Managing high-risk patients: the Mass General care management programme

Directory of Open Access Journals (Sweden)

Dennis L Kodner

2015-09-01

Full Text Available The Massachusetts General Care Management Program (Mass General CMP or CMP was designed as a federally supported demonstration to test the impact of intensive, practice-based care management on high-cost Medicare fee-for-service (FFS beneficiaries—primarily older persons—with multiple hospitalisations and multiple chronic conditions. The Massachusetts General Care Management Program operated over a 6-year period in two phases (3 years each. It started during the first phase at Massachusetts General Hospital, a major academic medical centre in Boston, Massachusetts in collaboration with Massachusetts General Physicians Organisation. During the second phase, the programme expanded to two more affiliated sites in and around the Boston area, including a community hospital, as well as incorporated several modifications primarily focused on the management of transitions to post-acute care in skilled nursing facilities. At the close of the demonstration in July 2012, Mass General Massachusetts General Care Management Program became a component of a new Pioneer accountable care organisation (ACO. The Massachusetts General Care Management Program is focused on individuals meeting defined eligibility criteria who are offered care that is integrated by a case manager embedded in a primary care practice. The demonstration project showed substantial cost savings compared to fee-for-service patients served in the traditional Medicare system but no impact on hospital readmissions. The Massachusetts General Care Management Program does not rest upon a “whole systems” approach to integrated care. It is an excellent example of how an innovative care co-ordination programme can be implemented in an existing health-care organisation without making fundamental changes in its underlying structure or the way in which direct patient care services are paid for. The accountable care organisation version of the Massachusetts General Care Management Program

The transition to general management in South Africa

Directory of Open Access Journals (Sweden)

Stephen J. Mallaby

2017-05-01

Full Text Available Orientation: Understanding the nature and challenges of making the transition from a functional role to a general management role in South African organisations. Research purpose: The objective of this study was to gain insight into the obstacles that affect the transition from functional to general management and identify steps that may be taken to overcome these challenges. Motivation for the study: One of the most difficult crossroads for a manager is making the shift from being a functional specialist to becoming a general manager. New competencies and behaviours are required, as well as a more strategic mind set. If the transition is not made successfully, the manager and the organisation suffer. Research design, approach and method: A qualitative design was used consisting of in-depth, semi-structured interviews, with 19 senior business leaders who had successfully made the transition. The interviews were used to gather insights into the challenges they faced during their transitions, and how these were overcome. Main findings: To make the transition successfully, functional managers need to gain relevant experience to prepare them for the broader scope of a general management role. They need to develop appropriate skills, attitudes and personal characteristics. Mentoring is an effective development process. Newly appointed general managers need to learn to let go of control while maintaining ownership, build relationships and strike the right balance between strategic thinking and execution. There are unique aspects of being a general manager in South Africa, such as dealing with Black Economic Empowerment and challenges of race and identity, given the country’s history. Practical and managerial implications: Specific interventions are suggested which are directed at both aspiring general managers and organisations seeking to assist middle managers to make the transition to general managers. Contribution: This study contributes to

Construction Manager or General Contractor?

Science.gov (United States)

McKinley, John

1991-01-01

Unlike the general contractor approach, the construction management firm acts on behalf of the school district in school construction. Examines the development and nature of construction management, and cites its advantages and disadvantages. (MLF)

Long-term management of chronic spontaneous urticaria with omalizumab.

Science.gov (United States)

Pinto Gouveia, M; Gameiro, A; Pinho, A; Gonçalo, M

2017-10-01

Clinical trials have shown the efficacy of omalizumabs efficacy in refractory chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU), but real-life management strategies are lacking. To assess the long-term efficacy and safety of omalizumab, and to identify predictive factors and optimum dosage regimens. This was a prospective study of 13 patients (11 women, 2 men) with severe CSU [weekly urticaria activity score (UAS7) > 28] resistant to anti-H1 antihistamines. Patients were started on omalizumab 150 mg subcutaneously every 4 weeks. Dose and interval between administrations were adjusted according to clinical response (189 administrations; treatment duration range 2-38 months). Mean UAS7 was 36.3 ± 5.4. Of the 13 patients, all had experienced angio-oedema, while in addition, 7 had delayed pressure urticaria (DPU) and 1 had solar urticaria (SU). After omalizumab treatment, 4 (30.8%) of the 13 patients had complete response (CR), and the remaining 8 (61.5%) had partial response. CR was achieved with a dose of 150 mg every 4 (n = 2 patients) or 5 (n = 2) weeks. One of these patients remained disease-free after stopping treatment. Partial responses were achieved with 150 mg every 4 weeks (n = 4) and with 300 mg (n = 4) at intervals of 5 weeks (n = 1), 4 weeks (n = 2) or 3 weeks (n = 1). Only one patient (7.7%) did not show significant improvement, despite a dose of 300 mg every 4 weeks. There were no significant differences in epidemiological, clinical and laboratory data between the different response groups. Only two adverse events were observed: one was mild headache and the other was severe angio-oedema and aggravation of urticaria within 6 h of omalizumab administration. Omalizumab dose and interval between administrations could be individualized for long-term management of CSU. © 2017 British Association of Dermatologists.

Identifying management competencies of hotel owner-managers & general managers in the Republic of Ireland

OpenAIRE

O’Reilly, C

2015-01-01

The objective of this research was to investigate the concept of competencies, explore and identify the management competencies of hotel owner-managers and general managers in the hospitality industry in the Republic of Ireland. In other words, this research explored how hotel owner-managers and general managers identified, interpreted and made sense of their notion of managerial competencies in a complex work environment. The research was set within the context of the Irish hospitality and t...

Management in general practice: the challenge of the new General Medical Services contract.

Science.gov (United States)

Checkland, Kath

2004-10-01

Managers in general practice perform a variety of roles, from purely administrative to higher-level strategic planning. There has been little research investigating in detail how they perform these roles and the problems that they encounter. The new General Medical Services (GMS) contract contains new management challenges and it is not clear how practices will meet these. To improve understanding of the roles performed by managers in general practice and to consider the implications of this for the implementation of the new GMS contract. In-depth qualitative case studies covering the period before and immediately after the vote in favour of the new GMS contract. Three general practices in England, chosen using purposeful sampling. Semi-structured interviews with all clinical and managerial personnel in each practice, participant and non-participant observation, and examination of documents. Understanding about what constitutes the legitimate role of managers in general practice varies both within and between practices. Those practices in the study that employed a manager to work at a strategic level with input into the direction of the organisation demonstrated significant problems with this in practice. These included lack of clarity about what the legitimate role of the manager involved, problems relating to the authority of managers in the context of a partnership, and lack of time available to them to do higher-level work. In addition, general practitioners (GPs) were not confident about their ability to manage their managers' performance. The new GMS contract will place significant demands on practice management. These results suggest that it cannot be assumed that simply employing a manager with high-level skills will enable these demands to be met; there must first be clarity about what the manager should be doing, and attention must be directed at questions about the legitimacy enjoyed by such a manager, the limits of his or her authority, and the

Place of Budget Management in the General System of Trade Enterprise Management

OpenAIRE

Kravchenko Olena S.; Brahina Olha S.

2014-01-01

The article grounds urgency of identification of the place of budget management in the general system of trade enterprise management. It analyses points of view of economists with respect to definitions of the “budgeting” and “budget management” terms. It considers main functions of budget management. It identifies the place of budget management in the general system of enterprise management. Pursuant to definition of the budget management as a managerial technology, which should meet a numbe...

General principles of the quality management

International Nuclear Information System (INIS)

Koutaniemi, P.

2005-01-01

The objective of the presentation is to outline some general infrastructure of nuclear industry with regard to the quality management; to emphasise significance of safety management as an integral part of the quality management; and to highlight different steps of the management process in a near-time working, at an annual level and as a strategic process

LOGISTICS MANAGEMENT IN THE GENERAL STRUCTURE OF COMPANY MANAGEMENT

OpenAIRE

SERGIU PETROVICI; ALA GUDIMA

2011-01-01

The paper is dedicated to the place of logistics management in the general structure of an enterprise. It states some rules to improve the logistic system through development of logistic management as integral system and through a complex approach, development of a market-orientated logistic management with clear short-term and long-term purposes, development of information system in logistics. The course of Logistics Management is taught at the Cooperative-Commercial University of Moldova at...

Mediators of Inflammation and Angiogenesis in Chronic Spontaneous Urticaria: Are They Potential Biomarkers of the Disease?

Directory of Open Access Journals (Sweden)

Ilaria Puxeddu

2017-01-01

Full Text Available In chronic spontaneous urticaria (CSU, different pathophysiological mechanisms, potentially responsible for the development of the disease, have been recently described. It is likely that the activation of skin mast cells with consequent release of histamine and other proinflammatory mediators is responsible for vasodilation in the lesional skin of CSU. However, the underlying causes of mast cell activation in the disease are largely unknown and remain to be identified. Thus, in this review, we discuss new insights in the pathogenesis of CSU, focusing on inflammation and angiogenesis. The understanding of these mechanisms will enable the identification of biomarkers useful for the diagnosis, follow-up, and management of CSU and will allow the development of novel, more specific, and patient-tailored therapies.

7 CFR 1717.609 - RUS approval of general manager.

Science.gov (United States)

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false RUS approval of general manager. 1717.609 Section... Operational Controls § 1717.609 RUS approval of general manager. (a) If a borrower's mortgage or loan contract... general manager of the borrower's system, such approval is hereby granted provided that the borrower is in...

Place of Budget Management in the General System of Trade Enterprise Management

Directory of Open Access Journals (Sweden)

Kravchenko Olena S.

2014-01-01

Full Text Available The article grounds urgency of identification of the place of budget management in the general system of trade enterprise management. It analyses points of view of economists with respect to definitions of the “budgeting” and “budget management” terms. It considers main functions of budget management. It identifies the place of budget management in the general system of enterprise management. Pursuant to definition of the budget management as a managerial technology, which should meet a number of requirements, which would be determined by specific features of enterprise practical activity, the article identifies its main principles. It groups principles of budget management in accordance with the functions it performs.

DRUG MANAGEMENT REVIEWS IN DISTRICT DRUG MANAGEMENT UNIT AND GENERAL HOSPITAL

Directory of Open Access Journals (Sweden)

Max Joseph Herman

2009-12-01

Full Text Available Drug is one of the essential elements in healthcare that should be effectively and efficiently managed. Following thedecentralization in 2001 in Indonesia, drug management has changed in district drug management units and also in District General Hospitals. Certainly this condition influences the sustainability of drug access in primary health care such as in Community Health Center and District General Hospital, especially in drug financing policy. A cross sectional descriptive study to obtain information on drug management in public healthcare in district had been carried out between July and December 2006 in 10 District Public Drug Management Units from 10 district health offices and 9 district general hospitals as samples. Data were collected by interviewing heads of Drug Section in District Health Offices and heads of Hospital Pharmacies using structured questionnaires and observing drug storage in District Drug Management Units, Community Health Centers, and Hospital Pharmacies. Results of the study show that drug planning in District Health Offices and General Hospitals did not meet the basic real need in some districts nor District Hospitals. The minimum health service standards had no been achieved yet. Furthermore, drug procurement, storage and recording as well as reporting was not good enough either, such as shown by the existence of expired drugs. Lead time for drug delivery to community health centers in some districts was longer than the average of lead time in the past 3 years.

Hotel Nikko Tianjin General Manager Interview

Institute of Scientific and Technical Information of China (English)

2007-01-01

Before the grand opening of Hotel Nikko Tianjin on April 11,Beijing Review conducted an interview with Mr.Hiroshi O’ishi,General Manager of the new hotel,in order to share the operational and management expertise of Nikko Hotels International with our readers.

75 FR 58330 - Minerals Management: General

Science.gov (United States)

2010-09-24

... DEPARTMENT OF THE INTERIOR Bureau of Land Management 43 CFR Part 3000 Minerals Management: General CFR Correction In Title 43 of the Code of Federal Regulations, Part 1000 to End, revised as of October 1, 2009, on page 331, in [[Page 58331

Role of Management Accounting in Accounting in General

OpenAIRE

Oleksandr Panadiy

2015-01-01

The article elucidates main scientific approaches to understanding of essence of management accounting. From scientific studies of domestic scientists it is concluded that most of them classify management accounting under competence of accounting in general. It is shown that the first institutional factors concomitant with division of general theory of accounting into financial and management components were development of forms of business and implementation of accounting standards and manua...

Generalized data management systems and scientific information

International Nuclear Information System (INIS)

Anon.

1978-01-01

This report aims to stimulate scientists of all disciplines to consider the advantages of using a generalized data management system (GDMS) for storage, manipulation and retrieval of the data they collect and often need to share. It should also be of interest to managers and programmers who need to make decisions on the management of scientific (numeric or non-numeric) data. Another goal of this report is to expose the features that a GDMS should have which are specifically necessary to support scientific data, such as data types and special manipulation functions. A GDMS is a system that provides generalized tools for the purpose of defining a database structure, for loading the data, for modification of the data, and for organizing the database for efficient retrieval and formatted output. A data management system is 'generalized' when it provides a user-oriented language for the different functions, so that it is possible to define any new database, its internal organization, and to retrieve and modify the data without the need to develop special purpose software (program) for each new database

Itch Management: General Principles.

Science.gov (United States)

Misery, Laurent

2016-01-01

Like pain, itch is a challenging condition that needs to be managed. Within this setting, the first principle of itch management is to get an appropriate diagnosis to perform an etiology-oriented therapy. In several cases it is not possible to treat the cause, the etiology is undetermined, there are several causes, or the etiological treatment is not effective enough to alleviate itch completely. This is also why there is need for symptomatic treatment. In all patients, psychological support and associated pragmatic measures might be helpful. General principles and guidelines are required, yet patient-centered individual care remains fundamental. © 2016 S. Karger AG, Basel.

Retrospective case note review of chronic spontaneous urticaria outcomes and adverse effects in patients treated with omalizumab or ciclosporin in UK secondary care.

Science.gov (United States)

Savic, Sinisa; Marsland, Alexander; McKay, David; Ardern-Jones, Michael R; Leslie, Tabi; Somenzi, Olivier; Baldock, Laura; Grattan, Clive

2015-01-01

Omalizumab is approved in the UK as add-on treatment for chronic spontaneous urticaria (CSU) in patients with inadequate response to H1-antihistamines. Ciclosporin is an established but unlicensed 3rd line option for CSU. Two parallel retrospective observational studies were conducted to describe outcomes of treatment and adverse events with omalizumab or ciclosporin for CSU treatment. Data from UK specialist centres prescribing omalizumab (five centres) or ciclosporin (three centres) in CSU patients were collected from hospital records by clinical staff and pooled for analysis. Forty-six patients prescribed omalizumab and 72 patients prescribed ciclosporin were included. Twenty-two (48%) omalizumab-treated patients had paired Urticaria Activity Scores (UAS7), showing a 25.4 point improvement during treatment (P making causality assignment difficult, whereas those for ciclosporin were consistent with its known adverse effect profile. Validated patient-reported measures of disease severity and quality of life should be used routinely in CSU management. Based on clinician comments and DLQI scores, symptoms and quality of life showed a greater improvement in the omalizumab-treated cohort than in the ciclosporin-treated cohort.

Costs at Public Universities: How Does California Compare with Other States? Report 10-12

Science.gov (United States)

Fuller, Ryan

2010-01-01

The cost of attending the University of California (UC) and California State University (CSU) has increased in recent years as UC and CSU have raised fees in response to reduced state funding. Fees are generally lower than fees at public universities in other states, but with California's higher living costs, the overall cost of attendance at UC…

Opioid dependence - management in general practice.

Science.gov (United States)

Frei, Matthew

2010-08-01

Addiction to opioids, or opioid dependence, encompasses the biopsychosocial dysfunction seen in illicit heroin injectors, as well as aberrant behaviours in patients prescribed opioids for chronic nonmalignant pain. To outline the management of opioid dependence using opioid pharmacotherapy as part of a comprehensive chronic illness management strategy. The same principles and skills general practitioners employ in chronic illness management underpin the care of patients with opioid dependence. Opioid pharmacotherapy, with the substitution medications methadone and buprenorphine, is an effective management of opioid dependence. Training and regulatory requirements for prescribing opioid pharmacotherapies vary between jurisdictions, but this treatment should be within the scope of most Australian GPs.

Management of upper dyspepsia in general practice

DEFF Research Database (Denmark)

Kjeldsen, Hans Christian; Kier, Svend; Husum, Gitte

) for two weeks. If symptoms were unchanged after to weeks => referral to endoscopy. Later recurrence of symptoms => endoscopy (> 45 year) or management strategy according to helicobacter pylori status and/or clinical reflux (measures...... of dyspepsia, dyspeptic episodes, main symptom, previous contact to general practice, previous gastroscopia, use of antacids or NSAID's, Helicobacter Pylori status and mental/physical well being (SF-36 measurement scale) (Table 1). After two weeks the GPs assessed 46 % of the patients to be free of symptoms...... Aim: To compare the effect of two strategies for management of dyspepsia. Evaluation based on GP's assessment after two weeks and patients assessment after three months.   Design: Prospective randomised controlled trial in general practice   Methods: 357 patients with dyspepsia where the general...

Dental management of hemophiliac child under general anesthesia.

Science.gov (United States)

Rayen, R; Hariharan, V S; Elavazhagan, N; Kamalendran, N; Varadarajan, R

2011-01-01

Hemophilia is the most common inherited bleeding disorder. Hemophilic patients should be cosidered as special patients. There is no contraindication to general dental treatment for hemophiliacs, as they generally do not involve bleeding. But caution must be used with any surgical procedures that involve the local and general anesthesia. Such patients should always be managed in the setting of specialized units with appropriate clinical expertise and laboratory support. Recent advances in the management of hemophilia have enabled many hemophiliac patients to receive surgical dental procedures in an outpatient dental care on a routine basis. The purpose of this case report is to provide a few management strategies when providing full mouth rehabilitation under anesthesia and replacement therapies that are available. In addition, overviews of possible complication that may be encountered when providing such treatment are discussed here.

Dental management of hemophiliac child under general anesthesia

Directory of Open Access Journals (Sweden)

R Rayen

2011-01-01

Full Text Available Hemophilia is the most common inherited bleeding disorder. Hemophilic patients should be cosidered as special patients. There is no contraindication to general dental treatment for hemophiliacs, as they generally do not involve bleeding. But caution must be used with any surgical procedures that involve the local and general anesthesia. Such patients should always be managed in the setting of specialized units with appropriate clinical expertise and laboratory support. Recent advances in the management of hemophilia have enabled many hemophiliac patients to receive surgical dental procedures in an outpatient dental care on a routine basis. The purpose of this case report is to provide a few management strategies when providing full mouth rehabilitation under anesthesia and replacement therapies that are available. In addition, overviews of possible complication that may be encountered when providing such treatment are discussed here.

Leadership and management skills of general practice nurses: experience or education?

Science.gov (United States)

Lau, Rosalind; Cross, Wendy; Moss, Cheryle; Campbell, Annie; De Castro, Magali; Oxley, Victoria

2014-12-01

A key finding of this qualitative exploratory descriptive study into advanced nursing for general practice nurses (Australian setting) revealed that participants viewed leadership and management as best learnt 'apprenticeship' style on the job by years of experience. Participants (48) comprised of general practice nurses, practice managers and general practitioners from metropolitan Melbourne were interviewed. Other findings demonstrated that the participants generally had limited awareness that postgraduate education can assist in the development of leadership and management in advanced nursing practice. The participants lacked clarity about professional competencies and generally did not connect these to leadership and management. Professional bodies need to take the opportunity to promote awareness of the national competency standards. All three groups of participants expressed hopes about the future provision of professional development opportunities and support by the Medicare Local for leadership and management aspirations within advanced practice nursing.

Adding a nitrogen footprint to Colorado State University’s sustainability plan

Science.gov (United States)

Kimiecik, Jacob; Baron, Jill S.; Weinmann, Timothy; Taylor, Emily

2017-01-01

As a large land grant university with more than 32,000 students, Colorado State University has both on-campus non-agricultural and agricultural sources of nitrogen (N) released to the environment. We used the Nitrogen Footprint Tool to estimate the amount of N released from different sectors of the university for the CSU 2014 academic year. The largest on campus sources were food production, utilities (heating, cooling, electricity), and research animals. The total on-campus N footprint in 2014 was 287 metric tons. This value was equivalent to the nitrogen footprint of agricultural experiment stations and other agricultural facilities, whose nitrogen footprint was 273 metric tons. CSU has opportunities to reduce its on-campus footprint through educational programs promoting low-meat diets and commuting by bicycle or bus. There is also an opportunity to advance ideas of agricultural best management practices, including precision farming and better livestock management. This article describes the planned and ongoing efforts to educate CSU about how societal activities release nitrogen to the environment, contributing to global change. It offers personal and institutional options for taking action, which would ultimately reduce CSU’s excess reactive nitrogen loss to the environment. The N-footprint for CSU, including scenarios of possible future nitrogen reductions, is also discussed.

Preventing and managing awareness during general anesthesia

Directory of Open Access Journals (Sweden)

Jelena Berger

2014-03-01

Full Text Available Background: General anesthesia is a reversible state of a temporary loss of consciousness, analgesia, muscle paralysis, blunted autonomic responses and amnesia. To achieve this, an adequate depth of anesthesia should be maintained throughout the surgery. Awareness is a serious complication of general anesthesia, which occurs when the depth of anesthesia is not appropriate due to various causes.In this paper the underlying neurobiology of intraoperative awareness is presented, as well as risk factors for awareness and methods for assessing the depth of anesthesia. Possible psychological consequences of awareness and their management are also discussed. At the end, the recommendations for preventing intraoperative awareness are given.Conclusions: Awareness during general anesthesia may have adverse psychological sequelae in individual patients, therefore guidelines for preventing and managing of intraoperative awareness need to be adopted. In case of a possible awareness, the recommendations for offering a psychological support should also be followed.

Position statement for the use of omalizumab in the management of chronic spontaneous urticaria in Indian patients

Directory of Open Access Journals (Sweden)

Kiran Godse

2016-01-01

Full Text Available Chronic spontaneous urticaria (CSU affects 1% of the world population and also their quality of life, and 50% of these patients are refractory to H1-antihistamines. Omalizumab is a humanized monoclonal anti-IgE antibody that binds with free IgE antibodies and reduces the circulating levels of free IgE. This reduction in free IgE prevents mast-cell degranulation. The EAACI/GA2LEN/EDF/WAO guidelines recommend omalizumab as the third-line of therapy as an add-on to antihistamines. The recommended dose of omalizumab is 300 mg, 4 weekly in the management of CSU refractory to standard of care with H1-antihistamines in adults and adolescents ≥12 years of age. In some patients, a dose of 150 mg may be acceptable. Omalizumab has a good safety profile. However, due to the biologic nature of the drug, all patients administered omalizumab must be observed for 2 h after administration for anaphylactoid reactions. There have been no studies on the effect of impaired renal or hepatic function on the pharmacokinetics of omalizumab. While no particular dose adjustment is recommended, omalizumab should be administered with caution in these patients.

41 CFR 105-1.101 - General Services Administration Property Management Regulations.

Science.gov (United States)

2010-07-01

...-INTRODUCTION 1.1-Regulations System § 105-1.101 General Services Administration Property Management Regulations... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false General Services Administration Property Management Regulations. 105-1.101 Section 105-1.101 Public Contracts and Property...

Design management of general contractor under nuclear power project EPC mode

International Nuclear Information System (INIS)

Su Shaojian

2013-01-01

Design management has not yet formed a theoretical system recognized, general contractor design managers under nuclear power project EPC Mode lack the clear theory basis. This paper aims to discuss Design management from the angle of general contractor under nuclear power project EPC mode, Gives the concept of design management Clearly, by Combining the characteristics of nuclear power project, Gives the specific content and meaning of the design management of nuclear power project. (authors)

Surgical management of generalized gingival enlargement - a case series

International Nuclear Information System (INIS)

Akhtar, M.U.; Nazir, A.; Montmorency College of Dentistry, Lahore; Kiran, S.; Montmorency College of Dentistry, Lahore

2014-01-01

Generalized gingival enlargement is characterized by massive and exuberant gingival overgrowth that poses social, aesthetic, phonetic and functional problems for the patient. Therefore, it requires meticulous management. Objective: To describe the surgical management of generalized gingival enlargement by electrosurgical excision of patients presenting to a tertiary care centre. Study Design: Case series. Materials and Methods: The study was conducted at the Department of Oral and Maxillofacial Surgery, de'Montmorency College of Dentistry, Lahore, from January 2010 to December 2012. A total of sixteen patients were operated by using electrosurgical approach under general anaesthesia for surgical excision of generalized gingival enlargement. Results: All of the sixteen patients, 11 males and 5 females, showed excellent healing postoperatively without any recurrent gingival overgrowth. Discussion: To the best of our knowledge, the current study presents the largest case series of generalized gingival enlargement. Most of these cases were with massive disease due to lack of information of the study population about their disease, delay in referral by the general dental practitioners, painless and innocent nature of the problem. Early referral of such patients to tertiary care centers can prevent the patients from social and psychological embarrassment. Conclusion: Electrosurgical excision is an excellent surgical technique for management of generalized gingival enlargement. Moreover, cross comparative studies are required to establish some diagnostic and therapeutic standards for such patients. (author)

12 CFR 615.5180 - Interest rate risk management by banks-general.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Interest rate risk management by banks-general... FISCAL AFFAIRS, LOAN POLICIES AND OPERATIONS, AND FUNDING OPERATIONS Risk Assessment and Management § 615.5180 Interest rate risk management by banks—general. The board of directors of each Farm Credit Bank...

Management of venous leg ulcers in general practice - a practical guideline.

Science.gov (United States)

Sinha, Sankar; Sreedharan, Sadhishaan

2014-09-01

Chronic venous leg ulcers are the most common wounds seen in general practice. Their management can be both challenging and time-consuming. To produce a short practical guideline incorporating the TIME concept and A2BC2D approach to help general practitioners and their practice nurses in delivering evidence-based initial care to patients with chronic venous leg ulcers. Most chronic venous leg ulcers can be managed effectively in the general practice setting by following the simple, evidence-based approach described in this article. Figure 1 provides a flow chart to aid in this process. Figure 2 illustrates the principles of management in general practice. Effective management of chronic ulcers involves the assessment of both the ulcer and the patient. The essential requirements of management are to debride the ulcer with appropriate precautions, choose dressings that maintain adequate moisture balance, apply graduated compression bandage after evaluation of the arterial circulation and address the patient's concerns, such as pain and offensive wound discharge.

Treatment management between orthodontists and general practitioners performing clear aligner therapy.

Science.gov (United States)

Best, Alexandra D; Shroff, Bhavna; Carrico, Caroline K; Lindauer, Steven J

2017-05-01

To investigate differences in case selection, treatment management, and aligner treatment expertise between orthodontists and general practitioners. A parallel pair of original surveys with three sections (case selection, treatment management, and demographics) was sent to orthodontists (N = 1000) and general dentists (N = 1000) who were providers of aligner treatment. Orthodontists had treated significantly more patients with aligners, had treated more patients with aligners in the previous 12 months, and had received more aligner training than general dentists (P aligner case confidence between orthodontists and general dentists for several malocclusions. General dentists were more confident than orthodontists in treating deep bite, severe crowding, and Class II malocclusions with aligners (P ≤ .0001). Significant differences were also found for all treatment management techniques except interproximal reduction. There was a significant difference in case selection, treatment management, and aligner expertise between orthodontists and general dentists, although the differences in case selection were small. Overall, it was shown that orthodontists and general dentists elected to treat a variety of moderate to severe malocclusions with aligners but with different utilization of recommended auxiliaries, perhaps demonstrating a difference in treatment goals.

Dutch general practitioners’ weight management policy for overweight and obese patients.

NARCIS (Netherlands)

Kloek, C.J.J.; Tol, J.; Veenhof, C.; Wulp, I. van der; Swinkels, I.C.S.

2014-01-01

Background: General practitioners (GPs) can play an important role in both the prevention and management of overweight and obesity. Current general practice guidelines in the Netherlands allow room for GPs to execute their own weight management policy. Objective: To examine GPs’ current weight

29 CFR 541.201 - Directly related to management or general business operations.

Science.gov (United States)

2010-07-01

... management or general business operations. (a) To qualify for the administrative exemption, an employee's... operations of the employer or the employer's customers. The phrase “directly related to the management or... 29 Labor 3 2010-07-01 2010-07-01 false Directly related to management or general business...

75 FR 71730 - General Management Plan/Wilderness Study/Off-Road Vehicle Management Plan, Final Environmental...

Science.gov (United States)

2010-11-24

... management under alternative B would be to enable visitor participation in a wide variety of outdoor... DEPARTMENT OF THE INTERIOR National Park Service [2031-A046-409] General Management Plan/Wilderness Study/Off-Road Vehicle Management Plan, Final Environmental Impact Statement, Big Cypress National...

Evaluation and Management of Patch Test-Negative Patients With Generalized Dermatitis.

Science.gov (United States)

Spiker, Alison; Mowad, Christen M

Patients with generalized dermatitis are common in dermatology practices. Allergic contact dermatitis is often suspected, and patients frequently undergo patch testing. When the patch testing result is negative, further evaluation and management of these patients are challenging. The purpose of this study was to survey members of the American Contact Dermatitis Society regarding the evaluation and management of patch test-negative patients with generalized dermatitis. Generalized dermatitis was the most common term identified for patch test-negative patients with diffuse dermatitis. After having negative expanded patch testing results, most physicians proceeded with additional testing including skin biopsy, complete blood cell count with differential, and liver and renal function tests. The most commonly used systemic treatment is prednisone, followed by methotrexate. Narrow-band ultraviolet B (UVB) is the most commonly used light source. Antihistamines are frequently prescribed. Food allergy is not felt to be causative. This cohort of patients experiences significant impairment in quality of life, stress on personal relationships, and time off work. The management of patch test-negative patients with generalized dermatitis is challenging. This study provides insight into management of these complex patients. It also demonstrates practice gaps in the management of these patients, indicating a need for further studies to direct the evaluation and management of this patient population.

Generalized File Management System or Proto-DBMS?

Science.gov (United States)

Braniff, Tom

1979-01-01

The use of a data base management system (DBMS) as opposed to traditional data processing is discussed. The generalized file concept is viewed as an entry level step to the DBMS. The transition process from one system to the other is detailed. (SF)

An Object-oriented Knowledge Link Model for General Knowledge Management

OpenAIRE

Xiao-hong, CHEN; Bang-chuan, LAI

2005-01-01

The knowledge link is the basic on knowledge share and the indispensable part in knowledge standardization management. In this paper, a object-oriented knowledge link model is proposed for general knowledge management by using objectoriented representation based on knowledge levels system. In the model, knowledge link is divided into general knowledge link and integrated knowledge with corresponding link properties and methods. What’s more, its BNF syntax is described and designed.

24 CFR 990.310 - Purpose-General policy on financial management, monitoring and reporting.

Science.gov (United States)

2010-04-01

... Management Systems, Monitoring, and Reporting § 990.310 Purpose—General policy on financial management, monitoring and reporting. All PHA financial management systems, reporting, and monitoring of program... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Purpose-General policy on financial...

Improvement of the Model of Enterprise Management Process on the Basis of General Management Functions

Directory of Open Access Journals (Sweden)

Ruslan Skrynkovskyy

2017-12-01

Full Text Available The purpose of the article is to improve the model of the enterprise (institution, organization management process on the basis of general management functions. The graphic model of the process of management according to the process-structured management is presented. It has been established that in today's business environment, the model of the management process should include such general management functions as: 1 controlling the achievement of results; 2 planning based on the main goal; 3 coordination and corrective actions (in the system of organization of work and production; 4 action as a form of act (conscious, volitional, directed; 5 accounting system (accounting, statistical, operational-technical and managerial; 6 diagnosis (economic, legal with such subfunctions as: identification of the state and capabilities; analysis (economic, legal, systemic with argumentation; assessment of the state, trends and prospects of development. The prospect of further research in this direction is: 1 the formation of a system of interrelation of functions and management methods, taking into account the presented research results; 2 development of the model of effective and efficient communication business process of the enterprise.

Effects of pasture management and off-stream water on temporal/spatial distribution of cattle and stream bank characteristics in cool-season grass pastures.

Science.gov (United States)

Schwarte, K A; Russell, J R; Morrical, D G

2011-10-01

A 2-yr grazing experiment was conducted to assess the effects of grazing management on cattle distribution and pasture and stream bank characteristics. Six 12.1-ha cool-season grass pastures in central Iowa were allotted to 1 of 3 treatments: continuous stocking with unrestricted stream access (CSU), continuous stocking with stream access restricted to 4.9-m-wide stabilized crossings (CSR), or rotational stocking with stream access restricted to a riparian paddock (RP). Pastures were stocked with 15 fall-calving Angus cows (Bos taurus L.) from mid-May to mid-October for 153 d in 2008 and 2009. A global positioning system (GPS) collar recording cow position every 10 min was placed on at least 1 cow per pasture for 2 wk of each month from May through September. Off-stream water was provided to cattle in CSU and CSR treatments during the second of the 2 wk when GPS collars were on the cattle. A black globe temperature relative humidity index (BGTHI) was measured at 10-min intervals to match the time of the GPS measurements. Each month of the grazing season, forage characteristics (sward height, forage mass, and CP, IVDMD, and P concentrations) and bare and fecal-covered ground were measured. Stream bank erosion susceptibility was visually scored in May, August, and October (pre-, mid-, and post-stocking). Cattle in RP and CSR treatments spent less time (P CSR treatment reduced the probability (P CSR and RP treatments in the stream and streamside zones in September and October and in July and September. Streams in pastures with the CSU treatment had less stable banks (P CSR treatments. Results show that time spent by cattle near pasture streams can be reduced by RP or CSR treatments, thereby decreasing risks of sediment and nutrient loading of pasture streams even during periods of increased BGTHI.

Electronically Induced Redox Barriers for Treatment of Groundwater

National Research Council Canada - National Science Library

Sale, Tom; Gilbert, David

2006-01-01

...) and Colorado State University (CSU). The focus is an innovative electrolytic approach for managing redox-sensitive contaminants in groundwater, referred to as electrically induced redox barrier (e-barriers...

Chinese hotel general managers' perspectives on energy-saving practices

Science.gov (United States)

Zhu, Yidan

As hotels' concern about sustainability and budget-control is growing steadily, energy-saving issues have become one of the important management concerns hospitality industry face. By executing proper energy-saving practices, previous scholars believed that hotel operation costs can decrease dramatically. Moreover, they believed that conducting energy-saving practices may eventually help the hotel to gain other benefits such as an improved reputation and stronger competitive advantage. The energy-saving issue also has become a critical management problem for the hotel industry in China. Previous research has not investigated energy-saving in China's hotel segment. To achieve a better understanding of the importance of energy-saving, this document attempts to present some insights into China's energy-saving practices in the tourist accommodations sector. Results of the study show the Chinese general managers' attitudes toward energy-saving issues and the differences among the diverse hotel managers who responded to the study. Study results indicate that in China, most of the hotels' energy bills decrease due to the implementation of energy-saving equipments. General managers of hotels in operation for a shorter period of time are typically responsible for making decisions about energy-saving issues; older hotels are used to choosing corporate level concerning to this issue. Larger Chinese hotels generally have official energy-saving usage training sessions for employees, but smaller Chinese hotels sometimes overlook the importance of employee training. The study also found that for the Chinese hospitality industry, energy-saving practices related to electricity are the most efficient and common way to save energy, but older hotels also should pay attention to other ways of saving energy such as water conservation or heating/cooling system.

Emergent management of postpartum hemorrhage for the general and acute care surgeon

Directory of Open Access Journals (Sweden)

Blankenship Charles L

2009-11-01

Full Text Available Abstract Background Postpartum hemorrhage is one of the rare occasions when a general or acute care surgeon may be emergently called to labor and delivery, a situation in which time is limited and the stakes high. Unfortunately, there is generally a paucity of exposure and information available to surgeons regarding this topic: obstetric training is rarely found in contemporary surgical residency curricula and is omitted nearly completely from general and acute care surgery literature and continuing medical education. Methods The purpose of this manuscript is to serve as a topic specific review for surgeons and to present a surgeon oriented management algorithm. Medline and Ovid databases were utilized in a comprehensive literature review regarding the management of postpartum hemorrhage and a management algorithm for surgeons developed based upon a collaborative panel of general, acute care, trauma and obstetrical surgeons' review of the literature and expert opinion. Results A stepwise approach for surgeons of the medical and surgical interventions utilized to manage and treat postpartum hemorrhage is presented and organized into a basic algorithm. Conclusion The manuscript should promote and facilitate a more educated, systematic and effective surgeon response and participation in the management of postpartum hemorrhage.

Evaluation of general dentists’ knowledge regarding management of dental trauma

Directory of Open Access Journals (Sweden)

Nasim Seyfi

2017-03-01

Full Text Available Background and Aims: Traumatic dental injuries (TDIs are of the most common dental problems in children and adolescents, which usually occur in the anterior segment and have a significant role in patient’s physical and psychological health. Immediate intervention for damaged teeth can elevate the success rate of treatment in TDI. Thus, general dentists’ knowledge and their effective intervention in TDI are important factors in prognosis of traumatized teeth. The objective of this study was to assess the general dentists’ knowledge and awareness regarding the diagnosis and management of traumatic dental injuries. Materials and Methods: In this cross-sectional study, the questionnaire data were collected from 130 general dentists, including the demographic data and general dentists’ knowledge about TDIs. The data were analyzed using the Student t-test and Analysis of Variance (ANOVA, Spearman’s and Pearson’s correlation coefficient. Results: The mean score of general dentists’ knowledge was 8.5 ± 1.5 (total score:10 and it was the same between both males and females (P=0.083. Dentists’ work place does not have any influence in their knowledge (P=0.133. Also, there was no statically significant relationship between the age, job experience and dentists’ knowledge (P=0.805. The relationship between the frequency of TDI managed cases and dentists’ knowledge was not significant (P=0.507. Conclusion: Considering that the overall knowledge of general dentists regarding the management of TDI was sufficient, it could be a good opportunity in treating these injuries. As TDI is a developing science, it is important to motivate general dentists being up to date regarding this matter.

Leadership style and choice of strategy in conflict management among Israeli nurse managers in general hospitals.

Science.gov (United States)

Hendel, Tova; Fish, Miri; Galon, Vered

2005-03-01

To identify conflict mode choices of head nurses in general hospitals and examine the relationship between leadership style, choice of strategy in handling conflicts and demographic characteristics. Nurse managers deal with conflicts daily. The choice of conflict management mode is associated with managerial effectiveness. The ability to creatively manage conflict situations, towards constructive outcomes is becoming a standard requirement. Head nurses (N = 60) in five general hospitals in central Israel were surveyed, using a 3-part questionnaire: The Thomas-Kilmann Conflict Mode Instrument, the Multi-factor Leadership Questionnaire, Form 5X-Short (MLQ 5X) and demographic data. Head nurses perceive themselves significantly more as transformational leaders than as transactional leaders. Compromise was found to be the most commonly used conflict management strategy. Approximately half of the nurses surveyed used only one mode in conflict management. Transformational leadership significantly affected the conflict strategy chosen. Head nurses tend to choose a conflict-handling mode which is concerned a form of a Lose-Lose approach. Preparation in conflict management should start from undergraduate education.

Leadership and management curriculum planning for Iranian general practitioners.

Science.gov (United States)

Khosravan, Shahla; Karimi Moonaghi, Hossein; Yazdani, Shahram; Ahmadi, Soleiman; Mansoorian, Mohammad Reza

2015-10-01

Leadership and management are two expected features and competencies for general practitioners (GPs). The purpose of this study was leadership and management curriculum planning for GPs which was performed based on Kern's curriculum planning cycle. This study was conducted in 2011- 2012 in Iran using an explanatory mixed-methods approach. It was conducted through an initial qualitative phase using two focus group discussions and 28 semi-structured interviews with key informants to capture their experiences and viewpoints about the necessity of management courses for undergraduate medical students, goals, objectives, and educational strategies according to Kern's curriculum planning cycle. The data was used to develop a questionnaire to be used in a quantitative written survey. Results of these two phases and that of the review of medical curriculum in other countries and management curriculum of other medical disciplines in Iran were used in management and leadership curriculum planning. In the qualitative phase, purposeful sampling and content analysis with constant comparison based on Strauss and Corbin's method were used; descriptive and analytic tests were used for quantitative data by SPSS version 14. In the qualitatively stage of  this research, 6 main categories including the necessity of management course, features and objectives of management curriculum, proper educational setting, educational methods and strategies, evolutionary method and feedback result were determined. In the quantitatively stage of the research, from the viewpoints of 51.6% of 126 units of research who filled out the questionnaire, ranked high necessary of management courses. The coordination of care and clinical leadership was determined as the most important role for GPs with a mean of 6.2 from sample viewpoint. Also, team working and group dynamics had the first priority related to the principles and basics of management with a mean of 3.59. Other results were shown in the paper

Bulk material management mode of general contractors in nuclear power project

International Nuclear Information System (INIS)

Zhang Jinyong; Zhao Xiaobo

2011-01-01

The paper introduces the characteristics of bulk material management mode in construction project, and the advantages and disadvantages of bulk material management mode of general contractors in nuclear power project. In combination with the bulk material management mode of China Nuclear Power Engineering Co., Ltd, some improvement measures have been put forward as well. (authors)

Smart Management in Effective Schools: Effective Management Configurations in General and Vocational Education in the Netherlands

Science.gov (United States)

Hofman, W. H. Adriaan; Hofman, Roelande H.

2011-01-01

Purpose: In this study the authors focus on different (configurations of) leadership or management styles in schools for general and vocational education. Findings: Using multilevel (students and schools) analyses, strong differences in effective management styles between schools with different student populations were observed. Conclusions: The…

Determination of contact maps in proteins: A combination of structural and chemical approaches

Energy Technology Data Exchange (ETDEWEB)

Wołek, Karol; Cieplak, Marek, E-mail: mc@ifpan.edu.pl [Institute of Physics, Polish Academy of Science, Al. Lotników 32/46, 02-668 Warsaw (Poland); Gómez-Sicilia, Àngel [Instituto Cajal, Consejo Superior de Investigaciones Cientificas (CSIC), Av. Doctor Arce, 37, 28002 Madrid (Spain); Instituto Madrileño de Estudios Avanzados en Nanociencia (IMDEA-Nanociencia), C/Faraday 9, 28049 Cantoblanco (Madrid) (Spain)

2015-12-28

Contact map selection is a crucial step in structure-based molecular dynamics modelling of proteins. The map can be determined in many different ways. We focus on the methods in which residues are represented as clusters of effective spheres. One contact map, denoted as overlap (OV), is based on the overlap of such spheres. Another contact map, named Contacts of Structural Units (CSU), involves the geometry in a different way and, in addition, brings chemical considerations into account. We develop a variant of the CSU approach in which we also incorporate Coulombic effects such as formation of the ionic bridges and destabilization of possible links through repulsion. In this way, the most essential and well defined contacts are identified. The resulting residue-residue contact map, dubbed repulsive CSU (rCSU), is more sound in its physico-chemical justification than CSU. It also provides a clear prescription for validity of an inter-residual contact: the number of attractive atomic contacts should be larger than the number of repulsive ones — a feature that is not present in CSU. However, both of these maps do not correlate well with the experimental data on protein stretching. Thus, we propose to use rCSU together with the OV map. We find that the combined map, denoted as OV+rCSU, performs better than OV. In most situations, OV and OV+rCSU yield comparable folding properties but for some proteins rCSU provides contacts which improve folding in a substantial way. We discuss the likely residue-specificity of the rCSU contacts. Finally, we make comparisons to the recently proposed shadow contact map, which is derived from different principles.

Financial management challenges for general hospital psychiatry 2001.

Science.gov (United States)

Goldberg, R J

2001-01-01

Psychiatry programs are facing significant business and financial challenges. This paper provides an overview of these management challenges in five areas: departmental, hospital, payment system, general finance, and policy. Psychiatric leaders will require skills in a variety of business management areas to ensure their program success. Many programs will need to develop new compensation models with more of an emphasis on revenue collection and overhead management. Programs which cannot master these areas are likely to go out of business. For academic programs, incentive systems must address not only clinical productivity, but academic and teaching output as well. General hospital programs will need to develop increased sophistication in differential cost accounting in order to be able to advocate for their patients and program in the current management climate. Clinical leaders will need the skills (ranging from actuarial to negotiations) to be at the table with contract development, since those decisions are inseparable from clinical care issues. Strategic planning needs to consider the value of improving integration with primary care, along with the ability to understand the advantages and disadvantages of risk-sharing models. Psychiatry leaders need to define and develop useful reports shared with clinical division leadership to track progress and identify problems and opportunities. Leaders should be responsible for a strategy for developing appropriate information system architecture and infrastructure. Finally, it is hoped that some leaders will emerge who can further our needs to address inequities in mental health fee schedules and parity issues which affect our program viability.

The role of the General Practitioner in weight management in primary care – a cross sectional study in General Practice

Directory of Open Access Journals (Sweden)

Young Doris

2008-12-01

Full Text Available Abstract Background Obesity has become a global pandemic, considered the sixth leading cause of mortality by the WHO. As gatekeepers to the health system, General Practitioners are placed in an ideal position to manage obesity. Yet, very few consultations address weight management. This study aims to explore reasons why patients attending General Practice appointments are not engaging with their General Practitioner (GP for weight management and their perception of the role of the GP in managing their weight. Methods In February 2006, 367 participants aged between 17 and 64 were recruited from three General Practices in Melbourne to complete a waiting room self – administered questionnaire. Questions included basic demographics, the role of the GP in weight management, the likelihood of bringing up weight management with their GP and reasons why they would not, and their nominated ideal person to consult for weight management. Physical measurements to determine weight status were then completed. The statistical methods included means and standard deviations to summarise continuous variables such as weight and height. Sub groups of weight and questionnaire answers were analysed using the χ2 test of significant differences taking p as Results The population sample had similar obesity co-morbidity rates to the National Heart Foundation data. 74% of patients were not likely to bring up weight management when they visit their GP. Negative reasons were time limitation on both the patient's and doctor's part and the doctor lacking experience. The GP was the least likely person to tell a patient to lose weight after partner, family and friends. Of the 14% that had been told by their GP to lose weight, 90% had cardiovascular obesity related co-morbidities. GPs (15% were 4th in the list of ideal persons to manage weight after personal trainer Conclusion Patients do not have confidence in their GPs for weight management, preferring other health

Managing corneal foreign bodies in office-based general practice.

Science.gov (United States)

Fraenkel, Alison; Lee, Lawrence R; Lee, Graham A

2017-03-01

Patients with a corneal foreign body may first present to their general practitioner (GP). Safe and efficacious management of these presentations avoids sight-threatening and eye-threatening complications. Removal of a simple, superficial foreign body without a slit lamp is within The Royal Australian College of General Practitioners' (RACGP's) curriculum and scope of practice. Knowing the rele-vant procedural skills and indications for referral is equally important. The objective of this article is to provide an evidence-based and expert-based guide to the management of corneal foreign bodies in the GP's office. History is key to identifying patient characteristics and mechanisms of ocular injury that are red flags for referral. Examination tech-niques and methods of superficial foreign body removal without a slit lamp are outlined, as well as the procedural threshold for referral to an ophthalmologist.

Genome-wide analysis of esterase-like genes in the striped rice stem borer, Chilo suppressalis.

Science.gov (United States)

Wang, Baoju; Wang, Ying; Zhang, Yang; Han, Ping; Li, Fei; Han, Zhaojun

2015-06-01

The striped rice stem borer, Chilo suppressalis, a destructive pest of rice, has developed high levels of resistance to certain insecticides. Esterases are reported to be involved in insecticide resistance in several insects. Therefore, this study systematically analyzed esterase-like genes in C. suppressalis. Fifty-one esterase-like genes were identified in the draft genomic sequences of the species, and 20 cDNA sequences were derived which encoded full- or nearly full-length proteins. The putative esterase proteins derived from these full-length genes are overall highly diversified. However, key residues that are functionally important including the serine residue in the active site are conserved in 18 out of the 20 proteins. Phylogenetic analysis revealed that most of these genes have homologues in other lepidoptera insects. Genes CsuEst6, CsuEst10, CsuEst11, and CsuEst51 were induced by the insecticide triazophos, and genes CsuEst9, CsuEst11, CsuEst14, and CsuEst51 were induced by the insecticide chlorantraniliprole. Our results provide a foundation for future studies of insecticide resistance in C. suppressalis and for comparative research with esterase genes from other insect species.

78 FR 13081 - Draft Environmental Impact Statement for General Management Plan, Everglades National Park, Florida

Science.gov (United States)

2013-02-26

... visitor use in the Park. The GMP will provide updated management direction for the entire park. The EEWS....YP0000] Draft Environmental Impact Statement for General Management Plan, Everglades National Park... the General Management Plan (GMP) and East Everglades Wilderness Study (EEWS) for Everglades National...

76 FR 75557 - Draft Environmental Impact Statement for General Management Plan/Wilderness Study, Hawaii...

Science.gov (United States)

2011-12-02

... Environmental Impact Statement for General Management Plan/ Wilderness Study, Hawaii Volcanoes National Park, Hawaii AGENCY: National Park Service, Interior. ACTION: Notice of intent. SUMMARY: The National Park... updating the General Management Plan (GMP) for Hawaii Volcanoes National Park. As part of this conservation...

34 CFR 76.565 - General management costs-restricted rate.

Science.gov (United States)

2010-07-01

... that are for the direction and control of the grantee's affairs that are organization-wide. An activity...) Components of the grantee are those organizational units supervised directly or indirectly by the chief executive officer. These organizational units generally exist one management level below the executive...

Omalizumab for treating chronic spontaneous urticaria: an expert review on efficacy and safety.

