Peculiarities of the risk management system organization in current conditions

OpenAIRE

MIKHIN P.O.

2014-01-01

Risk-management system organization problem is topical nowadays. The innovation activity is defined as an activity vulnerable to risk and needs more attention. The basic approaches and elements of organization structure development in risk-management system are considered to find out the best structure for business modelling usage. Balance and combination of risk-management system types are required in current conditions.

SSAT State-of-the-Art Conference: Current Surgical Management of Gastric Tumors.

Science.gov (United States)

Norton, Jeffrey A; Kim, Teresa; Kim, Joseph; McCarter, Martin D; Kelly, Kaitlyn J; Wong, Joyce; Sicklick, Jason K

2018-01-01

The current era of gastric surgery is marked by low morbidity and mortality rates, innovative strategies to approach resections with a minimally invasive fashion or hyperthermic intraperitoneal chemotherapy (HIPEC), as well as improved understanding of the biology of sporadic and hereditary stromal, neuroendocrine, and epithelial malignancies. In 2017, the Society for Surgery of the Alimentary Tract convened a State-of-the-Art Conference on Current Surgical Management of Gastric Tumors with both international experts and emerging leaders in the field of gastric surgery. Martin D. McCarter, MD of the University of Colorado discussed the current management of gastric gastrointestinal stromal tumors (GIST). Kaitlyn J. Kelly, MD of the University of California, San Diego discussed the management of gastric carcinoid tumors. Jeffrey A. Norton of Stanford University discussed recent advances in the management of gastric adenocarcinoma including a focus on hereditary diffuse gastric cancer (HDGC). Joseph Kim, MD of Stony Brook University discussed a systematic approach to minimally invasive gastrectomy for cancer. Joyce Wong, MD of Pennsylvania State University discussed the role for cytoreductive surgery (CRS) and HIPEC for gastric adenocarcinoma. This review provides gastrointestinal surgeons with a concise update on the current surgical management of gastric tumors.

Treatment of Thrombotic Antiphospholipid Syndrome: The Rationale of Current Management-An Insight into Future Approaches.

Science.gov (United States)

Chighizola, Cecilia Beatrice; Ubiali, Tania; Meroni, Pier Luigi

2015-01-01

Vascular thrombosis and pregnancy morbidity represent the clinical manifestations of antiphospholipid syndrome (APS), which is serologically characterized by the persistent positivity of antiphospholipid antibodies (aPL). Antiplatelet and anticoagulant agents currently provide the mainstay of APS treatment. However, the debate is still open: controversies involve the intensity and the duration of anticoagulation and the treatment of stroke and refractory cases. Unfortunately, the literature cannot provide definite answers to these controversial issues as it is flawed by many limitations, mainly due to the recruitment of patients not fulfilling laboratory and clinical criteria for APS. The recommended therapeutic management of different aPL-related clinical manifestations is hereby presented, with a critical appraisal of the evidence supporting such approaches. Cutting edge therapeutic strategies are also discussed, presenting the pioneer reports about the efficacy of novel pharmacological agents in APS. Thanks to a better understanding of aPL pathogenic mechanisms, new therapeutic targets will soon be explored. Much work is still to be done to unravel the most controversial issues about APS management: future studies are warranted to define the optimal management according to aPL risk profile and to assess the impact of a strict control of cardiovascular risk factors on disease control.

Fuel management approach in IRIS Reactor

International Nuclear Information System (INIS)

Petrovic, B.; Franceschini, F.

2004-01-01

This paper provides an overview of fuel management approach employed in IRIS (International Reactor Innovative and Secure). It introduces the initial, rather ambitious, fuel management goals and discusses their evolution that reflected the fast pace of progress of the overall project. The updated objectives rely on using currently licensed fuel technology, thus enabling near-term deployment of IRIS, while still providing improved fuel utilization. The paper focuses on the reference core design and fuel management strategy that is considered in pre-application licensing, which enables extended cycle of three to four years. The extended cycle reduces maintenance outage time and increases capacity factor, thus reducing the cost of electricity. Approaches to achieving this goal are discussed, including use of different reloading strategies. Additional fuel management options, which are not part of the licensing process, but are pursued as long-term research for possible future implementation, are presented as well. (Author)

Current Therapeutic Strategies and Novel Approaches in Osteosarcoma

International Nuclear Information System (INIS)

Ando, Kosei; Heymann, Marie-Françoise; Stresing, Verena; Mori, Kanji; Rédini, Françoise; Heymann, Dominique

2013-01-01

Osteosarcoma is the most frequent malignant primary bone tumor and a main cause of cancer-related death in children and adolescents. Although long-term survival in localized osteosarcoma has improved to about 60% during the 1960s and 1970s, long-term survival in both localized and metastatic osteosarcoma has stagnated in the past several decades. Thus, current conventional therapy consists of multi-agent chemotherapy, surgery and radiation, which is not fully adequate for osteosarcoma treatment. Innovative drugs and approaches are needed to further improve outcome in osteosarcoma patients. This review describes the current management of osteosarcoma as well as potential new therapies

Risk assessment and management approaches on mental health units.

Science.gov (United States)

Woods, P

2013-11-01

This exploratory and descriptive study took place in one Canadian province. The study aimed to: (1) to identify and describe the nature and extent of current risk assessment and management approaches used in the adult inpatient mental health and forensic units; and (2) to identify good practice and shortfalls in the nature and extent of the approaches currently utilized. Data were collected from 48 participants through nine focus groups. Participants reported that they used a clinical approach to risk assessment. They had also not considered risk assessment and management as a proactive structured process. Education and training was also limited and skills were developed over time through practice. Five keys issues are discussed as important: reliance on clinical judgement alone is not the best choice to make; the need to consider risk as a whole concept; risk management being more reactive than proactive; education and training; and client involvement in risk assessment. © 2012 John Wiley & Sons Ltd.

Approach to transaction management for Space Station Freedom

Science.gov (United States)

Easton, C. R.; Cressy, Phil; Ohnesorge, T. E.; Hector, Garland

1989-01-01

An approach to managing the operations of the Space Station Freedom based on their external effects is described. It is assumed that there is a conflict-free schedule that, if followed, will allow only appropriate operations to occur. The problem is then reduced to that of ensuring that the operations initiated are within the limits allowed by the schedule, or that the external effects of such operations are within those allowed by the schedule. The main features of the currently adopted transaction management approach are discussed.

PROJECT APPROACH TO ENERGY MANAGEMENT

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Інга Борисівна СЕМКО

2016-02-01

Full Text Available Project management is widely used around the world as a tool to improve business performance. Correct implementation of the program of implementation of energy efficiency is accompanied by the adoption of an appropriate legislative framework, support programs, the approval of market-based instruments. Currently, it is paying enough attention to the effective application of market-based instruments, although most of the activities in the field of energy efficiency from the economic side are quite profitable. The authors suggested the use of the methodology of project management to the management of energy-saving measures, new approaches to the place and role of project management in the hierarchy of guidance. As a result, this innovation can improve the competitiveness of enterprises. The conclusions that the energy-saving project management allows you to get the best results for their implementation by reducing the time, resources, risk reduction.

Current DOE direction in low-level waste management

International Nuclear Information System (INIS)

Wilhite, E.L.; Dolenc, M.R.; Shupe, M.W.; Waldo, L.C.

1989-01-01

The U.S. Department of Energy (DOE) is implementing revised DOE Order 5820.2A Radioactive Waste Management. Chapter III of the revised order provides prescriptive requirements for managing low-level waste and is the subject of this paper. The revised order requires that all DOE low-level radioactive and mixed waste be systematically managed, using an approach that considers the combination of waste management practices used in waste generation reduction, segregation, treatment, packaging, storage, and disposal. The Order defines performance objectives for protecting groundwater, for protecting against intrusion, and for maintaining adequate operational practices. A performance assessment will be required to ensure that waste management operations comply with these performance objectives. DOE implementation of the revised Order includes work in the areas of leach testing, waste stabilization, waste certification, facility monitoring, and management of unique waste streams. This paper summarizes the status of this work and the current direction DOE is taking in managing low-level waste under DOE 5820.2A

Using ecological thresholds to inform resource management: current options and future possibilities

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Melissa M Foley

2015-11-01

Full Text Available In the face of growing human impacts on ecosystems, scientists and managers recognize the need to better understand thresholds and nonlinear dynamics in ecological systems to help set management targets. However, our understanding of the factors that drive threshold dynamics, and when and how rapidly thresholds will be crossed is currently limited in many systems. In spite of these limitations, there are approaches available to practitioners today—including ecosystem monitoring, statistical methods to identify thresholds and indicators, and threshold-based adaptive management—that can be used to help avoid ecological thresholds or restore systems that have crossed them. We briefly review the current state of knowledge and then use real-world examples to demonstrate how resource managers can use available approaches to avoid crossing ecological thresholds. We also highlight new tools and indicators being developed that have the potential to enhance our ability to detect change, predict when a system is approaching an ecological threshold, or restore systems that have already crossed a tipping point.

Approaches to the mathematical description of NPP operational safety management and oversight

International Nuclear Information System (INIS)

Bilej, D.V.; Berzhanskij, S.V.

2014-01-01

The paper presents analysis of features related to NPP operational safety management and oversight. According to analysis results, approaches are proposed to perform mathematical description of specific processes and to develop a scale for management to the current safety level as regards NPP power generation. Proposed approaches are making experimental equations and process approach of ISO-9001 quality system

Current approach to liver traumas.

Science.gov (United States)

Kaptanoglu, Levent; Kurt, Necmi; Sikar, Hasan Ediz

2017-03-01

out of 300). A multidisciplinary approach to the management of hepatic injuries has evolved over the last few decades, but the basic principles of trauma continue to be observed. Diagnostic and therapeutic endeavors are chosen based mainly on the stability of the patient. Stable patients with reliable examinations and available resources can be managed nonoperatively. Unstable patients require surgery. Our current approach to liver traumas is non operative technique, if possible. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Current Approaches to the Management of Pediatric Overweight and Obesity

Science.gov (United States)

Ridolfi, Danielle R.; Hayes, Jacqueline F.; St Paul, Michelle; Wilfley, Denise E.

2015-01-01

Opinion Statement Family-based behavioral intervention has been demonstrated to be an effective and safe treatment for childhood obesity and should be considered a first-line treatment option. However, access to such intensive evidence-based treatment is limited and, currently, obesity care is dominated by high intensity behavioral treatment implemented in specialty clinics or less effective, low intensity treatments implemented in primary care. However, capitalizing on the established and ongoing relationship between primary care providers and families, primary care providers hold an invaluable role in early identification of overweight and obesity, and subsequent referral to an evidence-based treatment. key aspects of effective treatment include: early intervention, moderate- to high-intensity intervention of sufficient duration, multi-component intervention targeting dietary modification, physical activity and behavioral strategies, family involvement and goals targeting family members, and follow-up contact during maintenance. The purpose of this review is to present the current empirically supported treatment options for pediatric obesity including primary care-based interventions and diagnostic tools, multi-component behavioral intervention with a focus on family-based behavioral intervention, immersion treatment, and pharmacologic and surgical management. PMID:25205083

Supporting self-management of chronic health conditions: common approaches.

Science.gov (United States)

Lawn, Sharon; Schoo, Adrian

2010-08-01

The aims of this paper are to provide a description of the principles of chronic condition self-management, common approaches to support currently used in Australian health services, and benefits and challenges associated with using these approaches. We examined literature in this field in Australia and drew also from our own practice experience of implementing these approaches and providing education and training to primary health care professionals and organizations in the field. Using common examples of programs, advantages and disadvantages of peer-led groups (Stanford Courses), care planning (The Flinders Program), a brief primary care approach (the 5As), motivational interviewing and health coaching are explored. There are a number of common approaches used to enhance self-management. No one approach is superior to other approaches; in fact, they are often complimentary. The nature and context for patients' contact with services, and patients' specific needs and preferences are what must be considered when deciding on the most appropriate support mode to effectively engage patients and promote self-management. Choice of approach will also be determined by organizational factors and service structures. Whatever self-management support approaches used, of importance is how health services work together to provide support. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

APPROACHES TO QUALITY MANAGEMENT AT EUROPEAN LEVEL

OpenAIRE

Salagean Horatiu Catalin; Ilies Radu; Gherman Mihai; Cioban Bogdan

2013-01-01

In the current economic context, quality has become a source of competitive advantage and organizations must perceive quality as something natural and human in order to achieve excellence. The proper question for the context of the internationalisation of the economy is whether the culture of the regions, states or nations affects the development in the quality management field and the quality approach. The present study tries to give a theoretical approach of how culture influences the quali...

COMPARATIVE STUDY BETWEEN TRADITIONAL AND ENTERPRISE RISK MANAGEMENT -A THEORETICAL APPROACH

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Cican Simona-Iulia

2014-07-01

Full Text Available The complexity, volatility and unpredictability of the current economic environment are a daily reminder that organizations face many risks. The traditional approach, according to which risk is a necessary evil which must be removed, is no longer sufficient and that is why companies nowadays are forced to spend significant resources to manage risks. Risk transparency is what one looks for; therefore, identification and management of risks within an organization become increasingly necessary for success and longevity. Risk approach has a major role in a company’s ability to avoid, reduce and turn risks into opportunities. Enterprise risk management is a new concept that revolutionizes the traditional approach and summarizes risk management in an integrated, comprehensive and strategic system. Studies use several synonyms for enterprise risk management such as integrated risk management, holistic risk management, global risk management and strategic risk management. Enterprise risk management implements at the end of the last century a new way to deal with risks: the holistic approach. This risks approach – i.e. interaction of several types of risks which become increasingly threatening and varied and may cause more damage than individual risk – brings forward the need of risk management and raises issues at the highest level of company management. For a proper view on company risks, each individual risk and the possibility of risk interaction must be understood. This is essential to establish a risk classification according to their impact on the company. Traditional approach on risk management, as a management function, is limited to only threats and losses, so relatively few organizations see risks as potential earning-generated opportunities. However, risk management process is not radically changed. Enterprise risk management is an improved version of the traditional risk management, created by expanding its scope. The new risk

DOE systems approach to a low-level waste management information system: summary paper

International Nuclear Information System (INIS)

Esparza, V.

1987-01-01

The LLWMP is performing an assessment of waste information systems currently in use at each DOE site for recording LLW data. The assessment is being conducted to determine what changes to the waste information systems, if any, are desirable to support implementation of this systems approach to LLW management. Recommendations will be made to DOE from this assessment and what would be involved to modify current DOE waste generator information practices to support an appropriately structured overall DOE LLW data systems. In support of reducing the uncertainty of decision-making, DOE has selected a systems approach to keep pace with an evolving regulatory climate to low-level waste. This approach considers the effects of each stage of the entire low-level waste management process. The proposed systems approach starts with the disposal side of the waste management system and progresses towards the waste generation side of the waste management system. Using this approach provides quantitative performance to be achieved. In addition, a systems approach also provides a method for selecting appropriate technology based on engineering models

Analysis of the Current Nutrient Management Practices in Semi-Arid Areas of Eastern Kenya: A Nutmon Approach

International Nuclear Information System (INIS)

Karuku, A.M.

2002-01-01

Declining soil fertility caused mainly by continuous cultivation without adequate replenishment of nutrients, is a major factor contributing to low crop yields in the arid and semi arid areas of Kenya. Development of appropriate nutrient management strategies for suitable agricultural production in these areas is, therefore, a priority issue. in the study reported here, analyses of the current nutrient management practices were carried out using the nutrient monitoring (NUTMON) approach in order to create farm house-hold awareness on nutrient management aspects. The procedure involved participatory soil and nutrient flow maps and soil sampling at farm level. laboratory analysis of the soil samples was later carried out. Structured questionnaires were used for systematic collection of information on farm management practices in order to quantify flows of materials with emphasis on soil nutrients and cash. Results of the laboratory soil analysis were also presented to the farmers and discussed during feedback sessions. The test was carried out in three places namely, Kibwezi, Kasikeu and Kiomo. In all the three clusters, off-farm income was an important component of the total family income. Farm net cash flow was highest in Kibwezi cluster due to horticultural crop production activities. Household net cash flow was highest in Kasikeu, largely originating from off-farm income. It was concluded that NUTMON methodology appeared a suitable tool for the diagnostic of the farming system analysis and design in the arid and semi-arid lands of Kenya

A BIM-based approach to reusing construction firm’s management information

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Zhiliang Ma

2012-12-01

Full Text Available Nowadays most construction firms have begun to use information management systems in their business to work more efficiently. At the same time, a lot of management information is being accumulated and some of the information can be reused to support the decision-making. Up to now, the information has not been reused so effectively in construction firms as expected. This paper introduces a new approach to reusing construction firm’s management information, which is based on BIM (Building Information Modeling technology. In the paper, the current approaches are reviewed at first, and then the framework of the new approach is described. Next, the key issues of the new approach are clarified. Finally, a use case of the new approach is demonstrated. It is concluded that the new approach can be used in construction firms to better reuse the accumulated management information.

Language Management Theory as One Approach in Language Policy and Planning

Science.gov (United States)

Nekvapil, Jirí

2016-01-01

Language Policy and Planning is currently a significantly diversified research area and thus it is not easy to find common denominators that help to define basic approaches within it. Richard B. Baldauf attempted to do so by differentiating between four basic approaches: (1) the classical approach, (2) the language management approach (Language…

Systems approaches to integrated solid waste management in developing countries

International Nuclear Information System (INIS)

Marshall, Rachael E.; Farahbakhsh, Khosrow

2013-01-01

Highlights: ► Five drivers led developed countries to current solid waste management paradigm. ► Many unique factors challenge developing country solid waste management. ► Limited transferability of developed country approaches to developing countries. ► High uncertainties and decision stakes call for post-normal approaches. ► Systems thinking needed for multi-scale, self-organizing eco-social waste systems. - Abstract: Solid waste management (SWM) has become an issue of increasing global concern as urban populations continue to rise and consumption patterns change. The health and environmental implications associated with SWM are mounting in urgency, particularly in the context of developing countries. While systems analyses largely targeting well-defined, engineered systems have been used to help SWM agencies in industrialized countries since the 1960s, collection and removal dominate the SWM sector in developing countries. This review contrasts the history and current paradigms of SWM practices and policies in industrialized countries with the current challenges and complexities faced in developing country SWM. In industrialized countries, public health, environment, resource scarcity, climate change, and public awareness and participation have acted as SWM drivers towards the current paradigm of integrated SWM. However, urbanization, inequality, and economic growth; cultural and socio-economic aspects; policy, governance, and institutional issues; and international influences have complicated SWM in developing countries. This has limited the applicability of approaches that were successful along the SWM development trajectories of industrialized countries. This review demonstrates the importance of founding new SWM approaches for developing country contexts in post-normal science and complex, adaptive systems thinking

Systems approaches to integrated solid waste management in developing countries

Energy Technology Data Exchange (ETDEWEB)

Marshall, Rachael E., E-mail: rmarsh01@uoguelph.ca [School of Engineering, University of Guelph, Albert A. Thornbrough Building, Guelph, ON, Canada N1G 2W1 (Canada); Farahbakhsh, Khosrow, E-mail: khosrowf@uoguelph.ca [School of Engineering, University of Guelph, Albert A. Thornbrough Building, Guelph, ON, Canada N1G 2W1 (Canada)

2013-04-15

Highlights: ► Five drivers led developed countries to current solid waste management paradigm. ► Many unique factors challenge developing country solid waste management. ► Limited transferability of developed country approaches to developing countries. ► High uncertainties and decision stakes call for post-normal approaches. ► Systems thinking needed for multi-scale, self-organizing eco-social waste systems. - Abstract: Solid waste management (SWM) has become an issue of increasing global concern as urban populations continue to rise and consumption patterns change. The health and environmental implications associated with SWM are mounting in urgency, particularly in the context of developing countries. While systems analyses largely targeting well-defined, engineered systems have been used to help SWM agencies in industrialized countries since the 1960s, collection and removal dominate the SWM sector in developing countries. This review contrasts the history and current paradigms of SWM practices and policies in industrialized countries with the current challenges and complexities faced in developing country SWM. In industrialized countries, public health, environment, resource scarcity, climate change, and public awareness and participation have acted as SWM drivers towards the current paradigm of integrated SWM. However, urbanization, inequality, and economic growth; cultural and socio-economic aspects; policy, governance, and institutional issues; and international influences have complicated SWM in developing countries. This has limited the applicability of approaches that were successful along the SWM development trajectories of industrialized countries. This review demonstrates the importance of founding new SWM approaches for developing country contexts in post-normal science and complex, adaptive systems thinking.

Current approaches to cyanotoxin risk assessment and risk management around the globe

Science.gov (United States)

Ibelings, Bas W.; Backer, Lorraine C.; Kardinaal, W. Edwin A.; Chorus, Ingrid

2015-01-01

Toxic cyanobacteria became more widely recognized as a potential health hazard in the 1990s, and in 1998 the World Health Organization (WHO) first published a provisional Guideline Value of 1 μg L−1 for microcystin-LR in drinking-water. In this publication we compare risk assessment and risk management of toxic cyanobacteria in 17 countries across all five continents. We focus on the three main (oral) exposure vehicles to cyanotoxins: drinking-water, water related recreational and freshwater seafood. Most countries have implemented the provisional WHO Guideline Value, some as legally binding standard, to ensure the distribution of safe drinking-water with respect to microcystins. Regulation, however, also needs to address the possible presence of a wide range of other cyanotoxins and bioactive compounds, for which no guideline values can be derived due to insufficient toxicological data. The presence of microcystins (commonly expressed as microcystin-LR equivalents) may be used as proxy for overall guidance on risk management, but this simplification may miss certain risks, for instance from dissolved fractions of cylindrospermopsin and cyanobacterial neurotoxins. An alternative approach, often taken for risk assessment and management in recreational waters, is to regulate cyanobacterial presence – as cell numbers or biomass – rather than individual toxins. Here, many countries have implemented a two or three tier alert level system with incremental severity. These systems define the levels where responses are switched from Surveillance to Alert and finally to Action Mode and they specify the short-term actions that follow. Surface bloom formation is commonly judged to be a significant risk because of the elevated concentration of microcystins in a scum. Countries have based their derivations of legally binding standards, guideline values, maximally allowed concentrations (or limits named otherwise) on very similar scientific methodology, but underlying

Current approaches to cyanotoxin risk assessment and risk management around the globe.

Science.gov (United States)

Ibelings, Bas W; Backer, Lorraine C; Kardinaal, W Edwin A; Chorus, Ingrid

2015-12-01

Toxic cyanobacteria became more widely recognized as a potential health hazard in the 1990s, and in 1998 the World Health Organization (WHO) first published a provisional Guideline Value of 1 μg L -1 for microcystin-LR in drinking-water. In this publication we compare risk assessment and risk management of toxic cyanobacteria in 17 countries across all five continents. We focus on the three main (oral) exposure vehicles to cyanotoxins: drinking-water, water related recreational and freshwater seafood. Most countries have implemented the provisional WHO Guideline Value, some as legally binding standard, to ensure the distribution of safe drinking-water with respect to microcystins. Regulation, however, also needs to address the possible presence of a wide range of other cyanotoxins and bioactive compounds, for which no guideline values can be derived due to insufficient toxicological data. The presence of microcystins (commonly expressed as microcystin-LR equivalents) may be used as proxy for overall guidance on risk management, but this simplification may miss certain risks, for instance from dissolved fractions of cylindrospermopsin and cyanobacterial neurotoxins. An alternative approach, often taken for risk assessment and management in recreational waters, is to regulate cyanobacterial presence - as cell numbers or biomass - rather than individual toxins. Here, many countries have implemented a two or three tier alert level system with incremental severity. These systems define the levels where responses are switched from Surveillance to Alert and finally to Action Mode and they specify the short-term actions that follow. Surface bloom formation is commonly judged to be a significant risk because of the elevated concentration of microcystins in a scum. Countries have based their derivations of legally binding standards, guideline values, maximally allowed concentrations (or limits named otherwise) on very similar scientific methodology, but underlying

Current Risk Management Practices in Psychotherapy Supervision.

Science.gov (United States)

Mehrtens, Ilayna K; Crapanzano, Kathleen; Tynes, L Lee

2017-12-01

Psychotherapy competence is a core skill for psychiatry residents, and psychotherapy supervision is a time-honored approach to teaching this skill. To explore the current supervision practices of psychiatry training programs, a 24-item questionnaire was sent to all program directors of Accreditation Council for Graduate Medical Education (ACGME)-approved adult psychiatry programs. The questionnaire included items regarding adherence to recently proposed therapy supervision practices aimed at reducing potential liability risk. The results suggested that current therapy supervision practices do not include sufficient management of the potential liability involved in therapy supervision. Better protections for patients, residents, supervisors and the institutions would be possible with improved credentialing practices and better documentation of informed consent and supervision policies and procedures. © 2017 American Academy of Psychiatry and the Law.

PROACTIVE APPROACH TO THE INCIDENT AND PROBLEM MANAGEMENT IN COMMUNICATION NETWORKS

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Vjeran Strahonja

2007-06-01

Full Text Available Proactive approach to communication network maintenance has the capability of enhancing the integrity and reliability of communication networks, as well as of reducing maintenance costs and overall number of incidents. This paper presents approaches to problem and incident prevention with the help of root-cause analysis, aligning that with the goal to foresee software performance. Implementation of proactive approach requires recognition of enterprise's current level of maintenance better insights into available approaches and tools, as well as their comparison, interoperability, integration and further development. The approach we are proposing and elaborating in this paper lies on the construction of a metamodel of the problem management of information technology, particularly the proactive problem management. The metamodel is derived from the original ITIL specification and presented in an object-oriented fashion by using structure (class diagrams conform to UML notation. Based on current research, appropriate metrics based on the concept of Key Performance Indicators is suggested.

Sepsis: Current Definition, Pathophysiology, Diagnosis, and Management.

Science.gov (United States)

Taeb, Abdalsamih M; Hooper, Michael H; Marik, Paul E

2017-06-01

Sepsis is a clinical syndrome that results from the dysregulated inflammatory response to infection that leads to organ dysfunction. The resulting losses to society in terms of financial burden, morbidity, and mortality are enormous. We provide a review of sepsis, its underlying pathophysiology, and guidance for diagnosis and management of this common disease. Current established treatments include appropriate antimicrobial agents to target the underlying infection, optimization of intravascular volume to improve stroke volume, vasopressors to counteract vasoplegic shock, and high-quality supportive care. Appropriate implementation of established treatments combined with novel therapeutic approaches promises to continue to decrease the impact of this disease.

Managing peri-implant bone loss: current understanding.

Science.gov (United States)

Aljateeli, Manar; Fu, Jia-Hui; Wang, Hom-Lay

2012-05-01

With the improved macro- and micro-designs, dental implants enjoy a high survival rate. However, peri-implant bone loss has recently emerged to be the focus of implant therapy. As such, researchers and clinicians are in need of finding predictable techniques to treat peri-implant bone loss and stop its progression. Literature search on the currently available treatment modalities was performed and a brief description of each modality was provided. Numerous techniques have been proposed and none has been shown to be superior and effective in managing peri-implant bone loss. This may be because of the complex of etiological factors acting on the implant-supported prosthesis hence the treatment approach has to be individually tailored. Due to the lack of high-level clinical evidence on the management of peri-implant bone loss, the authors, through a literature review, attempt to suggest a decision tree or guideline, based on sound periodontal surgical principles, to aid clinicians in managing peri-implantitis associated bone loss. © 2011 Wiley Periodicals, Inc.

Current concepts in the management of acute pancreatitis

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Gautham Srinivasan

2016-01-01

Full Text Available Guidelines for the management of acute pancreatitis (AP are based on the Western experience, which may be difficult to extrapolate in India due to socioeconomic constraints. Hence, modifications based on the available resources and referral patterns should be introduced so as to ensure appropriate care. We reviewed the current literature on the management of AP available in English on Medline and proposed guidelines locally applicable. Patients of AP presenting with systemic inflammatory response syndrome are at risk of moderate-severe pancreatitis and hence, should be referred to a tertiary center early. The vast majority of patients with AP have mild disease and can be managed at smaller centers. Early aggressive fluid resuscitation with controlled fluid expansion, early enteral nutrition, and culture-directed antibiotics improve outcomes in AP. Infected pancreatic necrosis should be managed in a tertiary care hospital within a multidisciplinary setup. The “step up” approach involving antibiotics, percutaneous drainage, and minimally invasive necrosectomy instituted sequentially based on clinical response has improved the outcomes in this subgroup of patients.

Disease Management Evaluation: A Comprehensive Review of Current State of the Art

OpenAIRE

Conklin, Annalijn; Nolte, Ellen

2011-01-01

Many countries across Europe and elsewhere have been experimenting with various structured approaches to manage patients with chronic illness as a way to improve quality of care, reduce costs and lead to better population health outcomes in the long run. Despite a body of studies of disease management interventions, uncertainty about the effects of these remains not least because current guidance on evaluation methods and metrics require further development to enhance scientific rigour while ...

Comparison of approaches to Total Quality Management. Including an examination of the Department of Energy`s position on quality management

Energy Technology Data Exchange (ETDEWEB)

Bennett, C.T.

1994-03-01

This paper presents a comparison of several qualitatively different approaches to Total Quality Management (TQM). The continuum ranges from management approaches that are primarily standards -- with specific guidelines, but few theoretical concepts -- to approaches that are primarily philosophical, with few specific guidelines. The approaches to TQM discussed in this paper include the International Organization for Standardization (ISO) 9000 Standard, the Malcolm Baldrige National Quality Award, Senge`s the Learning Organization, Watkins and Marsick`s approach to organizational learning, Covey`s Seven Habits of Highly Successful People, and Deming`s Fourteen Points for Management. Some of these approaches (Deming and ISO 9000) are then compared to the DOE`s official position on quality management and conduct of operations (DOE Orders 5700.6C and 5480.19). Using a tabular format, it is shown that while 5700.6C (Quality Assurance) maps well to many of the current approaches to TQM, DOE`s principle guide to management Order 5419.80 (Conduct of Operations) has many significant conflicts with some of the modern approaches to continuous quality improvement.

Breast cancer treatment: historical review and current approaches

International Nuclear Information System (INIS)

Kulakowski, A.

1994-01-01

The evolution and development of opinions on the diagnosis and treatment of breast cancer since Galen to present time is presented. The concept of breast cancer as a local disease has been replaced by the understanding of its systemic character. On this background described are the methods of surgical treatment beginning from early - supraradical, to present -conservative approaches. The ''milestones'' in diagnosis and treatment of breast cancer of the last 40 years are presented. Current methods of breast cancer management include correct diagnosis (clinical examination, mammography, ultrasound, fine needle aspiration biopsy), TNM staging, adequate loco-regional therapy, systemic therapy, rehabilitation, reconstruction and careful follow-up. (author)

A Balanced Scorecard Approach to Public Relations Management Assessment.

Science.gov (United States)

Fleisher, Craig S.; Mahaffy, Darren

1997-01-01

Describes a new managerial approach to assessing public relations/communications (PR/C) performance using a "balanced scorecard." Reviews the current state of PR/C management assessment; illustrates the balanced scorecard framework; highlights its strengths and weaknesses; describes the process of applying the scorecard to PR/C units;…

Approach on origin management of nuclear materials at KAERI

International Nuclear Information System (INIS)

Kim, Hyun-Jo; Lee, Sung-Ho; Lee, Byung-Doo; Kim, In-Chul; Kim, Hyun-Sook; Jung, Juang

2017-01-01

This paper describes the current origin management approach and reviews the requirement to be reflected to meet the bilateral agreements. KAERI developed the origin management system to efficiently and effectively manage the origin information. The system is connected with KASIS to share the information on the inventory changes of nuclear material. After development of the system, however, the new concept of obligated nuclear material is introduced according to the amended ROK-US agreement. Also, the origin management system based on IAEA accounting reports needs to revise to include the nuclear material exempted from safeguards. Therefore KAERI will improve the origin management system to meet the requirement of bilateral agreements and NSSC notice to be revised.

MULTIFACETED APPROACH TO NATURAL RESOURCE MANAGEMENT: ETHNOLOGY, GEOGRAPHY, CULTURE

Directory of Open Access Journals (Sweden)

Mikhail Slipenchuk

2016-12-01

Full Text Available Nowadays, the issue of interaction between man and nature is one of the most pressing challenges. One of the aspects of this interaction, as well as one of the prior scientific directions and use of natural resources, is natural resource management. A limited amount of many resources and the limits of environmental capacity of nature raise questions of equity to the interests of different generations, which implies the need to decide on the optimal use of natural resource potential of territories currently and in the future. The complex nature of the relationships that form the structure of resources management as a complex system, dictates the need for a comprehensive approach to its study. System analysis is this type of approach. It allows holding studies of the functions of resources management and identifying problems to its development.

A holistic approach to the mycetoma management.

Science.gov (United States)

Bakhiet, Sahar Mubarak; Fahal, Ahmed Hassan; Musa, Ahmed Mudawi; Mohamed, El Samani Wadaa; Omer, Rowa Fathelrahman; Ahmed, Eiman Siddig; El Nour, Mustafa; Mustafa, El Rayah Mohamed; Sheikh A Rahman, Manar El; Suliman, Suliman Hussein; El Mamoun, Mohamed A Gadir; El Amin, Hajo Mohamed

2018-05-01

Mycetoma, one of the badly neglected tropical diseases, it is a localised chronic granulomatous inflammatory disease characterised by painless subcutaneous mass and formation of multiple sinuses that produce purulent discharge and grains. If untreated early and appropriately, it usually spread to affect the deep structures and bone resulting in massive damage, deformities and disabilities. It can also spread via the lymphatics and blood leading to distant secondary satellites associated with high morbidity and mortality. To date and despite progress in mycetoma research, a huge knowledge gap remains in mycetoma pathogenesis and epidemiology resulting in the lack of objective and effective control programmes. Currently, the available disease control method is early case detection and proper management. However, the majority of patients present late with immense disease and for many of them, heroic substantial deforming surgical excisions or amputation are the only prevailing treatment options. In this communication, the Mycetoma Research Center (MRC), Sudan shares its experience in implementing a new holistic approach to manage mycetoma patients locally at the village level. The MRC in collaboration with Sennar State Ministry of Health, Sudan had established a region mycetoma centre in one of the endemic mycetoma villages in the state. The patients were treated locally in that centre, the local medical and health personals were trained on early case detection and management, the local community was trained on mycetoma advocacy, and environmental conditions improvement. This comprehensive approach had also addressed the patients' socioeconomic constraints that hinder early presentation and treatment. This approach has also included the active local health authorities, community and civil society participation and contributions to deliver the best management. This holistic approach for mycetoma patients' management proved to be effective for early case detection and

An assessment of the current municipal solid waste management system in Lahore, Pakistan.

Science.gov (United States)

Masood, Maryam; Barlow, Claire Y; Wilson, David C

2014-09-01

The current status of solid waste management in Lahore, a metropolitan city of Pakistan, is reviewed in this article using an existing approach, the UN-Habitat city profile. This involves a systematic quantitative and qualitative assessment of physical components and governance features of the current waste management system. A material flow diagram (MFD) is developed, which allows visualisation of the current waste management system with all related inputs and outputs. This study shows that in the current system, waste collection and transportation is the main focus, however the collection coverage is only about 68%. There is no controlled or even semi-controlled waste disposal facility in Lahore. There is no official recycling system in the city. It is estimated that currently ~27% of waste by weight is being recycled through the informal sector. Making use of the organic content of the waste, a composting facility is operative in the city, producing 47,230 tonnes year(-1) of organic compost. Lahore does not perform very well in governance features. Inclusivity of users and providers of the waste management system is low in the city, as not all stakeholders are consulted in the decision making processes. Waste management costs US$20 per tonne of waste, where the main focus is only on waste collection, and the current user fees are much lower than the actual costs. This study recommends that recycling should be promoted by increasing public awareness and integrating the informal sector to make the current system sustainable and financially viable. © The Author(s) 2014.

Holistic approach to fraud management in health insurance

Directory of Open Access Journals (Sweden)

Štefan Furlan

2008-12-01

Full Text Available Fraud present an immense problem for health insurance companies and the only way to fight fraud is by using specialized fraud management systems. The current research community focussed great efforts on different fraud detection techniques while neglecting other also important activities of fraud management. We propose a holistic approach that focuses on all 6 activities of fraud management, namely, (1 deterrence, (2 prevention, (3 detection, (4 investigation, (5 sanction and redress, and (6 monitoring. The main contribution of the paper are 15 key characteristics of a fraud management system, which enable construction of a fraud management system that provides effective and efficient support to all fraud management activities. We base our research on literature review, interviews with experts from different fields, and a case study. The case study provides additional confirmation to expert opinions, as it puts our holistic framework into practice.

Current management of peptic ulcer perforations

International Nuclear Information System (INIS)

Menakuru, S.R.

2004-01-01

Perforation is a life-threatening complication of peptic ulcer disease. Smoking and use of non-steroidal anti-inflammatory drugs are important risk factors for perforation. Diagnosis is made clinically and confirmed by the presence of pneumoperitoneum on radiographs. Nonoperative management is successful in patients identified to have a spontaneously sealed perforation proven by water-soluble contrast gastroduodenogram. Operative management consists of the time-honoured practice of mental patch closure, but now this can be done by laparoscopic methods. The practice of addition of acid-reducing procedures is currently being debated though it continues to be recommended in good-risk patients. Laparoscopic approaches to closure of duodenal perforation are now being applied widely and may become the gold standard in the future especially in patients with < 10 mm perforation size presenting within the first 24 hours of onset of pain. The role of Helicobacter pylori in duodenal ulcer perforation is controversial and more studies are needed to answer this question though recent indirect evidence suggests that eradicating H pylori may reduce the necessity for adding acid reducing procedures and the associated morbidity. Perforation is a life-threatening complication of peptic ulcer disease. The management of peptic ulcer disease has evolved over the decades, due to advances in operative techniques, bacteriology and pharmacology. While the recognition of the role of Helicobacter pylori (H. pylori) in peptic ulceration has resulted in a paradigm shift in the management of uncomplicated peptic ulcers, debate continues about the appropriate management of perforated duodenal bulb and prepyloric ulcers. A new dimension has been added to this controversy by the advent of laparoscopic techniques for closing the perforation. A Medline search of all articles dealing with the management of peptic ulcer perforation published after 1985 was undertaken. The short listed articles were

Management of infantile hemangiomas: Current trends

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Gomathy Sethuraman

2014-01-01

Full Text Available Infantile hemangiomas (IH are common vascular tumours. IH have a characteristic natural course. They proliferate rapidly during the early infantile period followed by a period of gradual regression over several years. Most of the uncomplicated IH undergo spontaneous involution, with a small proportion of cases requiring intervention. These are children with IH in life-threatening locations, local complications like haemorrhage, ulceration and necrosis and functional or cosmetic disfigurements. Systemic corticosteroids have been the first line of treatment for many years. Recently, non-selective beta-blockers, such as oral propranalol and topical timolol, have emerged as promising and safer therapies. Other treatment options include interferon α and vincristine which are reserved for life-threatening haemangiomas that are unresponsive to conventional therapy. This review mainly focuses on the current trends and evidence-based approach in the management of IH.

Contaminated land in Colombia: A critical review of current status and future approach for the management of contaminated sites.

Science.gov (United States)

Arias Espana, Victor Andres; Rodriguez Pinilla, Alfonso R; Bardos, Paul; Naidu, Ravi

2018-03-15

Environmental contaminants can have negative effects on human health and land, air and water resources. Consequently, there have been significant advances in regulation for protecting the environment in developed countries including the development of remediation frameworks and guidelines. On the other hand, fewer studies have been reported on the risks and health effects of contaminants in developing regions and there is scarce information regarding contaminated land assessment and environmental remediation. Colombia is an important emerging economy and has started to take the first steps towards the development of a framework for the management of contaminated sites and there are opportunities for the country to learn from countries with well-established frameworks such as the United States (US) and the United Kingdom (UK) and for international collaboration with organisations such as CRC for Contamination Assessment and Remediation of the Environment (CARE). We review main pollution issues, current status of contaminated land management in Colombia to identify the gaps in policy and regulation. We also review the UK and US contaminated land policies and regulations to identify the elements of those experiences that could support progress in the country. Finally, we propose recommendations (e.g. risk based approach, soil screening criteria, clean-up funding, liability) for Colombia that could support further development and implementation of a more effective contaminated land management framework. Copyright © 2017 Elsevier B.V. All rights reserved.

Management of Neuropsychiatric Systemic Lupus Erythematosus: Current Approaches and Future Perspectives.

Science.gov (United States)

Magro-Checa, César; Zirkzee, Elisabeth J; Huizinga, Tom W; Steup-Beekman, Gerda M

2016-03-01

Neuropsychiatric systemic lupus erythematosus (NPSLE) is a generic definition referring to a series of neurological and psychiatric symptoms directly related to systemic lupus erythematosus (SLE). NPSLE includes heterogeneous and rare neuropsychiatric (NP) manifestations involving both the central and peripheral nervous system. Due to the lack of a gold standard, the attribution of NP symptoms to SLE represents a clinical challenge that obligates the strict exclusion of any other potential cause. In the acute setting, management of these patients does not differ from other non-SLE subjects presenting with the same NP manifestation. Afterwards, an individualized therapeutic strategy, depending on the presenting manifestation and severity of symptoms, must be started. Clinical trials in NPSLE are scarce and most of the data are extracted from case series and case reports. High-dose glucocorticoids and intravenous cyclophosphamide remain the cornerstone for patients with severe symptoms that are thought to reflect inflammation or an underlying autoimmune process. Rituximab, intravenous immunoglobulins, or plasmapheresis may be used if response is not achieved. When patients present with mild to moderate NP manifestations, or when maintenance therapy is warranted, azathioprine and mycophenolate may be considered. When symptoms are thought to reflect a thrombotic underlying process, anticoagulation and antiplatelet agents are the mainstay of therapy, especially if antiphospholipid antibodies or antiphospholipid syndrome are present. Recent trials on SLE using new biologicals, based on newly understood SLE mechanisms, have shown promising results. Based on what we currently know about its pathogenesis, it is tempting to speculate how these new therapies may affect the management of NPSLE patients. This article provides a comprehensive and critical review of the literature on the epidemiology, pathophysiology, diagnosis, and management of NPSLE. We describe the most

Lean management in the current context of evolution of an organization

Directory of Open Access Journals (Sweden)

AMALIA VENERA TODORUŢ

2011-06-01

Full Text Available In this paper I have approached issues concerning the importance of Lean Management method in the current context of evolution of an organization. With roots in the just in time method, Lean Management model focuses on the process of changes evolving and adapting to them and regards issues such as: the dimensioning of life cycle, the dimensioning of processes, the dimensioning of ranges of products. I have also presented the relationship between Lean Management method and the human factor as a determinant in forming an organizational culture which leads to the formation and development of Lean thinking. Relevant factors which determine the change and interact with the Lean Management method are: training, motivation, teamwork spirit, communication methods, training and motivation. An important aspect of this paper is to integrate Lean Management with Six Sigma, and with other managerial techniques leading to getting quality products at low costs

Current diagnostic approaches to subarachnoid haemorrhage

International Nuclear Information System (INIS)

U-King-Im, Jean Marie; Koo, Brendan; Trivedi, Rikin A.; Higgins, Nicholas J.; Tay, Keng Y.; Cross, Justin J.; Antoun, Nagui M.; Gillard, Jonathan H.

2005-01-01

Over the past decade, significant advances have been made in the field of subarachnoid haemorrhage (SAH). Prompt diagnosis with high-resolution CT and intensive critical care support remain key aspects of good patient management. Early identification and definitive treatment of underlying ruptured aneurysms is generally advocated to reduce the risk of re-bleeding, a complication with high mortality and morbidity. Although intra-arterial digital subtraction angiography (DSA) is still considered the gold standard for sourcing aneurysms, CT angiography, especially with the evolution of multi-slice technology, is slowly gaining acceptance as a rapid, accessible and minimally invasive method which appears likely to replace DSA as first-line modality in the future. Furthermore, the advent of Guglielmi detachable coils and the ISAT trial have revolutionised the treatment of ruptured aneurysms, with a significant trend towards endovascular coiling away from operative clipping. Improvements in clinical experience, coiling technology and assistive devices now allow interventionalists to potentially treat the majority of aneurysms, including wide-necked or complex lesions. The uncertain long-term results of coiling, however, still fuel strong debate and controversy. This review summarises current diagnostic approaches to SAH from a radiological perspective, with an emphasis on aneurysmal SAH and an evidence-based approach to the role of imaging and interventional radiology in diagnosis, treatment and follow-up. (orig.)

Current diagnostic approaches to subarachnoid haemorrhage

Energy Technology Data Exchange (ETDEWEB)

U-King-Im, Jean Marie; Koo, Brendan; Trivedi, Rikin A.; Higgins, Nicholas J.; Tay, Keng Y.; Cross, Justin J.; Antoun, Nagui M.; Gillard, Jonathan H. [Addenbrooke' s Hospital, University Department of Radiology, Cambridge (United Kingdom)

2005-06-01

Over the past decade, significant advances have been made in the field of subarachnoid haemorrhage (SAH). Prompt diagnosis with high-resolution CT and intensive critical care support remain key aspects of good patient management. Early identification and definitive treatment of underlying ruptured aneurysms is generally advocated to reduce the risk of re-bleeding, a complication with high mortality and morbidity. Although intra-arterial digital subtraction angiography (DSA) is still considered the gold standard for sourcing aneurysms, CT angiography, especially with the evolution of multi-slice technology, is slowly gaining acceptance as a rapid, accessible and minimally invasive method which appears likely to replace DSA as first-line modality in the future. Furthermore, the advent of Guglielmi detachable coils and the ISAT trial have revolutionised the treatment of ruptured aneurysms, with a significant trend towards endovascular coiling away from operative clipping. Improvements in clinical experience, coiling technology and assistive devices now allow interventionalists to potentially treat the majority of aneurysms, including wide-necked or complex lesions. The uncertain long-term results of coiling, however, still fuel strong debate and controversy. This review summarises current diagnostic approaches to SAH from a radiological perspective, with an emphasis on aneurysmal SAH and an evidence-based approach to the role of imaging and interventional radiology in diagnosis, treatment and follow-up. (orig.)

Advancing current approaches to disease management evaluation: capitalizing on heterogeneity to understand what works and for whom.

