial parotidectomy in contemporary practice for the treatment of benign parotid tumours. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Mandathara, Preeji S; Stapleton, Fiona J; Willcox, Mark D P
To describe the past 20 years' contemporary management modalities for keratoconus (KC) and their outcomes and failures and to propose recommendations in reporting their outcomes. A systematic review of the literature on KC management options for the last 20 years was performed. Original articles that reported the outcome of any form of KC management other than full-thickness or lamellar corneal graft were reviewed to collect information on their outcomes and complications and the level of scientific evidence of the study. A total of 1,147 articles retrieved and of those, 241 satisfied the inclusion criteria, and 41.1% of them were prospective case series. The higher level of evidence studies, that is, randomized controlled trials (RCTs), were limited to only one intervention, that is, corneal collagen cross-linking (CXL). However, the quality of most RCTs was limited because of performance and detection bias. Contact lenses (CLs) remain the mainstream of KC management and were associated with reversible and non-sight-threatening complications. Surgical options such as intracorneal segment implantation and phakic intraocular lens are considered in the visual rehabilitation of CL intolerants, and CXL is the only available option to stop or delay the disease progression. Generally, these surgical procedures are associated with transient inflammatory events and permanent sequelae. The published studies on KC management options varied significantly with respect to the study population, age of participants, severity of KC, clinical outcome measurements, and follow-up period. High-quality longer follow-up RCTs are required to evaluate the long-term effects of KC interventions.
Barshes, Neal R; Chambers, James D; Cohen, Joshua; Belkin, Michael
The care of patients with critical limb ischemia (CLI) and tissue loss is notoriously challenging and expensive. We evaluated the cost-effectiveness of various management strategies to identify those that would optimize value to patients. A probabilistic Markov model was used to create a detailed simulation of patient-oriented outcomes, including clinical events, wound healing, functional outcomes, and quality-adjusted life-years (QALYs) after various management strategies in a CLI patient cohort during a 10-year period. Direct and indirect cost estimates for these strategies were obtained using transition cost-accounting methodology. Incremental cost-effectiveness ratios (ICERs), in 2009 U.S. dollars per QALYs, were calculated compared with the most conservative management strategy of local wound care with amputation as needed. With an ICER of $47,735/QALY, an initial surgical bypass with subsequent endovascular revision(s) as needed was the most cost-effective alternative to local wound care alone. Endovascular-first management strategies achieved comparable clinical outcomes but at higher cost (ICERs ≥$101,702/QALY); however, endovascular management did become cost-effective when the initial foot wound closure rate was >37% or when procedural costs were decreased by >42%. Primary amputation was dominated (less effectiveness and more costly than wound care alone). Contemporary clinical effectiveness and cost estimates show an initial surgical bypass is the most cost-effective alternative to local wound care alone for CLI with tissue loss and can be supported even in a cost-averse health care environment. Copyright © 2012. Published by Mosby, Inc.
Full Text Available Summary: Water is an essential nutrient for all physiological functions and particularly important for thermoregulation. About 60% of our body weight is made of water. Under standard conditions (18-20 °C and moderate activity, water balance is regulated within 0.2 % of body weight over a 24-hour period. Water requirement varies between individuals and according to environmental conditions. Concerning considerations related to obesity, the health impact of fluid intake is commonly overlooked. Fluid intake advices are missing in most of food pyramids offered to the public, and water requirements and hydration challenges remain often neglected. The purpose of this paper is to emphasize and discuss the role of water consumption in the context of other important public health measures for weight management. Attention will be focused on fluid intake patterns and hydration-related questions in the context of global interventions and/or physical activity programs settled in weight management protocols.
Lafontan, Max; Visscher, Tommy L.S.; Farpour-Lambert, Nathalie; Yumuk, Volkan
Water is an essential nutrient for all physiological functions and particularly important for thermoregulation. About 60% of our body weight is made of water. Under standard conditions (18-20 °C and moderate activity), water balance is regulated within 0.2 % of body weight over a 24-hour period. Water requirement varies between individuals and according to environmental conditions. Concerning considerations related to obesity, the health impact of fluid intake is commonly overlooked. Fluid intake advices are missing in most of food pyramids offered to the public, and water requirements and hydration challenges remain often neglected. The purpose of this paper is to emphasize and discuss the role of water consumption in the context of other important public health measures for weight management. Attention will be focused on fluid intake patterns and hydration-related questions in the context of global interventions and/or physical activity programs settled in weight management protocols. PMID:25765164
Frisch, Uriel; Grimberg, Gérard; Villone, Barbara
The present paper is a companion to the paper by Villone and Rampf (2017), titled "Hermann Hankel's On the general theory of motion of fluids, an essay including an English translation of the complete Preisschrift from 1861" together with connected documents [Eur. Phys. J. H 42, 557-609 (2017)]. Here we give a critical assessment of Hankel's work, which covers many important aspects of fluid dynamics considered from a Lagrangian-coordinates point of view: variational formulation in the spirit of Hamilton for elastic (barotropic) fluids, transport (we would now say Lie transport) of vorticity, the Lagrangian significance of Clebsch variables, etc. Hankel's work is also put in the perspective of previous and future work. Hence, the action spans about two centuries: from Lagrange's 1760-1761 Turin paper on variational approaches to mechanics and fluid mechanics problems to Arnold's 1966 founding paper on the geometrical/variational formulation of incompressible flow. The 22-year-old Hankel - who was to die 12 years later — emerges as a highly innovative master of mathematical fluid dynamics, fully deserving Riemann's assessment that his Preisschrift contains "all manner of good things."
Rana, Bushra S; Calvert, Patrick A; Punjabi, Prakash P; Hildick-Smith, David
Percutaneous mitral valve (MV) repair has been performed in over 20,000 patients worldwide. As clinical experience in this technique grows indications for its use are being defined. Mitral regurgitation (MR) encompasses a complex heterogeneous group and its treatment is governed by determining a clear understanding of the underlying aetiology. Surgical MV repair remains the gold standard therapy for severe MR. However in select groups of high-risk surgical patients, a percutaneous approach to MV repair is establishing its role. This review gives an overview of the published data in percutaneous MV repair and its impact on the contemporary management of MR. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Subedi, Navaraj; Prestwich, Robin; Chowdhury, Fahmid; Patel, Chirag
Abstract Neuroendocrine tumours (NETs) of the head and neck are rare neoplasms and can be of epithelial or non-epithelial differentiation. Although the natural history of NETs is variable, it is crucial to establish an early diagnosis of these tumours as they can be potentially curable. Conventional anatomical imaging and functional imaging using radionuclide scintigraphy and positron emission tomography/computed tomography can be complementary for the diagnosis, staging and monitoring of treatment response. This article describes and illustrates the imaging features of head and neck NETs, discusses the potential future role of novel positron-emitting tracers that are emerging into clinical practice and reviews contemporary management of these tumours. Familiarity with the choice of imaging techniques and the variety of imaging patterns and treatment options should help guide radiologists in the management of this rare but important subgroup of head and neck neoplasms. PMID:24240099
Brooke Balauf McBride; Fernando Sanchez-Trigueros; Stephen J Carver; Alan E Watson; Linda Moon Stumpff; Roian Matt; William T. Borrie
Traditional knowledge about fire and its effects held by indigenous people, who are connected to specific landscapes, holds promise for informing contemporary fire and fuels management strategies and augmenting knowledge and information derived from western science. In practice, however, inadequate means to organize and communicate this traditional knowledge with...
Full Text Available The modern information society in ever increasing business projects and time limits to achieve the objectives at minimum cost leads to a search for ways to manage them. Today, more and more managers use IT tools for project management, and the term itself is associated with software solutions for the optimization and management of projects in different fields of human activity. The paper examines the main characteristics of project management by means of information technology. Key tasks and processes in the project implementation and management are discussed.
Full Text Available Authors: Helen Schultz (Ed., Jeffrey Bagraim, Tracy Potgieter, Conrad Viedge, Amanda Werner Publisher: Van Schaik Publishers According to the authors the aim of this book is to present an interdisciplinary approach to the understanding of organisational behaviour within the contemporary South African environment. Within this framework, the book targets (senior undergraduate and postgraduate students in Industrial/Organisational Psychology and Human Resources Management. The text is written in a simple, conversational style (as was the intention of the authors that should be suitable for most undergraduate students at English-speaking tertiary institutions. The book is organised into three sections based on a model of four components of organizational behaviour: the individual, the group and the organisation. The fourth component of the model, the environment, refers specifically in the context of this book, to a contemporary South African approach to understanding behaviour in organisations. In the ‘individual’ section, the authors cover topics such as individual differences (e.g. personality, attitudes, perceptions, emotional intelligence, etc., ethics, work motivation, and performance management. In the ‘group’ section, the authors look at issues of group and team dynamics, power and empowerment, communication, decision-making and leadership. Finally, in the ‘organisation’ section, the authors address issues of contemporary organisational design, organisational change and employee well-being (e.g. stress management, job satisfaction, etc..
Kawanishi, Hideki; Akiba, Takashi; Masakane, Ikuto; Tomo, Tadashi; Mineshima, Michio; Kawasaki, Tadayuki; Hirakata, Hideki; Akizawa, Tadao
The Committee of Scientific Academy of the Japanese Society for Dialysis Therapy (JSDT) proposes a new standard on microbiological management of fluids for hemodialysis and related therapies. This standard is within the scope of the International Organization for Standardization (ISO), which is currently under revision. This standard is to be applied to the central dialysis fluid delivery systems (CDDS), which are widely used in Japan. In this standard, microbiological qualities for dialysis water and dialysis fluids are clearly defined by endotoxin level and bacterial count. The qualities of dialysis fluids were classified into three levels: standard, ultrapure, and online prepared substitution fluid. In addition, the therapeutic application of each dialysis fluid is clarified. Since high-performance dialyzers are frequently used in Japan, the standard recommends that ultrapure dialysis fluid be used for all dialysis modalities at all dialysis facilities. It also recommends that the dialysis equipment safety management committee at each facility should validate the microbiological qualities of online prepared substitution fluid.
Rugh, J. P.
Plug-in hybrid electric vehicles and electric vehicles have increased vehicle thermal management complexity, using separate coolant loop for advanced power electronics and electric motors. Additional thermal components result in higher costs. Multiple cooling loops lead to reduced range due to increased weight. Energy is required to meet thermal requirements. This presentation for the 2013 Annual Merit Review discusses integrated vehicle thermal management by combining fluid loops in electric drive vehicles.
Taniguchi, Hideki; Sasaki, Toshio; Fujita, Hisae; Takamori, Mina; Kawasaki, Rieko; Momiyama, Yukinori; Takano, Osami; Shibata, Toshinari; Goto, Takahisa
We hypothesized that oral rehydration therapy using an oral rehydration solution may be effective for preoperative fluid and electrolyte management in surgical patients before the induction of general anesthesia, and we investigated the safety and effectiveness of oral rehydration therapy as compared with intravenous therapy. Fifty female patients who underwent breast surgery were randomly allocated to two groups. Before entry to the operation room and the induction of general anesthesia, 25 patients drank 1000 ml of an oral rehydration solution ("oral group") and 25 patients were infused with 1000 ml of an intravenous electrolyte solution ("intravenous group"). Parameters such as electrolyte concentrations in serum and urine, urine volume, vital signs, vomiting and aspiration, volumes of esophageal-pharyngeal fluid and gastric fluid (EPGF), and patient satisfaction with the therapy (as surveyed by a questionnaire) were assessed. After treatment, the serum sodium concentration and the hematocrit value, which both declined within the normal limits, were significantly higher in the oral group than in the intravenous group (sodium, 140.8 +/- 2.9 mEq x l(-1) in the oral group and 138.7 +/- 1.9 mEq x l(-1) in the intravenous group; P = 0.005; hematocrit, 39.03 +/- 4.16% in the oral group and 36.15 +/- 3.41% in the intravenous group; P = 0.01). No significant difference was observed in serum glucose values. Urine volume was significantly larger in the oral group (864.9 +/- 211.5 ml) than in the intravenous group (561.5 +/- 216.0 ml; P rehydration therapy, as judged by factors such as "feeling of hunger", "occurrence of dry mouth", and "less restriction in physical activity". The volume of EPGF collected following the induction of anesthesia was significantly smaller in the oral group than in the intravenous group (6.03 +/- 9.14 ml in the oral group and 21.76 +/- 30.56 ml in the intravenous group; P rehydration therapy with an oral rehydration solution before surgery is
Stigliano, Serena; Sternby, Hanna; de Madaria, Enrique; Capurso, Gabriele; Petrov, Maxim S
In the 20th century early management of acute pancreatitis often included surgical intervention, despite overwhelming mortality. The emergence of high-quality evidence (randomized controlled trials and meta-analyses) over the past two decades has notably shifted the treatment paradigm towards predominantly non-surgical management early in the course of acute pancreatitis. The present evidence-based review focuses on contemporary aspects of early management (which include analgesia, fluid resuscitation, antibiotics, nutrition, and endoscopic retrograde cholangiopancreatography) with a view to providing clear and succinct guidelines on early management of patients with acute pancreatitis in 2017 and beyond. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Marlon Aparecido Mercaldi
Full Text Available Contemporary jewelry terminology is open to many criticism and weaknesses as it is confronted with the classic definition of jewelry and also often attached to the historical widespread idea of adornment and jewelry to modernity. Therefore one of the this article issues is to approach about what it is contemporary jewelry and how it can be defined. Thus, we present the topics related to the jewel discussion in contemporary times that are organized into a set of assumptions and approaches that help us provide an overview about the contemporary jewelry.
Xin Pingping; Lu Yan
According to the development of the internet and multimedia technology, the information service models in the contemporary library become both of the traditional and digital information service. The libraries in each country do their best to make the voluminous information and the complex technology be High-integrated in the background management, and also make the front interface be more and more convenient to the users. The essential characteristics of the information service of the contemporary library are all-in-one and humanness. In this article, we will describe several new hot information service models of the contemporary library in detail, such as individualized service, reference service, reference service and strategic information service. (authors)
Full Text Available This analysis of Terry Smith’s 'What Is Contemporary Art?' evaluates Smith’s ongoing project to theorise contemporary art around the theme of multiple, interconnected temporalities. It questions how this ‘contemporaneity’ differs from the classic teleologism of modernism and postmodern relativism and suggests that Smith’s categories may be valuable for understanding other cultural areas, such as contemporary music. It then raises methodological problems associated with charting the terrain of contemporary art and how they overlap with economic considerations, arguing that the task implies particular forms of privilege that may threaten the autonomy of critical analysis, but that Smith’s work goes some way toward exposing this problem.
Chupin, A.; Hu, L. W.; Buongiorno, J.
Water-based nano-fluid, colloidal dispersions of nano-particles in water; have been shown experimentally to increase the critical heat flux and surface wettability at very low concentrations. The use of nano-fluids to enhance accidents management would allow either to increase the safe margins in case of severe accidents or to upgrade the power of an existing power plant with constant margins. Building on the initial work, computational fluid dynamics simulations of the nano-fluid injection system have been performed to evaluate the feasibility of a nano-fluid injection system for in-vessel retention application. A preliminary assessment was also conducted on the emergency core cooling system of the European Pressurized Reactor (EPR) to implement a nano-fluid injection system for improving the management of loss of coolant accidents. Several design options were compared/or their respective merits and disadvantages based on criteria including time to injection, safety impact, and materials compatibility. (authors)
Khourdaji, Iyad; Burks, Frank; Killinger, Kim A.
Fournier’s gangrene, an obliterative endarteritis of the subcutaneous arteries resulting in gangrene of the overlying skin, is a rare but severe infective necrotizing fasciitis of the external genitalia. Mainly associated with men and those over the age of 50, Fournier’s gangrene has been shown to have a predilection for patients with diabetes as well as people who are long-term alcohol misusers. The nidus for the synergistic polymicrobial infection is usually located in the genitourinary tract, lower gastointestinal tract or skin. Early diagnosis remains imperative as rapid progression of the gangrene can lead to multiorgan failure and death. The diagnosis is often made clinically, although radiography can be helpful when the diagnosis or the extent of the disease is difficult to discern. The Laboratory Risk Indicator for Necrotizing Fasciitis score can be used to stratify patients into low, moderate or high risk and the Fournier’s Gangrene Severity Index (FGSI) can also be used to determine the severity and prognosis of Fournier’s gangrene. Mainstays of treatment include rapid and aggressive surgical debridement of necrotized tissue, hemodynamic support with urgent resuscitation with fluids, and broad-spectrum parental antibiotics. After initial radical debridement, open wounds are generally managed with sterile dressings and negative-pressure wound therapy. In cases of severe perineal involvement, colostomy has been used for fecal diversion or alternatively, the Flexi-Seal Fecal Management System can be utilized to prevent fecal contamination of the wound. After extensive debridement, many patients sustain significant defects of the skin and soft tissue, creating a need for reconstructive surgery for satisfactory functional and cosmetic results. PMID:26445600
Malouf, Phillip; Gibbs, Peter; Shapiro, Jeremy; Sockler, Jim; Bell, Stephen
This article outlines the current Australian multidisciplinary treatment of synchronous metastatic colorectal adenocarcinoma and assesses the factors that influence patient outcome. This is a retrospective analysis of the prospective 'Treatment of Recurrent and Advanced Colorectal Cancer' registry, describing the patient treatment pathway and documenting the extent of disease, resection of the colorectal primary and metastases, chemotherapy and biological therapy use. Cox regression models for progression-free and overall survival were constructed with a comprehensive set of clinical variables. Analysis was intentionn-ton-treat, quantifying the effect of treatment intent decided at the multidisciplinary team meeting (MDT). One thousand one hundred and nine patients presented with synchronous metastatic disease between July 2009 and November 2015. Median follow-up was 15.8 months; 4.4% (group 1) had already curative resections of primary and metastases prior to MDT, 22.2% (group 2) were considered curative but were referred to MDT for opinion and/or medical oncology treatment prior to resection and 70.2% were considered palliative at MDT (group 3). Overall, 83% received chemotherapy, 55% had their primary resected and 23% had their metastases resected; 13% of resections were synchronous, 20% were staged with primary resected first and 62% had only the colorectal primary managed surgically. Performance status, metastasis resection (R0 versus R1 versus R2 versus no resection), resection of the colorectal primary and treatment intent determined at MDT were the most significant factors for progression-free and overall survival. This is the largest Australian series of synchronous metastatic colorectal adenocarcinoma and offers insight into the nature and utility of contemporary practice. © 2016 Royal Australasian College of Surgeons.
Sandy, Edward Allen; Kaminski, Robert; Simhan, Hygriv; Beigi, Richard
The role of obstetric triage in the care of pregnant women has expanded significantly. Factors driving this change include the Emergency Medical Treatment and Active Labor Act, improved methods of testing for fetal well-being, increasing litigation risk, and changes in resident duty hour guidelines. The contemporary obstetric triage facility must have processes in place to provide a medical screening examination that complies with regulatory statues while considering both the facility's maternal level of care and available resources. This review examines the history of the development of obstetric triage, current considerations in a contemporary obstetric triage paradigm, and future areas for consideration. An example of a contemporary obstetric triage program at an academic medical center is presented. A successful contemporary obstetric triage paradigm is one that addresses the questions of "sick or not sick" and "labor or no labor," for every obstetric patient that presents for care. Failure to do so risks poor patient outcome, poor patient satisfaction, adverse litigation outcome, regulatory scrutiny, and exclusion from federal payment programs. Understanding the role of contemporary obstetric triage in the current health care environment is important for both providers and health care leadership. This study is for obstetricians and gynecologists as well as family physicians. After completing this activity, the learner should be better able to understand the scope of a medical screening examination within the context of contemporary obstetric triage; understand how a facility's level of maternal care influences clinical decision making in a contemporary obstetric triage setting; and understand the considerations necessary for the systematic evaluation of the 2 basic contemporary obstetric questions, "sick or not sick?" and "labor or no labor?"
Book review of: Christian Homburg, Sabine Kuester, Harley Krohmer, Marketing Management – A Contemporary Perspective, McGraw-Hill Higher Education, 2009......Book review of: Christian Homburg, Sabine Kuester, Harley Krohmer, Marketing Management – A Contemporary Perspective, McGraw-Hill Higher Education, 2009...
Full Text Available This article addresses the role of private foundations in commissioning site-specific ephemeral art works: contemporary art projects of a temporary nature that are realised outside of public institutions. Though small in number, I argue that the private individuals creating and managing private foundations of this nature demonstrate a new form of patronage, creating in the process a new role of ‘curator/patron’. Equally, this process of realisation reflects the changing needs of contemporary art practice. Work of this scale and ambition would increasingly not be possible without the vision, perseverance and funding of these kinds of foundation. In Australia, this trend is demonstrated by two foundations: Kaldor Art Projects, and their commissioning of works by artists such as Christo and Jeanne-Claude, Gilbert & George and Jeff Koons; and the more recently formed Sherman Contemporary Art Foundation, whose first project was with Chinese artist Ai Weiwei. In this article, these examples are placed within the broader international context of foundation models such as Artangel, UK, Fondazione Nicola Trussardi, Milan, and The Public Art Fund, New York.
Intravenous fluids are administered in virtually every parenteral sedation and general anesthetic. The purpose of this article is to review the physiology of body-water distribution and fluid dynamics at the vascular endothelium, evaluation of fluid status, calculation of fluid requirements, and the clinical rationale for the use of various crystalloid and colloid solutions. In the setting of elective dental outpatient procedures with minor blood loss, isotonic balanced crystalloid solutions are the fluids of choice. Colloids, on the other hand, have no use in outpatient sedation or general anesthesia for dental or minor oral surgery procedures but may have several desirable properties in long and invasive maxillofacial surgical procedures where advanced hemodynamic monitoring may assess the adequacy of intravascular volume.
Moghadamyeghaneh, Zhobin; Hanna, Mark H; Alizadeh, Reza Fazl; Carmichael, Joseph C; Mills, Steven; Pigazzi, Alessio; Stamos, Michael J
We sought to investigate contemporary management of anastomosis leakage (AL) after colonic anastomosis. The American College of Surgeons National Surgical Quality Improvement Program database 2012 to 2013 was used to identify patients with AL. Multivariate regression analysis was performed to find predictors of the need for surgical intervention in management of AL. A total of 32,280 patients underwent colon resection surgery with 1,240 (3.8%) developing AL. Overall, 43.9% of patients with AL did not require reoperation. Colorectal anastomosis had significantly higher risk of AL compared with ileocolonic anastomosis (adjusted odds ratio [AOR], 1.20; P = .04). However, the rate of need for reoperation was higher for AL in colocolonic anastomosis compared with ileocolonic anastomosis (AOR, 1.48; P = .04). White blood cell count (AOR, 1.07; P < .01), the presence of intra-abdominal infection with leakage (AOR, 1.47; P = .01), and protective stoma (AOR, .43, P = .02) were associated with reoperation after AL. Nonoperative treatment is possible in almost half of the patients with colonic AL. The anatomic location of the anastomosis impacts the risk of AL. Severity of leakage, the presence of a stoma, and general condition of patients determine the need for reoperation. Copyright © 2015 Elsevier Inc. All rights reserved.
Full Text Available As part of the contemporary media culture, advertising constantly mediates the relationship between the institutional dimension of religion (namely the church and the community, given the specific position of the Catholic religion: transparent, based on dialogue and the continuous questioning of the relationship between man and divinity. To manage their presence in public life, the church constantly approaches new media and specific forms of communication (posters, street banners and meshes, websites or interactive mobile structures.
PARENTE, TOBIAS COUTINHO; LUCAS, ANGELA CHRISTINA; CORDEIRO, RAFAELA ALMEIDA
ABSTRACT Purpose: Identify the practices adopted by companies to monitor and prevent contemporary slavery and the elements that differentiate companies that adopt monitoring practices for prevention of slavery and those that do not. Originality/value: This question is investigated from the perspective of management, reputation and institutional environment literature, pointing out the reasons that lead companies to adopt or avoid contemporary slavery. Design/methodology/approach: We used s...
Vilmann, Andreas S; Menachery, John; Tang, Shou-Jiang
complications of pancreatitis can include acute peri-pancreatic fluid collection, acute necrotic collection, pseudocyst formation, and walled-off necrosis. Interventional endoscopic ultrasound (EUS) has been increasing utilized in managing these local complications. After performing a PubMed search, the authors...... manually applied pre-defined inclusion criteria or a filter to identify publications relevant to EUS and pancreatic collections (PFCs). The authors then reviewed the utility, efficacy, and risks associated with using therapeutic EUS and involved EUS devices in treating PFCs. Due to the development...... to diagnose PFCs and perform image-guided interventions. After draining a PFC, the amount of tissue necrosis is the most important predictor of a successful outcome. Hence, it seems logical to classify these collections based on their percentage of necrotic component or debris present when viewed by imaging...
Colbert, S D; Green, Ben; Brennan, P A; Mercer, N
Babies born with clefts of the lip, and the alveolus or palate, or both, require multidisciplinary, highly specialised treatment from birth to early adulthood. We review the contemporary management of clefts and outline the current treatment protocol adopted by cleft networks in the United Kingdom. We also look at the level of evidence and the restructuring of services that has defined current practice. In light of the recent Cleft Care UK study, we ask whether it is now time to adopt a new philosophy towards the surgical techniques that are used. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Kwong, Tai C; Magnani, Barbarajean; Moore, Christine
In recent years, the abuse of opioid drugs has resulted in greater prevalence of addiction, overdose, and deaths attributable to opioid abuse. The epidemic of opioid abuse has prompted professional and government agencies to issue practice guidelines for prescribing opioids to manage chronic pain. An important tool available to providers is the drug test for use in the initial assessment of patients for possible opioid therapy, subsequent monitoring of compliance, and documentation of suspected aberrant drug behaviors. This review discusses the issues that most affect the clinical utility of drug testing in chronic pain management with opioid therapy. It focuses on the two most commonly used specimen matrices in drug testing: urine and oral fluid. The advantages and disadvantages of urine and oral fluid in the entire testing process, from specimen collection and analytical methodologies to result interpretation are reviewed. The analytical sensitivity and specificity limitations of immunoassays used for testing are examined in detail to draw attention to how these shortcomings can affect result interpretation and influence clinical decision-making in pain management. The need for specific identification and quantitative measurement of the drugs and metabolites present to investigate suspected aberrant drug behavior or unexpected positive results is analyzed. Also presented are recent developments in optimization of test menus and testing strategies, such as the modification of the standard screen and reflexed-confirmation testing model by eliminating some of the initial immunoassay-based tests and proceeding directly to definitive testing by mass spectrometry assays.
Paracelsus is considered to have been the first to record the viscid quality of the synovial fluid. However, his contemporary Bernardino de Sahagún, a Franciscan friar who came to Mexico shortly after the Spanish conquest, obtained from elderly Aztec Indians who spoke only Nahuatl the descriptions of therapeutic arthrocentesis and of the viscid nature of the synovial fluid. They compared the fluid from the knee joint to the viscid fluid from the leaves of the nopal cactus (Opuntia sp.). We here record their description and confirm the accuracy of their comparison.
This volume represents an ongoing committment to examining the concepts and techniques of business strategy analysis in the context of real business situations. The cases have been written to accompany Contemporary Strategy Analysis textbook. Each case presents issues that illuminate the ideas, concepts, and analytical techniques contained in one or more chapters of the textbook. Most important, the cases promote deep learning by students of strategic management by requiring the application o...
Barber, John P.; Johnston, Kyle B.; Daigle, Matthew
Simulations serve as important tools throughout the design and operation of engineering systems. In the context of sys-tems health management, simulations serve many uses. For one, the underlying physical models can be used by model-based health management tools to develop diagnostic and prognostic models. These simulations should incorporate both nominal and faulty behavior with the ability to inject various faults into the system. Such simulations can there-fore be used for operator training, for both nominal and faulty situations, as well as for developing and prototyping health management algorithms. In this paper, we describe a methodology for building such simulations. We discuss the design decisions and tools used to build a simulation of a cryogenic fluid test bed, and how it serves as a core technology for systems health management development and maturation.
Dudley, Peter N; Bonazza, Riccardo; Jones, T Todd; Wyneken, Jeanette; Porter, Warren P
As global temperatures increase throughout the coming decades, species ranges will shift. New combinations of abiotic conditions will make predicting these range shifts difficult. Biophysical mechanistic niche modeling places bounds on an animal's niche through analyzing the animal's physical interactions with the environment. Biophysical mechanistic niche modeling is flexible enough to accommodate these new combinations of abiotic conditions. However, this approach is difficult to implement for aquatic species because of complex interactions among thrust, metabolic rate and heat transfer. We use contemporary computational fluid dynamic techniques to overcome these difficulties. We model the complex 3D motion of a swimming neonate and juvenile leatherback sea turtle to find power and heat transfer rates during the stroke. We combine the results from these simulations and a numerical model to accurately predict the core temperature of a swimming leatherback. These results are the first steps in developing a highly accurate mechanistic niche model, which can assists paleontologist in understanding biogeographic shifts as well as aid contemporary species managers about potential range shifts over the coming decades.
Peter N Dudley
Full Text Available As global temperatures increase throughout the coming decades, species ranges will shift. New combinations of abiotic conditions will make predicting these range shifts difficult. Biophysical mechanistic niche modeling places bounds on an animal's niche through analyzing the animal's physical interactions with the environment. Biophysical mechanistic niche modeling is flexible enough to accommodate these new combinations of abiotic conditions. However, this approach is difficult to implement for aquatic species because of complex interactions among thrust, metabolic rate and heat transfer. We use contemporary computational fluid dynamic techniques to overcome these difficulties. We model the complex 3D motion of a swimming neonate and juvenile leatherback sea turtle to find power and heat transfer rates during the stroke. We combine the results from these simulations and a numerical model to accurately predict the core temperature of a swimming leatherback. These results are the first steps in developing a highly accurate mechanistic niche model, which can assists paleontologist in understanding biogeographic shifts as well as aid contemporary species managers about potential range shifts over the coming decades.
Full Text Available We assessed the synergetic benefits of simultaneous formation fluid extraction during CO2 injection for reservoir pressure management by coupled hydro-mechanical simulations at the prospective Vedsted storage site located in northern Denmark. Effectiveness of reservoir pressure management was investigated by simulation of CO2 storage without any fluid extraction as well as with 66% and 100% equivalent volume formation fluid extraction from four wells positioned for geothermal heat recovery. Simulation results demonstrate that a total pressure reduction of up to about 1.1 MPa can be achieved at the injection well. Furthermore, the areal pressure perturbation in the storage reservoir can be significantly decreased compared to the simulation scenario without any formation fluid extraction. Following a stress regime analysis, two stress regimes were considered in the coupled hydro-mechanical simulations indicating that the maximum ground surface uplift is about 0.24 m in the absence of any reservoir pressure management. However, a ground uplift mitigation of up to 37.3% (from 0.24 m to 0.15 m can be achieved at the injection well by 100% equivalent volume formation fluid extraction. Well-based adaptation of fluid extraction rates can support achieving zero displacements at the proposed formation fluid extraction wells located close to urban infrastructure. Since shear and tensile failure do not occur under both stress regimes for all investigated scenarios, it is concluded that a safe operation of CO2 injection with simultaneous formation fluid extraction for geothermal heat recovery can be implemented at the Vedsted site.
The types of objects scientifically researched and the types of sciences used for research. The crisis of contemporary science. Classical and holistic management. The knowledge pillar of management, the application pillar of management, social pillar of management. Holistic intelligence (HQ), knowledge intelligence (KQ), application intelligence (AQ), social intelligence (SQ). Holistic management and its role in solving the contemporary problems of mankind.
Paula Guimarães Simões
Full Text Available This paper discusses the hermeneutic power of a celebrity (seen from the concept of event, seeking to understand what it reveals about the contemporary context. Based on this premise, we attempt to recognize some aspects of contemporary social life that emerge from the trajectory of a specific celebrity: the former soccer player Ronaldo Fenômeno. This analysis brings to light the hermeneutic power of Ronaldo, i.e., how his life story reveals characteristics of contemporary social life. Individualism, machismo, emphasis on a heteronormative ideal, shifts in the construction of romantic relationships, and the overlapping spheres of public and private life, are some important aspects of contemporary society revealed by this analysis.
Leng, Xinyi; Wong, Ka Sing; Leung, Thomas W
Intracranial atherosclerotic disease is the most common cause of cerebral vasculopathy and an important stroke etiology worldwide, with a higher prevalence in Asian, Hispanic and African ethnicities. Symptomatic intracranial atherosclerotic disease portends a recurrent stroke risk as high as 18% at one year. The key to secondary prevention is an understanding of the underlying stroke mechanism and aggressive control of conventional cardiovascular risks. Contemporary treatment includes antiplatelet therapy, optimal glycemic and blood pressure control, statin therapy and lifestyle modifications. For patients with high-grade (70-99%) symptomatic steno-occlusion, short-term dual antiplatelet therapy with aspirin and clopidogrel followed by life-long single antiplatelet therapy may reduce the recurrent risk. Current evidence does not advocate percutaneous transluminal angioplasty and stenting as an initial treatment. External counterpulsation, encephaloduroarteriosynangiosis and remote limb ischemic preconditioning are treatments under investigation. Future studies should aim at predicting patients prone to recurrence despite of medical therapies and testing the efficacy of emerging therapies.
Tan, Hung-Jui; Filson, Christopher P; Litwin, Mark S
Although kidney cancer incidence and nephrectomy rates have risen in tandem, clinical advances have generated new uncertainty regarding the optimal management of patients with small renal tumors, especially the elderly. To clarify existing practice patterns, we assessed contemporary trends in the incidence and management of patients with early-stage kidney cancer. Using Surveillance, Epidemiology, and End Results data, we identified adult patients diagnosed with T1aN0M0 kidney cancer from 2000 to 2010. We determined age-adjusted and age-specific incidence and management rates (i.e., nonoperative, ablation, partial nephrectomy [PN], and radical nephrectomy) per 100,000 adults and determined the average annual percent change (AAPC). Finally, we compared management groups using multinomial logistic regression accounting for patient characteristics, cancer information, and county-level measures for health. From 2000 to 2010, we identified 41,645 adults diagnosed with T1aN0M0 kidney cancer. Overall incidence increased from 3.7 to 7.0 per 100,000 adults (AAPC = 7.0%, Pmanagement and ablation approached nephrectomy rates for those aged 75 to 84 years and became the predominant strategy for patients older than 84 years. Adjusting for clinical, oncological, and environmental factors, older patients less frequently underwent PN and more often received ablative or nonoperative management (P<0.001). As the incidence of early-stage kidney cancer rises, patients are increasingly treated with nonoperative and nephron-sparing strategies, especially among the most elderly. The broader array of treatment options suggests opportunities to better personalize kidney cancer care for seniors. Published by Elsevier Inc.
Winchester, David E; Pepine, Carl J
Considerable progress has been made over the last few decades in the management of clinically stable coronary heart disease (SCHD), including improvements in interventions (e.g., percutaneous revascularization), pharmacological management, and risk factor control (e.g., smoking, diet, activity level, hypercholesterolemia, hypertension). Although β blockers have long been used for the treatment of SCHD, their efficacy was established in the era before widespread use of reperfusion interventions, modern medical therapy (e.g., angiotensin-converting enzyme inhibitors, angiotensin receptor blockers), or preventive treatments (e.g., aspirin, statins). On the basis of these older data, β blockers are assumed beneficial, and their use has been extrapolated beyond patients with heart failure and previous myocardial infarction, which provided the best evidence for efficacy. However, there are no randomized clinical trials demonstrating that β blockers decrease clinical events in patients with SCHD in the modern era. Furthermore, these agents are associated with weight gain, problems with glycemic control, fatigue, and bronchospasm, underscoring the fact that their use is not without risk. In conclusion, data are currently lacking to support the widespread use of β blockers for all SCHD patients, but contemporary data suggest that they be reserved for a well-defined high-risk group of patients with evidence of ongoing ischemia, left ventricular dysfunction, heart failure, and perhaps some arrhythmias. Copyright © 2014 Elsevier Inc. All rights reserved.
Rabey, Martin; Hall, Toby; Hebron, Clair; Palsson, Thorvaldur Skuli; Christensen, Steffan Wittrup; Moloney, Niamh
With conflicting evidence regarding the effectiveness of manual therapy calls have arisen within some quarters of the physiotherapy profession challenging the continued use of manual skills for assessment and treatment. A reconceptualisation of the importance of manual examination findings is put forward, based upon a contemporary understanding of pain science, rather than considering these skills only in terms of how they should "guide" manual therapy interventions. The place for manual examination findings within complex, multidimensional presentations is considered using vignettes describing the presentations of five people with low back pain. As part of multidimensional, individualised management, the balance of evidence relating to the effectiveness, mechanisms of action and rationale for manual skills is discussed. It is concluded that if manual examination and therapeutic skills are used in a manner consistent with a contemporary understanding of pain science, multidimensional patient profiles and a person-centred approach, their selective and judicious use still has an important role. Copyright © 2017 Elsevier Ltd. All rights reserved.
Ogunbayo, Gbolahan O; Bidwell, Katrina; Misumida, Naoki; Ha, Le Dung; Abdel-Latif, Ahmed; Elayi, Claude S; Smyth, Susan; Messerli, Adrian W
Studies have reported sex differences in the management of patients with acute myocardial infarction (AMI) in the general population. This observational study is designed to evaluate whether sex differences exist in the contemporary management of human immunodeficiency virus (HIV) patients admitted for diagnosis of AMI. There is no difference in management of HIV patients with AMI. Using the National Inpatient Sample database, we identified patients with a primary diagnosis of AMI and a secondary diagnosis of HIV. We described baseline characteristics and outcomes using NIS documentation. Our primary areas of interest were revascularization and mortality. Among 2 977 387 patients presenting from 2010 to 2014 with a primary diagnosis of AMI, 10907 (0.4%) had HIV (mean age, 54.1 ± 9.3 years; n = 2043 [18.9%] female). Females were younger, more likely to be black, and more likely to have hypertension, diabetes, obesity, and anemia. Although neither males nor females were more likely to undergo coronary angiography in multivariate analysis, revascularization was performed less frequently in females than in males (45.4% vs 62.7%; P < 0.01), driven primarily by lower incidence of PCI. In a multivariate model, females were less likely to undergo revascularization (OR: 0.59, 95% CI: 0.45-0.78, P < 0.01), a finding driven solely by PCI (OR: 0.64, 95% CI: 0.49-0.83, P < 0.01). All-cause mortality was similar in both groups. AMI was more common in males than females with HIV. Females with HIV were more likely to be younger and black and less likely to be revascularized by PCI. © 2018 Wiley Periodicals, Inc.