Science.gov (United States)

Giménez-Arnau, Ana M

2017-03-01

Chronic spontaneous urticaria (CSU) is characterized by the recurrence of itchy hives and/or angioedema for greater than six weeks, with no known external trigger. Omalizumab, a humanized, recombinant, monoclonal anti-IgE antibody, is the only approved add-on therapy for H1-antihistamine refractory CSU patients. Areas covered: The objective of this article is to discuss the mechanism of action, pharmacokinetics and pharmacodynamics of omalizumab for the treatment of CSU. The review also summarizes efficacy and safety data from proof-of-concept, phase II (X-CUISITE, MYSTIQUE), and pivotal phase III omalizumab studies (ASTERIA I, ASTERIA II, and GLACIAL). Expert opinion: Omalizumab is a clinically effective and safe biological therapy for treating H1-antihistamine refractory CSU patients. It significantly reduces CSU symptoms (hives, itch and angioedema), and improves patient health-related quality of life. While omalizumab is already integral to the treatment of antihistamine refractory CSU, widespread use will depend on legal and economic factors, as well as improvements in the early and accurate diagnosis of CSU patients who would benefit from treatment.

75 FR 28055 - General Management Plan; Joshua Tree National Park; San Bernardino and Riverside Counties, CA...

Science.gov (United States)

2010-05-19

... kinds of resource management activities, visitor activities, and developments that would be appropriate... DEPARTMENT OF THE INTERIOR National Park Service General Management Plan; Joshua Tree National... National Park Service is updating the General Management Plan (GMP) for Joshua Tree National Park...

How Agile Methods Conquers General Project Management - The Project Half Double Initiative

DEFF Research Database (Denmark)

Tordrup Heeager, Lise; Svejvig, Per; Schlichter, Bjarne Rerup

2016-01-01

Increased complexity in projects has forced new project management initiatives. In software development several agile methods have emerged and methods such as Scrum are today highly implemented in practice. General project management practice has been inspired by agile software development...

Efficacy and safety of omalizumab in Japanese and Korean patients with refractory chronic spontaneous urticaria.

Science.gov (United States)

Hide, Michihiro; Park, Hae-Sim; Igarashi, Atsuyuki; Ye, Young-Min; Kim, Tae-Bum; Yagami, Akiko; Roh, Jooyoung; Lee, Jae-Hyun; Chinuki, Yuko; Youn, Sang Woong; Lee, Soo-Keol; Inomata, Naoko; Choi, Jeong-Hee; Fukunaga, Atsushi; Wang, Junyi; Matsushima, Soichiro; Greenberg, Steve; Khalil, Sam

2017-07-01

Many patients with chronic spontaneous/idiopathic urticaria (CSU/CIU) do not respond adequately to treatment with non-sedating H1 antihistamines (H1AH). There are limited studies on use of omalizumab as add-on therapy for treatment of CSU in an Asian population. The POLARIS study (NCT02329223), representing the first randomized, double-blind, placebo-controlled phase III trial of omalizumab for CSU in an Eastern Asian population, evaluated efficacy and safety of omalizumab as add-on therapy for treatment of CSU. This 26-week multicenter (41 Japanese/Korean sites) study enrolled patients (12-75 years) who were symptomatic despite H1AH treatment. Eligible participants (N=218) were randomized 1:1:1 to receive three subcutaneous injections of omalizumab 300mg, 150mg, or placebo every 4 weeks, followed by 12 weeks of follow-up. Primary outcome was change from baseline to Week 12 (Wk12) in weekly itch severity score (ISS7). Safety was assessed through the summary of adverse events (AEs). Baseline demographics and disease characteristics were generally well balanced across treatment groups. At Wk12, statistically significant decreases from baseline were observed in ISS7 with omalizumab vs placebo (mean changes -10.22, -8.80, and -6.51 for omalizumab 300mg, 150mg and placebo; pomalizumab 300mg, 150mg, and placebo groups, respectively); nasopharyngitis was the most frequently reported AE in all treatment arms. The POLARIS study demonstrates that omalizumab is an efficacious and well-tolerated add-on therapy in Japanese and Korean H1AH-refractory patients with CSU. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

78 FR 63974 - Student Assistance General Provisions-Subpart K-Cash Management; Extension of Public Comment...

Science.gov (United States)

2013-10-25

... DEPARTMENT OF EDUCATION Student Assistance General Provisions--Subpart K--Cash Management... an information collection entitled, ``Student Assistance General Provisions--Subpart K--Cash Management''. ED is extending the comment period to November 18, 2013 due to the public's inability to access...

Management of arterial hypertension in Cotonou city, Benin: general practitioners' knowledge, attitudes and practice.

Science.gov (United States)

Houenassi, Martin Dèdonougbo; Codjo, Léopold Houétondji; Dokoui, David; Dohou, Serge Hugues Mahougnon; Wanvoegbe, Armand; Agbodande, Anthelme; Attinsounon, Angelo Cossi; Alassani, Adebayo; Ahoui, Séraphin; Dovonou, Albert Comlan; Adoukonou, Thierry Armel

2016-08-23

We aimed to assess the management of hypertensive patients by general practitioners in Cotonou city. This was a cross-sectional study based on a multicentre survey conducted from 1 May to 31 July 2011. We recruited all consenting general practitioners who worked in public and private centres in Cotonou city. We used the 7th report of the Joint National Committee to assess the management of hypertension by general practitioners. A tested and validated self-questionnaire was used to collect the data on hypertension management by general practitioners. In eight centres that approved the study, 41 general practitioners were included. The definition of hypertension was known by 20 (48.8%) practitioners. Only 25 (61.0%) could describe the conditions for blood pressure measurement. Ten of them were unable to list half of the minimum recommended tests for hypertension, and the majority (92.7%) did not have any idea of global cardiovascular risk. The blood pressure goal was known by only 18 (43.9%) practitioners. Lifestyle (82.9%) and monotherapy (70.7%) were the therapeutic modalities most prescribed. Antihypertensive agents commonly used by practitioners were calcium channel blockers (82.9%), angiotensin converting enzyme inhibitors (53.7%) and diuretics (36.6%). The general practitioners referred their patients to cardiologists mainly for uncontrolled hypertension (63.4%) and the onset of acute complications (56.1%). The general practitioners' knowledge of hypertension was insufficient and their management did not reflect international guidelines.

Analysis of Circulating Vascular Endothelial Growth Factor and Its Soluble Receptors in Patients with Different Forms of Chronic Urticaria

Directory of Open Access Journals (Sweden)

Julia Jagodzinska

2015-01-01

Full Text Available Background. Vascular endothelial growth factor (VEGF is a powerful enhancer of vascular permeability and inflammatory response; however its significance in chronic urticaria is poorly recognised. Aim. To compare free circulating levels of VEGF and its soluble receptors (sVEGFR1 and VEGFR2 in patients with different forms of chronic urticaria. Methods. The concentrations of VEGF and its receptors in plateletpoor plasma (PPP/plasma were measured using enzyme-linked immunosorbent assay in chronic urticaria: (1 chronic spontaneous urticaria (CSU with positive autologous serum skin test (ASST, (2 CSU with negative response to ASST, (3 CSU with concomitant euthyroid Hashimoto’s thyroiditis (CSU/Hashimoto, (4 delayed pressure urticaria (DPU, and the healthy subjects. Results. There were no significant differences in VEGF concentration in PPP between CSU groups and the healthy subjects. Contrary, VEGF concentration was significantly higher in DPU and CSU/Hashimoto patients as compared with the healthy subjects and CSU groups. Furthermore, VEGF value in CSU/Hashimoto patients during the remission was similar to that of the active period and significantly higher than the healthy subjects; VEGF concentration was significantly correlated with TSH. Plasma concentrations of sVEGF1 and sVEGF2 were similar in chronic urticaria patients and the healthy subjects. Conclusions. Increased free circulating VEGF concentration may result from the urticarial process itself as well as concomitant Hashimoto’s thyroiditis.

Municipal solid waste management problems: an applied general equilibrium analysis

NARCIS (Netherlands)

Bartelings, H.

2003-01-01

Keywords: Environmental policy; General equilibrium modeling; Negishi format; Waste management policies; Market distortions.

About 40% of the entire budget spent on environmental problems in the

75 FR 1806 - Draft General Management Plan and Environmental Impact Statement, New River Gorge National River, WV

Science.gov (United States)

2010-01-13

... visitor experiences. Management actions would build upon the cultural resource, interpretive, and... DEPARTMENT OF THE INTERIOR National Park Service Draft General Management Plan and Environmental... Interior. ACTION: Notice of availability of the Draft General Management Plan and Environmental Impact...

Management of osteoarthritis in general practice in Australia.

Science.gov (United States)

Brand, Caroline A; Harrison, Christopher; Tropea, Joanne; Hinman, Rana S; Britt, Helena; Bennell, Kim

2014-04-01

To describe management of osteoarthritis (OA) of the hip (OA-hip) and knee (OA-knee) by Australian general practitioners (GPs). We analyzed data from the Bettering the Evaluation and Care of Health program, from April 1, 2005 to March 31, 2010. Patient and GP characteristics and encounter management data were extracted. Data were classified by the International Classification of Primary Care, version 2, and summarized using descriptive statistics and 95% confidence intervals around point estimates. There were 489,900 GP encounters at which OA was managed (rate of 26.4 per 1,000 encounters). OA-hip was managed at a rate of 2.3 per 1,000 encounters (n = 1,106, 8.6% OA) and OA-knee at a rate of 6.2 per 1,000 (n = 3,058, 23.7% OA). The encounter management rate per 1,000 for OA-hip was higher among non-metropolitan dwellers (2.85 per 1,000 versus 1.97 per 1,000) and lower for non-English-speaking people (1.53 per 1,000 encounters versus 2.39 per 1,000). The rate for OA-knee was higher for non-English-speaking background (8.50 per 1,000 encounters versus 6.24 per 1,000) and lower among indigenous people (3.16 per 1,000 encounters versus 6.46 per 1,000). Referral to an orthopedic surgeon was the most frequently used nonpharmacologic management (OA-knee 17.4 per 100 contacts and OA-hip 17.7 per 100), followed by advice, education, and counselling. As first-line treatment, medication prescription rates (OA-knee 78.7 per 100 contacts and OA-hip 73.2 per 100) were substantially higher than rates of lifestyle management (OA-knee 20.7 per 100 contacts and OA-hip 14.8 per 100). OA-hip and OA-knee encounters and management differ. Nonpharmacologic treatments as first-line management were low compared with pharmacologic management rates, and surgical referral rates were high. However, lack of longitudinal data limits definitive assessment of appropriateness of care. Copyright © 2014 by the American College of Rheumatology.

General survey of technology management

Energy Technology Data Exchange (ETDEWEB)

Shin, Yong Ha; Jang Dong Hun; Lee, In Woo

1999-02-15

The content of this book are technology and management, conception of technology management, feature and model of technology management system, elements of technology management, performance measurement of technology management, connectivity between technology and business function, system management of technology, manpower management, readership and technology management, motivation and technology management, management of technical investment evaluation, new item development and marketing, product liability management, intellectual property rights and transfer of technology.

General survey of technology management

International Nuclear Information System (INIS)

Shin, Yong Ha; Jang Dong Hun; Lee, In Woo

1999-02-01

The content of this book are technology and management, conception of technology management, feature and model of technology management system, elements of technology management, performance measurement of technology management, connectivity between technology and business function, system management of technology, manpower management, readership and technology management, motivation and technology management, management of technical investment evaluation, new item development and marketing, product liability management, intellectual property rights and transfer of technology.

Comparison between the intravenous and caudal routes of sufentanil in children undergoing orchidopexy and further evaluation of the association of caudal adrenaline and neostigmine

Directory of Open Access Journals (Sweden)

Gabriela Rocha Lauretti

2014-01-01

Full Text Available Background: The aim of this study was to compare the intravenous (IV and caudal routes of administration of sufentanil for children undergoing orchidopexy and also to evaluate the effects on addition of caudal adrenaline and neostigmine. Materials and Methods: Sixty patients scheduled for orchidopexy were divided into the following groups: 1 Group IVSu received IV 0.5 μg/kg sufentanil and caudal saline; 2 Group CSu received caudal 0.5 μg/kg sufentanil and IV saline; 3 Group CSuAdr received caudal sufentanil plus adrenaline 5 μg/ml (1:200,000 and IV saline; 4 Group CSuNeo received caudal sufentanil plus neostigmine, and IV saline; and 5 Group CSuNeoAdr received caudal sufentanil plus neostigmine plus adrenaline, and IV saline. Heart rate and mean blood pressure >15% was treated with increasing isoflurane concentration. Consumption of isoflurane, side effects, quality of sleep, time to first administration of analgesic, and number of doses of 24-h rescue analgesic were recorded. Results: Groups were demographically similar. Isoflurane consumption showed the following association: Group IVSu = Group CSuNeo = Group CSuNeoAdr Group CSuNeo = Group CSuNeoAdr (P < 0.005. Incidence of adverse effects was similar among groups. Conclusion: Caudal sufentanil alone was no better than when administered in the IV route, and would just be justified by the association of neostigmine, but not adrenaline. Neostigmine association resulted in better perioperative analgesia.

76 FR 31359 - Notice of Intent To Prepare an Environmental Impact Statement on a General Management Plan...

Science.gov (United States)

2011-05-31

... management activities, visitor activities, and developments that would be appropriate in the park in the future. In addition, the plan will generally address visitor-use related issues and provide management... Environmental Impact Statement on a General Management Plan Amendment/Wilderness Study for Lake Clark National...

Current contraceptive management in Australian general practice: an analysis of BEACH data.

Science.gov (United States)

Mazza, Danielle; Harrison, Christopher; Taft, Angela; Brijnath, Bianca; Britt, Helena; Hobbs, Melissa; Stewart, Kay; Hussainy, Safeera

2012-07-16

To determine current contraceptive management by general practitioners in Australia. Analysis of data from a random sample of 3910 Australian GPs who participated in the Bettering the Evaluation and Care of Health (BEACH) survey, a continuous cross-sectional survey of GP activity, between April 2007 and March 2011. Consultations with female patients aged 12-54 years that involved all forms of contraception were analysed. GP and patient characteristics associated with the management of contraception; types of contraception used; rates of encounters involving emergency contraception. Increased age, ethnicity, Indigenous status and holding a Commonwealth Health Care Card were significantly associated with low rates of encounters involving management of contraception. The combined oral contraceptive pill was the most frequently prescribed method of contraception, with moderate prescription of long-acting reversible contraception (LARC), especially among women aged 34-54 years. Rates of consultations concerned with emergency contraception were low, but involved high rates of counselling, advice or education (48%) compared with encounters for general contraception (> 20%). A shift towards prescribing LARC, as recommended in clinical guidelines, has yet to occur in Australian general practice. Better understanding of patient and GP perspectives on contraceptive choices could lead to more effective contraceptive use.

Virginia Space Grant Consortium Management of National General Aviation Design Competition

Science.gov (United States)

2002-01-01

This report summarizes the management of the National General Aviation Design Competition on behalf of NASA, the FAA and the Air Force by the Virginia Space Grant Consortium (VSGC) for the time period October 1, 2000 through September 30, 2001. This was the VSGC's seventh and final year of managing the Competition, which the Consortium originally designed, developed and implemented for NASA and the FAA. The competition is now being managed in-house by NASA. Awards to winning university teams were presented at a ceremony held at AirVenture 2001, the Experimental Aircraft Association's Annual Convention and Fly-In at Oshkosh, Wis. by NASA and FAA officials. The competition called for individuals or teams of undergraduate and graduate students from U.S. engineering schools to participate in a major national effort to rebuild the U.S. general aviation sector. Participants were challenged to meet the engineering goals of the Advanced General Aviation Transport Experiment (AGATE) project. For the purpose of the contest, general aviation aircraft are typically defined as single or twin engine (turbine or piston), single-pilot, fixed-wing aircraft for 2 - 6 passengers. The competition seeks to raise student awareness of the importance of general aviation by having students address design challenges for a small aircraft transportation system. NASA, AFRL and the FAA hope to stimulate breakthroughs in technology and their application in the general aviation marketplace. National goals for revitalizing the industry offer excellent, open-ended design challenges with real world applications for the Innovative Design Category. Both individual and team submissions were encouraged. University faculty advisors and students consistently cite the value of this kind of educational experience for their engineering students. Eight proposals were submitted for the 2001 Competition for the Innovative Design Category. Eleven faculty members and 124 students participated. Since inception

A preliminary study for the implementation of general accident management strategies

International Nuclear Information System (INIS)

Yang, Soo Hyung; Kim, Soo Hyung; Jeong, Young Hoon; Chang, Soon Heung

1997-01-01

To enhance the safety of nuclear power plants, implementation of accident management has been suggested as one of most important programs. Specially, accident management strategies are suggested as one of key elements considered in development of the accident management program. In this study, generally applicable accident management strategies to domestic nuclear power plants are identified through reviewing several accident management programs for the other countries and considering domestic conditions. Identified strategies are as follows; 1) Injection into the Reactor Coolant System, 2) Depressurize the Reactor Coolant System, 3) Depressurize the Steam Generator, 4) Injection into the Steam Generator, 5) Injection into the Containment, 6) Spray into the Containment, 7) Control Hydrogen in the Containment. In addition, the systems and instrumentation necessary for the implementation of each strategy are also investigated

Wireless Time Tracking Improves Productivity at CSU Long Beach.

Science.gov (United States)

Charmack, Scott; Walsh, Randy

2002-01-01

Describes California State University Long Beach's implementation of new maintenance management software, which integrated maintenance, inventory control, and key control and allows technicians to enter and receive information through handheld wireless devices for more accurate time accounting. The school estimates a 10 percent increase in…

Developing a framework of, and quality indicators for, general practice management in Europe.

NARCIS (Netherlands)

Engels, Y.M.P.; Campbell, S.M.; Dautzenberg, M.G.H.; Hombergh, P. van den; Brinkmann, H.; Szecsenyi, J.; Falcoff, H.; Seuntjens, L.; Kuenzi, B.; Grol, R.P.T.M.

2005-01-01

OBJECTIVES: To develop a framework for general practice management made up of quality indicators shared by six European countries. METHODS: Two-round postal Delphi questionnaire in the setting of general practice in Belgium, France, Germany, The Netherlands, Switzerland and the United Kingdom. Six

Software Design Document SAF Simulation Host CSCI (8). Volume 1, Sections 1.0 - 2.7

Science.gov (United States)

1991-06-01

in leader asm->pstate is none of the expected states. Errors Error Name I Reason for Error ERROR ABORTI Value in leader asm->pstate is none of the...Error ERROR ABORTI There is no air vehicle. Table 2.6-262: airvehmobility_kill CSU [8.6.4.6.6] 2.6.4.6.7 airvehbcatastrophickill CSU This CSU sets the

A preliminary study for the implementation of general accident management strategies

Energy Technology Data Exchange (ETDEWEB)

Yang, Soo Hyung; Kim, Soo Hyung; Jeong, Young Hoon; Chang, Soon Heung [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of)

1998-12-31

To enhance the safety of nuclear power plants, implementation of accident management has been suggested as one of most important programs. Specially, accident management strategies are suggested as one of key elements considered in development of the accident management program. In this study, generally applicable accident management strategies to domestic nuclear power plants are identified through reviewing several accident management programs for the other countries and considering domestic conditions. Identified strategies are as follows; 1) Injection into the Reactor Coolant System, 2) Depressurize the Reactor Coolant System, 3) Depressurize the Steam Generator, 4) Injection into the Steam Generator, 5) Injection into the Containment, 6) Spray into the Containment, 7) Control Hydrogen in the Containment. In addition, the systems and instrumentation necessary for the implementation of each strategy are also investigated. 11 refs., 3 figs., 3 tabs. (Author)

A preliminary study for the implementation of general accident management strategies

Energy Technology Data Exchange (ETDEWEB)

Yang, Soo Hyung; Kim, Soo Hyung; Jeong, Young Hoon; Chang, Soon Heung [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of)

1997-12-31

To enhance the safety of nuclear power plants, implementation of accident management has been suggested as one of most important programs. Specially, accident management strategies are suggested as one of key elements considered in development of the accident management program. In this study, generally applicable accident management strategies to domestic nuclear power plants are identified through reviewing several accident management programs for the other countries and considering domestic conditions. Identified strategies are as follows; 1) Injection into the Reactor Coolant System, 2) Depressurize the Reactor Coolant System, 3) Depressurize the Steam Generator, 4) Injection into the Steam Generator, 5) Injection into the Containment, 6) Spray into the Containment, 7) Control Hydrogen in the Containment. In addition, the systems and instrumentation necessary for the implementation of each strategy are also investigated. 11 refs., 3 figs., 3 tabs. (Author)

Why the general dentist needs to know how to manage oral lichen planus.

Science.gov (United States)

Price, Stephanie M; Murrah, Valerie A

2015-01-01

Oral lichen planus (OLP) is a frequently mismanaged chronic disease that requires care throughout a patient's life, and therefore a condition the general dentist must know how to manage. Patients with OLP often suffer considerable physical discomfort and an inability to perform proper oral hygiene, eventually resulting in poor periodontal health. In addition, these patients are confronted with the psychological stress of knowing that OLP is not curable. This is accompanied by a fear of other negative health developments, particularly oral cancer. The objective of this study was to identify major issues surrounding the management of OLP by the general dentist. A literature review of over 1100 articles was performed. An eclectic compilation of the issues revealed 12 major areas of concern. This article reviews those concerns and presents strategies for coping with the myriad signs, symptoms, and complications associated with this disease, as well as educational approaches and legal considerations. A rationale is provided to place the responsibility for the management of these patients under the person best positioned to coordinate care for this condition--the general dentist. A general dentist can contribute to the overall oral health of an OLP patient with timely diagnosis, effective treatment, thorough patient education, and the orchestration of efforts by a team of health care providers.

Views of the Scottish general public on community pharmacy weight management services: international implications.

Science.gov (United States)

Weidmann, Anita Elaine; Cunningham, Scott; Gray, Gwen; Hansford, Denise; Bermano, Giovanna; Stewart, Derek

2012-04-01

Obesity has reached pandemic levels, with more than 1.5 billion adults being affected worldwide. In Scotland two-thirds of men and more than half of women are either overweight or obese, placing Scotland overall third behind the United States of America and Mexico. All community pharmacies in Scotland are contracted to provide public health services such as smoking cessation and there is increasing interest in their contribution to weight management. Researching this area in Scotland may provide valuable information to facilitate the development of community pharmacy services in other parts of the UK and internationally. To describe the views of the Scottish general public on the provision of weight management services via community pharmacies. General public in Scotland. A cross-sectional postal questionnaire survey of 6,000 randomly selected members of the Scottish general public aged 18 years and over. Views on community pharmacy led weight management services. Questionnaires were returned by 20.6% (n = 1,236). Over half 60.1% (n = 751) agreed or strongly agreed that they had easy access to pharmacy services in general and around one-third agreed (35%; n = 438) that it was more convenient to obtain weight management advice from a pharmacist than it is to make an appointment with a GP. Most respondents however lacked awareness of the types of health services available through community pharmacy (13.2%; n = 162) and would not feel comfortable speaking to a pharmacist or medicines counter assistant about weight related issues (25%; n = 320). Concerns over privacy (47.3%; n = 592) and perceived lack of pharmacists' specialist knowledge (open comments) were identified as potential barriers to service uptake by the general public. Overall, respondents appear to be receptive to the idea of accessing weight management services through community pharmacy but a perceived lack of privacy, poor knowledge of pharmacists' skill level and of public health services available to

REGISTRO: Informatic application for a general file management

International Nuclear Information System (INIS)

Botija, L.

1988-01-01

It makes easier the mechanization of a 'General File' for a great Center as it allows the management, storage, maintenance and retrieval of all the circulating documents, involving any unit or section, to be considered officially or not. Shortly, it is a system which makes possible the inclusion, within the same Data Base, of references to official and unofficial documents of different classes, as well as document associated with them, under a number of registration correlative for each document and originated by the application. (Author)

REGISTRO: Informatics application for a general file management

International Nuclear Information System (INIS)

Botija, L.

1988-01-01

It makes easier the mechanization of a General Fill for a great Center as it allows the management, storage, maintenance and retrieval of all the circulating documents, involving any unit or section, to be considered officially or not. Shortly, it is a system which makes possible the inclusion, within the same Data Base, of references to official and unofficial documents of different classes, as well as document associated with them, under a number of registration correlative for each document and originated by the application. (Author)

CERT tribal internship program. Final intern report: Karen Sandoval, 1994

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-09-01

The purpose of the project was to: create a working relationship between CERT and Colorado State University (CSU); involve and create relationships among individuals and departments at CSU; empower Native communities to run their own affairs; establish programs for the benefit of Tribes; and create Native American Program Development Office at CSU. The intern lists the following as the project results: revised a Native American Program Development document; confirmation from 45 departments across campus for Summit attendance [Tribal Human Resource Development Summit]; created initial invitee list from CSU departments and colleges; and informed CERT and CSU staff of results. Much of the response from the campus community has been positive and enthusiastic. They are ready to develop new Native American programs on campus, but need the awareness of what they can do to be respectful of Tribal needs.

41 CFR 102-192.130 - What are your general responsibilities as an agency mail manager?

Science.gov (United States)

2010-07-01

... responsibilities as an agency mail manager? 102-192.130 Section 102-192.130 Public Contracts and Property... ADMINISTRATIVE PROGRAMS 192-MAIL MANAGEMENT Agency Mail Manager Requirements § 102-192.130 What are your general responsibilities as an agency mail manager? In addition to carrying out the responsibilities in Subparts B, C, D...

The effectiveness of a semi-tailored facilitator-based intervention to optimise chronic care management in general practice

DEFF Research Database (Denmark)

Due, Tina Drud; Thorsen, Thorkil; Kousgaard, Marius Brostrøm

2014-01-01

BACKGROUND: The Danish health care sector is reorganising based on disease management programmes designed to secure integrated and high quality chronic care across hospitals, general practitioners and municipalities. The disease management programmes assign a central role to general practice; and...

Electric portfolio modeling with stochastic water - climate interactions: Implications for co-management of water and electric utilities

Science.gov (United States)

Woldeyesus, Tibebe Argaw

Water supply constraints can significantly restrict electric power generation, and such constraints are expected to worsen with future climate change. The overarching goal of this thesis is to incorporate stochastic water-climate interactions into electricity portfolio models and evaluate various pathways for water savings in co-managed water-electric utilities. Colorado Springs Utilities (CSU) is used as a case study to explore the above issues. The thesis consists of three objectives: Characterize seasonality of water withdrawal intensity factors (WWIF) for electric power generation and develop a risk assessment framework due to water shortages; Incorporate water constraints into electricity portfolio models and evaluate the impact of varying capital investments (both power generation and cooling technologies) on water use and greenhouse gas emissions; Compare the unit cost and overall water savings from both water and electric sectors in co-managed utilities to facilitate overall water management. This thesis provided the first discovery and characterization of seasonality of WWIF with distinct summertime and wintertime variations of +/-17% compared to the power plant average (0.64gal/kwh) which itself is found to be significantly higher than the literature average (0.53gal/kwh). Both the streamflow and WWIF are found to be highly correlated with monthly average temperature (r-sq = 89%) and monthly precipitation (r-sq of 38%) enabling stochastic simulation of future WWIF under moderate climate change scenario. Future risk to electric power generation also showed the risk to be underestimated significantly when using either the literature average or the power plant average WWIF. Seasonal variation in WWIF along with seasonality in streamflow, electricity demand and other municipal water demands along with storage are shown to be important factors for more realistic risk estimation. The unlimited investment in power generation and/or cooling technologies is also

Developing a framework of, and quality indicators for, general practice management in Europe.

Science.gov (United States)

Engels, Yvonne; Campbell, Stephen; Dautzenberg, Maaike; van den Hombergh, Pieter; Brinkmann, Henrik; Szécsényi, Joachim; Falcoff, Hector; Seuntjens, Luc; Kuenzi, Beat; Grol, Richard

2005-04-01

To develop a framework for general practice management made up of quality indicators shared by six European countries. Two-round postal Delphi questionnaire in the setting of general practice in Belgium, France, Germany, The Netherlands, Switzerland and the United Kingdom. Six national expert panels, each consisting of 10 members, primarily primary care practitioners and experts in the field of quality in primary care participated in the study. The main outcome measures were: (a) a European framework with indicators for the organization of primary care; and (b) ratings of the face validity of the usefulness of the indicators by expert panels in six countries. Agreement was reached about a definition of practice management across five domains (infrastructure, staff, information, finance, and quality and safety), and a common set of indicators for the organization of general practice. The panellist response rate was 95%. Sixty-two indicators (37%) were rated face valid by all six panels. Examples include out of hours service, accessibility, the content of doctors' bags and staff involvement in quality improvement. No indicators were rated invalid by all six panels. It proved to be possible to develop a European set of indicators for assessing the quality of practice management, despite the differences in health care systems and cultures in the six different countries. These indicators will now be used in a quality assessment procedure of practice management in nine European countries. While organizational indicators are part of the new GMS contract in the UK, this research shows that many practice management issues within primary care are also of relevance in other European countries.

Promoting leadership and management in Australian general practice nursing: what will it take?

Science.gov (United States)

Halcomb, Elizabeth J; Davidson, Patricia M; Patterson, Elizabeth

2008-10-01

This paper outlines the current state of Australian practice nursing, describes the context of general practice and establishes the importance of promoting leadership and management in this setting. Australian general practice nurses have emerged as key stakeholders in primary health care. However, their role in leadership and management has been largely invisible. The reasons for this are multifactorial, including the delay to establish a strong professional organization, their negative power relationships with general medical practitioners, limited nursing leadership and poorly defined roles. To date, the impetus for practice nurse growth has been largely external to the nursing profession. Growth has been driven by the increasing burden of chronic disease and workforce shortages. This has further weakened the control of nurse leaders over the development of the specialty. The Australian practice nurse role is at a crossroads. While the practice nurse role is a viable force to improve health outcomes, the growing strength of the practice nurse challenges traditional professional roles and practice patterns. There is an urgent need to develop practice nurse leaders and managers to not only embrace the challenges of Australian general practice from an operational perspective, but also undertake a clinical leadership role. As clinical leaders, these nurses will need to develop a culture that not only optimizes health outcomes but also advances the status of the nursing profession.

77 FR 16558 - General Management Plan/Final Environmental Impact Statement, Hampton National Historic Site...

Science.gov (United States)

2012-03-21

... Management Plan/Final Environmental Impact Statement, Hampton National Historic Site, Maryland AGENCY...) announces the availability of the Final Environmental Impact Statement for the General Management Plan.../Baltimore County Library, 320 York Avenue, Towson, Maryland 21204. Baltimore County Tourism Office and...

Appraisal of cooperation with a palliative care case manager by general practitioners and community nurses: a cross-sectional questionnaire study.

Science.gov (United States)

van der Plas, Annicka G M; Onwuteaka-Philipsen, Bregje D; Vissers, Kris C; Deliens, Luc; Jansen, Wim J J; Francke, Anneke L

2016-01-01

To investigate how general practitioners and community nurses value the support that they receive from a nurse case manager with expertise in palliative care, whether they think the case manager is helpful in realizing appropriate care and what characteristics of the patient and case management are associated with this view. For sustainable palliative care in an ageing society, basic palliative care is provided by generalists and specialist palliative care is reserved for complex situations. Acceptance of and cooperation with specialist palliative care providers by the general practitioner and community nurse is pivotal. Cross-sectional questionnaire study. Questionnaire data from 168 general practitioners and 125 community nurses were analysed using chi-square tests, univariate and multivariate logistic regression. Data were gathered between March 2011-December 2013. Of general practitioners, 46% rated the case manager as helpful in realizing care that is appropriate for the patient; for community nurses this was 49%. The case manager did not hinder the process of care and had added value for patients, according to the general practitioners and community nurses. The tasks of the case manager were associated with whether or not the case manager was helpful in realizing appropriate care, whereas patient characteristics and the number of contacts with the case manager were not. General practitioners and community nurses are moderately positive about the support from the case manager. To improve cooperation further, case managers should invest in contact with general practitioners and community nurses. © 2015 John Wiley & Sons Ltd.

Stakeholders Involvement in Performance Management in Public General Schools

Directory of Open Access Journals (Sweden)

Kristi Ploom

2013-01-01

Full Text Available In response to increasing concerns with the legitimacy and efficiency of public spending, performance management as a part of world-wide public sector reform, called New Public Management (NPM has taken place. This is also the case of educational sector. In Estonian education system, legislation formally enables to design an integrated performance management system. But there is few research done to investigate how these policies and regulations ought to be put into force in order to gain the benefits considering the schools' and pupils' better performance. This study investigates how different stakeholders are involved into the performance management in Estonian general schools. The study is based on empirical survey data gathered from 303 schools providing secondary education in Estonia. The research findings have three main implications. Firstly, the paper contributes to the scarce knowledge about implementation of performance management issues in public schools. Our analysis revealed that compilation of school development plans in Estonian schools is rather a formal obligation. Therefore we propose that the analysis and discussion of the school development plans is needed to organize on regional level, involving all main stakeholders of a school. Secondly, we suggest that in the circumstances of a decentralised education system, like in Estonia, it is needed to implement, central practical performance assessment principles and guidance for the schools. Thirdly, it is highly necessary to improve schools’ cooperation with different stakeholder groups. Also the framework involving different stakeholder groups in the decentralized schools management system should be built up.

General Business Model Patterns for Local Energy Management Concepts

International Nuclear Information System (INIS)

Facchinetti, Emanuele; Sulzer, Sabine

2016-01-01

The transition toward a more sustainable global energy system, significantly relying on renewable energies and decentralized energy systems, requires a deep reorganization of the energy sector. The way how energy services are generated, delivered, and traded is expected to be very different in the coming years. Business model innovation is recognized as a key driver for the successful implementation of the energy turnaround. This work contributes to this topic by introducing a heuristic methodology easing the identification of general business model patterns best suited for Local Energy Management concepts such as Energy Hubs. A conceptual framework characterizing the Local Energy Management business model solution space is developed. Three reference business model patterns providing orientation across the defined solution space are identified, analyzed, and compared. Through a market review, a number of successfully implemented innovative business models have been analyzed and allocated within the defined solution space. The outcomes of this work offer to potential stakeholders a starting point and guidelines for the business model innovation process, as well as insights for policy makers on challenges and opportunities related to Local Energy Management concepts.

REJUVENATING CHRONIC DISEASE MANAGEMENT IN MALAYSIAN PRIVATE GENERAL PRACTICE

Directory of Open Access Journals (Sweden)

PITERMAN L

2010-01-01

Full Text Available Rapid epidemiological transition globally has witnessed a rising prevalence of major chronic diseases such as hypertension, diabetes, hyperlipidaemia, obesity, chronic respiratory diseases and cancers over the past 30 years. In Malaysia, these conditions are commonly managed in primary care and published evidence has consistently shown suboptimal management and poor disease control. This in turn, has led to the massive burden of treating complications in secondary care, burden tothe patients and their families with regards to morbidity and premature death, and burden to the country with regards to premature loss of human capital. The crushing burden and escalating health care costs in managing chronic diseases pose a daunting challenge to our primary care system, as we remain traditionally oriented to care for acute, episodic illnesses. This paper re-examines the current evidence supporting the implementation of Wagner Chronic Care Model in primary careglobally; analyses the barriers of implementation of this model in the Malaysian private general practice through SWOT(strengths, weaknesses, opportunities and threats analysis; and discusses fundamental solutions needed to bridge the gap to achieve better outcomes.

General Business Model Patterns for Local Energy Management Concepts

Energy Technology Data Exchange (ETDEWEB)

Facchinetti, Emanuele, E-mail: emanuele.facchinetti@hslu.ch; Sulzer, Sabine [Lucerne Competence Center for Energy Research, Lucerne University of Applied Science and Arts, Horw (Switzerland)

2016-03-03

The transition toward a more sustainable global energy system, significantly relying on renewable energies and decentralized energy systems, requires a deep reorganization of the energy sector. The way how energy services are generated, delivered, and traded is expected to be very different in the coming years. Business model innovation is recognized as a key driver for the successful implementation of the energy turnaround. This work contributes to this topic by introducing a heuristic methodology easing the identification of general business model patterns best suited for Local Energy Management concepts such as Energy Hubs. A conceptual framework characterizing the Local Energy Management business model solution space is developed. Three reference business model patterns providing orientation across the defined solution space are identified, analyzed, and compared. Through a market review, a number of successfully implemented innovative business models have been analyzed and allocated within the defined solution space. The outcomes of this work offer to potential stakeholders a starting point and guidelines for the business model innovation process, as well as insights for policy makers on challenges and opportunities related to Local Energy Management concepts.

78 FR 29245 - U.S. General Services Administration Federal Property Management Regulations; Administrative Wage...

Science.gov (United States)

2013-05-20

... Federal Property Management Regulations; Administrative Wage Garnishment AGENCY: Office of the Chief... the U.S. General Services Administration Property Management Regulation (GSPMR) to remove information... Administrative Wage Garnishment Code of Federal Regulations (CFR) Parts affected are as follows: 41 CFR part 105...

41 CFR 102-192.140 - What are your general responsibilities as a Federal mail center manager?

Science.gov (United States)

2010-07-01

... responsibilities as a Federal mail center manager? 102-192.140 Section 102-192.140 Public Contracts and Property... ADMINISTRATIVE PROGRAMS 192-MAIL MANAGEMENT Mail Center Manager Requirements § 102-192.140 What are your general responsibilities as a Federal mail center manager? A Federal mail center manager should— (a) Implement policies and...

What's it worth? A general manager's guide to valuation.

Science.gov (United States)

Luehrman, T A

1997-01-01

Behind every major resource-allocation decision a company makes lies some calculation of what that move is worth. So it is not surprising that valuation is the financial analytical skill general managers want to learn more than any other. Managers whose formal training is more than a few years old, however, are likely to have learned approaches that are becoming obsolete. What do generalists need in an updated valuation tool kit? In the 1970s, discounted-cash-flow analysis (DCF) emerged as best practice for valuing corporate assets. And one version of DCF-using the weighted-average cost of capital (WACC)-became the standard. Over the years, WACC has been used by most companies as a one-size-fits-all valuation tool. Today the WACC standard is insufficient. Improvements in computers and new theoretical insights have given rise to tools that outperform WACC in the three basic types of valuation problems managers face. Timothy Luehrman presents an overview of the three tools, explaining how they work and when to use them. For valuing operations, the DCF methodology of adjusted present value allows managers to break a problem into pieces that make managerial sense. For valuing opportunities, option pricing captures the contingent nature of investments in areas such as R&D and marketing. And for valuing ownership claims, the tool of equity cash flows helps managers value their company's stake in a joint venture, a strategic alliance, or an investment that uses project financing.

Dental management of PHACE syndrome under general anesthesia

Directory of Open Access Journals (Sweden)

S Fernandes

2011-01-01

Full Text Available PHACE syndrome was first described by Dr. Ilonia Frieden and colleagues in 1996. It is an under-recognized rather than a very rare condition among patients with large facial hemangiomas. It is challenging as it has significant neurological, vascular and airway implications. Vascular malformations compromising cerebral blood flow predispose the patient to strokes and seizures. Subglottic hemangiomas, if present, could bleed during intubation. Meticulous neurological monitoring is mandatory in those undergoing repair of the great vessels. We describe the perioperative management of a child with PHACE syndrome subjected to dental treatment under general anesthesia.

Discussion on the operation of quality management system in general agent of nuclear pants

International Nuclear Information System (INIS)

Ji Cunxing; Ran Muzi; Shi Lei; Cui Hannan; Wang Gang; Hou Yanli; Li Qilong

2010-01-01

In view of some questions encountered in operation process of quality management system in general agent of nuclear plants of CNNC China Nuclear Power Engineering Co., Ltd. Discussion is made on the questions from four aspect, which should be paid attentions in operation and improvement in order to perfect enterprise management system, increase management level, competitive power to ensurereliable and stable incomes for enterprises. (authors)

Transportation and General Traffic Management, Change 2

Science.gov (United States)

1979-01-01

This Handbook sets forth those transportation and general traffic management responsibilities, guidelines, and procedures governing the use of commercial and Government transportation for NASA. Transportation is an integral function of the logistic process, involving all activities incident to the movement of persons and things. The fundamental and continuous objectives of transportation are to control and diminish the time-distance of lines of communication by the most suitable means. The function of transportation is accomplished through, and encompasses all, the planning, direction, supervision, and execution of the technical, operational, and administrative tasks required to procure or furnish efficient and economical conveyance of cargo and personnel by all modes of commercial and Government transportation. This Handbook is applicable to NASA Headquarters and Field Installations.

41 CFR 102-192.150 - What are your general responsibilities as a program level mail manager?

Science.gov (United States)

2010-07-01

... responsibilities as a program level mail manager? 102-192.150 Section 102-192.150 Public Contracts and Property... general responsibilities as a program level mail manager? Your responsibilities at the program level include— (a) Working closely with the agency mail manager and mail center managers who handle significant...

Siting of nuclear power plants in accordance with the scenario of a ''fossil nuclear energy mix'' prepared by the CDU/CSU and FDP in the inquiry commission of the Bundestag on ''Sustainable energy supply in times of globalisation and deregulation''. Short study

International Nuclear Information System (INIS)

Benik, G.; Gundelach, T.

2002-01-01

In effect the present study makes concrete proposals for the installation of a nuclear power plant capacity of 91.8 GW as determined by the CDU/CSU and FDP in the inquiry commission on ''Sustainable development''. Because of the infrastructural requirements and the large number of plants that would have to be planned in Germany alone these siting proposals must be regarded as an outline for the implementation of a nuclear climate protection strategy. Without extensive assessment work a short study such as this cannot of course replace the detailed planning that would be required for authorisation procedures. The primary benefit of the study is that it makes clear the true consequences of a nuclear climate protection policy that is now being discussed as a hypothetical possibility [de

Practice nurse and health visitor management of acute minor illness in a general practice.

Science.gov (United States)

Pritchard, A; Kendrick, D

2001-11-01

To evaluate practice nurse (PN) and health visitor (HV) management of patients with acute minor illnesses, monitor the effect on general practitioner (GP) workload, and describe the range of conditions seen by nurses. Patients requesting 'urgent' appointments (within 24 hours) were offered consultations with a PN or HV trained in the management of acute minor illness. Comparative data were collected before and after the establishment of the acute minor illness service. A general practice in Nottingham, England. Patient satisfaction, consultation rate, prescriptions, investigations, referrals and urgent re-consultations for the same condition within 2 weeks. About 2056 urgent consultations were recorded in the study period, of which 332 (16.1%) were seen by PNs and 46 (2.2%) by a HV. High levels of patient satisfaction were reported for all health professionals. Patients seeing the HV reported higher levels of satisfaction than those consulting GPs (P=0.033) and PNs (P=0.010). There was no difference by health professional for prescription rates (P=0.76), re-consultations (P=0.14), or referrals to secondary care (P=0.07). General practitioners were more likely to initiate further investigations than the PNs or HV (P manage patients with a range of conditions. General practitioner workload can be reduced while maintaining high patient satisfaction levels.

Cost Utility of Omalizumab Compared with Standard of Care for the Treatment of Chronic Spontaneous Urticaria.

Science.gov (United States)

Graham, Jonathan; McBride, Doreen; Stull, Donald; Halliday, Anna; Alexopoulos, Stamatia Theodora; Balp, Maria-Magdalena; Griffiths, Matthew; Agirrezabal, Ion; Zuberbier, Torsten; Brennan, Alan

2016-08-01

Chronic spontaneous urticaria (CSU) negatively impacts patient quality of life and productivity and is associated with considerable indirect costs to society. The aim of this study was to assess the cost utility of add-on omalizumab treatment compared with standard of care (SOC) in moderate or severe CSU patients with inadequate response to SOC, from the UK societal perspective. A Markov model was developed, consisting of health states based on Urticaria Activity Score over 7 days (UAS7) and additional states for relapse, spontaneous remission and death. Model cycle length was 4 weeks, and total model time horizon was 20 years in the base case. The model considered early discontinuation of non-responders (response: UAS7 ≤6) and retreatment upon relapse (relapse: UAS7 ≥16) for responders. Clinical and cost inputs were derived from omalizumab trials and published sources, and cost utility was expressed as incremental cost-effectiveness ratios (ICERs). Scenario analyses included no early discontinuation of non-responders and an altered definition of response (UAS7 omalizumab was associated with increased costs and benefits relative to SOC. Probabilistic sensitivity analysis supported this result. Productivity inputs were key model drivers, and individual scenarios without early discontinuation of non-responders and adjusted response definitions had little impact on results. ICERs were generally robust to changes in key model parameters and inputs. In this, the first economic evaluation of omalizumab in CSU from a UK societal perspective, omalizumab consistently represented a treatment option with societal benefit for CSU in the UK across a range of scenarios.

76 FR 70483 - Environmental Impact Statement and General Management Plan, Paterson Great Falls National...

Science.gov (United States)

2011-11-14

... planning process and will remain actively involved throughout the development of the plan. Prepared by... the long-term management of Paterson Great Falls NHP early in the process through public meetings and... Impact Statement and General Management Plan, Paterson Great Falls National Historical Park, NJ AGENCY...

Implementation of a Self-Management System for Students with Disabilities in General Education Settings

Science.gov (United States)

Schulze, Margaret A.

2016-01-01

Despite the fact that self-management procedures have a robust literature base attesting to their efficacy with students with disabilities, the use of these strategies in general education settings remains limited. This mixed methods study examined the implementation of self-management procedures using both quantitative and qualitative methods.…

Generalized Information Architecture for Managing Requirements in IBM?s Rational DOORS(r) Application.

Energy Technology Data Exchange (ETDEWEB)

Aragon, Kathryn M.; Eaton, Shelley M.; McCornack, Marjorie Turner; Shannon, Sharon A.

2014-12-01

When a requirements engineering effort fails to meet expectations, often times the requirements management tool is blamed. Working with numerous project teams at Sandia National Laboratories over the last fifteen years has shown us that the tool is rarely the culprit; usually it is the lack of a viable information architecture with well- designed processes to support requirements engineering. This document illustrates design concepts with rationale, as well as a proven information architecture to structure and manage information in support of requirements engineering activities for any size or type of project. This generalized information architecture is specific to IBM's Rational DOORS (Dynamic Object Oriented Requirements System) software application, which is the requirements management tool in Sandia's CEE (Common Engineering Environment). This generalized information architecture can be used as presented or as a foundation for designing a tailored information architecture for project-specific needs. It may also be tailored for another software tool. Version 1.0 4 November 201

Basic concepts in the management of heart failure in general clinical ...

African Journals Online (AJOL)

Basic concepts in the management of heart failure in general clinical practice. KO Ogunyankin. Abstract. No Abstract. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

Investigation of science faculty with education specialties within the largest university system in the United States.

Science.gov (United States)

Bush, Seth D; Pelaez, Nancy J; Rudd, James A; Stevens, Michael T; Tanner, Kimberly D; Williams, Kathy S

2011-01-01

Efforts to improve science education include university science departments hiring Science Faculty with Education Specialties (SFES), scientists who take on specialized roles in science education within their discipline. Although these positions have existed for decades and may be growing more common, few reports have investigated the SFES approach to improving science education. We present comprehensive data on the SFES in the California State University (CSU) system, the largest university system in the United States. We found that CSU SFES were engaged in three key arenas including K-12 science education, undergraduate science education, and discipline-based science education research. As such, CSU SFES appeared to be well-positioned to have an impact on science education from within science departments. However, there appeared to be a lack of clarity and agreement about the purpose of these SFES positions. In addition, formal training in science education among CSU SFES was limited. Although over 75% of CSU SFES were fulfilled by their teaching, scholarship, and service, our results revealed that almost 40% of CSU SFES were seriously considering leaving their positions. Our data suggest that science departments would likely benefit from explicit discussions about the role of SFES and strategies for supporting their professional activities.

The Clinical Correlations of Helicobacter pylori Virulence Factors and Chronic Spontaneous Urticaria

Directory of Open Access Journals (Sweden)

Yi-Chun Chiu

2013-01-01

Full Text Available Background and Study Aims. The association between Helicobacter pylori (H. pylori and chronic spontaneous urticaria (CSU remains controversial. This study explored the role of H. pylori in CSU among different virulent genotypes patients. Patients and Methods. Patients infected by H. pylori were sorted into two groups as group A (with CSU and group B (without CSU. The tissue materials were taken via endoscopy for polymerase chain reaction study to determine virulence factors. After H. pylori eradication therapy, the eradication rate and response of urticaria were evaluated by using C13-UBT and a three-point scale (complete remission, partial remission, or no improvement. Results. The results were comparable between patients of groups A and B in terms of H. pylori infection rates and eradication rate. Longitudinal follow-up of 23.5 months showed complete remission of urticaria in 63.6% but no improvement in 36.4% of the patients after H. pylori eradication. H. pylori infected patients with different virulence factors such as cytotoxin-associated gene A, vacuolating cytotoxin gene A signal region and middle region have similar remission rates for CSU. Conclusions. Current study suggests that H. pylori may play a role in the development and disease course of CSU but may be irrelevant to different virulent genotypes.

A Reinforcement Model of the Relationships of Supervisors' General Communication Styles and Conflict Management Styles to Task Attraction.

Science.gov (United States)

Wheeless, Lawrence R.; Reichel, Lisa S.

1990-01-01

Investigates the relationship between general styles of communicating and more situation-specific conflict management styles. Finds substantial relationships between general communication styles and conflict management styles, as well as very substantial relationships between the style constructs and task attraction of supervisors. (SR)

Treatment of chronic spontaneous urticaria with a single dose of omalizumab: A study of four cases

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Radhakrishnan Subramaniyan

2016-01-01

Full Text Available Background: Chronic spontaneous urticaria (CSU has a detrimental effect on patients′ emotional and physical quality of life. Omalizumab, an anti-immunoglobulin E humanized monoclonal antibody, has been shown to be very effective in the treatment of refractory chronic urticaria patients but may not be an economically viable option for all CSU patients. However, we present a case series where a single dose of omalizumab gave sustained relief of symptoms in patients with CSU, which may be an economical option. Aims: The aim of this study is to assess the efficacy of a single dose of omalizumab in the treatment of CSU. Materials and Methods: Four patients of CSU whose disease was not controlled with four times the licensed dose of tablet fexofenadine 180 mg were exhibited one subcutaneous injection of omalizumab and were followed up at 4 weekly intervals for 24 weeks for Weekly Urticaria Activity Score 7 (UAS7 and Dermatology Life Quality Index (DLQI. Results: A sharp decline in UAS7 and DLQI was documented in 7-10 days. The decline was maintained up to 16 weeks in one case and 20 weeks in the other three cases. Both the scores at the end of the follow-up period of 24 weeks were better than the pre-omalizumab scores. Conclusion: The results of this case series indicate the efficacy of a single-dose omalizumab in treating moderate to severe refractory CSU. Further studies are required to identify the minimum frequency of administering omalizumab to effectively control CSU. This would greatly reduce the cost of this novel therapy.