Science.gov (United States)

Elissen, Arianne M J; Adams, John L; Spreeuwenberg, Marieke; Duimel-Peeters, Inge G P; Spreeuwenberg, Cor; Linden, Ariel; Vrijhoef, Hubertus J M

2013-03-14

Evaluating large-scale disease management interventions implemented in actual health care settings is a complex undertaking for which universally accepted methods do not exist. Fundamental issues, such as a lack of control patients and limited generalizability, hamper the use of the 'gold-standard' randomized controlled trial, while methodological shortcomings restrict the value of observational designs. Advancing methods for disease management evaluation in practice is pivotal to learn more about the impact of population-wide approaches. Methods must account for the presence of heterogeneity in effects, which necessitates a more granular assessment of outcomes. This paper introduces multilevel regression methods as valuable techniques to evaluate 'real-world' disease management approaches in a manner that produces meaningful findings for everyday practice. In a worked example, these methods are applied to retrospectively gathered routine health care data covering a cohort of 105,056 diabetes patients who receive disease management for type 2 diabetes mellitus in the Netherlands. Multivariable, multilevel regression models are fitted to identify trends in clinical outcomes and correct for differences in characteristics of patients (age, disease duration, health status, diabetes complications, smoking status) and the intervention (measurement frequency and range, length of follow-up). After a median one year follow-up, the Dutch disease management approach was associated with small average improvements in systolic blood pressure and low-density lipoprotein, while a slight deterioration occurred in glycated hemoglobin. Differential findings suggest that patients with poorly controlled diabetes tend to benefit most from disease management in terms of improved clinical measures. Additionally, a greater measurement frequency was associated with better outcomes, while longer length of follow-up was accompanied by less positive results. Despite concerted efforts to adjust

Nanorobotics current approaches and techniques

CERN Document Server

Ferreira, Antoine

2013-01-01

Nanorobot devices now perform a wide variety of tasks at the nanoscale in a wide variety of fields including but not limited to fields such as manufacturing, medicine, supply chain, biology, and outer space. Nanorobotics: Current Approaches and Techniques is a comprehensive overview of this interdisciplinary field with a wide ranging discussion that includes nano-manipulation and industrial nanorobotics, nanorobotics in biology and medicine, nanorobotic sensing, navigation and swarm behavior, and protein and DNA-based nanorobotics. Also included is the latest on topics such as bio-nano-actuators and propulsion and navigation of nanorobotic systems using magnetic fields. Nanorobotics: Current Approaches and Techniques is an ideal book for scientists, researchers, and engineers actively involved in applied and robotic research and development.

Optimizing nitrogen fertilizer use: Current approaches and simulation models

International Nuclear Information System (INIS)

Baethgen, W.E.

2000-01-01

Nitrogen (N) is the most common limiting nutrient in agricultural systems throughout the world. Crops need sufficient available N to achieve optimum yields and adequate grain-protein content. Consequently, sub-optimal rates of N fertilizers typically cause lower economical benefits for farmers. On the other hand, excessive N fertilizer use may result in environmental problems such as nitrate contamination of groundwater and emission of N 2 O and NO. In spite of the economical and environmental importance of good N fertilizer management, the development of optimum fertilizer recommendations is still a major challenge in most agricultural systems. This article reviews the approaches most commonly used for making N recommendations: expected yield level, soil testing and plant analysis (including quick tests). The paper introduces the application of simulation models that complement traditional approaches, and includes some examples of current applications in Africa and South America. (author)

A total system approach to sustainable pest management

Science.gov (United States)

Lewis, W. J.; van Lenteren, J. C.; Phatak, Sharad C.; Tumlinson, J. H.

1997-01-01

A fundamental shift to a total system approach for crop protection is urgently needed to resolve escalating economic and environmental consequences of combating agricultural pests. Pest management strategies have long been dominated by quests for “silver bullet” products to control pest outbreaks. However, managing undesired variables in ecosystems is similar to that for other systems, including the human body and social orders. Experience in these fields substantiates the fact that therapeutic interventions into any system are effective only for short term relief because these externalities are soon “neutralized” by countermoves within the system. Long term resolutions can be achieved only by restructuring and managing these systems in ways that maximize the array of “built-in” preventive strengths, with therapeutic tactics serving strictly as backups to these natural regulators. To date, we have failed to incorporate this basic principle into the mainstream of pest management science and continue to regress into a foot race with nature. In this report, we establish why a total system approach is essential as the guiding premise of pest management and provide arguments as to how earlier attempts for change and current mainstream initiatives generally fail to follow this principle. We then draw on emerging knowledge about multitrophic level interactions and other specific findings about management of ecosystems to propose a pivotal redirection of pest management strategies that would honor this principle and, thus, be sustainable. Finally, we discuss the potential immense benefits of such a central shift in pest management philosophy. PMID:9356432

Neuroeconomics and Management Educations: Perspectives for New Applications and Approaches

Directory of Open Access Journals (Sweden)

Titov Sergei

2016-01-01

Full Text Available Since the 1990s economics started importing interesting insights from psychology and the new discipline of behavioral economics elaborated many interesting models that changed the traditional economic and management theories. Nowadays the applications from neuroscience are extensively used in economics which led to the birth of neuroeconomics. The article attempts to overview the current state and topics in neuroscience and neuroeconomics in order to elaborate the suggestions pertaining to management education. The article is based on several examples of the neuroeconomic research and formulates new applications and approaches to management training curriculum and methods of learning.

[Improvement approaches in the hospital setting: From total quality management to Lean].

Science.gov (United States)

Curatolo, N; Lamouri, S; Huet, J-C; Rieutord, A

2015-07-01

Hospitals have to deal strong with economic constraints and increasing requirements in terms of quality and safety of care. To address these constraints, one solution could be the adoption of approaches from the industry sector. Following the decree of April 6, 2011 on the quality management of the medication use process, some of these approaches, such as risk management, are now part of the everyday work of healthcare professionals. However, other approaches, such as business process improvement, are still poorly developed in the hospital setting. In this general review, we discuss the main approaches of business process improvements that have been used in hospitals by focusing specifically on one of the newest and most currently used: Lean. Copyright © 2014. Published by Elsevier Masson SAS.

The Branding Management Approaches

Institute of Scientific and Technical Information of China (English)

YAKOUBI; Mohamed Lamine

2014-01-01

[Abstract]We wil try to present,through the display of the various branding concepts and theories, the different branding management approaches.This wil present the different visions of the discipline depending on the author to try and demonstrate their differences,at first, and their complementarities at last to help the different branding management practitioners (brand managers,marketing managers,advertisers,media-planners……) apprehend the right brand positioning strategy to engage.

Treasury Financial Management company in the current economic crisis

Directory of Open Access Journals (Sweden)

FLOAREA GEORGESCU

2015-03-01

Full Text Available Abstract. Any management decision has a direct monetary impact on the structure uses and sources of cash. Cash Management aims to permanently maintain a balance between inflows and outflows of cash and cash to predict the impact of any operational decisions that could affect these flows. The success of any business requires good management of all these flows. The principle of this approach is relatively simple: using a minimum of ores to obtain maximum performance in a given period. Cash management is an extremely complex issue, and balancing receipts and payments flow is a constant struggle for survival of firms. In It work we will focus on how they are oriented in a going concern basis, cash inflows and financing needs of current operations. Managers should understand and know the specific movements of cash within the business system, driven daily decisions on operating, investing or financing, and a variety of external circumstances which affect the company. Such decisions and events can affect the company's ability to pay its obligations to obtain credit from suppliers, banks or credit institutions and to maintain an operational level in line with the company's products and services through investments.

Risk Management Standards: Towards a contemporary, organisation-wide management approach

OpenAIRE

Koutsoukis, Nikitas-Spiros

2010-01-01

Risk management has been progressively evolving into a systemic approach for organisational decision making in today’s dynamic economic environment of the global era. In this context, risk management is reaching beyond its traditional finance and insurance application context and is entering the sphere of generic, organisation-wide management approaches. In support of this argument we consider four generic risk management standards issued at the institutional, national or international level...

In acceptance we trust? Conceptualising acceptance as a viable approach to NGO security management.

Science.gov (United States)

Fast, Larissa A; Freeman, C Faith; O'Neill, Michael; Rowley, Elizabeth

2013-04-01

This paper documents current understanding of acceptance as a security management approach and explores issues and challenges non-governmental organisations (NGOs) confront when implementing an acceptance approach to security management. It argues that the failure of organisations to systematise and clearly articulate acceptance as a distinct security management approach and a lack of organisational policies and procedures concerning acceptance hinder its efficacy as a security management approach. The paper identifies key and cross-cutting components of acceptance that are critical to its effective implementation in order to advance a comprehensive and systematic concept of acceptance. The key components of acceptance illustrate how organisational and staff functions affect positively or negatively an organisation's acceptance, and include: an organisation's principles and mission, communications, negotiation, programming, relationships and networks, stakeholder and context analysis, staffing, and image. The paper contends that acceptance is linked not only to good programming, but also to overall organisational management and structures. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

Approach for systematic evaluation of transuranic waste management alternatives

International Nuclear Information System (INIS)

Hong, K.; Koebnick, B.; Kotek, T.

1994-01-01

This paper describes an approach for systematic evaluation of management alternatives that are being considered for the treatment, storage, and disposal of transuranic waste (TRUW) at U.S. Department of Energy sites. The approach, which is currently under development, would apply WASTE-MGMT, a database application model developed at Argonne National Laboratory, to estimate projected environmental releases and would evaluate impact measures such as health risk and costs associated with each of the waste management alternatives. The customized application would combine site-specific TRUW inventory and characterization data with treatment and transportation parameters to estimate the quantities and characteristics of the wastes to be treated, emissions of hazardous substances from the treatment facilities, and the quantities and characteristics of the wastes to be shipped between sites. These data would then be used to estimate for several TRUW management scenarios the costs and health risks of constructing and operating the required treatment facilities and of transporting TRUW for treatment and final disposal. Treatment, storage, and disposal of TRUW at DOE sites is composed of many variables and options at each stage. The approach described in this paper would provide for efficient consideration of all of these facets when evaluating potentially feasible TRUW management alternatives. By expanding existing databases, this model could eventually be adapted to accommodate the introduction of new treatment technologies, updated TRUW characterization data, and/or revised waste acceptance criteria

Management Approach for NASA's Earth Venture-1 (EV-1) Airborne Science Investigations

Science.gov (United States)

Guillory, Anthony R.; Denkins, Todd C.; Allen, B. Danette

2013-01-01

The Earth System Science Pathfinder (ESSP) Program Office (PO) is responsible for programmatic management of National Aeronautics and Space Administration's (NASA) Science Mission Directorate's (SMD) Earth Venture (EV) missions. EV is composed of both orbital and suborbital Earth science missions. The first of the Earth Venture missions is EV-1, which are Principal Investigator-led, temporally-sustained, suborbital (airborne) science investigations costcapped at $30M each over five years. Traditional orbital procedures, processes and standards used to manage previous ESSP missions, while effective, are disproportionally comprehensive for suborbital missions. Conversely, existing airborne practices are primarily intended for smaller, temporally shorter investigations, and traditionally managed directly by a program scientist as opposed to a program office such as ESSP. In 2010, ESSP crafted a management approach for the successful implementation of the EV-1 missions within the constructs of current governance models. NASA Research and Technology Program and Project Management Requirements form the foundation of the approach for EV-1. Additionally, requirements from other existing NASA Procedural Requirements (NPRs), systems engineering guidance and management handbooks were adapted to manage programmatic, technical, schedule, cost elements and risk. As the EV-1 missions are nearly at the end of their successful execution and project lifecycle and the submission deadline of the next mission proposals near, the ESSP PO is taking the lessons learned and updated the programmatic management approach for all future Earth Venture Suborbital (EVS) missions for an even more flexible and streamlined management approach.

Scope and approach to management of mixed wastes: introduction to the session

International Nuclear Information System (INIS)

Ausmus, B.S.

1986-01-01

Mixed wastes are those that are termed both radioactive and chemically hazardous based on regulatory criteria in the United States. Historically, mixed wastes that could be classified as radioactive wastes were treated, stored, and disposed under statutes governing radioactive wastes. In recent years, it has become apparent that: (a) hazardous wastes are generated in nuclear facilities; (b) many wastes are both radioactive and chemically hazardous; and (c) the management of chemically hazardous wastes and mixed wastes requires reexamination of current waste treatment/disposal methods and development/implementation of modified methods. The purpose of this session is to discuss specific aspects of the mixed waste management problems and to provide a forum for discussion of the technical and institutional barriers to problem solutions. The paper addresses several mixed waste problems and current approaches to their solutions, including: (1) mixed waste management in fuel cycle facilities; (2) mixed waste management in a US Dept. of Energy production facility; and (3) mixed wastes impacts on 10CFR61 compliance. Technical and institutional approaches to mixed waste management are explored in three areas: (1) alternatives for treatment prior to shallow land disposal; (2) potential benefits of recovery of strategic/critical materials from mixed wastes; and (3) shallow land disposal system compatibilities/problems

Product family approach in e-waste management

DEFF Research Database (Denmark)

Parajuly, Keshav; Wenzel, Henrik

2017-01-01

As the need for a more circular model is being increasingly pronounced, a fundamental change in the end-of-life (EoL) management of electrical and electronic products (e-products) is required in order to prevent the resource losses and to promote the reuse of products and components with remaining...... functionality. However, the diversity of product types, design features, and material compositions pose serious challenges for the EoL managers and legislators alike. In order to address these challenges, we propose a framework that is based on the ‘product family’ philosophy, which has been used...... in the manufacturing sector for a long time. For this, the product families can be built based on intrinsic and extrinsic attributes of e-products as well as of the EoL management system. Such an approach has the potential to improve the current EoL practices and to support designers in making EoL thinking operational...

Current Perspectives on Desmoid Tumors: The Mayo Clinic Approach

International Nuclear Information System (INIS)

Joglekar, Siddharth B.; Rose, Peter S.; Sim, Franklin; Okuno, Scott; Petersen, Ivy

2011-01-01

Desmoid tumors are a rare group of locally aggressive, non malignant tumors of fibroblastic origin that can lead to significant morbidity due to local invasion. Despite advances in the understanding of these tumors, their natural history is incompletely understood and the optimal treatment is still a matter of debate. Local control is the main goal of treatment and there has been a change in philosophy regarding the management of these tumors from aggressive surgical resection to function preservation. A multidisciplinary approach is essential to plan local control with acceptable morbidity. The current Mayo Clinic algorithm for the treatment of these tumors is based on institutional experience and the available evidence in the literature: asymptomatic/non progressive lesions away from vital structures are managed with observation and regular imaging; primary or recurrent desmoid tumors which are symptomatic or progressive or near vital structures are managed with wide surgical resection when wide surgical margins are possible with minimal functional and cosmetic loss. When positive or close surgical margins are likely, surgical resection with adjuvant radiotherapy or definitive radiotherapy is preferred. If likely functional or cosmetic deficit is unacceptable, radiotherapy is the treatment of choice. Unresectable lesions are considered for radiotherapy, chemotherapy or newer modalities however an unresectable lesion associated with a painful, functionless, infected extremity is managed with an amputation

Current Perspectives on Desmoid Tumors: The Mayo Clinic Approach

Directory of Open Access Journals (Sweden)

Scott Okuno

2011-08-01

Full Text Available Desmoid tumors are a rare group of locally aggressive, non malignant tumors of fibroblastic origin that can lead to significant morbidity due to local invasion. Despite advances in the understanding of these tumors, their natural history is incompletely understood and the optimal treatment is still a matter of debate. Local control is the main goal of treatment and there has been a change in philosophy regarding the management of these tumors from aggressive surgical resection to function preservation. A multidisciplinary approach is essential to plan local control with acceptable morbidity. The current Mayo Clinic algorithm for the treatment of these tumors is based on institutional experience and the available evidence in the literature: asymptomatic/non progressive lesions away from vital structures are managed with observation and regular imaging; primary or recurrent desmoid tumors which are symptomatic or progressive or near vital structures are managed with wide surgical resection when wide surgical margins are possible with minimal functional and cosmetic loss. When positive or close surgical margins are likely, surgical resection with adjuvant radiotherapy or definitive radiotherapy is preferred. If likely functional or cosmetic deficit is unacceptable, radiotherapy is the treatment of choice. Unresectable lesions are considered for radiotherapy, chemotherapy or newer modalities however an unresectable lesion associated with a painful, functionless, infected extremity is managed with an amputation.

Exploring the current application of professional competencies in human resource management in the South African context

Directory of Open Access Journals (Sweden)

Nico Schutte

2015-11-01

Full Text Available Orientation: Human research (HR practitioners have an important role to play in the sustainability and competitiveness of organisations. Yet their strategic contribution and the value they add remain unrecognised. Research purpose: The main objective of this research was to explore the extent to which HR practitioners are currently allowed to display HR competencies in the workplace, and whether any significant differences exist between perceived HR competencies, based on the respondents’ demographic characteristics. Motivation for the study: Limited empirical research exists on the extent to which HR practitioners are allowed to display key competencies in the South African workplace. Research approach, design, and method: A quantitative research approach was followed. A Human Resource Management Professional Competence Questionnaire was administered to HR practitioners and managers (N = 481. Main findings: The results showed that HR competencies are poorly applied in selected South African workplaces. The competencies that were indicated as having the poorest application were talent management, HR metrics, HR business knowledge, and innovation. The white ethic group experienced a poorer application of all human research management (HRM competencies compared to the black African ethnic group. Practical/managerial implications: The findings of the research highlighted the need for management to evaluate the current application of HR practices in the workplace and also the extent to which HR professionals are involved as strategic business partners. Contribution/value-add: This research highlights the need for the current application of HR competencies in South African workplaces to be improved.

Low current approach to ignition

International Nuclear Information System (INIS)

Cenacchi, G.; Sugiyama, L.; Airoldi, A.; Coppi, B.

1996-01-01

The open-quotes standardclose quotes path to achieve ignition conditions so far has been that of producing plasmas with the maximum current and poloidal field that axe compatible with the applied toroidal field and the geometry of the adopted configuration (the low q a approach.) The other approach is that motivated by recent experiments with reversed shear configurations, with relatively low currents and high fields corresponding to high values of q a (e-g., q a ≅ 6). While the first approach can be pursued with ohmic heating alone, the second one necessarily involves an auxiliary heating system. One of the advantages of this approach is that the onset of large scale internal modes can be avoided as q(ψ) is kept above 1 over the entire plasma column. Since quite peaked density profiles are produced in the regimes where enhanced confinement is observed, the α-particle power levels for which ignition can be reached and therefore the thermal wall loading on the first wall, can be reduced relatively to the standard, low q a , approach. The possibility is considered that ignition is reached in the reversed shear, high q a , regime and that this is followed by a transition to non-reversed profiles, or even the low q a regime, assuming that the excitation of modes involving magnetic reconnection will not undermine the needed degree of confinement. These results have been demonstrated by numerical transport simulation for the Ignitor-Ult machine, but are applicable to all high field ignition experiments

Improvement of radiology services based on the process management approach

International Nuclear Information System (INIS)

Amaral, Creusa Sayuri Tahara; Rozenfeld, Henrique; Costa, Janaina Mascarenhas Hornos; Magon, Maria de Fatima de Andrade; Mascarenhas, Yvone Maria

2011-01-01

The health sector requires continuous investments to ensure the improvement of products and services from a technological standpoint, the use of new materials, equipment and tools, and the application of process management methods. Methods associated with the process management approach, such as the development of reference models of business processes, can provide significant innovations in the health sector and respond to the current market trend for modern management in this sector (Gunderman et al. (2008) ). This article proposes a process model for diagnostic medical X-ray imaging, from which it derives a primary reference model and describes how this information leads to gains in quality and improvements.

Current Status of On-Site Wastewater Management

Science.gov (United States)

Senn, Charles L.

1978-01-01

Wastewater management is becoming an important environmental issue nationally. This article reports the history and current status of wastewater management. Regulatory programs are discussed with specific state examples. Needs assessment is also included. (MA)

Managing projects using a project management approach

Directory of Open Access Journals (Sweden)

Marko D. Andrejić

2011-04-01

Full Text Available Modern management theory treats all complex tasks and duties like projects and make these projects possible to be managed by a particular organizational-management concept in order to achieve a goal effectively. A large number of jobs and tasks performed in the system of defense or for defense purposes have the characteristics of projects. Project management is both a skill and a science of monitoring human, material, financial, energy and other resources to achieve required objectives within the given limits: deadlines, time, budget, possibility of realization and the satisfaction of the interests of all project participants. Project management is a traditional area of applied (or functional management focused on managing complex and uncertain situations with defined goals. Introduction In conditions of rapid change and high uncertainty, only adaptive organizations survive, i. e. those that are able not only to react quickly to changes but also to proactively take advantage of changes. Development of project management The biggest influence on the development of the area had complex jobs within the engineering profession. In parallel with the traditional approach new approaches began to develop, while the traditional one still remained in use. Contrary to the traditional engineering approach, a dynamic model first developed in order to respond to demands for greater control of costs. Project management Project management is a skill and knowledge of human and material resources to achieve set objectives within prescribed limits: deadlines, time, budget, possibility of realization, and the satisfaction of all participants in the project. In order to realize a project effectively, it is necessary to manage it rationally. Planning and project management A project plan is a document that allows all team members insight on where to go, when to start and when to arrive, what is necessary to be done in order to achieve the project objectives and what

Current management of severe dengue infection.

Science.gov (United States)

Lee, Tau Hong; Lee, Linda Kay; Lye, David Chien; Leo, Yee Sin

2017-01-01

Traditionally a disease mainly affecting the pediatric population, dengue burden has increased significantly in recent decades and adults with severe disease may become more common. There is currently no effective anti-viral agent available for the treatment of dengue and supportive care is the mainstay of management. Areas covered: We present a review of current literature on dengue severity classification systems and the management of severe dengue in adults. In particular, emphasis was placed on organ impairment in dengue and management of elderly individuals with multiple medical problems. Expert commentary: There is an urgent need to search for an effective anti-viral agent to treat infected individuals. The commercial availability of a dengue vaccine in older children has provided optimism in reducing the disease burden but long term efficacy and safety are unknown. The results from phase III trials of two new candidate vaccines are eagerly awaited.

Data management in HEP: An approach

CERN Document Server

Furano, F

2011-01-01

In this work we describe an approach to data access and data management in High Energy Physics (HEP), which privileges performance, simplicity and scalability, in storage systems that co-operate. We also show why the typical HEP workload is well positioned to access geographically distributed data repositories and then weigh the advantages and disadvantages of accessing data across the Wide Area Network. We discuss some points related to the architecture that a data access/management system should have in order to exploit these possibilities. Currently, this kind of methods were explored by using the xrootd/Scalla software suite, that is a workable example of a distributed non-transactional data repository for the HEP environment. The Scalla architecture naturally allows us to build globally federated repositories congruent with diverse HEP collaborations and their data access needs. These methodologies, however, are based on the concept of caching associated to a performant messaging system and to an efficie...

Managing corporate capabilities:theory and industry approaches.

Energy Technology Data Exchange (ETDEWEB)

Slavin, Adam M.

2007-02-01

This study characterizes theoretical and industry approaches to organizational capabilities management and ascertains whether there is a distinct ''best practice'' in this regard. We consider both physical capabilities, such as technical disciplines and infrastructure, and non-physical capabilities such as corporate culture and organizational procedures. We examine Resource-Based Theory (RBT), which is the predominant organizational management theory focused on capabilities. RBT seeks to explain the effect of capabilities on competitiveness, and thus provide a basis for investment/divestment decisions. We then analyze industry approaches described to us in interviews with representatives from Goodyear, 3M, Intel, Ford, NASA, Lockheed Martin, and Boeing. We found diversity amongst the industry capability management approaches. Although all organizations manage capabilities and consider them to some degree in their strategies, no two approaches that we observed were identical. Furthermore, we observed that theory is not a strong driver in this regard. No organization used the term ''Resource-Based Theory'', nor did any organization mention any other guiding theory or practice from the organizational management literature when explaining their capabilities management approaches. As such, we concluded that there is no single best practice for capabilities management. Nevertheless, we believe that RBT and the diverse industry experiences described herein can provide useful insights to support development of capabilities management approaches.

Fournier's gangrene current approaches.

Science.gov (United States)

Ozkan, Omer F; Koksal, Neset; Altinli, Ediz; Celik, Atilla; Uzun, Mehmet A; Cıkman, Oztekin; Akbas, Alpaslan; Ergun, Ersin; Kiraz, Hasan A; Karaayvaz, Muammer

2016-10-01

Fournier's gangrene is a rare but highly mortal infectious disease characterised by fulminant necrotising fasciitis involving the genital and perineal regions. The objective of this study is to analyse the demographics, clinical feature and treatment approaches as well as outcomes of Fournier's gangrene. Data were collected retrospectively from medical records and operative notes. Patient data were analysed by demographics, aetiological factors, clinical features, treatment approaches and outcomes. Twelve patients (five female and seven male) were enrolled in this study. The most common aetiology was perianal abscess (41·6%). Wound cultures showed a mixture of microorganisms in six (50%) patients. For faecal diversion, while colostomy was performed in six cases (50%), Flexi-Seal was used in two cases (16·6%). In four patients (33·4%), no faecal diversion was performed. Negative pressure wound therapy (NPWT) system was effective in the last four patients (33·4%). The mean hospitalisation period in patients who used NPWT was 18 days, while it was 20 days in the others. NPWT in Fournier's gangrene is a safe dressing method. It promotes granulation formation. Flexi-Seal faecal management is an alternative method to colostomy and provides protection from its associated complications. The combination of two devices (Flexi-Seal and NPWT) is an effective and comfortable method in the management of Fournier's gangrene in appropriate patients. © 2014 The Authors. International Wound Journal © 2014 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Towards integrated hygiene and food safety management systems: the Hygieneomic approach.

Science.gov (United States)

Armstrong, G D

1999-09-15

Integrated hygiene and food safety management systems in food production can give rise to exceptional improvements in food safety performance, but require high level commitment and full functional involvement. A new approach, named hygieneomics, has been developed to assist management in their introduction of hygiene and food safety systems. For an effective introduction, the management systems must be designed to fit with the current generational state of an organisation. There are, broadly speaking, four generational states of an organisation in their approach to food safety. They comprise: (i) rules setting; (ii) ensuring compliance; (iii) individual commitment; (iv) interdependent action. In order to set up an effective integrated hygiene and food safety management system a number of key managerial requirements are necessary. The most important ones are: (a) management systems must integrate the activities of key functions from research and development through to supply chain and all functions need to be involved; (b) there is a critical role for the senior executive, in communicating policy and standards; (c) responsibilities must be clearly defined, and it should be clear that food safety is a line management responsibility not to be delegated to technical or quality personnel; (d) a thorough and effective multi-level audit approach is necessary; (e) key activities in the system are HACCP and risk management, but it is stressed that these are ongoing management activities, not once-off paper generating exercises; and (f) executive management board level review is necessary of audit results, measurements, status and business benefits.

Integrated Approach for Pain Management in Parkinson Disease.

Science.gov (United States)

Geroin, Christian; Gandolfi, Marialuisa; Bruno, Veronica; Smania, Nicola; Tinazzi, Michele

2016-04-01

Pain, one of the most frequent nonmotor symptoms of Parkinson disease (PD), is recognized as an important component of the illness that adversely affects patient quality of life. The aims of this review are to summarize the current knowledge on the clinical assessment and to provide a detailed overview of the evidence-based pharmacologic and nonpharmacologic approaches to treating pain. Results of a literature search include studies investigating pain/sensory abnormalities in PD. The effects of levodopa administration, deep brain stimulation (DBS), pallidotomy, spinal cord stimulation, rehabilitation, and complementary/alternative medicine are reviewed critically. PD patients have altered pain and sensory thresholds; levodopa and DBS improve pain and change sensory abnormalities toward normal levels through antinociceptive and/or modulatory effects that remain unknown. A wide range of nonpharmacologic approaches require further investigation. A multidisciplinary approach is fundamental in managing pain syndromes in PD.

Best practice in English Local Air Quality Management: principles illustrated by some examples of current practice

Energy Technology Data Exchange (ETDEWEB)

Beattie, C.I.; Ling, K.; Longhurst, J.W.S. [Univ. of the West of England, Faculty of Applied Sciences, Bristol (GB)] [and others

1999-07-01

The Local Air Quality Management (LAQM) process, a holistic approach to management, is well underway in England. The process aims to tackle air pollution problems from a variety of diverse sources, operating over different time scales and spatial areas. Although technical guidance from the Government has been published over the last two years, little guidance has been available for the management aspects of the process. Arguably, the management of air quality will be the crucial test of the LAQM process. Only by collaboration can technologies and policy actions, such as traffic management schemes, be put into effective action. The authors present an overview of the process, including a model of current LAQM procedures in the UK. Current practice is illustrated by way of results from a questionnaire survey of local authorities, health authorities and the Environment Agency and also by reference to specific examples from local authorities. (Author)

Electronic resource management systems a workflow approach

CERN Document Server

Anderson, Elsa K

2014-01-01

To get to the bottom of a successful approach to Electronic Resource Management (ERM), Anderson interviewed staff at 11 institutions about their ERM implementations. Among her conclusions, presented in this issue of Library Technology Reports, is that grasping the intricacies of your workflow-analyzing each step to reveal the gaps and problems-at the beginning is crucial to selecting and implementing an ERM. Whether the system will be used to fill a gap, aggregate critical data, or replace a tedious manual process, the best solution for your library depends on factors such as your current soft

Untangling approaches to management and leadership across systems of medical education.

Science.gov (United States)

Hartley, Kathy

2016-05-24

How future doctors might be educated and trained in order to meet the population and system needs of countries is currently being debated. Incorporation of a broad range of capabilities, encompassed within categories of management and, increasingly, leadership, form part of this discussion. The purpose of this paper is to outline a framework by which countries' progress in this area might be assessed and compared. Key databases and journals related to this area were reviewed. From relevant articles potential factors impacting on the incorporation of aspects of management and leadership within medical education and training were identified. These factors were tested via an online survey during 2013 with six members of a European Association of doctors who promote medical involvement in hospital management, including members from countries less represented in the health management literature. A framework for analysing how management and leadership education is being approached within different systems of healthcare is developed and presented. More systematic work across a wider range of countries is needed if we are to have a better understanding of how countries within and beyond Europe are approaching and progressing the education of doctors in management and leadership.

Pubertal induction in hypogonadism: Current approaches including use of gonadotrophins.

Science.gov (United States)

Zacharin, Margaret

2015-06-01

Primary disorders of the gonad or those secondary to abnormalities of the hypothalamic pituitary axis result in hypogonadism. The range of health problems of childhood and adolescence that affect this axis has increased, as most children now survive chronic illness, but many have persisting deficits in gonadal function as a result of their underlying condition or its treatment. An integrated approach to hormone replacement is needed to optimize adult hormonal and bone health, and to offer opportunities for fertility induction and preservation that were not considered possible in the past. Timing of presentation ranges from birth, with disorders of sexual development, through adolescent pubertal failure, to adult fertility problems. This review addresses diagnosis and management of hypogonadism and focuses on new management strategies to address current concerns with fertility preservation. These include Turner syndrome, and fertility presevation prior to childhood cancer treatment. New strategies for male hormone replacement therapy that may impinge upon future fertility are emphasized. Copyright © 2015 Elsevier Ltd. All rights reserved.

Improvement of radiology services based on the process management approach.

Science.gov (United States)

Amaral, Creusa Sayuri Tahara; Rozenfeld, Henrique; Costa, Janaina Mascarenhas Hornos; Magon, Maria de Fátima de Andrade; Mascarenhas, Yvone Maria

2011-06-01

The health sector requires continuous investments to ensure the improvement of products and services from a technological standpoint, the use of new materials, equipment and tools, and the application of process management methods. Methods associated with the process management approach, such as the development of reference models of business processes, can provide significant innovations in the health sector and respond to the current market trend for modern management in this sector (Gunderman et al. (2008) [4]). This article proposes a process model for diagnostic medical X-ray imaging, from which it derives a primary reference model and describes how this information leads to gains in quality and improvements. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Management of reprocessed uranium. Current status and future prospects

International Nuclear Information System (INIS)

2007-02-01

There is worldwide interest in developing advanced and innovative technologies for nuclear fuel cycles, minimizing waste and environmental impacts. As of the beginning of 2003, about 171000 tonnes heavy metal spent nuclear fuel is in storage, while smaller amounts have been reprocessed. In several countries, including France, India, Japan and the Russian Federation, spent fuel has been viewed as a national energy resource. Some countries hold reprocessed uranium as the result of their commercial reprocessing service contracts for reprocessing the spent fuel of others. Reprocessed uranium has a potential value for recycling either directly or after appropriate treatment. This report analyses the existing options, approaches and developments in the management of reprocessed uranium. It includes the technical issues involved in managing reprocessed uranium which are RepU arisings, storage, chemical conversion, re-enrichment, fuel fabrication, transport, reactor irradiation, subsequent reprocessing and disposal options, as well as assessment of holistic environmental impacts. The objective of this document is to overview the information on the current status and future trends in the management of RepU and to identify major issues to be considered for future projects

Approaches to the management of antenatally diagnosed congenital tumours

International Nuclear Information System (INIS)

Mahony, Rhona; McParland, Peter

2009-01-01

Congenital fetal tumours are rare, but current imaging modalities including US and MRI facilitate antenatal diagnosis and investigation, allowing a presumptive diagnosis and management strategy. Although the prevalence of fetal tumours is difficult to ascertain, an incidence of 7.2 per 100,000 live births has previously been reported, with the incidence of neonatal malignancy estimated at 36.5 per million births. Teratomas and neuroblastomas are the most common solid tumours described. Tumours may be very large or associated with severe hydrops leading to significant dystocia with the potential for difficult vaginal or caesarean delivery. Once the diagnosis of a fetal tumour is made, optimal management incorporates a multidisciplinary approach including obstetrician, neonatologist, paediatric surgeon and paediatric oncologist so that counselling is appropriate and a clear management plan is in place for parents. (orig.)

Approaches to the management of antenatally diagnosed congenital tumours

Energy Technology Data Exchange (ETDEWEB)

Mahony, Rhona; McParland, Peter [National Maternity Hospital, Department of Fetal and Maternal Medicine, Dublin (Ireland)

2009-11-15

Congenital fetal tumours are rare, but current imaging modalities including US and MRI facilitate antenatal diagnosis and investigation, allowing a presumptive diagnosis and management strategy. Although the prevalence of fetal tumours is difficult to ascertain, an incidence of 7.2 per 100,000 live births has previously been reported, with the incidence of neonatal malignancy estimated at 36.5 per million births. Teratomas and neuroblastomas are the most common solid tumours described. Tumours may be very large or associated with severe hydrops leading to significant dystocia with the potential for difficult vaginal or caesarean delivery. Once the diagnosis of a fetal tumour is made, optimal management incorporates a multidisciplinary approach including obstetrician, neonatologist, paediatric surgeon and paediatric oncologist so that counselling is appropriate and a clear management plan is in place for parents. (orig.)

United States high-level radioactive waste management program: Current status and plans

International Nuclear Information System (INIS)

Williams, J.

1992-01-01

The inventory of spent fuel in storage at reactor sites in the United States is approximately 20,000 metric tons heavy metal (MTHM). It is increasing at a rate of 1700 to 2100 MTHM per year. According to current projections, by the time the last license for the current generation of nuclear reactors expires, there will be an estimated total of 84,000 MTHm. No commercial reprocessing capacity exists or is planned in the US. Therefore, the continued storage of spent fuel is required. The majority of spent fuel remains in the spent fuel pools of the utilities that generated it. Three utilities are presently supplementing pool capacity with on-site dry storage technologies, and four others are planning dry storage. Commercial utilities are responsible for managing their spent fuel until the Federal waste management system, now under development, accepts spent fuel for storage and disposal. Federal legislation charges the Office of Civilian Radioactive Waste Management (OCRWM) within the US Department of Energy (DOE) with responsibility for developing a system to permanently dispose of spent fuel and high level radioactive waste in a manner that protects the health and safety of the public and the quality of the environment. We are developing a waste management system consisting for three components: a mined geologic repository, with a projected start date of 2010; a monitored retrievable storage facility (MRS), scheduled to begin waste acceptance in 1998; and a transportation system to support MRS and repository operations. This paper discusses the background and framework for the program, as well as the current status and plans for management of spent nuclear fuel at commercial utilities; the OCRWM's development of a permanent geologic repository, an MRS, and a transportation system; the OCRWM's safety approach; the OCRWM's program management initiatives; and the OCRWM's external relations activities

Simple engineering design for complex thermoelectric generators based on reduced current approach

DEFF Research Database (Denmark)

Wijesooriyage, Waruna Dissanayaka; Rezaniakolaei, Alireza; Rosendahl, Lasse

2015-01-01

Thermoelectric generators (TEGs) are niche candidate for the field of energy management as electrical generator devices. Generally, comprehensive and accurate design techniques for TEGs (thermoelectric generators), such as reduced current approach (RCA), are complex and time consuming processes....... This study develops a simple, comprehensive and accurate TEG designing technique based on RCA. The proposed method can predict the most efficient TEG architecture with more than 97% accuracy comparing to the RCA over wide range of possible temperature and zT for present TEG applications. Moreover...

Strengthening the Focus on Business Results: The Need for Systems Approaches in Organizational Behavior Management

Science.gov (United States)

Hyten, Cloyd

2009-01-01

Current Organizational Behavior Management (OBM) research and practice may be characterized as either behavior focused or results focused. These two approaches stem from different origins and have different characteristics. The behavior-focused approach stems from applied behavior analysis (ABA) methods and emphasizes direct observation of and…

Current best practice in the management of Turner syndrome

Science.gov (United States)

Shankar, Roopa Kanakatti; Backeljauw, Philippe F.

2017-01-01

Turner syndrome (TS) is characterized by partial or complete loss of the second X-chromosome in phenotypic females resulting in a constellation of clinical findings that may include lymphedema, cardiac anomalies, short stature, primary ovarian failure and neurocognitive difficulties. Optimizing health care delivery is important to enable these individuals achieve their full potential. We review the current best practice management recommendations for individuals with TS focusing on the latest consensus opinion in regard to genetic diagnosis, treatment of short stature, estrogen supplementation, addressing psychosocial issues, as well screening for other comorbidities. A multidisciplinary approach and a well-planned transition to adult follow-up care will improve health care delivery significantly for this population. PMID:29344338

DOE waste management program-current and future

International Nuclear Information System (INIS)

Coleman, J.A.

1993-01-01

The back end of the nuclear fuel cycle, as well as many operations in the Department of Energy, involves management of radioactive and hazardous waste and spent nuclear fuel. Described herein is the current and anticipated Department's Waste Management Program and general information about the Program for managing and disposing of waste that will illustrate the importance of air cleaning and treatment in assuring protection of the public and our environment. The structure and responsibilities of the Office of Environmental Restoration and Waste Management (EM) are described. The categories of waste managed by the Office of Waste Management (OWM) are defined. The problems of waste management, waste minimization, and waste treatment, storage, and disposal are discussed. 4 figs

Integrated management system - management standards evolution and the IAEA new approach

International Nuclear Information System (INIS)

Oliveira, Dirceu Paulo de; Zouain, Desiree Moraes

2007-01-01

The management standards application began in military and nuclear areas towards the end of Second World War, when some westerns countries developed quality standards to improve their means to assess suppliers' conditions to assure their products conformance, which was increasingly complex and required a higher degree of reliability. Afterwards, the quality standards application was extended to the consumer market focused on consumers' requirements satisfaction. Coming along the society crescent concern about quality of life, other management standards were developed, such as those dealing with environmental and sustainable development, occupational health and safety, social accountability and so on. As a consequence, the management process became complex. The management system integrated form approach makes possible the compatibility of distinct and complementary interests from several functions and disciplines involved and supply the absence of the organizations' holistic approach. According to this integrated management approach, the Agency - 'International Atomic Energy Agency' (IAEA) - decided to review the structure of the 50-C-Q standard - 'Quality Assurance for Safety in Nuclear Power Plants and Other Nuclear Installations', from 1996, publishing in 2006 the new GS-R-3 standard - 'The Management System for Facilities and Activities - Safety Requirements'. This work presents a brief evolution of management standards and integrated management approach, showing the Agency's new vision concerning this issue with the GS-R-3 standard publication. (author)

A holistic approach to managing a patient with heart failure.

Science.gov (United States)

Duncan, Alison; Cunnington, Colin

2013-03-01

Despite varied and complex therapeutic strategies for managing patients with heart failure, the prognosis may remain poor in certain groups. Recognition that patients with heart failure frequently require input from many care groups formed the basis of The British Society of Heart Failure Annual Autumn Meeting in London (UK), in November 2012, entitled: 'Heart failure: a multidisciplinary approach'. Experts in cardiology, cardiac surgery, general practice, care of the elderly, palliative care and cardiac imaging shared their knowledge and expertise. The 2-day symposium was attended by over 500 participants from the UK, Europe and North America, and hosted physicians, nurses, scientists, trainees and representatives from the industry, as well as patient and community groups. The symposium, accredited by the Royal College of Physicians and the Royal College of Nursing, focused on the multidisciplinary approach to heart failure, in particular, current therapeutic advances, cardiac remodeling, palliative care, atrial fibrillation, heart rate-lowering therapies, management of acute heart failure and the management of patients with mitral regurgitation and heart failure.

APPROACHES TO QUALITY MANAGEMENT AT EUROPEAN LEVEL

Directory of Open Access Journals (Sweden)

Salagean Horatiu Catalin

2013-07-01

Full Text Available In the current economic context, quality has become a source of competitive advantage and organizations must perceive quality as something natural and human in order to achieve excellence. The proper question for the context of the internationalisation of the economy is whether the culture of the regions, states or nations affects the development in the quality management field and the quality approach. The present study tries to give a theoretical approach of how culture influences the quality approach at the European level. The study deals only with the European quality approach, beacuse at European level one could meet a great variety of models and methodologies. In the U.S.A. and Japan one could identify a specific cultural approach regarding quality. At the European level, we cannot discuss in the same terms, because each country has a different cultural specifics in terms of quality. In order to determine the cultural specificity of the countries surveyed, the study has used the most popular analysis tool of cultural dimensions, namely the Dutch Professor Geert Hofstede\\'s model. The model illustrates according to a survey, the organizational behavior of several countries and was able to identify a set of variables and fundamental dimensions, that differentiates one culture from another. An attempt was made to see if there are connections between the values of Hofestede \\'s cultural dimensions and the quality characteristics in the analysed countries. The study, describes on the one hand,the quality evolution from quality control to Total Quality Management and on the other hand, focuses on the quality approach modalities at European level. The second part of the paper is structured into two parts, addressing on the one hand the quality in countries of Western Europe, such as United Kingdom, France and Germany,because these three countries are considered to be the exponents of quality development in Western Europe. In the same time, the

The role of adaptive management as an operational approach for resource management agencies

Science.gov (United States)

Johnson, B.L.

1999-01-01

In making resource management decisions, agencies use a variety of approaches that involve different levels of political concern, historical precedence, data analyses, and evaluation. Traditional decision-making approaches have often failed to achieve objectives for complex problems in large systems, such as the Everglades or the Colorado River. I contend that adaptive management is the best approach available to agencies for addressing this type of complex problem, although its success has been limited thus far. Traditional decision-making approaches have been fairly successful at addressing relatively straightforward problems in small, replicated systems, such as management of trout in small streams or pulp production in forests. However, this success may be jeopardized as more users place increasing demands on these systems. Adaptive management has received little attention from agencies for addressing problems in small-scale systems, but I suggest that it may be a useful approach for creating a holistic view of common problems and developing guidelines that can then be used in simpler, more traditional approaches to management. Although adaptive management may be more expensive to initiate than traditional approaches, it may be less expensive in the long run if it leads to more effective management. The overall goal of adaptive management is not to maintain an optimal condition of the resource, but to develop an optimal management capacity. This is accomplished by maintaining ecological resilience that allows the system to react to inevitable stresses, and generating flexibility in institutions and stakeholders that allows managers to react when conditions change. The result is that, rather than managing for a single, optimal state, we manage within a range of acceptable outcomes while avoiding catastrophes and irreversible negative effects. Copyright ?? 1999 by The Resilience Alliance.

The Role of Adaptive Management as an Operational Approach for Resource Management Agencies

Directory of Open Access Journals (Sweden)

Barry L. Johnson

1999-12-01

Full Text Available In making resource management decisions, agencies use a variety of approaches that involve different levels of political concern, historical precedence, data analyses, and evaluation. Traditional decision-making approaches have often failed to achieve objectives for complex problems in large systems, such as the Everglades or the Colorado River. I contend that adaptive management is the best approach available to agencies for addressing this type of complex problem, although its success has been limited thus far. Traditional decision-making approaches have been fairly successful at addressing relatively straightforward problems in small, replicated systems, such as management of trout in small streams or pulp production in forests. However, this success may be jeopardized as more users place increasing demands on these systems. Adaptive management has received little attention from agencies for addressing problems in small-scale systems, but I suggest that it may be a useful approach for creating a holistic view of common problems and developing guidelines that can then be used in simpler, more traditional approaches to management. Although adaptive management may be more expensive to initiate than traditional approaches, it may be less expensive in the long run if it leads to more effective management. The overall goal of adaptive management is not to maintain an optimal condition of the resource, but to develop an optimal management capacity. This is accomplished by maintaining ecological resilience that allows the system to react to inevitable stresses, and generating flexibility in institutions and stakeholders that allows managers to react when conditions change. The result is that, rather than managing for a single, optimal state, we manage within a range of acceptable outcomes while avoiding catastrophes and irreversible negative effects.

Managing the Cumulative Impacts of Land Uses in the Western Canadian Sedimentary Basin: A Modeling Approach

OpenAIRE

Richard, R. Schneider; J. Brad Stelfox; Stan Boutin; Shawn Wasel

2003-01-01

This case study from northeastern Alberta, Canada, demonstrates a fundamentally different approach to forest management in which stakeholders balance conservation and economic objectives by weighing current management options from the point of view of their long-term effects on the forest. ALCES®, a landscape-scale simulation model, is used to quantify the effects of the current regulatory framework and typical industrial practices on a suite of ecological and economic indicators over the nex...

Managing Cardiovascular Disease Risk in Rheumatoid Arthritis: Clinical Updates and Three Strategic Approaches.