Accountability is of growing importance in contemporary governance. The academic literature on public accountability is fraught with concerned analyses, suggesting that accountability is a problematic issue for public managers. This article investigates how public managers experience accountability
Wanna, George B; Sweeney, Alex D; Haynes, David S; Carlson, Matthew L
Jugular paragangliomas are generally benign slow-growing tumors that can cause pulsatile tinnitus, hearing loss, and cranial nerves neuropathy. Progressive growth can also lead to intracranial extension. Historically, the treatment of choice for these lesions has been gross total resection. However, over the last 15 years, many groups have adopted less invasive management strategies including stereotactic radiation therapy, subtotal resection, and primary observation in order to reduce treatment-associated morbidity. The focus of this article is to review the modern management of jugular paraganglioma, highlighting the evolving treatment paradigm at the Otology Group of Vanderbilt. Copyright © 2015 Elsevier Inc. All rights reserved.
Edwards, Joel; Othman, Maazuza; Crossin, Enda; Burn, Stewart
Municipal food waste (FW) represents 35-45% of household residual waste in Australia, with the nation generating 1.6Tg annually. It is estimated that 91% of this FW ends up in landfill. This study used life cycle assessment to determine and compare the environmental impact of seven contemporary FW management systems for two real-life jurisdictions; incorporating the complete waste service and expanding the system to include inert and garden waste. Although, no system exhibited a best ranking across all impact categories, FW digestion based systems were all revealed to have a lower global warming potential than composting and landfilling systems. Mechanical biological treatment, anaerobic co-digestion, and home composting all demonstrated the lowest environmental impacts for two or more of the environmental impact categories assessed. The assessment included market and technological specific variables and uncertainties providing a framework for robust decision making at a municipality level. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.
Havens, Vance; Ragaller, Dana
Management of two-phase fluid and control of the heat transfer process in microgravity is a technical challenge that must be addressed for an orbital Organic Rankine Cycle (ORC) application. A test program was performed in 1-g that satisfactorily demonstrated the two-phase management capability of the rotating fluid management device (RFMD) and shear-flow condenser. Operational tests of the RFMD and shear flow condenser in adverse gravity orientations, confirmed that the centrifugal forces in the RFMD and the shear forces in the condenser were capable of overcoming gravity forces. In a microgravity environment, these same forces would not have to compete against gravity and would therefore be dominant. The specific test program covered the required operating range of the Space Station Solar Dynamic Rankine Cycle power system. Review of the test data verified that: fluid was pumped from the RFMD in all attitudes; subcooled states in the condenser were achieved; condensate was pushed uphill against gravity; and noncondensible gases were swept through the condenser.
Dunlay, Shannon M; Pereira, Naveen L; Kushwaha, Sudhir S
Heart failure (HF) is an important public health problem, and strategies are needed to improve outcomes and decrease health care resource utilization and costs. Its prevalence has increased as the population ages, and HF continues to be associated with a high mortality rate and frequent need for hospitalization. The total cost of care for patients with HF was $30.7 billion in 2012, and it is estimated to more than double to $69.8 billion by 2030. Given this reality, there has been recent investigation into ways of identifying and preventing HF in patients at risk (stage A HF) and those with cardiac structural and functional abnormalities but no clinical HF symptoms (stage B). For patients who have symptoms of HF (stage C), there has been important research into the most effective ways to decongest patients hospitalized with acute decompensated HF and prevent future hospital readmissions. Successful strategies to treat patients with HF and preserved ejection fraction, which has increased in prevalence, continue to be sought. We are in the midst of a rapid evolution in our ability to care for patients with end-stage HF (stage D) because of the introduction of and improvements in mechanical circulatory support. Left ventricular assist devices used as destination therapy offer an important therapeutic option to patients who do not qualify for heart transplant because of advanced age or excessive comorbidity. This review provides a thorough update on contemporary strategies in the diagnosis and management of HF by stage (A to D) that have emerged during the past several years. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
Vana, P Geoff; Neubauer, Daniel C; Luchette, Fred A
Thoracic injury is currently the second leading cause of trauma-related death and rib fractures are the most common of these injuries. Flail chest, as defined by fracture of three or more ribs in two or more places, continues to be a clinically challenging problem. The underlying pulmonary contusion with subsequent inflammatory reaction and right-to-left shunting leading to hypoxia continues to result in high mortality for these patients. Surgical stabilization of the fractured ribs remains controversial. We review the history of management for flail chest alone and when combined with pulmonary contusion. Finally, we propose an algorithm for nonoperative and surgical management.
Veselin I. Mrdak
Full Text Available The paper wants to emphasize the importance of contemporary strategic management approachs in the defense system. Displays the work of American author Leslie Lewis and C. Robert Roll "Strategy-to- tasks: a methodology for resource allocation and management". It were used by parts of the discussion above, in order to describe the strategy-to-tasks methodology for planning, programming and budgeting system (PPBS. In developed Western countries adopted some elements of strategic management to determine and monitor the execution of strategic plans in the defense system. This trend is spreading to other countries as a result of the necessity of obeying certain methodological and technological achievements. The uncritical acceptance of a strategic management approach can cause great confusion and problems, and the terminology and scientific explanation for this trend is of great importance. Introduction PPBS is a resource management framework based on force planning concept. It was developed at the lRand Company during the late eighties and is adapted to the special needs of several DoD organization. The planning, programming and budgeting system (PPBS PPBS is DoD`ş primary system for planning and managing defense resources. It links the overall U.S. national security strategy to specific programs. It was designed to facilitate fiscally-constrained planning, programming and budgeting in terms of complete programs (i.e. forces and systems rather than through artificial budget categories. The goal is to determine forces, systems and program costs. Strategy-to-tasks and the PPBS The Strategy-To-Tasks methodology, regardless of its application, it must be consistent and supportive of each phase of the PPBS. This section describes the basics frameworks of which are adapted to resource allocation and management activities for the Special Operations Command (USSOCOM. The authors have used it during the various phases of the PPBS. The National Security
Danish contemporary art is currently expanding bot quantitatively and qualitatively to such a degree that we can speak of a new Danish Golden Age. The article introduces some of the most interesting, Danish contemporary artists which are being exposed at the exhibition in the European Central Bank...
Hu, Wei; Lin, Chang-Wen; Liu, Bing-Wei; Hu, Wei-Hang; Zhu, Ying
Extravascular lung water (EVLW) is a sensitive prognostic indicator of pulmonary edema. Thus, EVLW may be an advantageous method of fluid management. This study aims to evaluate the outcomes of using EVLW and pulmonary artery wedge pressure (PAWP) as strategies for fluid management in patients with acute respiratory distress syndrome (ARDS). Twenty-nine patients were randomly divided into the EVLW and PAWP groups. The survival rate, ICU (Intensive Care Unit) length of stay, duration of mechanical ventilation, acute lung injury scores, and oxygenation index of the EVLW and PAWP groups were compared. No significant difference in the survival rates at 28 and 60 days (d) after treatment was found between the two groups (p = 0.542). The duration of mechanical ventilation and ICU length of stay were significantly lower (p management improved clinical results in patients with ARDS better than PAWP.
This article examines some of the fundamental challenges facing the district nurse in delivery of the managerial aspects of her role in contemporary practice. It discusses the personal attributes that are essential for this role to ensure safe, effective and compassionate leadership and management. The communication skills and ethos underpinning collaborative multidiscilplinary team work and person-centred care are discussed. Issues that compromise positive and productive team working are identified, and strategies dealing with conflict and also change management are debated. These factors are interrelated with the everyday demands of caseload management, the development of educational needs to meet the demands of increased complexity in care needs, and the place of technology in modern health care. It is evidenced that sustained organisational support for this role is more important than ever, due to increasing demand and decreasing capacity. Potential solutions to these challenges are offered to assist the contemporary district nurse.
Ademir Alves da Silva
Full Text Available This text presents a critical reflection about social management trends. In spite of the widespread and generalized use of the expression social management in the 1990’s, it constitutes, under multidisciplinary perspective, the object of professional intervention of the Brazilian Social Work, since the genesis of the profession in Brazil, in the 1930’s, even under different approaches, that have promoted opposite society projects. The social management involves the reproduction of the social life, responding, either direct or indirectly, to demands of the production sphere. Its object is the goods and social services provision, emphasizing the solution of the social demands, in opposition to the mercantile logic. Social management has been the arena of struggles for access to social wealth and social and political participation; it is studied under the perspective of searching alternatives toward an egalitarian and just society.
Jiao, Zunsheng [Univ. of Wyoming, Laramie, WY (United States)
This report provides the results from the project entitled Field Demonstration of Reservoir Pressure Management through Fluid Injection and Displaced Fluid Extraction at the Rock Springs Uplift, a Priority Geologic CO2 Storage Site for Wyoming (DE-FE0026159 for both original performance period (September 1, 2015 to August 31, 2016) and no-cost extension (September 1, 2016 to January 6, 2017)).
Serafin, Ana Gil
This paper offers a rationale for research studies of educational leadership to be conducted by the Venezuelan education community. The research studies are needed to: (1) analyze organizational differences between management and leadership, (2) examine various contemporary theories of leadership and leadership styles, (3) enlighten the role of…
Risk management has been progressively evolving into a systemic approach for organisational decision making in today’s dynamic economic environment of the global era. In this context, risk management is reaching beyond its traditional finance and insurance application context and is entering the sphere of generic, organisation-wide management approaches. In support of this argument we consider four generic risk management standards issued at the institutional, national or international level...
Full Text Available In the article author presents the development of psychoanalytic theory of addiction from early writings to contemporary ego, self psychological and theories of object relations. Classical psychoanalysis understood addiction as a regressive gratification of libidinal drives, whereas contemporary authors understand it as an attempt of adaptation to certain problems and worries. The neurotic conflict is not anymore in the foreground, but disturbances in ego, self and object relations. On the basis of a review of contemporary psychoanalytical theories, the author concludes that individuals prone to addiction have a disturbance in self-regulation. Because of that, they have problems in tolerating and coping with certain emotions. With the help of outer means they tend to re-establish internal balance, which they can't manage alone. This outer 'help' can be seen in various forms of addiction (drugs, food, relationships, sex .... So, the core problem of addicted people is a deficit of self-regulation, which is a consequence of a lack of internalisaton of regulatory functions of primary object. Contemporary psychoanalytical theories of addiction bring us greater insight in personality factors which influence the formation of addiction, thus giving us guidelines for adequate psychotherapy of addiction.
Rossini, Zefferino; Milani, Davide; Costa, Francesco; Castellani, Carlotta; Lasio, Giovanni; Fornari, Maurizio
Chiari malformation type I is a hindbrain abnormality characterized by descent of the cerebellar tonsils beneath the foramen magnum, frequently associated with symptoms or brainstem compression, impaired cerebrospinal fluid circulation, and syringomyelia. Foramen magnum decompression represents the most common way of treatment. Rarely, subdural fluid collection and hydrocephalus represent postoperative adverse events. The treatment of this complication is still debated, and physicians are sometimes uncertain when to perform diversion surgery and when to perform more conservative management. We report an unusual occurrence of subdural fluid collection and hydrocephalus that developed in a 23-year-old patient after foramen magnum decompression for Chiari malformation type I. Following a management protocol, based on a step-by-step approach, from conservative therapy to diversion surgery, the patient was managed with urgent external ventricular drainage, and then with conservative management and wound revision. Because of the rarity of this adverse event, previous case reports differ about the form of treatment. In future cases, finding clinical and radiologic features to identify risk factors that are useful in predicting if the patient will benefit from conservative management or will need to undergo diversion surgery is only possible if a uniform form of treatment is used. Therefore, we believe that a management algorithm based on a step-by-step approach will reduce the use of invasive therapies and help to create a standard of care. Copyright © 2017 Elsevier Inc. All rights reserved.
Kocaoglu, Celebi; Selma Solak, Ece; Kilicarslan, Cengizhan; Arslan, Sukru
To investigate serum creatinine and electrolyte status of children with diarrhea-related hyponatremic or hypernatremic dehydration. Medical history of 83 patients admitted to the Pediatric Intensive Care Unit of the Konya Education and Research Hospital, Konya, Turkey with diarrhea, dehydration and electrolyte imbalance was retrospectively evaluated according to the degree of dehydration, serum creatinine, electrolytes, blood gas, approaches to the treatment such as content of given fluid, HCO3- and acute periotenal dialysis. Of 65 patients with hyponatremia, 44 (67.7%) were given fluids at appropriate concentration according to their age, and 21 (32.3%) were given fluids at higher concentration. Of 18 hypernatremic patients, 11 (61.1%) were given fluids at appropriate concentration for age, and seven (38.9%) were given fluids at higher concentration. Mean duration of amelioration of serum sodium levels for those admitted with hyponatremia and given fluids at appropriate concentration for age and at higher concentration were 33.9 ± 28.3 h and 53.7 ± 31.6 h, respectively. Mean duration of amelioration of serum sodium levels for hypernatremics and given fluids at appropriate concentration for age and at higher concentration were 34.7 ± 22.1 h and 46.3 ± 32 h, respectively. Four (4.8%) hyponatremic patients and three (3.6%) with hypernatremia were treated with acute peritoneal dialysis. Mortality rate was 6% (five of all patients). The children with severe diarrhea should be closely followed-up as to clinical examination, serum electrolytes, creatinine and blood gases, and because no single intravenous fluid management is optimal for all children, intravenous fluid therapy should be individualized for each patient.
Summarising recent research on the physics of complex liquids, this in-depth analysis examines the topic of complex liquids from a modern perspective, addressing experimental, computational and theoretical aspects of the field. Selecting only the most interesting contemporary developments in this rich field of research, the authors present multiple examples including aggregation, gel formation and glass transition, in systems undergoing percolation, at criticality, or in supercooled states. Connecting experiments and simulation with key theoretical principles, and covering numerous systems including micelles, micro-emulsions, biological systems, and cement pastes, this unique text is an invaluable resource for graduate students and researchers looking to explore and understand the expanding field of complex fluids.
Angela B. Kleiman
Full Text Available In this paper I examine the relationship between literacy and contemporaneity. I take as a point of departure for my discussion school literacy and its links with literacies in other institutions of the contemporary scene, in order to determine the relation between contemporary ends of reading and writing (in other words, the meaning of being literate in contemporary society and the practices and activities effectively realized at school in order to reach those objectives. Using various examples from teaching and learning situations, I discuss digital literacy practices and multimodal texts and multiliteracies from both printed and digital cultures. Throughout, I keep as a background for the discussion the functions and objectives of school literacy and the professional training of teachers who would like to be effective literacy agents in the contemporary world.
Vanga, Rohini; Long, Millie D
We discuss the newest evidence-based data on management of ulcerative colitis (UC). We emphasize risk-stratification, optimizing medical therapies, and surgical outcomes of UC. Recent medical advances include introduction of novel agents for UC. Vedolizumab, an anti-adhesion molecule, has demonstrated efficacy in moderate to severe UC. Tofacitinib, a small molecule, has also demonstrated efficacy. Data on optimization of infliximab show the superiority of combination therapy with azathioprine over monotherapy with infliximab or azathioprine alone. Data on anti-tumor necrosis factor-alpha (anti-TNF) therapeutic drug monitoring also hold promise, as do preliminary data on the dose escalation of infliximab in severe hospitalized UC. Surgical outcome data are reassuring, with new fertility data showing the effectiveness of in vitro fertilization. UC management is multi-disciplinary and changing. While novel therapies hold promise, better optimization of our current arsenal will also improve outcomes.
Sodha, M.S.; Tewari, D.P.; Subbarao, D.
The book consists of review articles on some selected contemporary aspects of plasma physics. The selected topics present a panoramic view of contemporary plasma physics and applications to fusion, space and MHD power generation. Basic non-linear plasma theory is also covered. The book is supposed to be useful for M.S./M.Sc. students specialising in plasma physics and for those beginning research work in plasma physics. It will also serve as a valuable reference book for more advanced research workers. (M.G.B.)
Explores a spatial approach to trend mechanisms that is argued to be more contemporary than the traditional temporal appraoch.......Explores a spatial approach to trend mechanisms that is argued to be more contemporary than the traditional temporal appraoch....
Gauthier-Lafaye, F.; Weber, F.
New data about fluid inclusions associated to a siliceous diagenesis show that a deformation phase in the first stage of catagenesis disturbed their microthermometric behaviour. Nevertheless, temperature and pressure of fluids associated to the uraniferous paragenesis and contemporary with the Oklo natural reactors are estimated at 140-160 0 C and 250-500 bar [fr
Sexton, Stephanie J; Granieri, Michael A; Lentz, Aaron C
clean intermittent catheterization dependence. A urethral injury during penile prosthesis implantation might not mandate termination of the procedure despite classic teaching. The strength of this study is that it provides difficult to obtain epidemiologic data on the frequency and management of this clinically significant injury. Limitations include the inherent biases from a survey-based study including response bias and recall bias. The survey response rate could not be obtained. Urethral injury during penile prosthesis implantation is a rare but clinically significant risk of the procedure, with many variations in management of the injury. Termination and delayed implantation might not be necessary after injury, although long-term outcome data are difficult to obtain. Sexton SJ, Granieri MA, Lentz AC. Survey on the Contemporary Management of Intraoperative Urethral Injuries During Penile Prosthesis Implantation. J Sex Med 2018;15:576-581. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.
Robinson, William P; Patel, Rupal K; Columbo, Jesse A; Flahive, Julie; Aiello, Francesco A; Baril, Donald T; Schanzer, Andres; Messina, Louis M
Most existing series of acute aortic occlusion (AAO) predate the changes in surgical and endovascular therapy of the last 2 decades. We examined the contemporary management and outcomes of AAO. We reviewed consecutive patients with AAO at a tertiary referral center from 2004 to 2012. Outcomes were stratified and compared according to etiology and procedure performed. AAO in 29 patients was due to in situ thrombosis in 21 (72%) and embolism in 8 (28%) patients. Vascular patients with embolism were on average older (77 ± 7 vs. 66 ± 12 years, P = 0.02) and had higher rates of atrial fibrillation (100% vs. 20%, P = 0.0002) and congestive heart failure (75% vs. 0%, P = 0.0001) in comparison with those with in situ thrombosis. Neurologic deficit was present in 16 (55%) patients. Six patients (21%) presented with bilateral paresis/paralysis secondary to spinal cord or lumbosacral plexus ischemia, and primary neurologic etiology was investigated before vascular consultation was obtained in 4 of these 6 patients. Of the 29 patients, 28 (97%) underwent revascularization including transfemoral embolectomy (n = 6), transperitoneal aortoiliac thrombectomy (n = 2), axillobifemoral bypass (n = 10), aortobifemoral bypass (n = 6), and endovascular therapy including thrombolysis, angioplasty ± stenting (n = 4). In-hospital mortality was 31% and did not vary significantly according to etiology (embolism 38% vs. in situ thrombosis 29%, P = 0.67). In-hospital mortality varied widely according to procedure (transfemoral embolectomy 50%, aortoiliac thrombectomy 100%, axillobifemoral bypass 30%, aortobifemoral bypass 0%, and endovascular therapy 25%, P = 0.08). Major morbidity (59%), length of stay (8.6 ± 8.0 days), and discharge to a rehabilitation facility (50%) did not vary by etiology or procedure. At a media follow-up of 361 ± 460 days (range 3-2014), overall survival was 42%. There were no amputations among 20 survivors of initial
Talving, Peep; Pålstedt, Joakim; Riddez, Louis
Few previous studies have been conducted on the prehospital management of hypotensive trauma patients in Stockholm County. The aim of this study was to describe the prehospital management of hypotensive trauma patients admitted to the largest trauma center in Sweden, and to assess whether prehospital trauma life support (PHTLS) guidelines have been implemented regarding prehospital time intervals and fluid therapy. In addition, the effects of the age, type of injury, injury severity, prehospital time interval, blood pressure, and fluid therapy on outcome were investigated. This is a retrospective, descriptive study on consecutive, hypotensive trauma patients (systolic blood pressure Karolinska University Hospital in Stockholm, Sweden, during 2001-2003. The reported values are medians with interquartile ranges. Basic demographics, prehospital time intervals and interventions, injury severity scores (ISS), type and volumes of prehospital fluid resuscitation, and 30-day mortality were abstracted. The effects of the patient's age, gender, prehospital time interval, type of injury, injury severity, on-scene and emergency department blood pressure, and resuscitation fluid volumes on mortality were analyzed using the exact logistic regression model. In 102 (71 male) adult patients (age > or = 15 years) recruited, the median age was 35.5 years (range: 27-55 years) and 77 patients (75%) had suffered blunt injury. The predominant trauma mechanisms were falls between levels (24%) and motor vehicle crashes (22%) with an ISS of 28.5 (range: 16-50). The on-scene time interval was 19 minutes (range: 12-24 minutes). Fluid therapy was initiated at the scene of injury in the majority of patients (73%) regardless of the type of injury (77 blunt [75%] / 25 penetrating [25%]) or injury severity (ISS: 0-20; 21-40; 41-75). Age (odds ratio (OR) = 1.04), male gender (OR = 3.2), ISS 21-40 (OR = 13.6), and ISS >40 (OR = 43.6) were the significant factors affecting outcome in the exact
A contemporary organization is becoming more and more complex and dynamic. Managing such an organization often requires new solutions in order to face the fast-expanding comprehensiveness in economy, politics and private life. Understanding complex connections between the elements of a system can remedy this situation. Therefore, when planning and making decisions a lot of factors should be taken into consideration and their interdependencies should be seen. Know-why methodology, thanks to wh...
This paper is based on my experience with teaching a course on ethical dilemmas faced by individuals, managers and businesses in contemporary societies. Modern economic thinking generally presumes that individuals and businesses in a society follow their own self-interest, or private economic incentives. The course highlighted the importance of ethical considerations for action that are based on consideration of others rather than ones own. Four significant ethical dilemmas of modern societie...
Smuszkiewicz, Piotr; Szrama, Jakub
Interpreting acid base disturbances according to the physicochemical Stewart approach allows the cause of such abnormalities to be discovered. This method is based on three independent variables: SID (strong ion difference), mainly sodium and chloride; weak acids concentration - Atot, mainly albumins and phosphate; and carbon dioxide tension - pCO₂. These three independent variables are responsible for the change of water dissociation and for the change in H+ concentration and, consequently, the change in serum pH value. The SID value of the fluids administered to a patient is responsible for the change of serum SID value and therefore causes a change in the patient's acid base status. During the infusion of a given fluid, the SID value of the serum becomes closer to the SID value of that fluid; on the other hand, the infusion causes a decrease in Atot concentration. In order to avoid acid base disturbances connected with fluid administration, the SID value of fluids being administered should be greater than 0 and lower then the serum SID. It has been suggested that fluids should be given of which the SID value is as close as possible to the actual serum HCO₃ concentration. Knowing the SID value of the fluid administered, and the serum HCO₃ concentration, one can expect a change of serum pH after a fluid infusion. Administering a fluid with a SID greater than the HCO₃ concentration causes a pH increase towards alkalosis. Likewise, administering a a fluid with a SID lower than the HCO₃ concentration causes a pH decrease towards acidosis. It seems that knowledge of the electrolyte concentration and the SID value of an administered fluid is an important factor regarding acid base disturbances.
Jason A. Hubbart
Full Text Available Attribution of in-stream biological impairment to anthropogenic activities and prioritization for restoration and/or conservation can be challenging in contemporary mixed-land-use watersheds. Critical information necessary to improve decision making can be costly and labor intensive, and thus unobtainable for many municipalities. A reduced cost, rapid stream physical habitat assessment (rPHA can yield information that, when paired with land use data may reveal causal patterns in aquatic physical habitat degradation, and thus assist targeting sites for restoration. However, a great deal of work is needed to reduce associated costs, and validate the potential of rPHA for documenting fine-scale incremental change in physical habitat conditions in complex contemporary watersheds. The following commentary serves to draw attention to rPHA challenges and research needs including (but not limited to field-based validation and optimization of new remote sensing technologies, evaluation of the accuracy and representativeness of rapid vegetation survey methods, refinement of analytical methods, and consideration of legacy land use impacts and hydrologic system evolution in rPHA results interpretation. Considering the value of rPHA-generated data for improvement of watershed resource management, such challenges constitute timely, high-impact research opportunities for investigators wishing to advance complex, contemporary aquatic ecosystem management.
Diana T. Kudaibergenova
Full Text Available This paper re-focuses the Silk Road discussions from the position of contemporary art in Central Asian region. Since the late 1980s contemporary art in Central Asia boomed and it eventually became an alternative public space for the discussion of cultural transformations, social and global processes and problems that local societies faced. Initially the questions raised by many artists concerned issues of lost identity and lost heritage during the period of Soviet domination in the region. Different artists started re-imagining the concept of the Self in their works and criticising the old rigid approaches to geography, history and mobility. Nomadic heritage became one of the central themes in contemporary art of Central Asia in the 1990s. Artists started experimenting with symbols of mobility, fluid borders and imagined geography of the “magic steppe” (see Kudaibergenova 2017, “Punk Shamanism”. Contemporary art in Central Asia continues to serve as a space for social critique and a space for search and re-conceptualisation of new fluid identities, geographies and region's place on the world map. In this paper I critically evaluate three themes connected to the symbolism of Silk Road heritage that many artists engage with – imagined geography, routes, roads and mobility. All three themes are present in the selected case studies of Gulnara Kasmalieva's and Muratbek Djumaliev's TransSiberian Amazons (2005 and A New Silk Road: Algorithm of Survival and Hope (2007 multi-channel video art, Victor and Elena Vorobievs' (NonSilk Road (2006 performance and photography, Almagul Menlibayeva's My Silk Road to You video-art and photography (2010–2011, Yerbossyn Meldibekov's series on imagining Central Asia and the Mountains of Revolution (2012–2015, and Syrlybek Bekbotaev's Kyrgyz Pass installation (2014–2015 as well as Defenders of Issyk Kul (2014. I trace how artists modernise, mutate and criticise main discourses about Silk Road and what
Simulating fast transient phenomena involving fluids and structures in interaction for safety purposes requires both accurate and robust algorithms, and parallel computing to reduce the calculation time for industrial models. Managing kinematic constraints linking fluid and structural entities is thus a key issue and this contribution promotes a dual approach over the classical penalty approach, introducing arbitrary coefficients in the solution. This choice however severely increases the complexity of the problem, mainly due to non-permanent kinematic constraints. An innovative parallel strategy is therefore described, whose performances are demonstrated on significant examples exhibiting the full complexity of the target industrial simulations. (authors)
Ingelse, SA; Wösten-van Asperen, RM; Lemson, J; Daams, JG; Bem, R.A.; van Woensel, JB
The administration of an appropriate volume of intravenous fluids, while avoiding fluid overload, is a major challenge in the pediatric intensive care unit. Despite our efforts, fluid overload is a very common clinical observation in critically ill children, in particular in those with pediatric
Ingelse, Sarah A.; Wösten-van Asperen, Roelie M.; Lemson, Joris; Daams, Joost G.; Bem, Reinout A.; van Woensel, Job B.
The administration of an appropriate volume of intravenous fluids, while avoiding fluid overload, is a major challenge in the pediatric intensive care unit. Despite our efforts, fluid overload is a very common clinical observation in critically ill children, in particular in those with pediatric
Park, Chan S
Contemporary Engineering Economics, 5/e, is intended for undergraduate engineering students taking introductory engineering economics while appealing to the full range of engineering disciplines for which this course is often required: industrial, civil, mechanical, electrical, computer, aerospace, chemical, and manufacturing engineering, as well as engineering technology. This edition has been thoroughly revised and updated while continuing to adopt a contemporary approach to the subject, and teaching, of engineering economics. This text aims not only to build a sound and comprehensive coverage of engineering economics, but also to address key educational challenges, such as student difficulty in developing the analytical skills required to make informed financial decisions.
Willen, G. S.; Riemer, D. H.; Hustvedt, D. C.
The conceptual design of a Spacelab experiment to develop the technology associated with low gravity propellant management is presented. The proposed facility consisting of a supply tank, receiver tank, pressurization system, instrumentation, and supporting hardware, is described. The experimental objectives, the receiver tank to be modeled, and constraints imposed on the design by the space shuttle, Spacelab, and scaling requirements, are described. The conceptual design, including the general configurations, flow schematics, insulation systems, instrumentation requirements, and internal tank configurations for the supply tank and the receiver tank, is described. Thermal, structural, fluid, and safety and reliability aspects of the facility are analyzed. The facility development plan, including schedule and cost estimates for the facility, is presented. A program work breakdown structure and master program schedule for a seven year program are included.
Maron, Barry J; Rowin, Ethan J; Casey, Susan A; Lesser, John R; Garberich, Ross F; McGriff, Deepa M; Maron, Martin S
Youthful age has been considered the time of greatest risk for patients with hypertrophic cardiomyopathy (HCM), largely because of the possibility of sudden death. The last 2 decades have witnessed more reliable identification of at-risk patients and utilization of implantable cardioverter-defibrillators for prevention of sudden death, and other contemporary treatment options. Whether such management advances have significantly altered the considerable mortality rate for young HCM patients remains unresolved. We studied long-term outcome in 474 consecutive HCM patients between 7 and 29 years of age presenting at 2 referral institutions. Over 7.1±5.1 years of follow-up (6.0 [3.0, 10.0]), 452 patients (95%) survived, with 95% experiencing no or mild symptoms. HCM-related death occurred in 18 patients (3%; 0.54%/y): arrhythmic sudden death (n=12), progressive heart failure and heart transplant complications (n=5), or postoperatively (n=1). In contrast, aborted life-threatening events occurred in 63 other high-risk patients (13%) with implantable cardioverter-defibrillator interventions for ventricular tachyarrhythmias (n=31), resuscitated out-of-hospital cardiac arrest (n=20), or heart transplant for advanced heart failure (n=12), 1.8%/y, 3-fold higher than HCM mortality. Five- and 10-year survival (considering only HCM deaths) was high (97% and 94%, respectively), virtually identical to that reported in middle-aged adult HCM patients (98% and 94%, P=0.23). In a large hospital-based cohort of young HCM patients, representing an age group considered at greatest risk, low mortality rates can be achieved with the application of contemporary cardiovascular treatment strategies, largely because of reliable identification of high-risk patients who benefited from implantable cardioverter-defibrillators for sudden death prevention, thereby creating the opportunity for extended longevity and good quality of life. © 2015 American Heart Association, Inc.
Sorensen, Roslyn; Iedema, Rick; Severinsson, Elisabeth
To examine nursing leadership in contemporary health care and its potential contribution to health service organization and management. As the nursing profession repositions itself as an equal partner in health care beside medicine and management, its enhanced nursing standards and clinical knowledge are not leading to a commensurate extension of nursing's power and authority in the organization. An ethnographic study of an ICU in Sydney, Australia, comprising: interviews with unit nursing managers (4); focus groups (3) with less experienced, intermediate and experienced nurses (29 in total); and interviews with senior nurse manager (1). Inter- and intra-professional barriers in the workplace, fragmentation of multidisciplinary clinical systems that collectively deliver care, and clinical and administrative disconnection in resolving organizational problems, prevented nurses articulating a model of intensive and end-of-life care. Professional advocacy skills are needed to overcome barriers and to articulate and operationalize new nursing knowledge and standards if nurses are to enact and embed a leadership role. The profession will need to move beyond a reliance on professional clinical models to become skilled multidisciplinary team members and professional advocates for nurses to take their place as equal partners in health care.
Griffin, DeVon; Kohl, Fred; Massa, Gioia D.; Motil, Brian; Parsons-Wingerter, Patricia; Quincy, Charles; Sato, Kevin; Singh, Bhim; Smith, Jeffrey D.; Wheeler, Raymond M.
Microgravity Fluids for Biology represents an intersection of biology and fluid physics that present exciting research challenges to the Space Life and Physical Sciences Division. Solving and managing the transport processes and fluid mechanics in physiological and biological systems and processes are essential for future space exploration and colonization of space by humans. Adequate understanding of the underlying fluid physics and transport mechanisms will provide new, necessary insights and technologies for analyzing and designing biological systems critical to NASAs mission. To enable this mission, the fluid physics discipline needs to work to enhance the understanding of the influence of gravity on the scales and types of fluids (i.e., non-Newtonian) important to biology and life sciences. In turn, biomimetic, bio-inspired and synthetic biology applications based on physiology and biology can enrich the fluid mechanics and transport phenomena capabilities of the microgravity fluid physics community.
Frank, Kenneth T.; Brickman, David
Stock collapses have occurred worldwide. The most frequently cited cause is over-fishing, suggesting that fisheries management has been ineffective in controlling exploitation rates. The progression of a fishery from an over-exploited to a collapsed state involves impairment of the reproductive capacity of the target species, i.e. recruitment over-fishing. In many cases, this occurs by reduction of the spawning stock biomass (SSB) through the systematic elimination of spawning components within a stock complex. While operational definitions of minimum levels of SSB have been developed, they have seldom been applied and never adopted in a Canadian groundfish management context. The answer to the question of how much is enough to perpetuate a stock under exploitation has been illusive. Serebryakov [J. Cons. Int. Explor. Mer, 47 (1990) 267] has advocated definition of critical levels of SSB based on survival rates (R/SSB). We review his method and discuss the utility of the approach. An alternative approach to the problem of estimating minimum SSB is through a fundamental revision of the traditional stock and recruitment relationship. Explicit theoretical SSB thresholds below which reproduction/recruitment is severely impaired based upon density-dependent mating success (or Allee effects) is considered a superior approach to the question of how much is enough because of its ecological grounding. However, the successful application of this approach will require re-definition of the space/time scales of the management unit. Finally, support is growing for the establishment of closed areas or "no-take zones" as an alternative approach to managing the problems of fishing a stock complex by enabling sub-populations to escape fishing. While the expected benefits of areas protected from fishing are numerous, clear demonstrations of benefits of such areas in marine temperate ecosystems are lacking. In fact, unintended negative consequences may result from such actions.
Gupta, Milan; Szmitko, Paul; Singh, Narendra; Tsigoulis, Michelle; Kajil, Mahesh; Stone, James
Although clinical practice guidelines for the management of hypertension exist in Canada, the rate of contemporary blood pressure (BP) control remains unclear. In the Primary Care Audit of Global Risk Management (PARADIGM) study, 3015 healthy, middle-aged Canadians, free of cardiovascular disease (CVD) or diabetes were evaluated. In this analysis, we characterized the CVD risk factors, treatment patterns, and BP control rates in subjects with uncomplicated hypertension. A total of 917 subjects (30.4%) had a diagnosis of hypertension. The median age was 59 ± 8 years. The mean treated systolic/diastolic BP were 134 ± 14 mm Hg/82 ± 9 mm Hg, respectively. CVD risk factors included past/current smoking (35.9%), abdominal obesity (62.5%), and dyslipidemia (59.4%). Using the Framingham Risk Score, 20.4%, 41.0%, and 38.5% of the subjects were at low, intermediate, and high risk, respectively. Of the 88% with treated hypertension, 46.9%, 38.7%, and 14.3% received 1, 2, or ≥3 drugs, respectively. The rate of BP control was 57.4% (systolic BP Risk Score, and was lower in patients with metabolic syndrome vs those without (P risk factors are prevalent in Canadians with uncomplicated hypertension. BP control was modest (57.4%) and was lowest in patients prescribed diuretic monotherapy and in those at highest CVD risk. Despite the success of national hypertension strategies, enhanced efforts are warranted to improve BP control in Canada. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Zeytounian, Radyadour Kh
Rationality - as opposed to 'ad-hoc' - and asymptotics - to emphasize the fact that perturbative methods are at the core of the theory - are the two main concepts associated with the Rational Asymptotic Modeling (RAM) approach in fluid dynamics when the goal is to specifically provide useful models accessible to numerical simulation via high-speed computing. This approach has contributed to a fresh understanding of Newtonian fluid flow problems and has opened up new avenues for tackling real fluid flow phenomena, which are known to lead to very difficult mathematical and numerical problems irrespective of turbulence. With the present scientific autobiography the author guides the reader through his somewhat non-traditional career; first discovering fluid mechanics, and then devoting more than fifty years to intense work in the field. Using both personal and general historical contexts, this account will be of benefit to anyone interested in the early and contemporary developments of an important branch of the...
Gunasekaran, Prasad; Parashara, Deepak K
Non vitamin-K oral anticoagulants (NOAC) have considerably enhanced anticoagulation practice for non-valvular atrial fibrillation with specific advantages of fixed dosing, non-fluctuant therapeutic levels and obviation of therapeutic level monitoring. NOAC pharmacology is remarkable for considerable renal excretion. Heterogeneity in the precise time cut-offs for discontinuation of NOACs prior to elective surgical or percutaneous procedures arise from the non-linear variations of drug excretion with different levels of creatinine clearances as in chronic kidney disease. Multiple authors have suggested cut-offs leading to ambiguity among practicing clinicians. Recent data pertaining to systemic thromboembolism, stroke and major bleeding derived from randomized controlled clinical trials have simplified the periprocedural management of NOACs. This review focusses on heterogeneity in the management of NOACs in patients with CKD in this peculiar scenario and highlights the contemporary evidence to support a unified approach towards perioperative management of NOACs. Multiple antidotes targeted towards binding of specific NOACs have been developed and are in the testing phase, thereby offering immense potential for rapid and complete reversal of NOAC activity in emergent procedures and major bleeding episodes. Targeted research on thromboembolism, stroke and major bleeding following temporary periprocedural interruption of NOACs using multicentric registries could further expand the clinical utility of these agents.
Seidel, Natan E; Arlen, Angela M; Smith, Edwin A; Kirsch, Andrew J
To review the clinical manifestations and operative management of a large contemporary pediatric cohort of patients with prune-belly syndrome (PBS). PBS patients aged <21 years followed up in our pediatric urology clinic were identified by the International Classification of Diseases, Ninth Revision code (756.71). Demographics, concomitant diagnoses, surgical history, imaging studies, and renal or bladder function were evaluated. Data were available for 46 pediatric patients (44 boys and 2 girls). Mean age was 7.6 ± 4.7 years (range, 0.9-20 years). Average length of clinical follow-up was 6.8 ± 5 years. Forty-five children (97.8%) had hydroureteronephrosis, and 36 of them (78.3%) had vesicoureteral reflux. Five patients (10.9%) had significant pulmonary insufficiency, and 2 patients (4.3%) were oxygen dependent. Eighteen children (39.1%) had other congenital malformations, including cardiac in 4 patients (8.7%) and musculoskeletal anomalies in 10 patients (21.7%). Orchidopexy was the most common surgery, with all boys aged ≥3 years having undergone the procedure. Twenty-two patients (47.8%) had a history of ureteral surgery, 22 (47.8%) had bladder surgery, 11 (23.9%) had renal surgery, and 6 (13%) had urethral procedures. Nineteen patients (41.3%) underwent abdominoplasty. Eighteen children (39.1%) had documented chronic kidney disease, and 8 children (17.4%) underwent renal transplantation. Average age at transplantation was 5.1 ± 2.9 years. The mean nadir creatinine level for patients with end-stage renal disease was 1.4 mg/dL compared with 0.4 mg/dL for those not requiring transplantation (P <.001). Children with PBS have significant comorbidities and require frequent operative intervention, with disease heterogeneity necessitating an individualized management approach. Early end-stage renal disease is prevalent, with approximately 15% of children requiring kidney transplantation. Copyright © 2015 Elsevier Inc. All rights reserved.