Decreased management of genital warts in young women in Australian general practice post introduction of national HPV vaccination program: results from a nationally representative cross-sectional general practice study.

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Christopher Harrison

Full Text Available OBJECTIVES: Since the introduction of Australia's human papillomavirus vaccination program, the management rate of genital warts in sexual health clinics and private hospitals has decreased in women of vaccine-eligible age. However, most genital warts in Australia are managed in general practice. This study examines whether a similar decrease occurred in Australian general practice after the introduction of the program. METHODS: Analysis of a nationally representative cross-sectional database of Australian general practice activity (1,175,879 patient encounters with 11,780 general practitioners. Genital warts management rates were estimated for the periods before and after introduction of the program (Pre-program, July 2002-June 2006; Post-program, July 2008-June 2012. Control conditions included genital herpes and gardnerella/bacterial vaginosis in female patients and genital herpes and urethritis in male patients. Trends in management rates by year, pre-vaccine (July 2000-June 2007 and post-vaccine (July 2007-June 2012 were also calculated. RESULTS: Management rate of genital warts among women potentially covered by program (aged 15-27 years decreased by 61% from 4.33 per 1,000 encounters in the Pre-program period to 1.67 in the Post-program period. Trend analysis of the post-vaccine period showed, among women of vaccine eligible age, a significant year-on-year reduction in the rate of genital warts management (p<0.0001 and a significant increase in the management rate of control conditions per year (p<0.0001. For all other age-sex groups there was no significant change in the management rate of genital warts between the Pre- and Post-program periods. CONCLUSION: The large decrease in general practice management of genital warts in women of vaccine-eligible age highlights the success of the program in the wider community.

Surveillance Monitoring Management for General Care Units: Strategy, Design, and Implementation.

Science.gov (United States)

McGrath, Susan P; Taenzer, Andreas H; Karon, Nancy; Blike, George

2016-07-01

The growing number of monitoring devices, combined with suboptimal patient monitoring and alarm management strategies, has increased "alarm fatigue," which have led to serious consequences. Most reported alarm man- agement approaches have focused on the critical care setting. Since 2007 Dartmouth-Hitchcock (Lebanon, New Hamp- shire) has developed a generalizable and effective design, implementation, and performance evaluation approach to alarm systems for continuous monitoring in general care settings (that is, patient surveillance monitoring). In late 2007, a patient surveillance monitoring system was piloted on the basis of a structured design and implementation approach in a 36-bed orthopedics unit. Beginning in early 2009, it was expanded to cover more than 200 inpatient beds in all medicine and surgical units, except for psychiatry and labor and delivery. Improvements in clinical outcomes (reduction of unplanned transfers by 50% and reduction of rescue events by more than 60% in 2008) and approximately two alarms per patient per 12-hour nursing shift in the original pilot unit have been sustained across most D-H general care units in spite of increasing patient acuity and unit occupancy. Sample analysis of pager notifications indicates that more than 85% of all alarm conditions are resolved within 30 seconds and that more than 99% are resolved before escalation is triggered. The D-H surveillance monitoring system employs several important, generalizable features to manage alarms in a general care setting: alarm delays, static thresholds set appropriately for the prevalence of events in this setting, directed alarm annunciation, and policy-driven customization of thresholds to allow clinicians to respond to needs of individual patients. The systematic approach to design, implementation, and performance management has been key to the success of the system.

Teaching Management Information Systems as a General Education Requirement (GER) Capstone

Science.gov (United States)

Hoanca, Bogdan

2012-01-01

Although many IS programs nationwide use capstone courses in the major, this paper reports on the use of an upper division Management Information Systems (MIS) class as a general education requirements (GER) capstone. The class is a core requirement for all majors in the Bachelor of Business Administration (BBA) program at the University of Alaska…

Strategic directions for developing the Australian general practice nurse role in cardiovascular disease management.

Science.gov (United States)

Halcomb, Elizabeth J; Davidson, Patricia M; Yallop, Julie; Griffiths, Rhonda; Daly, John

2007-08-01

Practice nursing is an integral component of British and New Zealand primary care, but in Australia it remains an emerging specialty. Despite an increased focus on the Australian practice nurse role, there has been limited strategic role development, particularly relating to national health priority areas. This paper reports the third stage of a Project exploring the Australian practice nurse role in the management of cardiovascular disease (CVD). This stage involved a consensus development conference, undertaken to identify strategic, priority recommendations for practice nurse role development. 1. Practice nurses have an important role in developing systems and processes for CVD management; 2. A change in the culture of general practice is necessary to promote acceptance of nurse-led CVD management; 3. Future research needs to evaluate specific models of care, incorporating outcome measures sensitive to nursing interventions; 4. Considerable challenges exist in conducting research in general practice; and 5. Changes in funding models are necessary for widespread practice nurse role development. The shifting of funding models provides evidence to support interdisciplinary practice in Australian general practice. The time is ripe, therefore, to engage in prospective and strategic planning to inform development of the practice nurse role.

Analysis of tethered balloon, ceilometer and class sounding data taken on San Nicolas Island during the FIRE project

Science.gov (United States)

Schubert, Wayne H.; Ciesielski, Paul E.; Guinn, Thomas A.; Cox, Stephen K.; Mckee, Thomas B.

1990-01-01

During the FIRE Marine Stratocumulus Program on San Nicolas Island, Colorado State University (CSU) and the British Meteorological Office (BMO) operated separate instrument packages on the NASA tethered balloon. The CSU package contained instrumentation for the measurement of temperature, pressure, humidity, cloud droplet concentration, and long and short wave radiation. Eight research flights, performed between July 7 and July 14, are summarized. An analysis priority to the July 7, 8 and 11 flights was assigned for the purposes of comparing the CSU and BMO data. Results are presented. In addition, CSU operated a laser ceilometer for the determination of cloud base, and a CLASS radiosonde site which launched 69 sondes. Data from all of the above systems are being analyzed.

Management of the open abdomen: clinical recommendations for the trauma/acute care surgeon and general surgeon.

Science.gov (United States)

Fernández, Luis G

2016-09-01

Traditionally, the surgical approach to managing abdominal injuries was to assess the extent of trauma, repair any damage and close the abdomen in one definitive procedure rather than leave the abdomen open. With advances in medicine, damage control surgery using temporary abdominal closure methods is being used to manage the open abdomen (OA) when closure is not possible. Although OA management is often observed in traumatic injuries, the extension of damage control surgery concepts, in conjunction with OA, for the management of the septic patient requires that the general surgeon who is faced with these challenges has a comprehensive knowledge of this complex subject. The purpose of this article is to provide guidance to the acute care and general surgeon on the use of OA negative pressure therapy (OA-NPT; ABTHERA™ Open Abdomen Negative Pressure Therapy System, KCI, an ACELITY Company, San Antonio, TX) for OA management. A literature review of published evidence, clinical recommendations on managing the OA and a case study demonstrating OA management using OA-NPT have been included. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

THE USE OF ICT IN THE MANAGEMENT OF SCHOOLS OF GENERAL EDUCATION IN THE FORMING OF CIVIL SOCIETY

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Sergiy I. Netyosov

2013-03-01

Full Text Available The status and character of the use of ICT in the management of schools of general education and related utilization of information technology in the organization of management of educational institutions with the requirements of the formation of civil society is considered in the article. The author proves that the management of general education institutions involves a significant amount of social information, and the use of ICT in these activities contributes to the inclusion of the public in the mission of education. But the actual state of realization of ICTs in management of secondary schools is mainly directed at the use of technocratic information technology capabilities and the realization of social component in the management of institutions of general education is involved partially, that is an indicator of the rather slow progress of Ukraine toward the establishment of a civil society.

Tracking the evolution of the disaster management cycle: A general system theory approach

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Christo Coetzee

2012-12-01

Full Text Available Officials and scholars have used the disaster management cycle for the past 30 years to explain and manage impacts. Although very little understanding and agreement exist in terms of where the concept originated it is the purpose of this article to address the origins of the disaster management cycle. To achieve this, general system theory concepts of isomorphisms, equifinality, open systems and feedback arrangements were applied to linear disaster phase research (which emerged in the 1920s and disaster management cycles. This was done in order to determine whether they are related concepts with procedures such as emergency, relief, recovery and rehabilitation.

How general dentists could manage a patient with oral lichen planus

Science.gov (United States)

Robledo-Sierra, Jairo

2018-01-01

Background The literature hardly contains information on how patients suffering from oral lichen planus could be managed by dentists. Material and Methods Based on the limited available literature and particularly on the long-term clinical and histopathological experience of one of the authors, suggestions on how dentists could manage patients with oral lichen planus have been put forward. Results: In most cases, the dentist should be able to establish a correct diagnosis. Results In most cases, the dentist should be able to establish a correct diagnosis. Occasionally, the dentist may call upon a specialist, usually an oral medicine specialist or an oral and maxillofacial surgeon for confirmation of the diagnosis, possibly a biopsy procedure, and management of the patient in case of severe symptoms. Proper patient information is of utmost importance in the management. Conclusions General dentists can be expected to manage the majority of patients with oral lichen planus. Some patients may need to be referred for diagnostic purposes to a specialist; this is also the case for the rare patient with severe symptoms, possibly requiring systemic treatment. Key words:Oral mucosal disease, oral lichen planus. PMID:29476684

Omalizumab: what benefits should we expect?

Science.gov (United States)

Giménez-Arnau, Ana; Velasco, Manel; Armario Hita, Jose Carlos; Labrador-Horrillo, Moises; Silvestre Salvador, Juan Francisco

2016-08-01

Chronic spontaneous urticaria (CSU) is a skin disease characterised by wheal appearance, swelling, itching, and painful skin. Omalizumab has been used for CSU treatment demonstrating good efficacy. To investigate the efficacy and safety of omalizumab treatment in CSU patients in real-life practice. A retrospective analysis was performed on 38 patients suffering from CSU who received 300 mg of omalizumab every four weeks. After omalizumab treatment, 68.4% of patients showed a complete response (UAS7 = 0). All the patients were able to stop treatment with corticosteroids, cyclosporine, and anti-leukotrienes, and only 39.5% of patients remained on anti-histamines. Omalizumab treatment led to a 96% and 65% decrease in emergency room and primary health care visits, respectively, as well as a reduction in the direct costs associated with the disease. No omalizumab-related adverse events were reported. Omalizumab exhibits good efficacy in alleviating the symptoms of CSU, leads to a decrease in concomitant medication use, restores patients' quality of life, and has economic benefits by reducing disease-related health care costs.

Informatics application for a general file management; Aplicacion informatica para la gestion de un registro general

Energy Technology Data Exchange (ETDEWEB)

Botija, L

1988-07-01

It makes easier the mechanization of a General Fill for a great Center as it allows the management, storage, maintenance and retrieval of all the circulating documents, involving any unit or section, to be considered officially or not. Shortly, it is a system which makes possible the inclusion, within the same Data Base, of references to official and unofficial documents of different classes, as well as document associated with them, under a number of registration correlative for each document and originated by the application. (Author)

An Executive Appraisal of Courses which Best Prepare One for General Management.

Science.gov (United States)

Hildebrandt, H. W.; And Others

1982-01-01

Summarizes 1980-81 data from 1,158 newly promoted executives who rated business administration courses that best prepare a young person for a general management career. Business communication--oral and written--was the course selected as "very important" more often than any of 13 courses. (PD)

Comparing stream-specific to generalized temperature models to guide salmonid management in a changing climate

Science.gov (United States)

Andrew K. Carlson,; William W. Taylor,; Hartikainen, Kelsey M.; Dana M. Infante,; Beard, Douglas; Lynch, Abigail

2017-01-01

Global climate change is predicted to increase air and stream temperatures and alter thermal habitat suitability for growth and survival of coldwater fishes, including brook charr (Salvelinus fontinalis), brown trout (Salmo trutta), and rainbow trout (Oncorhynchus mykiss). In a changing climate, accurate stream temperature modeling is increasingly important for sustainable salmonid management throughout the world. However, finite resource availability (e.g. funding, personnel) drives a tradeoff between thermal model accuracy and efficiency (i.e. cost-effective applicability at management-relevant spatial extents). Using different projected climate change scenarios, we compared the accuracy and efficiency of stream-specific and generalized (i.e. region-specific) temperature models for coldwater salmonids within and outside the State of Michigan, USA, a region with long-term stream temperature data and productive coldwater fisheries. Projected stream temperature warming between 2016 and 2056 ranged from 0.1 to 3.8 °C in groundwater-dominated streams and 0.2–6.8 °C in surface-runoff dominated systems in the State of Michigan. Despite their generally lower accuracy in predicting exact stream temperatures, generalized models accurately projected salmonid thermal habitat suitability in 82% of groundwater-dominated streams, including those with brook charr (80% accuracy), brown trout (89% accuracy), and rainbow trout (75% accuracy). In contrast, generalized models predicted thermal habitat suitability in runoff-dominated streams with much lower accuracy (54%). These results suggest that, amidst climate change and constraints in resource availability, generalized models are appropriate to forecast thermal conditions in groundwater-dominated streams within and outside Michigan and inform regional-level salmonid management strategies that are practical for coldwater fisheries managers, policy makers, and the public. We recommend fisheries professionals reserve resource

General practitioners' management of mental disorders: A rewarding practice with considerable obstacles

Directory of Open Access Journals (Sweden)

Fleury Marie-Josée

2012-03-01

Full Text Available Abstract Background Primary care improvement is the cornerstone of current reforms. Mental disorders (MDs are a leading cause of morbidity worldwide and widespread in industrialised countries. MDs are treated mainly in primary care by general practitioners (GPs, even though the latter ability to detect, diagnose, and treat patients with MDs is often considered unsatisfactory. This article examines GPs' management of MDs in an effort to acquire more information regarding means by which GPs deal with MD cases, impact of such cases on their practices, factors that enable or hinder MD management, and patient-management strategies. Methods This study employs a mixed-method approach with emphasis on qualitative investigation. Based on a previous survey of 398 GPs in Quebec, Canada, 60 GPs representing a variety of practice settings were selected for further study. A 10-minute-long questionnaire comprising 27 items was administered, and 70-minute-long interviews were conducted. Quantitative (SPSS and qualitative (NVivo analyses were performed. Results At least 20% of GP visits were MD-related. GPs were comfortable managing common MDs, but not serious MDs. GPs' based their treatment of MDs on pharmacotherapy, support therapy, and psycho-education. They used clinical intuition with few clinical tools, and closely followed their patients with MDs. Practice features (salary or hourly fees payment; psycho-social teams on-site; strong informal networks, and GPs' individual characteristics (continuing medical education; exposure and interest in MDs; traits like empathy favoured MD management. Collaboration with psychologists and psychiatrists was considered key to good MD management. Limited access to specialists, system fragmentation, and underdeveloped group practice and shared-care models were impediments. MD management was seen as burdensome because it required more time, flexibility, and emotional investment. Strategies exist to reduce the burden (one

75 FR 4413 - Notice of Intent to Prepare an Environmental Impact Statement for a General Management Plan...

Science.gov (United States)

2010-01-27

... also will outline the kinds of resource management activities, visitor activities, and developments... visitor-use related issues and provide management direction for the six designated wild rivers within the... Impact Statement for a General Management Plan Amendment/Wilderness Study, for Gates of the Arctic...

DEFINING ASPECTS OF HUMAN RESOURCE MANAGEMENT STRATEGY WITHIN THE GENERAL STRATEGY OF THE MODERN ORGANIZATION

Directory of Open Access Journals (Sweden)

Emanoil MUSCALU

2013-07-01

Full Text Available The field of human resources requires the presence and action of several categories of persons and managerial structures interested in the quality of human resources and the activities developed by them. Besides managers and employees there are also the shareholders, the unions, the customers, the different national or local agencies, the local community, etc., with major interests regarding decisions in the human resources area. In order to harmonize their activities and achieve an optimal perspective within the evolution of Human Resource Management, special attention is paid to the strategy of human resources management. According to many specialists, strategies in the field of Human Resource Management show, in the first place, that personnel function adopts a broader perspective and a more dynamic view of human resources, which enables its full integration within the other functions of the organization. In the second place, strategies in the field of Human Resource Management designate the assembly of long term objectives concerning human resources, the main modalities of achieving them and the necessary resources which guarantee that the organization’s structure, value and culture as well as the utilization of its personnel contribute to fulfilling the general objectives of the organization. Therefore, we approached in this paper the problems of grounding and elaborating the Human Resource Management strategy, and we outlined their specific traits, as these are necessary aspects in order to emphasise at the end of our paper the correlation between the strategy in the field of Human Resource Management and the general strategy of the organization. Taking into account specialists and practitioners’ increased interest in knowing, substantiating and implementing strategies in the area of Human Resource Management, we consider that the aspects presented in this paper are modern issues and a starting pointing in solving the great problems of

Using Self-Management Interventions to Address General Education Behavioral Needs: Assessment of Effectiveness and Feasibility

Science.gov (United States)

Briesch, Amy M.; Daniels, Brian

2013-01-01

A comprehensive self-management intervention was utilized to increase the on-task behavior of three African American students within an urban middle-school setting. The intervention was designed to necessitate minimal management on the part of the general education classroom teacher by utilizing an electronic prompting device, as well as a…

Development of CSA N1600-14: general requirements for nuclear emergency management programs

Energy Technology Data Exchange (ETDEWEB)

Sellar, C. [Canadian Standards Association Group, Mississauga, ON (Canada); Coles, J. [Ontario Power Generation, Darlington, ON (Canada)

2014-07-01

CSA Group has published a new standard on General requirements for nuclear emergency management programs (CSA N1600-14). The standard establishes criteria for the emergency management programs of on- and off-site organizations to address nuclear emergencies at Canadian nuclear power plants (NPPs). It provides the requirements to develop, implement, evaluate, maintain, and continuously improve a nuclear emergency management program for prevention and mitigation, preparedness, response, and recovery from a nuclear emergency at a NPP. This paper discusses the development of the standard, and provides the key drivers, structure, scope, and outline of the standard, while highlighting key features, impacts, and benefits. (author)

Peer-Led Self-Management of General Medical Conditions for Patients With Serious Mental Illnesses: A Randomized Trial.

Science.gov (United States)

Druss, Benjamin G; Singh, Manasvini; von Esenwein, Silke A; Glick, Gretl E; Tapscott, Stephanie; Tucker, Sherry Jenkins; Lally, Cathy A; Sterling, Evelina W

2018-02-01

Individuals with serious mental illnesses have high rates of general medical comorbidity and challenges in managing these conditions. A growing workforce of certified peer specialists is available to help these individuals more effectively manage their health and health care. However, few studies have examined the effectiveness of peer-led programs for self-management of general medical conditions for this population. This randomized study enrolled 400 participants with a serious mental illness and one or more chronic general medical conditions across three community mental health clinics. Participants were randomly assigned to the Health and Recovery Peer (HARP) program, a self-management program for general medical conditions led by certified peer specialists (N=198), or to usual care (N=202). Assessments were conducted at baseline and three and six months. At six months, participants in the intervention group demonstrated a significant differential improvement in the primary study outcome, health-related quality of life. Specifically, compared with the usual care group, intervention participants had greater improvement in the Short-Form Health Survey physical component summary (an increase of 2.7 versus 1.4 points, p=.046) and mental component summary (4.6 versus 2.5 points, p=.039). Significantly greater six-month improvements in mental health recovery were seen for the intervention group (p=.02), but no other between-group differences in secondary outcome measures were significant. The HARP program was associated with improved physical health- and mental health-related quality of life among individuals with serious mental illness and comorbid general medical conditions, suggesting the potential benefits of more widespread dissemination of peer-led disease self-management in this population.

Focused cardiac ultrasound is feasible in the general practice setting and alters diagnosis and management of cardiac disease

Directory of Open Access Journals (Sweden)

James Yates

2016-08-01

Full Text Available Background: Ultrasound-assisted examination of the cardiovascular system with focused cardiac ultrasound by the treating physician is non-invasive and changes diagnosis and management of patient’s with suspected cardiac disease. This has not been reported in a general practice setting. Aim: To determine whether focused cardiac ultrasound performed on patients aged over 50 years changes the diagnosis and management of cardiac disease by a general practitioner. Design and setting: A prospective observational study of 80 patients aged over 50 years and who had not received echocardiography or chest CT within 12 months presenting to a general practice. Method: Clinical assessment and management of significant cardiac disorders in patients presenting to general practitioners were recorded before and after focused cardiac ultrasound. Echocardiography was performed by a medical student with sufficient training, which was verified by an expert. Differences in diagnosis and management between conventional and ultrasound-assisted assessment were recorded. Results and conclusion: Echocardiography and interpretation were acceptable in all patients. Significant cardiac disease was detected in 16 (20% patients, including aortic stenosis in 9 (11% and cardiac failure in 7 (9%, which were missed by clinical examination in 10 (62.5% of these patients. Changes in management occurred in 12 patients (15% overall and 75% of those found to have significant cardiac disease including referral for diagnostic echocardiography in 8 (10%, commencement of heart failure treatment in 3 (4% and referral to a cardiologist in 1 patient (1%. Routine focused cardiac ultrasound is feasible and frequently alters the diagnosis and management of cardiac disease in patients aged over 50 years presenting to a general practice.

Elevations in vascular markers and eosinophils in chronic spontaneous urticarial weals with low-level persistence in uninvolved skin

Science.gov (United States)

Kay, AB; Ying, S; Ardelean, E; Mlynek, A; Kita, H; Clark, P; Maurer, M

2014-01-01

Background In chronic spontaneous urticaria (CSU) mast cell activation together with inflammatory changes in the skin are well documented and may play an important role in mechanisms of tissue oedema. Objectives To confirm and extend these observations by measuring microvascular markers, leucocytes and mast cell numbers in lesional and uninvolved skin and to compare findings with a control group. Methods Paired biopsies (one from 4–8-h spontaneous weals and one from uninvolved skin) were taken from eight patients with CSU and nine control subjects and studied using immunohistochemistry and confocal microscopy using the lectin Ulex europaeus agglutinin 1 (UEA-1). Results Lesional skin in CSU contained significantly more CD31+ endothelial cells; CD31+ blood vessels, neutrophils, eosinophils, basophils and macrophages; and CD3+ T cells than nonlesional skin. Increased vascularity was confirmed by confocal imaging using the lectin UEA-1. Uninvolved skin from CSU contained significantly more CD31+ endothelial cells, CD31+ blood vessels and eosinophils compared with the control subjects. There was a threefold increase in mast cell numbers when CSU was compared with controls but no difference was observed between lesional and uninvolved skin. Conclusions Increased vascular markers together with eosinophil and neutrophil infiltration are features of lesional skin in CSU and might contribute to tissue oedema. Eosinophils and microvascular changes persist in uninvolved skin, which, together with increased mast cells, suggests that nonlesional skin is primed for further wealing. PMID:24665899

78 FR 67187 - Notice of Availability of the Draft General Management Plan/Wilderness Study/Environmental Impact...

Science.gov (United States)

2013-11-08

... focus on protecting natural resources and systems. Under this alternative, most of the Big Spring... Availability of the Draft General Management Plan/ Wilderness Study/Environmental Impact Statement for the... Management Plan/Wilderness Study/Environmental Impact Statement (GMP/WS/EIS) for the Ozark National Scenic...

76 FR 70166 - Electrical Standards for Construction and General Industry; Extension of the Office of Management...

Science.gov (United States)

2011-11-10

...] Electrical Standards for Construction and General Industry; Extension of the Office of Management and Budget... contained in the Electrical Standards for Construction (29 CFR part 1926, Subpart K) and for General... maintenance of electric utilization equipment that prevent death and serious injuries among construction and...

The overexpression of insect endogenous small RNAs in transgenic rice inhibits growth and delays pupation of striped stem borer (Chilo suppressalis).

Science.gov (United States)

Jiang, Shan; Wu, Hao; Liu, Haoju; Zheng, Jie; Lin, Yongjun; Chen, Hao

2017-07-01

The striped stem borer (SSB), Chilo suppressalis Walker, is a major rice insect pest worldwide. RNA interference (RNAi) has become a promising strategy for developing insect-resistant crops. In a previous study, five double-stranded RNAs (dsRNAs) targeting important SSB housekeeping genes were overexpressed in rice, but none of the acquired dsRNA-transgenic rice plants showed significant effects on SSB. Thirteen selected SSB endogenous small RNAs, predicted as SSB novel microRNAs (miRNAs), were overexpressed in rice using artificial miRNA (amiRNA) expression technology. Feeding tests showed that two out of 13 selected SSB novel miRNAs caused significant growth inhibition for feeding SSB larvae based on transgenic rice expression. Pupation was delayed 4 days when SSB larvae consecutively fed on transgenic rice expressing the SSB novel miRNA candidate csu-novel-miR15 (csu-15 rice). Gene expression analysis confirmed that the expression levels of at least six SSB unigenes significantly changed (i.e., were up- or down-regulated) after feeding on csu-15 rice. Our research demonstrated a novel RNAi strategy using SSB endogenous small RNAs to develop RNAi crops for pest management; this strategy is different from the common RNAi resulting from transgenic dsRNAs or amiRNAs targeting certain insect endogenous genes. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

78 FR 18960 - Atlantic Coastal Fisheries Cooperative Management Act Provisions; General Provisions for Domestic...

Science.gov (United States)

2013-03-28

... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration RIN 0648-XC586 Atlantic Coastal Fisheries Cooperative Management Act Provisions; General Provisions for Domestic Fisheries; Application for Exempted Fishing Permits AGENCY: National Marine Fisheries Service (NMFS), National Oceanic...

A Business Process Management System based on a General Optimium Criterion

Directory of Open Access Journals (Sweden)

Vasile MAZILESCU

2009-01-01

Full Text Available Business Process Management Systems (BPMS provide a broadrange of facilities to manage operational business processes. These systemsshould provide support for the complete Business Process Management (BPMlife-cycle [16]: (redesign, configuration, execution, control, and diagnosis ofprocesses. BPMS can be seen as successors of Workflow Management (WFMsystems. However, already in the seventies people were working on officeautomation systems which are comparable with today’s WFM systems.Recently, WFM vendors started to position their systems as BPMS. Our paper’sgoal is a proposal for a Tasks-to-Workstations Assignment Algorithm (TWAAfor assembly lines which is a special implementation of a stochastic descenttechnique, in the context of BPMS, especially at the control level. Both cases,single and mixed-model, are treated. For a family of product models having thesame generic structure, the mixed-model assignment problem can be formulatedthrough an equivalent single-model problem. A general optimum criterion isconsidered. As the assembly line balancing, this kind of optimisation problemleads to a graph partitioning problem meeting precedence and feasibilityconstraints. The proposed definition for the "neighbourhood" function involvesan efficient way for treating the partition and precedence constraints. Moreover,the Stochastic Descent Technique (SDT allows an implicit treatment of thefeasibility constraint. The proposed algorithm converges with probability 1 toan optimal solution.

Omalizumab for the treatment of chronic spontaneous urticaria: A meta-analysis of randomized clinical trials.

Science.gov (United States)

Zhao, Zuo-Tao; Ji, Chun-Mei; Yu, Wen-Jun; Meng, Ling; Hawro, Tomasz; Wei, Ji-Fu; Maurer, Marcus

2016-06-01

Chronic spontaneous urticaria (CSU) is defined by itchy hives, angioedema, or both for at least 6 weeks. Omalizumab, an anti-IgE antibody that affects mast cell and basophil function, is a promising new treatment option. As of now, however, the efficacy and safety of different doses of omalizumab used in clinical trials for CSU have not been systematically analyzed and summarized. We sought to assess the efficacy and safety of different doses of omalizumab for the treatment of CSU in a meta-analysis of clinical trial results. Suitable trials were identified by searching PubMed, Medline, Embase, and Web of Science databases and with the help of omalizumab's manufacturers. Only double-blind, randomized, placebo-controlled studies with omalizumab-treated versus placebo-treated patients with CSU were included in this analysis. We identified 7 randomized, placebo-controlled studies with 1312 patients with CSU. Patients treated with omalizumab (75-600 mg every 4 weeks) had significantly reduced weekly itch and weekly wheal scores compared with the placebo group. Omalizumab's effects were dose dependent, with the strongest reduction in weekly itch and weekly wheal scores observed with 300 mg. Rates of complete response were significantly higher in the omalizumab group (relative risk, 4.55; P omalizumab and placebo groups. This meta-analysis provides high-quality evidence for the efficacy and safety of omalizumab in patients with CSU and for treating these patients with 300 mg of omalizumab every 4 weeks. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Effective treatment of different phenotypes of chronic urticaria with omalizumab: Case reports and review of literature.

Science.gov (United States)

Kasperska-Zajac, A; Jarząb, J; Żerdzińska, A; Bąk, K; Grzanka, A

2016-06-01

Despite the excellent efficacy and safety profile of omalizumab in chronic spontaneous urticaria (CSU), there are scarce data concerning its role in the treatment of refractory cases with different phenotypes of urticaria. We describe our experience with the therapy of nine patients with CSU co-existing with delayed pressure urticaria (DPU) or angioedema or both and refractory to treatment with high-dose antihistamines. The first patient, with severe CSU and recurrent angioedema, did not respond well to cyclosporine A or corticosteroids and suffered from numerous side effects of long-term corticosteroid therapy. The second patient presented with severe symptoms of DPU, which first of all prevented any daily activities of the professional routines. Both patients showed a complete remission of urticaria after the first injection of omalizumab. The third patient with CSU and severe DPU had been ineffectively treated for more than 20 years with various medications. Following the administration of omalizumab, the symptoms of CSU subsided but those of DPU intensified, and the drug was withdrawn after two cycles. In another four patients with refractory CSU and angioedema, the symptoms subsided after the first administration of omalizumab, and the patients have been in remission for about 5 weeks. In the remaining two patients, the symptoms did not resolve despite four 300 mg doses of omalizumab. It is important to establish a therapeutic regimen with omalizumab (150-300 mg; every 4-8 weeks) tailored to individual patient's needs and dependent on the type of urticaria; this may minimize unnecessary the medication exposure, adverse drug effects, and healthcare costs. © The Author(s) 2015.

“Management of Overweight during Childhood: A Focus Group Study on Health Professionals’ Experiences in General Practice,”

DEFF Research Database (Denmark)

Larsen, Lone Marie; Ledderer, Loni; Jarbol, Dorte E

2015-01-01

Background. Because of the increasing prevalence of overweight and obesity in childhood in the Western world, focus on the management in general practice has also increased. Objective. To explore the experiences of general practitioners (GPs) and practice nurses participating in a randomised...... controlled trial (RCT) comparing two management programmes in general practice for children who are overweight or obese. Methods. Three focus groups with GPs and nurses participating in the RCT. Transcribed data were analysed using systematic text condensation followed by thematic analysis. Results. Health...... to addressing overweight in children. However, increasing awareness of obesity in childhood and its consequences in society was considered helpful to reach an understanding of the articulations concerning how best to address the issue. Conclusions. Health professionals in general practice recognised...

Mechanical lift of profile

Energy Technology Data Exchange (ETDEWEB)

O`Mahoney, H.

1999-04-01

Continuous ship unloaders (CSUs) are continuing to become more popular than grab unloaders for dealing with greater capacities of coal. The article surveys current major manufacturers` equipment. Krupp Foerdertechnik, for example, offers seven mechanical ship unloaders, including CSU with scraper chain or L-shaped bucket-elevators, CSU with vertical screw conveyor and horizontal screw-type feeder conveyors. CSU with bucket-elevator and feeding scraper and a continuous barge unloader with bucket elevator, BMH Marine Siwertell continues to be the benchmark for technology advances. HW Carlsan has recently entered the field with a new screw-type ship unloader. 4 photos.

Les politiques visant la couverture sanitaire universelle et les perceptions de la qualité des soins de santé

OpenAIRE

Gautier , Lara; Ridde , Valery

2017-01-01

International audience; Le début de la décennie 2010 a été marqué par l’avènement sur la scène internationale de la couverture sanitaire universelle (CSU) comme politique de santé mondiale. La consécration, en 2015, de la CSU comme sous-objectif du nouveau programme de développement mondial – les Objectifs de développement durable 2016-2030 – invite les acteurs de la santé mondiale à se mobiliser en faveur de l’atteinte des trois volets phares de la CSU : assurer la protection du risque finan...

Effectiveness of post-discharge case management in general-medical outpatients: A randomized, controlled trial

NARCIS (Netherlands)

Latour, C.H.M.; de Vos, R.; Huyse, F.J.; De Jonge, P.; van Gemert, L.A.M.; Stalman, W.A.B.

2006-01-01

This study was initiated to determine the impact of post- discharge, nurse- led, home- based case management intervention on the number of emergency readmissions, level of care utilization, quality of life, and psychological functioning. Patients discharged home from a general hospital (N = 147)

Effectiveness of post-discharge case management in general-medical outpatients : A randomized, controlled trial

NARCIS (Netherlands)

Latour, Corine H. M.; de Vos, Rien; Huyse, Frits J.; de Jonge, Peter; van Gemert, Liesbeth A. M.; Stalman, Wim A. B.

2006-01-01

This study was initiated to determine the impact of post- discharge, nurse- led, home- based case management intervention on the number of emergency readmissions, level of care utilization, quality of life, and psychological functioning. Patients discharged home from a general hospital (N = 147)

Tools for Management of Chlorinated Solvent - Contaminated Sites

Science.gov (United States)

2009-12-03

Movie Lee Ann Doner – (2008) MS CSU “Sandy aquifers” Image from Fred Payne /ARCADIS New Paradigm After NRC 2005 l~r SERDP. Advancing solvent plume...Situ Bioremediation Using Emulsified  Edible  Oil”   AFCEE (http://www.afcee.brooks.af.mil/products/techtrans/) - “Principles and Practices of Enhanced...Anaerobic Bioremediation of  Chlorinated Solvents”  - “Protocol for In Situ Bioremediation of Chlorinated Solvents Using  Edible  Oil” 232 Short Course

A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder.

Science.gov (United States)

McMain, Shelley F; Links, Paul S; Gnam, William H; Guimond, Tim; Cardish, Robert J; Korman, Lorne; Streiner, David L

2009-12-01

The authors sought to evaluate the clinical efficacy of dialectical behavior therapy compared with general psychiatric management, including a combination of psychodynamically informed therapy and symptom-targeted medication management derived from specific recommendations in APA guidelines for borderline personality disorder. This was a single-blind trial in which 180 patients diagnosed with borderline personality disorder who had at least two suicidal or nonsuicidal self-injurious episodes in the past 5 years were randomly assigned to receive 1 year of dialectical behavior therapy or general psychiatric management. The primary outcome measures, assessed at baseline and every 4 months over the treatment period, were frequency and severity of suicidal and nonsuicidal self-harm episodes. Both groups showed improvement on the majority of clinical outcome measures after 1 year of treatment, including significant reductions in the frequency and severity of suicidal and nonsuicidal self-injurious episodes and significant improvements in most secondary clinical outcomes. Both groups had a reduction in general health care utilization, including emergency visits and psychiatric hospital days, as well as significant improvements in borderline personality disorder symptoms, symptom distress, depression, anger, and interpersonal functioning. No significant differences across any outcomes were found between groups. These results suggest that individuals with borderline personality disorder benefited equally from dialectical behavior therapy and a well-specified treatment delivered by psychiatrists with expertise in the treatment of borderline personality disorder.

Abnormal vaginal bleeding in women of reproductive age: a descriptive study of initial management in general practice

NARCIS (Netherlands)

de Vries, Corlien J. H.; Wieringa-de Waard, Margreet; Vervoort, Cléo-Lotte A. G.; Ankum, Willem M.; Bindels, Patrick J. E.

2008-01-01

BACKGROUND: Abnormal vaginal bleeding (AVB) in women of reproductive age is a common reason for consulting a general practitioner. Nevertheless, how general practitioners (GPs) choose to initially manage AVB is largely unknown, as is the prevalence of underlying pathology of AVB in primary care.

CFD Modeling of Free-Piston Stirling Engines

Science.gov (United States)

Ibrahim, Mounir B.; Zhang, Zhi-Guo; Tew, Roy C., Jr.; Gedeon, David; Simon, Terrence W.

2001-01-01

NASA Glenn Research Center (GRC) is funding Cleveland State University (CSU) to develop a reliable Computational Fluid Dynamics (CFD) code that can predict engine performance with the goal of significant improvements in accuracy when compared to one-dimensional (1-D) design code predictions. The funding also includes conducting code validation experiments at both the University of Minnesota (UMN) and CSU. In this paper a brief description of the work-in-progress is provided in the two areas (CFD and Experiments). Also, previous test results are compared with computational data obtained using (1) a 2-D CFD code obtained from Dr. Georg Scheuerer and further developed at CSU and (2) a multidimensional commercial code CFD-ACE+. The test data and computational results are for (1) a gas spring and (2) a single piston/cylinder with attached annular heat exchanger. The comparisons among the codes are discussed. The paper also discusses plans for conducting code validation experiments at CSU and UMN.

Basophil FcεRI Expression in Chronic Spontaneous Urticaria: A Potential Immunological Predictor of Response to Omalizumab Therapy.

Science.gov (United States)

Deza, Gustavo; Bertolín-Colilla, Marta; Pujol, Ramon M; Curto-Barredo, Laia; Soto, Dulce; García, Maribel; Hernández, Pilar; Gimeno, Ramon; Giménez-Arnau, Ana M

2017-06-09

Although the efficacy of omalizumab has been clearly demonstrated in the treatment of chronic spontaneous urticaria (CSU), its mechanism of action, which results in improvement in CSU symptoms, is not entirely understood. This study investigated the effect of omalizumab on expression of the high-affinity IgE receptor (FcεRI) on blood basophils from patients with active CSU, and its association with the clinical response. Patients exhibiting significant clinical improvement showed a sharp reduction in the levels of basophil FcεRI after 4 weeks, which was maintained throughout the total duration of the treatment. Such evolution was not observed in non-responder patients. Furthermore, non-responders showed significantly lower baseline levels of FcεRI than responders. Baseline basophil FcεRI expression was found to be a potential immunological predictor of response to omalizumab (100% sensitivity and 73.2% specificity). The results of this study contribute to our knowledge of the therapeutic benefit and mechanism of action of anti-IgE therapy in CSU.

Periodontal instrumentation for the general dental practitioner: Pt. 2. Management maintenance and sterilization

Energy Technology Data Exchange (ETDEWEB)

Touyz, L.Z.G. (University of the Witwatersrand, Johannesburg (South Africa). Dept. of Oral Medicine and Periodontology); De Waal, J.

1983-03-01

The purpose of this article is to describe the management, maintenance and sterilization of periodontal instrumentation used by the general dental practitioner. The pre-sterilization, decontamination and cleaning, the sharpening of instrumentation and the packaging, identification and grouping for sterilization are discussed. Attention is also given to various techniques of sterilization, including gamma radiation.

Effectiveness of post-discharge case management in general-medical outpatients: a randomized, controlled trial

NARCIS (Netherlands)

Latour, Corine H. M.; de Vos, Rien; Huyse, Frits J.; de Jonge, Peter; van Gemert, Liesbeth A. M.; Stalman, Wim A. B.

2006-01-01

This study was initiated to determine the impact of post-discharge, nurse-led, home-based case management intervention on the number of emergency readmissions, level of care utilization, quality of life, and psychological functioning. Patients discharged home from a general hospital (N=147) were

Effectiveness of post-discharge case management in general-medical outpatients: A randomized, controlled trial

NARCIS (Netherlands)

Latour-Delfgaauw, C.H.M.; Vos, R.; Huyse, F.J.; de Jonge, P.; van Gemert, L.A.M.; Stalman, W.A.B.

2006-01-01

This study was initiated to determine the impact of post-discharge, nurse-led, home-based case management intervention on the number of emergency readmissions, level of care utilization, quality of life, and psychological functioning. Patients discharged home from a general hospital (N=147) were

Emergency general surgery in Rwandan district hospitals: a cross-sectional study of spectrum, management, and patient outcomes.

Science.gov (United States)

Mpirimbanyi, Christophe; Nyirimodoka, Alexandre; Lin, Yihan; Hedt-Gauthier, Bethany L; Odhiambo, Jackline; Nkurunziza, Theoneste; Havens, Joaquim M; Omondi, Jack; Rwamasirabo, Emile; Ntirenganya, Faustin; Toma, Gabriel; Mubiligi, Joel; Bayitondere, Scheilla; Riviello, Robert

2017-12-01

Management of emergency general surgical conditions remains a challenge in rural sub-Saharan Africa due to issues such as insufficient human capacity and infrastructure. This study describes the burden of emergency general surgical conditions and the ability to provide care for these conditions at three rural district hospitals in Rwanda. This retrospective cross-sectional study included all patients presenting to Butaro, Kirehe and Rwinkwavu District Hospitals between January 1st 2015 and December 31st 2015 with emergency general surgical conditions, defined as non-traumatic, non-obstetric acute care surgical conditions. We describe patient demographics, clinical characteristics, management and outcomes. In 2015, 356 patients presented with emergency general surgical conditions. The majority were male (57.2%) and adults aged 15-60 years (54.5%). The most common diagnostic group was soft tissue infections (71.6%), followed by acute abdominal conditions (14.3%). The median length of symptoms prior to diagnosis differed significantly by diagnosis type (p operated on at the district hospital, either by a general surgeon or general practitioner. Patients were more likely to receive surgery if they presented to a hospital with a general surgeon compared to a hospital with only general practitioners (75% vs 43%, p operation in a hospital with a general surgeon as opposed to a general practitioner. This provides evidence to support increasing the surgical workforce in district hospitals in order to increase surgical availability for patients.

Should the General Practitioner Consider Mesotherapy (Intradermal Therapy) to Manage Localized Pain?

OpenAIRE

Mammucari, M; Maggiori, E; Lazzari, M; Natoli, S

2016-01-01

Wide variations in the types of pain and response to analgesic pharmacotherapy mean that a variety of treatment strategies are needed. One approach is mesotherapy (intradermal therapy). This consists of microinjections into the skin and is ideally suited to the management of localized pain. Advantages include increasing the duration of drug activity, reduced risk of adverse events and interactions, and possible synergy with other therapies. Mesotherapy provides general practitioners with anot...

Understanding the process of patient satisfaction with nurse-led chronic disease management in general practice.

Science.gov (United States)

Mahomed, Rosemary; St John, Winsome; Patterson, Elizabeth

2012-11-01

  To investigate the process of patient satisfaction with nurse-led chronic disease management in Australian general practice.   Nurses working in the primary care context of general practice, referred to as practice nurses, are expanding their role in chronic disease management; this is relatively new to Australia. Therefore, determining patient satisfaction with this trend is pragmatically and ethically important. However, the concept of patient satisfaction is not well understood particularly in relation to care provided by practice nurses.   A grounded theory study underpinned by a relativist ontological position and a relativist epistemology.   Grounded theory was used to develop a theory from data collected through in-depth interviews with 38 participants between November 2007-April 2009. Participants were drawn from a larger project that trialled a practice nurse-led, collaborative model of chronic disease management in three Australian general practices. Theoretical sampling, data collection, and analysis were conducted concurrently consistent with grounded theory methods.   Patients undergo a cyclical process of Navigating Care involving three stages, Determining Care Needs, Forming Relationship, and Having Confidence. The latter two processes are inter-related and a feedback loop from them informs subsequent cycles of Determining Care Needs. If any of these steps fails to develop adequately, patients are likely to opt out of nurse-led care.   Navigating Care explains how and why time, communication, continuity, and trust in general practitioners and nurses are important to patient satisfaction. It can be used in identifying suitable patients for practice nurse-led care and to inform the practice and organization of practice nurse-led care to enhance patient satisfaction. © 2012 Blackwell Publishing Ltd.

Active Learning in Aging Research

Science.gov (United States)

Singelis, Theodore M.

2006-01-01

This article describes the involvement of undergraduate students in research at the California State University (CSU), Chico funded through an Academic Research Enhancement Award (AREA) from the National Institute on Aging (NIA). CSU, Chico is a "teaching" university and has students with a variety of motivations and abilities. The…

36 CFR 251.123 - Most directly affected Native Corporation determination.

Science.gov (United States)

2010-07-01

... affected by the establishment or expansion of the CSU under section 1307(b) of ANILCA (16 U.S.C. 1397(b... landownership patterns) on the Native Corporation resulting from establishment or expansion of the applicable... Native Corporation's population centers and/or business address to the applicable CSU; (2) Socioeconomic...

Management of acute rhinosinusitis in Danish general practice: a survey

Directory of Open Access Journals (Sweden)

Hansen JG

2011-07-01

Full Text Available Jens Georg HansenDepartment of Clinical Epidemiology, Aarhus University Hospital and Aalborg Hospital, Aalborg, DenmarkPurpose: To evaluate whether the ongoing debate over diagnostic problems and treatment choices for acute rhinosinusitis has had any influence on the management of the disease.Methods: We randomly selected 300 Danish general practitioners (GPs from the files of the Research Unit for General Practice at Aarhus University. Invitations to participate and a questionnaire were sent to the GPs by mail.Results: A total of 149 (49% GPs answered the questionnaire. When asked about symptoms, the highest priority was given to sinus pain and signs of tenderness. The most frequent examinations were objective examination of the ear-nose-throat (ENT, palpation of the maxillofacial area, and C-reactive protein point-of-care testing (or CRP rapid test. Nearly all GPs prescribed local vasoconstrictors, and in 70% of cases, antibiotics were prescribed. Phenoxymethylpenicillin was the preferred antibiotic. Use of the CRP rapid test, years in practice, or employment in an ENT department did not have a significant impact on the diagnostic certainty and antibiotic prescribing rate.Conclusion: The clinical diagnoses are based on a few symptoms, signs, and the CRP rapid test. Other examinations, including imaging techniques, are seldom used. Phenoxymethylpenicillin is the preferred antibiotic, and the GPs' diagnostic certainty was 70%.Keywords: general practice, acute rhinosinusitis, diagnosis, treatment, antibiotic

Building chronic disease management capacity in General Practice: The South Australian GP Plus Practice Nurse Initiative.

Science.gov (United States)

Fuller, Jeffrey; Koehne, Kristy; Verrall, Claire C; Szabo, Natalie; Bollen, Chris; Parker, Sharon

2015-01-01

This paper draws on the implementation experience of the South Australian GP Plus Practice Nurse Initiative in order to establish what is needed to support the development of the chronic disease management role of practice nurses. The Initiative was delivered between 2007 and 2010 to recruit, train and place 157 nurses across 147 General Practices in Adelaide. The purpose was to improve chronic disease management in General Practice, by equipping nurses to work as practice nurses who would coordinate care and establish chronic disease management systems. Secondary analysis of qualitative data contained in the Initiative evaluation report, specifically drawing on quarterly project records and four focus groups conducted with practice nurses, practice nurse coordinators and practice nurse mentors. As evidenced by the need to increase the amount of support provided during the implementation of the Initiative, nurses new to General Practice faced challenges in their new role. Nurses described a big learning curve as they dealt with role transition to a new work environment and learning a range of new skills while developing chronic disease management systems. Informants valued the skills development and support offered by the Initiative, however the ongoing difficulties in implementing the role suggested that change is also needed at the level of the Practice. While just over a half of the placement positions were retained, practice nurses expressed concern with having to negotiate the conditions of their employment. In order to advance the role of practice nurses as managers of chronic disease support is needed at two levels. At one level support is needed to assist practice nurses to build their own skills. At the level of the Practice, and in the wider health workforce system, support is also needed to ensure that Practices are organisationally ready to include the practice nurse within the practice team.

Optimization of power plants management structure based on the generalized criteria of the efficiency

Directory of Open Access Journals (Sweden)

Salov Aleksey

2017-01-01

Full Text Available In the article, the analysis of the operation of power plants in the conditions of economic restructuring to ensure successful entry into the market is carried out. The analysis of the five management structures, including current, typical structure and re-designed by the authors is presented. There are developed the partial efficiency criteria of the management structures that characterize the most important properties - the balance, integrity, controllability and stability. Local criteria of the analyzed structures do not allow to make a definite conclusion about the effectiveness of one of the structures analyzed, formulated global efficiency criterion. There is developed the global criterion of the comparative effectiveness of the management systems based on the DEA method (Data envelopment analysis, taking into account the complex of the proposed local criteria. The considered management structures are ranked based on the generalized criterion of efficiency.

Impact on diabetes management of General Practice Management Plans, Team Care Arrangements and reviews.

Science.gov (United States)

Wickramasinghe, Leelani K; Schattner, Peter; Hibbert, Marienne E; Enticott, Joanne C; Georgeff, Michael P; Russell, Grant M

2013-08-19

To investigate whether General Practice Management Plans (GPMPs), Team Care Arrangements (TCAs) and reviews of these improve the management and outcomes of patients with diabetes when supported by cdmNet, a web-based chronic disease management system; and to investigate adherence to the annual cycle of care (ACOC), as recommended in diabetes guidelines. A before-and-after study to analyse prospectively collected data on 577 patients with type 1 or 2 diabetes mellitus who were managed with a GPMP created using cdmNet between June 2008 and November 2012. Completion of the clinical tests in the ACOC (process outcome) and values of six of these clinical measurements (clinical outcomes). Significant improvements were seen after creation of a GPMP in the proportion of ACOC clinical tests completed (57.9% v 74.8%, P < 0.001), total cholesterol level (P < 0.01), low-density lipoprotein (LDL) cholesterol level (P < 0.001) and body mass index (BMI) (P < 0.01). Patients using GPMPs and TCAs also improved their glycated haemoglobin (HbA1c) level (P < 0.05). Patients followed up with irregular reviews had significant improvements in the proportion of ACOC clinical tests completed (59.2% v 77.6%, P < 0.001), total cholesterol level (P < 0.05), and BMI (P < 0.01), but patients with regular reviews had greater improvements in the proportion of ACOC clinical tests completed (58.9% v 85.0%, P < 0.001), HbA(1c) level (57.7 v 53.0 mmol/mol, P < 0.05), total cholesterol level (4.8 v 4.5 mmol/L, P < 0.05), LDL cholesterol level (2.8 v 2.4 mmol/L, P < 0.01) and diastolic blood pressure (76.0 v 74.0 mmHg, P < 0.05). There were significant improvements in process and clinical outcomes for patients on a GPMP or a GPMP and TCA, particularly when these were followed up by regular reviews. Patients using cdmNet were four times more likely to have their GPMP or TCA followed up through regular reviews than the national average.