Science.gov (United States)

Chodara, Ann M; Wattiaux, Aimée; Bartels, Christie M

2017-04-01

ᅟ: The increase in cardiovascular disease (CVD) risk in rheumatoid arthritis (RA) is well known; however, appropriate management of this elevated risk in rheumatology clinics is less clear. By critically reviewing literature published within the past 5 years, we aim to clarify current knowledge and gaps regarding CVD risk management in RA. We examine recent guidelines, recommendations, and evidence and discuss three approaches: (1) RA-specific management including treat-to-target and medication management, (2) assessment of comprehensive individual risk, and (3) targeting traditional CVD risk factors (hypertension, smoking, hyperlipidemia, diabetes, obesity, and physical inactivity) at a population level. Considering that 75% of US RA visits occur in specialty clinics, further research is needed regarding evidence-based strategies to manage and reduce CVD risk in RA. This review highlights clinical updates including US cardiology and international professional society guidelines, successful evidence-based population approaches from primary care, and novel opportunities in rheumatology care to reduce CVD risk in RA.

Status, Restrictions and Suggested Approaches in Wastewater Management in Rural Areas of Iran

Directory of Open Access Journals (Sweden)

Mohammad Fahiminia

2012-08-01

Full Text Available Please cite this article as: Fahiminia M, Farrokhi M, Talebi M, Memary G, Fazlzadeh Davil M. Status, restrictions and suggested approaches in wastewater management in rural areas of Iran. Arch Hyg Sci 2012;1(1:12-9. Aims of the Study: The objective of this study was to appraise wastewater management approaches in rural areas of Iran, restrictions, effects on environment and also definition of suitable management approaches in wastewater for future. Materials & Methods: This descriptive study was performed in 2010 in rural areas of Iran. A questionnaire was prepared with subjects such as available management approaches on wastewater, suggested approaches on collecting wastewater and its final disposal and was sent to rural area’s wastewater companies in each province. Study results of 4588 rural areas of Iran (with above 200 families were collected. Results were analyzed using mean and percentage. Results: The current available management systems were mainly based on absorption wells. The main problem in this system was high ground water levels, and low permeability of soil. The most important current problem of the absorbing wells was considerable damaging effects on surface and ground water. Conclusions: The current wastewater management in rural areas especially in the field of wastewater collection was improper and undesirable. To overcome the current problem, it is necessary to use collecting methods relative to that of region. Considerable attention is required for the application of reused wastewater in agriculture. References: 1. Wilderer PA, Schreff D. Decentralized and centralized wastewater management: a challenge for technology developers. Wat Sci Tech 2000; 41(1:1-8. 2. Jackson HB. Global needs and developments in urban sanitation. in: Mara D, editor. Low-Cost sewerage. Chichester, UK: John Wiley & Sons; 1996. p. 77-90. 3. UNEP/GPA. Strategy options for sewage management to protect the marine environment. The Netherlands: UNEP

Current approaches to the diagnosis, treatment, and reporting of trichomoniasis and candidosis.

Science.gov (United States)

O'Connor, B H; Adler, M W

1979-02-01

The current approach to the management of trichomoniasis and candidosis in sexually transmitted disease (STD) clinics in England and Wales is described. Microscopy alone was used in the diagnosis of trichomoniasis in 44% of clinics and of candidosis in 35% of clinics. Oral metronidazole was used for the treatment of trichomoniasis in women in 92% of clinics. Vaginal pessaries containing nystatin or clotrimazole were routinely used to treat candidosis in 95% of clinics. Male sexual contacts of female patients with candidosis and trichomoniasis were invited to attend for examination in 88% of clinics. Physicians in 81% of clinics prescribed treatment on epidemiological grounds for male contacts of female patients with trichomoniasis. A more uniform approach to the diagnostic categories used for the quarterly returns for cases treated epidemiologically is recommended.

Adjoint current-based approaches to prostate brachytherapy optimization

International Nuclear Information System (INIS)

Roberts, J. A.; Henderson, D. L.

2009-01-01

This paper builds on previous work done at the Univ. of Wisconsin - Madison to employ the adjoint concept of nuclear reactor physics in the so-called greedy heuristic of brachytherapy optimization. Whereas that previous work focused on the adjoint flux, i.e. the importance, this work has included use of the adjoint current to increase the amount of information available in optimizing. Two current-based approaches were developed for 2-D problems, and each was compared to the most recent form of the flux-based methodology. The first method aimed to take a treatment plan from the flux-based greedy heuristic and adjust via application of the current-displacement, or a vector displacement based on a combination of tissue (adjoint) and seed (forward) currents acting as forces on a seed. This method showed promise in improving key urethral and rectal dosimetric quantities. The second method uses the normed current-displacement as the greedy criterion such that seeds are placed in regions of least force. This method, coupled with the dose-update scheme, generated treatment plans with better target irradiation and sparing of the urethra and normal tissues than the flux-based approach. Tables of these parameters are given for both approaches. In summary, these preliminary results indicate adjoint current methods are useful in optimization and further work in 3-D should be performed. (authors)

Managing projects a team-based approach

CERN Document Server

Brown, Karen A

2010-01-01

Students today are likely to be assigned to project teams or to be project managers almost immediately in their first job. Managing Projects: A Team-Based Approach was written for a wide range of stakeholders, including project managers, project team members, support personnel, functional mangers who provide resources for projects, project customers (and customer representatives), project sponsors, project subcontractors, and anyone who plays a role in the project delivery process. The need for project management is on the rise as product life cycles compress, demand for IT systems increases, and business takes on an increasingly global character. This book adds to the project management knowledge base in a way that fills an unmet need—it shows how teams can apply many of the standard project management tools, as well as several tools that are relatively new to the field. Managing Projects: A Team-Based Approach offers the academic rigor found in most textbooks along with the practical attributes often foun...

Effective emergency management: reconsidering the bureaucratic approach.

Science.gov (United States)

Neal, D M; Phillips, B D

1995-12-01

The command and control approach is compared with the Emergent Human Resources Model (EHRM) approach to emergency management. Four decades of systematic research shows that a rigid, bureaucratic command and control approach to emergency management generally leads to an ineffective emergency response. Previous studies and our own research suggest that flexible, malleable, loosely coupled, organizational configurations can create a more effective disaster response.

E-waste: Environmental Problems and Current Management

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D. Aktsoglou

2010-01-01

Full Text Available In this paper the environmental problems related with the discarded electronic appliances, known as e-waste, are reviewed.Moreover, the current and the future production of e-waste, the potential environmental problems associated with theirdisposal and management practices are discussed whereas the existing e-waste management schemes in Greece and othercountries (Japan, Switzerland are also quoted.

Operations management approach to hospitals.

Science.gov (United States)

Harvey, J; Duguay, C R

1988-06-01

An operations management systems approach can be a useful tool for coordinating and planning in a complex organization. The authors argue for adapting such an approach to health care from the manufacturing industries in order to facilitate strategy formulation, communication and implementation.

Stress Management: A Rational Approach.

Science.gov (United States)

Reeves, Cecil

This workbook was designed for use as the primary resource tool during a l-day participatory stress management seminar in which participants identify stressful situations, conduct analyses, and develop approaches to manage the stressful situations more effectively. Small group warm-up activities designed to introduce participants, encourage…

A Systematic Knowledge Management Approach Using Object-Oriented Theory in Customer Complaint Management

Directory of Open Access Journals (Sweden)

Wusheng Zhang

2010-12-01

Full Text Available Research into the effectiveness of customer complaint management has attracted researchers, yet there has been little discussion on customer complaint management in the context of systematic knowledge management approach particularly in the domain of hotel industry. This paper aims to address such gap through the application of object-oriented theory for which the notation of unified modelling language has been adopted for the representation of the concepts, objects, relationships and vocabularies in the domain. The paper used data from forty seven hotel management staff and academics in hospitalitymanagement to investigate lessons learned and best practices in customer complaint management and knowledge management. By providing insights into the potential of a knowledge management approach using object oriented theory, this study advances our understanding on how a knowledge management approach can systematically support the management of hotel customer complaints.

Management Approach for Earth Venture Instrument

Science.gov (United States)

Hope, Diane L.; Dutta, Sanghamitra

2013-01-01

The Earth Venture Instrument (EVI) element of the Earth Venture Program calls for developing instruments for participation on a NASA-arranged spaceflight mission of opportunity to conduct innovative, integrated, hypothesis or scientific question-driven approaches to pressing Earth system science issues. This paper discusses the EVI element and the management approach being used to manage both an instrument development activity as well as the host accommodations activity. In particular the focus will be on the approach being used for the first EVI (EVI-1) selected instrument, Tropospheric Emissions: Monitoring of Pollution (TEMPO), which will be hosted on a commercial GEO satellite and some of the challenges encountered to date and corresponding mitigations that are associated with the management structure for the TEMPO Mission and the architecture of EVI.

Utilizing a disease management approach to improve ESRD patient outcomes.

Science.gov (United States)

Anand, Shaan; Nissenson, Allen R

2002-01-01

In this era of processes and systems to improve quality, disease management is one methodology to improve care delivery and outcomes for patients with chronic kidney disease (CKD). In most disease management systems a senior renal nurse coordinates all aspects of the patient's care and ensures that the prescribed and necessary care is delivered for both CKD-related and comorbid conditions. The nurse also continually monitors outcomes on quality indicators and key performance measures. These outcome data are then aggregated and analyzed, are compared with local and national benchmarks, and drive the continuous quality improvement (CQI) process. Such a system attempts to centralize the currently fragmented care delivery system, continually improve patient outcomes, and conserve scarce economic resources. Early data suggest a disease management approach may improve both the morbidity and mortality of CKD patients.

Natural Resource Management Schemes as Entry Points for Integrated Landscape Approaches: Evidence from Ghana and Burkina Faso.

Science.gov (United States)

Foli, Samson; Ros-Tonen, Mirjam A F; Reed, James; Sunderland, Terry

2017-04-20

In recognition of the failures of sectoral approaches to overcome global challenges of biodiversity loss, climate change, food insecurity and poverty, scientific discourse on biodiversity conservation and sustainable development is shifting towards integrated landscape governance arrangements. Current landscape initiatives however very much depend on external actors and funding, raising the question of whether, and how, and under what conditions, locally embedded resource management schemes can serve as entry points for the implementation of integrated landscape approaches. This paper assesses the entry point potential for three established natural resource management schemes in West Africa that target landscape degradation with involvement of local communities: the Chantier d'Aménagement Forestier scheme encompassing forest management sites across Burkina Faso and the Modified Taungya System and community wildlife resource management initiatives in Ghana. Based on a review of the current literature, we analyze the extent to which design principles that define a landscape approach apply to these schemes. We found that the CREMA meets most of the desired criteria, but that its scale may be too limited to guarantee effective landscape governance, hence requiring upscaling. Conversely, the other two initiatives are strongly lacking in their design principles on fundamental components regarding integrated approaches, continual learning, and capacity building. Monitoring and evaluation bodies and participatory learning and negotiation platforms could enhance the schemes' alignment with integrated landscape approaches.

Certifying leaders? high-quality management practices and healthy organisations: an ISO-9000 based standardisation approach.

Science.gov (United States)

Montano, Diego

2016-08-05

The present study proposes a set of quality requirements to management practices by taking into account the empirical evidence on their potential effects on health, the systemic nature of social organisations, and the current conceptualisations of management functions within the framework of comprehensive quality management systems. Systematic reviews and meta-analyses focusing on the associations between leadership and/or supervision and health in occupational settings are evaluated, and the core elements of an ISO 9001 standardisation approach are presented. Six major occupational health requirements to high-quality management practices are identified pertaining to communication processes, organisational justice, role clarity, decision making, social influence processes and management support. It is concluded that the quality of management practices may be improved by developing a quality management system of management practices that ensures not only conformity to product but also to occupational safety and health requirements. Further research may evaluate the practicability of the proposed approach.

Current Challenges in Social Media Management

DEFF Research Database (Denmark)

Tørning, Kristian; Jaffari, Zeshan Ali; Vatrapu, Ravi

2015-01-01

and sales, customer support, product innovation etc. To investigate current social media managerial practices, we conducted a multiple case study, employing structured in-depth interviews with social media managers at some of the leading multi-national companies headquartered in Denmark (LEGO®, Mærsk...

Pancreaticoduodenal injuries: Re-evaluating current management ...

African Journals Online (AJOL)

Background. Pancreaticoduodenal injuries are uncommon owing to the protected position of the pancreas and duodenum in the retroperitoneum. Management depends on the extent of injury. This study was undertaken to document outcome of pancreaticoduodenal injuries and to re-evaluate our approach. Patients and ...

ECOSYSTEM APPROACH TO FISHERIES MANAGEMENT IN THE ...

African Journals Online (AJOL)

To date, fisheries management has been based largely on a single-stock approach, but Namibia is committed to implement, in addition, an ecosystem approach to fisheries (EAF) management. The work leading to this implementation is described, in particular an ecosystem modelling study undertaken to summarize the ...

Brainstem tumors: Current management and future directions

Directory of Open Access Journals (Sweden)

Pablo F Recinos

2012-01-01

Full Text Available Tumors arising in the brainstem comprise 10-20% of all pediatric central nervous system (CNS tumors and account for a small percentage in adults. The prognosis for these tumors was considered uniformly poor prior to the era of modern neuroimaging and the location was fraught with disaster being considered a ′no man′s land′ for neurosurgeons. Following the introduction of advanced imaging modalities and neurophysiological monitoring, striking progress has occurred in the management of these lesions. Brainstem tumors are presently classified based on their anatomic location, focality, and histopathology. This article reviews the current classification of brainstem tumors, current management options, and future directions in the treatment for these rare tumors.

The multidisciplinary approach to the management toxic epidermal ...

African Journals Online (AJOL)

Complete haematological and biochemical tests were carried out and management was symptomatic. This report shows the multidisciplinary approach to the management and highlights the role of the dental surgeon in the management. It concludes that multidisciplinary approach to healthcare provision will be of benefit to ...

Nanotechnology Based Theranostic Approaches in Alzheimer's Disease Management: Current Status and Future Perspective.

Science.gov (United States)

Ahmad, Javed; Akhter, Sohail; Rizwanullah, Md; Khan, Mohammad Ahmed; Pigeon, Lucie; Addo, Richard T; Greig, Nigel H; Midoux, Patrick; Pichon, Chantal; Kamal, Mohammad Amjad

2017-01-01

Alzheimer's disease (AD), a cognitive dysfunction/dementia state amongst the elders is characterized by irreversible neurodegeneration due to varied pathophysiology. Up till now, anti-AD drugs having different pharmacology have been developed and used in clinic. Yet, these medications are not curative and only lowering the AD associated symptoms. Improvement in treatment outcome required drug targeting across the blood-brain barrier (BBB) to the central nervous system (CNS) in optimal therapeutic concentration. Nanotechnology based diagnostic tools, drug carriers and theranostics offer highly sensitive molecular detection, effective drug targeting and their combination. Over the past decade, significant works have been done in this area and we have seen very remarkable outocome in AD therapy. Various nanoparticles from organic and inorganic nanomaterial category have successfully been investigated against AD. This paper discussed the role of nanoparticles in early detection of AD, effective drug targeting to brain and theranostic (diagnosis and therapy) approaches in AD's management. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

A management approach that drives actions strategically: balanced scorecard in a mental health trust case study.

Science.gov (United States)

Schmidt, Stefan; Bateman, Ian; Breinlinger-O'Reilly, Jochen; Smith, Peter

2006-01-01

Achieving excellence is a current preoccupation in U.K. public health organisations. This article aims to use a case study to explain how a mental health trust delivers excellent performance using a balanced scorecard (BSC) management approach. Reports a project to implement a BSC approach in the South West Yorkshire Mental Health NHS Trust to achieve its "excellence" objectives. The authors were participants in the project. The design of the pilot project was informed theoretically by the work of Kaplan and Norton and practically by in-house discussions on a strategy to achieve excellence. Explains the process of building a BSC strategy step-by-step. Discusses how the vision and strategies of a mental health trust can be translated into tangible measures, which are the basis for actions that are driven strategically. There are many possibilities for a BSC management approach and this case study is specific to mental health trusts in the UK, although it is believed that the case has a universally applicable modus operandi. This article will help healthcare managers to evaluate the benefits of a BSC management approach. This article explains how actions can be structured in connection with a BSC management approach.

A review of Spacelab mission management approach

Science.gov (United States)

Craft, H. G., Jr.

1979-01-01

The Spacelab development program is a joint undertaking of the NASA and ESA. The paper addresses the initial concept of Spacelab payload mission management, the lessons learned, and modifications made as a result of the actual implementation of Spacelab Mission 1. The discussion covers mission management responsibilities, program control, science management, payload definition and interfaces, integrated payload mission planning, integration requirements, payload specialist training, payload and launch site integration, payload flight/mission operations, and postmission activities. After 3.5 years the outlined overall mission manager approach has proven to be most successful. The approach does allow the mission manager to maintain the lowest overall mission cost.

Current approaches to nuclear power plant life management in Japan

International Nuclear Information System (INIS)

Noda, T.; Tajima, K.; Ishikawa, M.; Koyama, M.

2002-01-01

extracted additional maintenance measures and incorporated them into their long-term maintenance plans, thereby reinforcing their current maintenance activities. Considering the latest information including domestic and overseas operating experiences and knowledge of academics and experts consigned by the Minister of Economy, Trade and Industry (METI), the Nuclear and Industry Safety Agency (NISA) of the METI reviewed and studied the technical evaluation and long-term maintenance plans of these electric utility companies. This paper describes the outlines of the NISA's report and related activities on current approaches to cope with the ageing of nuclear power plants in Japan. (Note) In 2001, the MITI was reorganized to the Ministry of Economy, Trade and Industry (METI). (author)

Approaches to long-term conditions management and care for older people: similarities or differences?

Science.gov (United States)

Tullett, Michael; Neno, Rebecca

2008-03-01

In the past few years, there has been an increased emphasis both on the care for older people and the management of long-term conditions within the United Kingdom. Currently, the Department of Health and the Scottish Executive identify and manage these two areas as separate entities. The aim of this article is to examine the current approaches to both of these areas of care and identify commonalities and articulate differences. The population across the world and particularly within the United Kingdom is ageing at an unprecedented rate. The numbers suffering long-term illness conditions has also risen sharply in recent years. As such, nurses need to be engaged at a strategic level in the design of robust and appropriate services for this increasing population group. A comprehensive literature review on long-term conditions and the care of older people was undertaken in an attempt to identify commonalities and differences in strategic and organizational approaches. A policy analysis was conducted to support the paper and establish links that may inform local service development. Proposing service development based on identified needs rather than organizational boundaries after the establishment of clear links between health and social care for those with long-term conditions and the ageing population. Nurse Managers need to be aware of the similarities and differences in political and theoretical approaches to the care for older people and the management of long-term conditions. By adopting this view, creativity in the service redesign and service provision can be fostered and nurtured as well as achieving a renewed focus on partnership working across organizational boundaries. With the current renewed political focus on health and social care, there is an opportunity in the UK to redefine the structure of care. This paper proposes similarities between caring for older people and for those with long-term conditions, and it is proposed these encapsulate the wider

Ewing Sarcoma: Current Management and Future Approaches Through Collaboration

NARCIS (Netherlands)

Gaspar, Nathalie; Hawkins, Douglas S.; Dirksen, Uta; Lewis, Ian J.; Ferrari, Stefano; Le Deley, Marie-Cecile; Kovar, Heinrich; Grimer, Robert; Whelan, Jeremy; Claude, Line; Delattre, Olivier; Paulussen, Michael; Picci, Piero; Sundby Hall, Kirsten; van den Berg, Hendrik; Ladenstein, Ruth; Michon, Jean; Hjorth, Lars; Judson, Ian; Luksch, Roberto; Bernstein, Mark L.; Marec-Bérard, Perrine; Brennan, Bernadette; Craft, Alan W.; Womer, Richard B.; Juergens, Heribert; Oberlin, Odile

2015-01-01

Ewing sarcoma (ES) is an aggressive sarcoma of bone and soft tissue occurring at any age with a peak incidence in adolescents and young adults. The treatment of ES relies on a multidisciplinary approach, coupling risk-adapted intensive neoadjuvant and adjuvant chemotherapies with surgery and/or

METHODICAL APPROACHES TO THE COST MANAGEMENT OF INDUSTRIAL ENTERPRISES

Directory of Open Access Journals (Sweden)

Trunina Iryna

2018-03-01

Full Text Available Introduction. The paper deals with the actual issues of managing the costs of industrial enterprises, because in the conditions of an unstable market environment the financial performance depends on the efficiency of the cost management system, competitiveness, financial sustainability and investment attractiveness of any subject of economic activity. Purpose of the article is analys is of approaches to cost management, theoretical substantiation and development of recommendations regarding the formation of strategic cost management. Results. The economic content of cost management in the treatment of different authors and on different approaches: functional, process-oriented and system approaches has been considered. Their essence and features, the direction for operational or strategic management of expenses of the enterprise, ways of spending management in different approaches are determined. It is stated that all considered approaches to cost management of enterprises are aimed at optimal use of resources and ensuring the growth of the efficiency of enterprises. Conclusions. Based on the review of methodological approaches to cost management, recommendations are developed for expanding the implementation of cost management at various levels of enterprise management and the formation of strategic cost management within the framework of strategic management of an enterprise. The strategic cost management is complex category aimed at achieving a rational level of costs in the long run, which allows for the consideration of competitive cost advantages and increase the competitiveness of an industrial enterprise. The implementation of cost reduction strategies should be a constant and important part of the company’s work, while the strategy of cost reduction should be integrated into the overall business strategy of the enterprise.

A Reliable, Non-Invasive Approach to Data Center Monitoring and Management

Directory of Open Access Journals (Sweden)

Moises Levy

2017-08-01

Full Text Available Recent standards, legislation, and best practices point to data center infrastructure management systems to control and monitor data center performance. This work presents an innovative approach to address some of the challenges that currently hinder data center management. It explains how monitoring and management systems should be envisioned and implemented. Key parameters associated with data center infrastructure and information technology equipment can be monitored in real-time across an entire facility using low-cost, low-power wireless sensors. Given the data centers’ mission critical nature, the system must be reliable and deployable through a non-invasive process. The need for the monitoring system is also presented through a feedback control systems perspective, which allows higher levels of automation. The data center monitoring and management system enables data gathering, analysis, and decision-making to improve performance, and to enhance asset utilization.

Laparoscopic approach for inflammatory bowel disease surgical managment.

Science.gov (United States)

Maggiori, Léon; Panis, Yves

2012-01-01

For IBD surgical management, laparoscopic approach offers several theoretical advantages over the open approach. However, the frequent presence of adhesions from previous surgery and the high rate of inflammatory lesions have initially questioned its feasibility and safety. In the present review article, we will discuss the role of laparoscopic approach for IBD surgical management, along with its potential benefits as compared to the open approach.

Evaluating Adaptive Governance Approaches to Sustainable Water Management in North-West Thailand

Science.gov (United States)

Clark, Julian R. A.; Semmahasak, Chutiwalanch

2013-04-01

Adaptive governance is advanced as a potent means of addressing institutional fit of natural resource systems with prevailing modes of political-administrative management. Its advocates also argue that it enhances participatory and learning opportunities for stakeholders over time. Yet an increasing number of studies demonstrate real difficulties in implementing adaptive governance `solutions'. This paper builds on these debates by examining the introduction of adaptive governance to water management in Chiang Mai province, north-west Thailand. The paper considers, first, the limitations of current water governance modes at the provincial scale, and the rationale for implementation of an adaptive approach. The new approach is then critically examined, with its initial performance and likely future success evaluated by (i) analysis of water stakeholders' opinions of its first year of operation; and (ii) comparison of its governance attributes against recent empirical accounts of implementation difficulty and failure of adaptive governance of natural resource management more generally. The analysis confirms the potentially significant role that the new approach can play in brokering and resolving the underlying differences in stakeholder representation and knowledge construction at the heart of the prevailing water governance modes in north-west Thailand.

Comprehensive change management concepts. Development of a participatory approach.

Science.gov (United States)

Zink, Klaus J; Steimle, Ulrich; Schröder, Delia

2008-07-01

During the last years, many change projects in organizations did not have the planned success. Therefore at first, the causes for these failures and the success factors contributing to organizational change have to be discussed. To get better results, a comprehensive change management concept has been developed and tested in an ongoing research project. By using concepts for an integrated assessment and design of organizations, an approach for analyzing the current situation has been elaborated to identify "lack of integration" in the change initiatives of a company. To realize an integrated overall approach of modernization by harmonizing different methods and concepts, first, one has to prove their relationship to policy and strategy (vertical harmonization). The second step is to take into account the fact that there has to be a logical fit between the single concepts (horizontal harmonization). But even if all elements are logically coherent, that does not mean that the people working in the company also see this coherence. Therefore, in addition to the "logical fit", one has to examine the "psychological fit". In the end, a concept for analyzing the status quo in an organization as a result of "objective data" and "subjective data" originated. Subsequently, instruments for harmonizing different modernizing concepts have been applied. As part of the comprehensive change management concept participatory ergonomic approaches have been used during the project. The present study shows this approach in the case of one company.

Food Waste to Energy: An Overview of Sustainable Approaches for Food Waste Management and Nutrient Recycling.

Science.gov (United States)

Paritosh, Kunwar; Kushwaha, Sandeep K; Yadav, Monika; Pareek, Nidhi; Chawade, Aakash; Vivekanand, Vivekanand

2017-01-01

Food wastage and its accumulation are becoming a critical problem around the globe due to continuous increase of the world population. The exponential growth in food waste is imposing serious threats to our society like environmental pollution, health risk, and scarcity of dumping land. There is an urgent need to take appropriate measures to reduce food waste burden by adopting standard management practices. Currently, various kinds of approaches are investigated in waste food processing and management for societal benefits and applications. Anaerobic digestion approach has appeared as one of the most ecofriendly and promising solutions for food wastes management, energy, and nutrient production, which can contribute to world's ever-increasing energy requirements. Here, we have briefly described and explored the different aspects of anaerobic biodegrading approaches for food waste, effects of cosubstrates, effect of environmental factors, contribution of microbial population, and available computational resources for food waste management researches.

RISK MANAGEMENT: AN INTEGRATED APPROACH TO RISK MANAGEMENT AND ASSESSMENT

OpenAIRE

Szabo Alina

2012-01-01

Purpose: The objective of this paper is to offer an overview over risk management cycle by focusing on prioritization and treatment, in order to ensure an integrated approach to risk management and assessment, and establish the ‘top 8-12’ risks report within the organization. The interface with Internal Audit is ensured by the implementation of the scoring method to prioritize risks collected from previous generated risk report. Methodology/approach: Using evidence from other research in ...

The Self-Aware Organization: A Metacognitive Approach to Change Management in a Small Rural School District

Science.gov (United States)

Harrison, Charles E., Jr.

2010-01-01

Educational leaders have often been ineffective in managing change in their environment. Change vectors were used in the current study to identify areas of needed change, along with a metacognitive approach to organizational change. A qualitative case study was employed to explore the use of such a metacognitive approach to change by a small rural…

Advanced simulation capability for environmental management - current status and future applications

Energy Technology Data Exchange (ETDEWEB)

Freshley, Mark; Scheibe, Timothy [Pacific Northwest National Laboratory, Richland, Washington (United States); Robinson, Bruce; Moulton, J. David; Dixon, Paul [Los Alamos National Laboratory, Los Alamos, New Mexico (United States); Marble, Justin; Gerdes, Kurt [U.S. Department of Energy, Office of Environmental Management, Washington DC (United States); Stockton, Tom [Neptune and Company, Inc, Los Alamos, New Mexico (United States); Seitz, Roger [Savannah River National Laboratory, Aiken, South Carolina (United States); Black, Paul [Neptune and Company, Inc, Lakewood, Colorado (United States)

2013-07-01

The U.S. Department of Energy (US DOE) Office of Environmental Management (EM), Office of Soil and Groundwater (EM-12), is supporting development of the Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific tool and approach that is currently aimed at understanding and predicting contaminant fate and transport in natural and engineered systems. ASCEM is a modular and open source high-performance computing tool. It will be used to facilitate integrated approaches to modeling and site characterization, and provide robust and standardized assessments of performance and risk for EM cleanup and closure activities. The ASCEM project continues to make significant progress in development of capabilities, with current emphasis on integration of capabilities in FY12. Capability development is occurring for both the Platform and Integrated Tool-sets and High-Performance Computing (HPC) multi-process simulator. The Platform capabilities provide the user interface and tools for end-to-end model development, starting with definition of the conceptual model, management of data for model input, model calibration and uncertainty analysis, and processing of model output, including visualization. The HPC capabilities target increased functionality of process model representations, tool-sets for interaction with Platform, and verification and model confidence testing. The integration of the Platform and HPC capabilities were tested and evaluated for EM applications in a set of demonstrations as part of Site Applications Thrust Area activities in 2012. The current maturity of the ASCEM computational and analysis capabilities has afforded the opportunity for collaborative efforts to develop decision analysis tools to support and optimize radioactive waste disposal. Recent advances in computerized decision analysis frameworks provide the perfect opportunity to bring this capability into ASCEM. This will allow radioactive waste

Systems approach in energy management

International Nuclear Information System (INIS)

Dutta-Choudhury, K.

1993-01-01

Several years ago when the author was working in the chemicals division of a paper company in Instrumentation and Controls, one experience had a lasting impact on his work approach which is systems approach. The maintenance manager told the author that a very important piece of boiler instrument of the power plant had broken down and delivery of the replacement needed to be expedited. The instrument was ordered over the phone in another city. The purchase order was personally delivered at the supplier's office and arrangements were made so the instrument was put on the next flight. A week later the maintenance manager indicated that the particular instrument still had not arrived in the plant and he could not run the power plant. Thus the company incurred substantial losses. Further inquiries showed that the instrument did indeed arrive at the plant stores on time. But, in the absence of any instructions thereon, the instrument was not delivered to the power plant. The sense of urgency was lost in the existing delivery process. In other words, the process or system failed. The whole process from requisitioning to delivery of ordered items was analyzed and corrective procedures were incorporated to prevent future repetitions. This brings up the subject of systems approach in engineering management in general and energy management in particular. This involves defining an objective and designing a system for an effective way of getting there

Current Issues and Situation of Producer Responsibility in Waste Management in Indonesia

Directory of Open Access Journals (Sweden)

Antonius Priyo Nugroho Sulami

2017-11-01

Full Text Available Producer responsibility for wastes has been encouraged in Indonesia since 2008. The Ministry of Environment of the Republic of Indonesia also promoted the reduce, reuse, and recycle (3R concept using the community-based approach of waste banks integrated with the extended producer responsibility (EPR concept. However, related research and implementation are still limited. This study aims to identify the challenges of fulfilling producer responsibility in waste management and determine whether the integration concept could generate outcomes expected from the EPR concept. A semi-structured interview survey of several stakeholders from the government, industrial, and waste management sectors was conducted and the data generated was used to simulate an integration scheme using a system dynamics approach. Secondary data and information from Bandung municipality were used as input for the simulation. The interview survey found that the concerns and issues of fulfilling producer responsibility in waste management include lack of awareness, unavailability of clear guidelines, and the limited capacity of the current recycling sector. The results of the simulation suggested that if the integration scheme is applied, each business entity might bear the responsibility of IDR 29.4 million per year and 14.7 tons of waste per year for the scope of four sectors and IDR 34.1 million per year and 17 tons of waste per year for the scope of two sectors.

The screening approach for review of accident management programmes

International Nuclear Information System (INIS)

Misak, J.

1999-01-01

In this lecture the screening approach for review of accident management programmes are presented. It contains objective trees for accident management: logic structure of the approach; objectives and safety functions for accident management; safety principles

Developing a holistic approach to obesity management.

Science.gov (United States)

Brown, Jenny; Wimpenny, Peter

2011-02-01

The aim of this paper is to discuss the theoretical background and relevance of a holistic approach to obesity management by nurses. There is a global rise in the number of people with obesity, such that it now represents one of the major health challenges. However, nurses are often influenced by physical and dietetic focused approaches and could fail to acknowledge a range of other factors that can impact on weight management. As part of the development of a holistic approach to obesity a literature search was undertaken to establish relevant theoretical perspectives that underpin practice in physical, psychological and social aspects of care (focused on the period 1995-2005). In addition, experiences of working in a secondary care weight management clinic were also drawn upon. Psychobiological, attribution and social support theories were identified that could contribute to a better understanding of obesity. If these theoretical perspectives and supporting evidence can be integrated in a holistic approach to care and management it might be possible to promote better health and well-being in those with obesity. Creating a greater understanding of the range of theoretical perspectives and supporting evidence related to obesity could, it is argued, provide enhanced care and management. © 2011 Blackwell Publishing Asia Pty Ltd.

Multidisciplinary management of intrahepatic cholangiocarcinoma: Current approaches.

Science.gov (United States)

Guro, Hanisah; Kim, Jin Won; Choi, YoungRok; Cho, Jai Young; Yoon, Yoo-Seok; Han, Ho-Seong

2017-06-01

Intrahepatic cholangiocarcinoma (ICC) is a common primary hepatic tumor. However, its outcomes are usually worse than those of hepatocellular carcinoma owing to its non-specific presentation and detection at an advanced stage. The most widely used serum marker, carbohydrate antigen 19-9, is non-specific. Furthermore, imaging studies rarely identify any pathognomonic features. Surgery is the only treatment option that offers a chance of long-term survival. However, the resectability rate is low owing to the high frequencies of intrahepatic metastases, peritoneal carcinomatosis, or extrahepatic metastases. Surgical treatment should be tailored according to the macroscopic classification of ICC (e.g. mass-forming, periductal infiltrating, and intraductal growth types) because it reflects the tumor's dissemination pattern. Although lymph node metastasis is a negative prognostic factor, the importance and extent of lymph node dissection is still controversial. To improve patient survival, liver transplantation is considered in some patients with unresectable ICC, especially in those with an insufficient remnant liver volume. Minimally invasive procedures, including laparoscopic and robotic liver resection, have been tested and achieved comparable outcomes to conventional surgery in preliminary studies. No randomized trials have confirmed the efficacy of adjuvant chemotherapy in ICC, and several trials have evaluated molecular-targeted agents as monotherapy or in combination with cytotoxic chemotherapy. Multidisciplinary approaches are necessary to improve the outcomes of ICC. Copyright © 2017 Elsevier Ltd. All rights reserved.

A template-based approach for responsibility management in executable business processes

Science.gov (United States)

Cabanillas, Cristina; Resinas, Manuel; Ruiz-Cortés, Antonio

2018-05-01

Process-oriented organisations need to manage the different types of responsibilities their employees may have w.r.t. the activities involved in their business processes. Despite several approaches provide support for responsibility modelling, in current Business Process Management Systems (BPMS) the only responsibility considered at runtime is the one related to performing the work required for activity completion. Others like accountability or consultation must be implemented by manually adding activities in the executable process model, which is time-consuming and error-prone. In this paper, we address this limitation by enabling current BPMS to execute processes in which people with different responsibilities interact to complete the activities. We introduce a metamodel based on Responsibility Assignment Matrices (RAM) to model the responsibility assignment for each activity, and a flexible template-based mechanism that automatically transforms such information into BPMN elements, which can be interpreted and executed by a BPMS. Thus, our approach does not enforce any specific behaviour for the different responsibilities but new templates can be modelled to specify the interaction that best suits the activity requirements. Furthermore, libraries of templates can be created and reused in different processes. We provide a reference implementation and build a library of templates for a well-known set of responsibilities.

The unique entity of nodular lymphocyte-predominant Hodgkin lymphoma: current approaches to diagnosis and management.

Science.gov (United States)

Hawkes, Eliza A; Wotherspoon, Andrew; Cunningham, David

2012-03-01

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare disease constituting only 3-8% of all Hodgkin lymphoma. It has a distinct histological and clinical presentation as well as significantly different natural history compared to the classical form of Hodgkin lymphoma. Presenting most often as early-stage disease, NLPHL is characterized by frequent relapses, but paradoxically an overall good prognosis. The approach to management should therefore reflect this pattern and focus on attaining prolonged remissions, with long-term follow-up paramount. Due to the rarity of the disease, few prospective data exist. Options for treatment include radiotherapy, chemotherapy or combined chemotherapy plus radiotherapy and targeted anti-CD20 antibody therapy, as well as observation in selected patients.

Understanding Approaches for Managing Diversity in the Workplace

DEFF Research Database (Denmark)

Ravazzani, Silvia

2016-01-01

Purpose – This paper aims to enhance understanding of how companies actually implement diversity management, and of factors that may explain their approach. It does this by framing a tripartite model that articulates a combination of indicators, and by using this model to investigate the prevalent...... approach for managing diversity in Italy and the contingent factors at play. Design/methodology/approach – The paper presents data from a survey conducted among 90 Italian companies, and two focus groups consisting of experts and managers. Findings – The most common approach among Italian companies...... in Italy, where interest in diversity is growing due to the increased participation of women and immigrants in the labor market and the initiatives inspired by the EU and multinational companies. In addition, the research model used in this study integrates existing typologies of diversity management...

State-of-the-art report on systematic approaches to safety management - Special Expert Group on Human and Organisational Factors (SEGHOF)

International Nuclear Information System (INIS)

Van den Berghe, Yves; Frischknecht, Albert; Gil, Benito; Martin, Anibal; McRobbie, Helen; Reiersen, Craig; Tasset, Daniel; Aastrand, Kaisa; Dahlgren-Persson, Kerstin; Pyy, Pekka; Mauny, Elisabeth

2006-02-01

There is a growing awareness of the significant contribution which human and organisational factors (HOF) make to nuclear safety. Within the HOF area, attention is increasingly focused on addressing management and organisational issues. This reflects an evolving recognition that the members of a nuclear licensee form part of a socio-technological system, and that their performance is influenced by the organisation and the culture within that organisation. A series of events across the nuclear industry and other sectors has reinforced the appreciation of the importance of robust safety management. Also, the management and organisation of nuclear installations is impacted by a number of current challenges such as deregulation, change in institutional ownership of the industry, contractorization and an ageing plant and workforce. It is in this context that the CSNI (Committee on Safety of Nuclear Installations) Special Experts' Group on Human and Organisational Factors (SEGHOF) was requested by the CNRA (Committee on Nuclear Regulatory Actions) to examine the role and influence of safety management in nuclear plant operations in 2000. A workshop on 'systematic approaches to safety management' was held in spring 2002 and this was followed by a survey in 2003-4 of relevant practices and developments across licensees and regulators. This report provides a brief explanation of the relationship between safety management and safety culture. It reinforces the need for nuclear licensees and regulators to take positive steps to ensure that licensees develop and sustain a robust safety management system as a part of their management systems as a whole. The report draws out the main findings of the workshop and presents the results of the survey in more detail. It seeks to identify current issues and areas warranting further consideration. The workshop explored the development of current organisational theories and their application to nuclear plant safety management. It

Approaches of Improving University Assets Management Efficiency

Science.gov (United States)

Wang, Jingliang

2015-01-01

University assets management, as an important content of modern university management, is generally confronted with the issue of low efficiency. Currently, to address the problems exposed in university assets management and take appropriate modification measures is an urgent issue in front of Chinese university assets management sectors. In this…

Current management of Parkinson's disease | Salawu | Annals of ...

African Journals Online (AJOL)

Annals of African Medicine. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 9, No 2 (2010) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Current management of Parkinson's disease. F Salawu, A ...

Current management for word finding difficulties by speech-language therapists in South African remedial schools.

Science.gov (United States)

de Rauville, Ingrid; Chetty, Sandhya; Pahl, Jenny

2006-01-01

Word finding difficulties frequently found in learners with language learning difficulties (Casby, 1992) are an integral part of Speech-Language Therapists' management role when working with learning disabled children. This study investigated current management for word finding difficulties by 70 Speech-Language Therapists in South African remedial schools. A descriptive survey design using a quantitative and qualitative approach was used. A questionnaire and follow-up focus group discussion were used to collect data. Results highlighted the use of the Renfrew Word Finding Scale (Renfrew, 1972, 1995) as the most frequently used formal assessment tool. Language sample analysis and discourse analysis were the most frequently used informal assessment procedures. Formal intervention programmes were generally not used. Phonetic, phonemic or phonological cueing were the most frequently used therapeutic strategies. The authors note strengths and raise concerns about current management for word finding difficulties in South African remedial schools, particularly in terms of bilingualism. Opportunities are highlighted regarding the development of assessment and intervention measures relevant to the diverse learning disabled population in South Africa.

Accident management approach in Armenia

International Nuclear Information System (INIS)

Ghazaryan, K.

1999-01-01

In this lecture the accident management approach in Armenian NPP (ANPP) Unit 2 is described. List of BDBAs had been developed by OKB Gydropress in 1994. 13 accident sequences were included in this list. The relevant analyses had been performed in VNIIAES and the 'Guidelines on operator actions for beyond design basis accident (BDBA) management at ANPP Unit 2' had been prepared. These instructions are discussed

Adult asthma disease management: an analysis of studies, approaches, outcomes, and methods.

Science.gov (United States)

Maciejewski, Matthew L; Chen, Shih-Yin; Au, David H

2009-07-01

Disease management has been implemented for patients with asthma in various ways. We describe the approaches to and components of adult asthma disease-management interventions, examine the outcomes evaluated, and assess the quality of published studies. We searched the MEDLINE, EMBASE, CINAHL, PsychInfo, and Cochrane databases for studies published in 1986 through 2008, on adult asthma management. With the studies that met our inclusion criteria, we examined the clinical, process, medication, economic, and patient-reported outcomes reported, and the study designs, provider collaboration during the studies, and statistical methods. Twenty-nine articles describing 27 studies satisfied our inclusion criteria. There was great variation in the content, extent of collaboration between physician and non-physician providers responsible for intervention delivery, and outcomes examined across the 27 studies. Because of limitations in the design of 22 of the 27 studies, the differences in outcomes assessed, and the lack of rigorous statistical adjustment, we could not draw definitive conclusions about the effectiveness or cost-effectiveness of the asthma disease-management programs or which approach was most effective. Few well-designed studies with rigorous evaluations have been conducted to evaluate disease-management interventions for adults with asthma. Current evidence is insufficient to recommend any particular intervention.

Exploring Conflict Management Using Qualitative Approach

OpenAIRE

Yazid, Zaleha

2015-01-01

This paper focuses on qualitative methods in researching the area of conflict management, specifically in Self-Managed Project Team (SMPT). The research aims to explore the evolvement of conflict management strategies in SMPT as this type of team is given the responsibility to solve problems and make decision by themselves. The inductive approach will overcome the limitation of quantitative method in management research as one of its objectives is to explain the different elements of the expl...

Current possibilities in occlusal caries management

Directory of Open Access Journals (Sweden)

Hrvoje Jurić

2013-11-01

Full Text Available Dental caries is a multifactorial disease that affects most populations throughout the world and it is still the primary cause of oral pain and tooth loss. The occlusal surfaces of posterior teeth are the most vulnerable sites for dental caries due to their anatomy. Therefore, the aim of the following article is to summarize current knowledge on occlusal caries development and the possibilities of its prevention. Although the overall caries rate today has fallen for populations in industrialized countries, the rate of occlusal surface caries has not decreased. This may be explained with fact that topically applied fluorides and their mode of action prevent caries better on smooth than on occlusal surfaces. As we know, tooth decay of first permanent molars causes a great deal of different short and long term difficulties for patients. Therefore, there is a continuous need for implementation of programs for caries prevention in permanent teeth. Nowadays, we like to treat our patients by minimally invasive methods. A very important step in our effective preventive treatment is sealing pits and fissures as a cornerstone of occlusal caries management. Reliable assessment of caries activity is also very important for defining treatment needs and plans. A very important decision, which should be made during occlusal caries management, is the selection of restorative material according to the treatment plan. Conclusion. Current possibilities in occlusal caries prevention and management are very effective. Therefore, dentists today do not have any excuse for avoiding the philosophy of Minimally Invasive Dentistry, especially when we talk about caries management of occlusal surfaces in permanent molars.

A partial Hamiltonian approach for current value Hamiltonian systems

Science.gov (United States)

Naz, R.; Mahomed, F. M.; Chaudhry, Azam

2014-10-01

We develop a partial Hamiltonian framework to obtain reductions and closed-form solutions via first integrals of current value Hamiltonian systems of ordinary differential equations (ODEs). The approach is algorithmic and applies to many state and costate variables of the current value Hamiltonian. However, we apply the method to models with one control, one state and one costate variable to illustrate its effectiveness. The current value Hamiltonian systems arise in economic growth theory and other economic models. We explain our approach with the help of a simple illustrative example and then apply it to two widely used economic growth models: the Ramsey model with a constant relative risk aversion (CRRA) utility function and Cobb Douglas technology and a one-sector AK model of endogenous growth are considered. We show that our newly developed systematic approach can be used to deduce results given in the literature and also to find new solutions.

Diagnosis and management of neuropathic pain: a balanced approach to treatment.

Science.gov (United States)

Nicholson, Bruce D

2003-12-01

To provide nurse practitioners with a conceptual framework from which to diagnose and manage chronic neuropathic pain, specifically postherpetic neuralgia (PHN). A current review of the available treatment options for the management of neuropathic pain and PHN is provided. A comprehensive literature review was conducted. Clinical articles, meta-analyses, and reviews were selected for their relevance to the diagnosis and management of chronic neuropathic pain and PHN. Managing patients with chronic neuropathic pain is a common clinical challenge due to variability in individual symptoms, mechanisms, and treatment responses. In patients with PHN, a balanced treatment approach focusing on efficacy, safety, and tolerability is recommended. With appropriate treatment, most patients are able to achieve clinically significant relief from neuropathic pain. Diagnosis and management of neuropathic pain syndromes is challenging. Because of the complexity of chronic pain, successful long-term treatment can be especially difficult (Nicholson, 2003b). While most acute pain is nociceptive (i.e., a response to noxious stimuli), chronic pain can be nociceptive, neuropathic, or of mixed origin. PHN is a chronic pain syndrome that can last for years, causing physical and social disability and psychological distress (Kanazi, 2000). Despite major recent advances in the treatment of PHN, many patients remain refractory to current therapy (Dworkin, 2003). For practicing clinicians, including nurse practitioners, viewing pain as a disease rather than a symptom is the first step towards its successful management. Understanding the pathophysiology of chronic pain and emerging treatment paradigms for the management of neuropathic pain and PHN is critical to optimal care.

Healthcare waste management: an interpretive structural modeling approach.