Weiner, A B; Matulewicz, R S; Schaeffer, E M; Liauw, S L; Feinglass, J M; Eggener, S E
Surgery and radiation-based therapies are standard management options for men with clinically localized high-risk prostate cancer (PCa). Contemporary patterns of care are unknown. We hypothesize the use of surgery has steadily increased in more recent years. Using the National Cancer Data Base for 2004-2013, all men diagnosed with high-risk localized PCa were identified using National Comprehensive Cancer Network criteria. Temporal trends in initial management were assessed. Multivariable logistic regression was used to evaluate demographic and clinical factors associated with undergoing radical prostatectomy (RP). In total, 127 391 men were identified. Use of RP increased from 26% in 2004 to 42% in 2013 (adjusted risk ratio (RR) 1.51, 95% CI 1.42-1.60, P<0.001), while external beam radiation therapy (EBRT) decreased from 49% to 42% (P<0.001). African American men had lower odds of undergoing RP (unadjusted rate of 28%, adjusted RR 0.69, 95% CI 0.66-0.72, <0.001) compared to White men (37%). Age was inversely associated with likelihood of receiving RP. Having private insurance was significantly associated with the increased use of RP (vs Medicare, adjusted odds ratio 1.04, 95% CI 1.01-1.08, P=0.015). Biopsy Gleason scores 8-10 with and without any primary Gleason 5 pattern were associated with decreased odds of RP (vs Gleason score ⩽6, both P<0.001). Academic and comprehensive cancer centers were more likely to perform RP compared to community hospitals (both P<0.001). The likelihood of receiving RP for high-risk PCa dramatically increased from 2004 to 2013. By 2013, the use of RP and EBRT were similar. African American men, elderly men and those without private insurance were less likely to receive RP.
Lee, Teng C; Kon, Zachary; Cheema, Faisal H; Grau-Sepulveda, Maria V; Englum, Brian; Kim, Sunghee; Chaudhuri, Paramita S; Thourani, Vinod H; Ailawadi, Gorav; Hughes, G Chad; Williams, Matthew L; Brennan, J Matthew; Svensson, Lars; Gammie, James S
Management of acute type A aortic dissection (AAAD) is challenging and operative strategies are varied. We used the STS Adult Cardiac Surgery Database (STS ACSD) to describe contemporary surgical strategies and outcomes for AAAD. Between July 2011 and September 2012, 2982 patients with AAAD underwent operations at 640 centers in North America. In this cohort, median age was 60 years old, 66% were male, and 80% had hypertension. The most common arterial cannulation strategies included femoral (36%), axillary (27%), and direct aortic (19%). The median perfusion and cross-clamp times were 181 and 102 min, respectively. The lowest temperature on bypass showed significant variation. Hypothermic circulatory arrest (HCA) was used in 78% of cases. Among those undergoing HCA, brain protection strategies included antegrade cerebral perfusion (31%), retrograde cerebral perfusion (25%), both (4%), and none (40%). Median HCA plus cerebral perfusion time was 40 min. Major complications included prolonged ventilation (53%), reoperation (19%), renal failure (18%), permanent stroke (11%), and paralysis (3%). Operative mortality was 17%. The median intensive care unit and hospital length of stays were 4.7 and 9.0 days, respectively. Among 640 centers, the median number of cases performed during the study period was three. Resuscitation, unresponsive state, cardiogenic shock, inotrope use, age >70, diabetes, and female sex were found to be independent predictors of mortality. These data describe contemporary patient characteristics, operative strategies, and outcomes for AAAD in North America. Mortality and morbidity for AAAD remain high. © 2018 Wiley Periodicals, Inc.
Jovanović Petar M.
Full Text Available In this paper we analyze contemporary managerial positions such as program manager, project portfolio manager, crisis manager and others. The idea is to promote managerial positions in Serbia, which is quite unjustifiably undervalued, primarily because of the lack of knowledge in the field of management and other issues related to management education.
Full Text Available The new positron emission tomography (PET/CT methods for neuroendocrine tumors detection are presented and compared with classic, conventional methods. Conventional methods use a gamma scintillation camera for patients with neuroendocrine tumor imaging, after intravenous injection of one of the following radiopharmaceuticals: 1 somatostatin analogues labeled with indium-111 (111In-pentetreotide or technetium-99m (99mTc-EDDA/HYNIC-TOC; 2 noradrenaline analogue labeled with iodine-131 or -123 (131I/123I-MIBG; or 3 99mTc(V-DMSA. Contemporary methods use PET/CT equipment for patients with neuroendocrine tumor imaging, after intravenous injection of pharmaceuticals labeled with positron emitters [fluorine-18 (18F, galium-68 (68Ga, or carbon-11 (11C]: 1 glucose analogue (18FDG; 2 somatostatin analogue (68Ga-DOTATOC/68Ga-DOTATATE/68Ga-DOTANOC; 3 aminoacid precursors of bioamines: [a dopamine precursor 18F-DOPA (6-18F-dihydroxyphenylalanine, b serotonin precursor 11C-5HTP (11C-5-hydroxytryptophan]; or 4 dopamine analogue 18F-DA (6-18F-fluorodopamine. Conventional and contemporary (PET/ CT somatostatin receptor detection showed identical high specificity (92%, but conventional had very low sensitivity (52% compared to PET/CT (97%. It means that almost every second neuroendocrine tumor detected by contemporary method cannot be discovered using conventional (classic method. In metastatic pheochromocytoma detection contemporary (PET/ CT methods (18F-DOPA and 18F-DA have higher sensitivity than conventional (131I/123I-MIBG. In medullary thyroid carcinoma diagnostics contemporary method (18F-DOPA is more sensitive than conventional 99mTc(V-DMSA method, and is similar to 18FDG, computed tomography and magnetic resonance. In carcinoid detection contemporary method (18F-DOPA shows similar results with contemporary somatostatin receptor detection, while for gastroenteropancreatic neuroendocrine tumors it is worse. To conclude, contemporary (PET/CT methods for
This paper examines the affective dimensions of new forms of informal entrepreneurial work carried out in spaces of unemployment. Situating the analysis within contemporary scholarship on deservingness and on affect and labour, I shed light on the forms of entrepreneurial labour that rely upon affect-driven economies of exchange underpinned by moral judgements of deservingness, value and worth. In particular, this paper draws on a multi-city (Melbourne, London, San Francisco) study of homeless street press sellers (The Big Issue and Street Sheet) to explore the ways in which contemporary practices of charity and care are carried out through individualized market-place exchanges. Sellers' accounts of their work reveal how smiling and being (or looking) happy is a performative expectation that must be managed in the face of poverty and precarity. © London School of Economics and Political Science 2018.
Full Text Available Modern business is characterized by risk and uncertainty, and such an environment is reflected in the decisions taken by managers. On the other hand, management consulting is one of the most important management techniques developed over the last fifty years. The secondary effect of this invention is the rapid development of new frameworks, tools, and techniques improving the operations in a number of companies. Exposure of consulting organizations to varying combinations of business circumstances and experiences of different companies have allowed for the accumulation of valuable knowledge and business experience. From this coupling, or interaction of knowledge and experience of consulting companies, on the one hand and the needs of management companies to recognize their role and hire consultants, on the other hand, developed the importance of financial consulting and auditing. Rational management processes cannot be imagined without reliable information provided by the audit, especially as the strategic management includes the control phase. The importance and relationship between consulting and management in companies that do business according to modern principles is a central topic of consideration in this paper.
Bosmia, Anand N; Zimmermann, Terence M; Griessenauer, Christoph J; Shane Tubbs, R; Rosenthal, Eben L
Various case reports on nasal myiasis written during the 1990s and 2000s state that nasal myiasis, which is known as peenash among South Asian natives, is a form of divine punishment in Hindu mythology, but do not provide citations from Hindu scriptures that would suggest this interpretation. This paper aims to discuss the phenomenon of peenash in a historical context by examining medical literature written during the nineteenth and early twentieth centuries, to identify Hindu texts contributing to the belief of some Hindus that nasal myiasis is a form of divine punishment, and to provide an overview of contemporary treatment for and management of nasal myiasis.
Full Text Available Purpose: The article presents and discusses some findings derived from a research project about University academic management, and it is focused on the identification of principal clues –even related to subjects and methodology– for the design of training programmes on this task. Design/methodology/approach: The research design adopted a qualitative approach and contemplated the development of in-depth interviews to 71 academic managers at the university who were valued as good in that task, in three Spanish Universities –Universidad de Las Palmas de Gran Canaria (ULP, Universidad de Lleida (UdL y Universidad de Sevilla (US. Data were analyzed using MAXQDA.11 and their interpretations were contrasted with the opinions obtained in a second round of interviews with 15 of those managers. Findings: Results allows to identify some kind of “vital cycle” in academic managers, inform about their reasons to continue in their managing charges, about their worries related to interpersonal relationships and conflict management, as well as about the recognized need of receiving a specific training for academic management, based on an active an participative methodology which can promote a practical learning. Research limitations/implications: The most important limitations of the study have to do with two unrelated issues. First of them, from a methodological point of view, is related to the limited number of participants. Second of them derives of the changing environment in which management and government model of Spanish is changing. This could probably affect the value and the interest showed by a academics on University management. Practical implications: According to one of the original mains of the study, a training program for academics in university management was already designed and developed. Social implications: The development of training Programs on University management as the one derived from the commented study would represent a
Mullin, Gerard E; Shepherd, Sue J; Chander Roland, Bani; Ireton-Jones, Carol; Matarese, Laura E
Irritable bowel syndrome is a complex disorder whose pathophysiology involves alterations in the enteric microbiota, visceral hypersensitivity, gut immune/barrier function, hypothalamic-pituitary-adrenal axis regulation, neurotransmitters, stress response, psychological factors, and more. The importance of diet in the management of irritable bowel syndrome has taken center stage in recent times as the literature validates the relationship of certain foods with the provocation of symptoms. Likewise, a number of elimination dietary programs have been successful in alleviating irritable bowel syndrome symptoms. Knowledge of the dietary management strategies for irritable bowel syndrome will help guide nutritionists and healthcare practitioners to deliver optimal outcomes. This tutorial reviews the nutrition management strategies for irritable bowel syndrome. © 2014 American Society for Parenteral and Enteral Nutrition.
Thayer, N S
Contemporary mysticism is in continuity with religious mysticism of all ages. Mysticism, like all religion, has an ideological and an experiential dimension. Traditional Freudian theory is inadequate for understanding either the ideological or the cognitive aspect, because it does not adequately account for either the cognitive process or the self-conscious "I." Categories of both ego psychology and the social scientific approach to religion illuminate contemporary mysticism in ways unavailable to the traditional Freudian psychoanalytic approach. The epistemological implications of the mystical attitude are considered, in both the religious and the scientific enterprises.
Zhai, Jiliang; Panchal, Ripul R; Tian, Ye; Wang, Shujie; Zhao, Lijuan
Cerebrospinal fluid (CSF) leak is a rare but potentially troublesome and occasionally catastrophic complication after anterior cervical decompression surgery. There is limited literature describing this complication, and the management of CSF leak varies. The aim of this study was to retrospectively review the treatment of cases with CSF leak and develop a management algorithm. A series of 14 patients with CSF leak from January 2011 to May 2016 were included in this study. Their characteristics, management of CSF leak, and outcomes were documented. There were 5 male and 9 female patients. Mean age at surgery was 57.1±9.9 years (range, 37-76 years). All instances of CSF leak, except 1 noted postoperatively, were indirectly repaired intraoperatively. A closed straight wound drain was placed for all patients. A lumbar subarachnoid drain was placed immediately after surgery in 4 patients and postoperatively in 7 patients. In 1 patient, lumbar drain placement was unsuccessful. In 2 additional patients, the surgeon decided not to place a lumbar drain. One patient developed meningitis and recovered after antibiotic therapy with meropenem and vancomycin. Another patient had a deep wound infection and required a revision surgery. Wound drains and lumbar drains should be immediately considered when CSF leak is identified. Antibiotics also should be considered to prevent intradural infection. [Orthopedics. 2018; 41(2):e283-e288.]. Copyright 2018, SLACK Incorporated.
Mead, Sarah M.; Ellerbrock, Cheryl R.; Cruz, Bárbara C.
Contemporary global issues can be examined through the lens of modern photographic art. In an effort to prepare global-ready graduates, this article explores the pressing problems of environmental degradation, urbanization, and homelessness through the work of three contemporary artists. Illustrative works, suggested approaches, and curriculum…
Full Text Available The critical analysis of Habermas’ Public Sphere Theory and the comparative undertaking to the current day enables us to assert that in contemporary society, public sphere is no longer a political public sphere, this dimension being completed by a societal dimension, the public sphere has extended and now we can talk about partial public spheres in an ever more commercial environment. The new rebuilding and communication technologies create a new type of public character: the visible sphere – non-located, non-dialogical and open. Information and communication are more and more involved in the restructuring of capitalism on an international scale and the reorganization of leadership and management systems. The reevaluation of the public sphere, public opinion, communication allows us to define public sphere according to the profound mutations from today’s democratic societies.
Full Text Available Nothing is eternal, except changes. This statement characterizes the contemporary world, as succinctly and correctly as possible. The field of economic affairs, strongly marked by the effects of the economic globalization process development, by the manifestation of the knowledge-based economy and by the moral, ecological and social consciousness of contemporary economic organizations, within the framework of the aggravation of some social and ecological problems, faces today the need for various fundamental changes, starting from the reconsideration of the validity of those principles that have governed it for the last decades. Respecting the ethical norms or principles in developing economic affairs does not represent a recent approach, but, as a result of the changes that marked the contemporary economy, tends to become an organic component of the process of adopting organizational decisions and an indissolubly respected principle in the process of planning the future of the organization. Moreover, the international organizations’ experience proclaimed the importance of respecting a unitary set of business ethics principles, disregarding the market or the geographical area where they develop their activity, leading thus to the enrichment of science and management functions with an ethical part.
Lee, Jiwon M; Jung, Younghwa; Lee, Se Eun; Lee, Jun Ho; Kim, Kee Hyuck; Koo, Ja Wook; Park, Young Seo; Cheong, Hae Il; Ha, Il-Soo; Choi, Yong; Kang, Hee Gyung
Recent studies have established the association between hypotonic fluids administration and hospital-acquired hyponatremia in children. The present paper investigated the pattern of current practice in intravenous fluid prescription among Korean pediatric residents, to underscore the need for updated education. A survey-based analysis was carried out. Pediatric residents at six university hospitals in Korea completed a survey consisting of four questions. Each question proposed a unique scenario in which the respondents had to prescribe either a hypotonic or an isotonic fluid for the patient. Ninety-one responses were collected and analyzed. In three of the four scenarios, a significant majority prescribed the hypotonic fluids (98.9%, 85.7%, and 69.2%, respectively). Notably, 69.2% of the respondents selected the hypotonic fluids for postoperative management. Almost all (96.7%) selected the isotonic fluids for hydration therapy. In the given scenarios, the majority of Korean pediatric residents would prescribe a hypotonic fluid, except for initial hydration. The current state of pediatric fluid management, notably, heightens the risk of hospital-acquired hyponatremia. Updated clinical practice education on intravenous fluid prescription, therefore, is urgently required.
Strong competition in the market has caused the development of a new management approach known as Total Quality Management (TQM). Due to importance that quality plays in achieving competitive advantage, the hotel industry started to apply TQM. During the introduction of these systems, hotel companies may use different approaches to suit their own buseiness requirements. In doing so, 'TQM standards' can be used, or various international standards and models of business ...
Keihani, Sorena; Xu, Yizhe; Presson, Angela P; Hotaling, James M; Nirula, Raminder; Piotrowski, Joshua; Dodgion, Christopher M; Black, Cullen M; Mukherjee, Kaushik; Morris, Bradley J; Majercik, Sarah; Smith, Brian P; Schwartz, Ian; Elliott, Sean P; DeSoucy, Erik S; Zakaluzny, Scott; Thomsen, Peter B; Erickson, Bradley A; Baradaran, Nima; Breyer, Benjamin N; Miller, Brandi; Santucci, Richard A; Carrick, Matthew M; Hewitt, Timothy; Burks, Frank N; Kocik, Jurek F; Askari, Reza; Myers, Jeremy B
The rarity of renal trauma limits its study and the strength of evidence-based guidelines. Although management of renal injuries has shifted toward a nonoperative approach, nephrectomy remains the most common intervention for high-grade renal trauma (HGRT). We aimed to describe the contemporary management of HGRT in the United States and also evaluate clinical factors associated with nephrectomy after HGRT. From 2014 to 2017, data on HGRT (American Association for the Surgery of Trauma grades III-V) were collected from 14 participating Level-1 trauma centers. Data were gathered on demographics, injury characteristics, management, and short-term outcomes. Management was classified into three groups-expectant, conservative/minimally invasive, and open operative. Descriptive statistics were used to report management of renal trauma. Univariate and multivariate logistic mixed effect models with clustering by facility were used to look at associations between proposed risk factors and nephrectomy. A total of 431 adult HGRT were recorded; 79% were male, and mechanism of injury was blunt in 71%. Injuries were graded as III, IV, and V in 236 (55%), 142 (33%), and 53 (12%), respectively. Laparotomy was performed in 169 (39%) patients. Overall, 300 (70%) patients were managed expectantly and 47 (11%) underwent conservative/minimally invasive management. Eighty-four (19%) underwent renal-related open operative management with 55 (67%) of them undergoing nephrectomy. Nephrectomy rates were 15% and 62% for grades IV and V, respectively. Penetrating injuries had significantly higher American Association for the Surgery of Trauma grades and higher rates of nephrectomy. In multivariable analysis, only renal injury grade and penetrating mechanism of injury were significantly associated with undergoing nephrectomy. Expectant and conservative management is currently utilized in 80% of HGRT; however, the rate of nephrectomy remains high. Clinical factors, such as surrogates of
Davison, Scott; Alger, Nicholas; Turner, Daniel Zack; Subia, Samuel Ramirez; Carnes, Brian; Martinez, Mario J.; Notz, Patrick K.; Klise, Katherine A.; Stone, Charles Michael; Field, Richard V., Jr.; Newell, Pania; Jove-Colon, Carlos F.; Red-Horse, John Robert; Bishop, Joseph E.; Dewers, Thomas A.; Hopkins, Polly L.; Mesh, Mikhail; Bean, James E.; Moffat, Harry K.; Yoon, Hongkyu
This document summarizes research performed under the SNL LDRD entitled - Computational Mechanics for Geosystems Management to Support the Energy and Natural Resources Mission. The main accomplishment was development of a foundational SNL capability for computational thermal, chemical, fluid, and solid mechanics analysis of geosystems. The code was developed within the SNL Sierra software system. This report summarizes the capabilities of the simulation code and the supporting research and development conducted under this LDRD. The main goal of this project was the development of a foundational capability for coupled thermal, hydrological, mechanical, chemical (THMC) simulation of heterogeneous geosystems utilizing massively parallel processing. To solve these complex issues, this project integrated research in numerical mathematics and algorithms for chemically reactive multiphase systems with computer science research in adaptive coupled solution control and framework architecture. This report summarizes and demonstrates the capabilities that were developed together with the supporting research underlying the models. Key accomplishments are: (1) General capability for modeling nonisothermal, multiphase, multicomponent flow in heterogeneous porous geologic materials; (2) General capability to model multiphase reactive transport of species in heterogeneous porous media; (3) Constitutive models for describing real, general geomaterials under multiphase conditions utilizing laboratory data; (4) General capability to couple nonisothermal reactive flow with geomechanics (THMC); (5) Phase behavior thermodynamics for the CO2-H2O-NaCl system. General implementation enables modeling of other fluid mixtures. Adaptive look-up tables enable thermodynamic capability to other simulators; (6) Capability for statistical modeling of heterogeneity in geologic materials; and (7) Simulator utilizes unstructured grids on parallel processing computers.
Zhao, S; Ai, L; Zhang, H
To discuss the significance of amnioinfusion and amniotic fluid exchange under continuous internal fetal heart rate (FHR) monitoring for management of fetal distress during labor. 136 cases with frequent variable deceleration (VD) and meconium stained amniotic fluid during labor were divided into two groups: the study group (68 cases) and the control group (68 cases). The former were treated by amnioinfusion and amniotic fluid exchange, while oxygen inhalation, change of body position, and intravenous infusion for the control group. In the study group, VD disappeared or relieved in 62 cases obviously, and the efficacy rate reached 91.2% (62/68). 48 cases with II degree meconium stained amniotic fluid were treated by amniotic fluid exchange, amniotic fluid became clear or turned to I degree stained in 39 cases. In the control group, VD relieved in 20 cases, the efficacy rate was 19.4%, significantly lower than that of the study group (P 0.05). Amnioinfusion and AF exchange during labor are one of the effective treatment methods for fetal distress and prevention for MAS.
Carlos Fernando Torres Oviedo
Full Text Available This review article lays out some conceptual guidelines regarding careers in organizations. Special emphasis has been made on the transformation that this practice has experienced since the late twentieth century, given the new working conditions created by the technological, economic, and cultural changes that have taken place. The literature shows a more dynamic and complex stage for people and organizations in the current historical moment. It was found that, under the current conditions, people guide their own careers, aiming at achieving higher levels within and/or outside the organization. This poses new challenges and ways of thinking about managing people, leading to the development of alternative practices. Finally, as a suggestion, some questions to be addressed by those responsible of human management are presented, aimed at building reciprocal relationships that contribute to mutual development.
Yates, D R; Rouprêt, M
It is advocated that patients with high-risk non-muscle-invasive bladder cancer (NMIBC) receive an adjuvant course of intravesical Bacille Calmette-Guerin (BCG) as first-line treatment. However, a substantial proportion of patients will 'fail' BCG, either early with persistent (refractory) disease or recur late after a long disease-free interval (relapsing). Guideline recommendation in the 'refractory' setting is radical cystectomy, but there are situations when extirpative surgery is not feasible due to competing co-morbidity, a patient's desire for bladder preservation or reluctance to undergo surgery. In this review, we discuss the contemporary management of NMIBC in patients who have failed prior BCG and are not suitable for radical surgery and highlight the potential options available. These options can be categorised as immunotherapy, chemotherapy, device-assisted therapy and combination therapy. However, the current data are still inadequate to formulate definitive recommendations, and data from ongoing trials and maturing studies will give us an insight into whether there is a realistic efficacious second-line treatment for patients who fail intravesical BCG but are not candidates for definitive surgery.
NASA's Office of Aeronautics and Space Technology (OAST) conducted a workshop on technology for space station evolution 16-19 Jan. 1990 in Dallas, Texas. The purpose of this workshop was to collect and clarify Space Station Freedom technology requirements for evolution and to describe technologies that can potentially fill those requirements. These proceedings are organized into an Executive Summary and Overview and five volumes containing the Technology Discipline Presentations. Volume 3 consists of the technology discipline sections for Extravehicular Activity/Manned Systems and the Fluid Management System. For each technology discipline, there is a Level 3 subsystem description, along with the papers.
Pestel, G; Fukui, K
Fluid optimization is a major contributor to improved outcome in patients. Unfortunately, anesthesiologists are often in doubt whether an additional fluid bolus will improve the hemodynamics of the patient or not as excess fluid may even jeopardize the condition. This article discusses physiological concepts of liberal versus restrictive fluid management followed by a discussion on the respective capabilities of various monitors to predict fluid responsiveness. The parameter difference in pulse pressure (dPP), derived from heart-lung interaction in mechanically ventilated patients is discussed in detail. The dPP cutoff value of 13% to predict fluid responsiveness is presented together with several assessment techniques of dPP. Finally, confounding variables on dPP measurements, such as ventilation parameters, pneumoperitoneum and use of norepinephrine are also mentioned.
Jiwon M. Lee
Full Text Available Purpose: Recent studies have established the association between hypotonic fluids administration and hospital-acquired hyponatremia in children, and have contended that hypotonic fluids be removed from routine practice. To assess current intravenous fluid prescription practices among Korean pediatric residents and to call for updated clinical-practice education Methods: A survey-based analysis was carried out. Pediatric residents at six university hospitals in Korea completed a survey consisting of four questions. Each question supposed a unique scenario in which the respondents were to prescribe either a hypotonic or an isotonic fluid for the patient. Results: Ninety-one responses were collected and analyzed. In three of the four scenarios, a significant majority prescribed the hypotonic fluids (98.9%, 85.7%, and 69.2%, respectively. Notably, 69.2% of the respondents selected the hypotonic fluids for postoperative management. Almost all (96.7% selected the isotonic fluids for hydration therapy. Conclusion: In the given scenarios, the majority of Korean pediatric residents would prescribe a hypotonic fluid, except for initial hydration. The current state of pediatric fluid management, notably, heightens the risk of hospital-acquired hyponatremia. Updated clinical practice education on intravenous fluid prescription, therefore, is urgently required.
Saundry, Richard Arthur; Latreille, Paul; Dickens, Linda; Irvine, Charlie; Teague, Paul; Urwin, Peter; Wibberley, Gemma
The resolution of individual workplace conflict has assumed an increasingly important place in policy debates over contemporary work and employment. This is in part due to the decline in collective industrial action and the parallel rise in the volume of employment tribunal applications. It reflects a growing concern over the\\ud implications of individual employment disputes for those involved but has perhaps been driven by concerns over the cost of litigation and the perceived burden that th...
Veronika Zavřelová Bachelor thesis Charles University in Prague, Faculty of Education, Department of Art Education Randomness in contemporary graphic art imaginative picture card game ANNOTATION This (bachelor) thesis concerns itself with a connection between verbal and visual character system within the topic of Randomness in contemporary graphic art - imaginative picture card game. The thesis is mainly based on the practical part - exclusively created card game Piktim. The card game uses as...
Svetlana Vukotić; Jugoslav Aničić; Radovan Vukotić
Modern business is characterized by risk and uncertainty, and such an environment is reflected in the decisions taken by managers. On the other hand, management consulting is one of the most important management techniques developed over the last fifty years. The secondary effect of this invention is the rapid development of new frameworks, tools, and techniques improving the operations in a number of companies. Exposure of consulting organizations to varying combin...
Brothers, D.S.; Ruppel, C.; Kluesner, J.W.; ten Brink, Uri S.; Chaytor, J.D.; Hill, J.C.; Andrews, B.D.; Flores, C.
Identifying the spatial distribution of seabed fluid expulsion features is crucial for understanding the substrate plumbing system of any continental margin. A 1100 km stretch of the U.S. Atlantic margin contains more than 5000 pockmarks at water depths of 120 m (shelf edge) to 700 m (upper slope), mostly updip of the contemporary gas hydrate stability zone (GHSZ). Advanced attribute analyses of high-resolution multichannel seismic reflection data reveal gas-charged sediment and probable fluid chimneys beneath pockmark fields. A series of enhanced reflectors, inferred to represent hydrate-bearing sediments, occur within the GHSZ. Differential sediment loading at the shelf edge and warming-induced gas hydrate dissociation along the upper slope are the proposed mechanisms that led to transient changes in substrate pore fluid overpressure, vertical fluid/gas migration, and pockmark formation.
Huong, Nguyen Thu
This paper examines the social management of rape within kin groups in contemporary Vietnam, with a particular focus on the decision whether or not to seek legal redress. Post-rape management entails negotiations among families on matters such as apology and compensation before a decision is made about whether to report the incident to the authorities. By drawing on an ethnographic study of a limited number of respondents, this paper highlights how rape disclosure is often bound up with notions of family honour, with assumptions about kinship, gender relations, social belonging and shared responsibility in a collective society such as Vietnam.
Full Text Available Strong competition in the market has caused the development of a new management approach known as Total Quality Management (TQM. Due to importance that quality plays in achieving competitive advantage, the hotel industry started to apply TQM. During the introduction of these systems, hotel companies may use different approaches to suit their own buseiness requirements. In doing so, 'TQM standards' can be used, or various international standards and models of business excellence Malcolm Balridge National Quality Award and European Quality Award.
Lillis, Kevin M.
The management crisis within higher education in developing countries reflects the wider crisis in educational management and public administration. The contemporary management context is further threatened by narrowing management capacity and capability due to the continued dwindling of already scarce resources and the increasing across-the-board…
Full Text Available Each major pedagogical orientation brings with it a set of certain potential actions, a potential that becomes reality at the level of invariably at the level of educational reality. Assuming a certain pedagogical educational paradigm is thus equivalent to the transposition into practice of a certain type of experimental research and promoting a particular way of conceiving and modeling of human nature. In a world characterized by contradicting realities, by turmoil, fast developing technologies, discussing and deciding on the most appropriate educational paradigms should be a core process in the attempt of conceiving the educational vision and objectives of tomorrow. The present paper aims at discussing the role of educational paradigms within the framework of contemporary educational strategies.
Full Text Available Communication technologies shape how political activist networks are produced and maintain themselves. In Cuba, despite ideologically and physically oppressive practices by the state, a severe lack of Internet access, and extensive government surveillance, a small network of bloggers and cyberactivists has achieved international visibility and recognition for its critiques of the Cuban government. This qualitative study examines the blogger collective known as Voces Cubanas in Havana, Cuba in 2012, advancing a new approach to the study of transnational activism and the role of technology in the construction of political narrative. Voces Cubanas is analyzed as a network of connections between human and non-human actors that produces and sustains powerful political alliances. Voces Cubanas and its allies work collectively to co-produce contentious political discourses, confronting the dominant ideologies and knowledges produced by the Cuban state. Transnational alliances, the act of translation, and a host of unexpected and improvised technologies play central roles in the production of these narratives, indicating new breed of cyborg sociopolitical action reliant upon fluid and flexible networks and the act of writing.
M. Tayfun Gülle
Full Text Available The book mainly focuses on the divergences in the competitive environment resulting from the entrance of information and communications technologies into commercial life. Denoting that these divergences are rooted, above all, in the differences among countries in historical, social and geographic terms, the book claims that the increased use of trade information combined with these divergences will facilitate obtaining results in trade and that the synergy to emerge will pave the way for trade intelligence. The book also underlines that such trade intelligence, which is actually the natural commercial manner of Turkish entrepreneurs, could be accepted as the Turkish Style in international trade, with the rational management of the export process, and that this would ferment the national competition intelligence, as the strategy of contemporary exports.
... all philosophies remain context-dependent and cultureoriented. A contrary view ignores the proper nature of philosophy. A new phenomenon confronts currently confronts all comers to contemporary African philosophy: an expansive vision of African philosophical discourse. Contemporary African philosophers attempt to ...
Hansen, Jesper Rosenberg; Ewan, Ferlie
This article discusses the utility of two different strategic management theories in different types of public organizations including contemporary New Public Management-based public organizations, namely Porter's strategic positioning model and the resource-based view of strategy. We argue...... conditions: the degree of administrative autonomy, performance-based budgeting and market-like competition. We give empirical examples drawn from public servives in the UK and Denmark. We call for more exploration of these (and other) strategic management approaches within contemporary public services...
Scaturo, Douglas J
The transtheoretical nature of fundamental dilemmas in contemporary psychotherapy is explored. The basic distinction between technical and ethical dilemmas in clinical practice is discussed, as well as the ramifications for the psychotherapist. Clinical dilemmas identified by survey research studies and interviews with master psychotherapists are reviewed. In addition to dilemmas relevant to circumscribed areas of psychotherapy, such as brief therapy, managed mental health care, sexual questions, feminist therapy, dilemmas fundamental to the psychotherapeutic process as a whole are examined. Finally, clinical examples are provided that include such issues as hospitalization of the suicidal patient, dealing with known contraindications, treating the intractable patient, and self-care of the psychotherapist.
This article reviews contemporary methodological and theoretical approaches to the problem situations in management activity. Revealed and analyzed the types of problem situations managers dealing with in their activity. Rank correlation of problem situations shows distinctions depending on management work experience. Revealed gender distinctions in the managers' ideas of management problems.
Ulhøi, John Parm; Madsen, Henning
Managers are facing the challenge of an ever-changing environment, ranging from increasing globalization, through the technologization of physical processes, to virtual ways of communicating. The response to this has been a gradual shift from rule-based to value-based management styles...... and practices. In order to obtain an insight into how far this development has proceeded, a structured survey of about 1500 top, middle and line managers from the private and public sectors was carried out. Among other interesting results, the study suggests that 'softer' as well as externally oriented roles...... in general are gaining increasing importance at the expense of rules and control. Moreover, managers from the private sector seem to be more steeped in traditional 'hard' managerial roles related to the operational level than their public-sector counterparts. Put another way, evidence supports the conclusion...
Full Text Available Echocardiography is ideally suited to guide fluid resuscitation in critically ill patients. It can be used to assess fluid responsiveness by looking at the left ventricle, aortic outflow, inferior vena cava and right ventricle. Static measurements and dynamic variables based on heart–lung interactions all combine to predict and measure fluid responsiveness and assess response to intravenous fluid esuscitation. Thorough knowledge of these variables, the physiology behind them and the pitfalls in their use allows the echocardiographer to confidently assess these patients and in combination with clinical judgement manage them appropriately.
Perner, Anders; Prowle, John; Joannidis, Michael
Acute kidney injury (AKI) and fluids are closely linked through oliguria, which is a marker of the former and a trigger for administration of the latter. Recent progress in this field has challenged the physiological and clinical rational of using oliguria as a trigger for the administration...... of crystalloids and colloids on kidney function and the effect of various resuscitation and de-resuscitation strategies on the course and outcome of AKI....
Berg, Regan J; Inaba, Kenji; Okoye, Obi; Pasley, Jason; Teixeira, Pedro G; Esparza, Michael; Demetriades, Demetrios
Selective non-operative management (NOM) is standard of care for clinically stable patients with blunt splenic trauma and expectant management approaches are increasingly utilised in penetrating abdominal trauma, including in the setting of solid organ injury. Despite this evolution of clinical practice, little is known about the safety and efficacy of NOM in penetrating splenic injury. Trauma registry and medical record review identified all consecutive patients presenting to LAC+USC Medical Center with penetrating splenic injury between January 2001 and December 2011. Associated injuries, incidence and nature of operative intervention, local and systemic complications and mortality were determined. During the study period, 225 patients experienced penetrating splenic trauma. The majority (187/225, 83%) underwent emergent laparotomy. Thirty-eight clinically stable patients underwent a deliberate trial of NOM and 24/38 (63%) were ultimately managed without laparotomy. Amongst patients failing NOM, 3/14 (21%) underwent splenectomy while an additional 6/14 (42%) had splenorrhaphy. Hollow viscus injury (HVI) occurred in 21% of all patients failing NOM. Forty percent of all NOM patients had diaphragmatic injury (DI). All patients undergoing delayed laparotomy for HVI or a splenic procedure presented symptomatically within 24h of the initial injury. No deaths occurred in patients undergoing NOM. Although the vast majority of penetrating splenic trauma requires urgent operative management, a group of patients does present without haemodynamic instability, peritonitis or radiologic evidence of hollow viscus injury. Management of these patients is complicated as over half may remain clinically stable and can avoid laparotomy, making them potential candidates for a trial of NOM. HVI is responsible for NOM failure in up to a fifth of these cases and typically presents within 24h of injury. Delayed laparotomy, within this limited time period, did not appear to increase
Laura Alfonsina Chang-Martínez
Full Text Available Spatially-explicit land cover land use change (LCLUC models are becoming increasingly useful tools for historians and archaeologists. Such kinds of models have been developed and used by geographers, ecologists and land managers over the last few decades to carry out prospective scenarios. In this paper, we review historical models to compare them with prospective models, with the assumption that the ample experience gained in the development of models of prospective simulation can benefit the development of models having as their objective the simulation of changes that happened in the past. The review is divided into three sections: in the first section, we explain the functioning of contemporary LCLUC models; in the second section, we analyze historical LCLUC models; in the third section, we compare the former two types of models, and finally, we discuss the contributions to historical LCLUC models of contemporary LCLUC models.
Brush management has been widely practiced with the general intent of curtailing or reversing the proliferation of shrubs and trees in grasslands and savannas. The traditional aim of brush management has been to increase livestock forage or to improve water yield. Its potential role for restoring h...
Schneider, S.; Thurnher, D.; Erovic, B. M.
The goal of this paper is to review contemporary multidisciplinary treatment with reference to Milkier cell carcinoma. Management of this rare but highly aggressive skin cancer is a complex undertaking that necessitates an understanding of its etiology, epidemiology, clinical presentation, and the coordinated work of several clinical specializations. Recent Findings. The contemporary literature employs a multidisciplinary approach to achieve the best patient's treatment. Conclusion. This paper presents an algorithm for contemporary management for the rare and aggressive Merkel cell carcinoma. Multidisciplinary approach in a tumor center provides high-quality care for patients with Merkel cell carcinoma.
Full Text Available Background. The goal of this paper is to review contemporary multidisciplinary treatment with reference to Merkel cell carcinoma. Management of this rare but highly aggressive skin cancer is a complex undertaking that necessitates an understanding of its etiology, epidemiology, clinical presentation, and the coordinated work of several clinical specializations. Recent Findings. The contemporary literature employs a multidisciplinary approach to achieve the best patient's treatment. Conclusion. This paper presents an algorithm for contemporary management for the rare and aggressive Merkel cell carcinoma. Multidisciplinary approach in a tumor center provides high-quality care for patients with Merkel cell carcinoma.
Fang, Chengqing; Mao, Jianhua; Dai, Yuwen; Xia, Yonghui; Fu, Haidong; Chen, Yifang; Wang, Yaping; Liu, Aimin
To compare the fluid management of hypernatraemic dehydration in acute gastroenteritis in those who developed cerebral oedema (cases) versus those who did not (controls). A retrospective study of 97 cases of hypernatraemic dehydration at a tertiary children's hospital in China over five years, in which rehydration regimes of 49 children who developed cerebral oedema were compared with 48 children who made an uneventful recovery. Risk factors for cerebral oedema (vs. no cerebral oedema) were an initial fluid bolus (29/49 vs. 15/48, P=0.006), the mean rate of bolus infusion (14.7+/-2.2 vs. 10.8+/-1.4 mL/kg/hr, Pdehydration were too rapid a rate of rehydration, an initial fluid bolus to rapidly expand plasma volume and the severity of the hypernatraemia. Thus, we conclude that a uniformly slow rate of rehydration is the best way of preventing cerebral oedema.
to the newer economic approaches based on Amartya Sen. While all approaches contribute with important insights on famine dynamics, they also struggle to capture the political dimension of contemporary famines. The Brief develops a political approach capable of addressing this important but messy political...