Profile of omalizumab in the treatment of chronic spontaneous urticaria.

Science.gov (United States)

Labrador-Horrillo, Moises; Ferrer, Marta

2015-01-01

Chronic spontaneous urticaria (CSU) is a disease with significant morbidity and relative prevalence that has important effects on the quality of life (QoL) of those who suffer from it. Omalizumab is a recombinant humanized anti-immunoglobulin E (IgE) antibody that binds to the Cε3 domain of the IgE heavy chain and prevents it from binding to its high-affinity receptor FcεRI. It has been largely studied in the field of asthma and is currently approved for the treatment of both adult and pediatric (children; >6-year-old) patients. In addition, in recent, well-controlled clinical trials in patients with CSU resistant to antihistamines, add-on therapy with subcutaneous omalizumab significantly reduced the severity of itching, and the number and size of hives, and increased patients' health-related QoL and the proportion of days free from angioedema compared with placebo, with an excellent tolerance. Thus, omalizumab is an effective and well-tolerated add-on therapy for patients with CSU who are symptomatic despite background therapy with H1 antihistamines. In this review, we cover the following points: epidemiology, pathogenesis, assessment of activity, impact on QoL, and treatment of CSU, and finally, we focus on omalizumab in the treatment of CSU including the pharmacokinetic properties and mechanism of action, and use in pregnant women, nursing infants, and children.

Perioperative management of patients for osteo-odonto-kreatoprosthesis under general anaesthesia: A retrospective study.

Science.gov (United States)

Garg, Rakesh; Khanna, Puneet; Sinha, Renu

2011-05-01

An osteo-odonto-keratoprosthesis (OOKP) procedure is indicated in patients with failed corneal transplant but having intact retina for visual improvement. We studied perioperative concerns of patients who underwent the staged OOKP procedure. This was a retrospective analysis of patients who underwent OOKP. The information regarding symptoms, associated comorbidities, perioperative events including anaesthetic management were collected. Eight patients (five females and three males) underwent the staged OOKP procedure. The median age was 18 years. The median weight was 45 kg. The median duration of loss of vision was 4 years. The aetiology of blindness included Stevens-Johnson's syndrome (SJS) (7) and chemical burn (1). Four patients had generalized skin problem due to SJS. All cases were managed under general anaesthesia, and airway management included nasotracheal intubation for stage I and orotracheal intubation for stage II. The median mallampati classification was I prior to OOKP stage I procedure while it changed to II at stage II procedure. Two patients required fibreoptic nasotracheal intubation. One patient had excessive oozing from the mucosal harvest site and was managed conservatively. In one patient, tooth harvesting was done twice as the first tooth was damaged during creating a hole in it. We conclude that OOKP requires multidisciplinary care. Anaesthesiologist should evaluate the airway carefully and disease-associated systemic involvements. The use of various drugs requires caution and steroid supplementation should be done. Airway difficulty should be anticipated, mandating thorough evaluation. Re-evaluation of airway is prudent as it may become difficult during the staged OOKP procedure.

Perioperative management of patients for osteo-odonto-kreatoprosthesis under general anaesthesia: A retrospective study

Directory of Open Access Journals (Sweden)

Rakesh Garg

2011-01-01

Full Text Available An osteo-odonto-keratoprosthesis (OOKP procedure is indicated in patients with failed corneal transplant but having intact retina for visual improvement. We studied perioperative concerns of patients who underwent the staged OOKP procedure. This was a retrospective analysis of patients who underwent OOKP. The information regarding symptoms, associated comorbidities, perioperative events including anaesthetic management were collected. Eight patients (five females and three males underwent the staged OOKP procedure. The median age was 18 years. The median weight was 45 kg. The median duration of loss of vision was 4 years. The aetiology of blindness included Stevens-Johnson′s syndrome (SJS (7 and chemical burn (1. Four patients had generalized skin problem due to SJS. All cases were managed under general anaesthesia, and airway management included nasotracheal intubation for stage I and orotracheal intubation for stage II. The median mallampati classification was I prior to OOKP stage I procedure while it changed to II at stage II procedure. Two patients required fibreoptic nasotracheal intubation. One patient had excessive oozing from the mucosal harvest site and was managed conservatively. In one patient, tooth harvesting was done twice as the first tooth was damaged during creating a hole in it. We conclude that OOKP requires multidisciplinary care. Anaesthesiologist should evaluate the airway carefully and disease-associated systemic involvements. The use of various drugs requires caution and steroid supplementation should be done. Airway difficulty should be anticipated, mandating thorough evaluation. Re-evaluation of airway is prudent as it may become difficult during the staged OOKP procedure.

General Managers' and building managers' different evaluation of building value and quality - as built and over time

DEFF Research Database (Denmark)

Jensen, Per Anker

2007-01-01

building. Furthermore, the respondents were asked to prioritize the quality factors. In the analysis the quality factors were grouped into cultural value and use value and into quality as built and over time. The paper presents the general results of the survey with focus on the differences between......This paper is one of the results of a research project on real estate strategies and building values based on a case study of the corporate buildings of DR (Danish Broadcasting Corporation). The paper presents some of the results from a questionnaire survey among select groups of managers in DR...... concerning their evaluation of 5 buildings. The overall purpose of the survey was to evaluate the different buildings’ values and quality, both as built and over time. A second purpose was to develop and test a methodology to describe the values and quality of buildings at a general but still differentiated...

Waste management 86. Volume 1:General interest

International Nuclear Information System (INIS)

Post, R.G.

1986-01-01

This book presents the papers given at a symposium on radioactive waste management. Topics considered at the symposium included the status of radioactive waste disposal, the status of international nuclear waste management, waste management activities at the Idaho National Engineering Laboratory, legal and liability issues, risk perceptions and public involvement, waste transportation, waste processing, remedial action, decontamination, predisposal processing and treatment processes, low-level and mixed waste management, and mixed chemical and radioactive waste disposal

Bernie's Odyssey: Denver Nuggets' General Manager Bernie Bickerstaff's Basketball Roots in Harlan County, Ky.

Science.gov (United States)

Nelson, Glenn

1992-01-01

Bernie Bickerstaff discusses how growing up as an African-American athlete in rural Kentucky prepared him to become the general manager of the Denver Nuggets. Triumphing over the area's racial segregation, poverty, and mining perils gave him a sense of strength that enabled him to overcome barriers in advancing his career. (LP)

Nurse-led case management for ambulatory complex patients in general health care: A systematic review

NARCIS (Netherlands)

Latour-Delfgaauw, C.H.M.; van der Windt, D.A.W.M.; de Jonge, P.; Riphagen, II; Vos, R.; Huyse, F.J.; Stalman, W.A.B.

2007-01-01

Objective: The aim of this study was to summarize the available literature on the effectiveness of ambulatory nurse-led case management for complex patients in general health care. Method: We searched MEDLINE, EMBASE, the Cochrane Controlled Trials Register, and Cinahl. We included randomized

The Effect of Mandatory Furloughs on Self-Determination, Financial Strain, and Decision to Leave the California State University System in Social Work Faculty

Science.gov (United States)

Hohman, Melinda; Packard, Thomas; Finnegan, Daniel; Jones, Loring

2013-01-01

In uncertain economic times, universities have taken steps to address financial problems by including the use of business models. In 2009, the California State University (CSU) system implemented furloughs of a 10% pay reduction and 18 days removed from the academic calendar. Faculty in 16 CSU schools of social work participated in a Web-based…

77 FR 49011 - Privacy Act of 1974; New System of Records, Office of General Counsel E-Discovery Management...

Science.gov (United States)

2012-08-15

... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5613-N-06-A] Privacy Act of 1974; New System of Records, Office of General Counsel E-Discovery Management System--Change in Final Effective... the OGC E-Discovery Management System until after the opportunity for further comment is provided to...

Basophil FcεRI Expression in Chronic Spontaneous Urticaria: A Potential Immunological Predictor of Response to Omalizumab Therapy

Directory of Open Access Journals (Sweden)

Gustavo Deza

2017-03-01

Full Text Available Although the efficacy of omalizumab has been clearly demonstrated in the treatment of chronic spontaneous urticaria (CSU, its mechanism of action, which results in improvement in CSU symptoms, is not entirely understood. This study investigated the effect of omalizumab on expression of the high-affinity IgE receptor (FcεRI on blood basophils from patients with active CSU, and its association with the clinical response. Patients exhibiting significant clinical improvement showed a sharp reduction in the levels of basophil FcεRI after 4 weeks, which was maintained throughout the total duration of the treatment. Such evolution was not observed in non-responder patients. Furthermore, non-responders showed significantly lower baseline levels of FcεRI than responders. Baseline basophil FcεRI expression was found to be a potential immunological predictor of response to omalizumab (100% sensitivity and 73.2% specificity. The results of this study contribute to our knowledge of the therapeutic benefit and mechanism of action of anti-IgE therapy in CSU.

Are managers' and the general public's perceptions of risk communication needs in line? A French alpine valley case study

Science.gov (United States)

Charrière, Marie; Sprague, Teresa; Bogaard, Thom; Greiving, Stefan; Malet, Jean-Philippe; Mostert, Erik

2013-04-01

Risk communication is a crucial element of risk management. It contributes to social capacity building by influencing the knowledge, attitude, behavior, psychology, as well as social and organizational aspects1,2. It is globally recognized that effective risk communication should address needs and requirements of targeted audiences, especially those of the public. This study compares needs and requirements related to risk communication as seen by the risk managers, with the needs and requirements as expressed by the general public. Two surveys were conducted in a mountainous region facing multi-hazards, the Ubaye valley (France). The first survey, conducted within the context of the Marie Curie Research and Training Network 'Mountain Risk', was addressed to the local community. It aimed at gathering perceptions, needs and requirements of the general public (344 respondents) on risk communication3. The second survey, conducted in the context of the Marie Curie Initial Training Network 'CHANGES', targeted risk managers (16 stakeholders of the authorities, technical services and emergency units) at both the local and the regional scale to evaluate their perceptions regarding risk communication with the general public. The needs and requirements were analyzed with respect to several dimensions: 1) the information provided to the public, 2) the legal requirements for communication, 3) the level of trust the population has in risk managers, 4) insights on awareness and preparedness, and 5) information on the media used in past communication efforts. Results of the analysis concerning the last dimension reveal that, while the general public mentioned press, official reports and technical reports as the top three media by which they received information, the risk managers cited the press but in contrast also selected radio and television. Other results indicate that a potential mismatch exists as more than 80% of the respondents of the population find all listed topics

Members of the German Federal Parliament Research Committee visiting ALICE experiment on Wednesday, 15th November.

CERN Multimedia

Maximilien Brice

2006-01-01

From left to right Mr Georg Jürgens, Counsellor at the German Mission in Geneva; MdB Klaus Hagemann, SPD; MdB Cornelia Pieper, FDP, Stellvertretende Ausschussvorsitzende, Delegationsleiterin; MdB Dr. Petra Sitte, DIE LINKE; MdB Ilse Aigner, CDU/CSU; MdB Carsten Müller, CDU/CSU; Mr Andreas Meyer, Leiter Ausschusssekretariat; MdB Jörg Tauss, SPD.

Management of patients with epistaxis by general practitioners: impact of otolaryngology experience on their practice

NARCIS (Netherlands)

Tassone, Peter; Georgalas, Christos; Appleby, Esther; Kotecha, Bhik

2006-01-01

This study aims to assess the management of patients with epistaxis by general practitioners (GPs) and to show whether previous experience as a junior doctor in ear, nose and throat (ENT) surgery influences their practice. A questionnaire was sent together with self-addressed reply envelopes to a

Attitudes, norms and controls influencing lifestyle risk factor management in general practice

Directory of Open Access Journals (Sweden)

McKenzie Suzanne H

2009-08-01

Full Text Available Abstract Background With increasing rates of chronic disease associated with lifestyle behavioural risk factors, there is urgent need for intervention strategies in primary health care. Currently there is a gap in the knowledge of factors that influence the delivery of preventive strategies by General Practitioners (GPs around interventions for smoking, nutrition, alcohol consumption and physical activity (SNAP. This qualitative study explores the delivery of lifestyle behavioural risk factor screening and management by GPs within a 45–49 year old health check consultation. The aims of this research are to identify the influences affecting GPs' choosing to screen and choosing to manage SNAP lifestyle risk factors, as well as identify influences on screening and management when multiple SNAP factors exist. Methods A total of 29 audio-taped interviews were conducted with 15 GPs and one practice nurse over two stages. Transcripts from the interviews were thematically analysed, and a model of influencing factors on preventive care behaviour was developed using the Theory of Planned Behaviour as a structural framework. Results GPs felt that assessing smoking status was straightforward, however some found assessing alcohol intake only possible during a formal health check. Diet and physical activity were often inferred from appearance, only being assessed if the patient was overweight. The frequency and thoroughness of assessment were influenced by the GPs' personal interests and perceived congruence with their role, the level of risk to the patient, the capacity of the practice and availability of time. All GPs considered advising and educating patients part of their professional responsibility. However their attempts to motivate patients were influenced by perceptions of their own effectiveness, with smoking causing the most frustration. Active follow-up and referral of patients appeared to depend on the GPs' orientation to preventive care, the

Attitudes, norms and controls influencing lifestyle risk factor management in general practice.

Science.gov (United States)

Ampt, Amanda J; Amoroso, Cheryl; Harris, Mark F; McKenzie, Suzanne H; Rose, Vanessa K; Taggart, Jane R

2009-08-26

With increasing rates of chronic disease associated with lifestyle behavioural risk factors, there is urgent need for intervention strategies in primary health care. Currently there is a gap in the knowledge of factors that influence the delivery of preventive strategies by General Practitioners (GPs) around interventions for smoking, nutrition, alcohol consumption and physical activity (SNAP). This qualitative study explores the delivery of lifestyle behavioural risk factor screening and management by GPs within a 45-49 year old health check consultation. The aims of this research are to identify the influences affecting GPs' choosing to screen and choosing to manage SNAP lifestyle risk factors, as well as identify influences on screening and management when multiple SNAP factors exist. A total of 29 audio-taped interviews were conducted with 15 GPs and one practice nurse over two stages. Transcripts from the interviews were thematically analysed, and a model of influencing factors on preventive care behaviour was developed using the Theory of Planned Behaviour as a structural framework. GPs felt that assessing smoking status was straightforward, however some found assessing alcohol intake only possible during a formal health check. Diet and physical activity were often inferred from appearance, only being assessed if the patient was overweight. The frequency and thoroughness of assessment were influenced by the GPs' personal interests and perceived congruence with their role, the level of risk to the patient, the capacity of the practice and availability of time. All GPs considered advising and educating patients part of their professional responsibility. However their attempts to motivate patients were influenced by perceptions of their own effectiveness, with smoking causing the most frustration. Active follow-up and referral of patients appeared to depend on the GPs' orientation to preventive care, the patient's motivation, and cost and accessibility of

Outcomes and opportunities: a nurse-led model of chronic disease management in Australian general practice.

Science.gov (United States)

Eley, Diann S; Patterson, Elizabeth; Young, Jacqui; Fahey, Paul P; Del Mar, Chris B; Hegney, Desley G; Synnott, Robyn L; Mahomed, Rosemary; Baker, Peter G; Scuffham, Paul A

2013-01-01

The Australian government's commitment to health service reform has placed general practice at the centre of its agenda to manage chronic disease. Concerns about the capacity of GPs to meet the growing chronic disease burden has stimulated the implementation and testing of new models of care that better utilise practice nurses (PN). This paper reports on a mixed-methods study nested within a larger study that trialled the feasibility and acceptability of a new model of nurse-led chronic disease management in three general practices. Patients over 18 years of age with type 2 diabetes, hypertension or stable ischaemic heart disease were randomised into PN-led or usual GP-led care. Primary outcomes were self-reported quality of life and perceptions of the model's feasibility and acceptability from the perspective of patients and GPs. Over the 12-month study quality of life decreased but the trend between groups was not statistically different. Qualitative data indicate that the PN-led model was acceptable and feasible to GPs and patients. It is possible to extend the scope of PN care to lead the routine clinical management of patients' stable chronic diseases. All GPs identified significant advantages to the model and elected to continue with the PN-led care after our study concluded.

Usual care and management of fall risk increasing drugs in older dizzy patients in Dutch general practice

Science.gov (United States)

Stam, Hanneke; Harting, Thomas; van der Sluijs, Marjolijn; van Marum, Rob; van der Horst, Henriëtte; van der Wouden, Johannes C.; Maarsingh, Otto R.

2016-01-01

Objective For general practitioners (GPs) dizziness is a challenging condition to deal with. Data on the management of dizziness in older patients are mostly lacking. Furthermore, it is unknown whether GPs attempt to decrease Fall Risk Increasing Drugs (FRIDs) use in the management of dizziness in older patients. The aim of this study is to gain more insight into GP’s management of dizziness in older patients, including FRID evaluation and adjustment. Design Data were derived from electronic medical records, obtained over a 12-month period in 2013. Setting Forty-six Dutch general practices. Patients The study sample comprised of 2812 older dizzy patients of 65 years and over. Patients were identified using International Classification of Primary Care codes and free text. Main outcome measures Usual care was categorized into wait-and-see strategy (no treatment initiated); education and advice; additional testing; medication adjustment; and referral. Results Frequently applied treatments included a wait-and-see strategy (28.4%) and education and advice (28.0%). Additional testing was performed in 26.8%; 19.0% of the patients were referred. Of the patients 87.2% had at least one FRID prescription. During the observation period, GPs adjusted the use of one or more FRIDs for 11.7% of the patients. Conclusion This study revealed a wide variety in management strategies for dizziness in older adults. The referral rate for dizziness was high compared to prior research. Although many older dizzy patients use at least one FRID, FRID evaluation and adjustment is scarce. We expect that more FRID adjustments may reduce dizziness and dizziness-related impairment. Key PointsIt is important to know how general practitioners manage dizziness in older patients in order to assess potential cues for improvement.This study revealed a wide variety in management strategies for dizziness in older patients.There was a scarcity in Fall Risk Increasing Drug (FRID) evaluation and adjustment

Self-Management of Social Initiations by Kindergarten Students with Disabilities in the General Education Classroom

Science.gov (United States)

Reynolds, Brooke M.; Gast, David L.; Luscre, Deanna

2014-01-01

The effectiveness of a self-management intervention on social interaction behaviors was evaluated for students with disabilities and social deficits. Four students enrolled in a general education kindergarten classroom were taught to self-monitor social initiations during nonstructured social time via a digital wrist counter. The number of social…

Management of mediastinal syndromes in pediatrics: a new challenge of ultrasound guidance to avoid high-risk general anesthesia.

Science.gov (United States)

Sola, Chrystelle; Choquet, Olivier; Prodhomme, Olivier; Capdevila, Xavier; Dadure, Christophe

2014-05-01

Adverse events associated with anesthetic management of anterior mediastinal masses in pediatrics are common. To avoid an extremely hazardous general anesthesia, the use of real-time ultrasonography offers an effective alternative in high-risk cases. We report the anesthetic management including a light sedation and ultrasound guidance for regional anesthesia, surgical node biopsy, and placement of a central venous line in two children with an anterior symptomatic mediastinal mass. For pediatric patients with clinical and/or radiologic signs of airway compression, ultrasound guidance provides safety technical assistance to avoid general anesthesia and should be performed for the initial diagnostic and therapeutic procedures. © 2013 John Wiley & Sons Ltd.

Managing patient demand: a qualitative study of appointment making in general practice.

Science.gov (United States)

Gallagher, M; Pearson, P; Drinkwater, C; Guy, J

2001-04-01

Managing patients' requests for appointments is an important general practice activity. No previous research has systematically observed how patients and receptionists negotiate appointments. To observe appointment making and investigate patients' and professionals' experiences of appointment negotiations. A qualitative study using participant observation. Three general practices on Tyneside; a single-handed practice, a practice comprising three doctors, and a seven-doctor practice. Participant observation sessions, consisting of 35 activity recordings and 34 periods of observation and 38 patient and 15 professional interviews, were set up. Seven groups of patients were selected for interview. These included patients attending an 'open access' surgery, patients who complained about making an appointment, and patients who complimented the receptionists. Appointment making is a complex social process. Outcomes are dependent on the process of negotiation and factors, such as patients' expectations and appointment availability. Receptionists felt that patients in employment, patients allocated to the practice by the Health Authority, and patients who did not comply with practice appointment rules were most demanding. Appointment requests are legitimised by receptionists enforcing practice rules and requesting clinical information. Patients volunteer information to provide evidence that their complaint is appropriate and employ strategies, such as persistence, assertiveness, and threats, to try and persuade receptionists to grant appointments. Appointment making is a complex social process where outcomes are negotiated. Receptionists have an important role in managing patient demand. Practices should be explicit about how appointments are allocated, including publishing practice criteria.

Knowledge Management Systems as an Interdisciplinary Communication and Personalized General-Purpose Technology

Directory of Open Access Journals (Sweden)

Ulrich Schmitt

2015-10-01

Full Text Available As drivers of human civilization, Knowledge Management (KM processes have co-evolved in line with General-Purpose-Technologies (GPT, such as writing, printing, and information and communication systems. As evidenced by the recent shift from information scarcity to abundance, GPTs are capable of drastically altering societies due to their game-changing impact on our spheres of work and personal development. This paper looks at the prospect of whether a novel Personal Knowledge Management (PKM concept supported by a prototype system has got what it takes to grow into a transformative General-Purpose-Technology. Following up on a series of papers, the KM scenario of a decentralizing revolution where individuals and self-organized groups yield more power and autonomy is examined according to a GPT's essential characteristics, including a wide scope for improvement and elaboration (in people's private, professional and societal life, applicability across a broad range of uses in a wide variety of products and processes (in multi-disciplinary educational and work contexts, and strong complementarities with existing or potential new technologies (like organizational KM Systems and a proposed World Heritage of Memes Repository. The result portrays the PKM concept as a strong candidate due to its personal, autonomous, bottom-up, collaborative, interdisciplinary, and creativity-supporting approach destined to advance the availability, quantity, and quality of the world extelligence and to allow for a wider sharing and faster diffusion of ideas across current disciplinary and opportunity divides.

41 CFR 101-39.300 - General.

Science.gov (United States)

2010-07-01

... FEDERAL PROPERTY MANAGEMENT REGULATIONS AVIATION, TRANSPORTATION, AND MOTOR VEHICLES 39-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.3-Use and Care of GSA Interagency Fleet Management System Vehicles § 101-39.300 General. (a) The objective of the General Services Administration (GSA) Interagency Fleet Management System...

Management of perforated peptic ulcer in a district general hospital.

Science.gov (United States)

Critchley, A C; Phillips, A W; Bawa, S M; Gallagher, P V

2011-11-01

Laparoscopic surgery has become increasingly popular for elective surgery but it has gained slow transference to emergency surgery. The management of perforated peptic ulcers (PPU) laparoscopically is an accepted strategy yet it still remains infrequently used. The purpose of this study was to analyse the utility and outcomes of laparoscopy versus open repair for PPU in a district general hospital. In addition, we evaluated whether the subspecialty of the on-call consultant affected the method of repair performed and the training opportunities for trainee surgeons. Between 2003 and 2009, 53 patients underwent laparoscopic repair, 89 patients underwent open repair and a further 20 patients had laparoscopic repair that was converted to open repair for PPU. The results from a prospectively compiled database were analysed with primary outcome measures including operative time, length of hospital stay and mortality. The median operating time in the laparoscopic group was 60.0 minutes compared with 50.5 minutes in the open group. Hospital stay in surviving patients was significantly shorter in patients treated completely laparoscopically (5 days) when compared with the open group (6 days) ( p management of PPU. Our findings support the view that this procedure can be successfully used as a training operation.

Nurse managers: Determinants and behaviours in relation to patient and visitor aggression in general hospitals. A qualitative study.

Science.gov (United States)

Heckemann, Birgit; Peter, Karin A; Halfens, Ruud Jg; Schols, Jos Mga; Kok, Gerjo; Hahn, Sabine

2017-12-01

To explore nurse managers' behaviours, attitudes, perceived social norms, and behavioural control in the prevention and management of patient and visitor aggression in general hospitals. Patient and visitor aggression in general hospitals is a global problem that incurs substantial human suffering and organizational cost. Managers are key persons for creating low-aggression environments, yet their role and behaviours in reducing patient and visitor aggression remains unexplored. A qualitative descriptive study underpinned by the Reasoned Action Approach. Between October 2015-January 2016, we conducted five focus groups and 13 individual interviews with nurse leaders in Switzerland. The semi-structured interviews and focus groups were recorded, transcribed, and analysed in a qualitative content analysis. We identified three main themes: (i) Background factors: "Patient and visitor aggression is perceived through different lenses"; (ii) Determinants and intention: "Good intentions competing with harsh organizational reality"; (iii) Behaviours: "Preventing and managing aggressive behaviour and relentlessly striving to create low-aggression work environments". Addressing patient and visitor aggression is difficult for nurse managers due to a lack of effective communication, organizational feedback loops, protocols, and procedures that connect the situational and organizational management of aggressive incidents. Furthermore, tackling aggression at an organizational level is a major challenge for nurse managers due to scant financial resources and lack of interest. Treating patient and visitor aggression as a business case may increase organizational awareness and interest. Furthermore, clear communication of expectations, needs and resources could optimize support provision for staff. © 2017 John Wiley & Sons Ltd.

Cooperative Institute for Research in the Atmosphere (CIRA) Requirements Review

Energy Technology Data Exchange (ETDEWEB)

Zurawski, Jason, W; Mace, Kathryn, P

2016-08-11

In August 2016 The Energy Sciences Network (ESnet) and Colorado State University (CSU) organized a review to characterize the networking requirements of the Cooperative Institute for Research in the Atmosphere (CIRA) located on the campus of Colorado State University. Several key findings highlighting the results from the review were discovered, with benefits to improve the overall scientific process for CIRA and CSU.

Generalized data management systems and scientific information. Report of a specialist study

Energy Technology Data Exchange (ETDEWEB)

1978-06-01

Separate abstracts were prepared for 19 of the papers in this volume. Four additional papers have already been cited in ERA; these can be found by referring to CONF-771062-- in the Report Number Index. Five other papers were not in the scope of coverage of ERA; these dealt with an introduction to generalized data management systems and capabilities required of them in handling data, a programming language for data bases, and specialized applications of data bases to laboratory animals (environmental husbandry, hematology, clinical chemistry) and environmental chemicals. (RWR)

Optimization of Candu fuel management with gradient methods using generalized perturbation theory

International Nuclear Information System (INIS)

Chambon, R.; Varin, E.; Rozon, D.

2005-01-01

CANDU fuel management problems are solved using time-average representation of the core. Optimization problems based on this representation have been defined in the early nineties. The mathematical programming using the generalized perturbation theory (GPT) that was developed has been implemented in the reactor code DONJON. The use of the augmented Lagrangian (AL) method is presented and evaluated in this paper. This approach is mandatory for new constraint problems. Combined with the classical Lemke method, it proves to be very efficient to reach optimal solution in a very limited number of iterations. (authors)

Use of omalizumab in the treatment of chronic urticaria.

Science.gov (United States)

Cordeiro Moreira, A S; Rosmaninho Lopes de Soares E Silva, M I; Pereira Guilherme, M A; da Silva Ferreira, J A; Fonseca Moreira da Silva, J P

2016-11-01

Omalizumab is indicated to treat chronic spontaneous urticaria (CSU) refractory to antihistamines. We aim to describe the experience of our department in the treatment of CSU with omalizumab. Retrospective review of the clinical records of patients. Six patients (5 females, median age 33 years) treated with omalizumab for a median of 17.5 months were evaluated. All patients had improvement of symptoms after the first dose. In one case, the treatment was suspended after 7 months, but in 9 weeks there was recurrence of symptoms. The main side effect was headache in the drug administration's day. Currently, all patients maintain therapy with omalizumab and are clinically stable. Omalizumab proved to be an effective and safe drug for the treatment of patients with refractory CSU.

[Contribution of Perioperative Oral Health Care and Management for Patients who Underwent General Thoracic Surgery].

Science.gov (United States)

Saito, Hajime; Minamiya, Yoshihiro

2016-01-01

Due to the recent advances in radiological diagnostic technology, the role of video-assisted thoracoscopic surgery in thoracic disease has expanded, surgical indication extended to the elderly patients. Cancer patients receiving surgery, radiation therapy and/or chemotherapy may encounter complications in conjunction with the oral cavity such as aspiration pneumonia, surgical site infection and various type of infection. Recently, it is recognized that oral health care management is effective to prevent the postoperative infectious complications, especially pneumonia. Therefore, oral management should be scheduled before start of therapy to prevent these complications as supportive therapy of the cancer treatment. In this background, perioperative oral function management is highlighted in the remuneration for dental treatment revision of 2012,and the importance of oral care has been recognized in generally. In this manuscript, we introduce the several opinions and evidence based on the recent previous reports about the perioperative oral health care and management on thoracic surgery.

Recovery Act - Sustainable Transportation: Advanced Electric Drive Vehicle Education Program

Energy Technology Data Exchange (ETDEWEB)

Caille, Gary

2013-12-13

The collective goals of this effort include: 1) reach all facets of this society with education regarding electric vehicles (EV) and plug–in hybrid electric vehicles (PHEV), 2) prepare a workforce to service these advanced vehicles, 3) create web–based learning at an unparalleled level, 4) educate secondary school students to prepare for their future and 5) train the next generation of professional engineers regarding electric vehicles. The Team provided an integrated approach combining secondary schools, community colleges, four–year colleges and community outreach to provide a consistent message (Figure 1). Colorado State University Ventures (CSUV), as the prime contractor, plays a key program management and co–ordination role. CSUV is an affiliate of Colorado State University (CSU) and is a separate 501(c)(3) company. The Team consists of CSUV acting as the prime contractor subcontracted to Arapahoe Community College (ACC), CSU, Motion Reality Inc. (MRI), Georgia Institute of Technology (Georgia Tech) and Ricardo. Collaborators are Douglas County Educational Foundation/School District and Gooru (www.goorulearning.org), a nonprofit web–based learning resource and Google spin–off.

General principles of nuclear safety management related to research reactor decommissioning

International Nuclear Information System (INIS)

Banciu, Ortenzia; Vladescu, Gabriela

2003-01-01

The paper contents the general principles applicable to the decommissioning of research reactors to ensure a proper nuclear safety management, during both decommissioning activities and post decommissioning period. The main objective of decommissioning is to ensure the protection of workers, population and environment against all radiological and non-radiological hazards that could result after a reactor shutdown and dismantling. In the same time, it is necessary, by some proper provisions, to limit the effect of decommissioning for the future generation, according to the new Romanian, IAEA and EU Norms and Regulations. Assurance of nuclear safety during decommissioning process involves, in the first step, to establish of some safety principles and requirements to be taken into account during whole process. In the same time, it is necessary to perform a series of analyses to ensure that the whole process is conducted in a planned and safe manner. The general principles proposed for a proper management of safety during research reactor decommissioning are as follows: - Set-up of all operations included in a Decommissioning Plan; - Set-up and qualitative evaluation of safety problems, which could appear during normal decommissioning process, both radiological and nonradiological risks for workers and public; - Set-up of accident list related to decommissioning process the events that could appear both due to some abnormal working conditions and to some on-site and off-site events like fires, explosions, flooding, earthquake, etc.); - Development and qualitative/ quantitative evaluation of scenarios for each incidents; - Development (and evaluation) of safety indicator system. The safety indicators are the most important tools used to assess the level of nuclear safety during decommissioning process, to discover the weak points and to establish safety measures. The paper contains also, a safety case evaluation (description of facility according to the decommissioning

Appraisal of cooperation with a palliative care case manager by general practitioners and community nurses: a cross-sectional questionnaire study.

NARCIS (Netherlands)

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

2016-01-01

Aims: To investigate how general practitioners and community nurses value the support that they receive from a nurse case manager with expertise in palliative care, whether they think the case manager is helpful in realizing appropriate care and what characteristics of the patient and case

41 CFR 101-39.400 - General.

Science.gov (United States)

2010-07-01

... FEDERAL PROPERTY MANAGEMENT REGULATIONS AVIATION, TRANSPORTATION, AND MOTOR VEHICLES 39-INTERAGENCY FLEET... responsible for the operation of General Services Administration (GSA) Interagency Fleet Management System... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true General. 101-39.400...

Omalizumab may not inhibit mast cell and basophil activation in vitro.

Science.gov (United States)

Gericke, J; Ohanyan, T; Church, M K; Maurer, M; Metz, M

2015-09-01

In March 2014, omalizumab, a monoclonal anti-IgE antibody, was approved for the treatment of chronic spontaneous urticaria (CSU). The primary mode of action of omalizumab is considered to be the reduction in free IgE serum levels and the subsequent down-regulation of FcεRI, the high affinity receptor for IgE, on mast cells and basophils. Recently, it has been suggested that most CSU patients have an autoimmune aetiology which may lead to chronic activation of mast cells and basophils. To understand more of the mechanisms by which omalizumab may exert its effects in CSU, its efficacy was tested on human mast cells and basophils. Omalizumab, which was or was not preincubated with serum from healthy donors or CSU patients, was coincubated with isolated healthy donor skin mast cells or peripheral blood-derived monocytes containing 1-2% basophils. Degranulation was induced using anti-human IgE, C5a, or substance P and histamine release determined. Anti-human IgE-induced histamine release from mast cells or basophils was not altered in the presence or absence of omalizumab. In contrast, preincubation of mast cells with DARPin Fc fusion protein, a positive control for negative signalling via FcεRI-FcγRIIb cross activation, significantly diminished histamine release. Moreover, omalizumab, that was preincubated with healthy donor serum, CSU patient serum or auto-reactive CSU serum to allow for the formation of potential immune complexes, did not alter induced histamine release in a coincubation setup with mast cells or basophils as compared to the absence of omalizumab. In vivo, blood basophil numbers and basophil histamine content increase under omalizumab therapy. Our results suggest that the rapid response to omalizumab therapy is more likely to result from the elimination of an activating signal rather than the generation of a negative, inhibitory signal. © 2014 European Academy of Dermatology and Venereology.

Should the General Practitioner Consider Mesotherapy (Intradermal Therapy) to Manage Localized Pain?

Science.gov (United States)

Mammucari, Massimo; Maggiori, Enrica; Lazzari, Marzia; Natoli, Silvia

2016-06-01

Wide variations in the types of pain and response to analgesic pharmacotherapy mean that a variety of treatment strategies are needed. One approach is mesotherapy (intradermal therapy). This consists of microinjections into the skin and is ideally suited to the management of localized pain. Advantages include increasing the duration of drug activity, reduced risk of adverse events and interactions, and possible synergy with other therapies. Mesotherapy provides general practitioners with another tool for the treatment of local pain. However, it is important to provide patients with full details of the pros and cons of this approach and obtain informed patient consent.

How General Practitioners and Their Patients Adhere to Osteoporosis Management: A Follow-Up Survey among Czech General Practitioners

Directory of Open Access Journals (Sweden)

Magda Vytrisalova

2017-05-01

Full Text Available Introduction: General practitioners (GPs are key participants in osteoporosis (OP management. The aim was to evaluate their adherence to lege artis management of the disease, potential barriers, and to discuss differences observed in comparison with the baseline survey carried out in 2007; the focus was on secondary prevention.Methods: On behalf of two professional associations, 2-round postal survey among randomly selected GPs (>1/4 of all Czech GPs was performed in 2014. The questionnaire covered areas concerning GP's role in the fight against OP, knowledge about OP, management of OP-related fractures, barriers to the management of OP, system- and patient-related in particular, and availability and use of information sources.Results: The overall questionnaire return rate was 37% (551 respondents; mean age of the respondents was 53 year (37% men. The GP's role in the treatment of OP was rated as essential in 28 and 37% of men and women, respectively (P = 0.012. The guideline for diagnosis and treatment of OP for GPs was considered accessible by 92% of respondents. As much as 60% of the respondents were adherent to the guideline, i.e., used it repeatedly. The knowledge of several risk factors was very good, however, recommended daily intake of calcium was stated correctly by only 41% of respondents, and daily intake of vitamin D by only 40%. Three quarters reported active steps after a fracture: referral to a specialist, life-style recommendations, prescription of calcium/vitamin D supplements. Half of the respondents focus on fall prevention. System-related barriers, such as lack of possibility to prescribe selected drugs (61% and financial limits set by health insurance company (44% were most frequently reported. Patient-related barriers were also common, patient's non-adherence (reported by 29% and patient's reluctance to go to a specialist (18%.Conclusion: GPs adhered to OP management more than in 2007. Knowledge of risk factors and

77 FR 71711 - Commission's Rules Regarding the Office of Managing Director and the Office of Inspector General

Science.gov (United States)

2012-12-04

...In this document, the Federal Communications Commission (Commission) amends its rules to reassign to the Office of Managing Director (OMD) certain audit activities formerly assigned to the Office of Inspector General (OIG). The activities concern oversight of the annual audit of the Universal Service Administrative Corporation (USAC) required by the Commission's rules. In addition, the Commission delegates of authority to OMD, in consultation with the Office of General Counsel, to issue subpoenas concerning matters within its jurisdiction.

The opinion of the general practitioner toward clinical management of patients with psychogenic nonepileptic seizures.

LENUS (Irish Health Repository)

O'Sullivan, S S

2012-02-03

OBJECTIVE: The purpose of this work was to assess the opinion of general practitioners (GPs) regarding the diagnosis of psychogenic nonepileptic seizures (PNES) and the role they feel they should play in the management of the disorder. METHODS: Patients with PNES were identified from hospital records. Seizure and patient characteristics were recorded. Their GPs were surveyed regarding their understanding of the diagnosis and ongoing management of PNES. RESULTS: Twenty-three patients were identified over a 3-year period as having been diagnosed with PNES. Sixty-five percent of GPs agreed with the diagnosis, and when asked to grade their understanding of the diagnosis (poor = 1, excellent = 10), the mean score was 5.7 (+\\/-SD 2.3). Thirty-five percent of GPs felt psychological input was of benefit to their patients. Fifty-two percent of GPs felt comfortable following up these patients, either with or without neurology outpatient services. CONCLUSIONS: PNES remains a difficult disease to manage. There is a high level of uncertainty regarding the optimum management of PNES among primary care physicians, for which further education is needed.

Leadership and Management for Safety. General Safety Requirements

International Nuclear Information System (INIS)

2016-01-01

This Safety Requirements publication establishes requirements that support Principle 3 of the Fundamental Safety Principles in relation to establishing, sustaining and continuously improving leadership and management for safety and an integrated management system. It emphasizes that leadership for safety, management for safety, an effective management system and a systemic approach (i.e. an approach in which interactions between technical, human and organizational factors are duly considered) are all essential to the specification and application of adequate safety measures and to the fostering of a strong safety culture. Leadership and an effective management system will integrate safety, health, environmental, security, quality, human-and-organizational factor, societal and economic elements. The management system will ensure the fostering of a strong safety culture, regular assessment of performance and the application of lessons from experience. The publication is intended for use by regulatory bodies, operating organizations (registrants and licensees) and other organizations concerned with facilities and activities that give rise to radiation risks

A Management Information System Design for a General Museum. Museum Data Bank Research Report No. 12.

Science.gov (United States)

Scholtz, Sandra

A management information system (MIS) is applied to a medium sized general museum to reflect the actual curatorial/registration functions. The recordkeeping functions of loan and conservation activities are examined since they too can be effectively handled by computer and constitute a complementary data base to the accession/catalog information.…

Interpretive Management: What General Managers Can Learn from Design.

Science.gov (United States)

Lester, Richard K.; Piore, Michael J.; Malek, Kamal M.

1998-01-01

An analytical management approach reflects a traditional perspective and an interpretive approach involves a perspective suited to rapidly changing, unpredictable markets. Both approaches are valid, but each serves different purposes and calls for different strategies and skills. (JOW)

Nuclear power life cycle management, managing nuclear knowledge, and nuclear security. Introductory statement to the 5th scientific forum during the 46th session of the IAEA General Conference. Vienna, 17 September 2002

International Nuclear Information System (INIS)

ElBaradei, M.

2002-01-01

The document reproduces the text of the introductory statement made by the Director General of the IAEA at the 5th scientific forum organized during the 46th session of the IAEA General Conference, Vienna, 17 september 2002, on the nuclear power life cycle management, managing nuclear knowledge, and nuclear security. In the area of nuclear power life cycle management two aspects were emphasized: licence extension and facility decommissioning. Nuclear knowledge management includes ensuring the continued availability of the qualified personnel. Nuclear security must be considered for all nuclear applications, in a manner that encompasses all phases of nuclear activity - the use, storage and transport of nuclear and other radioactive material, as well as the design, operation, and decommissioning of nuclear facilities

Omalizumab therapy for treatment of recalcitrant chronic spontaneous urticaria in an Asian population.

Science.gov (United States)

Kulthanan, Kanokvalai; Tuchinda, Papapit; Chularojanamontri, Leena; Likitwattananurak, Chayanee; Ungaksornpairote, Chanida

2017-03-01

There are limited data regarding omalizumab in the treatment of recalcitrant chronic spontaneous urticaria (CSU) in Asian populations. This study evaluated the effectiveness and the proper dosage of omalizumab for Asian CSU patients in a real-life setting. We retrospectively reviewed recalcitrant CSU patients seeking treatment at the Skin Allergy Clinic, Siriraj Hospital during the 3-year period. All patients were treated with omalizumab as an add-on therapy. Standard seven-day urticaria activity score (UAS7) and medication score were used to assess omalizumab response. Of 13 patients, 9 patients (70%) responded well to 150 mg omalizumab injection every month, whereas 4 patients requiring updosing to 300 mg. In the 150 mg group, one patient achieved complete symptom control without antihistamine intake. Most of them required antihistamines without prednisolone and ciclosporin. Onset of omalizumab was fast, usually within the first week. Though only two patients in the 300 mg group achieved complete absence of symptoms, ciclosporin and oral corticosteroids could be discontinued. No patients reported adverse effects. Omalizumab at an initial dosage of 150 mg was effective in the treatment of recalcitrant CSU among Asians. Updosing to 300 mg was required to achieve satisfactory outcomes.

The first chimpanzee sanctuary in Japan: an attempt to care for the "surplus" of biomedical research.

Science.gov (United States)

Morimura, Naruki; Idani, Gen'ichi; Matsuzawa, Tetsuro

2011-03-01

This article specifically examines several aspects of the human-captive chimpanzee bond and the effort to create the first chimpanzee sanctuary in Japan. We discuss our ethical responsibility for captive chimpanzees that have been used in biomedical research. On April 1, 2007, the Chimpanzee Sanctuary Uto (CSU) was established as the first sanctuary for retired laboratory chimpanzees in Japan. This initiative was the result of the continuous efforts by members of Support for African/Asian Great Apes (SAGA), and the Great Ape Information Network to provide a solution to the large chimpanzee colony held in biomedical facilities. However, the cessation of invasive biomedical studies using chimpanzees has created a new set of challenges because Japan lacks registration and laws banning invasive ape experiments and lacks a national policy for the life-long care of retired laboratory chimpanzees. Therefore, CSU has initiated a relocation program in which 79 retired laboratory chimpanzees will be sent to domestic zoos and receive life-long care. By the end of 2009, the number of chimpanzees living at CSU had decreased from 79 to 59 individuals. A nationwide network of care facilities and CSU to provide life-long care of retired laboratory chimpanzees is growing across Japan. This will result in humane treatment of these research animals. 2010 Wiley-Liss, Inc.

Engaging general practice nurses in chronic disease self-management support in Australia: insights from a controlled trial in chronic obstructive pulmonary disease.

Science.gov (United States)

Walters, Julia A E; Courtney-Pratt, Helen; Cameron-Tucker, Helen; Nelson, Mark; Robinson, Andrew; Scott, Jenn; Turner, Paul; Walters, E Haydn; Wood-Baker, Richard

2012-01-01

The growing burden of chronic disease will increase the role of primary care in supporting self-management and health behaviour change. This role could be undertaken to some extent by the increased practice nurse workforce that has occurred over recent years. Mixed methods were used to investigate the potential for general practice nurses to adopt this role during a 12-month randomised controlled study of telephone-delivered health mentoring in Tasmanian practices. Nurses (general practice and community health) were trained as health mentors to assist chronic obstructive pulmonary disease patients to identify and achieve personal health related goals through action plans. Of 21% of invited practices that responded, 19 were allocated to health mentoring; however, general practice nurses were unable to train as health mentors in 14 (74%), principally due to lack of financial compensation and/or workload pressure. For five general practice nurses trained as health mentors, their roles had previously included some chronic disease management, but training enhanced their understanding and skills of self-management approaches and increased the focus on patient partnership, prioritising patients' choices and achievability. Difficulties that led to early withdrawal of health mentors were competing demands, insufficient time availability, phone calls having lower priority than face-to-face interactions and changing employment. Skills gained were rated as valuable, applicable to all clinical practice and transferable to other health care settings. Although these results suggest that training can enhance general practice nurses' skills to deliver self-management support in chronic disease, there are significant system barriers that need to be addressed through funding models and organisational change.

Expert opinion

DEFF Research Database (Denmark)

Ferrer, Marta; Boccon-Gibod, Isabelle; Gonçalo, Margarida

2017-01-01

Omalizumab (a recombinant, humanized anti-immunoglobulin-E antibody) has been shown in three pivotal Phase III trials (ASTERIA I, II and GLACIAL) and real-world studies to be effective and well-tolerated for the treatment of chronic spontaneous urticaria (CSU), and is the only licensed third......-line treatment for CSU. However, the definition of response to omalizumab treatment often differs between clinical trials, real-world studies, and daily practice of individual physicians globally. As such, a consensus definition of "complete", "partial" and "non-response" to omalizumab is required in order...... into a patient's disease burden and its changes during treatment. A potential omalizumab treatment approach based on speed and pattern of response at 1-3 and 3-6 months is suggested. In cases where there is no response during the first 1-3 months, physicians should consider reassessing the original CSU diagnosis...

Study of General Applicability and Particularity of Management Basis on Toyota Management%从丰田模式的发展看管理学的普适性和特殊性

Institute of Scientific and Technical Information of China (English)

常文娟

2012-01-01

在认同“社会科学领域内存在着普适的管理学”这一理论前题的条件下，通过剖析丰田管理模式与科学管理及文化之间的关系，探索决定管理学普适性和特殊性的因素。科学管理的思想决定了管理学的普适性，而科学管理思想与不同文化环境的结合决定了管理学的特殊性。%This article agrees with that there would be a generally applicable management theory in the field of social sciences. After analyzing the relationship between the Toyota Management and the scientific management and the culture , the deciding factors of the general applicability and particularity are explored. The conclusion is that the general applicability is determined by the thoughts of scientific management , and the particularity is determined by different cultures.

41 CFR 101-25.103-1 - General.

Science.gov (United States)

2010-07-01

... System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 25-GENERAL 25.1-General Policies... accounting controls. [48 FR 48232, Oct. 18, 1983] ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true General. 101-25.103-1...

Validated Competency Task Lists for General Merchandise Retailing, Food Service Management, and Business and Personal Services Marketing.

Science.gov (United States)

Faught, Suzanne G.

This publication contains competency task lists that address principal entry-level and career-sustaining jobs in the occupational categories of general merchandise retailing, food service management, and business and personal services marketing. Section I, Development of the Competency Task Lists, provides details on how the competencies were…

Achieving Competitive Advantage in Human Resource Management in General School District of Riyadh in Saudi Arabia

Science.gov (United States)

Al dakeel, Taghreed M.; Almannie, Mohamed A.

2015-01-01

The general school district of Riyadh is one of largest in the country of (45) school districts in Saudi Arabia. The school districts play an important roles in the development of education, therefore the objective of the study is to examine the roles of the management in the school districts to see if it is achieving competitive advantage. After…

Recognition and management of perinatal depression and anxiety by general practitioners: a systematic review.

Science.gov (United States)

Ford, Elizabeth; Shakespeare, Judy; Elias, Fatin; Ayers, Susan

2017-02-01

Perinatal anxiety and depression are widespread, with up to 20% of women affected during pregnancy and after birth. In the UK, management of perinatal mental health falls under the remit of general practitioners (GPs). We reviewed the literature on GPs' routine recognition, diagnosis and management of anxiety and depression in the perinatal period. A systematic search of Embase, Medline, PsycInfo, Pubmed, Scopus and Web of Science was conducted. Studies were eligible if they reported quantitative measures of GPs' or Family Physicians' assessment, recognition and management of anxiety or depression in pregnancy or post-partum. Thirteen papers, reporting 10 studies, were identified from the United States, Australia, UK, Netherlands and Canada. All reported on depression; two included anxiety disorders. Reported awareness and ability to diagnose perinatal depression among GPs was high. GPs knew about and used screening tools in the UK but less so in US settings. Antidepressants were the first line of treatment, with various SSRIs considered safest. Counseling by GPs and referrals to specialists were common in the post-natal period, less so in pregnancy. Treatment choices were determined by resources, attitudes, knowledge and training. Data on GPs' awareness and management of perinatal depression were sparse and unlikely to be generalizable. Future directions for research are proposed; such as exploring the management of anxiety disorders which are largely missing from the literature, and understanding more about barriers to disclosure and recognition in primary care. More standardized training could help to improve recognition and management practices. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

General Practitioner's Attitudes and Confidence in Managing Patients with Dementia in Singapore.