Science.gov (United States)

Thakur, Vikas; Anbanandam, Ramesh

2016-06-13

Purpose - The World Health Organization identified infectious healthcare waste as a threat to the environment and human health. India's current medical waste management system has limitations, which lead to ineffective and inefficient waste handling practices. Hence, the purpose of this paper is to: first, identify the important barriers that hinder India's healthcare waste management (HCWM) systems; second, classify operational, tactical and strategical issues to discuss the managerial implications at different management levels; and third, define all barriers into four quadrants depending upon their driving and dependence power. Design/methodology/approach - India's HCWM system barriers were identified through the literature, field surveys and brainstorming sessions. Interrelationships among all the barriers were analyzed using interpretive structural modeling (ISM). Fuzzy-Matrice d'Impacts Croisés Multiplication Appliquée á un Classement (MICMAC) analysis was used to classify HCWM barriers into four groups. Findings - In total, 25 HCWM system barriers were identified and placed in 12 different ISM model hierarchy levels. Fuzzy-MICMAC analysis placed eight barriers in the second quadrant, five in third and 12 in fourth quadrant to define their relative ISM model importance. Research limitations/implications - The study's main limitation is that all the barriers were identified through a field survey and barnstorming sessions conducted only in Uttarakhand, Northern State, India. The problems in implementing HCWM practices may differ with the region, hence, the current study needs to be replicated in different Indian states to define the waste disposal strategies for hospitals. Practical implications - The model will help hospital managers and Pollution Control Boards, to plan their resources accordingly and make policies, targeting key performance areas. Originality/value - The study is the first attempt to identify India's HCWM system barriers and prioritize

Childhood obesity: Current and novel approaches.

Science.gov (United States)

Sabin, Matthew A; Kiess, Wieland

2015-06-01

The prevalence of childhood obesity has increased over the last fifty years by approximately 5% per decade, and approximately a quarter of all children are now either overweight or obese. These children have a significantly increased risk of many future health problems including adult obesity, type 2 diabetes and heart disease. Despite this relentless increase, common-sense approaches aimed at prevention and treatment have failed to solve the problem. Current approaches at prevention have faced major challenges with some progress in implementing smaller scale programs and social marketing, but little action on broad public policy approaches which often appears unpalatable to society or individual governments. Meanwhile, treatment approaches have mainly focused on lifestyle change, and novel approaches are urgently needed. Prevention needs to shift to improving maternal health prior to conception, with more research focussed on the impact of early years in programming offspring to future overweight/obesity. Likewise, treatment paradigms need to move from simply thinking that obesity can be solved by readdressing diet and activity levels. Novel approaches are needed which take into consideration the complex physiology which regulates early childhood growth and the development of obesity in susceptible individuals. Copyright © 2015 Elsevier Ltd. All rights reserved.

Managing environmental radioactivity monitoring data: a geographic information system approach

International Nuclear Information System (INIS)

Heywood, I.; Cornelius, S.

1993-01-01

An overview of the current British approach to environmental radiation monitoring is presented here, followed by a discussion of the major issues which would have to be considered in formulating a geographical information system (GIS) for the management of radiation monitoring data. Finally, examples illustrating the use of spatial data handling and automated cartographic techniques are provided from work undertaken by the authors. These examples are discussed in the context of developing a National Radiological Spatial Information System (NRSIS) demonstrator utilising GIS technology. (Author)

THE SYSTEMATIC APPROACH TO MANAGEMENT IN EDUCATION

Directory of Open Access Journals (Sweden)

Nikita S. Iskrin

2015-01-01

Full Text Available The purpose of this article is to study the potential of a systematic approach as the basic element of the course content in system training of managers in education. Methods. Methods involve analysis of the theory and practice of application of the system approach to management challenges in education; positions of the general systems’ theory; synergetic approach as «the optimum control mechanism of complex systems»; adaptation of administrative technologies for an education sphere, implemented before and mainly in economy; questioning of educators of an education system of different levels. Results. The authors have proved the necessity of formation of managers’ systems thinking, with the specialization – a variety of educational services rendering. Managerial process characteristics of educational institution are defined. The course as training variant «Education of Managers» is proposed on the basis of the analysis of a historiography and summary results of questioning. Scientific novelty. Theoretical blocks of retraining and reorientation program to new paradigms of educators’ service or activities of are specified. The systematic approach to activity operations management has become the basis of the proposed program. Practical significance. Developed on the basis of results of research and approved course « Systematic approach in educational institution practice: technologies and management issues» helps get over some thinking and the stereotypes that generate the problems in education system development; promotes understanding of management methods in accordance with principles of systematic thinking; realizes and sets the abilities of interrelations revealing between external and internal processes and phenomena in relation to the system; develops an ability to predict the future systems behaviour and readiness to change structure of system, cohesion between its elements and functions.

An Approach for Implementation of Project Management Information Systems

Science.gov (United States)

Běrziša, Solvita; Grabis, Jānis

Project management is governed by project management methodologies, standards, and other regulatory requirements. This chapter proposes an approach for implementing and configuring project management information systems according to requirements defined by these methodologies. The approach uses a project management specification framework to describe project management methodologies in a standardized manner. This specification is used to automatically configure the project management information system by applying appropriate transformation mechanisms. Development of the standardized framework is based on analysis of typical project management concepts and process and existing XML-based representations of project management. A demonstration example of project management information system's configuration is provided.

Applying the competence-based approach to management in the aerospace industry

Directory of Open Access Journals (Sweden)

Arpentieva Mariam

2018-01-01

Full Text Available Problems of management in aerospace manufacturing are similar to those we observe in other sectors, the main of which is the flattening of strategic management. The main reason lies in the attitude towards human resource of the organization. In the aerospace industry employs 250 thousand people, who need individual approach. The individual approach can offer competence-based approach to management. The purpose of the study is proof of the benefits of the competency approach to human resource management in context strategic management of the aerospace organization. To achieve this goal it is possible to obtain the method of comparative analysis. The article compares two approaches to personnel management. The transition to competence-based human resource management means (a a different understanding of the object of management; (b involvement in all functions of human resource management «knowledge – skills – abilities» of the employee; (c to change the approach to strategic management aerospace industry.

Challenges and opportunities for fleet- and métier-based approaches for fisheries management under the European Common Fishery Policy

DEFF Research Database (Denmark)

Ulrich, Clara; Wilson, Douglas C.K.; Nielsen, J. Rasmus

2012-01-01

in the management system has been slow and difficult, being hampered by a number of intrinsic issues. Mixed fisheries are an ongoing “governance headache” combining management complexity, scientific uncertainty and political sensitivity. This paper summarises the current state of play for fleet-based approaches...... in EU fisheries management, and highlights our views on both their potential and the challenges they face in the context of the future CFP. As a convenient layer between the current single-stock level and the level of the individual vessel, fleet/metier- approaches could potentially address a wide range......The inconsistency of single-species objectives in a mixed-fisheries context has repeatedly been highlighted as a key issue in the current European Common Fishery Policy, and it has long been suggested that this issue would be better addressed through fleet (group of vessels) and métier (type...

Managing three approaches to organizational behaviour for ...

African Journals Online (AJOL)

Managing three approaches to organizational behaviour for effectiveness and ... job description, productivity, individual performance and management matters. ... having attained a high productivity level, the organization starts going down.

Towards a strategic approach to special events management in the post-9/11 world

OpenAIRE

Jones, G. B.

2005-01-01

CHDS State/Local This thesis reviews background related to counterterrorism and law enforcement planning for major special events and it identifies some of the strategic issues that have emerged in special events management since the terrorist attacks of September 11, 2001. It focuses on the subjective and objective components of the systems currently used by DHS and the FBI to categorize and resource special events, and it evaluates whether the current approach to major event planning ...

Current industrial practice of managing risks in product development project portfolios

DEFF Research Database (Denmark)

Weng, R.; Oehmen, Josef; Ben-Daya, M.

2013-01-01

Managing portfolios of development and engineering projects currently presents significant challenges to companies. This is even more the case in the management of portfolio risks, where both industry and academia currently lack a clear conceptual understanding of what portfolio risks are and what...

Enhancing Critical Thinking by Teaching Two Distinct Approaches to Management

Science.gov (United States)

Dyck, Bruno; Walker, Kent; Starke, Frederick A.; Uggerslev, Krista

2012-01-01

The authors explore the effect on students' critical thinking of teaching only one approach to management versus teaching two approaches to management. Results from a quasiexperiment--which included a survey, interviews, and case analysis--suggest that compared with students who are taught only a conventional approach to management (which…

Overview of groundwater management approaches at salinisation risk

Science.gov (United States)

Polemio, Maurizio; Zuffianò, Livia Emanuela

2013-04-01

All natural waters contain dissolved minerals from interactions with atmospheric and soil gases, mixing with other solutions, and/or interactions with the biosphere and lithosphere. In many cases, these processes result in natural waters containing solute or salinity above concentrations recommended for a specified use, which creates significant social and economic problems. Groundwater salinisation can be caused by natural phenomena and anthropogenic activities. For the former case, we can distinguish terrestrial and marine phenomena. Approximately 16% of the total area of continental earth is potentially involved in groundwater salinisation. Seawater intrusion can be considered to be the primary phenomenon to be studied in terms of groundwater salinisation. Three schematic approaches to the protection of groundwater via salinisation mitigation and/or groundwater salinity improvement are described based on the classifications of the primary salinisation sources and focusing on the effect of seawater intrusion. The complexity of these approaches generally increases due to difficulties caused by groundwater quality and quantity degradation and increased demand for quality water. In order from the lowest to the highest complexity, these approaches are the engineering approach, the discharge management approach, and the water and land management approach. The engineering approach is realised on the local or detailed scale with the purpose of controlling the salinisation, optimising the well discharge with specific technical solutions and/or completing works to improve the quality and/or quantity of the discharged fresh groundwater. The discharge management approach encompasses at least an entire coastal aquifer and defines rules concerning groundwater utilisation and well discharge. The water and land management approach should be applied on the regional scale. Briefly, this approach becomes necessary when one or more need creates an overall framework of high

System approach to machine building enterprise innovative activity management

Directory of Open Access Journals (Sweden)

І.V. Levytska

2016-12-01

Full Text Available The company, which operates in a challenging competitive environment should focus on new products and provide innovative services that enhance their innovation to maintain the company’s market position. The article deals with the peculiarities of such an activity in the company. The authors analyze the various approaches used in the management, and supply the advantages and disadvantages of each. It is determine that the most optimal approach among them is a system approach. The definition of the consepts "a system" and "a systematic approach to innovative activity management" are suggested. The article works out the system of machine building enterprise innovative activity management, the organization of machine building enterprise innovative activity; the planning of machine building enterprise innovative activity; the control in the system of machine building enterprise innovative activity management; the elements of the control subsystem. The properties, typical for the system of innovative management, are supplied. The managers, engaged in enterprise innovative activity management, must perform a number of the suggested tasks, which affect the efficiency of the enterprise as a whole. These exact tasks are performed using the systematic approach, providing the enterprise competitive operation and quick adaptation to changes in the external environment.

Integrated, regional approach to risk management of industrial systems

International Nuclear Information System (INIS)

Chakraborty, S.

1992-01-01

This paper focuses on the following four main issues: (1) necessity for an integrated, regional approach to risk management of industrial systems; (2) principles of risk management; (3) integrated approach and overall methodology; and (4) implementation of risk management strategies on a regional basis. The U.N. Interagency project on risk management for large industrial areas, which is a pioneer type of international initiative for an integrated approach to risk management, is discussed in this context. Another encouraging activity for further development of overall methodologies for risk management is the ongoing project on the risk and safety of technical systems at the Swiss Federal Institute of Technology in Aurich. The concept of integral risk management takes into account multidimensional factors including technical, economic, political, social, and ethical considerations to allow a well-balanced decision-making process

Managing Cuscuta gronovii (Swamp Dodder in Cranberry Requires an Integrated Approach

Directory of Open Access Journals (Sweden)

Hilary A. Sandler

2010-02-01

Full Text Available Dodders (Cuscuta spp. are parasitic plants that threaten the sustainability of many crops. Because this parasite is very adept and successful from biological and ecological perspectives, a single control strategy is unlikely to provide sufficient economic control. Dodder (C. gronovii is a particularly serious pest in commercial cranberry (Vaccinium macrocarpon production. Multiple viable strategies must be integrated and tailored into a weed management plan to provide acceptable control. The key to sustainable management of this serious pest will require a combination of chemical and cultural approaches, supported by understanding the complicated nature of dodder biology. Research from small fruit production systems like cranberry into the biology of dodder (e.g., germination patterns, host preference, use of plant growth regulators may provide insights that could ultimately be useful for other crop system management plans. This paper will present the current knowledge base for integrated management of dodder in cranberry as well as highlight relevant research from other crops and potential topics for future research.

Systems approach to project risk management

Energy Technology Data Exchange (ETDEWEB)

Kindinger, J. P. (John P.)

2002-01-01

This paper describes the need for better performance in the planning and execution of projects and examines the capabilities of two different project risk analysis methods for improving project performance. A quantitative approach based on concepts and tools adopted from the disciplines of systems analysis, probabilistic risk analysis, and other fields is advocated for managing risk in large and complex research & development projects. This paper also provides an overview of how this system analysis approach for project risk management is being used at Los Alamos National Laboratory along with examples of quantitative risk analysis results and their application to improve project performance.

Sustainable operations management: A typological approach

Directory of Open Access Journals (Sweden)

Lawrence Michael Corbett

2009-07-01

Full Text Available This paper discusses the nature of sustainability and sustainable development as they relate to operations management. It proposes a typology for sustainable operations management that is based on the life cycle stages of a product and the three dimensions of corporate social responsibility. The aim is to show how this typology development could provide a useful approach to integrating the diverse strands of sustainability in operations, using industrial ecology and carbon neutrality as examples. It does this by providing a focused subset of environmental concerns for an industrial ecology approach, and some research propositions for the issue of carbon neutrality.

Brain abscess: Current management

Directory of Open Access Journals (Sweden)

Hernando Alvis-Miranda

2013-01-01

Full Text Available Brain abscess (BA is defined as a focal infection within the brain parenchyma, which starts as a localized area of cerebritis, which is subsequently converted into a collection of pus within a well-vascularized capsule. BA must be differentiated from parameningeal infections, including epidural abscess and subdural empyema. The BA is a challenge for the neurosurgeon because it is needed good clinical, pharmacological, and surgical skills for providing good clinical outcomes and prognosis to BA patients. Considered an infrequent brain infection, BA could be a devastator entity that easily left the patient into dead. The aim of this work is to review the current concepts regarding epidemiology, pathophysiology, etiology, clinical presentation, diagnosis, and management of BA.

Three-dimensional GIS approach for management of assets

Science.gov (United States)

Lee, S. Y.; Yee, S. X.; Majid, Z.; Setan, H.

2014-02-01

Assets play an important role in human life, especially to an organization. Organizations strive and put more effort to improve its operation and assets management. The development of GIS technology has become a powerful tool in management as it is able to provide a complete inventory for managing assets with location-based information. Spatial information is one of the requirements in decision making in various areas, including asset management in the buildings. This paper describes a 3D GIS approach for management of assets. An asset management system was developed by integrating GIS concept and 3D model assets. The purposes of 3D visualization to manage assets are to facilitate the analysis and understanding in the complex environment. Behind the 3D model of assets is a database to store the asset information. A user-friendly interface was also designed for more easier to operate the application. In the application developed, location of each individual asset can be easily tracked according to the referring spatial information and 3D viewing. The 3D GIS approach described in this paper is certainly would be useful in asset management. Systematic management of assets can be carried out and this will lead to less-time consuming and cost-effective. The results in this paper will show a new approach to improve asset management.

Three-dimensional GIS approach for management of assets

International Nuclear Information System (INIS)

Lee, S Y; Yee, S X; Majid, Z; Setan, H

2014-01-01

Assets play an important role in human life, especially to an organization. Organizations strive and put more effort to improve its operation and assets management. The development of GIS technology has become a powerful tool in management as it is able to provide a complete inventory for managing assets with location-based information. Spatial information is one of the requirements in decision making in various areas, including asset management in the buildings. This paper describes a 3D GIS approach for management of assets. An asset management system was developed by integrating GIS concept and 3D model assets. The purposes of 3D visualization to manage assets are to facilitate the analysis and understanding in the complex environment. Behind the 3D model of assets is a database to store the asset information. A user-friendly interface was also designed for more easier to operate the application. In the application developed, location of each individual asset can be easily tracked according to the referring spatial information and 3D viewing. The 3D GIS approach described in this paper is certainly would be useful in asset management. Systematic management of assets can be carried out and this will lead to less-time consuming and cost-effective. The results in this paper will show a new approach to improve asset management

System approach for the management of radioactive waste

International Nuclear Information System (INIS)

Fearnley, I.G.

1997-01-01

An integrated approach to Waste Management and Decommissioning, which takes account of the lifetime implications (safety, dose uptake, discharges and cost) is an important strategic process in forward planning. This type of approach is particularly relevant when making decisions concerning waste minimisation and segregation, packaging and surface storage of high and intermediate level waste in advance of the existence of disposal facilities. Such a systematic approach forms an integral part of a process which enable progress to be assessed and plans to be updated in response to changing demands upon business operations and can continually be applied to waste management policy and to optimise the detailed waste management plans. (author)

Management and modeling approaches for controlling raccoon rabies: The road to elimination.

Science.gov (United States)

Elmore, Stacey A; Chipman, Richard B; Slate, Dennis; Huyvaert, Kathryn P; VerCauteren, Kurt C; Gilbert, Amy T

2017-03-01

Rabies is an ancient viral disease that significantly impacts human and animal health throughout the world. In the developing parts of the world, dog bites represent the highest risk of rabies infection to people, livestock, and other animals. However, in North America, where several rabies virus variants currently circulate in wildlife, human contact with the raccoon rabies variant leads to the highest per capita population administration of post-exposure prophylaxis (PEP) annually. Previous rabies variant elimination in raccoons (Canada), foxes (Europe), and dogs and coyotes (United States) demonstrates that elimination of the raccoon variant from the eastern US is feasible, given an understanding of rabies control costs and benefits and the availability of proper tools. Also critical is a cooperatively produced strategic plan that emphasizes collaborative rabies management among agencies and organizations at the landscape scale. Common management strategies, alone or as part of an integrated approach, include the following: oral rabies vaccination (ORV), trap-vaccinate-release (TVR), and local population reduction. As a complement, mathematical and statistical modeling approaches can guide intervention planning, such as through contact networks, circuit theory, individual-based modeling, and others, which can be used to better understand and predict rabies dynamics through simulated interactions among the host, virus, environment, and control strategy. Strategies derived from this ecological lens can then be optimized to produce a management plan that balances the ecological needs and program financial resources. This paper discusses the management and modeling strategies that are currently used, or have been used in the past, and provides a platform of options for consideration while developing raccoon rabies virus elimination strategies in the US.

Management and modeling approaches for controlling raccoon rabies: The road to elimination.

Directory of Open Access Journals (Sweden)

Stacey A Elmore

2017-03-01

Full Text Available Rabies is an ancient viral disease that significantly impacts human and animal health throughout the world. In the developing parts of the world, dog bites represent the highest risk of rabies infection to people, livestock, and other animals. However, in North America, where several rabies virus variants currently circulate in wildlife, human contact with the raccoon rabies variant leads to the highest per capita population administration of post-exposure prophylaxis (PEP annually. Previous rabies variant elimination in raccoons (Canada, foxes (Europe, and dogs and coyotes (United States demonstrates that elimination of the raccoon variant from the eastern US is feasible, given an understanding of rabies control costs and benefits and the availability of proper tools. Also critical is a cooperatively produced strategic plan that emphasizes collaborative rabies management among agencies and organizations at the landscape scale. Common management strategies, alone or as part of an integrated approach, include the following: oral rabies vaccination (ORV, trap-vaccinate-release (TVR, and local population reduction. As a complement, mathematical and statistical modeling approaches can guide intervention planning, such as through contact networks, circuit theory, individual-based modeling, and others, which can be used to better understand and predict rabies dynamics through simulated interactions among the host, virus, environment, and control strategy. Strategies derived from this ecological lens can then be optimized to produce a management plan that balances the ecological needs and program financial resources. This paper discusses the management and modeling strategies that are currently used, or have been used in the past, and provides a platform of options for consideration while developing raccoon rabies virus elimination strategies in the US.

Evaluation of Current Approaches to Stream Classification and a Heuristic Guide to Developing Classifications of Integrated Aquatic Networks

Science.gov (United States)

Melles, S. J.; Jones, N. E.; Schmidt, B. J.

2014-03-01

Conservation and management of fresh flowing waters involves evaluating and managing effects of cumulative impacts on the aquatic environment from disturbances such as: land use change, point and nonpoint source pollution, the creation of dams and reservoirs, mining, and fishing. To assess effects of these changes on associated biotic communities it is necessary to monitor and report on the status of lotic ecosystems. A variety of stream classification methods are available to assist with these tasks, and such methods attempt to provide a systematic approach to modeling and understanding complex aquatic systems at various spatial and temporal scales. Of the vast number of approaches that exist, it is useful to group them into three main types. The first involves modeling longitudinal species turnover patterns within large drainage basins and relating these patterns to environmental predictors collected at reach and upstream catchment scales; the second uses regionalized hierarchical classification to create multi-scale, spatially homogenous aquatic ecoregions by grouping adjacent catchments together based on environmental similarities; and the third approach groups sites together on the basis of similarities in their environmental conditions both within and between catchments, independent of their geographic location. We review the literature with a focus on more recent classifications to examine the strengths and weaknesses of the different approaches. We identify gaps or problems with the current approaches, and we propose an eight-step heuristic process that may assist with development of more flexible and integrated aquatic classifications based on the current understanding, network thinking, and theoretical underpinnings.

Structural transformation of the machine-building enterprises: management approaches

OpenAIRE

Obydiennova, T.

2014-01-01

The article considers the «classical» approach to the issues of enterprise management: process, system, situational, concrete, functional, resource, factorial approach. Outlines the definitions of each of the approaches to the management of the enterprise, as well as advantages and disadvantages. The author suggests the schematic image of the aspects of the system approach and its application; a scheme of contents resource and functional approaches. For research on the structural transformati...

E-waste management challenges in Iran: presenting some strategies for improvement of current conditions.

Science.gov (United States)

Taghipour, Hassan; Nowrouz, Parviz; Jafarabadi, Mohamad Asghari; Nazari, Jalil; Hashemi, Ahmad Asl; Mosaferi, Mohammad; Dehghanzadeh, Reza

2012-11-01

E-waste is one of the fastest-growing waste streams in Iran, owing to an increase in consumption of electrical and electronic equipment. Nevertheless, as is the case in some other countries, E-waste management has not received sufficient attention. For the successful implementation of any waste management plan (including an E-waste management plan), the availability of sufficient and accurate information on the quantities and composition of the waste generated and on current management conditions is a fundamental prerequisite. At present, in Iran, there is no available and accurate information that describes the characteristics and generation rate of E-waste or the actual practice of management and handling of the waste. For this initial study, eight electronic products were selected for the determination of their E-waste generation rate in the country, and two cities, Tehran and Tabriz, were selected for assessment of the current condition of E-waste management. The study found that the amount of E-waste generation in the country for the eight selected electronic items alone was 115,286, 112,914 and 115,151 metric tons in 2008, 2009 and 2010, respectively. Of the types of electronic items included in the study, televisions, with an average of 42.42%, and PCs, with an average of 32.66% accounted for the greatest proportions of the total mass of E-waste generated during 2008-2010. Currently, despite the fact that primary legislation for E-waste management (as part of general waste legislation) exists in Iran, this primary legislation has not yet been implemented. In practical terms, there is no definite policy or plan for the allocation of funds to prepare suitable equipment and facilities for the management and recycling of E-waste at the end of the products' useful life. Proposed improvements in current conditions are identified, first by considering other countries' experiences and then suggesting specific practical policies, rules, and regulations that should be

Approaches and perioperative management in periacetabular osteotomy surgery

DEFF Research Database (Denmark)

Søballe, Kjeld; Troelsen, Anders

2012-01-01

.9 to 8.1 years) of 209 PAOs performed using this approach have shown Kaplan-Meier survivorship rates of 94.7% at 5 years and 88.6% at 8.1 years, with conversion to total hip arthroplasty as the end point. Perioperative management includes a patient education program, optimized pain treatment strategies...... (local infiltration analgesia), and a progressive mobilization and exercise program. The transsartorial approach coupled with a specific perioperative management program has proved successful for PAO surgery.......In the early days of periacetabular osteotomy (PAO), surgical approaches were characterized by extensive soft-tissue dissection. The Smith-Petersen approach (and iliofemoral modifications) and the ilioinguinal approach have traditionally been used for PAO. The optimal surgical approach for PAO...

USING OF THE PROJECT-ORIENTED APPROACH IN THE INNOVATIVE ACTIVITY MANAGEMENT

Directory of Open Access Journals (Sweden)

Варвара Михайлівна ПІТЕРСЬКА

2016-02-01

Full Text Available The article describes the current state of science in Ukraine, indicated the main directions of research funding. The methodological approach of working out of the project-oriented strategy of innovative development of scientific activity, including the implementation of international trends and support of research is proposed. Using of a project-oriented approach of research activities due to the need of reducing of the research cycle and strengthen expenditure control capabilities due to restrictions of funding research projects from the state. It should be noted that the structuring of research, given the project approach, allows engaging of the implementation of the research project professionals with good knowledge and skills and create a team activity focused on quality results. Innovations aren‘t still properly means the improvement of competitiveness in Ukraine. Thus, the problem of transition to an innovative development model retains its relevance, that significantly enhanced in the light of current external and internal trends. Using of the project-oriented innovation management due to the need to shorten the cycle of research and to strengthen the control over the expenditure of funds in connection with the limited funding of scientific research by the state.

Comprehensive management of pressure ulcers in spinal cord injury: Current concepts and future trends

Science.gov (United States)

Kruger, Erwin A.; Pires, Marilyn; Ngann, Yvette; Sterling, Michelle; Rubayi, Salah

2013-01-01

Pressure ulcers in spinal cord injury represent a challenging problem for patients, their caregivers, and their physicians. They often lead to recurrent hospitalizations, multiple surgeries, and potentially devastating complications. They present a significant cost to the healthcare system, they require a multidisciplinary team approach to manage well, and outcomes directly depend on patients' education, prevention, and compliance with conservative and surgical protocols. With so many factors involved in the successful treatment of pressure ulcers, an update on their comprehensive management in spinal cord injury is warranted. Current concepts of local wound care, surgical options, as well as future trends from the latest wound healing research are reviewed to aid medical professionals in treating patients with this difficult problem. PMID:24090179

The process approach to service quality management

OpenAIRE

Kamila Kowalik; Dorota Klimecka-Tatar

2018-01-01

In this paper a model of service quality management based on the process approach has been presented. The first part of the article contains the theoretical framework of service quality and the process approach in management. Next, quality of service process has been presented in reference to a process-based definition in quoted literature. Finally, the outcomes of a customer questionnaire concerning the validity of particular quality attributes has been presented. The collected data in relat...

THE DEVELOPMENT OF THE PROCESS-BASED APPROACH TO MANAGEMENT

Directory of Open Access Journals (Sweden)

Urij V. Lyandau

2013-01-01

Full Text Available This article considers the timeline of the approaches to management of the industrial processes and organizations in general.The Adam Smith’s idea of specialization, the Henry Ford’s conveyor and Frederick Taylor’s scientific approach created functional corporations, in which specialized departments consisted of specialized workers. Such organizational chart was optimized for every department’s tasks, which are necessary to perform.During the life cycle evolution of industrial and then informational ages external conditions of production has changed. In consequence, there was born the necessity to change key factors of the management paradigm. These changes are the transfer from the functional management to the process-based approach. The functional management was the basic type of management in many organizations during the 20th century. Only in the end of 1990 companies started to integrate the process-based approach. This conversion was born cause of special conditions that the informational age created.

A multilayer approach for turbidity currents

Science.gov (United States)

Fernandez-Nieto, Enrique; Castro Díaz, Manuel J.; Morales de Luna, Tomás

2017-04-01

When a river that carries sediment in suspension enters into a lake or the ocean it can form a plume that can be classified as hyperpycnal or hypopycnal. Hypopycnal plumes occurs if the combined density of the sediment and interstitial fluid is lower than that of the ambient. Hyperpycnal plumes are a class of sediment-laden gravity current commonly referred to as turbidity currents [7,9]. Some layer-averaged models have been previously developed (see [3, 4, 8] among others). Although this layer-averaged approach gives a fast and valuable information, it has the disadvantage that the vertical distribution of the sediment in suspension is lost. A recent technique based on a multilayer approach [1, 2, 6] has shown to be specially useful to generalize shallow water type models in order to keep track of the vertical components of the averaged variables in the classical shallow water equations. In [5] multilayer model is obtained using a vertical discontinuous Galerkin approach for which the vertical velocity is supposed to be piecewise linear and the horizontal velocity is supposed to be piecewise constant. In this work the technique introduced in [5] is generalized to derive a model for turbidity currents. This model allows to simulate hyperpycnal as well as hypopycnal plumes. Several numerical tests will be presented. References [1] E. Audusse, M. Bristeau, B. Perthame, and J. Sainte-Marie. A multilayer Saint-Venant system with mass exchanges for shallow water flows. derivation and numerical validation. ESAIM: Mathematical Modelling and Numerical Analysis, 45(1):169-200, (2010). [2] E. Audusse, M.-O. Bristeau, M. Pelanti, and J. Sainte-Marie. Approximation of the hydrostatic Navier–Stokes system for density stratified flows by a multilayer model: Kinetic interpretation and numerical solution. Journal of Computational Physics, 230(9):3453-3478, (2011). [3] S. F. Bradford and N. D. Katopodes. Hydrodynamics of turbid underflows. i: Formulation and numerical

Importance of an Interprofessional Team Approach in Achieving Improved Management of the Dizzy Patient.

Science.gov (United States)

Rodriguez, Amanda I; Zupancic, Steven; Song, Michael M; Cordero, Joehassin; Nguyen, Tam Q; Seifert, Charles

2017-03-01

Because of its multifaceted nature, dizziness is difficult for clinicians to diagnose and manage independently. Current treatment trends suggest that patients are often referred to the otolaryngologist for intervention despite having a nonotologic disorder. Additionally, many individuals with atypical presentations are often misdiagnosed and spend a significant amount of time waiting for consultation by the otolaryngologist. Few studies have alluded that implementation of an interprofessional team approach in the diagnosis and management of the dizzy patient can improve clinical decision-making. However, to the authors' knowledge, there is no information specifically quantifying the outcomes and potential benefits of using an interprofessional balance care team approach. To compare dizziness diagnoses trends and referral practices with and without the use of an interprofessional management approach within a university healthcare system. Over the course of a 3-yr period, a retrospective review of the diagnosis and management of dizziness was performed with and without implementation of an interprofessional team. To observe potential differences, year 3 incorporated the interprofessional management approach while years 1-2 did not. The two periods were then compared to each other. A total of 134 patients referred to a university hearing clinic for a vestibular and balance function evaluation. Diagnoses and management trends were examined with descriptive statistics (percentages and frequencies). Fisher's exact tests, analysis of contingency tables, were conducted to evaluate the influence of interprofessional management on dizziness diagnoses and treatment patterns. Results demonstrated that before implementation of an interprofessional team approach, (1) referring clinicians used unspecific dizziness diagnosis codes (e.g., dizziness and giddiness), (2) a low number of patients with dizziness were referred for balance function testing, (3) diagnoses remained

Disease Management Evaluation: A Comprehensive Review of Current State of the Art.

Science.gov (United States)

Conklin, Annalijn; Nolte, Ellen

2011-01-01

Many countries across Europe and elsewhere have been experimenting with various structured approaches to manage patients with chronic illness as a way to improve quality of care, reduce costs and lead to better population health outcomes in the long run. Despite a body of studies of disease management interventions, uncertainty about the effects of these remains not least because current guidance on evaluation methods and metrics require further development to enhance scientific rigour while also being practical in routine operations. This article provides details from a report that reviews the academic and grey literature to help advance the task of improving the science of assessing disease management initiatives in Europe. Challenges identified are methodological, analytical and conceptual in nature, with a key issue being the establishment of the counterfactual. An array of sophisticated statistical techniques and analytical frameworks can assist in the construction of a sound comparison strategy when a randomised controlled trial is not possible. Issues to consider include: a clear framework of the mechanisms of action and expected effects of disease management; an understanding of the characteristics of disease management (scope, content, dose, context), and of the intervention and target populations (disease type, severity, case-mix); a period of observation over multiple years; and a logical link between performance measures and the intervention's aims and underlying theory of behaviour change.

Cost-effectiveness in the management of Dupuytren's contracture. A Canadian cost-utility analysis of current and future management strategies.

Science.gov (United States)

Baltzer, H; Binhammer, P A

2013-08-01

In Canada, Dupuytren's contracture is managed with partial fasciectomy or percutaneous needle aponeurotomy (PNA). Injectable collagenase will soon be available. The optimal management of Dupuytren's contracture is controversial and trade-offs exist between the different methods. Using a cost-utility analysis approach, our aim was to identify the most cost-effective form of treatment for managing Dupuytren's contracture it and the threshold at which collagenase is cost-effective. We developed an expected-value decision analysis model for Dupuytren's contracture affecting a single finger, comparing the cost-effectiveness of fasciectomy, aponeurotomy and collagenase from a societal perspective. Cost-effectiveness, one-way sensitivity and variability analyses were performed using standard thresholds for cost effective treatment ($50 000 to $100 000/QALY gained). Percutaneous needle aponeurotomy was the preferred strategy for managing contractures affecting a single finger. The cost-effectiveness of primary aponeurotomy improved when repeated to treat recurrence. Fasciectomy was not cost-effective. Collagenase was cost-effective relative to and preferred over aponeurotomy at $875 and $470 per course of treatment, respectively. In summary, our model supports the trend towards non-surgical interventions for managing Dupuytren's contracture affecting a single finger. Injectable collagenase will only be feasible in our publicly funded healthcare system if it costs significantly less than current United States pricing.

A Review of the Wood Pellet Value Chain, Modern Value/Supply Chain Management Approaches, and Value/Supply Chain Models

Directory of Open Access Journals (Sweden)

Natalie M. Hughes

2014-01-01

Full Text Available We reviewed 153 peer-reviewed sources to provide identification of modern supply chain management techniques and exploration of supply chain modeling, to offer decision support to managers. Ultimately, the review is intended to assist member-companies of supply chains, mainly producers, improve their current management approaches, by directing them to studies that may be suitable for direct application to their supply chains and value chains for improved efficiency and profitability. We found that information on supply chain management and modeling techniques in general is available. However, few Canadian-based published studies exist regarding a demand-driven modeling approach to value/supply chain management for wood pellet production. Only three papers were found specifically on wood pellet value chain analysis. We propose that more studies should be carried out on the value chain of wood pellet manufacturing, as well as demand-driven management and modeling approaches with improved demand forecasting methods.

Regional approaches to the management of patients with advanced, radioactive iodine-refractory differentiated thyroid carcinoma.

Science.gov (United States)

Brose, Marcia S; Smit, Johannes; Capdevila, Jaume; Elisei, Rossella; Nutting, Christopher; Pitoia, Fabian; Robinson, Bruce; Schlumberger, Martin; Shong, Young Kee; Takami, Hiroshi

2012-09-01

For patients with advanced, radioactive iodine-refractory differentiated thyroid cancer, current treatment guidelines recommend clinical trial enrollment or small-molecule kinase inhibitor therapy. However, details of patient management vary between countries depending on trial availability and national regulatory policies. Insufficient clinical trial data and variable disease characteristics challenge the creation of universal guidelines, and treatment plans often reflect regional influences. A multidisciplinary, multiregional panel of experts met to discuss regional approaches to managing patients with advanced, radioactive iodine-refractory differentiated thyroid cancer and the potential impact of emerging therapies on current treatment strategies. Despite process-oriented regional differences, the decision-making strategies were similar. Multidisciplinary teams used to manage high-risk patients varied in composition across regions, particularly regarding the responsible physician's specialty. Cytotoxic chemotherapy was viewed as limited in clinical benefit, and targeted agents as attractive, based on promising data. Panel members support clinical trial enrollment as the preferred treatment strategy for managing these patients.

Streamlined approach to waste management at CRL

International Nuclear Information System (INIS)

Adams, L.; Campbell, B.

2011-01-01

Radioactive, mixed, hazardous and non-hazardous wastes have been and continue to be generated at Chalk River Laboratories (CRL) as a result of research and development activities and operations since the 1940s. Over the years, the wastes produced as a byproduct of activities delivering the core missions of the CRL site have been of many types, and today, over thirty distinct waste streams have been identified, all requiring efficient management. With the commencement of decommissioning of the legacy created as part of the development of the Canadian nuclear industry, the volumes and range of wastes to be managed have been increasing in the near term, and this trend will continue into the future. The development of a streamlined approach to waste management is a key to successful waste management at CRL. Waste management guidelines that address all of the requirements have become complex, and so have the various waste management groups receiving waste, with their many different processes and capabilities. This has led to difficulties for waste generators in understanding all of the requirements to be satisfied for the various CRL waste receivers, whose primary concerns are to be safe and in compliance with their acceptance criteria and license conditions. As a result, waste movement on site can often be very slow, especially for non-routine waste types. Recognizing an opportunity for improvement, the Waste Management organization at CRL has implemented a more streamlined approach with emphasis on early identification of waste type and possible disposition path. This paper presents a streamlined approach to waste identification and waste management at CRL, the implementation methodology applied and the early results achieved from this process improvement. (author)

Program Management Approach to the Territorial Development of Small Business

Directory of Open Access Journals (Sweden)

Natalia Aleksandrovna Knysh

2016-06-01

Full Text Available This article presents the results of the research of the application on a state level of the program management approach to the territorial development of small business. Studying the main mechanism of the state policy implementation in the sphere of small business on a regional level, the authors have revealed the necessity to take into account the territorial specificity while the government programs of small business development are being formed. The analysis of the national practice of utilizing the program management mechanism in the regional system of the government support of small entrepreneurship was conducted on the example of Omsk region. The results of the analysis have shown the inefficiency of the current support system for small business and have determined the need to create an integrated model of territorial programming, which would not only contribute to the qualitative development of small business, but also provide the functioning efficiency of program management mechanism. As a result, the authors have created the two-level model of the programming of the territorial development of small business, which allows to satisfy purposefully the needs of entrepreneurship taking into account the specificity of the internal and external environment of the region. The first level of the model is methodological one and it is based on the marketing approach (the concepts of place marketing and relationship marketing to the operation of the program management mechanism. The second level of the model is methodical one. It offers the combination of the flexible methods of management of programming procedure (benchmarking, foresight, crowdsourcing and outsourcing. The given model raises the efficiency of the management decisions of the state structures in the sphere of small business. Therefore, it is interesting for the government authorities, which are responsible for the regional and municipal support programs of small business, as well

Narcolepsy: current treatment options and future approaches

Science.gov (United States)

Billiard, Michel

2008-01-01

The management of narcolepsy is presently at a turning point. Three main avenues are considered in this review: 1) Two tendencies characterize the conventional treatment of narcolepsy. Modafinil has replaced methylphenidate and amphetamine as the first-line treatment of excessive daytime sleepiness (EDS) and sleep attacks, based on randomized, double blind, placebo-controlled clinical trials of modafinil, but on no direct comparison of modafinil versus traditional stimulants. For cataplexy, sleep paralysis, and hypnagogic hallucinations, new antidepressants tend to replace tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs) in spite of a lack of randomized, double blind, placebo-controlled clinical trials of these compounds; 2) The conventional treatment of narcolepsy is now challenged by sodium oxybate, the sodium salt of gammahydroxybutyrate, based on a series of randomized, double-blind, placebo-controlled clinical trials and a long-term open label study. This treatment has a fairly good efficacy and is active on all symptoms of narcolepsy. Careful titration up to an adequate level is essential both to obtain positive results and avoid adverse effects; 3) A series of new treatments are currently being tested, either in animal models or in humans, They include novel stimulant and anticataplectic drugs, endocrine therapy, and, more attractively, totally new approaches based on the present state of knowledge of the pathophysiology of narcolepsy with cataplexy, hypocretine-based therapies, and immunotherapy. PMID:18830438

Prevention of musculoskeletal disorders within management systems: A scoping review of practices, approaches, and techniques.

Science.gov (United States)

Yazdani, Amin; Neumann, W Patrick; Imbeau, Daniel; Bigelow, Philip; Pagell, Mark; Wells, Richard

2015-11-01

The purpose of this study was to identify and summarize the current research evidence on approaches to preventing musculoskeletal disorders (MSD) within Occupational Health and Safety Management Systems (OHSMS). Databases in business, engineering, and health and safety were searched and 718 potentially relevant publications were identified and examined for their relevance. Twenty-one papers met the selection criteria and were subjected to thematic analysis. There was very little literature describing the integration of MSD risk assessment and prevention into management systems. This lack of information may isolate MSD prevention, leading to difficulties in preventing these disorders at an organizational level. The findings of this review argue for further research to integrate MSD prevention into management systems and to evaluate the effectiveness of the approach. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Biomedical waste management in Ayurveda hospitals - current practices & future prospectives.

Science.gov (United States)

Rajan, Renju; Robin, Delvin T; M, Vandanarani

2018-03-16

Biomedical waste management is an integral part of traditional and contemporary system of health care. The paper focuses on the identification and classification of biomedical wastes in Ayurvedic hospitals, current practices of its management in Ayurveda hospitals and its future prospective. Databases like PubMed (1975-2017 Feb), Scopus (1960-2017), AYUSH Portal, DOAJ, DHARA and Google scholar were searched. We used the medical subject headings 'biomedical waste' and 'health care waste' for identification and classification. The terms 'biomedical waste management', 'health care waste management' alone and combined with 'Ayurveda' or 'Ayurvedic' for current practices and recent advances in the treatment of these wastes were used. We made a humble attempt to categorize the biomedical wastes from Ayurvedic hospitals as the available data about its grouping is very scarce. Proper biomedical waste management is the mainstay of hospital cleanliness, hospital hygiene and maintenance activities. Current disposal techniques adopted for Ayurveda biomedical wastes are - sewage/drains, incineration and land fill. But these methods are having some merits as well as demerits. Our review has identified a number of interesting areas for future research such as the logical application of bioremediation techniques in biomedical waste management and the usage of effective micro-organisms and solar energy in waste disposal. Copyright © 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Published by Elsevier B.V. All rights reserved.

Approach to accident management in RBMK-1500

International Nuclear Information System (INIS)

Kaliatka, A.; Urbonavicius, E.; Uspuras, E.

2008-01-01

In order to ensure the safe operation of the nuclear power plants accident management programs are being developed around the world. These accident management programs cover the whole spectrum of accidents, including severe accidents. A lot of work is done to investigate the severe accident phenomena and implement severe accident management in NPPs with vessel-type reactors, while less attention is paid to channel-type reactors CANDU and RBMK. Ignalina NPP with RBMK-1500 reactor has implemented symptom based emergency operation procedures, which cover management of accidents until the core damage and do not extend to core damage region. In order to ensure coverage of the whole spectrum of accidents and meet the requirements of IAEA the severe accident management guidelines have to be developed. This paper presents the basic principles and approach to management of beyond design basis accidents at Ignalina NPP. In general, this approach could be applied to NPPs with RBMK-1000 reactors that are available in Russia, but the design differences should be taken into account

Controllable Load Management Approaches in Smart Grids

Directory of Open Access Journals (Sweden)

Jingshuang Shen

2015-10-01

Full Text Available With rapid smart grid technology development, the customer can actively participate in demand-side management (DSM with the mutual information communication between the distributor operation company and the smart devices in real-time. Controllable load management not only has the advantage of peak shaving, load balance, frequency regulation, and voltage stability, but is also effective at providing fast balancing services to the renewable energy grid in the distributed power system. The load management faces an enormous challenge as the customer has a large number of both small residential loads and dispersed renewable sources. In this paper, various controllable load management approaches are discussed. The traditional controllable load approaches such as the end users’ controllable appliances, storage battery, Vehicle-to-Grid (V2G, and heat storage are reviewed. The “broad controllable loads” management, such as the microgrid, Virtual Power Plant (VPP, and the load aggregator are also presented. Furthermore, the load characteristics, control strategies, and control effectiveness are analyzed.

Current management of urethral stricture disease

Directory of Open Access Journals (Sweden)

Thomas G Smith

2016-01-01

Conclusions: Progress is being made toward consistent terminology, and nomenclature which will, in turn, help to standardize treatment within the field of urology. Treatment for urethral stricture and stenosis remains inconsistent between reconstructive and nonreconstructive urologists due to varying treatment algorithms and approaches to disease management. Tissue engineering appears to be future for reconstructive urethral surgery with reports demonstrating feasibility in the use of different tissue substitutes and grafts.

Investigating the management of diabetes in nursing homes using a mixed methods approach.

LENUS (Irish Health Repository)

Hurley, L

2017-03-21

As populations age there is an increased demand for nursing home (NH) care and a parallel increase in the prevalence of diabetes. Despite this, there is growing evidence that the management of diabetes in NHs is suboptimal. The reasons for this are complex and poorly understood. This study aimed to identify the current level of diabetes care in NHs using a mixed methods approach.

An approach to pavement management in Virginia.

Science.gov (United States)

1981-01-01

The report summarizes the objectives and benefits of formal pavement management systems and outlines an approach believed by the author to be practical for Virginia. The management of Virginia interstate pavements and a proposed random-sampling plan ...

Integrated Approach to User Account Management

Science.gov (United States)

Kesselman, Glenn; Smith, William

2007-01-01

IT environments consist of both Windows and other platforms. Providing user account management for this model has become increasingly diffi cult. If Microsoft#s Active Directory could be enhanced to extend a W indows identity for authentication services for Unix, Linux, Java and Macintosh systems, then an integrated approach to user account manag ement could be realized.