Berg, J. J.; Oliveira, J. M.; Congiardo, J. F.; Walls, L. K.; Putman, P. T.; Haberbusch, M. S.
Development for an in-space demonstration of a CubeS at as a Cryogenic Fluid Management (CFM) test bed is currently underway. The favorable economics of CubeSats make them appealing for technology development activity. While their size limits testing to smaller scales, many of the regimes relevant to CFM can still be achieved. The first demo flight of this concept, CryoCube®-1, will focus on oxygen liquefaction and low-gravity level sensing using Reduced Gravity CryoTracker®. An extensive thermal modeling effort has been underway to both demonstrate concept feasibility and drive the prototype design. The satellite will utilize both a sun- and earth-shield to passively cool its experimental tank below 115 K. An on-board gas generator will create high pressure gaseous oxygen, which will be throttled into a bottle in the experimental node and condensed. The resulting liquid will be used to perform various experiments related to level sensing. Modeling efforts have focused on the spacecraft thermal performance and its effects on condensation in the experimental node. Parametric analyses for both optimal and suboptimal conditions have been considered and are presented herein.
Weinberg, Jordan A; Moore, Andrew H; Magnotti, Louis J; Teague, Rebecca J; Ward, Tyler A; Wasmund, Joshua B; Lamb, Elena M P; Schroeppel, Thomas J; Savage, Stephanie A; Minard, Gayle; Maish, George O; Croce, Martin A; Fabian, Timothy C
The management of arterial injury at the thoracic outlet has long hinged on the fundamental principles of extensile exposure and vascular anastomosis. Nonetheless, treatment options for such injuries have evolved to include both endovascular stent placement and temporary vascular shunts. The purpose of this study was to evaluate our recent experience with penetrating cervicothoracic arterial injuries in light of these developments in trauma care. Patients with penetrating injuries to the innominate, carotid, subclavian, or axillary arteries managed at a single civilian trauma center between 2000 and 2013 were categorized as the modern era (ME) cohort. The management strategies and outcomes pertaining to the ME group were compared to those of previously reported experience (PE) concerning injuries to the innominate, carotid, subclavian, or axillary arteries at the same institution from 1974 to 1988. Over the two eras, there were 202 patients: 110 in the ME group and 92 in the PE group. Most of the injuries in both groups were managed with primary repair (45% vs. 46%; p = 0.89). A similar proportion of injuries in each group was managed with anticoagulation alone (14% vs. 10%; p = 0.40). In the ME group, two cases were managed with temporary shunt placement, and endovascular stent placement was performed in 12 patients. Outcomes were similar between the groups (bivariate comparison): mortality (ME, 15% vs. PE, 14%; p = 0.76), amputation following subclavian or axillary artery injury (ME, 5% vs. PE, 4%; p = 0.58), and posttreatment stroke following carotid injury (ME, 2% vs. PE, 6%; p = 0.57). Experience with penetrating arterial cervicothoracic injuries at a high-volume urban trauma center remained remarkably similar with respect to both anatomic distribution of injury and treatment. Conventional operative exposure and repair remain the cornerstone of treatment for most civilian cervicothoracic arterial injuries. Therapeutic study, level V.
Shin, Christina H; Long, Dustin R; McLean, Duncan; Grabitz, Stephanie D; Ladha, Karim; Timm, Fanny P; Thevathasan, Tharusan; Pieretti, Alberto; Ferrone, Cristina; Hoeft, Andreas; Scheeren, Thomas W L; Thompson, Boyd Taylor; Kurth, Tobias; Eikermann, Matthias
OBJECTIVE: Evaluate the dose-response relationship between intraoperative fluid administration and postoperative outcomes in a large cohort of surgical patients. BACKGROUND: Healthy humans may live in a state of fluid responsiveness without the need for fluid supplementation. Goal-directed protocols
Full Text Available Contemporary trends in global competition, rapid technological developments and increased use of management information systems and the Internet, developments in planning and control and management thinking, and changing demographics are putting pressures
Bain, Steve F.
This article seeks to review the topic of school counselors and the contemporary issues surrounding this profession. An introduction to the profession and overview of its history provides a comprehensive basis on which to understand today's school counseling profession. An examination of contemporary themes of school counseling will include job…
Rangeland management has long been described as both a science and an art (Stoddart et al. 1975). Certainly, the management of rangeland resources, especially during the last half of the 20th century, can be characterized as practices commonly informed by science. There are a number of management...
Full Text Available Star Wars Episode VII: The Force Awakens is not the hero’s journey as George Lucas previously conceptualized it. Instead, the story line of The Force Awakens leads me to believe that it creates a new iteration of the hero myth. It follows the contemporary heroine’s journey while conforming to the essential construct of the hero monomyth. First, the contemporary heroine’s journey focuses primarily on the greater good and secondarily on her own personal journey, which is the converse of the traditional hero’s journey. Second, the contemporary heroine’s self is awakened and called to adventure in a different way than the traditional hero. Third, the traditional hero receives guidance on his journey, while the contemporary heroine pushes ahead alone, striving to save her society from despair.
Sead Rešić; Eldina Atić
In this research, the application of contemporary teaching aids in Mathematics teaching in elementary school was analyzed from the aspect of teachers, students and parents. The application of contemporary teaching aids in Mathematics teaching was analyzed through a sample of 100 students, and attitudes about the aids were examined from the points of view of students, teachers and parents. In this research, descriptive method, questionnaire and test were used. Results of the resear...
Rangel-Castilla, Leonardo; Russin, Jonathan J; Zaidi, Hasan A; Martinez-Del-Campo, Eduardo; Park, Min S; Albuquerque, Felipe C; McDougall, Cameron G; Nakaji, Peter; Spetzler, Robert F
Spinal arteriovenous fistulas (AVFs) and arteriovenous malformations (AVMs) are rare, complex spinal vascular lesions that are challenging to manage. Recently, understanding of these lesions has increased thanks to neuroimaging technology. Published reports of surgical results and clinical outcome are limited to small series. The authors present a large contemporary series of patients with spinal AVFs and AVMs who were treated at Barrow Neurological Institute in Phoenix, Arizona. Retrospective detailed review of a prospective vascular database was performed for all patients with spinal AVFs and AVMs treated between 2000 and 2013. Patient demographic data, AVF and AVM characteristics, surgical results, clinical outcomes, complications, and long-term follow-up were reviewed. Between 2000 and 2013, 110 patients (57 male and 53 female) underwent obliteration of spinal AVFs and AVMs. The mean age at presentation was 42.3 years (range 18 months-81 years). There were 44 patients with AVFs and 66 with AVMs. The AVM group included 27 intramedullary, 21 conus medullaris, 12 metameric, and 6 extradural. The most common location was thoracic spine (61%), followed by cervical (22.7%), lumbar (14.5%), and sacral (1.8%). The most common presenting signs and symptoms included paresis/paralysis (75.5%), paresthesias (60%), pain (51.8%), bowel/bladder dysfunction (41.8%), and myelopathy (36.4%). Evidence of rupture was seen in 26.4% of patients. Perioperative embolization was performed in 42% of patients. Resection was performed in 95 patients (86.4%). Embolization alone was the only treatment in 14 patients (12.7%). One patient was treated with radiosurgery alone. Angiographically verified AVF and AVM obliteration was achieved in 92 patients (83.6%). At a mean follow-up duration of 30.5 months (range 1-205 months), 43 patients (97.7%) with AVFs and 57 (86.4%) with AVMs remained functionally independent (McCormick Scale scores ≤ 2). Perioperative complications were seen in 8
van Diepen, Sean; Katz, Jason N; Albert, Nancy M; Henry, Timothy D; Jacobs, Alice K; Kapur, Navin K; Kilic, Ahmet; Menon, Venu; Ohman, E Magnus; Sweitzer, Nancy K; Thiele, Holger; Washam, Jeffrey B; Cohen, Mauricio G
Cardiogenic shock is a high-acuity, potentially complex, and hemodynamically diverse state of end-organ hypoperfusion that is frequently associated with multisystem organ failure. Despite improving survival in recent years, patient morbidity and mortality remain high, and there are few evidence-based therapeutic interventions known to clearly improve patient outcomes. This scientific statement on cardiogenic shock summarizes the epidemiology, pathophysiology, causes, and outcomes of cardiogenic shock; reviews contemporary best medical, surgical, mechanical circulatory support, and palliative care practices; advocates for the development of regionalized systems of care; and outlines future research priorities. © 2017 American Heart Association, Inc.
Sarhad Hamza Khdir
Full Text Available This paper analyses the frauds of employee embezzlement by Gary Foster (Citigroup and insider trading by Raj Rajaratnam (Galleon Group both in 2011. By comparing to the notorious cases of Enron and WorldCom, it is found that the contemporary frauds tend to be committed through a diversified scheme rather than accounting manipulation. Fraudsters tend to take advantage of their positions to override strict rules and regulations. Shareholders and related stakeholders including governments will suffer the financial losses and ineffective macro-economic control, which may even result in the encouragement of other frauds. Therefore, it is strongly recommended that management, educators and regulators should jointly work on the prevention of frauds. Management should be highly aware of importance of fraud prevention and detection, with the assistance of regulators to prosecute criminals. Educators, on the other hand, should normalize the decisions under the challenges of ethical dilemma
Full Text Available This text presents the challenges that the modern world poses for the Orthodox Church. In every historical period, the Church has struggled with internal and external problems. While preserving its traditions and historical foundations, the theology of the Orthodox Church struggles with contemporary problems by showing the current, contemporary teaching about God, man and the world.
Bryan, Andrew J; Abdel, Matthew P; Sanders, Thomas L; Fitzgerald, Steven F; Hanssen, Arlen D; Berry, Daniel J
There are conflicting data on the results of irrigation and debridement with component retention in patients with acute periprosthetic hip infections. The goals of this study were to examine contemporary results of irrigation and debridement with component retention for acute infection after primary hip arthroplasty and to identify host, organism, antibiotic, or implant factors that predict success or failure. Ninety hips (57 total hip arthroplasties and 33 hemiarthroplasties) were diagnosed with acute periprosthetic hip infection (using strict criteria) and were treated with irrigation and debridement and component retention between 2000 and 2012. The mean follow-up was 6 years. Patients were stratified on the basis of McPherson criteria. Hips were managed with irrigation and debridement and retention of well-fixed implants with modular head and liner exchange (70%) or irrigation and debridement alone (30%). Seventy-seven percent of patients were treated with chronic antibiotic suppression. Failure was defined as failure to eradicate infection, characterized by a wound fistula, drainage, intolerable pain, or infection recurrence caused by the same organism strain; subsequent removal of any component for infection; unplanned second wound debridement for ongoing deep infection; and/or occurrence of periprosthetic joint infection-related mortality. Treatment failure occurred in 17% (15 of 90 hips), with component removal secondary to recurrent infection in 10% (9 of 90 hips). Treatment failure occurred in 15% (10 of 66 hips) after early postoperative infection and 21% (5 of 24 hips) after acute hematogenous infection (p = 0.7). Patients with McPherson host grade A had a treatment failure rate of 8%, compared with 16% (p = 0.04) in host grade B and 44% in host grade C (p = 0.006). Most treatment failures (12 of 15 failures) occurred within the initial 6 weeks of treatment; failures subsequent to 6 weeks occurred in 3% of those treated with chronic antibiotic
This book is a comprehensive treatise on the mechanics of solids and fluids, with a significant application to structural mechanics. In reading through the text, I can not help being impressed with Dr. Ziegler's command of both historical and contemporary developments of theoretical and applied mechanics. The book is a unique volume which contains information not easily found throughout the related literature. The book opens with a fundamental consideration of the kinematics of particle motion, followed by those of rigid body and deformable medium .In the latter case, both small and finite deformation have been presented concisely, paving the way for the constitutive description given later in the book. In both chapters one and two, the author has provided sufficient applications of the theoretical principles introduced. Such a connection between theory and appication is a common theme throughout every chapter, and is quite an attractive feature of the book
Common Property Resource Management, Institutional Change and ... Most contemporary discussions on African development since independence forty ... theories on CPR Resource Management in a specific ecological and political setting.
Jakov Crnkovic; Peter Ross; Sanjay Desai
The volume and complexity of Project Management (PM) raises many questions for managers. What exactly are we managing? People? Performance? Efficiency? Effectiveness? Cost? Time? At what levels do projects become challenging and worthy of significant management attention? Can some projects be left on auto-pilot? Must others be managed more aggressively? What metrics are useful in Project Management? How can they be integrated with normal performance metrics in the organization? How can metric...
Mônica dos Santos Marçal
Full Text Available Contemporary fluvial geomorphology faces challenging questions, especially as it goes by understanding the Late Holocene/Anthropocene period, which has repercussions today and are intrinsically important to understand the human river disturbance. Given the scale that physical rates operate in complex river systems, two conceptual paths were developed to analyze the spatial and temporal organization. The network view emphasizes controls on catchment-scale and a reach approach focuses on discontinuity and local controls. Fluvial geomorphology has seek to understand the organization of complex river systems from the integrated view of the continuity and discontinuity paradigm. This integrated approach has stimulated within the geomorphology, the emergence of new theoretical-methodological instruments. It is recognized that rivers management is an ongoing process, part of the socio-cultural development, which refers to both a social movement and scientific exercise.
Calabrò, Paolo; Gragnano, Felice; di Maio, Marco; Patti, Giuseppe; Antonucci, Emilia; Cirillo, Plinio; Gresele, Paolo; Palareti, Gualtiero; Pengo, Vittorio; Pignatelli, Pasquale; Pennacchi, Mauro; Granatelli, Antonino; De Servi, Stefano; De Luca, Leonardo; Marcucci, Rossella
The epidemiology and management of patients with acute coronary syndromes (ACSs) have evolved. We aimed to describe recent demographics and therapeutic changes in the Italian ACS population. We analyzed data from 2 multicenter consecutive Italian registries (the EYESHOT [EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalised in iTalian cardiac care units] and START-ANTIPLATELET registries) enrolling patients with ACS between December 2013 and June 2016. An overall population of 3756 patients with ACS was enrolled: 2585 in the EYESHOT and 1171 in the START-ANTIPLATELET. Compared with the EYESHOT, patients in the START-ANTIPLATELET registry presented more frequently with ST-segment elevation myocardial infarction and were more often smokers and dyslipidemic (all P START-ANTIPLATELET (all P START-ANTIPLATELET compared with the EYESHOT. The START-ANTIPLATELET and EYESHOT registries provide consecutive snapshots in the contemporary management of patients with ACS in Italy, showing important changes in both demographic characteristics and treatment strategies.
Maron, Barry J; Rowin, Ethan J; Casey, Susan A; Link, Mark S; Lesser, John R; Chan, Raymond H M; Garberich, Ross F; Udelson, James E; Maron, Martin S
Hypertrophic cardiomyopathy (HCM) has been prominently associated with adverse disease complications, including sudden death or heart failure death and a generally adverse prognosis, with annual mortality rates of up to 6%. This study determined whether recent advances in management strategy, including implantable cardioverter-defibrillators (ICDs), heart transplantation, or other therapeutic measures have significantly improved survival and the clinical course of adult HCM patients. We addressed long-term outcomes in 1,000 consecutive adult HCM patients presenting at 30 to 59 years of age (mean 45±8 years) over 7.2±5.2 years of follow-up. Of 1,000 patients, 918 (92%) survived to 53±9.2 years of age (range 32 to 80 years) with 91% experiencing no or only mild symptoms at last evaluation. HCM-related death occurred in 40 patients (4% [0.53%/year]) at 50±10 years from the following events: progressive heart failure (n=17); arrhythmic sudden death (SD) (n=17); and embolic stroke (n=2). In contrast, 56 other high-risk patients (5.6%) survived life-threatening events, most commonly with ICD interventions for ventricular tachyarrhythmias (n=33) or heart transplantation for advanced heart failure (n=18 [0.79%/year]). SD occurred in patients who declined ICD recommendations, had evaluations before application of prophylactic ICDs to HCM, or were without conventional risk factors. The 5- and 10-year survival rates (confined to HCM deaths) were 98% and 94%, respectively, not different from the expected all-cause mortality in the general U.S. population (p=0.25). Multivariate independent predictors of adverse outcome were younger age at diagnosis, female sex, and increased left atrial dimension. In a large longitudinally assessed adult HCM cohort, we have demonstrated that contemporary management strategies and treatment interventions, including ICDs for SD prevention, have significantly altered the clinical course, now resulting in a low disease-related mortality rate of
Vrcelj, Nikolina; Jurčić, Ana; Bučalin-Matić, Andrea
Return to Asian markets would have a beneficial effect on the development of the Serbian economy. An important condition for this is the rediscovery of Asian markets and ways of doing business between business units from different cultural backgrounds. Intercultural management means that companies and individuals have to learn how to cope and manage jobs across national borders and within the framework of foreign cultures. It is a known fact that in practice, business and national culture are...
Breeze, J; Tong, D; Gibbons, A
Ballistic maxillofacial trauma in the UK is fortunately relatively rare, and generally involves low velocity handguns and shotguns. Civilian terrorist events have, however, shown that all maxillofacial surgeons need to understand how to treat injuries from improvised explosive devices. Maxillofacial surgeons in the UK have also been responsible for the management of soldiers evacuated from Iraq and Afghanistan, and in this review we describe the newer types of treatment that have evolved from these conflicts, particularly that of damage-control maxillofacial surgery. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.
Yap, Adrian U.; Chua, Ai Ping
Bruxism is defined as the repetitive jaw muscle activity characterized by the clenching or grinding of teeth. It can be categorized into awake and sleep bruxism (SB). Frequent SB occurs in about 13% of adults. The exact etiology of SB is still unknown and probably multifactorial in nature. Current literature suggests that SB is regulated centrally (pathophysiological and psychosocial factors) and not peripherally (morphological factors). Cited consequences of SB include temporomandibular disorders, headaches, tooth wear/fracture, implant, and other restoration failure. Chairside recognition of SB involves the use of subjective reports, clinical examinations, and trial oral splints. Definitive diagnosis of SB can only be achieved using electrophysiological tools. Pharmacological, psychological, and dental strategies had been employed to manage SB. There is at present, no effective treatment that “cures” or “stops” SB permanently. Management is usually directed toward tooth/restoration protection, reduction of bruxism activity, and pain relief. PMID:27656052
Yap, Adrian U; Chua, Ai Ping
Bruxism is defined as the repetitive jaw muscle activity characterized by the clenching or grinding of teeth. It can be categorized into awake and sleep bruxism (SB). Frequent SB occurs in about 13% of adults. The exact etiology of SB is still unknown and probably multifactorial in nature. Current literature suggests that SB is regulated centrally (pathophysiological and psychosocial factors) and not peripherally (morphological factors). Cited consequences of SB include temporomandibular disorders, headaches, tooth wear/fracture, implant, and other restoration failure. Chairside recognition of SB involves the use of subjective reports, clinical examinations, and trial oral splints. Definitive diagnosis of SB can only be achieved using electrophysiological tools. Pharmacological, psychological, and dental strategies had been employed to manage SB. There is at present, no effective treatment that "cures" or "stops" SB permanently. Management is usually directed toward tooth/restoration protection, reduction of bruxism activity, and pain relief.
Hunsicker, Mary E; Ciannelli, Lorenzo; Bailey, Kevin M; Buckel, Jeffrey A; Wilson White, J; Link, Jason S; Essington, Timothy E; Gaichas, Sarah; Anderson, Todd W; Brodeur, Richard D; Chan, Kung-Sik; Chen, Kun; Englund, Göran; Frank, Kenneth T; Freitas, Vânia; Hixon, Mark A; Hurst, Thomas; Johnson, Darren W; Kitchell, James F; Reese, Doug; Rose, George A; Sjodin, Henrik; Sydeman, William J; van der Veer, Henk W; Vollset, Knut; Zador, Stephani
Predator-prey interactions are a primary structuring force vital to the resilience of marine communities and sustainability of the world's oceans. Human influences on marine ecosystems mediate changes in species interactions. This generality is evinced by the cascading effects of overharvesting top predators on the structure and function of marine ecosystems. It follows that ecological forecasting, ecosystem management, and marine spatial planning require a better understanding of food web relationships. Characterising and scaling predator-prey interactions for use in tactical and strategic tools (i.e. multi-species management and ecosystem models) are paramount in this effort. Here, we explore what issues are involved and must be considered to advance the use of predator-prey theory in the context of marine fisheries science. We address pertinent contemporary ecological issues including (1) the approaches and complexities of evaluating predator responses in marine systems; (2) the 'scaling up' of predator-prey interactions to the population, community, and ecosystem level; (3) the role of predator-prey theory in contemporary fisheries and ecosystem modelling approaches; and (4) directions for the future. Our intent is to point out needed research directions that will improve our understanding of predator-prey interactions in the context of the sustainable marine fisheries and ecosystem management. 2011 Blackwell Publishing Ltd/CNRS.
Daly, Christopher; Dobrowski, Solomon Z.; Dulen, Deanna M.; Ebersole, Joseph L.; Jackson, Stephen T.; Lundquist, Jessica D.; Millar, Constance I.; Maher, Sean P.; Monahan, William B.; Nydick, Koren R.; Redmond, Kelly T.; Sawyer, Sarah C.; Stock, Sarah; Beissinger, Steven R.
Refugia have long been studied from paleontological and biogeographical perspectives to understand how populations persisted during past periods of unfavorable climate. Recently, researchers have applied the idea to contemporary landscapes to identify climate change refugia, here defined as areas relatively buffered from contemporary climate change over time that enable persistence of valued physical, ecological, and socio-cultural resources. We differentiate historical and contemporary views, and characterize physical and ecological processes that create and maintain climate change refugia. We then delineate how refugia can fit into existing decision support frameworks for climate adaptation and describe seven steps for managing them. Finally, we identify challenges and opportunities for operationalizing the concept of climate change refugia. Managing climate change refugia can be an important option for conservation in the face of ongoing climate change. PMID:27509088
Morelli, Toni L.; Jackson, Stephen T.
Refugia have long been studied from paleontological and biogeographical perspectives to understand how populations persisted during past periods of unfavorable climate. Recently, researchers have applied the idea to contemporary landscapes to identify climate change refugia, here defined as areas relatively buffered from contemporary climate change over time that enable persistence of valued physical, ecological, and socio-cultural resources. We differentiate historical and contemporary views, and characterize physical and ecological processes that create and maintain climate change refugia. We then delineate how refugia can fit into existing decision support frameworks for climate adaptation and describe seven steps for managing them. Finally, we identify challenges and opportunities for operationalizing the concept of climate change refugia. Managing climate change refugia can be an important option for conservation in the face of ongoing climate change.
Brissonneau, L.; Simon, N.; Baque, F.
Among the Generation IV systems, Sodium Fast Reactors (SFR) are promising and benefit of considerable technological experience, but improvements are researched on safety approach and capital cost reduction. One of the main drawback to be solved by the standard SFR design is the proper management of the risk of leakage between the intermediate circuit filled with sodium and the energy conversion system using a water Rankine cycle. The limitation of this risk requires notably an early detection of water leakage to prevent a water-sodium reaction. One innovative solution consists in the replacement of the sodium in the secondary loops by an alternative liquid fluid, not or less reactive with water. This alternative fluid might also allow innovative designs, e.g. intermediate heat exchanger and steam generator grouped in the same component. CEA, Areva NP and EdF have joined in a working group in order to evaluate different 'alternative fluids' that might replace sodium. A first selection retained seven fluids on the basis of 'required properties' as large operating range (low melting point, high boiling point ...), fluid cost and availability, acceptable corrosion at SFR working temperature. These are three bismuth alloys, two nitrate salts, one hydroxide melt and sodium with nanoparticles of nickel. Then, it was decided to evaluate these fluids through a multi-criteria analysis in order to quantify advantages and drawbacks of each fluid and to compare them with sodium. Lack of knowledge, impact on materials, design, working conditions and reactor availability should be emphasized by this analysis, in order to provide sound arguments for a research program on one or two promising fluids. A global note is given to each fluid by evaluating them with respect to 'grand criteria', weighted differently according to their importance. The grand criteria are : thermal properties, reactivity with structures, reactivity with other fluids (air, water, sodium), chemistry control
Woodall, L C; Koldewey, H J; Shaw, P W
This first genetic study of Hippocampus hippocampus covers the species' entire geographic range and employs two mtDNA markers (control region and cytochrome b) to establish patterns of population structuring. A total of 255 specimens from 21 locations were used to obtain 89 concatenated haplotypes. The common haplotype was present in all but one population, however, most haplotypes were unique. The haplotype network had a star-like construction, suggesting expansion from a bottleneck event. F(ST) and AMOVA revealed population subdivision into three geographic regions (English Channel + Bay of Biscay, Mediterranean Sea + Atlantic Ocean Iberian coast + Macaronesian Islands, and West Africa) with barriers to gene flow indentified at Cape Finisterre and the Cape Verde frontal zone. Neutrality tests and nested clade analysis suggest a complex demographic history, with both historic events and contemporary processes shaping patterns of genetic differentiation. The genetic population subdivision detected in this study indicates that H. hippocampus should be managed as three separate units. This is especially pertinent as H. hippocampus populations within the West African region are the only ones known to be specifically targeted for exploitation. © 2011 The Authors. Journal of Fish Biology © 2011 The Fisheries Society of the British Isles.
Traboulsi, S.L.; Witjes, J.A.; Kassouf, W.
Primary urethral cancer is one of the rare urologic tumors. Distal urethral tumors are usually less advanced at diagnosis compared with proximal tumors and have a good prognosis if treated appropriately. Low-stage distal tumors can be managed successfully with a surgical approach in men or radiation
Doherty, Leo; Mutlu, Levent; Sinclair, Donna; Taylor, Hugh
Uterine fibroids (leiomyomata) are extremely common lesions that are associated with detrimental effects including infertility and abnormal uterine bleeding. Fibroids cause molecular changes at the level of endometrium. Abnormal regulation of growth factors and cytokines in fibroid cells may contribute to negative endometrial effects. Understanding of fibroid biology has greatly increased over the last decade. Although the current armamentarium of Food and Drug Administration-approved medical therapies is limited, there are medications approved for use in heavy menstrual bleeding that can be used for the medical management of fibroids. Emergence of the role of growth factors in pathophysiology of fibroids has led researchers to develop novel therapeutics. Despite advances in medical therapies, surgical management remains a mainstay of fibroid treatment. Destruction of fibroids by interventional radiological procedures provides other effective treatments. Further experimental studies and clinical trials are required to determine which therapies will provide the greatest benefits to patients with fibroids. © The Author(s) 2014.
Nemirovskii, P E
Contemporary Models of the Atomic Nucleus discusses nuclear structure and properties, expounding contemporary theoretical concepts of the low-energy nuclear processes underlying in nuclear models. This book focuses on subjects such as the optical nuclear model, unified or collective model, and deuteron stripping reaction. Other topics discussed include the basic nuclear properties; shell model; theoretical analysis of the shell model; and radiative transitions and alpha-decay. The deuteron theory and the liquid drop nuclear model with its application to fission theory are also mentioned, but o
In this dissertation, I study the relation between narrativity and contemporary composed music. The purpose of this study is twofold. Firstly, in so doing, I am able to articulate what musical narrativity is in a precise manner. Since many contemporary musical works question or problematize the
The Economic Situation in Contemporary Africa: Comment on Questions Posed by Lansana Keita. P Bond, DM Dembele. Abstract. The economic situation in contemporary Africa is highly problematic, creating populations that are in general much discontented with matters as they now stand. Africa's populations are now ...
Sim, Hao-Wen; Morgan, Erin R; Mason, Warren P
High-grade gliomas, including glioblastoma, are the most common malignant brain tumors in adults. Despite intensive efforts to develop new therapies for these diseases, treatment options remain limited and prognosis is poor. Recently, there have been important advances in our understanding of the molecular basis of glioma, leading to refinements in our diagnostic and management approach. There is new evidence to guide the treatment of elderly patients. A multitude of new agents have been investigated, including targeted therapies, immunotherapeutics and tumor-treating fields. This review summarizes the key findings from this research, and presents a perspective on future opportunities to advance the field.
Perin, Jamie; Carvajal-Velez, Liliana; Carter, Emily; Bryce, Jennifer; Newby, Holly
The foundation of recommended diarrhea management in young children is increased fluids and continued feeding. This increase in fluids is necessary to replace those lost during diarrhea and ultimately prevent dehydration. There may be an opportunity to prevent deaths in children under five by discouraging the practice of reducing or curtailing fluids during diarrhea episodes across different settings worldwide. We quantify and describe the extent of fluid curtailment in children with diarrhea in a selection of countries (Burkina Faso, Democratic Republic of Congo, Ethiopia, Nigeria, Tanzania, and Uganda) with high burden of diarrhea-related mortality with national cross sectional survey data. We examine the practice of fluid curtailment in these countries and its relationship to child and household traits and to characteristics of diarrhea management. The prevalence of fluid curtailment among children under five with diarrhea is strikingly high in these countries: 55 % in Nigeria, 49 % in Ethiopia, 44 % in Uganda, 37 % in Tanzania, 36 % in DR Congo and 32 % in Burkina Faso. Fluid curtailment is associated with giving less food, potentially worsening the impact of this harmful practice. Children who were reported to have had fluids curtailed during diarrhea episodes were also 3.51 (95 % confidence, 2.66 - 4.64) times more likely to be reported to have food withheld (α = 0.05; p water source. Children of poorer or less educated mothers and those living in rural areas are more likely to have curtailed fluids, compared to children of less poor or more educated mothers, or those living in urban areas. The harmful practice of curtailing fluids for a child with diarrhea is highly prevalent, representing an increased risk of dehydration and complications due to diarrhea, including death, especially for children in specific subgroups.
Full Text Available Introduction Non-cardiogenic pulmonary edema is the hallmark of the acute respiratory distress syndrome (ARDS. The amount of fluid and which fluid should be used in these patients is controversial. Methods 43 patients with ARDS treated in the intensive care unit (ICU of the Second Hospital, Jilin University between November 1, 2011-November 1, 2012 were prospectively analyzed and was observational. Volume and the type of fluid administered were compared to 90 day mortality and the 24 and 72 hour sequential organ failure assessment (SOFA score, lactate level, oxygenation index (PaO2/FiO2, duration of ICU stay, total ventilator days, and need for continuous renal replacement therapy (CRRT. Results Mortality was increased when hydroxylethyl starch (HES was used in the first day or plasma substitutes were used during the first 3 days (P3000 ml during the first 24 hours or >8000 ml during the first 72 hours were associated with higher SOFA scores at 24 and 72 hours (P<0.05, both comparisons. Colloid, especially higher volume colloid use was also associated with increased SOFA scores at either 24 or 72 hours. Conclusions Limiting the use of colloids and the total amount of fluid administered to patients with ARDS is associated with improved mortality and SOFA scores.
Fisselier, Francois; Comut, A Alper
Sjögren syndrome is a chronic autoimmune disorder with xerostomia, increased tooth wear, high rates of caries, and repeated failure of dental restorations as the main oral symptoms. These render the prosthetic treatment challenging. This clinical report describes a contemporary approach to the treatment of a patient with Sjögren syndrome using translucent multilayered monolithic zirconia restorations and focuses on the treatment protocols before, during, and after the prosthetic treatment. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
Fundamental research related to organic geochemistry, fluid-rock interactions, and the processes by which fluids migrate through basins has long been a part of the U.S. Department of Energy Geosciences program. Objectives of this program were to emphasize those principles and processes which would be applicable to a wide range of problems associated with petroleum discovery, occurrence and extraction, waste disposal of all kinds, and environmental management. To gain a better understanding of the progress being made in understanding basinal fluids, their geochemistry and movement, and related research, and to enhance communication and interaction between principal investigators and DOE and other Federal program managers interested in this topic, this workshop was organized by the School of Geology and Geophysics and held in Norman, Oklahoma in November, 1991.
International Journal of Development and Management Review ... social Development and Management practices and theories while providing an institutional ... The Igbo care for the elderly in contemporary times: an old testament evaluation ...
Tessler, Zachary D.; Vörösmarty, Charles J.; Overeem, Irina; Syvitski, James P. M.
Modern deltas are dependent on human-mediated freshwater and sediment fluxes. Changes to these fluxes impact delta biogeophysical functioning and affect the long-term sustainability of these landscapes for human and for natural systems. Here we present contemporary estimates of long-term mean sediment balance and relative sea level rise across 46 global deltas. We model scenarios of contemporary and future water resource management schemes and hydropower infrastructure in upstream river basins to explore how changing sediment fluxes impact relative sea level rise in delta systems. Model results show that contemporary sediment fluxes, anthropogenic drivers of land subsidence, and sea level rise result in delta relative sea level rise rates that average 6.8 mm/y. Assessment of impacts of planned and under-construction dams on relative sea level rise rates suggests increases on the order of 1 mm/y in deltas with new upstream construction. Sediment fluxes are estimated to decrease by up to 60% in the Danube and 21% in the Ganges-Brahmaputra-Meghna if all currently planned dams are constructed. Reduced sediment retention on deltas caused by increased river channelization and management has a larger impact, increasing relative sea level rise on average by nearly 2 mm/y. Long-term delta sustainability requires a more complete understanding of how geophysical and anthropogenic change impact delta geomorphology. Local and regional strategies for sustainable delta management that focus on local and regional drivers of change, especially groundwater and hydrocarbon extraction and upstream dam construction, can be highly impactful even in the context of global climate-induced sea level rise.
Hedayat, A.; Johnson, W. L.; Stephens, J. R.
Long-term storage, supply, and transfer of cryogenic fluids are critical capabilities needed to advance the human exploration of space. Technologies and advanced development programs have been pursued to address issues likely to confront the designers and developers of future cryogenic fluid management (CFM) subsystems and propulsion systems. NASA and aerospace industries have continued to conduct research and development for the propulsion applications of cryogenic fluids. From the well known in-space applications, to new applications involving superconducting motors within multiple different aircraft, and a renewed interest in production of oxygen on Mars, NASA continues to probe cryogenic applications within propulsion. This article presents brief reviews of several of the current CFM efforts to support future space missions. NASA GRC is currently focusing on understanding some of the finer points in the application of multilayer insulation. GRC recently finished the activation of a new calorimeter that operates at 20 K with a warm boundary that can operate either around 90 K or at 300 K. Current testing is focused on investigating multiple different seam concepts, initially between temperatures of 300 K and 20 K, and between 20 K and 90 K. One of the larger recent NASA investments has been on the Structural Heat Intercept, Insulation, and Vibration Experiment Rig (SHIIVER). SHIIVER is a 4 m diameter tank that is approximately 1/2 scale of the planned upper stage of the new Space Launch System (SLS) rocket. SHIIVER is focused on demonstrating the thermal benefits of multilayer insulation on the tank domes and boil-off vapor cooling on structural cylinders that hold the tank in-line on the rocket. It will also quantify any damage that may incur during the acoustic environment of over 160 decibels that SLS will experience on its trip to Earth orbit. In support of the possible production of oxygen out of the Mars' atmosphere, a team comprised of four NASA centers
Full Text Available Contemporary curricula of preschool education are the result of the improvement of pedagogical and didactic theories. They imply a technical plan with which it is possible to achieve measurable objectives of preschool education. The curriculum is also defined as a tool for quality and equal education for all. It represents a reflection of the time, society and culture in which it exists, but also a model for future society and education. Thus an important research question arises as to what extent we recognize traditional ideas about learning and the development of a preschool child in contemporary preschool programs. Are traditional ideas about educating young children unjustly neglected or do we recognize them in contemporary pedagogical theory even today, at the same time forgetting about the past and declaring them innovations? This paper deals with the starting points for the development of a curriculum. The goal of the research was to determine to what extent can the starting points for the development of preschool children, which have existed in the first preschool programs in Serbia in the late 19th century, be recognized in contemporary preschool programs. A descriptive method was applied as well as a procedure for content analysis of program documents. Research results confirm that the elements of the first preschool programs, which remain relevant until today, can be recognized in contemporary preschool programs. They are related to target orientations, principles and functions of preschool education. However, these ideas are defined as contemporary tendencies, and the fact that they existed in preschool programs that were developed a long time ago is unjustly ignored.
Erickson, Mary; Hales, Laura
This study describes the effects of a yearlong, multivisit teen program in a contemporary art museum on adolescents' reflections about art. Our purpose was to discover whether this program, focused on experiences with contemporary art and artists with its metacognitive approach, affected students' thinking about their own artmaking. The…
Nguyen, Hung D.; Steele, Gynelle C.
Technological innovation is the overall focus of NASA's Small Business Innovation Research (SBIR) program. The program invests in the development of innovative concepts and technologies to help NASA's mission directorates address critical research and development needs for agency projects. This report highlights innovative SBIR Phase II projects from 2007-2012 specifically addressing Areas in In-Space Propulsion and Cryogenic Fluids Management which is one of six core competencies at NASA Glenn Research Center. There are nineteen technologies featured with emphasis on a wide spectrum of applications such as high-performance Hall thruster support system, thruster discharge power converter, high-performance combustion chamber, ion thruster design tool, green liquid monopropellant thruster, and much more. Each article in this booklet describes an innovation, technical objective, and highlights NASA commercial and industrial applications. This report serves as an opportunity for NASA personnel including engineers, researchers, and program managers to learn of NASA SBIR's capabilities that might be crosscutting into this technology area. As the result, it would cause collaborations and partnerships between the small companies and NASA Programs and Projects resulting in benefit to both SBIR companies and NASA.