Science.gov (United States)

Subramaniam, Mythily; Ong, Hui Lin; Abdin, Edimansyah; Chua, Boon Yiang; Shafie, Saleha; Siva Kumar, Fiona Devi; Foo, Sophia; Ng, Li Ling; Lum, Alvin; Vaingankar, Janhavi A; Chong, Siow Ann

2018-03-01

The number of people living with dementia is increasing globally as a result of an ageing population. General practitioners (GPs), as the front-line care providers in communities, are important stakeholders in the system of care for people with dementia. This commentary describes a study conducted to understand GPs' attitudes and self-perceived competencies when dealing with patients with dementia and their caregivers in Singapore. A set of study information sheet and survey questionnaires were mailed to selected GP clinics in Singapore. The survey, comprising the "GP Attitudes and Competencies Towards Dementia" questionnaire, was administered. A total of 400 GPs returned the survey, giving the study a response rate of 52.3%. About 74% of the GPs (n=296) were seeing dementia patients in their clinics. Almost all the GPs strongly agreed that early recognition of dementia served the welfare of the patients (n=385; 96%) and their relatives (n=387; 97%). About half (51.5%) of the respondents strongly agreed or agreed that they felt confident carrying out an early diagnosis of dementia. Factor analysis of questionnaire revealed 4 factors representing "benefits of early diagnosis and treatment of patients with dementia", "confidence in dealing with patients and caregiver of dementia", "negative perceptions towards dementia care" and "training needs". GPs in Singapore held a generally positive attitude towards the need for early dementia diagnosis but were not equally confident or comfortable about making the diagnosis themselves and communicating with and managing patients with dementia in the primary care setting. Dementia education and training should therefore be a critical step in equipping GPs for dementia care in Singapore. Shared care teams could further help build up GPs' knowledge, confidence and comfort in managing patients with dementia.

The Effectiveness of Group Training of CBT-Based Stress Management on Anxiety, Psychological Hardiness and General Self-Efficacy Among University Students.

Science.gov (United States)

Molla Jafar, Hamdam; Salabifard, Seddigheh; Mousavi, Seyedeh Maryam; Sobhani, Zahra

2015-09-28

Admission to university is a very sensitive period of life for efficient, active, and young workforces in any country, and it is mostly associated with many changes in social and human relationships. These changes lead to anxiety in students. Moreover, humans need certain functions in order to adaptively deal with different life situations and challenges. By training stress management, these functions can help human acquire the required abilities. The present study was aimed at investigating the effectiveness of stress management training in anxiety, psychological hardiness, and general self-efficacy among university students. The study was a quasi-experimental intervention (pretest-posttest-follow-up) including a control group, it was a fundamental applied study. The statistical population consisted of all students of Islamic Azad University, Karaj, Iran. Convenient sampling was employed to select 30 students who were divided into an experimental group (n=15) and a control group (n=15). Before stress management training, both groups filled out Beck Anxiety Inventory, Long and Goulet scale of psychological hardiness, and General Self-efficacy Scale (GSE-10). Afterwards, the experimental group was provided with stress management training. And after the experiment, the abovementioned questionnaires and scales were responded by the two groups. Finally the collected data were analyzed and compared using one-way MANOVA. The results of MANOVA indicated that there was a significant difference between the two groups in terms of anxiety, hardiness, and general self-efficacy (pstress management among university students cause anxiety to drop; moreover, it enhances their psychological hardiness and self-efficacy. In regard with the role and importance of stress management, training this skill should be included in educational plans of university.

Self-reported confidence and skills of general practitioners in management of mental health disorders.

Science.gov (United States)

Oakley Browne, Mark; Lee, Adeline; Prabhu, Radha

2007-10-01

To identify the predictors of self-reported confidence and skills of GPs in management of patients with mental health problems. Cross-sectional survey, with questionnaire presented to 246 GPs working in 62 practices throughout Gippsland. Rural general practices in Gippsland. One hundred and thirty-four GPs across Gippsland. GPs completed a questionnaire assessing self-perception of knowledge and skills in recognition and management of common mental health problems. Of 134 GPs, 45% reported that they have a specific interest in mental health, and 39% of GPs reported that they had previous mental health training. Only 22% of GPs describe having both an interest and prior training in mental health care. Age and years since graduation are not significantly related to self-reported confidence and skills. The results of this study highlight that self-professed interest and prior training in mental health are associated. Self-professed interest in mental health care predicts confidence and self-perceived skills in recognition, assessment and management of common mental health disorders. Similarly, prior training in mental health care predicts confidence and self-perceived skills in recognition, assessment and management of common mental health problems. Self-professed interest in mental health issues is also associated with hours of participation in continuing medical education related to mental health care. Unfortunately, only a minority described having both interest and prior training in mental health care.

75 FR 51392 - Federal Management Regulation; Transportation Management

Science.gov (United States)

2010-08-20

...; Docket Number 2010-0011, sequence 1] RIN 3090-AJ03 Federal Management Regulation; Transportation Management AGENCY: Office of Governmentwide Policy, General Services Administration (GSA). ACTION: Final rule. SUMMARY: The General Services Administration (GSA) is amending the Federal Management Regulation (FMR) by...

Training and validation of standardized patients for evaluation of general practitioners′ performance in management of obesity and overweight

Directory of Open Access Journals (Sweden)

Tahereh Changiz

2014-01-01

Conclusion: SP could be a powerful instrument for evaluating medical performance of general practitioners in the field of obesity/overweight management. Further research is needed to find the more aspects of training and validation of unannounced SPs in this field.

Australian general practitioners’ current practice for chronic kidney disease (CKD detection and management

Directory of Open Access Journals (Sweden)

Marie Ludlow

2017-06-01

Full Text Available Background Guidelines for early detection of chronic kidney disease (CKD emphasise regular testing of kidney health in high-risk individuals. However, evidence suggests that CKD is not being adequately detected or appropriately managed in primary care. Aims Assess Australian general practitioners’ (GP current practice in relation to CKD detection and management. Methods This was a cross-sectional study utilising a random sample of GPs identified by interrogation of the national online telephone directory, and stratified by geographical location. Data collection occurred between October 2014 and January 2015. Of 2,815 eligible contacts, the final response rate was 23 per cent. Results Of the 656 respondents, over 90 per cent assessed kidney health at least annually in people with diabetes or high blood pressure, and 71 per cent correctly assessed kidney health every 3–6 months in a patient with Stage 3b CKD. The tests most commonly used to assess kidney health were serum creatinine (with eGFR, blood pressure and urine albumin creatinine ratio. The most commonly reported CKD management strategies were ‘blood pressure reduction using pharmacological agents’ (81 per cent and ‘glycaemic control if diabetes present’ (64 per cent. Knowledge testing highlighted that 32 per cent of respondents were not able to correctly identify how to properly assess absolute cardiovascular risk, and this was significantly more common in more experienced GPs (p=0.003. Conclusion The results indicate that Australian GPs are mainly practising in accordance with current guidelines for detection and management of patients with CKD, but with room for improvement in some areas

INTRA-ABDOMINAL INFECTION AND ACUTE ABDOMEN-EPIDEMIOLOGY, DIAGNOSIS AND GENERAL PRINCIPLES OF SURGICAL MANAGEMENT

Directory of Open Access Journals (Sweden)

Jovanović Dušan

2015-03-01

Full Text Available Intra-abdominal infections are multifactorial and present an complex inflammatory response of the peritoneum to microorganisms followed by exudation in the abdominal cavity and systemic response Despite advances in management and critical care of patients with acute generalized peritonitis due to hollow viscus perforation, prognosis is still very poor, with high mortality rate. Early detection and adequate treatment is essential to minimize complications in the patient with acute abdomen. Prognostic evaluation of complicated IAI by modern scoring systems is important to assess the severity and the prognosis of the disease. Control of the septic source can be achieved either by nonoperative or operative means. Nonoperative interventional procedures include percutaneous drainages of abscesses. The management of primary peritonitis is non-surgical and antibiotic- treatment. The management of secondary peritonitis include surgery to control the source of infection, removal of toxins, bacteria, and necrotic tissue, antibiotic therapy, supportive therapy and nutrition. "Source control" is sine qua non of success and adequate surgical procedure involves closure or resection of any openings into the gastrointestinal tract, resection of inflamed tissue and drainage of all abdominal and pelivic collections.

''Improving the EEG''. PHOTON discussion with experts of German political parties on the future of reimbursement for alternative energy; ''Das EEG weiter entwickeln''. PHOTON-Streitgesprach mit Energie-Experten der Bundestagsfraktionen ueber die kuenftige Solarstromfoerderung

Energy Technology Data Exchange (ETDEWEB)

Anon.

2002-08-01

In a PHOTON discussion with Rainer Brinkmann (SPD), Franz Obermeier (CSU), Hans-Josef Fell (Buendnis 90/Die Gruenen), Walter Hirche (FDP) and Eva Bullinger-Schrter (PDS), it became clear that the FDP is not the only political party in Germany to oppose the EEG (Renewable Energy Act). The CSU is thinking about replacing reimbursement for alternative energy sources by a tendering procedure. [German] Weil Wahlprogramme sich meist in Allgemeinplaetzen verlieren, baten wir Energie-Experten aus den fuenf Bundestagsfraktionen in einem Streitgespraech um Klartext: Wie sehen die Plaene zur Solarstromfoerderung aus? Bei der lebhaften Diskussion zwischen Rainer Brinkmann (SPD), Franz Obermeier (CSU), Hans-Josef Fell (Buendnis 90/Die Gruenen), Walter Hirche (FDP) und Eva Bulling-Schroeter (PDS) wurde deutlich: Nicht nur die FDP ist gegen das Erneuerbaree-Energien-Gesetz (EEG). Auch in der Union gibt es Ueberlegungen, die Einspeiseverguetung fuer Solarstrom durch einen Ausschreibungswettbewerb abzuloesen. (orig.)

Profile of omalizumab in the treatment of chronic spontaneous urticaria

Directory of Open Access Journals (Sweden)

Labrador-Horrillo M

2015-08-01

Full Text Available Moises Labrador-Horrillo,1 Marta Ferrer2 1Allergy Section, Internal Medicine Department, Vall d’Hebron Hospital, Universitat Autònoma de Barcelona, Barcelona, 2Department of Allergy and Clinical Immunology, Clínica Universidad de Navarra, IDISNA, Instituto de Investigación de Navarra, Pamplona, Spain Abstract: Chronic spontaneous urticaria (CSU is a disease with significant morbidity and relative prevalence that has important effects on the quality of life (QoL of those who suffer from it. Omalizumab is a recombinant humanized anti-immunoglobulin E (IgE antibody that binds to the Cε3 domain of the IgE heavy chain and prevents it from binding to its high-affinity receptor FcεRI. It has been largely studied in the field of asthma and is currently approved for the treatment of both adult and pediatric (children; >6-year-old patients. In addition, in recent, well-controlled clinical trials in patients with CSU resistant to antihistamines, add-on therapy with subcutaneous omalizumab significantly reduced the severity of itching, and the number and size of hives, and increased patients’ health-related QoL and the proportion of days free from angioedema compared with placebo, with an excellent tolerance. Thus, omalizumab is an effective and well-tolerated add-on therapy for patients with CSU who are symptomatic despite background therapy with H1 antihistamines. In this review, we cover the following points: epidemiology, pathogenesis, assessment of activity, impact on QoL, and treatment of CSU, and finally, we focus on omalizumab in the treatment of CSU including the pharmacokinetic properties and mechanism of action, and use in pregnant women, nursing infants, and children. Keywords: omalizumab, chronic spontaneous urticaria, antihistamines, subcutaneous administration, add-on therapy

Physical modeling of river spanning rock structures: Evaluating interstitial flow, local hydraulics, downstream scour development, and structure stability

Science.gov (United States)

Collins, K.L.; Thornton, C.I.; Mefford, B.; Holmquist-Johnson, C. L.

2009-01-01

Rock weir and ramp structures uniquely serve a necessary role in river management: to meet water deliveries in an ecologically sound manner. Uses include functioning as low head diversion dams, permitting fish passage, creating habitat diversity, and stabilizing stream banks and profiles. Existing information on design and performance of in-stream rock structures does not provide the guidance necessary to implement repeatable and sustainable construction and retrofit techniques. As widespread use of rock structures increases, the need for reliable design methods with a broad range of applicability at individual sites grows as well. Rigorous laboratory testing programs were implemented at the U.S. Bureau of Reclamation (Reclamation) and at Colorado State University (CSU) as part of a multifaceted research project focused on expanding the current knowledge base and developing design methods to improve the success rate of river spanning rock structures in meeting project goals. Physical modeling at Reclamation is being used to measure, predict, and reduce interstitial flow through rock ramps. CSU is using physical testing to quantify and predict scour development downstream of rock weirs and its impact on the stability of rock structures. ?? 2009 ASCE.

Managing the consultation with patients with medically unexplained symptoms: a grounded theory study of supervisors and registrars in general practice.

Science.gov (United States)

Stone, Louise

2014-12-05

Patients with medically unexplained symptoms (MUS) commonly present in general practice. They often experience significant disability and have difficulty accessing appropriate care. Many feel frustrated and helpless. Doctors also describe feeling frustrated and helpless when managing these patients. These shared negative feelings can have a detrimental effect on the therapeutic relationship and on clinical outcomes. The aim of this study was to explore how novice and experienced GPs manage patients with MUS and how these skills are taught and learned in GP training. A constructivist grounded theory study with 24 general practice registrars and supervisors in GP training practices across Australia. Registrars lacked a framework for managing patients with MUS. Some described negative feelings towards patients that were uncomfortable and confronting. Registrars also were uncertain about their clinical role: where their professional responsibilities began and ended. Supervisors utilised a range of strategies to address the practical, interpersonal and therapeutic challenges associated with the care of these patients. Negative feelings and a lack of diagnostic language and frameworks may prevent registrars from managing these patients effectively. Some of these negative feelings, such as frustration, shame and helplessness, are shared between doctors and patients. Registrars need assistance to identify and manage these difficult feelings so that consultations are more effective. The care of these patients also raises issues of professional identity, roles and responsibilities. Supervisors can assist their registrars by proactively sharing models of the consultation, strategies for managing their own feelings and frustrations, and ways of understanding and managing the therapeutic relationship in this difficult area of practice.

Combating information overload: a six-month pilot evaluation of a knowledge management system in general practice.

Science.gov (United States)

O'Brien, C; Cambouropoulos, P

2000-01-01

A six-month prospective study was conducted on the usefulness and usability of a representative electronic knowledge management tool, the WAX Active Library, for 19 general practitioners (GPs) evaluated using questionnaires and audit trail data. The number of pages accessed was highest in the final two months, when over half of the access trails were completed within 40 seconds. Most GPs rated the system as easy to learn, fast to use, and preferable to paper for providing information during consultations. Such tools could provide a medium for the activities of knowledge officers, help demand management, and promote sharing of information within primary care groups and across NHSnet or the Internet. PMID:10962792

Review of guidance on recurrence risk management for general practitioners in breast cancer, colorectal cancer and melanoma guidelines.

NARCIS (Netherlands)

Spronk, I.; Korevaar, J.C.; Burgers, J.S.; Albreht, T.; Schellevis, F.G.

2017-01-01

Background. General practitioners (GPs) will face cancer recurrences more frequently due to the rising number of cancer survivors and greater involvement of GPs in the follow-up care. Currently, GPs are uncertain about managing recurrence risks and may need more guidance. Objective. To explore what

Survey of diagnostic and treatment practices for multiple sclerosis (MS) in Europe. Part 2: Progressive MS, paediatric MS, pregnancy and general management.

Science.gov (United States)

Fernández, O; Delvecchio, M; Edan, G; Fredrikson, S; Giovannoni, G; Hartung, H-P; Havrdova, E; Kappos, L; Pozzilli, C; Soerensen, P S; Tackenberg, B; Vermersch, P; Comi, G

2018-05-01

The European Charcot Foundation supported the development of a set of surveys to understand current practice patterns for the diagnosis and management of multiple sclerosis (MS) in Europe. Part 2 of the report summarizes survey results related to secondary progressive MS (SPMS), primary progressive MS (PPMS), pregnancy, paediatric MS and overall patient management. A steering committee of MS neurologists developed case- and practice-based questions for two sequential surveys distributed to MS neurologists throughout Europe. Respondents generally favoured changing rather than stopping disease-modifying treatment (DMT) in patients transitioning from relapsing-remitting MS to SPMS, particularly with active disease. Respondents would not initiate DMT in patients with typical PPMS symptoms, although the presence of ≥1 spinal cord or brain gadolinium-enhancing lesion might affect that decision. For patients considering pregnancy, respondents were equally divided on whether to stop treatment before or after conception. Respondents strongly favoured starting DMT in paediatric MS with active disease; recommended treatments included interferon, glatiramer acetate and, in John Cunningham virus negative patients, natalizumab. Additional results regarding practice-based questions and management are summarized. Results of part 2 of the survey of diagnostic and treatment practices for MS in Europe largely mirror results for part 1, with neurologists in general agreement about the treatment and management of SPMS, PPMS, pregnancy and paediatric MS as well as the general management of MS. However, there are also many areas of disagreement, indicating the need for evidence-based recommendations and/or guidelines. © 2018 EAN.

Tetralogy of Fallot: General Principles of Management.

Science.gov (United States)

Downing, Tacy E; Kim, Yuli Y

2015-11-01

Repaired tetralogy of Fallot (TOF) is one of the most common diagnoses encountered when caring for adults with congenital heart disease. Although long-term survival after childhood TOF repair is excellent, morbidity is common and most patients require reintervention in adulthood. This review provides an overview of key surveillance and management issues for adults with TOF, including residual right ventricular outflow tract disease and timing of pulmonary valve replacement, arrhythmias and risk stratification, left-sided heart disease and heart failure, and pregnancy management. Copyright © 2015 Elsevier Inc. All rights reserved.

Airway management by the general practitioner in trauma patients. Technical and non-technical skills

Directory of Open Access Journals (Sweden)

Juan David Dominguez-Sánchez

2016-07-01

Full Text Available General practitioners must constantly face challenges imposed by their profession when performing interventions that are necessary for their patients. Many of these interventions not only require proper use of theoretical knowledge, but also putting into practice non-technical and psychomotor skills developed through professional training. Given the specific characteristics of each patient, the clinical setting in the which procedure takes place and the limited skills of the professional, the management of the airway of a patient with trauma injuries in the emergency room represents a major challenge for physicians.

Management of Clostridium difficile diarrhoea in District General ...

African Journals Online (AJOL)

... four cases of Clostridium difficile in our hospital over duration of three months. We looked into the demographic features of the patient population and compliance with the Trust guidelines for the management of the diarrhoea. Keywords:Diarrhoea, Clostridium difficile, Management. Internet Journal of Medical Update Vol.

General survey of solid-waste management

Science.gov (United States)

Reese, T. G.; Wadle, R. C.

1974-01-01

Potential ways of providing solid-waste management for a building complex serviced by a modular integrated utility system (MIUS) were explored. Literature surveys were conducted to investigate both conventional and unusual systems to serve this purpose. The advantages and disadvantages of the systems most compatible with MIUS are discussed.

A generalization information management system applied to electrical distribution

Energy Technology Data Exchange (ETDEWEB)

Geisler, K.I.; Neumann, S.A.; Nielsen, T.D.; Bower, P.K. (Empros Systems International (US)); Hughes, B.A.

1990-07-01

This article presents a system solution approach that meets the requirements being imposed by industry trends and the electric utility customer. Specifically, the solution addresses electric distribution management systems. Electrical distribution management is a particularly well suited area of application because it involves a high diversity of tasks, which are currently supported by a proliferation of automated islands. Islands of automation which currently exist include (among others) distribution operations, load management, automated mapping, facility management, work order processing, and planning.

Tailoring Earned Value Management. General Guidelines

National Research Council Canada - National Science Library

2002-01-01

Partial Contents: General Principles, A Spectrum of Implementation, OMB Guidance, A Special Note about DOD, Risk Factors to Consider, How can EVMS be tailored, Tailor EVMS to Inherent Risk, Application Thresholds-DoD...

"Psychological Boarding" and Community-Based Behavioral Health Crisis Stabilization.

Science.gov (United States)

Mukherjee, Dhrubodhi; Saxon, Verletta

2018-01-27

This exploratory paper presents a case study where a community based mental health organization forging a partnership with a local hospital system to establish a crisis stabilization unit (CSU) to address behavioral health emergency care. The study takes a mixed methods case study approach to address two research questions; (a) did this approach reduce the overall length of stay in the hospital emergency departments? (b) What challenges did the taskforce face in implementing this CSU model? The paper shares recommendation from the findings.

41 CFR 101-27.101 - General.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true General. 101-27.101 Section 101-27.101 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 27-INVENTORY MANAGEMENT 27.1-Stock...

Chronic disease management in general practice: results from a national study.

Science.gov (United States)

Darker, C; Martin, C; O'Dowd, T; O'Kelly, F; O'Shea, B

2012-04-01

The aim of this study was to provide baseline data on chronic disease management (CDM) provision in Irish general practice (GP). The survey instrument was previously used in a study of primary care physicians in 11 countries, thus allowing international comparisons. The response rate was 72% (380/527).The majority of GPs (240/380; 63%) reported significant changes are needed in our health care system to make CDM work better. Small numbers of routine clinical audits are being performed (95/380; 25%). Irish GPs use evidence based guidelines for treatment of diabetes (267/380; 71%), asthma / COPD (279/380; 74%) and hypertension (297/380; 79%), to the same extent as international counterparts. Barriers to delivering chronic care include increased workload (379/380; 99%), lack of appropriate funding (286/380; 76%), with GPs interested in targeted payments (244/380; 68%). This study provides baseline data to assess future changes in CDM.

Chronic disease management in general practice: results from a national study.

LENUS (Irish Health Repository)

Darker, C

2012-04-01

The aim of this study was to provide baseline data on chronic disease management (CDM) provision in Irish general practice (GP). The survey instrument was previously used in a study of primary care physicians in 11 countries, thus allowing international comparisons. The response rate was 72% (380\\/527).The majority of GPs (240\\/380; 63%) reported significant changes are needed in our health care system to make CDM work better. Small numbers of routine clinical audits are being performed (95\\/380; 25%). Irish GPs use evidence based guidelines for treatment of diabetes (267\\/380; 71%), asthma \\/ COPD (279\\/380; 74%) and hypertension (297\\/380; 79%), to the same extent as international counterparts. Barriers to delivering chronic care include increased workload (379\\/380; 99%), lack of appropriate funding (286\\/380; 76%), with GPs interested in targeted payments (244\\/380; 68%). This study provides baseline data to assess future changes in CDM.

41 CFR 101-39.100 - General.

Science.gov (United States)

2010-07-01

... FEDERAL PROPERTY MANAGEMENT REGULATIONS AVIATION, TRANSPORTATION, AND MOTOR VEHICLES 39-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.1-Establishment, Modification, and Discontinuance of Interagency Fleet Management... fleet management systems. (a) Based on these studies, the Administrator of General Services, with the...

Financial Management: DOD Needs to Clarify Its General Gift Fund Policies to Provide for Effective Oversight

Science.gov (United States)

2009-05-27

Representatives Subject: Financial Management: DOD Needs to Clarify Its General Gift Fund Policies to Provide for Effective Oversight From fiscal...year 2005 through fiscal year 2008, the military services received about $295 million in monetary and nonmonetary gifts from individuals and...organizations wishing to donate gifts to the Department of Defense (DOD).1 Section 2601(a) of Title 10, U.S. Code is a long-standing authority under which

78 FR 9721 - Privacy Act of 1974; New System of Records, Office of General Counsel E-Discovery Management...

Science.gov (United States)

2013-02-11

... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5613-N-06-C] Privacy Act of 1974; New System of Records, Office of General Counsel E-Discovery Management System: Republication of System.... SUMMARY: Pursuant to the provision of the Privacy Act of 1974, HUD is providing notice of its formal...

Management of spontaneous pneumothorax compared to British Thoracic Society (BTS) 2003 guidelines: a district general hospital audit.

Science.gov (United States)

Medford, Andrew Rl; Pepperell, Justin Ct

2007-10-01

In 1993, the British Thoracic Society (BTS) issued guidelines for the management of spontaneous pneumothorax (SP). These were refined in 2003. To determine adherence to the 2003 BTS SP guidelines in a district general hospital. An initial retrospective audit of 52 episodes of acute SP was performed. Subsequent intervention involved a junior doctor educational update on both the 2003 BTS guidelines and the initial audit results, and the setting up of an online guideline hyperlink. After the educational intervention a further prospective re-audit of 28 SP episodes was performed. Management of SP deviated considerably from the 2003 BTS guidelines in the initial audit - deviation rate 26.9%. After the intervention, a number of clinical management deviations persisted (32.1% deviation rate); these included failure to insert a chest drain despite unsuccessful aspiration, and attempting aspiration of symptomatic secondary SPs. Specific tools to improve standards might include a pneumothorax proforma to improve record keeping and a pneumothorax care pathway to reduce management deviations compared to BTS guidelines. Successful change also requires identification of the total target audience for any educational intervention.

41 CFR 105-1.109-50 - General plan.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false General plan. 105-1.109-50 Section 105-1.109-50 Public Contracts and Property Management Federal Property Management....109-50 General plan. Chapter 105 is divided into parts, subparts, and further subdivisions as...

STRATEGIC KNOWLEDGE MANAGEMENT IN THE ARMED FORCES ACADEMY OF GENERAL M. R. ŠTEFÁNIK IN LIPTOVSKÝ MIKULÁŠ, THE SLOVAK REPUBLIC

Directory of Open Access Journals (Sweden)

Mária PETRUFOVÁ

2015-10-01

Full Text Available The article stresses the importance of strategic knowledge management in the era of global competition. Strategic knowledge management raises the demand for permanent learning stressing the visions and personal aspirations of everyone within the modern effi cient organisation. Within the AFA of General M.R. Štefánik and, inherently, in the Armed Forces of the Slovak Republic, strategic knowledge management employs and implements knowledge as the ultimate step in the knowledge pyramid.

Similar Efficacy with Omalizumab in Chronic Idiopathic/Spontaneous Urticaria Despite Different Background Therapy.

Science.gov (United States)

Casale, Thomas B; Bernstein, Jonathan A; Maurer, Marcus; Saini, Sarbjit S; Trzaskoma, Benjamin; Chen, Hubert; Grattan, Clive E; Gimenéz-Arnau, Ana; Kaplan, Allen P; Rosén, Karin

2015-01-01

Data from the 3 omalizumab pivotal trials in patients with chronic idiopathic urticaria/chronic spontaneous urticaria (CIU/CSU) represent the largest database of patients reported to date with refractory disease (omalizumab, n = 733; placebo, n = 242). The objective of this study was to compare results from ASTERIA I and II, which included only approved doses of H1-antihistamine as background therapy based on regulatory authority requirements, to those from GLACIAL, which permitted higher doses of H1-antihistamines as well as other types of background therapy, in a post hoc analysis. Efficacy data from the placebo, omalizumab 150-mg, and omalizumab 300-mg treatment arms of ASTERIA I and II were pooled and analyzed (n = 162 and n = 160, respectively). The 300-mg treatment arm analyses were compared with the analysis of data from GLACIAL (n = 252) using analysis of covariance models. The key efficacy endpoint was change from baseline to week 12 in mean weekly itch severity score (ISS); other endpoints were also evaluated. Safety data were pooled from all 3 studies. Mean ISS was significantly reduced from baseline at week 12 in the pooled ASTERIA I and II omalizumab 150- and 300-mg treatment arms and in the GLACIAL omalizumab 300-mg arm. The weekly ISS reduction magnitude at week 12 was similar between the omalizumab 300-mg groups in the ASTERIA I and II pooled and GLACIAL studies. Similar treatment effect sizes were observed across multiple endpoints. Omalizumab was well tolerated and the adverse-event profile was similar regardless of background therapy for CIU/CSU. The overall safety profile was generally consistent with omalizumab therapy in allergic asthma. Omalizumab 300 mg was safe and effective in reducing CIU/CSU symptoms regardless of background therapy. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Do General Practices of Management Play Role as Drivers for Employee Job Satisfaction in Pakistani Entrepreneurial Companies?

Directory of Open Access Journals (Sweden)

Sergey Nikolaevich Polbitsyn

2017-03-01

Full Text Available Using general practices of management is management philosophy; many organizations practice these tools that endeavor to improve their efficiency and competitiveness in the business markets. It is an integrated approach to reaching and maintaining high-quality production and services focusing on the maintenance and continuous improvement of operations in order to satisfy or exceed the customer satisfaction. Many researchers have done a lot of work on other management practices; total quality management is an important one of them in this competitive era, which has rarely studied especially in small and medium size entrepreneurial companies in Pakistan. This quantitative research study tried to determine the impact of Total Quality Management practices on job satisfaction level of the employees of those small and medium size companies based on new and creative ideas in the capital city. The conducted survey among 550 employees of small and medium size entrepreneurial companies in the capital of Pakistan got 200 employees response properly in filling out the questionnaire. The collected data was analyzed after applying software (version 20 Statistical Package for Social Sciences. Multiple regression was applied to test the proposed model, which was found satisfied. Leadership and top management support were founded the most dominant practice among the selected Total Quality Management practices which has a significant effect on employee job satisfaction. The findings of this study prove that the implementation of Total Quality Management practices can help in increasing employees’ job satisfaction which intern would increase Productivity of small and medium size entrepreneurial companies.

Do longer consultations improve the management of psychological problems in general practice? A systematic literature review

Directory of Open Access Journals (Sweden)

Hutton Catherine

2007-05-01

Full Text Available Abstract Background Psychological problems present a huge burden of illness in our community and GPs are the main providers of care. There is evidence that longer consultations in general practice are associated with improved quality of care; but this needs to be balanced against the fact that doctor time is a limited resource and longer consultations may lead to reduced access to health care. The aim of this research was to conduct a systematic literature review to determine whether management of psychological problems in general practice is associated with an increased consultation length and to explore whether longer consultations are associated with better health outcomes for patients with psychological problems. Methods A search was conducted on Medline (Ovid databases up to7 June 2006. The following search terms, were used: general practice or primary health care (free text or family practice (MeSH AND consultation length or duration (free text or time factors (MeSH AND depression or psychological problems or depressed (free text. A similar search was done in Web of Science, Pubmed, Google Scholar, and Cochrane Library and no other papers were found. Studies were included if they contained data comparing consultation length and management or detection of psychological problems in a general practice or primary health care setting. The studies were read and categories developed to enable systematic data extraction and synthesis. Results 29 papers met the inclusion criteria. Consultations with a recorded diagnosis of a psychological problem were reported to be longer than those with no recorded psychological diagnosis. It is not clear if this is related to the extra time or the consultation style. GPs reported that time pressure is a major barrier to treating depression. There was some evidence that increased consultation length is associated with more accurate diagnosis of psychological problems. Conclusion Further research is needed to

Selected General Controls Over the Defense Business Management System

National Research Council Canada - National Science Library

1996-01-01

.... The Defense Business Management System performs appropriation accounting, cost accounting, personnel, payroll, manpower, and management information functions for the Navy, the Air Force, five Defense...

Exploring the perspectives of clinical professionals and support staff on implementing supported self-management for asthma in UK general practice: an IMP2ART qualitative study.

Science.gov (United States)

Morrow, Susan; Daines, Luke; Wiener-Ogilvie, Sharon; Steed, Liz; McKee, Lorna; Caress, Ann-Louise; Taylor, Stephanie J C; Pinnock, Hilary

2017-07-18

Despite an overwhelming evidence base, supported self-management of asthma is poorly implemented into routine practice. Strategies for implementation must address organisational routines, as well as provide resources for patients and training to improve professionals' skills. We aimed to explore the priority that primary care practices attach to asthma self-management, to describe their existing asthma management routines, and to generate innovative implementation strategies. We recruited 33 participants (23 general practitioners; seven nurses; three administrative staff) from 14 general practices. The 12 interviews and three focus groups were transcribed, coded and analysed thematically. Supported self-management was largely a nurse-led task within clinic-based annual reviews. Barriers included poor attendance at asthma clinics, lack of time, demarcation of roles, limited access to a range of tailored resources, and competing agendas in consultation, often due to multimorbidity. Suggestions for initiatives to improve the provision of supported self-management included emphasising the evidence for benefit (to influence prioritisation), improving teamwork (including team-based education), organisational strategies (including remote consulting) which need to fit within existing practice routines. Technology offers some potential solutions (e.g., improved templates, 'app'-based plans), but must be integrated with the practice information technology systems. Building on these insights, we will now develop a theoretically-based implementation strategy that will address patient, professional, and organisational buy-in, provide team-based education and offer a range of practical options and tools, which can be adapted and integrated within existing routines of individual practices.OVERCOMING THE ORGANISATIONAL BARRIERS TO IMPLEMENTING ASTHMA SELF-MANAGEMENT: Understanding the routines of primary care practices can suggest strategies to implement supported self-management

Practical and effective management of libraries integrating case studies, general management theory and self-understanding

CERN Document Server

Moniz, Jr, Richard

2010-01-01

Aimed at library science students and librarians with newly assigned administrative duties the book is about improving one's thinking and decision making in a role as a library manager. Most librarians get very little exposure to management issues prior to finding themselves in a management role. Furthermore, most library science students do not expect that they will need to understand management yet they quickly find that there is a need to understand this perspective to be effective at almost any library job. Effective library management is about having some tools to make decisions (such as

MANAGEMENT OF DIABETES IN ACUTE MYOCARDIAL INFARCTION IN CELJE GENERAL HOSPITAL IN 1999

Directory of Open Access Journals (Sweden)

Gregor Veninšek

2001-12-01

Full Text Available Background. DIGAMI study showed that intrahospital mortality and mortality at one year after myocardial infarction can be significantly reduced in diabetics treated in acute phase of myocardial infarction by GI infusion and afterwards for at least three months with intensive insulin treatment. Mortality can be reduced for more than 50% in a subgroup of patients younger than 70 years, without congestive heart failure, with first myocardial infarction, not treated with insulin or digitalis. In this perspective we reviewed treatment of diabetics with acute myocardial infarction in 1999 in Celje General Hospital.Methods. We reviewed documentation of treatment of all diabetics with acute myocardial infarction treated in Celje General Hospital in 1999. We collected data on number of newly discovered diabetes, on previous treatment of diabetes, on treatment of diabetes during hospitalization and at discharge, on drugs used for treatment of diabetes and on mortality during hospitalization.Results. Diabetics presented 20% of all patients with acute myocardial infarction treated in Celje General Hospital in 1999. None of patients received GI infusion, none had intensively managed blood sugar. 24% of patients were treated with sulfonylureas in acute phase of myocardial infarction. 33% of patients were discharged from hospital with insulin therapy. Intrahospital mortality was 9%, comparable with patients without diabetes.Conclusions. In 1999 was intrahospital treatment of diabetics with acute myocardial infarction in Celje General Hospital successful as their intrahospital mortality equaled non-diabetics. Treatment of diabetes itself, during hospitalization and after discharge, on the other hand, in 1999 had not been up to date according to results of recent studies. In our opinion, it is mandatory for diabetologist to make part of the team that treats diabetic with acute myocardial infarction

Development and demonstration of biosorbents for clean-up of uranium in water. CRADA final report

International Nuclear Information System (INIS)

Faison, B.D.; Hu, M.Z.C.; Norman, J.M.; Reeves, M.E.; Williams, L.; Schmidt-Kuster, W.; Darnell, K.

1997-08-01

Pseudomonas aeruginosa strain CSU, a nongenetically engineered bacterial strain known to bind dissolved hexavalent uranium, shows particular promise as the basis of an immobilized-cell process for removal of dissolved uranium from contaminated wastewaters. It was characterized with respect to its sorptive active. Living, heat-killed, permeabilized, and unreconstituted lyophilized cells were all capable of binding uranium. The uranium biosorption equilibrium could be described by the Langmuir isotherm. The rate of uranium adsorption increased following permeabilization of the outer and/or cytoplasmic membrane by organic solvents such as acetone. P. aeruginosa CSU biomass was significantly more sorptive toward uranium than certain novel, patented biosorbents derived from algal or fungal biomass sources. P. aeruginosa CSU biomass was also competitive with commercial cation-exchange resins, particularly in the presence of dissolved transition metals. Uranium binding by P. aeruginosa was clearly pH dependent. Uranium loading capacity increased with increasing pH under acidic conditions, presumably as a function of uranium speciation and due to the H + competition at some binding sites. Nevertheless, preliminary evidence suggests that this microorganism is also capable of binding anionic hexavalent uranium complexes. Ferric iron was a strong inhibitor of uranium binding to P. aeruginosa CSU biomass, and the presence of uranium also decreased the Fe 3+ loading when the biomass was not saturated with Fe 3+ , suggesting that Fe 3+ and uranium may share the same binding sites on biomass

Development and demonstration of biosorbents for clean-up of uranium in water. CRADA final report

Energy Technology Data Exchange (ETDEWEB)

Faison, B.D.; Hu, M.Z.C.; Norman, J.M.; Reeves, M.E.; Williams, L.; Schmidt-Kuster, W.; Darnell, K. [Oak Ridge National Lab., TN (United States)]|[Ogden Environmental Service, Oak Ridge, TN (United States)

1997-08-01

Pseudomonas aeruginosa strain CSU, a nongenetically engineered bacterial strain known to bind dissolved hexavalent uranium, shows particular promise as the basis of an immobilized-cell process for removal of dissolved uranium from contaminated wastewaters. It was characterized with respect to its sorptive active. Living, heat-killed, permeabilized, and unreconstituted lyophilized cells were all capable of binding uranium. The uranium biosorption equilibrium could be described by the Langmuir isotherm. The rate of uranium adsorption increased following permeabilization of the outer and/or cytoplasmic membrane by organic solvents such as acetone. P. aeruginosa CSU biomass was significantly more sorptive toward uranium than certain novel, patented biosorbents derived from algal or fungal biomass sources. P. aeruginosa CSU biomass was also competitive with commercial cation-exchange resins, particularly in the presence of dissolved transition metals. Uranium binding by P. aeruginosa was clearly pH dependent. Uranium loading capacity increased with increasing pH under acidic conditions, presumably as a function of uranium speciation and due to the H{sup +} competition at some binding sites. Nevertheless, preliminary evidence suggests that this microorganism is also capable of binding anionic hexavalent uranium complexes. Ferric iron was a strong inhibitor of uranium binding to P. aeruginosa CSU biomass, and the presence of uranium also decreased the Fe{sup 3+} loading when the biomass was not saturated with Fe{sup 3+}, suggesting that Fe{sup 3+} and uranium may share the same binding sites on biomass.

BRAND MANAGEMENT AT GENERAL MOTOR’S EUROPE

Directory of Open Access Journals (Sweden)

Liliana Adela ZIMA

2013-06-01

Full Text Available Brand is a trustworthy, relevant, and distinctive promise to the consumer. The Brand Manager must understand that he is responsible for the building of long term brand equity and he must keep the brand from both a Strategic and Tactical standpoint.The strategy of Adam Opel AG is focused on brand equity because it is important to add value for customer from products and services. The total sum of all the benefits, features, and associations, both functional and non-functional that make a brand competitive and distinctive in its market is the process of Brand Positioning. I made a study at Adam Opel AG in particularly at European Business In this study are observed the main tasks and responsibilities of each member of the team. The European Business Team has a lot of influence over the company which is a Marketing lead company. Brand Management is the management of the marketing value chain to consistently build brand equity, market share and profitability. In present, it is shifting our focus to brands, which include all the five “P”s of marketing: Product, Price, Place, Promotion and People. Our vehicles will always be a critical factor to our success. We are simply going to enhance our market potential by building on our brands at both the umbrella and vehicle line levels.

Predisposal Management of Radioactive Waste. General Safety Requirements Pt. 5

International Nuclear Information System (INIS)

2010-01-01

There are a large number of facilities and activities around the world in which radioactive material is produced, handled and stored. This Safety Requirements publication presents international consensus requirements for the management of radioactive waste prior to its disposal. It provides the safety imperatives on the basis of which facilities can be designed, operated and regulated. The publication is supported by a number of Safety Guides that provide up to date recommendations and guidance on best practices for management of particular types of radioactive waste, for storage of radioactive waste, for assuring safety by developing safety cases and supporting safety assessments, and for applying appropriate management systems. Contents: 1. Introduction; 2. Protection of human health and the environment; 3. Responsibilities associated with the predisposal management of radioactive waste; 4. Steps in the predisposal management of radioactive waste; 5. Development and operation of predisposal radioactive waste management facilities and activities; Annex: Predisposal management of radioactive waste and the fundamental safety principles.

Predisposal Management of Radioactive Waste. General Safety Requirements Pt. 5

International Nuclear Information System (INIS)

2009-01-01

There are a large number of facilities and activities around the world in which radioactive material is produced, handled and stored. This Safety Requirements publication presents international consensus requirements for the management of radioactive waste prior to its disposal. It provides the safety imperatives on the basis of which facilities can be designed, operated and regulated. The publication is supported by a number of Safety Guides that provide up to date recommendations and guidance on best practices for management of particular types of radioactive waste, for storage of radioactive waste, for assuring safety by developing safety cases and supporting safety assessments, and for applying appropriate management systems. Contents: 1. Introduction; 2. Protection of human health and the environment; 3. Responsibilities associated with the predisposal management of radioactive waste; 4. Steps in the predisposal management of radioactive waste; 5. Development and operation of predisposal radioactive waste management facilities and activities; Annex: Predisposal management of radioactive waste and the fundamental safety principles.

41 CFR 109-39.300 - General.

Science.gov (United States)

2010-07-01

... 39-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.3-Use and Care of GSA Interagency Fleet Management System... operators and passengers in GSA Interagency Fleet Management System (IFMS) motor vehicles are aware of the... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false General. 109-39.300...

The Centralized Temporary Storage (ATC) Spanish. General and operational readiness in the management of high level radioactive waste

International Nuclear Information System (INIS)

Reyes, S.; Diaz, A.; Dilla, A.; Gonzalez, J. R.; Haro, R.

2014-01-01

The high-level waste will go to Centralized Temporary Storage (ATC) in Villar de Canas (Cuenca), which is the solution to your management until finished designing its final disposal in the Deep Geological Storage (AGP). Transport containers of high activity radioactive waste will be stored on arrival at the ATC. In time of management, waste will be taken remotely, will be encapsulated in secure conditions and stored in vaults designed to be cooled by natural convection of air confinement. The buildings in the facility will have a general provision optimize the movement of packages and people for the development of all these activities. (Author)

A critical incident study of general practice trainees in their basic general practice term.

Science.gov (United States)

Diamond, M R; Kamien, M; Sim, M G; Davis, J

1995-03-20

To obtain information on the experiences of general practice (GP) trainees during their first general practice (GP) attachment. Critical incident technique--a qualitative analysis of open-ended interviews about incidents which describe competent or poor professional practice. Thirty-nine Western Australian doctors from the Royal Australian College of General Practitioners' (RACGP) Family Medicine Program who were completing their first six months of general practice in 1992. Doctors reported 180 critical incidents, of which just over 50% involved problems (and sometimes successes) with: difficult patients; paediatrics; the doctor-patient relationship; counselling skills; obstetrics and gynaecology; relationships with other health professionals and practice staff; and cardiovascular disorders. The major skills associated with both positive and negative critical incidents were: the interpersonal skills of rapport and listening; the diagnostic skills of thorough clinical assessment and the appropriate use of investigations; and the management skills of knowing when and how to obtain help from supervisors, hospitals and specialists. Doctors reported high levels of anxiety over difficult management decisions and feelings of guilt over missed diagnoses and inadequate management. The initial GP term is a crucial transition period in the development of the future general practitioner. An analysis of commonly recurring positive and negative critical incidents can be used by the RACGP Training Program to accelerate the learning process of doctors in vocational training and has implications for the planning of undergraduate curricula.

The minimum activation peptide from ilvH can activate the catalytic subunit of AHAS from different species.

Science.gov (United States)

Zhao, Yuefang; Niu, Congwei; Wen, Xin; Xi, Zhen

2013-04-15

Acetohydroxyacid synthases (AHASs), which catalyze the first step in the biosynthesis of branched-chain amino acids, are composed of a catalytic subunit (CSU) and a regulatory subunit (RSU). The CSU harbors the catalytic site, and the RSU is responsible for the activation and feedback regulation of the CSU. Previous results from Chipman and co-workers and our lab have shown that heterologous activation can be achieved among isozymes of Escherichia coli AHAS. It would be interesting to find the minimum peptide of ilvH (the RSU of E. coli AHAS III) that could activate other E. coli CSUs, or even those of ## species. In this paper, C-terminal, N-terminal, and C- and N-terminal truncation mutants of ilvH were constructed. The minimum peptide to activate ilvI (the CSU of E. coli AHAS III) was found to be ΔN 14-ΔC 89. Moreover, this peptide could not only activate its homologous ilvI and heterologous ilvB (CSU of E. coli AHAS I), but also heterologously activate the CSUs of AHAS from Saccharomyces cerevisiae, Arabidopsis thaliana, and Nicotiana plumbaginifolia. However, this peptide totally lost its ability for feedback regulation by valine, thus suggesting different elements for enzymatic activation and feedback regulation. Additionally, the apparent dissociation constant (Kd ) of ΔN 14-ΔC 89 when binding CSUs of different species was found to be 9.3-66.5 μM by using microscale thermophoresis. The ability of this peptide to activate different CSUs does not correlate well with its binding ability (Kd ) to these CSUs, thus implying that key interactions by specific residues is more important than binding ability in promoting enzymatic reactions. The high sequence similarity of the peptide ΔN 14-ΔC 89 to RSUs across species hints that this peptide represents the minimum activation motif in RSU and that it regulates all AHASs. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Logistics, Management and Efficiency

OpenAIRE

Mircea UDRESCU; Sandu CUTURELA

2014-01-01

The problem related to the efficiency of the management for organization is general being the concern off all managers. In the present essay we consider that the efficacy of the organization begins from the structural systemization of the organizational management into general management, management of logistics and management of production which demands a new managerial process, more competitive based on economic efficiency.

Generic functional requirements for a NASA general-purpose data base management system

Science.gov (United States)

Lohman, G. M.

1981-01-01

Generic functional requirements for a general-purpose, multi-mission data base management system (DBMS) for application to remotely sensed scientific data bases are detailed. The motivation for utilizing DBMS technology in this environment is explained. The major requirements include: (1) a DBMS for scientific observational data; (2) a multi-mission capability; (3) user-friendly; (4) extensive and integrated information about data; (5) robust languages for defining data structures and formats; (6) scientific data types and structures; (7) flexible physical access mechanisms; (8) ways of representing spatial relationships; (9) a high level nonprocedural interactive query and data manipulation language; (10) data base maintenance utilities; (11) high rate input/output and large data volume storage; and adaptability to a distributed data base and/or data base machine configuration. Detailed functions are specified in a top-down hierarchic fashion. Implementation, performance, and support requirements are also given.

7 CFR 1773.1 - General.

Science.gov (United States)

2010-01-01

... internal control over financial reporting, and management letter are required to meet the reporting... in accordance with generally accepted government auditing standards (GAGAS). (2) The management... indicates otherwise. (c) This complies with the 1994 revision of Government Auditing Standards, issued by...

[The acute (surgical) abdomen - epidemiology, diagnosis and general principles of management].

Science.gov (United States)

Grundmann, R T; Petersen, M; Lippert, H; Meyer, F

2010-06-01

This review comments on epidemiology, diagnosis and general principles of surgical management in patients with acute abdomen. DEFINITION AND EPIDEMIOLOGY: The most common cause of acute abdominal pain is non-specific abdominal pain (24 - 44.3 % of the study populations), followed by acute appendicitis (15.9 - 28.1 %), acute biliary disease (2.9 - 9.7 %) and bowel obstruction or diverticulitits in elderly patients. Acute appendicitis represents the cause of surgical intervention in two-thirds of the children with acute abdomen. A standardised physical examination combined with ultrasonography (US) represents the initial investigation in patients with acute abdominal pain. Due to the risk associated with radiation and due to the costs, a selective use of CT imaging is recommended. The work-flow given in this paper restricts the use of CT imaging to less than 50 % of patients with acute abdominal pain. Diagnostic laparoscopy should be considered in patients without a specific diagnosis after appropriate imaging and as an alternative to active clinical observation which is the current practice in patients with non-specific abdominal pain. Acute small bowel obstruction has previously been considered as a relative contraindication for laparoscopic management, but it has been shown in the meantime that laparoscopic treatment is an elegant tool for the management of simple band small bowel obstruction. Bedside diagnostic laparoscopy is recommended in intensive care unit (ICU) patients with acute abdomen or sepsis of unknown origin, in suspicion of acute cholecystitis, diffuse gut hypoperfusion and mesenteric ischaemia or in refractory lactic acidosis, especially after cardiac surgery. Early administration of analgesia to patients with acute abdominal pain in the emergency department will reduce the patient's discomfort without impairing clinically important diagnostic accuracy and is recommended on the basis of some prospective randomised trials. However, the impact on

Exploring the opinions and perspectives of general practitioners towards the use of social networking sites for concussion management.

Science.gov (United States)

Ahmed, Osman; Sullivan, S John; Schneiders, Anthony; Moon, Sam; McCrory, Paul

2013-03-01

Social networking sites (SNSs) are increasingly being used for health-related purposes. Many patients now use sites such as Facebook to discuss symptoms, seek support, and search for advice on health conditions, including concussion. Innovative methods of delivering health information using these technologies are starting to emerge and it is important to seek the input of key stakeholder groups (including general practitioners) to establish their feasibility and to highlight areas of concern. This study aimed to seek the opinions of general practitioners towards the use of SNSs in concussion management. Semi-structured interviews were captured with a digital voice recorder and analysed using interpretative description methodology. Participants were general practitioners whose caseload included persons with a concussion between the ages of 16 and 30 years, and who had treated a patient with a concussion in the past 12 months. The clinical experience of the participants ranged from 3 to 35 years and 50% of the participants had a Facebook account themselves. While all participants were positive towards the use of SNSs for this purpose, concerns were raised regarding the issues of privacy and moderation. SNSs, particularly Facebook, have the potential (if correctly utilised) to be a viable adjunct to traditional concussion management programmes. In order for SNSs to be successfully used in this manner, the quality of information shared needs to be accurate and patients using them need to ensure that they get adequate cognitive rest.