Bacterial Diseases of Bananas and Enset: Current State of Knowledge and Integrated Approaches Toward Sustainable Management

Directory of Open Access Journals (Sweden)

Guy Blomme

2017-07-01

Full Text Available Bacterial diseases of bananas and enset have not received, until recently, an equal amount of attention compared to other major threats to banana production such as the fungal diseases black leaf streak (Mycosphaerella fijiensis and Fusarium wilt (Fusarium oxysporum f. sp. cubense. However, bacteria cause significant impacts on bananas globally and management practices are not always well known or adopted by farmers. Bacterial diseases in bananas and enset can be divided into three groups: (1 Ralstonia-associated diseases (Moko/Bugtok disease caused by Ralstonia solanacearum and banana blood disease caused by R. syzygii subsp. celebesensis; (2 Xanthomonas wilt of banana and enset, caused by Xanthomonas campestris pv. musacearum and (3 Erwinia-associated diseases (bacterial head rot or tip-over disease Erwinia carotovora ssp. carotovora and E. chrysanthemi, bacterial rhizome and pseudostem wet rot (Dickeya paradisiaca formerly E. chrysanthemi pv. paradisiaca. Other bacterial diseases of less widespread importance include: bacterial wilt of abaca, Javanese vascular wilt and bacterial fingertip rot (probably caused by Ralstonia spp., unconfirmed. This review describes global distribution, symptoms, pathogenic diversity, epidemiology and the state of the art for sustainable disease management of the major bacterial wilts currently affecting banana and enset.

Exploring Academics' Approaches to Managing Team Assessment

Science.gov (United States)

Augar, Naomi; Woodley, Carolyn J.; Whitefield, Despina; Winchester, Maxwell

2016-01-01

Purpose: The purpose of this paper is to develop an understanding of academics' approaches to managing team assessment at an Australian University with a view to informing policy development and assessment design. Design/methodology/approach: The research was conducted using a single exploratory case study approach focussing on the team assessment…

Management approach recommendations. Earth Observatory Satellite system definition study (EOS)

Science.gov (United States)

1974-01-01

Management analyses and tradeoffs were performed to determine the most cost effective management approach for the Earth Observatory Satellite (EOS) Phase C/D. The basic objectives of the management approach are identified. Some of the subjects considered are as follows: (1) contract startup phase, (2) project management control system, (3) configuration management, (4) quality control and reliability engineering requirements, and (5) the parts procurement program.

Setting conservation management thresholds using a novel participatory modeling approach.

Science.gov (United States)

Addison, P F E; de Bie, K; Rumpff, L

2015-10-01

We devised a participatory modeling approach for setting management thresholds that show when management intervention is required to address undesirable ecosystem changes. This approach was designed to be used when management thresholds: must be set for environmental indicators in the face of multiple competing objectives; need to incorporate scientific understanding and value judgments; and will be set by participants with limited modeling experience. We applied our approach to a case study where management thresholds were set for a mat-forming brown alga, Hormosira banksii, in a protected area management context. Participants, including management staff and scientists, were involved in a workshop to test the approach, and set management thresholds to address the threat of trampling by visitors to an intertidal rocky reef. The approach involved trading off the environmental objective, to maintain the condition of intertidal reef communities, with social and economic objectives to ensure management intervention was cost-effective. Ecological scenarios, developed using scenario planning, were a key feature that provided the foundation for where to set management thresholds. The scenarios developed represented declines in percent cover of H. banksii that may occur under increased threatening processes. Participants defined 4 discrete management alternatives to address the threat of trampling and estimated the effect of these alternatives on the objectives under each ecological scenario. A weighted additive model was used to aggregate participants' consequence estimates. Model outputs (decision scores) clearly expressed uncertainty, which can be considered by decision makers and used to inform where to set management thresholds. This approach encourages a proactive form of conservation, where management thresholds and associated actions are defined a priori for ecological indicators, rather than reacting to unexpected ecosystem changes in the future. © 2015 The

Concept of sustainable waste management in the city of Zagreb: Towards the implementation of circular economy approach.

Science.gov (United States)

Ribić, Bojan; Voća, Neven; Ilakovac, Branka

2017-02-01

Improvement of the current waste management is one of the main challenges for most municipalities in Croatia, mainly due to legal obligations set in different European Union (EU) directives regarding waste management, such as reduction of waste generation and landfilling, or increase of separately collected waste and recycling rates. This paper highlights the current waste management in the city of Zagreb by analyzing the waste generation, collection, and disposal scenario along with the regulatory and institutional framework. Since the present waste management system mainly depends upon landfilling, with the rate of separate waste collection and recycling far from being adequate, it is necessary to introduce a new system that will take into account the current situation in the city as well as the obligations imposed by the EU. Namely, in the coming years, the Waste Framework and Landfill Directives of the European Union will be a significant driver of change in waste management practices and governance of the city of Zagreb. At present, the yearly separate waste collection makes somewhat less than 5 kg per capita of various waste fractions, i.e., far below the average value for the (28) capital cities of the EU, which is 108 kg per capita. This is possible to achieve only by better and sustainable planning of future activities and facilities, taking into account of environmental, economic, and social aspects of waste management. This means that the city of Zagreb not only will have to invest in new infrastructure to meet the targets, but also will have to enhance public awareness in diverting this waste at the household level. The solution for the new waste management proposed in this paper will certainly be a way of implementing circular economy approach to current waste management practice in the city of Zagreb. Municipal waste management in the developing countries in the EU (new eastern EU members) is often characterized by its limited utilization of recycling

RISK MANAGEMENT: AN INTEGRATED APPROACH TO RISK MANAGEMENT AND ASSESSMENT

Directory of Open Access Journals (Sweden)

Szabo Alina

2012-12-01

Full Text Available Purpose: The objective of this paper is to offer an overview over risk management cycle by focusing on prioritization and treatment, in order to ensure an integrated approach to risk management and assessment, and establish the ‘top 8-12’ risks report within the organization. The interface with Internal Audit is ensured by the implementation of the scoring method to prioritize risks collected from previous generated risk report. Methodology/approach: Using evidence from other research in the area and the professional expertise, this article outlines an integrated approach to risk assessment and risk management reporting processes, by separating the risk in two main categories: strategic and operational risks. The focus is on risk prioritization and scoring; the final output will comprise a mix of strategic and operational (‘top 8-12’ risks, which should be used to establish the annual Internal Audit plan. Originality/value: By using an integrated approach to risk assessment and risk management will eliminate the need for a separate Internal Audit risk assessment over prevailing risks. It will reduce the level of risk assessment overlap by different functions (Tax, Treasury, Information System over the same risk categories as a single methodology, is used and will align timings of risk assessment exercises. The risk prioritization by usage of risk and control scoring criteria highlights the combination between financial and non-financial impact criteria allowing risks that do not naturally lend themselves to a financial amount to be also assessed consistently. It is emphasized the usage of score method to prioritize the risks included in the annual audit plan in order to increase accuracy and timelines.

A Design Thinking Approach to Teaching Knowledge Management

Science.gov (United States)

Wang, Shouhong; Wang, Hai

2008-01-01

Pedagogies for knowledge management courses are still undeveloped. This Teaching Tip introduces a design thinking approach to teaching knowledge management. An induction model used to guide students' real-life projects for knowledge management is presented. (Contains 1 figure.)

Designing a Model for Trauma System Management Using Public Health Approach: The Case of Iran

Directory of Open Access Journals (Sweden)

Farzad Panahi

2012-01-01

Full Text Available Trauma is a leading cause of death and disability around the world. Injuries are responsible for about six million deaths annually, of which ninety percent occur in developing countries. In Iran, injuries are the most common cause of death among age groups below fifty. Trauma system development is a systematic and comprehensive approach to injury prevention and treatment whose effectiveness has been proved. The present study aims at designing a trauma system management model as the first step toward trauma system establishment in Iran. In this qualitative research, a conceptual framework was developed based on the public health approach and three well-known trauma system models. We used Benchmarks, Indicators and Scoring (BIS to analyze the current situation of Iran trauma care system. Then the trauma system management was designed using the policy development phase of public health approach The trauma system management model, validated by a panel of experts, describes lead agency, trauma system plan, policy-making councils, and data-based control according to the four main functions of management: leading, planning, organizing and controlling. This model may be implemented in two phases: the exclusive phase, focusing on resource integration and the inclusive phase, which concentrates on system development. The model could facilitate the development of trauma system in Iran through pilot studies as the assurance phase of public health approach. Furthermore, the model can provide a practical framework for trauma system management at the international level.

Managing the Cumulative Impacts of Land Uses in the Western Canadian Sedimentary Basin: A Modeling Approach

Directory of Open Access Journals (Sweden)

Richard, R. Schneider

2003-07-01

Full Text Available This case study from northeastern Alberta, Canada, demonstrates a fundamentally different approach to forest management in which stakeholders balance conservation and economic objectives by weighing current management options from the point of view of their long-term effects on the forest. ALCES®, a landscape-scale simulation model, is used to quantify the effects of the current regulatory framework and typical industrial practices on a suite of ecological and economic indicators over the next 100 yr. These simulations suggest that, if current practices continue, the combined activities of the energy and forestry industries in our 59,000 km2 study area will cause the density of edge of human origin to increase from 1.8 km/km 2 to a maximum of 8.0 km/km2. We also predict that older age classes of merchantable forest stands will be largely eliminated from the landscape, habitat availability for woodland caribou will decline from 43 to 6%, and there will be a progressive shortfall in the supply of softwood timber beginning in approximately 60 yr. Additional simulations involving a suite of "best practices" demonstrate that substantial improvements in ecological outcome measures could be achieved through alternative management scenarios while still maintaining a sustainable flow of economic benefits. We discuss the merits of our proposed approach to land use planning and apply it to the Western Canadian Sedimentary Basin.

Waste management in Greenland: current situation and challenges

DEFF Research Database (Denmark)

Eisted, Rasmus; Christensen, Thomas Højlund

2011-01-01

Waste management in Greenland (56 000 inhabitants) is characterized by landfilling, incineration and export to Denmark of small quantities of metals and hazardous waste. The annual amount of waste is estimated to about 50 000 tons but actual data are scarce. Data on the waste composition is basic...... are small and equipped with only moderate flue gas cleaning technology. This report summarizes the current waste management situation in Greenland and identifies important challenges in improving the waste management....... is basically lacking. The scattered small towns and settlements, the climate and the long transport distances between towns and also to recycling industries abroad constitute a complex situation with respect to waste management. The landfills have no collection of gas and leachate and the incinerators...

Promising novel therapeutic approaches in the management of gastrointestinal stromal tumors.

Science.gov (United States)

Szucs, Zoltan; Thway, Khin; Fisher, Cyril; Bulusu, Ramesh; Constantinidou, Anastasia; Benson, Charlotte; van der Graaf, Winette Ta; Jones, Robin L

2017-01-01

Primary and secondary resistance to currently available licensed tyrosine kinase inhibitors poses a real clinical challenge in the management of advanced gastrointestinal stromal tumors. Within the frame of early phase clinical trials novel systemic treatments are currently being evaluated to target both the well explored and novel emerging downstream effectors of KIT and PDGFRA signaling. Alternative therapeutic approaches also include exploring novel inhibitors of the KIT/PDGFRA receptors, immune checkpoint and cyclin-dependent kinase inhibitors. The final clinical trial outcome data for these agents are highly anticipated. Integration of new diagnostic techniques into routine clinical practice can potentially guide tailored delivery of agents in the treatment of a highly polyclonal, heterogeneous disease such as heavily pretreated advanced gastrointestinal stromal tumor.

Remediation management of complex sites using an adaptive site management approach.

Science.gov (United States)

Price, John; Spreng, Carl; Hawley, Elisabeth L; Deeb, Rula

2017-12-15

Complex sites require a disproportionate amount of resources for environmental remediation and long timeframes to achieve remediation objectives, due to their complex geologic conditions, hydrogeologic conditions, geochemical conditions, contaminant-related conditions, large scale of contamination, and/or non-technical challenges. A recent team of state and federal environmental regulators, federal agency representatives, industry experts, community stakeholders, and academia worked together as an Interstate Technology & Regulatory Council (ITRC) team to compile resources and create new guidance on the remediation management of complex sites. This article summarizes the ITRC team's recommended process for addressing complex sites through an adaptive site management approach. The team provided guidance for site managers and other stakeholders to evaluate site complexities and determine site remediation potential, i.e., whether an adaptive site management approach is warranted. Adaptive site management was described as a comprehensive, flexible approach to iteratively evaluate and adjust the remedial strategy in response to remedy performance. Key aspects of adaptive site management were described, including tools for revising and updating the conceptual site model (CSM), the importance of setting interim objectives to define short-term milestones on the journey to achieving site objectives, establishing a performance model and metrics to evaluate progress towards meeting interim objectives, and comparing actual with predicted progress during scheduled periodic evaluations, and establishing decision criteria for when and how to adapt/modify/revise the remedial strategy in response to remedy performance. Key findings will be published in an ITRC Technical and Regulatory guidance document in 2017 and free training webinars will be conducted. More information is available at www.itrc-web.org. Copyright © 2017 Elsevier Ltd. All rights reserved.

New therapeutic approaches for management of sport-induced muscle strains.

Science.gov (United States)

De Carli, Angelo; Volpi, Piero; Pelosini, Iva; Ferretti, Andrea; Melegati, Gianluca; Mossa, Luigi; Tornese, Davide; de Girolamo, Laura; Scarpignato, Carmelo

2009-12-01

Muscle strains are one of the most common sports-induced injuries. Depending on the severity and location of the muscle strain, different treatment approaches can be taken. This review highlights recent trends in conservative, pharmacologic, and surgical approaches to the management of sports-induced muscle injuries as presented at a symposium held during the 93rd Annual Congress of the Italian Society of Orthopedics and Traumatology (SIOT) in Rome, Italy in November 2008. Conservative approaches now include growth factor therapy and administration of autologous platelet-rich plasma during the early postinjury period; however, its use is currently considered a doping violation under the World Anti-Doping Agency code, therefore restricting its use to nonelite sports people only. Topical anti-inflammatory therapy is a promising therapeutic strategy, since it allows local analgesic and anti-inflammatory effects while minimizing systemic adverse events. As the drug delivery system is critical to clinical effectiveness, the advent of a new delivery system for ketoprofen via a new-generation plaster with a marked increase in tissue penetration and a clinical efficacy comparable with that of oral administration, provides a viable option in the treatment of single sport lesions. Surgical treatment of muscle lesions is less common than conservative and topical therapies and indications are limited to more serious injuries. Presentations from SIOT 2008 show that advances in our understanding of the healing process and in conservative, pharmacologic, and surgical treatment approaches to the management of sports-induced muscle strains contribute to better clinical outcomes, faster healing, and a swifter return to normal training and activity levels.

Managing Cybersecurity Research and Experimental Development: The REVO Approach

OpenAIRE

Dan Craigen; Drew Vandeth; D’Arcy Walsh

2013-01-01

We present a systematic approach for managing a research and experimental development cybersecurity program that must be responsive to continuously evolving cybersecurity, and other, operational concerns. The approach will be of interest to research-program managers, academe, corporate leads, government leads, chief information officers, chief technology officers, and social and technology policy analysts. The approach is compatible with international standards and procedures published by the...

From Scorecard to Social Learning: A Reflective Coassessment Approach for Promoting Multiagency Cooperation in Natural Resource Management

Directory of Open Access Journals (Sweden)

Dirk J. Roux

2011-03-01

Full Text Available The responsibility for managing and conserving freshwater ecosystems is typically shared by multiple organizations with sometimes conflicting policy mandates. However, scorecard-based approaches for measuring management effectiveness in natural resource management are usually confined to single organizations. This paper describes a social learning approach which acknowledges cooperation as an essential precondition for effective management and that encourages reflective coassessment of cooperative relationships. The approach was pilot tested with eight participating organizations in one water management area in South Africa. It specifically aimed to allow for a multiagency reflective assessment of issues determining cooperative behavior, allow context-specific adaptations, and be embedded in adaptive management. It involved development of a spreadsheet-based scorecard-type tool that can be used to facilitate a multiagency workshop. This workshop serves to bring parties face-to-face and helps them codiscover their interdependence, shortcomings, and strengths. The spreadsheet structures reflection on their respective roles and effectiveness while the reflective coassessment motivates participants to address shortcomings. Overall, insights that emerged included: cooperation should be an explicit component of each organization's operational strategy; facilitation of appropriate cooperative behavior could be very effectively achieved by external "bridging organizations"; the reflective assessment process must be followed by purposefully adaptive interventions; the ability of the scorecard to be contextually adaptive was important; and institutional readiness requires investigation as the approach does sit somewhat uncomfortably with much current practice.

Financial Service of Wealth Management Banking: Balanced Scorecard Approach

OpenAIRE

Cheng-Ru Wu; Chin-Tsai Lin; Pei-Hsuan Tsai

2008-01-01

Problem Statement: There are four main banking business sectors in Taiwan, involving the areas of consumer, corporate, wealth management, and investment banking. The wealth management banking sector is actively promoted for reaping a risk-free premium. In the proposed model, the dimensions of financial services for wealth management banks have been taken from four perspectives derived from balanced scorecard approach, viz. finance, customer, internal business, learning and growth. Approach: T...

Pedestrian safety management using the risk-based approach

Directory of Open Access Journals (Sweden)

Romanowska Aleksandra

2017-01-01

Full Text Available The paper presents a concept of a multi-level pedestrian safety management system. Three management levels are distinguished: strategic, tactical and operational. The basis for the proposed approach to pedestrian safety management is a risk-based method. In the approach the elements of behavioural and systemic theories were used, allowing for the development of a formalised and repeatable procedure integrating the phases of risk assessment and response to the hazards of road crashes involving pedestrians. Key to the method are tools supporting pedestrian safety management. According to the risk management approach, the tools can be divided into two groups: tools supporting risk assessment and tools supporting risk response. In the paper attention is paid to selected tools supporting risk assessment, with particular emphasis on the methods for estimating forecasted pedestrian safety measures (at strategic, national and regional level and identification of particularly dangerous locations in terms of pedestrian safety at tactical (regional and local and operational level. The proposed pedestrian safety management methods and tools can support road administration in making rational decisions in terms of road safety, safety of road infrastructure, crash elimination measures or reducing the consequences suffered by road users (particularly pedestrians as a result of road crashes.

Error Management in ATLAS TDAQ: An Intelligent Systems approach

CERN Document Server

Slopper, John Erik

2010-01-01

This thesis is concerned with the use of intelligent system techniques (IST) within a large distributed software system, specically the ATLAS TDAQ system which has been developed and is currently in use at the European Laboratory for Particle Physics(CERN). The overall aim is to investigate and evaluate a range of ITS techniques in order to improve the error management system (EMS) currently used within the TDAQ system via error detection and classication. The thesis work will provide a reference for future research and development of such methods in the TDAQ system. The thesis begins by describing the TDAQ system and the existing EMS, with a focus on the underlying expert system approach, in order to identify areas where improvements can be made using IST techniques. It then discusses measures of evaluating error detection and classication techniques and the factors specic to the TDAQ system. Error conditions are then simulated in a controlled manner using an experimental setup and datasets were gathered fro...

Review: Current trends in coral transplantation – an approach to preserve biodiversity

Directory of Open Access Journals (Sweden)

ABDELNABY ORABI

2013-04-01

Full Text Available Ammar MSA,El-Gammal F, Nassar M, Belal A, Farag W, El-Mesiry G, El-Haddad K, Orabi A, Abdelreheem A, Shaaban A. 2013. Review: Current trends in coral transplantation – an approach to preserve biodiversity. Biodiversitas 14: 43-53. The increasing rates of coral mortality associated with the rise in stress factors and the lack of adequate recovery worldwide have urged recent calls for actions by the scientific, conservation, and reef management communities. This work reviews the current trends in coral transplantation. Transplantation of coral colonies or fragments, whether from aqua-, mariculture or harvesting from a healthy colony, has been the most frequently recommended action for increasing coral abundance on damaged or degraded reefs and for conserving listed or “at-risk” species. Phytoplanktons are important for providing transplanted corals with complex organic compounds through photosynthesis. Artificial surfaces like concrete blocks, wrecks or other purpose-designed structures can be introduced for larval settlement. New surfaces can also be created through electrolysis. Molecular biological tools can be used to select sites for rehabilitation by asexual recruits. Surface chemistry and possible inputs of toxic leachate from artificial substrates are considered as important factors affecting natural recruitment. Transplants should be carefully maintained , revisited and reattached at least weekly in the first month and at least fortnightly in the next three months. Studies on survivorship and the reproductive ability of transplanted coral fragments are important for coral reef restoration. A coral nursery may be considered as a pool for local species that supplies reef-managers with unlimited coral colonies for sustainable management. Transplanting corals for making artificial reefs can be useful for increasing biodiversity, providing tourist diving, fishing and surfing; creating new artisanal and commercial fishing opportunities

Food quality management : A techno-managerial approach

NARCIS (Netherlands)

Luning, P.A.; Marcelis, W.J.; Jongen, W.M.F.

2002-01-01

The book focuses on consumer-driven Quality Management in food production systems using a product-based approach. It integrates organizational and technological aspects of food product quality into one techno-managerial concept and it presents an integrated view of how Quality Management is to be

Book Review: Current Issues in International Human Resource Management and Strategy Research

DEFF Research Database (Denmark)

Gretzinger, Susanne

2009-01-01

The article reviews the book "Current Issues in International Human Resource Management and Strategy Research," edited by Marion Festing and Susanne Royer.......The article reviews the book "Current Issues in International Human Resource Management and Strategy Research," edited by Marion Festing and Susanne Royer....

Two Approaches for the Management of Virtual Machines on Grid Infrastructures

International Nuclear Information System (INIS)

Tapiador, D.; Rubio-Montero, A. J.; Juedo, E.; Montero, R. S.; Llorente, I. M.

2007-01-01

Virtual machines are a promising technology to overcome some of the problems found in current Grid infrastructures, like heterogeneity, performance partitioning or application isolation. This work shows a comparison between two strategies to manage virtual machines in Globus Grids. The first alternative is a straightforward deployment that does not require additional middle ware to be installed. It is only based on standard Grid services and is not bound to a given virtualization technology. Although this option is fully functional, it is only suitable for single process batch jobs. The second solution makes use of the Virtual Workspace Service which allows a remote client to securely negotiate and manage a virtual resource. This approach better exploits the potential benefits offered by the virtualization technology and provides a wider application range. (Author)

[Current management of epilepsy].

Science.gov (United States)

Mizobuchi, Masahiro

2013-09-01

Epilepsy is one of the most common neurological disorders. Global neurological knowledge is essential for differential diagnosis of epileptic syndromes due to the diversity of ictal semiology, causes and syndromes. Neurologists play an important role in planning the medical care for patients with epilepsy, as medication is the most fundamental therapeutic strategy. Some patients with early-onset epilepsy require joint care by pediatric neurologists, those with intractable epilepsy by neurosurgeons, and those with psychological comorbidity by psychiatrists, and neurologists should play a coordinating role. While there is a great need for neurologists to participate in epilepsy care, neurologists in Japan currently do not participate substantially in the epilepsy management system. It is necessary to train more neurologists who can provide epilepsy care and conduct basic and clinical research on epilepsy by providing continuous education on epilepsy for general neurologists as well as pre- and post-graduate medical students. Most of the patients who require long-term treatment experience many medical problems and social handicaps, such as adverse effects of medication, social stigma, educational disadvantages and difficulties in obtaining driver's license. To improve the quality of life of patients with epilepsy, it is desirable to build broad medical-social networks participated by patients, doctors, neurological nurses, psychologists, social workers, school teachers, managers of employment support facilities and care givers.

Integrating a Project Management Approach to E-Business Application Course

Science.gov (United States)

Chen, Kuan C.; Chuang, Keh-Wen

2008-01-01

Teaching students project managements requires a hands-on approach. Incorporating project management concepts and processes into a student team Web development project adds a dimension that exposes students to the realities of effective Web development. This paper will describe the project management approach used in a Web development course in…

Environmental management: A system approach

Science.gov (United States)

Petak, William J.

1981-05-01

This paper presents a system framework whose purpose is to improve understanding of environmental management. By analyzing the links between elements of the environmental management system, it is possible to construct a model that aids thinking systematically about the decision-making subsystem, and other subsystems, of the entire environmental management system. Through a multidisciplinary environmental approach, each of the individual subsystems is able to adapt to threats and opportunities. The fields of government, market economics, social responsibility and ecology, for example, are so complex that it is extremely difficult to develop a framework that gives full consideration to all aspects. This paper, through the application of a highly idealized system framework, attempts to show the general relationships that exist between complex system elements.

Current Management of Sickle Cell Anemia

Science.gov (United States)

McGann, Patrick T.; Nero, Alecia C.; Ware, Russell E.

2013-01-01

Proper management of sickle cell anemia (SCA) begins with establishing the correct diagnosis early in life, ideally during the newborn period. The identification of affected infants by neonatal screening programs allows early initiation of prophylactic penicillin and pneumococcal immunizations, which help prevent overwhelming sepsis. Ongoing education of families promotes the early recognition of disease-released complications, which allows prompt and appropriate medical evaluation and therapeutic intervention. Periodic evaluation by trained specialists helps provide comprehensive care, including transcranial Doppler examinations to identify children at risk for primary stroke, plus assessments for other parenchymal organ damage as patients become teens and adults. Treatment approaches that previously highlighted acute vaso-occlusive events are now evolving to the concept of preventive therapy. Liberalized use of blood transfusions and early consideration of hydroxyurea treatment represent a new treatment paradigm for SCA management. PMID:23709685

Novel approach to information security management of confidential ...

African Journals Online (AJOL)

Novel approach to information security management of confidential and propriety information ... Journal of Fundamental and Applied Sciences ... valuable information by using steganography it can have a major impact security management.

A system approach for the management of radioactive waste

Energy Technology Data Exchange (ETDEWEB)

Fearnley, I.G. [British Nuclear Fuels plc, Warrington, Cheshire (United Kingdom)

1995-12-31

An integrated approach to Waste Management and Decommissioning, which takes account of the lifetime implications (safety, dose uptake, discharges and cost) is an important strategic process in forward planning. This type of approach is particularly relevant when making decisions concerning waste minimization and segregation, packaging and surface storage of high and intermediate level waste in advance of the existence of disposal facilities. Such a systematic approach forms an integral part of a process which enables progress to be assessed and plans to be updated in response to changing demands upon business operations and can continually be applied to waste management policy and to optimise the detailed waste management plans. (author)

A system approach for the management of radioactive waste

International Nuclear Information System (INIS)

Fearnley, I.G.

1995-01-01

An integrated approach to Waste Management and Decommissioning, which takes account of the lifetime implications (safety, dose uptake, discharges and cost) is an important strategic process in forward planning. This type of approach is particularly relevant when making decisions concerning waste minimization and segregation, packaging and surface storage of high and intermediate level waste in advance of the existence of disposal facilities. Such a systematic approach forms an integral part of a process which enables progress to be assessed and plans to be updated in response to changing demands upon business operations and can continually be applied to waste management policy and to optimise the detailed waste management plans. (author)

Knowledge Management in healthcare libraries: the current picture.

Science.gov (United States)

Hopkins, Emily

2017-06-01

Knowledge management has seen something of a resurgence in attention amongst health librarians recently. Of course it has never ceased to exist, but now many library staff are becoming more involved in organisational knowledge management, and positioning themselves as key players in the sphere. No single model of knowledge management is proliferating, but approaches that best fit the organisation's size, structure and culture, and a blending of evidence based practice and knowledge sharing. Whatever it is called and whatever models are used, it's clear that for librarians and information professionals, the importance of putting knowledge and evidence into practice, sharing knowledge well and capturing it effectively, are still what we will continue to do. © 2017 Health Libraries Group.

Current management of anorectal malformation in Egypt: a survey of ...

African Journals Online (AJOL)

Background/aim: Anorectal malformation (ARM) represents a wide spectrum of anomalies. Its management includes various strategies. This survey aims at detecting the current preferences of Egyptian pediatric surgeons regarding the management of ARM. Materials and methods: A survey was circulated individually to the ...

Regulatory approach to accident management in Sweden

International Nuclear Information System (INIS)

Hoegberg, L.

1989-01-01

The Swedish accident management program includes the following components: definition of overall safety and radiation protection objectives for the program; definition of appropriate accident management strategies to reach these objectives, based on plant-specific severe accident analysis; development and installation of appropriate accident management systems and associated management procedure; definition of roles and resposibilities for plant staff involved in accident management and implementation of appropriate training programs. The discussion of these components tries to highlight the basic technical concepts and approaches and the underlying safety philosophy rather than going into design details. 5 figs., 7 refs

A Review of the Wood Pellet Value Chain, Modern Value/Supply Chain Management Approaches, and Value/Supply Chain Models

OpenAIRE

Hughes, Natalie M.; Shahi, Chander; Pulkki, Reino

2014-01-01

We reviewed 153 peer-reviewed sources to provide identification of modern supply chain management techniques and exploration of supply chain modeling, to offer decision support to managers. Ultimately, the review is intended to assist member-companies of supply chains, mainly producers, improve their current management approaches, by directing them to studies that may be suitable for direct application to their supply chains and value chains for improved efficiency and profitability. We found...

Historical and Current Trends in Colon Trauma

Science.gov (United States)

Causey, Marlin Wayne; Rivadeneira, David E.; Steele, Scott R.

2012-01-01

The authors discuss the evolution of the evaluation and management of colonic trauma, as well as the debate regarding primary repair versus fecal diversion. Their evidence-based review covers diagnosis, management, surgical approaches, and perioperative care of patients with colon-related trauma. The management of traumatic colon injuries has evolved significantly over the past 50 years; here the authors describe a practical approach to the treatment and management of traumatic injuries to the colon based on the most current research. However, management of traumatic colon injuries remains a challenge and continues to be associated with significant morbidity. Familiarity with the different methods to the approach and management of colonic injuries will allow surgeons to minimize unnecessary complications and mortality. PMID:24294119

Applying the competence-based approach to management in the aerospace industry

OpenAIRE

Arpentieva Mariam; Duvalina Olga; Braitseva Svetlana; Gorelova Irina; Rozhnova Anna

2018-01-01

Problems of management in aerospace manufacturing are similar to those we observe in other sectors, the main of which is the flattening of strategic management. The main reason lies in the attitude towards human resource of the organization. In the aerospace industry employs 250 thousand people, who need individual approach. The individual approach can offer competence-based approach to management. The purpose of the study is proof of the benefits of the competency approach to human resource ...

Surgical management of inverted papilloma: approaching a new standard for surgery.

Science.gov (United States)

Carta, Filippo; Blancal, Jean-Philippe; Verillaud, Benjamin; Tran, Hugo; Sauvaget, Elisabeth; Kania, Romain; Herman, Philippe

2013-10-01

Inverted papilloma surgery is currently performed primarily with an endoscopic approach, a technique that has a recurrence rate of 12%. However, a recent study reported a recurrence rate of 5% with a strategy based on subperiosteal dissection of the tumor, with limited indications for using an external approach. The aim of this work was to evaluate whether different teams using the same surgical concepts could reproduce the excellent results that were recently reported. This study is a retrospective chart review of 71 consecutive patients with inverted papilloma who were treated during the last 10 years. In all, 80% of the patients were treated using a purely endoscopic approach. The mean follow-up period was 31.6 months. The recurrence rate was 3.3% for cases with at least a 12-month follow-up. This work confirms the results described in recent literature and further supports transnasal endoscopic surgery to manage inverted papilloma. Copyright © 2013 Wiley Periodicals, Inc.

Integrated approach for managing health risks at work--the role of occupational health nurses.

Science.gov (United States)

Marinescu, Luiza G

2007-02-01

Currently, many organizations are using a department-centered approach to manage health risks at work. In such a model, segregated departments are providing employee benefits such as health insurance, workers' compensation, and short- and long-term disability or benefits addressing work-life issues. In recent years, a new model has emerged: health and productivity management (HPM). This is an employee-centered, integrated approach, designed to increase efficiency, reduce competition for scarce resources, and increase employee participation in prevention activities. Evidence suggests that corporations using integrated HPM programs achieve better health outcomes for their employees, with consequent increased productivity and decreased absenteeism. Occupational health nurses are well positioned to assume leadership roles in their organizations by coordinating efforts and programs across departments that offer health, wellness, and safety benefits. To assume their role as change agents to improve employees' health, nurses should start using the language of business more often by improving their communication skills, computer skills, and ability to quantify and articulate results of programs and services to senior management.

Child and Youth Care Approaches to Management

Science.gov (United States)

Gharabaghi, Kiaras

2008-01-01

This article explores the themes and issues related to child and youth care approaches to management. The profession is significantly underrepresented at the management level. To some extent, this reflects the challenges of being recognized in the broader human services sector as a profession, but perhaps more so, it reflects an underdevelopment…

Analysis of Current Supplier Relationship Management Practices: A Solution Proposal

OpenAIRE

Gomes Campelo Filho, Eulalio

2009-01-01

The work contributes with the existing literature by investigating current SRM practices. Based on the research, the author has designed an information system framework, which provides companies with an innovative SRM solution to manage their indirect material purchasing process through an environment that supports companies entire plan-to-order activities, including functionalities such as central data management, spend data management, e-sourcing and the usual e-procurement features.

Current approaches in atrial fibrillation treatment

Directory of Open Access Journals (Sweden)

Cenk Sarı

2014-09-01

Full Text Available Atrial fibrillation (AF is the most common sustained arrhythmia encountered in clinical practice. Its incidence increases with age. AF is classified into subtypes according to the duration and/or able to provide sinus rhytym. İnitially, patients should be evaluated for rhythm or rate control for appropriate treatment. Second stage of strategy aimed to investigate the feasibility of anticoagulation therapy. Recently, due to the progress made in treatment with rhythm control and anticoagulation therapy, either American or European guidelines have been renovated. These developments have taken place in the newly published guide. In this article, the current change in the management of AF is discussed.

Integrated management of water resources in urban water system: Water Sensitive Urban Development as a strategic approach

Directory of Open Access Journals (Sweden)

Juan Joaquín Suárez López

2014-08-01

Full Text Available The urban environment has to be concerned with the integrated water resources management, which necessarily includes the concept of basin unity and governance.  The traditional urban water cycle framework, which includes water supply, sewerage and wastewater treatment services, is being replaced by a holistic and systemic concept, where water is associated with urbanism and sustainability policies. This global point of view cannot be ignored as new regulations demand systemic and environmental approaches to the administrations, for instance, in the management of urban drainage and sewerage systems. The practical expression of this whole cluster interactions is beginning to take shape in several countries, with the definition of Low Impact Development and Water Sensitivity Urban Design concepts. Intends to integrate this new strategic approach under the name: “Water Sensitive Urban Development” (WSUD. With WSUD approach, the current urban water systems (originally conceived under the traditional concept of urban water cycle can be transformed, conceptual and physically, for an integrated management of the urban water system in new models of sustainable urban development. A WSUD implementing new approach to the management of pollution associated with stormwater in the urban water system is also presented, including advances in environmental regulations and incorporation of several techniques in Spain.

An interdisciplinary review of current and future approaches to improving human-predator relations.

Science.gov (United States)

Pooley, S; Barua, M; Beinart, W; Dickman, A; Holmes, G; Lorimer, J; Loveridge, A J; Macdonald, D W; Marvin, G; Redpath, S; Sillero-Zubiri, C; Zimmermann, A; Milner-Gulland, E J

2017-06-01

In a world of shrinking habitats and increasing competition for natural resources, potentially dangerous predators bring the challenges of coexisting with wildlife sharply into focus. Through interdisciplinary collaboration among authors trained in the humanities, social sciences, and natural sciences, we reviewed current approaches to mitigating adverse human-predator encounters and devised a vision for future approaches to understanding and mitigating such encounters. Limitations to current approaches to mitigation include too much focus on negative impacts; oversimplified equating of levels of damage with levels of conflict; and unsuccessful technical fixes resulting from failure to engage locals, address hidden costs, or understand cultural (nonscientific) explanations of the causality of attacks. An emerging interdisciplinary literature suggests that to better frame and successfully mitigate negative human-predator relations conservation professionals need to consider dispensing with conflict as the dominant framework for thinking about human-predator encounters; work out what conflicts are really about (they may be human-human conflicts); unravel the historical contexts of particular conflicts; and explore different cultural ways of thinking about animals. The idea of cosmopolitan natures may help conservation professionals think more clearly about human-predator relations in both local and global context. These new perspectives for future research practice include a recommendation for focused interdisciplinary research and the use of new approaches, including human-animal geography, multispecies ethnography, and approaches from the environmental humanities notably environmental history. Managers should think carefully about how they engage with local cultural beliefs about wildlife, work with all parties to agree on what constitutes good evidence, develop processes and methods to mitigate conflicts, and decide how to monitor and evaluate these. Demand for

Management of adenovirus infection in patients after haematopoietic stem cell transplantation: State-of-the-art and real-life current approach: A position statement on behalf of the Infectious Diseases Working Party of the European Society of Blood and Marrow Transplantation.

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Hiwarkar, Prashant; Kosulin, Karin; Cesaro, Simone; Mikulska, Malgorzata; Styczynski, Jan; Wynn, Robert; Lion, Thomas

2018-05-01

The important insights gained over the past years in diagnosis and treatment of invasive adenoviral infections provide new paradigms for the monitoring and clinical management of these life-threatening complications. A meeting was held to discuss and subsequently disseminate the current advances in our understanding of the aetiology/pathogenesis and future treatment options facilitating effective control or prevention of adenovirus-related diseases in the allogeneic haematopoietic stem cell transplant setting. Invited experts in the field discussed recent progress with leading members of the Infectious Diseases Working Party of the European Society of Blood and Marrow Transplantation at the "State-of-the-art" Meeting in Poznan, Poland, in October 2017. In this review article, the panel of experts presents a concise summary of the current evidence based on published data from the last 15 years and on recent achievements resulting from real-life practice. The present position statement reflects an expert opinion on current approaches to clinical management of adenovirus infections in patients undergoing allogeneic haematopoietic stem cell transplant and provides graded recommendations of the panel for diagnostic approaches and preemptive therapy reflecting the present state of knowledge. Copyright © 2018 John Wiley & Sons, Ltd.

ECOSYSTEM APPROACH TO FISHERIES MANAGEMENT IN THE ...

African Journals Online (AJOL)

A workshop was held in Cape Town in December 2002 to introduce the concept of an ecosystem approach to fisheries (EAF) management in the southern Benguela, and to examine the options for implementing an EAF in. South Africa. The workshop considered alternative modelling approaches that may have potential for ...

The current management of spinal cord cavernoma.

Science.gov (United States)

Velz, Julia; Bozinov, Oliver; Sarnthein, Johannes; Regli, Luca; Bellut, David

2018-01-04

Spinal cavernous malformations (SCM) were once thought to be rare lesions of the spinal cord. However, with the broad use of modern imaging techniques the incidence of SCM has significantly increased over the last decades. Management of both symptomatic and incidental findings is therefore of growing importance. However, experience with treatment and follow-up is very limited. We performed a single institution retrospective review of consecutive patients with SCM treated at our Department between 2006-2016 and discuss the clinical features as well as surgical versus conservative outcomes. We further provide a systematic literature search and discuss the best management of SCM, analyzing recent publications on SCM imaging techniques, surgical approaches and natural history. From a total number of 406 consecutive patients with cavernous malformations (CM) treated at our Department between 2006-2016, 29 (7.1 %) were found to be affected by SCM. The localization was cervical in 10 (34.5 %), cervicothoracic in 3 (10.4 %) and thoracic in 16 (55.2 %) patients. In 90 % of patients (n = 26) the diagnosis was made after onset of clinical symptoms. Conservative management was performed for 8 patients, whereas 21 patients underwent surgical removal of the lesion via a posterior approach using (hemi-) laminectomy or laminoplasty. Functional status improved in 15 patients (62. 5%) and remained unchanged in 6 patients (28.5 %) in the operative group, whereas 2 patients (25 %) improved and 6 patients (75 %) remained unchanged in the conservative group during long-term follow-up. Gross-total resection is the only definitive treatment option for symptomatic SCM. Surgical extirpation of the symptomatic SCM lesion through an unilateral laminectomy ( = hemilaminectomy) approach within 3 months of presentation seems to be good treatment option with an acceptable risk of complications and good long-term outcomes. Conservative treatment should be performed in asymptomatic patients and

Energy Management in Prosumer Communities: A Coordinated Approach

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Rodrigo Verschae

2016-07-01

Full Text Available The introduction of uncontrollable renewable energy is having a positive impact on our health, the climate, and the economy, but it is also pushing the limits of the power system. The main reason for this is that, in any power system, the generation and consumption must match each other at all times. Thus, if we want to further introduce uncontrollable generation, we need a large ability to manage the demand. However, the ability to control the power consumption of existing demand management approaches is limited, and most of these approaches cannot contribute to the introduction of reneweables, because they do not consider distributed uncontrolled consumption and generation in the control. Furthermore, these methods do not allow users to exchange or jointly manage their power generation and consumption. In this context, we propose an augmented energy management model for prosumers (i.e., producer and consumer. This model considers controlled and uncontrolled generation and consumption, as well as the prosumer’s ability (i to plan the intended power consumption; and (ii to manage real-time deviations from the intended consumption. We apply this model to the energy management of prosumer communities, by allowing the prosumers to coordinate their power consumption plan, to manage the deviations from the intended consumption, and to help each other by compensating deviations. The proposed approach seeks to enhance the power system, and to enable a prosumer society that takes account social and environmental issues, as well as each prosumer’s quality of life.

Footrot and interdigital dermatitis in sheep: farmer satisfaction with current management, their ideal management and sources used to adopt new strategies.

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Wassink, G J; George, T R N; Kaler, J; Green, L E

2010-08-01

The aims of this research were to identify management practices that sheep farmers currently use to treat and prevent footrot in sheep and whether they consider that these are successful management tools and to find out how sheep farmers would ideally like to manage footrot in their flock. Over 90% of lameness in sheep in the UK is caused by Dichelobacter nodosus, which presents clinically as interdigital dermatitis (ID) alone or with separation of hoof horn (FR). A questionnaire was sent to 265 farmers to investigate their current management and their satisfaction with current management of the spectrum of clinical presentations of footrot. Farmers were also asked their ideal management of footrot and their interest in, and sources of information for, change. Approximately 160 farmers responded. Farmers satisfied with current management reported a prevalence of lameness 5%. These farmers practised routine foot trimming, footbathing and vaccination against footrot. Whilst 89% of farmers said they were satisfied with their management of FR over 34% were interested in changing management. Farmers identified veterinarians as the most influential source for new information. Farmers reported that ideally they would control FR by culling/isolating lame sheep, sourcing replacements from non-lame parents, trimming feet less, using antibacterial treatments less and using vaccination more. Footbathing was a commonly used management that was linked with dissatisfaction and that also was listed highly as an ideal management. Consequently, some of the ideal managements are in agreement with our understanding of disease control (culling and isolation, sourcing healthy replacements) but others are in contrast with our current knowledge of management and farmers self-reporting of satisfaction of management of footrot (less use of antibacterial treatment, more footbathing and vaccination). One explanation for this is the theory of cognitive dissonance where belief follows behaviour

Epistaxis management: current understanding amongst junior doctors.

Science.gov (United States)

Fox, R; Nash, R; Liu, Z-W; Singh, A

2016-03-01

Epistaxis is a common and potentially life-threatening emergency. This survey assesses understanding and confidence in epistaxis management amongst current junior doctors. A cross-sectional study was conducted of foundation year one and two doctors based at three National Health Service trusts within a single region of the UK, assessing basic understanding and procedural confidence. A total of 111 foundation doctors completed this survey. The average duration of undergraduate exposure to otolaryngology was 8.1 days. Forty-one per cent of respondents stated that they would apply pressure to the nasal bones to control epistaxis. Seventy-five per cent lacked confidence in their ability to manage epistaxis. Those with two weeks or more of undergraduate exposure to otolaryngology were more confident than those with one week or less of exposure (p epistaxis management, with patient safety implications. Confidence is associated with the duration of undergraduate exposure to otolaryngology. A minimum emergency safe competency should be a priority during foundation training if not achieved in UK medical schools.

Object-oriented Approach to High-level Network Monitoring and Management

Science.gov (United States)

Mukkamala, Ravi

2000-01-01

An absolute prerequisite for the management of large investigating methods to build high-level monitoring computer networks is the ability to measure their systems that are built on top of existing monitoring performance. Unless we monitor a system, we cannot tools. Due to the heterogeneous nature of the hope to manage and control its performance. In this underlying systems at NASA Langley Research Center, paper, we describe a network monitoring system that we use an object-oriented approach for the design, we are currently designing and implementing. Keeping, first, we use UML (Unified Modeling Language) to in mind the complexity of the task and the required model users' requirements. Second, we identify the flexibility for future changes, we use an object-oriented existing capabilities of the underlying monitoring design methodology. The system is built using the system. Third, we try to map the former with the latter. APIs offered by the HP OpenView system.

A Multicultural Competencies Approach to Developing Human Capital Management

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Woolliscroft, Paul; Cagáňová, Dagmar; Čambál, Miloš; Šefčíková, Miriam; Kamenova, Joana Valery

2012-12-01

The globalisation phenomenon has been prevalent since the last decade of 20th century and remains a significant factor influencing both organisations and individuals today. Within a globalised business environment the effective management of multicultural aspects and differences has become imperative to ensure success. It is increasingly evident there is a need to develop a clear understanding of multicultural competencies in order to fully develop a strategic approach to human capital management (HCM). The adoption of a strategic approach is necessary to ensure a focus on the issues critical to success and competitive advantage including multicultural management, professional skills and knowledge management. This paper aims to identify the importance of intercultural management and the impact of globalisation upon international business.

Methodical approach to financial stimulation of logistics managers

OpenAIRE

Melnykova Kateryna V.

2014-01-01

The article offers a methodical approach to financial stimulation of logistics managers, which allows calculation of the incentive amount with consideration of profit obtained from introduction of optimisation logistics solutions. The author generalises measures, which would allow increase of stimulation of labour of logistics managers by the enterprise top managers. The article marks out motivation factors, which exert influence upon relation of logistics managers to execution of optimisatio...

Thermal and electrical energy management in a PEMFC stack - An analytical approach

Energy Technology Data Exchange (ETDEWEB)

Pandiyan, S.; Jayakumar, K.; Rajalakshmi, N.; Dhathathreyan, K.S. [Centre for Fuel Cell Technology, ARC International (ARCI), 120, Mambakkam Main Road, Medavakkam, Chennai 601 302 (India)

2008-02-15

An analytical method has been developed to differentiate the electrical and thermal resistance of the PEM fuel cell assembly in the fuel cell operating conditions. The usefulness of this method lies in the determination of the electrical resistance based on the polarization curve and the thermal resistance from the mass balance. This method also paves way for the evaluation of cogeneration from a PEMFC power plant. Based on this approach, the increase in current and resistance due to unit change in temperature at a particular current density has been evaluated. It was observed that the internal resistance of the cell is dependent on the electrode fabrication process, which also play a major role in the thermal management of the fuel cell stack. (author)

Healthcare waste management: current practices in selected healthcare facilities, Botswana.