Magistro, Giuseppe; Wagenlehner, Florian M E; Grabe, Magnus; Weidner, Wolfgang; Stief, Christian G; Nickel, J Curtis
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common condition that causes severe symptoms, bother, and quality-of-life impact in the 8.2% of men who are believed to be affected. Research suggests a complex pathophysiology underlying this syndrome that is mirrored by its heterogeneous clinical presentation. Management of patients diagnosed with CP/CPPS has always been a formidable task in clinical practice. Due to its enigmatic etiology, a plethora of clinical trials failed to identify an efficient monotherapy. A comprehensive review of published randomized controlled trials (RCTs) on the treatment of CP/CPPS and practical best evidence recommendations for management. Medline and the Cochrane database were screened for RCTs on the treatment of CP/CPPS from 1998 to December 2014, using the National Institutes of Health Chronic Prostatitis Symptom Index as an objective outcome measure. Published data in concert with expert opinion were used to formulate a practical best evidence statement for the management of CP/CPPS. Twenty-eight RCTs identified were eligible for this review and presented. Trials evaluating antibiotics, α-blockers, anti-inflammatory and immune-modulating substances, hormonal agents, phytotherapeutics, neuromodulatory drugs, agents that modify bladder function, and physical treatment options failed to reveal a clear therapeutic benefit. With its multifactorial pathophysiology and its various clinical presentations, the management of CP/CPPS demands a phenotypic-directed approach addressing the individual clinical profile of each patient. Different categorization algorithms have been proposed. First studies applying the UPOINTs classification system provided promising results. Introducing three index patients with CP/CPPS, we present practical best evidence recommendations for management. Our current understanding of the pathophysiology underlying CP/CPPS resulting in this highly variable syndrome does not speak in favor of a
Miller, Wayne L; Mullan, Brian P
This study sought to quantitate total blood volume (TBV) in patients hospitalized for decompensated chronic heart failure (DCHF) and to determine the extent of volume overload, and the magnitude and distribution of blood volume and body water changes following diuretic therapy. The accurate assessment and management of volume overload in patients with DCHF remains problematic. TBV was measured by a radiolabeled-albumin dilution technique with intravascular volume, pre-to-post-diuretic therapy, evaluated at hospital admission and at discharge. Change in body weight in relation to quantitated TBV was used to determine interstitial volume contribution to total fluid loss. Twenty-six patients were prospectively evaluated. Two patients had normal TBV at admission. Twenty-four patients were hypervolemic with TBV (7.4 ± 1.6 liters) increased by +39 ± 22% (range, +9.5% to +107%) above the expected normal volume. With diuresis, TBV decreased marginally (+30 ± 16%). Body weight declined by 6.9 ± 5.2 kg, and fluid intake/fluid output was a net negative 8.4 ± 5.2 liters. Interstitial compartment fluid loss was calculated at 6.2 ± 4.0 liters, accounting for 85 ± 15% of the total fluid reduction. TBV analysis demonstrated a wide range in the extent of intravascular overload. Dismissal measurements revealed marginally reduced intravascular volume post-diuretic therapy despite large reductions in body weight. Mobilization of interstitial fluid to the intravascular compartment with diuresis accounted for this disparity. Intravascular volume, however, remained increased at dismissal. The extent, composition, and distribution of volume overload are highly variable in DCHF, and this variability needs to be taken into account in the approach to individualized therapy. TBV quantitation, particularly serial measurements, can facilitate informed volume management with respect to a goal of treating to euvolemia. Copyright © 2014 American College of Cardiology Foundation. Published
In the paper, we discuss theoretical and practical aspects of management and its rational and irrational behavior in the light of traditional management theories and contemporary social theories and theories of complexity. We exposed differences between middle and top management, where rationality is ascribed mainly to middle management, while top management often acts on seemingly irrational way. For the part of this irrationality, we cannot blame management because it originates from the na...
Manzoor, Nauman F; Rezaee, Rod P; Ray, Abhishek; Wick, Cameron C; Blackham, Kristine; Stepnick, David; Lavertu, Pierre; Zender, Chad A
To illustrate complex interdisciplinary decision making and the utility of modern endovascular techniques in the management of patients with carotid blowout syndrome (CBS). Retrospective chart review. Patients treated with endovascular strategies and/or surgical modalities were included. Control of hemorrhage, neurological, and survival outcomes were studied. Between 2004 and 2014, 33 patients had 38 hemorrhagic events related to head and neck cancer that were managed with endovascular means. Of these, 23 were localized to the external carotid artery (ECA) branches and five localized to the ECA main trunk; nine were related to the common carotid artery (CCA) or internal carotid artery (ICA), and one event was related to the innominate artery. Seven events related to the CCA/ICA or innominate artery were managed with endovascular sacrifice, whereas three cases were managed with a flow-preserving approach (covered stent). Only one patient developed permanent hemiparesis. In two of the three cases where the flow-preserving approach was used, the covered stent eventually became exposed via the overlying soft tissue defect, and definitive management using carotid revascularization or resection was employed to prevent further hemorrhage. In cases of soft tissue necrosis, vascularized tissues were used to cover the great vessels as applicable. The use of modern endovascular approaches for management of acute CBS yields optimal results and should be employed in a coordinated manner by the head and neck surgeon and the neurointerventionalist. 4. Laryngoscope, 2016 127:383-390, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.
Luis David Castiel
Full Text Available This is an essay on the issue of the identity of the Brazilian youth related to risks in our contemporary culture. There is a brief approach towards conceptual dimensions connected to categories such as ‘health’, ‘contemporaneity’, ‘identity’, ‘youth’. Some statistical aspects related to morbidity and mortality are presented in order to generate a synthetic framework of the epidemiological situation in our context. An analysis is proposed, from a sociological point of view, concerning the construction of fluid identities in a society characterized by precariousness and excess in many levels. At last, it is suggested how the link between risk and ambivalence in many ways frame respective attitudes of exposure (adventure and avoidance (prevention. Keywords: risk, identity, youth, social sciences in health.
Van Horne, Katie
This dissertation investigates the implementation issues and the educational opportunities associated with "taking the practice turn" in science education. This pedagogical shift focuses instructional experiences on engaging students in the epistemic practices of science both to learn the core ideas of the disciplines, as well as to gain an understanding of and personal connection to the scientific enterprise. In Chapter 2, I examine the teacher-researcher co-design collaboration that supported the classroom implementation of a year-long, project-based biology curriculum that was under development. This study explores the dilemmas that arose when teachers implemented a new intervention and how the dilemmas arose and were managed throughout the collaboration of researchers and teachers and between the teachers. In the design-based research of Chapter 3, I demonstrate how students' engagement in epistemic practices in contemporary science investigations supported their conceptual development about genetics. The analysis shows how this involved a complex interaction between the scientific, school and community practices in students' lives and how through varied participation in the practices students come to write about and recognize how contemporary investigations can give them leverage for science-based action outside of the school setting. Finally, Chapter 4 explores the characteristics of learning environments for supporting the development of scientific practice-linked identities. Specific features of the learning environment---access to the intellectual work of the domain, authentic roles and accountability, space to make meaningful contributions in relation to personal interests, and practice-linked identity resources that arose from interactions in the learning setting---supported learners in stabilizing practice-linked science identities through their engagement in contemporary scientific practices. This set of studies shows that providing students with the
Kueh, Shaw Hua Anthony; Devlin, Gerry; Lee, Mildred; Doughty, Rob N; Kerr, Andrew J
Acute heart failure (HF) associated with an acute coronary syndrome (ACS) predicts adverse outcome. There have been important recent improvements in ACS management. Our aim was to describe the management and outcomes in those with and without HF in a contemporary ACS cohort. Consecutive patients presenting with ACS between 2007 and 2011 were enrolled in the All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) registry. Outcomes and medication dispensing were obtained using anonymised linkage to national data sets. A summary pharmacotherapy measure of "quadruple therapy" was defined as dispensing of at least one agent from each of the four evidence-based classes - anti-platelet, statin, angiotensin converting enzyme inhibitor/angiotensin receptor blocker and beta blocker. Of 3743 ACS patients 14% had acute HF. Acute heart failure patients were older (69.2±12.6 vs 62.3±12.8 years, pcoronary angiography (66% vs 86%, pAcute heart failure complicating ACS is associated with heightened risk of short-term and long-term mortality. One in three ACS patients with HF did not have coronary angiography and less than half received quadruple therapy a year after presentation. Copyright © 2016. Published by Elsevier B.V.
Renkema, T.J.W.; Farbey, B.; Serafeimidids, V.
Evaluation and management of IT investments have come to play an essential role in the corporate success of contemporary organisations. Senior management's prime concern has shifted from controlling IT costs to managing and delivering IT benefits. An emerging notion in the successful exploitation of
Bennion, Kevin; Moreno, Gilberto
Thermal management for electric machines (motors/ generators) is important as the automotive industry continues to transition to more electrically dominant vehicle propulsion systems. Cooling of the electric machine(s) in some electric vehicle traction drive applications is accomplished by impinging automatic transmission fluid (ATF) jets onto the machine's copper windings. In this study, we provide the results of experiments characterizing the thermal performance of ATF jets on surfaces representative of windings, using Ford's Mercon LV ATF. Experiments were carried out at various ATF temperatures and jet velocities to quantify the influence of these parameters on heat transfer coefficients. Fluid temperatures were varied from 50 degrees C to 90 degrees C to encompass potential operating temperatures within an automotive transaxle environment. The jet nozzle velocities were varied from 0.5 to 10 m/s. The experimental ATF heat transfer coefficient results provided in this report are a useful resource for understanding factors that influence the performance of ATF-based cooling systems for electric machines.
Full Text Available Investment risk is the principal threat to the assets side of the balance sheets of financial institutions. It is evident that investors who concentrate their wealth on one type of securities can rarely be found. Instead, they tend to invest diversified portfolio of securities. This reduces the degree of risk of the expected return, which depends both on the absolute risk of each investment in the portfolio, and the relationship that exists between individual investments within the portfolio. The paper analyzes the investment risk management by using modern portfolio theory in both national and global financial f lows. At the same time, the paper considers the risk management models that ensures efficient portfolio diversification, aiming at investment risk reduction. It is pointed out that the investment risk management in modern financial f lows is a complex process, and that the development of financial theory goes towards improving, soft risk management method.
Nielsen, Peter Axel; Persson, John Stouby
Municipalities’ effectiveness in managing information technology (IT) is increasingly important in adhering to their responsibilities for providing services to citizens. While the municipalities’ difficulty in managing IT has been well documented, it is more elusive what specific problems are most...... relevant in contemporary municipal IT management practice. On this basis, we present an engaged scholarship approach to formulate IT management problems together with municipalities - not for municipalities. We have come to understand such engaged problem formulation as joint researching and defining...... of a contemporary and complex problem by researchers and those who experience and know the problem. We present the formulated IT management problems and discuss the engaged problem formulation process in relation to engaged scholarship. Furthermore, we discuss how engaged problem formulation may contribute...
Full Text Available The volume and complexity of Project Management (PM raises many questions for managers. What exactly are we managing? People? Performance? Efficiency? Effectiveness? Cost? Time? At what levels do projects become challenging and worthy of significant management attention? Can some projects be left on auto-pilot? Must others be managed more aggressively? What metrics are useful in Project Management? How can they be integrated with normal performance metrics in the organization? How can metrics be built into assessment programs that work? How can projects be monitored, re-planned to stay within the original budget and schedule deadlines? How good is the PM software support? Do we really need PM software packages or it should be the integral part of the company's information system (IS? Where is the knowledge about company's previous projects and performance? Are we able to establish company or even industry wide standards for project management? Can we (or should we move from the PMBOK® guidelines and use other approaches? We discussing important questions in PM: software products, responsibilities for concurrently executing several projects (multi-projects with multi objectives and multiple deadlines, introducing a need for initiation, design, execution, and control using a virtual project management and application of the organizational project maturity model.
D. Ali Arslan
This study was designed to find general characteristics of Contemporary Turkish political Elites since 1995 up to date. Social background characteristics were employed to realise the purposes. Documentary and historical research techniques were used during the study. As a result of examining the Contemporary Turkish political elites (since 1995 up to 2005) these major findings were discovered: the large majority of the Turkish parliamentary elites were well educated, male, middle aged, marrie...
White, Herbert S.
Traces the recent history of libraries and mentions loss of status, insufficient funds, insufficient evaluation methods, and unspecified goals as major contributors to contemporary management problems. Also outlined is a management strategy, which includes public relations, long-range and short-range goals, and budget and financing. (JVP)
Cheng, Suk F; Brown, Martin M
Contemporary medical therapy consists of identification and treatment of all patient-modifiable vascular risk factors. Specific atherosclerotic disease therapies are designed to reduce the risk of thrombosis, and the disease progression in order to reduce the risk of future cardiovascular events. Contemporary medical management emphasizes the need to support the patient in achieving lifestyle modifications and to adjust medication to achieve individualized target values for specific quantifiable risk factors. Antiplatelet therapy in the form of aspirin or clopidogrel is routinely used for the prevention of ischemic stroke in patients who have had a transient ischemic attack or stroke. There is evidence from a recent trial that the use of combination antiplatelet therapy with aspirin and clopidogrel started within 24 hours of minor stroke or transient ischemic attack reduces the risk of recurrent stroke compared to the use of aspirin alone, and therefore we use aspirin plus clopidogrel in recently symptomatic patients with carotid stenosis pending carotid revascularization. Anticoagulation with heparins or vitamin K antagonist is not recommended except in patients at risk for cardio-embolic events. Lowering blood pressure to target levels has been shown to slow down the progression of carotid artery stenosis and reduces the intima-media thickness of the carotid plaque, while lowering lipid levels with statins has become an essential element in the medical therapy of carotid artery stenosis. Diabetes management should be optimized. Lifestyle choices, including tobacco smoking, physical inactivity, unhealthy diet, obesity, and excessive alcohol intake, are all important modifiable vascular risk factors. The combination of dietary modification, physical exercise, and use of aspirin, a statin, and an antihypertensive agent can be expected to give a cumulative relative stroke risk reduction of 80%. The evidence suggests that intensive medical therapy is so effective that
Lee, Graham R
Non-cardiac surgery is associated with major vascular complications and higher incidences of elevated plasma troponin (cTn) concentration. Goal-directed therapy (GDT) is a stroke volume (SV)-guided approach to intravenous (IV) fluid therapy that improves tissue perfusion, oxygenation and reduces post-operative complications. In patients undergoing major gastro-intestinal surgery, we compared high sensitive and contemporary troponin assays and correlated results with patient outcome.
The fifth International Conference on Management was held 18-19th of July 2015 in Gödöllö, Hungary. The topics of this conference were built around the contemporary issues in leadership, management and entrepreneurship from an interdisciplinary perspective.
Nwofor, A M E; Ekwunife, C N
To determine the demographic pattern, indications and complications associated with tube thoracostomy in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi. A 5-year review of case records of patients who underwent tube thoracostomy at NAUTH Nnewi between January 1999 and December 2003. Demographic data, clinical features, duration of drainage, complications and outcomes were analyzed. A total of 65 cases were studied, male: female ratio was 2.4:1. Eighteen patients (27.7%) were below 10 years of age. Infective cases accounted for 63.1% (41) of the cases that had tube thoracostomy. Forty-one patients (63.1%) had tube drainage for 10 days or less. Complication rate was 41.5% (27), mostly mild, with dislodgement of the tube accounting for about half. Failure rate of 13.7% (9) was recorded for the procedure. A mortality of 6.2% (4) was recorded but there was no procedure related death. Seven patients (10.8%) required further surgery. Tube thoracostomy is a simple and efficacious procedure for the treatment of pleural space collections. The safety of the procedure can be improved upon by adequate training in the insertion procedure, while proper selection of cases will reduce failure rate and unnecessary morbidity. Early resort to thoracoscopic or open surgery when tube thoracostomy is considered inappropriate or has failed will improve the success rate in the overall management of pleural fluid collections.
Bálint Károly Zabán
Full Text Available Biblical wisdom literature is a treasure-trove of powerful metaphors. This article presents a sample of these metaphors and their significant impact on contemporary artwork. The impact is characterized by both appropriation and adaptation, similitude and analogy, respectively. The highlighted metaphors are not merely catalogued but, more or less, analyzed with regard to relevant contemporary artwork. This augments the importance of contemporary biblical literacy analysis and uses it as one of the tools by which it is possible to gauge the impact and interaction, in this case, of the metaphor-world of the wisdom tradition on contemporary art. More importantly, however, this study underscores the relevance of these metaphors for biblical exegesis, hermeneutics, and theology. The analysis of the reception of these metaphors in contemporary artworks undergirds and informs the process of interpretation. The reception of these metaphors in their contemporary art contexts is best understood within the framework of imagery and imagistic language. Metaphor, as a subset of imagery and imagistic language, is foundational for the examined wisdom books, Proverbs, Job, and Qoheleth, and for the relevant contemporary artwork, alike. Moreover, metaphor also constitutes a bridge between the ancient and contemporary context. With this backdrop in mind, this article argues for the necessity of exploring the connections between these wisdom books, metaphor studies, and contemporary artwork.
Carla Barrio Romera
Full Text Available Book Review: Instagram and contemporary image, Lev Manovich, California Institute for Telecommunication and Information & The Graduate Center, City University of New York (CUNY, Cultural Analytics Lab, 2017, http://manovich.net/index.php/projects/instagram-and-contemporary-image, Attribution-NonCommercial-NoDerivatives 4.0 International Creative Commons license, 148 págs.
Full Text Available Accurate assessments of intravascular fluid status are an essential part of perioperative care and necessary in the management of the hemodynamically unstable patient. Goal-directed fluid management can facilitate resuscitation of the hypovolemic patient, reduce the risk of fluid overload, reduce the risk of the injudicious use of vasopressors and inotropes, and improve clinical outcomes. In this paper, we discuss the strengths and limitations of a spectrum of noninvasive and invasive techniques for assessing and monitoring intravascular volume status and fluid responsiveness in the perioperative and critically ill patient.
Gogovor, Amédé; Savoie, Michelle; Moride, Yola; Krelenbaum, Marilyn; Montague, Terrence
Health or disease management (DM) has emerged as a promising solution to improve the quality of healthcare and patient outcomes in a cost-efficient way. This solution is particularly relevant in the care of our increasing, and aging, patient populations with multiple chronic diseases. This article reviews the recent history and current status of DM in the province of Quebec and summarizes its evolving perspectives and future prospects. Most DM projects in Quebec have developed from a public-private partnership, and they have addressed several disease states. The results of completed programs confirmed the presence of care gaps--the differences between best and usual care in several disease states. They also identified process changes leading to improved practices and enhanced professional satisfaction among stakeholders. Priorities identified for further research include increased knowledge of the underlying causes of care gaps and greater concentration on the measurement of clinical, humanistic and fiscal outcomes and their causal links to DM structures and processes. Although still embryonic in Quebec and Canada, the available evidence suggests that DM partnerships are practical and functional vehicles to expedite knowledge creation and transfer in the care of whole populations of patients. Future projects offer the promise of updated knowledge and continuously improved care and outcomes.
For the purpose of supplying information on actual contemporary Russian usage, this article excerpts sections on noun usage and variations of the genitive ending in the masculine singular from "Stilistik der russischen Sprache" (Russian Language Style) by D. Rosental and M. Telenkowa. (Text is in German.) (FB)
Bravo-Berguño, D.; Mereu, R.; Cavalcante, P.; Carlini, M.; Ianni, A.; Goretti, A.; Gabriele, F.; Wright, T.; Yokley, Z.; Vogelaar, R. B.; Calaprice, F.; Inzoli, F.
A comprehensive monitoring system for the thermal environment inside the Borexino neutrino detector was developed and installed in order to reduce uncertainties in determining temperatures throughout the detector. A complementary thermal management system limits undesirable thermal couplings between the environment and Borexino's active sections. This strategy is bringing improved radioactive background conditions to the region of interest for the physics signal thanks to reduced fluid mixing induced in the liquid scintillator. Although fluid-dynamical equilibrium has not yet been fully reached, and thermal fine-tuning is possible, the system has proven extremely effective at stabilizing the detector's thermal conditions while offering precise insights into its mechanisms of internal thermal transport. Furthermore, a Computational Fluid-Dynamics analysis has been performed, based on the empirical measurements provided by the thermal monitoring system, and providing information into present and future thermal trends. A two-dimensional modeling approach was implemented in order to achieve a proper understanding of the thermal and fluid-dynamics in Borexino. It was optimized for different regions and periods of interest, focusing on the most critical effects that were identified as influencing background concentrations. Literature experimental case studies were reproduced to benchmark the method and settings, and a Borexino-specific benchmark was implemented in order to validate the modeling approach for thermal transport. Finally, fully-convective models were applied to understand general and specific fluid motions impacting the detector's Active Volume.
Pikoulis, Emmanouil; Salem, Karim M; Avgerinos, Efthymios D; Pikouli, Anastasia; Angelou, Anastasios; Pikoulis, Antreas; Georgopoulos, Sotirios; Karavokyros, Ioannis
Early management of vascular injury, starting at the field, is imperative for survival no less than any operative maneuver. Contemporary prehospital management of vascular trauma, including appropriate fluid and volume infusion, tourniquets, and hemostatic agents, has reversed the historically known limb hemorrhage as a leading cause of death. In this context, damage control (DC) surgery has evolved to DC resuscitation (DCR) as an overarching concept that draws together preoperative and operative interventions aiming at rapidly reducing bleeding from vascular disruption, optimizing oxygenation, and clinical outcomes. This review addresses contemporary DCR techniques from the prehospital to the surgical setting, focusing on civilian vascular injuries.
Full Text Available The aim of the paper is to present and explain the important role and meanings of projects for modern organizations. The particular attention was paid on differing project’s features and premises that substantiate incremental interest of project management methodic of diagnosis key conditionality, which has fundamental meaning for correct planning of project venture. Important element of led analysis was presenting and discussing project limitation and key processes related with project preparation phase. A very significant accent of led consideration are recommendations for management practice related with identifying the needs, expectations and stakeholders influence on project success, as well as calling particular attention on benefits gained by organizations due to realized project.
Castro-Christiansen, L.; Farndale, E.; Biron Ben Gera, M.; Kuvaas, B.
This casebook is a collection of international teaching cases focusing on contemporary human resource management issues. Each case centers primarily on one country and illustrates a significant challenge faced by managers and HR practitioners, helping students to understand how the issues they learn
Whether you're new to the field or looking to broaden your knowledge of contemporary cryptography, this newly revised edition of an Artech House classic puts all aspects of this important topic into perspective. Delivering an accurate introduction to the current state-of-the-art in modern cryptography, the book offers you an in-depth understanding of essential tools and applications to help you with your daily work. The second edition has been reorganized and expanded, providing mathematical fundamentals and important cryptography principles in the appropriate appendixes, rather than summarize
Full Text Available Purpose: The research objective was to examine to what extent line manager competencies are linked to intelligence, and more specifically, three types of intelligence: analytical (fluid, practical and emotional. Methodology: The research was carried out with line managers (N=98 who took part in 12 Assessment Centre sessions and completed tests measuring analytical, practical and emotional intelligence. The adopted hypotheses were tested using a multiple regression. In the regression model, the dependent variable was a managerial competency (management and striving for results, social skills, openness to change, problem solving, employee development and the explanatory variables were the three types of intelligence. Five models, each for a separate management competency, were tested in this way. Findings: In the study, it was hypothesized that practical intelligence relates to procedural tacit knowledge and is the strongest indicator of managerial competency. Analysis of the study results testing this hypothesis indicated that practical intelligence largely accounts for the level of competency used in managerial work (from 21% to 38%. The study findings suggest that practical intelligence is a better indicator of managerial competencies among line managers than traditionally measured IQ or emotional intelligence. Originality: This research fills an important gap in the literature on the subject, indicating the links between major contemporary selection indicators (i.e., analytical, practical and emotional intelligence and managerial competencies presented in realistic work simulations measured using the Assessment Centre process.
Full Text Available The aim of this paper is two-fold: first, to analyze several contemporary theories of democracy, and secondly, to propose a theoretical framework for further investigations based on analyzed theories. The following four theories will be analyzed: pluralism, social choice theory, deliberative democracy and participatory democracy.
Przednowek Karolina H.
Full Text Available Introduction. Physique and body composition are often explored in sport-related research. This is due to the fact that morphological features can be useful for determining a person’s predispositions for practising a given type of physical activity. Dance, as any other sports discipline, has an impact on the physique and motor skills of those who practise it. Most research concerning the physique and body composition of dancers conducted so far has focused on persons practising ballet or competitive ballroom dancing. Investigating these issues in contemporary dancers is a new field of study. The aim of the current study was to examine the physique and body composition of girls aged 14-17 years practising contemporary dance. Material and methods. The study involved 23 girls who trained contemporary dance twice a week for 2 hours. The participants of the study had been training since the age of six. Basic anthropometric measurements were performed. Body composition was analysed based on parameters measured using a Tanita body composition analyser. Conclusions. The analysis found that girls training contemporary dance were characterised by a leptosomatic physique. BMI values in both younger and older contemporary dancers indicated that their weight was normal. Compared to girls who did not practise any particular type of sport, contemporary dancers had a lower weight, a lower body water percentage, and a lower body fat percentage. The dancers were also characterised by a greater circumference of the waist, hips, arm, and chest compared to untrained peers.
Turner, Max A.; Vanbuskirk, P. D.
The synthesis of a control system for a cryogenic fluid management facility was studied. The severe demand for reliability as well as instrumentation and control unique to the Space Station environment are prime considerations. Realizing that the effective control system depends heavily on quantitative description of the facility dynamics, a methodology for process identification and parameter estimation is postulated. A block diagram of the associated control system is also produced. Finally, an on-line adaptive control strategy is developed utilizing optimization of the velocity form control parameters (proportional gains, integration and derivative time constants) in appropriate difference equations for direct digital control. Of special concern are the communications, software and hardware supporting interaction between the ground and orbital systems. It is visualized that specialist in the OSI/ISO utilizing the Ada programming language will influence further development, testing and validation of the simplistic models presented here for adaptation to the actual flight environment.
Full Text Available In this comparison of portraits of authorial anxiety, I focus on contemporary attitudes to fan fiction and on discussions of authors in Imperial Rome (notably Galen and Martial to consider the assumptions of textuality that frame imagined textual abuse. Revealed are parallel discourses for different concerns—for the reader as a potentially ill-educated consumer and the text as an object in the ancient world; in the contemporary world, for the author's personal violation and the text as an agent within readerly experience. I discuss how fan fiction's lack of commercial publication is used to distinguish it from other contemporary literature within this framework. Fan fiction's noncommercial publication can thus be appreciated as a marginalizing act in itself.
Zappoli, Bernard; Garrabos, Yves
This book investigates the unique hydrodynamics and heat transfer problems that are encountered in the vicinity of the critical point of fluids. Emphasis is given on weightlessness conditions, gravity effects and thermovibrational phenomena. Near their critical point, fluids indeed obey universal behavior and become very compressible and expandable. Their comportment, when gravity effects are suppressed, becomes quite unusual. The problems that are treated in this book are of interest to students and researchers interested in the original behavior of near-critical fluids as well as to engineers that have to manage supercritical fluids. A special chapter is dedicated to the present knowledge of critical point phenomena. Specific data for many fluids are provided, ranging from cryogenics (hydrogen) to high temperature (water). Basic information in statistical mechanics, mathematics and measurement techniques is also included. The basic concepts of fluid mechanics are given for the non-specialists to be able to ...
Full Text Available João Enxuto and Erica Love are artists and writers living in New York City. Their writing has appeared in Art in America, Mousse Contemporary Art Magazine, Wired, and X-TRA Contemporary Art Quarterly. They have given talks and exhibited work at the Centre Pompidou, Whitney Museum of Art, the New Museum, Anthology Film Archives, Walker Art Center, Yossi Milo Gallery, Carriage Trade, Louisiana Museum in Denmark, ArtCenter/South Florida, and the Tamayo Museum in Mexico City.
Hung, R. J.; Lee, C. C.; Tsao, Y. D.
The instability of liquid and gas interface can be induced by the presence of longitudinal and lateral accelerations, vehicle vibration, and rotational fields of spacecraft in a microgravity environment. In a spacecraft design, the requirements of settled propellant are different for tank pressurization, engine restart, venting, or propellent transfer. In this paper, the dynamical behavior of liquid propellant, fluid reorientation, and propellent resettling have been carried out through the execution of a CRAY X-MP super computer to simulate fluid management in a microgravity environment. Characteristics of slosh waves excited by the restoring force field of gravity jitters have also been investigated.
Ana Maria Jerônimo Soares; Rodrigo Leone Alves; Elma Núbia de Medeiros Araújo Targino
Developing participatory and critical skills are essential to the role of the contemporary manager, so it becomes relevant that such mechanisms focus on the teaching / learning process. The present study sought to identify the effects of the use of active methodologies for the students of a Private Higher Education Institution, as well as the perception and propensity of the students to be favorable or not to the implementation of said didactic innovation in the formation of the administrator...
Jamshed J. Dalal
Training and displaying the clinical algorithm depicting the role of hs-TnI assay in acute cardiac care units and in EDs are an efficient way to deliver the new standard of care to patients. Compared with contemporary troponin assays, the hs-cTn assay accelerates the diagnostic pathway to 0–1 h, thus reducing the time for diagnosis of NSTEMI and hence, its management.
Rauh, Nicholas; Gurley, John; Saha, Sibu
Pulmonary arteriovenous malformations (PAVMs) are atypical vascular structures involving a direct connection between the pulmonary arterial and venous circulations. While PAVMs are a relatively uncommon disorder, unmanaged cases are at risk for the development of serious complications including embolization and infection. Since their first description in 1897, PAVMs have been identified and treated in a variety of ways. Advancements in diagnostic methods and operative techniques have allowed for more effective treatment of the disease. Most recently, the use of vascular plug transcatheter embolization has been described as an effective therapeutic procedure in the management of PAVMs. In this report, we present our experience with nine cases of PAVMs treated at the University of Kentucky, including special consideration of an exemplary case that illustrates the typical course of treatment for the disease.
Full Text Available What can we understand better about contemporary economic, social, political and cultural processes using the category of neoliberalism? What can it add to an understanding of the present existing forms of social organization? The article tries to answer these main questions in theoretical terms considering the arguments of those who claim to have stopped using the concept and of those who, on the contrary, sus-tain its theoretical value. Neoliberalism is considered as the "connective tissue" of contemporary capitalism, which is able to shape historically significant links between processes, ideas and practices re-garding not only different sub-social systems (political, economic, cultural, etc., but also diverse scales of action (from global to local scale and vice versa. For this "ontological" reason the concept of neoliberalism seems to show an epistemological relevance, which rests on the capacity of this concept to disclose the interconnections not only between different phenomena, but also between each of them and a more general fabric of contemporary society. This regards especially functional relationships between the ontic and ontological dimensions of neoliberalism and contemporary capitalism. For this purpose the concept of neoliberalism as a "connective tissue" shows potential analytical advantages
Contemporary theories of management tend to account for and help interpret the rapidly changing nature of today’s organizational environment. This paper deals with several important modern theories in management. Among them we can mention: the Scientific Management School, the Classical Organizational Theory School, the Behavioural School, the Management Science School, as well as recent developments in management theory comprising works such as: Systems approach, Situational or Contingency t...
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Full Text Available This study provides a numerical treatment for rotating flow of viscoelastic (Maxwell fluid bounded by a linearly deforming elastic surface. Mass transfer analysis is carried out in the existence of homogeneous-heterogeneous reactions. By means of usual transformation, the governing equations are changed into global similarity equations which have been tackled by an expedient shooting approach. A contemporary numerical routine bvp4c of software MATLAB is also opted to develop numerical approximations. Both methods of solution are found in complete agreement in all the cases. Velocity and concentration profiles are computed and elucidated for certain range of viscoelastic fluid parameter. The solutions contain a rotation-strength parameter λ that has a considerable impact on the flow fields. For sufficiently large value of λ, the velocity fields are oscillatory decaying function of the non-dimensional vertical distance. Concentration distribution at the surface is found to decrease upon increasing the strengths of chemical reactions. A comparison of present computations is made with those of already published ones and such comparison appears convincing. Keywords: Maxwell fluid, Similarity solution, Numerical method, Chemical reaction, Stretching sheet
de Chadarevian, Soraya
Historians working on recent science work close to where the archives are created or become accessible. Based on this experience, the essay presents a reflection on the archives of contemporary life sciences. It addresses three questions: firstly, what is special about the archival situation of contemporary sciences? Secondly, which sources do contemporary historians use and what opportunities and challenges do they offer? And finally, what potential changes to the archives of contemporary sciences are we witnessing? The essay draws a distinction between, on the one side, the history of science when the actors are still alive-a situation that presents a particular set of issues in respect to the available sources-and, on the other side, questions relating specifically to the life sciences at the turn of the millennium--a period which will eventually not be considered as 'contemporary' any more. It reviews changes in scientific practice, historiographical trends and archival practices and considers the place of paper records, digital sources, material artefacts and oral sources in the archives of contemporary sciences. It argues that the commercialisation and privatisation of science may prove a bigger problem for the future historian than the shift to the digital medium. It concludes by welcoming the closer interactions between scientists, historians, curators and archivists prompted by recent developments. Copyright © 2015 Elsevier Ltd. All rights reserved.
Contemporary Journal of African Studies. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 3, No 1 (2015) >. Log in or Register to get access to full text downloads.
A critical discussion of the contentious problem of language in contemporary African philosophy is attempted in this paper. The problem centres on whether or not African languages can be used in 'doing' contemporary African philosophy, where 'doing' means teaching, writing and researching. It also revolves around the ...
Sooudi, O.K.; Velthuis, O.; Baia Curioni, S.
The Indian contemporary art market developed dramatically over the 1990s and 2000s. More buyers and increased prices for, as well as new attention on, Indian contemporary art, both domestically and abroad, also entailed the maturation of local art scenes, especially in Mumbai and Delhi, as new
Examines how the contemporary women's movement in India (1975-present) has addressed the issue of women's education. Highlights contributions of the 19th-century social-reformist movement and the nationalist movement. Details the role of the contemporary women's movement in redefining knowledge and the curriculum. Concludes with challenges facing…
Andreasen, Torsten Arni Caleb
The present article questions the construction of 'the contemporary' in digital cultural heritage archives as specific strategic articulations between past and present with regard to the future. A historical exploration of the discourse of cultural heritage presents three strategic axes supposedly...... the possibility of ascribing inherent epistemological, existential, empirical and geopolitical force to a given technological archival order. - See more at: http://twentyfour.fibreculturejournal.org/2015/06/04/fcj-174-constructing-the-contemporary-via-digital-cultural-heritage/#sthash.sNhW8uuA.dpuf...
Towsley, Don; Gong, Weibo; Hollot, Kris; Liu, Yong; Misra, Vishal
.... The resulting fluid models were used to develop novel active queue management mechanisms resulting in more stable TCP performance and novel rate controllers for the purpose of providing minimum rate...
Bailey, Landon C
... for knowledge management. This study culminates in the development and field-testing of the resultant knowledge management readiness instrument, filling in an important gap in contemporary literature.
Mohamad Faizuan Mat
Full Text Available In Malaysia, there is a question in term of intellectualism activities in the context of visual epistemology. Therefore, this paper revealed the problems that linger in the Malaysian contemporary visual art scene. In fact, Malaysian contemporary artists appear to have insufficient intellectualism values and less discourse activities. The lacks of scholars in the field of visual arts create a gap in the visual arts scene in Malaysia. The question of this study was to uncover the main problems in Malaysian visual arts that led to the problem of art intellectual development. In addition, this paper presents the awareness of the valuable contributions in the intellectual development that able to enhance the communication in the art object.Keywords: art knowledge; art object; contemporary art; interpretation; perception;
Schild, Susie A.
Knowledge management thinking has resulted in the perception that the organization is the relevant beneficiary of knowledge. Individual approaches to and experiences with personal knowledge management are not well documented in empirical studies, which uncovered the specific problem that the situatedness of knowledge worker contemporaries within…
Endacott, R; Boulanger, C; Chamberlain, W; Hendry, J; Ryan, H; Chaboyer, W
Contemporary nursing leadership roles in critical care are a reflection of the changing environment in which critical care is provided. In the UK, critical care nursing faces challenges in the form of: reduced number and seniority of medical staff cover for acute wards; mandated responsibility for management of patients outside of critical care units, without corresponding responsibility for managing staff; increased public and political awareness of deficits in critical care; increased use of Assistant Practitioners; and emphasis on longer-term outcomes from intensive care. New leadership roles have met these challenges head on with two main foci: patient management across the acute/critical care interface and hospital wide policies and practice. The leadership roles examined in this paper highlight three underpinning goals: improved quality and safety of patient care; improved communication between professionals; and empowerment of junior nurses and doctors. There has been considerable investment in strategic leadership roles for critical care nursing; evidence is developing of the return on this investment for patient and service outcomes. Consideration must now be given to the preparation, mentorship and development of leadership roles for the next generation of nurse leaders.
Full Text Available Contemporary organizations have faced the growing management of digital assets of audiovisual and multimedia nature, many of them of heritage interest. This article reviews and analyzes five multimedia asset managers of contemporary full significance. After systematizing an analysis sheet on the general characteristics and modules that this type of systems must satisfy, we proceeded to evaluate each one of the selected digital management systems, offering as a result the discussion of the advantages provided by each one of them, their distinctive characteristics, as well as the evaluation of their professional suitability.
The word 'contemporary' refers to approximately the last ten years and 'German' to novels written in the German language, i.e. novels from Switzerland (for example) are also included. The nature, quantity and function of utterances from three selected contemporary German novels will be presented, in order to show how ...
Zervas, K; Glazzard, J
In recent years there has been growing interest over the role of major sport events and the sports industry. The aftermath of 2008 global crisis exposed the myth of ‘end of history’ and raised several questions over the role of management and organisational practices and theories in all aspects of human activity, including sport. This article reviews the emergence of critical management studies (CMS) as a field within management and organisational studies. We focus on critical performativity ...
Lisa M. Steffek
Full Text Available Historically, individuals in search of a romantic partner have expanded their pool of alternatives by meeting others through their personal social networks. In the last few decades, however, a growing singles population, coupled with advances in technology, has promoted the utilisation and modernization of contemporary marriage market intermediaries (MMIs, including online dating sites, social networking sites, and professional matchmaking services. Importantly, these contemporary MMIs depart from more normative methods for meeting others, making their use ripe for social stigmatization, as evidenced by myriad portrayals in the popular media. The purpose of the present research was to provide an empirical exploration of the validity of the layperson stigma towards users of contemporary MMIs by assessing the extent to which users and nonusers of these various services differ on key individual characteristics relevant to relationship initiation and progression. Specifically, we surveyed 96 individuals, all of whom were attending a singles‘ happy hour, and compared users and nonusers of contemporary MMIs on several important characteristics. Although users reported going on more dates and perceived greater attractiveness in others at the event, no differences were observed in personality (i.e., the Big 5 or adult attachment classification (i.e., secure vs. insecure. Altogether, our findings suggest that users of contemporary MMIs are not socially undesirable people (or at least any more undesirable than nonusers.