Leadership and Management for Safety. General Safety Requirements (Arabic Edition)

International Nuclear Information System (INIS)

2016-01-01

This Safety Requirements publication establishes requirements that support Principle 3 of the Fundamental Safety Principles in relation to establishing, sustaining and continuously improving leadership and management for safety and an integrated management system. It emphasizes that leadership for safety, management for safety, an effective management system and a systemic approach (i.e. an approach in which interactions between technical, human and organizational factors are duly considered) are all essential to the specification and application of adequate safety measures and to the fostering of a strong safety culture. Leadership and an effective management system will integrate safety, health, environmental, security, quality, human-and-organizational factors, societal and economic elements. The management system will ensure the fostering of a strong safety culture, regular assessment of performance and the application of lessons from experience. The publication is intended for use by regulatory bodies, operating organizations and other organizations concerned with facilities and activities that give rise to radiation risks.

Leadership and Management for Safety. General Safety Requirements (Chinese Edition)

International Nuclear Information System (INIS)

2016-01-01

This Safety Requirements publication establishes requirements that support Principle 3 of the Fundamental Safety Principles in relation to establishing, sustaining and continuously improving leadership and management for safety and an integrated management system. It emphasizes that leadership for safety, management for safety, an effective management system and a systemic approach (i.e. an approach in which interactions between technical, human and organizational factors are duly considered) are all essential to the specification and application of adequate safety measures and to the fostering of a strong safety culture. Leadership and an effective management system will integrate safety, health, environmental, security, quality, human-and-organizational factors, societal and economic elements. The management system will ensure the fostering of a strong safety culture, regular assessment of performance and the application of lessons from experience. The publication is intended for use by regulatory bodies, operating organizations and other organizations concerned with facilities and activities that give rise to radiation risks.

Leadership and Management for Safety. General Safety Requirements (French Edition)

International Nuclear Information System (INIS)

2016-01-01

This Safety Requirements publication establishes requirements that support Principle 3 of the Fundamental Safety Principles in relation to establishing, sustaining and continuously improving leadership and management for safety and an integrated management system. It emphasizes that leadership for safety, management for safety, an effective management system and a systemic approach (i.e. an approach in which interactions between technical, human and organizational factors are duly considered) are all essential to the specification and application of adequate safety measures and to the fostering of a strong safety culture. Leadership and an effective management system will integrate safety, health, environmental, security, quality, human-and-organizational factors, societal and economic elements. The management system will ensure the fostering of a strong safety culture, regular assessment of performance and the application of lessons from experience. The publication is intended for use by regulatory bodies, operating organizations and other organizations concerned with facilities and activities that give rise to radiation risks.

Leadership and Management for Safety. General Safety Requirements (Spanish Edition)

International Nuclear Information System (INIS)

2017-01-01

his Safety Requirements publication establishes requirements that support Principle 3 of the Fundamental Safety Principles in relation to establishing, sustaining and continuously improving leadership and management for safety and an integrated management system. It emphasizes that leadership for safety, management for safety, an effective management system and a systemic approach (i.e. an approach in which interactions between technical, human and organizational factors are duly considered) are all essential to the specification and application of adequate safety measures and to the fostering of a strong safety culture. Leadership and an effective management system will integrate safety, health, environmental, security, quality, human-and-organizational factors, societal and economic elements. The management system will ensure the fostering of a strong safety culture, regular assessment of performance and the application of lessons from experience. The publication is intended for use by regulatory bodies, operating organizations and other organizations concerned with facilities and activities that give rise to radiation risks.

Modelo de dirección estratégica para el departamento de Medicina General Integral Model of strategical management for the Department of General Comprehensive Medicine

Directory of Open Access Journals (Sweden)

Alcides Abad Ochoa Alonso

2005-12-01

Full Text Available La creciente complejidad del proceso organizacional del Departamento de Medicina General Integral, de la Facultad de Ciencias Médicas “Mariana Grajales Coello” de Holguín, evidenció la necesidad de una intervención de carácter estratégico, capaz de guiar la gestión del cambio y de facilitar la sostenibilidad de las estrategias en curso en el departamento. Valiéndose de métodos de investigación científica, como son, el dialéctico, la modelación y la triangulación, y otros propios de las ciencias de la administración, se construyó un modelo de dirección estratégica específico para este departamento. El proyecto de intervención concebido es producto del análisis crítico de los modelos de dirección estratégica estudiados, y de la introducción de momentos, procedimientos y técnicas adecuados a las condiciones del departamento. Los enfoques rectores del proceso, aplicados en el modelo construido, permiten una mayor integración entre los niveles estratégico, táctico y operativo, con el consiguiente impacto esperado sobre la eficacia y la eficiencia en el alcance de los objetivos.The increasing complexity of the organizational process of the Department of General Comprehensive Medicine of “Mariana Grajales Coello” Faculty of Medical Sciences, in Holguin , evidenced the need of an intervention of strategical character capable of guiding the change management and of facilitating the sustainability of the strategies under way in the department. By using methods of scientific research, such as the dialectic methods, modeling, triangulation and others characteristic of the management science, it was constructed a specific model of strategical management for this department.The intervention project created is the result of the critical analysis of studied strategic management models, and of the introduction of moments, procedures and techniques adjusted to the conditions of the department. The ruling approaches of the

Investigation of thiol-disulphide balance in patients with acute urticaria and chronic spontaneous urticaria.

Science.gov (United States)

Akbas, Ayse; Kilinc, Fadime; Sener, Sertac; Aktaş, Akın; Baran, Pervin; Ergin, Merve

2017-09-01

Thiol-disulphide balance plays a major role in health and diseases. This balance may be disrupted by various diseases. We aimed to determine status of the effect of thiol-disulphide balance in urticaria. We aimed to investigate the thiol-disulphide balance in patients with acute urticaria (AUP) and chronic spontaneous urticaria (CSU). Study included 53 AUP and 47 healthy controls plus 57 patients with chronic spontaneous urticaria (CSUP) and 57 healthy controls. Levels of native thiols, disulphides and total thiols were evaluated in plasma using a new and automated spectrophotometric method. Ratios of disulphides/total thiols, disulphides/native thiols and native thiols/total thiols were calculated. For AU, there was no statistical difference compared to control group in levels of native thiols, disulphides and total thiols. For CSU, however, there was an increase in levels of native thiols, disulphides and total thiols and the ratio of thiol/disulphide in favour of disulphide. Thiol-disulphide balance was not affected by AU but shifted towards to disulphide in CSU indicating the presence of oxidative stress (OS).

General practitioners' perspectives on management of early-stage chronic kidney disease: a focus group study.

Science.gov (United States)

van Dipten, Carola; van Berkel, Saskia; de Grauw, Wim J C; Scherpbier-de Haan, Nynke D; Brongers, Bouke; van Spaendonck, Karel; Wetzels, Jack F M; Assendelft, Willem J J; Dees, Marianne K

2018-06-06

Guideline adherence in chronic kidney disease management is low, despite guideline implementation initiatives. Knowing general practitioners' (GPs') perspectives of management of early-stage chronic kidney disease (CKD) and the applicability of the national interdisciplinary guideline could support strategies to improve quality of care. Qualitative focus group study with 27 GPs in the Netherlands. Three analysts open-coded and comparatively analysed the data. Mind-mapping sessions were performed after data-saturation. Five themes emerged: defining CKD, knowledge and awareness, patient-physician interaction, organisation of CKD care and value of the guideline. A key finding was the abstractness of the CKD concept. The GPs expressed various perspectives about defining CKD and interpreting estimated glomerular filtration rates. Views about clinical relevance influenced the decision-making, although factual knowledge seems lacking. Striving to inform well enough without creating anxiety and to explain suitably for the intellectual ability of the patient caused tension in the patient-physician interaction. Integration with cardiovascular disease-management programmes was mentioned as a way of implementing CKD care in the future. The guideline was perceived as a rough guide rather than a leading document. CKD is perceived as an abstract rather than a clinical concept. Abstractness plays a role in all formulated themes. Management of CKD patients in primary care is complex and is influenced by physician-bound considerations related to individual knowledge and perception of the importance of CKD. Strategies are needed to improve GPs' understanding of the concept of CKD by education, a holistic approach to guidelines, and integration of CKD care into cardiovascular programmes. Not applicable.

41 CFR 109-26.501-1 - General.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false General. 109-26.501-1 Section 109-26.501-1 Public Contracts and Property Management Federal Property Management Regulations System (Continued) DEPARTMENT OF ENERGY PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 26...

[Survey of general practioners in the management of diabetes in primary health facilities of Casablanca city, Morocco: opportunities and constraints].

Science.gov (United States)

Nani, S; Hassoune, S; Chinab, N; Boumdi, Z; Maaroufi, A

2013-06-01

Diabetes is a global health problem in full expansion, because of its increasing frequency, it frightening complications and the costs of its medical covering. In this study, we tried to make the current situation of the diabetes management in first-line public structures of the city of Casablanca. The survey of transverse observation to descriptive aiming was conducted using a pre questionnaire tested and selfadministered. It shows that 46.7 % of the questioned general practitioner judged that the quantity and the quality of average therapeutic existing in the center were insufficient to meet the needs for their diabetic patients. The weak socio-economic statute of the patients (78.8% of the cases), the lack of personnel (76.6%), the low educational level of patients (75.2%) and the problem of access to hospital (73.3%) constituted major problems of the correct diabetic medical covering. However, the majority of the doctors (98.1%) estimated to need training on diabetes management. The most required topics requested are: The control of the insulin treatment (97%), the diabetic education (91%) and the follow-up of diabetic (89%). The training of general practitioners particularly motivated and interested in diabetes could be the solution to improve the management of diabetes especially because of the lack of specialists in our country.

Effect of omalizumab on angioedema in H1 -antihistamine-resistant chronic spontaneous urticaria patients: results from X-ACT, a randomized controlled trial.

Science.gov (United States)

Staubach, P; Metz, M; Chapman-Rothe, N; Sieder, C; Bräutigam, M; Canvin, J; Maurer, M

2016-08-01

Chronic spontaneous urticaria (CSU) severely impacts quality of life (QoL), especially in patients with wheals and angioedema. Omalizumab is approved as add-on therapy for CSU patients; however, its effect on patients who are double-positive for wheals and angioedema has not been systematically studied. The primary objective was to evaluate the efficacy of omalizumab vs placebo at week 28 using the Chronic Urticaria Quality of Life (CU-Q2oL) questionnaire. Number of angioedema-burdened days, time interval between successive angioedema episodes, disease activity, angioedema-specific and overall QoL impairment were secondary objectives. X-ACT was a phase III, randomized, double-blind study conducted in 24 centres (Germany), which selectively included CSU patients with angioedema and wheals. Patients were randomized (1 : 1) to omalizumab 300 mg or placebo (every 4 weeks up to week 24) (ClinicalTrials.gov number: NCT01723072). Of the 91 patients randomized to omalizumab (n = 44) or placebo (n = 47) at baseline, 68 completed the 28-week treatment phase (omalizumab, 35; placebo, 33). Omalizumab was superior to placebo in improving CU-Q2oL scores at week 28 (P omalizumab (0.3) vs placebo (1.1). The median time to first recurrence of angioedema was 57-63 days with omalizumab and Omalizumab significantly improved angioedema-specific QoL (P omalizumab. Omalizumab was an effective treatment option for patients with moderate-to-severe CSU symptoms and angioedema unresponsive to high doses of antihistamine treatment. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

48 CFR 45.103 - General.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false General. 45.103 Section 45.103 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT... voluntary consensus standards (see FAR 11.101(b)) and industry-leading practices and standards to manage...

Development and implementation of a decision pathway for general practitioners for the management or referral of suspected allergy

Directory of Open Access Journals (Sweden)

Ray B. Jones

2014-07-01

Full Text Available Many patients with suspected allergy are referred to specialist care inappropriately. We aimed to develop and implement an online decision pathway to aid General Practitioners’ (GPs management decisions in suspected allergy. Our study involved 1487 GPs, 3 referral management centres, 5 GP system suppliers, 4 primary care trusts, and 1 specialist allergy clinic. The pathway was implemented by 3/5 GP system suppliers, published to Map of Medicine and on a specialist clinic website. In the first year, the pathway ranked in the top 10/160 local care maps accessed via Map of Medicine and was viewed 900 times. Only 96 GPs registered to use the clinic website. Only 110 (7% GPs responded to the feedback request, of which 13/110 (12% had used the pathway; nearly all thought it useful. It was used by referral management centres as explanation of rejected referrals. Alternative approaches to embed its use are required.

IT Management: How IT managers gain IT knowledge

DEFF Research Database (Denmark)

Søndergård, Jes; Tambo, Torben; Koch, Christian

2010-01-01

It is not a secret that, IT management has become more and more and integrated part of almost all organizations. IT managers posses an enormous amount of knowledge within both organizational knowledge and general IT knowledge. This article investigates how IT managers keep themselves updated...... on IT knowledge in general and looks into how much time IT managers spend on weekly basis searching the net for new or problem solving IT knowledge. The theory used in this paper is used to investigate the current role of IT managers and what issues they are facing. Furthermore a research is conducted where 7...... IT managers in medium sized and large Danish companies are interviewed to add further focus on the role of the IT manager and to focus on how they keep themselves updated. Beside finding substantial need for more research, IT managers - generalists or specialists - only have limited knowledge resources...

Case-specific colleague guidance for general practitioners' management of sickness absence.

Science.gov (United States)

Nordhagen, H P; Harvey, S B; Rosvold, E O; Bruusgaard, D; Blonk, R; Mykletun, A

2017-12-02

General practitioners (GPs) report sickness absence certification as challenging. They express need for support with functional assessment beyond guidelines and reforms. Case-specific collegial one-to-one guidance for other clinical topics has proved popular with GPs and may be an acceptable and effective way to improve GPs skills and competence in sickness absence certification. To present a new model of case-specific colleague guidance focusing on the management of long-term sickness absence and to describe its feasibility in terms of application and reception among GPs, and also GPs' self-reports of effects on their practice. Randomly selected GPs received case-specific collegial guidance over a 12-month period, in two Norwegian trials, delivered by former GPs employed by the social security administration. We measured reception and perceived effects by GPs' self-report and registered participation and withdrawal rates. The participation rate (n = 165) was 94%, and no GPs withdrew during training. Among the 116 GPs responding to the survey (70%), 112 (97%; 95% CI 92-99) stated they would recommend it to their colleagues. Considerable benefit from the guidance was reported by 68 (59%; 95% CI 50-68). The GPs self-reported other effects on their sickness absence certification, specifically an increased use of part-time sickness absence (Fit-Note equivalent). This model of case-specific colleague guidance to aid GPs' management of long-term sickness absence is feasible and was popular. This type of guidance was perceived by GPs to be somewhat beneficial and to alter their sickness absence certification behaviour, though the true impact requires further testing in controlled trials. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

5 CFR 1303.1 - General

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false General 1303.1 Section 1303.1 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET ADMINISTRATIVE PROCEDURES PUBLIC INFORMATION PROVISIONS OF THE ADMINISTRATIVE PROCEDURES ACT Organization § 1303.1 General This information is furnished for...

Small business, cash budgets and general practice.

Science.gov (United States)

Jackson, A R

1991-01-01

In practice management, general practice falls into the category of small business with all its attendant generic problems. Disciplined planning and good financial management are not often seen in small business. These are required if general practitioners are to continue (or return to) the provision of high quality medical services. An effective budget process, especially cash-flow budgeting, is the key to successful planning and financial management. Budgeting will bring Control, Co-ordination, and Credibility to your practice. It will enable you to set goals and to achieve them.

Health Management Technology as a General Solution Framework

Science.gov (United States)

Nakajima, Hiroshi; Hasegawa, Yoshifumi; Tasaki, Hiroshi; Iwami, Taro; Tsuchiya, Naoki

Health maintenance and improvement of humans, artifacts, and nature are pressing requirements considering the problems human beings have faced. In this article, the health management technology is proposed by centering cause-effect structure. The important aspect of the technology is evolvement through human-machine collaboration in response to changes of target systems. One of the reasons why the cause-effect structure is centered in the technology is its feature of transparency to humans by instinct point of view. The notion has been spreaded over wide application areas such as quality control, energy management, and healthcare. Some experiments were conducted to prove effectiveness of the technology in the article.

Management of needlestick injuries in general dental practice

OpenAIRE

Smith, A.J.; Cameron, S.O.; Bagg, J.; Kennedy, D.

2001-01-01

The objective of this paper is to advise on the development of practical policies for needlestick injuries in general dental practice. Policies for dealing with occupational exposure to chronic blood borne viruses, namely, hepatitis B, C and HIV are evolving. This article was particularly prompted by recent changes in post exposure prophylaxis for HIV infection. A flow chart is also included which should be of possible use in general dental practice. Needlestick injuries are of increasing con...

Management of dental trauma in primary care: a postal survey of general dental practitioners.

Science.gov (United States)

Jackson, N G; Waterhouse, P J; Maguire, A

2005-03-12

To determine the self-perceived knowledge and attitudes of general dental practitioners (GDPs) concerning management of dental trauma in primary care. To identify potential barriers to the management of dental trauma in primary care. A self-completion postal questionnaire survey of 417 GDPs in six local health authority districts in northeast England. Likert scale responses to 20 statements designed to test self-perceived knowledge and attitudes. Following descriptive statistical analysis. Factor analysis with principle components analysis was undertaken to identify areas of correlation in questionnaire responses, followed by Chi squared test, Spearman's Rank Correlation and analysis of variance (ANOVA) to measure association between variables. The response rate was 74%. Enamel and dentine fractures were the most common injury, with 45% of GDPs responding seeing more than 10 cases of dental trauma in the preceding year and 53% of respondents seeing one to three cases of complicated crown fracture. Seventy-eight per cent believed that NHS remuneration was inadequate, but only 8% would refer patients with dental trauma to secondary care for this reason. Half of the GDPs believed that trauma could be treated more effectively in practice if NHS payments were greater. GDPs were significantly more likely to agree with this statement if they had previously undertaken a postgraduate course in the treatment of dental trauma (p=0.002). Single handed GDPs were statistically significantly more likely to agree with the statements 'I would not treat dental trauma cases at my practice because the NHS payment is inadequate' (p=0.008) and 'Treating dental trauma at my practice requires too much of my clinical time to be worthwhile' (p=0.002). Ninety-six per cent of GDPs disagreed that treatment of dental trauma rested solely within secondary care. Ninety-six per cent of GDPs agreed that they had a responsibility to provide initial emergency treatment for trauma patients prior to

Relationship between harmonic analysis on SU(2) and on SL(2,C)/SU(2)

International Nuclear Information System (INIS)

Healy, D.M. Jr.

1986-01-01

A topic of interest in harmonic analysis is the comparison of Fourier transforms on compact and noncompact spaces. The Poisson summation formula provides a classical example of this idea by providing an explicit relationship between harmonic analysis on the real line R and on the circle S 1 . This dissertation provides a new geometric proof of this formula, and then generalizes this approach to obtain a relationship between Fourier transforms on Upsilon, the space of positive matrices in SL(2,C), and Fourier transforms on SU(2)

23 CFR 710.401 - General.

Science.gov (United States)

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false General. 710.401 Section 710.401 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RIGHT-OF-WAY AND ENVIRONMENT RIGHT-OF-WAY AND REAL ESTATE Real Property Management § 710.401 General. This subpart describes the acquiring agency's...

48 CFR 225.7301 - General.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false General. 225.7301 Section... General. (a) The U.S. Government sells defense articles and services to foreign governments or... under the same acquisition and contract management procedures used for other defense acquisitions. (c...

An 18-year-old patient with Prader-Willi syndrome: a case report on dental management under sedation and general anesthesia.

Science.gov (United States)

Song, Ki Un; Nam, Ok Hyung; Kim, Mi Sun; Choi, Sung Chul; Lee, Hyo-Seol

2015-12-01

Prader-Willi syndrome (PWS) is a rare genetic disorder reported rarely in dentistry. Dental practitioners should know the features of PWS because affected patients have a variety of dental symptoms. The current report describes a case of PWS. An 18-year-old male patient presented with traumatic injuries. Initial emergency treatments were performed under sedation, and further treatments were conducted under general anesthesia. After adequate healing, periodic follow-up and dietary management according to the patient's age and nutritional phase were recommended. Dental management of PWS patients consists of active preventive measures in addition to dietary consultation according to age and nutritional phase.

78 FR 37846 - Resource Management Plan/General Plan and Environmental Impact Statement/Environmental Impact...

Science.gov (United States)

2013-06-24

...The Bureau of Reclamation and the California Department of Parks and Recreation (CDPR) have prepared a Final Environmental Impact Statement/Environmental Impact Report (EIS/EIR) for the San Luis Reservoir State Recreation Area Resource Management Plan/General Plan (RMP/GP). The Final EIS/EIR describes and presents the environmental effects of the No Action/No Project Alternative and three Action Alternatives for implementing the RMP/GP. A Notice of Availability of the Draft EIS/EIR was published in the Federal Register on August 3, 2012 (77 FR 46518). The comment period on the Draft EIS/EIR ended on October 2, 2012. The Final EIS/EIR contains responses to all comments received and reflects comments and any additional information received during the review period.

The Core Competencies for General Orthopaedic Surgeons.

Science.gov (United States)

Kellam, James F; Archibald, Douglas; Barber, James W; Christian, Eugene P; D'Ascoli, Richard J; Haynes, Richard J; Hecht, Suzanne S; Hurwitz, Shepard R; Kellam, James F; McLaren, Alexander C; Peabody, Terrance D; Southworth, Stephen R; Strauss, Robert W; Wadey, Veronica M R

2017-01-18

With the changing delivery of orthopaedic surgical care, there is a need to define the knowledge and competencies that are expected of an orthopaedist providing general and/or acute orthopaedic care. This article provides a proposal for the knowledge and competencies needed for an orthopaedist to practice general and/or acute care orthopaedic surgery. Using the modified Delphi method, the General Orthopaedic Competency Task Force consisting of stakeholders associated with general orthopaedic practice has proposed the core knowledge and competencies that should be maintained by orthopaedists who practice emergency and general orthopaedic surgery. For relevancy to clinical practice, 2 basic sets of competencies were established. The assessment competencies pertain to the general knowledge needed to evaluate, investigate, and determine an overall management plan. The management competencies are generally procedural in nature and are divided into 2 groups. For the Management 1 group, the orthopaedist should be competent to provide definitive care including assessment, investigation, initial or emergency care, operative or nonoperative care, and follow-up. For the Management 2 group, the orthopaedist should be competent to assess, investigate, and commence timely non-emergency or emergency care and then either transfer the patient to the appropriate subspecialist's care or provide definitive care based on the urgency of care, exceptional practice circumstance, or individual's higher training. This may include some higher-level procedures usually performed by a subspecialist, but are consistent with one's practice based on experience, practice environment, and/or specialty interest. These competencies are the first step in defining the practice of general orthopaedic surgery including acute orthopaedic care. Further validation and discussion among educators, general orthopaedic surgeons, and subspecialists will ensure that these are relevant to clinical practice. These

5 CFR 179.303 - General.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false General. 179.303 Section 179.303 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CLAIMS COLLECTION STANDARDS Administrative Offset § 179.303 General. (a) The Director or his or her designee, after attempting to collect a...

41 CFR 128-48.503 - General procedures.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false General procedures. 128-48.503 Section 128-48.503 Public Contracts and Property Management Federal Property Management... bills of sale, contracts, mortgages, or other satisfactory documentary evidence. (3) The facts and...

Predisposal management of radioactive waste. General safety requirements. Pt. 5

International Nuclear Information System (INIS)

2009-01-01

The objective of this Safety Requirements publication is to establish, the requirements that must be satisfied in the predisposal management of radioactive waste. This publication sets out the objectives, criteria and requirements for the protection of human health and the environment that apply to the siting, design, construction, commissioning, operation and shutdown of facilities for the predisposal management of radioactive waste, and the requirements that must be met to ensure the safety of such facilities and activities. This Safety Requirements publication applies to the predisposal management of radioactive waste of all types and covers all the steps in its management from its generation up to its disposal, including its processing (pretreatment, treatment and conditioning), storage and transport. Such waste may arise from the commissioning, operation and decommissioning of nuclear facilities; the use of radionuclides in medicine, industry, agriculture, research and education; the processing of materials that contain naturally occurring radionuclides; and the remediation of contaminated areas. The introduction of the document (Section 1) informs about its objective, scope and structure. The protection of human health and the environment is considered in Section 2 of this publication. Section 3 establishes requirements for the responsibilities associated with the predisposal management of radioactive waste. Requirements for the principal approaches to and the elements of the predisposal management of radioactive waste are established in Section 4. Section 5 establishes requirements for the safe development and operation of predisposal radioactive waste management facilities and safe conduct of activities. The Annex presents a discussion of the consistency of the safety requirements established in this publication with the fundamental safety principles

78 FR 48660 - Agency Information Collection Activities; Comment Request; Student Assistance General Provisions...

Science.gov (United States)

2013-08-09

...; Comment Request; Student Assistance General Provisions--Subpart K--Cash Management AGENCY: Federal Student... of Collection: Student Assistance General Provisions--Subpart K--Cash Management OMB Control Number... administration of 34 CFR 668 Subpart K Cash Management of the Student Assistance General Provisions. The...

General considerations in fuel management for thermal reactors

International Nuclear Information System (INIS)

Tyror, J.G.; Fayers, F.J.

1971-07-01

By fuel management we mean the strategy for fuelling and refuelling a reactor together with any associated absorber movements. It incorporates (a) decisions made about the timing of fuel loading operations; (b) choice of enrichments to be loaded; (c) selection of sites at which reloading occurs; (d) programming of control rods and any other reactivity control facilities such as soluble or burnable poisons; and (e) evaluation of the resulting fuel element performance consequences. The topic of fuel management is thus a vast and vital one. It embraces most of the various aspects of core performance and determines many of a reactor's design characteristics. In this paper we review what to us appear to be some of the important issues in this important field

23 CFR 1200.20 - General.

Science.gov (United States)

2010-04-01

... cost principles govern the implementation and management of State highway safety programs carried out under 23 U.S.C. 402. Cost principles include those referenced in 49 CFR 18.22 and those set forth in... Implementation and Management of the Highway Safety Program § 1200.20 General. Except as otherwise provided in...

Modeling post-wildfire hydrological processes with ParFlow

Science.gov (United States)

Escobar, I. S.; Lopez, S. R.; Kinoshita, A. M.

2017-12-01

Wildfires alter the natural processes within a watershed, such as surface runoff, evapotranspiration rates, and subsurface water storage. Post-fire hydrologic models are typically one-dimensional, empirically-based models or two-dimensional, conceptually-based models with lumped parameter distributions. These models are useful for modeling and predictions at the watershed outlet; however, do not provide detailed, distributed hydrologic processes at the point scale within the watershed. This research uses ParFlow, a three-dimensional, distributed hydrologic model to simulate post-fire hydrologic processes by representing the spatial and temporal variability of soil burn severity (via hydrophobicity) and vegetation recovery. Using this approach, we are able to evaluate the change in post-fire water components (surface flow, lateral flow, baseflow, and evapotranspiration). This work builds upon previous field and remote sensing analysis conducted for the 2003 Old Fire Burn in Devil Canyon, located in southern California (USA). This model is initially developed for a hillslope defined by a 500 m by 1000 m lateral extent. The subsurface reaches 12.4 m and is assigned a variable cell thickness to explicitly consider soil burn severity throughout the stages of recovery and vegetation regrowth. We consider four slope and eight hydrophobic layer configurations. Evapotranspiration is used as a proxy for vegetation regrowth and is represented by the satellite-based Simplified Surface Energy Balance (SSEBOP) product. The pre- and post-fire surface runoff, subsurface storage, and surface storage interactions are evaluated at the point scale. Results will be used as a basis for developing and fine-tuning a watershed-scale model. Long-term simulations will advance our understanding of post-fire hydrological partitioning between water balance components and the spatial variability of watershed processes, providing improved guidance for post-fire watershed management. In reference

Lack of asthma and rhinitis control in general practitioner-managed patients prescribed fixed-dose combination therapy in Australia.

Science.gov (United States)

Bosnic-Anticevich, Sinthia; Kritikos, Vicky; Carter, Victoria; Yan, Kwok Yin; Armour, Carol; Ryan, Dermot; Price, David

2018-06-01

The first aim of the study (i) assess the current asthma status of general-practitioner-managed patients receiving regular fixed-dose combination inhaled corticosteroid and long-acting beta 2 agonist (FDC ICS/LABA) therapy and (ii) explore patients' perceptions of asthma control and attitudes/behaviors regarding preventer inhaler use. A cross-sectional observational study of Australian adults with a current physician diagnosis of asthma receiving ≥2 prescriptions of FDC ICS/LABA therapy in the previous year, who were recruited through general practice to receive a structured in-depth asthma review between May 2012 and January 2014. Descriptive statistics and Chi-Square tests for independence were used for associations across asthma control levels. Only 11.5% of the patients had controlled asthma based on guideline-defined criteria. Contrarily, 66.5% of the patients considered their asthma to be well controlled. Incidence of acute asthma exacerbations in the previous year was 26.5% and 45.6% of the patients were without a diagnosis of rhinitis. Asthma medication use and inhaler technique were sub-optimal; only 41.0% of the preventer users reported everyday use. The side effects of medication were common and more frequently reported among uncontrolled and partially controlled patients. The study revealed the extent to which asthma management needs to be improved in this patient cohort and the numerous unmet needs regarding the current state of asthma care. Not only there is a need for continuous education of patients, but also education of health care practitioners to better understand the way in which patient's perceptions impact on asthma management practices, incorporating these findings into clinical decision making.

Scientific forum during the 46th regular session of the IAEA General Conference. Topical issues: Nuclear Power - Life Cycle Management; Managing Nuclear Knowledge; Nuclear Security. Programme and synopses

International Nuclear Information System (INIS)

2002-01-01

In response to the recommendations of several Agency advisory committees, to address issues related to nuclear power life cycle management, knowledge management in the field of nuclear power, and security of radiation sources and other nuclear material the IAEA is organizing the scientific forum to be held during the General Conference. The purpose of the meeting is to sharpen awareness and understanding of the emerging concerns about the aging of nuclear power plants, maintenance and preservation of knowledge and expertise in nuclear science, technology and applications, to emphasise the significance of security and physical protection of radiation sources and other radioactive material, and to better comprehend the role of the Agency in these processes

Mobile task management tool that improves workflow of an acute general surgical service.

Science.gov (United States)

Foo, Elizabeth; McDonald, Rod; Savage, Earle; Floyd, Richard; Butler, Anthony; Rumball-Smith, Alistair; Connor, Saxon

2015-10-01

Understanding and being able to measure constraints within a health system is crucial if outcomes are to be improved. Current systems lack the ability to capture decision making with regard to tasks performed within a patient journey. The aim of this study was to assess the impact of a mobile task management tool on clinical workflow within an acute general surgical service by analysing data capture and usability of the application tool. The Cortex iOS application was developed to digitize patient flow and provide real-time visibility over clinical decision making and task performance. Study outcomes measured were workflow data capture for patient and staff events. Usability was assessed using an electronic survey. There were 449 unique patient journeys tracked with a total of 3072 patient events recorded. The results repository was accessed 7792 times. The participants reported that the application sped up decision making, reduced redundancy of work and improved team communication. The mode of the estimated time the application saved participants was 5-9 min/h of work. Of the 14 respondents, nine discarded their analogue methods of tracking tasks by the end of the study period. The introduction of a mobile task management system improved the working efficiency of junior clinical staff. The application allowed capture of data not previously available to hospital systems. In the future, such data will contribute to the accurate mapping of patient journeys through the health system. © 2015 Royal Australasian College of Surgeons.

29 CFR 215.2 - General.

Science.gov (United States)

2010-07-01

... 29 Labor 2 2010-07-01 2010-07-01 false General. 215.2 Section 215.2 Labor Regulations Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR GUIDELINES, SECTION 5333(b), FEDERAL TRANSIT LAW § 215.2 General. Upon receipt of copies of applications for Federal assistance subject to 49 U...

Treatment and retreatment with omalizumab in chronic spontaneous urticaria: Real life experience with twenty-five patients.

Science.gov (United States)

Türk, Murat; Yılmaz, İnsu; Bahçecioğlu, Sakine Nazik

2018-01-01

Previous data have shown the high efficacy of omalizumab in chronic spontaneous urticaria (CSU). However, factors that may be effective on the response to therapy, relapse rates after drug discontinuation, and efficacy of retreatment remain unclear. This study aimed to determine the efficacy of omalizumab in CSU refractory to conventional therapy, to identify possible factors affecting treatment response and relapse, and also to evaluate the efficacy of retreatment on relapsed disease. The data of CSU patients treated with 300 mg/month omalizumab for at least 3 months were retrospectively analyzed. In order to evaluate the efficacy of treatment and retreatment, baseline and follow-up concomitant medication score (CMS) and urticaria activity score (UAS) were calculated. Possible factors affecting treatment response and relapse were identified. Twenty-five patients were included. The median duration of omalizumab therapy was 6 (6-12) months. Of the patients with baseline UAS 6 (5.5-6) and CMS 13 (10-15), 8 (32%) had complete response (UAS = 0) and 2 (8%) were non-responders after 3 months of therapy. None of the complete responders were positive for IgG-anti-TPO. After discontinuation of omalizumab therapy, 11 (61%) patients experienced relapse and 10 of them received retreatment with omalizumab. Half of the patients had complete response, and half had partial response (UAS = 1-4) after retreatment. No treatment related adverse events were documented. Omalizumab has high efficacy in both the treatment and retreatment of CSU; however, relapse rates after discontinuation are high. Autoimmune markers may be helpful in predicting treatment response and relapse. Copyright © 2017 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

Unicameral bone cysts: general characteristics and management controversies.

Science.gov (United States)

Pretell-Mazzini, Juan; Murphy, Robert Francis; Kushare, Indranil; Dormans, John P

2014-05-01

Unicameral bone cysts are benign bone lesions that are often asymptomatic and commonly develop in the proximal humerus and femur of skeletally immature patients. The etiology of these lesions remains unknown. Most patients present with a pathologic fracture, but these cysts can be discovered incidentally, as well. Radiographically, a unicameral bone cyst appears as a radiolucent lesion with cortical thinning and is centrally located within the metaphysis. Although diagnosis is frequently straightforward, management remains controversial. Because the results of various management methods are heterogeneous, no single method has emerged as the standard of care. New minimally invasive techniques involve cyst decompression with bone grafting and instrumentation. These techniques have yielded promising results, with low rates of complications and recurrence reported; however, prospective clinical trials are needed to compare these techniques with current evidence-based treatments.

Participation of general practitioners in disease management: experiences from the Netherlands

Directory of Open Access Journals (Sweden)

L.M.G. Steuten

2002-03-01

Full Text Available Objective: To investigate the extent to which GPs in the Netherlands participate in disease management and how personal opinions, impeding and promoting incentives as well as physician characteristics influence their attitude towards disease management. Methods: The attitude-model of Fishbein and Ajzen was used to describe the attitude of GPs towards disease management and main influencing factors. After interviewing seventeen representatives of the GPs and testing a questionnaire, the final questionnaire was sent to all GPs in the Netherlands (7680 GPs barring those involved in the testing of the questionnaire. Results: At least 10.4% of all Dutch GPs are active in disease management. The main factors predicting a positive attitude towards disease management are the following: GPs' opinion that they are improving quality and efficiency of care when executing disease management, presence of a good quality network between actors involved prior to the start of disease management, working in a health centre, and performing sideline activities besides their daily activities as GPs. The main factors predicting a negative attitude are: GPs' opinion that the investment-time is too high, lack of reimbursement for disease management activities, working in a solo practice, and not performing any sideline activities beside their daily activities as GP. Conclusions: The factors predicting a negative attitude of Dutch GPs towards disease management dominate the factors predicting a positive attitude. The arguments in favour of disease management are matters of belief, for example concerning improvements in the quality of care, while arguments against are more concrete barriers e.g. high workload and financial reimbursement. Placed on the innovation timeline, the 10.4% participation might be taken to represent the start of a trend.

Highly Enhanced Raman Scattering on Carbonized Polymer Films.

Science.gov (United States)

Yoon, Jong-Chul; Hwang, Jongha; Thiyagarajan, Pradheep; Ruoff, Rodney S; Jang, Ji-Hyun

2017-06-28

We have discovered a carbonized polymer film to be a reliable and durable carbon-based substrate for carbon enhanced Raman scattering (CERS). Commercially available SU8 was spin coated and carbonized (c-SU8) to yield a film optimized to have a favorable Fermi level position for efficient charge transfer, which results in a significant Raman scattering enhancement under mild measurement conditions. A highly sensitive CERS (detection limit of 10 -8 M) that was uniform over a large area was achieved on a patterned c-SU8 film and the Raman signal intensity has remained constant for 2 years. This approach works not only for the CMOS-compatible c-SU8 film but for any carbonized film with the correct composition and Fermi level, as demonstrated with carbonized-PVA (poly(vinyl alcohol)) and carbonized-PVP (polyvinylpyrollidone) films. Our study certainly expands the rather narrow range of Raman-active material platforms to include robust carbon-based films readily obtained from polymer precursors. As it uses broadly applicable and cheap polymers, it could offer great advantages in the development of practical devices for chemical/bio analysis and sensors.

Colorado State University: A Midscale Market Solar Customer Case Study

Energy Technology Data Exchange (ETDEWEB)

Holm, Alison [National Renewable Energy Lab. (NREL), Golden, CO (United States); Chernyakhovskiy, Ilya [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2016-12-01

Despite substantial increases in solar photovoltaic (PV) deployment between 2005 and 2015, a large untapped market for solar PV deployment still exists in midscale market investments by universities. Recent estimates show that if all universities in the United States installed enough solar PV to meet 25% of their annual electricity consumption, this would cumulatively result in just over 16 gigawatts (GW) of additional installed PV capacity. Within this context, midscale market projects - loosely defined as solar PV installations ranging from 100 kilowatts (kW) to 2 megawatts (MW), but more broadly representing installations not captured in the residential or utility-scale sectors - could be an attractive option for universities. This case study focuses on one university solar customer, Colorado State University (CSU), to provide a detailed example of the challenges, solutions, and opportunities associated with university solar power procurement. Between 2009 and 2015, a combined 6,754 kW of both ground-mounted and rooftop solar PV was installed across multiple CSU campuses in Fort Collins, Colorado. This case study highlights CSU's decision-making process, campus engagement strategies, and relationships with state, local, and utility partners, which have culminated in significant on-campus PV deployment.

Handbook of hazardous waste management

International Nuclear Information System (INIS)

Metry, A.A.

1980-01-01

The contents of this work are arranged so as to give the reader a detailed understanding of the elements of hazardous waste management. Generalized management concepts are covered in Chapters 1 through 5 which are entitled: Introduction, Regulations Affecting Hazardous Waste Management, Comprehensive Hazardous Waste Management, Control of Hazardous Waste Transportation, and Emergency Hazardous Waste Management. Chapters 6 through 11 deal with treatment concepts and are entitled: General Considerations for Hazardous Waste Management Facilities, Physical Treatment of Hazardous Wastes, Chemical Treatment of Hazardous Wastes, Biological Treatment of Hazardous Wastes, Incineration of Hazardous Wastes, and Hazardous Waste Management of Selected Industries. Chapters 12 through 15 are devoted to ultimate disposal concepts and are entitled: Land Disposal Facilities, Ocean Dumping of Hazardous Wastes, Disposal of Extremely Hazardous Wastes, and Generalized Criteria for Hazardous Waste Management Facilities

Financial Management: Ending Balance Adjustments to General Ledger Data for the Army General Fund

National Research Council Canada - National Science Library

2002-01-01

The Chief Financial Officers Act of 1990, Public Law 101-576, November 15, 1990, as amended by the Federal Financial Management Act of 1994, Public Law 103-356, October 13, 1994, requires the annual...

Dialectical behavior therapy compared with general psychiatric management for borderline personality disorder: clinical outcomes and functioning over a 2-year follow-up.

Science.gov (United States)

McMain, Shelley F; Guimond, Tim; Streiner, David L; Cardish, Robert J; Links, Paul S

2012-06-01

The authors conducted a 2-year prospective naturalistic follow-up study to evaluate posttreatment clinical outcomes in outpatients who were randomly selected to receive 1 year of either dialectical behavior therapy or general psychiatric management for borderline personality disorder. Patients were assessed by blind raters 6, 12, 18, and 24 months after treatment. The clinical effectiveness of treatment was assessed on measures of suicidal and nonsuicidal self-injurious behaviors, health care utilization, general symptom distress, depression, anger, quality of life, social adjustment, borderline psychopathology, and diagnostic status. The authors conducted between-group comparisons using generalized estimating equation, mixed-effects models, or chi-square statistics, depending on the distribution and nature of the data. Both treatment groups showed similar and statistically significant improvements on the majority of outcomes 2 years after discharge. The original effects of treatment did not diminish for any outcome domain, including suicidal and nonsuicidal self-injurious behaviors. Further improvements were seen on measures of depression, interpersonal functioning, and anger. However, even though two-thirds of the participants achieved diagnostic remission and significant increases in quality of life, 53% were neither employed nor in school, and 39% were receiving psychiatric disability support after 36 months. One year of either dialectical behavior therapy or general psychiatric management was associated with long-lasting positive effects across a broad range of outcomes. Despite the benefits of these specific treatments, one important finding that replicates previous research is that participants continued to exhibit high levels of functional impairment. The effectiveness of adjunctive rehabilitation strategies to improve general functioning deserves additional study.

Periodontal Emergencies in General Practice.

Science.gov (United States)

Wadia, Reena; Ide, Mark

2017-05-01

Diagnosing and managing periodontal emergencies is a common part of general dental practice. This article summarises the presentation, aetiology and management of the key periodontal emergencies, including gingival abscess, periodontal abscess, peri-coronitis/peri-coronal abscess, perio-endo lesion/ abscess, necrotising gingivitis and periodontitis, acute herpetic gingivostomatitis, acute physical/chemical/thermal injury and subgingival root fracture.

48 CFR 750.7102 - General policy.

Science.gov (United States)

2010-10-01

... MANAGEMENT EXTRAORDINARY CONTRACTUAL ACTIONS Extraordinary Contractual Actions To Protect Foreign Policy Interests of the United States 750.7102 General policy. Extra-contractual claims arising from foreign... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false General policy. 750.7102...

Opinions of general practitioners about psychotherapy and their relationships with mental health professionals in the management of major depression: A qualitative survey.

Directory of Open Access Journals (Sweden)

Hélène Dumesnil

Full Text Available French general practitioners (GPs refer their patients with major depression to psychiatrists or for psychotherapy at particularly low rates.This qualitative study aims to explore general practitioners' (GP opinions about psychotherapy, their relationships with mental health professionals, their perceptions of their role and that of psychiatrists in treating depression, and the relations between these factors and the GPs' strategies for managing depression.In 2011, in-depth interviews based on a semi-structured interview guide were conducted with 32 GPs practicing in southeastern France. Verbatim transcripts were examined by analyzing their thematic content.We identified three profiles of physicians according to their opinions and practices about treatment strategies for depression: pro-pharmacological treatment, pro-psychotherapy and those with mixed practices. Most participants considered their relationships with psychiatrists unsatisfactory, would like more and better collaboration with them and shared the same concept of management in general practice. This concept was based both on the values and principles of practice shared by GPs and on their strong differentiation of their management practices from those of psychiatrists.Several attitudes and values common to GPs might contribute to their low rate of referrals for psychotherapy in France: strong occupational identity, substantial variations in GPs' attitudes and practices regarding depression treatment strategies, representations sometimes unfavorable toward psychiatrists. Actions to develop a common culture and improve cooperation between GPs and psychiatrists are essential. They include systems of collaborative care and the development of interdisciplinary training common to GPs and psychiatrists practicing in the same area.

Opinions of general practitioners about psychotherapy and their relationships with mental health professionals in the management of major depression: A qualitative survey

Science.gov (United States)

Dumesnil, Hélène; Apostolidis, Thémis; Verger, Pierre

2018-01-01

Background French general practitioners (GPs) refer their patients with major depression to psychiatrists or for psychotherapy at particularly low rates. Objectives This qualitative study aims to explore general practitioners' (GP) opinions about psychotherapy, their relationships with mental health professionals, their perceptions of their role and that of psychiatrists in treating depression, and the relations between these factors and the GPs' strategies for managing depression. Methods In 2011, in-depth interviews based on a semi-structured interview guide were conducted with 32 GPs practicing in southeastern France. Verbatim transcripts were examined by analyzing their thematic content. Results We identified three profiles of physicians according to their opinions and practices about treatment strategies for depression: pro-pharmacological treatment, pro-psychotherapy and those with mixed practices. Most participants considered their relationships with psychiatrists unsatisfactory, would like more and better collaboration with them and shared the same concept of management in general practice. This concept was based both on the values and principles of practice shared by GPs and on their strong differentiation of their management practices from those of psychiatrists, Conclusion Several attitudes and values common to GPs might contribute to their low rate of referrals for psychotherapy in France: strong occupational identity, substantial variations in GPs' attitudes and practices regarding depression treatment strategies, representations sometimes unfavorable toward psychiatrists. Actions to develop a common culture and improve cooperation between GPs and psychiatrists are essential. They include systems of collaborative care and the development of interdisciplinary training common to GPs and psychiatrists practicing in the same area. PMID:29385155

Self-reported hair loss in patients with chronic spontaneous urticaria treated with omalizumab: an under-reported, transient side effect?

Science.gov (United States)

Konstantinou, G N; Chioti, A G; Daniilidis, M

2016-09-01

Omalizumab has been recently approved for treating patients with refractory to H1- antihistamines chronic spontaneous urticaria (CSU). Although hair loss is listed among omalizumab side effects, there are no available data to estimate its frequency. We describe for the first time hair loss as a side effect associated with omalizumab administration in three women, 38, 62 and 70 years old, suffering from refractory to H1-antihistamines CSU. This information was retrieved from their Chronic Urticaria Quality of Life Questionnaires. Despite this side effect, all patients agreed to continue omalizumab regular administration. Hair loss appeared to be transient, lasting up to four months. All cases finally benefited from omalizumab continuation.

Fuel management optimization based on generalized perturbation theory

International Nuclear Information System (INIS)

White, J.R.; Chapman, D.M.; Biswas, D.

1986-01-01

A general methodology for optimization of assembly shuffling and burnable poison (BP) loadings for LWR reload design has been developed. The uniqueness of this approach lies in the coupling of Generalized Perturbation Theory (GPT) methods and standard Integer Programming (IP) techniques. An IP algorithm can simulate the discrete nature of the fuel shuffling and BP loading problems, and the use of GPT sensitivity data provides an efficient means for modeling the behavior of the important core performance parameters. The method is extremely flexible since the choice of objective function and the number and mix of constraints depend only on the ability of GPT to determine the appropriate sensitivity functions

Acitretin for the management of generalized cutaneous lichen planus.

Science.gov (United States)

Vazirnia, Aria; Cohen, Philip R

2014-09-16

Lichen planus is an inflammatory disease that affects the skin, the oral mucosa, or both. Generalized cutaneous lichen planus may pose a therapeutic challenge for clinicians if the condition persists or flares after topical or systemic corticosteroid therapy. Acitretin, a systemic retinoid, can be considered a potential second-line treatment for patients with generalized cutaneous lichen planus. Herein, we describe a postmenopausal woman with generalized cutaneous lichen planus who was successfully treated with acitretin. A 58-year-old woman presented with generalized cutaneous lichen planus involving her upper and lower extremities as well as her lower back. After failing corticosteroid therapy, she was started on acitretin 20 mg/day, which was later increased to 30 mg/day. To review the literature on the use of acitretin in cutaneous lichen planus, we used the PubMed search engine and searched for the terms "acitretin" and "cutaneous lichen planus." Our patient had complete resolution of pruritus within one week of initiating acitretin 20 mg/day. After an increase in dose to 30 mg/day, the cutaneous lesions completely resolved over a 3-month period. There was no recurrence of disease as acitretin was tapered and discontinued. Generalized cutaneous lichen planus may pose a therapeutic challenge for the symptomatic relief of skin lesions. Topical and systemic corticosteroids are first-line treatments. In patients who fail corticosteroids, relapse after corticosteroid therapy, or have contraindications to corticosteroids, acitretin may be considered a potential second-line therapy.

A methodology model for quality management in a general hospital.

Science.gov (United States)

Stern, Z; Naveh, E

1997-01-01

A reappraisal is made of the relevance of industrial modes of quality management to the issues of medical care. Analysis of the nature of medical care, which differentiates it from the supplier-client relationships of industry, presents the main intrinsic characteristics, which create problems in application of the industrial quality management approaches to medical care. Several examples are the complexity of the relationship between the medical action and the result obtained, the client's nonacceptance of economic profitability as a value in his medical care, and customer satisfaction biased by variable standards of knowledge. The real problems unique to hospitals are addressed, and a methodology model for their quality management is offered. Included is a sample of indicator vectors, measurements of quality care, cost of medical care, quality of service, and human resources. These are based on the trilogy of planning quality, quality control, and improving quality. The conclusions confirm the inadequacy of industrial quality management approaches for medical institutions and recommend investment in formulation of appropriate concepts.

GENERAL ASPECTS REGARDING THE MANAGEMENT ACTIVITY IN INTERNATIONAL BUSINESS

Directory of Open Access Journals (Sweden)

Mihaela Loredana LĂPĂDUŞI

2010-09-01

Full Text Available The strategy of penetrating and developing the external markets is an important objective of the international enterprises management. This involves a specific analysis of the business environment for illustrating the opportunities of business and risks and the business potential of a particular enterprise in order to establish the internalisation objectives and types. The international management is individualised by the environment where the enterprises develop their economical activity, supposing that the world market of international business involves the access to new markets and the enterprises must adapt to the specific needs and opportunities.

41 CFR 51-5.1 - General.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true General. 51-5.1 Section 51-5.1 Public Contracts and Property Management Other Provisions Relating to Public Contracts... commodities, information such as the latest solicitation and amendments, bid abstracts, procurement history...

General anesthesia and postoperative pain management in analgesic intolerant patients with/without asthma: is it safe?