Science.gov (United States)

Mbongwe, Bontle; Mmereki, Baagi T; Magashula, Andrew

2008-01-01

Healthcare waste management continues to present an array of challenges for developing countries, and Botswana is no exception. The possible impact of healthcare waste on public health and the environment has received a lot of attention such that Waste Management dedicated a special issue to the management of healthcare waste (Healthcare Wastes Management, 2005. Waste Management 25(6) 567-665). As the demand for more healthcare facilities increases, there is also an increase on waste generation from these facilities. This situation requires an organised system of healthcare waste management to curb public health risks as well as occupational hazards among healthcare workers as a result of poor waste management. This paper reviews current waste management practices at the healthcare facility level and proposes possible options for improvement in Botswana.

Narcolepsy: current treatment options and future approaches

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Michel Billiard

2008-06-01

Full Text Available Michel BilliardDepartment of Neurology, Gui de Chauliac Hospital, Montpellier, FranceAbstract: The management of narcolepsy is presently at a turning point. Three main avenues are considered in this review: 1 Two tendencies characterize the conventional treatment of narcolepsy. Modafinil has replaced methylphenidate and amphetamine as the first-line treatment of excessive daytime sleepiness (EDS and sleep attacks, based on randomized, double blind, placebo-controlled clinical trials of modafinil, but on no direct comparison of modafinil versus traditional stimulants. For cataplexy, sleep paralysis, and hypnagogic hallucinations, new antidepressants tend to replace tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs in spite of a lack of randomized, double blind, placebo-controlled clinical trials of these compounds; 2 The conventional treatment of narcolepsy is now challenged by sodium oxybate, the sodium salt of gammahydroxybutyrate, based on a series of randomized, double-blind, placebo-controlled clinical trials and a long-term open label study. This treatment has a fairly good efficacy and is active on all symptoms of narcolepsy. Careful titration up to an adequate level is essential both to obtain positive results and avoid adverse effects; 3 A series of new treatments are currently being tested, either in animal models or in humans, They include novel stimulant and anticataplectic drugs, endocrine therapy, and, more attractively, totally new approaches based on the present state of knowledge of the pathophysiology of narcolepsy with cataplexy, hypocretine-based therapies, and immunotherapy.Keywords: narcolepsy, treatment, conventional drugs, modafinil, sodium oxybate, future treatments

Hypertensive crisis: an update on clinical approach and management.

Science.gov (United States)

Ipek, Emrah; Oktay, Ahmet Afşin; Krim, Selim R

2017-07-01

Here, we review current concepts on hypertensive crisis (HTN-C) with a focus on epidemiology, causes, pathophysiology and prognosis. We also offer a practical approach to the management of HTN-C. HTN-C is characterized by a severe and abrupt increase in blood pressure (BP) with impending or progressive acute end-organ damage (EOD). HTN-C can be divided into hypertensive emergency (HTN-E) and hypertensive urgency (HTN-U) based on the presence or absence of acute EOD, respectively. Recent retrospective studies have demonstrated that emergency department (ED) referrals from an outpatient clinic or rapid BP-lowering strategies in the ED do not lead to improved outcomes in patients with HTN-U. HTN-C can be a de-novo manifestation or a complication of essential or secondary HTN. The presence of acute EOD is a major poor prognostic indicator in HTN-C. The main objectives of the management of HTN-C are distinction of HTN-E from HTN-U and appropriate risk stratification, prevention or regression of acute EOD due to severely elevated BP, prevention of recurrence of HTN-C with an effective long-term management plan and avoidance of rapid lowering of BP except in some special circumstances. The majority of patients with asymptomatic HTN-U can be safely managed in the outpatient setting without exposing them to the risks of aggressive BP lowering. However, patients with HTN-E require hospitalization, prompt treatment and close monitoring.

Between Oais and Agile a Dynamic Data Management Approach

Science.gov (United States)

Bennett, V. L.; Conway, E. A.; Waterfall, A. M.; Pepler, S.

2015-12-01

In this paper we decribe an approach to the integration of existing archival activities which lies between compliance with the more rigid OAIS/TRAC standards and a more flexible "Agile" approach to the curation and preservation of Earth Observation data. We provide a high level overview of existing practice and discuss how these procedures can be extended and supported through the description of preservation state. The aim of which is to facilitate the dynamic controlled management of scientific data through its lifecycle. While processes are considered they are not statically defined but rather driven by human interactions in the form of risk management/review procedure that produce actionable plans, which are responsive to change. We then proceed by describing the feasibility testing of extended risk management and planning procedures which integrate current practices. This was done through the CEDA Archival Format Audit which inspected British Atmospheric Data Centre and NERC Earth Observation Data Centre Archival holdings. These holdings are extensive, comprising of around 2 Petabytes of data and 137 million individual files, which were analysed and characterised in terms of format, based risk. We are then able to present an overview of the format based risk burden faced by a large scale archive attempting to maintain the usability of heterogeneous environmental data sets We continue by presenting a dynamic data management information model and provide discussion of the following core model entities and their relationships: Aspirational entities, which include Data Entity definitions and their associated Preservation Objectives. Risk entities, which act as drivers for change within the data lifecycle. These include Acquisitional Risks, Technical Risks, Strategic Risks and External Risks Plan entities, which detail the actions to bring about change within an archive. These include Acquisition Plans, Preservation Plans and Monitoring plans which support

Do diabetes-specialty clinics differ in management approach and ...

African Journals Online (AJOL)

Objectives: To evaluate management approach and outcome in two endocrinologist-managed clinics using data on treatment adherence, diabetes specific parameters, prescribed medications and self-management practices among ambulatory type 2 diabetes patients. Opinion on cause(s) and perceived fear about ...

Integrating Genomic Data Sets for Knowledge Discovery: An Informed Approach to Management of Captive Endangered Species

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Kristopher J. L. Irizarry

2016-01-01

Full Text Available Many endangered captive populations exhibit reduced genetic diversity resulting in health issues that impact reproductive fitness and quality of life. Numerous cost effective genomic sequencing and genotyping technologies provide unparalleled opportunity for incorporating genomics knowledge in management of endangered species. Genomic data, such as sequence data, transcriptome data, and genotyping data, provide critical information about a captive population that, when leveraged correctly, can be utilized to maximize population genetic variation while simultaneously reducing unintended introduction or propagation of undesirable phenotypes. Current approaches aimed at managing endangered captive populations utilize species survival plans (SSPs that rely upon mean kinship estimates to maximize genetic diversity while simultaneously avoiding artificial selection in the breeding program. However, as genomic resources increase for each endangered species, the potential knowledge available for management also increases. Unlike model organisms in which considerable scientific resources are used to experimentally validate genotype-phenotype relationships, endangered species typically lack the necessary sample sizes and economic resources required for such studies. Even so, in the absence of experimentally verified genetic discoveries, genomics data still provides value. In fact, bioinformatics and comparative genomics approaches offer mechanisms for translating these raw genomics data sets into integrated knowledge that enable an informed approach to endangered species management.

Integrating Genomic Data Sets for Knowledge Discovery: An Informed Approach to Management of Captive Endangered Species.

Science.gov (United States)

Irizarry, Kristopher J L; Bryant, Doug; Kalish, Jordan; Eng, Curtis; Schmidt, Peggy L; Barrett, Gini; Barr, Margaret C

2016-01-01

Many endangered captive populations exhibit reduced genetic diversity resulting in health issues that impact reproductive fitness and quality of life. Numerous cost effective genomic sequencing and genotyping technologies provide unparalleled opportunity for incorporating genomics knowledge in management of endangered species. Genomic data, such as sequence data, transcriptome data, and genotyping data, provide critical information about a captive population that, when leveraged correctly, can be utilized to maximize population genetic variation while simultaneously reducing unintended introduction or propagation of undesirable phenotypes. Current approaches aimed at managing endangered captive populations utilize species survival plans (SSPs) that rely upon mean kinship estimates to maximize genetic diversity while simultaneously avoiding artificial selection in the breeding program. However, as genomic resources increase for each endangered species, the potential knowledge available for management also increases. Unlike model organisms in which considerable scientific resources are used to experimentally validate genotype-phenotype relationships, endangered species typically lack the necessary sample sizes and economic resources required for such studies. Even so, in the absence of experimentally verified genetic discoveries, genomics data still provides value. In fact, bioinformatics and comparative genomics approaches offer mechanisms for translating these raw genomics data sets into integrated knowledge that enable an informed approach to endangered species management.

A socio-ecological adaptive approach to contaminated mega-site management: From 'control and correct' to 'coping with change'

Science.gov (United States)

Schirmer, Mario; Lyon, Ken; Armstrong, James E.; Farrell, Katharine N.

2012-01-01

Mega-sites have a notable impact on surrounding ecological systems. At such sites there are substantial risks associated with complex socio-ecological interactions that are hard to characterize, let alone model and predict. While the urge to control and clean-up mega-sites (control and correct) is understandable, rather than setting a goal of cleaning up such sites, we suggest a more realistic response strategy is to address these massive and persistent sources of contamination by acknowledging their position as new features of the socio-ecological landscapes within which they are located. As it seems nearly impossible to clean up such sites, we argue for consideration of a 'coping with change' rather than a 'control and correct' approach. This strategy recognizes that the current management option for a mega-site, in light of its physical complexities and due to changing societal preferences, geochemical transformations, hydrogeology knowledge and remedial technology options may not remain optimal in future, and therefore needs to be continuously adapted, as community, ecology, technology and understanding change over time. This approach creates an opportunity to consider the relationship between a mega-site and its human and ecological environments in a different and more dynamic way. Our proposed approach relies on iterative adaptive management to incorporate mega-site management into the overall socio-ecological systems of the site's context. This approach effectively embeds mega-site management planning in a triple bottom line and environmental sustainability structure, rather than simply using single measures of success, such as contaminant-based guidelines. Recognizing that there is probably no best solution for managing a mega-site, we present a starting point for engaging constructively with this seemingly intractable issue. Therefore, we aim to initiate discussion about a new approach to mega-site management, in which the complexity of the problems posed

Management of scalp psoriasis: current perspectives

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Blakely K

2016-03-01

Full Text Available Kim Blakely,1 Melinda Gooderham2 1Faculty of Medicine, University of Toronto, Toronto, ON, Canada; 2Skin Centre for Dermatology, Peterborough, ON, Canada Abstract: Psoriasis is a chronic inflammatory condition. The age of onset, chronicity, physical, and psychosocial consequences of the disease cause psoriasis to have a significant impact on patient quality of life. Scalp psoriasis is no different, and effective treatment results in an improvement in quality of life. Successful management of scalp psoriasis includes topical therapies that are acceptable to the patient for mild-to-moderate disease, and systemic therapies for recalcitrant or moderate-to-severe disease. The most effective topical therapies are corticosteroid products, or combination products with calcipotriol and corticosteroid. Newer vehicle options provide more attractive and pleasing products for patients and may improve adherence. The current perspectives for management of scalp psoriasis are discussed including available data for systemic therapy of severe disease. Keywords: psoriasis, scalp psoriasis, topical therapies, systemic therapies, biologics

An Investigation on the Current Situation of Management Information Systems Discipline in Turkey

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Serdar YARLIKAŞ

2015-09-01

Full Text Available The purpose of this research is to investigate the development of management information systems field by evaluating the theses conducted at universities in Turkey in the departments of management information systems and science of management information systems. First, this study aims to determine the distribution of the theses in terms of years, subjects and the research methods used. Another purpose of this study was to determine which of the related disciplines of management information systems are used most in the theses. In addition, as a result of the study, the compatibility degree between the theses written and the courses taught in the graduate programs of management information systems were determined. In this research, content analysis method is used. Through this method, each of the theses was evaluated with a 10-question ‘thesis evaluation question set' constructed towards the purpose of the study. Through this evaluation, the current situation of the field was determined. It was observed that the number of doctoral theses associated with the field was less. Using the combination of qualitative and quantitative techniques most in the theses denoted that the interdisciplinary approaches were adopted in the theses associated with management information systems. It was observed that the literature analysis and survey techniques were the most studied research methods in the theses. Besides, statistical techniques were used highly in the theses. As a result of this study, it was concluded that out of the associated disciplines of management information systems, management science, computer science and statistics disciplines were more associated with the investigated theses. When the study results were evaluated as a whole, it was seen that significant progress was made in the discipline of management information systems compared to the early 2000s.

The Scientific-Methodical Approaches to Interpretation of the Essence and Value of the Staff Management of Enterprises

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Tarnavskyi Mykhailo I.

2018-03-01

Full Text Available The scientific literature on the issues of interpretation of essence of the economic category of «staff» and «staff management» is analyzed with the purpose of definition of their content and role in the process of activity of enterprise. As a result of the carried out research was found out that the category of «staff» reflects the current tendencies and approaches to the management of people in the enterprise to the utmost, because it is based on the transition from the resource, consumer attitude to the humanistic in the relationship between employers and their employees. The economic content of the category of «staff management» has been defined from the standpoint of presenting seven approaches to the interpretation of this phenomenon: «human resources management» as a process, «staff management» as a system, «staff management» as an activity, «staff management» as an influence, «staff management» as an aggregate (of activities, principles, methods, etc., «staff management» as a control element (component of enterprise management and «staff management» as a science. Prospects for further research are identification of the main participants in the process of personnel management in the enterprise and the special body that will carry out these processes.

Product Family Approach in E-Waste Management: A Conceptual Framework for Circular Economy

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Keshav Parajuly

2017-05-01

Full Text Available As the need for a more circular model is being increasingly pronounced, a fundamental change in the end-of-life (EoL management of electrical and electronic products (e-products is required in order to prevent the resource losses and to promote the reuse of products and components with remaining functionality. However, the diversity of product types, design features, and material compositions pose serious challenges for the EoL managers and legislators alike. In order to address these challenges, we propose a framework that is based on the ‘product family’ philosophy, which has been used in the manufacturing sector for a long time. For this, the product families can be built based on intrinsic and extrinsic attributes of e-products as well as of the EoL management system. Such an approach has the potential to improve the current EoL practices and to support designers in making EoL thinking operational during the product design stage. If supported by a better EoL collection, presorting and testing platform, and a family-centric approach for material recovery, such a framework carries the potential to avoid the losses occurring in today’s e-waste management system. This, in turn, could facilitate a smooth transition towards a circular model for the electrical and electronic industry.

Impact of Antibiotic Shortage on H. Pylori Treatment: A Step-Wise Approach for Pharmacist Management

Directory of Open Access Journals (Sweden)

Ann Lloyd, Pharm.D., BCPS

2013-01-01

Full Text Available The current drug shortage crisis involving multiple oral antibiotics has significantly impacted preferred therapeutic options for treatment of H.pylori infection. Pharmacists may help alleviate the impact of this shortage through a proposed step-wise approach which includes proper inventory management, verification of indication, evaluation of regimen, therapeutic monitoring, and communication with patients and providers regarding alternative therapy or symptomatic relief.

Exploration Systems Development (ESD) Approach to Enterprise Risk Management

Science.gov (United States)

Bauder, Stephen P.

2014-01-01

The National Aeronautics and Space Administration (NASA) Exploration Systems Development (ESD) Division has implemented an innovative approach to Enterprise Risk Management under a unique governance structure and streamlined integration model. ESD's mission is to design and build the capability to extend human existence to deep space. The Enterprise consists of three Programs: Space Launch System (SLS), Orion, and Ground Systems Development and Operations (GSDO). The SLS is a rocket and launch system that will be capable of powering humans, habitats, and support systems to deep space. Orion will be the first spacecraft in history capable of taking humans to multiple destinations within deep space. GSDO is modernizing Kennedy's spaceport to launch spacecraft built and designed by both NASA and private industry. ESD's approach to Enterprise Risk Management is commensurate with affordability and a streamlined management philosophy. ESD Enterprise Risk Management leverages off of the primary mechanisms for integration within the Enterprise. The Enterprise integration approach emphasizes delegation of authority to manage and execute the majority of cross-program activities and products to the individual Programs, while maintaining the overall responsibility for all cross-program activities at the Division. The intent of the ESD Enterprise Risk Management approach is to improve risk communication, to avoid replication and/or contradictory strategies, and to minimize overhead process burden. This is accomplished by the facilitation and integration of risk information within ESD. The ESD Division risks, Orion risks, SLS risks, and GSDO risks are owned and managed by the applicable Program. When the Programs have shared risks with multiple consequences, they are jointly owned and managed. When a risk is associated with the integrated system that involves more than one Program in condition, consequence, or mitigation plan, it is considered an Exploration Systems Integration

An Intelligent Alternative Approach to the efficient Network Management

Directory of Open Access Journals (Sweden)

MARTÍN, A.

2012-12-01

Full Text Available Due to the increasing complexity and heterogeneity of networks and services, many efforts have been made to develop intelligent techniques for management. Network intelligent management is a key technology for operating large heterogeneous data transmission networks. This paper presents a proposal for an architecture that integrates management object specifications and the knowledge of expert systems. We present a new approach named Integrated Expert Management, for learning objects based on expert management rules and describe the design and implementation of an integrated intelligent management platform based on OSI and Internet management models. The main contributions of our approach is the integration of both expert system and managed models, so we can make use of them to construct more flexible intelligent management network. The prototype SONAP (Software for Network Assistant and Performance is accuracy-aware since it can control and manage a network. We have tested our system on real data to the fault diagnostic in a telecommunication system of a power utility. The results validate the model and show a significant improvement with respect to the number of rules and the error rate in others systems.

Nursing approaches in the postoperative pain management

Directory of Open Access Journals (Sweden)

Sevilay Yüceer

2011-12-01

Full Text Available Patients frequently experience moderate to severe pain inthe postoperative period. Although the pain managementis an integral and important part of the nursing care, studiessuggest that, nursing management of postoperativepain remains inadequate.Postoperative care nurses are responsible to assess thepatient’s pain, teach the patient strategies to deal with thepain, apply the analgesic treatment plan, monitor the resultsof treatment, educate the patient and the family onpain management and document the pain managementoutcomes. The nurses’ holistic approach to pain managementminimizes the patients’ discomfort caused by pain inthe postoperative period after the surgery. In this article,nurses’ approaches to postoperative pain managementare discussed. J Clin Exp Invest 2011; 2 (4: 474-478

Integrated Management System as constituent of balanced development approach

International Nuclear Information System (INIS)

Pasternak, J.

2005-01-01

Globalization of the economy makes RAFAKO S.A. react promptly and efficiently to what goes on in the surrounding world. The way this company is organized and managed constitutes the fundamental condition for success and it is this subject that the authors have concentrated on. The restructuring process of the company started in 1998. A business management structure was established and individual fields of activity, as profit or cost centers for budgeting and reporting, were separated. Employment rationalization was started, labour valuation system, its effectiveness and a new payment policy were implemented. In accordance with the stipulation resulting from standard PN-EN ISO 9000:2001, process-like approach to management was assumed. This paper presents the process based approach to management and elements of project management at RAFAKO S.A. The experiences in project management, originating from the history of this company, facilitated considerably the first stages of process management implementation. A brief description of budget planning technique and elements of cost account, as well as how the budget and account are interpreted in the Integrated Management System were presented. (author)

QUALITY MANAGEMENT IN TERMS OF STRENGTHENING THE "THREE LINES OF DEFENCE" IN RISK MANAGEMENT - PROCESS APPROACH

OpenAIRE

Radoica Luburic; Milan Perovic; Rajko Sekulovic

2015-01-01

The authors of the paper analyze risk management processes contained in the model considering its longstanding application in many European organisations. The paper also analyses quality management system (QMS) standards and risk management (RM) standards. It particularly addresses the process approach to QMS which, when coupled with active involvement of employees and constant improvements, makes this approach interesting as the topic of this paper. The analyses herein resulted in integratin...

Survey process quality: a question of healthcare manager approach.

Science.gov (United States)

Nilsson, Petra; Blomqvist, Kerstin

2017-08-14

Purpose The purpose of this paper is to explore how healthcare first-line managers think about and act regarding workplace survey processes. Design/methodology/approach This interview study was performed at a hospital in south Sweden. First-line healthcare managers ( n=24) volunteered. The analysis was inspired by phenomenography, which aims to describe the ways in which different people experience a phenomenon. The phenomenon was a workplace health promotion (WHP) survey processes. Findings Four main WHP survey process approaches were identified among the managers: as a possibility, as a competition, as a work task among others and as an imposition. For each, three common subcategories emerged; how managers: stated challenges and support from hospital management; described their own work group and collaboration with other managers; and expressed themselves and their situation in their roles as first-line managers. Practical implications Insights into how hospital management can understand their first-line managers' motivation for survey processes and practical suggestions and how managers can work proactively at organizational, group and individual level are presented. Originality/value Usually these studies focus on those who should respond to a survey; not those who should run the survey process. Focusing on managers and not co-workers can lead to more committed and empowered managers and thereby success in survey processes.

Pain management in primary care – current perspectives | Meyer ...

African Journals Online (AJOL)

According to a 1998 World Health Organization Survey of 26 000 primary care ... in pain medicine and continue to follow the biomedical approach, which ... The modern paradigm of pain management has moved from this biomedical to the ...

Exploring Conflict Management Using Qualitative Approach

Directory of Open Access Journals (Sweden)

Zaleha Yazid

2015-04-01

Full Text Available This paper focuses on qualitative methods in researching the area of conflict management, specifically in Self-Managed Project Team (SMPT. The research aims to explore the evolvement of conflict management strategies in SMPT as this type of team is given the responsibility to solve problems and make decision by themselves. The inductive approach will overcome the limitation of quantitative method in management research as one of its objectives is to explain the different elements of the explored social system and their interconnection. Hence, it aims at the contextual understanding of social behavior rather than extensive measurement. This paper also includes the research activities in details such as the data collection methods which involved semi-structured interviews and weekly telephone interviews. The findings of the research proposed that conflict management strategies in SMPT changes over time from confrontation and cooperative style towards avoidance due to the issues of reputation and the deadline.

Stepwise approach to decision making for long-term radioactive waste management. Experience, issues and guiding principles

International Nuclear Information System (INIS)

2004-01-01

Radioactive waste exists as a result of both past and current practices. One of the most challenging tasks is the management of long-lived waste that must be isolated from the human environment for many thousands, or even hundreds of thousands, of years. Although significant technical progress has been made in developing management schemes that, according to technical experts, would ensure long-term safety (e.g. engineered geologic disposal), the rate of progress towards implementing such solutions has been slower than expected. The contrast between expected and observed rates may be partly attributable to an earlier technical optimism. More significant, however, are the setbacks, which have arisen mainly from an underestimation of the societal and political dimensions. In long-term radioactive waste management, consideration is increasingly being given to concepts such as stepwise decision making and adaptive staging in which the public, and especially the local public, are to be meaningfully involved in the review and planning of developments. The key feature of these concepts is development by steps or stages that are reversible, within the limits of practicability. This is designed to provide reassurance that decisions can be reversed if experience shows them to have adverse or unwanted effects. A stepwise approach to decision making has thus come to the fore as being of value in advancing long-term radioactive waste management solutions in a societally acceptable manner. Despite its early identification within the radioactive waste management community as an important means for reaching solutions and decisions in which there is broad-based confidence, the bases for and application of stepwise decision making has not been widely reviewed. Guiding principles of any such process are still being formulated, its roots in empirical social science research have not been fully reviewed, nor the difficulties of its implementation analysed. The report reviews current

Systemic Right Ventricle in Adults With Congenital Heart Disease: Anatomic and Phenotypic Spectrum and Current Approach to Management.

Science.gov (United States)

Brida, Margarita; Diller, Gerhard-Paul; Gatzoulis, Michael A

2018-01-30

The systemic right ventricle (SRV) is commonly encountered in congenital heart disease representing a distinctly different model in terms of its anatomic spectrum, adaptation, clinical phenotype, and variable, but overall guarded prognosis. The most common clinical scenarios where an SRV is encountered are complete transposition of the great arteries with previous atrial switch repair, congenitally corrected transposition of the great arteries, double inlet right ventricle mostly with previous Fontan palliation, and hypoplastic left heart syndrome palliated with the Norwood-Fontan protocol. The reasons for the guarded prognosis of the SRV in comparison with the systemic left ventricle are multifactorial, including distinct fibromuscular architecture, shape and function, coronary artery supply mismatch, intrinsic abnormalities of the tricuspid valve, intrinsic or acquired conduction abnormalities, and varied SRV adaptation to pressure or volume overload. Management of the SRV remains an ongoing challenge because SRV dysfunction has implications on short- and long-term outcomes for all patients irrespective of underlying cardiac morphology. SRV dysfunction can be subclinical, underscoring the need for tertiary follow-up and timely management of target hemodynamic lesions. Catheter interventions and surgery have an established role in selected patients. Cardiac resynchronization therapy is increasingly used, whereas pharmacological therapy is largely empirical. Mechanical assist device and heart transplantation remain options in end-stage heart failure when other management strategies have been exhausted. The present report focuses on the SRV with its pathological subtypes, pathophysiology, clinical features, current management strategies, and long-term sequelae. Although our article touches on issues applicable to neonates and children, its main focus is on adults with SRV. © 2018 American Heart Association, Inc.

Obesity in Nigeria: Current trends and management | Akpa ...

African Journals Online (AJOL)

The objective of the study is to review the current knowledge on the problems associated with obesity, as well as the measures and strategies that have evolved in its management. A review of the literature on the subject of obesity, its epidemiology, risk factors, clinical complications and treatment (using Medline computer ...

Rehabilitation Medicine Approaches to Pain Management.

Science.gov (United States)

Cheville, Andrea L; Smith, Sean R; Basford, Jeffrey R

2018-06-01

Rehabilitation medicine offers strategies that reduce musculoskeletal pain, targeted approaches to alleviate movement-related pain, and interventions to optimize patients' function despite the persistence of pain. These approaches fall into four categories: modulating nociception, stabilizing and unloading painful structures, influencing pain perception, and alleviating soft tissue musculotendinous pain. Incorporating these interventions into individualized, comprehensive pain management programs offers the potential to empower patients and limit pain associated with mobility and required daily activities. Rehabilitative approach may be particularly helpful for patients with refractory movement-associated pain and functional vulnerability, and for those who do not wish for, or cannot, tolerate pharmacoanalgesia. Copyright © 2018 Elsevier Inc. All rights reserved.

Comparisons on International Approaches of Business and Project Risk Management

OpenAIRE

Nadia Carmen ENE

2005-01-01

In this article we intend to present a comparative approach between three recognized international methodologies for risk management: RISKMAN, Project Management Institute Methodology-PMBoK and Project Risk Analysis and Management Guide (produced by Association for Project Management).

General Biology and Current Management Approaches of Soft Scale Pests (Hemiptera: Coccidae).

Science.gov (United States)

Camacho, Ernesto Robayo; Chong, Juang-Horng

We summarize the economic importance, biology, and management of soft scales, focusing on pests of agricultural, horticultural, and silvicultural crops in outdoor production systems and urban landscapes. We also provide summaries on voltinism, crawler emergence timing, and predictive models for crawler emergence to assist in developing soft scale management programs. Phloem-feeding soft scale pests cause direct (e.g., injuries to plant tissues and removal of nutrients) and indirect damage (e.g., reduction in photosynthesis and aesthetic value by honeydew and sooty mold). Variations in life cycle, reproduction, fecundity, and behavior exist among congenerics due to host, environmental, climatic, and geographical variations. Sampling of soft scale pests involves sighting the insects or their damage, and assessing their abundance. Crawlers of most univoltine species emerge in the spring and the summer. Degree-day models and plant phenological indicators help determine the initiation of sampling and treatment against crawlers (the life stage most vulnerable to contact insecticides). The efficacy of cultural management tactics, such as fertilization, pruning, and irrigation, in reducing soft scale abundance is poorly documented. A large number of parasitoids and predators attack soft scale populations in the field; therefore, natural enemy conservation by using selective insecticides is important. Systemic insecticides provide greater flexibility in application method and timing, and have longer residual longevity than contact insecticides. Application timing of contact insecticides that coincides with crawler emergence is most effective in reducing soft scale abundance.

Ecosystem Approach to Urban Household Waste Management in ...

International Development Research Centre (IDRC) Digital Library (Canada)

Ecosystem Approach to Urban Household Waste Management in the context of ... in Ecohealth (COPEH) supported by IDRC's Ecosystem Approaches to Human ... Call for new OWSD Fellowships for Early Career Women Scientists now open ... International Water Resources Association, in close collaboration with IDRC, ...

A complex systems approach to constructing better models for managing financial markets and the economy

Science.gov (United States)

Farmer, J. Doyne; Gallegati, M.; Hommes, C.; Kirman, A.; Ormerod, P.; Cincotti, S.; Sanchez, A.; Helbing, D.

2012-11-01

We outline a vision for an ambitious program to understand the economy and financial markets as a complex evolving system of coupled networks of interacting agents. This is a completely different vision from that currently used in most economic models. This view implies new challenges and opportunities for policy and managing economic crises. The dynamics of such models inherently involve sudden and sometimes dramatic changes of state. Further, the tools and approaches we use emphasize the analysis of crises rather than of calm periods. In this they respond directly to the calls of Governors Bernanke and Trichet for new approaches to macroeconomic modelling.

Component-Based Approach in Learning Management System Development

Science.gov (United States)

Zaitseva, Larisa; Bule, Jekaterina; Makarov, Sergey

2013-01-01

The paper describes component-based approach (CBA) for learning management system development. Learning object as components of e-learning courses and their metadata is considered. The architecture of learning management system based on CBA being developed in Riga Technical University, namely its architecture, elements and possibilities are…

Initial impact of a systematic multidisciplinary approach on the management of patients with gastroenteropancreatic neuroendocrine tumor.

LENUS (Irish Health Repository)

Tamagno, Gianluca

2013-10-01

According to the international guidelines, a multidisciplinary approach is currently advised for the optimal care of patients with a gastroenteropancreatic neuroendocrine tumor (GEP NET). In our institution (tertiary care center), a systematic multidisciplinary approach was established in May 2007. In this study, we have aimed to assess the initial impact of establishing a systematic multidisciplinary approach to the management of GEP NET patients. We have collected and compared the biochemical, imaging, and pathological data and the therapeutic strategies in GEP NET patients diagnosed, treated, or followed-up from January 1993 to April 2007 versus GEP NET patients attending our institution after the multidisciplinary approach starting, from May 2007 to October 2008. Data of 91 patients before and 42 patients after the establishment of the multidisciplinary approach (total: 133 consecutive GEP NET patients) have been finally collected and analyzed. Before the establishment of the multidisciplinary approach, a lack of consistency in the biochemical, imaging, and pathological findings before treatment initiation as well as during follow-up of GEP NET patients was identified. These inconsistencies have been reduced by the systematic multidisciplinary approach. In addition, the therapeutic management of GEP NET patients has been altered by the multidisciplinary approach and became more consistent with recommended guidelines. We think that a systematic multidisciplinary approach significantly impacts on GEP NET patient care and should be established in all centers dealing with these tumors.

The Concept Of A Sustainable Approach To Corporate Real Estate Management

Directory of Open Access Journals (Sweden)

Ziemba Ewa

2015-12-01

Full Text Available This paper is conceptual in nature and presents the assumptions of a holistic approach to corporate real estate management. The approach is based on the imperative of sustainability, which has become a determinant of the proposed Sustainable Corporate Real Estate Management (SCREM model. Moreover, the authors indicate that in addition to the presence of the sustainability imperative, corporate real estate management requires the integration and formalization of knowledge about the concepts of corporate real estate management (CREM with those of corporate social responsibility (CSR. This approach is intended to enable the identification and improvement of real estate management processes and, as a result, contribute to more efficient and effective corporate real estate management and continuous and flexible development of enterprises, as well as boosting economic growth and building prosperity for present and future generations.

Strategic Niche Management and Transition Management: different but complementary approaches

NARCIS (Netherlands)

D.A. Loorbach (Derk); R. van Raak (Ronald)

2006-01-01

textabstractThis discussion paper sets out to compare two different, yet related, approaches to achieve sustainable development and (technological) innovation. Strategic Niche Management (SNM) (Kemp, Schot et al. 1998; Weber 1999) emerged as a novel concept by the end of the 1990’s and is presented

OSSA - An optimized approach to severe accident management: EPR application

International Nuclear Information System (INIS)

Sauvage, E. C.; Prior, R.; Coffey, K.; Mazurkiewicz, S. M.

2006-01-01

There is a recognized need to provide nuclear power plant technical staff with structured guidance for response to a potential severe accident condition involving core damage and potential release of fission products to the environment. Over the past ten years, many plants worldwide have implemented such guidance for their emergency technical support center teams either by following one of the generic approaches, or by developing fully independent approaches. There are many lessons to be learned from the experience of the past decade, in developing, implementing, and validating severe accident management guidance. Also, though numerous basic approaches exist which share common principles, there are differences in the methodology and application of the guidelines. AREVA/Framatome-ANP is developing an optimized approach to severe accident management guidance in a project called OSSA ('Operating Strategies for Severe Accidents'). There are still numerous operating power plants which have yet to implement severe accident management programs. For these, the option to use an updated approach which makes full use of lessons learned and experience, is seen as a major advantage. Very few of the current approaches covers all operating plant states, including shutdown states with the primary system closed and open. Although it is not necessary to develop an entirely new approach in order to add this capability, the opportunity has been taken to develop revised full scope guidance covering all plant states in addition to the fuel in the fuel building. The EPR includes at the design phase systems and measures to minimize the risk of severe accident and to mitigate such potential scenarios. This presents a difference in comparison with existing plant, for which severe accidents where not considered in the design. Thought developed for all type of plants, OSSA will also be applied on the EPR, with adaptations designed to take into account its favourable situation in that field

Assessment of different construction and demolition waste management approaches

Directory of Open Access Journals (Sweden)

Manal S. Abdelhamid

2014-12-01

Full Text Available The waste generated from construction and demolition sites is considered one of the most irritating problems in Egypt. In the last 10 years some effort has been made toward solving this problem, the most outstanding is the newly issued Egyptian rating system “Green Pyramids Rating System”. It emphasizes on waste management and particularly “site provision and environment” which contributes to 75% of the management category score. However the traditional practice which is limited to dumping all the generated waste is still dominating. The absence of sustainable practices in construction sector in Egypt led to the lack in financial and environmental data. From strategic perspective, the research aims at developing a detailed procedure to evaluate two construction and demolition waste management approaches by means of Decision Matrix technique. A detailed study is introduced for the two approaches; for each approach a flow chart is developed to demonstrate its lifecycle, as well as the cost break down structure and the different stakeholders’ roles. A penetration discussion of the pros and cons for each approach was developed accordingly and came out with sixteen influencing attributes for both approaches. The previous steps paved the ground to construct a Decision Matrix to decide on one of the approaches from a strategic environmentally oriented perspective. The study relied on the detailed and deep demonstration of the two approaches to justify the assigned weight for attributes and scores for corresponding approach. From a strategic perspective, the decision came out in favor of the more environmentally friendly approach.

Congenital nasal neuroglial heterotopia and encephaloceles: An update on current evaluation and management.

Science.gov (United States)

Adil, Eelam; Robson, Caroline; Perez-Atayde, Antonio; Heffernan, Colleen; Moritz, Ethan; Goumnerova, Liliana; Rahbar, Reza

2016-09-01

To describe our experience and current management approach for congenital nasal neuroglial heterotopia (NGH) and encephaloceles. Retrospective chart review at a tertiary pediatric hospital from 1970 to 2013. Thirty patients met inclusion criteria: 21 NGH and nine encephaloceles. Data including demographics, pathology, imaging modality, surgical approach, resection extent, outcomes, and complications were analyzed. Fourteen NGH patients (67%) presented with an internal nasal mass and nasal obstruction. Three patients (14%) presented with an external nasal mass and four (19%) had a mixed lesion. Median age at surgery was 0.51 years (interquartile range 1.32 years). Thirteen (62%) had an intranasal endoscopic approach. Median operative time was 1.6 hours (interquartile range 1.2 hours), and there were no major complications. Nine patients with encephalocele were identified: six (67%) presented with transethmoidal encephaloceles, two (22%) presented with nasoethmoidal encephaloceles, and one (11%) presented with a nasofrontal lesion. The median age at surgery was 1.25 years (interquartile range 1.4 years). All patients required a craniotomy for intracranial extension. Median operative time was 5 hours (interquartile range 1.9 hours), and eight patients (88%) had a total resection. Length of stay ranged from 3 to 14 days. Nasal neuroglial heterotopia and encephaloceles are very rare lesions that require multidisciplinary evaluation and management. At our institution, there has been a shift to magnetic resonance imaging alone for the evaluation of NGH to avoid radiation exposure. Endoscopic extracranial resection is feasible for most intranasal and mixed NGH without an increase in operative time, residual disease, or complications. 4. Laryngoscope, 126:2161-2167, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

A Model-Driven Approach to e-Course Management

Science.gov (United States)

Savic, Goran; Segedinac, Milan; Milenkovic, Dušica; Hrin, Tamara; Segedinac, Mirjana

2018-01-01

This paper presents research on using a model-driven approach to the development and management of electronic courses. We propose a course management system which stores a course model represented as distinct machine-readable components containing domain knowledge of different course aspects. Based on this formally defined platform-independent…

Current Approaches to the Treatment of Systemic-Sclerosis-Associated Pulmonary Arterial Hypertension (SSc-PAH).

Science.gov (United States)

Sobanski, Vincent; Launay, David; Hachulla, Eric; Humbert, Marc

2016-02-01

Pulmonary arterial hypertension (PAH) is a severe condition causing significant morbidity and mortality in patients with systemic sclerosis (SSc). Despite the use of specific treatments, SSc-PAH survival remains poorer than in idiopathic PAH (IPAH). Recent therapeutic advances in PAH show a lower magnitude of response in SSc-PAH and a higher risk of adverse events, as compared to IPAH. The multifaceted underlying mechanisms and the multisystem nature of SSc probably explain part of the worse outcomes in SSc-PAH compared to IPAH. This review describes the current management of SSc-PAH with an emphasis on the impact of the different organ involvements in the prognosis and treatment response. An earlier detection of PAH and a better characterization of the clinical phenotypes of SSc-PAH are warranted in clinical practice and future trials. Determinants of prognosis, surrogate markers of clinical improvement or worsening, and relevance of the common endpoints used in clinical trials should be evaluated in this specific population. A multidisciplinary approach in expert referral centers is mandatory for SSc-PAH management.

Current Standards in the Management of Cerebral Metastases

Directory of Open Access Journals (Sweden)

Pablo Goetz

2012-01-01

Full Text Available The last 30 years have seen major changes in attitude toward patients with cerebral metastases. This paper aims to outline the major landmarks in this transition and the therapeutic strategies currently used. The controversies surrounding control of brain disease are discussed, and two emerging management trends are reviewed: tumor bed radiosurgery and salvage radiation.

Impact of Antibiotic Shortage on H. Pylori Treatment: A Step-Wise Approach for Pharmacist Management

Directory of Open Access Journals (Sweden)

Michelle M. Lamb

2013-01-01

Full Text Available The current drug shortage crisis involving multiple oral antibiotics has significantly impacted preferred therapeutic options for treatment of H.pylori infection. Pharmacists may help alleviate the impact of this shortage through a proposed step-wise approach which includes proper inventory management, verification of indication, evaluation of regimen, therapeutic monitoring, and communication with patients and providers regarding alternative therapy or symptomatic relief.   Type: Original Research

A integrated talent management approach towards sustaing the value of facility management leadership

NARCIS (Netherlands)

Brink, Henk Willem

2016-01-01

Trend reports project up to 50% of the experienced FM workforce within the upper and middle management levels of an organization will leave the workplace within the next 10-15 years. Current leadership continues to be tested by early retirement incentives, and constricting human resource management

Evaluation of current trends and recent development in insulin therapy for management of diabetes mellitus.

Science.gov (United States)

Nawaz, Muhammad Sarfraz; Shah, Kifayat Ullah; Khan, Tahir Mehmood; Rehman, Asim Ur; Rashid, Haroon Ur; Mahmood, Sajid; Khan, Shahzeb; Farrukh, Muhammad Junaid

2017-12-01

Diabetes mellitus is a major health problem in developing countries. There are various insulin therapies to manage diabetes mellitus. This systematic review evaluates various insulin therapies for management of diabetes mellitus worldwide. This review also focuses on recent developments being explored for better management of diabetes mellitus. We reviewed a number of published articles from 2002 to 2016 to find out the appropriate management of diabetes mellitus. The paramount parameters of the selected studies include the insulin type & its dose, type of diabetes, duration and comparison of different insulin protocols. In addition, various newly developed approaches for insulin delivery with potential output have also been evaluated. A great variability was observed in managing diabetes mellitus through insulin therapy and the important controlling factors found for this therapy include; dose titration, duration of insulin use, type of insulin used and combination therapy of different insulin. A range of research articles on current trends and recent advances in insulin has been summarized, which led us to the conclusion that multiple daily insulin injections or continuous subcutaneous insulin infusion (insulin pump) is the best method to manage diabetes mellitus. In future perspectives, development of the oral and inhalant insulin would be a tremendous breakthrough in Insulin therapy. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Methodical approaches to providing sustainable development of the transport industry management system based on self-organization

Science.gov (United States)

Belyantseva, Oksana; Panenkov, Andrey; Safonova, Nataliya

2017-10-01

Current conditions of the cognitive economy formation demand to take into account the leading role of information, knowledge and human capital in the development of the transport industry management system. The article substantiates the conceptual approach to the self-organization of a management system on the basis of innovative changes. Human capital is the key aspect of self-organization, so the directions of improving the workforce quality are justified. Basing on the information-innovative genesis of the process of self-organization, the authors justified the necessity of preventing asymmetric information. For this pupose the actions against the resistance to innovations were proposed. The implementation of certain measures contributes to the effective development of the transport management system.

MULTI-DIMENSIONAL APPROACH TO CRISIS MANAGEMENT IN ...

African Journals Online (AJOL)

HP

; and ... multidisciplinary approaches to the management of conflict in the church while still .... classifies them into three: Inherency (Micro), contingency (Macro) and, .... Contemporary Evangelicals are fairly accused of uncritically importing ...

Approach to Spacelab Payload mission management

Science.gov (United States)

Craft, H. G.; Lester, R. C.

1978-01-01

The nucleus of the approach to Spacelab Payload mission management is the establishment of a single point of authority for the entire payload on a given mission. This single point mission manager will serve as a 'broker' between the individual experiments and the STS, negotiating agreements by two-part interaction. The payload mission manager, along with a small support team, will represent the users in negotiating use of STS accommodations. He will provide the support needed by each individual experimenter to meet the scientific, technological, and applications objectives of the mission with minimum cost and maximum efficiency. The investigator will assume complete responsibility for his experiment hardware definition and development and will take an active role in the integration and operation of his experiment.

Harvest Strategies for an Ecosystem Approach to Fisheries Management in Western Mediterranean Demersal Fisheries

Directory of Open Access Journals (Sweden)

Antoni Quetglas

2017-04-01

Full Text Available The serious overfishing of most Mediterranean stocks demands urgent reforms of the management measures aiming to guarantee the sustainability of resources, notably when compared with the improvement observed in other European areas. The new EU Common Fisheries Policy (CFP constitutes an excellent opportunity to introduce the changes needed for such a reform. According to this CFP, all European fish stocks should be brought to a state where they can produce at MSY by 2020 at the latest. The CFP also establishes that the objective of sustainable exploitation should be achieved through multiannual plans (MAPs adopted in consultation with relevant stakeholders having fisheries management interests such as fishermen, non-governmental organizations, and policy makers. Together with the MSY and MAP approaches, the new CFP contains several other measures, directed to guarantee the ecological and socio-economic sustainability of fisheries by means of the implementation of the ecosystem approach to fisheries management (EAFM. With this new perspective, the CFP wants to avoid past failures of fisheries management based on monospecific approaches. This study is a first step toward the application of the EAFM in the Balearic Islands by means of the development of a harvest strategy with defined objectives, targets, limits, and clear management control rules aimed at optimizing socioeconomic and ecological objectives in the framework of the new CFP. Different management scenarios designed to achieve that goal were modeled for the main demersal commercial fisheries from the study area, the bottom trawl, and small-scale fisheries. The work begins with a general description of those fisheries, their main fishing grounds, and assessments of the exploitation status of the main target stocks in order to establish the current situation. Secondly, alternative management scenarios to maximize catch and profits while considering societal objectives were evaluated by

An exploration of Bureau of Reclamation approaches for managing conflict over diverging science

Science.gov (United States)

Burkardt, Nina; Ruell, Emily; Clark, Douglas

2008-01-01

As a major institutional agent supplying Western water resources, the Bureau of Reclamation (Reclamation) provides important leadership, technical, and financial resources in water management, serving as the West's "water broker" (Bowersox 2000; Pisani 2003). In recent years, growing numbers of constituencies using water and the over-allocation of water resources have contributed to conflict over the resource in the American West (National Research Council 2004). Although the conflicts arise from many sources, one common theme is that Reclamation managers often must make decisions about water use and allocation when scientific studies provide uncertain or competing recommendations. We conducted a preliminary study of Reclamation water managers and water scientists to try to understand the approaches or techniques they use or consider useful for dealing with scientific conflicts over water allocation and how these compare to techniques found in the relevant literature. We report the results of (1) an electronic survey of Reclamation senior managers and (2) a panel discussion amongst Reclamation senior managers as to the current institutional capabilities for managing diverging scientific findings in water dispute resolution processes. We conclude with a discussion of the strengths and weaknesses of the different tools and techniques managers reported in the survey and in the panel discussion.

Harvest Regulation for Multi-Resource Management, Old and New Approaches (Old and New

Directory of Open Access Journals (Sweden)

Martin Alfonso Mendoza

2015-03-01

Full Text Available Current Mexican forest management is the product of a history that dates back to 1926. Earlier approaches were directly or indirectly aimed at attaining the normal forest model. Around 1980, multi-resource and environmental impact considerations were mandated for all private timber operations. Timber-oriented silviculture was deemed insufficient to take proper care of non-timber values in the forest. Concerns about water quality, biodiversity, and natural conservation were the motives for promoting voluntary best management practices, in 2012 and afterwards. In this research, two traditional Mexican forest management schemes, Sicodesi and Plan Costa, enhanced with best management practices, are compared to Mapa, a management method specifically designed to manage landscape attributes. Results from two successive forest inventories 10 and 13 years apart show that Sicodesi and Plan Costa, even when modified to comply with best management practices, failed to maintain proper stewardship of non-timber values. Mapa, however, employed multiple means to drive forest dynamics to fulfill multi-resource objectives, constrained by self-financing and competitive profitability. These capabilities in Mapa enabled some degree of control over non-timber values, but many more important processes occur beyond the property boundary, and beyond the planning scope considered in Mapa and all other forest planning methods.