Taylor, Joshua T; Chidsey, Geoffrey; Disalvo, Thomas G; Byrne, John G; Maltais, Simon
Tricuspid regurgitation (TR) is a complex and insidious valvular pathology that represents a complex decision and management algorithm for patients. TR is present in a significant proportion of the population and is especially prevalent in patients with advanced heart failure. Patients with TR have been demonstrated to have a decreased survival even with normal left heart function. TR can be a result of pathology that directly affects the valvular structure (i.e., Ebstein anomaly) or as a result of increased forward pressures (ie, pulmonary hypertension, left heart failure). Conservative management of patients with TR is primarily symptomatic relief. Definitive therapy involves surgical repair of the tricuspid valve. Furthermore, as more patients develop advanced heart failure, the management of TR in patients with left ventricular assist devices has become necessary because of the evidence of increased in-hospital morbidity and a trend toward decreased survival.
Benes, Jan; Kirov, Mikhail; Kuzkov, Vsevolod; Lainscak, Mitja; Molnar, Zsolt; Voga, Gorazd; Monnet, Xavier
Fluid therapy is still the mainstay of acute care in patients with shock or cardiovascular compromise. However, our understanding of the critically ill pathophysiology has evolved significantly in recent years. The revelation of the glycocalyx layer and subsequent research has redefined the basics of fluids behavior in the circulation. Using less invasive hemodynamic monitoring tools enables us to assess the cardiovascular function in a dynamic perspective. This allows pinpointing even distinct changes induced by treatment, by postural changes, or by interorgan interactions in real time and enables individualized patient management. Regarding fluids as drugs of any other kind led to the need for precise indication, way of administration, and also assessment of side effects. We possess now the evidence that patient centered outcomes may be altered when incorrect time, dose, or type of fluids are administered. In this review, three major features of fluid therapy are discussed: the prediction of fluid responsiveness, potential harms induced by overzealous fluid administration, and finally the problem of protocol-led treatments and their timing.
N. L. Polyakova
Full Text Available The problem of identity has come to the fore of contemporary societies in the conditions when the institutional structures of these societies their ascriptive statuses have become looser when modernity is “liquid”, “soft”. Varions conceptualizations of identity are becoming a basic part of contemporary sociological theory. The paper aims to reveal the key problems that sociology faces when striving to work out a theory of identity. The paper takes as its starting point the classic notion of identity. This notion was shaped by Erik Erikson on the basis of his dynamic psychology. The paper proves that the contemporary identity is connected with the process of individualization in modern societies. Numerous and varied studies of contemporary identity can be divided into three large groups according to three methodological approaches: constructivist, postmodern and interactionist. The paper compares the major theories based on these approaches and reveals their theoretical and methodological problems. The paper shows that the constructivist approach is based on the notion of reflexivity which is viewed as a mechanism of identity formation by an individual. Identity is a reflexive project which is being realized in a conscious manner. The postmodern theories of identity reveal the fragmentation incompleteness of ego-identitity and it’s narcissic decay. They also reveal the inability of the individual to solve the problem of continuity and unity of her (his own personality. Identity as a notion is replaced by the notion of identification which reduces identity to varions modes of repsentation. The interactionist methodology conld open up the way to tackle, the problem of individual’s unity and continuity as the main problem of human existence. This is the condition of the individual’s psychic and social health.
Shah, Apeksha; Denicola, Richard; Edirisuriya, Cynthia; Siddiqui, Ali A
Pancreatic fluid collections are a frequent complication of acute pancreatitis. The revised Atlanta criterion classifies chronic fluid collections into pseudocysts and walled-off pancreatic necrosis (WON). Symptomatic PFCs require drainage options that include surgical, percutaneous, or endoscopic approaches. With the advent of newer and more advanced endoscopic tools and expertise, minimally invasive endoscopic drainage has now become the preferred approach. An endoscopic ultrasonography (EUS)-guided approach for pancreatic fluid collection drainage is now the preferred endoscopic approach. Both plastic stents and metal stents are efficacious and safe; however, metal stents may offer an advantage, especially in infected pseudocysts and in WON. Direct endoscopic necrosectomy is often required in WON. Lumen apposing metal stents allow for direct endoscopic necrosectomy and debridement through the stent lumen and are now preferred in these patients. Endoscopic retrograde cholangiopancreatography with pancreatic duct exploration should be performed concurrent to PFC drainage in patients with suspected PD disruption. PD disruption is associated with an increased severity of pancreatitis, an increased risk of recurrent attacks of pancreatitis and long-term complications, and a decreased rate of PFC resolution after drainage. Ideally, pancreatic ductal disruption should be bridged with endoscopic stenting.
Schoemaker, M.J.R.; Jonker, J.
- Purpose – To develop a concept of managing intangible assets in contemporary organisations. Insight is given into the rise of the network organisation and the importance of talent, social capital and identity in this kind of organisation. - Design/methodology/approach – This paper develops a
Full Text Available Traditional houses are the most essential architectural experience that is in harmony with the people's culture, beliefs, environment and lifestyles. The development of design values in contemporary architecture by tracking traditional design values in architecture paves the way for arguments concerning the implementation of authentic Malay traditional house design values in contemporary Malay houses. In addition, it is hypothesized that the Malay traditional houses theoretically provide a constructive innovative framework for the design performance of the contemporary Malay house. In this research, data was compiled through field observation and documentary review. The evidence revealed that Malay traditional houses convey a concrete message of richness encompassing architectural design values and theoretical propositions. The credibility of the results was improved and confirmed by a confluence of evidence via a confirmation process. The findings suggested that there is a rich source of subjective support, lending proof to the premise of the research investigation. The research has highlighted the significance of traditional architectural design values towards innovative design in the architecture of contemporary Malay houses as a workable pattern for use in the design of contemporary architecture.
Verma, Vivek; Burt, Lindsay; Gimotty, Phyllis A.; Ojerholm, Eric
Purpose: To test the hypothesis that recent resident research productivity might be different than a decade ago, and to provide contemporary information about resident scholarly activity. Methods and Materials: We compiled a list of radiation oncology residents from the 2 most recent graduating classes (June 2014 and 2015) using the Association of Residents in Radiation Oncology annual directories. We queried the PubMed database for each resident's first-authored publications from postgraduate years (PGY) 2 through 5, plus a 3-month period after residency completion. We abstracted corresponding historical data for 2002 to 2007 from the benchmark publication by Morgan and colleagues (Int J Radiat Oncol Biol Phys 2009;74:1567-1572). We tested the null hypothesis that these 2 samples had the same distribution for number of publications using the Wilcoxon rank-sum test. We explored the association of demographic factors and publication number using multivariable zero-inflated Poisson regression. Results: There were 334 residents publishing 659 eligible first-author publications during residency (range 0-17; interquartile range 0-3; mean 2.0; median 1). The contemporary and historical distributions were significantly different (P<.001); contemporary publication rates were higher. Publications accrued late in residency (27% in PGY-4, 59% in PGY-5), and most were original research (75%). In the historical cohort, half of all articles were published in 3 journals; in contrast, the top half of contemporary publications were spread over 10 journals—most commonly International Journal of Radiation Oncology • Biology • Physics (17%), Practical Radiation Oncology (7%), and Radiation Oncology (4%). Male gender, non-PhD status, and larger residency size were associated with higher number of publications in the multivariable analysis. Conclusion: We observed an increase in first-author publications during training compared with historical data from the mid-2000s. These
Verma, Vivek [Department of Radiation Oncology, University of Nebraska, Omaha, Nebraska (United States); Burt, Lindsay [Department of Radiation Oncology, University of Utah, Salt Lake City, Utah (United States); Gimotty, Phyllis A. [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Ojerholm, Eric, E-mail: email@example.com [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)
Purpose: To test the hypothesis that recent resident research productivity might be different than a decade ago, and to provide contemporary information about resident scholarly activity. Methods and Materials: We compiled a list of radiation oncology residents from the 2 most recent graduating classes (June 2014 and 2015) using the Association of Residents in Radiation Oncology annual directories. We queried the PubMed database for each resident's first-authored publications from postgraduate years (PGY) 2 through 5, plus a 3-month period after residency completion. We abstracted corresponding historical data for 2002 to 2007 from the benchmark publication by Morgan and colleagues (Int J Radiat Oncol Biol Phys 2009;74:1567-1572). We tested the null hypothesis that these 2 samples had the same distribution for number of publications using the Wilcoxon rank-sum test. We explored the association of demographic factors and publication number using multivariable zero-inflated Poisson regression. Results: There were 334 residents publishing 659 eligible first-author publications during residency (range 0-17; interquartile range 0-3; mean 2.0; median 1). The contemporary and historical distributions were significantly different (P<.001); contemporary publication rates were higher. Publications accrued late in residency (27% in PGY-4, 59% in PGY-5), and most were original research (75%). In the historical cohort, half of all articles were published in 3 journals; in contrast, the top half of contemporary publications were spread over 10 journals—most commonly International Journal of Radiation Oncology • Biology • Physics (17%), Practical Radiation Oncology (7%), and Radiation Oncology (4%). Male gender, non-PhD status, and larger residency size were associated with higher number of publications in the multivariable analysis. Conclusion: We observed an increase in first-author publications during training compared with historical data from the mid-2000s. These
Smith, H L; Reinow, F D; Reid, R A
Does Japanese management possess sufficient practical validity to warrant retraining of nursing administrators and their staffs? Can Japanese management really address the complexities of contemporary nursing administration? Before espousing the benefits of Theory Z and implementing quality circles in your hospital, read this analysis of the advantages and disadvantages of Japanese management--the benefits can be substantial but so can the costs!
Wu, Jashin J
Psoriasis is a multisystem inflammatory disease that is often underdiagnosed, leaving many patients untreated. Plaque psoriasis, the most common form of the disease, affects approximately 80% to 90% of patients with psoriasis. Formulating a treatment plan can be complicated when various factors are considered. For example, type of therapy is dependent on the severity of the disease. Topical agents are preferred for mild disease, while phototherapy alone or in combination with systemic agents is recommended for the treatment of moderate to severe plaque psoriasis. Traditional systemic agents have the convenience of oral dosing; however, their toxicity profile can be a limiting factor. Newer biologic agents haven proven efficacious, if not superior to traditional oral agents, but their high cost can be a substantial disadvantage. Psoriasis has also been associated with increased risk of developing comorbidities, such as cardiovascular disease, obesity, and psoriatic arthritis, all of which increase the patient's overall mortality and further worsen their overall physical well-being. Management of these comorbidities is often overlooked. Moreover, psoriasis may affect a patient's psychological and social well-being. Patients with psoriasis are at a higher risk of developing clinical depression than patients without psoriasis. Inadequate management of comorbidities inevitably leads to poor outcomes, which increases the economic burden to the patient and society. Prevention and management of comorbidities, including cardiovascular and mental health, must be addressed as a part of a patient's overall treatment plan. Specialist coordination may be beneficial for patients with psoriasis. Improved patient care may lead to better clinical and economical outcomes.
Full Text Available From the vantage point of contemporary management paradigm shift and new knowledge-based economy, we underscore the importance of relations and support of quality management system - QMS (according to ISO 9001 standard for management of knowledge and intellectual capital. QMS implementation, documenting, application, maintenance and continuous improvement, as a catalyst of effective organization management, provides a foundation for effective knowledge management and intellectual capital enlargement, via knowledge, skills, management systems, procedures, information and product flow, culture, inovation, relations with customers and other stakeholders. Simultaneous implementation and dynamic interaction of these advanced management concepts intended to attain competitive advantage can result in synergic effects and improved performance. From the perspective of knowledge, as a central unifying notion, organizational behavior based on learning influences long-term business success, process effectiveness and customer satisfaction.
A research contract was agreed between the IAEA and the Centre de Recherches Petrographiques et Geochimiques of Nancy (France) to analyze some aspects of the fluid phases present during diagenesis of the Precambrian Francevillean sandstones of Gabon, which include the Oklo uranium deposit in which because of the geometry of the ore body, the high ore grade, etc., a natural uranium reactor was formed. The investigation was orientated to define some special characteristics of the fluid inclusions and two main methods were applied for this purpose: The Raman spectroscopy (MOLE microsonde) and microthermometric analysis. The main conclusions of the research are the following: 1. The Francevillean sandstones were buried up to a depth of 4-5 km where the corresponding geothermal temperature was of around 240 0 C but during the Oklo nuclear reaction, the fluid temperatures were higher than 450 0 C and in at least one case (Zone II) up to 600 0 C. 2. The tectonic fracturing has favoured the fluid circulation, which was possibly the responsible of the mineral re-concentration after the Oklo nuclear reaction. 3. The diagenetic fluids were essentially aqueous solutions and no sulphur components were identified. 4. The hydrogen presence in a quartz veinlet is surprising and possibly due to water decomposition by strong irradiation
Leake, Maria D.
In this article, Leake is arguing for the relevance of contemporary art as a way to bridge the gap between theory and practice in the spaces of art education. Graeme Sullivan develops a similar argument in his "Studies" article, "The Art of Research." Where Leake looks to possibilities for contemporary art as it is presented in…
Wouters, M.; Morales, S.; Epstein, M.J.; Lee, J.Y.
Purpose To provide an overview of research published in the management accounting literature on methods for cost management in new product development, such as a target costing, life cycle costing, component commonality, and modular design. Methodology/approach The structured literature search
Reiser, M F
This article offers selective reviews of cogent sectors of research regarding the dream in contemporary psychiatry. First, the author discusses relatively recent research (1953-1999) on the neurobiology and clinical psychophysiology of dreaming sleep; second, he reviews experimental cognitive neuroscientific studies of perception, emotion, and memory and the putative interrelationships among them in generating dream imagery; and third, he interprets psychoanalytic studies (1900-1999) on related aspects of dreams and the dream process. Exploration for interrelationships among information from these three areas entails discussion of the mind/brain problem. These considerations illuminate some of the logical and interpretive dilemmas that enter into debates about Freud's theory of the dream. The author proposes a preliminary psychobiologic concept of the dream process and discusses, in light of the foregoing considerations, the importance of collaborative research for developing a realistic perspective concerning the proper place of the dream in contemporary psychiatry.
Filaković, Pavo; Pozgain, Ivan
Ethics in the contemporary psychiatry, as well as in medicine in general, is based on the two core ethical traditions: deontological and theological. Good ethical decision takes into the consideration both traditions, and is preceded with ethical dilemmas to provide the best possible care to the patients in that moment. In the article are presented most recent research results of the literature about ethical dilemmas in psychiatry. Ethical dilemmas in everyday practice as well as compliance with the patients, psychiatric consultations, informed consent, treatment of personality disorders, pharmacological investigations, forensic psychiatry, forced hospitalisation, promotion of mental health, and dealing with the stigma of the mental diseases are showed in the article. The authors emphasize the necessity of constant questioning of ethical dilemmas in the contemporary psychiatry, because of the special status of psychiatry as a potentially risky field in practice, and because of intensive pharmacological investigations in psychiatric patients.
Huizing, A.; Cavanagh, M.
Introduction. The purpose of this paper is to introduce to information science in a coherent fashion the core premises of contemporary practice theory, and thus to engage the information research community in further debate and discussion. Method. Contemporary practice-based approaches are
Full Text Available Early management of vascular injury, starting at the field, is imperative for survival no less than any operative maneuver. Contemporary prehospital management of vascular trauma, including appropriate fluid and volume infusion, tourniquets, and hemostatic agents, has reversed the historically known limb hemorrhage as a leading cause of death. In this context, damage control (DC surgery has evolved to DC resuscitation (DCR as an overarching concept that draws together preoperative and operative interventions aiming at rapidly reducing bleeding from vascular disruption, optimizing oxygenation, and clinical outcomes. This review addresses contemporary DCR techniques from the prehospital to the surgical setting, focusing on civilian vascular injuries.
Full Text Available The relationships between children and parents seem to be one of the most urgent issues in the contemporary world, spanning from the United States and European countries to East Asian societies, as a consequence of the transformation of traditional family ethics, values and institutions brought about by the processes of modernization and globalization. The present paper aims to reveal the ways and problems of the application of xiao 孝 (filial piety ethics in the contemporary Western and Chinese societies, as reflected in the works by a number of famous Western Protestant missionaries, religious philosophers, sinologists and present-day Lithuanian Sinology students, and counterbalance their views with the insights of contemporary Chinese sociologists. The place of xiao in the contemporary inter-cultural dialogue will be discussed from the point of view of dialogue between religions, theory and practice, Western and Chinese culture, traditional and modern societies and values.
Holte, Kathrine; Jensen, Peter; Kehlet, Henrik
Dose regimens in perioperative fluid management are rarely evidence based. Therefore, we investigated responses to an IV fluid infusion in healthy volunteers to assess basic physiologic effects of a fluid infusion per se. In a prospective, double-blinded, cross-randomized study, 12 healthy...... volunteers with a median age of 63 yr (range, 59-67 yr) received an infusion of lactated Ringer's solution 40 mL/kg (median, 2820 mL) or 5 mL/kg (median, 353 mL; background infusion) in random order on two separate occasions. The study was designed to mimic the perioperative course with preoperative fasting...... by fluid administration. These findings may serve as a basis for clinical studies applying the same type of fluid in different amounts to determine the optimal amount of perioperative fluid in various surgical procedures. IMPLICATIONS: Infusion of 40 mL/kg of lactated Ringer's solution in volunteers led...
Tarcisio Torres Silva
Full Text Available In this paper, it is intended to propose a theoretical approach to the political effects of the sense of touch/haptic in order to understand to what extent the intensification of contemporary haptic experience contributes to create proximity and engagement among individuals overloaded by too much visual information offered by multiple media. At the end, it is mentioned the work of Brazilian artist Rodrigo Braga to exemplify the contemporary political use of haptic sense.
amounts of fluid caused adverse physiologic effects in healthy volunteers indicates that addition of the surgical trauma per se increases fluid requirements. Volume kinetic analysis applied 4 hours postoperatively was not able to detect the presence of either overhydration or hypovolemia regardless...... mobilization. In major (colonic) surgery with a standardized multimodal rehabilitation regimen, over-all functional recovery was not affected with a "liberal" ( approximately 5 liters) vs. "restrictive" 1.5 liter crystalloid-based regimen, however based on three anastomotic leakages in the "restrictive" group...
In the dissertation entitled "Image Acts and Visual Communities: Contemporary Nationalism in Turkey", I investigate the image politics of nationalist practices in everyday life by focusing on contemporary Turkey and tracking the way images of the nation travel through a variety of fields. I depart
Venzke, I.; Brölmann, C.; Radi, Y.
Many contemporary theories approach international law-making with a shift in emphasis from the sources of law towards the communicative practices in which a plethora of actors use, claim and speak international law. The contribution proceeds by sketching the move from sources to communicative
Hay, Melissa E; Connelly, Denise M; Kinsella, Elizabeth Anne
Contemporary discourses in the health sciences vary in their treatment of aging bodies and the mind-body relationship, yet our understanding of aging experiences and health care practices can be limited by an overreliance on biomedical or social constructionist approaches alone. This paper offers a conceptual exploration of embodiment as an innovative approach to enhance our understandings of aging bodies and health in physiotherapy practice. Embodiment attends to body and mind, nature and culture, structure and agency, while appreciating differences in aging bodies and health in aging. Conclusions consider embodiment in the practice and disciplinary discourse of contemporary physiotherapy, specifically, considering the ways embodied perspectives can support therapists in their health care practice and relationships with people with aging bodies.
a creative force in building constructions, structural features and architectural design (construing) – helps to identify and refine technology transfer in contemporary industrialized building construction’. Through various references from the construction industry, business theory and architectural practice......This paper argues for a new critical approach to the ways architectural design strategies are developing. Contemporary construction industry appears to evolve into highly specialized and optimized processes driven by industrialized manufacturing, therefore the role of the architect...... and the understanding of the architectural design process ought to be revised. The paper is based on the following underlying hypothesis: ‘Tectonic thinking – defined as a central attention towards the nature, the properties, and the application of building materials (construction) and how this attention forms...
Tobias G. Erhart
Full Text Available The results in this work show the influence of long-term operation on the decomposition of working fluids in eight different organic rankine cycle (ORC power plants (both heat-led and electricity-led in a range of 900 kW el to 2 MW el . All case study plants are using octamethyltrisiloxane (MDM as a working fluid; the facilities are between six to 12 years old. Detailed analyses, including the fluid distribution throughout the cycle, are conducted on one system. All presented fluid samples are analyzed via head space gas chromatography mass spectrometry (HS-GC-MS. Besides the siloxane composition, the influence of contaminants, such as mineral oil-based lubricants (and their components, is examined. In most cases, the original working fluid degrades to fractions of siloxanes with a lower boiling point (low boilers and fractions with a higher boiling point (high boilers. As a consequence of the analyses, a new fluid recycling and management system was designed and tested in one case study plant (Case Study #8. Pre-post comparisons of fluid samples prove the effectiveness of the applied methods. The results show that the recovery of used working fluid offers an alternative to the purchase of fresh fluid, since operating costs can be significantly reduced. For large facilities, the prices for new fluid range from € 15 per liter (in 2006 to € 22 per liter (in 2013, which is a large reinvestment, especially in light of filling volumes of 4000 liters to 7000 liters per unit. Using the aforementioned method, a price of € 8 per liter of recovered MDM can be achieved.
Tomasz W. Kolasinski
Full Text Available Purpose: The paper presents the results of a qualitative analysis of selected aspects of general business environment. The author strives to answer the following question formulated in the context of postcolonial deliberations: has the general business environment been affected by European colonialism? Methodology: Semantic and semiotic analysis of primary sources (statistical data and research findings formulated by international organisations, such as the World Bank, OECD, UNIDO and secondary sources (scientific and research studies of Polish and foreign authors based on primary sources; literature review. Findings: In the postcolonial perspective, qualitative analysis shows neither a positive nor a negative impact of colonialism on the contemporary general business environment. If certain signs of its deterioration are observed, they are mostly due to the erosion of state capacity, whose origins can be traced back to the Berlin Conference. Originality: Papers on Postcolonial Management and Critical Management Studies (CMS bridge the gap in literaturę pertaining to management issues, especially in Poland. Due to their interdisciplinary nature, Postcolonial Management and CMS cover a broad range of research areas (i.e. theory of state and nation, sociology, economic history. They pertain to both economics an management, and are therefore difficult to classify.
This aim of this article is to identify unusual strategic-management matters in times of crisis. The research scope is strategic management processes, the characteristics of the processes and methods of strategic crisis management. The study reports research on the contemporary state of strategic crisis-management problems and provides an analysis of some theoretical and methodological principles. The analysis includes a classification of the main problems which must be solved for efficient, ...
Full Text Available Modern public companies, organizations and services management is a process that influences certain group, resulting in change of reality or function of it reaching certain, previously set objective. A new philosophy and approach to adaptive creativity, emphasize importance and capabilities of creativity improvement for employees, teams and all organizations.
Vincenzo Paolo Bagnato
Full Text Available In the face of increasing and differentiating the low-cost housing demand and the trend of establishing new paradigms in the contemporary housing design, the architectural investigation has replaced into its disciplinary statement the topic of housing as central question in research and design experimentation. The city of Barcelona has codified in the last years innovative modalities of public management in social housing, offering interesting points of reflection on the idea of housing and of Mediterranean quality in urban, architectural and constructive terms. The paper proposes a key to the reading on the recent experiences of social housing in Barcelona illustrating the different forms through which architecture interprets the relationship between housing and public space, between innovation and constructive tradition.
Oral rehydration therapy (ORT) remains the ideal first line therapy for acute gastroenteritis (AGE). Our aim was to assess the impact of introducing an Oral Fluid Challenge (OFC) protocol on outcomes such as intravenous fluid use and documentation in our institution. A single centre study with data collected retrospectively pre-implementation (April 2015) of the OFC protocol and post implementation (April 2016). Consecutive sampling of the first 55 patients presenting with GE like symptoms and underwent OFC were recruited. One hundred and ten patients were included in this study with 55 patients per cycle. The rates of IVF use decreased from 22% (12) in cycle one to 18% (10) in cycle two. There was an improvement in documentation by 26% (14) for level of dehydration and 52% (31) for OFC volume from cycle one to two. Overall, the addition of the OFC protocol to the management of patients with uncomplicated AGE would help streamline and improve care.
Full Text Available In the paper, we discuss theoretical and practical aspects of managementand its rational and irrational behavior in the light of traditionalmanagement theories and contemporary social theories and theoriesof complexity. We exposed differences between middle and top management,where rationality is ascribed mainly to middle management,while top management often acts on seemingly irrational way. For thepart of this irrationality, we cannot blame management because it originatesfrom the nature of the complex dynamic systems, as human organizationsare. However, a significant part of an apparently irrationalbehavior of management should be attributed to its particular and personalgoals that deviate from the goals of organization in which topmanagement absconded to the control of owners and even social norms.
Full Text Available This study focuses on the substantive area of sales management and it suggests that the main concern of a sales manager is to reach the sales and economical goals of the sales organization. The social process by which this main concern is resolved is called goal-oriented balancing and it describes two complementary organizational dimensions, frame development and individual development that are continuously balanced against each other. That is, the sales manager must establish effective organizational processes and structures as well as find the keys to maximum individual performance. These two processes have to be in balance and supportive of each other.
National Aeronautics and Space Administration — Acute challenges are faced by the designers of fluid systems for spacecraft because of the persistently unfamiliar and unforgiving low-g environment. For example,...
Tudor Cristian Ţiclău
Full Text Available Education and professional development is considered central issues in civil service development and public administration reform. While this may be true, the content of such programs bears equal influence in skill acquirement, which in turn, has an impact on managerial performance (Perry, 1989. The contemporary economic and social environment poses numerous and complex challenges to public leaders, who need to be equipped with the adequate set of skills and competencies in order to have a proper response. The present paper aims to find out the whether the current educational programs from the business field can be a solution for preparing the next generation of public (and private leaders. My argument is that the latest developments in public management reform (New Public Management, Good Governance and Public Entrepreneurship combined with new demands for effectiveness, efficiency and high quality public services could increase the relevance of such programs. In support for this I presented a series of research results that point to a set of common leadership challenges that transcend the public-private divide. Finally I explored the offerings of the top 5 MBA programs in the world to see whether this is reflected in their educational programs. Not surprisingly, three out of the five programs analysed offer dual degree programs that combine business and public management education as a solution for the leadership challenges that lay ahead.
Bork Petersen, Franziska
In this thesis I investigate what ‘authenticity’ means in a contemporary popular context and how it is used in the staging of bodies. Furthermore, I analyse works of dance and fashion from the past fifteen years with a focus on their strategies of challenging the notion of ‘bodily authenticity...... self’. I scrutinise the staging techniques and the codes of appearance that bodies have to comply with in order to be deemed ‘authentic’ on the shows. To define them and place them in the history of the idea of ‘bodily authenticity’, I complement my study with an outline of how ‘authenticity...... and by a depiction of 'working hard'. But various techniques also mask the hard work, for example by showing a participant ‘having fun’ performing it. Contemporary works of dance and fashion challenge the problematic implications in the notion of ‘bodily authenticity’. I analyse three strategies of undermining...
Traboulsi, Samer L; Witjes, Johannes Alfred; Kassouf, Wassim
Primary urethral cancer is one of the rare urologic tumors. Distal urethral tumors are usually less advanced at diagnosis compared with proximal tumors and have a good prognosis if treated appropriately. Low-stage distal tumors can be managed successfully with a surgical approach in men or radiation therapy in women. There are no clear-cut indications for the choice of the most appropriate treatment modality. Organ-preserving modalities have shown effective and should be used whenever they do not compromise the oncological safety to decrease the physical and psychological trauma of dismemberment or loss of sexual/urinary function. Copyright © 2016 Elsevier Inc. All rights reserved.
Chanaron , Jean-Jacques; Grange , Thierry
The paper is proposing an historical approach of the definition and constitution of technology management as a discipline leading to a re-visited approach more in line with contemporary issues and problems facing businesses. It is suggested to expand its scope to the strategic management of technology and innovation.
Caraway, James E.
The theories of several contemporary management theorists are examined in order to demonstrate that their administrative stance is that of a person-intensive approach to management. After exploring leadership theory and the positions of Douglas McGregor, John J. Morse, Jay W. Lorsch, Rensis Likert, Bernard M. Bass, William Reddin, George H. Rice,…
Rahimi, Fatemeh; Møller, Charles; Hvam, Lars
of IT on process innovations, the association between business process management and IT management is under-explored. Drawing on a literature analysis of the capabilities of business process and IT governance frameworks and findings from a case study, we propose the need for horizontal integration between the two......The importance of business processes and the centrality of IT to contemporary organizations' performance calls for a specific focus on business process management and IT management. Despite the wide scope of business process management covering both business and IT domains, and the profound impact...... management functions to enable strategic and operational business - IT alignment. We further argue that the role of IT in an organization influences the direction of integration between the two functions and thus the choice of integration mechanisms. Using case study findings, we propose...
Nasir, Nazrila Hairin; Mohamad, Mohazmi; Lum, Lucy Chai See; Ng, Chirk Jenn
Dengue infection is the fastest spreading mosquito-borne viral disease in the world. One of the complications of dengue is dehydration which, if not carefully monitored and treated, may lead to shock, particularly in those with dengue haemorrhagic fever. WHO has recommended oral fluid intake of five glasses or more for adults who are suspected to have dengue fever. However, there have been no published studies looking at self-care intervention measures to improve oral fluid intake among patients suspected of dengue fever. To assess the feasibility and effectiveness of using a fluid chart to improve oral fluid intake in patients with suspected dengue fever in a primary care setting. This feasibility study used a randomized controlled study design. The data was collected over two months at a primary care clinic in a teaching hospital. The inclusion criteria were: age > 12 years, patients who were suspected to have dengue fever based on the assessment by the primary healthcare clinician, fever for > three days, and thrombocytopenia (platelets dengue home care card. The intervention group received the fluid chart and a cup (200ml). Baseline clinical and laboratory data, 24-hour fluid recall (control group), and fluid chart were collected. The main outcomes were: hospitalization rates, intravenous fluid requirement and total oral fluid intake. Among the 138 participants who were included in the final analysis, there were fewer hospital admissions in the intervention group (n = 7, 10.0%) than the control group (n = 12, 17.6%) (p = 0.192). Similarly, fewer patients (n = 9, 12.9%) in the intervention group required intravenous fluid compared to the control group (n = 15, 22.1%), (p = 0.154). There was an increase in the amount of daily oral fluid intake in the intervention group (about 3,000 ml) compared to the control group (about 2,500 ml, p = 0.521). However, these differences did not reach statistical significance. This is a feasible and acceptable study to perform in
Full Text Available The paper explores, in the context of feminist discussions about the Bildungsroman, a contemporary British novel that offers shocking images of female coming of age at the turn of the millennium. Queering gender and introducing male elements into the heroine’s process of maturation, the analysed novel appears to raise questions about the continuous relevance of the feminist distinction between male and female version of the genre. The paper however argues that although significantly rewriting both female Bildung and pornographic narratives, Helen Walsh’s Brass can still be read as a variation of the female Bildungsroman and an example of its contemporary developments.
MacQueen, Hector; Laurie, Graeme; Brown, Abbe
Contemporary Intellectual Property: Law and Policy offers a unique perspective on intellectual property law, unrivalled amongst IP textbooks available today. Beyond providing an up-to-date account of intellectual property law, the text examines the complex policies that inform and guide modern IP law at the domestic (including Scottish), European and international levels, giving the reader a true insight into the discipline and the shape of things to come. The focus is on contemporary challenges to intellectual property law and policy and the reader is encouraged to engage critically both with the text and the subject matter. Carefully developed to ensure that the complexities of the subject are addressed in a clear and approachable manner, the extensive use of practical examples, exercises and visual aids throughout the text enliven the subject and stimulate the reader.
Waelde, Charlotte; Kheria, Smita; Cornwell, Jane
Contemporary Intellectual Property: Law and Policy offers a unique perspective on intellectual property law. It goes beyond an up-to-date account of the law and examines the complex policies that inform and guide modern intellectual property law at the domestic (including Scottish), European and international levels, giving the reader a true insight into the discipline and the shape of things to come. The focus is on contemporary challenges to intellectual property law and policy and the reader is encouraged to engage critically both with the text and the subject matter. Carefully developed to ensure that the complexities of the subject are addressed in a clear and approachable manner, the extensive use of practical examples, exercises and visual aids throughout the text enliven the subject and stimulate the reader.
Callaghan, Chris William
Knowledge management as a field is concerned with the management of knowledge, including the management of knowledge in research processes. Knowledge management theory has the potential to support research into problems such as HIV, antibiotic resistance and others, particularly in terms of aspects of scientific research related to the contribution of social science. To date, however, these challenges remain with us, and theoretical contributions that can complement natural science efforts to eradicate these problems are needed. This paper seeks to offer a theoretical contribution grounded in Kuhn's paradigm theory of innovation, and in the argument by Lakatos that scientific research can be fundamentally non-innovative, which suggests that social science aspects of knowledge creation may hold the key to more effective biomedical innovation. Given the consequences of ongoing and emerging global crises, and the failure of knowledge systems of scientific research to solve such problems outright, this paper provides a review of theory and literature arguing for a new paradigm in scientific research, based on the development of global systems to maximise research collaborations. A global systems approach effectively includes social science theory development as an important complement to the natural sciences research process. Arguably, information technology and social media technology have developed to the point at which solutions to knowledge aggregation challenges can enable solutions to knowledge problems on a scale hitherto unimaginable. Expert and non-expert crowdsourced inputs can enable problem-solving through exponentially increasing problem-solving inputs, using the 'crowd,' thereby increasing collaborations dramatically. It is argued that these developments herald a new era of participatory research, or a democratisation of research, which offers new hope for solving global social problems. This paper seeks to contribute to this end, and to the recognition
Full Text Available Changes in the twenty-first century are faster and appear unexpectedly. They are not always necessary for the smooth functioning of the company. This is the domain of globalization, where new events - opportunities or threats are challenging the viability against which the questions are now all companies. More and more depends on the intangible assets of the undertaking, its strategic potential. Therefore Przedsiębiorsto creates and develops skills which then turns on competence. It is ond become the basis for competitiveness. The main determinant in this process is not only optimal, but the skillful management of intellectual capital. Its importance in recent years is constantly increasing, and the success of the market determines the joint commitment of all organizational units. Certain types of work require to the larger amount of knowledge, experience and independent thinking, and custom than others. For all employers, it is important to recognize these differences and create a new management principles ketegorią professionals who have knowledge useful for the enterprise - are knowledge workers. Therefore, the purpose of this article is an attempt to show management knowledge workers in modern companies, based on tests carried out in the years 2013 - 2015, in 100 large companies operating in the Baltic Sea Region
This article introduces the notion of "contemporary" play in relation to existing ideas about children's play, learning and development from a sociocultural perspective. The need to think about the nature of contemporary play is considered in response to arguments suggesting that the quality of children's play has declined in…
Full Text Available A conversation with Diana Hambardzumyan, a contemporary Armenian writer, translator and lecturer in English Literature at the University of Yerevan, foregrounds a series of significant features of contemporary Armenian literature and the country’s key social and cultural issues. She interconnects current events with the literary memory, highlighting and confirming the Armenian writers’ need to maintain their traditional role as representatives of the cultural will of their people.
Zhang, Pengwei; Li, Min; Jiao, Xiaojing; Zhou, Ruijin
The contemporary company attaches great importance to marketing relationship and customer relations is the core of this relationship. Further, customer satisfaction and loyalty is the core of the customer relationship management. Sometimes, high customer satisfaction causes low profit because enterprises do not realize that strengthening the loyalty of the aimed customer is the key of customer relationship management.
Kheang, Lim Hack; And Others
"Contemporary Cambodian" consists of seven parts: the "Grammatical Sketch," the "Introduction," four intermediate modules, and a Cambodian-English glossary containing all the words in the series. After completing the "Introduction," a student can study the intermediate modules in any order, since each serves as a partial review of the others. This…
Dr. Boulaares * Djemai
Full Text Available Pragmatic Dimension of the Contemporary Language and Principles of Curriculum Development Dr. Boulaares Djemai * Abstract Textbooks have been very significant and valuable for our precedents because education is very significant and through it, everybody can achieve fulfillment. Knowledge and its application can be achieved through the person’s interaction with society, worldview and his intellectual development. The criteria of social discipline, behavioral values snd civilization should evoke knowledge in the students. Therefore, a textbook should benefit from contemporary linguistic culture which is summarized as follows: 1 - Debate and conversation, question and answer. 2 - Storytelling, narrative and representation of characters and imitation. 3 - Reports and speeches, words and conversations. 4 – Giving directions and instructions. 5 – Holding personal interviews and managing meetings, 6 - Describing realistic things, arguments, defending their opinion, explanation, dialogue, analysis, survey and commentary. These aspects must be observed in the language and style of the book when a person wants to develop educational materials because these factors implicitly form the ideology of the students who are the next generation of our society. Keywords : Paradigmatic, text book, curriculum, design * Assistant Professor, King Saud University, Saudi Arabic kingdom, E-mail: firstname.lastname@example.org .
T V Semina
Full Text Available The article considers sociological aspects of one of the most complex and urgent problems of the contemporary Russian society - the growing imbalance of social relationships between patients and doctors. Undoubtedly, in medicine each group - doctors and patients - is an element of poorly structured social network and an integral part of all types of interaction in the prevention and treatment of various diseases. This system of relationships is institutionalized and complex in itself, but social and economic processes can complicate or facilitate its functioning. Unfortunately, the growth of social differentiation in the Russian society in the last decades had a negative impact on all spheres of life including healthcare. Under given conditions and social stratification trends each group - doctors and patients - has developed specific value orientations as a kind of professional and personal quintessence of the current fundamental values. In particular, dissatisfaction with the financial situation in the light of work efforts and high level of education explains why doctors consider their social status inadequate and are forced to satisfy their material needs with the help of illegal means. The author proposes some measures to reduce the imbalance of medicine and society relationships in the contemporary Russian society, which suggest changing traditional models of healthcare and conflict management through the purposeful influence on the subject and object of the unbalanced relationships.
Rudan, Dusko; Jakovljevic, Miro; Marcinko, Darko
The article discusses the impact of contemporary culture on the individual's personality. We used the "psychocultural" approach whose key feature is the amalgamation of theories and methods belonging to psychodynamic and psychosocial studies, as well as those used in the field of media and cultural studies. The idea of a potentially therapeutic effect of culture (therapy culture) can already been seen in Freud's and Lacan's texts, and it is often used in critical analyses of contemporary corporate culture, which is more or less developed in some parts of the world. In their criticisms, many contemporary authors emphasize that modern societies have a tendency towards the weakening of basic commitment, or lack thereof, to a social equivalent of Winnicott's concept of environmental provisions as an inalienable democratic right essential for human emotional and mental progress or emotional well-being. The article describes frequent resorting to the so-called manic defences that defensively distort, deny and obscure the awareness that a human being is not the omnipotent source of life, but instead depends on other human beings, and often tries to compensate for loss through various activities. The article describes excessive shopping as an activity that often serves as an attempt to find what was lost, i.e. to fill an emotional void. This solution (resorting to manic defences) is encouraged by contemporary culture, especially through promotional material (e.g. advertising). The main theses of this article are supported by quotations and data from world literature.