Science.gov (United States)

Celiker, V; Basgül, E; Karakaya, G; Oguzalp, H; Bozkurt, B; Kalyoncu, A F

2004-01-01

Analgesic intolerance (AI) appears in approximately 1 % of the general population. The triad of bronchial asthma, nasal polyposis, and analgesic intolerance is called analgesic-induced asthma (AIA). These patients are frequently referred to adult allergy clinics for preoperative evaluation for possible analgesic cross reactivity and intolerance to anesthetic agents. To determine allergic problems related to anesthesia and postoperative pain management in AI patients with and without asthma. The medical records of 45 patients who had been diagnosed with AI between January 1991 and December 2002 in the adult allergy unit and who underwent surgery in the same hospital in the last 4 years were retrospectively analyzed. The mean age of the patients was 44.4 13.4 years and 30 (66.6 %) were female. Thirty-six (80 %) had AIA, 34 (75.6 %) had persistent allergic rhinitis and 21 (46.7 %) had nasal polyps. Fifty-one surgical procedures were performed in 45 patients, in whom ear, nose and throat surgery was the main procedure (64.7 %). Anesthesia was induced with propofol, fentanyl, and vecuronium and was maintained by sevoflurane or isoflurane. Fentanyl was used for early postoperative pain relief. No complications appeared in relation to anesthesia or early pain management except in a 44-year-old AIA woman who had a reaction in the postoperative period after receiving an inappropriate analgesic. None of the patients had anesthesia-related allergic problems. Atropine and diazepam in the premedication, propofol and fentanyl during induction, muscle relaxation facilitation by vecuronium, and sevoflurane or isoflurane for maintenance seem to be a safe general anesthetic choice for analgesic intolerant patients with and without asthma.

NELS 2.0 - A general system for enterprise wide information management

Science.gov (United States)

Smith, Stephanie L.

1993-01-01

NELS, the NASA Electronic Library System, is an information management tool for creating distributed repositories of documents, drawings, and code for use and reuse by the aerospace community. The NELS retrieval engine can load metadata and source files of full text objects, perform natural language queries to retrieve ranked objects, and create links to connect user interfaces. For flexibility, the NELS architecture has layered interfaces between the application program and the stored library information. The session manager provides the interface functions for development of NELS applications. The data manager is an interface between session manager and the structured data system. The center of the structured data system is the Wide Area Information Server. This system architecture provides access to information across heterogeneous platforms in a distributed environment. There are presently three user interfaces that connect to the NELS engine; an X-Windows interface, and ASCII interface and the Spatial Data Management System. This paper describes the design and operation of NELS as an information management tool and repository.

The complexity of managing COPD exacerbations: a grounded theory study of European general practice

Science.gov (United States)

Risør, Mette Bech; Spigt, Mark; Iversen, R; Godycki-Cwirko, M; Francis, N; Altiner, A; Andreeva, E; Kung, K; Melbye, H

2013-01-01

Objectives To understand the concerns and challenges faced by general practitioners (GPs) and respiratory physicians about primary care management of acute exacerbations in patients with chronic obstructive pulmonary disease (COPD). Design 21 focus group discussions (FGDs) were performed in seven countries with a Grounded Theory approach. Each country performed three rounds of FGDs. Setting Primary and secondary care in Norway, Germany, Wales, Poland, Russia, The Netherlands, China (Hong Kong). Participants 142 GPs and respiratory physicians were chosen to include urban and rural GPs as well as hospital-based and out patient-clinic respiratory physicians. Results Management of acute COPD exacerbations is dealt with within a scope of concerns. These concerns range from ‘dealing with comorbidity’ through ‘having difficult patients’ to ‘confronting a hopeless disease’. The first concern displays medical uncertainty regarding diagnosis, medication and hospitalisation. These clinical processes become blurred by comorbidity and the social context of the patient. The second concern shows how patients receive the label ‘difficult’ exactly because they need complex attention, but even more because they are time consuming, do not take responsibility and are non-compliant. The third concern relates to the emotional reactions by the physicians when confronted with ‘a hopeless disease’ due to the fact that most of the patients do not improve and the treatment slows down the process at best. GPs and respiratory physicians balance these concerns with medical knowledge and practical, situational knowledge, trying to encompass the complexity of a medical condition. Conclusions Knowing the patient is essential when dealing with comorbidities as well as with difficult relations in the consultations on exacerbations. This study suggests that it is crucial to improve the collaboration between primary and secondary care, in terms of, for example, shared consultations

Energy management systems in buildings

Energy Technology Data Exchange (ETDEWEB)

Lush, D. M.

1979-07-01

An investigation is made of the range of possibilities available from three types of systems (automatic control devices, building envelope, and the occupants) in buildings. The following subjects are discussed: general (buildings, design and personnel); new buildings (envelope, designers, energy and load calculations, plant design, general design parameters); existing buildings (conservation measures, general energy management, air conditioned buildings, industrial buildings); man and motivation (general, energy management and documentation, maintenance, motivation); automatic energy management systems (thermostatic controls, optimized plant start up, air conditioned and industrial buildings, building automatic systems). (MCW)

General RMP Guidance - Chapter 9: Risk Management Plan

Science.gov (United States)

You must submit one risk management plan (RMP) to EPA for all of your covered processes. The internet-based RMP*eSubmit allows you to submit your RMP in EPA's Central Data Exchange (CDX), where you can access and change/correct existing RMPs.

Computer templates in chronic disease management: ethnographic case study in general practice.

Science.gov (United States)

Swinglehurst, Deborah; Greenhalgh, Trisha; Roberts, Celia

2012-01-01

To investigate how electronic templates shape, enable and constrain consultations about chronic diseases. Ethnographic case study, combining field notes, video-recording, screen capture with a microanalysis of talk, body language and data entry-an approach called linguistic ethnography. Two general practices in England. Ethnographic observation of administrative areas and 36 nurse-led consultations was done. Twenty-four consultations were directly observed and 12 consultations were video-recorded alongside computer screen capture. Consultations were transcribed using conversation analysis conventions, with notes on body language and the electronic record. The analysis involved repeated rounds of viewing video, annotating field notes, transcription and microanalysis to identify themes. The data was interpreted using discourse analysis, with attention to the sociotechnical theory. Consultations centred explicitly or implicitly on evidence-based protocols inscribed in templates. Templates did not simply identify tasks for completion, but contributed to defining what chronic diseases were, how care was being delivered and what it meant to be a patient or professional in this context. Patients' stories morphed into data bytes; the particular became generalised; the complex was made discrete, simple and manageable; and uncertainty became categorised and contained. Many consultations resembled bureaucratic encounters, primarily oriented to completing data fields. We identified a tension, sharpened by the template, between different framings of the patient-as 'individual' or as 'one of a population'. Some clinicians overcame this tension, responding creatively to prompts within a dialogue constructed around the patient's narrative. Despite their widespread implementation, little previous research has examined how templates are actually used in practice. Templates do not simply document the tasks of chronic disease management but profoundly change the nature of this work

31 CFR 281.9 - General provisions.

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false General provisions. 281.9 Section 281.9 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE FOREIGN EXCHANGE OPERATIONS § 281.9 General...

41 CFR 51-4.1 - General.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true General. 51-4.1 Section 51-4.1 Public Contracts and Property Management Other Provisions Relating to Public Contracts... nonprofit agency assigned by the Committee on the basis of the nonprofit agency's articles of incorporation...

General Assembly

CERN Multimedia

Staff Association

2016-01-01

5th April, 2016 – Ordinary General Assembly of the Staff Association! In the first semester of each year, the Staff Association (SA) invites its members to attend and participate in the Ordinary General Assembly (OGA). This year the OGA will be held on Tuesday, April 5th 2016 from 11:00 to 12:00 in BE Auditorium, Meyrin (6-2-024). During the Ordinary General Assembly, the activity and financial reports of the SA are presented and submitted for approval to the members. This is the occasion to get a global view on the activities of the SA, its financial management, and an opportunity to express one’s opinion, including taking part in the votes. Other points are listed on the agenda, as proposed by the Staff Council. Who can vote? Only “ordinary” members (MPE) of the SA can vote. Associated members (MPA) of the SA and/or affiliated pensioners have a right to vote on those topics that are of direct interest to them. Who can give his/her opinion? The Ordinary General Asse...

Management and marketing for the general practice dental office.

Science.gov (United States)

Clarkson, Earl; Bhatia, Sanjeev

2008-07-01

This article reviews trends in the dental marketplace. Marketing is an essential element of dentistry. Communicating treatment options with patients is one aspect of marketing. Treatment planning helps patients understand the relationships between oral health, occlusion, temporomandibular joint function, and systemic health. Through marketing, dental practice owners inform patients of ever-changing treatment modalities. Understanding treatment options allows patients to make better, informed choices. More options leads to a higher level of care and more comprehensive dental treatment. Managing a practice requires tracking its financial health. Economic statistics measure the effect of management decisions that mark the direction of a dental practice.

Managing ANSA Objects with OSI Network Management Tools

OpenAIRE

Polizzi, Marc; Genilloud, Guy

1995-01-01

OSI Network Management provides a general framework for the management of OSI systems, and by extension of any distributed system. However, as this model is not well-adapted for the management of software components, distributed programming environments (e.g. DCE, CORBA, ANSAware) essentially ignore the OSI Network Management model. We assume nevertheless that OSI Network managers will want to have some control of a distributed infrastructure and application. We examine how access to some of ...

Use of antimicrobial resistance information and prescribing guidance for management of urinary tract infections: survey of general practitioners in the West Midlands.

Science.gov (United States)

Ironmonger, Dean; Edeghere, Obaghe; Gossain, Savita; Hawkey, Peter M

2016-05-24

There is a marked variation in both antibiotic prescribing practice and urine sampling rates for diagnostic microbiology across general practices in England. To help understand factors driving this variation, we undertook a survey in 2012/13 to determine sampling protocols and antibiotic formularies used by general practitioners (GPs) for managing urinary tract infections (UTIs) in the West Midlands region of England. Cross-sectional survey of all eligible general practices in the West Midlands region of England undertaken in November 2012. GPs were invited to complete an online survey questionnaire to gather information on policies used within the practice for urine sampling for microbiological examination, and the source of antibiotic formularies used to guide treatment of UTIs. The questionnaire also gathered information on how they would manage five hypothetical clinical scenarios encountered in the community. The response rate was 11.3 % (409/3635 GPs), equivalent to a practice response rate of 26 % (248/950). Only 50 % of GPs reported having a practice policy for urine sampling. Although there was good agreement from GPs regarding collecting specimens in scenarios symbolising treatment failure (98 %), UTI in an adult male (98 %) and asymptomatic UTI in pregnancy (97 %), there was variation in GPs requesting a specimen for the scenarios involving a suspected uncomplicated urinary tract infection (UTI) and an asymptomatic catheterised elderly patient; with 40 and 38 % respectively indicating they would collect a specimen for microbiological examination. Standardised evidence based clinical management policies and antibiotic formularies for GPs should be readily available. This will promote the rational use of diagnostic microbiology services, improve antimicrobial stewardship and aid the interpretation of ongoing antimicrobial resistance surveillance.

Feasibility and impact of a computer-guided consultation on guideline-based management of COPD in general practice.

Science.gov (United States)

Angus, Robert M; Thompson, Elizabeth B; Davies, Lisa; Trusdale, Ann; Hodgson, Chris; McKnight, Eddie; Davies, Andrew; Pearson, Mike G

2012-12-01

Applying guidelines is a universal challenge that is often not met. Intelligent software systems that facilitate real-time management during a clinical interaction may offer a solution. To determine if the use of a computer-guided consultation that facilitates the National Institute for Health and Clinical Excellence-based chronic obstructive pulmonary disease (COPD) guidance and prompts clinical decision-making is feasible in primary care and to assess its impact on diagnosis and management in reviews of COPD patients. Practice nurses, one-third of whom had no specific respiratory training, undertook a computer-guided review in the usual consulting room setting using a laptop computer with the screen visible to them and to the patient. A total of 293 patients (mean (SD) age 69.7 (10.1) years, 163 (55.6%) male) with a diagnosis of COPD were randomly selected from GP databases in 16 practices and assessed. Of 236 patients who had spirometry, 45 (19%) did not have airflow obstruction and the guided clinical history changed the primary diagnosis from COPD in a further 24 patients. In the 191 patients with confirmed COPD, the consultations prompted management changes including 169 recommendations for altered prescribing of inhalers (addition or discontinuation, inhaler dose or device). In addition, 47% of the 55 current smokers were referred for smoking cessation support, 12 (6%) for oxygen assessment, and 47 (24%) for pulmonary rehabilitation. Computer-guided consultations are practicable in general practice. Primary care COPD databases were confirmed to contain a significant proportion of incorrectly assigned patients. They resulted in interventions and the rationalisation of prescribing in line with recommendations. Only in 22 (12%) of those fully assessed was no management change suggested. The introduction of a computer-guided consultation offers the prospect of comprehensive guideline quality management.

The quality of COPD care in general practice

DEFF Research Database (Denmark)

Rasmussen, F.V.; Borgeskov, H.; Dollerup, J.

2008-01-01

We investigated whether the quality of management of COPD in general practice could be improved by the participation of general practitioners and their staff in a COPD-specific educational programme. One-hundred and fifty-four doctors participated in the study, and 2549 patient record forms were...... included in the first audit and 2394 in the second audit. We observed a significantly increased utilisation of spirometry from the first (52.7%) to the second audit (71.4%) (p quality of management. We conclude that participation in an educational...... programme can improve the quality of COPD care in general practice Udgivelsesdato: 2008/8/25...

Water management - management actions applied to water resources system

International Nuclear Information System (INIS)

Petkovski, Ljupcho; Tanchev, Ljubomir

2001-01-01

In this paper are presented a general description of water resource systems, a systematisation of the management tasks and the approaches for solution, including a review of methods used for solution of water management tasks and the fundamental postulates in the management. The management of water resources is a synonym for the management actions applied to water resource systems. It is a general term that unites planning and exploitation of the systems. The modern planning assumes separating the water racecourse part from the hydro technical part of the project. The water resource study is concerned with the solution for the resource problem. This means the parameters of the system are determined in parallel with the definition of the water utilisation regime. The hydro-technical part of the project is the design of structures necessary for the water resource solution. (Original)

Diagnosis and management of perinatal depression and anxiety in general practice: a meta-synthesis of qualitative studies.

Science.gov (United States)

Ford, Elizabeth; Lee, Suzanne; Shakespeare, Judy; Ayers, Susan

2017-08-01

Up to 20% of women experience anxiety and depression during the perinatal period. In the UK, management of perinatal mental health falls under the remit of GPs. This review aimed at synthesising the available information from qualitative studies on GPs' attitudes, recognition, and management of perinatal anxiety and depression. Meta-synthesis of the available published qualitative evidence on GPs' recognition and management of perinatal anxiety and depression. A systematic search was conducted on Embase, Medline, PsycInfo, Pubmed, Scopus, and Web of Science, and grey literature was searched using Google, Google Scholar, and British Library EThOS. Papers and reports were eligible for inclusion if they reported qualitatively on GPs' diagnosis or treatment of perinatal anxiety or depression. The synthesis was constructed using meta-ethnography. Five themes were established from five eligible papers: labels: diagnosing depression; clinical judgement versus guidelines; care and management; use of medication; and isolation: the role of other professionals. GPs considered perinatal depression to be a psychosocial phenomenon, and were reluctant to label disorders and medicalise distress. GPs relied on their own clinical judgement more than guidelines. They reported helping patients make informed choices about treatment, and inviting them back regularly for GP visits. GPs sometimes felt isolated when dealing with perinatal mental health issues. GPs often do not have timely access to appropriate psychological therapies and use several strategies to mitigate this shortfall. Training must focus on these issues and must be evaluated to consider whether this makes a difference to outcomes for patients. © British Journal of General Practice 2017.

Radioactive waste management. Introductory statement of the 3rd scientific forum during the 44th session of the IAEA General Conference. Vienna, 19 September 2000

International Nuclear Information System (INIS)

ElBaradei, M.

2000-01-01

The document reproduces the text of the introductory statement made by the Director General of the IAEA at the 3rd scientific forum organized during the 44th session of the IAEA General Conference, Vienna, 19 september 2000, on the management of radioactive waste. He emphasized the following aspects: progress made in technology and public acceptance, global challenges, international co-operation, building a stronger framework

Knowledge management: another management fad?

Directory of Open Access Journals (Sweden)

Leonard J. Ponzi

2002-01-01

Full Text Available Knowledge management is a subject of a growth body of literature. While capturing the interest of practitioners and scholars in the mid-1990s, knowledge management remains a broadly defined concept with faddish characteristics. Based on annual counts of article retrieved from Science Citation Index, Social Science Citation Index, and ABI Inform referring to three previous recognized management fad, this paper introduces empirical evidence that proposes that a typical management movement generally reveals itself as a fad in approximately five years. In applying this approach and assumption to the case of knowledge management, the findings suggest that knowledge management is at least living longer than typical fads and perhaps is in the process of establishing itself as a new aspect of management. To further the understanding of knowledge management's development, its interdisciplinary activity and breadth are reported and briefly discussed.

General and special education teachers' relations within teamwork ...

African Journals Online (AJOL)

and instruction, assessment and evaluation, and classroom management and behavior. Typically, the ... teaching techniques and learning processes. ... general objective of this research is to establish the relations of general and special.

Towards General Temporal Aggregation

DEFF Research Database (Denmark)

Boehlen, Michael H.; Gamper, Johann; Jensen, Christian Søndergaard

2008-01-01

associated with the management of temporal data. Indeed, temporal aggregation is complex and among the most difficult, and thus interesting, temporal functionality to support. This paper presents a general framework for temporal aggregation that accommodates existing kinds of aggregation, and it identifies...

General Fund Enterprise Business System Did Not Provide Required Financial Information

Science.gov (United States)

2012-03-26

Management of the General Fund Enterprise Business System,” January 14, 2008 Army AAA Report No. A-2010-0187- FFM , “General Fund Enterprise Business System...A-2009-0232- FFM , “General Fund Enterprise Business System – Federal Financial Management Improvement Act Compliance, Examination of Releases...1.4.1, 1.4.2, 1.4.3, and 1.4.4 Requirements,” September 30, 2009 AAA Report No. A-2009-0231- FFM , “General Fund Enterprise Business System – Federal

GENERAL REQUIREMENTS FOR SIMULATION MODELS IN WASTE MANAGEMENT

International Nuclear Information System (INIS)

Miller, Ian; Kossik, Rick; Voss, Charlie

2003-01-01

Most waste management activities are decided upon and carried out in a public or semi-public arena, typically involving the waste management organization, one or more regulators, and often other stakeholders and members of the public. In these environments, simulation modeling can be a powerful tool in reaching a consensus on the best path forward, but only if the models that are developed are understood and accepted by all of the parties involved. These requirements for understanding and acceptance of the models constrain the appropriate software and model development procedures that are employed. This paper discusses requirements for both simulation software and for the models that are developed using the software. Requirements for the software include transparency, accessibility, flexibility, extensibility, quality assurance, ability to do discrete and/or continuous simulation, and efficiency. Requirements for the models that are developed include traceability, transparency, credibility/validity, and quality control. The paper discusses these requirements with specific reference to the requirements for performance assessment models that are used for predicting the long-term safety of waste disposal facilities, such as the proposed Yucca Mountain repository

Management salaries

International Nuclear Information System (INIS)

Moody, D.

1993-01-01

Salary charts presenting the median salaries of general managers of locally owned electric utilities are given. These data are given by revenue class, and by customer size class. It was found that general managers of locally owned electric utilities earned a mean (average) salary of $56,034 as of June 1, 1992 and the median salary was $52,000. The data show that utilities servicing a larger customer base and hence, earning higher receives pay higher salaries

31 CFR 208.6 - General account requirements.

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false General account requirements. 208.6 Section 208.6 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE MANAGEMENT OF FEDERAL AGENCY...

Quantity & quality analysis and associated management practices of solid waste generated in the general dentistry offices in the city of Arak, 2015

Directory of Open Access Journals (Sweden)

Ali Koolivand

2016-10-01

Full Text Available Abstract Background: As dental solid waste are among the most important environmental pollutants due to its high contents of toxic and hazardous agents, suitable treatment and management of it are of great importance. The objective of this study was to quantity & quality analyses of dental solid waste and associated management practices in the general dentistry offices in the city of Arak. Materials and Methods: 15 samples of solid waste were taken from the 5 selected general dentistry offices, classified into 66 components and 4 fractions, and then the quantity & quality characteristics were evaluated. Management practices of the solid waste were also investigated by using a questionnaire. Results: According to the results, per capita and the average generation rate of each dentistry office were 66.71 g/day-patient and 1340.45 g/day, respectively. Potential infectious, domestic-type, chemical & pharmaceutical, and toxic wastes consisted of 54.25%, 35.14%, 8.19%, and 2.14% of the waste generated, respectively. 10 components including latex gloves, nylon & plastic, saliva & blood-contaminated kleenex, paper & cardboard, used ampoules, saliva ejector tubes, gypsum, food waste, saliva & blood-contaminated dental rolls, and nylon gloves were responsible for more than 80% of the total waste generated, respectively. Conclusion: Each fraction of dental solid waste (toxic, chemical & pharmaceutical, potential infectious and domestic-type wastes should be separately collected and disposed of according to the related criteria.

The effectiveness of a semi-tailored facilitator-based intervention to optimise chronic care management in general practice: a stepped-wedge randomised controlled trial.

Science.gov (United States)

Due, Tina Drud; Thorsen, Thorkil; Kousgaard, Marius Brostrøm; Siersma, Volkert Dirk; Waldorff, Frans Boch

2014-04-09

The Danish health care sector is reorganising based on disease management programmes designed to secure integrated and high quality chronic care across hospitals, general practitioners and municipalities. The disease management programmes assign a central role to general practice; and in the Capital Region of Denmark a facilitator-based intervention was undertaken to support the implementation of the programmes in general practice. The purpose of the study was to assess the effectiveness of this semi-tailored facilitator-based intervention. The study was a stepped-wedge, randomised, controlled trial among general practices in the Capital Region of Denmark. The intervention group was offered three one-hour visits by a facilitator. The intervention was semi-tailored to the perceived needs as defined by each general practice, and the practices could choose from a list of possible topics. The control group was a delayed intervention group. The primary outcome was change in the number of annual chronic disease check-ups. Secondary outcomes were: changes in the number of annual check-ups for type 2 diabetes (DM2) and chronic obstructive pulmonary disease (COPD); changes in the number of spirometry tests, changes in the use of ICPC diagnosis coding and patient stratification; sign-up for a software program for patient overview; and reduction in number of practices with few annual chronic disease check-ups. We randomised 189 general practices: 96 practices were allocated to the intervention group and 93 to the delayed intervention group. For the primary outcome, 94 and 89 practices were analysed. Almost every outcome improved from baseline to follow-up in both allocation groups. At follow-up there was no difference between allocation groups for the primary outcome (p = 0.1639). However, some secondary outcomes favoured the intervention: a higher reported use of ICPC diagnosis coding for DM2 and COPD (p = 0.0050, p = 0.0243 respectively), stratification for COPD (p = 0

Crisis del sistema de gobierno en las universidades públicas colombianas. Aportes a una sociología del poder en las universidades

Directory of Open Access Journals (Sweden)

Víctor Manuel Gómez Campo

2012-01-01

Full Text Available Uno de los grandes temas en la sociología de la educación superior es la ‘sociología del poder’ en las instituciones, cuya principal expresión es el gobierno institucional, entendido como el conjunto de normas que definen y regulan tanto los órganos de toma de decisiones y su relación jerárquica, como la participación y representación de diversos grupos, estamentos y sectores de la sociedad en dichos órganos. Dado que en las universidades públicas colombianas el principal órgano de gobierno es el Consejo Superior Universitario (CSU, reglado en la Ley 30 de 1992, se define como un importante objeto de estudio sociológico la composición del CSU, el origen de sus miembros y sus respectivas filiaciones, lealtades y grupos o sectores sociales que representa. Este análisis permite comprender la naturaleza democrática de la composición del CSU, el alcance y los límites de la representatividad de sus miembros, así como la legitimidad de las decisiones que este órgano supremo de gobierno toma, todo lo cual configura las posibilidades y los límites de la ‘democracia universitaria’.

Datasets collected in general practice: an international comparison using the example of obesity.

Science.gov (United States)

Sturgiss, Elizabeth; van Boven, Kees

2018-06-04

International datasets from general practice enable the comparison of how conditions are managed within consultations in different primary healthcare settings. The Australian Bettering the Evaluation and Care of Health (BEACH) and TransHIS from the Netherlands collect in-consultation general practice data that have been used extensively to inform local policy and practice. Obesity is a global health issue with different countries applying varying approaches to management. The objective of the present paper is to compare the primary care management of obesity in Australia and the Netherlands using data collected from consultations. Despite the different prevalence in obesity in the two countries, the number of patients per 1000 patient-years seen with obesity is similar. Patients in Australia with obesity are referred to allied health practitioners more often than Dutch patients. Without quality general practice data, primary care researchers will not have data about the management of conditions within consultations. We use obesity to highlight the strengths of these general practice data sources and to compare their differences. What is known about the topic? Australia had one of the longest-running consecutive datasets about general practice activity in the world, but it has recently lost government funding. The Netherlands has a longitudinal general practice dataset of information collected within consultations since 1985. What does this paper add? We discuss the benefits of general practice-collected data in two countries. Using obesity as a case example, we compare management in general practice between Australia and the Netherlands. This type of analysis should start all international collaborations of primary care management of any health condition. Having a national general practice dataset allows international comparisons of the management of conditions with primary care. Without a current, quality general practice dataset, primary care researchers will not

Proceedings of the public debate on the general options of management of high and intermediate activity and long-lived radioactive wastes

International Nuclear Information System (INIS)

2006-01-01

The law from December 30, 1991, precisely defines 3 axes of researches for the management of high level and long-lived radioactive wastes: separation/transmutation, surface storage and underground disposal. A global evaluation report about these researches is to be supplied in 2006 by the French government to the Parliament. A first synthesis of the knowledge gained after 14 years of research has led the national commission of the public debate (CNDP) to organize a national debate about the general options of management of high-level and long-lived radioactive wastes before the 2006 date line. The debate comprised 4 public hearings (September 2005: Bar-le-Duc, Saint-Dizier, Pont-du-Gard, Cherbourg), 12 round-tables (October and November 2005: Paris, Joinville, Caen, Nancy, Marseille), a synthesis meeting (December 2005, Dunkerque) and a closing meeting (January 2006, Lyon). This document is a summary of the main questions tackled during this debate from its preparation to its closing meeting and dealing with: the acceptation of the debate, the progress of the debate, the socio-technical problem of gathering the different points to be debated with respect to the different areas in concern, the general questions about the overall nuclear wastes and materials (radioactivity, health, radioprotection, management, reprocessing, control, actors organization, knowledge sharing, perenniality of the financing), the specific questions about long-lived wastes (inventory, separation-transmutation feasibility, nuclear energy and energy policy, management solutions, storage and geologic disposal feasibility, impact of debates on the 2006 law, long-lived waste territories), the conclusions for the 2006 law: mastering the overall nuclear wastes and materials and step-by-step building up of a solution for long-lived wastes (difficulties, lessons learnt from foreign experience, first draft of the 2006 law). Some opinions expressed by some participants about these proposals conclude

76 FR 69333 - Derivatives Clearing Organization General Provisions and Core Principles

Science.gov (United States)

2011-11-08

... Management)); 75 FR 78185 (Dec. 15, 2010) (Core Principles J, K, L, and M (Information Management)); 75 FR... Parts 1, 21, 39 et al. Derivatives Clearing Organization General Provisions and Core Principles; Final... Derivatives Clearing Organization General Provisions and Core Principles AGENCY: Commodity Futures Trading...

Do general practitioners adhere to the guideline on infectious conjunctivitis? Results of the Second Dutch National Survey of General Practice

Directory of Open Access Journals (Sweden)

Schellevis François G

2007-09-01

Full Text Available Abstract Background In 1996 the guideline 'The Red Eye' was first published by the Dutch College of General Practitioners. The extent to which general practitioners adhere to this guideline is unclear. Recently, data on the management of infectious conjunctivitis by general practitioners became available from the Second Dutch National Survey of General Practice. We measured the age-specific incidence of infectious conjunctivitis, described its management by Dutch general practitioners, and then compared these findings with the recommendations made in the guideline. Methods In 2001, over a 12-month period, data from all patient contacts with 195 general practitioners were taken from electronic medical records. Registration was episode-oriented; all consultations dealing with the same health problem were grouped into disease episodes. Data concerning all episodes of infectious conjunctivitis (ICPC-code F70 and sub codes were analysed. Results Over one year, 5,213 new and recurrent episodes of infectious conjunctivitis were presented to general practitioners from a population of N = 375,899, resulting in an overall incidence rate of 13.9 per 1000 person-years, varying from more than 80/1000 py in children up to one-year old, to less than 12/1000 py in children over the age of 4. Topical ophthalmic ointments were prescribed in 87% of the episodes, of which 80% was antibiotic treatment. Fusidic acid gel was most frequently prescribed (69%. In most episodes general practitioners did not adhere to the guideline. Conclusion In 2001, the management of infectious conjunctivitis by Dutch general practitioners was not in accordance with the recommendations of the consensus-based guideline published five years previously, despite its wide distribution. In 2006 this guideline was revised. Its successful implementation requires more than distribution alone. Probably the most effective way to achieve this is by following a model for systemic implementation.

An 18-year-old patient with Prader-Willi syndrome: a case report on dental management under sedation and general anesthesia

OpenAIRE

Song, Ki Un; Nam, Ok Hyung; Kim, Mi Sun; Choi, Sung Chul; Lee, Hyo-Seol

2015-01-01

Prader-Willi syndrome (PWS) is a rare genetic disorder reported rarely in dentistry. Dental practitioners should know the features of PWS because affected patients have a variety of dental symptoms. The current report describes a case of PWS. An 18-year-old male patient presented with traumatic injuries. Initial emergency treatments were performed under sedation, and further treatments were conducted under general anesthesia. After adequate healing, periodic follow-up and dietary management a...

United States Air Force Summer Research Program -- 1991. High School Apprenticeship Program (HSAP) Reports, Volume 12: Rome Laboratory, Arnold Engineering Development Plan

Science.gov (United States)

1991-12-01

convenient document retrieval and internal voice communications system. 12-12 AFOSR High School Apprenticeship Program July 22-August 16 1991 Gene ...with the computer software packages used here at Sverdrup; Gene Smith and Gail Arnold for their aid in faxing my pay voucher every two weeks. GENERAL...10M .,.n Z~ w z .; z z ZZ r3r M z X E X 2 z Y ZiMZ . Z Z Z Z X2X Z X Z X 2 rZ Z Z W: I. I 1 It W6 hfe II 1 - -- m _ V m-! ’ =t2Csu C1 M 0 oNt - ;I

Use of ARM Data to address the Climate Change Further Development and Applications of A Multi-scale Modeling Framework

Energy Technology Data Exchange (ETDEWEB)

David A. Randall; Marat Khairoutdinov

2007-12-14

The Colorado State University (CSU) Multi-scale Modeling Framework (MMF) is a new type of general circulation model (GCM) that replaces the conventional parameterizations of convection, clouds and boundary layer with a cloud-resolving model (CRM) embedded into each grid column. The MMF that we have been working with is a “super-parameterized” version of the Community Atmosphere Model (CAM). As reported in the publications listed below, we have done extensive work with the model. We have explored the MMF’s performance in several studies, including an AMIP run and a CAPT test, and we have applied the MMF to an analysis of climate sensitivity.

48 CFR 970.2303-2-70 - General.

Science.gov (United States)

2010-10-01

... Technologies, Occupational Safety and Drug-Free Work Place 970.2303-2-70 General. (a) The Department of Energy... inclusion of environmental, safety and health clauses in DOE contracts shall be made by the contracting... health program management personnel. (c)(1) For DOE management and operating contracts and other...

Computer templates in chronic disease management: ethnographic case study in general practice

Science.gov (United States)

Swinglehurst, Deborah; Greenhalgh, Trisha; Roberts, Celia

2012-01-01

Objective To investigate how electronic templates shape, enable and constrain consultations about chronic diseases. Design Ethnographic case study, combining field notes, video-recording, screen capture with a microanalysis of talk, body language and data entry—an approach called linguistic ethnography. Setting Two general practices in England. Participants and methods Ethnographic observation of administrative areas and 36 nurse-led consultations was done. Twenty-four consultations were directly observed and 12 consultations were video-recorded alongside computer screen capture. Consultations were transcribed using conversation analysis conventions, with notes on body language and the electronic record. The analysis involved repeated rounds of viewing video, annotating field notes, transcription and microanalysis to identify themes. The data was interpreted using discourse analysis, with attention to the sociotechnical theory. Results Consultations centred explicitly or implicitly on evidence-based protocols inscribed in templates. Templates did not simply identify tasks for completion, but contributed to defining what chronic diseases were, how care was being delivered and what it meant to be a patient or professional in this context. Patients’ stories morphed into data bytes; the particular became generalised; the complex was made discrete, simple and manageable; and uncertainty became categorised and contained. Many consultations resembled bureaucratic encounters, primarily oriented to completing data fields. We identified a tension, sharpened by the template, between different framings of the patient—as ‘individual’ or as ‘one of a population’. Some clinicians overcame this tension, responding creatively to prompts within a dialogue constructed around the patient's narrative. Conclusions Despite their widespread implementation, little previous research has examined how templates are actually used in practice. Templates do not simply document the

The Spanish general radioactive waste plan

International Nuclear Information System (INIS)

Redondo, J.M.

2007-01-01

The author summarized the current status of Spain's general radioactive waste management plan. This plan forms the basis for a national radioactive waste management policy and decommissioning strategy. It is updated periodically, the current 5. plan was approved in 1999. The most important element of the current strategy is the development of a centralized interim HLW storage facility by 2010. (A.L.B.)

Patch Test Negative Generalized Dermatitis.

Science.gov (United States)

Spiker, Alison; Mowad, Christen

2016-01-01

Allergic contact dermatitis is a common condition in dermatology. Patch testing is the criterion standard for diagnosis. However, dermatitis is not always caused by an allergen, and patch testing does not identify a culprit in every patient. Generalized dermatitis, defined as eczematous dermatitis affecting greater than 3 body sites, is often encountered in dermatology practice, especially patch test referral centers. Management for patients with generalized dermatitis who are patch test negative is challenging. The purpose of this article is to outline an approach to this challenging scenario and summarize the paucity of existing literature on patch test negative generalized dermatitis.

Public debate on the general options relative to the management of high-medium activity and long-lived radioactive wastes

International Nuclear Information System (INIS)

2005-09-01

The law from December 30, 1991, precisely defines 3 axes of researches for the management of high level and long-lived radioactive wastes: separation/transmutation, surface storage and underground disposal. A global evaluation report about these researches is to be supplied in 2006 by the French government to the Parliament. A first synthesis of the knowledge gained after 14 years of research has led the national commission of the public debate (CNDP) to organize a national debate about the general options of management of high-level and long-lived radioactive wastes before the 2006 date line. This document presents the organizational aspects of the debate: origin, organization committee (mission, members, commitments), framework (the December 31, 1991 law, technical enlargement, society aspects), topics (summary of the debate in ten questions), organization modalities (4 main steps, schedule, venues), objectives and perspectives (sharing information, decision making processes to be implemented by 2006). (J.S.)

General Motors' R&D: Managing Innovation Globally

Science.gov (United States)

Taub, Alan

2006-03-01

The rapid pace of technology development and the globalization of the automobile industry are major forces driving General Motors to devise new ways to innovate faster and more efficiently. In response, GM has developed a global R&D network that has transformed GM's research and development organization from a U.S.-based enterprise to one that is over 30 percent leveraged with collaboration in 16 countries. This talk will focus on the challenges faced as well as the lessons learned and best practices developed in building this network.

Economic evaluation of an implementation strategy for the management of low back pain in general practice.

Science.gov (United States)

Jensen, Cathrine Elgaard; Riis, Allan; Petersen, Karin Dam; Jensen, Martin Bach; Pedersen, Kjeld Møller

2017-05-01

In connection with the publication of a clinical practice guideline on the management of low back pain (LBP) in general practice in Denmark, a cluster randomised controlled trial was conducted. In this trial, a multifaceted guideline implementation strategy to improve general practitioners' treatment of patients with LBP was compared with a usual implementation strategy. The aim was to determine whether the multifaceted strategy was cost effective, as compared with the usual implementation strategy. The economic evaluation was conducted as a cost-utility analysis where cost collected from a societal perspective and quality-adjusted life years were used as outcome measures. The analysis was conducted as a within-trial analysis with a 12-month time horizon consistent with the follow-up period of the clinical trial. To adjust for a priori selected covariates, generalised linear models with a gamma family were used to estimate incremental costs and quality-adjusted life years. Furthermore, both deterministic and probabilistic sensitivity analyses were conducted. Results showed that costs associated with primary health care were higher, whereas secondary health care costs were lower for the intervention group when compared with the control group. When adjusting for covariates, the intervention was less costly, and there was no significant difference in effect between the 2 groups. Sensitivity analyses showed that results were sensitive to uncertainty. In conclusion, the multifaceted implementation strategy was cost saving when compared with the usual strategy for implementing LBP clinical practice guidelines in general practice. Furthermore, there was no significant difference in effect, and the estimate was sensitive to uncertainty.

Sewer System Management Plan.

Energy Technology Data Exchange (ETDEWEB)

Holland, Robert C. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2017-08-01

A Sewer System Management Plan (SSMP) is required by the State Water Resources Control Board (SWRCB) Order No. 2006-0003-DWQ Statewide General Waste Discharge Requirements (WDR) for Sanitary Sewer Systems (General Permit). DOE, National Nuclear Security Administration (NNSA), Sandia Field Office has filed a Notice of Intent to be covered under this General Permit. The General Permit requires a proactive approach to reduce the number and frequency of sanitary sewer overflows (SSOs) within the State. SSMPs must include provisions to provide proper and efficient management, operation, and maintenance of sanitary sewer systems and must contain a spill response plan.

Project management under uncertainty beyond beta: The generalized bicubic distribution

Directory of Open Access Journals (Sweden)

José García Pérez

2016-01-01

Full Text Available The beta distribution has traditionally been employed in the PERT methodology and generally used for modeling bounded continuous random variables based on expert’s judgment. The impossibility of estimating four parameters from the three values provided by the expert when the beta distribution is assumed to be the underlying distribution has been widely debated. This paper presents the generalized bicubic distribution as a good alternative to the beta distribution since, when the variance depends on the mode, the generalized bicubic distribution approximates the kurtosis of the Gaussian distribution better than the beta distribution. In addition, this distribution presents good properties in the PERT methodology in relation to moderation and conservatism criteria. Two empirical applications are presented to demonstrate the adequateness of this new distribution.

Conflict Management.

Science.gov (United States)

Fisher, William; Koue, Glen

1991-01-01

Discusses general issues involved in conflict management and provides more specific examples of conflict management in libraries. Causes of conflict are considered, including organizational structure, departmentalization, performance appraisal, poor communication, and technological change; and methods of dealing with conflict are described,…

General practitioners knowledge and management of whiplash associated disorders and post-traumatic stress disorder: implications for patient care.

Science.gov (United States)

Brijnath, Bianca; Bunzli, Samantha; Xia, Ting; Singh, Nabita; Schattner, Peter; Collie, Alex; Sterling, Michele; Mazza, Danielle

2016-07-20

In Australia, general practitioners (GPs) see around two-thirds of people injured in road traffic crashes. Road traffic crash injuries are commonly associated with diverse physical and psychological symptoms that may be difficult to diagnose and manage. Clinical guidelines have been developed to assist in delivering quality, consistent care, however the extent to which GPs knowledge and practice in diagnosing and managing road traffic crash injuries concords with the guidelines is unknown. This study aimed to explore Australian GPs knowledge, attitudes and practices regarding the diagnosis and management of road traffic crash injuries, specifically whiplash associated disorders (WAD) and post-traumatic stress disorder (PTSD). A cross-sectional survey of 423 GPs across Australia conducted between July and December 2014. We developed a questionnaire to assess their knowledge of WAD and PTSD, confidence in diagnosing and managing WAD and PTSD, frequency of referral to health providers, barriers to referral, and attitudes towards further education and training. Factor analysis, Spearman's correlation, and multiple ordered logistic regressions were performed. Overall, GPs have good level knowledge of WAD and PTSD; only 9.6 % (95 % CI: 7.1 %, 12.8 %) and 23.9 % (95 % CI: 20.8 %, 28.2 %) of them were deemed to have lower level knowledge of WAD and PTSD respectively. Key knowledge gaps included imaging indicators for WAD and indicators for psychological referral for PTSD. GPs who were male, with more years of experience, working in the urban area and with higher knowledge level of WAD were more confident in diagnosing and managing WAD. Only GPs PTSD knowledge level predicted confidence in diagnosing and managing PTSD. GPs most commonly referred to physiotherapists and least commonly to vocational rehabilitation providers. Barriers to referral included out-of-pocket costs incurred by patients and long waiting times. Most GPs felt positive towards further education

Hospital management. The reflective practitioner.

Science.gov (United States)

Campbell, I

Ian Campbell's paper, originally delivered at a conference on the development of 'The reflective practitioner' while he was Unit General Manager of Sunderland Royal Infirmary, describes the liaison between general and nurse managers in the hospital. Management must give a hospital organisation direction and must set the parameters of corporate and individual performance, but it must also be responsive to the feedback received from practising clinicians. The key concept is quality of service, and in this managers and practitioners can work together towards a common goal.

12 CFR 563f.6 - General exemption.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false General exemption. 563f.6 Section 563f.6 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY MANAGEMENT OFFICIAL INTERLOCKS... controlled or managed by persons who are members of a minority group, or women; (3) Is a depository...

Several factors influenced general practitioner participation in the implementation of a disease management programme.

Science.gov (United States)

Ribe, Anette Riisgaard; Fenger-Grøn, Morten; Vedsted, Peter; Bro, Flemming; Kærsvang, Lone; Vestergaard, Mogens

2014-09-01

Disease management programmes (DMPs) require a high degree of participation from general practitioners (GPs) in order to succeed. We aimed to describe the participation among Danish GPs in a DMP. A quality improvement project entitled the Chronic Care Compass (CCC) was introduced in 2010 by the Central Denmark Region. The project was based on DMPs targeting persons suffering from three chronic diseases (diabetes, chronic obstructive pulmonary disease and acute coronary syndrome). All GPs in the region were invited to participate. We obtained data from administrative registries and studied the participation and its association with characteristics of practices and patients. Differences in participation were assessed using binomial regression models. A total of 271 (69.1%) practices participated in the CCC. The participation was 28.9 percentage points (pp) (confidence interval (CI): 14.3; 43.6) lower among GPs who were older than 60 years versus younger than 50 years, 32.2 pp (CI: 19.1; 45.2) lower among GPs who provided few versus many chronic care consultations, 13.7 pp (CI: 1.7; 25.6) lower among GPs with lower versus medium practice gross income, and 16.9 pp (CI:6.1; 27.8) lower among GPs with a patient population with medium versus low degree of socio-economic deprivation. Participation in the CCC was lower among GPs who provided less chronic care, had a lower practice gross income and had a patient population with a higher degree of deprivation. The project was supported by the Research Unit for General Practice, Aarhus University, and the Lundbeck Foundation. not relevant.

Attitudes to diagnosis and management in dementia care: views of future general practitioners.

Science.gov (United States)

Tang, Eugene Yee Hing; Birdi, Ratika; Robinson, Louise

2018-03-01

ABSTRACTConsiderable international governmental support is focused on the timely diagnosis of dementia and post-diagnostic care of people with dementia. Identifying those at high risk of dementia is one approach to timely diagnosis. General practitioners (GPs) are well-placed clinicians in the community to provide both pre- and post-diagnostic dementia care. However, GPs have in the past consistently demonstrated low confidence in both diagnosing dementia and providing care for these complex patients particularly for patients in the post-diagnostic phase. It is currently unclear how future GPs view dementia care. We aimed to evaluate the current attitudes and experiences of future GPs in dementia care and their views on targeting high risk groups. All (n = 513) GP trainees were approached by email to participate in a cross-sectional web and paper-based survey in the North of England. A further reminder was sent out two months after the initial invitation. We received 153 responses (29.8% response rate, 66.7% female, average age 31 (range 25-55 years old). The main difficulties encountered included coordinating supporting services for carers and the person with dementia and responding to co-existing behavioral and psychiatric symptoms. Further education in dementia management was considered to be important by respondents. GP trainees were generally very positive about their future role in caring for people with dementia, particularly in the area of earlier diagnosis via identification of high-risk individuals. Future GPs in one area of England are very positive about their key role in dementia care. In order to facilitate the delivery of high quality, community-based care, work is required to establish core post-diagnostic dementia support services. Further research is needed to identify effective systems to enable accurate assessment and to ensure earlier diagnosis in high-risk groups.

Averting a Disaster with Groundwater Depletion in India: The General Case of Water Management Principles and Development (Invited)

Science.gov (United States)

Lall, U.

2013-12-01

Many countries, including the USA, China, and India are experiencing chronic groundwater depletion. In part this unsustainable water use results from climatic factors that reduce surface water availability and also the recharge to the aquifer system. However, a more critical factor is uncontrolled use for agriculture and energy and mineral processing. Interestingly in places such as India endowments have been politically created that lead to ever increasing use, through the provision of free energy for pumping. Reversing the situation is considered politically challenging, and the concept of metering and payment for what is essentially economic use of water is also considered difficult to apply. In this talk I use the Indian situation as a general example and discuss the role central planning strategies for demand and resource management can play recognizing the private action by millions of users as an inevitable tool that needs to be leveraged without necessarily the high transaction costs that come with monitoring and fee collection for monitored use. Specifically, targeting and stimulating potential cropping strategies and on farm water and energy management emerge as a choice in a difficult management environment. In a broader development context, I argue that the role of private sector aggregators in developing farm to market procurement strategies can play a role in both improving rural economies and providing a trajectory for more efficient water use through technology and crop choice.

A cross-sectional study of the knowledge, attitude, and practice of general practitioners regarding dog bite management in nothern India

Directory of Open Access Journals (Sweden)

Abhishek Singh

2013-01-01

Full Text Available Context: There are many myths and false beliefs associated with wound management. These include application of oils, herbs, and red chilies on wound inflicted by rabid animals, and not washing the wound properly. General practitioners (GPs constitute a key source of medical care in study area and are approached for anti-rabies treatment by victims of animal bites. Aim: The aim of the present study is to assess the knowledge and practices among the general practitioners (GPs regarding dog bite management. Settings and Design : Community-based cross-sectional study. Materials and Methods: The present study was carried out in the private and public clinics of Ambala city from January 2012 to April 2012 using a pre-tested self-administered questionnaire. The study population composed of 100 GPs comprising 45 MBBS or above degree holders (Group 1 and 55 other GPs like BAMS, RMPs, etc (Group 2. Statistical Analysis Used: Interpretation of data was done using percentages and proportions. χ2 -Test was used to test the statistical difference in the knowledge between the two groups. Results: Out of the total, 68% and 29% respondents in Group 1 and Group 2, respectively, correctly told that wound must be washed with soap and water for minimum period of 15 min. A total 71% and 11% respondents in Group 1 and Group 2, respectively, could correctly answer about the target groups for pre-exposure prophylaxis. A total 62% GPs did not know the high-risk groups to whom pre-exposure prophylaxis has to be given. Conclusions: There was an apparent lack of awareness among the GPs regarding appropriate animal wound management and vaccine administration. Reorientation programs and continued medical education for GPs are required to highlight the WHO guidelines regarding treatment of animal bite.

Decisionmaking under risk in invasive species management: risk management theory and applications

Science.gov (United States)

Shefali V. Mehta; Robert G. Haight; Frances R. Homans

2010-01-01

Invasive species management is closely entwined with the assessment and management of risk that arises from the inherently random nature of the invasion process. The theory and application of risk management for invasive species with an economic perspective is reviewed in this synthesis. Invasive species management can be delineated into three general categories:...

Treatment and retreatment with omalizumab in chronic spontaneous urticaria: Real life experience with twenty-five patients

Directory of Open Access Journals (Sweden)

Murat Türk

2018-01-01

Conclusions: Omalizumab has high efficacy in both the treatment and retreatment of CSU; however, relapse rates after discontinuation are high. Autoimmune markers may be helpful in predicting treatment response and relapse.

Crew Factors in Flight Operations XV: Alertness Management in General Aviation Education Module

Science.gov (United States)

Rosekind, Mark R.; Co, Elizabeth L.; Neri, David F.; Oyung, Raymond L.; Mallis, Melissa M.; Cannon, Mary M. (Technical Monitor)

2002-01-01

Regional operations encompass a broad range of pilots and equipment. This module is intended to help all those involved in regional aviation, including pilots, schedulers, dispatchers, maintenance technicians, policy makers, and others, to understand the physiological factors underlying fatigue, how flight operations affect fatigue, and what can be done to counteract fatigue and maximize alertness and performance in their operations. The overall purpose of this module is to promote aviation safety, performance, and productivity. It is intended to meet three specific objectives: (1) to explain the current state of knowledge about the physiological mechanisms underlying fatigue; (2) to demonstrate how this knowledge can be applied to improving flight crew sleep, performance, and alertness; and (3) to offer strategies for alertness management. Aviation Safety Reporting System (ASRS) and National Transportation Safety Board (NISH) reports are used throughout this module to demonstrate that fatigue is a safety issue in the regional operations community. The appendices at the end of this module include the ASRS reports used for the examples contained in this publication, brief introductions to sleep disorders and relaxation techniques, summaries of relevant NASA publications, and a list of general readings on sleep, sleep disorders, and circadian rhythms.

[Evaluation of general practitioners' knowledge about diagnostic and therapeuthic management of erysipelas in the city of Marrakech].