New Approaches to Airway Management in Tracheal Resections-A Systematic Review and Meta-analysis.

Science.gov (United States)

Schieren, Mark; Böhmer, Andreas; Dusse, Fabian; Koryllos, Aris; Wappler, Frank; Defosse, Jerome

2017-08-01

Although endotracheal intubation, surgical crossfield intubation, and jet ventilation are standard techniques for airway management in tracheal resections, there are also reports of new approaches, ranging from regional anesthesia to extracorporeal support. The objective was to outline the entire spectrum of new airway techniques. The literature databases PubMed/Medline and the Cochrane Library were searched systematically for prospective and retrospective trials as well as case reports on tracheal resections. No restrictions applied to hospital types or settings. Adult patients undergoing surgical resections of noncongenital tracheal stenoses with end-to-end anastomoses. Airway management techniques were divided into conventional and new approaches and analyzed regarding their potential risks and benefits. A total of 59 publications (n = 797 patients) were included. The majority of publications (71.2%) describe conventional airway techniques. Endotracheal tube placement after induction of general anesthesia and surgical crossfield intubation after incision of the trachea were used most frequently without major complications. A total of 7 new approaches were identified, including 4 different regional anesthetic techniques (25 cases), supraglottic airways (4 cases), and new forms of extracorporeal support (25 cases). Overall failure rates of new techniques were low (1.8%). Details on patient selection and procedural specifics are provided. New approaches have several theoretical benefits, yet further research is required to establish criteria for patient selection and evaluate procedural safety. Given the low level of evidence, it currently is impossible to compare methods of airway management regarding outcome-related risks and benefits. Copyright © 2017 Elsevier Inc. All rights reserved.

Identifying Silence Climate in Organizations in the Framework of Contemporary Management Approaches

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Mustafa Emre Civelek

2015-10-01

Full Text Available Dynamic competition conditions in present day, bring about the consequence for businesses to face varied problems with each passing day. At this point, current management approaches include studies that would shed light on the new problems of businesses. Organizational Silence, a concept that has recently been being voiced in business world, has come up in such context. Organizational silence could be expressed as the employee behavior of keeping silent about certain negativities due to various reasons in an organization. Since knowledge sharing in modern organizations is of capital importance in terms of responding hastily to the changes in a competitive environment, spread of this behavior of employees to organization culture and climate presents a threat of indifference. In this study, the concept of Organizational Silence is defined and the effects of conceived silence climate on management of organizations are discussed.

Identifying Silence Climate in Organizations in the Framework of Contemporary Management Approaches

Directory of Open Access Journals (Sweden)

Mustafa Emre Civelek

2015-12-01

Full Text Available Dynamic competition conditions in present day bring about the consequence for businesses to face varied problems with each passing day. At this point, current management approaches include studies that would shed light on the new problems of businesses. Organizational Silence, a concept that has recently been being voiced in business world, has come up in such context. Organizational silence could be expressed as the employee behavior of keeping silent about certain negativities due to various reasons in an organization. Since knowledge sharing in modern organizations is of capital importance in terms of responding hastily to the changes in a competitive environment, spread of this behavior of employees to organization culture and climate presents a threat of indifference. In this study, the concept of Organizational Silence is defined and the effects of conceived silence climate on management of organizations are discussed.

FINANCIAL ASPECTS OF CURRENT ASSETS MANAGEMENT IN SERBIAN ECONOMY

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Jugoslav Aničić

2017-04-01

Full Text Available Efficient current assets management should provide optimum level of company’s net current assets as interrelation between current assets and short-term liabilities. The companies whose short-term liabilities are not proportionate to cashable current assets face the problem of insolvency and all negative consequences caused by insolvency. Rate of return to total assets measures how good is the management’s use of the company property for the purpose of creating operating profit, regardless of the fact how these assets are financed. Serbian economy is burdened by insolvency and significant indebtedness under unfavorable loan terms, so adequate attention has to be dedicated to the matters of the structure of operating property and its financing in order to improve competitiveness and efficiency of business.

Application of the graded management approach to Battelle's nuclear project

International Nuclear Information System (INIS)

Voth, C.B.

1996-01-01

Battelle's graded management approach provides an effective and efficient method to perform the Battelle Columbus Laboratories Decommissioning Project (BCLDP). The project is managed by Battelle under their US Nuclear Regulatory Commission (NRC) license but is partially funded by the US Department of Energy (DOE) on a cost-shared basis. Battelle's graded management approach adheres to the regulations and orders governing the BCLDP by the interaction of various plans, procedures, permits, and work instructions. By independent assessment, quality control, and worker training, Battelle has been able to establish a cost-effective approach to performing work and, at the same time, have a controlled checks and balance system to assure the proper safety considerations and project particulars are taken into account

Biographical approach to human resource management

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Ratković-Njegovan Biljana

2015-01-01

Full Text Available The paper discusses the importance of biographical approach to managing human resources, which is especially important in the first, anticipatory stage of organizational socialization, in which interview for the job is performed. Biographical principle is based on a broader and more complex approach to the candidate, which enables him to present his working career, personal qualities, professional knowledge and skills, social skills, interests and aspirations. Biographical approach allows an individual who has applied for a certain job to reflect, identify and present their work and life path in their own way.. The organization, in turn, through the biographical method receives valid information to predict the future behavior of candidates and their performance.

Unmanned Aircraft Systems Traffic Management (UTM): Conflict Mitigation Approach

Science.gov (United States)

Johnson, Marcus

2018-01-01

This is a presentation that describes the UAS Traffic Management Approach to an alternate means of compliance with 91.113 right of way regulations. UTM is an "air traffic management" ecosystem for uncontrolled operations.

Prognostics and Health Management of Wind Turbines: Current Status and Future Opportunities

Energy Technology Data Exchange (ETDEWEB)

Sheng, Shuangwen

2016-10-04

This presentation was given at the 2016 Annual Conference of the Prognostics and Health Management Society. It covers the current status and challenges and opportunities of prognostics and health management of wind turbines.

Overcoming mixed waste management obstacles - A company wide approach

International Nuclear Information System (INIS)

Buckley, R.N.

1996-01-01

The dual regulation of mixed waste by the Nuclear Regulatory Commission and the Environmental Protection Agency has significantly complicated the treatment, storage and disposal of this waste. Because of the limited treatment and disposal options available, facilities generating mixed waste are also being forced to acquire storage permits to meet requirements associated with the Resource Conservation and Recovery Act. Due to the burdens imposed by the regulatory climate, Entergy Operations has undertaken a proactive approach to managing its mixed waste. Their approach is company wide and simplistic in nature. Utilizing the peer groups to develop strategies and a company wide procedure for guidance on mixed waste activities, they have focused on areas where they have the most control and can achieve the greatest benefits from their efforts. A key aspect of the program includes training and employee awareness regarding mixed waste minimization practices. In addition, Entergy Operations is optimizing the implementation of regulatory provisions that facilitate more flexible management practices for mixed waste. This presentation focuses on the team approach to developing mixed waste managements programs and the utilization of innovative thinking and planning to minimize the regulatory burdens. It will also describe management practices and philosophies that have provided more flexibility in implementing a safe and effective company wide mixed waste management program

Managing hyperthyroidism in pregnancy: current perspectives

Science.gov (United States)

Andersen, Stine Linding; Laurberg, Peter

2016-01-01

Hyperthyroidism in women who are of childbearing age is predominantly of autoimmune origin and caused by Graves’ disease. The physiological changes in the maternal immune system during a pregnancy may influence the development of this and other autoimmune diseases. Furthermore, pregnancy-associated physiological changes influence the synthesis and metabolism of thyroid hormones and challenge the interpretation of thyroid function tests in pregnancy. Thyroid hormones are crucial regulators of early development and play an important role in the maintenance of a normal pregnancy and in the development of the fetus, particularly the fetal brain. Untreated or inadequately treated hyperthyroidism is associated with pregnancy complications and may even program the fetus to long-term development of disease. Thus, hyperthyroidism in pregnant women should be carefully managed and controlled, and proper management involves different medical specialties. The treatment of choice in pregnancy is antithyroid drugs (ATDs). These drugs are effective in the control of maternal hyperthyroidism, but they all cross the placenta, and so need careful management and control during the second half of pregnancy considering the risk of fetal hyper- or hypothyroidism. An important aspect in the early pregnancy is that the predominant side effect to the use of ATDs in weeks 6–10 of pregnancy is birth defects that may develop after exposure to available types of ATDs and may be severe. This review focuses on four current perspectives in the management of overt hyperthyroidism in pregnancy, including the etiology and incidence of the disease, how the diagnosis is made, the consequences of untreated or inadequately treated disease, and finally how to treat overt hyperthyroidism in pregnancy. PMID:27698567

Managing hyperthyroidism in pregnancy: current perspectives.

Science.gov (United States)

Andersen, Stine Linding; Laurberg, Peter

2016-01-01

Hyperthyroidism in women who are of childbearing age is predominantly of autoimmune origin and caused by Graves' disease. The physiological changes in the maternal immune system during a pregnancy may influence the development of this and other autoimmune diseases. Furthermore, pregnancy-associated physiological changes influence the synthesis and metabolism of thyroid hormones and challenge the interpretation of thyroid function tests in pregnancy. Thyroid hormones are crucial regulators of early development and play an important role in the maintenance of a normal pregnancy and in the development of the fetus, particularly the fetal brain. Untreated or inadequately treated hyperthyroidism is associated with pregnancy complications and may even program the fetus to long-term development of disease. Thus, hyperthyroidism in pregnant women should be carefully managed and controlled, and proper management involves different medical specialties. The treatment of choice in pregnancy is antithyroid drugs (ATDs). These drugs are effective in the control of maternal hyperthyroidism, but they all cross the placenta, and so need careful management and control during the second half of pregnancy considering the risk of fetal hyper- or hypothyroidism. An important aspect in the early pregnancy is that the predominant side effect to the use of ATDs in weeks 6-10 of pregnancy is birth defects that may develop after exposure to available types of ATDs and may be severe. This review focuses on four current perspectives in the management of overt hyperthyroidism in pregnancy, including the etiology and incidence of the disease, how the diagnosis is made, the consequences of untreated or inadequately treated disease, and finally how to treat overt hyperthyroidism in pregnancy.

Assessing the risk of attack in the management of asthma: a review and proposal for revision of the current control-centred paradigm.

Science.gov (United States)

Blakey, John D; Woolnough, Kerry; Fellows, Jodie; Walker, Samantha; Thomas, Mike; Pavord, Ian D

2013-09-01

Asthma guidelines focus on day-to-day control of symptoms. However, asthma attacks remain common. They continue to cause mortality and considerable morbidity, and are a major financial burden to the UK National Health Service (NHS) and the wider community. Asthma attacks have chronic consequences, being associated with loss of lung function and significant psychological morbidity. In this article we argue that addressing daily symptom control is only one aspect of asthma treatment, and that there should be a more explicit focus on reducing the risk of asthma attacks. Management of future risk by general practitioners is already central to other conditions such as ischaemic heart disease and chronic renal impairment. We therefore propose a revised approach that separately considers the related domains of daily control and future risk of asthma attack. We believe this approach will have advantages over the current 'stepwise' approach to asthma management. It should encourage individualised treatment, including non-pharmacological measures, and thus may lead to more efficacious and less harmful management strategies. We speculate that this type of approach has the potential to reduce morbidity and healthcare costs related to asthma attacks.

Obesity Management in Europe: Current Status and Objectives for the Future

Science.gov (United States)

Uerlich, Magdalena F.; Yumuk, Volkan; Finer, Nick; Basdevant, Arnaud; Visscher, Tommy L.S.

2016-01-01

Objective This study aims at assessing the status of obesity management in the European region and identifying future goals and objectives of professionals working in the field of obesity. Methods Presidents of all 31 EASO-affiliated (EASO = European Association for the Study of Obesity) national associations for the study of obesity were asked to invite 5 obesity experts from their country to participate in a survey. A total of 74 obesity professionals out of 23 countries participated. Questions addressed the development of guidelines, the status of obesity management, and goals and objectives for the future in obesity management. Further, EASO's three vice-presidents participated in in-depth, semi-structured interviews, in which they were asked to provide their reflection on the survey data. Results Most countries define obesity as a clinical and chronic disease, but various differences in obesity management standards exist across Europe. Existing guidelines mainly focus on the acute treatment of obesity rather than on long-term approaches. Conclusion Multidisciplinary approaches for obesity management and the collaboration between general practitioners and hospitals as well as between professionals at the local level and networks of obesity management centers need to be improved across Europe. Good practices and evidence are available. PMID:27553443

Obesity Management in Europe: Current Status and Objectives for the Future

Directory of Open Access Journals (Sweden)

Magdalena F. Uerlich

2016-08-01

Full Text Available Objective: This study aims at assessing the status of obesity management in the European region and identifying future goals and objectives of professionals working in the field of obesity. Methods: Presidents of all 31 EASO-affiliated (EASO = European Association for the Study of Obesity national associations for the study of obesity were asked to invite 5 obesity experts from their country to participate in a survey. A total of 74 obesity professionals out of 23 countries participated. Questions addressed the development of guidelines, the status of obesity management, and goals and objectives for the future in obesity management. Further, EASO's three vice-presidents participated in in-depth, semi-structured interviews, in which they were asked to provide their reflection on the survey data. Results: Most countries define obesity as a clinical and chronic disease, but various differences in obesity management standards exist across Europe. Existing guidelines mainly focus on the acute treatment of obesity rather than on long-term approaches. Conclusion: Multidisciplinary approaches for obesity management and the collaboration between general practitioners and hospitals as well as between professionals at the local level and networks of obesity management centers need to be improved across Europe. Good practices and evidence are available.

Obesity Management in Europe: Current Status and Objectives for the Future.

Science.gov (United States)

Uerlich, Magdalena F; Yumuk, Volkan; Finer, Nick; Basdevant, Arnaud; Visscher, Tommy L S

2016-01-01

This study aims at assessing the status of obesity management in the European region and identifying future goals and objectives of professionals working in the field of obesity. Presidents of all 31 EASO-affiliated (EASO = European Association for the Study of Obesity) national associations for the study of obesity were asked to invite 5 obesity experts from their country to participate in a survey. A total of 74 obesity professionals out of 23 countries participated. Questions addressed the development of guidelines, the status of obesity management, and goals and objectives for the future in obesity management. Further, EASO's three vice-presidents participated in in-depth, semi-structured interviews, in which they were asked to provide their reflection on the survey data. Most countries define obesity as a clinical and chronic disease, but various differences in obesity management standards exist across Europe. Existing guidelines mainly focus on the acute treatment of obesity rather than on long-term approaches. Multidisciplinary approaches for obesity management and the collaboration between general practitioners and hospitals as well as between professionals at the local level and networks of obesity management centers need to be improved across Europe. Good practices and evidence are available. © 2016 The Author(s) Published by S. Karger GmbH, Freiburg.

A Comparative Assessment of Knowledge Management Leadership Approaches within the Department of Defense

Science.gov (United States)

2007-03-01

A COMPARATIVE ASSESSMENT OF KNOWLEDGE MANAGEMENT LEADERSHIP APPROACHES WITHIN THE DEPARTMENT OF DEFENSE... MANAGEMENT LEADERSHIP APPROACHES WITHIN THE DEPARTMENT OF DEFENSE THESIS Presented to the Faculty Department of Systems and Engineering...KNOWLEDGE MANAGEMENT LEADERSHIP APPROACHES WITHIN THE DEPARTMENT OF DEFENSE Tommy V. S. Marshall II, BS Captain, USAF Approved

Strategic Management Model with Lens of Knowledge Management and Competitive Intelligence: A Review Approach

OpenAIRE

Shujahat, Muhammad; Hussain, Saddam; Javed, Sammar; Muhammad, Imran Malik; Thursamy, Ramayah; Ali, Junaid

2017-01-01

Purpose:\\ud First purpose of this study is to discuss the synergic and separate use of knowledge and\\ud intelligence, via knowledge management and competitive intelligence, in each stage of strategic\\ud management process. Second purpose is to discuss the implications of each stage of strategic\\ud management process for knowledge management and competitive intelligence and vice versa.\\ud Methodology/Design/Approach:\\ud A systematic literature review was performed within timeframe of 2000 to 2...

The national approach to radioactive waste management: the Philippine experience

International Nuclear Information System (INIS)

Valdezco, E.M.; Marcelo, E.A.; Junio, J.B.; Alamares, A.L.; Salom, D.S.

1996-01-01

The Philippine Nuclear Research Institute (PNRI), under the Department of Science and Technology (DOST) is tasked, among others, with the legally-mandated twin function of advancing and regulating the beneficial uses of nuclear energy and radiation technology. The PNRI is also responsible, among others, for the safe management of radioactive wastes generated by all licensed users of radioisotopes, including about 100 medical and industrial users. This papers describes the efforts taken by the PNRI, with technical assistance provided by the International Atomic Energy Agency to establish a low level radioactive waste management facility in the country and the subsequent upgrading of its waste management infrastructure. The conceptual approach and sebsequent implementation of the work programme is presented. Problems attendant to these efforts are briefly outlined including treatment methodologies for specific wastes. The commissioning and operational experiences using a batch type chemical precipitation plant appropriate for the volume of liquid wastes generated in the country is also presented. Data on radioactive waste arisings from 1980 are also presented including anticipated or projected wastes arisings should the repair of the PRR-1 (Philippine Research Reactor-1) research reactor be completed. The government initiatives towards the organizational development of a centralized waste management facility for low level wastes are also discussed. The formulation and adoption of a waste acceptance criteria and the R and D activities on various treatment procedures are also described. The current activities of the PNRI, as the lead agency in two important areas, one of which is in radioactive waste management, will be reported. National, regional and international cooperation in radioactive waste management will also be presented

Chiropractic approach to the management of children

Directory of Open Access Journals (Sweden)

Miller Joyce

2010-06-01

Full Text Available Abstract Background Chiropractic (Greek: done by hand is a health care profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. There is an emphasis on manual techniques, including joint adjustment and/or manipulation, with a particular focus on joint subluxation (World Health Organization 2005 or mechanical lesion and restoring function. The chiropractor's role in wellness care, prevention and treatment of injury or illness is based on education in anatomy and physiology, nutrition, exercise and healthy lifestyle counseling as well as referral to other health practitioners. Depending on education, geographic location, scope of practice, as well as consumer preference, chiropractors may assume the role of primary care for families who are pursuing a more natural and holistic approach to health care for their families. Objective To present a perspective on current management of the paediatric patient by members of the chiropractic profession and to make recommendations as to how the profession can safely and effectively manage the paediatric patient. Discussion The chiropractic profession holds the responsibility of ethical and safe practice and requires the cultivation and mastery of both an academic foundation and clinical expertise that distinguishes chiropractic from other disciplines. Research into the effectiveness of chiropractic care for paediatric patients has lagged behind that of adult care, but this is being addressed through educational programs where research is now being incorporated into academic tracks to attain advanced chiropractic degrees. Conclusion Studies in the United States show that over the last several decades, chiropractors are the most common complementary and alternative medicine providers visited by children and adolescents. Chiropractors continue to seek integration with other healthcare providers to

Cognitive-behavioural approaches to self-management in rheumatic disease.

Science.gov (United States)

Dures, Emma; Hewlett, Sarah

2012-09-01

Patients with rheumatic disease must adjust psychosocially and behaviourally in order to manage the impact of symptoms and treatment on their daily lives, and the emotional consequences of the disease. However, patients can improve their well-being by taking a proactive role in self-management, for example by using coping strategies. Support for patient self-management from clinical teams usually comprises information and advice on disease management; however, this largely didactic approach often focuses on the biomedical aspects of rheumatic disease, without addressing how these aspects interact with psychosocial factors to influence health behaviours and thus outcomes. A cognitive-behavioural approach based on the biopsychosocial model of rheumatic disease can facilitate the identification of effective self-management strategies through collaboration between patients and clinicians. Most patients do not require intense cognitive-behavioural therapy from a clinical psychologist; rather, basic cognitive-behavioural techniques and tools could be used by rheumatology clinical teams to expand and enhance the support already offered to patients.

A partnership approach to research data management

OpenAIRE

Brown, Mark L.; White, Wendy

2013-01-01

This outlines developments to support and enhance research data management policy and practice at the University of Southampton. It details a research-led approach to identify institutional challenges and priorities and use of this evidence-base to inform the creation of a 10 year roadmap and policy framework. The particular issues relating to workflow, storage, security and archiving are discussed and examples are given of both pilot and embedded services including data management planning s...

OPTIMIZATION OF MANAGEMENT APPROACHES: RESERVES GROWTH OF EFFICIENCY OF NR-MANAGEMENT IN THE BUSINESS

Directory of Open Access Journals (Sweden)

F. Sh. Fedorova

2016-01-01

Full Text Available The article describes one of the possible ways of building more eff ective relationships between managers and subordinates, taking into account variable range of individual motivation, capabilities and potential of people belonging to diff erent types of employees.The topic is urgent due to the changes in modern business processes that require new approaches to management. Goal/objectives. Our aim is to develop an approach to the creation of human resources management model that takes into account not only the knowledge and skills of employees, but also their deeper individual characteristics. The approach accounts for the hierarchy of one's life values and drives, temperament, strains, habitual and unfamiliar social roles, way of thinking, preferred pattern of communication, peculiarities of the behavior in power relations and a host of other features. We suggest that asking them into account is an incredible opportunity for productivity growth and team eff ectiveness improvements.Methodology. The theoretical basis of the article are studies of Russian and foreign authors on the classifications and typologies of personality, of social roles, roles in the team, as well as subordinate types. The article refl ects the results of studies and observations of the authors on the peculiarities of manifestation of diff erent types of people in decision-making and business communications.Results. We suggest the typology of subordinates describing the key characteristics and preferences of representatives of the types. The typology allows to build relationships between managers and subordinates more eff ectively.Conclusions/significance. We propose typology of subordinates that can be used to develop management models focused on certain types of employees. This, in turn, may be useful for structuring of human management, retrieval of unused but eff ective management tools, and for building an eff ective staff -management relations network as a whole to

Management of sexual problems: the approach of mindfulness.

Science.gov (United States)

Vilarinho, Sandra

2017-11-01

During the last 10 years mindfulness has been progressively integrated into protocols for the management of sexual problems. The purpose of this study is to systematize potential benefits of mindfulness in sexual well-being (considering mind, emotion, and body), and to shortly review current applications and effectiveness of mindfulness-based interventions to the treatment of sexual problems. The majority of evidence available focuses on women's sexual desire and arousal problems, although there are also preliminary findings for the effectiveness of mindfulness-based interventions in enhancing other components of the sexual response. Relationship issues, sexual pain, sexual abuse, and sexual distress have also revealed to benefit from mindfulness-based interventions. The practice of mindfulness is a promising clinical approach with encouraging results for women's sexual problems. Further empirical research with different populations and greater methodological rigour is still needed to clarify the effectiveness of mindfulness as a specific component and the mechanisms contributing to therapeutic change.

Structured ecosystem-scale approach to marine water quality management

CSIR Research Space (South Africa)

Taljaard, Susan

2006-10-01

Full Text Available and implement environmental management programmes. A structured ecosystem-scale approach for the design and implementation of marine water quality management programmes developed by the CSIR (South Africa) in response to recent advances in policies...

THE INFLUENCE OF TOP MANAGEMENT DEMOGRAPHIC CHARACTERISTICS ON DECISION MAKING APPROACHES

Directory of Open Access Journals (Sweden)

Ivana Bulog

2016-12-01

Full Text Available Today’s organizational environment requires managers to be an excellent decision maker with the ability to make effective decisions which will shape business performance. Because of the role that managers have in today’s business settings, research interest in the relationship between individual characteristics and managerial decision making in all its aspects has increased over the last decade. This paper aims to provide an overview and discussion of how individuals make choices and decisions by examining the influence of top management demographic characteristics on decision making approaches. Findings suggest that demographic characteristics appear to be valuable for predicting which decision making approach managers prefer. The results of the study show that the average age and education level of decision makers is positively related to the rational decision making approach and negatively to the intuitive decision making approach. Tenure is positively related to the intuitive decision making approach, but the influence is not statistically significant. Also, a difference in the decision making approach was found with respect to gender. In light of the research findings, implications and limitations were discussed and some possibilities for future research are suggested.

Participatory knowledge-management design: A semiotic approach

DEFF Research Database (Denmark)

Valtolina, Stefano; Barricelli, Barbara Rita; Dittrich, Yvonne

2012-01-01

vocabularies, notations, and suitable visual structures for navigating among interface elements. To this end, the paper describes how our semiotic approach supports processes for representing, storing, accessing, and transferring knowledge through which the information architecture of an interactive system can......The aim of this paper is to present a design strategy for collaborative knowledge-management systems based on a semiotic approach. The contents and structure of experts' knowledge is highly dependent on professional or individual practice. Knowledge-management systems that support cooperation...... a semiotic perspective to computer application and human–computer interaction. From a semiotic perspective, the computer application is both a message from the designer to the user about the structure of the problem domain, as well as about interaction with it, and a structured channel for the user...

The drivers of sea lice management policies and how best to integrate them into a risk management strategy: An ecosystem approach to sea lice management.

Science.gov (United States)

Jackson, D; Moberg, O; Stenevik Djupevåg, E M; Kane, F; Hareide, H

2018-06-01

The control of sea lice infestations on cultivated Atlantic salmon is a major issue in many regions of the world. The numerous drivers which shape the priorities and objectives of the control strategies vary for different regions/jurisdictions. These range from the animal welfare and economic priorities of the producers, to the mitigation of any potential impacts on wild stocks. Veterinary ethics, environmental impacts of therapeutants, and impacts for organic certification of the produce are, amongst others, additional sets of factors which should be considered. Current best practice in both EU and international environmental law advocates a holistic ecosystem approach to assessment of impacts and risks. The issues of biosecurity and ethics, including the impacts on the stocks of species used as cleaner fish, are areas for inclusion in such a holistic ecosystem assessment. The Drivers, Pressures, State, Impacts, Responses (DPSIR) process is examined as a decision-making framework and potential applications to sea lice management are outlined. It is argued that this is required to underpin any integrated sea lice management (ISLM) strategy to balance pressures and outcomes and ensure a holistic approach to managing the issue of sea lice infestations on farmed stock on a medium to long-term basis. © 2017 The Authors. Journal of Fish Diseases Published by John Wiley & Sons Ltd.

CURRENT TRENDS FOR DEVELOPMENT AND IMPROVEMENT OF THE ORGANIZATIONAL STRUCTURES IN MANAGEMENT

Directory of Open Access Journals (Sweden)

Angel Doraliyski

2017-03-01

Full Text Available One of the key components of the management system is the organizational structure of management. This report presents the current trends of development and improvement of organizational structures of management. The semantics of the term "organizational structure" used in the report is clarified. Key aspects of structural policy of organizations are discussed, as well as the introduction of flexible organizational forms. The main directions for analysis of organizational policy of organizations are also mentioned. It is stressed that the analysis of current trends for the future development of organizational structures of management should be an integral component of the management policy of every organization. The trends are flexibility and adaptability of the organizational structure, rational proportion between centralization and decentralization, an appropriate balance between the rights, duties and responsibilities, reducing regulations, rules and other normative documents. A recommendetaion is made that organizational governance structures must be adapted constantly in accordance with changes in the overall management system, as they are one of its main components.

Comparing Teaching Approaches About Maxwell's Displacement Current

Science.gov (United States)

Karam, Ricardo; Coimbra, Debora; Pietrocola, Maurício

2014-08-01

Due to its fundamental role for the consolidation of Maxwell's equations, the displacement current is one of the most important topics of any introductory course on electromagnetism. Moreover, this episode is widely used by historians and philosophers of science as a case study to investigate several issues (e.g. the theory-experiment relationship). Despite the consensus among physics educators concerning the relevance of the topic, there are many possible ways to interpret and justify the need for the displacement current term. With the goal of understanding the didactical transposition of this topic more deeply, we investigate three of its domains: (1) The historical development of Maxwell's reasoning; (2) Different approaches to justify the term insertion in physics textbooks; and (3) Four lectures devoted to introduce the topic in undergraduate level given by four different professors. By reflecting on the differences between these three domains, significant evidence for the knowledge transformation caused by the didactization of this episode is provided. The main purpose of this comparative analysis is to assist physics educators in developing an epistemological surveillance regarding the teaching and learning of the displacement current.

Neuroendoscopic Trans-Third Ventricular Approach for Surgical Management of Ecchordosis Physaliphora.

Science.gov (United States)

Adib, Sasan Darius; Bisdas, Sotirios; Bornemann, Antje; Schuhmann, Martin U

2016-06-01

We sought to report the successful surgical management of a case of ecchordosis physaliphora (EP) using a neuro-endoscopic trans-third ventricular approach (ETTVA) and to provide a current review of literature on EP. A 57-year-old man presenting with a 2-year history of diplopia due to right abducens nerve palsy and paresthesia of the left body underwent magnetic resonance imaging, which revealed a retroclival intracisternal lesion. The cystic lesion was considered to be most likely EP according to neuroradiologic features. The patient underwent an endoscopic trans-third ventricular resection. A pediatric endoscope was passed from a precoronal burr hole through the left lateral into the third ventricle. The floor of the third ventricle was opened by a 2-micron laser. This approach permitted us to expose the lesion in the retroclival cistern and follow up with a subtotal removal. Remnants of the capsule, which were firmly adherent to small pontine arteries and the left abducens nerve, were left. Histology confirmed EP. The patient recovered well from surgery, and symptoms regressed at clinical follow-up. The endoscopic approach for third ventriculostomy can also be used for the surgical management of retroclival lesions. However, a small pediatric endoscope with an angled view, which can be passed through the floor of the third ventricle without causing harm, is mandatory to explore all important structures in the narrow surgical space. Limitations in this delicate environment are firm adhesions to vessels and nerves because only 1-instrument manipulation is possible and bleeding must be avoided. Copyright © 2016 Elsevier Inc. All rights reserved.

Current approaches on the management of disused sealed sources in Bulgaria

International Nuclear Information System (INIS)

Benitez-Navarro, J. C.; Canizares, J.; Asuar, O.; Tapia, J.; Demireva, E.; Yordanova, O.; Stefanova, I.; Karadzhov, S.

2005-01-01

The main options for the safe management of existing Disused Sealed Radioactive Sources (DSRS) in Bulgaria are discussed. The specific installations for handling and conditioning of all type of DSRS are being designed. The necessary equipment and materials for all conditioning operations have been defined. As the final disposal route for the radioactive wastes in Bulgaria is not defined yet, the proposed conditioning process for the DSRS ensures that end-point disposal of DSRS is not jeopardized by actions taken at present. All the DSRS would be packaged in secure, safe, monitorable and retrievable manner for interim storage

The pasture-type approach for mountain pasture description and management

Directory of Open Access Journals (Sweden)

Giovanni Argenti

2012-10-01

Full Text Available The study of pastoral resources can take different approaches with the main goal of characterizing pasture vegetation and its potential carrying capacity. In recent times, the pasture-type approach has been developed in several Alpine areas – on a regional and on a district scale – starting from sward surveys carried out taking the approach formerly developed by the French pastoral school. The pasture-type approach may play an important role in defining the management of mountain and marginal environments where grazing pressure reduction remarkably affects the agro-ecosystems functions (production, landscape, wildlife, recreation, etc.. This approach is based on the concept of pasture type, which could be defined as a semi-natural vegetation (mainly exploited by grazing animals, rather homogeneous in terms of botanic composition and influenced by environmental factors and agro-pastoral management. This paper presents the pasture-type approach by discussing the results of two large studies carried out in two areas of the south side of the Alps (Piedmont and Veneto. In order to identify pasture types, the vegetation composition was assessed with a point quadrat method. It allowed the computation of species-specific contribution, and of sward forage value and carrying capacity, after a multivariate statistical procedure for type classification and ordination. The site conditions (altitude, slope, aspect and other environmental variables were surveyed. Moreover, to characterize the pasture types from the point of view of the ecological and management factors affecting vegetation composition, the Landolt indicators were used. The results achieved in the two areas were synthesised and organised into reference technical tools with the aim of using the pasture-type approach for pastoral planning. For each study area an identification key to recognize pasture types was drafted, and a handbook containing the technical sheets for pasture type

A moni-modelling approach to manage groundwater risk to pesticide leaching at regional scale.

Science.gov (United States)

Di Guardo, Andrea; Finizio, Antonio

2016-03-01

Historically, the approach used to manage risk of chemical contamination of water bodies is based on the use of monitoring programmes, which provide a snapshot of the presence/absence of chemicals in water bodies. Monitoring is required in the current EU regulations, such as the Water Framework Directive (WFD), as a tool to record temporal variation in the chemical status of water bodies. More recently, a number of models have been developed and used to forecast chemical contamination of water bodies. These models combine information of chemical properties, their use, and environmental scenarios. Both approaches are useful for risk assessors in decision processes. However, in our opinion, both show flaws and strengths when taken alone. This paper proposes an integrated approach (moni-modelling approach) where monitoring data and modelling simulations work together in order to provide a common decision framework for the risk assessor. This approach would be very useful, particularly for the risk management of pesticides at a territorial level. It fulfils the requirement of the recent Sustainable Use of Pesticides Directive. In fact, the moni-modelling approach could be used to identify sensible areas where implement mitigation measures or limitation of use of pesticides, but even to effectively re-design future monitoring networks or to better calibrate the pedo-climatic input data for the environmental fate models. A case study is presented, where the moni-modelling approach is applied in Lombardy region (North of Italy) to identify groundwater vulnerable areas to pesticides. The approach has been applied to six active substances with different leaching behaviour, in order to highlight the advantages in using the proposed methodology. Copyright © 2015 Elsevier B.V. All rights reserved.

Water management: Current and future challenges and research directions

Science.gov (United States)

Cosgrove, William J.; Loucks, Daniel P.

2015-06-01

Water distinguishes our planet compared to all the others we know about. While the global supply of available freshwater is more than adequate to meet all current and foreseeable water demands, its spatial and temporal distributions are not. There are many regions where our freshwater resources are inadequate to meet domestic, economic development and environmental needs. In such regions, the lack of adequate clean water to meet human drinking water and sanitation needs is indeed a constraint on human health and productivity and hence on economic development as well as on the maintenance of a clean environment and healthy ecosystems. All of us involved in research must find ways to remove these constraints. We face multiple challenges in doing that, especially given a changing and uncertain future climate, and a rapidly growing population that is driving increased social and economic development, globalization, and urbanization. How best to meet these challenges requires research in all aspects of water management. Since 1965, the journal Water Resources Research has played an important role in reporting and disseminating current research related to managing the quantity and quality and cost of this resource. This paper identifies the issues facing water managers today and future research needed to better inform those who strive to create a more sustainable and desirable future.

A survey of current practices in management of Hirschsprung′s disease in Nigeria

Directory of Open Access Journals (Sweden)

Abdulrasheed A. Nasir

2014-01-01

Full Text Available Background: Although there are several modalities of treatment for Hirschsprung′s disease (HD, there are presently no clear guidelines on treatment of the condition by paediatric surgeons in Nigeria. This survey determines the current approach to treatment among Nigerian paediatric surgeons and should help in establishing a consensus and guidelines for care in this and similar setting. Materials and Methods: An online questionnaire was designed using survey Monkey ® to determine current clinical and operative management of patients with HD by consultant paediatric surgeons practicing in the Nigeria. The paediatric surgeons were notified by E-mail, which included a link to the survey on survey Monkey ® . The survey was also administered at the 12 th annual meeting of Association of Paediatric Surgeons of Nigeria in September, 2013, to capture those who did not complete the online survey. Thirty-one paediatric surgeons from 21 different tertiary paediatric surgery centres completed the survey. Results: Sixteen (52% respondents see up to 20% of their patients with HD in the neonatal period. Twenty-six (84% respondents do routine barium enema. Twenty six (84% respondents do full thickness rectal biopsy under general anaesthesia (GA. There was no consistency in operative techniques, with transabominal Swenson′s operation being practiced by 17 (57% respondents and 11 (37% transanal endorectal pull through. 14 (45% do pull through at any age. 12 (39% respondents do more than half of their patient as primary pull through. Conclusion: Full thickness rectal biopsy under GA is still the vogue with variations in the surgical technique for management of Hirshsprung′s disease in Nigeria. Primary pull through procedures is becoming increasingly popular. There′s a need for Paediatric Surgeons in Nigeria to come up with a guideline on management of HD, to guide trainees and other surgeons in the care of these patients.

Managing pressures ulcers in a resource constrained situation: A holistic approach

Directory of Open Access Journals (Sweden)

Abhijit Dam

2011-01-01

Full Text Available Managing pressure ulcers remain a challenge and call for a multidisciplinary team approach to care. Even more daunting is the management of such patients in remote locations and in resource constrained situations. The management of pressure sores in a patient with progressive muscular atrophy has been discussed using resources that were locally available, accessible, and affordable. Community participation was encouraged. A holistic approach to care was adopted.

Assessing confidence in management adaptation approaches for climate-sensitive ecosystems

International Nuclear Information System (INIS)

West, J M; Julius, S H; Weaver, C P

2012-01-01

A number of options are available for adapting ecosystem management to improve resilience in the face of climatic changes. However, uncertainty exists as to the effectiveness of these options. A report prepared for the US Climate Change Science Program reviewed adaptation options for a range of federally managed systems in the United States. The report included a qualitative uncertainty analysis of conceptual approaches to adaptation derived from the review. The approaches included reducing anthropogenic stressors, protecting key ecosystem features, maintaining representation, replicating, restoring, identifying refugia and relocating organisms. The results showed that the expert teams had the greatest scientific confidence in adaptation options that reduce anthropogenic stresses. Confidence in other approaches was lower because of gaps in understanding of ecosystem function, climate change impacts on ecosystems, and management effectiveness. This letter discusses insights gained from the confidence exercise and proposes strategies for improving future assessments of confidence for management adaptations to climate change. (letter)

Conservation and Management of Archaeological Monuments and Sites in Greece and Turkey: A Value-Based Approach to Anastylosis

Directory of Open Access Journals (Sweden)

Kalliopi Vacharopoulou

2005-11-01

Full Text Available Heritage management and monument conservation play a significant role in the preservation of archaeological heritage. Anastylosis, a process with a long history in the Mediterranean region, is discussed with relevance to current debates concentrating on concepts of value-based approaches. Examination of the diverse values that may be attributed to monuments provides an insight into the evolution of ideas in heritage management, conservation and restoration practices. In the current theoretical framework the concept of values, as attributed by all stakeholders, and its application when preserving archaeological heritage, are constantly debated. The participation of stakeholders in the process of value identification is considered fundamental by heritage management experts. This paper presents the findings of a survey conducted to collect the opinions of anastylosis and restoration professionals, with reference to case studies on a number of monuments subjected to anastylosis in Greece and Turkey, highlighting the importance of assessing values in order to establish the appropriate type and extent of intervention. The paper concludes that a value-based approach to decision-making and planning for anastylosis, or any other form of architectural conservation, is crucial for preserving monuments in a way that satisfies those who want to experience and benefit from heritage.

Quality management, a directive approach to patient safety.

Science.gov (United States)

Ayuso-Murillo, Diego; de Andrés-Gimeno, Begoña; Noriega-Matanza, Concha; López-Suárez, Rafael Jesús; Herrera-Peco, Ivan

Nowadays the implementation of effective quality management systems and external evaluation in healthcare is a necessity to ensure not only transparency in activities related to health but also access to health and patient safety. The key to correctly implementing a quality management system is support from the managers of health facilities, since it is managers who design and communicate to health professionals the strategies of action involved in quality management systems. This article focuses on nursing managers' approach to quality management through the implementation of cycles of continuous improvement, participation of improvement groups, monitoring systems and external evaluation quality models (EFQM, ISO). The implementation of a quality management system will enable preventable adverse effects to be minimized or eliminated, and promote patient safety and safe practice by health professionals. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Sleep bruxism: Current knowledge and contemporary management

Science.gov (United States)

Yap, Adrian U.; Chua, Ai Ping

2016-01-01

Bruxism is defined as the repetitive jaw muscle activity characterized by the clenching or grinding of teeth. It can be categorized into awake and sleep bruxism (SB). Frequent SB occurs in about 13% of adults. The exact etiology of SB is still unknown and probably multifactorial in nature. Current literature suggests that SB is regulated centrally (pathophysiological and psychosocial factors) and not peripherally (morphological factors). Cited consequences of SB include temporomandibular disorders, headaches, tooth wear/fracture, implant, and other restoration failure. Chairside recognition of SB involves the use of subjective reports, clinical examinations, and trial oral splints. Definitive diagnosis of SB can only be achieved using electrophysiological tools. Pharmacological, psychological, and dental strategies had been employed to manage SB. There is at present, no effective treatment that “cures” or “stops” SB permanently. Management is usually directed toward tooth/restoration protection, reduction of bruxism activity, and pain relief. PMID:27656052

Sleep bruxism: Current knowledge and contemporary management.

Science.gov (United States)

Yap, Adrian U; Chua, Ai Ping

2016-01-01

Bruxism is defined as the repetitive jaw muscle activity characterized by the clenching or grinding of teeth. It can be categorized into awake and sleep bruxism (SB). Frequent SB occurs in about 13% of adults. The exact etiology of SB is still unknown and probably multifactorial in nature. Current literature suggests that SB is regulated centrally (pathophysiological and psychosocial factors) and not peripherally (morphological factors). Cited consequences of SB include temporomandibular disorders, headaches, tooth wear/fracture, implant, and other restoration failure. Chairside recognition of SB involves the use of subjective reports, clinical examinations, and trial oral splints. Definitive diagnosis of SB can only be achieved using electrophysiological tools. Pharmacological, psychological, and dental strategies had been employed to manage SB. There is at present, no effective treatment that "cures" or "stops" SB permanently. Management is usually directed toward tooth/restoration protection, reduction of bruxism activity, and pain relief.

Applying a Problem Based Learning Approach to Land Management Education

DEFF Research Database (Denmark)

Enemark, Stig

Land management covers a wide range activities associated with the management of land and natural resources that are required to fulfil political objectives and achieve sustainable development. This paper presents an overall understanding of the land management paradigm and the benefits of good...... land governance to society. A land administration system provides a country with the infrastructure to implement land-related policies and land management strategies. By applying this land management profile to surveying education, this paper suggests that there is a need to move away from an exclusive...... engineering focus toward adopting an interdisciplinary and problem-based approach to ensure that academic programmes can cope with the wide range of land administration functions and challenges. An interdisciplinary approach to surveying education calls for the need to address issues and problems in a real...

Methodical approach to financial stimulation of logistics managers

Directory of Open Access Journals (Sweden)

Melnykova Kateryna V.

2014-01-01

Full Text Available The article offers a methodical approach to financial stimulation of logistics managers, which allows calculation of the incentive amount with consideration of profit obtained from introduction of optimisation logistics solutions. The author generalises measures, which would allow increase of stimulation of labour of logistics managers by the enterprise top managers. The article marks out motivation factors, which exert influence upon relation of logistics managers to execution of optimisation logistical solutions, which minimise logistical costs. The author builds a scale of financial encouragement for introduction of optimisation logistical solutions proposed by logistics managers. This scale is basic for functioning of the encouragement system and influences the increase of efficiency of logistics managers operation and also optimisation of enterprise logistical solutions.

Blood Falls: A novel management approach for a subglacial feature of outstanding scientific importance

Science.gov (United States)

Carr, J. R.; Penhale, P. A.; Dahood, A.; Biletnikoff, N.; Harris, C. M.

2012-04-01

Blood Falls is a subglacial feature located in the ablation zone of the Taylor Glacier, Taylor Valley, McMurdo Dry Valleys, Antarctica. Blood Falls has a unique physical configuration, microbial ecology and geochemistry and consists of a subglacial brine reservoir and an iron-rich, saline surface discharge at the Taylor Glacier terminus. The feature provides a rare opportunity to sample properties of a subglacial reservoir and its ecosystem without the need for direct contact and is a key site for exobiological studies. The Blood Falls subglacial feature is globally unique and of outstanding scientific importance. As such, it warrants special protection from potential damage by drilling and/or surface activities. Moreover, currently subglacial environments are not represented in the Antarctic protected area network. To address these points, the United States National Science Foundation is working with the scientific community to develop at Blood Falls the first subglacial protected area in Antarctica. The protected area aims to maintain the integrity of the Blood Falls system, whilst allowing continued access for scientific and management purposes. Novel management approaches are being designed to protect the values of the site in three dimensions. Specific guidelines on activities conducted within the area, most notably drilling and coring, are being defined in a management plan. This new approach incorporates uncertainties in the location of the Blood Falls brine reservoir and the connectivity of the subglacial hydrological system of the Taylor Glacier. The management approaches employed at Blood Falls draw on the experience of the subglacial research community and potentially offer an effective framework for the protection of other subglacial environments.

Approaches to emergency management teaching at the master's level.

Science.gov (United States)

Alexander, David

2013-01-01

Training and education enable emergency managers to deal with complex situations, create durable networks of people with appropriate expertise, and ensure that knowledge is utilized to improve resilience in the face of disaster risk. Although there is a discrete literature on emergency management training, few attempts have been made to create an overview that discusses the key issues and proposes a standardized approach. This article examines the nature of training and education in emergency and disaster management. It analyzes the composition and requirements of courses at the master's degree level, which is considered to be the most appropriate tier for in-depth instruction in this field. This article defines "training" and "education" in the context of emergency management courses. It reviews the developing profile of the emergency manager in the light of training requirements. This article examines the question of whether emergency management is a branch of management science or whether it is something distinct and separate. Attention is given to the composition of a core curriculum and to the most appropriate pedagogical forms of delivering it. The article reviews the arguments for and against standardization of the curriculum and describes some of the pedagogical methods for delivering courses. Briefly, it considers the impact on training and education of new pedagogic methods based on information technology. It is concluded that the master's level is particularly suited to emergency and crisis management education, as it enables students to complement the in-depth knowledge they acquired in their disciplinary first degrees with a broader synthetic approach at the postgraduate level. Some measures of standardization of course offerings are desirable, in favor of creating a core curriculum that will ensure that essential core knowledge is imparted. Education and training in this field should include problem-solving approaches that enable students to learn

Breast Cancer In Pregnancy: Management Approach

African Journals Online (AJOL)

reflecting the more advanced stage of the disease at diagnosis. An approach to the management of breast cancer in pregnancy is presented by a case illustration and a review of literature. KEY WORDS: Breast Cancer, ... function tests, haemogram and ultra— sound. She delivered a live female baby weighing 2.8 kilogram's ...