Bäck, Thomas; Krause, Peter
Evolution strategies have more than 50 years of history in the field of evolutionary computation. Since the early 1990s, many algorithmic variations of evolution strategies have been developed, characterized by the fact that they use the so-called derandomization concept for strategy parameter adaptation. Most importantly, the covariance matrix adaptation strategy (CMA-ES) and its successors are the key representatives of this group of contemporary evolution strategies. This book provides an overview of the key algorithm developments between 1990 and 2012, including brief descriptions of the a
There are a plethora of social problems present throughout theworld in which America has deemed a type of ‘war.’ Some of theseunconventional wars include: The War on Poverty presented in 1964; The War on Drugs announced in 1971; The War on Cancer commencing in1971; The War Against Illiteracy beginning in the 1970s; and afterSeptember 11, 2001 The War on Terror was announced (Raz, 2008).These contemporary ‘wars’ have transformed the meaning of the word‘war.’ Labeling these missions ‘wars,’ pre...
N М Belgarokova
Full Text Available The article provides the analysis of the conditions and results of the processes of political culture development and political socialization of the contemporary youth in the frame of sociological research. The analysis of the conflicting influences of the agents of political socialization (family, system of education, mass media, the difficult circumstances and the challenging economic status of the contemporary Russian youth as well as the macropolitical environment in the country provides an opportunity to arrive at the conclusion concerning the socialization crisis of youth in contemporary Russia.
Crighton, Gemma L; Scarborough, Ri; McQuilten, Zoe K; Phillips, Louise E; Savoia, Helen F; Williams, Bronwyn; Holdsworth, Rhonda; Henry, Amanda; Wood, Erica M; Cole, Stephen A
To describe the natural history, antenatal and postnatal therapy, and clinical outcomes of Australian patients with fetomaternal/neonatal alloimmune thrombocytopenia (NAIT) recorded in the Australian NAIT registry. Analysis of registry data of Australian mothers treated antenatally for NAIT and any fetus/newborn with thrombocytopenia (TCP) and maternal human platelet antigen (HPA) antibodies. Ninety four potential cases (91 pregnancies; three twin pregnancies) were registered between December 2004 and September 2015 with 76 confirmed or treated as NAIT. NAIT was frequently unanticipated (44 cases, 58%), whilst 32 cases (42%) were anticipated due to personal or family history. In 70/76 cases, the diagnosis of NAIT was made based on HPA antibody results; anti-HPA-1a was most commonly detected (58/70, 82%), followed by anti-HPA-5b (5/70, 7%). Intracranial haemorrhage (ICH) was detected in seven cases (9%). Maternal antenatal therapy resulted in improved clinical outcomes. For antenatally treated cases, whilst 10/29 (34%) neonates had severe TCP, only one ICH was detected. This study provides data on contemporary "real world" management of Australian mothers and babies with NAIT. Antenatal IVIG therapy was associated with better neonatal outcomes. Maternal side-effects and treatment costs were substantial.
Phillips, C D; Hoffman, J I; George, J C; Suydam, R S; Huebinger, R M; Patton, J C; Bickham, J W
Patterns of genetic variation observed within species reflect evolutionary histories that include signatures of past demography. Understanding the demographic component of species' history is fundamental to informed management because changes in effective population size affect response to environmental change and evolvability, the strength of genetic drift, and maintenance of genetic variability. Species experiencing anthropogenic population reductions provide valuable case studies for understanding the genetic response to demographic change because historic changes in the census size are often well documented. A classic example is the bowhead whale, Balaena mysticetus, which experienced dramatic population depletion due to commercial whaling in the late 19th and early 20th centuries. Consequently, we analyzed a large multi-marker dataset of bowhead whales using a variety of analytical methods, including extended Bayesian skyline analysis and approximate Bayesian computation, to characterize genetic signatures of both ancient and contemporary demographic histories. No genetic signature of recent population depletion was recovered through any analysis incorporating realistic mutation assumptions, probably due to the combined influences of long generation time, short bottleneck duration, and the magnitude of population depletion. In contrast, a robust signal of population expansion was detected around 70,000 years ago, followed by a population decline around 15,000 years ago. The timing of these events coincides to a historic glacial period and the onset of warming at the end of the last glacial maximum, respectively. By implication, climate driven long-term variation in Arctic Ocean productivity, rather than recent anthropogenic disturbance, appears to have been the primary driver of historic bowhead whale demography. PMID:23403722
Full Text Available Cardiac electrophysiologic derangements often coexist with disorders of the circulatory system. Capturing and diagnosing arrhythmias and conduction system disease may lead to a change in diagnosis, clinical management and patient outcomes. Standard 12-lead electrocardiogram (ECG, Holter monitors and event recorders have served as useful diagnostic tools over the last few decades. However, their shortcomings are only recently being addressed by emerging technologies. With advances in device miniaturization and wireless technologies, and changing consumer expectations, wearable ‘on-body’ ECG patch devices have evolved to meet contemporary needs. These devices are unobtrusive and easy to use, leading to increased device wear time and diagnostic yield. While becoming the standard for detecting arrhythmias and conduction system disorders in the outpatient setting where continuous ECG monitoring in the short to medium term (days to weeks is indicated, these cardiac devices and related digital mobile health technologies are reshaping the clinician-patient interface with important implications for future healthcare delivery.
Hertig, John B; Hultgren, Kyle E; Weber, Robert J
The discipline of studying medication errors and implementing medication safety programs in hospitals dates to the 1970s. These initial programs to prevent errors focused only on pharmacy operation changes - and not the broad medication use system. In the late 1990s, research showed that faulty systems, and not faulty people, are responsible for errors and require a multidisciplinary approach. The 2013 ASHP Statement on the Role of the Medication Safety Leader recommended that medication safety leaders be integrated team members rather than a single point of contact. Successful medication safety programs must employ a new approach - one that embraces the skills of all health care team members and positions many leaders to improve safety. This approach requires a new set of leadership skills based on contemporary management principles, including followership, team-building, tracking and assessing progress, storytelling and communication, and cultivating innovation, all of which promote transformational change. The application of these skills in developing or changing a medication safety program is reviewed in this article.
Lacombe, Olivier; Rolland, Yann
Fluids exert a first-order control on the structural, petrological and rheological evolution of the continental crust. Fluids interact with rocks from the earliest stages of sedimentation and diagenesis in basins until these rocks are deformed and/or buried and metamorphosed in orogens, then possibly exhumed. Fluid-rock interactions lead to the evolution of rock physical properties and rock strength. Fractures and faults are preferred pathways for fluids, and in turn physical and chemical interactions between fluid flow and tectonic structures, such as fault zones, strongly influence the mechanical behaviour of the crust at different space and time scales. Fluid (over)pressure is associated with a variety of geological phenomena, such as seismic cycle in various P-T conditions, hydrofracturing (including formation of sub-horizontal, bedding-parallel veins), fault (re)activation or gravitational sliding of rocks, among others. Fluid (over)pressure is a governing factor for the evolution of permeability and porosity of rocks and controls the generation, maturation and migration of economic fluids like hydrocarbons or ore forming hydrothermal fluids, and is therefore a key parameter in reservoir studies and basin modeling. Fluids may also help the crust partially melt, and in turn the resulting melt may dramatically change the rheology of the crust.
Hjortrup, Peter B; Haase, Nicolai; Bundgaard, Helle
reactions differed statistically significantly between the groups. Major protocol violations occurred in 27/75 patients in the fluid restriction group. Ischaemic events occurred in 3/75 in the fluid restriction group vs. 9/76 in the standard care group (odds ratio 0.32; 0.08-1.27; p = 0.11), worsening...
Mulenburg, Gerald M.; Impaeilla, Cliff (Technical Monitor)
This paper reports on a research study by the author that examined ten contemporary National Aeronautics and Space Administration (NASA) complex projects. In-depth interviews with the project managers of these projects provided qualitative data about the inner workings of the project and the methodologies used in establishing and managing the projects. The inclusion of a variety of space, aeronautics, and ground based projects from several different NASA research centers helped to reduce potential bias in the findings toward any one type of project, or technical discipline. The findings address the participants and their individual approaches. The discussion includes possible implications for project managers of other large, complex, projects.
Contemporary Journal of African Studies. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 2, No 1 (2014) >. Log in or Register to get access to full text downloads.
; and ... multidisciplinary approaches to the management of conflict in the church while still .... classifies them into three: Inherency (Micro), contingency (Macro) and, .... Contemporary Evangelicals are fairly accused of uncritically importing ...
Muir-Cochrane, Eimear; Gerace, Adam; Mosel, Krista; O'Kane, Debra; Barkway, Patricia; Curren, David; Oster, Candice
Risk assessment and management is a major component of contemporary mental health practice. Risk assessment in health care exists within contemporary perspectives of management and risk aversive practices in health care. This has led to much discussion about the best approach to assessing possible risks posed by people with mental health problems. In addition, researchers and commentators have expressed concern that clinical practice is being dominated by managerial models of risk management at the expense of meeting the patient's health and social care needs. The purpose of the present study is to investigate the risk assessment practices of a multidisciplinary mental health service. Findings indicate that mental health professionals draw on both managerial and therapeutic approaches to risk management, integrating these approaches into their clinical practice. Rather than being dominated by managerial concerns regarding risk, the participants demonstrate professional autonomy and concern for the needs of their clients.
Sumpio, Bauer E.
Foot problems in patients with diabetes remain a major public health issue and are the commonest reason for hospitalization of patients with diabetes with prevalence as high as 25%. Ulcers are breaks in the dermal barrier with subsequent erosion of underlying subcutaneous tissue that may extend to muscle and bone, and superimposed infection is a frequent and costly complication. The pathophysiology of diabetic foot disease is multifactorial and includes neuropathy, infection, ischemia, and abnormal foot structure and biomechanics. Early recognition of the etiology of these foot lesions is essential for good functional outcome. Managing the diabetic foot is a complex clinical problem requiring a multidisciplinary collaboration of health care workers to achieve limb salvage. Adequate off-loading, frequent debridement, moist wound care, treatment of infection, and revascularization of ischemic limbs are the mainstays of therapy. Even when properly managed, some of the foot ulcers do not heal and are arrested in a state of chronic inflammation. These wounds can frequently benefit from various adjuvants, such as aggressive debridement, growth factors, bioactive skin equivalents, and negative pressure wound therapy. While these, increasingly expensive, therapies have shown promising results in clinical trials, the results have yet to be translated into widespread clinical practice leaving a huge scope for further research in this field. PMID:24278695
Full Text Available Nowadays leadership is considered a managerial and organizational process that influences and guides the activities of the companies. As a management process, leadership can systematically influence the relationships that occur between managers and employees as a result of applying the management functions application. This study aims to highlight the main elements that designate the modern and revolutionary concept named”leadership”. The main objectives of the study are: 1. explaining the importance of leadership in the contemporary context; 2. analyzing the similarities and differences between two seemingly similar concepts - “leadership” and “management”; 3. description of the main management styles; 4. analyzing the correlation between leadership and emotional intelligence; 5. explaining leadership role in the public sector in Romania. In every company leadership has a very important role in achieving performance. The leader also plays an important role in a company, because a leader is the person who influences the behavior, actions, positive or negative attitude of others who are determined to act and take decisions voluntarily without fear of being punished if they do not follow the leader. Emotional self-awareness, trust, adaptability, initiative, optimism and team spirit are the ingredients of modern management style which determines the competitiveness of an organization.
In this article I analyze contemporary Argentine cinematic production assessing the impact of Law 24,377 that was implemented in 1995 and that provided much-needed funds for national productions. By looking at film production and consumption, the emergence of young filmmakers and the performance of both commercial films and those belonging to the…
Semeiks, Jonna Gormely
Depending primarily on Joseph Campbell's treatment of the quest or hero myth, this paper provides analyses of recent women's fiction in terms of contemporary women's quests for personal identity and freedom. Following discussions of a proposed definition of myth, its connotations, and its use as a literary device and as a tool for critical…
Full Text Available The article aims to focus on the analysis of the contemporary language issues in Ukraine. A characteristic feature of contemporary language situation in Ukraine is a co-existence on its territory of two languages, Ukrainian and Russian, along with various forms of Ukrainian-Russian bilingualism. Narrowing down the spheres of use of the Ukrainian language and the strong interferential influence of Russian have led to the emergence of the hybrid of Ukrainian-Russian forms of the everyday language known as Surzhyk. The article discusses how language forms are connected with conceptualizations of national identity in contemporary Ukrainian language ideology. It especially focuses on Surzhyk a pejorative collective label for non-standard language varieties that dissolve the language boundary between Ukrainian and Russian standard languages. Although most attention in Ukrainian debates on language is directed towards the complex relations between two standard languages, Surzhyk is considered an important problem, not the least among those for whom it is a major threat to the survival of the Ukrainian language.
Maqsood, Najwa; Mustafa, M.; Khan, Junaid Ahmad
This study provides a numerical treatment for rotating flow of viscoelastic (Maxwell) fluid bounded by a linearly deforming elastic surface. Mass transfer analysis is carried out in the existence of homogeneous-heterogeneous reactions. By means of usual transformation, the governing equations are changed into global similarity equations which have been tackled by an expedient shooting approach. A contemporary numerical routine bvp4c of software MATLAB is also opted to develop numerical approximations. Both methods of solution are found in complete agreement in all the cases. Velocity and concentration profiles are computed and elucidated for certain range of viscoelastic fluid parameter. The solutions contain a rotation-strength parameter λ that has a considerable impact on the flow fields. For sufficiently large value of λ , the velocity fields are oscillatory decaying function of the non-dimensional vertical distance. Concentration distribution at the surface is found to decrease upon increasing the strengths of chemical reactions. A comparison of present computations is made with those of already published ones and such comparison appears convincing.
This article provides an account of how people's career management is given prominence in contemporary European policy documents pertaining to career education for entrepreneurship in higher education and in vocational education and training. This study concerns the ways in which policy discourses of career management and governmental practices…
Ulhøi, John Parm; Madsen, Henning
This paper reports empirical findings from a recent survey of Danish managers with a special focus on managers from smaller companies. The survey has been initiated in Denmark and it is called the 'Danish Management Barometer'. The project is a joint research program between the Aarhus School of Business and the Danish Association of Managers and Executives. It is based on a structured, pre-tested questionnaire send out to 1500 pre-notified managers in Denmark aiming at establishing a...
Wilcox, Rand R
Applying Contemporary Statistical Techniques explains why traditional statistical methods are often inadequate or outdated when applied to modern problems. Wilcox demonstrates how new and more powerful techniques address these problems far more effectively, making these modern robust methods understandable, practical, and easily accessible.* Assumes no previous training in statistics * Explains how and why modern statistical methods provide more accurate results than conventional methods* Covers the latest developments on multiple comparisons * Includes recent advanc
Audience participation has polarized the critical debate surrounding contemporary art's social, moral and aesthetic potential. This incisive collection of essays sheds new light on the political, ethical and artistic capacity of participatory works and tests the most recent theoretical approaches to
Lundgren, Jens; Mocroft, Amanda; Ryom, Lene
PURPOSE OF REVIEW: To review the evidence linking use of HIV protease inhibitors with excess risk of cardiovascular disease (CVD) in HIV+ populations. RECENT FINDINGS: For the two contemporary most frequently used protease inhibitors, darunavir and atazanavir [both pharmacologically boosted...
Kawanishi, Hideki; Masakane, Ikuto; Tomo, Tadashi
The standard of fluids for hemodialysis is being evaluated by the International Organization for Standardization (ISO), and will be decided within a few years. In 2008, the Japanese Society for Dialysis Therapy (JSDT) proposed the standard of fluids for hemodialysis by taking the draft ISO standard into consideration and the circumstances in Japan. It was characteristically a standard for Japan, where the central dialysis fluid delivery system (CDDS) is routinely used. In addition, the therapeutic application of each dialysis fluid is clarified. Since high-performance dialyzers are frequently employed in Japan, the standard recommends that ultrapure dialysis fluid be used for all dialysis modalities at all dialysis facilities. It also recommends that the dialysis equipment safety management committee at each facility validate the microbiological qualities of online-prepared substitution fluid, making the responsibility of the dialysis facility clear. This standard is more rigid than those of other countries, and is expected to contribute to improvements in the survival outcome of dialysis patients. (c) 2009 S. Karger AG, Basel.
Holton, Sara; Rowe, Heather; Kirkman, Maggie; Jordan, Lynne; McNamee, Kathleen; Bayly, Christine; McBain, John; Sinnott, Vikki; Fisher, Jane
As part of research investigating the complexities of managing fertility in Australia, public opinions about how Australians manage their fertility were sought from women and men. To identify public opinion about sexual and reproductive health in Australia. To ensure access to a diverse group of people throughout Australia, an online group was advertised and convened on Facebook from October through December 2013. In a closed-group moderated discussion, participants responded to questions about how people in Australia attempt to manage three aspects of fertility: avoiding pregnancy, achieving pregnancy, and difficulties conceiving. Nonidentifiable demographic information was sought; no personal accounts of fertility management were requested. The discussion transcript was analyzed thematically. There were 61 female and 2 male Facebook users aged 18 to 50 years living in Australia participating in the study. Four main themes about fertility management were identified: access, geographical location, knowledge, and cost. Participants reported that young people and people from rural areas face barriers accessing contraception and fertility services. Limited knowledge about sex and reproduction and the cost of fertility services and contraception were also said to impede effective fertility management. Reasons for inequalities in effective fertility management that are amenable to change were identified. Facebook is an effective method for gaining insights into public opinion about sexual and reproductive health.
Full Text Available The aim of this paper is twofold. First, to explain the distinction between Kant’s notions of the sublime and ugliness, and to answer an important question that has been left unnoticed in contemporary studies, namely why it is the case that even though both sublime and ugliness are contrapurposive for the power of judgment, occasioning the feeling of displeasure, yet that after all we should feel pleasure in the former, while not in the latter. Second, to apply my interpretation of the sublime and ugliness to contemporary art, and to resolve certain issues that have been raised in accounting for the possibility of artistic sublimity. I argue that an experience of a genuine artistic sublimity is an uncommon occurrence. I propose that the value of contemporary art can be best explained by referring to Kant’s notion of ugliness and his theory of aesthetic ideas.
Sekine, Kazuhiko; Kitano, Mitsuhide; Shimizu, Masayuki; Matsumoto, Shokei; Yoshii, Hiroshi; Yamazaki, Motoyasu; Aikawa, Naoki
Nonoperative management (NOM) of hepatic injuries caused by blunt trauma in hemodynamically stable patients is widely accepted, but the feasibility of NOM for severe hepatic injuries has not been fully evaluated. Among all patients with blunt severe hepatic injury (type IIIb) admitted to Saiseikai Kanagawa-ken Hospital and Keio University Hospital from 1988 to 2004, those who had been hemodynamically stable after fluid resuscitation at the emergency department were initially managed nonoperatively. We reviewed demographic, physiological, and laboratory data; computed tomography (CT) findings; 80-day cumulative laparotomy rate; and complications. The anatomical severity of the hepatic injuries was evaluated based on the CT findings, such as hepatic vein injuries and area lacerated according to the Couinaud liver segment. In patients who underwent surgery after admission, the surgical indications and operative findings were reviewed. Overall, 34 consecutive patients were enrolled in this study. Five patients underwent surgery, and all of their surgical indications were attributable to liver-related complications after injury. The indication for surgery was hemodynamic instability in 3 patients with hepatic vein injures in the early phase (<15 hours after estrogen receptor (ER) arrival) and intra-abdominal septic complications in 2 patients in the late phase (hospital days 14 and 64). The cumulative 80-day laparotomy rate in the early phase was significantly higher (p<0.0001) in the patients suspected of having hepatic vein injury, and in the late phase it was higher (p=0.002) in those with injuries in 4 or more segments of hepatic injuries. For the successful NOM of blunt hepatic injury type IIIb in patients who are hemodynamically stable after fluid resuscitation, a strong suspicion of concurrent hepatic vein injury is critical in the early phase, and laceration in 4 or more segments should be noted in the late phase. (author)
contemporary challenge to sensitize and synergize instructional, ... project financial outcomes as underscored in this work. ... Balance of payments. .... Problem diagnosis/solutions. **. *** .... Money, Work, Sex, Kids, and Life's Other Challenges.
It is difficult to find a visual representation of any fat individual, let alone a queer woman, that is not denigrating and oppressive in conventional media outlets and contemporary visual culture. But even as the negative imagery of fat individuals has expanded over the past forty years in mainstream distribution channels, fat-positive imagery has come to the fore within many feminist and lesbian publications during this same time frame. This article looks at the strategies of representation taken by three contemporary United States lesbian feminist periodicals in visualizing fat and lesbian women within their pages since the 1980s.
M. A. Rodionov
Full Text Available The problematic aspects have been considered with regard to the information and analytical support of a strategic decision making in the modern management. The role and place are clarified in relation to a process of elaboration and making a management decision in strategic planning. The existing approaches are analyzed regarding the estimating of regularities in the course and outcome of strategic processes. The strategic forecasting matters have been studied as well as a decision maker`s attitude to the risks.
Krekelberg, William P; Siderius, Daniel W; Shen, Vincent K; Truskett, Thomas M; Errington, Jeffrey R
Using molecular simulations, we investigate how the range of fluid-fluid (adsorbate-adsorbate) interactions and the strength of fluid-solid (adsorbate-adsorbent) interactions impact the strong connection between distinct adsorptive regimes and distinct self-diffusivity regimes reported in [Krekelberg, W. P.; Siderius, D. W.; Shen, V. K.; Truskett, T. M.; Errington, J. R. Langmuir 2013 , 29 , 14527-14535]. Although increasing the fluid-fluid interaction range changes both the thermodynamics and the dynamic properties of adsorbed fluids, the previously reported connection between adsorptive filling regimes and self-diffusivity regimes remains. Increasing the fluid-fluid interaction range leads to enhanced layering and decreased self-diffusivity in the multilayer-formation regime but has little effect on the properties within film-formation and pore-filling regimes. We also find that weakly attractive adsorbents, which do not display distinct multilayer formation, are hard-sphere-like at super- and subcritical temperatures. In this case, the self-diffusivity of the confined and bulk fluid has a nearly identical scaling-relationship with effective density.
Peeters, M.C.W.; Jonge, de J.; Taris, Toon W.
This is the first comprehensive overview of work psychology, with coverage of classic models, current theories, and contemporary issues affecting the 21st-century worker. Examines the positive aspects of work–motivation, performance, creativity, and engagement—instead of focusing only on adverse
Background As part of research investigating the complexities of managing fertility in Australia, public opinions about how Australians manage their fertility were sought from women and men. Objective To identify public opinion about sexual and reproductive health in Australia. Methods To ensure access to a diverse group of people throughout Australia, an online group was advertised and convened on Facebook from October through December 2013. In a closed-group moderated discussion, participants responded to questions about how people in Australia attempt to manage three aspects of fertility: avoiding pregnancy, achieving pregnancy, and difficulties conceiving. Nonidentifiable demographic information was sought; no personal accounts of fertility management were requested. The discussion transcript was analyzed thematically. Results There were 61 female and 2 male Facebook users aged 18 to 50 years living in Australia participating in the study. Four main themes about fertility management were identified: access, geographical location, knowledge, and cost. Participants reported that young people and people from rural areas face barriers accessing contraception and fertility services. Limited knowledge about sex and reproduction and the cost of fertility services and contraception were also said to impede effective fertility management. Conclusions Reasons for inequalities in effective fertility management that are amenable to change were identified. Facebook is an effective method for gaining insights into public opinion about sexual and reproductive health. PMID:26878865
Kiseleva, T. V.; Mikhailov, V. G.; Mikhailov, G. S.
The article deals with the effective functioning of ecological and economic systems of various levels on the basis of an adequate organizational and economic management mechanism. The compliance matrix of the presented innovative elements in the structure of organizational and economic mechanism of environmental management is developed. The practical component of the conducted study can be recommended to municipal, regional and federal authorities, as well as industrial enterprises, to support effective, environmentally reasonable management decisions that are consistent with the global concept of sustainable development.
Jorns, J J; Thiel, D D; Castle, E P
Renal cell carcinoma (RCC) continues to increase in incidence with the largest increase manifesting in small, organ-confined tumors. This review outlines the epidemiology and current data pertaining to the management of clinically-localized RCC. In this manuscript, the current data outlining the benefit of nephron sparing to the overall survival of the patient is described. The data pertaining to minimally invasive nephron sparing is also explained in detail. From laparoscopic and robotic partial nephrectomy to watchful waiting and percutaneous ablation, the urologist is continually assaulted with new data for the management of clinically-localized RCC. The data can be confusing, and much of it is conflicting. The addition of new scoring systems or nomograms may aid in predicting which therapy would be most beneficial in certain patient groups. New scoring systems may also predict the difficulty of surgical resection and predict surgical complications. The limitations of the data pertaining to the management of clinically-localized RCC are also outlined.
Ergonomists need to adopt a more proactive approach to management concepts. it is insufficient to wait until the workplace examples have evolved.In the contribution BPR is used as an examplar of a typical contemporary management concept....
Champagne, Pierre-Olivier; Decarie, Jean-Claude; Crevier, Louis; Weil, Alexander G
Hydrocephalus is a common condition in the pediatric population known to have many causes and presentation patterns. We report from the analysis of 2 cases the existence of a new complication of pediatric hydrocephalus. Naming this entity "dissecting intraparenchymal cerebrospinal fluid collection", we advance a hypothesis regarding its pathophysiology and discuss its clinical implications and management. Copyright © 2018 Elsevier Ltd. All rights reserved.
Jackman, W. Marc
This article examines the key tenets of contemporary education philosophy and compares it to the principles of the Adventist educational philosophy. The intent is to determine whether Adventist educational philosophy aligns with the demands of contemporary education. In this vein, 10 key principles of contemporary education are first described.…
Dind, Ashleigh; Allahwala, Usaid; Asrress, Kaleab N; Jolly, Sanjit S; Bhindi, Ravinay
Recent advances have caused a major shift in the way ST-elevation myocardial infarctions are managed. This review explores the pharmacological and interventional techniques that have evidence for improving outcomes and the landmark trials that have sparked change. The new P2Y 12 inhibitors, ticagrelor and prasugrel, have been shown to be superior to clopidogrel in STEMI patients undergoing primary percutaneous coronary intervention. Concurrently, many technical aspects of percutaneous coronary intervention have been further clarified by trial data, with bare-metal stents, routine thrombus aspiration and femoral access showing evidence of inferiority. Ongoing trials will provide more information on the role of non-culprit lesion PCI, bioresorbable vascular scaffolds, mechanical devices in persistent ischaemia and early automatic implantable cardioverter-defibrillators for inducible ventricular tachycardia. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.
Ulhøi, John Parm; Madsen, Henning
This paper reports empirical findings from a recent survey of Danish managers with a special focus on managers from smaller companies. The survey has been initiated in Denmark and it is called the 'Danish Management Barometer'. The project is a joint research program between the Aarhus School...... of Business and the Danish Association of Managers and Executives. It is based on a structured, pre-tested questionnaire send out to 1500 pre-notified managers in Denmark aiming at establishing a data base to further monitor and identify interesting changes and patterns within a broad range of managerial...
Banerjee, A.; Frencken, J.E.F.M.; Schwendicke, F.; Innes, N.P.
The International Caries Consensus Collaboration (ICCC) presented recommendations on terminology, on carious tissue removal and on managing cavitated carious lesions. It identified 'dental caries' as the name of the disease that dentists should manage, and the importance of controlling the activity
Full Text Available The subject matter of this paper is divorce by mutual consent in Roman law and contemporary law. In the first part of this article, the authors analyzes the key tenets of consensual divorce in Roman law, with specific reference to the impact of Christian religious teaching on the concepts of marriage and divorce as well as on the Roman rulers' constitutions, which marked the beginning of the process of restricting the right to divorce. In the central part of the paper, the authors examines the regulation on the consensual divorce in some contemporary legal systems. In addition, the authors provides a substantial analysis of the normative framework on the termination of marriage in the positive Serbian legislation. In the final part of the paper, the authors provides a comparative analysis and underscores the observed similarities and differenced in the regulation of the institute of consensual divorce in Roman law and in the contemporary legislation.
Sander L. Gilman
Full Text Available The question I wish to address in this essay is really quite simple: Given the fact that there are "Jews" who seem to play a major role in contemporary German "Kultur" (at least that narrower definition of culture, meaning the production of cultural artifacts, such as books—a field which, at least for Englemann, was one of the certain indicators of a Jewish component in prewar German culture—what happened to these "Jews" (or at least the category of the "Jewish writer" in postwar discussions of culture? Or more simply: who lulled the remaining Jews in contemporary German culture and why? Why is it not possible to speak about "German-Jews" in the contemporary criticism about German culture? And, more to the point, what is the impact of this denial on those who (quite often ambivalently see (or have been forced to see themselves as "Germans" and "Jews," but not as both simultaneously.
Title: Time management in sport managers The main goal of this project was to describe the problems of time management in sport managers. This project analyses the contemporary situation, describes and compares the time management in five managers that represent the sport sphere in the Czech Republic: the manager of sport shop, the manager of the fitness centre, the manager of youth football club, the manager of football team and the manager of track and field club. A qualitative research was...
Demarco, Daniela Cassar; Papachristidis, Alexandros; Roper, Damian; Tsironis, Ioannis; Byrne, Jonathan; Monaghan, Mark
Objectives To compare how patients with chest pain would be investigated, based on the two guidelines available for UK cardiologists, on the management of patients with stable chest pain. The UK National Institute of Clinical Excellence (NICE) guideline which was published in 2010 and the European society of cardiology (ESC) guideline published in 2013. Both guidelines utilise pre-test probability risk scores, to guide the choice of investigation. Design We undertook a large retrospective study to investigate the outcomes of stress echocardiography. Setting A large tertiary centre in the UK in a contemporary clinical practice. Participants Two thirds of the patients in the cohort were referred from our rapid access chest pain clinics. Results We found that the NICE risk score overestimates risk by 20% compared to the ESC Risk score. We also found that based on the NICE guidelines, 44% of the patients presenting with chest pain, in this cohort, would have been investigated invasively, with diagnostic coronary angiography. Using the ESC guidelines, only 0.3% of the patients would be investigated invasively. Conclusion The large discrepancy between the two guidelines can be easily reduced if NICE adopted the ESC risk score. PMID:26673458
Lallemand, A. [Institut National des Sciences Appliquees (INSA), 69 - Lyon (France)
In the framework of the diminution of heat transfer fluid consumption, the concept of indirect refrigerating circuits, using cooling intermediate fluids, is reviewed and the fluids that are currently used in these systems are described. Two-phase cooling fluids advantages over single-phase fluids are presented with their thermophysical characteristics: solid fraction, two-phase mixture enthalpy, thermal and rheological properties, determination of heat and mass transfer characteristics, and cold storage through ice slurry
Lahner, D; Kabon, B; Marschalek, C; Chiari, A; Pestel, G; Kaider, A; Fleischmann, E; Hetz, H
Fluid management guided by oesophageal Doppler monitor has been reported to improve perioperative outcome. Stroke volume variation (SVV) is considered a reliable clinical predictor of fluid responsiveness. Consequently, the aim of the present trial was to evaluate the accuracy of SVV determined by arterial pulse contour (APCO) analysis, using the FloTrac/Vigileo system, to predict fluid responsiveness as measured by the oesophageal Doppler. Patients undergoing major abdominal surgery received intraoperative fluid management guided by oesophageal Doppler monitoring. Fluid boluses of 250 ml each were administered in case of a decrease in corrected flow time (FTc) to 10%. The ability of SVV to predict fluid responsiveness was assessed by calculation of the area under the receiver operating characteristic (ROC) curve. Twenty patients received 67 fluid boluses. Fifty-two of the 67 fluid boluses administered resulted in fluid responsiveness. SVV achieved an area under the ROC curve of 0.512 [confidence interval (CI) 0.32-0.70]. A cut-off point for fluid responsiveness was found for SVV > or =8.5% (sensitivity: 77%; specificity: 43%; positive predictive value: 84%; and negative predictive value: 33%). This prospective, interventional observer-blinded study demonstrates that SVV obtained by APCO, using the FloTrac/Vigileo system, is not a reliable predictor of fluid responsiveness in the setting of major abdominal surgery.
Fractures, whether natural or engineered, exert significant controls over resource exploitation from contemporary energy sources including enhanced geothermal systems and unconventional oil and gas reserves. Consequently, fracture characterization, i.e., estimating the permeability, connectivity, and spacing of the fractures is of critical importance for determining the viability of any energy recovery program. While some progress has recently been made towards estimating these critical fracture parameters, significant uncertainties still remain. A review of tracer technology, which has a long history in fracture characterization, reveals that uncertainties exist in the estimated parameters not only because of paucity of scale-specific data but also because of knowledge gaps in the interpretation methods, particularly in interpretation of tracer data in reactive fluid-rock systems. We have recently demonstrated that the transient tracer evolution signatures in reactive fluid-rock systems are significantly different from those in non-reactive systems (Mukhopadhyay et al., 2013, 2014). For example, the tracer breakthrough curves in reactive fluid-fractured rock systems are expected to exhibit a long pseudo-state condition, during which tracer concentration does not change by any appreciable amount with passage of time. Such a pseudo-steady state condition is not observed in a non-reactive system. In this paper, we show that the presence of this pseudo-steady state condition in tracer breakthrough patterns in reactive fluid-rock systems can have important connotations for fracture characterization. We show that the time of onset of the pseudo-steady state condition and the value of tracer concentration in the pseudo-state condition can be used to reliably estimate fracture spacing and fracture-matrix interface areas.
Full Text Available The article discusses the recent international interest in contemporary Romanian art and its growth in market share, with a focus on the United States. The theme is followed thorough in numerous museum exhibitions, increased collector following, art fair presence, gallery representation and auction activity initially in Europe and the United States. The phenomenon is discussed both in the context of the larger international movement conducive to the contemporary art price bubble, and in that of the local socio-economic changes. My chief interest lies in the factors leading up to the entry of post 1989 Romanian art in the global arena as a manifestation of market forces in the field. The analysis follows its grass roots local emergence through non-profit institutions, individual artists, small publications, low budget galleries, as well as the lack of contribution (with few notable exceptions of state institutions, while pointing out the national context of increasing deregulation of social support systems resulting in lack of focus on cultural manifestations. The conclusion is that the recent ascent of contemporary Romanian art (and coincidentally, the award winning contemporary Romanian cinematography is a fortuitous convergence of various factors, among which, increased international mobility and sharing. At the same time, it is also the result of the evolution of various individual artists that pursued a form of art rooted in Romanian artistic tradition but with a focus on the symbolic figurative. The result is a personal semiotics of raising the mundane to extraordinary levels that reconfigured the anxiety of entering a new system into an unmistakable and lasting visual language.
Flaker, Greg C; Theriot, Paul; Binder, Lea G; Dobesh, Paul P; Cuker, Adam; Doherty, John U
Interruption of oral anticoagulation (AC) for surgery or an invasive procedure is a complicated process. Practice guidelines provide only general recommendations, and care of such patients occurs across multiple specialties. The availability of direct oral anticoagulants further complicates decision making and guidance here is limited. To evaluate current practice patterns in the United States for bridging AC, a survey was developed by the American College of Cardiology Anticoagulation Work Group. The goal of the survey was to assess how general and subspecialty cardiologists, internists, gastroenterologists, and orthopedic surgeons currently manage patients who receive AC and undergo surgery or an invasive procedure. The survey was completed by 945 physicians involved in the periprocedural management of AC. The results provide a template for educational and research projects geared toward the development of clinical pathways and point-of-care tools to improve this area of health care. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Full Text Available The concept of conflict, being an outcome of behaviours, is an integral part of human life. Wherever there is a difference of opinion there are chances of conflict. Managing conflict effectively demands multifarious professional abilities and acumen. To resolve and manage conflict, the organisations must understand the causes, theories, approaches and strategies of conflict management. Conflict and stress are interlinked as they are dependent on each other. It is a psychological phenomenon that requires a high level of attention and thorough understanding. It appears that there is a very little margin to remain unaffected from the clutches of stress in contemporary time.
Petrick, Joseph A.; Polak, George G.; Scherer, Robert F.; Munoz, Carmen Gloria
Criticisms of graduate management education have led to changes in the balance between business and academic standards, strategic leadership, curriculum, faculty performance incentives, graduate proficiencies, and relations with the business community. Operations management/management sciences have similarly changed in terms of curricular…
Walsh, D M
Kant's conception of organisms as natural purposes raises a challenge to the adequacy of mechanistic explanation in biology. Certain features of organisms appear to be inexplicable by appeal to mechanical law alone. Some biological phenomena, it seems, can only be accounted for teleologically. Contemporary evolutionary biology has by and large ignored this challenge. It is widely held that Darwin's theory of natural selection gives us an adequate, wholly mechanical account of the nature of organisms. In contemporary biology, the category of the organism plays virtually no explanatory role. Contemporary evolutionary biology is a science of sub-organismal entities-replicators. I argue that recent advances in developmental biology demonstrate the inadequacy of sub-organismal mechanism. The category of the organism, construed as a 'natural purpose' should play an ineliminable role in explaining ontogenetic development and adaptive evolution. According to Kant the natural purposiveness of organisms cannot be demonstrated to be an objective principle in nature, nor can purposiveness figure in genuine explain. I attempt to argue, by appeal to recent work on self-organization, that the purposiveness of organisms is a natural phenomenon, and, by appeal to the apparatus of invariance explanation, that biological purposiveness provides genuine, ineliminable biological explanations.
Riisgaard, Lone; Gibbon, Peter
This paper describes the labour management system applied since around 2005 on farms accounting for the bulk of the output of the Kenyan cut flower sector, and provides an analysis of the foundations of this system. Using categories drawn from convention theory, this system is characterized...... in terms of specific approaches to hiring, training and promotion; labour retention; work organization and worker deployment; payment systems and supervision, as well as to collective bargaining. In convention theory terms, the combination of approaches identified in Kenya embodies a mixture of ‘industrial...
Rasmussen, Henrik Koblitz; Hassager, Ole; Saasen, Arild
The arbitrary Lagrange-Euler (ALE) kinematic description has been implemented in a 3D transient finite element program to simulate multiple fluid flows with fluid-fluid interface or surface displacements. The description of fluid interfaces includes variable interfacial tension, and the formulation...... is useful in the simulation of low and intermediate Reynolds number viscous flow. The displacement of two immiscible Newtonian fluids in a vertical (concentric and eccentric) annulus and a (vertical and inclined)tube is simulated....