Science.gov (United States)

Ihbibane, Fatima; Arsène, Ntini Lebi; Adarmouch, Latifa; Amine, Mohamed; Tassi, Noura

2018-01-01

Erysipelas is the most common non necrotizing bacterial dermohypodermitis (NNBDH). This study aimed to evaluate the adequacy of general practitioners' knowledge about literature data on the diagnostic and therapeuthic management of erysipelas. We conducted a cross-sectional descriptive and analytical survey of 167 general practitioners in the public and private sectors in Marrakech over the period from 19 May to 20 October 2014. The 114 questionnaires which had been returned revealed that local and general risk factors were often reported for erysipelas. 92 (80.7%) physicians thought that positive diagnosis of common types was based on clinical examination. 97(85.1%) physicians thought that it required only out-patient service and that hospitalization and para-clinical examinations should only be performed in patients with severe, atypical or complicated erysipelas. 25 (21.9%) physicians thought that oral amoxicillin should be the gold standard therapy. 15(13.2%) physicians thought that bi-antibiotic therapy including antistreptococcique molecule should be the gold standard. 16 doctors (14%) advocated anti-inflammatory drugs. The primary and secondary prevention levels generated interest from physicians of whom 108 (94.7%) were favorable to the treatment of the portals of entry in the skin while 53 (46.5%) to the antibioprophylaxis after the second recurrence. Our study highlights that erysipelas is relatively frequent in city medical practice; clinical diagnosis guidelines should be shared between the specialists in order to improve the diagnostic and therapeutic approch of our physicians.

Lessons from Management 101: Learning to Manage Ourselves

Science.gov (United States)

Miller, John A.

2017-01-01

The Management 101 Project continues to shape our understanding of what's essential to an introductory general education course in management. Our ongoing challenge is to integrate responsibilities to people (Who needs to learn? Everybody.), to best practices (How can we best learn? Active, experiential methods.), and to the contents of our…

PWR in-core nuclear fuel management optimization utilizing nodal (non-linear NEM) generalized perturbation theory

International Nuclear Information System (INIS)

Maldonado, G.I.; Turinsky, P.J.; Kropaczek, D.J.

1993-01-01

The computational capability of efficiently and accurately evaluate reactor core attributes (i.e., k eff and power distributions as a function of cycle burnup) utilizing a second-order accurate advanced nodal Generalized Perturbation Theory (GPT) model has been developed. The GPT model is derived from the forward non-linear iterative Nodal Expansion Method (NEM) strategy, thereby extending its inherent savings in memory storage and high computational efficiency to also encompass GPT via the preservation of the finite-difference matrix structure. The above development was easily implemented into the existing coarse-mesh finite-difference GPT-based in-core fuel management optimization code FORMOSA-P, thus combining the proven robustness of its adaptive Simulated Annealing (SA) multiple-objective optimization algorithm with a high-fidelity NEM GPT neutronics model to produce a powerful computational tool used to generate families of near-optimum loading patterns for PWRs. (orig.)

Generalized Database Management System Support for Numeric Database Environments.

Science.gov (United States)

Dominick, Wayne D.; Weathers, Peggy G.

1982-01-01

This overview of potential for utilizing database management systems (DBMS) within numeric database environments highlights: (1) major features, functions, and characteristics of DBMS; (2) applicability to numeric database environment needs and user needs; (3) current applications of DBMS technology; and (4) research-oriented and…

Service management: New Zealand's model of resource management.

Science.gov (United States)

Malcolm, L

1990-12-01

The health system in New Zealand, which in many respects is similar to that of the United Kingdom NHS, is currently undergoing massive change. In 1989 fourteen area health boards were formed, each board being accountable to the minister of health for achieving health goals and providing comprehensive health services for its defined population. This process has been assisted by the promulgation of a set of national health goals and a national health charter. Within area health boards the principle of general management is being implemented. Organisational structures are moving away from hospitals to services in a process which is being called service management which may be defined as the decentralisation of general management to the clinical workface. Similar in many respects to the resource management initiatives in the NHS it brings together medical, nursing and business management at the operational level with one person being accountable for the achievement of quality of care objectives within a budgetary framework. Budgetary restraints in excess of 10% have been achieved in the last 12 months partly through the service management process. Service management is seen to be a major paradigm shift in health services organisation and could be of international significance in its potential for achieving medical accountability for cost containment and quality assurance, and for coordinating care across agency and disciplinary boundaries.

Head injury management guidelines for general practitioners

Directory of Open Access Journals (Sweden)

Jeremy C Ganz

2011-01-01

Full Text Available A complete examination of a head injured patient in the hospital requires a number of instruments. These include a stethoscope, sphygmomanometer, ophthalmoscope, otoscope, cotton wool, safety pin, tuning fork, reflex hammer and a small key to test the plantar response. Few of these are required at the accident scene. This is because, in the hospital, the aim is optimal definitive treatment. At the accident scene, the aim is prevention of secondary injury, rapid recording of the most important findings and safe efficient transport to the hospital. This short paper reviews how the local doctor should undertake a neurosurgical assessment of traumatic brain injury patients. Moreover, the primary management at accident scenes is described and the rationale behind the approach is outlined

Chronic care management in Danish general practice - a cross‒sectional study of workload and multimorbidity

Directory of Open Access Journals (Sweden)

Moth Grete

2012-06-01

Full Text Available Abstract Background About 30% of the Danish population has one or more chronic conditions, and general practitioners (GPs play a key role in effective chronic care management. However, little is known about these encounters in general practice. The aim was to describe the frequency of patients with one or more chronic conditions in general practice and how these consultations were experienced by the GPs. Methods All GPs in the Central Denmark Region were invited to register all contacts during one day in the 12‒month study period from December; 404 (46% accepted. For each patient contact, the GPs were asked to fill in a one‒page registration form covering information on chronic disease, reason for encounter, diagnosis, number of additional psychosocial problems raised by the patient during the consultation, time consumption, experienced burden of the consultation, referral to specialized care, and whether a nurse could have substituted the GP. Patients were categorized according to the number of chronic conditions (none, one, two, three or more and the categories compared with regard to the GP‒experienced burden of the contacts. Moreover, we examined which chronic conditions posed the the greatest challenge to the GPs. Results Patients aged 40 years or more had a total of 8,236 contacts. Among these patients 2,849 (34.6%; 95% CI 33.6‒35.6 had one and 2,596 (31.5%; CI 30.5‒32.5 had more than one chronic disease. The time consumption and the burden of their contacts tended to rise with the number of chronic conditions. Being present in 22.9% (CI 21.6‒24.3 of all face‒to‒face contacts, hypertension was the most common chronic condition. The burden of the contacts was experienced as particularly heavy for patients with depression and dementia due to more additional psychosocial problems and the time consumption. Conclusion General practitioners considered consultations with multimorbid patients demanding and not easily delegated to

A tool to measure whether business management capacity in general practice impacts on the quality of chronic illness care.

Science.gov (United States)

Holton, Christine H; Proudfoot, Judith G; Jayasinghe, Upali W; Grimm, Jane; Bubner, Tanya K; Winstanley, Julie; Harris, Mark F; Beilby, Justin J

2010-11-01

Our aim was to develop a tool to identify specific features of the business and financial management of practices that facilitate better quality care for chronic illness in primary care. Domains of management were identified, resulting in the development of a structured interview tool that was administered in 97 primary care practices in Australia. Interview items were screened and subjected to factor analysis, subscales identified and the overall model fit determined. The instrument's validity was assessed against another measure of quality of care. Analysis provided a four-factor solution containing 21 items, which explained 42.5% of the variance in the total scores. The factors related to administrative processes, human resources, marketing analysis and business development. All scores increased significantly with practice size. The business development subscale and total score were higher for rural practices. There was a significant correlation between the business development subscale and quality of care. The indicators of business and financial management in the final tool appear to be useful predictors of the quality of care. The instrument may help inform policy regarding the structure of general practice and implementation of a systems approach to chronic illness care. It can provide information to practices about areas for further development.

The elderly and general anesthesia

DEFF Research Database (Denmark)

Steinmetz, J; Rasmussen, L S

2010-01-01

Due to the aging population, the number of elderly patients taking advantage of healthcare services is increasing. A general physical decline of all organ systems and a high frequency of chronic disease accompanying aging.Comorbidity and polypharmacy are therefore common in the elderly. Hence, th......, the administration of general anesthesia to the elderly can be a very challenging task. This paper aims to highlight some of the important issues presented to the elderly undergoing surgery and to suggest some strategies for management....

7 CFR 227.1 - General purpose and scope.

Science.gov (United States)

2010-01-01

... management training of school foodservice personnel, and (c) the conduct of nutrition education activities in... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS NUTRITION EDUCATION AND TRAINING PROGRAM General § 227.1 General purpose...

Management of generalized spasticity of lower limbs by selective ...

African Journals Online (AJOL)

Wael Fouad

2011-08-09

Aug 9, 2011 ... All cases underwent MDT that consisted of a longitudinal incision of the ... The methods of surgical management are classified accord- ... nerves, dorsal roots, dorsal root entry zone or spinal cord.7,8 ... bedridden and totally dependent patient). ... paraplegia of cerebral origin include cerebral palsy, cerebro-.

General directions and practices for management of radioactive waste

International Nuclear Information System (INIS)

Fioroni, M.

1990-12-01

The present work underlines and synthesises the essential principles, directions and methodologies developed by Industrialized Nations and by the International Organizations for management of radioactive waste of high, intermediate and low levels. It fills a gap in scientific Italian literature and represents a valid introduction to the subject. (author)

The role of the internal medicine specialist in the management of infective complications in general surgical wards

Directory of Open Access Journals (Sweden)

Patrizia Zoboli

2013-05-01

Full Text Available BACKGROUND Internal medicine specialists are often asked to evaluate a patient before surgery. Perioperative risk evaluation for elderly patients is important, because complications increase with age. The increasing age of the general population increases the probabilities of surgery in the older patients. The manifestation of a surgical problem, is more likely to be severe and complicated in the elderly patients. In fact, emergency surgery treatment occurs more frequently in the elderly (e.g., it is much more common to see intestinal obstruction complicating colorectal cancer in the elderly compared with a younger population. Old age is an independent factor for long hospital stay after surgery. The role of the preoperative medical consultant is to identify and evaluate a patient’s current medical status and provide a clinical risk profile, in order to decide whether further tests are indicated prior to surgery, and to optimise the patient’s medical condition in the attempt of reducing the risk of complications. The medical consultant must know which medical condition could eventually influence the surgery, achieve a good contact and communication between the medical and surgical team, in order to obtain the best management planning. AIM OF THE STUDY This paper focuses on the rational use of antibiotic prophylaxis and on the treatment of the complications of post-surgery infections (e.g., pulmonary complication, peritonitis, intra-abdominal infection. Specific aspects of pre-operative risk evaluation and peri and post-operative management are discussed. CONCLUSIONS The internal medicin specialist in collaboration with the surgical team is necessary in the peri and post-surgery management.

The Knowledge, Awareness, and Practices of Portuguese General Practitioners Regarding Multimorbidity and its Management: Qualitative Perspectives from Open-Ended Questions.

Science.gov (United States)

Prazeres, Filipe; Santiago, Luiz

2016-11-08

Multimorbidity's high prevalence and negative impact has made it a subject of worldwide interest. The main aim of this study was to access the Portuguese knowledge, awareness, and practices of general practitioners (GPs) regarding multimorbidity and its management, in order to aid in the development of interventions for improving outcomes in multimorbid patients in primary care. A web-based qualitative descriptive study was carried out in the first trimester of 2016 with primary care physicians working in two districts of the Centre region of Portugal. Open-ended questions were analysed via inductive thematic content analysis. GPs pointed out several difficulties and challenges while managing multimorbidity. Extrinsic factors were associated with the healthcare system logistics' management (consultation time, organization of care teams, clinical information) and society (media pressure, social/family support). Intrinsic factors related to the GP, patient, and physician-patient relationship were also stated. The most significant conclusion to emerge from this study is that although GPs perceived difficulties and challenges towards multimorbidity, they also have the tools to deal with them: the fundamental characteristics of family medicine. Also, the complex care required by multimorbid patients needs adequate consultation time, multidisciplinary teamwork, and more education/training.

Treatment of Generalized Convulsive Status Epilepticus in Pediatric Patients

Science.gov (United States)

Alford, Elizabeth L.; Wheless, James W.

2015-01-01

Generalized convulsive status epilepticus (GCSE) is one of the most common neurologic emergencies and can be associated with significant morbidity and mortality if not treated promptly and aggressively. Management of GCSE is staged and generally involves the use of life support measures, identification and management of underlying causes, and rapid initiation of anticonvulsants. The purpose of this article is to review and evaluate published reports regarding the treatment of impending, established, refractory, and super-refractory GCSE in pediatric patients. PMID:26380568

Autologous serum skin test as an indicator of chronic autoimmune urticaria in a tertiary care hospital in South India.

Science.gov (United States)

Vikramkumar, Adaikalampillai Ganapathy; Kuruvila, Sheela; Ganguly, Satyaki

2014-12-01

Autologous serum skin test (ASST) is a simple in-vivo clinical test for the detection of basophil histamine releasing activity and to diagnose chronic autoimmune urticaria (CAU) among chronic spontaneous urticaria (CSU) patients. Diagnosing these patients is also important as they may need high doses of antihistamines and systemic corticosteroids during acute exacerbations. The aim of this study is to study the prevalence of CAU among cases of CSU by using ASST. This was a cross-sectional study done among 48 patients presenting with CSU. Detailed history, physical examination and routine investigations were recorded for all patients. ASST was done on all the 48 patients. Of the 48 patients included in the study, 20 patients (41.6%) were ASST positive, while the remaining 28 (58%) were ASST negative. The median duration of disease in both ASST positive and negative patients was 1 year. ASST positivity was higher (66.6%) among patients with a history of round shaped weals, though not statistically significant. ASST positivity was seen in 5 (71.4%) out of seven patients with systemic involvement, which was again not statistically significant. Our study did not show any significant difference between patients with and without antibodies regarding mean age and sex distribution, clinical morphology of individual weals, duration, severity, systemic symptoms, angioedema, atopy, and association with other autoimmune conditions.

Using the Mountain Pine Beetle Infestation of the Rocky Mountain West to Develop a Collaborative, Experiential Course on Science Communication

Science.gov (United States)

Gallagher, L.; Morse, M.; Maxwell, R. M.; Cottrell, S.; Mattor, K.

2016-12-01

An ongoing NSF-WSC project was used as a launchpad for implementing a collaborative honors course at the Colorado School of Mines (CSM) and Colorado State University (CSU). The course examined current physical and social science research on the effects of the Mountain Pine Beetle (MPB) on regional social and hydro-ecological systems in the Rocky Mountain West. In addition to general classroom content delivery, community outreach experience and development for the participating undergraduate students was integrated into the course. Upon learning about ongoing MPB research from project PIs and researchers, students were guided to develop their own methodology to educate students and the community about the main project findings. Participants at CSM and CSU worked together to this end in a synchronous remote classroom environment. Students at both universities practiced their methods and activities with various audiences, including local elementary students, other undergraduate and graduate peers, and delivered their activities to sixth-grade students at a local outdoor lab program (Windy Peak Outdoor Lab, Jefferson County, CO). Windy Peak Outdoor Lab has integrated the student-developed content into their curriculum, which reaches approximately 6,000 students in the Jefferson County, CO school district each year. This experiential learning course will be used as a template for future Honors STEM education course development at CSM and was a unique vessel for conveying the studied effects of the MPB to a K-12 audience.

Hospitality Management Education and Training.

Science.gov (United States)

Brotherton, Bob, Ed.; And Others

1995-01-01

Seven articles on hospitality management training discuss the following: computerized management games for restaurant manager training, work placement, real-life exercises, management information systems in hospitality degree programs, modular programming, service quality concepts in the curriculum, and General National Vocational Qualifications…

Evaluation of general practitioners' routine assessment of patients ...

African Journals Online (AJOL)

The authors wished to establish the use of existing diabetes management guidelines by general practitioners (GPs) in the City of Tshwane (Pretoria) Metropolitan Municipality of South Africa. Method: A cross-sectional and descriptive study was conducted. A total of 50 randomly selected general practitioners participated in ...

5 CFR 9901.331 - General.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false General. 9901.331 Section 9901.331 Administrative Personnel DEPARTMENT OF DEFENSE HUMAN RESOURCES MANAGEMENT AND LABOR RELATIONS SYSTEMS (DEPARTMENT.... chapter 59, subchapter III, to the extent authorized by the Department of State; (7) Recruitment...

77 FR 70381 - General Schedule Locality Pay Areas

Science.gov (United States)

2012-11-26

... 3206-AM51 General Schedule Locality Pay Areas AGENCY: U.S. Office of Personnel Management. ACTION: Proposed rule with request for comments. SUMMARY: On behalf of the President's Pay Agent, the Office of Personnel Management is issuing proposed regulations to tie the metropolitan area portion of locality pay...

Relationship between time management in construction industry and project management performance

Science.gov (United States)

Nasir, Najuwa; Nawi, Mohd Nasrun Mohd; Radzuan, Kamaruddin

2016-08-01

Nowadays, construction industry particularly in Malaysia struggle in achieving status of eminent time management for construction project. Project managers have a great responsibility to keep the project success under time of project completion. However, studies shows that delays especially in Malaysian construction industry still unresolved due to weakness in managing the project. In addition, quality of time management on construction projects is generally poor. Due to the progressively extended delays issue, time performance becomes an important subject to be explored to investigate delay factors. The method of this study is review of literature towards issues in construction industry which affecting time performance of project in general by focusing towards process involved for project management. Based on study, it was found that knowledge, commitment, cooperation are the main criteria as an overall to manage the project into a smooth process during project execution until completion. It can be concluded that, the strength between project manager and team members in these main criteria while conducting the project towards good time performance is highly needed. However, there is lack of establishment towards factors of poor time performance which strongly related with project management. Hence, this study has been conducted to establish factors of poor time performance and its relations with project management.

How do private general practitioners manage tuberculosis cases? A survey in eight cities in Indonesia.

Science.gov (United States)

Mahendradhata, Yodi; Lestari, Trisasi; Probandari, Ari; Indriarini, Lucia Evi; Burhan, Erlina; Mustikawati, Dyah; Utarini, Adi

2015-10-14

Private practitioners (PPs) in high-burden countries often provide substandard tuberculosis (TB) treatment, leading to increased risk of drug resistance and continued transmission. TB case management among PPs in Indonesia has not been investigated in recent years, despite longstanding recognition of inadequate care and substantial investment in several initiatives. This study aimed to assess case management practices of private general practitioners (GPs) in eight major cities across Indonesia. A cross-sectional survey of private GPs was carried out simultaneously in eight cities by trained researchers between August and December 2011. We aimed for a sample size of 627 in total, and took a simple random sample of GPs from the validated local registers of GPs. Informed consent was obtained from participants prior to interview. Diagnostic and treatment practices were evaluated based on compliance with national guidelines. Descriptive statistics are presented. Of 608 eligible GPs invited to participate during the study period, 547 (89.9%) consented and completed the interview. A low proportion of GPs (24.6-74.3%) had heard of the International Standards for TB care (ISTC) and only 41.2-68.9% of these GPs had participated in ISTC training. As few as 47.3% (90% CI: 37.6-57.0%) of GPs reported having seen presumptive TB. The median number of cases of presumptive TB seen per month was low (0-5). The proportion of GPs who utilized smear microscopy for diagnosing presumptive adult TB ranged from 62.3 to 84.6%. In all cities, a substantial proportion of GPs (12.0-45.5%) prescribed second-line anti-TB drugs for treating new adult TB cases. In nearly all cities, less than half of GPs appointed a treatment observer (13.8-52.0%). The pattern of TB case management practices among private GPs in Indonesia is still not in line with the guidelines, despite longstanding awareness of the issue and considerable trialing of various interventions.

Recurrent Pregnancy Loss: Generally Accepted Causes and Their Management.

Science.gov (United States)

Kaiser, Jennifer; Branch, D Ware

2016-09-01

Recurrent pregnancy loss (RPL), commonly defined as 3 consecutive losses causes include uterine malformation, antiphospholipid syndrome, and parental chromosomal abnormalities; however, the majority of RPL cases are idiopathic (up to 75%). This chapter covers these accepted causes of RPL and provides diagnosis and management strategies for patients falling within the above categories.

12 CFR 905.12 - Office of Management.

Science.gov (United States)

2010-01-01

... OPERATIONS DESCRIPTION OF ORGANIZATION AND FUNCTIONS General Organization § 905.12 Office of Management. (a) General. The Office of Management is the principal advisor to the chairperson and the Board of Directors... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Office of Management. 905.12 Section 905.12...

Gambling addiction in primary care: a survey of general practitioners ...

African Journals Online (AJOL)

Arun Kumar Agnihotri

experiences of, and confidence in, managing these patients in primary care, their perceived role and ... KEY WORDS: Gambling addiction; Primary care; General practitioners; Management ..... Petry NM, Blanco C, Auriacombe M, Borges.

Curriculum for undergraduate business management students:The ...

African Journals Online (AJOL)

curricula for undergraduate business management degrees. The business management areas investigated were: general management, marketing management, financial management, risk management, human resource management and entrepreneurship. The nominal group technique was used, with between six

Security and management; Securite et management

Energy Technology Data Exchange (ETDEWEB)

Moreau, A. [CEA, Direction du Centre d' Etudes de Saclay (France)

1992-07-01

All the studies performed about accident causes have emphasized the influence of Human Factors in the field of Safety and Radiological Protection. Human actions cannot be understood but also improved without exploring the enormous field of mental representations and emotions, therefore, all the sources of comportments. Among a working group, safety can be the field of all the comportments relative to this group: relationship with work and between persons. This leads to management questions. There is no specific management for the safety. It must be included in the general management policy. Pedagogy must consider this fact for the training of workers. (author)

Valimised tõid segaduse / Aino Siebert

Index Scriptorium Estoniae

Siebert, Aino

2005-01-01

Saksa Bundestagi 16. valimistel ei saanud uue valitsuse loomiseks enamust ei CDU/CSU-blokk (Kristlik-Demokraatlik Liit ja Kristlik-Sotsiaalne Liit) ega SPD (Sotsiaaldemokraatlik Partei). Vt. ka: Kantslerikandidaat tuleb idast. Saksamaa kantslerikandidaat Angela Merkel

A management agenda

NARCIS (Netherlands)

Man, de A.P.; Man, de A.P.

2008-01-01

Defining and implementing the correct knowledge management processes involves numerous steps and decisions. Knowledge management in network needs to be tailored to specific situations and consequently general guidelines are hard to give. However, the key problems and solution concepts have been

Multidisplinary Engineering, Project, and Production Management

OpenAIRE

Chien-Ho Ko

2012-01-01

Journal of Engineering, Project, and Production Management (EPPM-Journal) reflect the journal’s multidisciplinary approach to management research and can be categorized as belonging to three general topics: Project Management, Engineering and Project Management, and Project and Production Management.

A THIRD ERA OF MANAGEMENT

Directory of Open Access Journals (Sweden)

Liviu NEAMŢU

2009-12-01

Full Text Available Management like any social activity through specific stages of development trends from general society. Following these historical trends, this study summarizes the evolution of management at four stages of a full cycle of development, from a informal management to one perfect formalized. These stages of development are found differential represented at the various economic development regions in the world. Evolution increasingly grouped patterns of management and generalization for schools of thought management determines the current global development of worldwide management. For the current stage of evolution may be called as "the third era of management" or "imperial period” in which management pressures on individuals, employers or subordinate, are enormous. Evolution of companies, of markets and national economies also the global economy is driven by the current trend in management, leading to very strong mutations in the relationship of forces. The world economy is in what is called "war of resources" and the alternative that we believe is necessary in this "human management" although speculative trends of concentration of capital are binding on any plans or state regulators global ethical management.

Management of mandated networks from a dynamic perspective

NARCIS (Netherlands)

Segato, Federica; Raab, J.

2017-01-01

The management of networks has received increasing attention in recent years in the form of systematic empirical research. The general thrust of the results seem to indicate that network management resembles what we know about general management. However, there are also specific characteristics of

Tornado-borne missile speeds. Final report

International Nuclear Information System (INIS)

Simiu, E.; Cordes, M.

1976-04-01

An investigation of the question of tornado-borne missile speeds was carried out, with a view to identify pertinent areas of uncertainty and to estimate credible tornado-borne missile speeds - within the limitations inherent in the present state of the art. The investigation consists of two parts: (1) a study in which a rational model for the missile motion is proposed, and numerical experiments are carried out corresponding to various assumptions on the initial conditions of the missile motion, the structure of the tornado flow, and the aerodynamic properties of the missile; (2) a theoretical and experimental study of tornado-borne missile aerodynamics, conducted by Colorado State Univ. (CSU) to be covered in a separate report by CSU. In the present report, the factors affecting missile motion and their influence upon such motion are examined

Managing workplace health promotion in municipal organizations: The perspective of senior managers.

Science.gov (United States)

Larsson, Robert; Åkerlind, Ingemar; Sandmark, Hélène

2015-01-01

Previous research indicates that companies manage workplace health in various ways, but more in-depth empirical knowledge of how workplace health promotion (WHP) is managed in public sector organizations is needed. The aim of this study was to explore how WHP is managed and incorporated into the general management system in two large Swedish municipal organizations. A qualitative descriptive approach was used. Fourteen senior managers were purposefully selected and interviewed using semi-structured interviews. Documents were used as supplementary data. All data were analysed using qualitative content analysis. The management of WHP was described as a set of components that together contribute to the organization's capacity for WHP. The informants described WHP as dominated by fitness programmes and as following a problem-solving cycle, in which the annual employee survey emerged as an important managerial tool. Achieving feasible WHP measures and appropriate follow-ups were described as challenges. The provision of leadership competence for WHP and use of supportive resources were described as additional components. The WHP management approach needs to be broadened to include work environment and organizational factors. Further integration with occupational health and safety and the general management system in the organizations is also needed.

Probability concepts in quality risk management.

Science.gov (United States)

Claycamp, H Gregg

2012-01-01

Essentially any concept of risk is built on fundamental concepts of chance, likelihood, or probability. Although risk is generally a probability of loss of something of value, given that a risk-generating event will occur or has occurred, it is ironic that the quality risk management literature and guidelines on quality risk management tools are relatively silent on the meaning and uses of "probability." The probability concept is typically applied by risk managers as a combination of frequency-based calculation and a "degree of belief" meaning of probability. Probability as a concept that is crucial for understanding and managing risk is discussed through examples from the most general, scenario-defining and ranking tools that use probability implicitly to more specific probabilistic tools in risk management. A rich history of probability in risk management applied to other fields suggests that high-quality risk management decisions benefit from the implementation of more thoughtful probability concepts in both risk modeling and risk management. Essentially any concept of risk is built on fundamental concepts of chance, likelihood, or probability. Although "risk" generally describes a probability of loss of something of value, given that a risk-generating event will occur or has occurred, it is ironic that the quality risk management literature and guidelines on quality risk management methodologies and respective tools focus on managing severity but are relatively silent on the in-depth meaning and uses of "probability." Pharmaceutical manufacturers are expanding their use of quality risk management to identify and manage risks to the patient that might occur in phases of the pharmaceutical life cycle from drug development to manufacture, marketing to product discontinuation. A probability concept is typically applied by risk managers as a combination of data-based measures of probability and a subjective "degree of belief" meaning of probability. Probability as

Project management in building industry management

Directory of Open Access Journals (Sweden)

Martin Nový

2012-01-01

Full Text Available The article deals with contents of the project management on general level first. It mentions the most widespread project management standards, which have historically developed in global scale, their parts and objectives. Further, it describes position of the building industry in national economy, its specific features distinguishing it from the other industrial production, contents of the building industry management and project management of structures. The importance of the role of project manager is documented by characteristics of construction projects, their course, contents of sub-phases, and individual types of managing activities. Attention is devoted to project planning – determination of realization costs, necessary resources, sequence and time course of individual works. The most frequently used graphic methods of schedule presentation – Gantt chart, network chart and frequency bar chart are applied on examples of constructions. These charts can be focused in time sequence on individual types of resources – workforce, finance, materials, energies, and machinery. In conclusion, necessity to manage the project management procedures is emphasized as a part of skills of a construction engineer in the role of preparation manager or construction project realization manager.

Office of Inspector General semiannual report to Congress: April 1 to September 30, 1997

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-10-01

The report summarizes significant audit, inspection, and investigative accomplishments for the reporting period which facilitated Department of Energy management efforts to improve management controls and ensure efficient and effective operation of its programs. Narratives of the Office`s most significant reports are grouped by measures which the Office of Inspector General uses to gauge its performance. The common thread tying the performance measures together is their emphasis on supporting the Department efforts to produce high quality products at the lowest possible cost to the taxpayer. During this reporting period, the Office of Inspection General issued 59 reports. These reports included recommendations than, when implemented by management, could result in $211.7 million being put to better use. Furthermore, management has committed to taking corrective actions which the Office of Inspector General estimates will result in a more efficient use of funds totaling $57 million. Office of Inspector General investigations led to 7 criminal convictions, as well as criminal and civil prosecutions which resulted in fines and recoveries of approximately $1.95 million. The Office of Inspector General also provided 9 investigative reports to management for recommending positive change.

Previously Identified Deficiencies Not Corrected in the General Fund Enterprise Business System Program

Science.gov (United States)

2011-06-15

Army AAA Report No. A-2009-0226- FFM , “Examination of Federal Financial Management Improvement Act Compliance - Test Validation General Fund Enterprise...Business System Release 1.2,” September 30, 2009 AAA Report No. A-2009-0231- FFM , “General Fund Enterprise Business System - Federal Financial...Management Improvement Act Compliance Examination of Release 1.3 Functionality,” September 30, 2009 AAA Report No. A-2009-0232- FFM , “General Fund

Management of opioid addiction with buprenorphine: French history and current management

Directory of Open Access Journals (Sweden)

Poloméni P

2014-03-01

Full Text Available Pierre Poloméni,1 Raymund Schwan2,3 1Department of Addictology, Paris Seine Saint Denis University Hospital, AP-HP, Site René Muret Sevran, France; 2Care Center for the Treatment and Prevention of Addictions (CSAPA, Nancy University Hospital, 3General Psychiatric Division for the Greater Nancy Urban Community, Psychotherapeutic Center of Nancy, Laxou, France Abstract: The way in which opioid addiction is managed in France is unique, as it is based on the prescription of buprenorphine by general practitioners and is dispensed by retail pharmacies. This policy has had a direct, positive impact on the number of deaths caused by heroin overdose, which was reduced by four-fifths between 1994 and 2002. In addition, certain associated comorbidities, such as infection with the human immunodeficiency virus, have also been reduced; the incidence of acquired immune deficiency syndrome in intravenous drug users fell from 25% in the mid-1990s to 6% in 2010. Since the implementation of this French model of opioid management, major scientific progress has been made, leading to a better understanding of the pathophysiologic mechanisms of addiction and of the management modalities required for its treatment. However, despite notable advances in scientific knowledge and in the implementation of devices, opioid addiction remains a major public health care issue in France, with 275,000–360,000 "problem drug users" being reported in 2011. The situation is still particularly worrying due to psychoactive substance use and misuse of opioid substitution treatments. Since 2003, there has been a persistent increase in the number of deaths and comorbidities related to opioid addiction, principally hepatitis C virus infection, which affects up to 40% of intravenous drug users. In France, the direct involvement of general practitioners in the management of opioid addiction is indisputable. Nevertheless, management could be optimized through better understanding of the

Multidisplinary Engineering, Project, and Production Management

Directory of Open Access Journals (Sweden)

Chien-Ho Ko

2012-01-01

Full Text Available Journal of Engineering, Project, and Production Management (EPPM-Journal reflect the journal’s multidisciplinary approach to management research and can be categorized as belonging to three general topics: Project Management, Engineering and Project Management, and Project and Production Management.

Management of peritonsillar abscess

African Journals Online (AJOL)

Management of peritonsillar abscess at Harare. The optimal management of PTA is still a. Central Hospital Central Afr J Med 1990; 36: 187-90. controversial subject in otolaryngology. 8 Stronger SP, Schaefer SD, Close IS. A randomized trial for outpatient management of peritonsillar abscess. The generally accepted classic ...

General Employee Radiological Training and Radiological Worker Training: Program management manual

International Nuclear Information System (INIS)

1992-10-01

This manual defines and describes the DOE General Employee Radiological Training (GERT) and Radiological Worker I and II (RW I and II) Training programs. It includes material development requirements, standards and policies, and program administration. This manual applies to General Employee Radiological Training and Radiological Worker Training at all DOE contractor sites. The training materials of both GERT and RW I and II training reflect the requirements identified in the DOE Radiological Control Manual and DOE Order 5480.11. The training programs represent the minimum requirement for the standardized core materials. Each contractor shall implement the program in its entirety and may augment the standardized core materials to increase the general employee and radiological worker level of competency

Monitoring Based Commissioning: Benchmarking Analysis of 24 UC/CSU/IOU Projects

Energy Technology Data Exchange (ETDEWEB)

Mills, Evan; Mathew, Paul

2009-04-01

Buildings rarely perform as intended, resulting in energy use that is higher than anticipated. Building commissioning has emerged as a strategy for remedying this problem in non-residential buildings. Complementing traditional hardware-based energy savings strategies, commissioning is a 'soft' process of verifying performance and design intent and correcting deficiencies. Through an evaluation of a series of field projects, this report explores the efficacy of an emerging refinement of this practice, known as monitoring-based commissioning (MBCx). MBCx can also be thought of as monitoring-enhanced building operation that incorporates three components: (1) Permanent energy information systems (EIS) and diagnostic tools at the whole-building and sub-system level; (2) Retro-commissioning based on the information from these tools and savings accounting emphasizing measurement as opposed to estimation or assumptions; and (3) On-going commissioning to ensure efficient building operations and measurement-based savings accounting. MBCx is thus a measurement-based paradigm which affords improved risk-management by identifying problems and opportunities that are missed with periodic commissioning. The analysis presented in this report is based on in-depth benchmarking of a portfolio of MBCx energy savings for 24 buildings located throughout the University of California and California State University systems. In the course of the analysis, we developed a quality-control/quality-assurance process for gathering and evaluating raw data from project sites and then selected a number of metrics to use for project benchmarking and evaluation, including appropriate normalizations for weather and climate, accounting for variations in central plant performance, and consideration of differences in building types. We performed a cost-benefit analysis of the resulting dataset, and provided comparisons to projects from a larger commissioning 'Meta-analysis' database. A

[Management of eyelid tumors: general considerations].

Science.gov (United States)

Lasudry, J

2011-12-01

Despite the fact that the majority of eyelid tumors are benign, proper management in daily practice requires detection of the malignant ones. Several clinical criteria are usually proposed to support or reject a hypothesis of malignancy; however, most are of limited reliability. In any case of doubt, outpatient biopsy is recommended, so as to establish the correct diagnosis and formulate the most appropriate treatment plan. In all facial malignancies, the first (and absolutely mandatory) consideration is control of the cancer. Then, restoration of eyelid function can be addressed, in the following order: protection of the globe by complete dynamic eyelid closure and opening, visual function (and prevention of possible deprivation amblyopia) by insuring a clear visual axis, correction of the tear film, efficient lachrymal drainage, and only then the role of the eyelids in facial expression and esthetics. For most malignant eyelid tumors, the best assurance of complete excision is obtained by extemporaneous examination of the resection margins by frozen section (by Mohs' micrographic surgery techniques, or a variation thereof). Currently, advancement and transposition flaps, possibly in combination with tarso-conjunctival or skin grafts, are the most utilised techniques. Despite the lack of histological verification, new treatment modalities, including topical chemotherapy, photodynamic therapy and cryotherapy, may provide interesting treatment options, particularly in collaboration with the dermatologist. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Perceptions of Women Managers and Their Communicator Competencies.

Science.gov (United States)

Wheeless, Virginia Eman; Berryman-Fink, Cynthia

1985-01-01

Examined employee attitudes toward women in general and women as managers, and perceived communication competencies of women managers. Found that female employees demonstrated a more positive regard for women in general, a less traditional view of women as managers, and a more positive perception of their communication competencies. (PD)

The Knowledge, Awareness, and Practices of Portuguese General Practitioners Regarding Multimorbidity and its Management: Qualitative Perspectives from Open-Ended Questions

Directory of Open Access Journals (Sweden)

Filipe Prazeres

2016-11-01

Full Text Available Multimorbidity’s high prevalence and negative impact has made it a subject of worldwide interest. The main aim of this study was to access the Portuguese knowledge, awareness, and practices of general practitioners (GPs regarding multimorbidity and its management, in order to aid in the development of interventions for improving outcomes in multimorbid patients in primary care. A web-based qualitative descriptive study was carried out in the first trimester of 2016 with primary care physicians working in two districts of the Centre region of Portugal. Open-ended questions were analysed via inductive thematic content analysis. GPs pointed out several difficulties and challenges while managing multimorbidity. Extrinsic factors were associated with the healthcare system logistics’ management (consultation time, organization of care teams, clinical information and society (media pressure, social/family support. Intrinsic factors related to the GP, patient, and physician-patient relationship were also stated. The most significant conclusion to emerge from this study is that although GPs perceived difficulties and challenges towards multimorbidity, they also have the tools to deal with them: the fundamental characteristics of family medicine. Also, the complex care required by multimorbid patients needs adequate consultation time, multidisciplinary teamwork, and more education/training.

44 CFR 206.438 - Project management.

Science.gov (United States)

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Project management. 206.438 Section 206.438 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF... Project management. (a) General. The State serving as grantee has primary responsibility for project...

Tools to Minimize Inter-Laboratory Variability in Vitellogenin Gene Expression Monitoring Programs

Data.gov (United States)

U.S. Environmental Protection Agency — All data files are in excel format. Files with names CSU are different mesocosms qPCR data results for vitellogen gene and 18s a house keeping gene. Data files...

Talent Management for Universities

Science.gov (United States)

Bradley, Andrew P.

2016-01-01

This paper explores human resource management practices in the university sector with a specific focus on talent pools and talent management more generally. The paper defines talent management in the context of the university sector and then explores its interdependence with organisational strategy, the metrics used to measure academic performance…

48 CFR 3019.201 - General policy.

Science.gov (United States)

2010-10-01

... Section 3019.201 Federal Acquisition Regulations System DEPARTMENT OF HOMELAND SECURITY, HOMELAND SECURITY ACQUISITION REGULATION (HSAR) SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Policies 3019.201 General policy. (d) DHS is committed to a unified team approach involving senior management, small business...

Management Styles and Techniques: Time.

Science.gov (United States)

Matthews, Priscilla J.

1987-01-01

Discusses strategies to improve individuals' use of time and personal satisfaction through time management. The 126-item bibliography includes citations for time management in general and special sections for career development, family and parenting, women, and home management. (CLB)

KNOWLEDGE MANAGEMENT PROCESSES AND INTELLECTUAL PROPERTY MANAGEMENT PROCESSES: AN INTEGRATED CONCEPTUAL FRAMEWORK

OpenAIRE

HENAO-CALAD, MONICA; RIVERA-MONTOYA, PAULA; URIBE-OCHOA, BEATRIZ

2017-01-01

ABSTRACT Intellectual property management, knowledge management are disciplines that have been treated independently, both in academia and in the organizational field. Through the legal discipline of intellectual property, the former manages intangible assets that are eligible for protection (copyright, patents and trademarks, among others) leaving aside those assets that cannot be realized in any way. The latter is devoted to the processes of knowledge management in general, namely, the know...

Project management in nuclear equipment manufacture

International Nuclear Information System (INIS)

Liu Jiancheng

2005-01-01

The completion of the management organization shall be firstly considered in project management for a nuclear power plant. The organization of nuclear equipment quality assurance program and project management consists of 5 departments such as the nuclear power container department, the manufacture department and the quality assurance department. The general manager takes the overall responsibility for the quality of the nuclear press usr bearing equipment, and the vice general manager takes responsibility for the quality, technology and schedule related with the manufacture of the equipment, and organizes the organization department for the audit. The director of the quality assurance department takes the responsibility for the establishment and completion of the quality assurance program, with enough rights authorized by the general manager, including the right not bounded by the cost and schedule, and confirms the implementation of the program by related departments and personnel. The manufacture schedule shall be prepared to ensure the implementation feasibility, process continuity and flexibility. The schedule shall be followed and monitored for the whole process, to check and feedback the implementation. (authors)

Management services

International Nuclear Information System (INIS)

Adkins, S.K.; Alford, D.R.; Barnette, A.B.

1979-01-01

The Management Services Section provides coordinated professional administrative services to the Fusion Energy Division (FED), allowing the work of technical professionals to be more fully concentrated in their areas of specialty. Services are provided in general administration, personnel, financial management, communications (including text and graphics generation), management information, library, safety, quality assurance, and nonprogrammatic engineering services. Highlights of the past year included adoption of the Procurement Module in the FED Management Information System (MIS) for use by the entire Laboratory, completion of the Personnel Module of the MIS, greatly increased personnel recruiting activity, and increased industrial subcontracting activity

Readiness for organisational change among general practice staff.

Science.gov (United States)

Christl, B; Harris, M F; Jayasinghe, U W; Proudfoot, J; Taggart, J; Tan, J

2010-10-01

Increasing demands on general practice to manage chronic disease may warrant organisational change at the practice level. Staff's readiness for organisational change can act as a facilitator or barrier to implementing interventions aimed at organisational change. To explore general practice staff readiness for organisational change and its association with staff and practices characteristics. This is a cross-sectional study of practices in three Australian states involved in a randomised control trial on the effectiveness of an intervention to enhance the role of non-general practitioner staff in chronic disease management. Readiness for organisational change, job satisfaction and practice characteristics were assessed using questionnaires. 502 staff from 58 practices completed questionnaires. Practice characteristics were not associated with staff readiness for change. A multilevel regression analysis showed statistically significant associations between staff readiness for organisational change (range 1 to 5) and having a non-clinical staff role (vs general practitioner; B=-0.315; 95% CI -0.47 to -0.16; pchange which addresses the mix of practice staff. Moderately low job satisfaction may be an opportunity for organisational change.

Identifying critical issues in recreation planning and management: improving the management-research partnership

Science.gov (United States)

John H. Schomaker; David W. Lime

1988-01-01

The "nominal group" process is a proven technique to systematically arrive at a consensus about critical information needs in recreation planning and management. Using this process, 41 managers who attended a 1983 conference on river management identified 114 specific information needs grouped under 11 general questions. Clearly, some concerns of...

Online Canton Fairs Ready for Convenient Trade--An Interview with Ding Qiang, General Manager of MOFCOM China International Electronic Commerce Center

Institute of Scientific and Technical Information of China (English)

Li Yinghong; Sun Yongjian

2006-01-01

@@ In 2006, the Canton Fairs will greet the 99th and 100th respectively in spring and fall. To meet the need of the development of the convenient trade, the Canton Fairs website, the platform of the online Canton Fairs run by MOFCOM China International Electronic Commerce Center is ready to take several effective measures to offer more convenient services. On March 24, China's Foreign Trade took the occasion to interview with Mr. Ding Qiang, General Manager of MOFCOM China International Electronic Commerce Center.

Do pregnant women contact their general practitioner? A register-based comparison of healthcare utilisation of pregnant and non-pregnant women in general practice.

NARCIS (Netherlands)

Feijen-de Jong, E.I.; Baarveld, F.; Jansen, D.E.M.C.; Ursum, J.; Reijneveld, S.A.; Schellevis, F.G.

2013-01-01

Background: Midwives and obstetricians are the key providers of care during pregnancy and postpartum. Information about the consultations with a general practitioner (GP) during this period is generally lacking. The aim of this study is to compare consultation rates, diagnoses and GP management of

Do pregnant women contact their general practitioner? A register-based comparison of healthcare utilisation of pregnant and non-pregnant women in general practice

NARCIS (Netherlands)

Feijen-de Jong, Esther I.; Baarveld, Frank; Jansen, Danielle E. M. C.; Ursum, Jennie; Reijneveld, Sijmen A.; Schellevis, Francois G.

2013-01-01

Background: Midwives and obstetricians are the key providers of care during pregnancy and postpartum. Information about the consultations with a general practitioner (GP) during this period is generally lacking. The aim of this study is to compare consultation rates, diagnoses and GP management of

Inpatient iron deficiency detection and management: how do general physicians and gastroenterologists perform in a tertiary care hospital?

Science.gov (United States)

Fazal, Muhammad W; Andrews, Jane M; Thomas, Josephine; Saffouri, Eliana

2017-08-01

Iron deficiency (ID) is often an indicator of underlying pathology. Early detection and treatment avoids long-term morbidity and allows for prompt iron repletion, avoiding ID anaemia (IDA) and the need for blood transfusion. To evaluate the management of ID in two internal medicine units (general medical (GM) and gastroenterology (GE)) in a large metropolitan hospital and compare it to international guidelines. All consecutive inpatient admissions in the GM and GE units were retrospectively reviewed until 40 patients in each service were identified with anaemia and/or microcytic hypochromic blood counts. Patient records and electronic discharge summaries were then reviewed to assess the recognition, investigation and management of these abnormalities. Overall, only 60% (48/80) of the cases of microcytic hypochromic picture and/or anaemia were recognised. Cases were more likely to be detected under the GE unit, 77.5% (31/40) versus 42% (17/40) in GM (P < 0.002). Of the 31 recognised GE cases, 28 (90%) were investigated further with iron studies and/or endoscopic procedures. ID was confirmed in nearly half (5/11) of those tested; however, only 2 of 5 received iron replacement. Among GM patients, only 11 of the 17 recognised cases (64%) were investigated further. Iron studies were performed in all 11, confirming IDA in 4 (36%), all of whom received intravenous iron. A faecal human haemoglobin test was performed in two GM patients and one GE patient. There remains significant room for improvement in the recognition, investigation and management of ID in hospital practice in Australia. © 2017 Royal Australasian College of Physicians.

Health care engineering management.

Science.gov (United States)

Jarzembski, W B

1980-01-01

Today, health care engineering management is merely a concept of dreamers, with most engineering decisions in health care being made by nonengineers. It is the purpose of this paper to present a rationale for an integrated hospital engineering group, and to acquaint the clinical engineer with some of the salient features of management concepts. Included are general management concepts, organization, personnel management, and hospital engineering systems.

A Generalized DRM Architectural Framework

Directory of Open Access Journals (Sweden)

PATRICIU, V. V.

2011-02-01

Full Text Available Online digital goods distribution environment lead to the need for a system to protect digital intellectual property. Digital Rights Management (DRM is the system born to protect and control distribution and use of those digital assets. The present paper is a review of the current state of DRM, focusing on architectural design, security technologies, and important DRM deployments. The paper primarily synthesizes DRM architectures within a general framework. We also present DRM ecosystem as providing a better understanding of what is currently happening to content rights management from a technological point of view. This paper includes conclusions of several DRM initiative studies, related to rights management systems with the purpose of identifying and describing the most significant DRM architectural models. The basic functions and processes of the DRM solutions are identified.

CLOUDCLOUD : general-purpose instrument monitoring and data managing software

Science.gov (United States)

Dias, António; Amorim, António; Tomé, António

2016-04-01

An effective experiment is dependent on the ability to store and deliver data and information to all participant parties regardless of their degree of involvement in the specific parts that make the experiment a whole. Having fast, efficient and ubiquitous access to data will increase visibility and discussion, such that the outcome will have already been reviewed several times, strengthening the conclusions. The CLOUD project aims at providing users with a general purpose data acquisition, management and instrument monitoring platform that is fast, easy to use, lightweight and accessible to all participants of an experiment. This work is now implemented in the CLOUD experiment at CERN and will be fully integrated with the experiment as of 2016. Despite being used in an experiment of the scale of CLOUD, this software can also be used in any size of experiment or monitoring station, from single computers to large networks of computers to monitor any sort of instrument output without influencing the individual instrument's DAQ. Instrument data and meta data is stored and accessed via a specially designed database architecture and any type of instrument output is accepted using our continuously growing parsing application. Multiple databases can be used to separate different data taking periods or a single database can be used if for instance an experiment is continuous. A simple web-based application gives the user total control over the monitored instruments and their data, allowing data visualization and download, upload of processed data and the ability to edit existing instruments or add new instruments to the experiment. When in a network, new computers are immediately recognized and added to the system and are able to monitor instruments connected to them. Automatic computer integration is achieved by a locally running python-based parsing agent that communicates with a main server application guaranteeing that all instruments assigned to that computer are

Distributing radiation management system of nuclear power plants

International Nuclear Information System (INIS)

Mihoya, Eiichi; Akashi, Michio

1999-01-01

The importance of radiation management for nuclear facilities including nuclear power plants has increased as the general public understanding has progressed, and necessary information for management must be processed exactly and quickly. In nuclear power plants, radiation management is performed by each individual operation, and collected information is managed by the system of each operation. The distributing radiation management system has been developed aiming to use a general-purpose LAN and make quick and efficient use of information managed by individual operations. This paper describes the system configuration and functions. (author)

78 FR 52519 - Agency Information Collection Activities; Comment Request; Student Assistance General Provisions...

Science.gov (United States)

2013-08-23

...; Comment Request; Student Assistance General Provisions--Subpart K--Cash Management AGENCY: Federal Student... Provisions--Subpart K--Cash Management. OMB Control Number: 1845-0049. Type of Review: Revision of an... Collection Clearance Division, Privacy, Information and Records Management Services, Office of Management...

Hanford general employee training - A million dollar cost beneficial program

International Nuclear Information System (INIS)

Gardner, P.R.

1991-02-01

In January 1990, Westinghouse Hanford Company implemented an interactive videodisc training program entitled Hanford General Employee Training. Covering all Institute of Nuclear Power Operations general employee training objectives, training mandated by US Department of Energy orders, and training prescribed by internal Westinghouse Hanford Company policies, Hanford General Employee Training presents and manages engaging training programs individually tailored to each of the 9,000 employees. Development costs for a sophisticated program such as Hanford General Employee Training were high compared to similar costs for developing ''equivalent'' traditional training. Hardware ($500,000) and labor costs ($400,000) totaled $900,000. Annual maintenance costs, equipment plus labor, are totalling about $200,000. On the benefit side, by consolidating some 17 previous Westinghouse Hanford Company courses and more effectively managing the instructional process, Hanford General Employee Training reduced the average student training time from over 11 hours to just under 4 hours. For 9,000 employees, the computed net annual savings exceeds $1.3 million. 2 refs