A mixed-methods approach to assessing success in transitioning water management institutions: a case study of the Platte River Basin, Nebraska

Directory of Open Access Journals (Sweden)

Christina Hoffman Babbitt

2015-03-01

Full Text Available To address increasing conflicts between surface water and groundwater users, the state of Nebraska has adopted a more localized and integrated approach in managing water resources. Integrated approaches offer promise in better managing connected water resources within the state; however, little review of the potential benefits and/or challenges of these actions has been conducted. This case study uses both qualitative and quantitative data collection efforts to take an in-depth look at how this new and innovative management system is working through the eyes of stakeholders living and working in the basin. Data collection reveals that overall the current water management system is working relatively well, even though it is still in its infancy. However, the system could be further improved by ensuring all that stakeholder interests are represented, providing increased opportunities to participate, and continuing to work toward more holistic and proactive water management.

A hybrid linked data approach to support asset management

NARCIS (Netherlands)

Luiten, G.T.; Bohms, H.M.; O'Keeffe, A.; Nederveen, S. van; Bakker, J.; Wikstrom, L.

2016-01-01

This paper evaluates experiences with applying a linked data approach for coping with the many challenges for information management in asset management from the perspective of National Road Authorities (NRAs). As influential players, NRAs are often the initiators of innovation in the civil

Sustainable Groundwater Management Using Economic Incentive Approach

Science.gov (United States)

Yan, T.; Shih, J.; Sanchirico, J. N.

2006-12-01

Although groundwater accounts for about 20% of the water consumption in the US, recent urban development, land use changes and agricultural activities in many regions (for example, Chesapeake Bay and eastern shore of Maryland) have resulted in deleterious impacts on groundwater quality. These impacts have dramatically increased potential human health and ecological system risks. One example is nitrogen pollution delivered to local waterways from septic systems via groundwater. Conventional approaches for nitrogen removal, such as pumping and treatment (nitrification-denitrification) process, tend to be expensive. On the other hand, economic incentive approaches (such as marketable permits) have the potential to increase the efficiency of environmental policy by reducing compliance costs for regulated entities and individuals and/or achieving otherwise uneconomical pollution reduction. The success of the sulfur dioxide trading market has led to the creation of trading markets for other pollutants, especially at the regional, state, and smaller (e.g. watershed) scales. In this paper, we develop an integrated framework, which includes a groundwater flow and transport model, and a conceptual management model. We apply this framework to a synthetic set up which includes one farm and two development areas in order to investigate the potential of using economic incentive approaches for groundwater quality management. The policy analysis is carried out by setting up the objective of the modeling framework to minimize the total cost of achieving groundwater quality goals at specific observation point using either a transferable development right (TDR) system between development areas and/or using a tax for fertilizer usage in the farm area. The TDR system consists of a planning agency delineating a region into restricted-use (e.g., agriculture, open space) and high intensity zones (e.g., residential, commercial uses). The agency then endows landowners in the restricted area

Current status of spent fuel management in the Republic of Korea

International Nuclear Information System (INIS)

Min, D.K.; You, G.S.; Ro, S.G.; Park, H.S.

1999-01-01

Due to the lack of indigenous energy sources in Korea, the government selected nuclear energy as one of the major sources of electricity generation. According to the Korean government programme of a nuclear power development, currently, 14 nuclear power plants (NPPs) are in operation and 4 NPPs are under construction. In addition, further 10 NPPs are planned to be in operation by the year 2015. The large amount of spent fuel discharged from the nuclear power plants is accumulated in at-reactor (AR) storage pools. Due to the limited capacity of these AR storage pools, the safe and economic management of spent fuel is to be resolved. The spent fuel management strategy in Korea, basically depends on the interim storage in wet and dry storage facilities, including expansion of storage capacity. This paper describes the current status and plans of the spent fuel management in Korea. (author)

Approaches to self-management in chronic illness.

Science.gov (United States)

Novak, Marta; Costantini, Lucia; Schneider, Sabrina; Beanlands, Heather

2013-01-01

Management of a chronic medical condition is a complex process and requires coordinated action between healthcare providers and patients. This process is further complicated by the fact that an increasing number of patients suffer from multiple chronic conditions. Self-management involves active participation of the patients in the everyday care of the symptoms of their illness(es) and medical treatments, as well as maintaining general health and prevention of progression of medical conditions. Managing the psychosocial consequences of illness is also an important component of self-management. Data have demonstrated that enhancing self-management improves quality of life, coping, symptom management, disability, and reduces healthcare expenditures and service utilization. To foster self-management, potential barriers to implementation as well as facilitators and supports for this approach must be acknowledged. In this article, we review various aspects of self-management in chronic illness, focusing on chronic kidney disease. Better understanding of these concepts will facilitate patient-provider collaboration, improve patient care with increased patient and staff satisfaction, and may ultimately result in better clinical outcomes and enhanced quality of life for both the patients and their families. © 2013 Wiley Periodicals, Inc.

Evolution of an approach to configuration management

International Nuclear Information System (INIS)

Bowes, E.V.

1988-01-01

Virginia Power is currently in the process of developing and implementing an automated Equipment Data System/Bill of Materials (EDS/BOM) which will support many aspects of maintenance management, including planning, component tracking, materials management and historical reporting. The EDS/BOM system is being developed as an application of a comprehensive automated Work Planning and Tracking System (WPTS) which has become the main system for use in station maintenance management. In addition to these programs, the Company has also developed a Cost Planning and Tracking System (CPTS) and has invested over $20 million in an equipment mark numbering and drawing update program. As these programs have matured, the need has been recognized for a structured configuration management program to protect the multi-million dollar investment in documents and data, and to assure the existence of reliable information as a foundation for improved efficiency in maintenance management and engineering

Residents' values and fuels management approaches

Science.gov (United States)

Gwo-Bao Liou; Christine Vogt; Greg Winter; Sarah McCaffrey

2008-01-01

The research utilizes the Forest Value and Salient Value Similarity Scales to examine homeowners' value orientations and relate them to attitudes toward and support for fuels management approaches. Data were collected from homeowners living in the wildland-urban interface of the Huron- Manistee National Forest at two time periods, in 2002 and 2006. The panel data...

A practical approach to the management of high-output stoma

Science.gov (United States)

Mountford, Christopher G; Manas, Derek M; Thompson, Nicholas P

2014-01-01

The development of a high-output stoma (HOS) is associated with water, electrolyte and nutritional complications. Prompt, careful assessment and management is required to avoid rapid clinical deterioration in this patient population. A multidisciplinary approach to management ensures the best possible outcome and quality of life for patients who experience HOS. This article outlines the important considerations in the identification and pathophysiology of HOS. A systematic approach to the management of the condition is outlined, considering fluid and electrolyte requirements, nutrient deficiencies and manipulation of gastrointestinal absorption, motility and secretions using medical and surgical therapies. PMID:28839771

Arctic Ice Management: an integrated approach to climate engineering

Science.gov (United States)

Desch, S. J.; Hartnett, H. E.; Groppi, C. E.; Romaniello, S. J.

2017-12-01

The warming climate is having the most rapid and pronounced effects in the high Arctic. The loss of Arctic sea ice is not only changing the physical oceanography of the Arctic Ocean and its coastlines; it is also promoting new conversations about the dangers and benefits for trade, transportation, and industry in the Arctic. The rate of decrease of summer sea ice in the Arctic is currently -300 km3 yr-1, a rate that will lead to complete loss of end-summer sea ice as soon as 2030. Preventing the strong positive feedbacks and increased warming due to sea ice albedo loss must be an important component of climate mitigation strategies. Here, we explore a direct engineering approach we call Arctic Ice Management (AIM) to reduce the loss of Arctic sea ice. We predict that pumping seawater onto the ice surface during the Arctic winter using wind-powered pumps can thicken sea ice by up to 1 m per year, reversing the current loss rates and prolonging the time until the Arctic Ocean is ice-free. Thickening sea ice would not change CO2 levels, which are the underlying cause of ice loss, but it would prevent some of the strongest feedbacks and would buy time to develop the tools and governance systems necessary to achieve carbon-neutrality. We advocate exploration of AIM as a mitigation strategy employed in parallel with CO2 reduction efforts. The opportunity and risk profiles of AIM differ from other geoengineering proposals. While similar in principle to solar radiation management, AIM may present fewer large-scale environmental risks. AIM is separate from greenhouse gas emission reduction or sequestration, but might help prevent accelerated release of methane from thawing permafrost. Further, AIM might be usefully employed at regional and local scales to preserve Arctic ecosystems and possibly reduce the effects of ice-loss induced coastal erosion. Through presentation of the AIM concept, we hope to spark new conversations between scientists, stakeholders, and decision

Transient management using the safety function approach

International Nuclear Information System (INIS)

Corcoran, W.R.; Barrow, J.H.; Bischoff, G.C.; Callaghan, V.M.; Pearce, R.T.

1984-01-01

The safety function approach is described. Its use in the development of a transient management procedures system includes optimal recovery procedures tailored to specific, anticipated symptom sets and a functional recovery procedure which is more general. Simulator evaluations are described

Bounded Rational Managers Struggle with Talent Management - An Agent-based Modelling Approach

DEFF Research Database (Denmark)

Adamsen, Billy; Thomsen, Svend Erik

This study applies an agent-based modeling approach to explore some aspects of an important managerial task: finding and cultivating talented individuals capable of creating value for their organization at some future state. Given that the term talent in talent management is an empty signifier...... and its denotative meaning floating, we propose that bounded rational managers base their decisions on a simple heuristic, i.e. selecting and cultivating individuals so that their capabilities resemble their own capabilities the most (Adamsen 2015). We model the consequences of this talent management...... heuristic by varying the capabilities of today’s managers, which in turn impact which individuals will be selected as talent. We model the average level of capabilities and the distribution thereof in the sample where managers identify and select individuals from. We consider varying degrees of path...

Treatment of Thrombotic Antiphospholipid Syndrome: The Rationale of Current Management—An Insight into Future Approaches

Science.gov (United States)

Ubiali, Tania; Meroni, Pier Luigi

2015-01-01

Vascular thrombosis and pregnancy morbidity represent the clinical manifestations of antiphospholipid syndrome (APS), which is serologically characterized by the persistent positivity of antiphospholipid antibodies (aPL). Antiplatelet and anticoagulant agents currently provide the mainstay of APS treatment. However, the debate is still open: controversies involve the intensity and the duration of anticoagulation and the treatment of stroke and refractory cases. Unfortunately, the literature cannot provide definite answers to these controversial issues as it is flawed by many limitations, mainly due to the recruitment of patients not fulfilling laboratory and clinical criteria for APS. The recommended therapeutic management of different aPL-related clinical manifestations is hereby presented, with a critical appraisal of the evidence supporting such approaches. Cutting edge therapeutic strategies are also discussed, presenting the pioneer reports about the efficacy of novel pharmacological agents in APS. Thanks to a better understanding of aPL pathogenic mechanisms, new therapeutic targets will soon be explored. Much work is still to be done to unravel the most controversial issues about APS management: future studies are warranted to define the optimal management according to aPL risk profile and to assess the impact of a strict control of cardiovascular risk factors on disease control. PMID:26075289

Current advance care planning practice in the Australian community: an online survey of home care package case managers and service managers.

Science.gov (United States)

Sellars, Marcus; Detering, Karen M; Silvester, William

2015-04-23

Advance care planning (ACP) is the process of planning for future healthcare that is facilitated by a trained healthcare professional, whereby a person's values, beliefs and treatment preferences are made known to guide clinical decision-making at a future time when they cannot communicate their decisions. Despite the potential benefits of ACP for community aged care clients the availability of ACP is unknown, but likely to be low. In Australia many of these clients receive services through Home Care Package (HCP) programs. This study aimed to explore current attitudes, knowledge and practice of advance care planning among HCP service managers and case managers. An invitation to take part in a cross-sectional online survey was distributed by email to all HCP services across Australia in November 2012. Descriptive analyses were used to examine overall patterns of responses to each survey item in the full sample. 120 (response rate 25%) service managers and 178 (response rate 18%) case managers completed the survey. Only 34% of services had written ACP policies and procedures in place and 48% of case managers had previously completed any ACP training. In addition, although most case managers (70%) had initiated an ACP discussion in the past 12 months and viewed ACP as part of their role, the majority of the conversations (80%) did not result in documentation of the client's wishes and most (85%) of the case managers who responded did not believe ACP was done well within their service. This survey shows low organisational ACP systems and support for case managers and a lack of a normative approach to ACP across Australian HCP services. As HCPs become more prevalent it is essential that a model of ACP is developed and evaluated in this setting, so that clients have the opportunity to discuss and document their future healthcare wishes if they choose to.

Quality management of eLearning for medical education: current situation and outlook.

Science.gov (United States)

Abrusch, Jasmin; Marienhagen, Jörg; Böckers, Anja; Gerhardt-Szép, Susanne

2015-01-01

In 2008, the German Council of Science had advised universities to establish a quality management system (QMS) that conforms to international standards. The system was to be implemented within 5 years, i.e., until 2014 at the latest. The aim of the present study was to determine whether a QMS suitable for electronic learning (eLearning) domain of medical education to be used across Germany has meanwhile been identified. We approached all medical universities in Germany (n=35), using an anonymous questionnaire (8 domains, 50 items). Our results (response rate 46.3%) indicated very reluctant application of QMS in eLearning and a major information deficit at the various institutions. Authors conclude that under the limitations of this study there seems to be a considerable need to improve the current knowledge on QMS for eLearning, and that clear guidelines and standards for their implementation should be further defined.

The current waste generation and management trends in South Africa: A Review

CSIR Research Space (South Africa)

Nkosi, N

2013-04-01

Full Text Available This paper, a continuation and expansion of the work of Muzenda et al, 2012 [1] looks at the current waste generation and management trends in South Africa. The waste tyre problem in South Africa is also briefly discussed. Solid waste management...

Inorganic and Hazardous Solid Waste Management: Current Status and Challenges for Indonesia

NARCIS (Netherlands)

Aprilia, A.; Tezuka, T.; Spaargaren, G.

2013-01-01

This article focuses on household waste management in Indonesia, with particular emphasis on inorganic and hazardous waste. It seeks to identify the current situation and also aims to provide a review of the existing policies that are particularly related to inorganic and hazardous waste management.

APPLICATION OF PROJECT MANAGEMENT APPROACHES AT A SMALL BUSINESSES ENTERPRISES

OpenAIRE

Sergey V. Rajewski

2016-01-01

This article discusses the types of organizational structures of project management and their application in project management in small and medium-sized enterprises. Among the approaches and methods to organize projects emphasizing project management as part of the existing functional structure of the enterprise. Analyzed the most relevant organizational tools of project management in small business: a network schedule; matrix distribution of administrative and management tasks of the projec...

A global approach to risk management: lessons from the nuclear industry

International Nuclear Information System (INIS)

Lazo, T.; Kaufer, B.

2003-01-01

The industry's nuclear safety experts are continuously striving to minimise the possible risk and extent of a nuclear accident, while nuclear regulatory, authorities work to ensure that all safety requirements are met. Relying on a combination of deterministic and probabilistic approaches, they are obtaining positive results in terms of both risk-informed regulation and nuclear safety management. This article addresses this aspect of risk management, as well as the management of radiation exposure risk. It looks into nuclear emergency planning, preparedness and management, and stresses the importance of coordinating potential protection approaches and providing effective communication should a nuclear accident occur. (authors)

Strategic management of keloid disease in ethnic skin: a structured approach supported by the emerging literature.

Science.gov (United States)

Ud-Din, S; Bayat, A

2013-10-01

Keloid disease (KD) is a common, benign, dermal fibroproliferative growth of unknown aetiology. Lesions tend to grow over time; they often recur following therapy and do not regress spontaneously. KD causes considerable discomfort due to pain, pruritus and inflammation, and a significant psychosocial impact with reduced quality of life. It is unique to humans and occurrence is higher in individuals with dark, pigmented, ethnic skin. There is a strong familial heritability, with a high ethnic predisposition in individuals of African, Asian and Hispanic descent. High recurrence rates and unknown resolution rates present a major problem for both the patient and clinician. Many treatment modalities exist; however, there is no single advocated therapy. Therefore, the aim of this review was to explore the most current literature regarding the range of treatment options for KD and to offer a structured approach in the management of KD, based on evidence and experience, to aid clinicians in their current practice. A focused history involving careful evaluation of the patient's symptoms, signs, quality of life and psychosocial well-being should direct targeted therapy, complemented with regular follow-up and re-evaluation. Many treatment modalities, such as intralesional steroid injection, silicone gel application, cryotherapy, lasers, 5-fluorouracil and, relatively recently, photodynamic therapy, are currently being used in clinical practice for the management of KD. Combination therapies have also been shown to be beneficial. However, there is a lack of robust, randomized, level-one, evidence-controlled trials evaluating these treatment options. Management of KD in ethnic pigmented skin remains a clinical challenge. Thus, a strategic approach with structured assessment, targeted therapy and focus on prevention of recurrence is highly recommended. Quality evidence is essential in order to tailor treatment effectively for the ethnic patient presenting with KD. © 2013 The

A strategic value management approach for energy and maintenance management in a building

Science.gov (United States)

Nawi, Mohd Nasrun Mohd; Dahlan, Nofri Yenita; Nadarajan, Santhirasegaran

2015-05-01

Fragmentation process is always been highlighted by the stakeholders in the construction industry as one of the `critical' issue that diminishing the opportunity for stakeholders that involved during the operation and maintenance stage to influence design decisions. Failure of design professionals to consider how a maintenance contractor or facility manager will construct the design thus results in higher operating cost, wastage, defects during the maintenance and operation process. Moving towards team integration is considered a significant strategy for overcoming the issue. Value Management is a style of management dedicated to guiding people and promoting innovation with the aim to improve overall building performance through structured, team-oriented exercises which make explicit, and appraise subsequent decisions, by reference to the value requirements of the clients. Accordingly, this paper discusses the fragmentation issue in more detail including the definition, causes and effects to the maintenance and operation of building and at the same time will highlighted the potential of VM integrated team approach as a strategic management approach for overcoming that issue. It also explores that the team integration strategy alleviates scheduling problems, delays and disputes during the construction process, and, hence, prevent harming the overall building performance.

Economic versus technical approaches to frequency management

DEFF Research Database (Denmark)

Falch, Morten; Tadayoni, Reza

2004-01-01

to demonstrate how regulators could incorporate an econmic dimension into frequency allocation. The paper concludes that a free market approach is still not possible for some parts of the frequency management process; in short term, regulators must therefore continue to prioritize between applications....

A Survery of Timberland Investment Management Organizations Forestland Management in the South

Science.gov (United States)

Jacek Siry; Frederick W. Cubbage

2001-01-01

The assets of Timberland Investment Management Organizations (TIMOS) have rapidly grown over the past two decades. indicating their increasing importance for timber supply in the South. A TIMOS survey was conducted to assess their current and future investments and forest management approaches. The results indicate that TIMOS currently hold about 4.2 million acres of...

Current and emerging treatments for the management of osteogenesis imperfecta

Science.gov (United States)

Monti, Elena; Mottes, Monica; Fraschini, Paolo; Brunelli, PierCarlo; Forlino, Antonella; Venturi, Giacomo; Doro, Francesco; Perlini, Silvia; Cavarzere, Paolo; Antoniazzi, Franco

2010-01-01

Osteogenesis imperfecta (OI) is the most common bone genetic disorder and it is characterized by bone brittleness and various degrees of growth disorder. Clinical severity varies widely; nowadays eight types are distinguished and two new forms have been recently described although not yet classified. The approach to such a variable and heterogeneous disease should be global and therefore multidisciplinary. For simplicity, the objectives of treatment can be reduced to three typical situations: the lethal perinatal form (type II), in which the problem is survival at birth; the severe and moderate forms (types III–IX), in which the objective is ‘autonomy’; and the mild form (type I), in which the aim is to reach ‘normal life’. Three types of treatment are available: non-surgical management (physical therapy, rehabilitation, bracing and splinting), surgical management (intramedullary rod positioning, spinal and basilar impression surgery) and medical-pharmacological management (drugs to increase the strength of bone and decrease the number of fractures as bisphosphonates or growth hormone, depending on the type of OI). Suggestions and guidelines for a therapeutic approach are indicated and updated with the most recent findings in OI diagnosis and treatment. PMID:20856683

A structured approach to individual plant evaluation and accident management

International Nuclear Information System (INIS)

Klopp, G.T.

1991-01-01

The current requirements for the performance of individual plant evaluations (IPE's) include the derivation of accident management insights as and if they occur in the course of finalizing an IPE. The development of formal, structured accident management programs is, however, explicitly excluded from current IPE requirements. The Nuclear Regulatory Commission is following the Nuclear Management and Resources Council (NUMARC) efforts to establish the framework(s) for accident management program development and plants to issue requirements on such development at a later date. The Commonwealth Edison program consists of comprehensive level 2 PRA's which address the requirements for IPE's and which go beyond those requirements. From the start of the IPE efforts, it was firmly held, within Edison, that the best way to fully and economically extract a viable accident management program from an IPE was to integrate the two efforts from the start and include the accident management program development as a required IPE product

The current situation of waste management at German nuclear power plants

International Nuclear Information System (INIS)

Hottenrott, G.; Mirschinka, V.

2002-01-01

An overview is given about the main points of the agreement between the four utility companies and the German government on June 11, 2001, concerning waste management and disposal. The current waste management situation is compared with the effects of the agreement on the future development of the German waste management concept. Major innovations are the discontinuation of reprocessing, the establishment of local intermediate storage facilities for fuel elements and the suspension of the exploration works conducted on the salt dome at Gorleben. (orig.)

Prognostic and health management for engineering systems: a review of the data-driven approach and algorithms

Directory of Open Access Journals (Sweden)

Thamo Sutharssan

2015-07-01

Full Text Available Prognostics and health management (PHM has become an important component of many engineering systems and products, where algorithms are used to detect anomalies, diagnose faults and predict remaining useful lifetime (RUL. PHM can provide many advantages to users and maintainers. Although primary goals are to ensure the safety, provide state of the health and estimate RUL of the components and systems, there are also financial benefits such as operational and maintenance cost reductions and extended lifetime. This study aims at reviewing the current status of algorithms and methods used to underpin different existing PHM approaches. The focus is on providing a structured and comprehensive classification of the existing state-of-the-art PHM approaches, data-driven approaches and algorithms.

Managing geometric information with a data base management system

Science.gov (United States)

Dube, R. P.

1984-01-01

The strategies for managing computer based geometry are described. The computer model of geometry is the basis for communication, manipulation, and analysis of shape information. The research on integrated programs for aerospace-vehicle design (IPAD) focuses on the use of data base management system (DBMS) technology to manage engineering/manufacturing data. The objectives of IPAD is to develop a computer based engineering complex which automates the storage, management, protection, and retrieval of engineering data. In particular, this facility must manage geometry information as well as associated data. The approach taken on the IPAD project to achieve this objective is discussed. Geometry management in current systems and the approach taken in the early IPAD prototypes are examined.

A Catchment Systems Engineering (CSE) approach to managing intensively farmed land

Science.gov (United States)

Jonczyk, Jennine; Quinn, Paul; Barber, Nicholas; Wilkinson, Mark; ODonnell, Greg

2014-05-01

Rural land management practices can have a significant impact on the hydrological and nutrient dynamics within a catchment which can dramatically alter the way it processes water, exacerbating nutrient losses from the system. A collaborative and holistic approach for managing potential conflicts between land management activity for food production alongside the aspiration to achieve good water quality and the need to make space for water can ensure the long-term sustainability of our agricultural catchments. Catchment System Engineering (CSE) is an interventionist approach to altering the catchment scale runoff regime through the manipulation of hydrological flow pathways throughout the catchment. By targeting hydrological flow pathways at source, such as overland flow, field drain and ditch function, a significant component of the runoff generation can be managed, greatly reducing erosive soil losses. Coupled with management of farm nutrients at source many runoff attenuation features or measures can be co-located to achieve benefits for water quality. Examples of community-led mitigation measures using the CSE approach will be presented from two catchments in Northumberland, Northern England, that demonstrate the generic framework for identification of multipurpose features that slow, store and filter runoff at strategic locations in the landscape. Measures include within-field barriers, edge of field traps and within-field sediment filters and sediment traps which demonstrate how sediment can be trapped locally (including silt and clay fractions) and be recovered for use back on the land. Deliverables from this CSE approach includes the reduction of downstream flood risk and capturing of sediment and associated nutrients. The CSE approach allows for a more natural flood and nutrient management approach which helps to restore vital catchment functions to re-establish a healthy catchment system.

On the ALARP approach to risk management

International Nuclear Information System (INIS)

Melchers, R.E.

2001-01-01

There is an increasing trend by regulatory authorities for the introduction of the as low as reasonably practicable (ALARP) approach in dealing with risk management of proposed or existing complex hazardous systems. For these, decisions about acceptability or tolerability of risks and consequences can have very significant financial, economic and other consequences for the proponents. Conversely, there may be very significant social and socio-economic implications. ALARP as a guide to achieving a satisfactory outcome has a certain intuitive appeal for the practical management of industrial and other risks. However, as suggested herein, there are a number of areas of concern about the validity of this approach. These include representativeness, morality, philosophy, political reality and practicality. An important, and in some respects fundamental, difficulty is that the risk acceptance criteria are not fully open to public scrutiny and can appear to be settled by negotiation

Considerations on Integrating Risk and Quality Management

Directory of Open Access Journals (Sweden)

Maria POPESCU

2011-03-01

Full Text Available This paper aims to highlight the links between risk management and quality management and to study the possibility of their integrated approach. The study reviews the evolution of risk approach within organizations and stresses the need to increase the effectiveness of this approach by incorporating risk management methodology in the quality management system. Starting from this idea, the authors present the current state of risk approach into quality management, basic rules of integrated quality-risk management and major difficulties which may arise in the implementation of integrated quality–risk systems.

Water Utility Management Strategies in Turkey: The current situation and the challenges

Science.gov (United States)

Alp, E.; Aksoy, M. N.; Koçer, B.

2013-12-01

As the effects of climate change becomes more prominent, current challenges related to water and wastewater management is becoming more serious. Providing water that satisfies environmental and safety standards in terms of quantity and quality is needed to maintain human life without compromising the need of future generations. Besides providing safe and affordable water, necessary treatment should be achieved according to several important factors such as receiving body standards, discharge standards, water reuse options. Therefore, management of water becomes more crucial than ever that states have to provide accessibility of safe water with affordable cost to its citizens with the means of effective utility management, including water treatment facilities, wastewater treatment facilities, water supply facilities and water distribution systems. Water utilities encounter with several challenges related to cost, infrastructure, population, legislation, workforce and resource. This study aims to determine the current situation and the necessary strategies to improve utility management in Turkish municipalities in a sustainable manner. US Environment Protection Agency (EPA) has formed a tool on effective utility management that assists utilities to provide a solution for both current and future challenges. In this study, we used EPA's guidelines and developed a survey consists of 60 questions under 10 sub-topics (Product Quality, Employee & Leadership Development, Stakeholder Understanding & Support, Operational Optimization, Infrastructure Stability, Financial Viability, Community Sustainability, Customer Satisfaction, Operational Resiliency, and Water Resource Adequacy). This survey was sent to the managers of 25 metropolitan municipalities in Turkey to assess the current condition of municipalities. After the evaluation of the survey results for each topic, including the importance given by managers, facilities were rated according to their level of achievement

Electrostatic Discharge Current Linear Approach and Circuit Design Method

Directory of Open Access Journals (Sweden)

Pavlos K. Katsivelis

2010-11-01

Full Text Available The Electrostatic Discharge phenomenon is a great threat to all electronic devices and ICs. An electric charge passing rapidly from a charged body to another can seriously harm the last one. However, there is a lack in a linear mathematical approach which will make it possible to design a circuit capable of producing such a sophisticated current waveform. The commonly accepted Electrostatic Discharge current waveform is the one set by the IEC 61000-4-2. However, the over-simplified circuit included in the same standard is incapable of producing such a waveform. Treating the Electrostatic Discharge current waveform of the IEC 61000-4-2 as reference, an approximation method, based on Prony’s method, is developed and applied in order to obtain a linear system’s response. Considering a known input, a method to design a circuit, able to generate this ESD current waveform in presented. The circuit synthesis assumes ideal active elements. A simulation is carried out using the PSpice software.

Current UK practices in the management of subacromial impingement.

Science.gov (United States)

Bryceland, James K; Drury, Colin; Tait, Gavin R

2015-07-01

Controversy presently exists surrounding the management of patients with subacromial impingement. This study aims to highlight current UK practices in the management of these patients. BESS members were invited to complete a questionnaire and responses were received from 157 consultant shoulder surgeons. Physiotherapy is an integral part of management for 93% of surgeons with a minimum period of 12 weeks being most popular prior to consideration of arthroscopic subacromial decompression. Subacromial steroid injection is used by 95% and 86% repeat this if the patient has failed to respond to a previous injection by the general practioner. From initial presentation, 77% felt there should be at least 3 months of conservative management before proceeding to surgery. Good but transient response to subacromial injection was considered the best predictor of good surgical outcome by 77%. The coracoacromial ligament is fully released by 78%, although there was greater variation in how aggressive surgeons were with acromioplasty. Most (59%) do not include the nontender acromioclavicular joint to any extent in routine acromioplasty. Hospital physiotherapy protocols are used by 63% for postoperative rehabilitation. Variation exists in the management regimes offered to patients with subacromial impingement, but most employ a minimum period of 12 weeks of conservative management incorporating physiotherapy and at least 2 subacromial steriod injections.

Towards Current Profile Control in ITER: Potential Approaches and Research Needs

Science.gov (United States)

Schuster, E.; Barton, J. E.; Wehner, W. P.

2014-10-01

Many challenging plasma control problems still need to be addressed in order for the ITER Plasma Control System (PCS) to be able to successfully achieve the ITER project goals. For instance, setting up a suitable toroidal current density profile is key for one possible advanced scenario characterized by noninductive sustainment of the plasma current and steady-state operation. The nonlinearity and high dimensionality exhibited by the plasma demand a model-based current-profile control synthesis procedure that can accommodate this complexity through embedding the known physics within the design. The development of a model capturing the dynamics of the plasma relevant for control design enables not only the design of feedback controllers for regulation or tracking but also the design of optimal feedforward controllers for a systematic model-based approach to scenario planning, the design of state estimators for a reliable real-time reconstruction of the plasma internal profiles based on limited and noisy diagnostics, and the development of a fast predictive simulation code for closed-loop performance evaluation before implementation. Progress towards control-oriented modeling of the current profile evolution and associated control design has been reported following both data-driven and first-principles-driven approaches. An overview of these two approaches will be provided, as well as a discussion on research needs associated with each one of the model applications described above. Supported by the US Department of Energy under DE-SC0001334 and DE-SC0010661.

Managing and monitoring tuberculosis using web-based tools in combination with traditional approaches.

Science.gov (United States)

Chapman, Ann Ln; Darton, Thomas C; Foster, Rachel A

2013-01-01

Tuberculosis (TB) remains a global health emergency. Ongoing challenges include the coordination of national and international control programs, high levels of drug resistance in many parts of the world, and availability of accurate and rapid diagnostic tests. The increasing availability and reliability of Internet access throughout both affluent and resource-limited countries brings new opportunities to improve TB management and control through the integration of web-based technologies with traditional approaches. In this review, we explore current and potential future use of web-based tools in the areas of TB diagnosis, treatment, epidemiology, service monitoring, and teaching and training.

Halitosis: Current concepts on etiology, diagnosis and management

Science.gov (United States)

Kapoor, Uditi; Sharma, Gaurav; Juneja, Manish; Nagpal, Archna

2016-01-01

Halitosis or oral malodor is an offensive odor originating from the oral cavity, leading to anxiety and psychosocial embarrassment. A patient with halitosis is most likely to contact primary care practitioner for the diagnosis and management. With proper diagnosis, identification of the etiology and timely referrals certain steps are taken to create a successful individualized therapeutic approach for each patient seeking assistance. It is significant to highlight the necessity of an interdisciplinary method for the treatment of halitosis to prevent misdiagnosis or unnecessary treatment. The literature on halitosis, especially with randomized clinical trials, is scarce and additional studies are required. This article succinctly focuses on the development of a systematic flow of events to come to the best management of the halitosis from the primary care practitioner's point of view. PMID:27095913

An approach to systematic structural lifetime management

International Nuclear Information System (INIS)

Talja, H.; Solin, J.; Rintamaa, R.

2000-01-01

Many utilities are currently developing preventive maintenance and plant life management systems for their own use. Consideration of plant specific design and integrity problems support use of tailored programs and/or data bases for plant life management. The final applications will be developed on plant type, utility, plant or system level. However, common features can be included in the systems. The project Plant life management XVO conducted at VTT deals - as a whole - with systematic component lifetime management, operational loads in normal steady state operation and in transients, especially piping vibrations and integrity, NDE, materials ageing, interactions of coolant and materials, environmentally assisted cracking and ageing of reactor internals. One of the major challenges in the project is to define, how these multidisciplinary results should be integrated such that quantitative assessments on remaining safe life and failure risks are possible. In this paper a brief overview on the project is given. The work performed on piping vibration and integrity management is presented in more detail. (author)

Management of interstitial ectopic pregnancies with a combined intra-amniotic and systemic approach.

Science.gov (United States)

Swank, Morgan L; Harken, Tabetha R; Porto, Manuel

2013-08-01

Approximately 2% of all pregnancies are ectopic; of these, 4% are interstitial or cervical. There exists no clear consensus as to whether surgical or medical management is superior. We present three cases of advanced nonfallopian tube ectopic pregnancies from 6 to 8 weeks of gestation. Our first two cases were managed with a combined intrafetal, intra-amniotic and systemic approach using methotrexate and potassium chloride, whereas our third case was managed with an intra-amniotic approach alone. Our combined approach cases were successful, with resolution of human chorionic gonadotropin in 50 and 34 days, whereas our single approach case re-presented with bleeding requiring uterine artery embolization and operative removal of products of conception. Patients presenting with advanced interstitial or cervical pregnancies who are clinically stable can be offered medical management with a combined approach.

Developing a Step Wise Approach to Waste Management and Decommissioning at Sellafield Ltd

International Nuclear Information System (INIS)

Weston, Rebecca

2016-01-01

Developing a Step Wise Approach to Waste Management and Decommissioning at Sellafield Ltd: • Understand the challenge; • Understand preferred direction of travel; • Characterisation - enabling waste led decommissioning; • Engaging stakeholders; • Focus on the true drivers - alternative ILW approach; • Alternative ILW approach - simplification of waste handling process; • Manage future challenges; • Fit for purpose transport package for decommissioning wastes; • Risk based management framework

A techno-managerial approach in food quality management research

NARCIS (Netherlands)

Luning, P.A.; Marcelis, W.J.

2006-01-01

In this article it is discussed that food quality management issues are much more complex than often assumed and that it requires a specific research approach. It is argued that food quality management deals with dynamic and complex food systems and people systems involved in realising food quality.

Managing ankle ligament sprains and tears: current opinion

OpenAIRE

McGovern RP; Martin RL

2016-01-01

Ryan P McGovern,1 RobRoy L Martin,1,2 1Department of Physical Therapy, Rangos School of Health Sciences, Duquesne University, 2Centers for Sports Medicine – University of Pittsburgh, Pittsburgh, PA, USA Abstract: The purpose of this paper is to present a current review of pathoanatomical features, differential diagnosis, objective assessment, intervention, and clinical course associated with managing lateral ankle ligament sprains. Proper diagnosis and identification of affected st...

China's spent nuclear fuel management: Current practices and future strategies

International Nuclear Information System (INIS)

Zhou Yun

2011-01-01

Although China's nuclear power industry is relatively young and the management of its spent nuclear fuel is not yet a concern, China's commitment to nuclear energy and its rapid pace of development require detailed analyses of its future spent fuel management policies. The purpose of this study is to provide an overview of China's fuel cycle program and its reprocessing policy, and to suggest strategies for managing its future fuel cycle program. The study is broken into four sections. The first reviews China's current nuclear fuel cycle program and facilities. The second discusses China's current spent fuel management methods and the storage capability of China's 13 operational nuclear power plants. The third estimates China's total accumulated spent fuel, its required spent fuel storage from present day until 2035, when China expects its first commercialized fast neutron reactors to be operational, and its likely demand for uranium resources. The fourth examines several spent fuel management scenarios for the present period up until 2035; the financial cost and proliferation risk of each scenario is evaluated. The study concludes that China can and should maintain a reprocessing operation to meet its R and D activities before its fast reactor program is further developed. - Highlights: → This study provides an overview of China's fuel cycle program and its reprocessing policy.→ This study suggests strategies for managing its future fuel cycle program.→ China will experience no pressure to lessen the burden of spent fuel storage in the next 30 years.→ China should maintain sufficient reprocessing operations to meet its demands for R and D activities.→ China should actively invest on R and D activities of both fuel cycling and fast reactor programs.

A Social Network Approach to Provisioning and Management of Cloud Computing Services for Enterprises

DEFF Research Database (Denmark)

Kuada, Eric; Olesen, Henning

2011-01-01

This paper proposes a social network approach to the provisioning and management of cloud computing services termed Opportunistic Cloud Computing Services (OCCS), for enterprises; and presents the research issues that need to be addressed for its implementation. We hypothesise that OCCS...... will facilitate the adoption process of cloud computing services by enterprises. OCCS deals with the concept of enterprises taking advantage of cloud computing services to meet their business needs without having to pay or paying a minimal fee for the services. The OCCS network will be modelled and implemented...... as a social network of enterprises collaborating strategically for the provisioning and consumption of cloud computing services without entering into any business agreements. We conclude that it is possible to configure current cloud service technologies and management tools for OCCS but there is a need...

Silvicultural approaches to animal damage management in Pacific Northwest forests.

Science.gov (United States)

Hugh C. Black

1992-01-01

This book examines the potential of Silvicultural approaches for managing animal damage in forests at two levels: management of free-to-grow stands and sitespecific practices that foster prompt and successful regeneration. Introductory chapters provide a historical perspective of animal damage management in the Pacific Northwest, describe the elements of an integrated...

The TN Chawla Lecture – The current management of midfacial trauma

OpenAIRE

Sidebottom, Andrew J.

2013-01-01

The management of mid-facial trauma has changed very little in the last decade with minor modifications related to orbital trauma and minimal access approaches particularly related to secondary reconstruction.

Promise and problems with supply chain management approaches to health care purchasing.

Science.gov (United States)

Ford, Eric W; Scanlon, Dennis P

2007-01-01

Double-digit health care inflation, coupled with widespread reports of poor care quality and deadly medical errors, has caused private sector employers to reevaluate their health benefits purchasing strategies, with a focus on supply chain management approaches. In other industries, this strategy has proven to be an effective method for simultaneously reducing costs and increasing quality. This article describes four current applications of supply chain management network methodologies to health care systems and identifies potential ways to improve purchasers' return on investment. In particular, information exchanges, purchase decision, and payment agreement components of integrated supply chains are described. First, visual depictions of the health care supply chain are developed from a purchaser's perspective. Next, five nationwide programs designed to realign incentives and rewards across the health care supply chain are described. Although several nationwide efforts are gaining traction in the marketplace, at this time, no cost reduction and quality improvement program initiative appears to systematically align the entire health care supply chain from providers to purchasers, raising doubt about the ability of supply chain management network techniques to significantly impact the health care marketplace in the short run. Current individual efforts to coordinate the health care supply chain do not act on all of the actors necessary to improve outcomes, promote safety, and control costs. Nevertheless, there are indications that several of the individual efforts are coming together. If national efforts touching on all critical elements can coordinate with purchasers, then the health care supply chain's performance may improve significantly.

Current practice in airway management: A descriptive evaluation.

Science.gov (United States)

Kjonegaard, Rebecca; Fields, Willa; King, Major L

2010-03-01

Ventilator-associated pneumonia, a common complication of mechanical ventilation, could be reduced if health care workers implemented evidence-based practices that decrease the risk for this complication. To determine current practice and differences in practices between registered nurses and respiratory therapists in managing patients receiving mechanical ventilation. A descriptive comparative design was used. A convenience sample of 41 registered nurses and 25 respiratory therapists who manage critical care patients treated with mechanical ventilation at Sharp Grossmont Hospital, La Mesa, California, completed a survey on suctioning techniques and airway management practices. Descriptive and inferential statistics were used to analyze the data. Significant differences existed between nurses and respiratory therapists for hyperoxygenation before suctioning (P =.03). In the 2 groups, nurses used the ventilator for hyper-oxygenation more often, and respiratory therapists used a bag-valve device more often (P =.03). Respiratory therapists instilled saline (P <.001) and rinsed the closed system with saline after suctioning (P =.003) more often than nurses did. Nurses suctioned oral secretions (P <.001) and the nose of orally intubated patients (P =.01), brushed patients' teeth with a toothbrush (P<.001), and used oral swabs to clean the mouth (P <.001) more frequently than respiratory therapists did. Nurses and respiratory therapists differed significantly in the management of patients receiving mechanical ventilation. To reduce the risk of ventilator-associated pneumonia, both nurses and respiratory therapists must be consistent in using best practices when managing patients treated with mechanical ventilation.

Assessing The Current Status Of Solid Waste Management Of Gondar Town Ethiopia

Directory of Open Access Journals (Sweden)

Mohammed Gedefaw

2015-08-01

Full Text Available Abstract Ethiopia is facing rapid urbanization leading to overcrowding and the development of slums and informal settlements with poor waste management practices. Urban dwellers generally consume more resources than rural dwellers and so generate huge quantities of solid wastes. This study is focused on the overall assessment of the existing MSWM service of Gondar town. The overall objective of this study was assessing the current solid waste management service of Gondar town. Both primary and secondary sources were used to achieve the objectives. The analysis of this study was carried out using both qualitative and quantitative techniques. The findings of this study revealed that the present system of MSWM in Gondar town entirely relied on the municipality which provided the full range of waste collection transportation and disposal service. But the provision of this service is not kept in pace with the town solid waste generation. Based on the findings of this study the town households dominantly produced biodegradable solid wastes with generation rate of 0.21kgpersonday. This made the daily total solid waste generation of households to be 8140Kg. Together with other four solid waste sources the total daily solid waste generation of the town is about 11660 kg. So that MSWM of the town is found in very low status and spatial coverage. This poor status of MSWM is also intensified by three critical factors i.e poor institutional structure and capacity of Sanitation and beautification limited participation and contribution of stakeholders and poor households solid waste management practices. This study concluded that there should be sustainable solid waste management systems reuse recycle composting and incineration through awareness creation and training improvement of SB institutional structure and capacity and implementation of integrated MSWM approach which recognizes and comprises all stakeholders in the town.

Managing hyperthyroidism in pregnancy: current perspectives

Directory of Open Access Journals (Sweden)

Andersen SL

2016-09-01

Full Text Available Stine Linding Andersen,1,2 Peter Laurberg1,3,† 1Department of Endocrinology, Aalborg University Hospital, 2Department of Clinical Biochemistry, Aalborg University Hospital, 3Department of Clinical Medicine, Aalborg University, Aalborg, Denmark †Peter Laurberg passed away on June 20, 2016 Abstract: Hyperthyroidism in women who are of childbearing age is predominantly of autoimmune origin and caused by Graves’ disease. The physiological changes in the maternal immune system during a pregnancy may influence the development of this and other autoimmune diseases. Furthermore, pregnancy-associated physiological changes influence the synthesis and metabolism of thyroid hormones and challenge the interpretation of thyroid function tests in pregnancy. Thyroid hormones are crucial regulators of early development and play an important role in the maintenance of a normal pregnancy and in the development of the fetus, particularly the fetal brain. Untreated or inadequately treated hyperthyroidism is associated with pregnancy complications and may even program the fetus to long-term development of disease. Thus, hyperthyroidism in pregnant women should be carefully managed and controlled, and proper management involves different medical specialties. The treatment of choice in pregnancy is antithyroid drugs (ATDs. These drugs are effective in the control of maternal hyperthyroidism, but they all cross the placenta, and so need careful management and control during the second half of pregnancy considering the risk of fetal hyper- or hypothyroidism. An important aspect in the early pregnancy is that the predominant side effect to the use of ATDs in weeks 6–10 of pregnancy is birth defects that may develop after exposure to available types of ATDs and may be severe. This review focuses on four current perspectives in the management of overt hyperthyroidism in pregnancy, including the etiology and incidence of the disease, how the diagnosis is made, the

Marketing Management Relational Approaches Focused on Consumer’s and Customer’s Needs and Desires

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Gheorghe MINCULETE

2014-12-01

Full Text Available Currently, because of the evolution in the knowledge-based society, the marketing reveals another dimension, the one of relational marketing, which represents the special relationship established between the company and its consumers, with win-win advantages over a long period. In these circumstances, the managerial approach of marketing has new connotations for a more efficient managerial approach of the new national and international business environment. Within the marketing management process of a company, consumers or customers play a very critical role as these are the people who finally buy the goods and services of the organization, and the firm is always on the move to make them buy so as to earn revenue.This article presents the managerial approach of marketing management concept toward the strategic planning of a company and the marketing planning focused on needs and desires of consumers and customers. Therefore, consumers are the beneficiaries of the general and marketing strategy of the company while customers are those who respond to the loyalty process established by the firm. In this context, the purpose of this analysis is to highlight the strategic planning process of a company by integrating the strategic and operational marketing.In addition, we also consider important the issues related to Michael Porter’s generic strategies, which are thus presented in the context of relational knowledge within the process of marketing management. All these approaches are related to winning customers’ loyalty and obviously to customers' value that determines the company to achieve a value chain in the business process. Hence, the consumers and customers are the most important people for any organization. They are the resources which trigger the success of the business.