Considers contemporary Russian usage with regard to variations in the genitive, accusative and nominative inflections and the synonymity of full and shortened adjective forms. Material is excerpted from "Stilistik der russischen Sprache" (Russian Language Style) by D. Rosental and M. Telenkowa. (Text is in German.) (FB)
Many contemporary theories approach international law-making with a shift in emphasis from the sources of law towards the communicative practices in which a plethora of actors use, claim and speak international law. Whereas earlier approaches would look at the sources as the singular moment of
Elham Hosseini; Gurupiah Mursib; Raja Nafida Raja Shahminan
Traditional houses are the most essential architectural experience that is in harmony with the people's culture, beliefs, environment and lifestyles. The development of design values in contemporary architecture by tracking traditional design values in architecture paves the way for arguments concerning the implementation of authentic Malay traditional house design values in contemporary Malay houses. In addition, it is hypothesized that the Malay traditional houses theoretically provide a co...
Epps, J.M. (Epps and Associates Pty. Ltd. (Australia))
The environmental audit is a system of review of the environmental management of a mine or facility. The development of environmental audit requirements in Australia is noted and the different types of audit are explained. An example of a mine development in New South Wales is used. 2 tabs.
Full Text Available This article examines the spiritual value and role of dreams in the lives of South African Christians, based on the findings of a qualitative research project in which semistructured interviews were used to examine the dream-related beliefs and practices of contemporary Christians. The findings indicated that dreams are still considered to be of distinct religious value and importance by a significant number of the Christian participants who took part in the study. Specifically, the participants reported that their dreams often serve as source of spiritual inspiration, insight and guidance, as well as feedback on decisions and ways of living. It was also indicated that dreams sometimes constituted an important natural resource in coming to terms with bereavement. In response to this, the article closes with a call for a re-evaluation of the position and value of dreams in contemporary Christianity, and offers several practical suggestions for working with dreams in a spiritual context.
Corbella, Davide; Toppin, Patrick Jason; Ghanekar, Anand; Ayach, Nour; Schiff, Jeffery; Van Rensburg, Adrian; McCluskey, Stuart A
Intravenous fluid management for deceased donor kidney transplantation is an important, modifiable risk factor for delayed graft function (DGF). The primary objective of this study was to determine if goal-directed fluid therapy using esophageal Doppler monitoring (EDM) to optimize stroke volume (SV) would alter the amount of fluid given. This randomized, proof-of-concept trial enrolled 50 deceased donor renal transplant recipients. Data collected included patient characteristics, fluid administration, hemodynamics, and complications. The EDM was used to optimize SV in the EDM group. In the control group, fluid management followed the current standard of practice. The groups were compared for the primary outcome of total intraoperative fluid administered. There was no difference in the mean (standard deviation) volume of intraoperative fluid administered to the 24 control and 26 EDM patients [2,307 (750) mL vs 2,675 (842) mL, respectively; mean difference, 368 mL; 95% confidence interval (CI), - 87 to + 823; P = 0.11]. The incidence of complications in the control and EDM groups was similar (15/24 vs 17/26, respectively; P = 0.99), as was the incidence of delayed graft failure (8/24 vs 11/26, respectively; P = 0.36). Goal-directed fluid therapy did not alter the volume of fluid administered or the incidence of complications. This proof-of-concept trial provides needed data for conducting a larger trial to determine the influence of fluid therapy on the incidence in DGF in deceased donor kidney transplantation. www.clinicaltrials.gov (NCT02512731). Registered 31 July 2015.
Imazio, Massimo; Gaido, Luca; Battaglia, Alberto; Gaita, Fiorenzo
A pericardial effusion (PE) is a relatively common finding in clinical practice. It may be either isolated or associated with pericarditis with or without an underlying disease. The aetiology is varied and may be either infectious (especially tuberculosis as the most common cause in developing countries) or non-infectious (cancer, systemic inflammatory diseases). The management is essentially guided by the hemodynamic effect (presence or absence of cardiac tamponade), the presence of concomitant pericarditis or underlying disease, and its size and duration. The present paper reviews the current knowledge on the aetiology, classification, diagnosis, management, therapy, and prognosis of PE in clinical practice.
Full Text Available The geography includes rich, diverse and comprehensive themes that give us an understanding of our changing environment and interconnected world. It includes the study of the physical environment and resources; cultures, economies and societies; people and places; and global development and civic participation. As a subject, geography is particularly valuable because it provides information for exploring contemporary issues from a different perspective. This geographical information affects us all at work and in our daily lives and helps us make informed decisions that shape our future. All these facts result in a wide discussion on many topical issues in contemporary geography didactics. Subjects of research are the new geography and economics curriculum as well as construction of modern learning process. The paper presents briefly some of the current trends and key issues of geodidactics. As central notions we consider and analyze the training/educational goals, geography curriculum, target groups and environment of geography training, training methods as well as the information sources used in geography education. We adhere that all the above-mentioned finds its reflection in planning, analysis and assessment of education and thus in its quality and effectiveness.
Jensen, Jakob Søndergaard
This work considers nonlinear fluid-structure interaction for a vibrating pipe containing fluid. Transverse pipe vibrations will force the fluid to move relative to the pipe creating unidirectional fluid flow towards the pipe end. The fluid flow induced affects the damping and the stiffness...... of the pipe. The behavior of the system in response to lateral resonant base excitation is analysed numerically and by the use of a perturbation method (multiple scales). Exciting the pipe in the fundamental mode of vibration seems to be most effective for transferring energy from the shaker to the fluid......, whereas higher modes of vibration can be used to transport fluid with pipe vibrations of smaller amplitude. The effect of the nonlinear geometrical terms is analysed and these terms are shown to affect the response for higher modes of vibration. Experimental investigations show good agreement...
As historians of science increasingly turn to work on recent (post 1945) science, the historiographical and methodological problems associated with the history of contemporary science are debated with growing frequency and urgency. Bringing together authorities on the history, historiography and methodology of recent and contemporary science, this book reviews the problems facing historians of technology, contemporary science and medicine, and explores new ways forward. With contributions from key researchers in the field, the text covers topics that will be of ever increasing interest to historians of post-war science, including the difficulties of accessing and using secret archival material, the interactions between archivists, historians and scientists, and the politics of evidence and historical accounts.
Favero, N.; Meier, K.J.; O'Toole, Laurence J.
Much recent work in the study of public administration has emphasized new challenges, and relatively unusual aspects of management, such as managerial networking and interorganizational collaboration, cross-sectoral partnerships, the centrality of information technology in contemporary management,
Sanyal, Chiranjeev; Aprikian, Armen; Cury, Fabio; Chevalier, Simone; Dragomir, Alice
Background Prostate cancer (PCa) is the most common non-skin cancer among men in developed countries. Several novel treatments have been adopted by healthcare systems to manage PCa. Most of the observational studies and randomized trials on PCa have concurrently evaluated fewer treatments over short follow-up. Further, preceding decision analytic models on PCa management have not evaluated various contemporary management options. Therefore, a contemporary decision analytic model was necessary to address limitations to the literature by synthesizing the evidence on novel treatments thereby forecasting short and long-term clinical outcomes. Objectives To develop and validate a Markov Monte Carlo model for the contemporary clinical management of PCa, and to assess the clinical burden of the disease from diagnosis to end-of-life. Methods A Markov Monte Carlo model was developed to simulate the management of PCa in men 65 years and older from diagnosis to end-of-life. Health states modeled were: risk at diagnosis, active surveillance, active treatment, PCa recurrence, PCa recurrence free, metastatic castrate resistant prostate cancer, overall and PCa death. Treatment trajectories were based on state transition probabilities derived from the literature. Validation and sensitivity analyses assessed the accuracy and robustness of model predicted outcomes. Results Validation indicated model predicted rates were comparable to observed rates in the published literature. The simulated distribution of clinical outcomes for the base case was consistent with sensitivity analyses. Predicted rate of clinical outcomes and mortality varied across risk groups. Life expectancy and health adjusted life expectancy predicted for the simulated cohort was 20.9 years (95%CI 20.5–21.3) and 18.2 years (95% CI 17.9–18.5), respectively. Conclusion Study findings indicated contemporary management strategies improved survival and quality of life in patients with PCa. This model could be used
Considers two aspects of contemporary Russian language usage: (1) synonymity of prepositions, and (2) semantic and stylistic differences arising when certain verbs govern nouns in different cases. Material is excerpted from "Stilistik der russischen Sprache" (Russian Language Style) by Rosental and M. Telenkowa. (Text is in German.) (FB)
Jensen, Ole B.
further back to touch upon the legacy of Marinetti/Futurism and Le Corbusier). These ideas and visions, which at their time was considered extreme and far-fetched, are used as ‘prisms' for setting up the imaginary visioning of contemporary and future challenges to mobility within and between cities...
Full Text Available Time, the only non-replaceable resource is quite difficult to manage, although as it has been studied over and over again time management can be of crucial importance for a contemporary business organization. Individuals and managers in particular, must learn how to make the best out of their time and use time management as a tool in gaining and maintaining a competitive advantage. Although, researchers from throughout the world have managed to identify and develop hundreds if not even thousands of different time management approaches and techniques, it can be easily argued that such techniques are unknown when it comes to business in the Republic of Macedonia in general and the Pollog region in particular. But, the lack of a scientific approach does not necessarily mean a lack of dedication to a better usage of time by employees and managers alike. The paper strives to present the results of a rather extensive field research on time management implemented by the authors in over fifty business entities in the region.
This paper discusses the use of contemporary legends in the teaching of language and culture, specifically in English-as-a-second-language. Contemporary legends are a type of folk narrative, but unlike folk tales, they are believed to be true. They usually concern ordinary people who are known to the narrator, occur in familiar settings, and are…
Full Text Available A contemporary house located within a dense area of Dhaka, the capital city of Bangladesh was selected to evaluate its thermal performance. The study was based on the field measurements conducted during selected days in the summer period. The field survey was conducted using one set of thermal data logger installed in the selected house to record the air temperature and relative humidity of both indoor and outdoor spaces. The research result concluded that the contemporary house experienced much higher temperature during night and early morning. The indoor air temperature during the daytime was equal to the outdoor or sometime higher illustrating that it was overheating. On the other hand, previous study on traditional house within the same area showed that indoor air temperature was lower than outdoor air temperature, something that the contemporary house failed to achieve.
Full Text Available Realization of the determined targets in drastically changed working conditions requires development of new approaches, new business models and ideas of management. As a consequence, managerial practice and methods significantly changed in the last decade of the 20th century and those changes have been continuing in the 21st century. In that context, contemporary trends present in the managerial accounting are associated with its strategic concepts, such as: activity based costing system, just-in-time system and total quality management. Starting from the a.m., the main objective of this research will be directed towards providing data for that if Macedonian business entities are familiar with these concepts and how much they implement them. For this purposewe carried out a survey on a representative sample of Macedonian companies.The examination conducted in this paper shows that business entities in R. Macedonia still apply these accounting techniques not sufficiently. Obtained results are presented within this paper in details.
Robertson, Michael; Light, Edwina; Lipworth, Wendy; Walter, Garry
In this paper we survey briefly the components of the Holocaust directly relevant to the psychiatric profession and identify the main themes of relevance to contemporary psychiatry. The ‘euthanasia’ program; the persecution of lesbian, gay, bisexual, transgender, and intersex (LGBTI) citizens; and the complex relationship between the psychiatric profession and Nazi state are the main themes to emerge from this survey. We then compare this period with key themes in the history of Australian psychiatry and link these themes to some of the contemporary ethical challenges the profession faces.
Yankee Atomic Electric Company has developed the component degradation assessment tool (CoDAT), an expert system, that aids in handling and evaluating the large amounts of data required to support the license renewal process for nuclear power station fluid systems. In 1990, CoDAT evaluated the Yankee Nuclear Power Station fluid systems for age-related degradation. Its results are now being used to help focus the plant's maintenance programs and manage the expected degradation. CoDAT uses 'If-Then' rules, developed from industry codes, standards and publications, to determine the potential for 19 age-related degradation mechanisms. Other nuclear utilities pursuing the license renewal option also could use CoDAT. (author)
hand, governments and military services hope to develop game-changing technologies, that are ‘better, faster and cheaper’. In this paper, I wish to show how different and competing regimes of justification shape the technopolitical controversy and risk management of autonomous weapon systems...... of justification and risk management in contemporary conflicts....
Graney, K.; Chu, J.; Lin, P.C.
Full text: A 78-year old male in end stage renal failure (ESRF) with a background of NIDDM retinopathy, nephropathy, and undergoing continuous ambulatory peritoneal dialysis (CAPD) presented with anorexia, clinically unwell, decreased mobility and right scrotal swelling. There was no difficulty during CAPD exchange except there was a positive fluid balance Peritoneal dialysates remained clear A CAPD peritoneal study was requested. 100Mbq 99mTc Sulphur Colloid was injected into a standard dialysate bag containing dialysate. Anterior dynamic images were acquired over the abdomen pelvis while the dialysate was infused Static images with anatomical markers were performed 20 mins post infusion, before and after patient ambulation and then after drainage. The study demonstrated communication between the peritoneal cavity and the right scrotal sac. Patient underwent right inguinal herniaplasty with a marlex mesh. A repeat CAPD flow study was performed as follow up and no abnormal connection between the peritoneal cavity and the right scrotal sac was demonstrated post operatively. This case study shows that CAPD flow studies can be undertaken as a simple, minimally invasive method to evaluate abnormal peritoneal fluid flow dynamics in patients undergoing CAPD, and have an impact on dialysis management. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc
Chung, Hye Won; Lee, Kyung Won [Seoul Naitonal University, Seoul (Korea, Republic of). Coll. of Medicine; Song, Chi Sung [Seoul City Boramae Hospital, Seoul (Korea, Republic of); Han, Sang Wook; Kang, Heung Sik [Seoul Naitonal University, Seoul (Korea, Republic of). Coll. of Medicine
To evaluate the frequency, number and signal intensity of fluid-fluid levels of musculoskeletal diseases on MR images, and to determine the usefulness of this information for the differentiation of musculoskeletal diseases. MR images revealed fluid-fluid levels in the following diseases : giant cell tumor(6), telangiectatic osteosarcoma(4), aneurysmal bone cyst(3), synovial sarcoma(3), chondroblastoma(2), soft tissue tuberculous abscess(2), hematoma(2), hemangioma (1), neurilemmoma(1), metastasis(1), malignant fibrous histiocytoma(1), bursitis(1), pyogenic abscess(1), and epidermoid inclusion cyst(1). Fourteen benign tumors and ten malignant, three abscesses, and the epidermoid inclusion cyst showed only one fluid-fluid level in a unilocular cyst. On T1-weighted images, the signal intensities of fluid varied, but on T2-weighted images, superior layers were in most cases more hyperintense than inferior layers. Because fluid-fluid layers are a nonspecific finding, it is difficult to specifically diagnose each disease according to the number of fluid-fluid levels or signal intensity of fluid. In spite of the nonspecificity of fluid-fluid levels, they were frequently seen in cases of giant cell tumor, telangiectatic osteosarcoma, aneurysmal bone cycle, and synovial sarcoma. Nontumorous diseases such abscesses and hematomas also demonstrated this finding. (author). 11 refs., 1 tab., 4 figs.
Chung, Hye Won; Lee, Kyung Won; Han, Sang Wook; Kang, Heung Sik
To evaluate the frequency, number and signal intensity of fluid-fluid levels of musculoskeletal diseases on MR images, and to determine the usefulness of this information for the differentiation of musculoskeletal diseases. MR images revealed fluid-fluid levels in the following diseases : giant cell tumor(6), telangiectatic osteosarcoma(4), aneurysmal bone cyst(3), synovial sarcoma(3), chondroblastoma(2), soft tissue tuberculous abscess(2), hematoma(2), hemangioma (1), neurilemmoma(1), metastasis(1), malignant fibrous histiocytoma(1), bursitis(1), pyogenic abscess(1), and epidermoid inclusion cyst(1). Fourteen benign tumors and ten malignant, three abscesses, and the epidermoid inclusion cyst showed only one fluid-fluid level in a unilocular cyst. On T1-weighted images, the signal intensities of fluid varied, but on T2-weighted images, superior layers were in most cases more hyperintense than inferior layers. Because fluid-fluid layers are a nonspecific finding, it is difficult to specifically diagnose each disease according to the number of fluid-fluid levels or signal intensity of fluid. In spite of the nonspecificity of fluid-fluid levels, they were frequently seen in cases of giant cell tumor, telangiectatic osteosarcoma, aneurysmal bone cycle, and synovial sarcoma. Nontumorous diseases such abscesses and hematomas also demonstrated this finding. (author). 11 refs., 1 tab., 4 figs
Beatles and Rolling Stones groups, the astronaut J. Glenn, Dzh. (sic) Eisenhower and J. Kennedy, M.L. King and the screen actor M. Brando. At the ...JPRS-UWC-87-002 15 October 1987 FOREIGN BROADCAST INFORMATION SERVICE JPRS Report— Soviet Union THE WORKING CLASS & THE CONTEMPORARY WORLD...MmmKmoN STATEMENT A 19980714 146 mcWAUTtmBPBVmi Soviet Union The Working Class & The Contemporary World No 3, May-June 1987 JPRS-UWC-87-002
Khalid, Sameen; Abbass, Aamer; Nellis, Eric; Shah, Shashin; Shah, Hiral
Pancreatic pseudocysts and walled-off pancreatic necrosis arise as a complication of pancreatitis. Multiple fluid collections are seen in 5-20% of the patients who have walled-off peripancreatic fluid collections. There is a paucity of data regarding the role of endoscopic transmural drainage in the management of multiple pancreatic fluid collections. In this case report, we present the case of a 72-year-old male with three walled-off pancreatic fluid collections in the setting of acute necrotizing pancreatitis. The patient underwent simultaneous endoscopic ultrasound-assisted cyst gastrostomy and cyst duodenostomy and aggressive irrigation without index endoscopic necrosectomy of the three peripancreatic fluid collections. Significant improvement in the size of the fluid collections was seen on the computed tomography scan, as well as a remarkable immediate clinical improvement after 24 hours of the endoscopic intervention.
Bentley, Yongmei; Richardson, Diane; Duan, Yanqing; Philpott, Elly; Ong, Vincent; Owen, David
This article reports on the application of Research-Informed Curriculum Design (RICD) for the development and implementation of an MSc Program in Project Management. The research focused on contemporary issues in project management and provided an analysis of project management approaches, tools, and techniques currently used in organizations.…
Tolis, George; Sundt, Thoralf M
Acute Type A Dissection remains a surgical emergency with a relatively high operative mortality despite advances in cardiac surgical techniques and medical management over the past thirty years. In this presentation we will discuss the issues surrounding diagnosis, triage, surgical treatment and perioperative medical management as well as long term surveillance of patients suffering from Acute Type A Dissection and present the literature that supports our management strategies. Expert commentary: The ultimate goal of surgical intervention for patients with Type A Acute Aortic Dissection is an alive patient. A more complicated operation which addresses the root and arch and potentially reduces late complications should be approached with caution since it may increase the operative mortality of the procedure itself. With the recent evolution in endovascular techniques, there is hope that later complications can be reduced without increasing the risk of the primary operation. It remains to be seen whether the improved distal aortic remodeling afforded by a combined open/endovascular approach to Acute Type A Dissection will lead to decreased need for aortic reinterventions and overall long term complications of a residual descending thoracic chronic dissection.
Akkermans, J.; Seibert, S.E.; Mol, S.T.
Orientation – This paper addresses the interplay between individual agency and contextual factors in contemporary career development processes. In light of the prominence of the former in the contemporary scholarly debate, we present a case for a more comprehensive approach by heeding the latter as
Akkermans, Jos; Seibert, Scott E.; Mol, Stefan T.
Orientation: This article addresses the interplay between individual agency and contextual factors in contemporary career development processes. In light of the prominence of the former in the contemporary scholarly debate, we present a case for a more comprehensive approach by heeding the latter as
Andra Aldea-Partanen; Heimo Keränen; Susanna Nevalainen
This paper aims to analyse Project Cycle Management approach in the context of regional development. The theoretical framework covers contemporary concepts typical for regional development and specific project/programme management tools. The comparative approach is used to take into account the two versions of Project Cycle Management presented by European Commission among evaluation methods and instruments, in 1993 and 2001. A practical application is drawn using mid-term evaluation of Baren...
Full Text Available In contemporary houses in Iran, because of changes in the methods of designing and building houses, importance of entrance reduced to such level that now in contemporary houses entrance is just a door. Entrance correlates indoor safe space of house and outdoors. It`s importance lays in controlling entry, exit, territory and hierarchy. Since house owners were satisfied with traditional form of entrance, it is a good idea to learn from them in designing new entrances. The purpose of this research is to find a way for designing appropriate entrances for Iranian contemporary houses. To do this at first 40 traditional houses and 40 contemporary houses in Isfahan and Kashan were selected. These two cities are from margin of desert and the origin of traditional houses of Iran. Analysis showed that blockage of visual and phonic relation, creating a space between outdoor public space and indoor private space, creating access patterns to internal spaces and traits that separate in and out were the most significant properties of traditional entrances. All these traits are ignored in contemporary entrances. Suggestions made for design include creating public meeting space in yard and creating a separate entrance space for each house in apartments.
Full Text Available This paper inspects editorial production in the field of Japanese contemporary architecture, screening the contents of essays written during the last decade (2007–2010 by four selected authors in which a recurring interplay with nature-related subjects is noticeable. This analysis highlights the diversity and intrinsic individual originality of these books by relating their specific approach with the overall work themes of each architect and discussing the existence of a common ground among them. While investigating their philosophical and conceptual standpoints, the paper also attempts to contextualize these discourses both within the larger context of architectural theory—particularly of early postmodern ecological approaches—sustainable construction, and in the milieu of Japan, where an imprinted notion of harmonious coexistence between nature and culture has long been mystified from abroad and from within. By assessing its motives and influence and finally questioning the existence of a paradox amidst the multiple existing forms of paraenvironmental architecture, it is discussed whether these narratives and practices manage to communicate ecoliteracy with their audience. Architecture’s inherent traits as a visual, perceptive, and cognitive discipline to reflect contemporary environmental conflicts and encourage paradigm change are also highlighted.
Сергей Сергеевич Жильцов
The article idedicated to formation and development of Ukrainian nationalism after Ukraine’s independence. The author analyzes fundamental reasons of raise of influence of Ukrainian nationalism. Theoretical foundations of contemporary Ukrainian nationalism are analyzed. In addition, the author evaluates the possible role of nationalism in the future development of Ukraine.
de Oliveira Manoel, Airton Leonardo; Goffi, Alberto; Zampieri, Fernando Godinho; Turkel-Parrella, David; Duggal, Abhijit; Marotta, Thomas R; Macdonald, R Loch; Abrahamson, Simon
Spontaneous intracerebral hemorrhage (ICH), defined as nontraumatic bleeding into the brain parenchyma, is the second most common subtype of stroke, with 5.3 million cases and over 3 million deaths reported worldwide in 2010. Case fatality is extremely high (reaching approximately 60 % at 1 year post event). Only 20 % of patients who survive are independent within 6 months. Factors such as chronic hypertension, cerebral amyloid angiopathy, and anticoagulation are commonly associated with ICH. Chronic arterial hypertension represents the major risk factor for bleeding. The incidence of hypertension-related ICH is decreasing in some regions due to improvements in the treatment of chronic hypertension. Anticoagulant-related ICH (vitamin K antagonists and the newer oral anticoagulant drugs) represents an increasing cause of ICH, currently accounting for more than 15 % of all cases. Although questions regarding the optimal medical and surgical management of ICH still remain, recent clinical trials examining hemostatic therapy, blood pressure control, and hematoma evacuation have advanced our understanding of ICH management. Timely and aggressive management in the acute phase may mitigate secondary brain injury. The initial management should include: initial medical stabilization; rapid, accurate neuroimaging to establish the diagnosis and elucidate an etiology; standardized neurologic assessment to determine baseline severity; prevention of hematoma expansion (blood pressure management and reversal of coagulopathy); consideration of early surgical intervention; and prevention of secondary brain injury. This review aims to provide a clinical approach for the practicing clinician.
Julie K. Gorte; Ross W. Gorte
Discusses both the historic and contemporary influences of economic in formulating USDA, Forest Service fire management policy in allocating money for fire management and in appraising fire effects. Includes a partial listing of publications that deal with resource valuation.
Full Text Available Faculties of Education and Science at Monash University have designed a Masters unit to assist pre-service and in-service science teachers in exploring the practices of contemporary science and examine how varied understandings can influence science communication. Teachers are encouraged to explore their current understandings of the Nature of Science (NoS and to contrast their views with those known to be widely held by society (Cobern & Loving, 1998. Teachers are challenged to provide insights into their thinking relating to the NoS. In order to build understandings of contemporary science practice each teacher shadows a research scientist and engages them in conversations intended to explore the scientists’ views of NoS and practice. Findings suggest that teachers were initially uncomfortable with the challenge to express ideas relating to their NoS and were also surprised how diverse the views of NoS can be among teachers, scientists and their peers, and that these views can directly impact ways of communicating contemporary science practice.
Full Text Available Gender has been an important area of research in the field of popular music studies. Numerous scholars have found that contemporary popular music functions as a locus of diverse constructions and expressions of gender. While most studies focus on content analyses of popular music, there is still a need for more research on audience’s perception of popular music’s messages. This study examined adult Malay listeners’ perceptions of gender messages in contemporary Malay songs. A total of 16 contemporary Malay songs were analysed using Fairclough’s (1992 method of text analysis. The content of the songs that conveyed messages about gender were the basis for analysis. The results showed that the messages revolve mainly around socially constructed gender roles and expectations in romantic relationships. Gender stereotypes are also used in the songs to reinforce men’s and women’s roles in romantic relationships. The results also showed that, while listeners acknowledge the songs’ messages about gender, their own perceptions of gender and what it means to be a gendered being in today’s world are neither represented nor discussed fully in the songs analysed. It is hoped the findings from this, particularly the mismatch between projected and perceived notions of gender, contribute to the field of popular Malay music studies in particular, and popular music studies in general where gender messages in popular songs and their influence on listeners’ perceptions of their own gender is concerned.
Contemporary Journal of African Studies. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 2, No 1 (2014) >. Log in or Register to get access to full text downloads.
Na’ara, Shorook; Amit, Moran; Fridman, Eran; Gil, Ziv
Differentiated thyroid carcinoma (DTC) comprises over 90% of thyroid tumors and includes papillary and follicular carcinomas. Patients with DTC have an excellent prognosis, with a 10-year survival rate of over 90%. However, the risk of recurrent tumor ranges between 5% and 30% within 10 years of the initial diagnosis. Cervical lymph node disease accounts for the majority of recurrences and in most cases is detected during follow-up by ultrasound or elevated levels of serum thyroglobulin. Recurrent disease is accompanied by increased morbidity. The mainstay of treatment of nodal recurrence is surgical management. We provide an overview of the literature addressing surgical management of recurrent or persistent lymph node disease in patients with DTC. PMID:26886954
While developing a measurement acquisition system to be used to retrofit aging aircraft with vehicle health monitoring capabilities, Langley Research Center developed an innovative wireless fluid-level measurement system. The NASA technology was of interest to Tidewater Sensors LLC, of Newport News, Virginia, because of its many advantages over conventional fuel management systems, including its ability to provide an accurate measurement of volume while a boat is experiencing any rocking motion due to waves or people moving about on the boat. These advantages led the company to license this novel fluid-level measurement system from NASA for marine applications.
Сергей Сергеевич Жильцов
Full Text Available The article idedicated to formation and development of Ukrainian nationalism after Ukraine’s independence. The author analyzes fundamental reasons of raise of influence of Ukrainian nationalism. Theoretical foundations of contemporary Ukrainian nationalism are analyzed. In addition, the author evaluates the possible role of nationalism in the future development of Ukraine.
Fouda, Usama M; Sayed, Ahmed M; Abdelmoty, Hatem I; Elsetohy, Khaled A
The aim of this study was to compare the efficacy of ultrasound guided aspiration of hydrosalpinx fluid at the time of oocyte retrieval with salpingectomy in the management of patients with ultrasound visible hydrosalpinx undergoing IVF-ET. One hundred and sixty patients with ultrasound visible hydrosalpinx were randomized into salpingectomy group and aspiration group using computer generated randomization list and sequentially numbered sealed envelopes containing allocation information written on a card. The clinical pregnancy rate per started cycle and the implantation rate were non- significantly higher in the salpingectomy group compared with the aspiration group [40% vs. 27.5% (p value = 0.132) and 18.95% vs. 12.82% (p value =0.124), respectively]. In the aspiration group, 34.21% of patients had rapid re-accumulation of the hydrosalpinx fluid (i.e. within first two weeks after embryo transfer). Whereas, the clinical pregnancy rate per transfer cycle and the implantation rate were significantly higher in salpingectomy group compared with the subgroup of patients with rapid re-accumulation of hydrosalpinx fluid [42.67% vs. 19.23% (p value = 0.036) and 18.95% vs. 7.58% (p value = 0.032), respectively], no significant differences were detected between the salpingectomy group and the subgroup of patients with no re-accumulation of hydrosalpinx fluid (42.67% vs. 34% (p value = 0.356) and 18.95% vs. 15.5% (p value = 0.457), respectively). The small sample size could be the cause of failure of detecting significant increase in implantation and pregnancy rates in salpingectomy group compared with aspiration group. Further larger randomized controlled trials are needed to determine whether salpingectomy is more effective than aspiration of hydrosalpinx fluid or not. Moreover, the data presented in this study suggested that rapid re-accumulation of hydrosalpinx fluid is an obstacle against successful implantation and the cause of lower success rate
Explorations and analysis of soundscapes have, since Canadian R. Murray Schafer's work during the early 1970's, developed into various established research - and artistic disciplines. The interest in sonic environments is today present within a broad range of contemporary art projects and in arch......Explorations and analysis of soundscapes have, since Canadian R. Murray Schafer's work during the early 1970's, developed into various established research - and artistic disciplines. The interest in sonic environments is today present within a broad range of contemporary art projects...... and in architectural design. Aesthetics, psychoacoustics, perception, and cognition are all present in this expanding field embracing such categories as soundscape composition, sound art, sonic art, sound design, sound studies and auditory culture. Of greatest significance to the overall field is the investigation...
Martinez Rosario Domingo
Full Text Available This article explores the relationship between film, contemporary art and cultural memory. It aims to set out an overview of the use of film and media in artworks dealing with memory, history and the past. In recent decades, film and media projections have become some of the most common mediums employed in art installations, multi-screen artworks, sculptures, multi-media art, as well as many other forms of contemporary art. In order to examine the links between film, contemporary art and memory, I will firstly take a brief look at cultural memory and, secondly, I will set out an overview of some pieces of art that utilize film and video to elucidate historical and mnemonic accounts. Thirdly, I will consider the specific features and challenges of film and media that make them an effective repository in art to represent memory. I will consider the work of artists like Tacita Dean, Krzysztof Wodiczko and Jane and Louise Wilson, whose art is heavily influenced and inspired by concepts of memory, history, nostalgia and melancholy. These artists provide examples of the use of film in art, and they have established contemporary art as a site for memory.
Gissel, Line Engbo
This article studies the contemporary expression of transitional justice, a field of practice through which global governance is exercised. It argues that transitional justice is being normalised, given the normative and empirical de-legitimisation of its premise of exceptionalism. The article...... theorises exceptionalism and normalcy in transitional justice and identifies three macro-level causes of normalisation: the legalisation, internationalisation, and professionalization of the field. This argument is illustrated by a study of Uganda’s trajectory of transitional justice since 1986. Across five...... phases of transitional justice, processes of legalisation, internationalisation, and professionalization have contributed to the gradual dismantling of the country’s exceptional justice. The case demonstrates, further, that normalization is a contested and incomplete process....
Bernard, Larry C; Walsh, R Patricia; Mills, Michael
This is an historical review and contemporary empirical evaluation of the Motivation Analysis Test (MAT), one of the first tests to take a psychometric approach to the assessment of motivation. Reviews were quite positive, but the test is now over 50 years old. Nevertheless, it employs innovations in measurement not widely used in objective measurement then or now: (1) subtests with different formats, (2) disguised items, (3) speeded administration procedures, and (4) ipsative format and scoring procedures. These issues are discussed and a contemporary sample (N = 360) obtained to evaluate the Motivation Analysis Test in light of its innovative characteristics.
Egan, William H.
An audio technique uses contemporary music recordings to illustrate various personality disorders, including: schizoid, paranoid, compulsive, antisocial, and hysterical. The works of Bob Dylan, Paul Simon, Harry Chapin, the Beatles, Janis Ian, James Taylor, Tammy Wynette, and others are cited. (LBH)
Bacha, Obiyathulla Ismath
Despite the impressive growth of Islamic Banking and Finance (IBF), a number of weaknesses remain. The most important of this is perhaps the lack of shariah compliant risk management tools. While the risk sharing philosophy of Islamic Finance requires the acceptance of risk to justify returns, the shariah also requires adherents to avoid unnecessary risk-maysir. The requirement to avoid maysir is in essence a call for the prudent management of risk. Contemporary risk management revolves around financial engineering, the building blocks of which are financial derivatives. Despite the proven efficacy of derivatives in the management of risk in the conventional space, shariah scholars appear to be suspicious and uneasy with their use in IBF. Some have imposed outright prohibition of their use. This paper re-examines the issue of contemporary derivative instruments and shariah compliance. The shariah compatibility of derivatives is shown in a number of ways. First, by way of qualitative evaluation of whether derivatives can be made to comply with the key prohibitions of the sharia. Second, by way of comparing the payoff profiles of derivatives with risk sharing finance and Bai Salam contracts. Finally, the equivalence between shariah compliant derivatives like the IPRS and Islamic FX Currency Forwards with conventional ones is presented.
Nguyen, Hung D.; Steele, Gynelle C.
NASA's Small Business Innovation Research (SBIR) program focuses on technological innovation by investing in the development of innovative concepts and technologies to help NASA's mission directorates address critical research and development needs for Agency programs. This report highlights 11 of the innovative SBIR 2014 Phase I and II projects from 2010 to 2012 that focus on one of NASA Glenn Research Center's six core competencies-In-Space Propulsion and Cryogenic Fluids Management. The technologies cover a wide spectrum of applications such as divergent field annular ion engines, miniature nontoxic nitrous oxide-propane propulsion, noncatalytic ignition systems for high-performance advanced monopropellant thrusters, nontoxic storable liquid propulsion, and superconducting electric boost pumps for nuclear thermal propulsion. Each article describes an innovation and technical objective and highlights NASA commercial and industrial applications. This report provides an opportunity for NASA engineers, researchers, and program managers to learn how NASA SBIR technologies could help their programs and projects, and lead to collaborations and partnerships between the small SBIR companies and NASA that would benefit both.
Full Text Available The article presents anthropological views of some very influential Orthodox theologians. The author starts his attempt from sketching a direct historical context of a rapid development of anthropology since19th century. He indicates that since the middle of 20th century one cannotice an increasing interest concerning on the understanding of human person, human freedom and human rights in social structures. Then he summarizes main points of the mystical anthropology of Vladimir Lossky. This very influential theologian, who concentrated mostly oncategory of person in apophatic and Trinitarian perspective on the basisof the patristic wisdom, has influenced many contemporary religious thinkers.Grounds of the anthropological reflection of Orthodox theologians were described in the second part of the article. Contemporary theologians have been trying to find answers for such questions as: “Who is a human being?”; “How to understand his or her freedom, rights, morality, life and existence?”; “What does compose the essence of his or her relationswith other human beings in the community of the Church and society”– taking into account the Divine Scripture, the teaching of the Churchand modern philosophical reflections.The third part of the article shows four examples of Greek theologians who significantly have contributed to the contemporary discussion on the mystery of human person. Each of them characterizes of a specific attempt towards looking for anthropological solutions from Christian point of view. The author labeled the main interest of each of them by a specific title: Panayiotis Nellas – a Christocentric exponent of patristic anthropology, Nikos Nissiotis – a courageous searcher of bases of dialogical anthropology, Christos Yannaras – a brilliant architect of relational ontology of person, Metropolitan John Zizioulas – a persistent builder of personalistic ecclesiological anthropology.
Various approaches that teachers can use to help students interpret contemporary plays are presented in this discussion of teaching drama. Plays discussed include two from the Theater of Illusion ("Look Back in Anger,""A Raisin in the Sun"), two from the Theater of the Absurd ("Rhonoceros,""Rosencrantz and Guildenstern are Dead"), and two from…
Full Text Available The paper examines the development of contemporary administrative education, as a crucial criterion without which it is not possible to achieve professionalism in public administration. While the term professionalism has a variety of meanings, today it is largely deemed that specific educational preparation is a foundation without which other elements of professionalism in public administration cannot be achieved. The level of professionalism, competence, education and knowledge thus become critical variables of administration reforms in transitional countries. Afterwards, the author examines the trends in the development of contemporary administrative education, pointing particularly to the importance of establishing a coherent, vertically passable system, i.e. a system which encompasses all levels of education – from secondary school education to doctoral studies. In this matter, one of the most important features in the development of administrative studies is their diversification, with simultaneous strengthening of the general administrative profile. Thus, the general administrative profile becomes modified, updated and extended by new teaching disciplines. In the final section of the paper, the author addresses the performance of administrative education in Croatia, pointing to its underdevelopment. Indeed, the author suggests that there are no sustainable results of reforms without the training of staff for administration.
Full Text Available This article focuses on esotericism in contemporary Lithuanian prose. For the revelation of this topic, Donaldas Kajokas’ novel Ežeras ir kiti jį lydintys asmenys (The Lake and Other Escort Members, 2003 and Jurga Ivanauskaitė’s novel Placebas (Placebo, 2012 have been chosen. The analysed writings reveal the point of view of contemporary Lithuanian writers about esoteric beliefs. In this article, esotericism is related with persons’ feelings but is excluded from occult and parapsychology fields such as alchemy, cabbala, Tarot, etc. This work focuses on the idea that an individual, who has only a few senses, cannot reach actuality. On the other hand, the possibility of acquiring those senses is not rejected. In addition, obtaining those senses would help to reach higher, over-sensational worlds and in that way to discover personal correlation with forms of multiple personal identities. This article establishes an idea that awareness of higher worlds/spheres unlocks the possibilities of revealing the main core of human (as micro-cosmos and the Universe (as macro-cosmos. The possibility to perceive oneself as a micro-cosmos discloses not only personal identity, but also the value of Other’s entity and inevitable entities stratifying.